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: 1054965
Sex: F
Age: 26
State: WI

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

Lab Data:

Allergies: No

Symptoms: Symptoms of swollen, sore, and red throat. Body aches, arm soreness, fever.

Other Meds: Glycopyrrolate and Clonidine hcl

Current Illness: None

Date Died: 02/21/2021

ID: 1054966
Sex: M
Age: 79
State: NC

Vax Date: 02/12/2021
Onset Date: 02/16/2021
Rec V Date: 02/25/2021
Hospital: Y

Lab Data: 2/16/2021: Chest X-ray - boarderline CHF 2/16/2021: Head CT - no intracranial abnormality. stable severe chronic changes 2/16/2021: Chest CTA - no pneumothorax COVID-19 tests all negative CSF glucose: 137 CSF total protein: 176 D-dimer: >5250 BUN: 41-111 eGFR: 54.2-11.9 Potassium: 4.1-7.3 SCr: 1.28-4.75

Allergies: None

Symptoms: Mentation has declined since hospital discharger for fall on 2/6/20201. Patient has also had significant poor oral intake. Brought in due to apneic episodes. Abdominal pain - diffuse tenderness (right sided) Elevated liver enzymes - likely secondary to dehydration Increased serum creatine kinase - likely due to dehydration

Other Meds: Albuterol inhaler Allopurinol Aspirin Carvedilol Cyanocobalamin Escitalopram Fanny Cream Fluticasone nasal spray Furosemide Glipizide Insulin detemir Ipratropium/albuterol nebs Losartan Melatonin Metformin Olanzapine Fish oil Pravastatin Ps

Current Illness: None. Recently in hospital for a fall.

ID: 1054967
Sex: F
Age: 59
State: TX

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

Lab Data:

Allergies: None

Symptoms: Redness, pain and swelling at injection site about 1.5 inches in diameter.

Other Meds: Zoloft, Colace, Calcium, Pravastatin, Hydrochlorothiazide

Current Illness: None

ID: 1054968
Sex: F
Age: 68
State: VA

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: tinnitus in both ears - 24 hours after receiving shot

Other Meds:

Current Illness:

ID: 1054969
Sex: F
Age: 75
State: NH

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

Lab Data: n/a

Allergies: penicillin

Symptoms: VR stated burning sensation through neck and up into head. VR noted fatigue within 5 min of vaccination. Observed for an extra 15 min. vitals stable. symptoms subsided within 5 min of onset

Other Meds: ginger

Current Illness: n/a

ID: 1054970
Sex: M
Age: 59
State: WI

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

Lab Data: none

Allergies: NKDA

Symptoms: Given second dose at 3 weeks not 4 weeks.

Other Meds: Amlodopine, aspirin, atorvastatin, calcium acetate, carvedilol, clonidine, clopidogrel, folic Acid, lasix, hydralizine, isosorbide, multi vitamen, nitroglycerin

Current Illness: none

ID: 1054971
Sex: F
Age: 55
State: IL

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

Lab Data:

Allergies: Iodine

Symptoms: a few min after injection c/o head heaviness and throat felt different like "a marble in throat". Went to ED and it felt like a "ping pong ball" Then 3-4 hours noticed pain in L shoulder that moved up L side of neck. Has had constant pain since then. Called MD told her to take Alleve or Advil. Still has pain.

Other Meds: Vitamin D

Current Illness: no

ID: 1054972
Sex: M
Age: 49
State: CO

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/25/2021
Hospital: Y

Lab Data: Unable to obtain MRI of spine

Allergies: NKDA

Symptoms: Presumed partial myelitis, clinical diagnosis. Underwent 3 days of high-dose IV methylprednisolone followed by PLEX x5 exchanges

Other Meds: Multivitamin, Tylenol, ibuprofen, flonase

Current Illness: none

ID: 1054973
Sex: F
Age: 37
State: NJ

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

Lab Data:

Allergies:

Symptoms: Chills, high fever, body aches

Other Meds: Otc allegra, sunflower lecithin, ibuprofen

Current Illness:

ID: 1054974
Sex: F
Age: 4
State: TX

Vax Date: 02/22/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Amoxicillin

Symptoms: Mom stated that patient woke up in the AM of 2/24/21 with her legs red and swollen that then became bruised. Mom stated that the swelling was the size of a soft ball. Mom stated that patient was stumbling, patient had lost sensation in her legs, was fatigued and had cold sweats. Mom stated that patient's temperature was 96.8. Mom was informed that Dr. requested to have patient be evaluated in the ER. Unknown at this time of patient's outcome.

Other Meds: None

Current Illness: Positive Flu A

ID: 1054975
Sex: F
Age: 77
State: KS

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

Lab Data:

Allergies:

Symptoms: Progress Notes (Nurse Practitioner) ? ? Family Medicine Cosign Needed Expand AllCollapse All 2/25/2021 Date: 2/25/2021 Subjective a 77 y.o. female who was seen at Clinic today for her first dose of the COVID 19 vaccination. She was given the Pfizer vaccination in the left deltoid muscle. During her 15 minute waiting period after the injection, the patient began to experience L hand numbness. She denied rash, hives, welts, difficulty breathing, difficulty swallowing, wheezing, throat tightness, hoarseness, stridor, itching, lightheadedness, dizziness, facial swelling, lip swelling and tongue swelling. This provider was notified of patient reaction and she was then assessed in the emergency bay area. Monitored patient for severe reaction symptoms, including but not limited to blood pressure abnormality , chest pain, rapid progression of symptoms and respiratory distress. PMH includes DM, HTN, asthma. Takes metformin and losartan around noon every day. She has not taken her bp medication yet today as she takes it with lunch. ALLERGY REVIEW OF SYSTEMS: Patient denies chills, fever, malaise/fatigue, facial swelling, sore throat, eyes itching, cough, chest tightness, shortness of breath, wheezing, rash, hives, eczema, cysts, itching of skin, muscle aches, dizziness and headaches Previous Reactions: none Objective Vitals Vitals: 02/25/21 1145 02/25/21 1201 BP: (!) 160/97 124/83 Pulse: 72 SpO2: 99% Physical Exam Constitutional: General: She is not in acute distress. Appearance: Normal appearance. She is well-developed. She is not diaphoretic. Neck: Thyroid: No thyromegaly. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Heart sounds: Normal heart sounds. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No wheezing. Musculoskeletal: Cervical back: Neck supple. Skin: General: Skin is warm and dry. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Cranial Nerves: No cranial nerve deficit or facial asymmetry. Sensory: Sensation is intact. No sensory deficit. Coordination: Coordination is intact. Gait: Gait abnormal (walks with walker, steady gait). Comments: +5/5 strength against resistance to both upper and lower extremities. Assessment/Plan Treatment included: water Follow up response to treatment: excellent. Patient discharge: Stable to go home and follow up with PCP. Differential Diagnosis: Vaccine-Related Anxiety (include misc mental health) and Local reaction (arm pain, bleeding/bruising, mechanical irritation, localized rash) Exam is stable/unremarkable. VS improved. Pt monitored for 20 minutes. She feels well. Possible more likely anxiety related than a local reaction. Pt aware to monitor and follow up with pcp if needed. Pt here with husband whom walked out with her. She declined wheelchair. She feels well. APRN Electronically Signed 2/25/2021 11:59 AM

Other Meds:

Current Illness:

ID: 1054976
Sex: F
Age: 22
State: PA

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

Lab Data:

Allergies: Nka

Symptoms: I noticed Left underarm tenderness as I woke up on 1/25/21. Upon further examination, I discovered that what I believe to be my left lymph node is noticeably swollen and tender to the touch. No treatment has been initiated at this time.

Other Meds: Vitamin C 500mg OTC

Current Illness: N/a

ID: 1054977
Sex: F
Age: 40
State: NY

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

Lab Data: Cardiac work up, Labs, EKG, cardiac monitor, benadryl 25mg IV, pepcid 40mg IV, solu medrol 62.5mg IV. Monitored in ER

Allergies: Cephalexin, Doxycycline, Indomethacin, Tetanus, Sertraline, Sulfa

Symptoms: arm pain, numbness, chest pain

Other Meds: Gabapentin, motrin, loratadine

Current Illness: allergies

ID: 1054978
Sex: F
Age: 49
State: TN

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

Lab Data:

Allergies:

Symptoms: Patient received 2nd dose of Moderna in left deltoid, 3 minutes after receiving vaccine, patient started complaining of raised red rash all along the left arm.

Other Meds:

Current Illness:

ID: 1054979
Sex: F
Age: 63
State: FL

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

Lab Data:

Allergies:

Symptoms: on February 2, 2021 I had my second shot I felt really good but the following day I was so fatigued I had to sit down after one block just to be able to continue to my destination I felt this way all day so I am staying home today which is February 4 I didn?t want to come to work and turn around and have to go home. Mostly just fatigue, and her head felt strange. F

Other Meds:

Current Illness:

ID: 1054980
Sex: F
Age: 74
State: TX

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

Lab Data: Finger stick glucose-121

Allergies: Penicillin

Symptoms: Experienced warmth feeling on her 13 minutes after receiving the COVID-19 vaccine. Symptoms resolved immediately.

Other Meds: Experienced warmth feeling on her throat 13 minutes after receiving the vaccine. BP 142/67, HR 68, O2 sat 97%.

Current Illness: None

ID: 1054981
Sex: F
Age: 41
State: FL

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: palpitations

Other Meds:

Current Illness:

ID: 1054982
Sex: F
Age: 70
State: NC

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

Lab Data: None. N/A

Allergies: codeine, sulfur, iodides, neggram, cymbalta

Symptoms: Joint pain, Muscle discomfort Fever (began at 99.2 and rose to 100.6 for the remainder of the day, followed by sustained spike the next day up to 101.2, leveled off and began to reduce the following day first to 100.4 and then to 99.4 until it broke) Arm pain (could not lift arm for several days, felt like joint was locked; pain, discomfort continued for almost 2 weeks; still feel a little tightness but can finally get my arm raised over my head) Fatigue, tiredness (lasted beyond the fever stage for over a week) Chills (felt like I was in a deep freeze) Site itchiness, odd sensation during week 3 Did not take any Tylenol or any other similar medication either before the injection or afterward, even to this day.

Other Meds: Metoprol, protonix, luvox

Current Illness: None

ID: 1054983
Sex: F
Age: 22
State: KY

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt reported diarrhea, numbness in the left arm from the elbow to the fingertips, numbness in the right arm from the injection site to the fingertips, extreme weakness, nausea, and syncopal episode while showering.

Other Meds:

Current Illness:

ID: 1054984
Sex: M
Age: 77
State: NE

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
Hospital: Y

Lab Data: Upon admission 2/21, BUN 33, Creatinine 1.75, Alk Phos 141 HG decreased from 12.9 to 11.7. Increased neutrophil count Abs# 7.92 UA was negative for concerns on 2/21

Allergies: Naproxen

Symptoms: Increased weakness, fell twice at home. Unable to get back into bed. Admitted to observation status at hospital for weakness for until 2/23 when transferred to skilled care. On day of admission, patient was 2 assist when normally he was independent. IV fluids D51/2 normal at 75/hr

Other Meds: Carvedilol, glipizide, aspirin, metformin, omeprazole, mirtazapine, quetiapine, simvastatin, Tylenol,

Current Illness:

ID: 1054985
Sex: F
Age: 66
State: CA

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

Lab Data: BP 143/74, 141/71 HR 76, 71 SpO2 100% on RA RR 16

Allergies: Multiple allergies including but not limited to Erythromycin, penicillin, eggs, salmon, soy, MSG, petroleum products, latex.

Symptoms: Pt states she felt fine after receiving vaccine, but believes she had a reaction to water she was provided at the clinic. Pt states after drinking water, she developed ringing in ears, SOB, dizziness, nausea, HA. Pt states this has happened before after drinking the same brand of water (Nestle Pure Life). Symptoms resolved after rest.

Other Meds: Vitamin D

Current Illness:

ID: 1054986
Sex: M
Age: 78
State: IN

Vax Date: 02/10/2021
Onset Date: 02/13/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: shingles on right upper arm which is clearing up now after 2 weeks. Still some aching in right shoulder

Other Meds: tamsulosin .4mg-finasteride 5mg-verapamil 180mg-atorvastin10mg

Current Illness:

ID: 1054987
Sex: F
Age: 32
State: MD

Vax Date: 01/20/2021
Onset Date: 01/27/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: Ultrasound with low heart rate of fetus. Hcg levels decline from Wednesday 26-friday 29 from 5,400 to 1,500.

Allergies: None

Symptoms: Pregnancy history: 1 previous pregnancy with healthy full term vaginal delivery. No complications. Estimated due date: Sept, 23, 2021. Symptoms: vaginal bleeding starting Jan 26th. Progressing to miscarriage on 1/29/21

Other Meds: Prenatal vit

Current Illness: None

ID: 1054988
Sex: F
Age: 64
State: CA

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

Lab Data: Did not do any medical tests.

Allergies: None

Symptoms: I started experiencing chills within half an hour after the shot. The following 24 hours I experienced total insomnia, chills, headache, body ache, shoot pains, extreme weakness, and nausea. Insomnia lasted 3 nights. The other side effects began to decrease after 24 hours, but still prominent enough to prevent from actively engage in anything for another 24 hours. After the third night of insomnia, I thought I had turned the corner. But I continued to experience headache (I basically never have headache), occasional nights of insomnia (I usually sleep extremely well), and low level of nausea, and fatigue. Today, 8 days after the shot, after another night of difficulty in sleeping, I woke up with the same headache behind my right eye, nausea, weakness, and fatigue. This is when I thought to report these side effects.

Other Meds: Fish oil, glucosamine, multiple Vitamin, Vit B

Current Illness: None

ID: 1054989
Sex: F
Age: 65
State: FL

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

Lab Data: EKG (2/24):sinus tachycardia, rate 102 bpm, no ST elevation EKG (2/24): NSR, low voltage QRS, with no ischemic appearing ST changes

Allergies: Codeine

Symptoms: Within 15-minutes of vaccination, the patient reported feeling flush, near-syncopal, dizzy, and lightheaded with diaphoresis. EMS evaluated patient on-site. Patient was hypotensive (89/60). 12-lead EKG showed sinus tachycardia, rate 102 bpm, no ST elevation. EMS transported the patient to Emergency Department for further evaluation. In ED, patient was hypertensive (155/65) with all other vitals WNL. Repeat EKG indicated NSR, low voltage QRS, with no ischemic appearing ST changes. ED physician administered 1L saline bolus and 650mg Acetaminophen. Patient reported feeling better and was discharged with a differential diagnosis of vasovagal episode, electrolyte imbalance, and volume depletion.

Other Meds: Lisinopril, Tramadol

Current Illness:

ID: 1054990
Sex: M
Age: 59
State: CA

Vax Date: 01/09/2021
Onset Date: 01/11/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: no

Allergies: penicillin

Symptoms: pt states about 48 hours after getting vax he did not feel well. He had fatigue and nausea that would come and go for about 5 days before subsiding. Pt contacted his PCP regarding these symptoms and was told to give her a CB if his symptoms got worse.

Other Meds: sadiki, ginseng, rhodola, multivitamin, olive leaf

Current Illness: no

ID: 1054991
Sex: M
Age: 38
State:

Vax Date: 02/13/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Per Dr.'s admit note: "Etiology unclear though favor meningitis/encephalitis given 2 days of viral symptoms, headache, questionable neck pain, and low-grade fever of 100.6. Had first COVID-19 vaccination on 2/13. Cannot exclude paraneoplastic syndrome; possible hilar mass noted on CXR will need further work-up to rule out sarcoid/malignancy. Concern for viral meningitis. No known sick contacts. Another tonic-clonic seizure occurred around 08:00 on 2/24 AM with vomiting; no overt aspiration though certainly high risk given situation."

Other Meds:

Current Illness:

ID: 1054992
Sex: F
Age: 45
State: VA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: itching and rash with amoxicillin 20 years ago

Symptoms: Hours after my injection my arm was extremely sore; much worse than the first vaccination. I could barely move it. I got in the hot tub which did help a bit. I didn't sleep well that night and kept waking up feeling achy and hot. Around 6am my temperature was 101 degrees F, I felt fatigued, had body aches, and the area where I received the shot was very sore and a bit swollen, so I took IBU 200 mg. A couple hours later my temperature was 102 degrees, my fatigue and my body aches persisted , so I took another IBU 200mg. Around noon I started to get what felt like a migraine but my temperature was back to normal so I took an Excedrin migraine. My body aches, fatigue, and headache were resolving as the day went on although my arm was still very sore. I was a bit fatigued the following day but much improved. My arm soreness resolved after a few days.

Other Meds: daily multivitamin

Current Illness: none

ID: 1054993
Sex: F
Age: 42
State: FL

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

Lab Data:

Allergies:

Symptoms: Headache, brain fog, dizziness - working from home today 2/2

Other Meds:

Current Illness:

ID: 1054994
Sex: F
Age: 59
State: AL

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

Lab Data: n/a

Allergies: n/a

Symptoms: injection site pain, tiredness, headache, muscle pain, chills, joint pain, fever, injection site swelling, nausea, feeling unwell, numbness and tingling in left hand thumb and pointer finger

Other Meds: n/a

Current Illness: n/a

ID: 1054995
Sex: F
Age: 53
State:

Vax Date: 02/19/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Itchy hot skin at sight of injection and on both arms, hands and left shoulder turning into itchy spots with a scab in the middle. Started early morning after two days. Less itchy but still apparent. Also top of head itchy.

Other Meds: Sertraline

Current Illness: No

ID: 1054996
Sex: F
Age: 77
State: FL

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: N/A

Allergies: Penicillin; Clindamycin; Vancomycin; Metronidazole; Sulfa; Gentamicin; tomatoes; horses

Symptoms: Itching all over my body - arms legs back. Extreme itching hen starched causes swelling and/or hives.

Other Meds: Hydroxyurea, Zyrtec, Vit. D, Vit. C, Fish Oil, Baby Aspirin

Current Illness: N/A

ID: 1054997
Sex: F
Age: 59
State: TX

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

Lab Data:

Allergies:

Symptoms: Tingling in L arm that radiated to fingertips. Patient felt like it was anxiety related, refused to be seen by EMS

Other Meds:

Current Illness:

ID: 1054998
Sex: F
Age: 72
State: MD

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

Lab Data: None

Allergies: Sudafed, Seasonal Allergies, Latex

Symptoms: Light headed and dizziness, left side headache tingling sensation down entire left arm to finger tips, and up to chin neck and chest area for about 20 minutes

Other Meds: Metformin850mg; Telemisartin 40mg; Alive MV; Fish Oil; pravastatin

Current Illness: None

ID: 1054999
Sex: M
Age: 49
State: TX

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

Lab Data: None

Allergies: None

Symptoms: Ringing in ears severe

Other Meds: Metoprolol 50mg Losartan 100mg

Current Illness:

ID: 1055000
Sex: F
Age: 66
State:

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

Lab Data:

Allergies: penicillin

Symptoms: Sore arm, chills, headache, muscle ache - Two doses of 500mg Tylenol 12 hours apart relieved the symptoms. Fatigue (not able to complete the routine daily walk of 3 miles) the day after vaccination for one day.

Other Meds:

Current Illness: none

ID: 1055001
Sex: M
Age: 70
State: KY

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Fever 102.1 , Extreme muscle weakness, unable to stand or walk without help. Dizziness, vomiting. Tylenol and Ibuprophen to reduce fever. Slept all day and most of the night before being able to get up on my own. Took Zophran for stomach. Day 4 and still have weakness in muscles and loss of appetite.

Other Meds: levothyroxine 75 mcg 1 per day megestrol 40 mg 1 per day Opdivo Infusion every 2 weeks

Current Illness: None

ID: 1055002
Sex: F
Age: 72
State: MN

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: No diagnostic tests to date

Allergies: Atenolol, levofloxacin, ciprofloxacin, iodine, sulfa, tetracycline, milk, shellfish, cephalexin

Symptoms: Left axillary (ipsilateral) adenopathy with tenderness. Advised symptomatic treatment due to tenderness (OTC acetaminophen, warm packs) and monitoring for resolution. No evidence of local or systemic infection.

Other Meds: Apixaban, diltiazem, flecainide, lansoprazole, levothyroxine, lisinopril, Montelukast, Dulera

Current Illness: None

ID: 1055003
Sex: F
Age: 16
State: TX

Vax Date: 01/30/2021
Onset Date: 02/01/2021
Rec V Date: 02/25/2021
Hospital: Y

Lab Data: Due to concern for reactivation of varicella zoster/disseminated varicella zoster, she was urgently biopsied by dermatology on 2/25/21 (result pending) and is currently receiving IV acyclovir.

Allergies: shellfish and platelet blood products

Symptoms: 1. 48 hours after the first vaccine dose, she developed a raised, red, bump ~4-5cm area on her back with irregular borders. It was slightly itchy but not painful. 2. The area on her back worsened over the next 2-3 weeks and developed dark black scabs. 3. 24 hours after the second vaccine dose (which was given on 2/20/21), she developed scattered lesions on her neck, hairline, ear, face ? some with blisters, some with scabbed tops. Again slightly itchy but not painful. She also had a transient headache and chills that resolved on their own that same day.

Other Meds: prednisone, mercaptopurine, methotrexate, vincristine, trimethoprim-sulfamethoxazole, norethindrone, cholecalciferol, calcium carbonate, famotidine

Current Illness: currently undergoing chemotherapy for B cell acute lymphoblastic leukemia

ID: 1055004
Sex: F
Age: 50
State: NC

Vax Date: 02/04/2021
Onset Date: 02/10/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None yet

Allergies: None

Symptoms: Painful joints - ankles, knees, hips, shoulder, elbows, wrists, and fingers Fatigue Painful swelling of lower legs and ankles

Other Meds: Budesonide/Form 160/4.5MC Twice daily Triamterene 75MG/HCTZ 50MG Metoprolol ER Succinate 100MG

Current Illness: None

ID: 1055005
Sex: F
Age: 77
State: MD

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

Lab Data: none

Allergies: none listed

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

Other Meds: unknown

Current Illness: none at the time of vaccination

ID: 1055006
Sex: F
Age: 65
State: IA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: PCN and cephalosporins

Symptoms: Immediately had a headache, not severe. Next day felt like COVID again. Aches, nausea, headache, 3 episodes of not being able to breathe in or out, lasting a few seconds. Some wheezing that started the day after the shot that continued for about 24 hours, did use inhaler(albuterol). All symptoms pretty much over by 72 hours after. Did not seek care at this time. Did talk to heart doctor today and will follow up with them about getting the second shot.

Other Meds: metroprolol, plavix, ASA, another med for HTN not sure name

Current Illness: none in last month, hx covid 19 in November

ID: 1055007
Sex: F
Age: 62
State: CO

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

Lab Data: None

Allergies: None

Symptoms: Itchy red rash/urticaria at injection site that developed on the evening of day 7 after vaccination. Not debilitating... improved with topical cortisone cream. Present all of day 8 after vaccination and so far still present on first half of day 9.

Other Meds: None

Current Illness: Asthma

ID: 1055008
Sex: F
Age: 74
State: CT

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

Lab Data: 2/24/21: MRI of brain confirmed suspicion of stroke.

Allergies: Ciprofloxacin

Symptoms: Pt had right thalamus infarct 15-30 minutes after receiving vaccination. Paresthesia to right arm and right side of face.

Other Meds: Eliquis; Sotalol; Hydralazine

Current Illness:

Date Died: 02/09/2021

ID: 1055009
Sex: M
Age: 87
State: IL

Vax Date: 02/04/2021
Onset Date: 02/09/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient deceased 2/9/2021 when called for second dose vaccine appointment

Other Meds:

Current Illness:

ID: 1055010
Sex: F
Age: 54
State: KS

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

Lab Data:

Allergies:

Symptoms: Progress Notes by Family Medicine Nurse Practitioner COVID VACCINE CLINIC 2/19/2021 Patient is a 54 y.o. female who was seen at COVID Vaccine Clinic today for her first dose of the COVID 19 vaccination. She was given the Pfizer vaccination in the left deltoid muscle. During her 15 minute waiting period after the injection, the patient began to experience mouth dryness. She denied rash, hives, difficulty breathing, difficulty swallowing, wheezing, throat tightness, hoarseness, stridor, itching, lightheadedness, dizziness, facial swelling, lip swelling and tongue swelling. This provider was notified of patient reaction and she was then assessed in the emergency bay area. Monitored patient for severe reaction symptoms, including but not limited to blood pressure abnormality , drooling, hypotension, increased swelling, rapid progression of symptoms, respiratory distress, skin changes and tongue swelling. PMH includes seasonal allergies (took zyrtec this am as routinely scheduled), htn, hld. ALLERGY REVIEW OF SYSTEMS: Patient denies chills, fever, malaise/fatigue, facial swelling, itching in ears, sore throat, frequent throat clearing, cough, chest tightness, shortness of breath, wheezing, rash, hives, eczema, cysts, itching of skin, abdominal pain, muscle aches, dizziness and headaches Previous Reactions: none Objective Vitals Vitals: 02/19/21 1533 02/19/21 1536 02/19/21 1541 02/19/21 1600 BP: (!) 157/91 (!) 164/91 (!) 158/92 (!) 149/87 BP Location: Right arm Pulse: 88 SpO2: 99% Physical Exam Vitals and nursing note reviewed. Constitutional: General: She is not in acute distress. Appearance: Normal appearance. She is well-developed. She is not ill-appearing, toxic-appearing or diaphoretic. HENT: Mouth/Throat: Mouth: Mucous membranes are moist. Pharynx: Oropharynx is clear. Comments: Clear oral airway/intact. Eyes: Extraocular Movements: Extraocular movements intact. Conjunctiva/sclera: Conjunctivae normal. Pupils: Pupils are equal, round, and reactive to light. Neck: Thyroid: No thyromegaly. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Heart sounds: Normal heart sounds. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No wheezing. Skin: General: Skin is warm and dry. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Psychiatric: Mood and Affect: Mood normal. Behavior: Behavior normal. Thought Content: Thought content normal. Judgment: Judgment normal. Assessment/Plan Treatment included: antihistamines and water Follow up response to treatment: good. Patient discharge: Stable to go home and follow up with PCP. Differential Diagnosis: Vaccine-Related Anxiety (include misc mental health) and Red flag symptoms (CP, SOB, NVD, Visual/Neuro concerns) Pt stable and doing well. Pt agreeable to monitor symptoms. Aware of when to seek emergent care. Follow up with pcp otherwise. Pt given ride with one of her co-workers. Pt ambulatory out of the facility. Electronically Signed 2/19/2021 3:41 PM

Other Meds:

Current Illness:

ID: 1055011
Sex: F
Age: 78
State: NY

Vax Date: 02/13/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: sulfa drugs dust trees and grass

Symptoms: I have osteoarthritis, with Heberden's nodes on all of my fingers. 3 days ago the two nodes on the most affected finger (and the first that showed the arthritis) turned bright red. Now the whole joint is red and a few of the other nodes have turned red. Except for binding the first finger with the hope it would help (it didn't), I'm not treating them, since of course one can't do anything about osteoarthritis except ease the pain.

Other Meds:

Current Illness: none

ID: 1055012
Sex: F
Age: 82
State: MI

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: Biaxin-had rash on upper chest

Symptoms: Patient reported that during the first hour after vaccine she felt pain in her shoulders and back, and "intense chest tightening". She took a children's tylenol tab and put heat on her back and then rested and fell asleep for a period of time. SHe woke up to "pins and needles" feeling in her head and face that felt "intense" to her maybe 4-5 hours after vaccination. She continued to feel "discomfort, tightness in chest/back" for 2-3 days. SHe then stated around day 10 she had abdominal tightening, overwhelming nausea, and pressure in her stomach, but no diarrhea for about 6-7 days. She also states she had "bad reflux". Around Feb 14th-16th she started feeling a rash on both arms/neck/chest and then hives that were red/blotchy a few were raised and hard on thighs/hip/arms. She went to physician and was given Benadryl and Steroid cream. She then reports that on Feb 20th she had swollen lymph nodes under arm.

Other Meds: CoQ10 amd Vitamin D

Current Illness: denies any

ID: 1055013
Sex: F
Age: 74
State: PR

Vax Date: 02/10/2021
Onset Date: 02/12/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: The patient said that her arm, in the vaccination site, was itchy (no bumps, redness or swelling). Topical Benadryl was recommended and the situation resolved.

Other Meds: none

Current Illness:

ID: 1055014
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: Rash on right shoulder and neck, itchy, right arm feels numb, tingling right side of neck. Evaluated by EMS. 12:24 PM BP 100/80, HR-80, No c/o scratchy throat. 12:36 pm c/o throat itching, slight trouble swallowing. 12:40pm reevaluated by EMS. Breath sounds clear, throat clear. 12:45pm rash essentially gone, continues to c/o slight itching. Client offered transportation to hospital-declined. Client did not feel ER was necessary. Discharged home at 12:49pm.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm