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: 1055961
Sex: F
Age: 41
State: AK

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

Lab Data:

Allergies: Iodine, lamictal, tegretol

Symptoms: 20 minutes after the shot my heart rate went up. 25 minutes after the shot there was chest tightness, similar to when having an angioadema/allergic reaction. 25mg of Benadryl was taken and things calmed down. Since then there have been hives that have been slowly getting worse. Prior to the shot, the chronic hives were under control.

Other Meds: Xolair, Vimpat, Zyrtec, Potassium, pantoprazole, Flonase

Current Illness:

ID: 1055962
Sex: M
Age: 73
State: IN

Vax Date: 02/03/2021
Onset Date: 02/17/2021
Rec V Date: 02/25/2021
Hospital: Y

Lab Data: Blood cultures, CT, MRI, X-Rays, Heart Monitor, EKG. 2-17-2021 through 2-24-2021

Allergies: none

Symptoms: Seizures, with bad head pain, followed with loss of speech. High with blood cell count, indicating infection, but none found. Was on a breathing, and feeding tube. Was in hospital for one weeks time. Now in a Rehab facility, with loss of memory and balance.

Other Meds:

Current Illness: none

ID: 1055963
Sex: F
Age: 79
State: CA

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

Lab Data: None

Allergies: Levaquin, Neosporin Oint, Inhalents: Pollens, House Dust, Dog, Cat. Milk ,MSG

Symptoms: Fever(101.2), 4 degrees above my normal(97.4). Shaking chills. Generalized body aches, Fatigue, Slight Headache, Sore arm. Refrained from Ibuprofen and Tylenol. Rest. Fluids, All better in 48 hrs.

Other Meds: Premarin 0.30mg, 1 Tab AM 3X/Wk Premarin Vaginal Crean 30Gm, 1 Gm 2X/Wk Lipitor 20mg, l Tab HS Omega 3 Fish Oil 1000mg. 2 caps Am & HS Mature Vitamin, 1 cap AM Aller-Tec 10mgm, 1 Tab AM Azelastine Hcl 0.1%, 137mcg ,

Current Illness: None

ID: 1055964
Sex: F
Age: 53
State: NM

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

Lab Data: None

Allergies: Oxycodone, Azithromycin, Cheratussin AC Syrop, Tixocortol-21-Pivalate, IbuprofenRhinitus

Symptoms: Redness, Swelling and Pain at and around Injection Site. Muscle and Joint Pain from Head to Toe. Temperature of 102.1 F. Upset Stomach with Dry Heaves.

Other Meds: Flovent HFA, Fluticasone, Magnesium Glycinate, Curcumin, Cholecalciterol, Fish Oil, Multivitamin, PerserVision Eye Vitamin and Mineral Supplement, Allegra, Boswellia AKBA, Systane Eye Drops Ultra High Performing Dry Eye Relief,

Current Illness: Rhinitis, Mild Asthma, Low Diastolic Pressure

ID: 1055965
Sex: F
Age: 39
State: VT

Vax Date: 02/13/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: penicillin allergy (causes hives)

Symptoms: fever, chills, and extensive join swelling and pain including knees, ankles, wrists, elbows, fingers, and toes. Joint swelling in the knees, especially, led to visible edema with restriction in range of motion. Swelling lasted for four days before beginning to diminish. Joint swelling took about 1 week to resolve.

Other Meds: calcium + D

Current Illness: none

ID: 1055967
Sex: F
Age: 44
State: IA

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

Lab Data: None

Allergies: None

Symptoms: Woke up at 1 am with irritation in throat causing me to cough until I sat up . Throat just kept feeling very scratchy and irritated and like something was ? stuck ? in the back of my throat . Tried drinking some water and continued trying to clear throat . Eventually took Benadryl 50 mg orally And if it didn?t improve was contemplating going to ER. Was able to fall asleep about an hour and a half later . When I woke up throat was still sore and scratchy feeling but didn?t feel like there was anything ?stuck ? anymore . Also had some mild itching on face especially my eyelids .

Other Meds: Synthroid Escitalopram

Current Illness: None

ID: 1055968
Sex: F
Age: 79
State: IN

Vax Date: 02/10/2021
Onset Date: 02/16/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: Did not choose to seek treatment. Thinks just pretty bruised up.

Allergies: Sulpha medications

Symptoms: When making way to the bathroom, patient got dizzy and fell head first onto hardwood floor injuring her face and her knees. This bruised her entire face except a portion of her left cheek. She had already been having muscle and joint pain in her arms and shoulders and had been light headed since her 2nd vaccination. Patient did not make appointment.

Other Meds: Aspirin, Atorvastatin, Buspirone, Duloxetine, Lantus, Metroprolol, Ocuvite vitamins, Pantaprazole, Lisinopril, Vitamin B-12, Vitamin D.

Current Illness: All health issues had been well controlled.

ID: 1055969
Sex: F
Age: 70
State: CA

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

Lab Data: None

Allergies: Sulfa based antibiotics (rash) Tape (rash)

Symptoms: 1st dose-sore arm/no treatment required 2nd dose-sore arm & approx. 16 hours later I awoke to shivering, profuse sweating & temp of 101.8/Advil reduced temp. Next 18 hours temp would respond to Advil & go down to 100. This morning 02/25/2021, temp was 96.7 and now at bedtime is 99.8. I've also experienced. Slight body and headaches.

Other Meds: Diltiazem 240 Mg Sertraline 50 Mg Aller-Tec

Current Illness: None

ID: 1055970
Sex: F
Age: 41
State: IL

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

Lab Data: Blood pressure elevated to 136/91, pulse 121 per minutes about 5 minutes after vaccine was given. About 30 minutes later, BP lowered to 136/61 with pulse at 110. I took xanax in case it was anxiety. Also took 2 benedryl about an hour after vaccine was given. All symptoms subsided within 1.5-2 hours.

Allergies: Sulfa medications

Symptoms: Rapid heart beat, increased pulse and blood pressure, rapid beat, and light-headed.

Other Meds: Zoloft, Gabapentin, labatol, zyrtec, flonase, prevacid, clonazapam, budisonide/albuterol solution for nebulizer, Advair diskus, multivitamin, NAC supplement, probiotics, Xanax as needed only, benedryl as needed only, ibprofen as needed

Current Illness: Sinus infection between first and second vaccine.

ID: 1055971
Sex: F
Age: 85
State: CA

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

Lab Data:

Allergies:

Symptoms: Pt had a near syncopal episode where she became lethargic and nauseated at 1200. Pt became pale and diaphoretic and was assesed by paramedics. The patient stated she felt better and her skin signs became normal. AMR 235 arrived on scene and was cancelled after pt refused transport. did the AMA. Nurse did the asessment and paperwork. Pt stated she had diarhea in the morning. CAD #2021-00012425.

Other Meds:

Current Illness:

ID: 1055973
Sex: F
Age: 77
State: CA

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: Hospital Emerg Dept, CBC, metabolic profile, ECG 2/17/2021

Allergies: sulfa, macrodantin

Symptoms: vasovagal episode then perfuse sweating, then shaking chills

Other Meds: Zocor 10 mgm daily Vit D3 2000 IU daily Prolia 60 mgm every 6 months

Current Illness: none

ID: 1055974
Sex: F
Age: 47
State: CA

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

Lab Data: None

Allergies: None

Symptoms: Pain at injection site started the evening of date vaccine was received. resolved in 2 days. Rash at injection site- started with slight irritation on day 10. Rash appeared on day 14. Currently ongoing. Today is day 15 post vaccine injection.

Other Meds: Amlodipine 5 mg Doxycycline 100 mg Vitamin D 5000 IU

Current Illness: None

ID: 1055975
Sex: F
Age: 73
State: CA

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

Lab Data:

Allergies: Doxycycline, Levaquin, sulfa drugs, vicodine (all narcotics), Omnicef onions, garlic, melons adhesive

Symptoms: I got an allergic rash, very itchy and red, with small, clear, weeping blisters about a week after the shot (after the initial redness and swelling from the shot had subsided).

Other Meds: Imvexxy (vaginal estrogen), probiotic, multivitamins, Nasal Crom, Beano

Current Illness: None

ID: 1055976
Sex: F
Age: 52
State: CA

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

Lab Data:

Allergies:

Symptoms: The patient was sitting in a chair while in observation and reported to the observer that she was nauseated at 12:15pm. The patient stated she had a similar reaction to the first dose. The patient was assessed by paramedics and refused transport to the hospital. Pt stated she felt better after we checked her out. The patient signed out AMA as she did with the first dose. FFPM asissted with assessment and did the AMA paperwork.

Other Meds:

Current Illness:

ID: 1055977
Sex: M
Age: 51
State: NY

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

Lab Data:

Allergies:

Symptoms: Headache, sore joints and high fever with temperature slowly rising from 6 AM and eventually peaking at 102 at about 2:00 PM. Then holding steady at 101 till about 5 PM after which falling sharply to almost normal levels. Continued with slightly elevated body temperature till the morning.

Other Meds:

Current Illness:

ID: 1055978
Sex: F
Age: 71
State: NE

Vax Date: 02/16/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: Codeine (nausea) Augmenting (nausea)

Symptoms: 2/23/21 about 5pm started having heart palpitations that would not clear up with coughing, and also had mild shortness of breath with this irregular heart. And mild chest & left neck pain. Symptoms finally started to ease up near 10 pm and I went to bed and was quite tired. I woke up the next morning 2/24/21 around 7 am with reddening, hard swelling, and itching at injection site in my upper left arm. Arm symptoms slowly improving.

Other Meds: Simvastatin 20mg QHS Aspirin 81mg QHS

Current Illness: None

ID: 1055979
Sex: F
Age: 47
State: IL

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: eggplant

Symptoms: Injection site soreness for 3 days post injection which started about 8 hours after the injection. Under arm axillary swelling and pain which started about 2 days after the first vaccine dose and lasted about 10 days as the pain dissipated gradually over these days. After the axillary pain disappeared, Lt medial epicondyle sensitivity began along with burning and tingling skin sensitivity started on the ulnar side of the injected arm which has continued as of this date. Burning sensation on and off on the side of injected arm thenar eminence starting 3 days post first vaccination.

Other Meds: Daily multi-vitamin, vitamin C, lipoic acid, chlorella

Current Illness: none

ID: 1055980
Sex: F
Age: 55
State: FL

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

Lab Data:

Allergies: None

Symptoms: Arm pain, tiredness and headache

Other Meds: None

Current Illness: None

ID: 1055982
Sex: F
Age: 34
State: UT

Vax Date: 02/11/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: Latex

Symptoms: Itchy injection site and armpit. Itchy palms off and on for days.

Other Meds: None

Current Illness: None

ID: 1055983
Sex: F
Age: 73
State: WA

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

Lab Data: paramedics arrived in pharmacy after pharmacist gave 50mg of Benadryl IM.

Allergies: penicillin, dandruff

Symptoms: swelling of face and forehead, hot flashes. tremors pulse rate low, elvevated blood pressure

Other Meds: benadryl, lisinpril 40, vitamin c 500, venlafaxine er 75mg, atorvastatin 40mg, donepezil 10, topirimate 50mg. omeprazole dr 40mg , iron 65mg , gas x tablets , b12 tab 2500 units, tramadol 50, caridopa/levodopa , gabapention 100mg , d3 1000

Current Illness: none

ID: 1055984
Sex: F
Age: 35
State: NJ

Vax Date: 02/14/2021
Onset Date: 02/16/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: I got a cold sore on my lip. I was prescribed valtrex and the cold sore cleared up.

Other Meds: Armour thyroid, estrace

Current Illness: None

ID: 1055986
Sex: F
Age: 61
State: WA

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

Lab Data:

Allergies: CEPHALEXIN OR ANY CEPHALOSPORINS

Symptoms: PT RECEIVED VACCINE AT AROUND 11:05AM. PT REPORTED FEELING ITCHING AT BOTH ARMS THAT SPREAD TO BACK AND TORSO AT 11:20AM. SHE DID NOT HAVE ANY BREATHING PROBLEMS. SHE WAS GIVEN DIPHENHYDRAMINE 50MG/1ML, 1 ML IM INTO RIGHT DELTOID. SHE REPORTED ITCHING GETTING BETTER AND REDNESS LESSENING. AT 12PM, WHILE BEING OBSERVED AND WAITING FOR HER SON TO ARRIVE TO DRIVE HER HOME, SHE NOTICED THAT THE ITCHING INCREASED. SHE WAS GIVEN DIPHENHYDRAMINE 50MG/1ML, 1 ML IM INTO RIGHT DELTOID AGAIN. I SPOKE WITH HER ON THE PHONE AT 5:20PM. SHE FELL ASLEEP WHEN SHE GOT HOME AND WOKE UP LATER, GETTING ITCHY AGAIN. SHE NOTED THAT IT WAS TIME FOR ANOTHER BENADRYL 25MG DOSE (SHE WAS INSTRUCTED TO TAKE 1-2 CAPS (25MG TO 50MG) BY MOUTH EVERY 4 TO 6 HOURS FOR AT LEAST 1 TO 2 DAYS OR UNTIL THE RASH RECURRENCE STOPS). SHE TOOK THE ORAL DOSE AND SAID THAT THE ITCHING WENT DOWN.

Other Meds:

Current Illness:

ID: 1055987
Sex: F
Age: 74
State: FL

Vax Date: 02/08/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Coding, Demoral, Morphine, Adavan

Symptoms: Swollen glands under right arm starting 2 Weeks after vaccine 2/22/21. Still swollen and hurting today 2/25/21.

Other Meds: Synthroid, Estradiol, Losartan, Progesterone, Atenolol, Singular, Advair

Current Illness:

ID: 1055988
Sex: F
Age: 65
State: CA

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

Lab Data:

Allergies: sulfa drugs

Symptoms: Moderna COVID-19 Vaccine EUA Red, rectangular rash surrounding the injection site. Rash is approximately 8 cm by 7 cm and is warm to the touch. Also a little itchy.

Other Meds: Estradiol, hydrochlorothiazide, calcium, vitamin D, iron, biotin

Current Illness:

ID: 1055989
Sex: F
Age: 71
State: WI

Vax Date: 02/11/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: EKG-NSR.

Allergies: Bisacodyl, Levofloxacin, Lisinopril, Sulfa, MetroGel, Metronidazole, Dulcolax, Sulfacetamide

Symptoms: Pruritus developed 11 days after vaccination. Red pruritic rash to the anterior chest and upper back developed 14 days after vaccination. Patient had mild associated shortness of breath and chest pressure with onset of rash. Mild shortness of breath and chest pressure completely resolved within 1 hour.

Other Meds: Nothing new. Vitamin D; Restasis; Estrogen; Enbrel; Folic Acid; Cozaar; Methotrexate; Multivitamin; Zocor

Current Illness: None

Date Died: 01/16/2021

ID: 1059621
Sex: F
Age: 71
State: MA

Vax Date: 01/12/2021
Onset Date: 01/14/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: CXR - no CHF, pneumonia or effusion. No acute findings

Allergies: Daptomycin, Penicillin, Vancomycin, Cipro, Cubicin, Rocephine

Symptoms: 1/14/21 - Resident complained of SOB. SPO2 66% on RA, vs 105/66-96-20 T98.2 O2 administered Pox 97% Binax test revealed (+) COVID results. Resident transferred to COVID wing. Family (HCP) updated and declined transfer to hospital Resident continued with fever, hypoxia and lethargy. Family elected CMO and Hospice notified. Resident died on 1/16/2021 @ 930AM.

Other Meds:

Current Illness: Obesity, Diabetes Type 2, Heart Failure, Bipolar Edema, CVA, GERD, Cardiomegaly

Date Died: 02/08/2021

ID: 1059622
Sex: M
Age: 84
State: MA

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

Lab Data:

Allergies: Ace Inhibitors

Symptoms: Resident rec'd COVID vaccine #2 on 02/02/2021 and was hospitalized on 02/03/2021. Diagnosed with UTI & Metabolic Encephalopathy. He was re-admitted to facility on 02/05/2021. On 02/08/2021 resident was found to be unresponsive with small amount of tan emesis in mouth and on bed. CPR initiated and resident was transferred to ER. ER MD notified facility that resident had died.

Other Meds: Lipitor Renvela caps, Pantoprazole, Humalog, Midodrine, Neptro caps, Metoprolol, Levemir, Levothyroxine

Current Illness: UTI & metabolic encephalopathy

Date Died: 02/24/2021

ID: 1060524
Sex: M
Age: 78
State:

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

Lab Data:

Allergies:

Symptoms: Death, unknown cause Narrative: Patient received COVID19 vaccine on 2/23/2021 at 14:27. On 2/24/21, patient's family found patient deceased at 12:08am. The local coroner had called the MC to let us know on 2/24/21 at 12:55am. Coroner did not suspect foul play.

Other Meds:

Current Illness:

ID: 1279589
Sex: M
Age: 65
State:

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

Lab Data:

Allergies:

Symptoms: slipped in parking lot on cold day while transferring to car Narrative: pt, after this fall and ER trip that happened on the day of the vaccine, -pt had a history of metastatic lung cancer and was admitted to outside hospital with altered mental status and found to have brain mets, is now in hospice. Low likelihood that covid vaccine was responsible.

Other Meds:

Current Illness:

ID: 1279590
Sex: M
Age: 74
State:

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

Lab Data:

Allergies:

Symptoms: the patient was treated with steroids to attempt to treat the sudden hearing loss, it did not improve. With the high dose steroids, the patient was subsequently seen in the ER 2-11 for hyperglycemia, then meds were adjusted and admitted 2-16 with dehydration, dizziness.

Other Meds:

Current Illness:

ID: 1279591
Sex: M
Age: 85
State:

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

Lab Data:

Allergies:

Symptoms: COVID infection Narrative:

Other Meds:

Current Illness:

ID: 1279592
Sex: M
Age: 81
State:

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/25/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Narrative:

Other Meds:

Current Illness:

ID: 1279601
Sex: M
Age: 95
State: WI

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

Lab Data: 2/21/2021 CAT scan & MRI done

Allergies: Sulfa

Symptoms: 2/23/2021 - patient found in room w/ left groin pain & right sided numbness - upon admission to hospital he has no movement in right leg & minimal movement in right arm.

Other Meds: Unknown - patient does own meds.

Current Illness:

ID: 1279617
Sex: U
Age:
State: MA

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

Lab Data: Labs - Hemogram w PLT / diff manual, BMP and GFR

Allergies: NKA

Symptoms: Resident received 2nd COVID Vaccine and developed Flu-like Symptoms on 2/3/21. Vaccine administered on 2/2/21 Resident was sent to hospital on 2/4/2021and diagnosed with SOB. Readmitted to the facility on 2/5/2021

Other Meds:

Current Illness:

ID: 1291764
Sex: F
Age: 68
State: NY

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

Lab Data: NONE

Allergies: PCN

Symptoms: APPROXIMATELY 8-10 minutes Following Vaccination, Patient began to complain of Numbness sensation around lips, radiated to Nose, eyes and developed a headache. Patient placed on oxygen via nasal (97%) Due to involvement of mouth-lips-Epinephrine 0.3 mg given IM R thigh. EMS Dispatched pER policy transported to local Hospital.

Other Meds: MEDICATION LIST ATTACHED TO FAX

Current Illness: -

ID: 1300743
Sex: F
Age: 90
State: ID

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
Hospital: Y

Lab Data: X-rays

Allergies: Percocet, ASA

Symptoms: 02/18/21 0645 - non injury fall 0930 - non injury fall 1635 - Injury fall - fractured pubic bone Sent to ER -> Rehab

Other Meds: Aricept, Famotidine, Ferosul, Florastor, Gabapentin, Irbesartan, Levothyroxine Lovastatin Zoloft

Current Illness: Shingles, parotid neoplasm, anemia

ID: 1336323
Sex: M
Age:
State: WA

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

Lab Data:

Allergies: None

Symptoms: Patient is a 64-year-old male who has received 2 doses of the pfizer coronavirus vaccine. He received his last dose last week and started having pain in the shoulder which gradually spread to include the upper back and neck region. The pain would radiate down into the arm. he describes the pain as a very deep constant ache with no real aggravating factors. The pain is worse when he is lying down at night. It is best when he is up and active. He has no specific pain with movement of the neck, back, or arms/shoulder. He denies any lumps or bumps at the injection site. He denies any color changes in the overlying skin or swelling. He feels numbness in the entire hand in a stocking glove distribution.

Other Meds: None

Current Illness: None

ID: 1336325
Sex: M
Age: 74
State: HI

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

Lab Data: None yet- Prednisone prescribed

Allergies: Amoxicillin None

Symptoms: Severe pain in L shoulder joint after 2nd dose. Injection site too high on shoulder. Pain has persisted for 48 hours (at MDs office now) Not much better. Cannot raise (abduct) arm very well.

Other Meds: Inbisartan Ezetemibe Chlorthalidone baby ASA Crestor

Current Illness: None

ID: 1336326
Sex: F
Age: 68
State: FL

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

Lab Data: N/A

Allergies: Cecior, Celebrex, Neosporin, Sulfa

Symptoms: Neck Node Enlargement Both times. Severe R Knee pain & swelling could hardly walk

Other Meds:

Current Illness: HYPOTHYROID, ATHMA, RHCUM. ARTHRITIS

ID: 1336328
Sex: F
Age:
State: NY

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

Lab Data: none

Allergies:

Symptoms: soreness at the injection site, slight swelling and itching at the site

Other Meds:

Current Illness: none

ID: 1336329
Sex: F
Age: 69
State: AZ

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

Lab Data:

Allergies: nkda

Symptoms: Cellulits to right arm given antibiotics

Other Meds:

Current Illness:

ID: 1336330
Sex: F
Age: 66
State: CO

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

Lab Data: none

Allergies:

Symptoms: Drug store is doing covid vaccine clinics for long term care facilities, It was noted that the patient received a 3rd dose of covid vaccine (pfizer) on 2/19/21. facility confirmed and no adverse events reported

Other Meds: Unknown

Current Illness: none

ID: 1336331
Sex: F
Age: 81
State: NY

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

Lab Data: N/A

Allergies: NO

Symptoms: Two minutes post . vaccination Pt reponed neck pain. Pain level 5 out of 10. V/S taken BP 152/74 HR 95 Spo2 93 o/o RP 18. Patient observed for an additional 15 minutes. Prior to discharge v/s retaken BP 136/79, HR 86 Spo2 96o/o. Patient reponed pain level 2 out of 10

Other Meds: ambien 10mg tylenol thyroid meds albuterol vit c per pt.

Current Illness: N/A

ID: 1336334
Sex: F
Age: 64
State: CA

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

Lab Data:

Allergies: PCN

Symptoms: Bodyaches, fever, fatique, ChillS, Nausea Headache, muscle pain, lymph node Swelling, Hives, dizziness.

Other Meds: tylenol

Current Illness: None Known

ID: 1336335
Sex: F
Age: 56
State: KY

Vax Date: 02/01/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: 2-22-21, Positive result on Rapid test and PCR Covid-19 test through lab

Allergies: None

Symptoms: Patient received her 2nd Pfizer Covid-19 Vaccine on 2-1-21. She was exposed to Cvoid-19 through her husband who she lives with on 2-9-21 when he tested positive. She was tested through her place of work on 2-11-21 & 2-17-21 and was negative. She tested on 2-22-21 and returned positive results on both a rapid and PCR test. She has been placed on in-home quarantine and has no had any singificant effects at this time.

Other Meds: None

Current Illness: Sore Throat r/t chronic sinusitis

ID: 1336337
Sex: F
Age: 49
State: IL

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

Lab Data:

Allergies: Ivranvomycin- used Epi-Pen

Symptoms: Light-headed, fuzzy 0 HA, vision changes, 0 chest pressure, 0 SOB 0 wheezing 0 urtucaria

Other Meds: Folic acid

Current Illness:

ID: 1336338
Sex: M
Age: 54
State: OH

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

Lab Data:

Allergies:

Symptoms: Generalized not feeling well the day after vaccine administered then progressed to dizziness, nausea. Approx 20 hours after receiving his second dose of Moderna from Health Department he had a syncope episode with LOC of a few seconds. He sustained head injury that was treated and sutured. No further side effects after day 2 of vaccine.

Other Meds:

Current Illness:

ID: 1336339
Sex: F
Age: 85
State: NH

Vax Date: 01/08/2021
Onset Date: 01/12/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: THROMBOCYTOPENA- Platelet count usually 170K 1/8 covid vaccine #1 1/12 platelet count 15k 1/14 " 10k Given high dose dexamethasone 1/29 covid 1/25 platelets 46k vaccine #2 2/2 paltelets 4k again given high dose dexamethasone 2/9 platelets 184k 2/16 platelets 85k

Other Meds:

Current Illness: None

ID: 1399304
Sex: F
Age: 69
State: VA

Vax Date: 02/09/2021
Onset Date: 02/16/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: N/A

Allergies:

Symptoms: Pt received her 1st does of Moderna Covid 19 vaccine on 02/9/21 at another facility. A week afterwards developed itching at site. Mild pain in upper arm. Area of erythema on upper arm Some raised papules on the border with untrue clearing

Other Meds:

Current Illness: None

ID: 1399388
Sex: M
Age: 36
State: KY

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

Lab Data:

Allergies: NONE

Symptoms: BURNING IN Chest Pt states? Nervous patient says he thinks he just got nervous

Other Meds: NONE

Current Illness: NONE

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm