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: 0933144
Sex: F
Age: 30
State: CA

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

Lab Data: NONE IN FIELD, UNKNOWN IN HOSP

Allergies: AMOXICILLIN ? ANAPHYLACTOID REACTION TO INFLUENZA VACCINE

Symptoms: ABOUT 3 MINUTES AFTER RECEIVING VACCINE, PT REPORTED LIP SWELLING, PT EVALUATED AND FOUND TO HAVE MODERATE EDEMA TO LIPS, SENSATION OF SWELLING TONGUE AND THROAT. PT ALSO NOTED TO BE BRADYCARDIC, PLACED ON MONITOR, AND PT WAS IN BIGEMINY WITH A HR OF 55, PT GIVEN BENADRYL IM, VS WERE STABLE, MODERATELY HYPERTENSIVE, WITH AN 02 SAT OF 100%, IV ESTABLISHED AND PATIENT MONITOR WHILE AWAITING PARAMEDIC RECUSE AMBULANCE. PT DID NOT WORSEN AND BIGEMINY RESOLVED. 12 L PM WERE UNREMARKABLE, NO EPI GIVEN EN ROUTE, PT TRANSPORTED TO EMERGENCY DEPARTMENT WITHOUT INCIDENT.

Other Meds: FLOVENT, ALBUTEROL

Current Illness: NONE

ID: 0933145
Sex: M
Age: 81
State: IN

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data: None

Allergies: none

Symptoms: Serious weakness, inability to get up from sofa, very shivery, had to get assistance from facility nurse to get to bed. Temp was 102, talked to doctor by phone and took Tylenol. Slept for 4 hours. Was able to navigate again.

Other Meds: xarelto, mestinon

Current Illness: none

ID: 0933146
Sex: F
Age: 36
State: WY

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Hard swelling, heat, redness worsening daily for the last 12 days

Other Meds: Zyrtec, Albuterol

Current Illness: None

ID: 0933147
Sex: M
Age: 52
State: IL

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data: none

Allergies: Haldol, seasonal allergies

Symptoms: hypertension (pulse >100), dizziness. Pushed fluids.

Other Meds: levothyroxine 125mcg, loratadine 10mg, miralax.

Current Illness: none

ID: 0933148
Sex: F
Age: 45
State: OR

Vax Date: 01/10/2021
Onset Date: 01/10/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 1825 Patient reported feeling "Shaky", patient reports having same reaction with first vaccine and was observed in ED for 90 mins, had increased BP at that time that resolved by discharge. 1825 BP 156/101 HR 80 Patient declined ED, food, drink and had a rapid response nurse friend at chairside. assessment repeated at 1840 B/P 136/94 HR 80, 1850 BP 140/100 HR 75 pt. reporting feeling better. Pt. reported feeling much better and left with friend at 1900.

Other Meds:

Current Illness:

ID: 0933149
Sex: F
Age: 39
State: TX

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Day 2 Friday: Headache, Chills, Vertigo, severe Nausea & Vomiting; Treatment: Esgic for Headache, Zofran for N&V Day 3 Saturday: Headache, Fever 101.1, Severe N&V; Same treatment Day 4 Sunday: Moderate N&V with mild headache, no fever, Treatment: Zofran

Other Meds: Esgic

Current Illness: None

ID: 0933150
Sex: M
Age: 53
State: IL

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Temp of 101.2, crying out in agitation / discomfort. treated with PRN Tylenol.

Other Meds: zyloprim 100mg, celexa 10mg, claritin, miralax, prilosec otc tab 20mg, sucralfate 1gm, synthroid 88mcg, Vit D3 1000 units.

Current Illness: none

ID: 0933151
Sex: F
Age: 51
State:

Vax Date: 01/05/2021
Onset Date: 01/07/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received vaccine on 1/5/2021 and is complaining of swollen and stiff left arm and inability to move the left arm. States pain is 10 on a 10-point pain scale . Has been on Advil and Tylenol with no relief

Other Meds:

Current Illness:

ID: 0933152
Sex: M
Age: 38
State: IL

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data: none

Allergies: oxybutynin

Symptoms: Agitation and flushed face.

Other Meds: desmopressin 0.2mg, myrbetriq 25mg, vit D3 200 units.

Current Illness: none

ID: 0933153
Sex: F
Age: 37
State: AZ

Vax Date: 12/28/2020
Onset Date: 01/02/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: RawCauliflower

Symptoms: Painful Acne like rash around the Lower half of my face. With redness and pus filled bumps Possible perioral dermatitis.

Other Meds: Ginger, turmeric, benzoyl peroxide wash 10%, retin A, vitamin D, Vitamin E topical, tea tree topical, collagen, vitamin C, vitamin B12

Current Illness: None. LMP December 25, 2020

ID: 0933154
Sex: F
Age: 38
State: MN

Vax Date: 12/23/2020
Onset Date: 12/26/2020
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: Nickle sensitivity

Symptoms: Shot given in L deltoid. Day 3-10 post vaccine I had extreme pain in what seemed like my left trapezius muscles. The pain was much worse in the evening/night and was sometimes absent during the day. Also on day 14 post vaccine (1/7/2021) I developed a cold sore for the first time in my life.

Other Meds: Flonase a few days/week

Current Illness: None but most days environmental allergies

ID: 0933155
Sex: M
Age: 31
State: KY

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data: N/A Took two Tylenol extra strength, 500 mg tables, helped with symptoms to a degree

Allergies: None

Symptoms: Around 6 pm the following symptoms started: Heart rate was as high as 140 Body aches Felt like I had a fever Felt like pressure on chest Arm was very sore Had chills Nauseous

Other Meds:

Current Illness: None

ID: 0933156
Sex: M
Age: 52
State: CA

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

Lab Data:

Allergies: Nkda

Symptoms: General body aches, lost of appetite, general weakness, painful vaccination site

Other Meds: Clindamycin 300gm

Current Illness: None

ID: 0933157
Sex: F
Age: 39
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: dizziness moderate x 45 minutes and currently mild

Other Meds:

Current Illness:

ID: 0933158
Sex: F
Age: 34
State: MA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: Morphine - itching Percocet - itching

Symptoms: Employee became very itchy on left arm after vaccine administered. Left arm very red. Itchiness spread throughout her body.

Other Meds: None

Current Illness: None

ID: 0933159
Sex: F
Age: 45
State: CO

Vax Date: 01/07/2021
Onset Date: 01/10/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: None that I know of

Symptoms: No side effects with dose 1. After dose 2 at about 55 hours post injection, I woke up covered in hives head to toe. I took pictures if you need them.

Other Meds: 75mg Levothyroxine 10mg Prozac

Current Illness: None

ID: 0933160
Sex: F
Age: 61
State: MO

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: penicilin, MRI contrast

Symptoms: Moderna COVID-19 vaccine EUA 4-5 hours after vaccination, I started feeling sick: body aches, after that, during the night in addition to that I had a head ache. After that, i started feeling better. About 24 hours after the vaccination I started feeling worse again with body aches and headache. All my body was sick. During the night I had chills and a fever of 99.7. I felt sick and very tired all next day. More head ache and body aches. Was taking Tylenol every 5-6 hours, including the morning of day 5.

Other Meds: low dose aspirin, simvastatin, metformin, multi vitamins

Current Illness: diabetes, high cholesterol

ID: 0933161
Sex: M
Age: 71
State: FL

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Fever, Nausea, Chills, Muscle Ache, Rash on back ,lasting 48 hours

Other Meds: Amlodipine, Gabapentin, Hydralazine Calcitriol, Rosuvastatin, Baby Aspirin, Iron, Humalog

Current Illness: No

ID: 0933162
Sex: F
Age: 26
State: NY

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: Eucalyptus

Symptoms: Body wide hives and throat tightening

Other Meds: Prozac, birth control pill

Current Illness: Flu shot

ID: 0933163
Sex: F
Age: 42
State: NY

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data: I mentioned Covid 19 dx & hospital stay from earlier in year March 2020.

Allergies: Seasonal allergies

Symptoms: Wed 930pm tingling nerve endings head to toe, migraine headache with aura, fever 100.3 Thu 530am SEVERE body aches, chills, migraine, sweats. 630am fever 101.3 body aches,HA/fever& chills all day. Max fever 102. Friday fatigued, all day until HA starts again at 2pm, along with 101 fever by 5pm...carries on with chills and Migraine aura thru evening until 1245am. Max fever 102 again.

Other Meds: Zero

Current Illness: Zero

ID: 0933164
Sex: F
Age: 55
State: CA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: intense flu-like symptoms started suddenly...chills, weakness, joint pain in all my joints...fatigue. Symptoms started about 9:30 am Saturday 09jan2021, patient (I) took a Tylenol and went to bed curled into a ball and shivering under a pile of blankets.....spent most of the day in bed. Felt very badly. Got up about 4:30 pm ad felt a little bit better (no more chills..just joint pain and weakness)....made some dinner..and about 7pm the chills started again (joint pain still present)...I took a Tylenol...and I rushed back to bed...again curled into a small freezing ball...slept fitfully...finally got up about 8:30 am on Sunday morning (10jan)....still feeling weakness and slight joint pain. All symptoms abated by approximately 11:30 am on Sunday 10Jan2021

Other Meds: Tamoxifen

Current Illness: none

ID: 0933165
Sex: F
Age: 74
State: CA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data: None

Allergies: Sulfa drugs

Symptoms: Gastric pain Diarrhea

Other Meds: Omeprazole Estradiol

Current Illness: None

ID: 0933166
Sex: F
Age: 25
State:

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: dizzy and heart racing; denies respiratory issues

Other Meds:

Current Illness:

ID: 0933167
Sex: F
Age: 51
State: PA

Vax Date: 01/08/2021
Onset Date:
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0933168
Sex: F
Age: 63
State: MA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: Hx hives with cortizone injection. No vaccine reactions, drug, or food allergies.

Symptoms: At 13:10 the patient complained of sudden nausea while walking from injection room to seating area at vaccine clinic. States she did not eat lunch today, declined offer of snack or water. States she premedicated herself with 25 mg Benadryl 30 minutes before today's vaccine - as she does for all vaccines she gets.

Other Meds:

Current Illness:

ID: 0933169
Sex: F
Age: 59
State:

Vax Date: 01/06/2021
Onset Date: 01/08/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Reaction site pain, fatigue, chills and joint pain

Other Meds:

Current Illness:

ID: 0933170
Sex: M
Age: 34
State: MA

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: 0-14 hours: pain at injection site but no other notable symptoms. 14-18 hours: headache, muscle aches, joint aches, fatigue, increasing pain at injection site (without swelling or redness at injection site) 18-30 hours: headache, joint, and muscle aches, fatigue, with severe pain at injection site, fever of 99.6, chills, drenching sweating, puffy eyes, rash on torso and legs. 30-48 hours: all previous symptoms except puffy eyes and rash reduced with benadryl 48-60 hours: all previous symptoms. Fever increased to 100.4 F, Puffy eyes and rash returned more severe. Took benadryl and they reduced in severity. 60 hours: reduction in all symptoms. No more fever. Pain in arm reduced from severe to very mild (only noticeable if palpated). Only remaining symptom is fatigue.

Other Meds: Multivitamin

Current Illness:

ID: 0933171
Sex: F
Age: 46
State: HI

Vax Date: 01/09/2020
Onset Date: 01/09/2020
Rec V Date: 01/10/2021
Hospital:

Lab Data: Just nursing staff and hospital staff monitoring on day of adverse event - 1/9/20

Allergies: Shrimp Bell peppers Ingredient in Barium for medical test

Symptoms: 15 minutes and 21 seconds after shot was given, I felt suddenly very hot, lightheaded and I could feel my pulse escalating. Nurse in the post-shot monitoring tent took vitals to confirm pulse at 95, when typically 68. I was laid down and BP dropped to 110/78. Chest tightness that I am familiar with from asthma started to develop and my neck and throat and upper shoulders felt very tight and constricted. I had some trouble swallowing water as though my throat was constricted and my breathing felt shallow. Nurses provided care and I was asked to get up and sit in a chair again. Within a minute, I felt dizzy and disoriented again and heart rate went up. The tightness in my chest and throat and shallow breathing continued along with my voice becoming hoarse. The doctor on call asked if I?d had these symptoms before and I said I had after eating shrimp years ago. He decided to transfer me to the ER for monitoring . I stayed at the ER for about an hour and a half and was monitored. The constricted throat and asthma chest tightness did not subside but did not get worse. Doctor recommended Benadryl every 6 hours as symptoms persisted. Within a half hour of taking 25 mg of Benadryl, I started to feel improved breathing and less throat constriction and easier swallowing. After the second dose of Benadryl, symptoms were much 70% gone, except for hoarse voice abs very slight tightness with swallowing. I had informed the injection staff prior to receiving my vaccine that I am a person with a history of anaphylaxis (not to a vaccine) that required and epi pen and overnight hospital stay in the past .

Other Meds: Trazadone 50 mg for sleep Albuterol inhaler as needed for asthma

Current Illness: None

ID: 0933172
Sex: F
Age: 40
State: MA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: headache and jaw/tooth pain on left side only evaluated by EMTs Vital signs stable , neuros intact, lungs CTA

Other Meds:

Current Illness:

ID: 0933173
Sex: F
Age: 47
State:

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Location site pain X1 day and headache X2 days

Other Meds:

Current Illness:

ID: 0933174
Sex: F
Age: 59
State: MA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data: Tested for COVID 19, negative for antigen and PCR

Allergies: NKA

Symptoms: shaking, fever, nausea, headache, and flu like symptoms

Other Meds: Tylenol, Prilosec

Current Illness:

ID: 0933175
Sex: F
Age: 40
State: KS

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: latex, avocado, mango, penicillin, clindamycin, bactrim, tegaderm, adhesive tape, nickel

Symptoms: Immediate redness/burning of the injection site. Progressed to itchy throat/tongue and hoarse voice with persistent wheezy cough after 5 min Progressed to itchy/burning/red face/chest/ears after 10 min. Wheeled to the emergency department 20-25 minutes after injection. Had to have benadryl, solumedrol, pepcid, zofran, and an epinephrine injection to stop the anaphylaxic reaction.

Other Meds: Wellbutrin, Lamictal, Propranolol

Current Illness: None

ID: 0933176
Sex: F
Age: 26
State: MA

Vax Date: 12/21/2020
Onset Date: 12/22/2020
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Worsening tachycardia, shortness of breath on exertion, diaphoresis, fatigue

Other Meds: N/A

Current Illness:

ID: 0933177
Sex: F
Age: 63
State: WA

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data: Not applicable

Allergies: None

Symptoms: Fever 101, chills, sinus pressure, headache, loss of appetite, soreness injection site without redness or swelling

Other Meds: Trintellix, benicar

Current Illness: None

ID: 0933178
Sex: F
Age: 43
State:

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Immediately after injection, had headache, nausea, vomiting and metallic taste in mouth. Given 50mg Benadryl with improvement. Nausea/vomiting, metallic taste resolved after 24 hours. Headache and muscle aches lasted 48 hours and improving.

Other Meds:

Current Illness:

ID: 0933179
Sex: F
Age: 37
State: MA

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

Lab Data: None

Allergies: sulfa, PPD, Implanon, Clindamycin

Symptoms: During the first 15 minutes of vaccine administration my left ear felt blocked with a 2/10 pain. Then the left side of my face started to feel numb from the corner of my left eye to my hairline/ear and down to my chin. the numbness felt like that side of my face fell asleep. this persisted for the evening. I took Benadryl 50mg and claratin. The next day symptoms had improved but were still noticeable. I took an additional dose of 25 mg of benadryl and claratin 10mg. the following day (Tuesday) symptoms had resolved. The day following the vaccine I felt fatigue, nausea and headache. Tueday-Friday following vaccine fatigue and headache has persisted in varying degrees

Other Meds: yasmin birth control, biotin, multivitamin, vitamin D, vitamin C, probiotic

Current Illness: None

ID: 0933180
Sex: F
Age: 25
State: CA

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

Lab Data:

Allergies: Codeine

Symptoms: 2 inch diameter painful swelling at injection site. Red and raised skin. Extreme tender/soreness

Other Meds: Magnesium Depakote Buspirone Paxil Bupropion Baclofen Promethazine Latuda

Current Illness:

ID: 0933181
Sex: F
Age: 58
State: MA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: codeine

Symptoms: Patient c/o lightheadedness with rapid Heart Rate. Handoff to parametics with nurse observing patient. Remained alert and oriented x3, clear speech, without rash/hives. BP 190/118 HR 120 O2 98%.Lungs clear. Continued monitoring patient and at 0655 BP 140/80 HR 85 O2 95%.Family called to pick patient up. Will not be returning to work today.

Other Meds: amlodipine, metoprolol, omeprozole and aspirin

Current Illness:

ID: 0933182
Sex: M
Age: 34
State:

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache and muscle and body aches

Other Meds:

Current Illness:

ID: 0933183
Sex: M
Age: 29
State: TX

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: Tree nuts Shellfish Melon Avocado Azythromycin

Symptoms: Significant drowsiness began the morning after receiving the vaccine. I was unable to sustain a normal level of activity and slept for more than half of the usual waking hours.

Other Meds: Sertraline 50mg Lisinopril 2.5mg Claritin Ibuprofen Acetaminophen

Current Illness: N/a

ID: 0933184
Sex: F
Age: 31
State: MA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: nausea, feeling flushed, dizzy evaluated by EMTs - VSS and wnl employee continued to feel unwell

Other Meds: N/A

Current Illness: N/A

ID: 0933185
Sex: F
Age: 37
State: TX

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies: Allergic to Hydrocodone.

Symptoms: I developed body aches about 10-11 hours after the vaccine, then fever (100.4F degrees), chills, mild nasal congestion, and mild headache, which lasted for 1-1.5 days.

Other Meds: Zinc, vitamin D, vitamin E, fish oil, and elderberry syrup.

Current Illness: N/A.

ID: 0933186
Sex: F
Age: 37
State: WA

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

Lab Data:

Allergies: None

Symptoms: 01/09/2021- noticed mild itching in left upper arm at site of injection. 1/10/2021- worsening itching, scratching and development of hives and 2cm x 3cm warm edematous mass in the left upper arm. No pain and no streaking of erythema.

Other Meds: Fish Oil Flaxseed Oil Cetirizine

Current Illness: None

ID: 0933790
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 01/10/2021
Hospital:

Lab Data: N/A

Allergies: NKDA

Symptoms: 30 mins post injection dizziness - given water & reassurance, sm. bag of graham crackers c/o nausea after eating, some (L) arm tingling/numbness 3:01 pm BP 125/81, 92, 99% O2 3:23 pm BP 134/85, 68, 99% O2 Resolved numbness/tingling. Dizziness improved, able to stand

Other Meds: No meds taken-per patient

Current Illness: None

ID: 0934580
Sex: F
Age: 16
State: OK

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data: NA

Allergies: unknown

Symptoms: Patient is 16 yo female. She was given Moderna COVID-19 vaccine during an off-site vaccine POD reserved for First Responders and persons aged 65 and older. She should not have been scheduled for this event and nurse administered vaccine without verifying patient's age. Phone call to patient's mom, to inform of error. Mother states patient has had no side effects or adverse reactions to Moderna COVID-19 vaccine. Informed that patient will not receive second dose in 4 weeks and also is not eligible to receive Pfizer COVID-19 vaccine due to manufacturer's recommendation that vaccie is not interchangeable with other COVID-19 products.

Other Meds: unknown

Current Illness: unknown

ID: 0934619
Sex: F
Age: 45
State: MD

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

Lab Data:

Allergies: Crab

Symptoms: 6 cm erythema, inderation + itching at sitse

Other Meds:

Current Illness:

ID: 0951288
Sex: F
Age:
State:

Vax Date:
Onset Date: 01/06/2021
Rec V Date: 01/10/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: RespDepression found to have low potassium Narrative: Patient reports experiencing shortness of breath 24 hours after the vaccine was administered, went to ER and admitted for one night. Informed her supervisor she had low potassium.

Other Meds:

Current Illness:

Date Died: 01/07/2021

ID: 0964653
Sex: M
Age: 78
State:

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data: Patient's temperature log: 12-15-20 08:38:00 97.6 O 12-15-20 16:38:00 97.8 O 12-16-20 08:43:00 97.9 O 12-16-20 11:25:00 98.3 O 12-16-20 16:50:18 98.2 12-17-20 06:22:47 98.1 12-17-20 08:27:00 98.1 O 12-17-20 14:20:00 98.4 O 12-17-20 16:34:00 97.5 O 12-18-20 06:14:00 97.3 Ax 12-18-20 08:05:00 97.5 O 12-18-20 17:30:00 97.5 O 12-19-20 05:35:00 98.1 O 12-19-20 08:21:00 98.4 O 12-19-20 16:32:00 98.4 O 12-20-20 08:27:00 98 O 12-20-20 16:58:39 97.6 12-21-20 08:20:00 98 O 12-21-20 16:34:00 98.8 O 12-22-20 05:44:00 98.2 O 12-22-20 08:58:00 97.7 O 12-22-20 16:39:00 97.5 O 12-23-20 08:12:00 97.5 O 12-23-20 16:56:26 98.1 12-24-20 08:18:00 98.2 O 12-24-20 16:37:00 98.4 O 12-25-20 05:35:00 98 O 12-25-20 08:17:00 97.6 O 12-26-20 05:54:00 98.2 O 12-26-20 08:30:01 97.7 12-26-20 16:16:00 97.5 O 12-27-20 06:23:34 97.9 12-27-20 08:40:37 97.6 O 12-27-20 16:23:00 97.4 O 12-28-20 07:52:00 98.3 O 12-28-20 17:57:31 97.7 12-29-20 05:23:14 98.3 12-29-20 08:43:00 98.4 O 12-29-20 16:44:00 98.6 O 12-30-20 05:54:15 97.4 12-30-20 08:24:00 97.6 O 12-30-20 21:16:00 98.3 O 12-31-20 06:04:02 97.9 12-31-20 08:26:00 97.5 Ax 12-31-20 19:00:00 97.9 O 01-01-21 06:22:09 98.3 01-01-21 08:04:00 98.7 O 01-01-21 16:15:00 99.1 O 01-01-21 17:01:00 97.1 O 01-02-21 06:19:09 98 01-02-21 08:22:00 98.3 O 01-02-21 16:05:00 98 O 01-03-21 06:11:00 97.2 O 01-03-21 08:20:00 98.2 O 01-03-21 16:03:00 97.7 O 01-04-21 05:42:00 97.8 O 01-04-21 08:25:00 98.1 O 01-04-21 18:04:00 97.9 O 01-05-21 05:27:21 98 01-05-21 08:50:00 98.4 O 01-05-21 08:53:22 98.4 01-05-21 16:53:01 98.6 01-06-21 06:03:04 98.1 01-06-21 08:13:00 97.8 O 01-06-21 16:59:00 98 O ***01-07-21 05:35:15 102.9*** 01-07-21 08:15:00 98.5

Allergies:

Symptoms: loss of consciousness; respiratory distress Narrative: Patient tolerated his 1st dose of the COVID-19 vaccine well, on 12/16/2020, and received his 2nd dose on 1/6/2021. Patient had some mild clinical decline the past few days prior to 2nd vaccination, with a decreased appetite and some increased fatigue per nursing report, but no significant changes. He experienced nausea on the evening of 1/6/21, which was effectively managed, but by early morning he spiked a fever of 102.9 with a sat of 86.1%. He continued to deteriorate from that point on and died 1/7/21 @13:20. Clinically, the presentation was most consistent with an aspiration pneumonia.

Other Meds:

Current Illness:

ID: 0982180
Sex: M
Age: 68
State: WY

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Sedation, Myalgia, Diarrhea & NASAL CONGESTION

Other Meds:

Current Illness:

ID: 0982184
Sex: M
Age: 54
State:

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Fever, lump under left arm axilla the size of a baseball or bigger, not red, not hot, but very painful, also had chills yesterday, fever was at 102F Narrative: Has appt to see Occ Health provider today to evaluate the lump. Occupational health evaluated the mass, it appears to be fluid filled and may be larger than a baseball, it is substantial, the employee was sent to the ED for further evaluation to rule out infection or other possible diagnosis. Patient will need an ultrasound, CT scan, blood work, etc.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm