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: 1055318
Sex: F
Age: 73
State: IL

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

Lab Data: BLOOD GAS ARTERIAL(AKA ABG) Liter Flow/O2 Percentage: 3 LPM = 32% Fi02 1 Time ONE TIME 02/01/21 1641 cefTRIAXone (ROCEPHIN) 1 g in sodium chloride 0.9 % 100 mL IVPB EVERY 24 HOURS, Status: Discontinued 02/01/21 1516 azithromycin (ZITHROMAX) 500 mg in sodium chloride 0.9 % 250 mL IVPB EVERY 24 HOURS, Status: Discontinued 02/01/21 1516 levoFLOXacin (LEVAQUIN) IVPB 250 mg EVERY 24 HOURS, Status: Discontinued 02/01/21 1511 sodium chloride 0.9 % bolus 1,000 mL ONCE, Status: Discontinued 02/01/21 1452 Foley Catheter - Discontinue ONE TIME 02/01/21 1430 sodium chloride 0.9 % bolus 1,000 mL ONCE 02/01/21 1406 Insert peripheral IV ONE TIME 02/01/21 1406 Lactic Acid, Serum ONE TIME 02/01/21 1357 Procalcitonin ONE TIME 02/01/21 1357 CULTURE, BLOOD ONE TIME 02/01/21 1356 CULTURE, BLOOD ONE TIME 02/01/21 1356 Brain Natriuretic Peptide (BNP) ONE TIME 02/01/21 1356 XR Chest Portable RAD ONE TIME 02/01/21 1356 Catheter Straight ONE TIME 02/01/21 1356 CBC w Auto Diff ONE TIME 02/01/21 1356 Comprehensive metabolic panel ONE TIME 02/01/21 1356 Urinalysis ONE TIME 02/01/21 1356 azithromycin (ZITHROMAX) 250 MG tablet 02/01/21 1749

Allergies: codeine

Symptoms: Emergency room HPI a 73 y.o. female who presents with NURSING HOME REPORTED TO EMS THAT PT WAS SHORT OF BREATH FOR 1 WEEK AND GETTING WORSE. NURSING HOME REPORTED TO NURSE HERE THAT PT HAD ALTERED MENTAL STATUS IN THAT SHE WAS NO LONGER SCREAMING. PT IS UNABLE TO GIVE ANY HISTORY SECONDARY TO DEMENTIA

Other Meds: Current Outpatient Medications: ? acetaminophen (TYLENOL) 325 MG tablet, Take 650 mg by mouth every 6 hours as needed for Pain, Disp: , Rfl: ? albuterol (PROVENTIL) (2.5 MG/3ML) 0.083% nebulizer solution, Take 2.5 mg by nebulization 4 t

Current Illness:

ID: 1055319
Sex: F
Age: 28
State: MN

Vax Date: 02/17/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: N/A

Allergies: N/A

Symptoms: Raised rash developed near injection site slightly larger than fist sized

Other Meds: N/A

Current Illness: N/A

ID: 1055320
Sex: M
Age: 52
State: WV

Vax Date: 12/28/2020
Onset Date: 01/26/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: heart palpitations, tired, chest pain, anger outbursts, diarrhea , head ache.

Other Meds: Xanax sotalol blood pressure meds fish oil pepcid

Current Illness: none

ID: 1055321
Sex: F
Age: 37
State: MD

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

Lab Data:

Allergies: Gluten

Symptoms: Severe itchiness (small hives), scratchy throat, diziness. Took two Benadryl when reaction started, symptoms continued for 35 minutes until Benadryl started to take effect.

Other Meds: Levothyroxine, Zyrtec, Calcium with Vitamin D, Vitamin D, Biotin, B-12, Proair

Current Illness:

ID: 1055322
Sex: F
Age: 60
State: TX

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: CBC - xrays on 1 knee - spine , neck, head , face . - got referred to an ENT doc and I will be having nose surgery to fix the fractures of my nose . Was put on an antibiotic.

Allergies: Phenergan , cipro . Almonds

Symptoms: Got out of bed day after - 30 min later got super nauseated - passed out face down on ceramic tile in bathroom- broke nose - bruised both knees - busted forehead open- chills started about 1 hour later and lasted for several hours- temp of 100.4-

Other Meds: Celexa- Estradiol -B12- vit C - Vit D -zinc- famotidine

Current Illness: None

ID: 1055323
Sex: F
Age: 50
State: GA

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

Lab Data: Vital signs were 115/72, pulse 90 regular, RR 18, O2 90% on room air,Temp 97.4. Blood sugar was 221.

Allergies: Liver,Demerol,Penicillin

Symptoms: Facial Flushing,feeling hot,dizziness,Patient became sleepy and difficult to arouse,nauseated,shallow respiration's rate of about 18. Had patient remove her mask,cool compress applied to back of neck and forehead,checked vitals and blood sugar.When patient became fully aroused gave zofran odt,Patient complained of chest pain and mild sob,Benadryl 50mg given IM. Sat with patient until EMS arrived.

Other Meds: Rybelsus, Gabapentin,Loratadine,Levothyroxine,Glipizide,pravastatin,Tresiba,insulin aspart,metoprolol,lisinopril,furosemide,aspirin,Metformin,famotidine,Vitmamins E,C,D,Albuterol,Fish oil and potassium

Current Illness: None

ID: 1055324
Sex: F
Age: 49
State: MD

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

Lab Data:

Allergies: bees

Symptoms: large, red, swollen, raised and itchy area at the site of the injection

Other Meds: sertraline, wellbutrin

Current Illness: no

ID: 1055325
Sex: M
Age: 52
State: TX

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

Lab Data:

Allergies:

Symptoms: Body aches, nausea & chest (lung) discomfort lasting from approximately 4:00am until 12:00pm

Other Meds: lisinopril (10mg/day), ferosimide (40mg/every other day), carvetelol (3.125mg x 2/day), asprin (81mg/day), iron (325mg x 3/day), atorvastatin (20mg/day), vitamin D3 (2000 UI/day), magnesium oxide (400mg/day), venlafaxine hcl (75mg/day), mir

Current Illness:

ID: 1055326
Sex: F
Age: 74
State: SC

Vax Date: 02/09/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: possible allergy to keflex and bactrim

Symptoms: on 2/24/21 noted discomfort starting on scalp on top of head going down to left eyebrow, onto left orbit down face on left side of nose, also a fever blister on bottom lip starting 2/22/2021,discomfort continues. have not called M.D. Lysine ointment on lip. no other treatment

Other Meds: lisinopril with HZCTl,levothyroxine , meloxicam,duloxetine,pantoprazole,elderberry with zinc and vitamin c

Current Illness: none

ID: 1055327
Sex: F
Age: 74
State: CA

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

Lab Data: NoneNone

Allergies: None

Symptoms: About 8 p.m. the day of the vaccine Monday, I felt chilled, achy, fever, heart palpitations, until about 4 a.m. when it subsided. still tired the next morning with my legs that ached. rested until 3 that afternoon. Ate light dinner. By Wednesday, I felt fine with no symptoms at all. Never needed to call a doctor.

Other Meds: Losartan, amlodipine, Lovastin, Carvedilol, Vitamin D3

Current Illness: None

ID: 1055328
Sex: F
Age: 32
State: TX

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

Lab Data: None

Allergies: Cipro

Symptoms: My hair has been falling out in clumps, kind of hard to describe the amount and duration- mostly noticing when in the shower. I run my hands through my hair and large clumps come out. No changes have been made to other medications, diet, or bathing/shampooing habits.

Other Meds: Sertraline; Tri-sprintec

Current Illness: None

ID: 1055329
Sex: F
Age: 72
State: SC

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

Lab Data:

Allergies: Tetracycline, Singulair

Symptoms: Resident received her second vaccination on 2/19/21. She was sent to the hospital on 2/20/21 for respiratory distress. We think she aspirated (she has a history of dsyphagia) which caused pneumonia. However, I am reporting this because it was within 24 hours of receiving her vaccine.

Other Meds: Aspirin, Bupropion, Paxil, Melatonin, Miralax, renal vitamin, Docusate Sodium, Risperdal, Buspirone, Clonazepam, Miconazole Powder,

Current Illness:

ID: 1055330
Sex: F
Age: 36
State: CA

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

Lab Data: NA

Allergies: NKA

Symptoms: Patient complaint of feeling lightheaded, dizzy and heart racing. Vitals BP 130/88, O2 99%, P 85, T 98.1, R 18. After 30 minutes of observation, patient expressed that she felt better and has a history of anxiety. VItals BP 126/80, O2 99%, P 68, T 98.1, R 16. Patient was discharged from clinic.

Other Meds: Patient complaint of lightheadedness, dizziness and racing heart. BP 130/88, O2 99%, P 85, R 18, T 98.1. Patient expressed feeling better and that she has a history of anxiety. Vitals after 30 minutes: BP 126/80, O2 99%, P 68, R 16, T 98.1

Current Illness: Lightheadedness, dizziness and racing heart.

ID: 1055331
Sex: F
Age: 77
State: IL

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

Lab Data: atenolol (TENORMIN) tablet 12.5 mg ONCE 02/01/21 2305 Troponin I ONE TIME 02/01/21 2155 Urine culture ONE TIME 02/01/21 2031 Urinalysis with reflex to culture, if indicated ONE TIME 02/01/21 1942 cloNIDine (CATAPRES) tablet 0.1 mg ONCE 02/01/21 1914 Troponin I ONE TIME 02/01/21 1914 EKG ONE TIME 02/01/21 1914 CBC w Auto Diff ONE TIME 02/01/21 1914 Comprehensive metabolic panel ONE TIME 02/01/21 1914 XR Chest Portable RAD ONE TIME 02/01/21 1914 Cardiac Monitoring CONTINUOUS, Status: Canceled 02/01/21 1914 atenolol (TENORMIN) 25 MG tablet DAILY, Status: Discontinued 02/01/21 2244

Allergies: penicillins

Symptoms: A 77 year old female who presents with patient states went to see PCP today for six-month labs and was noted to have elevated BP. Patient's has never been diagnosed with hypertension. She states after going home she got a headache and dizzy since she recheck her blood pressure and noted that it was 190/106. Patient denies any chest pain or shortness of breath and says that her headache is resolved. 2039 BP 145/78, PT FEELS FINE. EXPLAINED TO PT WILL CHECK A SECOND TROPONIN WITH ABNORMAL EKG AND ELEVATED BP. PT VERBALIZED UNDERSTANDING. SECOND TROPONIN NEGATIVE WILL START PT ON ATENOLOL 25 MG DAILY AND DISCHARGE TO FOLLOW UP WITH PCP.

Other Meds: Current Outpatient Medications: ? acetaminophen (TYLENOL ARTHRITIS) 650 MG CR tablet, Take 650 mg by mouth every 8 hours, Disp: , Rfl: ? atenolol (TENORMIN) 25 MG tablet, Take 1 tablet (25 mg) by mouth daily for 30 days Indications: Hig

Current Illness:

ID: 1055332
Sex: M
Age: 64
State: MA

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

Lab Data:

Allergies:

Symptoms: Pfizer vaccine malfunctioned and started discharging medication just prior and just after patient injected. Spoke with Pharmacy, explained how much medication poured out of vaccine in open air instead of in patient deltoid, advised to give second vaccination. Second vaccination given with no issues.

Other Meds:

Current Illness:

ID: 1055333
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:

Allergies: SULFA, PCN, HCTZ, DOXYCYCLINE

Symptoms: Patient received her second dose of Pfizer vaccine today at 1230 today. Approximately 15 minutes later at 1246 she started to feel a flushed face, nasal and sinus congestion and stated that her throat felt as if it was swelling. Benadryl 50 mg orally was administered. VS were checked BP 128/80, HR 82. Pt stated she was feeling improved at 1315 and stated her throat felt much better, denies feeling swelling in her throat. No evidence of mouth, tongue or lip swelling, no evidence of angioedema. No evidence of respiratory distress, no wheezing, speaking in full sentences. No rash. Reassessment @ 1345: One hour after patient received benadryl she stated she felt much improved aside from mild body itching. Requesting to leave with husband. Advised to continue benadryl 50 mg every 6 hours as needed for symptomatic and follow up with her primary care doctor and allergist.

Other Meds:

Current Illness:

ID: 1055334
Sex: M
Age: 33
State: CA

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

Lab Data:

Allergies:

Symptoms: @ 12:19 initial vitals were taken prior to vaccine due to patient having to go to ER from primer vaccine. @12:36 He reported dizziness, BP sitting BP 110/65 P 90 O2 97%. Standing BP 110/80. Pt denied itching or discomfort. @1251 patient had emesis X3 @1259 BP 117/70, O2 97% P 87 @ 1315 pt reported feeling better, his PCP was notified and requested to get prescription for Zofran.

Other Meds:

Current Illness:

ID: 1055335
Sex: F
Age: 68
State: WA

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

Lab Data: None

Allergies: Codeine, Sulfa

Symptoms: Fever of 100+, aches, no appetite, lots of sleep.

Other Meds: Levothyroxine; Oxybutynin

Current Illness:

ID: 1055336
Sex: F
Age: 74
State: GA

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

Lab Data: None

Allergies: Celebrex

Symptoms: Freezing cold and uncontrollable whole body muscular contractions, chills, started at around 8:00PM on injection day, lasted about 2 hours Next morning , blood in nose at around 8:00AM. Single event.

Other Meds: Simvastatin 20 mg daily Timolol .25% eye drops to prevent glaucoma

Current Illness:

ID: 1055337
Sex: F
Age: 33
State: PA

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

Lab Data:

Allergies:

Symptoms: Patient states she has been experiencing mostly vomiting as side effect from vaccine. Pt denies fever or chills. Patient states she is also having a headache which can be due to not having a lot of fluids. Patient works for a healthcare organization. Pt received the vaccine from Pfizer per a doctor. Pt states she has been vomiting 5-6 times over the past 24 hours. Patient has not been able to hold anything down.

Other Meds:

Current Illness:

ID: 1055338
Sex: F
Age: 42
State: IL

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

Lab Data: None

Allergies: None that I know of.

Symptoms: Chills, headache and Fever 100.4 at 9pm on 2/23/2021. Sore arm. Swelling below injection site 2/24/2021. Swelling is spreading further down the arm 2/25/2021.

Other Meds: None

Current Illness: None

ID: 1055339
Sex: F
Age: 80
State: UT

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

Lab Data:

Allergies: N/A

Symptoms: Fever, chills, headache, painful joints

Other Meds: Aspirin, antihistamine, Tylenol, lisinopril, levothyroxine

Current Illness: N/A

ID: 1055340
Sex: F
Age: 67
State: NY

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 1/13/2021 I was feeling fatigue, pain on the vaccine site & I felt very low on energy. It lasted for 1 day only.

Other Meds: Tylenol

Current Illness:

Date Died: 02/13/2021

ID: 1055341
Sex: F
Age: 91
State: CA

Vax Date: 01/29/2021
Onset Date: 02/13/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Sudden death two weeks after first dose of vaccine was administered. No previous symptoms or signs. Family opted not to do an autopsy so cause of death (stroke or heart attack) not known.

Other Meds:

Current Illness:

ID: 1055342
Sex: F
Age: 65
State: WA

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

Lab Data:

Allergies:

Symptoms: PT RECEIVED A HIGHER DOSE THAN INDICATED 1.8 MLS

Other Meds:

Current Illness:

ID: 1055343
Sex: M
Age: 36
State: PA

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

Lab Data:

Allergies:

Symptoms: I am unable to regulate my body temperature. I fluctuate between shivering from chills to sweating profusely. I have a mild headache and joint pain. I am heavily fatigued to the point that walking to my kitchen is laborious. My temperature is only slightly elevated to 98.8 degrees F. My normal temperature is 98.1 degrees F. I have been drinking Gatorade when I?m able to make it to my kitchen and taking acetaminophen. The events started approximately 7 hours after vaccination and have been constant to this point.

Other Meds: Zyrtec Flonase Saw Palmetto

Current Illness:

ID: 1055344
Sex: M
Age: 47
State: CA

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

Lab Data: None ; I did not have to go to my primary Care; he is unaware as I have not needed to see him for this yet.

Allergies: Biaxin (hx of Rash) no other med or food allergies

Symptoms: About 3-5 minutes after getting the vaccine began experiencing a light headedness feeling. Took my blood pressure and it was a little high (140/95), I attributed this to anxiety but got home and my BP at home was down to about 120/76 about 1 hr. after. I laid down to sleep it off but could not sleep as about 1 hr. after trying to go to sleep I started to get a headache. After about 2 hours of battling it I decided to take a Extra Strength Tylenol which helped with the headache about 2 hrs later is was almost gone but the feeling of lightheadedness/dizziness was still there a bit worse than at the beginning. I slept it off and the next morning it was about 50 % better and by about noon it seemed to be 99% better. Today is Thursday ( on my 3rd day) and still feel a slight dizziness but I also have seasonal allergies which sometimes give me the same symptoms. I expect to be better soon.

Other Meds: Vit. D Vit. B12 Vit C Zyrtec Nexium Atenolol 25mg.

Current Illness: GERD Seasonal Allergies

ID: 1055345
Sex: F
Age: 62
State: AZ

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

Lab Data:

Allergies: penecillin

Symptoms: low grade fever first 2 days, continued off and on nausea, dizziness and confusion

Other Meds: none

Current Illness: none

ID: 1055346
Sex: F
Age: 70
State: TX

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

Lab Data: BP, Assessment

Allergies: Novacaine

Symptoms: Shortness of breath, Uncontrolled shaking, elevated BP, Pale, Clammy, eyes rolled back in head,

Other Meds: Unknown

Current Illness: HTN

ID: 1055347
Sex: F
Age: 42
State: MN

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

Lab Data:

Allergies: Humera, Lisinopril, Prednisone, Remicade, Contrast Dye

Symptoms: Patient has history of immunocompromised. Discussed vaccination with provider prior to vaccination. Client vaccinated with Covid 19 vaccine at 9:50 AM and advised to wait 30 minutes. At 10:00 am client c/o feeling light headed and dizzy. Client appeared pale. C/o scratchy throat. BP 110/70, Pulse 78, regular, RR 18. Client laying on cot. 10:05 client given Benadryl 25 mg po. 10:10 client c/o chest redness. Denies breathing difficulty or numbness or tingling. Throat feels "funny", not scratchy. 10:15 am BP 130/80, Pulse 86, regular, RR 20. 10:20 am Throat no longer feels "funny or scratchy. 10:25 client sitting in wheelchair. 10:30 BP 148/86, Pulse 86, regular. 10:45 BP 130/78, Pulse 88, regular. 11:00 client states she is feeling ok with no more allergic symptoms. Client went home for day. Phone call to client at 1:00 pm. Left message. Text from client at 3:12 that she is no longer experiencing any symptoms, except exhaustion.

Other Meds:

Current Illness: No

ID: 1055348
Sex: F
Age: 41
State: AZ

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Latex

Symptoms: 1st Dose -Nausea, Stomach ache, head ache 2nd dose on 2/17/2021 at 8:40 am. Side effects started at Midnight on 2/18- Fever of 102.0. Body chills/aches. 2/19- Fever 101.8. Body chills/aches. 2/20 -Fever 100.0. Voice felt froggy (not a sore throat), difficulty talking. 2/21- Fever 99.0. 2/22- Temp 99.0 voice is froggy. 2/23 - Normal temp. Voice is froggy. 2/24 Feeling better. Stayed in bed took 3.5 days off work, treated myself.

Other Meds: High Blood Pressure Medication Asthma- Inhalers, SVN Treatments Herpes/ Cold Sores Seasonal Allergies

Current Illness:

ID: 1055349
Sex: F
Age: 69
State: PA

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

Lab Data:

Allergies: none

Symptoms: severe headache, chills, body aches, fatigue, insomnia

Other Meds: none

Current Illness: none

ID: 1055350
Sex: F
Age: 43
State: CA

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

Lab Data: No

Allergies: NKDA

Symptoms: Right after injection, patient complaints of metallic taste and scratchy throat. 10 minutes after injection, patient developed mild swelling of lips. VS was stable, a dose of Benadryl 50 mg by mouth given. Patient was taken to ER.

Other Meds: No

Current Illness: None

ID: 1055351
Sex: F
Age: 67
State: WA

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

Lab Data:

Allergies: latex, tree and grass pollen, many antibiotics, many soaps, mushrooms, adhesive, etc.

Symptoms: Because of all of my allergies I took 25 milligrams of benadryl 30 minutes prior to the vaccine injection. Just a few minutes less than an hour after vaccine injection, my face turned beet red and got flaming hot. After 40 minutes of a red, hot face I took another 25 milligrams of benadryl. Now two hours and 40 minutes later my face is much less red and much less hot.

Other Meds: Benadryl 25 milligram

Current Illness: none

ID: 1055352
Sex: M
Age: 68
State: OR

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

Lab Data:

Allergies: Diphenhydramine

Symptoms: Note: Patient (me) reports similar adverse reaction to BOTH 1st & 2nd Moderna vaccinations. Chills and general body/joint aches started approx 26-30 hrs post injection. Fever (101.2F) peaked ~ 36 hrs after 1st injection. Mild but obvious headache ceased after 48 hrs. No injection site rash, just soreness of the arm (like all of my previous flu vaccinations). Second vaccination was followed with chills and peak fever of 101.4F along same time interval. Current 02/25/21 at 2:30 pm pacific fever has ?broke? with some sweating. Feeling much better. I know these symptoms are positive evidence that body is geared up building the protection system for which we are vaccinated. Self-medicated with acetaminophen (500 mg) to relieve aches. Thank you!!

Other Meds: Rusovastatin Meloxicam

Current Illness: None

ID: 1055353
Sex: F
Age: 34
State: CA

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

Lab Data: unknown

Allergies: none

Symptoms: debilitating shoulder pain to the point of affecting daily activities of living

Other Meds: unknown

Current Illness: unknown

ID: 1055354
Sex: F
Age: 66
State: CA

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

Lab Data: Covid injection

Allergies: CECLOR AND CEFTIN

Symptoms: Red raised patch at injection site 9 days after

Other Meds: BLOOD PRESSURE RX

Current Illness: NONE

ID: 1055355
Sex: F
Age: 72
State: CA

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

Lab Data:

Allergies:

Symptoms: Patient complain of tingling in tongue and numbness to left lower lip. Patient received 50 mg PO Diphenhydramine. Vital Signs stable prior to and after receiving medication. Patient informed staff of improvement to lip and tongue.

Other Meds:

Current Illness: Patient received Botox 1/21/21 for hx of migraines.

ID: 1055356
Sex: F
Age: 74
State: PA

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

Lab Data: None

Allergies:

Symptoms: Hives on mid to lower body. Benadryl seemed to help. In evening

Other Meds: Simvastatin. Daily vitamins. Restasis

Current Illness: None Hip replacement January 5, 2021

ID: 1055357
Sex: F
Age: 71
State: WA

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

Lab Data: Please advice what medical and laboratory tests I may need for this situation.

Allergies: N/A

Symptoms: Arrived at the fairgrounds to receive 2nd dose of Covid-19 vaccine. The phlebotomist stuck me in the left arm and announced there was no vaccine in the syringe and would need to stick me again. There were 2 other people with me. We all received the vaccine. The next day I became concerned that the needle with the empty syringe may have been previously used and has subjected me to an unknown disease or illness.

Other Meds: N/A

Current Illness: N/A

ID: 1055358
Sex: M
Age: 61
State: OR

Vax Date: 02/17/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none avail.

Allergies: nka, gluten allergy

Symptoms: Started feeling a bit dizzy Monday 22nd in the evening. Woke up Tuesday 23rd room was spinning (patient had labyrinthitis 18 years ago symptoms lasted 2-3 weeks) dizziness lasted throughout the day (Tuesday 23rd, 2021). Vomiting started late afternoon Tuesday. The symptoms were lessening Wednesday and Thursday.

Other Meds: lisinopril 40mg daily, spironolactone 25mg daily, allopurinol 300mg daily, Recently started (45 days ago) metformin er 500mg daily, MTV daily, Bcomplex daily, Vit D 1000daily

Current Illness: none

ID: 1055359
Sex: M
Age: 73
State: CA

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

Lab Data: NA

Allergies: NKA

Symptoms: Patient states he felt dizzy and had a light headache after administration of vaccine. Patient was monitored for 30 minutes and discharged from clinic.

Other Meds: Patient states he felt dizzy and had a headache after administration of vaccine. 1130 am vitals: BP 110/60, R 18, T 97.2, O2 98%, P 56. 12 pm vitals: BP 110/55, R 20, T 97.2, O2 98%, P 52. Patient discharged from clinic.

Current Illness: Light headache Dizziness

ID: 1055360
Sex: M
Age: 72
State:

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

Lab Data:

Allergies:

Symptoms: Patient had a small raised bump on his arm at injection site. It went down with an ice pack. Patient was not distressed and did not have any other symptoms.

Other Meds:

Current Illness:

ID: 1055361
Sex: M
Age: 71
State: MT

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

Lab Data: None

Allergies: Erythromiacin; zithromiacin

Symptoms: Fever of 102 degrees, extended episode of chills and shaking, fast heartbeat, weakness, loss of appetite, loss of taste, headache and loss of energy.

Other Meds: Xarelto 20 mg, hydroclorothiazide 25 mg, Potasium Chloride ER 20 MEQ, Clopidogrel 75 mg, carvedilol 6.25 mg, colesevelam 626 mg, diltiazem 24H ER 240 mg, and losartan 50 mg.

Current Illness: None

ID: 1055362
Sex: F
Age: 36
State: FL

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

Lab Data: n/a

Allergies: unknown

Symptoms: Patient hot and flushed. Felt tingling sensation in arms. Given benadryl. Feeling better after 30 minutes.

Other Meds: unknown

Current Illness: gall bladder removal 1 week prior

ID: 1055363
Sex: F
Age: 40
State: TX

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 02/25/2021
Hospital:

Lab Data: COVID test - January 6 - tested positive

Allergies: Sulpha

Symptoms: 5 am - sore arm - a little swollen. That evening of the second day at about 7 pm - I had body aches and a low grade fever. The third day, I felt back to normal and my arm was back to normal. The following week, the day after I tested positive for COVID, so that was January 7th. The arm was itchy and burny. It had a big rash on that area. (January 6 My upper back was hurting really bad and I had a fever. I wasn't feeling good at all. Had shortness of breath. So I went for a COVID test.) The rash lasted for about 48 hours and then it was gone. I didn't take anything for it. My other COVID symptoms lasted for about 6 days. I still didn't have taste though. I got that back on about day 10. I had the shortness of breath (feeling out of breath) which lasted a week and a half longer than when I felt better from the other COVID symptoms. I treated COVID symptoms with VIT C; Vit D3 and tylenol.

Other Meds: High blood pressure medicine - Kalmathartin

Current Illness: no

ID: 1055364
Sex: F
Age: 88
State: IL

Vax Date: 02/12/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: Inpatient Consult to Case Management ONE TIME, Status: Canceled Provider: (Not yet assigned) Comments: Request for home health or hos... 02/19/21 0030 Troponin I ONE TIME, Status: Canceled 02/18/21 2332 CBC w Auto Diff ONE TIME 02/18/21 2232 Comprehensive metabolic panel ONE TIME 02/18/21 2232 Lipase ONE TIME 02/18/21 2232 CKMB ONE TIME 02/18/21 2232 Troponin Series ONE TIME 02/18/21 2232 EKG ONE TIME 02/18/21 2232 XR Chest Portable RAD ONE TIME 02/18/21 2232

Allergies: ? Ambien [Zolpidem] Other/Unknown (See Comments) ? Crestor [Rosuvastatin] Muscle aches ? Nitrofurantoin Macrocrystal 12/20/2004-MACRODANTIN ? Penicillin G Potassium 12/20/2004-PENICILLIN ? Plavix [Clopidogrel] Rash ? Probenecid 12/20/2004-BENEMID ? Statins Myalgia

Symptoms: Emergency Room PT is a 88 y.o. female who presents with chest pain. Patient has a chronic intermittent chest pain due to coronary artery disease. She was recently evaluated and catheter to cessation demonstrated coronary artery disease that was not amenable to stenting. It was also felt that she was not a candidate for CABG due to her comorbid medical problems including renal insufficiency. Patient has been managed medically. She essentially has daily episodes of angina. Patient denies associa or lightheadedness. Patient had 1 sublingual nitroglycerin prior to arrival. The pain had been present approximately 2 hr time prior to its resolution. The pain had completely resolved prior to her arrival. In addition, she had received 324 mg of aspirin orally.

Other Meds: Current Outpatient Medications: ? acetaminophen (TYLENOL) 500 MG tablet, Take 500 mg by mouth as needed , Disp: , Rfl: ? amLODIPine (NORVASC) 10 MG tablet, TAKE ONE (1) TABLET BY MOUTH ONCE DAILY , Disp: 90 each, Rfl: 3 ? aspirin EC (

Current Illness:

ID: 1055365
Sex: U
Age:
State: CA

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

Lab Data: Pfizer second vaccine

Allergies:

Symptoms: The two days after the 2nd vaccine I felt fatigue, Headache, some small muscle pains that moved quickly from one area of my body to another. Then, while I continued to be a little more tired than usual, But was able to strenuous yard work, row on my rowing machine for 45 minutes, take a 3.5 mile walk with my dog. Then about 12 days in I began to feel like I was coming down with the flu, running a little warm or easily chilled, fatigue, body aches and a persistent but fairly mild headache. I never got above 99 degrees on the thermometer and that was after taking a nap in the direct sunlight for a couple of hours on my bed. Mostly it was low, occasionally getting up to 98 but normal the rest of the time, from 96.7 to 98.6. My back hurt from the heavy yard work, and I had similar body aches that I had in the two days after Shot #2. I got a little sicker on day 2 and 3, but began to feel better on the 4th day and then feel almost 100% on the fifth day. I believe it is a substantial, if delayed response to the vaccine at about the date I would expect to achieve maximum immunity. I wasn't sure of this when I wasn't feeling well. So about 3 and a half days of feeling sickish and then nearly fully recovered. I read that if your body has a strong immune response (which I believe this was) you might test positive for COVID if I took a test. Friends and family are urging me to get the test even though I feel pretty darn good today. I would rather wait a bit when my immune system is not in such an alarmed state and get it then to avoid a false positive. Advice?

Other Meds:

Current Illness:

ID: 1055366
Sex: F
Age: 69
State: CA

Vax Date: 02/18/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Shingles R face, diagnosed by ER visit on 2/24/2021. rash began 2/20/2021. pt called 911 and was transported by ambulance due to eye swollen shut from shingles.

Other Meds: aspirin 81mg daily multivitamin daily

Current Illness: none

ID: 1055367
Sex: F
Age: 31
State: PA

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

Lab Data:

Allergies: Shellfish-anaphylaxix

Symptoms: Pt reported when arriving for dose 2 that during dose 1 she had hives within a few hours of receiving Covid vaccine dose 1. She was instructed by her physician to take diphenhydramine every 4 hours around the clock until hives resolved. She stated this helped. She was also planning to do this when she took dose 2.

Other Meds: took diphenhydramine every 4 hours after hives started

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm