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: 1054579
Sex: M
Age: 52
State: GA

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none. I took an over the counter anti-diarrhea pill after 4 hours of symptoms and the diarrhea continued through the night until 4:30 the following morning (about 12 hours). Headache and pain on the right temple continues and I am taking Tylenol to help with the headache.

Allergies: Morphine

Symptoms: Diarrhea sharp pain on the left side of the temple of my head, and head ache loss of appetite for a day localized pain near injection site on left arm (expected and not too bad)

Other Meds: Trucilicity 1.5mg weekly Metformin EXT REL 500 daily Atrovastatin 40 mg TAB Lisinopril 20MG TAB Cyclobenzaprine 10 mg as needed to sleep Oxycodone / Tylenol / Advil / Alieve - as needed for pain

Current Illness: none

ID: 1054580
Sex: F
Age: 63
State:

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccine had been thawed 1/08/21, had expired before giving not caught until after given

Other Meds:

Current Illness:

ID: 1054581
Sex: M
Age: 39
State: WA

Vax Date: 12/29/2020
Onset Date: 01/05/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: no

Allergies: Tylenol; ibuprofen; barley; egg yolk

Symptoms: I had a sore arm that lasted about three or four days. It made it hard to hold anything heavy or lift it above my head for one day. One week later, I developed severe hives, and itching all over my body and it didn't stop until about 24 hours later. I went to urgent care. They put me on Prednisone.

Other Meds: no

Current Illness: No

ID: 1054582
Sex: F
Age: 32
State: FL

Vax Date: 01/08/2021
Onset Date: 01/15/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Rash to injection site, lymph nodes swollen under arms, indurated red rash around rash. Presented to EH to report a reaction to the COVID (Moderna) vaccine. Reports received vaccine 1/8. Noticed a small red rash to injection site on 1/15 and lymph nodes in both axilla noted. Today rash is larger with indurated ring-like border. C/O prutitis. Requested to have it evaluated by a HCP. Agreed to go to Care Spot. Injury report completed. Given Care Spot authorization, First Fill form and mileage form, with explanation given. States would like to go to Care Spot. Encouraged to call to make an appointment. Informed she may continue working today. Questions answered.

Other Meds:

Current Illness:

ID: 1054583
Sex: M
Age: 57
State: CA

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: no known drug allergies

Symptoms: Injection site erythema within 24 hours of injection with increased swelling of arm that developed to 6x8 cm on 2/22/21.

Other Meds: acetaminophen, 650 mg, 2 tab, Oral, q6h, PRN pain; aspirin, 81 mg, 1 tab, Oral, Daily; atorvastatin, 80 mg, 1 tab oral; benzoyl peroxide 10% topical gel, 1 app, Topical, BID; calamine 8% topical lotion, 1 app, Topical, TID-KOP, PRN rash; ca

Current Illness: none

ID: 1054584
Sex: F
Age: 47
State: MD

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Patient possibly inadvertently received 1cc of Moderna COVID vaccine instead of 0.5cc. Patient was notified. State of MD was notified

Other Meds: unknown

Current Illness: none at time of vaccination

ID: 1054585
Sex: F
Age: 85
State: PA

Vax Date: 02/04/2021
Onset Date: 02/16/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: Allergic to propylene glycol, formaldehyde, yeast, mold, animal hair, seasonal allergies

Symptoms: Itching and slight rash. Mild lasted two days

Other Meds: Losartan, furosemide

Current Illness: None

ID: 1054586
Sex: M
Age: 81
State: WI

Vax Date: 02/03/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital: Y

Lab Data: She was found to have an elevated d-dimer without pulmonary embolism or DVT identified.

Allergies: doxycycline, ibuprofen, levaquin, morphine, penicillin, cephalexin, tolmetin

Symptoms: The patient developed sudden onset nausea, diaphoresis and hypotension and shaking. Symptoms improved with IV fluids and rest. She was hospitalized 2 days.

Other Meds: docusate sodium, multivitamin, paroxetine, risperidone, trazodone, albuterol, ketoconazole shampoo, psyllium wafer

Current Illness: 1. Diastolic dysfunction 2. Anxiety with depression 3. Obstructive sleep apnea 4. Major neurocognitive disorder and mood disorder with psychotic features. 5. Frontotemporal dementia, following with neurology and underwent neuro-psych evaluation in fall 2020.

ID: 1054587
Sex: F
Age: 22
State:

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccine had been thawed 1/08/21, had expired before giving not caught until after given

Other Meds:

Current Illness:

ID: 1054588
Sex: F
Age: 67
State: AZ

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Fever (101) chills, body aches lasting about 12 hours

Other Meds: Multiple vitamin

Current Illness: None

ID: 1054589
Sex: F
Age: 67
State: RI

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Asa. Pcn. Sulphur. Aureomycin. Mysteclin. Decamycin. Ciprofloxacin avelox

Symptoms: Time of vaccination was 11:34 onst of symptoms 11:50. Patient feel dizzy hot sweaty. Skin was Clammy Diaphoretic. Pt all so c/o diarrhea. First set of vs bp 80/43, sp02 98% ra, 20 reps,hr 56. Bgl 143. Epi pen given 0.3 im . Right deltoid. At 1215 pm. Vs after epi 104/ 58 spo2 95% reps 18 hr 78 skin color improved . Pt sent out by ems

Other Meds: Metformin htz

Current Illness: None

ID: 1054590
Sex: F
Age: 43
State: CA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: N/A

Allergies: N/A

Symptoms: -Diarrhea & nausea began around 2:00 p.m. on 2/23/21 - took tums and Pepto bismol, ate crackers and drank ginger ale -Spike in blood sugar - Checked blood sugar at 3:30 (after lunch) and it was 162 (high for me). Tested blood sugar at 6:01 a.m. on Wednesday, February 24 and my fasting blood sugar was 197. -Lethargy I had to take the afternoon off and slept through the afternoon

Other Meds: Gabapentin 100mg (3X Day), A 100 mg (1x Day), B1 100mg (1x Day), B12 5,000 mg (1x Week), D3 2,000IU (1x Day), Multi Vitamin (2 - 1X Day), Calcium Citrate (3- 1X Day), Zinc (1x Day), Montelukast 10mv (1X Day), Zyrtec 10mg (1x Day).

Current Illness: N/A

ID: 1054591
Sex: M
Age: 47
State: IN

Vax Date: 01/08/2021
Onset Date: 01/20/2021
Rec V Date: 02/25/2021
Hospital: Y

Lab Data: January 26th, eye exam, thought I had detached retina. Have vision loss in both eyes upper left quadrant. Had field test done at eye appointment, Dr. said both eyes were effected and I had a stroke. January 26th in ER had CT scan. Admitted that evening had carotid ultrasound. January 27th, Echo and MRI with contrast. January 28th transesophageal echocardiogram.

Allergies: no

Symptoms: Stroke on January 20th, 2021. Unknown cause for blood clot.

Other Meds: None

Current Illness: none

Date Died: 02/24/2021

ID: 1054592
Sex: M
Age: 68
State: KY

Vax Date: 01/16/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: Resident had been treated for sepsis a week prior, returned to hospice services after hospital readmission.

Allergies: NKA

Symptoms: Resident expired on 2/24/21, under hospice care.

Other Meds: Tylenol, ASA, Cogentin, Bisacodyl, Cetrizine, B12, Depakote, Ativan, Metformin, Multivitamin, Risperdal, Senna tabs.

Current Illness: N/A

ID: 1054593
Sex: M
Age: 55
State: NY

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: Negative Covid test on 02/10/2021.

Allergies: None

Symptoms: My normal temperature is 97.3 degrees. Since my first vaccine, my temperature fluctuates daily between 97.3 and 99.3. I received my second vaccine on 02/08/2021. I haven't discussed this issue with my primary care as I have an appointment scheduled for 03/08/2021.

Other Meds: Protonix 40 mg per day Etodolac 500 mg bid

Current Illness: Gerd

ID: 1054594
Sex: F
Age: 24
State: MD

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Approximately 4 hours after the injection, around 1215, she had suddenly increased HR to 150 bpm and became diaphoretic. She was escorted to the Employee Health Office where her vital signs were checked and she laid down in a dark room. After about 30 minutes she was complaining of ongoing clamminess, mild nausea and some chest discomfort but no difficulty breathing. She was sent home to rest and given instructions for follow up. Vitals: 1240 - BP: 155/91 HR: 119 T: 98.3. 1300 - BP: 138/78 HR: 76

Other Meds: Citalopram, Pepcid

Current Illness:

ID: 1054595
Sex: M
Age: 68
State: ID

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: Thorazine

Symptoms: Pt. had facial swelling, and difficulty breathing the night he received the vaccine. Difficulty breathing resolved by morning and facial swelling resolved the next day. Patient also had redness, pain, and swelling at injection site. Patient never sought treatment for reaction and feels it has completely resolved

Other Meds: Allopurinol 300mg, Avandia 2mg, simvastatin 40mg, symbicort, singulair 10mg, metformin 850mg, lisinopril 20mg, multi vitamin, calcium 1000mg, fish oil capsules, potassium 10meq

Current Illness: none reported

ID: 1054596
Sex: F
Age: 27
State:

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccine had been thawed 1/08/21, had expired before giving not caught until after given

Other Meds:

Current Illness:

ID: 1054597
Sex: M
Age: 33
State: GA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Moderna COVID 19 Vaccine EUA: Patient reports about 30 minutes after receiving vaccine he experienced chest pain, heart palpitations and extreme body aches. Patient did not see medical attention at this time. He states he laid down and fell asleep for the remainder of the night . Upon waking the following day, he experienced a severe migraine headache, continued body aches and then developed a cough lasting several days. Patient followed up with PCP Tuesday, Feb. 2nd. Patient denies any fever. He states he has continued to have a "strange feeling in my heart" at night depending on the position he is lying in. Patient denies any history of heart problems.

Other Meds: Omega 3 , 300 mg DHA

Current Illness: URI one week prior, negative COVID test

ID: 1054598
Sex: F
Age: 38
State: WV

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: penicillin

Symptoms: sore arm, lethargy. Severe eye swelling the day after injection. rash on face.

Other Meds: jardiance, meloxicam

Current Illness:

ID: 1054599
Sex: M
Age: 73
State: FL

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Symptoms began 1/5 with temp of 101.3, pronounced chills, fatigue, H/A and muscle/body aches. Spoke with colleague who advised patient go home 1/5. 1/6 2:30 am temp still at 101.3 and experienced diarrhea. Hx of COVID with hospitalization 9/29 - 10/3/21. Sx resolved RTW 1/7/21.

Other Meds:

Current Illness:

ID: 1054600
Sex: F
Age: 31
State: WY

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Area the day after vaccination was very red, swollen, itchy, painful and indurated. Area was about 6cm in diameter. Area remained swollen, red, itchy and painful for several days following vaccination. Patient opted not to receive the second dose.

Other Meds: None

Current Illness: None

ID: 1054601
Sex: F
Age: 25
State: MD

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: Dayquil: tongue/throat swelling, SOB

Symptoms: 2/15 approx. 8PM: shoulder pain began 2/15 approx. 9PM: continued pain with arm heaviness/weakness, extremely limited range of motion 2/15 approx. 9PM: unable to perform ADL since; Tylenol 1000 mg q6h until 2/20 with little relief 2/18: resumed to work (remote computer work) 2/22: slight improvement in shoulder pain and range of motion, yet limited; could lay/put pressure on left side for the first time since 2/15 2/24: used arm for first time aside from ADLs as I had less pain and slightly improved ROM; worked COVID-19 vaccine clinic and lifted left arm to prepare doses for patients 2/24 5PM: took ibuprofen 400 mg with little relief 2/25: burning sensation/pain deep within left shoulder, range of motion more limited than on 2/24; took ibuprofen 400 mg with little relief; difficulty performing ADLs and typing on computer for remote work duties

Other Meds: Dicyclomine 10 mg tablet Drospirenone and Ethinyl Estradiol 3 mg/0.03 mg tablet

Current Illness: None

ID: 1054602
Sex: M
Age: 39
State: WA

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: no

Allergies: Tylenol; ibuprofen; barley; egg yolk

Symptoms: Lasted about 24 hours, fever - 100.8, chills, body aches - felt like 24 hour flu.

Other Meds: no

Current Illness: no - adverse event dose 1 - hives (Pfizer vaccine)

ID: 1054603
Sex: F
Age: 36
State: OH

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: Was monitored on telemetry, pulse ox and blood pressure entire time I was there

Allergies: Dhea, singular, thimerasol, tape, venlafaxine, gabapentin,

Symptoms: 20 minutes after receiving vaccine, my lips started to tingle, face started to swell, and tongue started to swell. 30 minutes after injection started to feel short of breath and coughing. Went to ER. While in ER I started to get very red and blotchy on face and arms. Was given IV Benadryl and IV Pepcid. Monitored for 3 hours and sent home. Need to continue taking Benadryl and Pepcid.

Other Meds: Wellbutrin, cymbalta, synthroid, vitamin d, Zyrtec, Pepcid, mag ox, topamax

Current Illness: Foliculitis

ID: 1054604
Sex: F
Age: 68
State: OH

Vax Date: 02/16/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: N/A

Allergies: Seasonal Allergies, Ampicillin, Omnicef, Levaquin

Symptoms: 7 days following vaccination, patient showered and noted red area with firmness at injection site. Area itchy with small raised areas.

Other Meds: Aspirin, Fish Oil, Multiple Vitamin, Vitamin D 2,000 units, Calcium with Vitamin D, Glucosamine Chondroitin

Current Illness: Runny nose

ID: 1054605
Sex: F
Age: 0
State: WA

Vax Date: 02/19/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: none

Symptoms: Hives on trunk 3 days after vaccine given. No breathing difficulty. somewhat fussy. resolved by the following day, 2/23/21.

Other Meds: Hydrocortisone 2.5% cream prn eczema

Current Illness:

ID: 1054606
Sex: F
Age: 29
State:

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccine had been thawed 1/08/21, had expired before giving not caught until after given

Other Meds:

Current Illness:

ID: 1054607
Sex: F
Age: 34
State: MT

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient developed mild rash on hands, itchy throat, flushing with 2nd dose of moderna. Patient with a history of allergic reactions. Diphenhydramine 50mg IM administered. Patient monitored and released without further worsening of symptoms.

Other Meds:

Current Illness:

ID: 1054608
Sex: F
Age: 56
State: UT

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: Antibiotics - severe headaches (I rarely get headaches ) and joints and ears get very red, hot and ache. Food - avocados.

Symptoms: Tightness in my chest like a panic attack - I've never had one but this is what it seemed like. I would deep breath to calm down. Took my Pulse/O2 and it was 98% and 62BPM and BP was 107/58 that day (6 Feb). Took it the next day and we had a 98% and BPM of 58 and BP went to 148/72 ( very unusual for me). 4 days later took Pulse/O2 at 98% 58BPM and BP at 120/62. I feel pain in the center of my chest where my heart is and I have never had this in my life until 2 days after the vaccination. I am now taking a lung support (Clear Lungs - Nutritional Therapeutics) in case I have a lung issue. I live at 5000' and can walk and I now only do light exercise so I don't feel the heaviness or "stress" feeling in my heart. I have not gone to the dr yet. On 8 Feb my chest was really hurting and did feel some pain on my lower jaw and this went on for about 2 hrs. I did not go to the hospital. Something is wrong since getting this shot even though the symptoms are subsiding. Again, for someone without comorbidities or a history of her heart ever hurting to have this happen 1 1/2 days after the vaccine is not a coincidence and from all data that can be found this is an anomaly. I am troubled and concerned about my reaction.

Other Meds: No prescriptions or OTC. Nutrients: Fish oil - Nordic Naturals, Ubiquinol - Solgar, Glycogenics - Metagenics, Estrovera - Metagenics, BioSil - Natural Factors, Healthy Aging - Nutritional Therapeutics, Biotin - Now Foods, Oolong Matcha - Ir

Current Illness: Felt under the weather 4 days before and I took Wellness Formula by Source Naturals and Oscillococcinum by Boiron and felt better the day before the vaccination. I did not have a temperature at any time. I did take a covid test on 12 Feb and did not have Covid.

ID: 1054609
Sex: F
Age: 31
State: FL

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: DIZZINESS, RESOLVED 25 MINS

Other Meds:

Current Illness:

ID: 1054610
Sex: F
Age: 92
State:

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccine had been thawed 1/08/21, had expired before giving, not caught until after given

Other Meds:

Current Illness:

ID: 1054611
Sex: F
Age: 51
State: FL

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: noticed erythema to the injection site. Denies pain or pruritus. (Got antibiotics . She followed up with her PCP who told her it was a common reaction to vaccine.

Other Meds:

Current Illness:

ID: 1054612
Sex: F
Age: 24
State: CA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: sent to ER.

Allergies: Morphine- SOB

Symptoms: patient stated she felt nausea and chest pressure after vaccine

Other Meds: unknown

Current Illness: Arthritis

ID: 1054613
Sex: M
Age: 24
State: TX

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: cinnamon, pork

Symptoms: Swelling in throat, difficulty swallowing, tingling in feet, warm sensation

Other Meds: Vit D, MVI

Current Illness:

ID: 1054614
Sex: U
Age: 45
State: AR

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: NA

Allergies: Tetracycline

Symptoms: Fever, body aches, fatigue, HA

Other Meds: Tylenol, affixer, Imitrex

Current Illness: None

ID: 1054615
Sex: M
Age: 16
State: OH

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: 05:45PM BP 118/80, HR 100, R 20, O2 SAT 98%, T- 98.4 (T)

Allergies: NONE

Symptoms: 05:02PM MOM STATES PT 'FEELS NAUSEA AND HEADACHE'. (PT HAS DIFFICULTY DESCRIBING HOW HE FEELS). PT ALERT, PINK,W/D, RESP REG WITH EASE. 05:06PM COOL CLOTH PLACED ON BACK OF NECK, TUMS GIVEN PO, LIQUID BENADRYL 25MG GIVEN PO. 05:20PM 'FEELS A LITTLE BETTER, LESS NAUSEA.' NOW HAS RT CLAVICLE PAIN. ALERT, PINK, W/D, RESP WITH EASE. 05:30PM STILL C/O HEADACHE, NAUSEA AND RT CLAVICLE PAIN. 05:55PM TO EXIT PER W/C TO BE DRIVEN HOME PER MOM. NO ACUTE DISTRESS NOTED. ALERT, PINK, W/D, RESP WITH EASE. 2-25-21 10AM TC- MOM STATES SHE GAVE PT LIQUID TYLENOL LAST NIGHT FOR DISCOMFORT. STATES HE DOES FEEL BETTER TODAY BUT STILL HAS HEADACHE AND RT CLAVICLE PAIN- NO NAUSEA. SHE STATES SHE DID KEEP HIM HOME FROM SCHOOL TODAY. HE HAS HIS REG APPT WITH HIS PCP ON 3-1-21 AND WILL ASK ABOUT HIM GETTING DOSE #2.

Other Meds:

Current Illness: NONE

ID: 1054616
Sex: F
Age: 68
State: OH

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt received vaccine and moved to observation area without event. 12:09 pt alerted nurse that she was "feeling light-headed". Sitting in chair, no other s/s or reaction noted. VSS BP 135/75 (pt reports this is normal for her), HR 65, resp 12. Pt does not wish to lay on the floor and put her feet up. Pt given water and says she feels ok sitting in the chair. 12:11 Pt reports "feeling better but still "a little light-headed, but it's better". Pt has a history of vertigo. She reports bouts of light-headedness with exercise that resolve within minutes by resting. She normally returns to exercise as soon as the light-headedness passes. 12:17 No change, pt continues to sip water and eating a snack. 12:26 VSS BP 132/76, HR 66, reports "feeling better but just a little light-headed". 12:35 Pt reports symptoms have completely resolved. Pt stood, walked around, no further symptoms. Reviewed s/s of reaction vs side effects. Pt agrees to notify 911 if any reaction symptoms appear. Recommended pt notify pcp of this event as well as other events of light-headedness. Reviewed pt's history, meds and today's events with site director and pharmacist. Pt cleared to leave. NM

Other Meds:

Current Illness:

ID: 1054617
Sex: F
Age: 70
State: NV

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: Valacyclovir

Symptoms: Reports 1 bout of vomiting

Other Meds: No prescriptions; vitamins such as Omega-3, lutein, potassium, Centrum Silver multi-vitamin, D (5000iu), calcium/magnesium/zinc, biotin, advanced joint support, and acetyl L-carnitine

Current Illness: Infected big toe

ID: 1054618
Sex: M
Age: 71
State: SC

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: Nkne

Symptoms: Nausea and vomiting body aches chills headaches night sweats loss of appetite

Other Meds: Meds taken: Zocor, Methimazole, Viagra OTC: Low dose aspirin, Multivitamin, Probiotic, Metamucil

Current Illness: Seasonal Flu - 21 Jan - 3 Feb

ID: 1054619
Sex: F
Age: 67
State: PA

Vax Date: 02/03/2021
Onset Date: 02/14/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: Bee stings

Symptoms: Rash redness lump in left arm, itchy. Stead next day to shoulder and elbow. Took Tylenol and Benadryl followed by ibuprofen and Benadryl for 3 days. Improved in 3 days Mgmt suggested by my family practice doctor , sent by health portal with picture etc

Other Meds: Janumet,losartan, metoprolol, nexium,

Current Illness: None

ID: 1054620
Sex: M
Age: 38
State:

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccine had been thawed 1/08/21, had expired before giving not caught until after given

Other Meds:

Current Illness:

ID: 1054621
Sex: F
Age: 39
State: WA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: n/a

Allergies:

Symptoms: Woke up the following morning on Saturday with major back pain. Was pretty miserable that day, i don't normally take pain meds but i took some that evening. Sunday I was still pretty miserable and went to the chiropractor on Monday morning for an adjustment in case it wasn't just the shot that created the pain. I was feeling much better by monday though. however i had shot 2 and the same thing happened again. as i assumed it was related to the shot and not the actual back i didn't see the chiropractor after that shot and the accompanying pain.

Other Meds: bupropion vitamin c, d, b probiotic Zyrtec

Current Illness: i have had a history of back pain - i don't think it had been playing up in that month prior

ID: 1054622
Sex: U
Age: 89
State: WA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: EXTRA VACCINE SHE RECEIVED 3 NOT 2

Other Meds:

Current Illness:

ID: 1054623
Sex: F
Age: 50
State: FL

Vax Date: 01/04/2021
Onset Date: 01/12/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: R arm injection site, warm, painful, swollen, red started 1/12/21. .( Dx Cellulitis - local reaction to COVID vaccine )

Other Meds:

Current Illness:

ID: 1054624
Sex: M
Age:
State: NM

Vax Date:
Onset Date: 02/17/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: hr below 40

Allergies:

Symptoms: fainted, low heart rate

Other Meds:

Current Illness:

ID: 1054625
Sex: F
Age: 75
State: MD

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Mild reaction lasting 48 hours - achy arm at injection site, brain fog, congestion, slight sore throat, fever: 98.9-99.9, fatigue

Other Meds: Amlodipine besylate 5 mg x 2 times a day Omeprazole DR 20mg Metformin ER 500mg x2 two times a day HairSkina and Nails Multi vitamin B12, Vit E, Calcium, D3 1000 iu,

Current Illness: none

ID: 1054626
Sex: F
Age: 26
State:

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Lactose intolerant

Symptoms: It started 5-6 hours after the shot with headache and dizziness . In the evening I had a fever of 37,6?C and because I was scared it will be higher I took pills for fever. On the second day I had muscular pain and my fingers were swollen in the morning. Also I had lower back pain, runny nose and I was nauseous . On the 3rd day I was feeling dizzy, nauseous, couldn't concentrate and an intense headache. Pills weren't helping at all

Other Meds:

Current Illness:

ID: 1054627
Sex: M
Age: 57
State: SC

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: n/a

Allergies: N/A

Symptoms: Febrile Seizure - treated at the hospital, happened the following day

Other Meds: N/A

Current Illness: N/A

ID: 1054628
Sex: M
Age: 41
State: NC

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Worst headache of my life, severe chills, night sweats, flu-like muscle soreness, extreme gas, fever

Other Meds: Jardiance, 25mg Metformin, 500 mg

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm