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: 1063521
Sex: F
Age: 27
State: VA

Vax Date: 12/30/2020
Onset Date: 01/04/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: Covid (results positive) Strep(results negative), Flu vaccine(results negative)

Allergies: Voltaren

Symptoms: I was diagnosed with Covid still exp residual symptoms .

Other Meds: Sperintal?, Womens Multi Vit,Probiotics

Current Illness: No

Date Died: 02/27/2021

ID: 1063522
Sex: M
Age: 71
State: MI

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: 1. 2/24/2021 at 18:35 ? 12-Lead EKG ? Paramedics 2. 2/24/2021 at 18:30 ? Vital Signs ? Paramedics 3. 2/24/2021 at 13:06 ? Vital Signs ? Paramedics 4. 2/24/2021 at 13:11 ? 12-Lead EKG ? Paramedics 5. 2/24/2021 at 13:06 ? Glucose Check ? Paramedics 6. 2/27/2021 at 01:32 ? Cardiac Arrest Protocol - Paramedics

Allergies: 1. Entresto

Symptoms: 1. Fatigue ? day 1 - Tuesday 2. Loss of appetite ? day 1 Tuesday 3. Fever 102.0 ? day 2 - Wednesday 4. Chills ? day 2 - - Wednesday 5. Weak ? day 2 - - Wednesday 6. Non-ambulatory (unusual) ? day 2 - - Wednesday 7. Two emergency service ambulance assessment ? day 2 - - Wednesday 8. Symptoms improved ? day 3 - Thursday 9. Ambulatory - day 3 - Thursday 10. Symptoms worsened ? day 4 - Friday 11. Chills ? day 4 - Friday 12. Non-ambulatory again ? day 4 - Friday 13. Fever 102.0 ? day 4 - Friday 14. Left side flank pain ? day 4 - Friday 15. CPR and declared decease at home by paramedics - day 5 - Saturday morning @ 1:32am

Other Meds: 1. Xarelto 20mg 2. Digoxin 125mcg 3. Aterbastatin 10mg 4. Escitalopram 10mg 5. Lopressor 50mg 6. Spironolactone 25mg 7. Lasix 20mg 8. Gabapentin 200mg 9. Diazepam 5mg 10. Lisinopril 2.5mg 11. Tylenol 800mg 12. Breoellieta 200/25 13. Spiriva

Current Illness: No new or acute illnesses reported within the last month

ID: 1063523
Sex: M
Age: 68
State: FL

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 2nd vaccine received on 2/22/2021, started feeling Atrial fibrulation on 2/23/2011 pulse 122-138. Normally is 56-70. Contacted cardiologist and he suggested to take double dose of Metoprolol. After several hrs heart went back to normal. Then on 2/27/2021 all the flu symptoms occured: fewer (101.5), chills, muscle and joint aches. Today is 3/1/2021, it looks like its better but not completely.

Other Meds: Eliquis 5mg Flecainide 100mg Metropolol 25 mg

Current Illness:

ID: 1063524
Sex: M
Age: 79
State: NC

Vax Date: 01/19/2021
Onset Date: 02/21/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: Aspirin

Symptoms: Red spots with what looks almost like scab in center Started about a week after 2nd injection, itched for several days...Now just there, but no itching

Other Meds: Lisinopril, Warfarin, Metformin, Diltiazem, Omeprasole

Current Illness: None

ID: 1063525
Sex: F
Age: 74
State: UT

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/01/2021
Hospital: Y

Lab Data: Typical signs and sxs Echo with characteristic findings which are acute trop 16 down trending cxr with pulmonary edema

Allergies: ACE inhibitors, amoxicillin, atorvastatin, codeine, losartan, nitrofurantoin, PCN, pravastatin, prochlorperazine, sulfa, verapamil

Symptoms: Takotsubo Cardiomyopathy, Acute Pulmonary Edema, Hospital Admission, Diuresis.

Other Meds: aspirin 81 mg oral delayed release tablet 81 mg = 1 tabs, Oral, Daily BD Ultra-Fine Pen Needle Nano 32G 4 mm (5/32 inch) 1 EA, PRN, N/A, As Directed Dexilant 60 mg oral delayed release capsule 1 cap, Oral, every morning doxazosin 2 mg or

Current Illness: CAD, lymphedema, OSA, DM2, HLD, obesity

ID: 1063526
Sex: F
Age: 50
State: TN

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: So far, I have not had medical tests or seen a doctor. I called for their advice and followed their directions by taking the Benadryl.

Allergies: Naproxen, cats, any plant with the word "white" in it, grasses, mold, mildew

Symptoms: The morning after the injection, I woke up with a horrible rash on the bottom part of both legs (knees down). The rash got worse throughout the day and started on my chest that evening. By the end of the night (the day after injection), my tongue and airway appeared to be swollen and I had trouble taking full breaths. I started taking 2 Benadryl every 4 hours. I took that dosage for the next 2 days. The breathing got better, but the rash is still present (as of day 5 after injection).

Other Meds: Biest, Tesosterone, Progesterone, Meloxicam, Welbutrin, Benazepril, Synthroid, Tizanidine, coconut oil, multivitamin, Biotin, Vitamin D, Vitamin E, multi-collagen protein, Benadryl, allergy shots

Current Illness: none

ID: 1063527
Sex: M
Age: 65
State: OH

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Hives and swelling of front, side and back of neck, severe itching, rash across shoulder and collar bone. Saw doctor 2/11 and received steroids for 5 days. Swelling and itching reduced then flared back up. Returned to the doctor.

Other Meds: Simvastatin,L-Thyroxine

Current Illness: None

ID: 1063528
Sex: F
Age: 38
State: NC

Vax Date: 02/15/2021
Onset Date: 02/20/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: Covid-19: negative

Allergies: Benadryll

Symptoms: Daily headaches with only 2 episodes of nausea. Ibuprofen and Tylenol altered but ibuprofen helps the most . Headaches keep coming back. Stronger headaches started on day 5 and I'm now at day 14 post 2nd moderna vaccine. Increased water intake significantly with no ease of headaches.

Other Meds: Ibuprofen and tylenol

Current Illness: None

ID: 1063529
Sex: F
Age: 71
State: OH

Vax Date: 02/11/2021
Onset Date: 02/19/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: UNKNOWN.

Allergies: PENICILLIN, CODEINE, SULFA, VARIOUS FOOD SUBSTANCES

Symptoms: CELLULITIS DEVELOPED 8 DAYS POST VACCINATION. PATIENT WAS PRESCRIBED ZITHROMAX Z-PAK AND ATARAX WITH NO SUCCESS. PATIENT WENT TO ER 16 DAYS POST VACCINATION AND WAS GIVEN 4 DOSES OF KEFLEX.

Other Meds: ROSUVASTATIN 5MG, CYANOCOLBALAMIN 1000MCG INJECTION, IPRATROPIUM 0.3% NASAL SPRAY

Current Illness: UNKNOWN

ID: 1063530
Sex: F
Age: 80
State: TX

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: N/A

Allergies: NO

Symptoms: Patient was dizzy and warm 15 minutes after receiving vaccines. EMS was called was examined and was told to go home with observation from family.

Other Meds: No

Current Illness: NOT KNOWN

ID: 1063531
Sex: M
Age: 47
State:

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

Lab Data:

Allergies:

Symptoms: Pt developed syncope and LOC for ~ 3 min. VS WNL when monitored.No other adverse reaction noted.

Other Meds:

Current Illness:

ID: 1063532
Sex: F
Age: 56
State: NY

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

Lab Data: NA

Allergies:

Symptoms: Patient received a dose of Moderna vaccine when she was fully vaccinated with Pfizer. She answered the following question with with the answer no. Have you received a vaccine in the last two weeks? This was a deceptive response There was no physical manifestation of issues/side effects. .

Other Meds:

Current Illness:

ID: 1063533
Sex: F
Age: 52
State: WI

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

Lab Data:

Allergies: NKDA

Symptoms: Menvo administer in error

Other Meds:

Current Illness:

ID: 1063534
Sex: F
Age: 77
State: MI

Vax Date: 02/15/2021
Onset Date: 02/17/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: none

Allergies: Codeine ; Penicillins

Symptoms: Entire body ache ; Lethargic The first day. Severe rash below shot. About 2x2 inch area My Dr. prescribed steroid and moisturizer unless you have other solution

Other Meds: Amlodipine 5mg , Zolpidem 5mg, Multivitamin

Current Illness: common cold; fiver blister

ID: 1063535
Sex: F
Age: 27
State: TX

Vax Date: 12/29/2020
Onset Date: 01/05/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: Allergy to Latex and Juniper

Symptoms: The injection site was red and swollen and hard and the skin felt rough. It was also hot to touch. I also felt tired and sluggish for the few days surrounding the event. Nurse Practitioner thought the vaccine reacted with an existing Tatoo( 2 years) at the injection site. Antibiotic prescribed and Ibuprophen for the swelling. Only one day of minor flu like symptoms after second vaccine. recweived01/26/2021

Other Meds: Daily Sertraline 15 mg Daily Vitamin Womens Peppermint supplement

Current Illness:

ID: 1063536
Sex: M
Age: 68
State: CA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 1246: After receiving Covid vaccine, pt stood to leave after 15 mins and felt "disoriented" 1248: BP 128/77 HR 77 SpO2 96% 1250: Water given 1254: Stood up again, feeling better 1255: Walked home

Other Meds:

Current Illness:

ID: 1063537
Sex: F
Age: 71
State: AZ

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: amoxicillan

Symptoms: black and blue bruising about three inches below injection site. Arm is blotchy, red and feels warm

Other Meds: carbidopa25/levodopa100, 6 pills daily lovastatin 20 mg 1 pill daily methimazole 5mg i pill daily risedronate sodium 35 mg one pill weekly

Current Illness: none

ID: 1063538
Sex: M
Age: 81
State: MN

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 03/01/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Patient developed significant nose bleed after receiving vaccine. Required emergency department visits x2 and hospitalization.

Other Meds:

Current Illness:

ID: 1063539
Sex: M
Age: 17
State: CA

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

Lab Data:

Allergies:

Symptoms: Patient was 17 years old at the time of vaccination. Moderna's vaccine is for patients 18 and older. On 2/25/21 patient came back for second dose. The error was caught at that time. The patient received a second dose of Moderna, consistent with the CDC recommendation.

Other Meds:

Current Illness:

ID: 1063540
Sex: M
Age: 52
State: TX

Vax Date: 12/16/2020
Onset Date: 01/02/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None

Allergies: NKDA NKFA

Symptoms: Consumer reports that 2 weeks following 1st vaccine, he began to experience post nasal drip, sneezing, cough, runny nose. These symptoms are still persistent and he believes might be vaccine related.

Other Meds: None

Current Illness: None

ID: 1063541
Sex: F
Age: 44
State: NC

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: EKG CBC Comprehensive metabolic panel I-stat beta hCG blood, ED urinalysis, Routine w reflex microscopic

Allergies: Suspected Sulfa allergy: rash Allergy to fibers in elastic: Rash/swelling

Symptoms: Sat 5pm eyeballs began to hurt. The entire eyeball was painfully sore. At night I woke up with tongue that felt thick or swollen. Then the next am woke up with aches, headache, chills, hot (suspected fever but did not get up and check) tiredness. Spit up yellow fluid (thought it might be from GERD) and laided around all day. Did not eat as stomach felt nauseated. At 3 pm I ate half a sandwich and at 4 ate half a banana and drank some water and 1/4 of cup of sweet tea. By 6pm I was really sick to my stomach got up and threw up sandwich and banana. I thought I saw some blood but was not sure. I continued to throw up and it became all blood (bright red) mixed with water. This occured twice and then I called doctors office and the dr on call advised me to go to ER since urgent cares were closed. I went to ER about 8:30pm with continued headache, nausea, lightheadedness. I tried to tell ER dr that I was there mainly for throwing up blood. I sat in waiting room. ER dr saw me at 3am and gave me Zofran for nausea as i thought I was going to be sick and gave me EKG, Blood panel and Blood Pressure readings. Told me I was mildly dehydrated. My BP was higher than I think I have ever seen it.

Other Meds: none

Current Illness: none

ID: 1063542
Sex: F
Age: 3
State: AK

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: No Known Allergies

Symptoms: I recorded the Vaccines and was rushing, I had seen the Number 2 on the expiration date of the Dtap and it did not register to me that it was expired earlier this month I had thought it would be the end of the month, After admistering the vaccine I tried to record it but realized it was expired, I went out to the waiting room and explained to Mom I had given patient and expired vaccine, I spoke with our pharmacist to see how soon I can give another Dtap vaccine he explained right away but our clinic was out of stock, I spoke with Mom and she is ok with coming back in for an up to date vaccine of Dtap for her Child

Other Meds: None

Current Illness: No Illnesses no other vaccines

ID: 1063543
Sex: F
Age: 45
State: MD

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

Lab Data: no

Allergies: no

Symptoms: pt stated about 15 minutes after receiving the covid vax that she started having a itchy face and scalp. Pt stated the itching spread all over her entire body. Also her left arm is sore from her elbow up to shoulder. She was checked by a doctor at the vaccine location and monitored for an hour. She was instructed to take Benadryl when she got home which she did but states she is still itchy. She says the itchiness comes and goes in different spots.

Other Meds:

Current Illness: no

ID: 1063544
Sex: F
Age: 49
State: MN

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Fever 103.0 F, Chills, Muscle Pain, Headache, Night Sweats, Dizziness/near-syncope, tachycardia (120's bpm), nausea, severe fatigue, severe soreness at injection site (but mild swelling, mild itching). Starting from 3:30 am on 02/21/21 until about 3 pm on 02/22/21. Milder headache and fatigue throughout rest of that week. Back to normal now.

Other Meds: none

Current Illness: none

ID: 1063545
Sex: F
Age: 76
State: TN

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: none

Allergies: Sulfa meds.

Symptoms: Pt c/o throat swelling.

Other Meds: Omeprazole 40mg 1 po bid; Amlodipine 10mg 1 po QD; Furosemide 40mg 1 po QD; Meloxicam 15mg 1 po QD; Levothyroxine 88mcg 1 po QD; Crestor 10 mg 1 po QD; Alendronate 70mg per week; Albuterol HFA 90 mcg prn wheezing; ASA 81 mg 1 po QD; Calci

Current Illness: None

ID: 1063546
Sex: F
Age: 65
State: MO

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: RASH ON NECK, CHEST, ARMS. RX: VISTARIL & PEPCID PO.

Other Meds:

Current Illness:

ID: 1063547
Sex: F
Age: 67
State: VA

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

Lab Data: None

Allergies: Keflex, ChloraPrep, Tetanus shots, Clindamycin, Cipro, Flagyl, Levequin, Azithromycin, mango, nickel, bee stings, cats, some cleaning products and perfumes

Symptoms: About six hours after the injection I experienced discomfort in my throat, mild swelling in both hands and face, some tingling in face, and head ache.I took Zyrtec 10 mg, Pepcid AC 20mg. Then I started to have tightness in my chest and used my albuterol inhaler. I was still having symptoms an hour later so took Benadryl 25 mg. During the night I woke up with mild wheezing and used my inhaler again. Throughout the next 2 days, I continued to have these symptoms (except for wheezing) off and on. Today, I still have some symptoms but not as often or severe.

Other Meds: Zyrtec, benedryl, pepcid AC, albuterol inhaler

Current Illness: Abscessed tooth extracted one week prior

ID: 1063548
Sex: F
Age: 34
State: WA

Vax Date: 02/20/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Swollen and itchy arm at the injection site

Other Meds: None

Current Illness: None

ID: 1063549
Sex: F
Age: 82
State: FL

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

Lab Data:

Allergies: Morphine, Levaquin, Vitamin K

Symptoms: Client proceeded to an upstairs restroom post-vaccination, rather than to observation area. Upon exiting rest room, client experienced weakness, mild light-headedness with elevated BP of 203/98. She was evaluated by paramedics on site who recommended further evaluation. Client declined stating she felt better and would take her medication when she arrived home. RN encouraged her to call her physician when she got home. A friend drove her home . A follow-up call was made at 1:46 p.m. by reporting RN. Client stated she took medication, was resting and BP was 168/70, and she was planning to call her doctor. She felt the episode was due to the exertion of going directly upstairs to the rest room, rather than sitting down in observation area.

Other Meds: Unknown - client stated on blood pressure medication

Current Illness: Unnown

ID: 1063550
Sex: M
Age: 46
State: OK

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt reports that vaccinator put the needle into his shoulder. He felt a lot of pressure and has had continuous joint pain and can't life his harm since injection. He has tried ice, heat, and IBU without relief. He is now seeking care and we will be referring him to orthopedic services.

Other Meds:

Current Illness:

ID: 1063551
Sex: F
Age: 53
State: GA

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

Lab Data: None

Allergies: mold; trees; dogs, cats

Symptoms: Red rash, hives, around neck and upper chest

Other Meds: phentermine; multi-vitamins

Current Illness: None

ID: 1063552
Sex: F
Age: 67
State: GA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None

Allergies: Prednisone

Symptoms: February 27: fatigue, headache,stiff arm, soreness at injection site, fever 99.9 degrees, lasted all day. February 28: severe diarrhea, projectile vomiting shortly after eating breakfast, fatigue all day. March 1: nausea, fatigue, stomach cramps, lightheadedness throughout the day, intermittent headaches.

Other Meds: Oxybutynin, ferrous sulfate, low dose aspirin, lisinopril, multivitamin, melatonin

Current Illness: None

ID: 1063553
Sex: F
Age: 45
State: VA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: ECG 12 lead - result normal (2/11) Basic Metabolic Panel (2/11) CBC and differential (2/11) GFR (2/11) UA Reflex to Micro-Reflex to Culture (2/11) Urine HCG, POC/Qualitative (2/11) At home BP monitoring with Omron upper arm cuff blood pressure monitor (2/11-3/1)

Allergies: none known

Symptoms: Very high Blood Pressure that was fluctuating but not lowering for several hours. Sent to ER after 1.5 hours at the clinic. No treatment given at ER, Bloodwork, urine, and ECG all normal with no indication of any type of organ damage resulting from uncontrolled High Blood Pressure. Sent home after 3 hours with blood pressure of 179/95 and pulse rate of 104 with recommendation to monitor blood pressure and follow up with primary care. By Feb 13 blood pressure became normal and has stayed in the normal range.

Other Meds: Levothroid

Current Illness: none

ID: 1063554
Sex: M
Age: 33
State: NJ

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 103 fever, chills, aches, headache, fatigue

Other Meds:

Current Illness:

ID: 1063555
Sex: F
Age: 33
State: CT

Vax Date: 02/05/2021
Onset Date: 02/09/2021
Rec V Date: 03/01/2021
Hospital: Y

Lab Data:

Allergies: Meperidine - anaphylaxis Bactrim - hives

Symptoms: 2/5- administered 2nd Moderna vaccine dose. 2/6-chills, body aches and pains, arm pain and welt, alternated Tylenol and Motrin q4 around the clock. 2/7-2/8 rested and was off of work (no symptoms- felt fine) 2/9- returned to work, passed safepass and while on zoom call at 9am developed wheezing and cough and slight low grade temp (99.5). Took symbicort (I have normally well controlled asthma). Called clinic and was advised that I was fine and could continue to work and to follow up with MD if symptoms got worse. Did virtual visit with Pulmonologist at 0945 and he advised me to get COVID swabbed and prescribed prednisone taper and albuterol MDI. COVID swabbed 2/9 at 5pm. Out of work 2/10 & 2/11 awaiting test results. Returned to work 2/12 after negative COVID result- passed safepass- worked, still SOB, but manageable. 2/13-2/14 had increasing SOB- albuterol MDI 6x/day. Monday 2/15 returned to work- saw doctor in person- increased prednisone from 20mg (tapered down) to 40mg (original dose) and added Spiriva. 2/17- Went to ED for status asthmaticus after using albuterol MDI 5-6x/day without any relief. Admitted 2/17 for asthma exacerbation- discharged 2/20. Discharged home with nebulized albuterol, prednisone slow taper, symbicort, Spiriva, Singulair & Claritin. 2/23-2/24 Albuterol nebs 5x/day, still SOB. Pulmonary visit 2/24 - added inhaled budesonide nebs. Out of work 2/25-2/26. Returned to work 3/1- finally feeling better!

Other Meds:

Current Illness:

ID: 1063556
Sex: M
Age: 67
State: NC

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

Lab Data: EKG- 2nd Degree block with PACs. BP: 127/65 Blood Glucose: 90 after juice

Allergies: NKA

Symptoms: Patient got up from the seat where he received his vaccine and was walking to the back to be seated and monitored. He past out once he got to the back. He hit the right side of his head. As he came too he reported mild nausea. He denied any pain or vision changes. He then reported a history of diabetes. He stated he had dialysis this morning and took insulin prior to coming to vaccine clinic but did not eat anything. He took a few sips of juice. He was diaphoretic and clammy. Pulse was 46, SPO2 was 96%. He had a mild audible murmur. Lung sounds: wheezing and crackles. There was a small area of swelling noted to the right side of his head. EMS was called for transport due to hitting his head and history of taking blood thinners.

Other Meds: Insulin-Diabetes Hypertension- Pt unsure of name of medication Plavix

Current Illness:

ID: 1063557
Sex: F
Age: 49
State: VA

Vax Date: 02/25/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: Developed a rash on the skin of the left arm early Saturday morning and doctor prescribed prednisone and benadryl for six days.

Other Meds: Lisinopril, insulin, atvorstatin, Tylenol

Current Illness: Diabetes

ID: 1063558
Sex: M
Age: 18
State: MN

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: Currently at ER. On IV fluids.

Allergies: Zithromax, Rocephyn,

Symptoms: On the 7th day of nausea, vomiting, diarrhea, headache, sore throat

Other Meds: None

Current Illness: None

ID: 1063559
Sex: F
Age: 79
State: MA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None, to date.

Allergies: Penicillin, cephalyxins, darvon, environmental allergies and one time reaction to chemicals in moisturizer causing swelling and redness of face

Symptoms: Moderna Covid 19 Vaccine EUA. Bright red arm below site of shot; 3/4 of way around arm; approximately 2? wide. Has increased in size over 3 day period since receiving vaccine

Other Meds: Statin, calcium, vitamin D, Magnesium

Current Illness: Mild heart valve disease

ID: 1063560
Sex: M
Age: 59
State: NJ

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: penicillin

Symptoms: Headache, sleepy, fever, chills.

Other Meds: none

Current Illness: none

Date Died: 02/07/2021

ID: 1063561
Sex: F
Age: 92
State: IL

Vax Date: 01/07/2021
Onset Date: 02/07/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: Lisinopril

Symptoms: Patient was a Resident on our LTC wing. Per the LTC Manager: Resident had hx of CVA with deficits in speech and extremities. Hx of decreased circulation to BLE's which resulted in wounds to bilateral feet on and off that needed treatment. Average meal consumption 25-50% of meals, started refusing more often in December and January. Would consume small amounts 60-120mL of fluids here or there. Vaccinated on 1/7/21. Stopped eating 1/18/21. Attempted bolus NS fluid 1/25/21. Resident refused all treatment afterwards. Went hospice on 2/3/21 and passed away on 2/7/21.

Other Meds:

Current Illness: Resident had hx of CVA with deficits in speech and extremities. Hx of decreased circulation to BLE's which resulted in wounds to bilateral feet on and off that needed treatment. Decreased oral Intake. Average meal consumption 25-50% of meals, started refusing more often in December and January. Would consume small amounts 60-120mL of fluids here or there.

ID: 1063562
Sex: F
Age: 79
State: AL

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: No

Allergies: bactrim topical benadryl (never taken oral benadryl) neosporin

Symptoms: When I started to get ready for bed I was overcome with fatigue, and I went to sleep and I woke up two hours later with terrible pain in my muscles and joints, and the injection site was sore. I woke up two other times throughout the night. I was weak, and yesterday the pain was somewhat lessened, but I had an intermittent mild head ache throughout the day, and I went to bed early last night. This morning the ache was still a little achy and tired, but that had cleared up by noon.

Other Meds: levothyroxine 100 mcg diltiazine 120 mg daily latanoprost solution .005 % eye drops atorvastatin 10 mg dijoxin 125 mcg daily warfarin 5mg taken as instructed by coumadin clinic instructs vitamin d3 1000 IU centrum silver tums calciu

Current Illness: no

ID: 1063563
Sex: M
Age: 41
State: SC

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient stated that the day after receiving the Moderna vaccine he started having issues with his vision and issues seeing color. Patient also states he felt like his body was locking up and aching all over. Pt started having rash on his arm today (4 days post injection).

Other Meds:

Current Illness:

ID: 1063564
Sex: F
Age: 80
State: OH

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: Extreme headache lasting 36 hours. Chills intermittent 36 hours. Fever between 101-102.2 lasting 48 hours. Unable to be reduced taking Tylenol

Other Meds: Budesonide Paxil 10 mg Trazadone 25mg

Current Illness: None

ID: 1063565
Sex: M
Age: 48
State: CA

Vax Date: 02/14/2021
Onset Date: 02/18/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: I had an X-ray to see if I had an abscess in the shoulder.

Allergies: Strawberries, some shellfish

Symptoms: My arm was sore for 3 days as though I had been punched really hard. After that my deltoid became incredibly irritated and I started having stabbing, excruciating pain in my should any time it moved. This lasted until I went in to get a shot of local anaesthetic from my doctor on 2/25/21. I was taking advil, tylenol, a muscle relaxer, lydecane cream and then I got the shot of anaesthetic. I slowly had a little bit of improvement in mobility. 13 days after my vaccine, I was no longer experiencing shooting pain in my shoulder. It is now March 1st and I think I have regained about 70% of my mobility in that arm. I believe that the shot made my deltoid flex and freak out and this ended up causing bicep tendinitis. This is also my doctor's theory.

Other Meds: Flovent

Current Illness:

ID: 1063566
Sex: F
Age: 69
State: CA

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

Lab Data: None; have not consulted doctor: can't afford the time off of work

Allergies: None

Symptoms: Tolerable dizziness for @ 15 mins immediately following injection. Within 30 minutes of injection: Excrutiating headache for 30 hours following the injection. Within minutes of injection: swelling at injection site 5"x5", 2'3" high (looked like a tennis ball sliced in half mounted on my arm) & redness and feverish heat at the injection site. 4 DAYS LATER: injection site still red, hot, swollen and now extremely painful with any use of upper arm

Other Meds: Losartan, Low-dose Bayer, Lano? (eye drops for glaucoma treatment), Wixela inhaler

Current Illness: None

ID: 1063567
Sex: F
Age: 25
State: MA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: severe injection site pain in left arm. Started about 6 hours after the injection and lasted for approximately 36 hours. Burning and throbbing sensation in top of arm at injection site, could not lift or move arm without severe pain, severe pain also with touch or simple tasks like putting on a jacket.

Other Meds: Lexapro, Lo Loestrin Fe

Current Illness: none

ID: 1063568
Sex: F
Age: 73
State: TN

Vax Date: 02/22/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None to date. Have called doctors office to schedule a visit. Was advised to complete a VAERS and see if other steps are necessary

Allergies: Latex allergy,

Symptoms: While working only an hour at my normal job not doing anything unusual or extraordinary, it became increasingly difficult to breathe. Chest felt very heavy and I became lethargic, not able to take a deep breath. Left work and became a couch potato the rest of the day and evening. Today symptoms about the same. Breathing still a problem and although it does not feel good, I am forcing myself to take an occastional deep breath. Did not report to work.

Other Meds: Eliquis 5mg, two times daily

Current Illness: None.

ID: 1063569
Sex: F
Age: 17
State: VA

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

Lab Data: n/a

Allergies:

Symptoms: Administration error- Moderna not licensed for age 17

Other Meds:

Current Illness:

ID: 1063570
Sex: F
Age: 43
State:

Vax Date: 02/05/2021
Onset Date: 02/13/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Moderna COVID-19 Vaccine EUA Hard , reddened area at injection site. Sore to touch. Fever Muscle aches Headaches Chills Fatigue All lasted 2 days

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm