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: 1056797
Sex: F
Age: 57
State: NJ

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Very bad headache, body chills, achy all over, could not sleep.

Other Meds: 40 Mg. Lexapro

Current Illness: None

ID: 1056798
Sex: F
Age: 78
State: GA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1056799
Sex: F
Age: 49
State: TX

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: None

Allergies: No

Symptoms: Internal chills, shivering but not cold, arm soreness. Still shivering on 02/26/2021, but seems improved.

Other Meds: Progesterone cream 6%, turmeric/ginger supplement, Omega3, Multivitamin, Biotin, D3

Current Illness: No

ID: 1056800
Sex: M
Age: 59
State: NC

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1056801
Sex: F
Age: 83
State: FL

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

Lab Data:

Allergies: Aspirin

Symptoms: Pt. was lightheaded at observation lane. paramedics assessed pt. once pt. was stable paramedics released her to leave.

Other Meds: unknown

Current Illness:

ID: 1056802
Sex: M
Age: 67
State: CA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1056803
Sex: F
Age: 33
State: NY

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: COVID test on 2/24

Allergies: None

Symptoms: Headache, fever, body aches and pain

Other Meds: Vitamin c , vitamin d, b. Complex , turmeric

Current Illness: None

ID: 1056804
Sex: M
Age: 72
State: OH

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Site: Itching at Injection Site-Mild, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Body Aches Generalized-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: FACE.THROAT NUMBNESS AND TINGLING-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Shakiness-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium

Other Meds:

Current Illness:

ID: 1056805
Sex: F
Age: 37
State: MT

Vax Date: 02/18/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: None

Allergies: NKA

Symptoms: 7 days post shot; itchy arm at injection site; raised, hive-like area approximately 2 inches in diameter; warm to touch

Other Meds: Fluoxetine Probiotics Daily vitamin

Current Illness: None

ID: 1056806
Sex: M
Age: 73
State: FL

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

Lab Data: None

Allergies: sotalol, flecanaide

Symptoms: Anaphylactic reaction....swelling of throat and tongue

Other Meds: Multaq, Warfarin, Finesteride, Terazosin

Current Illness: None

ID: 1056807
Sex: U
Age: 36
State: FL

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1056808
Sex: M
Age: 76
State:

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: mild shooting pains in my right testicle it also happened after my 2nd covid shot

Other Meds:

Current Illness:

ID: 1056809
Sex: F
Age: 51
State: AK

Vax Date: 02/17/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: On day 1-2: severe fatigue and lethargy. On day 10: sudden nighttime urinary incontinence - this has never happened before but both my husband and I have both now had this side effect

Other Meds:

Current Illness: None

ID: 1056810
Sex: F
Age: 73
State: FL

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

Lab Data: BP 148/83, O2 sat 97, Pulse 82, glucose 172

Allergies: None

Symptoms: Client verbalized feeling lightheaded after receiving the vaccine. Client was then evaluated by Paramedic onsite. Client was released to go home at 9:13 am by paramedic after symptom was resolved.

Other Meds: None

Current Illness:

ID: 1056811
Sex: F
Age: 74
State: IL

Vax Date: 01/29/2021
Onset Date: 02/09/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: none, Happened to be at hospital for tests and was noticed by and checked over by medical personnel

Allergies: none known

Symptoms: Red blotchy spot at injection site approx. 3 x 6 inches, hot to the touch. Never grew larger from original sighting. Stayed warm to the touch for several days later. General soreness and discomfort. Kept a photo.

Other Meds: Atorvastatin, Meloxicam, Lisinopril, Ibandronate, Vitamin D, baby aspirin, Multivitamin, Calcium chew

Current Illness: none

ID: 1056812
Sex: F
Age: 50
State: PA

Vax Date: 02/22/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: None

Allergies: Penicillin, codine

Symptoms: Severe headache and vertigo. With vertigo: spinning sensation, falling sensation and rapid eye movement.

Other Meds: None

Current Illness: None

ID: 1056813
Sex: F
Age: 16
State: NY

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Injection was administered to a 16 year old, even though it is only approved for ages 18+.

Other Meds:

Current Illness:

ID: 1056814
Sex: F
Age: 33
State: NY

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: very lethargic on 1/22, 1/23, 1/24

Other Meds:

Current Illness:

ID: 1056815
Sex: M
Age: 39
State: VA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: None

Allergies: NKDA

Symptoms: At approx 7:45 received FIRST dose of Moderna IM. Approx 15 min. after injection reported that tongue was swelling first dose Epi 0.3mg given @ 08:04; then complained of throat swelling and reported difficutly breathing second dose Epi 0.3mg given @ 08:09 - initially reported that breathing was getting better however third dose of Epi 0.3 mg given 08:19 due to complaints of increased difficulty breathing - he was able to in one word statements but was needing to sit forward. Oxygen saturations ranged:97-99%. Returned from ER approx 5 hours later. Continued with body rash, itching, tongue feeling thick. Medicated with Benadryl 25-50mg QID; Prednisone 50 mg daily; Pepcid 20mg BID all of these for 5 days.

Other Meds: None

Current Illness: None

ID: 1056816
Sex: U
Age: 45
State: NH

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: Hormone blood work 3 times MRI Pet scan

Allergies: Latex, pecans

Symptoms: First dose.. had weird couple days of feeling like I was unable to breath correctly. Tired .. swollen red round arm. Second dose. Felt loopy couple hours later, about 8 hours later started vomiting with the worse stomach ache. Slept 12 hours, felt off, had an obgyn appointment, took blood levels and hormone levels were off the chart, still not well ended up in ER, STOMACH PAIN, FOUND Enlarged nediatiatioal lymph nodes. Headaches Been in and out of the docs, now need scans, bloodwork and tons of medical . Blood pressure off the roof high.

Other Meds: Humeria, Prozac,

Current Illness: None

ID: 1056817
Sex: M
Age: 54
State: TX

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: NA.

Allergies: none known to date

Symptoms: Made me fell sick for about 36hours, low grade fever 101.5, flu like symptoms - body aches, chills, had sore throat as well. Was sick enough to call in sick to work next day after shot. All symptoms completely gone after about 36hrs.

Other Meds: Tamsulosin for enlarged prostate and that's it.

Current Illness: none.

ID: 1056818
Sex: F
Age: 45
State: OH

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: Latex

Symptoms: Severe headache, chills, fever, achey, nausea fatigue Received the vaccine at 1:30 pm and symptoms started at 7:30 the following morning, I still have symptoms 2 days later.

Other Meds: Adderal Zoloft

Current Illness:

ID: 1056819
Sex: F
Age: 54
State: PA

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: The day after the shot, I had nausea, fatigue and a slight fever. This lasted 24 hours. I fell much better 2 days after the shot but still have slight nausea.

Other Meds: Atorvastatin 20mg Estradiol Medroxyprogesterone Coq10 Multi Vitamin

Current Illness: None

ID: 1056820
Sex: F
Age: 47
State: MI

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: BP 174/100; 100% O2 on room air.

Allergies:

Symptoms: 47-year-old female complained of allergic type reaction. On-site team responded. vital below. She refused additional evaluation and care.

Other Meds:

Current Illness:

ID: 1056821
Sex: F
Age: 45
State: FL

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: None I talked to the Teledoc and took several doses for Benadryl and up dose of steroids I have on hand

Allergies: Bees

Symptoms: Flushing upper torso and face, tingling pins and needles skin on face and arms (more left side of face) and behind ears, lips stinging (this started first) tongue tingling, felt lightheaded or unsteady (pulse was up), and headache

Other Meds: mycophenolate, hydroxychloroquine, steroids

Current Illness: None

ID: 1056822
Sex: F
Age: 47
State: WI

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

Lab Data: None

Allergies: None

Symptoms: Large irregular shaped rash at injection site. It is red, raised, and slightly itchy. It is about 5 inches high and about 4 inches across.

Other Meds: Eliquis

Current Illness: None

ID: 1056823
Sex: F
Age: 40
State: MI

Vax Date: 02/19/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Sore arm and swollen, red and rash around injection site. Didn't start until 6 days after injection

Other Meds: Lisinprol 10 mg

Current Illness: None

ID: 1056824
Sex: F
Age: 28
State: DE

Vax Date: 01/22/2021
Onset Date: 01/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: I have a big oval shaped bruise that will not go away. It doesn't hurt but some times I get aches in that same arm.

Other Meds: Xarelto Levothyroxine

Current Illness: Superficial vein thrombosis

ID: 1056825
Sex: F
Age: 59
State: NC

Vax Date: 02/17/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Covid- Arm- Red splotchy itchy arm several days after injection

Other Meds: none

Current Illness: none

ID: 1056826
Sex: M
Age: 67
State: MI

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: He seen his doctor on Sunday February 21 at 12:10.

Allergies: penicillian, red and yellow dye

Symptoms: Started with pain in left arm and then the pain increased around 5pm on saturday. At midnight the pain increased and went down the left arm and across the shoulder and neck , down the right arm, down the back and ribs and into the legs. His hands and knuckles swelled up. From 1am to 5am he couldn't hardly walk, he felt almost paralyed. Around 6am(Sunday) he was starting to move more but the swelling in his hands lasted into Tuesday.

Other Meds: Oxycotin, Norco, prednisone, fish oil, multi-vitamin, turmeric,

Current Illness: Rhumetoid Arithitis,

ID: 1056827
Sex: F
Age: 61
State: NY

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

Lab Data: None.

Allergies: Allergic to shellfish (andioedema), contrast dye (anaphylaxis), PCN (rash)

Symptoms: chills, fever 3-4 hours after vaccine administration injection site pain: took Tylenol 1200mg, helped. Limited range of motion noted on L arm, could not lift arm ROM more than 30 degrees 12 hours after vaccine still had chills, and fever. Then started to itching on both hands, noticed and uncontrollable itching. Took Benadryl 25mg and feel asleep. hives and itching was gone by the time she woke up. Severe fever and body aches 22 hours after vaccine administration. Temperature was 101.8. Throat felt "sore, with some little difficulty swallowing", took Tylenol 1200mg and Vit C 2000mg and Vit D 10,000 IU and Zinc 100mg. Today, 48 hours after vaccine administration, having systemic hives, and eyes are puffy and swollen, R eye more than left, upper lid is swollen. Took Claritin 10mg and Famotidine 20mg. Hives are better but not fully resolved, but itching is persistent. Still discomfort noted in swallowing.

Other Meds: No

Current Illness: None

ID: 1056828
Sex: F
Age: 84
State: NY

Vax Date: 02/14/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: none

Allergies: Sulfa, macrodatin, cymbalta, cipro

Symptoms: On Feb. 24.2021, my left arm at the vaccine site started to itch. It now has a red patch about 5 inches long and 3 inches wide which itches and is sensitive to my touch. I tried putting anti-itch cream on it but that had no effect/ It itches and is sensitive to my touch, not pain but bothersome

Other Meds: Timolol; latanoprost. magnesium, glucosamine, Vitaabin D3, Vitamin B12, Preservision

Current Illness: None

ID: 1056829
Sex: M
Age: 55
State: VA

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: N/A

Allergies: No know allergies

Symptoms: Needle hub separated from the syringe body while attempting to administer the vaccine. The dose was wasted while attempting the injection. No adverse symptoms.

Other Meds: Lotrel,

Current Illness: No illnesses known

ID: 1056830
Sex: F
Age: 24
State: FL

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

Lab Data:

Allergies: Shrimp

Symptoms: Client stated she felt lightheaded after receiving her vaccine. Vital signs obtained: BP 117/81, HR 74, O2 sat 98%.

Other Meds: None

Current Illness: None

ID: 1056831
Sex: F
Age: 24
State: NV

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Body aches, fever (102.1F), headache, chills. Took Advil once fever hit 102.1 and used ice packs and fever reduced. Ongoing symptoms have not resolved yet.

Other Meds:

Current Illness:

ID: 1056832
Sex: F
Age: 71
State: OH

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: aspirin, seasonal allergies

Symptoms: the sinus pressure started the 1st two days then this week about 10 days after vaccine the symptoms were getting worst saw my GP and was told i had an ear infection and given 2 antibiotics. ear drops which i have started to take and Zithromax but have not used it yet.

Other Meds: singular and other things

Current Illness: No

ID: 1056833
Sex: F
Age: 86
State: NJ

Vax Date: 02/17/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: It started to itch about Tuesday the 23rd. My daughter said Mom look at your arm. It is red, warm and itching. It is the size of a baseball. The side of necks also seems a little puffy. I have took Benadryl and put ice on it. Today the redness and warmness is still these but it is not itching.

Other Meds: Euthyrox 75 MG daily, Omega 3 supplement, Core Immune Defense, Orosine

Current Illness:

ID: 1056834
Sex: F
Age: 28
State: LA

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever, chills, nausea

Other Meds:

Current Illness:

ID: 1056835
Sex: F
Age: 66
State: NY

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: None

Allergies: amoxicillin. latex

Symptoms: Almost immediately, sore injection site, later becoming sore shoulder muscle. Around 10 pm began feeling like onset of flu. Woke up around 3 am with temperature of 98, chills, cramps, muscle ache, headache. Temperature rose to 99.1 around 4 am. Woke up around 7 am still feeling same. Temp at 98.8 as of 8:45 pm.

Other Meds: none

Current Illness: none

ID: 1056837
Sex: F
Age: 51
State: FL

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: After the injection site reaction I called our Teladoc through and she informed me to put cold compresses, and take Tylenol for pain. Also, if it gets worse or doesn't go down to the hospital where I received the injection. It feels better now, I just have a 3 inch light bruise across the arm. Haven't received care for the rash on my lower legs yet.

Allergies: NONE

Symptoms: I received the 2nd vaccine on 2/18/21, in the evening of 2/19/21 my left arm swelled, turned hot, and was red. The size of the redness and swelling about 5" x 4". The entire are was painful and itched at the same time. One week later (2/25/21) I got a horrible rash on my lower legs just above my ankles. It was red, splotchy, and itched. I still have the rash on my legs.

Other Meds: NONE

Current Illness: Seasonal Allergies and allergy to cats. We own 3 cats

ID: 1056838
Sex: M
Age: 30
State: IL

Vax Date: 02/16/2021
Onset Date: 02/19/2021
Rec V Date: 02/26/2021
Hospital: Y

Lab Data:

Allergies: None

Symptoms: Patient recieved dose on 2/16/21. Diagnosed with febrile hemolytic anemia in the setting of hereditary spherocytosis in remission after 1st dose of Pfizer COVID-19 mRNA

Other Meds:

Current Illness:

ID: 1056839
Sex: F
Age: 73
State: FL

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

Lab Data: N/A

Allergies: Sulfur, MSG

Symptoms: Client c/o numbness and hot flush to the face w/slight lightheadedness. Client verbalized that she had not had anything to eat or drink due to nervousness of vaccine. Client seen and assessed by EMS. Vital signs are BP 132/70, HR 90, o@ 99. Client advised to drink and eat snack that she had in the car. After snack, client cleared to go home by EMS. Client also advised to seek medical attention if symptoms worsen.

Other Meds: Symbicort, Valium, Albuterol, monthly infusion

Current Illness: None

ID: 1056841
Sex: F
Age: 63
State: MI

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: Did not seek help.

Allergies: Sulfa, penicillin, aspirin, codeine, overall med sensitivities

Symptoms: Inflammation on right side of neck throat and back area. Causing choking feeling of right side of neck/ throat for approx. 8-10 hrs. .............Took several days to a gradual subsiding. Pressure felt in back of neck as well.... Same side loud tinnitus in right ear....took a couple days to subside.........during heightened swelling in nick muscles chest/ heartburn. Subsided after a short while.

Other Meds: Vitamin D

Current Illness:

Date Died: 02/15/2021

ID: 1056842
Sex: F
Age: 78
State: FL

Vax Date: 02/11/2021
Onset Date: 02/15/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: The medical facility did not treat patient as her primary care, but were informed that she passed away on 15 February 2021 of a stroke. I do not have further information on the medical aspect of this as we were not her treating provider but did administer the vaccine on 12 February.

Other Meds:

Current Illness:

ID: 1056843
Sex: F
Age: 69
State: TX

Vax Date: 01/16/2021
Onset Date: 01/26/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: NONE

Allergies: gluten, eggs, chickpeas, bell and other peppers

Symptoms: First dose: red, itchy rash on lateral aspect of lateral left arm beginning 10 days post vaccination, lasting 3 days; mild headache and stomach upset Second dose: pain at injection sit beginning 4 hours post vaccination intensifying to reduction of mobility for 24 hours and abating over the next 24 hours; intense shaking, chills, bone/joint pain, muscle aches and impairment, nausea, headache also intense for first 24 hours and abated over next 24 hours; at 48 hours I awakened with sweats and feeling better. I am still not fully recovered and experiencing shaking, brain fog.

Other Meds: Prescriptions: Armour 1 gr (60 mg) 1x/day (thyroid) Progesterone 50 mg 2x/week at bedtime (compounded) (inflammation, bone) Sirolimus .5 mg every 5 days (autophagy) Valacyclovir 250 mg 1x/day (anti-herpetic) Supplements: Methyl folate plus

Current Illness: NONE

ID: 1056844
Sex: F
Age: 43
State: CT

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: Still pending neurologist

Allergies: None

Symptoms: Seizure

Other Meds: None

Current Illness: Anemia

Date Died: 01/29/2021

ID: 1056845
Sex: F
Age: 87
State: OH

Vax Date: 01/20/2021
Onset Date: 01/23/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: Laboratory test on 26 January 2021 showed a creatinine level of 4.0 mg/dL and several other abnormal results.

Allergies:

Symptoms: Three days after second COVID-19 vaccine, patient became lethargic. Due to advance directive that instructed that no life saving interventions to take place, patient continued to decline and expired on 29 January 2021.

Other Meds: Medical records are on file at facility. Executor of the patient will grant FDA access to medical records.

Current Illness: Patient diagnosed with COVID-19 on 25 November. Mild symptoms. Tested negative within two weeks. Patient had significant Alzheimer's disease, but not life threatening. Other co-morbid conditions that were managed through medication. Facility administered first dose of COVID-19 shortly after Christmas and second dose on 29 January.

ID: 1056846
Sex: F
Age: 71
State: CT

Vax Date: 02/17/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: None

Allergies: None known

Symptoms: Rash itchy sore arm Fatigue Headache

Other Meds: Losartan, oxybutinin, mulitivitamin, calcium, baby aspirin, pentrophil

Current Illness: None

ID: 1056847
Sex: F
Age: 74
State: IN

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: Dr

Allergies: Sulfa Penicillin

Symptoms: Bells Palsy

Other Meds: N/a

Current Illness: N/a

ID: 1056848
Sex: F
Age: 63
State: MS

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: Vistaril, inderal, radioactive iodine and penicillin

Symptoms: Nausea, severe back pain, chills, weekness, nervousness

Other Meds: Omasartan, levoxyl,xyzol, nexium, pravastatin, prednisone 2.5mg, calcium, potassium, magnesium, symbicort, verapamil 260 mg, cymbalta 25mg , singular, Flonase, azelastine. Vitamin D C and Super B and Zinc! Nucala injection also use a C-

Current Illness: Asthma, copd,

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm