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: 1051657
Sex: F
Age: 65
State: OH

Vax Date: 02/11/2021
Onset Date: 02/17/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: none

Allergies: Buspar, none

Symptoms: Sore arm, red site, hot, 1/2 inch in size. Lasted 3 days, 4th day redness spreading, hot to touch. 5th day, redness spreading more, soreness comes back, tender to touch, warm area. 6th day itching started, redness area becomes becomes larger, still sore, soreness moves also inner arm, away from actual injection site. 13th day, it has not changed at all, red area 3" in diameter, still sore, warm and itchy. Have done acetaminophen, ibuprofen, ice packs, benadryl.

Other Meds: Zolpidem Tartrate 5mg, Rosuvastatin 20mg, Anastrozole 1mg, Duloxetine 60mg, Benadryl 1 tablet, 35,000 units vitamin D, melatonin 10mg

Current Illness: Cold, UTI

ID: 1051658
Sex: M
Age: 66
State: IN

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Penecillin

Symptoms: Onset of chills after 20 hours of injection followed by nausea and lightheadedness as day progressed. Symptoms completely gone after twelve hours.

Other Meds: Levothyroxine Atorvastatin

Current Illness: None

ID: 1051659
Sex: F
Age: 52
State: OH

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: To be determined when I see the Dr

Allergies: NKA

Symptoms: My rt arm pit was sore the next day, then began to swell...today the 24th. 17 days later it is the size of a baseball. Calling my Dr to have it looked at.

Other Meds: None

Current Illness: NONE

ID: 1051660
Sex: F
Age: 55
State:

Vax Date: 02/16/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: One week after the vaccination it started itching at the site of the vaccination. The next day it became red . Diameter around 3 inches

Other Meds:

Current Illness:

ID: 1051661
Sex: F
Age: 43
State: TX

Vax Date: 02/08/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: At and around the site of the shot: red rash, blotchy and itchy. It started a week or so after the shot.

Other Meds:

Current Illness: none

ID: 1051662
Sex: F
Age: 54
State: NM

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

Lab Data: None at this time.

Allergies: Allergic to Sulfa, Demerol and foods allergic to all corn, soy, nuts and eggs.

Symptoms: Waited 15 minutes as required and left. At 20-25 minutes as I was driving my mouth began to severely itch. Arrived home, and took Benadryl which lessened the itch and it was almost gone by 2am on 2/24/2021.

Other Meds: Folic acid, leuflodimide (stopped 4 days prior to vaccine), multi vitamin women's 50+.

Current Illness: No other illness other than rheumatoid arthritis.

ID: 1051663
Sex: F
Age: 77
State: NY

Vax Date: 02/14/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: red warm swelling at injection site Noticed 9 days after injection

Other Meds: synthetic, centrim sr, vit D

Current Illness: none

ID: 1051664
Sex: F
Age: 22
State: MI

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

Lab Data:

Allergies: none

Symptoms: fever, chills, body aches

Other Meds: fluoxetine 60mg phentermine 37.5mg apri oral contraceptive omeprazole 20mg

Current Illness: none

ID: 1051665
Sex: F
Age: 82
State: NJ

Vax Date: 02/11/2021
Onset Date: 02/17/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None

Allergies: None now but when young allergic to wool, cat fur and shrimp (outgrew these)

Symptoms: About five days after receiving first COVID shot I felt itchiness in left arm. Then I noticed large three large red blotches from almost shoulder to about six inches from elbow. They became a darker pink and outlined in red. They were very itchy for several days, but otherwise I felt fine. As of today I still have the blotches, but they seem to have faded a bit (red outline still visible) and the itchiness is much less.

Other Meds: No prescription medicine only vitamin D3

Current Illness: None

Date Died: 02/02/2021

ID: 1051666
Sex: M
Age: 85
State: OH

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/24/2021
Hospital: Y

Lab Data: CT PE Study: No PE, mild to moderate emphysematous changes,bil renal stones, no acute inflammatory process in the abdomen or pelvis. XR Chest: No acute cardiopulm disease. EKG: ventr

Allergies: Heparin,Cipro,Imdur

Symptoms: Pt presented to ER with SOB on 01-29-2021. He was admitted to Healthcare with acute CHF exacerbation, elevated lactate, anemia and elevated d-dimer. Pt reports getting SOB getting up to go to the bathroom. Pt was intubated. He developed pulmonary edema. Pt expired on 02-02-2021 at 10:13 PM.

Other Meds:

Current Illness: None

ID: 1051667
Sex: F
Age: 30
State: NY

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: N/a

Allergies: Peanuts

Symptoms: Localized rash

Other Meds: Sprintec

Current Illness: No

ID: 1051668
Sex: M
Age: 51
State: IL

Vax Date: 02/08/2021
Onset Date: 02/12/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Sore throat

Other Meds:

Current Illness:

ID: 1051669
Sex: F
Age: 36
State: TX

Vax Date: 02/10/2021
Onset Date: 02/12/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Aspirin

Symptoms: Rash all over neck and shoulders. Under breast and armpits. Red and painful. Itchy. Treated with steroid shot and steroid given to take orally for 1 week

Other Meds: None

Current Illness: None

ID: 1051670
Sex: F
Age: 55
State: NY

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: My arm was red and raised and hot directly at injection site at first. Then hotness went away the next day but was still raised up and red about the size of a silver dollar. After a couple of days, it was slightly itchy too. Today marks 2 weeks and I still have an small egg shaped red mark just slightly raised on my left arm at injection site that at times seems itchy. It is not bothersome at all, but I felt like you would want to know.

Other Meds: Synthroid and Meloxicam

Current Illness: None

ID: 1051671
Sex: M
Age: 77
State: WI

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: NONE

Allergies: 1. Cefalexin 2. Yellow Jacket venom

Symptoms: 1. Pain at site of injection started about 6 hours post second vaccine injection (7-8 on a 0-10 scale) that lasted for almost 48 hours, most intense during the day following injection. No treatment for that. 2. Significant fatigue on the morning 14 hours following the injection (could have started during the night) . Difficult to maintain balance. Just rested the whole day. Unable to exercise on stationary bike. 3. Low grade fever (just under 99 F; base line for me has been 97.6 F) in the evening following injection, gone next morning. No treatment.

Other Meds: CoQ10; multiple vitamins; Omega 3; Metformin; Simvastatin; Finasteride; Losartan + HTZ (100/25); Metoprolol.

Current Illness: None per se. Completed radiation treatment to right face and posterolateral upper neck.

ID: 1051672
Sex: M
Age: 62
State: NJ

Vax Date: 02/12/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: no tests

Allergies: Penicillin, clindamycin, nutra-sweet, adavan, Crestor (rosuvatatin), Albuterol Sufate, porazepam

Symptoms: Red rash, VERY itchy area around injection site. Did I mention VERY itchy. No medications, ointments, or creams used on itchy area. No oral medications taken for itch or rash. Currently on day three of itchy and it seems a little better. Waiting for a few days for condition to clear.

Other Meds: 81 mg aspirin, One-A-Day multi-vitamin

Current Illness: none

ID: 1051673
Sex: F
Age: 69
State: NC

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

Lab Data: None

Allergies: Walnuts, erthromyacin

Symptoms: Large raised sore red circle at the injection site

Other Meds: Omeprazole, doxycycline, cimiditine, multi-vitamins, Soothe XP,

Current Illness: None

ID: 1051674
Sex: M
Age: 64
State: TX

Vax Date: 02/19/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Chills, leg aches, for one full day, took Tylenol, fluids,rest, much better this morning.

Other Meds: Warfarin Metoprolol Lisinopril Multi vitamin Flowmax

Current Illness: None

Date Died: 02/01/2021

ID: 1051675
Sex: F
Age: 78
State: WI

Vax Date: 01/28/2021
Onset Date: 02/01/2021
Rec V Date: 02/24/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Patient passed away on 2/1/21 at the Health System. She was there for congestive heart failure (CHF) which had been a problem for her since contracting COVID-19 (symptoms began 10/29/20 and tested positive 10/30/20). She had been to see her medical provider several times after her isolation period as well as a few trips to the hospital for, what they called "CHF flare-ups". Her last hospitalization began on January 30, 2021. Her social worker reported on t1/31/21 that "she would likely be returning in another day or two".

Other Meds:

Current Illness: congestive heart failure

ID: 1051676
Sex: F
Age: 30
State: MO

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: I had the reaction colloquially called ?covid arm?. About 7 days after my first dose, my injection site started to itch and swell. The next day the injection site had swollen rather large in diameter, was red, itchy, and painful to the touch. The redness has has finally started to subside and the swelling is down but not entirely gone yet.

Other Meds: Birth control

Current Illness:

ID: 1051677
Sex: M
Age: 78
State: VA

Vax Date: 01/27/2021
Onset Date: 02/14/2021
Rec V Date: 02/24/2021
Hospital: Y

Lab Data: CT scan to rule out stroke 2/14/2021 Attempted MRI but unable to complete due to iron shrapnel in head Lyme panel 2/17/2021 CBC, CMP, APTT, Troponin, Lipase, Sed rate, HgA1C, Mg, Lipid panel, BnP, CrP, Procalcitonin, GFR, cheat x-ray, Abdominal CT 2/14/2021

Allergies: No known allergies

Symptoms: I noticed that the left side of my mouth was a little droopy around 10:00am on 2/14/2021 but didn?t think anything of it. Then around 4pm my daughter saw me and noticed it as well. We went to the ED immediately and got a stroke rule out work up. There were no other deficits besides the left sided facial palsy.

Other Meds: Aspirin 81mg daily Losartan 50mg daily Atorvastatin 40mg daily Fish oil One a day men?s vitamin

Current Illness: None

ID: 1051678
Sex: M
Age: 70
State: AZ

Vax Date: 02/19/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital: Y

Lab Data: diagnosis acute (likely gallstone) pancreatitis; AST 858; ALT 907; Lipase 12894; Alk phos 127; temp 102.7F (39.3C)

Allergies: none

Symptoms: 70-year-old male who presents to the emergency department for evaluation of abdominal pain. The patient was awakened from sleep this morning with severe sharp, stabbing pain in his epigastric region. Pain radiates into his lower abdomen and his back. He associates his symptoms with a bloating sensation. He took omeprazole with mild relief of symptoms. Symptoms recurred a few hours later. States that he became confused and diaphoretic at that time. He called EMS to transport him to the emergency department. The patient was found to have an objective fever at that time. He was given Zofran; Notes COVID vaccine several days earlier; on antibiotics, will need cholecystectomy while in hospital

Other Meds: aspirin, atorvastatin, omeprazole, miralax, probiotic, vitamin C

Current Illness: none

ID: 1051679
Sex: F
Age: 67
State: CT

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Developed Rash on Lower Back, on 2/23 since rash is still on back.

Other Meds: Sertraline HCL 50 mg Lisinopril HCTZ 10-12.5 mg Women?s Multivitamin Caltrate

Current Illness: None

ID: 1051680
Sex: F
Age:
State: FL

Vax Date: 02/20/2021
Onset Date:
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Pt has a PMH of allergies to " a lot of things" . Refused to give name. Stated the information was for her daughter not for her and she just want to know what to do .

Symptoms: hives in arms , chest, legs; advise was to seek medical attention; Caller did not provide the poison control hotline operator much information

Other Meds:

Current Illness:

ID: 1051681
Sex: F
Age: 67
State:

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

Lab Data: Paramedics from health center

Allergies: none

Symptoms: woke up this morning and fainted

Other Meds: Ramipril 10ng synthroid 75mcg escitalopram 5 mg rosuvastatin 10 mg metoprolol stearate 25 mg

Current Illness: none

ID: 1051682
Sex: F
Age: 80
State: VA

Vax Date: 02/10/2021
Onset Date: 02/21/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Biomax

Symptoms: after 11 days i couldn't move my hand and painful . the redness and hardness and itchiness. started to spread for the last four four days

Other Meds: thyroid, anti acid, blood pressure, Vitamin

Current Illness:

ID: 1051683
Sex: F
Age: 24
State: MI

Vax Date: 02/09/2021
Onset Date: 02/12/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Ceftin, Pineapple

Symptoms: Continued weakness, limited range of motion, area injection site gets inflamed and rise in temperature when stressed

Other Meds: Lamictal, Vraylar

Current Illness:

ID: 1051684
Sex: M
Age: 58
State: NY

Vax Date: 02/17/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: From shoulder to elbow swelling with itching around injection site appeared 7 days days after 2nd shot of Moderna

Other Meds: Rituxan Flecainide 50mg 2x Metoprolol 25mg 1x Simvastatin 20mg 1x Tamsulosin 0.4mg 1x Levothyroxine 200mcg 1x Aspirin 81mg 1x

Current Illness: Nodular Lymphocyte predominant hodgkins lymphoma

ID: 1051685
Sex: F
Age: 71
State: CT

Vax Date: 02/13/2021
Onset Date: 02/01/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: n/a

Allergies: seasonal, mold

Symptoms: I noticed a 3'X3" red, warm, slightly raised patch about 4 inches below vaccination site on my arm a couple of days after vaccination...itchy at times....slowly subsifing now.

Other Meds: Restasis, Cozaar, Crestor, Omeprazole, Bystolic, Allegra, Ubiquinol, Milk Thistle, Glutathione, Vit B12,C,D,E, Tumeric

Current Illness: n/a

ID: 1051686
Sex: M
Age: 24
State:

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

Lab Data:

Allergies:

Symptoms: fever, chills, headache, nausea, muscle aches, and SORE THROAT Treated with ibuprofen with mild improvement. Presented the following morning to COVID Testing Center with symptoms and was tested for COVID due to sore throat (not a "common side effect")

Other Meds:

Current Illness:

ID: 1051687
Sex: F
Age: 49
State: WA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: EKG (done by paramedics) I wore a halter monitor for 24 hours

Allergies: aspirin all NSAIDS raw sugar

Symptoms: I had a fast heart beat that started about an hour to half hour after my shot. My heart rate was at 120 BPM and I called 911. The highest my hear rate went was 140 BPM. The paramedics but me on an EKG and my heart rate dropped to 116 BPM. I was not admitted to the hospital, and after the paramedics left I was able to go back to sleep. I had heart palpitations for the next 8-10 days after the vaccine. I saw a cardiologist and they didn't find anything out of the ordinary, and then I saw an allergist and I'm following up with him soon.

Other Meds: metformin spirnolactone mulitvitamin vitamin D

Current Illness: No

ID: 1051688
Sex: M
Age: 74
State: OH

Vax Date: 01/29/2021
Onset Date:
Rec V Date: 02/24/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1051689
Sex: F
Age: 88
State: MI

Vax Date: 02/11/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
Hospital: Y

Lab Data: Positive for COVID19 on 2/18/21.

Allergies: Amoxicillin (nausea), diphenhydramine (delirium)

Symptoms: Presented to emergency department on 2/20/21 with shortness of breath and nasal congestion with symptoms starting 2 days prior to presenting. Had virtual appointment on 2/19/21 with primary care provider for sinus infection and was started on Bactrim. Patient was discharged on 2/23/21 then presented back to ED on 2/23/21 and was re-admitted. Patient is currently admitted at the time of reporting.

Other Meds: Ventolin, amlodipine, anastrozole, Eliquis, aspirin, atorvastatin, Symbicort, Calcium+D, Flonase, levothyroxine, mag-ox, meclizine, metoprolol, montelukast, Verzenio

Current Illness: Atrial fibrillation, metastatic breast cancer

ID: 1051690
Sex: F
Age: 69
State: NC

Vax Date: 02/14/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: red rash at injection area

Other Meds: metoporal, vitamin D, biotin, Alleve

Current Illness:

ID: 1051691
Sex: F
Age: 65
State: FL

Vax Date: 02/19/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: pfizer jan 29 pfizer feb 19 Pfizer #1 EL 9263 Pfizer #2 EL 9267 low grade fever of 99.0, palpitations, and diarrhea yesterday. Recommended that she see her primary provider if symptoms worsen.

Other Meds:

Current Illness:

ID: 1051692
Sex: F
Age: 90
State: MN

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: none

Allergies: no known allergies

Symptoms: Fall on 1/21/2021 following first vaccination and fall on 2/18/2021 following 2nd vaccination. No falls since admit in 3/2020. Falls causing increase pain with head strike on 1/21/2021. Is recovering slowly from pain of events

Other Meds: unnknown --manages own meds

Current Illness: none

ID: 1051693
Sex: F
Age: 71
State: NC

Vax Date: 02/12/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Day 2 2/13, herpes breakout back of upper rt leg Day 8 red itchy rash at injection sight, some soreness and heat. Enlarged to slight whelp about 2x4 inches. Reaction almost resolved 2/24. Treated with acetaminophen.

Other Meds: Atenelol, Amlodopine, HCTZ, Synthroid, Atorvastatin, Escitalopram, Latanoprost, Cosopt, Vitamin D, famotidine Prolia injection due May

Current Illness: Glaucoma, thyroid

ID: 1051694
Sex: F
Age: 27
State: WI

Vax Date: 01/22/2021
Onset Date: 02/04/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: Physical exam - noted rash as described above CBC - relatively normal

Allergies: sulfa drugs, latex

Symptoms: Rash appeared on the trunk, small red maculopapular spots, bright red in color, slightly itchy, with clusters of a few at each spot. Majority of the spots appears within the bra line of the patient, started about a week and a half after the first done (1/22/21) but became increasingly worse two days after the second dose (was received on 2/12/21). First there were many more on the trunk with some patches increasing in size and rash starting to appear on arms and legs as well. Tried benadryl, fexofenadine, and hydrocortisone which helped minorly. Sought medical advice in the clinic (5 days post second dose) and couldn't identify other source of rash (no new product, no bugs bites, etc). Was prescribed triamcinilone acetate cream to help relive itching and redness, which as of 2/24/2021 is improving slowly.

Other Meds: daily multivitamin OCP (orthotricyclin-lo) rosuvastiatin levothyroxine fish oil

Current Illness: none

ID: 1051695
Sex: F
Age: 25
State: OK

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

Lab Data:

Allergies: None

Symptoms: Raised red circle around injection site with another circle around it. Warm, sore, firm to the touch.

Other Meds: Estarylla

Current Illness: None

ID: 1051696
Sex: M
Age: 67
State: MD

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

Lab Data: none

Allergies: none known

Symptoms: Within 4 hours developed cephalgia, myalgias, fatigue, nausea, chills and fever that spiked to 102 deg. 24 hours later still fatigued, but afebrile.

Other Meds: ASA 81 mg/d, clopidogrel 75 mg/d; lisinopril 2.5 mg/d; atorvastatin 40 mg/d; ezitimibe 10 mg/d; tadalafil 5 mg/d; multiple vitamin, fish oil, vitamin D

Current Illness: none

ID: 1051697
Sex: F
Age: 70
State: IN

Vax Date: 01/20/2021
Onset Date: 01/27/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: Client had labwork, ultrasound and x-rays. The provider filling out this form does not have the results of these tests.

Allergies: NONE

Symptoms: Client states that 7-10 days after receiving vaccine, her left hand started swelling and turned gray, followed by swelling in right hand and then individual fingers. Client also stated that she had a stiff neck. Client was seen by MD around 1/30/21 and reports that several labs were drawn and that her "clotting level was off". She also had an ultrasound that revealed a nodule in her thyroid. She had xrays of her hands - results pending. Client's MD told her that she should be vaccinated with the 2nd COVID vaccine today.

Other Meds:

Current Illness: NONE

ID: 1051698
Sex: F
Age: 55
State: AZ

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: percocet, prednisone

Symptoms: presenting to the ED for evaluation of reported reaction to the COVID-19 vaccination. The patient reports undergoing her 1st COVID-19 vaccination recently and did not experience any reaction with this whatsoever. However, she received her 2nd vaccination yesterday and initially felt well, but awoke this morning with the feeling of "an elevated pulse", along with fatigue, nausea, nagging diffuse headache, left flank/low back pain, and soreness surrounding the vaccination site. No redness or significant swelling around the site. Also notes a brief episode of RLQ abdominal pain described as "cramping" earlier this morning that has since resolved. She has tried taking 500 mg Tylenol at 0800 without relief in her symptoms. No fevers, chills, dysuria, hematuria, chest pain, or shortness of breath. Patient reports being recently diagnosed with thyroid disease and began taking medications for this about two weeks ago. She denies any past medical history otherwise.

Other Meds: levothyroxine, cholecalciferol, tylenol prn, losartan, amlodipine

Current Illness:

Date Died: 02/15/2021

ID: 1051699
Sex: M
Age: 91
State: OH

Vax Date: 01/27/2021
Onset Date: 02/15/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Death on 02.15.2021.

Other Meds:

Current Illness: None

ID: 1051700
Sex: F
Age: 43
State: NJ

Vax Date: 02/07/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: N/A

Allergies: None

Symptoms: This was my second dose - within 14 hours I experienced fever, body aches and headaches which lasted about 24 hours. My menstrual period started earlier than expected this month (LMP 2/1/21, vaccine 2/7/21 and menstrual period 2/22/21) I am always regular - never early or late and wonder if this is a side effect of the vaccine.

Other Meds: None

Current Illness: None

ID: 1051701
Sex: F
Age: 40
State: TX

Vax Date: 12/29/2020
Onset Date: 01/06/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: no

Allergies: Penicillin

Symptoms: A week after the vaccination my arm was red, swollen and itchy. It increased in size over time and took benedryl and used hydrocorotsone cream to help with the itching. It disappeared after about 3 days but still itch to date and I still experience some muscle weakness also.

Other Meds: no

Current Illness: no

ID: 1051702
Sex: F
Age: 50
State: TX

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

Lab Data:

Allergies: no

Symptoms: My throat was sore, I broke out in hives and it lasts less than 24 hours. My upper left arm is swollen and pain in the entire arm. Having a bad headache.

Other Meds: Metformin 500 mg Lisinopril 40 mg glipizide 10 mg Hydrochlorothiazide Hydralazine 50 mg

Current Illness: n/a

ID: 1051703
Sex: M
Age: 79
State: TX

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/24/2021
Hospital: Y

Lab Data: CT scan, MRI, multiple lab test on 2/17/21, I do not have specific results, please call the hospital for records, patient was hospitalized 2/17/21 to 2/22/21

Allergies: Cipro and sulfa

Symptoms: Patient had sore arm the first day, the second day patient had slurred speech, couldn?t remember or say words, went to the hospital, CT scan and it showed a stroke, AFib came back that had been resolved, he had to be bagged for 2 minutes because he stopped breathing, MD told him the covid shot may have reacted negatively with his previous heart surgery

Other Meds: Avodart 0.5mg daily, anastrozole 1 mg weekly, atorvastatin 20 mg daily, loratadine 10 mg daily as needed for allergies, acetaminophen 500 mg every 6 hours as needed for pain, Colace 100 mg daily, metoprolol succinctness 50 mg daily,, coQ 10

Current Illness: None

ID: 1051704
Sex: F
Age: 63
State: MO

Vax Date: 02/01/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: none, I didn't go to the doctor since it was over so fast

Allergies: pennicillin, leaviquin, medrol, topimax, bee pollin

Symptoms: two hours after injection I ran across a road and my heart began to race and I felt like I couldn't breathe. I slowly went into the post office and was offered a chair. It was over as fast as it hit me and everything was fine after that. No other adverse effects since then

Other Meds: lyrica, Baclofen, Celecoxib, multi vitamin, hair, skin and nail vitamins,

Current Illness: none

ID: 1051705
Sex: F
Age: 74
State: IN

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

Lab Data:

Allergies: Keflex, Atorvastatin, Lisinopril, Codeine

Symptoms: Extreme drop in blood pressure: Vaccine at 3:30 PM first drop @ 5:15 Pm to 84/51 HR 93; @ 5:50 PM 80/41 HR95; 7:00 PM 128/60 HR 50; 3:40 AM 85/46 HR 58-Irregular. This continued -the up 7 down till this writing (2/24 @ 9:30 AM). Also body aches, chills, barely able to move. No headache this time. Almost forgot - vomiting from 8:00 PM (2/23) till midnight (approx). I have vision difficulty from time of vaccination till now. I think that is all. General not feel goods!

Other Meds: Aspirin 81mg, Eliquis 5mg x 2,Gabapentin100mg x 3, Lasix 80mg x 2, metFormin 500mg x 2, Metropolol 12.5mg x 2, Pantoprazole SOD DR 40mg, Ropinirole 1mg x 3, Rosuvastatin 20 mg, Spironolactone 25mg

Current Illness: None

ID: 1051706
Sex: F
Age: 53
State: IN

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: having flue symptoms, no energy began on 2/14/2021 consistant

Other Meds: amlodaphine anoro hydrochlororothiazide omeprazole

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm