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: 1059767
Sex: F
Age: 63
State: IL

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: They said I had Other headache syndrome, nausea without vomiting, low blood potassium, and influenza like symptoms. The did the following tests--basic metabolic panel, C Reactive protein, CBC with Diff, Magnesium, phosphorus and SED rate. They also gave me a CT head without contrast. They gave me Benadryl, Reglan, fluids, and potassium chloride.

Allergies: None

Symptoms: Starting a couple hours after vaccination, I began to feel unwell, overall poorly, nothing specific. Went to be early at 9:30 and awoke at one a.m.on February 26 with splitting headache. Could not get back to sleep well and felt terrible all that day with headache, nausea, and foggy thinking, not funcional after about 2:30 p.m. Took Ibuprofen at 3 p.m., called doctor and went to ER at Medical Center. Was seen at ER a few hours later. Slept some in waiting room. Had sore throat, the worst splitting migraine type headache ever, and was extremely foggy headed, couldn't process thoughts, eyes had difficulty focusing, nausea. My temperature was a little high for me, I am normally low and it was 99. My blood pressure is usually low and it was 105/59, pulse was 82 and respiration was 16 with 96 % Oxygen Saturation. They did tests and had an ophthalmoligist give me an exam also. They said I could go home with the same meds they were giving me in the hospital since they were working to alleviate my painful headache, 600 mg of ibuprofen, reglan and benadryl. Before I left they gave me the potassium chloride. I am continuing my medications today, two days after my vaccine.

Other Meds: Alendronate Sodium 70 MB Tablet once a week Vitamins D, Calcium, Vitamin K, Multivitamin

Current Illness: none

ID: 1059768
Sex: F
Age: 40
State: TX

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

Lab Data: N/a

Allergies: Codeine

Symptoms: About 25minutes after shot, I started having a tingling feeling near my left eye/cheek bone area followed immediately by slight swelling. I took 2 Diphenhydramine 25mg and and two Tylenol pills and felt better within a couple hours. I later had chills at night, but my husband said I felt hot to the touch.

Other Meds: Daily vitamin, clidamycin phosphate topical gel 1%

Current Illness: No illnesses. I did have a facial peel a couple days prior.

ID: 1059769
Sex: F
Age: 29
State: PA

Vax Date: 02/19/2021
Onset Date: 02/26/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies: Unknown

Symptoms: Rash at injection sight approximately 7 days after injection. I also had an episode of vertigo. Since I've had episodes of vertigo on and off for the past 10 years, this is likely unrelated.

Other Meds: N/A

Current Illness: N/A

ID: 1059770
Sex: F
Age: 65
State: IN

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: None

Allergies: Yeast allergy. Taking shots every 6 weeks for this

Symptoms: It started 15 hours after shot I was really tired. Not sleepy just tired, then 7 more hours I felt flu like symptoms with a low grade fever of 100 for 8 hours. Then 60 hours after shot still a little weak with a small grade headache. Getting better

Other Meds: Premarin Tablets 0.3 once daily, Spirolactone 100mg once daily

Current Illness: I have had a tooth abscess and was on antibiotics for 10 days prior

ID: 1059771
Sex: U
Age: 74
State: KY

Vax Date: 02/18/2021
Onset Date: 02/25/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient says she received her second Covid vaccine about a week ago. She is worried she could be having symptoms from that. Complains of left-sided flank pain that radiates around the flank into the abdomen just a little bit. No other abdominal pain. Movement makes it worse. No midline back pain. No numbness tingling or weakness. No incontinence. No urinary symptoms. No changes in bowels. Normal bowel movements. No nausea vomiting or diarrhea. No chest pain or shortness of breath or difficulty breathing. Slight cough at night but not unusual. Dry. No change in taste or smell. No headaches or neck pain. No fevers. Also complains of mild sore throat. Swallowing makes it worse. No change in voice. No difficulty swallowing. No known sick exposures. She has had this before. No headaches or neck pain or neck stiffness

Other Meds:

Current Illness:

ID: 1059772
Sex: M
Age: 44
State: NY

Vax Date: 02/20/2021
Onset Date: 02/27/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Client received dose of tetanus toxoid 10 days ago. Today is 42 days since first dose. Decision was made to administer dose of Moderna today as CDC cites tetanus as an example of a possible exception to the 10-day rule AND today is the last day of the current recommended maximum interval for the Moderna vaccine.

Other Meds:

Current Illness:

ID: 1059773
Sex: F
Age: 48
State: PA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies: Omnicef, chlorhexedine

Symptoms: Within hours of second injection had pain, swelling, itching, redness below injection site hot to touch. 4 days post vaccine affected area has progressively expanded to area 5x 3 inch rectangle mid deltoid to just above elbow. Remains red, itchy, hot, sore despite oral/ topical antihistamine, cold compresses and topical steroid use. Bicep more tender than deltoid but both muscles sore and swollen.

Other Meds:

Current Illness:

ID: 1059774
Sex: F
Age: 68
State: WI

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

Lab Data: none just waited for it to pass

Allergies: Celiac - Gluten (wheat, rye,barley etc.)

Symptoms: Breathing became labored, hard to catch breath, pressure lasted for about 3 hours This is the same symptoms I had before I found out I was allergic to gluten

Other Meds: amitriptyline, tramadol, protonix, larazapam, excedrin, vitiams B-compex, D-3, calicum, magnesim biotin antibotic for skin rash

Current Illness:

ID: 1059775
Sex: F
Age: 63
State: TX

Vax Date: 02/06/2021
Onset Date: 02/17/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: slight red and purple area on upper left arm where I received the vaccine

Other Meds:

Current Illness:

ID: 1059776
Sex: F
Age: 56
State: PA

Vax Date: 01/24/2021
Onset Date: 01/26/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Enlarged(swollen) Lymph node at the lower left side of throat, pain at lymph node, sore throat

Other Meds: None

Current Illness: None

ID: 1059777
Sex: F
Age: 61
State: MA

Vax Date: 01/16/2021
Onset Date: 01/23/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies: Keflax Bactrin

Symptoms: Thought by Doctor to be cellulitis but was Covid Arm symptom came on day 7 1/2 after first Moderna vaccine and was a 4 1/2 x 4 inch red itchy hot patch that lasted about a week

Other Meds: None

Current Illness: None

ID: 1059778
Sex: M
Age: 30
State: PA

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Received 0.3 ml of the total 0.5 ml volume due to a syringe malfunction.

Other Meds: None

Current Illness: None

ID: 1059779
Sex: F
Age: 30
State: AK

Vax Date: 02/19/2021
Onset Date: 02/26/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: I live in a rural community and the clinic is closed on Saturday so I left a message for the COVID technician. She won?t be at work until Monday.

Allergies: I had strong allergic reactions to poison Ivy when I was little but haven?t had reactions for a few years so I thought I grew of it as I still spend a lot of time in the o woods in the summer.

Symptoms: Last night my arm started having some separate raised bumps near the injection site. It was warm to the touch but I thought a shower would help it go away. I went to sleep around 10:45 pm it had seemed a little better (not itchy) but when I woke up all the raised dots had become one blob (about 2 inches by 1 and a half inches) and it?s more swollen than it was last night. It is hot to the touch and I feel a little light headed and woozy and my arm is a little sore. I?m not very worried about it- I read online that this reaction has happened to some people about 8 days after their shot and I just wanted to make sure that I reported so that the cdc and the fda or whoever needs it can collect the data.

Other Meds: None consistently but I do take women?s multivitamins when I remember but I don?t think I?ve remembered enough for it to count

Current Illness: Not that I know of

ID: 1059780
Sex: F
Age: 81
State: OH

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: Urine test - Unknown results

Allergies: Multiple Food and medication allergies - could not recall all IVP Dye, Iodine, Cipro, Codiene, "Aide" based meds, many antibiotics, Keflex Eggs

Symptoms: throat began swelling - difficulty talking - difficulty breathing

Other Meds: Many - unable to recall all medds

Current Illness: N/A

ID: 1059781
Sex: M
Age: 68
State: MI

Vax Date: 02/15/2021
Onset Date: 02/23/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Rash, redness, itchy, burning Temporary, vanishes upon application of cortisone gel or time, reappears at a different spots minutes to hours later.

Other Meds: Famotidine 20mg twice daily Lutein 20 mg daily Vitamin D3 5000iu

Current Illness: none

ID: 1059782
Sex: F
Age: 66
State: MD

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds: Prior diagnosis of L ong QT and a fib in 2016. On medications of beta blocker and blood thinners Approximately 45 minutes after receiving second moderna shot experienced tingling in lower lip on face. This was followed by going into a fib

Current Illness: None

ID: 1059783
Sex: M
Age: 67
State: AZ

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

Lab Data:

Allergies: None

Symptoms: Late in the evening on the date of my second shot, I experienced cold chills and unsound sleep overnight. No adverse issues the day after the second shot..

Other Meds: Amlopidine Bessyliate 5mg tabs, 1 tab per day Licinipril HCTZ 20/12.5 mg tabs, 1 tab per day Vitamin D3 2000 UI per day

Current Illness: Benign paroxsyl positional vertigo

ID: 1059784
Sex: F
Age: 51
State: ME

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies: Ranitidine

Symptoms: 24 hours after receiving the vaccine, I woke up feeling tired, with chills, joints, and muscle aches. It started to get better 3 days after, but it didn't go completely back to my normal, and I am already on the 10th day after the vaccine. Today I woke up again with chills, joint, and muscle aches, and I am having cough, sniffle, watery eyes, and sneezing. Since I have asthma and allergies in this period of the year, it wouldn't be a surprise, but the fatigue, chills, feeling sleepy, and body aches, make me wonder if this is still related to the vaccination, or it could be that I was unfortunately infected with COVID roughly at the same time I got the shot? I had to stay for 15 minutes at the vaccine place, there were other people, we were 6 feet apart, but the room was not well ventilated, so who knows.

Other Meds: Levothyroxine, Pristiq, Bupropione, Rozuvastatin, CoQ, Collagen, Probiotics/Vitamins, Lansoprazol, Montelukast, Clonazepam

Current Illness:

ID: 1059785
Sex: F
Age: 50
State: AR

Vax Date: 01/29/2021
Onset Date: 02/20/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: Currently receiving TRT treatments at Chiropractic clinic- started 2/24/2021.

Allergies: none

Symptoms: Sciatic nerve pain, burning, numbness, muscle cramping - started 2/20/21 in lower left back, traveled across left buttocks on 2/22/21, continued to left outer thigh on 2/23/21, continued to left lower leg and foot on 2/24/21. Loss of ability to walk properly due to left leg/foot pain and numbness which resulted in loss of contorl of left leg and foot on 2/24/2021. No prior history of injury or problems of this nature.

Other Meds: none

Current Illness: none

ID: 1059786
Sex: F
Age: 56
State: MN

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/27/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Developed fatigue, cough, and shortness of breath 1 day after 2nd dose of vaccine. Started on antibiotics and steroids empirically prior to admission 02/15. Initial CT with diffuse centri-lobular tree and bud opacities. Infectious (including BAL) and autoimmune work-up without clear explanation for infiltrate. Underwent VATS wedge resection for tissue diagonsis. Post-op developed hypoxia requiring up to 10L O2 and worsening infiltrates on CT in a pattern consistent with organizing pneumonia (possibly drug reaction). Started empirically on steroids for concern for organizing PNA/hypersensitivity pneumonitis. Pathology returned with organizing pneumonia with increased eosinophils. Timing of onset of symptoms is concerning for a hypersensitivity reaction to the COVID vaccine. Symptoms are improving with steroids (started 02/26). Recovery to be determined but I am optimistic for a good recovery.

Other Meds:

Current Illness:

ID: 1059787
Sex: F
Age: 69
State: PA

Vax Date: 02/25/2021
Onset Date:
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Modern a COVID -19 vaccine EUA??(moderna COVID-19EUA)

Other Meds:

Current Illness:

ID: 1059788
Sex: M
Age: 73
State: AL

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: Only vital signs checked, blood pressure and heart rate.

Allergies: azithromycin, lipitor

Symptoms: patient developed bilateral upper extremity flushing as well as facial flushing around 10:26 a.m after receiving the vaccine at 10:11 a.m.. Patient sat and drank a couple bottles of water, patient felt ok, no shortness of breath noted. Patients BP/HR were stable, 142/82, 80. Advised patient to go home after observation and take Benadryl if necessary.

Other Meds: only prescribed medications are acyclovir 400 mg tablet, and xarelto 20 mg tablet

Current Illness: no other illnesses present at time of vaccination or one month prior to vaccination

ID: 1059789
Sex: F
Age: 27
State: FL

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

Lab Data:

Allergies: None

Symptoms: Itchy and swollen eye lids

Other Meds: Birth control, escitalopram

Current Illness: None

ID: 1059790
Sex: F
Age: 82
State: GA

Vax Date: 02/06/2021
Onset Date: 02/26/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: On the advice of the PA I did have a Covid test Friday a week ago which would?ve been the 19th and it was negative. And yesterday the 26 I had regular blood work done at the cardiologist office but not related to this situation

Allergies: Sulfa and statins. Dr. has tested me twice and says I am allergic to something but they do not know what it is.

Symptoms: Chills, fever, headache, body aches, A couple of nosebleeds, and my arm hurt from the injection site down to the end of my fingers. Headache continued for four days and fever would come and go but usually at night. I did not receive treatment but I did let my cardiologist office know what was going on. When I continued with the headache, I contacted the internist?s office and I only had a TelMed visit with them. My nostrils had something like cold sores but then I started sneezing and realize there was infection also. Had a second TelMed visit with the PA who started me on an anabiotic Amoxicillian. The infection is clearing up in my sinuses but I am coughing a lot. Overall continue to feel very tired and weary

Other Meds: Furosemide, Potassium CL ER, Losartan Potassium, Prasugrel, Gabapentin, Repatha SureClick injections, Temazepam, Claratin or Zyrtec, 81 mg aspirin, D-3, C, Magnesium, COQ10, Quercetin with Zinc, and joint complex

Current Illness: Had a sinus infection and possible tracheitis or bronchitis in the fall with a cold sore in my nose. Took an anabiotic and it seem to clear up

ID: 1059791
Sex: F
Age: 44
State: MN

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: within 10 minutes of vqccine patient felt throat tightness and tongue swelling up; given epi pen with some relief

Other Meds: None known

Current Illness: None

ID: 1059792
Sex: F
Age: 55
State: IL

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: The very next day and for the next three days I had over 103 fever bodyaches nauseous fatigue for over a week and the arm I get the shot and did not feel better until a week later.

Other Meds: Eliquis, triamterene,trazodone

Current Illness: Covid long hauler symptoms.. dvt, clots in Rt leg, fatigue headaches taste issues

ID: 1059793
Sex: F
Age: 72
State: IA

Vax Date: 02/18/2021
Onset Date: 02/26/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient had the small rash that occurs with the vaccine the first two days, but it had gotten better. Then yesterday exactly 1 week and one day after administration her site started to itch really badly. She tried benadryl cream and that didn't work. She then called me on Saturday 02/27 and said that the site was red and itchy this morning. There was no soreness, pain, or heat coming from the site. I recommended OTC steroid cream for the itching. Also to try and put a cold compress on it for the redness. It it did turn to hot or painful to go see the urgent care. I am going to follow up on Monday 03/01 to see if she needs to be seen or if it is better.

Other Meds:

Current Illness:

ID: 1059794
Sex: F
Age: 81
State: FL

Vax Date: 02/17/2021
Onset Date: 02/25/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: 8 days later, Nauseated exhaustion, fever99.3 in bed 24 hours, 8 days later rash on both calves, pain in knees

Other Meds: Losartan 100/25, Ca 1000mg/day ,Vit D2000/day

Current Illness: none

ID: 1059795
Sex: F
Age: 80
State:

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Weak; lightheaded; cotton mouth; difficulty breathing; HA. Evaluated by EMS-cleared.

Other Meds:

Current Illness:

ID: 1059796
Sex: F
Age: 55
State: TX

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies: Penicillin Cleocin Tramadol

Symptoms: Fever of 101F started 8 hours after Shringrix. This was my second dose. The 1st dose being 5 months previous. Even with Tylenol fever was 100F. Fever lasted about 8 hours. Injection site was so sore I couldn?t lift up my arm for several days. I used a heating pad at the injection site for several days.

Other Meds: B12 2500mcg Biotin 5000mcg D3 4000IU

Current Illness: None

ID: 1059797
Sex: F
Age: 76
State: AZ

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

Lab Data:

Allergies: Penicillin, Cipro, Antihistamines

Symptoms: Fever, body aches.

Other Meds: Benicar

Current Illness: None

ID: 1059798
Sex: F
Age: 84
State: TX

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: None as haven?t consulted anyone. Thought it was hip replacement ending its life and/or loss of sleep for several nights.

Allergies:

Symptoms: Sharp pains in left hip and down leg?can?t step on left leg, dizziness, fatigue

Other Meds: Levothyroxine, pantoprazole, atorvastatin, oxybutynin,duloxetine (all morning) ; amotriptyline, lisinopril (all at bedtime). OTCs supplements, probiotic, and lactate (noon). Ibuprophen, Salon Plus (lidocaine cream) plus added trazadone

Current Illness: Artificial hips and knee, no thyroid due to cancer, skin cancer, high blood pressure, high cholesterol, arthritis, fibromyalgia, colon resection.

ID: 1059799
Sex: F
Age: 83
State: IL

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: non done yet

Allergies: no known allergy

Symptoms: Patient came to her COVID-19 shot and the student pulled the 0.3ml of her shot from PFIZER vial before its get diluted , so the patient got concentrated vaccine not diluted , patient was ok at the time of administration , at the time we discovered the incident we called the patient and after 2 hours we called her again to check on her and she was fine , the patient was educated about what happen and what she can experience and if she feel any side effect or any difference to head to the ER or call the doctor , patient assured us she will do so and we planed to check on her again after 4 h and after 12 h

Other Meds: losartan , lovastatin , latanoprost

Current Illness: NA

ID: 1059800
Sex: M
Age: 21
State: TX

Vax Date: 02/22/2021
Onset Date: 02/25/2021
Rec V Date: 02/27/2021
Hospital: Y

Lab Data: CBC, CMP, troponin, UDS, Chest Xray, CT scan of chest. EKG

Allergies: Penicillin

Symptoms: Patient developed typical fever, myalgias, body aches in the days after his vaccine. He would describe them as severe. This was followed by chest pains. These chest pains prompted him to seek care in the ER. Upon workup, I found the patient to have developed myocarditis with a significantly elevated troponin prompting hospitalization.

Other Meds: None

Current Illness: None

ID: 1059801
Sex: U
Age: 64
State:

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Tightness in throat, palpations, HA, nausea, cleared by medics

Other Meds:

Current Illness:

ID: 1059802
Sex: F
Age: 71
State: SC

Vax Date: 02/01/2021
Onset Date: 02/24/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: After approximately 5 days of receiving the second Moderna shot, my mom noticed a slight rash and red spot. The spot is better but the rash is now all over her body.

Other Meds: I am filling this out for my Mother, who was the patient with the skin rash all over her body, after receiving the second moderna vaccination. I am unsure of her prescriptions.

Current Illness:

ID: 1059803
Sex: F
Age: 90
State: CT

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: patient received the first dose of moderna on 2/13/2021. States was told to schedule second dose in 2 weeks on 2/27/2021. Patient received dose #2 of moderna early today, 2 weeks ahead of schedule. Patient monitored for 30 minutes, reports feels well. vaccination record completed noting early date of second dose.

Other Meds: unknown

Current Illness: unknown

ID: 1059804
Sex: U
Age: 37
State: MD

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies: Shellfish

Symptoms: SOB

Other Meds: No

Current Illness: None

ID: 1059805
Sex: F
Age: 37
State: NY

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: Serum labs: Will be uploaded MRI brain noncon 2/11/21: Few (3-4) punctate foci of FLAIR signal hyperintensity within subcortical white matter bilaterally, nonspecific and without mass effect. Otherwise normal. LP with normal CSF findings 2/9/11: Tube 1 had 0 RBC and 1 WBC and was colorless, glucose 51 mg/dL, protein 39 mg/dL (normal), Normal meningitis/encephalitis panel, MS oligoclonal banding panel normal, Lyme/NMDA/paraneoplastic pending NASA lean test normal

Allergies: History of abnormal vaccine reaction (e.coli vaccine, age 25, GI pain requiring hospitalization, thought she had Peyer?s patches ) Compazine (dystonia) Long acting benzo made her vomit once, years ago Took ambien in college, this triggered fatigue

Symptoms: Initial imbalance, "floppiness" Persistent fatigue 1 week later, onset of cognitive symptoms and insomnia -difficult time finding things at home, even when right in front of her (visuospatial inattention), misplacing things - missing words and wrong tense when writing, paraphasias, misspellings -trouble following stories communicated to her verbally -trouble understanding sentences she had typed -difficulty expressing her reasoning in document writing while at work -poor concentration Also onset of mild anxiety and fluctuating sadness Intermittent early satiety and lack of appetite Treatment: Melatonin 6mg 3-5hrs before sleep CBD oil 50mg nightly (she had started this before presenting to me on 1/30/21) I started her on gabapentin 300mg, she had some relief of sleep onset insomnia, still had middle-of-night awakenings without return to sleep, so added zaleplon PRN for rescue. Zaleplon insufficient duration so switched to Zolpidem PRN. She has not required more than a few doses of zolpidem but now we have uptitrated her to gabapentin 600mg nightly. She feels significant improvement in her sleep and work product, but continues to have intermittent cognitive errors and some decrease in work performance, that remain concerning to her.

Other Meds: Tylenol 1000mg Ibuprofen 600mg

Current Illness:

ID: 1059806
Sex: F
Age: 81
State: FL

Vax Date: 02/10/2021
Onset Date: 02/18/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: About 12 days after the first dose on Jan. 13, I experienced Vertigo which resolved after 2 days but was left with lingering dizziness for three more days. THEN, after the second doxe on Feb 10, about 12 days later, I once again experienced vertigo which lasted 4 days and experienced dizziness for days afterwards including today as I write this report. The dizziness does decrease daily but is worse in the morning and diminishes as the day proceeds.

Other Meds: Metropolol ER 50 mg, daily, Methemazole 5 mg daily Omega 3 Fish oil, B complex, Potassium, Magnesium, Calcium, Vit. D3, NAC, Milk Thistle,

Current Illness: Vertigo and subsequent , persistent dizzy feeling in my head. Began Around Jan 28 just 15 days after the first dose of the Moderna vaccine and again about 2 weeks after the second dose date noted above.

ID: 1059807
Sex: M
Age: 41
State: MA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Mid-grade fever (topped out at 102 F), severe body aches, joint pain, headache and nausea. Symptoms lasted for roughly 36 hours; they were very intense for the first 24 hours from the time of onset.

Other Meds: none

Current Illness: none

ID: 1059808
Sex: M
Age: 66
State: NY

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: B.P 138/78; SPo2 98; H.R 92

Allergies: NA

Symptoms: Seen by EMS on site for left Hip pain radiating downwards.

Other Meds: Na

Current Illness: NA

ID: 1059809
Sex: F
Age: 19
State:

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Chest heaviness in center of the chest, cant take a deep breath, evaluated by EMS-cleared

Other Meds:

Current Illness:

ID: 1059810
Sex: F
Age: 41
State: OK

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

Lab Data:

Allergies: none

Symptoms: i kept thinking my lip was swollen last night then when i woke up this morning half of my face is not working. classic bells palsy symptoms. called the dr and we are resarching steroids with the vaccine.

Other Meds: metformin, lamictal, lexapro

Current Illness: none

ID: 1059811
Sex: F
Age: 61
State: VA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Fever began at 1:45 am on 2/18/21 - 102.0 for almost 2 days, then down to 101.1, no fever on 2/21/21 Severe vomiting began 2/18 and was continuous for a little over 24 hours, then nauseous beyond that until Sat night 2/20/21 Could not drink fluids or eat for almost 24 hours, then took 1 tablespoon of water every 30 minutes for 5 hours Muscle soreness at site of injection, swollen

Other Meds: multi-vitamin

Current Illness: None

ID: 1059812
Sex: F
Age: 65
State: SC

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

Lab Data: None.

Allergies: Ampicillin broke me out in a rash 15 years ago on my legs several days into taking it.

Symptoms: Moderna COVID -19 Vaccine EULA A little over 7 hours after receiving the shot I saw an aura that lasted about 5 minutes. It only happened one time. I have seen auras twice before - once about 30 years ago and recently this past September. I do not get migraine headaches and did not get a headache after seeing the aura.

Other Meds: multi-vitamin, Occuvite, vitamin D3, extra vitamin C, and Bone Restore Elite with extra Potent Vitamin K2

Current Illness: None

ID: 1059813
Sex: F
Age: 37
State: MO

Vax Date: 02/14/2021
Onset Date: 02/22/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: COVID Arm - warm, red, itchy, splotchy rash with ~3" radius around the injection site.

Other Meds:

Current Illness:

ID: 1059814
Sex: F
Age: 48
State: MD

Vax Date: 02/21/2021
Onset Date: 02/26/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data: none

Allergies: amoxicillin / bactrim

Symptoms: Swollen lymph nodes - one even painful to touch in neck/collarbone area.

Other Meds: multivitamin with iron

Current Illness: none

ID: 1059815
Sex: F
Age:
State: KY

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

Lab Data:

Allergies:

Symptoms: Developed nausea and vomiting after her COVID vaccine earlier today. Associated with chills and tremors. These improved 45 minutes ago. Poor PO intake. No abdominal pain. COVID, flu negative. Mild systemic vaccine reaction. Zofran given and rx. Advised patient to speak with her PCP before considering second COVID vaccine.

Other Meds:

Current Illness:

ID: 1059816
Sex: F
Age: 51
State: TX

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient had immediate swelling to left hand (vaccine received in left arm). Bilateral grip strength equal, pulses equal bilaterally, ROM equal bilaterally. Patient is obese so it was difficult to detect swelling but her spouse stated her left hand "looked a little swollen." She was assessed by paramedics and given Benadryl 25 mg.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm