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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1057749
Sex: F
Age: 51
State: CA

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

Lab Data:

Allergies: Allergic to Sulfa drugs

Symptoms: 2 inch welt, red, hot, itchy, pain when touched

Other Meds: Synthroid, Sertraline, Melatonin

Current Illness:

Date Died: 02/14/2021

ID: 1057750
Sex: M
Age: 69
State: PR

Vax Date: 01/20/2021
Onset Date: 02/08/2021
Rec V Date: 02/26/2021
Hospital: Y

Lab Data: Test Date: 20210206; Test Name: Blood test; Result Unstructured Data: Blood test; Test Date: 20210206; Test Name: Influenza virus test negative; Test Result: Negative ; Result Unstructured Data: influenza virus test; Test Date: 20210206; Test Name: COVID-19 test; Test Result: Negative ; Result Unstructured Data: COVID-19 test

Allergies:

Symptoms: Started feeling unwell; Headaches; Body aches; Chest pain; Didn't had wishes to eat; Diarrhea; COVID-19 pneumonia; A spontaneous report was received from a consumer concerning a 69-year-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced COVID-19 pneumonia, feeling unwell, headaches, body aches, chest pain, decreased appetite and diarrhea The patient's medical history high blood pressure which was controlled with medication. Concomitant product use included nifedipine and fenofibrate. On 20-JAN-2021, approximately a week and a half or two prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number 030L20A) intramuscularly in the right arm for prophylaxis of COVID-19 infection. A week and a half or two later the patient stated feeling unwell, headaches, body aches, chest pain, decreased appetite and diarrhea for which patient was hospitalized on 06-FEB-2021. Since everything seemed to be fine the patient was discharged on an unknown date in FEB-2021 however, patient's family was not notified that it was a late reaction to the vaccine's first dose. Later, due to shortness of breath he was hospitalized again on 08-FEB-2021 and was diagnosed for pneumonia and was intubated on the same day. Due to COVID-19 situation patient's family could not be in the facilities and that there wasn't any follow up of the patient given to the family, so family did not have much information. During the first hospitalization(06-FEB-2021) the patient had a blood test which showed a normal result and was tested for COVID-19 and Influenza, both were negative. During second hospitalization (08-FEB-2021) the hospital said that the patient was stable. The patient's family did not know the results of the tests conducted at the time. The action taken with the vaccine in response to the events is not applicable. The outcome of COVID-19 pneumonia was fatal. The patient died on 14 Feb 2021 The cause of death was reported as COVID-19 related pneumonia. The autopsy was not done.; Reporter's Comments: Very limited information regarding this event has been provided at this time. The cause of death was reported as COVID-19 related pneumonia. Based on the current available information and the mechanism of action of mRNA-1237 vaccine, the events are assessed as unlikely related. Further information has been requested.; Reported Cause(s) of Death: COVID-19 pneumonia

Other Meds: PROCARDIA [NIFEDIPINE]; LOFIBRA [FENOFIBRATE]

Current Illness: Blood pressure high

ID: 1057751
Sex: F
Age: 63
State: MD

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: WBC 13 CRP and Sed rate over 50

Allergies: None

Symptoms: 7cm neck posterior lymphadenopathy on the left side, patient received the vaccine in left deltoid. Her CT scan showed diffuse matted necrotic lymphadenopathy with the largest one measuring 1.8cm. Patient is still symptomatic with diffuse myalgias, elevated CRP, SED rate with concern for severe inflammatory reaction.

Other Meds: Antihypertensives

Current Illness: COVID 19 in January. Was given BAM therapy

ID: 1057752
Sex: F
Age: 22
State: OH

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

Lab Data: none

Allergies: none

Symptoms: Patient states she returned to worksite after vaccine received and felt fine. States around 12:00 pm she was having a conversation with a coworker about her history of fainting spells when she speaks about medical procedures. While she was talking to coworker she fainted and hit the back of her head on the floor. States she recovered within 5 minutes. School nurse was notified and reported a faint pulse and blood pressure was low (around80/40). Was transported home by parents. States she felt groggy after fainting and a slight headache, tunnel vision, and muffled hearing that resolved the next day, 2/25/2021 around 7:00 pm. States she has a bump on the back right side of her head but denies other injuries. States she did return to work the next day.

Other Meds: Amoxicillin DS 800-160 BID x 5 days. 1st dose 2/23/2021

Current Illness: Urinary tract infection

ID: 1057753
Sex: F
Age: 39
State: MN

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

Lab Data:

Allergies: None

Symptoms: (nauseated, pale, diaphoretic, confused, Shaky, Dizzy) 1st dose. Sent to Urgent Care for evaluation. Unsure of outcome

Other Meds: None

Current Illness:

ID: 1057754
Sex: F
Age: 65
State: NY

Vax Date: 02/23/2012
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: none yet

Allergies: sulfa flagyl

Symptoms: Swelling in right arm below vaccination site began evening 02/25/2021 and worsened to entire upper right arm

Other Meds: metorpolol 25 mg lisinopril 2.5 mg biotin 1000 mg

Current Illness:

ID: 1057755
Sex: F
Age: 39
State: TX

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: N/A

Allergies: Fire any sting allergy

Symptoms: First, I got an extremely sore arm. The arm was so sore I could not sleep because every time I moved it hurt enough to wake me up. The next day (~midday) I broke out in severe hives. At around 12.20 I became very, very sleepy and I lost my voice. At around 12.30 my partner noticed my face was swelling (around my jaw and cheeks).

Other Meds: Cetirizine Fexofenadine Vyvanse Famotidine

Current Illness: Chronic Urticaria

ID: 1057756
Sex: M
Age: 80
State: MI

Vax Date: 01/30/2021
Onset Date: 02/04/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: Platelet count: 01/28/2021 169 02/04/2021 130 02/11/2021 170 02/18/2021 134 02/25/2021 121 No bleeding or bruising issues noted

Other Meds: Medication List Active Medications Ordered romiPLOStim: 84 mcg = 0.17 mL, Subcutaneous, On Call. Prescribed acetaminophen-hydrocodone: 1 tab(s), Oral, BID, PRN: AS NEEDED FOR PAIN, 60 unkn

Current Illness: ITP

ID: 1057757
Sex: F
Age: 64
State: WI

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

Lab Data:

Allergies: bee venom

Symptoms: Swollen eyelids and lips starting about 1 hour after the vaccine, lasted about another hour

Other Meds: Metoprolol

Current Illness: none

ID: 1057758
Sex: F
Age: 66
State: PA

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

Lab Data:

Allergies: States 'no' on administration form.

Symptoms: Patient presents with redness around the injection site, approximately 3' x 3', not raised or warm.

Other Meds: Amlodipine; Aspirin; Atorvastatin

Current Illness:

ID: 1057759
Sex: F
Age: 69
State: CA

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

Lab Data: None

Allergies: N/A

Symptoms: Beginning @ 8 hours following second dose, full range of side effects began, preventing any sleep that night, and continuing throughout the entire next day and night (02/24/2021), finally subsiding over the course of the next day (02/25/2021). Side effects included: Injection Site Pain; Tiredness; (raging) Headache; Muscle pain; Chills; Joint pain; What felt like fever (in between shuddering chills) - not evident in temperature; Nausea (non-productive); Feeling unwell; (tender) Lymph nodes. Debilitating and confusing. Glad to have received the vaccine in any case (small price to pay).

Other Meds: atorvastain; olmesartin, prilosec, VitD3; fiber

Current Illness: None

ID: 1057760
Sex: F
Age: 35
State:

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

Lab Data:

Allergies:

Symptoms: Itching, SOB, cough, evaluated by EMS-cleared

Other Meds:

Current Illness:

ID: 1057761
Sex: F
Age: 48
State: MO

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

Lab Data:

Allergies: seasonal allergies, mold, ragweed, has hives

Symptoms: Patient reported blotchy itchy rash on right cheek, neck and upper chest. No difficulty breathing, chest pain or shortness of air. Ambulatory and needed no assistance moving. Vitals HR 85 BP 126/82 pulse ox room air 98%. Benadryl 50 mg administered IM right arm at 11:40 am. Patient observed until 12:35 pm when discharged to home (HR 60 BP 110/78 100% O2). Rash was much improved by this time. Patient called 11:20 am. 2/26. Rash almost entirely gone - just one spot on check. Will take benadryl PO. Mentioned she had small spot of rash around injection site following first dose of vaccine.

Other Meds: zinc and acetaminophen before vaccine, bupropion newly started - 3 doses total so far

Current Illness:

ID: 1057762
Sex: F
Age: 67
State: AZ

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

Lab Data: None,

Allergies: None.

Symptoms: Chills and nausea for 2 hours; night sweats for 2 nights; body aches for 48 hours; fatigue lasting 48 hours.

Other Meds: Digoxin, hydrochlorthiazide, metoprolol.

Current Illness: None.

ID: 1057763
Sex: F
Age: 39
State: TX

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: N/A

Allergies: Fire ant stings

Symptoms: ~10 minutes after the vaccine I broke out in hives which spread over by body and continued for ~ 5 days.

Other Meds: Vyvanse Cetirizine Fexofenadine Famotidine

Current Illness: Chronic urticaria

ID: 1057764
Sex: F
Age: 77
State: IL

Vax Date: 02/16/2021
Onset Date: 02/22/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: Penicillin as a child. Not retested

Symptoms: Normal redness and soreness at vaccination site for the first few days then a 3? circle appeared at the site on the 7th day and caused itch and soreness. It is now fading away with no after effects

Other Meds: Levothyroxine, multivitamin, calcium with d and 2000 D. Also prolia shot every 6 months

Current Illness: None

ID: 1057765
Sex: M
Age: 69
State: AZ

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

Lab Data:

Allergies:

Symptoms: Completely out/eyes were closed; looked like he wasn't breathing; Began to shake, patient's head and arm shocked; Weak; little confused; A spontaneous report was received from a consumer concerning a 69 years-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced began to shake (MedDRA PT: tremor), head and arm shocked (MedDRA PT: tremor), completely out/eyes were closed (MedDRA PT: loss of consciousness), looked like he wasn't breathing (MedDRA PT: respiratory arrest), weak (MedDRA PT: asthenia), and little confused (MedDRA PT: confusional state). The patient's medical history included stroke. Concomitant product use included unspecified blood pressure pills, cholesterol pills, vitamins, and a drug for the patient's brain due to the stroke. On 17 Feb 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (lot #: 031M20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 17 Feb 2021, ten minutes after receiving the vaccination, the patient began to shake, patient's head and arm shocked and patient was completely out with eyes closed. The reporter stated it looked like the patient wasn't breathing. Seven minutes later, the patient was given an epi shot and oxygen. The patient was transported via ambulance to the emergency room (ER). At that time, a scan was performed - nothing was detected in patient's brain. Patient remained in ER from 0830 to 1500. Patient subsequently left ER very weak and a little confused. It was recommended for patient not to receive second vaccination dose. Treatment information included epi shot and oxygen. Action taken with mRNA-1273 in response to the events was not reported. The events began to shake, head and arm shocked, completely out/eyes were closed, and looked like he wasn't breathing were considered resolved on 17 Feb 2021. The events very weak and little confused were not resolved.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds: VITAMINS NOS

Current Illness:

ID: 1057766
Sex: F
Age: 43
State: MN

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

Lab Data:

Allergies:

Symptoms: tingling on tongue, neck pain, nausea.

Other Meds:

Current Illness:

ID: 1057767
Sex: F
Age: 25
State: TN

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

Lab Data:

Allergies: Amoxicillin

Symptoms: Chills, body aches - lasted approx. 1 day Headache, fatigue - lasted approx. 2 days Injection site swelling and Swollen lymph nodes in right armpit - lasted approx. 5 days Alternated Tylenol and Motrin to relieve head and body aches. All swelling reduced gradually without direct treatment.

Other Meds: N/A

Current Illness: N/A

ID: 1057768
Sex: M
Age: 66
State: VA

Vax Date: 02/17/2021
Onset Date: 02/22/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: None. Happened to see ophthalmology specialist, who suggested to give it a couple more days to see if it subsides.

Allergies: Minor lactose intolerance

Symptoms: Bilateral pain and swelling at location of Preauricular Lymph Nodes (below right and left temple and jaw joint, pain location where lower ear attaches to side of face, with swelling from temple area down to rear of lower jawline). Onset at about 4-5 days after injection.

Other Meds: Lisinopril Metformin Crestor Allopurinol Folic Acid Aspirin (80 mg) Prednisone Methotrexate

Current Illness: Being treated for Undifferentiated Connective Tissue Disease, presenting partly by bilateral Sclerosis (2020-present)

ID: 1057769
Sex: M
Age: 31
State: AR

Vax Date: 02/12/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Redness at injection site, slight swelling, itching

Other Meds: Zyrtec

Current Illness: None

ID: 1057770
Sex: F
Age: 79
State: AR

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

Lab Data:

Allergies: none reported

Symptoms: Patient received vaccine and proceeded to waiting area. She began to feel "off" and reported. She did not improve and staff assisted her to rise and she collapsed and was eased to floor and legs elevated and 911 was called. She did not lose consciousness. She was clammy and then color improved; low pulse; normal BP. No problems breathing and no rash. EMS arrived and transported her to hospital. We later learned she was being transported back and doing fine

Other Meds: unknown

Current Illness: none reported

ID: 1057771
Sex: F
Age: 40
State: OR

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

Lab Data: CT Head-normal.

Allergies: Lamotrigine, Cephelosporins, Flagyl, Macrobid, Seroquel, hydrocodone, tape.

Symptoms: Severe intractable headache with pain into neck

Other Meds: Unknown

Current Illness: None

ID: 1057772
Sex: F
Age: 75
State: PR

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/26/2021
Hospital: Y

Lab Data: Ct scan and laboratory.

Allergies: Unknown.

Symptoms: Patient looses control of it's left side, falls on it's left side and hits their head. Take to the Hospital and is now connected to a mechanical ventilator.

Other Meds: Unknown.

Current Illness: Unknown.

ID: 1057773
Sex: M
Age:
State: FL

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

Lab Data:

Allergies:

Symptoms: brachial plexus neuritis/Parsonage Turner syndrome; This spontaneous report was received from a consumer, who was reporting on himself as a 52-year-old male patient. His concurrent condition included seasonal allergy. No information regarding the patient's pertinent medical history, drug reactions and concomitant therapies was provided. On an unknown date, the patient was vaccinated with measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (manufacturer unknown) (formulation, strength, dose, frequency, route of administration, lot # and expiration date were not reported) for prophylaxis. On an unknown date, he experienced vaccine reaction-brachial plexus neuritis (Parsonage Turner syndrome). The outcome of the event was unknown. The reporter considered neuralgic amyotrophy to be related to Measles, Mumps, and Rubella (Wistar RA 27-3) Virus Vaccine, Live(M-M-R II).

Other Meds:

Current Illness: Seasonal allergy

ID: 1057774
Sex: M
Age: 70
State: IN

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

Lab Data:

Allergies: None reported

Symptoms: Pt had seizure like activity-- head back, eyes rolled back, face red Lasted about 1 minute PT was lowered to the ground by staff out of chair No other injuries Pt then had nausea and vomiting -- was observed for about 1 hour-- more nausea and vomiting as he was taken to the car Pt agreed to be seen in the ED-- was given zofran and released Later wife stated he has similar reactions to other immunizations

Other Meds: Losartan 100mg

Current Illness: None reported

ID: 1057775
Sex: F
Age: 27
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: At around 11PM on 2/24/21, I had a severe headache, fatigue, chills, nausea, muscle and joint pain, and felt feverish. At around 2AM, I had vasovagal syncope (I lost consciousness and then woke up covered in sweat). Directly after I regained consciousness, I vomited several times over the next couple of minutes. I drank water and took Tylenol to try and alleviate symptoms. After that, I no longer vomited or lost consciousness but I continued to feel feverish, had a severe headache, fatigue, chills off and on, nausea, and muscle and joint pain until around 4PM on 2/24/21.

Other Meds: Testosterone 1.62%, vitamin E 400 unit capsule

Current Illness: None

ID: 1057776
Sex: M
Age: 51
State: TX

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Report symptoms of dry mouth 2 days post vaccination. Treatment: drinking water. Outcome: Report increase urination due to drinking water.

Other Meds:

Current Illness:

ID: 1057777
Sex: F
Age: 44
State: WA

Vax Date: 02/03/2021
Onset Date: 02/12/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Left lymph node in armpit swollen and painful. Left deltoid swollen, hard, seriously bad itchiness.

Other Meds: Aderall

Current Illness: None

ID: 1057778
Sex: F
Age: 54
State: CA

Vax Date: 01/13/2021
Onset Date: 02/03/2021
Rec V Date: 02/26/2021
Hospital: Y

Lab Data: None, just monitoring that day

Allergies: None

Symptoms: After 2nd dose on 2/3/21, I waited 10 minutes and felt tingling and cold, heaviness and blood pressure dropped significantly. They put me onto a gurney and monitored my BP and waited, gave me some juice and crackers, but I continued to have the sensation of fainting (syncope). They transferred me to the ER for further monitoring. After a while, it stabilized more, but still continued to happen throughout the day.

Other Meds: Reclast, Lexapro

Current Illness: None

ID: 1057779
Sex: F
Age: 67
State: NY

Vax Date: 02/07/2021
Onset Date: 02/20/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: Rash/pink itchy covering upper arm where shot was given

Other Meds: Cymbalta Atenonol Letrozole

Current Illness:

ID: 1057780
Sex: M
Age: 32
State: PA

Vax Date: 01/29/2021
Onset Date: 02/21/2021
Rec V Date: 02/26/2021
Hospital: Y

Lab Data: Cardiac MRI 2/25/21

Allergies: Bactrim

Symptoms: Acute myocarditis

Other Meds: None

Current Illness: None reported

ID: 1057781
Sex: F
Age: 90
State: OR

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

Lab Data: ER visit w/: head and Chest CT-negative CMP, CBC, UA, BNP, Troponin I: negative EKG unremarkable

Allergies: clarithromycin

Symptoms: syncope followed by ER visit w/ many negative tests. persistent weakness, apathy and loss of appetite

Other Meds: Levothyroxine, Quetiapine, sertraline

Current Illness: None

ID: 1057782
Sex: F
Age: 63
State: NY

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

Lab Data: taken to E.D.

Allergies: none

Symptoms: Dizzy short of breath hypertensive

Other Meds: amlodipine 5 mg

Current Illness: hypertension

ID: 1057783
Sex: F
Age: 67
State: CA

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

Lab Data: n/a

Allergies: penicillin

Symptoms: sore arm, light headed, ringing in head, brain fog, disoriented, low energy

Other Meds: multi vitamin

Current Illness: n/a

ID: 1057784
Sex: F
Age: 71
State: TX

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

Lab Data:

Allergies: NKA

Symptoms: The hospital was administering Pfizer vaccine for the day, The patient was checked in at the front desk by the nurse. There are 2 nurses per station, one documents and gives vaccine. Patient identified and was cleared for vaccine administration. Per documentation nurse another screen popped up, which showed patient had moderna before. Incident was reported to charge nurse assessment done on patient, patient didn't have any adverse effect ,family was notified. she didn't have any adverse event

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1057785
Sex: M
Age: 90
State: TX

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

Lab Data: VITAS nurse came and checked temp and blood pressure the next day, back to normal

Allergies: penicillin

Symptoms: Patient not talking, Chills, trembling hands and upper body, eyes staring upward, fever up to 101, fever decreased to normal in one hour after giving 325 gr. Tylenol

Other Meds: Tamsulosin, acetamenophen, aspirin, omeprazole memantine

Current Illness: Tested positive for COVID on December 17, 2020 Tested negative for COVID on January 4, 2021

ID: 1057786
Sex: F
Age: 53
State: TN

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/26/2021
Hospital: Y

Lab Data: Heparin Drip, TPA and surgery was performed. A stent was placed, as well as an IVC filter. I am currently on blood thinners to prevent anymore clots from forming and am following up with Hematology and Vascular Surgery.

Allergies: N/A

Symptoms: Within 12 hours of receiving my second vaccine, My left leg felt like it internally rotated and started to hurt and feel like lead. On January 28, 2021, I went to the ER and an extensive blood clot (DVT) was found.

Other Meds: Valsartan/HCTZ Celexa Singulair Carvedilol Zyrtec

Current Illness: Sinus Infection

ID: 1057787
Sex: F
Age: 80
State: TN

Vax Date: 02/18/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: Sulfonamides

Symptoms: COVID arm and swelling to right jaw with extreme pain that lasted about 24 hours the week after the injection.

Other Meds: Albuterol Breo Elipta

Current Illness: no

ID: 1057788
Sex: F
Age: 34
State: OK

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

Lab Data:

Allergies:

Symptoms: VACCINE WAS DILUTED WITH INCORRECT VOLUME OF SALINE, QTY OF 0.8ML INSTEAD OF 1.8ML WHICH LED TO PT RECEIVING CONCENTRATED DOSE OF VACCINE. PT WAS OBSERVED FOR AT LEAST 30 MINUTES AND WAS OBSERVED BY A MEDICAL DOCTOR ON SITE WHO ADVISED PATIENT OF WHAT HAD HAPPENED. AFTER OBSERVATION PATIENT LEFT THE CLINIC WITHOUT ANY NOTED ADVERSE EVENT OR EFFECTS AT THE TIME.

Other Meds:

Current Illness:

ID: 1057789
Sex: F
Age: 28
State: CA

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

Lab Data:

Allergies: N/A

Symptoms: I have food poisoning cramps and aches, but no throwing up or diarrhea. Intense abdominal pains.

Other Meds: N/A

Current Illness: N/A

ID: 1057790
Sex: F
Age: 56
State: OK

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

Lab Data:

Allergies:

Symptoms: VACCINE WAS DILUTED WITH INCORRECT VOLUME OF SALINE, QTY OF 0.8ML INSTEAD OF 1.8ML WHICH LED TO PT RECEIVING CONCENTRATED DOSE OF VACCINE. PT WAS OBSERVED FOR AT LEAST 30 MINUTES AND WAS OBSERVED BY A MEDICAL DOCTOR ON SITE WHO ADVISED PATIENT OF WHAT HAD HAPPENED. AFTER OBSERVATION PATIENT LEFT THE CLINIC WITHOUT ANY NOTED ADVERSE EVENT OR EFFECTS AT THE TIME.

Other Meds:

Current Illness:

ID: 1057791
Sex: M
Age: 74
State: TX

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

Lab Data: none

Allergies: Penicillin shot, not pill

Symptoms: itching in hands, fingers, eyes . Took 5mg of benedryl. Still some discomfort next morning. BP OK.

Other Meds: Losartan, Atorvastin, Levothyroxine, Chlorthalidone, Fluticasone Propionate Multi-vitamin, Multi-mineral, vitamins C, D, CoQ10, Potassium,

Current Illness: none

ID: 1057792
Sex: F
Age: 90
State: NC

Vax Date: 02/03/2021
Onset Date: 02/07/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: erythromycin

Symptoms: I woke up with tingling on entire left side of body; Dr. ordered MRI; done on the 10th; showed no change in brain; Today, 2/26/2021, I still have some tingling; with left hand and fingers more so.

Other Meds: thyroid Vit D3 Calcium

Current Illness: none

ID: 1057793
Sex: M
Age: 66
State: MN

Vax Date: 10/13/2020
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: none-pt states that he hasn't been evaluated. I advised that he be evaluated locally. he verbalized his understanding but stated he is currently living out of his car. He may be evaluated locally (either urgent care or ER), otherwise, he stated the intent to address the problem when he returns to the clinic for HIV follow up in April.

Allergies: NKA

Symptoms: Patient called the clinic reporting that he continues to have pain at the injection site in his right arm. He originally called to see what vaccine he was given in that arm. He describes the pain as "right where the shot was given". He denies any redness, swelling or firmness at the injection site and he denies any pain in the right shoulder joint. He states that he has to take both Tylenol and advil pm to be able to sleep at night due to the discomfort. He relates having difficulty laying on his right side due to the discomfort. He states he is able to move his arm in full range of motion but if his Tylenol/advil has worn off, it is more painful to move the arm.

Other Meds: Tylenol, Biktarvy, ibuprofen, miralax

Current Illness: Worsening difficulty with left shoulder pain related to a previous MVA, also lesion on right forehead.

ID: 1057794
Sex: M
Age: 66
State: TX

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

Lab Data: I have not seen a doctor. I have not left my bed for three days.

Allergies: None

Symptoms: About six hours after receiving the Covid Moderna vaccine I quickly began constant tremors that was strong enough that I could not walk or stand. I did not have a thermometer but I?m certain I had a fever. This lasted throughout the night. The following morning I was bedridden, unable to eat and had flu like symptoms. This is continued for three days now. I am slowly Beginning to gain strength but I?m still bedridden.

Other Meds: Pramipexole Ezetimibe Rosuvastin Losartan Aspirin Fish oil Coenzyme Multi vitamin

Current Illness: None

Date Died:

ID: 1057795
Sex: F
Age: 82
State: OH

Vax Date: 01/20/2021
Onset Date: 02/22/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Death 02/22/2021.

Other Meds:

Current Illness: N/A

ID: 1057796
Sex: F
Age: 53
State: AZ

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

Lab Data:

Allergies: Latex

Symptoms: Pt complained of generalized itching and presented with a mild facial rash 20 mins post injection

Other Meds:

Current Illness:

ID: 1057798
Sex: F
Age: 67
State: CA

Vax Date: 02/15/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: sulphate, amoxicillin, superdose of flu vaccine for 65+

Symptoms: Swelling, hives, hot to touch, itchiness, soreness on upper left arm (approx 4" x 6")

Other Meds: daily statin, daily magnesium supplement, daily glucosamine/chron. supplement, daily multivitamin, daily CoQ10 supplement

Current Illness:

ID: 1057799
Sex: M
Age: 56
State: AL

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

Lab Data:

Allergies: Penicillin

Symptoms: Fever Headache Body aches

Other Meds: Cialis Clonazepam Prevastatin Losartin Omeprazole

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm