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: 1069311
Sex: F
Age: 56
State: OK

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

Lab Data: was just told it was a side effect from the shot

Allergies: NO

Symptoms: completely covered with hives and still getting worse.

Other Meds: SIMVASTAIN 40 MG,OLMESARTAN MEDOXOMILL 20 MG, MELOICAM 7.5MG.PHENTERMINE 37 MG,IBUPROFEN 800MG

Current Illness: tested positive for covid-19 on January 14,2021

ID: 1069312
Sex: F
Age: 90
State: MI

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

Lab Data:

Allergies:

Symptoms: The patient reported redness going down her left arm, about a foot in length. It was itchy as well. It has gone down from the initial time, but it is still visible. Patient says it is not bothersome

Other Meds:

Current Illness:

ID: 1069313
Sex: F
Age: 50
State: MN

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: About 2 days after my injection, the pain at the injection site has subsided, but my entire left shoulder became stiff and sore. My range of motion has been affected, and simple tasks like putting on a jacket have become painful. Prior to my vaccine, I did not have this issue.

Other Meds: Iron, vitamin d, prozac

Current Illness: None

ID: 1069314
Sex: F
Age: 59
State: KY

Vax Date: 01/20/2021
Onset Date: 02/10/2021
Rec V Date: 03/03/2021
Hospital: Y

Lab Data:

Allergies: Benadryl, Celebrex, Cymbalta, Lyrica, Risperidone, Vioxx

Symptoms: Tested positive for COVID19 12/01/2020 both vaccinations received and pt has now tested positive for COVID19 again on 03/02.

Other Meds: UK

Current Illness: Hx of aspiration pneumonia with respiratory distress, hx of CVA, COPD

ID: 1069315
Sex: F
Age: 47
State: MI

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

Lab Data:

Allergies: penicillin, sulfa, vancomycin, albuterol, CT contrast dye, shellfish and fish

Symptoms: redness in face an neck/chest. Mildly swollen/red eyes. Developed within 15 minutes. Improved with 50mg benadryl. Stayed an additional 30 minutes after benadryl and symptoms continued to improve.

Other Meds: wellbutrin, lamictal, zyrtec, omeprazole, probiotic, magnesium, xanax, flomax, oxybutinin, pyridium, melatonin, CBD/THC gummies. Toradol. B complex, zinc, vitamin D, Vitamin D, glucosamine, omega 3, advair inhaler, pulmicort inhaler, aimo

Current Illness: kidney stones, pyelonephritis, hydronephrosis.

Date Died: 02/21/2021

ID: 1069316
Sex: F
Age: 57
State: TN

Vax Date: 02/12/2021
Onset Date: 02/21/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: none

Allergies: unknown

Symptoms: death

Other Meds: unknown

Current Illness: unknown

ID: 1069317
Sex: F
Age: 70
State: GA

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

Lab Data:

Allergies: EGGS

Symptoms: PATIENT STATED TINGLING SENSATION ABOUT 15 MINUTES AFTER IMZ GIVEN, THEN SYNCOPE, THEN LOSS BODY FUNCTION 10 MINUTES LATER. CONSCIOUS ENTIRE TIME, ABLE TO BREATH ON OWN

Other Meds: NONE

Current Illness: NONE

ID: 1069318
Sex: M
Age: 46
State: CA

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

Lab Data:

Allergies:

Symptoms: Rash on neck, tingling, throat swelling. BP 148/86 (pulse 75), O2 sat 96%. Benadryl 50 mg IM x 1. Resolved. BP 137/83 (pulse 80).

Other Meds:

Current Illness:

ID: 1069319
Sex: F
Age: 30
State: IN

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

Lab Data: no

Allergies: Mepivacaine, Septocaine, Sodium Algonate, latex, outdoor environmental allergies and various other allergies

Symptoms: 11hrs after the vaccine I experienced numbness and tingling in my right eye, face, neck and tongue in which I took already prescribed antihistimine medication for that. I developed a migrane the following day which lasted about 7 days and I alternated Ubrelvy and Sumatriptan to manage the migrane. I reached out to my allergist who monitored me vitually for a few days and finally all symptoms finally subsided.

Other Meds: Singulair, Hydrozyzine, Xyzal

Current Illness: no

ID: 1069320
Sex: F
Age: 59
State:

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

Lab Data:

Allergies:

Symptoms: Weakness. Evaluated by EMS- Cleared

Other Meds:

Current Illness:

ID: 1069321
Sex: M
Age:
State: CA

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

Lab Data: None

Allergies: NKA

Symptoms: Chills, anxiety, cold, clammy, chest tightness, SOB

Other Meds: Unknown

Current Illness: Anxiety, Depression

ID: 1069322
Sex: M
Age: 68
State: TX

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

Lab Data: None

Allergies: NKDA

Symptoms: Febrile 102.9-101. x 24 hrs post vaccine good affect with Tylenol and Benadryl. N/V x 24 hours post vaccine, fatigue, body aches

Other Meds: Abilify, Acetaminophen, Cardizem, Cyanocobalamin, Eliquis, Flomax, Folic Acid, Lamictal, Lantus, Lasix, Lipitor, Lisinopril, Lopressor, Magnesium oxide, Melatonin, Prilosec, Remeron, Ritalin, Thiamine mononitrate,

Current Illness: Depression, anxiety, HTN, DM

ID: 1069323
Sex: F
Age: 82
State: AL

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

Lab Data: No

Allergies: No

Symptoms: I noticed that my injection site is the size of a baseball, its red, and itchy. It is also warm to the touch.

Other Meds: levothyroxine atenolol hydrothorazide lisinopril simvastatin Montelukast folic acid methotrexate Zyrtec

Current Illness: No

ID: 1069324
Sex: F
Age: 41
State: NY

Vax Date: 01/07/2021
Onset Date: 01/14/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: The lymph node on left side in neck,under armpit felt large(golf size balls). This prompted me to contact my PCP told me this was normal side effects from vaccine.

Other Meds: Wellness Vit

Current Illness: No

ID: 1069464
Sex: M
Age: 76
State: NH

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

Lab Data: none

Allergies: pistachio nut I had facial, lip, tongue swelling and abdominal cramps with diarrhea at age 38; one time event. no other nut or food or medication allergic reactions

Symptoms: stiffness soreness across both shoulders, shoulder blades and base of neck - started about six hours after injection but worsened in bed overnight. Began to ease off after 26 hours. Awakened 20 hours after shot with sense of lassitude, sluggish thinking - like the drowsiness an antihistamine may cause. Just felt strange almost not really present in the moment sensation. This is still still ongoing after 30 hours but easing off significantly. no fevers, chills, myalgias or flu feeling. no local swelling or redness at injection site. This odd feeling did not interfere with daily 10000 step walk. Feel much improved after exercise.

Other Meds: atorvastatin 20mg qd Vitamin D 3 5000IU qod

Current Illness: none

ID: 1069465
Sex: M
Age: 78
State: LA

Vax Date: 02/05/2021
Onset Date: 02/24/2021
Rec V Date: 03/03/2021
Hospital: Y

Lab Data: See Above

Allergies: See below

Symptoms: March 3, 2021 SUBJECT: Moderna COVID-19 Vaccine, Side Effects This letter/email is addressed to a number of individuals with a request that you seriously evaluate the below discussion, take action to alert medical staff of your respective agencies of these side effects, and work with the manufacturer, Moderna, to address them. As the recipient of them it has thus far been debilitating and interfered with my daily activities. It is my hope that the medical community can find ways to prevent or treat them such that daily activity can be unimpeded. I will first provide a chronology of my medical history and my Moderna vaccine experience. Then I will discuss my observations. My medical history: Age: 78 Gender: Male Pre-existing Conditions: Medications Hypertension: Blood pressure medication, 50 mg of Metoprolol Succinate ER daily Cholesterol: Atorvastatin, 40 mg daily Medical History 2018: Triple By-Pass Surgery 2019: Passed out, Hit head on falling, Brain bleed: Subdural Hematoma, Hospitalized: No surgery required and released. Subsequently, pacemaker installed. 2021: Moderna COVID-19 Vaccine administered. First Dose: Lot Number: 011J20A, Date: 01/08/2021, Clinic Site: Pharmacy Second Dose: Lot Number: 032L20A, Date: 02/05/2021, Clinic Site: Pharmacy Side Effects to Moderna Vaccine administration First Dose: Administration Site: Swelling, Site Redness and Fever. All dissipated within week after administration Second Dose: Fever and Chills day following administration. Lethargic for several days following administration. These symptoms disappeared. Observations February 24, 2021: Began to experience dizziness, symptoms progressed to mild vertigo. Based on history of presentation of these symptoms, assumed I had an inter-ear problem and began taking Zyrtec D, half a tablet. Experience with Zyrtec D has been that ear dries out and symptoms of dizziness and disorientation disappear. In this case the symptoms of vertigo progressed to the point of difficulty in walking and loss of balance. Stopped taking Zyrtec D on Friday, February 26th. February 26, 2021: Had more severe vomiting, walking difficulty and lose of balance. Used walker to stabilize walking. At approximately 7 to 7:30 PM, following consultation with wife and daughter, decided to go the emergency room of the Medical Center (MC). Was quickly seen by emergency room staff. Following questions on medical history, the ER doctor, based on head bleed history, I believe, had a CT conducted. I do not recall any questions about COVID-19, but do think we told them that both myself and my wife had been vaccinated for COVID-19. I specifically recall that prior to my transport, a nurse came in to do a nasal swab for COVID-19. I informed her that I had been vaccinated, but she said this was a requirement for admission to the location where I was being transported. Following the CT scan, the ER physician determined he believed there was a possibility of a small new brain bleed. At approximately 2 to 2:30 AM I was transported by ambulance to Health Center at approximately 5:00 AM. I am not certain about the exact times here. February 27, 2021: Health Center administered a number of tests including CT scan, EKG, and an echocardiogram. While there, physical therapists came to see me twice and exercised me to improve my balance and walking ability. The last one recommended exercises to help reset my vestibular system. Based on the administered CT scan there, the physicians saw no evidence of a new brain bleed and were prepared to release me. At the time of that discussion in my room, the attending nurse pointed out to the physician there that my blood pressure was elevated. He ordered a new EKG and deferred on releasing me until a cardiologist reviewed the results. Their concern was that I was experiencing episodes of atrial fibrillation (AFib). Subsequently, the cardiologist reviewed the new EKG and concluded the episodes were within the normal range, my understanding, but did note that my heart rate was elevated. At no time did the medical staff raise or question the possibility of COVID-19 side effects as being a possible explanation for my disorientation or heart rate problem. I was released later that day. February 28, 2021: While speaking to her sister, my wife shared with her my experience of dizziness and disorientation. Her sister related that her husband had and was experiencing a similar event. Further, her husband?s sister had experienced a similar event. Additionally, the husband?s sister had experienced vertigo. On further discussion it was determined all three of us had received the Moderna Vaccine, and approximately three to four weeks post second dose administration, developed these symptoms of vertigo. This prompted me to go to the internet for information on vaccine side effects. The Food and Drug Administration Fact Sheet, revised 12/2020 in the Section Titled: What are the risks of the Moderna COVID-19 vaccine? speaks of severe allergic reactions including: a fast heartbeat and dizziness and weakness. I believe that I have suffered these two reactions. March 1, 2021: Called both hospitals to alert them to inform their respective staffs of the need to question the possibility of these side effects should other patients present in their emergency rooms. In my case, it may have helped to alleviate my concerns had I been informed of these possible side effects. At MC I left a voice mail for the Chief Medical Officer and at Health Center I spoke to the Nursing Supervisor. The nursing supervisor advised me to report my side effects and directed me to call the entity who had administered the vaccine doses. I called the Pharmacist and spoke to her. She said she would report my concerns through her reporting system. Further she informed me that there was a medication my primary care provider could prescribe. I called my primary care provider, and he has prescribed Meclizine, 25 mg tablets. I am currently taking ? tablet, three times per day. A whole tablet made me drowsy. As of today, March 3, 2021, I am still experiencing disorientation. Hopefully this will subside and disappear. The above discussion is provided to assist medical professionals to further assess the side effects of the Moderna COVID-19 Vaccine. I am glad that I received it. I have no complaint about the care I received at the two medical facilities referenced. In fact, I think it was excellent. However, it would have helped me to have raised by either or both of them that my symptoms may have been COVID-19 Vaccine related. Further, it may have changed how they proceeded in assessing my situation. As an industrial hygienist with statistical training, it seems to me somewhat unusual to have three members of my extended family experiencing similar dizziness and weakness side effects, and for us all to have similar time periods following the administration of the second dose. Perhaps, if related to the vaccine, this cluster would suggest that this side effect may be more common than a ?remote chance.? Should any of you have further questions or wish to speak to me, please do not hesitate to call. Since I get a lot of calls from numbers I do not recognize, I do not always answer, but a voice mail left with a return call number normally results in a return call. Today, I received a return call from the Chief Medical Director of MC and told her she would receive a copy of this document. Thank you for your attention to this matter.

Other Meds: See below

Current Illness: See below

ID: 1069466
Sex: F
Age: 41
State: IL

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

Lab Data: Tested for covid 19 and strep. Both tests came back negative 2-28-2021

Allergies:

Symptoms: Severe sore throat, burning in throat, trouble swallowing, loss of voice, pain in and around neck, radiating pain to ears. Oral steroids, nebulizer treatments and benedryl every 4 hours. Still no relief.

Other Meds:

Current Illness: Slight sore throat on left side. Rapid heart beat immediately after injection od second moderna vaccine. Within the next 24 hours, excruciating sore throat, swollen larynx and throat, loss of voice, difficulty breathing. 6 days later, taking benedryl and oral steroids and nebulizers. Still in horrible pain and discomfort

ID: 1069467
Sex: M
Age: 45
State: IL

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Numbness and tingling in my left arm. Begins near the shoulder and extends into fingers. It is not happening all the time, but happens multiple times in an hour. Did not have this problem before vaccine.

Other Meds: None

Current Illness: None

ID: 1069468
Sex: F
Age: 77
State: SD

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

Lab Data:

Allergies: Vancomycin, Prednisone

Symptoms: Shortly after vaccination, upper legs felt weak and head felt as if she was "floating" similar to being put under anesthesia. Day 2 developed Redness and rash on chest and lower back. Day 3 developed a large cold sore on lower lip. Day 4 - 4 more cold sores on upper and lower lips. Day 5-6 fatigue. She was observed for an hour, offered water and juice following the vaccine and was released home.

Other Meds:

Current Illness:

ID: 1069469
Sex: M
Age: 62
State: OK

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

Lab Data: None

Allergies: Na

Symptoms: Very tired the evening of the vaccine (3/1/21) Flu-like symptoms on 3/2/21: tired, headache, body ache, No fever though Better after noon on 3/3/21

Other Meds: Humira 40mg Allopurinal 300mg Claritin Benadryl Aspirin 81mg Carisoprodol 350mg Vitamin B supplement Multivitamin Tramadol50mg iron 65mg Zinc Am Bein 10mg Synthroid 73mcg

Current Illness: Food poisoning 2/28/21

ID: 1069470
Sex: F
Age: 20
State: NC

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

Lab Data:

Allergies:

Symptoms: Patient passed out, but came to a minute later. Has a history of passing out with vaccines. Called EMS to check her okay and their cleared her. She waited 30 minutes post vaccine and left with mother.

Other Meds:

Current Illness:

ID: 1069472
Sex: M
Age: 67
State: FL

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

Lab Data: EKG with paramedics

Allergies: no

Symptoms: c/o nausea, sensation in left rib, dizziness. Paramedics attended to him. Upon reaching client, client was oriented to TPP. Communicative. Client was transferred to Medical Center for further review. Vitals by paramedics: O2 sat 99%, B/P 150/87, HR 80 BPM.

Other Meds: Did not ask at time of vaccine.

Current Illness: no

ID: 1069473
Sex: M
Age: 85
State: NY

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

Lab Data: 2/28/2021 I went to the ER of the local hospital Where we are staying. They took x-rays and ultrasound and a fluid sample from of my left knee which was the most swollen at the time. Today is Wednesday and I am a bit better but still cannot walk on my own.

Allergies: None

Symptoms: Within 36 hours, 2/27 my knees swelled and I was unable to walk. On Sunday we went to The ER near where we were and had x-rays and ultrasound of my knee. Dr. took a fluid sample for culture but said it looked clear. I have no history of arthritis nor any injury. I am an avid bike rider and suddenly cannot stand on my feet due to extreme pain.

Other Meds: Xarelto 20mg Wehlchol 625 625mg 2-2X a day Metroprolol Succ ER 50mg Lisinopril 10mg

Current Illness: None

ID: 1069474
Sex: F
Age: 60
State: KY

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

Lab Data:

Allergies: None

Symptoms: Debilitating Joint Pain so much that she can't walk. Generalized inflammation.

Other Meds: Losartan

Current Illness: Fibromyalgia

ID: 1069475
Sex: F
Age: 65
State: SC

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

Lab Data: Consulted with my physician and she does not recommend I get another vaccine with propylene glycol.

Allergies: Codeine, Terbinafine, Vagifem

Symptoms: About 2 hours after the vaccination, starting low on right side of neck, felt a mild burning sensation move up into my right side of face. Swelling on right side was noticeable for two days. Mild numbness also occurred that went away as swelling subsided. However on 3/3/21 I am noticing numbness in upper lip and jaw... also mild.

Other Meds: nONE

Current Illness: None

ID: 1069476
Sex: F
Age: 63
State: NC

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

Lab Data:

Allergies: none

Symptoms: Given 2nd dose before the 2 month interval.

Other Meds:

Current Illness:

ID: 1069477
Sex: M
Age: 70
State: OR

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

Lab Data: N/A

Allergies: Codeine

Symptoms: Patient experienced dizziness within 5 minutes that lasted intermittently for 30 minutes.

Other Meds: None

Current Illness: none

ID: 1069479
Sex: F
Age: 24
State: OR

Vax Date: 02/17/2021
Onset Date: 02/20/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: None

Allergies: Azithromycin

Symptoms: 3 days after vaccine I developed hives at the site of injection only and prior to this had surrounding erythema with mild swelling, warmth, and significant tenderness.

Other Meds: Methylphenidate HCl 10mg BID and 20mg QD, melatonin 3mg PRN, oral contraceptive

Current Illness: None

ID: 1069480
Sex: F
Age: 47
State:

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

Lab Data:

Allergies:

Symptoms: Palpitations, throat tightness. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1069481
Sex: F
Age: 93
State: MO

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

Lab Data: Nursing home facility informed the attending physician and patient's family of the administration error.

Allergies:

Symptoms: Patient received a 3rd dose of Covid19 (Moderna) due to the nursing home facility representative bringing incorrect patient for immunization. The intended patient was for a 2nd dose, however the nursing home mistakenly identified the wrong patient as the intended recipient. The incorrect patient had already completed the covid19 2 dose series (1/6/21 and 2/3/21). Patient was observed for an extended time, No adverse events noted during the extended observation. Nursing home instructed to continue to observe patient over the next 48-72 hours and informed that patient may exhibit stronger side effects as a result of receiving a 3rd dose. Additionally, facility instructed that there are currently no documented recommendations from them for this administration error.

Other Meds:

Current Illness:

ID: 1069482
Sex: M
Age: 52
State: MO

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

Lab Data: None

Allergies: Shellfish, Advair

Symptoms: 35 Minutes after receiving vaccine, itching on head, then body and face, including welt on chest, hives. 50 minutes later eye itchiness and swelling in left eye, throat felt weird (swelling), dizziness, change in voice, wheezing (not severe, but could tell breathing was more restricted than before shot). Almost went to ER, but symptoms subsided without any medication in 2 hours. Did not go to hospital or ER.

Other Meds: Nexium 24, BPH, GNC Multi Vitamin

Current Illness: none

ID: 1069483
Sex: F
Age: 72
State: CA

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

Lab Data: None

Allergies: Penicillin

Symptoms: Pfizer Covid-19 Vaccine second dose on 02/28/2021 at 1:00 P.M. Very chilly all day next day on 03/01/2021. Redness and pain on the arm at the vaccine site on 03/03/2021 at 9:00 A.M.

Other Meds: Multivitamin

Current Illness: None

ID: 1069484
Sex: F
Age: 71
State: NC

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

Lab Data: None

Allergies: Ceclor and Sulphur

Symptoms: Sore arm, extreme chills, achiness, low grade fever (100.9) and fatigue, all lasting 24 hours. Took Advil for fever and achiness twice during that time course.

Other Meds: Levothyroxine, Pantoprazole, Arnuity Ellipta Inhaler, Hydrochlorothiamide, OTC CVS Maximum Strength Allergy & Sinus Headache; Azithromycin, Doxycycline, Amoxicillin: take alternately first week of each month

Current Illness:

ID: 1069485
Sex: M
Age: 78
State: FL

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

Lab Data:

Allergies: None

Symptoms: severe muscle and joint pains lasting up to the present and continuing indefinitely., fatigue, fever, and chills,

Other Meds: calcium, vitamin D, folate, finasteride, lisinopril, metoprolol, Tamsulosin

Current Illness: sick sinus syndrome, pacemaker, osteoarthritis, iliac aneurysms, proteinuria, BPH, hepatitis C in remission, atrial fibrillation,

ID: 1069486
Sex: F
Age: 67
State: NV

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

Lab Data: EKG, interpretation: normal sinus rhythm, no abnormal findings noted. Rhythm: sinus. Rate: 85

Allergies: No knowiabn allergies

Symptoms: while waiting after vaccine, patient c/o of light-headed while sitting, headache. Then c/o dizziness coupled w/ bifrontotemproal headaches and extremity weakness, Her skin becae increasingly mottled, Pt. was given Dexamethasone and Benedryl. and then observed. Patient was then able to go home. Pt. had 3 days of gradually improving fatigue, Rash also gradually improved. Pt. is now fully recovered.

Other Meds: Start Date Medication Directions PRN Status PRN Reason Instruction Stop Date 06/08/2020 alendronate 70 mg tablet take 1 tablet by oral route every week in the morning, at least 30 min before first food, beverage, or medication of day N

Current Illness: Type 2 Diabetes, Hypertension

ID: 1069487
Sex: F
Age: 30
State: IN

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

Lab Data: no

Allergies: Mepivacaine, Septocaine, Sodium Algonate, latex, outdoor environmental allergies and various other allergies

Symptoms: A few hours after the vaccine I started feeling fatigued and having chills. I was so tired and sleepy I slept almost all day for the first 48 hrs after. Developed fever between 100.5-101 which lasted about 18hrs which did require me to have to call into work the following day. 2/3 I developed swelling and pain in the lymph nodes under my right arm and breast. The swelling subsided within 4days but I still have some tenderness to date. I took tylenol and ibuprophen for the first 48 hours to help with all the symptoms.

Other Meds: Singulair, Hydrozyzine, Xyzal

Current Illness: nothing besides the AE to the previous vaccine

ID: 1069488
Sex: F
Age: 66
State: CA

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

Lab Data:

Allergies: Pt reports multiple/numerous allergies. Currently being tested for allergies to medications.

Symptoms: Pt developed redness and itchiness on chest post-vaccination. Pt reports hx of allergic reactions after having surgeries in the past. Denies chest pain, palpitations, SOB, or trouble breathing. SpO2 99% on RA, un-labored breathing, lungs CTA bilaterally. Pt discharged under stable condition with Claritin 10mg x 1, ER precautions given.

Other Meds: Singulair daily

Current Illness: Chronic allergies.

ID: 1069489
Sex: F
Age: 46
State: CA

Vax Date: 02/23/2021
Onset Date: 02/28/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: I went to the ER where I had full blood workup, and CT Scan and MRI of the brain.

Allergies: PENICILIN: THROAT CLOSES UP

Symptoms: On Sunday I started with a severe headache. When I woke up on Monday morning I couldn't lift my head. The headache was intense. I could not open my left eye. I had facial paralysis on the right side of my face. I had slurring of speech. When I walked I was dizzy. I fell asleep all day long, and woke up each time completely disoriented.

Other Meds: OLMESARTAN-HYDROCHLOROTHIAZIDE 40 MG DAILY NORTRIPTYLINE 10 MG 5 CAPSULES A DAY PREGABALIN 400MG, 1 TABLET 3X PER DAY VITAMIN D3 25 MCG ASPIRIN 81 MG GABAPENTIN 300 MG, 1200MG 3X PER DAY

Current Illness: NONE

ID: 1069491
Sex: F
Age: 68
State: FL

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

Lab Data: none

Allergies: Sulfa Levaquin Wasp stings

Symptoms: 3- 4 minutes after injection I had tingling in my lips and a strange numb sort of feeling in my face, and then some "rubbery" weakness in my arms and legs. Treated in an ambulance at vaccine site with IV Benadryl, had some skin tingling, also given IV solumedrol and observed for almost 2 hours with no other symptoms. I was also hypertensive, probably due to anxiety.

Other Meds: Vitamin B12 Vitamin D3 Calcium

Current Illness:

ID: 1069492
Sex: M
Age: 43
State: VA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: ALT = 70 (don't know if related, previously normal) Eosinophils 5% Other labs normal (BMP, TSH, AST, CK, ANA, lupus anticoagulant)

Allergies: penicillin, sulfa

Symptoms: Day after second vaccine dose, patient began having extreme fatigue, overall body chills on/off throughout every day, joint aches in fingers and ankles, bilateral calf pain, wheezing, heart burn, brain fog, cold feeling in feet. These occur throughout every day, on and off. We are now at week 5.

Other Meds: none

Current Illness: None

ID: 1069493
Sex: M
Age: 36
State: TX

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

Lab Data: None. Patient vital signs immediately following the episode was : BP 135/79, HR 74, SPO2 98% on atmospheric air. Repeat vital signs 15 minutes later was: BP 104/66, HR 57, SPO2 98% on atmospheric air

Allergies:

Symptoms: Patient was unresponsive with eyes open for a brief moment ( 5 seconds) after receiving the vaccine.

Other Meds: No

Current Illness: None. Though patient reports history of syncope.

ID: 1069494
Sex: M
Age: 49
State:

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

Lab Data:

Allergies:

Symptoms: Had a similar reaction as he had to the first dose. Pruritis and severe itching on his back. On call provider contacted and order to give 50mg of Benadryl IM now and may give 50mg of oral Benadryl in 8 hours. Provider f/u today and denies SOB, cough, nausea, vomiting, flushing, or rash. No visible rash. Pt scratching at upper left arm and back. Pt received Benadryl 50mg IM last night and the first dose of 2 Benadryl 50mg caps this morning. Will continue to monitor

Other Meds:

Current Illness:

ID: 1069495
Sex: F
Age: 74
State: FL

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

Lab Data:

Allergies: Penicillin, IV iodine

Symptoms: Approximately 25 minutes after the shot, patient came back saying that she feels like her throat is closing, cheeks felt like swelling , he mouth tastes funny.

Other Meds:

Current Illness: none

ID: 1069496
Sex: M
Age: 30
State:

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

Lab Data:

Allergies:

Symptoms: Approx 17 hours after vaccine, pt was observed shaking and coughing, c/o chills and SOB. Mild respiratory distress noted, pt was given a nebulizer treatment which was not effective. Vs were obtained and on call provider was contacted. Order for Solumedrol 125mg injection IM was completed. Pt was observed following the injection and was instructed to drink water and rest. Provider f/u in the morning. Pt reports he is feeling much better today. He reports he ate this morning, is awake and alert and oriented. Pt reports he has not been coughing and no longer feels short of breath. Reports he has some lingering muscle aches related to the vaccination, denies fever or chills, nausea or vomiting. Tylenol for Myalgia

Other Meds:

Current Illness:

ID: 1069497
Sex: F
Age: 79
State: CA

Vax Date: 02/17/2021
Onset Date: 02/25/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: I had my first dose of the Moderna vaccine in my left arm on Feb. 17, 2021. On Feb. 25, 2021, my left arm was itching, and I noticed a red, round spot at the site of the injection, about 2-3" in diameter, warm and firm to the touch. An online search found that this has happened to others and called it "COVID arm" and suggested taking an antihistamine for the itching, which I did for two days. The itching was much better and, over the next week, the redness started to fade; but it's now two weeks post injection and the redness, although faded, is still there and seems to be moving down the arm. There is some itching from time to time, but not nearly as intense as it was the first time. I have no underlying conditions and have had no other side effects that I'm aware of.

Other Meds: Eliquis 2.5 mg twice a day Metoprolol 25 mg twice a day Biotin 5000 mcg once a day Metamucil one capsule twice a day Melatonin 3 mg once a day

Current Illness: None

ID: 1069498
Sex: F
Age: 68
State:

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

Lab Data:

Allergies:

Symptoms: tingling on left side of face. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1069499
Sex: F
Age: 48
State: MS

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

Lab Data:

Allergies:

Symptoms: aches and chills dehydration

Other Meds: vibryd

Current Illness:

ID: 1069501
Sex: F
Age: 58
State: NJ

Vax Date: 01/14/2021
Onset Date: 02/28/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: None

Allergies: none

Symptoms: Large amounts of hair falling out

Other Meds: Cholesterol medication, by mouth diabetes medication (does not know names)

Current Illness: none

ID: 1069502
Sex: F
Age: 40
State: KY

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

Lab Data:

Allergies: No

Symptoms: Flu like symptoms: headache, fever over 100 degrees for 24 hour period (even when taking Tylenol and Advil), extreme body pains, fatigue, brain fog.

Other Meds: Celexa, multivitamin (gummy form)

Current Illness: No

ID: 1069504
Sex: M
Age: 71
State: CA

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

Lab Data: None

Allergies: No Known Allergies

Symptoms: No adverse events. Reporting due to the incorrect timing of the vaccination.

Other Meds: Amlodipine, Aspirin, Atorvastatin, Clopidogrel, Furosemide, Lisinopril, Metformin, Metoprolol Patient received Bamlanivimab 700mg on 1/15/2021

Current Illness: Covid-19 virus infection on 1/11/21

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm