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: 1061355
Sex: F
Age: 70
State: WA

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

Lab Data: 3 Cat Scans found nothing wrong, many blood test and may various test ekg etc.

Allergies: none

Symptoms: within 1 hour started throwing up, continued for the next 12 hrs. Blood Sugar went to 700 and would not come down with long term and short term insulin. called 911, taken to Hospital ER. on feb. 27 @ 8:00 am Admitted and still is in ICU today 2-28-2021.

Other Meds: lisienpril, hydrochlorthiazide, potassium,

Current Illness: diabetes, high blood pressure, basal ganglia stroke

ID: 1061356
Sex: M
Age: 47
State: NJ

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

Lab Data:

Allergies: Denies/ NKA

Symptoms: 1:54 pm Post vaccination, reports feeling episode of chest tightness w/ no additional or associated symptoms; Monitor x 30 min w/ po hydration; BP 149/95 P123 RR 19 2:05pm BP 112/ 90 P90, reports "feels better and no longer anxious" ;post monitoring released from facility to home w/self

Other Meds: None reported

Current Illness:

ID: 1061357
Sex: F
Age: 82
State: CA

Vax Date: 02/23/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: none

Allergies: Bacitracin Not Specified Rash Neomycin Not Specified rash Neosporin [neomycin-polymyxin] Not Specified Rash. Polymyxin B Not Specified rash Sulfamethoxazole Not Specified 2003-01-13;RASH PER PT

Symptoms: Redness on arm, painful and itching

Other Meds: Prior to Admission Medications Outpatient Home Medications Taking? Alvesco 160 mcg/actuation Inhl HFAA Sig: Inhale 1 Puff by mouth 2 times a day for asthma prevention and control. Rinse mouth well after use Atorvastatin (LIPITOR) 20 mg Ora

Current Illness: no acute illnesses

ID: 1061358
Sex: M
Age: 74
State: HI

Vax Date: 01/25/2021
Onset Date: 02/15/2021
Rec V Date: 02/28/2021
Hospital: Y

Lab Data: 2/25 -2/26/2021: CRP, ECHOCARDIOGRAM, respiratory viral PCR, CBC, CMP, ASO titer, ANA, EKG

Allergies: NKA

Symptoms: Pericarditis with pericardial effusion.

Other Meds: Valsartan, ursadiol, citalopram, Montalukast, ASA, Ativan, tamsulosin, fluticasone

Current Illness:

ID: 1061359
Sex: F
Age: 29
State: VA

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

Lab Data:

Allergies: Peanuts, fish

Symptoms: Onset of soreness around injection site within two hours; lingering soreness remains after ~60 hours; at peak, pain rating 6/10. Onset of general "ill" feeling within 4 hours (mild fatigue and body aches, sensitivity to sound). Physical discomfort increased overnight, reaching peak ~15-20 hours after injection but remaining severe throughout day 2 (unable to perform daily activities). 400mg ibuprofen every 6 hours helped to alleviate symptoms. ~15 hours after injection, sleep was interrupted by severe body aches along with nausea; followed within 30 minutes by vomiting.

Other Meds: Zyrtec, alprazolam 0.25mg, biotin

Current Illness:

ID: 1061360
Sex: F
Age: 49
State: NM

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

Lab Data:

Allergies: sulfa, keflex, shellfish

Symptoms: arm swelling to the point I could not use it. It has now been 29 hours and movement is improving slightly. I went to bed at 630pm (4 hours after injection) and slept all night...woke for 3 hours and slept all day. I've experienced body, joint aches. This was my 1st dose. I'm hoping tomorrow is better. I read that the Moderna dose may be higher than what is needed. I am only 120lbs. I am afraid to get the second dose because I've read the 2nd dose is usually more intense reaction for most people.

Other Meds: none

Current Illness: none

ID: 1061361
Sex: F
Age: 55
State: CA

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: none

Allergies: Celiac

Symptoms: Dizziness

Other Meds: none

Current Illness: none

ID: 1061362
Sex: M
Age: 35
State: TX

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data:

Allergies: Penicillin Cellcept Prograf Red cabbage Grapefruit

Symptoms: Right shoulder pain (where I received the vaccine) Very very tired post 48 hours

Other Meds: Cyclosporine (Kidney/pancreas transplant) Prednisone Carvedilol Lisinopril Flomax

Current Illness:

ID: 1061363
Sex: F
Age: 68
State: NY

Vax Date: 01/21/2021
Onset Date: 01/23/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: rash about the size of a baseball that both itched and was irritated. Nausaus

Other Meds: Hydrochlorothiazide Atorvastin Almodipine Bosylate Ezetimibe Klor-can Estrodial Metoprolol succer Estrodial Medroxyprogesteron Amitripiline iron

Current Illness: non

ID: 1061364
Sex: F
Age: 55
State: MA

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

Lab Data: None

Allergies: CT dye Imodium Codeine

Symptoms: Around 8-9 PM on 2/26 I began to experience tachycardia and could feel my heart racing. I went to bed hoping to sleep, but my sleep was restless. I checked my blood pressure around 3:30 AM on the 27th and it was 124/70 Pulse 113. At that point I decided to wait until the morning to contact my doctor rather than go to the hospital. I got up around 8 AM and my pulse was still fast, but had slowed down from the night before. By around 9:30 AM my heart rate had normalized. I did not go to the hospital or call my doctor as I believed things had subsided.

Other Meds: Atorvastatin 10 mg. Rainbow Light Women?s One Multivitamin Rainbow Light Calcium with Magnesium and Vitamin D3 Everyday Wellness Vitamin D-3 Psyllium Husk 500 mg

Current Illness: None

ID: 1061365
Sex: F
Age: 62
State: AL

Vax Date: 01/29/2021
Onset Date: 02/06/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: None, did not contact doctor.

Allergies: Everything subsided by 02/14/2021 Morphine and Demorol - Rash Cipro - indigestion Spinal nerve block: rash along spine and bad headache; 2nd spinal nerve block - badly swollen left thigh and leg. Antibiotic unknown - shin shed/peeled over entire body including hands and feet

Symptoms: 1st dose. - Moderna - rash around injection occurred 1 week later and progressed down injection side of upper arm including hard lump at injection. Area felt hot. Entire arm ached.

Other Meds: Vitamins daily: D3, B12, E Teas daily: Green, chai, Tumeric, Chamamil Bluegrass Zertec D

Current Illness: None

ID: 1061366
Sex: F
Age: 47
State:

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: none

Allergies: Keflex, nifedipine, penicillin

Symptoms: nausea, vomiting, headache, fatigue

Other Meds: tacrolimus, prednisone, lisinopril, azathioprine, diltiazem

Current Illness: none

ID: 1061367
Sex: F
Age: 71
State: CA

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: None

Allergies: Keflex, yellow jackets venom

Symptoms: Headache, muscle ache, nausea, injection site sore. Lasted 36 hours

Other Meds: None

Current Illness: None

ID: 1061368
Sex: F
Age: 66
State: NJ

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data:

Allergies: Bactrim, tree fruit (apples, peaches, pears, plums, etc.), green peas

Symptoms: Headache began about 5 hours after getting vaccine. Chills, fever ranging from 100 - 102 degrees, terrible body aches and pain, and worsening headache lasted until about 10:00 p.m. the following day and then started to subside. Weak and tired on 2/19. Felt like having Covid all over again only worse because it came on suddenly. (Had Covid in March 2020).

Other Meds: Toprol XL, Folbic, Calcium, Viviscal, Vitamin C, Prolia

Current Illness: Cyst on my finger

ID: 1061369
Sex: F
Age: 28
State: CA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Mild fever, body aches, nausea, sore arm/red splotchiness/puffiness at injection site

Other Meds: Amitriptyline, orthotricylin lo, Claritin, citrucel, omeprazole

Current Illness: N/A

ID: 1061370
Sex: M
Age: 67
State: TX

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

Lab Data:

Allergies: PCN

Symptoms: 1114 C/O SOB 4 MINUTES AFTER RECEIVENG SECOND MODERNA DOSE 1123 98% ROOM AIR 137/74 BP 72 HR PPT C/O SOB 4 MINUTES AFTER RECEIVING SECOND DOSE OF MODERNA VACCINE VITALS STAABLE, OC SAT 98R/A. PATIENT DOES NOT APPEAR TO BE IN DISTRESS. PATIENT GIVEN WATER TO DRINK. WILL CONTINUE TO MONITOR 1127 PATIENT REPORTS HE FEELS BETTER. INSTRUICTED PATIENT TO STAY IN OBSERVATION FOR AT LEAST 30 MINUTES, WILL FOLLOWUP WITH HIM BEFORE LEAVING. PATIEN ADVISED IF CHANGE IN PHYSICAL CONDITION ONCE LEAVING, NOTIFY PCP, IF LIFE THREATENING CALL 911 OR GO TO NEAREST ER

Other Meds: DM, CHOLESTEROL, HIV MEDICACION AND VITAMINS

Current Illness:

ID: 1061371
Sex: F
Age: 68
State: NY

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: sore arm, fever of 102, every muscle ached and it felt like I had been it by a mack truck, and slept most of day

Other Meds: Hydrochloorothiazide Atorvastin Almodipine Bosylate Ezetimibe Klor-can Metoprolol Succer Estrodial Mddroxyprogesteron Amitripiline iron

Current Illness: None

ID: 1061372
Sex: F
Age: 31
State: NC

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

Lab Data: N/A

Allergies: lanolin, cockroaches, pollen, rizitriptan, Beeswax, Diclofenac, Atenolol, Lyrica, fragrance 2, adhesive

Symptoms: At first dizzy. That subsided. Then feeling tired. I got my shot at 11:11am. By 5pm on 2/27, I was feeling malaised and then nauseous. By 8pm, I started having diarrhea, vomited, whole body itching. On 2/28 at 9:06pm, still having whole body itching treated with Benadryl and azelastine spray, running a low-grade fever of 99.8, body aches, occasional sweating, chills, warmth at injection site, knot at injection site, sore arm, fatigue, vomiting. Drinking Gatorade.

Other Meds: bacatracin, Vitamin D3, Magnesium, One a Day Prenatal with DHA, Xyzal, famotidine (missed dose), Florinef, Meloxicam, Azelastine, Montelukast, Clindamyacin swab, Montulukast (Missed dose), Clobetsol solution, Protonix, Santura, Betaxalol,

Current Illness: Minor Respiratory virus 10 days prior

ID: 1061373
Sex: F
Age: 59
State: TX

Vax Date: 01/28/2021
Onset Date: 02/19/2021
Rec V Date: 02/28/2021
Hospital: Y

Lab Data: Multiple tests still pending.

Allergies: NKDA

Symptoms: Patient had gradual onset of urinary retention and a mix of upper/lower motor neuron dysfunction. Currently going under workup for acute demyelinating polyneuropathy. Currently admitted to Medical Center, receiving Solumedrol, undergoing plasma exchange.

Other Meds: Flonase 1 spray into each nostril daily as needed Cetirizine 10 mg 1 tablet by mouth daily Fenofibrate 160 mg 1 tablet by mouth nightly Montelukast 10 mg 1 tablet by mouth daily Aspirin 81 mg 1 tablet by mouth daily Magnesium OTC Probiotic

Current Illness: None

ID: 1061374
Sex: M
Age: 84
State: MA

Vax Date: 02/05/2021
Onset Date: 02/25/2021
Rec V Date: 02/28/2021
Hospital: Y

Lab Data: Given CT scan of brain and MRI of brain to rule out stroke.

Allergies: Cephalexin

Symptoms: Severe Vertigo lasting 12 hours requiring confinement to bed. Called ambulance and taken to Emergency Room. Treated with fluids and meclazine. Vertigo attributed to Vestibular Neuritis/labyrinthitis. This condition is often caused by a virus, however patient did not have any known virus prior to onset of symptoms.

Other Meds: Simvistatin 40 mg and 20 mg Mirtazipine 45 mg Levothyroxine 150 mcg Valsartan and hydrochlorothiazide 80 mg/12.5mg Venlafaxin hcl 25 mg Lamotrigne 100 mg Tamsulosin hcl .4 mg

Current Illness:

ID: 1061375
Sex: F
Age: 67
State: WA

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: N/A

Allergies: Clinoril

Symptoms: I experienced onset of a severe headache and vomiting (x2, small amounts) the day after (2/2/2021)receiving the vaccine at noon-3pm. That evening as the headache resolved, i noticed that the corners of my mouth and the area below my lips were sore and hard to the touch. These are all areas where i had fillers injected in the past (August 11, 2020). Restylane was the filler, i think. The symptoms i experienced felt exactly like when i received the injections in August 2020. The symptoms were gone by the next evening. I called my dermatologist when i saw on the CDC Moderna training site (i'm a Public Health Nurse volunteer vaccinator) that this "rare" side effect should be reported. She refused to file a VAERS report and told me that my symptoms were because i had vomiting and the muscles around my mouth were irritated, and that it was not from inflammation or a side effect of the vaccine.

Other Meds: None

Current Illness: None

ID: 1061376
Sex: F
Age: 25
State: NJ

Vax Date: 02/19/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data:

Allergies: Zithromax Sulfa Bactrim Imatrex Benzoyl peroxide

Symptoms: 1 week and 1 day later it was noted while showering that there was a 2 in red raised mark surrounding the injection site that was itchy. 2 days prior to red mark appearing I was experiencing extreme headaches, fatigue, sore throat, and swollen lymph nodes. At this time on 2/28/2021, I still have the raised red mark on my area but it has lightened and it is still itching. My lymph nodes are still swollen and a headache is still present as well as fatigue but the sore throat has mostly resolved.

Other Meds: Sharobel 0.35mg tablet once daily Propranolol ER 80 mg capsule once daily Topiramate 50 mg tablet twice daily

Current Illness: N/A

ID: 1061377
Sex: F
Age: 51
State: AL

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

Lab Data: ?

Allergies: ?

Symptoms: Patient had a mild reaction to the first injection. There was no apparent distress upon arrival in parking lot. At 15:30 the patient wants to leave and denies complaints with no apparent distress. The patient is instructed to continue medicine if necessary and if conditions worsen go to the ER.

Other Meds: ?

Current Illness: ?

ID: 1061378
Sex: F
Age: 36
State: VA

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: none, PCP recommended reporting symptoms

Allergies: none known

Symptoms: metallic taste in mouth numbness in left side of face, mostly cheek area from approximately 2PM and resolving around 8PM. 400mg Tylenol was taken at 5PM.

Other Meds: VItamin D Vitamin C Zinc

Current Illness: none

ID: 1061379
Sex: F
Age: 79
State: AZ

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data:

Allergies: Iodine

Symptoms: Began running low grade fever next morning, by evening the temp was 100 . I had no energy an began to fall asleep in the early evening.. Woke up in a sweat. Felt exhausted all the next day but temperature left. Should be almost normal by tomorrow. I hope.

Other Meds: Hydroxurea, mesalamin, Irbesartan,carvedilol, Travatan, vitamin, calcium, Vitamin D, Adult 50+ eye vitamin

Current Illness:

ID: 1061380
Sex: F
Age: 76
State: IA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/28/2021
Hospital: Y

Lab Data:

Allergies: ciprofloxacin, hydrocodone, indomethacin, levofloxacin, menthol, methyl salicylate, morphine, plastic tape, penicillin, vancomycin

Symptoms: Received the vaccine & the next day became very weak and ill with throwing up. Her sister came to visit and noticed her right face was drooping & her balance was off so she called ambulance. Subsequently has been hospitalized for a month with a heart failure exacerbation that has led to ICU care, sepsis with Klebsiella pneumonia, acute kidney injury now with long term dialysis, hyponatremia, & elevated liver enzymes

Other Meds: aspirin, atorvastatin, calcium, vit. D, diltiazem, doxycycline hyclate, Jardiance, furosemide, gabapentin, novolog, lantus, levothyroxine, magnesium oxide, potassium chloride, spironolactone, warfarin

Current Illness: Had Covid October 2020 with only symptoms reported being weakness. Had a small stroke with no residual effects at the time, unsure if related to Covid.

ID: 1061381
Sex: F
Age: 17
State: LA

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

Lab Data:

Allergies:

Symptoms: Moderna COVID-19 Vaccine EUA Underage patient was inappropriately vaccinated with Moderna product; no adverse effects

Other Meds:

Current Illness:

ID: 1061382
Sex: F
Age: 41
State: CO

Vax Date: 02/19/2021
Onset Date: 02/25/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Injection site red, swollen, itchy, painful a week after injection.

Other Meds: None

Current Illness: None

ID: 1061383
Sex: F
Age: 65
State: TX

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

Lab Data:

Allergies:

Symptoms: SHE FELT PAIN WHEN THE NEEDLE WAS STUCK IN THE BONE AND FELT NUMBNESS IN HER FINGERS FOR ABOUT 10 MINUTES. BP 169/83 PULSE 76 O2 96% REPEAT BP AFTER 10 MINUTES 144/73 HR 76 O297% PATIENT STAYEDN IN OBSERVATION FOR 30 MINUTES, STATES AFTER 30 MINUTES, NO NUMABNESS NOTED ANYMORE. PT VSS. PT DENIES SOV OR C/P GIVEN INSTRUCTIONS TO NOTIFY PCP IF NUMBNESS RETURNS

Other Meds:

Current Illness:

ID: 1061384
Sex: F
Age: 52
State: NY

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

Lab Data: no

Allergies: NO

Symptoms: This is my 3rd time trying to complete the form. Quick version. 8 hours later I'm experiencing soreness and discomfort in the my left arm. Pain occured when shot was administered. I felt needle moving in mass/muscle. The pain increased the longer the needle was inserted. I actually let out a muffled yell at the same time the nurse removed needle. The pain is a 6/7 on a scale of 10. I cannot lift my arm without experiencing pain. When I walk my left side/shoulder is lowered. The left side feels weighted.

Other Meds: Eye prescription -- Timolol 0.5%

Current Illness: NO

ID: 1061385
Sex: F
Age: 24
State: MD

Vax Date: 02/12/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: NA

Allergies: NA

Symptoms: Serious rash all over body and face ,redness,and bumps No action taken

Other Meds: NA

Current Illness: NA

ID: 1061386
Sex: F
Age: 62
State: PA

Vax Date: 02/08/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: None to date

Allergies:

Symptoms: Itchy red Rash on neck started c. 18 days after 2nd shot (unclear if related to vaccine but highly unusual for me)

Other Meds:

Current Illness:

ID: 1061387
Sex: F
Age: 27
State: NJ

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data:

Allergies: Amoxacilian

Symptoms: Stomach pain. Diarrhea. Headaches. Nausea. Wheezing. Troubling breathing. Mucus. pain in lungs when breathing.

Other Meds: none

Current Illness:

ID: 1061388
Sex: F
Age: 65
State: CA

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Itchy LUE, painful LUE, rash, hardness Lue

Other Meds: Metformin, Effexor, Atoravastin, Vytorin

Current Illness: DM 2, hbp mild, hpercholesterol, depression

ID: 1061389
Sex: F
Age: 79
State: WA

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

Lab Data:

Allergies: Unknown

Symptoms: After patient completed 15 minute waiting period post vaccination, she had almost left the clinic and noted that her nose was "running". She proceeded to have a gushing nosebleed that lasted approximately 1 hour. When we noted that the bleeding was continuing, we called her grandson to pick her up and take her to the ER. Called the ER at 6:15 pm and pt still there being evaluated.

Other Meds: Unknown

Current Illness: Unknown

ID: 1061390
Sex: F
Age: 29
State: NC

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

Lab Data:

Allergies: Hydrocodone

Symptoms: Circular red rash. Grew larger on day 2. Where it is red it is firm and painful to the touch. It is also itchy. Redness appeared below injection site.

Other Meds: Epiduo Forte pump

Current Illness: Nonr

ID: 1061391
Sex: F
Age: 23
State: VA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: N/A

Allergies: N/A

Symptoms: A was given to me. I didn?t show any initial reactions. Then about 24 hours later, I noticed redness around the injection site with extreme soreness and swelling. Is still present and inflamed after 48 hours since injection.

Other Meds: Birth control (Enskyce)

Current Illness: N/A

ID: 1061392
Sex: F
Age: 85
State: TX

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: None

Allergies: NKDA

Symptoms: Rash that began not quite 24 hours after injection; rash began on torso, chest and spread to back and later legs. Rash still present on day 5 post injection. Dr. suggested Benadryl and have been keeping up with Benadryl at least 2-3 x/day. Rash may be easing up now.

Other Meds: Bisoprolol 10mg, Furosemide 40mg, Nifedipine XL 30mg, ASA 81mg, Klor-Con 10mEq 2x/day, Ferrous Sulfate 325 mg x2, Levothyroxine 50mcg, Pravastatin 20mg, Kisqali, Letrozole 2.5mg, Multivitamin

Current Illness: Metastatic Breast Cancer

ID: 1061393
Sex: F
Age: 65
State: TN

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

Lab Data: none

Allergies: Sulfa, Amoxicillin, Wine, Seafood/Shellfish, Bees

Symptoms: On 02/27/2021, Patient received dose #1 of Moderna COVID vaccine at 12:00 p.m. at COVID Vaccine POD. Prior to vaccination, the pt. reported a history of anaphylaxis to shellfish and is prescribed an EPI Pen, she was instructed to wait 30 minutes after vaccination for monitoring. At 12:11, patient reported feeling anxious, tingling lips, and numbness around her mouth to nursing staff. On assessment, BP 150/80, resp. 20. Patient then reported her tongue was getting "thick". Staff continued to monitor symptoms, patient stated symptoms were not improving and her tongue continued to be getting "thick" At 12:15, EPI pen auto injector was administered in patient's right vastus lateralis. 12:27 EMS arrived, patient was assessed, symptoms had resolved, and she refused to be transported to the ER. Follow up instructions were given by EMS and patient was cleared to go home accompanied by her husband.

Other Meds: unknown

Current Illness: unknown

ID: 1061394
Sex: F
Age: 77
State: NM

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

Lab Data: None

Allergies: Sulfa drugs, tape

Symptoms: Severe side effects including chills, fever, headache, fatigue, diarrhea, loss of appetite, runny nose

Other Meds: Levothroxine, furosermide, amlopodine, atorovastin, hydrochlorithyazide,

Current Illness: Upper Respiratory infection

ID: 1061395
Sex: F
Age: 65
State: TX

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

Lab Data:

Allergies:

Symptoms: PATIENT FELT PAIN WHEN THE NEEDLE WAS STUCK IN THE BONE. SHE FELT THE NEEDLE WENT INT THE BONE AND FELT A LITTLE NUMBNESS IN HER FINGERS FOR ABOUT 10 MINUTES. BP 169/83 HR 76 O2 96% REPEAT BLOOD PRESSURE AFTER 10 MINUTES 144/73, HR 76 O2 97%. PATIENT STAYED IN OBSERVATION FOR 30 MINUTES , STATES AFTER 30 MINUTES NO NUMBNESS NOTED. PATIENT DENIES SOB AND CP. PATIENT GIVEN INSTRUCTIONS TO NOTIFY PCP IF NUMBNESS RETURNS

Other Meds:

Current Illness:

ID: 1061396
Sex: F
Age: 52
State: CA

Vax Date: 02/18/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data:

Allergies: Iodine

Symptoms: Large raised rash on arm near injection site.

Other Meds: Vyvanse 50mg

Current Illness: No e

ID: 1061397
Sex: M
Age: 74
State: TX

Vax Date: 02/20/2021
Onset Date: 02/24/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: No tests performed.

Allergies: Possibly bee stings.

Symptoms: Lymphadenopathy . A swelling at the intersection of the upper lip and the groove up to my nose. And rigidity of my nose. Minor pain at the injection site 3 or so hours after, continuing 36 hours until fading away.

Other Meds: Lisinopril 5 mg, 81 mg aspirin, Simvastatin 10 mg, multivitamin.

Current Illness: None

ID: 1061398
Sex: M
Age: 56
State: OH

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

Lab Data: none

Allergies: none

Symptoms: Swollen and sore Lymph node under right armpit. Lasted all day.

Other Meds: Synthroid, Gabapentin, Lisinopril, Simvastatin, Omeprazole, Meloxicam, Citalopram, Colchicine, Magnesium, Viyamin D

Current Illness: none

ID: 1061399
Sex: M
Age: 86
State: IL

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

Lab Data:

Allergies: None

Symptoms: Fever of 101

Other Meds: Lisinopril Simvastatin Finesteride

Current Illness: None

ID: 1061400
Sex: F
Age: 35
State: OH

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data:

Allergies: NA

Symptoms: Headache, chills, low grade fever, muscle aches, injection site pain, lymph node pain

Other Meds: Junel, singular, Flonase, colace, align

Current Illness: NA

ID: 1061401
Sex: F
Age: 80
State: CA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Irregular heartbeat for approximately 5-8 minutes. Light-headed during this time. Resolved on its own eventually.

Other Meds: multi-vitamins

Current Illness: kidney stone

ID: 1061402
Sex: F
Age: 51
State: CA

Vax Date: 02/18/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data: N/!

Allergies: Red swollen area where injection was given. Area has grown to be about 4 inches by 5 inches. It is itchy and warm. Asthma flare up. Treating symptoms with Benadryl, QVAR, and Albuterol. Confusion and forgetfulness are an issue as well, as is elevated blood pressure.

Symptoms: Hot, red, itchy 4 inch by 5 inch spot on left arm at the injection site, Asthma flare up and raised blood pressure concurring with rash.

Other Meds: Moderna Covid-10 Vaccine

Current Illness:

ID: 1061403
Sex: M
Age: 58
State: PA

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA. Muscle pain, joint pain, lymph node pain, fever, profuse sweating. Duration: 40 hrs.

Other Meds:

Current Illness:

ID: 1061404
Sex: M
Age: 62
State: WI

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

Lab Data:

Allergies: none

Symptoms: shot at 10:45am, firedness by 2pm naps 2:15 to 5:30 and 9pm-11:15 pm Sat and most of the day Sunday (two 2hr Upright & Mobile periods for food), Headache starting 3pm Saturday and continuous through form submission 8:45 pm Sunday; especially painful at awakening Sunday morning. Treated with Acetamenophin and sleep. Outcome will undubtedly be fine but I am in the midst of symptoms now.

Other Meds: Amlodipine

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm