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: 1049979
Sex: F
Age: 67
State:

Vax Date: 02/05/2021
Onset Date: 02/07/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Blood pressure jumped high. Heart rates speedy over 100 beats/min. Dizzy all the time. Constantly coughing.

Other Meds:

Current Illness:

ID: 1049980
Sex: F
Age: 24
State: HI

Vax Date: 02/12/2021
Onset Date: 02/19/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient had arm soreness x 2 days after injection, then resolution of symptom. On 2/19/21, patient developed annular, erythematous rash at injection site. TX: Benadryl and observation.

Other Meds:

Current Illness:

ID: 1049981
Sex: M
Age: 81
State: WV

Vax Date: 02/06/2021
Onset Date: 02/08/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Itchy rash all over the body. Red pimples and streaks of red welts.

Other Meds: Brewers Yeast, PreserVision AREDS2, Raw Zinc 30mg, Raw D 5,000IU, Saw Palmetto

Current Illness: Bakers cyst in right leg behind knee.

ID: 1049982
Sex: F
Age: 52
State: MN

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

Lab Data: None

Allergies: Hydrocodone, morphine

Symptoms: Fever, sweating, lightheadedness, fatigue, severe body aches, chills, sore throat, stabbing pain in various areas of my body. Shortness of breath. Pain with swallowing . All of these things still present.

Other Meds: None

Current Illness: None

ID: 1049983
Sex: F
Age: 32
State: GA

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

Lab Data:

Allergies: unknown

Symptoms: "Pfizer-Bio-Tech COVID-19 Vaccine EUA" Individual received the Pfizer Covid-19 vaccine. He began to feel dizzy and faint at 11:41 am. His vitals were 134/86, 20, 82 at 11:41 am. We applied chill towel to back of neck. B/P 104/84,20, 84 P, 98 % RA. 11:46 am. Individual report that he did not have breakfast and did not hydrate. Patient swallowing intact. He was given bottle of water. 1:58 pm vitals were 114/82, 99% SATS, 99, 18. Individual stated she felt better and was no longer dizzy. 2:04 pm vitals 118/84. 18, 72, 98% RA. After drinking 32 oz of water individual went home with family with no noted distress.

Other Meds: unknown

Current Illness: unknown

ID: 1049984
Sex: F
Age: 43
State:

Vax Date: 02/10/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Hive at injection site 2 weeks after vaccine. Soreness, itching, swelling at injection site.

Other Meds:

Current Illness:

ID: 1049985
Sex: F
Age: 43
State: WI

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

Lab Data: 2/2-Saw allergist and tested for PEG allergy. Test came back negative.

Allergies: allergic to penicillin

Symptoms: Within minutes of receiving the first dose of the vaccine, my tongue became itchy. As the evening went on, my neck became sore. I took an antihistamine that evening when I got home. The itchy tongue continued for approx 10 days, following the injection.

Other Meds: I take vitamin supplements, Natural Factors Vitamin D3, 5K units daily, Gaia Herbs Elderberry , 50mg, 1 capsule daily, MegaFood Ultra C-400, 400mg, daily, and Florajen daily

Current Illness: None

ID: 1049986
Sex: F
Age: 66
State: PA

Vax Date: 01/26/2021
Onset Date: 01/29/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: latex

Symptoms: Patient reported that approximately 3-4 days after receiving vaccine, she developed itching and redness around the shot area, with symptoms worsening each day. Reported that she self-treated with steroid cream (name not given), anti-itch cream, and diphenhydramine oral at bedtime. Symptoms lasted approx 10 days and were completely subsided when presented today for Dose 2.

Other Meds:

Current Illness:

ID: 1049987
Sex: F
Age: 65
State: OK

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: na to date

Allergies: pyridium

Symptoms: got vac at 12:30 pm 2/20/21, started feeling flue like approx 5:00 pm 2/20/21,sore arm running up my neck and shoulders, body aches w/ no thermometer but felt like I had a fever with chills, fatigue, wheezing, head ache that was not constant but hit spuratic from temples to back of head, thought I was feeling better 2/21/21 but symptoms returned and are continuing to current 2/23/21. My current symptoms; I woke up in the night w/loud wheezing continuing through the night and current worse at times when I'm up, some shortness of breath, some cough, some heavy chest feeling, I feel like I have a fever w/chills, fatigue, spuratic headache, cough, some blurred vision w/watery eyes and some crusting. I just feel flue like and want to rest. I have a doctor appt tomorrow 2/24/21 to get checked out. Just wanted to let you know my symptoms. I am healthy and do not take meds of any kind.

Other Meds: none

Current Illness: none

ID: 1049988
Sex: F
Age: 48
State: OR

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

Lab Data:

Allergies: NKDA

Symptoms: Pt received dose 2 of Pfizer Covid vaccine at 12:00pm and soon after reported symptoms of nausea, SOB, wheezing, sweating, and numbness on left side from face to arm. Pt was given oxygen and 0.3mg of epinephrine was given intramuscularly at 12:05pm, followed by 25mg of diphenhydramine intramuscularly at 12:08, both administered by RN on site. Paramedics arrived at the scene at 12:05pm and took over monitoring of pt; pt was taken to ambulance at 12:10pm

Other Meds: None reported

Current Illness: None reported

ID: 1049989
Sex: F
Age: 78
State: NY

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: None

Allergies: shell fish allergy

Symptoms: Bad headache, dizziness, achy, vomiting (3x) Lasted until about midnight, Monday, Feb.22. Felt totally recovered by 9AM Tuesday.

Other Meds: Gabapemtin, Metopropol. Meloxicam. Rovastatin, Vitamin D. Fish Oil. Tylenol Arthritis

Current Illness: None

ID: 1049990
Sex: F
Age: 74
State: WY

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: None necessary

Allergies: None

Symptoms: Extremely tired and aches all over. Slight upset stomach. No appetite.

Other Meds: Metformin hcl 500 mg Atorvastatin 40 mg Lisinopril 20 mg

Current Illness: None

ID: 1049991
Sex: M
Age:
State: CT

Vax Date: 02/12/2021
Onset Date: 02/16/2021
Rec V Date: 02/23/2021
Hospital: Y

Lab Data:

Allergies: None

Symptoms: 4 days after receiving the vaccine in his left arm, my father developed a blood clot in his left arm that required emergency hospitalization and large doses of blood thinners.

Other Meds:

Current Illness: None

ID: 1049992
Sex: F
Age: 25
State: OR

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: none

Allergies: NKDA

Symptoms: developed a lump over the left clavicle 24 hours after vaccination into ipsilateral deltoid

Other Meds: alprazolam (XANAX) 0.5 MG tablet alprazolam 0.5 mg tablet TAKE 1 TABLET BY MOUTH DAILY AS NEEDED FOR ANXIETY norethindrone-ethinyl estradiol-iron (ESTROSTEP FE) 1-20/1-30/1-35 MG-MCG TABS Take by mouth daily sertraline (ZOLOFT) 25 MG tabl

Current Illness: none

ID: 1049993
Sex: F
Age: 66
State: NY

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: EMG on 1/26/2021 MRI on 1/29/2021

Allergies: none

Symptoms: Injected on the top of my left shoulder? incorrect postision? After 3hours my left arm ?not injection area?very pain? weekness? unable to move? no fever?pain did not resolve after motrin and cold compress? Pain scale #10? seen doctor on 1/11/2021? pain released after Predisone?but returned when decrease predisone dosage? pain consistant ?unable to move? muscle weekness? seen neurolgist on 1/26/2021? EMG done? Dx Myositis? restarted Predisone and Gabapentine? MRI done? result negative?Pain resolved after Rx? Now pain and weakness decrease a lot, but still on Gabapentin once/ day.

Other Meds: Ambien 5mg? 5HPT? Famotidine 20mg? Montelukast 10mg? Vit D 2000u

Current Illness: Upper airway reaction? Acid reflex

ID: 1049994
Sex: M
Age: 69
State: IL

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: -soreness in arm muscle for 24 hours starting within a couple of hours of administration -about 16 hours after injection I had muscle and joint aching and very tender skin all over my body--symptoms lasted about 15 hours

Other Meds:

Current Illness: none

ID: 1049995
Sex: F
Age: 20
State: NH

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Constant dizziness, unable to focus

Other Meds: none

Current Illness: none

ID: 1049996
Sex: F
Age: 82
State: IL

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: Sulfa Penicillin Codeine

Symptoms: Muscle and joint aches, no fever, general tiredness. Went to bed, slept all night, felt pretty good when I woke up, felt fine by noon that day.

Other Meds: Famotidine, levothyroxine, potassium, hydrochlorothiazide, Allegra, vitamin D3

Current Illness: None

Date Died: 01/08/2021

ID: 1049997
Sex: F
Age: 89
State: SC

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: Ace inhibitors, solifenacin

Symptoms: Vaccine was administered at Nursing Facility. Patient is an 89-year-old female with prior medical history of CVA with dysphagia, history of possible dementia, GERD, hyperlipidemia, and a pacemaker. She is a resident from town. She was sent for hypotension with a blood pressure of 90/52, tachypnea respirations of 54, possible aspiration pneumonia. Status post Covid vaccine earlier today. History is limited as patient is nonverbal on my exam. Death within 24 hours of vaccination

Other Meds: Pliavis, tramadol, aspirin, statin, remeron, protonix

Current Illness: none identified

ID: 1049998
Sex: F
Age: 78
State: WA

Vax Date: 01/31/2021
Onset Date: 02/02/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: Codeine; penicillin

Symptoms: 02/02- Shivering chills, 6 hrs.; muscle & joint pain, 4 days; excessive fatigue and cold, 2 1/2 weeks; fatigue continues; 02/10- injection sight red, feverish. appt. at urgent care 02/11. entire back of right arm infected, cellulitis. RX antibiotic. End of 10 days, cellulitis appears gone.

Other Meds: Methotrexate; lantanaprost; dorzolamide;preservision; B12; cal

Current Illness: None

ID: 1049999
Sex: M
Age: 68
State: SC

Vax Date: 02/20/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: infraclavicular and sipraclavivular lymphadenopathy same side as vaccination

Other Meds: pravastatin, trilogy, albuterol inhaler

Current Illness: copd

ID: 1050000
Sex: M
Age: 72
State: CA

Vax Date: 02/11/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: NONE

Symptoms: Possibly unrelated to the vaccine: 2, 5, and 8 days after the vaccine was administered, I experienced short but very painful episodes of abdominal pain, similar to gas pains. Each attack lasted 15 to 25 minutes, and seemed to be alleviated by taking anti-acid (simethicone) pills. Quite likely related the vaccine: 11 days after the vaccine was administered, I experienced a rather severe headache, plus slight general weakness, and a raised temperature of between 98.9 and 100.4 degrees. The first 10 days I had discerned no adverse effects. This has lasted16 hours so far, with little alleviation.

Other Meds: NONE

Current Illness: NONE

ID: 1050001
Sex: F
Age: 32
State: SC

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Fatigue 2/18 5-8:30pm - went to sleep at 8:30pm Chills 2/18 8:00-8:30pm - went to sleep at 8:30pm Headache 2/18 4:00pm-3:00pm on 2/19 Neck joint soreness upon waking on 2/19 - 2/21 (ending around mid morning)

Other Meds: None

Current Illness: Cold

ID: 1050002
Sex: F
Age: 74
State: CT

Vax Date: 02/14/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Itching, swelling. redness around injection site.

Other Meds: None

Current Illness: none

ID: 1050003
Sex: F
Age: 77
State: CA

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

Lab Data:

Allergies: None

Symptoms: Itchy rash around injection site. About 4? diameter

Other Meds: Levothyroxin Xarelto Losar tan

Current Illness: None

ID: 1050004
Sex: M
Age: 40
State: TX

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, nausea, joint pain, fever

Other Meds:

Current Illness:

ID: 1050005
Sex: F
Age: 39
State: TX

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Very minor chills, fatigue and muscle aches for about 3 hours.

Other Meds: None

Current Illness: None

ID: 1050006
Sex: F
Age: 77
State:

Vax Date: 01/22/2021
Onset Date: 02/05/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: patient reports swelling at vaccine site 1 week after vaccine administered. swelling accompanied by itching, headache and nausea x 1 day. redness remained for 4 days

Other Meds:

Current Illness:

ID: 1050007
Sex: M
Age: 51
State: TX

Vax Date: 01/21/2021
Onset Date: 01/24/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 72 hours after injection severe abdominal rash, went to MD and was told it was related to vaccine

Other Meds:

Current Illness:

ID: 1050008
Sex: F
Age: 48
State: AR

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

Lab Data:

Allergies: Latex

Symptoms: Itchy, tingley, throat. Itchy bottom of feet. Drank water. Lasted ~20 minutes. No visible rash.

Other Meds: Vitamins

Current Illness: None

ID: 1050009
Sex: F
Age: 65
State: LA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Onset of Bell?s palsy 40 minutes after vaccine

Other Meds: None

Current Illness: None

ID: 1050010
Sex: F
Age: 50
State: MN

Vax Date: 02/13/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: none

Allergies: penicillin, erythromycin

Symptoms: Moderna COVID-19 Vaccine EUA With my arm being covered I hadn't noticed the rash until today (10 days after the injection). My arm had been sore, but today I noticed a rash and I noticed by arm being itchy since yesterday.

Other Meds: none

Current Illness: none

ID: 1050011
Sex: M
Age: 93
State: CA

Vax Date: 02/05/2021
Onset Date: 02/20/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: NONE

Allergies: NONE KNOWN

Symptoms: LEFT FACIAL DROOPING, WEAKNESS LEFT EYELIDS, TEARING OF LEFT EYE, NUMBNESS LEFT SIDE OF FACE

Other Meds: HYDRALAZINE HCL 50 MG, FEBUXOSTAT 40 MG,AMLODIPINE 5 MG, ATORVASTATIN 20 MG, ASPIRIN 81 MG, FERROUS SULFATE 325 MG, MULTIVITAMIN, VITAMION C 500 MG,

Current Illness: NONE

ID: 1050012
Sex: F
Age: 53
State: OK

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

Lab Data: n/a

Allergies: Sulfa Drugs, Nickel, Hydrogenated Oils, Cellulose Gum

Symptoms: 2/19/21 ? 6:30 pm start feeling fatigue. Right arm carpel tunnel started twitching randomly and frequently. This continued all evening and all the next day. 2/20/21 ? Woke with fatigue, upper arm pain round injection site, muscle pain randomly over body, joint pain in previous arthritic sites. Continued all day randomly. General feeling of tiredness or unwell. Evening the pain worsed, muscles contracting around spine creating spinal pains and severe headaches. 2/21/21 ? Woke feeling tired but better. 2/22/21 ? In the evening started feeling pain in spine and muscles in middle to upper back and cervical region. Lymph nodes under jaws and side of neck are painful and inflamed. 2/23/21 ? woke up feeling better.

Other Meds: Nexium, Buspar, Wellbutrin, Tizandine

Current Illness: n/a

ID: 1050013
Sex: M
Age: 48
State: TX

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache and nausea

Other Meds:

Current Illness:

ID: 1050014
Sex: F
Age: 93
State: GA

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

Lab Data:

Allergies: Iodine

Symptoms: 10 mins after injection, patient reported her tongue felt "rough and swollen". Reports being able to "taste vaccine". BP 189/110. 25mg benadryl given PO and patient given snack. Approximately 30 mins after injection, patient reports her tongue and lips were swelling. BP 170/128. Epi-pen administered, EMS called and patient transported to hospital at 12:45pm.

Other Meds:

Current Illness:

ID: 1050015
Sex: F
Age: 56
State:

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Fever of 100 degrees the day after vaccine and had muscle aches and then headaches. On the day after the vaccine, pain and redness/rash in left arm (lymph nodes) 4 inch long by 3 in. Red area has moved around the upper arm to a different spot on the left upper arm over the past three days. Red area is hot to touch and has not gone away yet.

Other Meds:

Current Illness: none

ID: 1050016
Sex: M
Age: 61
State: TX

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache and nausea

Other Meds:

Current Illness:

ID: 1050017
Sex: F
Age: 81
State: IN

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: ;

Allergies: Compazine

Symptoms: 12:01 am 2-18-21 pt. felt sick went to bathroom, passed out and lost control of bowel. Said she felt like she had the "flu".

Other Meds: Levothyroxine 75 mcg daily, Risperidone .25mg, Simvastatin 40mg, Citalopram 40 mg, Gabapentin 300mg, Losartin 50mg, Eszopidione 2 mg, vitamin D3, B12, multivitamin, glucosamine, calcium, gabapentin

Current Illness: None

ID: 1050018
Sex: F
Age: 24
State:

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: She received her vaccine on 2/17/2021 at 7:30 am. Immediately after receiving her vaccine, she started to feel lightheaded and stated she felt shortness of breath. She also felt her chest tight. She said she was monitored at the Vaccination Site for a longer period due to her feeling light headed, shortness of breath, and chest tightness. On 2/18/21, she still felt light headed. She started to feel fatigue and body aches from her waist up. On 2/18/ 21 she still felt lightheaded, fatigue, and body aches from her waist up. She treated these symptoms with ibuprofen. She felt lighted, fatigue. and body aches from her waist up for 48 hours.

Other Meds:

Current Illness:

ID: 1050019
Sex: F
Age: 60
State: TX

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache

Other Meds:

Current Illness:

ID: 1050020
Sex: F
Age: 62
State: VA

Vax Date: 10/28/2020
Onset Date: 10/28/2020
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: Right upper outer arm pain at the site where she received her Shingrix vaccine number one 10/28/20 with pain getting worse with time. It is exacerbated by doing certain motions at the elbow level such as flexing or reaching for items with a very sharp pain that will last 30 seconds to a minute or so. If she keeps her arm still, it does not hurt. Patient is taking nortriptyline and tizanidine without any benefit for her. Of note, patient has not had problems with any other vaccinations such as flu shots, tetanus shots, etc.

Other Meds: atorvastatin (Lipitor) 10 MG tablet; famotidine (PEPCID) 20 MG tablet; folic acid (FOLVITE); hydroCHLOROthiazide (HYDRODIURIL) 25 MG tablet; losartan (COZAAR) 50 MG tablet; nortriptyline (PAMELOR) 10 MG capsule; pantoprazole (PROTONIX) 40 M

Current Illness: Chronic Back Pain; Gerd; High Blood pressure

ID: 1050021
Sex: F
Age: 54
State: NC

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

Lab Data: None

Allergies: Egg, Penicillin, Macrolides, Codeine, Influenza vaccine, Keflex, Iodine, Levofloxacin

Symptoms: Patient became mildly short of breath with some chest tightness and light headedness approximately 23 minutes after receipt of the vaccine. She notified the nursing counter who notified me. Patient was A&Ox3 upon my arrival and able to speak in full sentences. Heart rate was noted to be 105 bpm. 50mg oral Benadryl was administered and patient was monitored for 25 minutes. Heart rate improved as did patient's work of breathing, chest tightness, and her dizziness subsided completely. Her final heart rate at time of discharge was 93 bpm and patient was able to ambulate under own power to depart the site. She was escorted to her husband's vehicle and he received instructions to take her to the hospital to fill her epi-pen prescription which was placed at the time of the incident as well as reasons to use the epi-pen and report to ED if needed.

Other Meds: Prazosin, Detrol, Bupropion XL, Montelukast, Cetirizine, Escitalopram, Climara, Progesterone, Premerin, Toperamate

Current Illness: None

ID: 1050022
Sex: M
Age: 28
State: CT

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Administration Error-vaccine dose not delivered.

Other Meds:

Current Illness:

ID: 1050023
Sex: F
Age: 59
State:

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Nausea, stomach cramps, body aches, and fatique

Other Meds:

Current Illness:

ID: 1050024
Sex: F
Age: 45
State:

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Migraine Headache

Other Meds:

Current Illness:

ID: 1050025
Sex: F
Age: 45
State:

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, nausea, and fever.

Other Meds:

Current Illness:

ID: 1050026
Sex: F
Age: 68
State: NY

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: Sulfa drugs

Symptoms: One week after shot was given, large, red, itchy spot appeared on right arm by injection site. By the evening, the itchiness had continued and skin felt hot. Right hand also felt almost "swollen". I took an antihistamine that evening and it felt better. 3 days later, the patch is lighter in color. less itchy.

Other Meds: Vitamin D

Current Illness: None

ID: 1050027
Sex: M
Age: 73
State: CA

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: Fall with temperature of 99.5. Low grade temperature continued for several hours. He appeared to be more fatigued and weaker.

Other Meds: atovastatin 20mg QHS finasteride 5mg QDay flecainide 25mg BID lisinopril 10mg BID metformin 1000mg BID metoprolol succinate 25mg BID olanzapine 10mg QHS rivaroxaban 20mg QDay valproic acid 2500mg QHS

Current Illness:

ID: 1050028
Sex: M
Age: 76
State: CA

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

Lab Data:

Allergies: allergies to almonds

Symptoms: Bell's Palsey, paralysis left side of face

Other Meds: fish oil on blood thinners and high blood pressure medication

Current Illness: attack of gout in the foot (first episode ever) one week after receive first dose of Moderna Covid vaccine

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm