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: 0917701
Sex: F
Age: 44
State: MA

Vax Date: 12/26/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: My head felt like It was under water, had sinus issues, headache and vaccine sight issues days after getting the vaccine, warm, red and pain at injection site

Other Meds: None

Current Illness: None

ID: 0917702
Sex: F
Age: 36
State: PA

Vax Date: 12/24/2020
Onset Date: 12/29/2020
Rec V Date: 01/03/2021
Hospital: Y

Lab Data: All tests WNL however my potassium level was low (2.9). Replaced with IV and PO but symptoms still present. Waxing and waning of symptoms.

Allergies: Percocet: itching

Symptoms: On 12/29: lightheadedness, flushed, felt like I was going to pass out, numbness/tingling down arms and hands, chest tightness, clammy hands and feet.

Other Meds: Vitamin D 2000 iu daily Melatonin 7.5mg daily Mirena (IUD inserted 4/2016)

Current Illness: None

ID: 0917703
Sex: M
Age: 55
State: MO

Vax Date: 09/16/2020
Onset Date: 09/21/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: Had staph infectin test and it was negative (biopsy) and had a swab test about 2 weeks later and it was negative for bacteria or staph also.

Allergies: None known

Symptoms: Started with Hives on back then bumps and then boils. This has been going on over my entire body but mainly at the injection site for 3 months. I have pictures and hospital/urgent care visitis. I've been to a dermetoglogist. Non stop bumps and boils for 3 months.

Other Meds: No prescriptions but do take Omneprizol on occasion (Prilosec)

Current Illness: None

ID: 0917704
Sex: F
Age: 62
State: ME

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: None

Allergies: None known

Symptoms: Approximately 12 hours after injection, sudden onset headache, went to bed and woke a couple hours later with severe back pain, neck pain, deep muscle ache in legs, low grade fever. 24 hours after injection, some decrease in pain with Tylenol, diarrhea, fatigue, general malaise. Loss of taste, loss of appetite . 48 hours post injection- subsiding muscle aches, other symptoms on going, 72 hours post to present, diarrhea, loss of appetite

Other Meds: Venlafaxine 150mg x1 daily

Current Illness: COVID positive 11/21/2020 Headaches, muscle aches, low grade fever, loss of smell/taste, fatigue, diarrhea

ID: 0917705
Sex: F
Age: 44
State: TX

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: NA

Allergies: No

Symptoms: I got covid-19 vaccine in campus 12/30/2020 around 11 Am . I felt sick around 11 pm (12 hours later , 12/30/2020). I felt dizziness , Chills , facial swelling and body aches for 24 hours . I took Benadryl and Tylenol every 8 hours . I felt better in 1//1/2010 around noon.

Other Meds: NO

Current Illness: No

ID: 0917706
Sex: F
Age: 70
State: AL

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: oral thermometer

Allergies:

Symptoms: Swelling and Redness at injection sight from quarter coin size to half dollar with pain. Myalgia, Fatigue, fever 101.3 F. Nausea and diarrhea. dizziness. (main problems of fever and bodyaches) treated with tylenol, zofran, lomotil, rest. no appetite. facial swelling

Other Meds: Neurontin, Advil, Tylenol, Singulair, estrogen oral, Parafon, Vistaril, vitamins minerals, folic acid, certirizine, Zofran, ASA 81mg, Lomotil, lorazepam, hydrocodone, antacids, fibercon, anti-gas

Current Illness:

ID: 0917707
Sex: F
Age: 56
State: MI

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: none

Allergies: morphine

Symptoms: nosebleeds X 3 12/31, 1/1 and 1/2 treated with pressure and ice

Other Meds: nexium, abilify, lexapro, synthroid, qvar

Current Illness: Covid 19 15 days prior

ID: 0917708
Sex: F
Age: 57
State: MD

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data: n/a

Allergies: PCN

Symptoms: Dizziness and nausea for 24 hours: resolved with rest and hydration

Other Meds: Pristiq 10 mg, Metamucil, Melatonin 10 mg

Current Illness: none

ID: 0917709
Sex: F
Age: 57
State: IL

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: Recipient reported seeing some red rash to arms approximately 10 minutes following vaccine. Benedryl given 50mg IM to Left Deltoid. Patient kept for additional observation.

Other Meds: Vitamins and supplements, Antivio

Current Illness:

ID: 0917710
Sex: F
Age: 37
State: NY

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: None

Allergies: Amoxicillin- urticaria

Symptoms: I received the vaccine on 12/29 at about 2:15pm. I had a sore left arm after shot which awoke me at 2am. I also work up due to fever (temp 100.1 ), chills, and myalgia. I had a lot of trouble sleeping that night and got very little rest as unable to get comfortable. The next day I still had fever, chills, myalgia, nausea, joint pain, low back pain, fatigue and headache (felt similar to prior bad flu symptoms). I was sent home from work early as symptoms continued throughout the day with a little relief from a 500mg of acetaminophen. The following day 12/31 symptoms were gone except for the left sore arm which was improving and now completely done on 1/3.

Other Meds: prenatal vitamins vitamin D supplement

Current Illness: None

ID: 0917711
Sex: F
Age: 32
State: KY

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

Lab Data:

Allergies:

Symptoms: 100.6 fever, headache, chills, fatigue

Other Meds:

Current Illness:

ID: 0917712
Sex: F
Age: 24
State: NY

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: Chest x-ray that was taken after all the I.V. medication was given was normal.

Allergies: SHELLFISH SEAFOOD ALL OF THE PENICILLIN GROUP ANTIBIOTICS

Symptoms: Anaphylaxis. The COVID shot was given, no reaction then. After 7 minutes, congestion, severe cough, vomiting phlegm, feeling like throat closing started happening. Code was called, Benadryl was immediately given intramuscular in the left arm, blood pressure, pulse ox was taken, and then was taken to the Emergency Department. In the ED, I was given prednisone, one EPI, anti-nausea medication all through I.V. and many more medications given to me via I.V. that I don't sincerely remember. I was under observation for 4 hours. I was discharged after all symptoms dissipated and was given Prednisone 20 MG (3 tabs a day) to take to help my lungs. Management followed up almost immediately, everyone from the moment I had the anaphylactic reaction was quick and prepared.

Other Meds: ESCITALOPRAM 20 MG TAB VITAMIN D3 5000 IU (125 MCG)

Current Illness: NONE

ID: 0917713
Sex: M
Age: 64
State: NY

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: none

Allergies: n/a

Symptoms: Pain at injection site; much less than flu shot. No treatment. Resolved by Jan 2. Brief bouts of dizziness and nausea; stayed home from work and rested. resolved by Jan 1. Seasonal allergy symptoms- runny nose, including bloody nose from left nostril. Resolved by Jan 2. Allergic reaction to a scented hand cream used by wife- burning eyes, nasopharyngeal tightness, nasal discharge. Wife since removed so I can't tell you brand. Occurred/Resolved Jan 1 when product was removed.

Other Meds: Metformin, Glimepiride, Victoza, Jardiance, Rosuvastatin, Tresiba

Current Illness: Diabetes T2; 5 yrs post T1B2 Kidney cancer

ID: 0917714
Sex: F
Age: 43
State: PA

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: Pulse ox 100 BP 96/68mmHg my BP usually runs low. Monitored again as symptoms were about the same BP O2 sats were WNL then went to employee health had a drink of water and pulse O2 sats 100 BP went up 98/72 or thereabouts

Allergies: Sulfa

Symptoms: Racing heart, dizziness, lightheadedness

Other Meds: Biotin, Vit C, edelberry, b12, calcium with d3

Current Illness: None

ID: 0917715
Sex: F
Age: 32
State: CA

Vax Date: 12/21/2020
Onset Date: 12/25/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Day 4 after receiving vaccine dose developed nerve pain in the groin and R glute/thigh, as well as fatigue. Sx worsened on day 5, so I had a virtual visit with a medical provider who prescribed me Valtrex x7d to treat suspected Herpes Zoster, which I previously had in my early 20s.

Other Meds: Sertraline

Current Illness:

ID: 0917716
Sex: F
Age: 43
State: TX

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Nauseous, Jitteriness, Tachycardia

Other Meds:

Current Illness:

ID: 0917717
Sex: U
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 01/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 1 -1/2 hours after vaccine I statred with a mild headache that is still lingering, Jan.1st I was fine, Jan 2nd I had fatigue, by night time I had mild body aches, mouth pain, sinus pressure, swollen gums, and extreme fatigue. Jan 3rd mild sinus pressure, only left arm pain into arm pit area, neck pain and fatigue.

Other Meds:

Current Illness:

ID: 0917718
Sex: F
Age: 19
State: OR

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

Lab Data:

Allergies:

Symptoms: Patient experienced a headache, arm pain (not at site), dizziness when standing. Patient was offered water and snacks. Sat in observation area for 30 minutes. Headache and dizziness with standing continued, after 30 minutes patient reported chest tightness. Caregiver was immediately taken to the Emergency Room for assessment.

Other Meds:

Current Illness:

ID: 0917719
Sex: F
Age: 35
State: WI

Vax Date: 12/28/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data: N/A

Allergies: Penicillian

Symptoms: Woke up Friday, 1/01, with sinus pain. Specifically burning pain in my sinuses and pain when I moved my eyes from right to left. Also had a generalized headache and body aches. On Saturday, 1/02, did have a fever of 100.2 but this has resolved. This morning, 1/03, the sinus pain has improved, still a slight headache and now major conplaint is lower back pain. Also have general malaise. No fever today either.

Other Meds: Zyrtec, zinc, vitamin c, and vitamin d.

Current Illness: None

ID: 0917720
Sex: M
Age: 73
State: FL

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: NONE

Allergies: NONE

Symptoms: *THE BELOW IS A LIST OF SYMPTOMS THAT ARE ONGOING SINCE INJECTION DATE: 12/30/2020 0830 HOURS- *FEVER HOLDS AT 100.5 -101.9 * OVER THE COUNTER TYLENOL REDUCES FEVER BY 1-1.5* *CHILLS , FATIGUE, JOINT & MUSCLE PAIN AND LO GRADE HEADACHE( ALL SEEM TO MARGINALLY LESS TODAY *DRY INTERMITTANT COUGH OVER LAST 12 HOURS *CHRONIC CONSTIPATION, NO BOWEL MOVEMENT OVER THE PAST THREE DAYS

Other Meds: LOSARTAN 25MG

Current Illness: NONE

ID: 0917721
Sex: M
Age: 29
State: WI

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Signs and symptoms started around 1700hrs which included: body aches, chills, fever, and pain in the arm. Signs and symptoms resolved the following morning (1/1/21) 0800hrs.

Other Meds: None

Current Illness: None

ID: 0917722
Sex: F
Age: 36
State: FL

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: None

Allergies: Bactrim

Symptoms: Received shot at 11:45 am. At 1700 that day developed sensation of racing heart and resting heart rate was 120. Baseline heart rate 80 at rest. This resolved overnight and returned to normal the next day. On 12/31/2020 develop sore throat and noted red vesicle like rash on my throat with petechia on my cheeks (buccal mucosa) and tongue. Swollen uvula. I had a medrol dose pack and Benadryl which I started immediately and rash/sore throat petechia resovlved 36 hours after starting the Medro dose pack. Unsure if this was related the vaccine but wanted to report just in case.

Other Meds: Nexium, Pepcid, Tumeric/ginger tea, Tylenol, ibuprofen

Current Illness: None

ID: 0917723
Sex: F
Age: 57
State: IN

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: With in 12 hours of the vaccine I woke up with 101 fever, chills, all over pain and nausea with vomiting a few times. Large amount of arm swelling and erythema about 5inches wide and 6 inches long. L had was tingly and painful. Nauseated most of the next day and feverish on and off all day as well ranging from 99.0 to 101.2 . L arm remains red, tender and itchy and it is 1/3/2021. Was unable to work 12/31/2020. treatment included. ibuprofen, Tylenol, Aleve, ice, and rest

Other Meds: Meloxicam 15 mg 1 x per day, Fluoxetine hcl 20 mg 1 x per day

Current Illness: none

ID: 0917724
Sex: F
Age: 33
State: CA

Vax Date: 12/30/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data:

Allergies: Penicillin Bactrim

Symptoms: Hives red dot rash swollen eyes and face

Other Meds: Mannose D ibuprofen

Current Illness:

ID: 0917725
Sex: F
Age: 59
State: PR

Vax Date: 12/24/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data: no

Allergies: no

Symptoms: I got Moderna vaccine on 12/24/2020 and had sore arm for 2 days, then 9 days later (1/1-2021) I woke up with a quarter size welt close to the injection site, which increased in size by end of day, associated with redness, heat , itching and tenderness, looks like cellulitis.On 1/2/2021 was bigger in size. It's day #11 (1/3/2021) the area is still inflamed, but it's less acute

Other Meds: Centrum -vitamins

Current Illness: no

ID: 0917726
Sex: F
Age: 44
State: FL

Vax Date: 12/29/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data: I was examined at the urgent care clinic on 1/3/21.

Allergies: NKDA

Symptoms: Facial swelling, orbital edema, blurred vision in right eye, red rash in neck, malaise, fatigue, and headache I took Benadryl 25mg Q6hrs on 1/1 and 1/2/21. When my vision became blurry I went to an urgent care clinic on 1/3/21

Other Meds: Amlodipine, Flonase, cranberry Fruit pill, multivitamin, alprazolam, trazadone, xyzal

Current Illness: None

ID: 0917727
Sex: M
Age: 38
State: NY

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
Hospital: Y

Lab Data: CT scan, CBC,CMP

Allergies: None

Symptoms: Patient with a history of thalassemia and Gilbert's disease, developed severe jaundice three days after vaccination. Had mild headache and sore arm but otherwise felt well. Had labs drawn - found to have highly elevated bilirubin (23) and LFTs in the 700s. Was admitted to the hospital and had CT showing Cholelithiasis, choledocholithiasis and minimal intrahepatic biliary ductal dilatation. Left hospital and was admitted to another facility where plan was for ERCP and cholecystectomy. Ultimately unclear if at all related to the vaccination - may be coincidental.

Other Meds: Folic acid, multivitamin

Current Illness:

ID: 0917728
Sex: F
Age: 54
State: OH

Vax Date: 12/30/2020
Onset Date: 01/02/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data: Negative Covid Test

Allergies:

Symptoms: No taste for food; lymph nodes swollen; painful teeth; fever

Other Meds:

Current Illness:

ID: 0917729
Sex: F
Age: 65
State: OR

Vax Date: 12/28/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: neuro exam in urgent care normal except for ptosis 1-2-2021

Allergies: sulfa bacitracin ointment

Symptoms: Ptosis left eye developed about 48 hours after vaccine, mild progressed to very noticeable currently improving

Other Meds: Advair, pantoprazole, montelukast, loratadine, multivitamin, fluticasone nasal spray, azelastine nasal spray

Current Illness: none

ID: 0917730
Sex: M
Age: 24
State: TX

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

Lab Data:

Allergies:

Symptoms: At around 1 in the morning on 01/03/2021 i woke up very cold. it took around 30mins to an hour for me to warm up and stop shaking. i then noticed that i had pain in my shoulder where i received the vaccine. i also became nauseous, my head started hurting, and i had a temperature of 101.1.

Other Meds:

Current Illness:

ID: 0917731
Sex: M
Age: 44
State: OH

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Moderna COVID-19 Vaccine EUA Took vaccine at 2:45 pm Shoulder was getting sore that night before going to bed Next day woke up and shoulder was sore but felt fine. As the morning progressed, started feeling worse. By 11:00 am, reached peak severity of side effects. Side effects lasted from 11:00 am till I woke up the next morning. Woke up feeling fine except shoulder was still a little sore. Side effects were (listed by order of severity): fatigue, body aches, feeling spaced-out. Tylenol and Advil did seem to lessen those effects.

Other Meds: pantoprazole, multivitamins and supplements

Current Illness: none

ID: 0917732
Sex: F
Age: 44
State: VT

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: None

Allergies: Sulfa Methimazole Cephalosporins

Symptoms: Diaphoretic palms, palpitations, jitteriness.

Other Meds: Synthroid

Current Illness: None

ID: 0917733
Sex: F
Age: 57
State: OK

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: None

Allergies: Codeine - Anaphylaxis

Symptoms: 16:40 - Moderna vaccine administered RN. 16:54 - Client reported being thirsty and having tingling face. 16:56 - Blood pressure 200/110, pulse 104 bpm, O2 sat 98% on room air. Client reports tingling face, but denies difficulty breathing, dizziness, and/or swelling of tongue. No observed hives and/or pale skin. 17:03- Blood pressure 208/108, pulse 103 bpm, O2 sat 99% on room air. Client reports tingling face, but denies difficulty breathing, dizziness, and/or swelling of tongue. No observed hives and/or pale skin. Client declined medical staff to call for medical intervention by emergency medical response. 17:10 - Blood pressure 204/108, pulse 110 bpm, O2 sat 98% on room air. Client reports tingling face, but denies difficulty breathing, dizziness, and/or swelling of tongue. No observed hives and/or pale skin. Observed flushed skin to chest. Asked client if she would be willing for husband to drive her to emergency room to be medically evaluated, client declined. 17:15 - Blood pressure 206/126. Client declined calling emergency medical response and being driven to hospital by husband for medical evaluation. Client reports being stressed out with life circumstances. Client reports she had not taken her blood pressure medication that day. Client reports having anxiety due to life circumstances and takes anxiety medication. Client reports wanting to go home, take her medication, and lay down. Recommended client take blood pressure twice daily, log readings, schedule f/u appointment with PCP in one week, and take logged readings to PCP to make sure no adjustment is needed with prescribed medication. 19:50 - F/U call to client's husband. Husband reports taking client's blood pressure at 175/101. Client reported in background that she had take her blood pressure and anxiety medications. 20:30 - Husband text reporting client's blood pressure reading at 163/94. 1/1/2021 at 10:10 - Husband text stating client took her blood pressure medication at 9:30 am and blood pressure is now reading 130/79. Husband reports client stated she no longer has facial numbness, but her arm was sore at injection site.

Other Meds: Client reported during f/u call that she takes Lexapro and Memantine for Anxiety/Stress and Quinapril for HTN.

Current Illness: HTN Anxiety

ID: 0917734
Sex: M
Age: 64
State: OK

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: None

Allergies: Penicillin

Symptoms: 2 hours after injection:- Sore arm. 12 hours-99 degree temp, elevated pulse, shivers. 14 hours-100 degree temp, elevated pulse (120 bpm), chills, persistent moderate headache, achy muscles, sore back. 24 hours-98 degree temp, head ache gone, just a worn out feeling, 36 hours-back to normal other than a very sore arm at injection site and a worn out feeling.

Other Meds: Prilosec, Ezetimibe, Chlorthalidone, Iron supplement, Fish Oil supplement,

Current Illness: None

ID: 0917735
Sex: M
Age: 62
State: VA

Vax Date: 12/17/2020
Onset Date: 12/19/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: NONE

Allergies: ultram

Symptoms: LEFT OCCULAR CONJUNCTIVITIS WITH DRAINAGE REQUIRING TREATMENT WITH ANTIBIOTIC AND STEROID OCCULAR DROPS FOR TEN DAYS. RESOLVED AFTER TREATMENT

Other Meds: diltiazem180 cd daily

Current Illness: none

ID: 0917736
Sex: F
Age: 46
State: MT

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: All normal labs

Allergies: Pyridium Environment

Symptoms: Nausea Fatigue Weakness Heart palpitations

Other Meds: Thyroid medicines

Current Illness: None

ID: 0917737
Sex: M
Age: 65
State: IN

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

Lab Data: None

Allergies: None

Symptoms: Sore arm at the site , and fatigue

Other Meds: DayQuil

Current Illness: None

ID: 0917738
Sex: F
Age: 64
State: DE

Vax Date: 12/26/2020
Onset Date: 01/02/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data: none

Allergies: KNDA

Symptoms: Itchy 50 cent coin size welt returned

Other Meds: prozac omeprozole Premarin aspirin

Current Illness: none

ID: 0917739
Sex: M
Age: 67
State: FL

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: minor headache/bodyache; severe chills

Other Meds: pantoprazole, rosuvastatin, amlodipine, pomegranate

Current Illness: none

ID: 0917740
Sex: M
Age: 41
State: MO

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: That night approximately 2300, started with minor chills and tiredness, 0430 with increased chills and body aches, headache, and took ibuprofen and Tylenol. Every 4-5 hours the body aches and chills came back, still taking the ibuprofen and Tylenol, napped later in the afternoon and woke up approximately 1630 feeling good. Laid in a recliner approximately 2000 and dozed off for about 30 minutes, woke up feeling worse with uncontrollably shaking chills, body aches, joint pain, fever of 101. Woke up the next day with minor body aches and joint pain. Sunday approximately 0730 had headache, joint pain flushed feeling/hot flashes/sweating, the body aches again.

Other Meds: Guaifenesin, Tylenol

Current Illness: COVID- dx 12/15/2020 with symptoms starting the day before

ID: 0917741
Sex: M
Age: 53
State: CT

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fatigue, headache, chills, muscle aches, difficulty sleeping- moderate enough to disrupt daily routine- felt the same as I did when I actually had covid 19

Other Meds:

Current Illness: Covid 19 October 26; 2020

ID: 0917742
Sex: F
Age: 52
State: NJ

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: Covid 19 swab done on Dec. 31st with negative result

Allergies: NKDA/NKA

Symptoms: Fevers,-38.2., chills on the same date at 825 pm. The next day, fevers,-38.6, chills, arthralgia, headache, hands and feet were very cold like I was thrown into the snowy place that I needed 3 sheets to cover me like comforter and fleece and heater at 74-75 degrees while in the small room of my son, alone. On the 3rd day, low grade fevers-37-38.2 , persistent severe headache and muscle ache. On the 4th day, no fevers but moderate headache and muscle ache and nausea.

Other Meds: Multivitamins(centrum), vit. C, Vit. E, Vit. B complex, fish oil, zinc, Vit. D3 and Protonix

Current Illness: None

ID: 0917743
Sex: F
Age: 31
State: TX

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Severe headache, nausea and vomiting >20x the next morning , dizziness, injection site redness, swelling, and tenderness. Stomach cramps Took zofran for vomiting. Nausea, headache, and dizziness lasted x 72 hours after injection Tylenol and Motrin also used which provided no relief

Other Meds: Multivitamin

Current Illness: None. COVID 10/27/2020, had negative test since then

ID: 0917744
Sex: F
Age: 42
State: CO

Vax Date: 12/31/2020
Onset Date: 01/02/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data: None

Allergies: KNA

Symptoms: Redness and swelling at the injection site. Arm hot to touch

Other Meds: Yaz Aleve

Current Illness: Covid 19

ID: 0917745
Sex: F
Age: 50
State: CA

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data: N/A

Allergies: Ace Inhibitors [Angiotensin-converting Enzyme Inhibitors], Bactrim [Co-trimoxazole], Fluticasone Propionate, Hydrocodone, Imitrex [Sumatriptan Succinate], nortriptyline, shellfish, zocor

Symptoms: S: Patient, RN from TCC/CCU came to Covid vaccine clinic on 1/3/2020 for Covid vaccine. She received vaccine at 7:23 am. Received injection on left arm. At 8:12am, she reported heaviness on left arm, tingling sensation on left 3rd and 4th fingers, and metallic taste. She denies motor weakness, sob, n/v, chest discomfort, palpitation, difficulty breathing, dizziness, headaches, blurry vision. Hx of HTN, mitral valve prolapse, asthma, migraine. Currently taking labetalol 400 mg bid, hctz/losartan 100/50 mg bid. Have not taken her BP medications this morning. She took benadryl 25 mg and tylenol 1000 mg at 6:35 am prior to coming to clinic. She is allergic to multiple medications. O: At 8:12, VS: 177/104, 97%, HR 66. Reports paresthesia to L arm, metallic taste At 8:25, VS: 157/102, 98%, HR 62. Continues to experience paresthesia and heaviness, but it has gradually improved, metallic taste resolved At 8:37, VS: 149/92, 98%, HR 64. Paresthesia and heaviness improved. AAOx 4, follows command, speech clear, lung sounds clear, heart sounds normal, normal rate and rhythm. Motor strength +5/5 bilaterally. No facial weakness/facial drooping. Subjective paresthesia on left 3rd and 4th fingers that gradually resolved. Subjective heaviness on left upper arm. No angioedema. No respiratory distress. A: Reaction to Covid-19 vaccine. P: Employee was closely observed in clinic. Provided fluids. VSS. Symptoms gradually improved. Employee was advised to closely monitor her symptoms, if she experience any worsening symptoms, she need to call 911 or go to the nearest emergency room. She states that she has epi pen and benadryl in her purse, and understand signs and symptoms to monitor for and when to use it if needed. Employee left to return home at 8:45 am in stable condition.

Other Meds: benadryl 25 mg, tylenol 1000 mg

Current Illness: history of hypertension, mitral valve prolapse, asthma

ID: 0917746
Sex: F
Age: 63
State: TN

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

Lab Data:

Allergies: Hydrocodone Fish

Symptoms: I have just been fitted for a CPAPand have been using it for 11 days with no ill effects. Last night at roughly 3:15 am I woke up because I was having difficulties breathing. I had trouble on the inhale but the worse part was not being able to exhale with the CPAP on. I could only exhale through the mouth. I had to take the CPAP off so as I could breath. I also got out of bed to get in a sitting position. At this point my breathing seemed somewhat ok. About 30 minutes later I took my blood pressure and pulse. BP was 123 over 70 and my pulse was 70.

Other Meds: Omeprazole 20mg Rosuvastatin 20mg Amlodipine Besylate 2.5 mg Fluticasone Cetirizine hydrochloride Garden of life raw enzymes women 50 and wiser

Current Illness: Sleep apnea

ID: 0917747
Sex: F
Age: 43
State: IN

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: CBC w/platelets & Indices & Differential: all results normal , Histamine release: NO results received yet , Ige: NO results received yet, Tryptase: No results received yet, and SARS-Co: negative

Allergies: none

Symptoms: Started the following day December 29th about 9PM having diarrhea. Diarrhea continued on December 30th. Also on December 30th my left eye began to swell. I took benadryl that evening before going to bed, but woke up the next morning December 31st with both eyes swollen. The left eye being worse and now under the eye was red and extremely itchy. Contacted employee health at hospital on December 30th and 31st. where vaccine was given and left a message detailing my side effects. Contacted my own primary dr on December 31st and was seen by Dr who believes I have had an allergic reaction to Moderna vaccine. I was prescribed predinsone and zyrtec for 5 days.

Other Meds: multi vitamin

Current Illness: none

ID: 0917748
Sex: M
Age: 51
State: FL

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient stated throat tightness and flushing on head

Other Meds:

Current Illness:

ID: 0917749
Sex: F
Age: 53
State: OK

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data: None

Allergies: Per Moderna pre-vaccination screening form, client marked NO on having ever had an allergic reaction (anaphylaxis) to something and needing an EpiPen or epinephrine for which she had to be taken to hospital.

Symptoms: At approximately 10:30 am, received call from (clerical at County Health Dept) stating client is on phone and she is reporting tongue swelling after receiving Moderna COVID-19 vaccine approximately one hour earlier. Staff instructed to tell client to go to emergency room for evaluation. Staff reported client stated she did not need ambulance and was okay to drive herself to the emergency room. At approximately 12:30, RN attempted to contact client at listed number, no answer, left message to call personal cell. RN contacted Hospital emergency dept. after not being able to reach client by phone. Nurse in emergency dept. stated client had not been there. Called another RN and had her request that Director of Facility (where vaccines were being administered to staff and residents) call her staff member (client) and f/u to see if she went to be medically evaluated. Director reported that client went to Urgent Med and they evaluated her. Director reported client was given Benadryl and sent home. Attempted to f/u with client a couple more times that afternoon and evening, no answer, left message to return call to personal cell. Never received call back from client. Attempted to contact client again on 1/3/21 at 11:14, no answer, left message to call personal cell. Spoke with Director via text and requested she reach out to client to have her call public health nurse . Director text client and requested she call RN with the County Health Dept. stating that nurse needed to f/u on her symptoms. Will await call back from client.

Other Meds: Unknown

Current Illness: Unknown

ID: 0917750
Sex: F
Age: 33
State: CA

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vibration in left thigh that last all day and first half of following day

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm