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: 0941044
Sex: F
Age: 37
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: body aches, fever. called in sick to work.

Other Meds:

Current Illness:

ID: 0941045
Sex: F
Age: 47
State: IL

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: none

Allergies: See food

Symptoms: Chills, headache and body ache that started approx 12 hours after vaccine admin

Other Meds: Metoprolol, Vitamin B12

Current Illness: no

ID: 0941046
Sex: F
Age: 82
State: MO

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: Sent to the Hospital ER and returned the following day.

Allergies: N/A

Symptoms: Altered mental status and seizure like tremors, slurring her speech, could not state day, time, place, or situation, salad like statements, increased weakness.

Other Meds: Amlodipine, aspirin, busiprone, calcium, chlorthalid, clopidogrel, vitamin + mineral, divalproex, ferrous sulfate, fiber, gabatentin, flipizide, lactase enz, levothyroxin, mapap, melatonin, metformin, metoprol tar, nateglinide, pramipexole,

Current Illness: N/A

ID: 0941047
Sex: F
Age: 34
State: AZ

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Covid-19 (mrna) Vaccine High Anaphylaxis EMS called for angioedema,scratchy throat, cough Walnut [tree Nut] High Anaphylaxis Demerol [meperidine] Not Specified BRADYCARDIA Dilaudid [hydromorphone] Not Specified BRADYCARDIA Fentanyl Not Specified Itching Hydrocodone Not Specified Itching Morphine Not Specified Itching Other Not Specified NUTS-N/V, STOMACHACHE, DIARRHEA COCONUT-N/V, STOMACHACHE, DIARRHEA Oxycodone Not Specified Itching

Symptoms: Pfizer Vaccine; Cough, SOB, uvula swelling, tachycardic, hot flashes, facial tingling and itching, "cotton ball" in back of throat, dry mouth; administered Epinephrine 0.3 mg IM x3, solumedrol 125 mg, diphenydramine IV 50 mg and 25 mg, famotidine 20 mg, racemic epi, ativan; reaction started 5 min after dose; discharged with epi pen and prednisone

Other Meds:

Current Illness:

ID: 0941048
Sex: F
Age: 89
State: MI

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Shell fish

Symptoms: dizziness, nausea

Other Meds:

Current Illness:

ID: 0941049
Sex: F
Age: 40
State: IN

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: unknown- advised to see PCP or report to ED PRN.

Allergies: yes

Symptoms: itching (benadryl did not relive) strange dark rash/bruising or lesions on left side of body- including lower extremity. Painful.

Other Meds: unknown known: ASA 81mg d/t factor 8

Current Illness: factor 8; denied other issues at time of vaccination

ID: 0941050
Sex: F
Age: 45
State: CA

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

Lab Data: none

Allergies: walnuts

Symptoms: Pt received vaccine on left deltoid at 8:56am. Checked on pt at 9:05 pt stated she had itchiness on her back, heart palpitations and right handed numbness, and felt flushed. Provider notified at9:05. Vitals taken at 9:15 temp 98.8, heart rate 83, blood pressure 150/91, and oxygen saturation 96% on room air, at 9:26 bp 151/88, heart rate 73, and oxygen saturation 99% on room air, blood pressure rechecked at 9:32 and was 151/88. Vitals rechecked at 9:56am temp 97.7, BP 164/89, HR 72, oxygen sat 100% on room air. Vitals at 10:00am BP 158/95, HR 75, oxygen sat 100% on room air, temp 97.7. Provider prescribed Diphenhydramine 25mg x2 capsules to be taken at home, and referred patient to urgent care and follow up with primary care provider.

Other Meds: n/a

Current Illness: none

ID: 0941051
Sex: M
Age: 41
State: IN

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Outdoor/environment allergies

Symptoms: 13.5 hrs after infection chills began. Fever developed and lasted about 9-10 hrs. Headache started after fever started and lasted about 20 hrs

Other Meds: Nasacort, xyzal, montukelast

Current Illness: None

ID: 0941052
Sex: F
Age: 36
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fever. called in sick to work.

Other Meds:

Current Illness:

ID: 0941053
Sex: F
Age: 46
State: WY

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: N/A

Allergies: Morphine, Imatrex

Symptoms: Client reports waking up with a very sore injection site- which became hard and swollen like a "softball". Client also reports opposite arm was numb and tingley. Client reports it took four days to resolve (1/12). Today (1/13) some swelling is still palpable on site. Denies redness or warmth and no redness is noted today. Denies headache or fevers.

Other Meds: N/A

Current Illness: Unknown

ID: 0941054
Sex: F
Age: 64
State: NY

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Exhaustion-Mild, Systemic: Fever-Mild, Systemic: Generalized Body Aches -Mild, Systemic: Headache-Mild, Systemic: patient experienced pain when taking deep breaths but was positive for covid in march2020 and out of work until june 2020. last covid swab was 12/22(negative)and 12/29. temperature was 99.6 and pulse

Other Meds:

Current Illness:

ID: 0941055
Sex: F
Age: 49
State: CA

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: tongue is numb, in the tip and mid anterior section dizzy

Other Meds: vitamin D Vyvanse Biotin

Current Illness: none

ID: 0941056
Sex: F
Age: 67
State: KY

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Shivering, body aches, site ache, fever up to 101.4, tiredness, unsteady pace walking

Other Meds: Prilosec 49 mg Trazadone 50 mg Rosustatin 10 mg Lotta done 10 mg One a day vitamin Castrates 1200 mg

Current Illness: None

ID: 0941057
Sex: F
Age: 53
State: TX

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

Lab Data:

Allergies: None

Symptoms: Pt c/o HA and vertigo. Stated she didn't take HTN or DM medication. Did not eat anything today. Last time to have food was 1/12/20 @ 8:00pm last night. Pt was transported by EMS to ER.

Other Meds: lisinopril hydrochlorothiazide, Glumetza, Levemir

Current Illness: None

ID: 0941058
Sex: F
Age: 53
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: muscle pain, severe joint pain. called in sick to work.

Other Meds:

Current Illness:

ID: 0941059
Sex: F
Age: 35
State: NJ

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: N/A

Allergies: Sulfa, Vancomycin

Symptoms: Pfizer-BioNTech COVID-19 Vaccine on 1/12/2021, patient experienced extreme fatigue and lightheadedness after receiving the vaccine. Patient did not go to ED for evaluation.

Other Meds: none

Current Illness: none

ID: 0941060
Sex: M
Age: 81
State: FL

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: None

Allergies: Morphine

Symptoms: Light headedness,Loss of balance, vomiting, sick feeling on 2nd day @ 12:00 pm recovered after laying down for 3 hrs.

Other Meds: Omeprazole 20mg., Amiodipine 10 mg.,CoQ10 300mg., Iron65mg., Quinapril 40mg., Tamsulosin 0.4mg., B-12 1000mg ,RosuvastatinCalcium 5mg.,

Current Illness: Light-headiness, sick feeling, vomiting, loss of balance for three hrs. recovered after laying down in 3 hrs.

ID: 0941061
Sex: F
Age: 44
State: LA

Vax Date: 12/31/2020
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Left arm red, itchy welp at injection site, hot to touch.

Other Meds: Lipitor, Metformin, Lexapro, Atenolol/Hctz, Albuterol inhaler

Current Illness: none

ID: 0941062
Sex: M
Age: 48
State: AL

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever and chills for approximately 24 hours post vaccination

Other Meds:

Current Illness:

ID: 0941063
Sex: F
Age: 37
State: CA

Vax Date: 12/24/2020
Onset Date: 12/27/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data: Blood work - normal Temperature - normal EKG - didn't show any heart concerns except that heart is way too fast Have tested for COVID twice - both negative Was referred to a cardiologist to wear a heart monitor - was put on January 11. Don't know results yet.

Allergies: Penicillin; Cephalosporin

Symptoms: Initially shot on 24th. Extremely benign - for 24 and 25th - dull headache and arm at injection site was sore. 27th - all of a sudden I had an elevated resting heartrate - 140 - would go up and down and when it was down it didn't go to normal - it went to 90s and my resting heart rate is in 60s. And also had chest tightness, shortness of breath and fatigue. Went to ER That all lasted for 10 days. Fatigue aspect got better; the heartrate slowly started getting a little better. Chest tightness and shortness of breath - even when heartrate went down a little, I was still experiencing those symptoms anyway. Off and on thing for 10 days. Last 10 days - have significant improvement. Due for 2nd dose tomorrow - dr has advised I hold off.

Other Meds: Vitamins- Women's Multi-Vitamin and Vit D

Current Illness: no

ID: 0941064
Sex: M
Age: 49
State: PA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Erythromycin Base and Azythromycin

Symptoms: I received my first dose of the Moderna vaccine on January 11, 2021. The morning of January 12, 2021 I woke with severe muscle and joint pain, headache, extreme fatigue. As the day progressed I developed chills to the point I could not get warm. I also developed a low grade fever. After taking two ibuprofen around 3p the pain subsided to an ache about my entire body by 9p, headache had subsided and I had no more chills or fever. On the morning of January 13, 2021 I woke with a red rash going up the inside of both arms and around the outside of my upper arms and down my entire back. As the day has progressed that rash has spread down the back of legs as well. I did take one Benadryl with minimal effect.

Other Meds:

Current Illness:

ID: 0941065
Sex: F
Age: 54
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received 1st Moderna vaccine on 1/12, woke up feeling sluggish, headache, low back pain, slight nausea. Went to work, had to go home. She is a diabetic, and was also hospitalized in march she was dx with Covid and bilat pneumonia.

Other Meds:

Current Illness:

ID: 0941066
Sex: F
Age: 22
State: GA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: no

Allergies: morphine

Symptoms: after I got the vaccine an hour after I started to get hives and a rash on my chest and face. The rash on my chest is gone but I still have the rash on my face. Warm to touch with hives. 1/13 Rib cage hurts, dizzines nausea and headache.

Other Meds: celexa, vite C,

Current Illness: no

ID: 0941067
Sex: F
Age: 64
State: GA

Vax Date: 12/30/2020
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: 12 days post vaccine, achiness at vaccine site and 3 X 4 inch area of redness.

Other Meds: Vitamin C Prevacid

Current Illness: None

ID: 0941068
Sex: F
Age: 48
State: NY

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Woke up at 12:30 am with severe chills and shaking. Headache, muscle aches, sweating and sore arm

Other Meds: Lisinopril, Pepcid, Gabapentin, Crestor, Prednisone, Vitamin D

Current Illness: none

ID: 0941069
Sex: F
Age: 74
State: MI

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Iodine

Symptoms: vomiting the morning of 1/13

Other Meds:

Current Illness:

ID: 0941070
Sex: F
Age: 58
State: WI

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: I was having diarrhea and stomach cramps which last the whole day and night.

Other Meds: none

Current Illness: none

ID: 0941071
Sex: F
Age: 44
State: IN

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: The night of the vaccine I experienced trouble sleeping and could not go to sleep. The morning after I had a very bad headache and a rash on my right arm and shoulder where near proximity of where the shot was given. It was red dots, no itching, no discomfort. I felt feverish as the day proceeded but never had a temperature. The second day after the shot I had the headache the rash was 75% resolved.

Other Meds: birth control pills

Current Illness: none

ID: 0941072
Sex: F
Age: 47
State:

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 1327: received injection - patient said it hurt much more than 1st injection 1337: Felt dizzy, HR 79, 125/78, O2 Sat 100%, placed supine position 1343: Felt shakey like low BG - got cookies, water, 80 HR, 128/88, 100% O2 1348: Felt like she wanted to sit up. 66 HR, 107/72, 100%, wave of dizziness and nausea 1349: HR 82, 123/86, 100% applied O2 8L Mask 1353: 92 HR 128/84, 100%, nauseated - coolw ash clothes applied - needed to transfer to a better chair that would lay back 1400: HR 72, 120/80, 100%, 36.7 - Felt warm but cool, wanted warm blankets - said she feels like she is sinking into the chair. HR 73, 118/78, 100% feeling better. 1409: 70 HR, 115/76, 100%, orthostatics taken. 1411: 69 HR 118/77, 100%, sat up 1414: 79 HR 123/87 99% took O2 off - felt ok. 1419 67 HR 121/83 100% standing felt okay, not dizzy.

Other Meds:

Current Illness:

ID: 0941073
Sex: F
Age: 66
State: IN

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Sudden onset of severe headache, dizziness, joint pain, exhaustion at 9:00pm

Other Meds: Coreg, entresto, sertraline, levothyroxine, metformin, furosemide, digoxin, vit D3, Slomag

Current Illness: None

ID: 0941074
Sex: M
Age: 60
State: FL

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data: Reported to MD

Allergies:

Symptoms: 1. Incontrollable Shaking of body and limbs-- for 2 days, 2. Migraine, Body aches, Stomach Cramps, Cough, Shortness of breath, Chills, Heavy chest, Hives, Soreness at injection site --all for 9 days

Other Meds: Losartan, Allopurinol, Pravastatin, Amlodipine Besylate

Current Illness:

ID: 0941075
Sex: F
Age: 54
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: received 1st Moderna vaccine on 1/12, woke up feeling sluggish, headache, low back pain, slight nausea. Went to work, had to go home. She is a diabetic, and was also hospitalized in march she was dx with Covid and bilat pneumonia.

Other Meds:

Current Illness:

ID: 0941076
Sex: F
Age: 26
State: NM

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: None

Allergies: sulfa drug

Symptoms: Fevers, chills, body aches experienced at 0200 on 1/12. Vaccine was received at 1100 on 1/11.

Other Meds: Nuvaring q4wk, levothyroxine 25mcg qday

Current Illness: Unknown

ID: 0941077
Sex: F
Age: 25
State: MT

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fever, body aches

Other Meds:

Current Illness:

ID: 0941078
Sex: F
Age: 40
State: CA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: blood panel

Allergies: latex, cardamom

Symptoms: 6 hours after vaccine, developed rash around waist line, next morning woke up to itchy rash on back of head and neck, took Claritin. Next day, developing more small rashes, called Kaiser and was told to take Benadryl. Next morning woke up with more hives and had to go to ER because throat felt like it was closing. Given epipen, prednisone, prevacid . Sent home and symptoms worsened again so gave herself epipen before heading back to the ER.

Other Meds: Prenatal pills, multivitamin, vit c, d , zinc

Current Illness: n/a

ID: 0941079
Sex: F
Age: 39
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fever, joint pain, nausea. called in sick to work.

Other Meds:

Current Illness:

ID: 0941080
Sex: M
Age: 66
State: FL

Vax Date: 12/28/2020
Onset Date: 01/02/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: Labs done on Jan 3, 2021. Covid Nasal Swab PCR (-). CBC, Comprehensive Chem profile and Lipase were (-). Abd CT with contrast done on Jan 3, 2021 demonstrated a non calcified plaque/thrombus in the celiac artery. There was stranding and local edema, consistent with acute event. Liver, spleen, pancreas, Gall Bladder, retroperitoneum were nl. Aorta and bowel were unremarkable. Kidney's has non significant cysts. Subsequent labs done 1/4/2021 to rule out hypercoagulable state and antiphospholipid Syndrome (APS) . Anticardiolipin (-); Beta-2-GPI (-), Lupus anticoag (-), LA DRVVT (-), Protein C and Protein S (-), Antithrombin III Activity (-); Silica Clot Cnfrm ratio 1.26 (elevated). 2D echo pending. ESR 8

Allergies: None

Symptoms: 5 days after Moderna vaccine, developed severe abd pain, mid epigastrium. No Nausea or vomiting. No fever. Mild diarrhea. after 48 hrs with no improvement went to ED

Other Meds: None

Current Illness: None

ID: 0941081
Sex: F
Age: 48
State: MD

Vax Date: 12/31/2020
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: none yet going to urgent care clinic on 1-13-2021.

Allergies: Bee Stings - anaphylaxis

Symptoms: "normal pain" at injection site for week after vaccine. On 1-8-2021, began to notice knot, pain and swelling in left arm. The morning of 1-13-2021; pain more significant and interfered with sleep and limits range of motion. Bruise, some swelling and knot the size of half of a fist to left arm at site of injection. No redness or streaks coming from site. Site appx 2-3 inches below proper site for IM deltoid injection.

Other Meds: MVT

Current Illness: none

ID: 0941082
Sex: F
Age: 30
State: UT

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Tachycardia and throat and chest tightening with second dose of Pfizer-BioNTech COVID-19 vaccine 0.3 mL IM in left deltoid. Called RRT. Patient took diphenhydramine 25 mg PO, and taken to ED for monitoring. ECG normal. Given 1 L NS and vitals monitored for 2 hours. Symptoms resolved and patient discharged in stable condition.

Other Meds:

Current Illness:

ID: 0941083
Sex: F
Age: 61
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received 1st Moderna vaccine on 1/12 on right arm and pain, numbness in right arm, headache; nausea and vomiting all night with last episode at 0130; chills but no fever. No symptoms prior to vaccine.

Other Meds:

Current Illness:

ID: 0941084
Sex: F
Age: 42
State: MA

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Loss of smell

Other Meds: None

Current Illness: None

ID: 0941085
Sex: F
Age: 66
State: MI

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: No labs ordered during ED visit on 1/12/21. Chest XRAY ordered during ED visit on 1/12/21: "FINDINGS: The soft tissues and bony thorax appear unremarkable. The heart and great vessels and hila are normal. The lungs are clear. IMPRESSION: Negative chest."

Allergies: Sulfa antibiotics

Symptoms: Patient presents to ED on 1/12/21 with Allergic Reaction (pt received Moderna Covid-19 vaccine , and pt states about 10 minutes later she started to feel dizzy, sob, heart racing, and developed rash on hands and chest. ) Pt seen by Dr . Pt was ordered NS 500 mL IV x1, diphenhydramine 25 mg IV x1, famotidine 20 mg IV x1, methylprednisolone 125 mg IV x1, and ondansetron 4 mg IV x1. Symptoms resolved prior to discharge from ED on 1/12/21. She was given scripts for diphenhydramine and prednisone with instructions to follow up with PCP.

Other Meds: Alprazolam, Aspirin-Acetaminophen-Caffeine, Cholecalciferol, Citalopram, Co-enzyme Q10, diphenhydramine, estradiol, melatonin, multivitamin, omega-3 fatty acids (fish oil), prednisone, probiotic, rosuvastatin

Current Illness: none

ID: 0941086
Sex: F
Age: 37
State: CA

Vax Date: 12/31/2020
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: Miscarriage

Other Meds: prenatal vitamins

Current Illness: none

ID: 0941087
Sex: F
Age: 47
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 1st Moderna vaccine 1/12, area is swollen, egg sized, with small hard bumps above it. Red, warm, yesterday temp 99.2, today swelling has slightly improved

Other Meds:

Current Illness:

ID: 0941088
Sex: F
Age: 26
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fever, body aches. called in sick to work.

Other Meds:

Current Illness:

ID: 0941089
Sex: F
Age: 58
State: TX

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

Lab Data: N/A

Allergies: NKA

Symptoms: Day 1 painful arm, fatigue Day 2 painful arm, extreme fatigue, nausea, headache Day 3 sudden onset extreme vestibular issues, dizziness, nausea/vomiting - unable to walk to bathroom, subsided after 3-4 hours, persistent headache. Day 4 residual mild-moderate dizziness, persistent nausea, sudden onset extreme headache extending from base of neck around R side of head to top of head lasting 3 hours. arm pain subsides. Day 5 - mild -mod dizziness, mild headache,nausea Day 6 - mild-mod dizziness, mild headache,nausea Day 7 - mild-mod dizziness, mild headache, nausea Day 8 - mild-mod dizziness, mild headache, nausea Day 9 - awoke with L arm itching, swelling, rash with welts at injection site and shoulder. persistent dizziness and nausea

Other Meds: N/A

Current Illness: N/A

ID: 0941090
Sex: F
Age: 48
State: MI

Vax Date: 12/31/2020
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: see above

Allergies: None

Symptoms: Near Syncopal Event on 1/8/2021, Er visit on 1/8 Ct of Brain and Ct chest done as well as blood work On 1/10 Return to Er visit with observation MRI of brain done as well as blood work

Other Meds: Lisinopril 5mg daily, B-Complex Daily, Caltrate 600mg+D3 Daily, Vitamin C 1,000mg Daily

Current Illness: None

ID: 0941091
Sex: M
Age: 42
State: WA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Muscle aches, lethargic, slight fever and chills for six hours

Other Meds: None

Current Illness: None

ID: 0941092
Sex: M
Age: 74
State: MI

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

Lab Data:

Allergies:

Symptoms: He c/o of dizziness and diaphoretic, sat down in hallway floor, placed pt on a stretcher, BP 97/57 ,Hr 48. waited 2 minites,He continued to be diaphoretic, called EMS/ 911, refused treatmen.t 12:40 repeat BP 119/64, HR 84 o2 sat 97% . Refused additional treatment and walked out of building.

Other Meds: alfuzosin, padalasil, myrbetriq

Current Illness:

ID: 0941093
Sex: F
Age: 34
State: MI

Vax Date: 01/09/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: None

Allergies: NKA

Symptoms: 8-10 hours following vaccine: Myalgia throughout body, severe pain at injection site - unable to raise arm above shoulder level and painful to move and touch. (resolved) 3 days following vaccine: Sudden onset chills, fever of 101.1, myalgia throughout body and fatigue. I slept for 14 hours straight, still have slight fever of 99.6 and some myalgia, but mostly resolved.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm