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: 1052266
Sex: F
Age: 42
State: NJ

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

Lab Data: none

Allergies: sulfa drugs

Symptoms: Immediate upon injection = severe burning in upper arm, lasting 15 minutes 18 hours after injection = migraine, fever (100.8), backache, general fatigue - all lasted 24 hours 48 hours after injection = "COVID arm" (delayed cutaneous hypersensitivity) - got progressively worse for 2 days, still present 5 days post-vaccination

Other Meds: OTC multivitamin

Current Illness: none

ID: 1052267
Sex: F
Age: 59
State: MA

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

Lab Data:

Allergies: None

Symptoms: Nausea, Fever 100.0, body aches, chills, headache, fatigue

Other Meds: Usual

Current Illness: None

ID: 1052268
Sex: F
Age: 37
State: PA

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

Lab Data: None

Allergies: Bactrim, Sulfa Antibiotics, Phenergan-codeine, Tetracycline

Symptoms: Employee received first dose of Moderna. Employee was administered Pfizer vaccination for second dose in error. No adverse reactions noted.

Other Meds: Phentermine HCI, Medroxyprogesterone, Naproxen

Current Illness: None

ID: 1052269
Sex: F
Age: 83
State: CA

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

Lab Data:

Allergies: Shell fish, penicillin, sulfa drugs, bees, junipers

Symptoms: Instant sender headache lasting 4 days, extreme high blood sugar, fatigue, tender left underarm lymph nodes, brain fog for 5 days

Other Meds: Lisinopril, Amlodopine, Glipizide, Metropolis, aspirin, CoQ10, AZO, E, D, potassium, Magnesium, culturelle, chromium picolinate, hydralazine, pravastatin, b-complex, NPH insulin

Current Illness: Diabetes, knee pain, high blood pressure, high cholesterol, over active bladder

ID: 1052270
Sex: F
Age: 50
State: TX

Vax Date: 01/04/2021
Onset Date: 01/12/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None. Just phone calls and emails to my doctors.

Allergies: no serious allergies; my skin will develop a red rash if I wear a plastic bandage for more than few hours; it does not happen with fabric bandages

Symptoms: After the injection , I had the usual sore arm for several days and was tired. On day 3 (Jan 6), I felt very dizzy while teaching at school. I did not pass out, but I had to sit down. My blood pressure was elevated. This feeling continued on and off for several weeks after the vaccine. The main adverse event was the vaccine red arm. On day 8, (Jan. 12), my vaccine site got red and swollen again. It was 5 cm by 8 cm. It became hot and swollen and itchy. My primary care doctor did not know what caused it. My school nurse did not know. I was able to contact the father of one of my students who worked in the Medical Center who advised me that it was just an allergic reaction. Days 8-10 had the most symptoms. It slowly went away after that. I treated it with topical hydrocortisone cream several times a day. It helped soothe the redness and itch. By Day 15, it was gone.

Other Meds: Famotidine (40 mg daily, 20 morning & evening) Quinipril (10 mg daily)

Current Illness: none

ID: 1052271
Sex: F
Age: 77
State: IN

Vax Date: 02/05/2021
Onset Date: 02/07/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: none

Allergies: Some Ststins, Klonapin, Some Sulfas (cream), Lyrica, Cymbalta, Welbutrin, Savelia, Methylprednisolone

Symptoms: Severe Diarrhea, vomiting, nausea, Severe weakness, Chills. Put on Ondansetron, the BRAT diet, and Pedialyte. Vomiting lasted 2 days, Nausea lasted 5 days, Diarrhea lasted off and on for 14 days, weakness lessened by lasted for 12 days, chills lasted for 14 days

Other Meds: Actos, Atenolol/Chlorthalidone, Crestor, Evista, Gabapentin, Irbesartan, Levothyroxine, Omeprazole, Paraxetine, Trulicity, Melatonin, Viactiv

Current Illness: None

ID: 1052272
Sex: F
Age: 1
State: PA

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

Lab Data: none

Allergies: None

Symptoms: patient developed redness and swelling on left thigh around injection site.

Other Meds: Pediatric Multivitamin

Current Illness: None

Date Died: 02/23/2021

ID: 1052273
Sex: M
Age: 77
State:

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/24/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Patient admitted to the hospital the day after receiving a COVID vaccine x 5 days. Patient passed away on 2/23/2021.

Other Meds:

Current Illness:

ID: 1052274
Sex: F
Age: 46
State: CO

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None

Allergies: Tetracycline

Symptoms: Large red spot and lump on injection site - still prevalent on 2/24 after first vaccination on 2/11. Pain subsided after 2nd day but site has become itchy at times.

Other Meds: Tylenol (200mg) periodically

Current Illness: None

ID: 1052275
Sex: F
Age: 27
State:

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

Lab Data:

Allergies:

Symptoms: 2/23 chills, 2/24 headache and diarrhea

Other Meds:

Current Illness:

ID: 1052276
Sex: M
Age: 72
State: NC

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

Lab Data: CBC does show mild elevation in eosinophils (WBC, H/H and Plt normal) UA with NO protein Other labs pending

Allergies: codine - itching

Symptoms: Patient reports noting bilateral lower extremity swelling and redness that started after vaccine and has persisted. He obtained care today at the clinic. There are many other possible causes but reporting due to patients report this began after 2nd dose of vaccine. No rash, no itching

Other Meds: carbamazepine carboxymethylcelulose cholecalciferol cyanocobalamin empagliflozin fenofibrate ferrous sulfate finasteride HCTZ hydrocodone/acetaminophen insulin aspart insulin glargine ketoconazole shampoo levothyroxine lisinopril magnesium

Current Illness:

ID: 1052277
Sex: F
Age: 71
State: CA

Vax Date: 02/12/2021
Onset Date: 02/21/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: none

Allergies: Alendronate 70mg

Symptoms: "Covid arm" 9 days after vaccine administered a small 2" red dot appeared at injection site with a larger patch of red on round part of shoulder, in subsequent days the red patches merged to one large patch

Other Meds: Levocetirizine, Montelukast, Fluticasone prop./Salmeterol Fish Oil, Magnesium citrate, Calcium/ vit. D, D3 2000iu, Biotin

Current Illness: Asthma Allergies (cedar, mold, dust, pollen)

ID: 1052278
Sex: F
Age: 70
State: SC

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None necessary

Allergies: No known drug allergies

Symptoms: Patient developed prodrome of herpes zoster on the initial date noted, the next day developed typical lesions of herpes zoster and saw me, was placed on Valtrex and when seen yesterday, 2/23/2021 the herpes zoster located in T11-12 distribution was markedly improved and patient's symptoms of pain and burning were markedly improved.

Other Meds: Ergocalciferol 50,000 units p.o. weekly Cardura 2 mg p.o. daily Singulair 10 mg p.o. nightly Hydrochlorothiazide 25 mg p.o. daily Albuterol HFA 2 puffs every 6 hours as needed asthma Lopressor 100 mg p.o. twice daily Lisinopril 40 mg p.o. d

Current Illness: None reported

ID: 1052279
Sex: F
Age: 76
State: AZ

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: no

Allergies: no

Symptoms: pt stated the next day after getting the 2nd dose of the covid vax, she had chills, slight fever, body aches and slightly nauseated. On 2/12/2021 she felt better, no fever, but noticed she had developed a slight rash around the injection site. On 2/14/2021 she noticed some red streaks moving down her left breast that disappeared fairly quickly. She had an apt w/ her Dermatologist on 2/15/2021 and the pt had a slight rash on her left arm. On 2/16/2021 she noticed she had a 'covid arm' rash that covered 3/4 of her left upper arm. On 2/18/2021 the rash was still noticeable and was itching so she took a Benadryl and then again on the 2/19/2021. She saw her Dermatologist again on 2/24/2021, her rash is less red and seems to be disappearing.

Other Meds: levothyroxine 88mcg, atorvastatin 10mg , aspirin 81mg, CoQ10-100mg, Critical +D3, Complete Omega, Vitamin D3 15mg

Current Illness: no

ID: 1052280
Sex: M
Age: 72
State: SC

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

Lab Data:

Allergies: Sulfa, Penicillin,Barium Sulfate, Flexeril, Librax

Symptoms: Body muscle aches especially in legs, irregular sinus feelings (not serious-just unusual), sore left arm, 98.8 fever had a hard time sleeping last night.

Other Meds: Vitamin D, Ocuvite, Milk Thistle, 81mg Aspirin, Saw Palmetto

Current Illness: None

ID: 1052281
Sex: F
Age: 93
State: NE

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: NA

Allergies: NA

Symptoms: Second dose given on day 15.

Other Meds: NA

Current Illness: NA

ID: 1052282
Sex: F
Age: 84
State: WI

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

Lab Data:

Allergies: sulfa, other antibiotics, kidney dye

Symptoms: Patient experienced a rash and itching on her neck and face and returned to the pharmacy about 1 & 1/2 hours after getting the vaccine. No shortness of breath was present. Pharmacist gave diphenhydramine 50mg to patient with water. Since her husband was with we recommended that he take her to the hospital (short distance away) for further observation.

Other Meds:

Current Illness:

ID: 1052283
Sex: F
Age: 69
State: KS

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Penicillin, Novocain, Ampicillin, Lisinopril

Symptoms: When I was getting the shot it felt like a burning feeling but that quickly went away. The next day my lymph nodes in my neck and throat area were swollen, it was in my neck and my front left side of chest area. I had a sore throat. I went to the ER on the evening of the 19th. They checked my vitals and they did not think it was a reaction to the vaccine, it was my body's response to the vaccine. They said I could take Tylenol or Ibuprofen and Benadryl if I needed to. As of today the swelling went down and I feel fine.

Other Meds: Losartan 100 MG daily, Metoprolol 25 MG daily, Omeprazole 20 MG daily, Hydrochlorothiazide 12.5 MG daily, L-lysin 1000 MG daily, Vitamin K2 100 MCG every other day, Vitamin D3 10,000 IU every other day, Magnesium 100 MG daily, Vitamin C 500

Current Illness:

ID: 1052284
Sex: F
Age: 74
State: AR

Vax Date: 02/11/2021
Onset Date: 02/21/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient states that they had a rash appear at the injection site that appeared at day 10 and last for three days

Other Meds:

Current Illness:

ID: 1052285
Sex: M
Age: 55
State: NY

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

Lab Data: None

Allergies: Demerol

Symptoms: Patient received first dose of Moderna. Patient was administered Pfizer vaccination for second dose in error. No adverse reactions noted.

Other Meds: Aspririn (ocasionally)

Current Illness: None

ID: 1052286
Sex: M
Age: 70
State: CT

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: On the morning after the vaccination, I woke up, turned to my left in bed, and got dizzy. Rolled back onto my back, let my head clear, turned to my right, and got dizzy again. Felt nauseous, but did not vomit. Problem was worse with eyes closed than with eyes open. Spent most of the day in bed. Vertigo slightly better on day 2 after vaccination, took Dramamine after consult with doctor. Much better on day 3. Essentially back to normal on day 4, but do experience slight dizziness upon waking before getting out of bed.

Other Meds: Lisinopril

Current Illness: None

ID: 1052287
Sex: F
Age: 48
State: MD

Vax Date: 02/10/2021
Onset Date: 02/17/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Celiac Disease- Gluten free

Symptoms: Very swollen arm. From elbow to shoulder and extremely painful. Arm has bumps (Knotty), very tender and swelling is expanding over last couple of days- Can no longer tell that I have an elbow.

Other Meds: Zyrtec, Vitamin C,D,E, Hydrochlorothiazide, Potassium Citrateer, Probiotic, Lexapro, Calcium

Current Illness:

ID: 1052288
Sex: F
Age: 83
State: NV

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

Lab Data: n/a

Allergies: NKDA, NKA

Symptoms: Hives over majority of body.

Other Meds: Lisinopril, Vitamin D, Levothyroxine

Current Illness: No

ID: 1052289
Sex: F
Age: 18
State: NY

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

Lab Data:

Allergies: Naproxen

Symptoms: Pt came up to the EMS table and stated she did not feel well. Pt lost conciousness from a standing position and was caught and lowered to the ground. Pt was unconcious for approx 5 minutes. Pt regained conciousness. Pt was placed in a wheelchair and wheeled to the examination room. Pt was monitored for 30 minutes. Pt states she is feeling better and would like to leave. Pt was walked out to her car. Pt was driven home by her mother. Pt did not require transport.

Other Meds: Fluoxetine

Current Illness: None

ID: 1052290
Sex: F
Age: 28
State: AZ

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

Lab Data:

Allergies: n/a

Symptoms: body aches, chills, headache, nausea, sore arm, fever, sinus congestion, sore throat, cough, difficulty sleeping, constipation

Other Meds: ibuprofen

Current Illness: n/a

ID: 1052291
Sex: F
Age: 59
State: AK

Vax Date: 02/13/2021
Onset Date: 02/15/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Hydrocodone and Z-Pack, and occasionally the sun

Symptoms: A red splotch first appeared a couple days after the injection. It was located right beneath the injection. It continued to grow with a slight itchiness. It went away after a few days. It reappeared on Feb. 23 with more redness and larger, and it itches more. I applied topical Benadryl but it doesn't seem to help the itching. The itching is annoying. There is no pain with slight swelling.

Other Meds: Saxenda

Current Illness:

ID: 1052292
Sex: F
Age: 40
State:

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: none

Allergies:

Symptoms: Left hand felt sluggish almost like cramping, duration about 7 days or more.

Other Meds:

Current Illness:

ID: 1052293
Sex: F
Age: 36
State: KY

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

Lab Data: N/A

Allergies: None

Symptoms: January 12, 2021: patient had a sore arm January 13, 2021: vaccination site left arm, "quarter-sized" red, hard, painful area. Patient also experienced chills, hard to move arm, fever (101) and muscle aches. January 14, 2021: area became more "itchy" and patient began to have flu-like symptoms. patient was referred to the ER by her PCM who then referred to back to Public Health around 8pm on January 14, 2021. Patient was previously diagnosed with COVID-19 and it was lab confirmed.

Other Meds: None

Current Illness: None

ID: 1052294
Sex: F
Age: 69
State:

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

Lab Data:

Allergies:

Symptoms: 0900 RASH. 0912 NO SOB, NO INCREASE RASH. 0922 DENIES SOB OR RASH,SPEECH CLEAR,MOOD CALM.D/C HOME

Other Meds:

Current Illness:

ID: 1052295
Sex: M
Age: 66
State: CA

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

Lab Data:

Allergies:

Symptoms: Site: Swelling at Injection Site-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Severe, Additional Details: Pt DID NOT recieve Covid-19 vaccine at Pharmacy but inquired about side effects and what to do. Pt states they had 1st dose of moderna Covid vaccine 2 weeks ago. Pt states they have had severe itching at injetion ever since injection and now the site is \"bumpy\" is as well. Advised pt to take diphenhydramine for itching and swelling and to follow up with primary care dr in the am.

Other Meds:

Current Illness:

ID: 1052296
Sex: F
Age: 16
State: AK

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

Lab Data:

Allergies: Drugs - Budesonide, fluconazole, lanolin plus many food and environmental allergies.

Symptoms: 16 y.o. scheduled into Moderna vaccine clinic and was given vaccine. Vaccinator did not recognize by DOB that patient was 16. (Age not specified on form). EUA for Moderna COVID vaccine is for persons age 18 and older. Patient did not have any reaction to 1st dose of Moderna vaccine. She returned to clinic on 2/22/21 for 2nd dose and it was recognized that she was 16. COVID Pharmacist consulted who in turn consulted with CDC/State officials. Per clinical considerations for the Moderna vaccine, 2nd dose of Moderna vaccine can be given to those 16-17y as off label use. Mother and patient informed of EUA age cutoff for Moderna vaccine and re: clinical considerations/off label use. Both gave verbal consent to patient having 2nd Moderna vaccine. 2nd dose given. No allergic reaction immediately following vaccine.

Other Meds:

Current Illness:

ID: 1052297
Sex: F
Age: 50
State: TX

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

Lab Data:

Allergies: none

Symptoms: The evening of the vaccine (Day 1 Jan 29), my arm was extremely painfully sore. That night, I developed a fever. Day 2 (Jan. 30), I had a fever, body aches, muscle aches, fatigue, and nausea throughout the day. My fever went up to 100.6. I treated it with Tylenol (2 extra strength every 6 hours). The fever broke around 9 PM (24 hours after it started) Day 3 (Jan 31), I just had severe fatigue and a sore arm. The fever and aches and nausea were gone. Day 4 (Feb 1), I just was more tired than usual. and my arm was still sore. For the first week, my arm got less sore each day, and by Day 7, I was feeling great with no other adverse reactions remaining.

Other Meds: Famotidine (40 mg daily) Quiipril (10 mg daily)

Current Illness: none

ID: 1052298
Sex: F
Age: 32
State: TX

Vax Date: 01/04/2021
Onset Date: 01/11/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: no

Allergies: Seszol

Symptoms: A couple of days - a normal kind of sore and it went away. 1 week later - quarter size lump - itchy, painful, hot - grew in the next four days - grew to the size of a grapefruit - it spread out - it had a bulls eye - the center was as big as Cutie orange (and it was red and painful) and the redness spread from their extending out from center about 4 inches. It took up my entire upper arm - the redness day. It was painful to sleep on but I could use it. On the third day of it ( a Wednesday, 13th) - to check in with DR - Telehealth appt - employee health - recommended ibuprofen and ice packs for a few days. They advised if I got a fever etc to seek more treatment. It took about two weeks for it to go entirely away.

Other Meds: anti-thyroid medication - levothyroxine

Current Illness: No

ID: 1052299
Sex: F
Age: 41
State: KS

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

Lab Data:

Allergies:

Symptoms: 5 minutes after injection I experienced tingling all over, nausea, sweating, dizziness and racing heart rate. It lasted for about 2 minutes and gradually subsided over next 5 minutes. Soreness in arm is only symptom 3 hours post injection. I did not notify health department staff because it subsided.

Other Meds: Vitamin D Sufficient-C (Vitamin C, L-Lysine Hydrochloride, Bromelain, EGCG) Ferrous Sulfate

Current Illness:

ID: 1052300
Sex: F
Age: 88
State:

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 02/24/2021
Hospital: Y

Lab Data:

Allergies: SULFA ANTIBIOTICS, NSAIDS

Symptoms: PATIENT ON 2ND DAY AFTER VACCINATION COULD NOT STAND OR WALK, COULD NOT UNDERSTAND COMMANDS OR CUES, COULD NOT FEED HERSELF, PRIOR TO VACCINATION AMBULATORY AND FEEDING HERSELF.

Other Meds: LEVOTHYROXINE 75 MCG, LEXAPRO 5 MG, KCL 10 MG, METFORMIN ER 500MG, VITAMIN C 500 MG, ZINC 220 MG, METOPROLOL 50 MG, NAMENDA 10 MG, ASPIRIN 81 MG, SIMASTATIN 40 MG, TYLENOL 500 MG

Current Illness: UTI, ADVANCED MEMORY LOSE, TYPE 2 DIABETES, ANXIETY

ID: 1052301
Sex: M
Age: 79
State: GA

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

Lab Data:

Allergies:

Symptoms: Systemic: Pt was injected with vaccine after RPh stuck herself with needle. -mild

Other Meds:

Current Illness:

ID: 1052302
Sex: F
Age: 27
State: OR

Vax Date: 02/19/2021
Onset Date: 02/21/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Sesame, hair dye

Symptoms: Very painful mouth ulcers (5) on lip and in mouth. Swollen around jaw line. Sore mouth. Treatment: I am swishing orajel and mylanta with lidocaine to relieve pain.

Other Meds: Vitamin D, Hormonal Balance (Rae Brand), multivitamin

Current Illness:

ID: 1052303
Sex: F
Age: 17
State: AK

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

Lab Data:

Allergies:

Symptoms: 17 y.o. scheduled into Moderna vaccine clinic and was given 1st dose on 1/27/21. Vaccinator did not recognize by DOB that patient was 17. (Age not specified on form). EUA for Moderna COVID vaccine is for persons age 18 and older. Patient did not have any reaction to 1st dose of Moderna vaccine. She returned to clinic on 2/24/21 for 2nd dose and it was recognized that she was 17. On 2/23/21, COVID Pharmacist consulted about this same issue and pharmacist consulted with CDC/State officials at that time. Per clinical considerations for the Moderna vaccine, 2nd dose of Moderna vaccine can be given to those 16-17y as off label use. Mother and patient informed of EUA age cutoff for Moderna vaccine and re: clinical considerations/off label use. Both gave verbal consent to patient having 2nd Moderna vaccine. 2nd dose given. No allergic reaction immediately following vaccine.

Other Meds:

Current Illness:

ID: 1052304
Sex: F
Age: 34
State: AR

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

Lab Data:

Allergies: Wellbutrin Amoxicillin Penicillin

Symptoms: Red inflamed circle on left arm, about the size of a tennis ball or so with heat, and a knot under the skin. Given antibiotics, steroid shot, and allergy meds.

Other Meds: none

Current Illness: none

ID: 1052305
Sex: F
Age: 36
State: KY

Vax Date: 02/08/2021
Onset Date: 02/16/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: I have not sought medical treatment at this time, but wanted to report this possible adverse event.

Allergies:

Symptoms: I took daily intramuscular progesterone in sesame oil (PIO) injections (hip) for IVF treatment, with injections ending in May 2020. While taking PIO I had swelling and lumps at the injection sites which dissipated over time. Following the 2nd Moderna vaccine, the swelling and lumps reappeared. I believe this is related to the vaccine, as clinical trial participants with dermal facial fillers had similar immunological reactions.

Other Meds:

Current Illness:

ID: 1052306
Sex: M
Age: 70
State: PA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1052307
Sex: F
Age: 62
State: MD

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

Lab Data: NONE

Allergies: PENICILLIN

Symptoms: 101 FEVER CHILLS SWEATS BAD BODY ACHES COUGH

Other Meds: 30MG TEMAZEPAM CENTRUM SILVER D3 2000IU

Current Illness: NONE

ID: 1052308
Sex: F
Age: 29
State: MI

Vax Date: 02/08/2021
Onset Date: 02/15/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Red dye

Symptoms: I experienced Covid Arm 7 days after my shot, as it became known to me after I looked up my symptoms and talked with my doctor. Started with itching at injection site, which became very warm. After about an hour or so I noticed it was very sore and swollen. It developed a red circle around it on the second day, and was at least 2 inches in diameter. It was hard, hot and itchy. Probably due to the swelling, my arm became sore from shoulder down through my hand for about 24 hours. Two days later the swelling began to go down, the heat went away, and I?d say the itching mostly subsided within the 48 hours since it started. All normal now!

Other Meds: Levothyroxine

Current Illness:

ID: 1052309
Sex: M
Age: 19
State:

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever, bodyaches

Other Meds:

Current Illness:

ID: 1052310
Sex: M
Age: 75
State: IN

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: Na

Allergies: None

Symptoms: Covid Arm. Silver dollar size red mark still on injection site with minimal swelling very little itching still at this date. Can feel lump under surface about size of tennis ball flat.

Other Meds: Tamsulosin, pottassium, Topiramate, Simvasitin

Current Illness: None

ID: 1052311
Sex: F
Age: 67
State: NC

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

Lab Data: none

Allergies: Cefuroxime Itching High Glucosamine Swelling Hives, facial swelling Iodine Other (See Comments), Swelling High 11/21/2013 Past Updates... IV contrast Hives, facial swelling Moderna Covid-19 Vaccine (eua) [Covid-19 Vacc,mrna(moderna)-pf] Anaphylaxis High 1/26/2021 Nsaids (non-steroidal Anti-inflammatory Drug) UGI bleed 5/20 Shellfish Containing Products Swelling Hives, facial swelling Metoclopramide Shakes, confusion Penicillins Rash, edema Verapamil GI upset Actos [Pioglitazone] fatigue, wt gain Apixaban Rash Codeine Nausea And dizzy Domperidone GI complaints Reglan [Metoclopramide Hcl] Shakes, confusion Cardizem [Diltiazem Hcl] Nausea

Symptoms: On 02/23/21, 67 yo F presented to clinic for dose #2 of COVID-19 vaccine (Moderna). On 01/26/21, after receiving dose #1, pt experienced an allergic reaction. For second dose, pt pre-medicated with diphenhydramine. At 1537, pt was administered 0.5 mL in left deltoid (lot #024M20A). Within 10 minutes of injection, pt developed cough, chest tightness and itching. Pt was administered epinephrine 0.3 mg IM, albuterol 2.5 mg via nebulization, methylprednisolone 125 mg IV and diphenhydramine 50 mg IV. Due to pt's previous reaction, pt was transported to ED for additional monitoring. EMS administered famotidine 20 mg IV. On arrival to ED, pt was placed in observation. Due to persistent coughing and sensation of throat closing, pt was given second doses of epinephrine 0.3 mg IM , albuterol nebulization and diphenhydramine 25 mg PO. Pt was then held in observation x 4 hours with return to baseline. and no symptom recurrence. Pt discharged with instructions to return to ER for any symptom recurrence.

Other Meds: unknown

Current Illness: unknown

ID: 1052312
Sex: F
Age: 16
State: WI

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Error: Patient Too Young for Vaccine Administered

Other Meds:

Current Illness:

ID: 1052313
Sex: F
Age: 74
State: GA

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

Lab Data:

Allergies: NO

Symptoms: There has been no treatment. just a little bit ago today I started to have a dizzy feeling in my head. made me very week for about a second. i could feel my body move like it might fall out. and i got up and moved to another chair and i felt it again. So far i have not felt it again

Other Meds: multivitamins, iron, Tylenol, protoperol, baby aspirin, atorvastatin

Current Illness:

ID: 1052314
Sex: M
Age: 76
State: WA

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None

Allergies: No

Symptoms: 3:15am Feb. 22nd Shakes, chills, muscle and joint aches and nausea for 2 hours. 8:15am Shakes, chills, muscle and joint aches and nausea. 12 noon vomiting yellow bile 4 times. Started feeling better about 5pm. Feb. 23rd chills off and on every few hours feeling week and achey.aches. Feb. 24th feeling nausea and achiness.

Other Meds: tamsulosin ER 0.4 mg 24 hr Cap take 1 capsule (0.4MG) by oral route every day 1/2 hour following the same meal each day 0.4 MG 06/05/2012 Active Lovaza 1 gram Cap take 1 capsule (1G) by ORAL route every day 1 G 05/14/2012 Active Vytorin

Current Illness: None

ID: 1052315
Sex: F
Age: 67
State: OR

Vax Date: 01/15/2021
Onset Date: 01/30/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Intense arm pain, starting at bicep all the way to the hand. Symptoms lasted 7 days.

Other Meds: ASPIRIN 81 MG TAB atorvastatin (LIPITOR) 80 mg tablet CALCIUM 600 + D(3) 600 MG (1,500 MG)-400 UNIT TAB chlorthalidone (HYGROTEN) 25 mg tablet cyanocobalamin (VITAMIN B-12) 1,000 mcg tablet glucosamine 500 mg tablet ibuprofen 20

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm