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: 1058189
Sex: F
Age: 81
State: CA

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

Lab Data: no

Allergies: no

Symptoms: pt stated after she received the vax she got a strange taste in her mouth. At 1 AM pt woke up with a heavy feeling in her left arm. Her left arm, hand and fingers started to swell. At 3 AM her head felt warm and the entire left side of her face was swollen, including lips, gums, nose and eyelids. Her teeth felt strange. At 5AM she could feel a sensation going down the left inside of her body moving from her neck to her toe. Then the right side of her face started to swell from the neck to the top of her head. Pt woke up at 7 AM next day and the swelling was starting to go down on the right side. On 2/26/2021 she is noticing the swelling is going down out of her left side. She never really had any pain or discomfort just swelling. Pt. has not contacted her PCP at this time.

Other Meds: Celebrex, high blood medicine, cholesterol medicine, calcium, vitamin D3

Current Illness:

Date Died: 02/24/2021

ID: 1058190
Sex: F
Age: 71
State: DE

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

Lab Data:

Allergies: pcn, doxycycline

Symptoms: On the evening of 2/23/221 at 9:00 pm, resident reported feeling SOB, BP 80/44, Pulse 53, O2Sat 95% on 3L oxygen, hands cold, pulse weak. Temp 92.5F MD notified. EMS activated. EMS arrival and HR 20. Family refused transport to ER. Resident expired at 2:40 am on 2/24/21 Meds continued: duloextine, VITd2,hydralazine, synthroid, lisinopril, mag ox, folplex, pantoprazole, potassium chloride, ellipta, ensure, hydrocortisone cream, boost, deprox, xanax, morphine, lorazepam, tylenol, albuterol inhlation, ventolin inh.

Other Meds: atenolol, atorvastatin, budesonide-formoterol, diltiazem

Current Illness: acute polynephritis, acute kidney failure

ID: 1058191
Sex: F
Age: 63
State: NE

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

Lab Data: NA

Allergies: PENICILLIN, ANTIINFLAMMATORIES- UNKNOWN REACTION INFLUENZA VACCINE- HIVES, THROAT TIGHTNESS, ABDOMINAL PAIN

Symptoms: (2/25/2021) PATIENT REPORTS TO OFF-SITE COVID-19 VACCINE CLINIC. PATIENT FILLS OUT VACCINE CHECKLIST AND IT IS NOTED THAT PATIENT HAS PREVIOUS ISSUES WITH FLU SHOT WITH A HISTORY OF TORUBLE BREATHING. TEACHING IS PROVIDED WITH PATIENT REGARDING POSSIBLE SIMILAR REACTIONS WITH COVID-19 VACCINE AND THAT SHE SHOULD STAY AT LEAST 30 MINUTES AFTER VACCINATION IF SHE WISHES TO PROCEED. PATIENT CONSENT TO PROCEED WITH COVID-19 VACCINATION. VACCINE IS GIVEN AT 1000 INTO RIGHT ARM AND PATIENT IS ASKED TO STAY FOR OBSERVATION. AT 1030 PATIENT REPORTS TO THIS NURSE ITCHING AND HIVES. PATIENT IS OBSERVED TO HAVE HIVES COVERING BILATERAL ARMS AND CHEST. PATIENT DENIES BREATHING TROUBLE AT THIS TIME. EMERGENCY REACTION KIT IS BROUGHT TO PATIENT?S TABLE. AT 1032 ON CALL PROVIDER IS NOTIFIED OF REACTION AND ORDERS ARE GIVEN FOR BENADRYL 50MG IM. THIS IS GIVEN AT 1034 RN INTO GUTEAL AND PATIENT IS OBSERVED AND VS OBTAINED. AT 1040 PATIENT STATES HER THROAT FEELS ?SCRATCHY? AND ?TIGHT.? IT IS RECOMMENDED TO PATIENT SHE SHOULD BE SEEN IN THE EMERGENCY ROOM. PATIENT AGREES TO THIS IF SHE IS ABLE TO DRIVE HERSELF. PATIENT IS FOLLOWED IN HER VEHICLE TO EMERGENCY ROOM FROM OFF-SITE CLINIC (APPROX. 8 BLOCKS). ON CALL PROVIDER IS NOTIFIED AND HOSPITAL EMERGENCY ROOM IS GIVEN REPORT FROM THIS NURSE. UPON ARRIVAL TO ER PATIENT IS SEEN PER MD. PATIENT REPORTS SYMPTOMS OF CHEST PRESSURE, DYSPNEA, LIGHT HEADEDNESS, ABDOMINAL PAIN, RASH, REDNESS, WARTHM AND ITCHING. PATIENT IS GIVEN 0.4 MG SUBCU ADRENALINE AND 40 MG PREDNISONE ORALLY. PATIENT IS OBSERVED IN EMERGENCY ROOM x 1 HOUR. PATIENT REPORTS SHE IS STARTING TO FEEL BETTER. PATIENT IS DISCHARGED TO AT 1206 FROM EMERGENCY ROOM.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

Date Died: 02/24/2021

ID: 1058192
Sex: M
Age: 90
State: NE

Vax Date: 02/18/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: 02/23 Labs. EKG: NSTEMI. Respiratory BioFire Negative, SCr 2.12 (baseline is 1.25-1.5), K 6.1, BUN 62, Troponin 0.182, AST 101, ALT 94, Lactate 3.7, procal 0.17.

Allergies: etodolac. reaction unknown.

Symptoms: 2/24/21 Patient Died. 02/23/21. Patient came to ED for weakness/falls. Patient had fallen on 02/21 and 02/23. UA was done in LTC, and he was started on ciprofloxacin 02/22/21. Treatment was to put patient on comfort cares (morphine + lorazepam)

Other Meds: Xanax, Vitamin d2, levothyroxine, Tylenol, ciprofloxacin, doxazosin, furosemide, Duo-Neb, melatonin metoprolol, pantoprazole, artificial tears, potassium chloride.

Current Illness: UTI on 02/21. 02/23 ED visit: AKI, HTN, Fall/weakness, NSTEMI, sepsis with hypoxic resp. failure.

ID: 1058193
Sex: F
Age: 76
State: TX

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

Lab Data: None

Allergies: Compazine. All nsaids. Epinephrine

Symptoms: Left side of face pain including eye inside mouth and throat. Felt like bad sinus infection. Still have some throat pain

Other Meds: Bystolic. Lisinopril. Calcium. Tylenol

Current Illness: Possible sinus?

ID: 1058194
Sex: F
Age: 69
State: IA

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

Lab Data:

Allergies:

Symptoms: numbing around the lips shortly after administration of Moderna Vaccine. symptoms resolved within 1/2 hour and patient left

Other Meds:

Current Illness:

ID: 1058195
Sex: F
Age: 70
State: IN

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

Lab Data: na

Allergies: na

Symptoms: The patient received the COVID vaccine for the second dose instead of the COVID vaccine.

Other Meds: na

Current Illness: na

ID: 1058196
Sex: F
Age:
State: FL

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

Lab Data: Test Name: Blood work; Result Unstructured Data: Test Result:normal; Comments: Blood work 4 months earlier was normal.; Test Date: 20210102; Test Name: Blood work; Result Unstructured Data: Test Result:showed absolute neutropenia; Comments: during routine check-up, showed absolute neutropenia, relative lymphocytosis, normocytic anemia and a typical monocular cells

Allergies:

Symptoms: absolute neutropenia, relative lymphocytosis, normocytic anemia and a typical monocular cells; Increasing fatigue and shortness of breath; Increasing fatigue and shortness of breath; absolute neutropenia, relative lymphocytosis, normocytic anemia and a typical monocular cells; absolute neutropenia, relative lymphocytosis, normocytic anemia and a typical monocular cells; This is a spontaneous report from a health care professional, the patient. A 75-years-old non-pregnant female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot Number: EN5318), via an unspecified route of administration from in the right arm on 29Jan2021 at 13:30 (at the age of 75-years-old) as a single dose, for COVID-19 vaccination. Medical history included heart valve replacement (under the care of cardiologist for heart valve leakage causing some shortness of breath & fatigue, but was manageable), thyroid cancer, breast cancer female and tricuspid valve disease. Patient did receive concomitant medications in two weeks but details were not provided. The patient previously took penicilin and experienced drug hypersensitivity.. No other vaccines were given within 4 weeks. Since the vaccination the patient had not been tested for COVID-19. Prior to vaccination, the patient was not diagnosed with COVID-19. On 01Feb2021 at 12:00, The patient experienced absolute neutropenia (medically significant) and relative lymphocytosis, normocytic anemia and a typical monocular cells, and increasing fatigue and shortness of breath (in 2 weeks since vaccine on 29Jan2021; almost debilitating). The patient underwent lab tests included Blood test 4 months earlier results were normal on an unspecified date, Blood Test during routine check-up on 02Jan2021, revealed absolute neutropenia, relative lymphocytosis, normocytic anemia and a typical monocular cells. . No treatment was given for the events. Consumer inquired if the vaccine can contribute to increase in fatigue and shortness of breath and new blood work reading. The clinical outcome of the events absolute neutropenia, lymphocytosis, normocytic anemia and a typical monocular cells, and increasing fatigue and shortness of breath was not recovered.

Other Meds:

Current Illness:

ID: 1058197
Sex: F
Age: 69
State: WI

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

Lab Data:

Allergies: Demerol

Symptoms: Per Client received first COVID 19 vaccine in left deltoid on 2/1/2021 and had mild discomfort at site for one day. Received second COVID 19 vaccine in left deltoid on 2/22/2025 and next day notice a reaction. Per Client left arm, vaccine site was hot to touch, tender, red raised whelps and swollen. Per Client left arm is still with all the previous descriptions. Per Client did take Tylenol for tenderness and has not seek any medical attention. Client also report to receiving both vaccines in left arm only due to already existing complication with right arm. Writer suggested that Client follow up with PCP and continue to monitor left arm, client verbalized plan to follow up with PCP or emergency attention if needed.

Other Meds: Prescriptions

Current Illness: None

ID: 1058198
Sex: F
Age: 45
State: MA

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: n/a

Allergies: Intolerance (not allergy) of eggs, lactose

Symptoms: severe vomiting and diarrhea lasting 8-10 hours

Other Meds: Calcium supplement Asacol Breo Ellipta

Current Illness: none

ID: 1058199
Sex: F
Age: 84
State: CA

Vax Date: 02/12/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: None

Allergies: Penicillin, Fosamax, Vioxx (urticaria), Alendronate, Codeine, levaquin, metronidazole (urticaria)

Symptoms: Redness at site; 7cm circular of erythema, palpable axillary lymph node Doubt infection Instructed to monitor, hot compresses

Other Meds: Atrovastin 10mg, Losartan 25mg, Meclizine 25mg

Current Illness: None

ID: 1058200
Sex: F
Age: 33
State: NJ

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

Lab Data:

Allergies:

Symptoms: Woke up at 2 am with a racing heart rate that lasted 20 mins

Other Meds: Flonase

Current Illness:

ID: 1058201
Sex: M
Age: 73
State: CT

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

Lab Data: None

Allergies: Penicillin

Symptoms: One and a half days after the injection, I had severe chills for about 5 hours. Chills started on Feb. 15 around 2 am and stopped around 7am.

Other Meds: Xarelto; Tamsulosin Hydrochloride; Metoprolol Tartrate; Atorvastatin; Ramipril; Cosentyx; D3; Osteo Bi-Flex; CoQ-10; Preservision Areds 2

Current Illness: None

ID: 1058202
Sex: F
Age: 69
State: FL

Vax Date: 02/14/2021
Onset Date: 02/20/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: The first week itching and a hard lump, painful to touch Feb 25,2021 itching started again, larger lump reappeared, very warm to touch, 4 inch red circle

Other Meds: Hydrochlorothiazide Simvastatin Sertraline

Current Illness: N/A

ID: 1058203
Sex: F
Age:
State: OH

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

Lab Data: Test Date: 20210212; Test Name: fever; Result Unstructured Data: Test Result:99.3 or 99; Comments: in the morning; Test Date: 20210212; Test Name: fever; Result Unstructured Data: Test Result:100.4; Comments: in the afternoon

Allergies:

Symptoms: right arm is sore; Fever; tired; This is a spontaneous report from a contactable Nurse (patient). An 89-year-old female patient received the 2nd dose of bnt162b2 (BNT162B2, Batch/lot # EM9809, Exp date 30Jun2021) intramuscular at single dose in right upper arm on 11Feb2021 16:24 for Covid-19 immunisation, administered at hospital. Medical history included ongoing chronic obstructive pulmonary disease (COPD) and ongoing arthritis both diagnosed about 5 or 6 years before, covid-19 and pneumonia in Nov2020 and she was in the hospital from 04Nov2020 to 09Nov2020, she was hard of hearing. There were no concomitant medications. The patient received no prior vaccinations (within 4 weeks), aside the 1st dose of bnt162b2 (BNT162B2, Lot: EL9261, Exp date 31May2021) intramuscular at single dose in right upper arm on 21Jan2021 16:24 for Covid-19 immunisation. No additional vaccines administered on same date of BNT162B2. No events occurred following prior vaccinations. The patient experienced right arm is sore, fever, tired on 12Feb2021. The events were considered medically significant. No event required a visit to Emergency Room or physician. No relevant test done. Course of events as follows: Her arm was sore. Sore arm started on 12Feb2021 morning. She has arthritis and stated maybe this had something to with the soreness in upper right arm, near shoulder, where the vaccine was administered about an inch below her shoulder. Soreness was just there, it hurt. She was very tired and running a temperature of 100.4. She noticed the fever when she got up on 12Feb2021 morning, it was only 99.3 or 99 something, in afternoon it was 100.4. She did not like the fever. She took of paracetamol (TYLENOL 500mg, Lot: 9HV1619, Expiration date May2021) 1000mg twice and it did not really take her fever down. The outcome of events was not recovered. The reporter considered there was a reasonable possibility that the events right arm is sore, fever, tired were related to the BNT162B2.; Sender's Comments: Based on information available, a acausal relationship between events right arm is sore, fever and tiredness and BNT162B2 vaccine cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds:

Current Illness: Arthritis (Diagnosed about 5 or 6 years ago); COPD (Diagnosed many years before, about 10-15 or more years before)

ID: 1058204
Sex: F
Age: 45
State: WA

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

Lab Data:

Allergies: Vanilla, cashews, almonds, chickpeas, gluten,

Symptoms: Moderna COVID-19 EUA. Severe headache, chills, nausea, dizziness, shortness of breath, and rash where I was injected

Other Meds: adderal 20mg, advil 800mg,

Current Illness: na

ID: 1058205
Sex: F
Age: 42
State: OK

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

Lab Data: None

Allergies: None

Symptoms: Mbr developed dizziness about an hour after receiving vaccination and was evaluated.. Vital signs and physical exam were all unremarkable. Negative for any other sxs. Negative for any neurological abnormalities on exam. No cognitive deficits. She was sent home to rest and hydrate with ED precautions.

Other Meds: None

Current Illness: None

ID: 1058206
Sex: F
Age: 77
State: WA

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

Lab Data: N/A

Allergies: Musinex

Symptoms: At 8 PM last night, 2/25/2021 patient began to feel nauseous and fatigued. This morning the symtoms were more pronounced and at 8:45AM she had a temperature of 100.4. She ate a piece of buttered toast and was drinking water. Both stayed down.

Other Meds: Levothyroxin 112mcg 1X daily; Atorvastatin 20mg 1X daily, Calcium , Fish Oil, Garlic, Multi-vitamin, Thistle and Vitmin D3.

Current Illness: None

ID: 1058207
Sex: F
Age: 46
State: TX

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

Lab Data: None

Allergies: None

Symptoms: Fever, chills, body aches, headache.

Other Meds: Thyroid medication; Anti-depression medication

Current Illness: None

ID: 1058208
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: sicker; Initial information was received on 16-Feb-2021 regarding an unsolicited valid non-serious case received from a consumer or Non-health care professional. This case involves a patient (unknown age and unknown gender) who experienced sickness (illness), while he/she received vaccine INFLUENZA VACCINE. Medical history, medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer) [lot number not reported and expiry date not provided] via unknown route in unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious event sickness (illness) (unknown latency) following the administration of INFLUENZA VACCINE. Details of laboratory data were not reported. It was not reported if the patient received any corrective treatment. The patient reported that got one once and was sicker that year than he/she ever was with the flu, haven't been sick with the flu since he/she stopped drinking almost 4 years ago. It is unknown if the patient physician provided consent to be contacted. It is unknown if the patient experienced any additional symptoms/events. At the time of report, the outcome of event was unknown. There will be no information available on batch number for this case.

Other Meds:

Current Illness:

ID: 1058209
Sex: F
Age: 93
State: MO

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

Lab Data:

Allergies:

Symptoms: Felt as if drunk, off balance, had to hold furniture to walk, lasted into 2nd day. No fever or soreness.

Other Meds:

Current Illness: None

ID: 1058210
Sex: F
Age: 75
State: CA

Vax Date: 02/15/2021
Onset Date: 02/18/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: Sulpha drugs

Symptoms: Worst flu ever symptoms. Chills; fatigue: sleepiness,

Other Meds: Candesartan, citalopram, gabapentin, methadone

Current Illness: Diagnostic mammogram, diagnostic breast ultrasound

ID: 1058211
Sex: F
Age: 57
State: OR

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

Lab Data: None

Allergies: Penicillin, gluten, nuts

Symptoms: The individual came in for their second dose of the Moderna vaccine. Approximately 10 minutes after vaccination she started to rub her chest and reported mild tightness which resolved quickly. She was monitored by a nurse for an additional 15 minutes for a total of thirty minutes. She reported the next day that approximately and hour after vaccinations she began to experience difficulty swallowing. She self administered her prescribed inhalers and took liquid diphenhydramine . She reports hives and dyspnea that resolved by the following day.

Other Meds: Unknown

Current Illness: Unknown

ID: 1058213
Sex: F
Age: 82
State: CT

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

Lab Data:

Allergies: PENICILLAN SULFA SCALLOPS

Symptoms: WITHIN THREE HOURS AFTER VAX, FACE BECAME REALLY FLUSHED, WOKE UP AT 2AM WITH SEVERE CHILLS, BODY & JOINT ACHES AND STIFF NECK ALONG WITH POUNDING HEADACHE.

Other Meds: ATENOLOL 25mg 1 daily VITAMIN C B12 CALTRATE CENTRUM SILVER

Current Illness: NONE

ID: 1058214
Sex: F
Age: 84
State: NC

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

Lab Data: CT brain - unremarkable CXR - mild right basilar atelectasis MRI brain - no acute infarct, remote lacunar infarcts Carotid Doppler - negative Mild hypokalemia (3.3) - corrected with oral replacement COVID-19 negative Sodium normal (132) UA negative. TSH normal (3.8), WBC normal.

Allergies: Lisinopril Macrobid

Symptoms: The day following Moderna #2 (on 2/17/21) she had sudden onset of confusion. She thought the remote control was the telephone and speech was confused. No motor deficits. Was taken to ER and then admitted to Medical Center for stroke-like symptoms. Admitted 2/18/21, discharged 2/20/21 with diagnosis of Acute Encephalopathy (possible TIA) and Accelerated hypertension.

Other Meds: Losartan 25mg Levothyroxine 112mcg Pantoprazole 40mg Polyethylene Glycol 3350 PRN Fluticasone Propionate 50mcg nasal spray Vitamin D3 2,000 iu ASA 81mg Vitamin B12 1000mcg

Current Illness: "Chest congestion" 2/8/21 - but normal vitals, normal pulse ox, and normal chest xray. Saw GI & Thought to be secondary to post-nasal drainage.

ID: 1058215
Sex: F
Age: 77
State: IL

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

Lab Data:

Allergies:

Symptoms: Shortness of breath and respiratory distress resulting in mechanical ventilation. Some concern for myasthenia crisis due to presentation, started on course of IVIG. Possible azithromycin (home medication) could have been contributing to this as well. Also in septic shock with extensive lung infiltrates started on broad spectrum antibiotics with vancomycin and Zosyn - Zosyn was transitioned to cefepime. Lactic acidosis secondary to shock (initially 7.2 which has trended down to 2.5 at time of submission).

Other Meds: Albuterol inhaler prn; atorvastatin 40mg daily; Azithromycin 500mg PO three times weekly; Symbicort 80-4.5mcg/act 2 puffs BID; calcium carbonate-Vit D3 600-400 units 1 tablet BID; Plavix 75mg po daily; Docusate 100mg po daily; Eliquis 2.5mg

Current Illness:

ID: 1058216
Sex: M
Age: 58
State: MA

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

Lab Data: None

Allergies: None

Symptoms: Raynaud?s left fingers 2-5

Other Meds:

Current Illness:

ID: 1058217
Sex: F
Age: 58
State: WA

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

Lab Data:

Allergies:

Symptoms: Pt received vaccination on Friday. On Friday evening she started to run a fever, but Sat am she reports temp of 102, chills, body aches, sore/red vaccination site. Presented to ER. Rapid COVID test negative. Determined to be vaccination reaction.

Other Meds:

Current Illness:

ID: 1058218
Sex: F
Age: 46
State: TN

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

Lab Data:

Allergies: NO KNOWN

Symptoms: APPROXIMATELY 10 MINUTES AFGER RECEIVING DOSE, PATIENT COMPLAINED OF "WEIRD METALLIC TASTE AND GETTING REALLY HOT" THAT ONLY LASTED A COUPLE MINUTES AND THEN WENT AWAY. . DENIED ANY OTHER SYMPTOMS. NO TREATMENT REQUIRED

Other Meds:

Current Illness:

ID: 1058219
Sex: F
Age: 83
State: WI

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

Lab Data: None at this poi9nt

Allergies: Penicillin

Symptoms: Shooting-sharp pains above the L elbow lateral/posterior ; lasts a few minutes then subsides. Not aggregated with movement nor relief with repostioning. Occurs randomly several times through the day.

Other Meds: Gabapentin Prilosec Fenofibrate Levothyroxin

Current Illness: None

ID: 1058220
Sex: F
Age: 30
State: AZ

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

Lab Data: N/A will need to be obtained from hospital.

Allergies: Vancomycin and morphine

Symptoms: Vaccine administered 9:10am and reaction began around 09:15am with throat swelling, nausea and dizzy after 5 mins. Had some improvement with observation at 15 mins, vitals remained stable. Patient was able to drink water although continued to have throat swelling after 30 mins of observation. EMS arrived at 35 minutes and determined stable, asked for non-emergent ambulance to be called for transfer. Patient transferred per guidelines via EMS to Hospital approximately 10:15am.

Other Meds: unknown

Current Illness: none

ID: 1058221
Sex: M
Age: 81
State: KY

Vax Date: 02/21/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital: Y

Lab Data:

Allergies: NKA

Symptoms: 1st dose vaccine 2/21/21; developed weakness and went to ED via EMS on 2/26/21 and admitted to Hospital from ED DX: Acute respiratory failure with hypoxia ; Pleural effusion, left; Community acquired pneumonia of right lung, unspecified part of lung currently admitted to hospital during time of this report.

Other Meds:

Current Illness:

ID: 1058222
Sex: F
Age: 74
State: CA

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

Lab Data: None.

Allergies: Formeldahyde, paint, carpeting, raspberries, pollens, flowers, lily's. Gluten issues, does not eat wheat, grains that she can't eat.

Symptoms: Following the vaccine, within 3 minutes her bottom lip got numb, then her tongue swelled and then her eyes got fluttery uncontrollably, dizziness and weak. They had her lie down in a recliner. Her BP was 190/110. She did not need an EPI pen and within 15 minutes her lip became unnumb, and her tongue swelling receded, was still a little thick, and her face was swollen, was red and flushed. So they waited 30 minutes, her BP was not coming down, sent to the ER and observed for 3 hours and slowly her BP came down, all her other symptoms subsided and she was able to drive herself home. Last night 2/25/21 she had great itching on her chest, which has since stopped. Her tongue is still a little swollen, about 20% still feels thick. When she left the hospital her BP was 146/86. She has not taken anything for the symptoms just her regular routine medications. She did feel tired and spacy feeling, and has been off of work since Wednesday as she could not focus to go to work.

Other Meds: Losartan, Levothyroxine, Tirisent, vitamin C, vitamin D, Claritin, Fluroxetine, Femotadine, Klonopin., folic acid, Symbicort.

Current Illness: None.

ID: 1058223
Sex: F
Age: 53
State:

Vax Date: 01/12/2021
Onset Date: 02/05/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: I received my first injection of the COVID-19 vaccine on 12/28/2020 and the second dose on 01/12/2021. Starting Friday February 5, I developed severe itching on my back that occurred during sleep only. The itching continued for the next several nights. I had to remove my bra in order to obtain any sleep. After removing the bra, the itching eventually stopped. I tried several bras, but all caused itching at bedtime only. Now, itching is occurring on other parts of my body. Hives and itching have developed on my back, chest, inner thighs and both hands. The itching is relieved by applying lotion. My skin is super sensitive to elastics (in most bras) and other items. I'm only reporting this just in case other people have experienced the same sensitivities. I don't believe the vaccine caused the itching and hives; but instead just hastened or exacerbated something already in my body.

Other Meds: No

Current Illness: None

ID: 1058224
Sex: F
Age: 76
State: MN

Vax Date: 02/19/2021
Onset Date: 02/22/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: Penicillan

Symptoms: Lot EN6203 .3 ml Table #3 Both the pharmacist and her own physician said that the vaccine was given too close to her elbow-- not intramuscularly; Dr. is treating for infection;

Other Meds: Unknown

Current Illness: Unknown

ID: 1058225
Sex: F
Age: 68
State: WA

Vax Date: 02/11/2021
Onset Date: 02/19/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: none

Allergies: "old" IVP dye, doxycycline, clindamycin, adhesives like BandAids, Tegaderm

Symptoms: red, hot, swollen, painful and itchy patch left arm surrounding injection site. Prednisone 20 mg daily on 2/22/2021 and Keflex 500 mg TID and 2/23/2021. Neither helped.

Other Meds: Vitamin D, glucosamine-chondroitin sulfate

Current Illness: none

ID: 1058226
Sex: M
Age:
State:

Vax Date: 01/07/2020
Onset Date: 04/24/2020
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Foetal exposure during pregnancy; Low birth weight of 2438 g; This is an observational study case, initially received on 19-Feb-2021 from other health professional and concerned a male neonate, whose mother was 18-year-old, pregnant, female subject of body weight 121 lbs, height 64.5 inches and body mass index (BMI) 20.4, enrolled in, a prospective observational safety study. The maternal concurrent conditions included anaemia and gestational thrombocytopenia. The mother's concomitant medications included Prenatal vitamins (minerals not specified (nos), vitamins nos) used for pregnancy, Injectafer (ferric carboxymaltose), ferrous sulfate and Ferralet (ferrous gluconate), all used for anemia. The maternal obstetrical history noted that the neonate's mother had no previous pregnancies. The mother had no maternal or paternal history with major congenital malformations (MCMs). The neonate's mother did not use tobacco, alcohol or illicit drugs during pregnancy. The mother's last menstrual period (LMP) date was 30-Jul-2019, the estimated delivery date (EDD) was reported as 05-May-2020, while the corrected estimated date of delivery (CEDD) was reported as 11-May-2020. The type of pregnancy was singleton. On 24-Sep-2019, the ultrasound scan revealed no MCM. On 29-Oct-2019, non-invasive prenatal test and nuchal translucency revealed no MCMs. On 26-Nov-2019, maternal serum alpha-fetoprotein screening (MSAFP), serum markers revealed no MCMs. On 07-Jan-2020, at approximately 23 weeks of gestation (calculated per LMP), the neonate's mother was administered Afluria QIV (Flu Vaccine Egg Split QIV CSL) (influenza vaccine; dose, anatomical location and route of administration: not reported) (explicitly coded as 'Foetal exposure during pregnancy') for influenza immunisation. The batch number reported was P100112488. On the same day, 20-week anatomy ultrasound scan revealed no MCM. At gestational age of 37 weeks (as reported), the mother delivered vaginally a live birth, male neonate. The neonate birth weight was 2438 grams, head circumference and length were not reported. The appearance, pulse, grimace, activity, and respiration (APGAR) scores at one, five and 10 minutes were not provided. No MCM was identified at birth. The outcome of the event was not reported. The reporter did not provide a causality assessment. The event of 'low birth weight baby' was considered to be medically significant by a Physician within Seqirus's Pharmacovigilance and Risk Management Department. This case is linked with the case 202002354, the corresponding mother case. Company comment: A male neonate patient experienced low birth weight, approximately 14 weeks after maternal receipt of Afluria QIV. Chronology is plausible. As reported, the maternal obstetrical history noted that the neonate's mother had no previous pregnancies. The mother had no maternal or paternal history with major congenital malformations (MCMs). The neonate's mother did not use tobacco, alcohol or illicit drugs during pregnancy. The ultrasound scan revealed no MCM. With currently available information, causality for the event low birth weight is unassessable. The event foetal exposure during pregnancy was assessed as not related considering the intended use of the vaccine. .; Sender's Comments: A male neonate patient experienced low birth weight, approximately 14 weeks after maternal receipt of Afluria QIV. Chronology is plausible. As reported, the maternal obstetrical history noted that the neonate's mother had no previous pregnancies. The mother had no maternal or paternal history with major congenital malformations (MCMs). The neonate's mother did not use tobacco, alcohol or illicit drugs during pregnancy. The ultrasound scan revealed no MCM. With currently available information, causality for the event low birth weight is unassessable. The event foetal exposure during pregnancy was assessed as not related considering the intended use of the vaccine.

Other Meds: PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]; FERROUS SULFATE; FERRALET [FERROUS GLUCONATE]; INJECTAFER

Current Illness:

ID: 1058227
Sex: F
Age: 47
State: CT

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: CXR with no acute findings

Allergies: Avelox Anaphylaxis ThiazidesTachycardia Demerol [Meperidine]Itching MorphineItching StarchItching Vicodin [Hydrocodone-acetaminophen

Symptoms: 47yo obese female h/o Asthma ambulated into the ED c/o severe allergy to the Moderna Vaccine which she received 40minutes ago. Patient state, she was advise about the risk and side effects of the vaccine. Patient state, she noticed nothing initial, then suddenly chest tightness, itching to the face, hoarseness, and wheezing. Patient state, she called the hotline for advise and advise to use her asthma inhaler and go to the nearest ED. Patient state, she received 40 of prednisone prior to receiving the Moderna vaccine in the left arm. 47yo female is in no acute distress. Patient symptoms resolving. Patient has no hoarseness or difficulty swallowing. Patient has no itchiness or respiratory distress. Patient chest xray shows no acute findings. Patient will continue with medication as prescribed. patient will be discharge home.

Other Meds: albuterol (ACCUNEB) 0.63 mg/3 mL nebulizer solution atenolol (TENORMIN) 50 MG tablet cholecalciferol, vitamin D3, (VITAMIN D3) 5,000 unit Tab cyanocobalamin, vitamin B-12, (VITAMIN B-12) 1,000 mcg Subl cyclobenzaprine (FLEXERIL) 10 MG table

Current Illness: unknown

ID: 1058228
Sex: F
Age: 31
State: IA

Vax Date: 12/29/2020
Onset Date: 01/06/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data: No

Allergies: Penicillin

Symptoms: I had shot on 29th - I had sore arm for two days after that. Morning of 6th, I woke up with really sore arm - worse than before and a couple of red dots that looked like hives and throughout the day my arm became more sore, redness increased and there was swelling. Next morning, the redness had taken over the whole upper arm and it was more swollen (the whole upper arm and it was painful). It worsened through the day. I was advised to see someone in walk-in at the hospital later that day - diagnosed with cellulitis and was prescribed cephalexin - an antibiotic. I took it right away. A few minutes after (at about the same time as I took the antibiotic) that I got a few hives and got more as the night went on. I woke up later that day after I had taken an antibiotic. I had chills, body aches, burning in my joints and I broke out in hives. The next day the hives were gone - still had the redness, swelling and body aches, chills. The next day, everything except the redness, swelling and pain were gone. By the 11th and 12th - swelling reduced and the redness went away soon after that. I completed my dose of antibiotic - I was told it was probably not cellulitis but more likely a reaction from vaccine.

Other Meds: Levothyroxine

Current Illness: No

ID: 1058229
Sex: F
Age: 76
State: MN

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

Lab Data: None

Allergies: Sulfa drugs

Symptoms: Chills, fatigue, body aches, headache, fever, nausea Took Tylenol after 24 hours Helped lessen the symptoms. Took more Tylenol after 6 more hours. 48 hours later-am 70% improved.

Other Meds: Simvastatin, levothyr oxide, metformin

Current Illness: None

ID: 1058230
Sex: F
Age: 73
State: OH

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

Lab Data: NONE

Allergies: TYLENOL, VICODIN, PENICILLIN

Symptoms: WITHIN THE FIRST HOUR PATIENT NOTICED HER ARM WAS HOT AND RED. THAT NIGHT ARM HURT ALL THE WAY TO HER FINGERS. ARM IS STILL RED AND HOT TO TOUCH. ALSO A QUARTER SIZED THICKNESS AT INJECTION SITE

Other Meds: ELIQUIS, LOSARTAN, METOPROLOL, SYNTHROID, SINGULAIR, HYDROCHLORTHIAZIDE

Current Illness: NONE

ID: 1058231
Sex: F
Age: 30
State: GA

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: flying stinging insects

Symptoms: Low grade fever (100.2) and headache; pregnant at time of vaccination, due date 3/27/2021

Other Meds: sertraline 75 mg, prenatal vitamin, Pepcid AC 10-20mg

Current Illness: pregnancy

ID: 1058232
Sex: F
Age: 63
State: KY

Vax Date: 02/22/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: Abt 2 hrs after receiving the injection my arm became very sore (which I thought was normal) & continued to worsen, The next day after the shot 2/23 it felt like it had a hard knot in it & continued to be sore. On the 24th in the evening, it felt like my shirt was to tight & started to . When I looked at my arm it was red, raised and felt hot around the injection site (the area was about 5 or 6 inches long and maybe 2-3 inches across) When I googled the symptoms & saw pictures, it seemed to resemble "covid arm" I applied a topical steriod that evening & next day and today 2/26 the redness, itchiness is almost gone

Other Meds: Lisinopril

Current Illness: none

ID: 1058233
Sex: F
Age: 63
State: MN

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

Lab Data:

Allergies:

Symptoms: Some numbness and tingling in arm and fingers. Not constant but noticed in certain positions. Numbness in tip of index finger. Symptoms are improving but have not yet completely resolved. believes "a nerve was nicked" and expects it to heal slowly. She has not reached out to a doctor or clinic; I recommended that she call her health care provider.

Other Meds:

Current Illness:

ID: 1058234
Sex: F
Age:
State: UT

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

Lab Data: None

Allergies: Penicillin and both Internal/External Iodine (resulting in anaphylaxis for both.)

Symptoms: Highest fever of 107 but hovers around 103 with Tylenol. Pain in joints from head to toes. Swollen armpit,like a golf ball and it is very painful. Vomiting and hard to keep anything in including .Tylenol and pain killer oxy 10 mg. I'm really dizzy but my fever has moved back down to 103 , these symptoms are still about 38 hours after the 2nd vaccine.

Other Meds: Gabapenton, Amitryptoline, oxy 10mg, Aderall 15mg, morphine XR.

Current Illness: Crohns

ID: 1058235
Sex: F
Age: 47
State: MD

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

Lab Data:

Allergies: None

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1058236
Sex: F
Age: 36
State: OR

Vax Date: 01/31/2021
Onset Date: 02/03/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: Dairy, gluten, sulfa antibiotics

Symptoms: Rash beginning from first dose, increasing after second. Covering torso area. Some nausea day 2 after dose 2

Other Meds: Anoro Ellipta inhaler, biweekly infusions of Gammagard.

Current Illness:

ID: 1058237
Sex: F
Age: 80
State: TN

Vax Date: 02/15/2021
Onset Date: 02/01/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: Patient reported swelling and redness that spread around the arm.

Other Meds: According to patient, she received a steroid shot and antibiotic. Her arm started swelling and turning red, the redness began to spread.

Current Illness:

ID: 1058238
Sex: F
Age: 75
State: IL

Vax Date: 02/11/2021
Onset Date: 02/20/2021
Rec V Date: 02/26/2021
Hospital:

Lab Data:

Allergies: allergic to penicillin

Symptoms: Nine days after receiving the vaccine, my upper right arm became very itchy and inflamed. The redness covered most of the upper arm centered around the injection site. The itchiness and redness slowly dissipated over the course of several days. 6 days later the arm was back to normal. I did not seek any medical attention for this occurrence. I am reporting this only because it was a very unusual occurrence for me as I have never had any such reaction to any vaccination received in my life.

Other Meds: Warfarin, metropolol, levothyroxine, simvastin, losartin, multivitamin, calcium, vit c, vit d, and low-dose aspirin

Current Illness: none

ID: 1058239
Sex: F
Age: 49
State: MN

Vax Date: 02/01/2021
Onset Date: 02/06/2021
Rec V Date: 02/26/2021
Hospital: Y

Lab Data: CT chest revealed diffuse patchy and consolidative groudglass opacities. TTE showed an EF of 30%. Significant labs included AKI (cr 3.5), AST 86, ALT 60, ferritin 3462, LDH 331, troponin 0.567, wbc 25, platelets dropped 50 to 11, procalcitonin 38, CK 940. Repeat covid PCR from nares and sputum was negative on 2/16. Suspicion for MIS-A: started as the inflammatory markers increased and we were unable to determine another source for infection: CRP 300, ferritin increased to 8100, LDH increased 1400, procalcitonin remained elevated at 43, BNP 160K, trop increased to 1.1, marked thrombocytopenia continued (TTP and ITP ruled out) and elevated LFTs. IL 1 1.1 and IL 6 67. Also had worsening respiratory status and hemodynamics. Treatment course: 2/17 the suspicion became higher as the inflammatory markers peaked and we discussed the case with our pediatric MIS-C colleagues. Received a dose of IVIG (1.2grams) and started methylpred 1 gram x 3 days. On 2/18 we started anakinra. After the 3 days of high dose methypred we changed to 1 mg/kg BID. She has also received 2 more doses of IVIG.

Allergies: None

Symptoms: Received COVID vaccine 1 on 1/13 and COVID vaccine #2 2/1. 49 y/o previously healthy female who had a COVID 19 exposure ~ 1/3. The person she was exposed to tested positive 1/6 (daughter had a fever and cough). On 1/11 the patient received the 1st dose of the Pfizer vaccine. 12-24 hours after the Pfizer vaccine she developed fevers, malaise, myalgias that lasted 2-3 days (Called off work). She then returned to a normal state of health. On 2/1 she received the second dose of the vaccine. On 2/6 she developed right pleuritic chest pain so went to an urgent care. COVID 19 PCR was positive and CXR unremarkable. She was told to take naproxen and her pleuritic chest pain slowly improved. On 2/8 she started to have general malaise followed by nausea. On 2/11 she developed increased nausea and vomiting followed by diarrhea-eventually that day she had a near syncopal episode prompting her presentation to the hospital. Seen at an outside hospital between 2/11-2/12. CT abd/pelvis showed patchy ground glass opacities at the base of the lungs and she was noted to have diffuse mural thickening. There was concern for possible cholecystitis so a perc cholecystostomy tube was placed. Ultimately she developed significant hypoxic respiratory failure and had to be intubated.She was transferred to another hospital on 2/12. Initially she was started on treatment with dexamethasone but continued to clinically get worse. Also on empiric antibiotics.

Other Meds: COVID vaccine #1 on 1/13/21 and COVID vaccine #2 2/1/21 Naproxen started 2/6/21-prn medication for chest pain

Current Illness: 49 y/o previously healthy female who had a COVID 19 exposure ~ 1/3. The person she was exposed to tested positive 1/6 (daughter had a fever and cough). On 1/13 the patient received the 1st dose of the Pfizer vaccine. 12-24 hours after the Pfizer vaccine she developed fevers, malaise, myalgias that lasted 3 days (Called off work). She then returned to a normal state of health. On 2/1 she received the second dose of the vaccine. On 2/6 she developed right pleuritic chest pain so went to an urgent care. COVID 19 PCR was positive and CXR unremarkable. She was told to take naproxen and her pleuritic chest pain slowly improved. On 2/8 she started to have general malaise followed by nausea. On 2/11 she developed increased nausea and vomiting followed by diarrhea-eventually that day she had a near syncopal episode prompting her presentation to the hospital.

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm