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: 1065677
Sex: F
Age: 67
State: AZ

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

Lab Data: BP 188/89; wt 44 kg; MRI identified acute L thalamic infarct; CTA confirmed intracranial stenosis

Allergies: none

Symptoms: UNKNOWN COVID VACCINE BRAND. 67 y.o. female presenting to the emergency department with a chief complaint of right sided numbness onset 2000 last night. Patient received her first dose of the COVID-19 vaccine at 1200 yesterday. She states she was feeling okay prior to 2000. Patient states she then developed numbness to the right side of her head, right arm, and right leg. She called EMS and was evaluated at her home. Patient was hypertensive at the time but was told she did not need to come to the ED. Afterward she took a Benadryl and went to bed. She states the benadryl just made her sleepy but did not improve her numbness. This morning she woke up still feeling numb and called her PCP. The RN she spoke to recommended she come to the ED. She is dizzy but she states this is normal per her baseline. States HTN previously resolved.

Other Meds: amitriptyline, gabapentin, progesterone, hctz

Current Illness:

ID: 1065679
Sex: F
Age: 73
State: TX

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

Lab Data: no testing was performed as the patient reports that she has no side effects now. She phoned her PCP, which in turn asked her to advise us of this "reaction"

Allergies: none

Symptoms: Patient reports that she experienced cramping in all of her extremities, paralysis in her right arm, she slept and took naproxen, tramadol and gabapentin, she felt better the next day after sleeping on and off all weekend. No other side effects, and all has cleared up to date.

Other Meds: none to our knowledge

Current Illness: unknown

ID: 1065680
Sex: M
Age: 31
State: NJ

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

Lab Data:

Allergies: None

Symptoms: 3 days after receiving the vaccine I started to see an aura and then once the aura went away I had a severe ocular migraine. This is the first ocular migraine/aura that I've ever experienced in my life. I don't know if it was vaccine related, but I don't know of any other triggers. I was not under stress, my eating habits were typical, and I exercise every morning. I woke up the next day and still have the migraine. I've never had a migraine that lasted this long.

Other Meds: None

Current Illness: None

ID: 1065681
Sex: F
Age: 67
State: MD

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

Lab Data:

Allergies:

Symptoms: Per the EUA, any adverse event or vaccine administration error is to be reported: Syringe hub broke during Pfizer Covid vaccination of patient. Medication splashed out of broken hub. Attempted to conatct Pfizer and CDC and were on hold for 90 minutes without response. ID doctor was consulted and was advised to give another dose of vaccine per CDC guidelines. Vaccine was administered

Other Meds:

Current Illness:

ID: 1065682
Sex: F
Age: 54
State: MO

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

Lab Data:

Allergies: Ancef, Percocet, Lisinopril, Shrimp

Symptoms: at 1550 BP was 144/81, O2 sat 94%. C/O lightheadedness, nausea and sever headache. Denies weakness, no facial droop noted and no dysphasia noted. at 1600 BP 138/91, Pulse 91, R is 6, O2 92%. Denies lightheadedness or nausea. unstable when trying to stand. At 1620 sitting BP=156/92, Pulse 90 and R were 16/min. Reported mild lightheadedness. Leaning way back in chair and closing her eyes whenever she sits down. patient stating that she was okay to leave on her own. Denies that she has someone to help her to get home. Asking this RN to call her PCP. This RN overheard her speaking to her PCP's office and staff member stating that he was gone for the day and that he would want her to be evaluated in the ED.

Other Meds: Lasix, Klorcon, Benafeloxican, Vitamin D, Baby ASA

Current Illness: N/A

ID: 1065683
Sex: M
Age: 74
State: DE

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

Lab Data: None to date

Allergies:

Symptoms: Headache, Fatigue and Fever - for 36 Hours. IMPORTANT NOTE: After the Fever and headache left, I had (And continue to have) swelling in my lymph node under the left arm - where I had the shot. At first it was painful but after several days, the pain subsided but I can feel a little pain ehen I touch the area.

Other Meds: Vitamin D, Curcumin, Vitamin B12, MCT Powder, Vitamin C, Magnesium, Elderberry

Current Illness: None

ID: 1065684
Sex: F
Age: 76
State: MA

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

Lab Data: 2/24/2021 skin allergic reaction test by dr

Allergies: bee sting

Symptoms: hives developing over several days lasting 3 weeks. Identified as 'strong immune reaction' as opposed to allergic reaction by Dr.

Other Meds: eliquis, Metropolol, vitamin d, Calcium, b12, glucosamine

Current Illness: none

ID: 1065685
Sex: F
Age: 74
State: NY

Vax Date: 02/17/2021
Onset Date: 02/22/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: NA

Allergies: naprosyn celebrex eggplant

Symptoms: Circular red rash at vaccination site; it has been extremely itchy. It began to fade after about day 10 post vaccine. It is still fading on day 14 but is still itchy. i' putting lidocane lotion on it at night.

Other Meds: aspirin 325 mg atorovastatin 20 mg esoprazole magnesium 40 mg montelukast 10 mg methylphenidate 10 mg

Current Illness: NA

ID: 1065687
Sex: F
Age: 60
State: IN

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: 1.29.21 HAD AN EKG, BLOOD WORK IN THE EMERGANCY ROOM DUE TO I WAS CLAIMY FOR FAST HEART BEAT. THEY GAVE ME IV FLUIDS TO FLUSH MY BODY.

Allergies: ASPIRNE, CODEINE, SULFER

Symptoms: SHORTNESS OF BREATH 1.29.21 TO CURRENT AND HAS NOT STOPPED, EXTREMLY TIRED FOR 7 DAY, FAST HEART BEAT. DIZZINESS FOR APPROX 4 DAYS, HEADACHE FOR APPROX 4 DAYS

Other Meds: OMEPRAZOLE DR 20 MG CAP 1 A DAY, ADVAIR 250-50 DISK BLISTER WITH DEVICE 1 PUFF 2 A DAY, ALLOPURINOL 300 MG TAB 1 TIMEAT BED TIME, HYDRALAZINE 50 MG TAB 2 TAB TWICE A DAY, MOMETASONE FUROATE 50 MCG SPRAY 1 SPRAY TWICE A DAY, CHLORTHALIDONE 5

Current Illness: HBP, GOUTE, LOW POTASSIUM, ACID REFLUX, ALLERGIES AND ASTHMA

ID: 1065688
Sex: F
Age: 26
State: MN

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

Lab Data: None

Allergies: Bees

Symptoms: Chest/ throat tightness, dizziness, Nausea no vomiting

Other Meds: Lexapro 20mg qd Metformin ER 1500mg qd Multi Vit

Current Illness:

ID: 1065689
Sex: M
Age: 82
State: FL

Vax Date: 02/05/2021
Onset Date: 02/22/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: Neosporin, Polysporin, amoxycillin-type medication

Symptoms: Chills, nausea, slight dizziness

Other Meds: Synthroid

Current Illness:

ID: 1065690
Sex: F
Age: 40
State: VA

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

Lab Data: Pt states "none"

Allergies: Pt states "none"

Symptoms: Pt states "I received my second covid vaccine 01/21/2021 at 2:30pm and approx 2 hours after the vaccine, I began to have a fatigue, fever and I started chilling. When I got home around 4:30pm, my temp was approx 99.8. Day 3,4, and 5 after vaccine my temperature stayed around 102. I took tylenol around the clock. I had severe fatigue, fever up to 102.9, chills, headache, nausea, and diarrhea. On day 4 I began to have severe stomach cramps. I could barely walk myself to the bathroom. I went 01/27/2021 and received 1 bag of IV fluids."

Other Meds: Pt states "I take Zanaflex 4mg 1x/day"

Current Illness: Pt states "none."

ID: 1065691
Sex: M
Age: 73
State: TX

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

Lab Data: None

Allergies: Statins

Symptoms: Moderate chills and fever occurred approximately 18 hours after second dose. Fever was as high as 101.4. The event lasted approximately 30 hours. By late Saturday night and into early Sunday morning the chills stopped and fever returned to 98.2. Have had no additional issues after the time line listed above.

Other Meds: Allopurinol 400mg tab, Aspirin 81mg Tab, Clopidogrel Bisulfate 75mg Tab, Ezetimibe 10mg Tab, Lisinopril 20mg Tab 2x day, Omeprazole 20mg Cap, Potassium CR 20 MEQ Tbrc, Rosuvastatin Calcium 5mg 2X a week, Spironolactone 25mg, Tadalafil 6mg 3

Current Illness: None

ID: 1065692
Sex: F
Age: 70
State: IN

Vax Date: 02/17/2021
Onset Date: 02/26/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: penicillin, sulfa

Symptoms: Sore arm for 4 days at injection site initially after injection. 9-13 days after vaccination, I developed itching, mild warmth, bumps, and now red patch at injection site. It has coincided with a runny nose. My arm is very uncomfortable. My continuation page isn't working. Additional medicines for #9: desvenlafaxine, folic acid, ezetimibe, bentyl, CO Q-10, vitamin D, fish oil, tizanidine HCL, benadryl, Tylenol

Other Meds: Rosuvastatin, clonazepam, esomeprazole, metoprolol, losartan,

Current Illness: none

ID: 1065693
Sex: F
Age: 88
State: MI

Vax Date: 02/23/2021
Onset Date: 02/25/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: none

Allergies: codeine, penicillin

Symptoms: 2 days after shot work up with red arm and spread in to near elbow, itchy and warm - continue to wash with soap and water, use of triamcinolone to area

Other Meds: Lipitor, Cardizem, Plavix, Toprol, isosorbide, clarinex,

Current Illness: none

ID: 1065694
Sex: F
Age: 66
State: IN

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

Lab Data: None

Allergies: None

Symptoms: Patient reported "something stuck in her throat" that began 7 minutes ago. She denied any swelling of the tongue, trouble swallowing, trouble breathing, or trouble speaking. Pt did not have any other generalized symptoms (no skin sx, no GI sx). Pt states she does not have any allergies and has never had a vaccine reaction before. We monitored her for an additional 15 minutes. Her sister was accompanying her so Benadryl was recommended. Pt was calm and after 30 minutes, her symptoms had not progressed at all, however they were still present. Again, counseled on the use of Benadryl and recommended that if symptoms worsened, to call 911 or go to the closest ER. Pt in agreement.

Other Meds: Unknown

Current Illness: Unknown

ID: 1065695
Sex: F
Age: 55
State: GA

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

Lab Data: none. I often have hives with my allergy reactions so I just continued taking my hydroxizine HCL.

Allergies: pine pollen, ragweed, mold, grasses, quinoa, stevia, penicillin, tetanus (shot)

Symptoms: Hives that started when I woke up one day after shot. Started as bullseye type hives about 2 inches in diameter on my knees and thighs, and one on my eyelid. Hives spread out and started to join together into generalized swelling over 75% of my body. Started on legs, moved to arms, hands, neck, face, mouth, and back, in that order. Lots of heat, redness, and mild itching.

Other Meds: Hydroxizine HCL, flonase

Current Illness: none

ID: 1065696
Sex: F
Age: 70
State: NY

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

Lab Data: None

Allergies: Bactrim

Symptoms: Large; painful; raised; warm; hard; reddened area extending down to elbow of her upper arm; with 1 1/2 blister formed. Given Tylenol PO and ice packs to area to reduce pain and swelling.

Other Meds: Baclofen; Clonazepam; Cymbalta; Tamsulosin; Furosemide; Metoprolol, Lisinopril; Vitamin D; B12; Multivite; Iron Sulfate; baby Aspirin

Current Illness: Multiple Sclerosis; Cardiac disease

ID: 1065697
Sex: M
Age: 69
State: OH

Vax Date: 02/12/2021
Onset Date: 02/19/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data: 2/22/2021 total CK = 9372 2/19/2021 AST = 455; ALT= 293 2/19/2021 sCr = 8.45

Allergies: NKDA

Symptoms: 2/19/2021- PCP visit for 1-week history of constipation, malaise and bilateral leg weakness . Abnormal sCr and LFTs AKI: likely ATN from rhabdomyolysis. Requiring HD 2/23/2021 initial hemodialysis 2/23/2021 kidney biopsy 3/1/2021 second hemodialysis

Other Meds: Crestor 40 mg daily, aspirin 81 mg every other day, Metformin 1000 mg daily, Naproxen 500 mg daily

Current Illness: none

ID: 1065698
Sex: F
Age: 61
State: CA

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

Lab Data: N/A

Allergies: Lactose intolerant

Symptoms: 99 degree fever and headache began 8 hours after injection and continued until 20 hours after injection when fever increased to 101. Fever peaked at 102 approx 30 hours post injection. Also, extreme headache, fatigue, muscle aches, chills began around 15 hours post injection. All symptoms ended 36 hours post injection.

Other Meds: Synthroid, atorvastatin, 81 aspirin, vitamin D, biotin, vitamin c, lyseine, black currant oil

Current Illness: None

ID: 1065699
Sex: F
Age: 62
State: MO

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

Lab Data:

Allergies:

Symptoms: at 1000 BP 125/87, P=92, R=16. Reports burning of her entire tongue and scratchiness at the back of her trhoat. Denies SOB or selling of tongue or throat. At 1010 denies that her S and S are worse. Instructed patient on the need to F/U with her PCP as needed.

Other Meds: Metformin, Metoprolol, Isosorbide, simvastatin, HCTZ, (cont'd)

Current Illness:

ID: 1065701
Sex: M
Age: 58
State: NE

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

Lab Data:

Allergies: none

Symptoms: chills body aches head aches

Other Meds: none

Current Illness: nonenone

ID: 1065702
Sex: M
Age: 82
State: MD

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Presented to the emergency department on 2/28/21 with exertional shortness of breath and upper abdominal discomfort for the past 2 days. Patient was admitted to the hospital, and pulmonary edema was contributed to right-sided heart failure from his mild COPD and suspected underlying interstitial lung disease. Per the EUA, hospitalizations are to be reported irrespective of attribution to vaccine. This hospitalization does not appear to be related to the vaccine.

Other Meds:

Current Illness: Recently admitted to the hospital with hypotension and non-ST elevation MI (1/12 - 1/13)

ID: 1065703
Sex: F
Age: 34
State: KY

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

Lab Data:

Allergies: none

Symptoms: Miscarriage at approximately 7 weeks pregnant

Other Meds: fluoxetine, pre-natal vitamins

Current Illness: none

ID: 1065704
Sex: F
Age: 46
State: CA

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

Lab Data: Virtual visit with my orthopaedic doctor, treatment with baclofen, IBU and heat.

Allergies: environmental allergies

Symptoms: Known AE's in literature, however I wanted to report- Intercostal pain- severe. My entire rib cage, inside and out were on a complete flare that I have never felt before. It was hard to breath, not shallow or during extent of deep breath, but in between the two. I was getting false chest pains as the intercostal pain over the chest would flare. This was constant pain that started within 12 hours of the dose. It resolved to about 90% by day 20, however I still have lingering intercostal pain. This may be a flare of my lyme reacting to the vaccine. It is still worth it to get dose 2, but I am not looking forward to the AE's.

Other Meds: amlodypine, disulfiram, baclofen, , xanax,b12, d3/k2, NAC, multi-vit, zinc, C, alka seltzer gold, H2 elite, phosphatidylchloline, fish oil, oregano oil

Current Illness: Lyme disease- currently treating with Disulfiram and the supplements noted above

ID: 1065705
Sex: F
Age: 57
State: MA

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

Lab Data: No test..

Allergies: Sulfa

Symptoms: 11:00pm when I was asleep I awoke to horrible shaking, chill and could not get warm. I do not know if I was delirious but when I got up for the extra blankets, I could hardly walk. I then got the electronic thermometer, and it read that my body temp was 80 and my surface temp was 101.1. I took a horse size Tylenol. Did not sleep much, when I woke up I had this horrible headache and a fever of 100. Sleep all day on Sunday, Feb28. Still feverish and very fatigued. Monday March 1, still, achy and foggy feeling and took a nap mid day.

Other Meds: Hydrochlorothiazide, Carvedilol, simivastatin, irbesartan and levothyroxine

Current Illness: no

ID: 1065706
Sex: F
Age: 60
State: IL

Vax Date: 02/17/2021
Onset Date: 02/19/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data: MRI brain, 02/19/21

Allergies: Hydrocodone

Symptoms: Acute CVA with Multiple small Infarcts to left Pariaetal and occipitral area Admitted to Medical Center Admit 02/19/2021, DC 02/22/2021

Other Meds: Amlodapine, Olmesartan, Spiriva, advair, albuterol, Lorazapam,

Current Illness:

ID: 1065707
Sex: F
Age: 76
State: WV

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: NO

Allergies: Brosefin, hydrolsine, sulfa

Symptoms: Tiredness that night and the next morning i felt like i had not slept and continued over 5 days. i was so sleepy. legs were very shaky and i was very nervous inside. I had shortness of breath and i still have it. I road a bike 4 to 6 miles every day and now i cant. i had chills and body pain, i feel like i had the flu. dizziness, just just random spouts of sleepiness and it would last for about an 1 hr and half. My muscle in my chest just tightens and is hard as a rock. and then it goes away.

Other Meds: vitamin D3, zinc, Eliquis, prevised, low presser, Tylenol, or ibuprofen PRN

Current Illness:

ID: 1065708
Sex: F
Age: 81
State: ND

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: Penecillin and latex, milk intolerance

Symptoms: Received vaccine on 2/23. On 2/24 arm became swollen and red and spread beyond injection site to approx 4 inches in diameter. There was slight itching, and pain. On 2/28 became nauseated in shower and felt extreme weakness requiring assistance to get to bed to lie down. Thought she would pass out. Lasted 3 hours and then was recovered.

Other Meds: Warfarin, Levothyroxine, Nifedipine, Asmanex inhaler, citalopram, trospium chloridine, Bayer Aspirin 81 mg, Vit D, Vit E, Vit B, Vit C

Current Illness: no

ID: 1065709
Sex: F
Age: 65
State: CO

Vax Date: 02/26/2021
Onset Date: 02/28/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: Codeine

Symptoms: 2-3 days after 2nd vaccine I noticed a large olive-sized lump in my neck, left side, next to the collar bone. My 2nd vaccine was given on 2/26/21 in my left arm. Lump is swollen and painful

Other Meds: Hizentra, Lisinopril, HCTZ,

Current Illness: None

ID: 1065711
Sex: F
Age: 31
State: MO

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

Lab Data:

Allergies: none

Symptoms: Diarrhea and upset stomach (started 2 days after the vaccine, still ongoing 4 days post vaccine. Treating with rehydration and pepto) Headache (started 1 day after the vaccine, still ongoing 4 days post vaccine. Treating with ibuprofen and rest.) Fatigue (started 1 day after the vaccine, still ongoing 4 days post vaccine)

Other Meds: zoloft, loratadine, sudafed

Current Illness: cold/pink eye

Date Died:

ID: 1065712
Sex: M
Age: 78
State: PR

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

Lab Data: A copy of the medical record and lab tests from the hospital was requested.

Allergies:

Symptoms: Patient started feeling weak, stomach pain, neck pain, respiratory problems, confusion, low blood pressure which led to death on February 21, 2021, 7 days after the vaccine was given.

Other Meds:

Current Illness:

ID: 1065713
Sex: F
Age: 34
State: OH

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

Lab Data:

Allergies: Shellfish

Symptoms: 1st shot: Dizzy within 10 mins, and fatigue set in within 2 hours. Body aches, chills, and sore arm occurred at 7pm. Headache lasted for one week along with fatigue and anxiety. Nausea and stomach issues occurred 2 days within the shot. Body aches lasted for four days. 2nd shot: Extreme fatigue set in within two hours. Followed by dizziness and a headache. Hunger and body aches. Anxiety with depression. All lasted for 7 days, slowly going away day by day.

Other Meds: Pepcid and baby aspirin

Current Illness: none

ID: 1065714
Sex: F
Age: 77
State: MA

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

Lab Data:

Allergies: Mushroom allergies

Symptoms: Red tender rash 3X 3 inches at site of vaccination. over two days.

Other Meds: Eye drops Ofloxacin, Ketorolac IC Prednisolone After Cataract Surgery

Current Illness: Cataract surgery

ID: 1065715
Sex: F
Age: 64
State: IN

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

Lab Data:

Allergies: no

Symptoms: upon receiving the vaccination I had a stinging pain and I bleed down my arm. The administer wiped it with a cotton ball. The person who administered the vaccine did not pull out or start over again. I believe she hit a vein. Now i have a scar on my arm. it is still painful and since it may not have been on a muscle I am not even sure I am vaccinated.

Other Meds: organic plant calcium, moringa ,omega D3,colon probiotics, digestive probiotics.

Current Illness: no

ID: 1065716
Sex: F
Age: 73
State: TN

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

Lab Data: None

Allergies: None

Symptoms: Patient describes as light pink spot 2 1/2 inches by 1 1/2 inches. No pain nor itching.

Other Meds: Alka-Seltzer; Excedrin Extra Strength

Current Illness: None

ID: 1065717
Sex: F
Age: 79
State: MN

Vax Date: 02/23/2021
Onset Date: 02/27/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: Amoxicillin Keflex [cephalexin]

Symptoms: Injection site redness, swelling, and warmth

Other Meds: calcium carbonate-vitamin D 600-400 MG-UNIT tablet fluticasone propionate (FLONASE) 50 MCG/ACT nasal solution loratadine (CLARITIN) 10 MG tablet Multiple Vitamins-Minerals (MULTIVITAMIN OR) simvastatin (ZOCOR) 20 MG tablet

Current Illness:

ID: 1065718
Sex: M
Age: 72
State:

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

Lab Data:

Allergies: Compizine

Symptoms: Muscle aches arm, legs Headaches, chills Glands in neck (left side) swollen, continues to enlarge and is sensitive to touch.

Other Meds: Xarelto, Ramipril, Rosuvastin, Amlodipine Besylate, metoprolol succinct, Latanoprost, lexapro CoQ10, Vit D3, B complex, Zinc, melatonin

Current Illness: Prostate cancer Afib High blood pressure (controlled)

Date Died: 02/22/2021

ID: 1065719
Sex: M
Age: 84
State: OH

Vax Date: 02/18/2021
Onset Date: 02/22/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: My grandpa got his second covid vaccine on Thursday. Saturday he complained of stiff neck. Sunday he had low grade fever, nausea and vomiting, chills, and mild headache. He was feeling bad enough to call squad at 3 pm. The paramedics did evaluation and thought he was just experiencing normal side effects from vaccine and felt no need to transport to hospital so my grandpa decided to stay home and just rest. At 2 am that same night he went into cardiac arrest and was not able to be brought back

Other Meds: simvastatin carvedilol glipizide pantoprazole

Current Illness:

ID: 1065721
Sex: F
Age: 69
State: NY

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

Lab Data: None

Allergies: None

Symptoms: Woke up (6a) with head ache, body aches, loss of appetite, fuzzy thinking, raised hard area at injection site - 5in long, 3in wide - slept most of day. Symptoms mostly gone by 3/2 7am, with exception of raised area at injection site and mild fuzzy thinking. Took two tylenol for headache 6p

Other Meds: Vit E, B12, Cranberry, Glucosamine/Chondroitin, Omega 3, Wellness (zinc), Probiotic

Current Illness: UTI 1wk prior

ID: 1065722
Sex: F
Age: 68
State: GA

Vax Date: 02/05/2021
Onset Date: 02/20/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: PCN, Brilinta

Symptoms: Numbness in perioral region - predominantly from frenelum to bottom of inside of upper lip, both sides of lip (interior of mouth) and inside lower lip. Circumfrential numbness and tingling, affects taste. Taste and smell remain intact. No obvious edema noted to outer lips.

Other Meds: Xarelto 20mg, Diltiazem 120mg, ASA 81mg, levothyroxine 88mcg,

Current Illness: None

ID: 1065723
Sex: F
Age: 41
State: CA

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: MRI-negative Lab work for peripheral neuropathy: all negative except for a slightly elevated vitamin B6

Allergies: None

Symptoms: Parasthesias/Peripheral Nueropathy throughout body

Other Meds: Zyrtec, Pepcid, postnatal vitamin

Current Illness: On and off itching without a rash, no known reason

ID: 1065724
Sex: F
Age: 73
State:

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

Lab Data:

Allergies: Anaphylaxis to shellfish and saltwater fish, sea salt, parsley, and parsnips.

Symptoms: Throat swelling, which developed gradually by the evening on the day patient received Pfizer 1 injection COVID 19 vaccine on Feb25. Patient did not report reaction until appointment today March 2. Patient reported slight improvement, but still had hoarseness and dyspnea during phone interview. Prescribed Medrol DosePak.

Other Meds:

Current Illness: CVID on IVIG

ID: 1065725
Sex: F
Age: 26
State: OR

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

Lab Data:

Allergies: King oyster mushrooms, KY jelly

Symptoms: Unable to sleep the night after receiving vaccine (unusual), soreness in arm, skin sensitive and sore all over (clothes causing discomfort), fever of 100.2 upon waking, severe headache, cramping in lower back and legs, extreme fatigue

Other Meds: women's vitamin

Current Illness: No

ID: 1065726
Sex: M
Age: 39
State: UT

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

Lab Data:

Allergies: None

Symptoms: Injection arm very sore. Started three to four hours after injection. Hard to move arm. It is now 20 hours after injection and arm is still very stiff and sore. Still have trouble lifting arm above shoulder height due to soreness.

Other Meds: Insulin (humalog), Simvastatin, Levothyroxine

Current Illness: None

ID: 1065727
Sex: F
Age: 76
State: NY

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

Lab Data:

Allergies:

Symptoms: . Following Covid-19 vaccine, patient complained of rapid heart rate @ 16:15. Vital signs were taken at 16:16: o2 Sat: 99%, Pulse: 76, BP: 200/99. Patient stated that she did not drink enough because she had a long commute home, and did not want to use the bathroom. RN recommended the patient to drink water, and handed her a bottle of water, which she drank completely. Vital signs were retaken at 16:21: o2 Sat: 100%, HR: 70, BP: 192/91. Patient was advised that she will be taken to the ER for continuous monitoring, but the patient insisted to decline, and stated that she did not want to go to the ER.

Other Meds:

Current Illness:

ID: 1065728
Sex: F
Age: 71
State: OH

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

Lab Data: 2/24/2021 - Dilated eye exam and eye pressure check (pressure was normal)

Allergies: Lamotrigine, (anaphylactic reaction to Augmentin), Lisinopril, Crestor, Lipitor, Recliast, Pletal, Gastrographin, Protonix, Rice, Shrimp, Mustard, Spinach, beats, Chocolate, dust, grass, weeds, trees,

Symptoms: About 1 hour and 15 minutes after receiving the vaccine I became dizzy. 3 1/5 hours later I developed chills which lastly briefly. The next day I had huge area on my left eye on my pupil which lasted for 5 days. I have blue eyes and right at toward the end of the blue I have white deposits. On 2/24/2021 I went see an eye doctor Dr. He diagnosed me with "whiss" ring around both of my eyes, and seen spot on my lenses on my left eye. I started starburst with my left eye, this did not develop until after I received the vaccine. I have a dot on my right eye now. On 02/26/2021 see another eye doctor Dr., he also said I have deposits around my cornea, acknowledged the starburst effect on the left eye, and noticed the "whiss" ring. Since I took the vaccine my eyes have become very light sensitive. The doctors have told me this conditions are permanent, if it gets worse they will have to scrape the eye and have a laser surgery. I do not remember when it started but it 2inches by 3 inches, red patch which started at the injection site and went diagonal.

Other Meds: Montelukast 10 MG daily, Losartan 100 MG daily, Metformin HCL 500 MG twice a day, Pentoxifylline ER 400 twice a day, Pravastatin 10 MG daily, Levocetirizine 10 MG daily, Calcium 315 MG 1.5 tablets, Vitamin D 625 MCG 1.5 tablets daily, Mult

Current Illness:

ID: 1065729
Sex: F
Age: 60
State: MI

Vax Date: 02/17/2021
Onset Date: 02/27/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Unknown as her care was local

Allergies: sufa drugs cause nausea

Symptoms: She received Moderna COVID-19 vaccine 2/17/21 and developed symptoms of left ear discomfort followed by left sided facial and eye droop on 2/27/21. She was seen by MD on 2/27/21 and was confirmed to have Bell's Palsy. She was given prednisone with taper and valacyclovir for 7 days. Also advised to wear an eye patch.

Other Meds: envarsus 2mg daily, cellcept 500mg q12 hrs, flonase 50mcg spray (2 sprays in each nostril daily), omeprazole 20mg daily, zoloft 100mg daily, gabapentin 300mg TID prn, metformin 1000mg in am and 500mg in pm, vit D3 2000IU daily, docusate 100

Current Illness: none

ID: 1065730
Sex: F
Age: 48
State: MD

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

Lab Data:

Allergies: Previous allergic reaction to Pfizer COVID vaccine on 2/5/21, including shortness of breath requiring transfer to emergency department; allergic reaction to Herceptin for cancer treatments

Symptoms: 253p 154/99, 139 HR, 24 RR, 100% O2 ? dizziness, itching on arms and face, R arm numbness ? gave diphenhydramine elixir 25 mg x1 307p 120 HR, trouble with BP cuff 313p R arm numbness, legs heavy, face and mouth tingling ? gave diphenhydramine elixir 25 mg x1 315p 142/89, 110 HR ? legs ?wonky?, R arm numbness remains, itching improving 330p symptoms significantly improved, ?feeling better?; family member with patient and able to drive patient at home and continue observation Telephone follow-up performed at 430p. No problems.

Other Meds: Premedicated with diphenhydramine (25mg) and prednisone (150mg) per discussion with PCP

Current Illness: None

ID: 1065731
Sex: F
Age: 62
State: KY

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

Lab Data: None

Allergies: Peanut - oral sensitivity Raspberries - oral sensitivity Hydrogen peroxide - skin History of allergies to: dust, feathers, mold, but no testing in 30 years.

Symptoms: 03/01/2021 -Delayed cutaneous hypersensitivity (COVID Arm) itching and rash appeared approximately 11:30am. The rash corresponds to the injection site and measures +/- 3.5?x2.5?. Itching began subsiding after approximately 3 hours. 03/01/2021 - Redness is still present but is somewhat faded and ?mottled? in appearance. The diameter has not reduced however.. No treatment. I am continuing to monitor it

Other Meds: Atenolol - 25 mg/day Aspirin - 81 mg /day C 1000/day Calcium 600/day D 125/day Fish Oil 200/day

Current Illness: Oral Herpes Simplex outbreak Nothing else

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm