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: 0942059
Sex: F
Age: 31
State: VA

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

Lab Data:

Allergies:

Symptoms: vaccine recipient had diffuse itching and burning feeling after her vaccine. reported she has had this with another medicine, penicillin. continued to itch all over so administered 25 mg of Bendaryl and 20 mg of Pepcid to treat symptoms.

Other Meds:

Current Illness:

ID: 0942060
Sex: F
Age: 25
State: NY

Vax Date: 01/04/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Amoxicillin (rash)

Symptoms: 7 days after vaccination a large, itchy, red splotch with defined borders appeared on my L arm about 10cm by 5cm over the injection site. It has continued for the past 2 days staying about the same. I experienced arm pain lasting about 12 hours after my injection and fatigue lasting 7 days.

Other Meds: Vitamin B12

Current Illness:

ID: 0942061
Sex: F
Age: 51
State: NY

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

Lab Data: no

Allergies: Novacaine, Lidocaine

Symptoms: Face started to get hot, swelling , hives and all red

Other Meds: no

Current Illness: no

ID: 0942062
Sex: M
Age: 57
State: AZ

Vax Date: 01/13/2001
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds: Lisinopril B12 Aspirin 81 mg

Current Illness:

ID: 0942063
Sex: F
Age: 27
State: WI

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

Lab Data:

Allergies: none

Symptoms: Strong headache, muscle pain, fatigue, dizziness

Other Meds: none

Current Illness: none

ID: 0942064
Sex: F
Age: 33
State: NH

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

Lab Data:

Allergies: Penicillin

Symptoms: Pfizer-biontech covid-19 vaccine eua Dizzy, light headed, hot, ears ringing, mild headache, tiredness, fatigue,

Other Meds: Elderberry

Current Illness:

ID: 0942065
Sex: F
Age: 48
State: NJ

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: None-have not seen doctor yet

Allergies: None

Symptoms: Red, swollen left upper arm where injection was given. Site is also warm, hardened and itchy/uncomfortable to touch.

Other Meds: Fluoxetine, DDAVP, Vyvanse, SamE

Current Illness: None

ID: 0942066
Sex: M
Age: 27
State: NM

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

Lab Data:

Allergies:

Symptoms: The patient presented to receive his second dose of the COVID vaccine. The patient did not disclose that he received the Phizer vaccine as his 1st dose until after he received the Moderna vaccine.

Other Meds:

Current Illness:

ID: 0942067
Sex: F
Age: 48
State: IN

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

Lab Data: No tests performed at Vaccine Clinic other than Biox reading (see previous note).

Allergies: NKA

Symptoms: Patient received dose of vaccine at 1630. At this time, Alert and oriented x 3, respirations easy and unlabored, skin pink warm and dry, denies any distress/discomfort. At 1640, patient complained of itching at injection site. Patient stated she has a history of developing itchy feeling due to adhesive from bandages. Patient removed the bandage. RN administering IM injection inspected site: no swelling, rash, hives, or other s/s of inflammation. Patient still alert and oriented x 3, respirations easy and unlabored, skin pink warm and dry, denies any feeling of doom, nausea, vomiting, shortness of breath, elevated heart rate, etc. RN administering injection gave patient an ice pack to apply to left upper arm. Monitoring patient. Patient sitting in chair in vaccine clinic waiting room area. Sipping on H2O due to complaint of feeling thirsty. No difficulty swallowing water. EMS called to Vaccine Clinic for unrelated issue. Once EMS on scene, patient further evaluated by EMS (Biox 98%). Patient asking to be transported to ER. EMS taking patient per patient request.

Other Meds: None dispensed at Vaccine Clinic; not stated by patient

Current Illness: Not stated

ID: 0942068
Sex: F
Age: 60
State: KS

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

Lab Data: unknown

Allergies: with history of an allergy withOUT anaphylaxis to antibiotics and pain meds.

Symptoms: pt had tightness in her chest and shortness of breath. BP-122/84, O2sat-99%, Pulse 102

Other Meds: unknown, pt reports had had covid with residual tightness in chest from that

Current Illness: recovered from Covid in November but has residual effects including shortness of breath

ID: 0942069
Sex: F
Age: 45
State: IN

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

Lab Data: none

Allergies: Shellfish, seafood, shrimp and advocado.

Symptoms: After receiving the 2nd dose of the Covid-19 vaccine on 1/11/2021 at 8:15 am. on 1/12/2021 at 5:36 am waking up I started experiencing slight fever, headaches, whole body aches and both of the back and front of my Calf's muscles felt very heavy. I took Ibuprofen every 6 hour .

Other Meds: Ibuprofen.

Current Illness: none

ID: 0942070
Sex: M
Age: 20
State: TX

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

Lab Data: none

Allergies: no

Symptoms: rash on arm , swelling

Other Meds: Minocyclem 100mg , Metformin centergy 250,250,.2,.7, phentermine 37.5

Current Illness:

ID: 0942071
Sex: F
Age: 64
State: AR

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

Lab Data: N/A

Allergies: Unavailable

Symptoms: She reported a headache. and pressure to the L side of her neck and chest. BP 136/105. Patient waited for 30 minutes and bp was 141/83. At that time she only reported having a headache. She declined to go to the medical clinic for evaluation. She said she would go home and take an aspirin. If symptoms worsened, she would go to the ER.

Other Meds: Unavailable

Current Illness: unavailable

Date Died: 01/05/2021

ID: 0942072
Sex: F
Age: 87
State: VT

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

Lab Data: COVID-19 PCR neg on 12/31/20 and 1/3/21

Allergies: No known allergies

Symptoms: Death occurred 3 days after vaccine receipt; attributed to complications of her chronic advanced dementia with aspiration at age 87. No evidence of acute vaccine reaction.

Other Meds: Tramadol, risperidone, fluoxetine, cyanocobalamin, colchicine, torsemide, levothyroxine

Current Illness: aspiration pneumonia- completed treatment prior to vaccination.

ID: 0942073
Sex: F
Age: 28
State: MT

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

Lab Data:

Allergies:

Symptoms: Body Aches, Fever, Cough

Other Meds:

Current Illness:

ID: 0942074
Sex: F
Age: 38
State: CA

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data: 12/28/20 - - Blood Sugar: wnl - CBC: wnl -Chem10: wnl - troponin: wnl - Ekg (12 lead): normal sinus - pregnancy test: negative

Allergies: PCN

Symptoms: The next morning (12/29/20) - I had typical symptoms -- > minimal body aches/fatigue and a sore Left arm At 6pm (12/29/20) -- > I just finished dinner and all of sudden I felt like I zoned out/passed out for a minute. When I came to -- > my sight was blurry, I felt very nauseous, dizzy, light-headed and felt like I was going to pass out. I ran to the kitchen and drank some water to try and calm it down, the sensation of passing out was still there with palpitations. I called out to my roommate who called an ambulance. My bp/hr were a bit on the lower side initially when the EMTs got to my apt. I was still feeling like I was going to pass out. My labs, vs, and tests all came back WNL when I got to the ED and by that time, I had a severe migraine and nothing else. From that night (Tuesday night 12/29) until the following Tuesday (1/5/21), I had a migraine, severe lethargy, body aches, and a swollen left armpit lymph node.

Other Meds: none

Current Illness: none

ID: 0942075
Sex: M
Age: 52
State: SC

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data: Blood work was completed and normal

Allergies: None Known

Symptoms: I tested positive for COVID 19 on 11/27/20. A chest scan was done on 12/6/20 and showed mild pneumonia. I was treated with Azithromycin and Prednisone. This was followed a a course of Cefdinir. A follow up chest scan on 12/28/20 showed "interval resolution of previously identified right lung base opacities".

Other Meds: Robitussin CF Effexor 37.5 Tylenol Extra Strength

Current Illness: COVID Positive on 11/27/20

ID: 0942076
Sex: F
Age: 41
State: TN

Vax Date: 12/18/2020
Onset Date: 12/21/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data: Covid test

Allergies:

Symptoms: Sunday I had al little ache and pain. On the 21st I had to leave work with a fever 101.4 also had body ache. It progressed from there then I tested positive for Covid. I went to a clinic to get tested was given Zpac, Zythrimac, steroids' .

Other Meds:

Current Illness:

ID: 0942077
Sex: M
Age: 34
State: TX

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

Lab Data:

Allergies:

Symptoms: Patient complained of anxiety and mouth tingling. Hx of anxiety and panic attacks, takes adderall. Cleared by EMS. Instructed patient to call his PCP, 911, or go to the nearest emergency room for any further issues.

Other Meds:

Current Illness:

ID: 0942078
Sex: F
Age: 48
State: VA

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data: Blood work resulting in raised eosinophils (01/10/2021)

Allergies: None

Symptoms: I received the vaccine on 12/30/2020. My arm was sore the day of and sore and slightly swollen the day after. I took Aleve (2 tab q 12 hrs) on 12/31. My arm was slightly swollen on 01/01/2021. I didn?t notice anything else until 01/07/2021. On that day I noticed the area around injection site to be hard and swollen. My arm was also red/warm/itchy half way down before elbow. I took Aleve as before for 2 more days. On 01/10 I went to urgent care since redness spread to above the elbow. Blood work was done. I was given Augmentin 875 (1 tab q 12 hrs x 10 days) and hydroxyzine 50 (1 TID). Currently on 01/13 a majority of redness above elbow is diminished and hardness around injection site and warmth is gone. Redness is now at elbow and under (traveling). I still have 7 days of abx and 3 days of antihistamine.

Other Meds: Dexilant (occasional use) but not at time of vaccination

Current Illness: GERD

ID: 0942079
Sex: M
Age: 25
State: MO

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

Lab Data:

Allergies: Augmitten Amoxicillin Penicillin

Symptoms: I was just fine until 34 hours after administration of the second dose. Then I was hit suddenly with fatigue, lethargy, I felt hot, ears burning, and diarrhea. I went to sleep 3 hours after onset and woke up without symptoms.

Other Meds: Adderall

Current Illness: None

ID: 0942080
Sex: F
Age: 61
State: IN

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

Lab Data: None

Allergies: Some Spring allergy but not bad.

Symptoms: On my drive back to work after getting the vaccine the left lower part of my face when numb and tingly. Then it focused on my left nostril. The overall effect didn't last long but my nostril still doesn't feel right. Somewhat numb but not always. The left side of my face feels strange at times as well. Hard to explain.

Other Meds: Valsartan-HCTZ 320-12.5mg Tab, Vitamin D3

Current Illness: None

ID: 0942081
Sex: F
Age: 36
State: OR

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

Lab Data:

Allergies: Morphine allergy

Symptoms: Had Vaccine on 12/24. Since then she has had daily episodic full-body itchiness and rash or redness; light-headedness, migraines, irregular heartbeat. She has also noted episodic throat tightness and SOB in the 10 days since the vaccine. She has a history of anaphylaxis w/ morphine. She has an autoimmune condition currently being evaluated by rheumatology. Has Von Willibrands and Hx stroke due to BCP. Will need Allergy Consultation with MD prior to 2nd dose.

Other Meds:

Current Illness:

ID: 0942082
Sex: F
Age: 46
State: IL

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

Lab Data:

Allergies:

Symptoms: Patient started itching and had mild hives. Reported to her manager who accompanied her back to the Covid Clinic. Patient was assessed and was given Diphenhydramine 25mg orally x 1.

Other Meds:

Current Illness:

ID: 0942083
Sex: F
Age: 34
State: WA

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

Lab Data: Patient was seen at clinic today to receive her COVID Vaccination at 0915, after 5 mins she started having symptoms. Was treated with O2 and rest No Labs or Xrays.

Allergies: Latex, Sulfa Meds, and Nickle

Symptoms: Patient reports to clinic after receiving the COVID-19 Vaccine at today. Patient states that she was given the vaccine at 0915 today and about 5 mins after started to have symptoms of a hot sensation from head to toe, heart racing, ears burning, and chest tightness, no breathing difficulty. Patient notified staff and was given O2 and allowed to drink her water. Her symptoms did improve and she was sent to the waiting area again. After about 10 mins her chest tightness came back. Patient states she can feel her blood flowing, "kinda like when your limb is numb". Patient also had symptoms of chills, body shakes, loss of smell, and a metallic taste in mouth. Patient states that she was seen again by staff and laid on a cot for 20 mins, and was then cleared to head back to work around 1000. Patient was seen in the clinic at 1157, and her symptoms since it started have improved. Currently she has the following symptoms: can't taste/smell, (L) arm is sore, H/A, with constant ache, localized to back of neck up to behind the both eyes. Body feels worn out, everything feels heavy, takes a few second to focus when she looks around "like there is a delay". Patient was sent home to recover and to let medical staff know if her symptoms return.

Other Meds: Spironolactone 100mg

Current Illness:

ID: 0942084
Sex: F
Age: 37
State: TX

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

Lab Data: BP 177/96 P 89

Allergies:

Symptoms: Red chest and tingling

Other Meds: Synthroid, Losartan

Current Illness:

Date Died: 01/08/2021

ID: 0942085
Sex: F
Age: 62
State: KS

Vax Date: 01/02/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Amoxicillin, Clavulanic Acid, Codeine, Morphine, Pencillin

Symptoms: No adverse effects from vaccination seen on 1/2/21. On 1/6/21 resident was seen by Dr and her baclofen pump was refilled with 20 ml Baclofen 4,000mcg/ml. ITB Rate increased by 6% to 455.5 mcg/day simple continuous rate over 3 days. On 1/8/21 at 0615 resident was shaking, lower extremities mottled, Sa02 70%, pulse 45. Oxygen started at 2 L/m per NC. At 0715 her primary physician was notified as well as her daughter. Oxygen increased to 4 L/min, sats at 83%. SOA noted, reported all over pain. At 0850 when they attempted to reposition the resident, she was not responsive. Licensed nurse assessed her and no heartbeat heard or pulse found.

Other Meds: Ativen, Butrans Patch, Tylenol, Potassium Citrate-Citric Acid

Current Illness: Medical diagnosis: quadriplegia, Atherosclerotic heart disease

ID: 0942086
Sex: F
Age: 29
State: IN

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Latex

Symptoms: Large erythematous area around injection sight. Swelling. Occured the following day after vaccination (1/6), resolved, then flared up in same spot on 1/12. Additional symptoms include pain at the injection site, and lymphadenopathy and pain in the left axilla.

Other Meds:

Current Illness: None

ID: 0942087
Sex: F
Age: 33
State: MT

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

Lab Data:

Allergies:

Symptoms: Elevated heart rate, chills, fatigue.

Other Meds:

Current Illness:

ID: 0942088
Sex: F
Age: 46
State: WV

Vax Date: 12/30/2020
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Ceclor

Symptoms: Initially warm swollen redness with knot headache on days 2 thru 4. Jan 8 swelling worse with redness and itching. Symptoms relieved with benadyrl. Day 14 redness rash hot burning to touch. Area spread around arm approx 4 inches wide. . Sent to urgent care. Given steroids and antibiotics.

Other Meds:

Current Illness:

ID: 0942089
Sex: F
Age: 36
State: HI

Vax Date: 01/10/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: NKDA; food = shrimp and scallops

Symptoms: itchy, fine, erythematous papular rash to face, scalp, chest and back 24 hours after vaccine treated with benadryl and H2 blocker

Other Meds: amoxicillin and ibuprofen

Current Illness: dental abscess

ID: 0942090
Sex: F
Age: 46
State: IL

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: I had some common symptoms after the 1st shot. Really run down a little nauseous arm hurt but not swollen for a couple days. I also had some symptoms that I don?t think are common. My arm muscle was twitching and my pinkie and ring finger were tingly and cold. All went away after a couple days. Day 8 discovered a lump on my arm where the injection site was. Was red, hot and a little itchy fingers tingly again. Saw doc on day 9. Gave antibiotics incase of cellulitis/infetion but not sure the cause. Now that is 90% cleared up.

Other Meds: none

Current Illness: none

ID: 0942091
Sex: F
Age: 66
State: IN

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

Lab Data:

Allergies:

Symptoms: Headache, generalized body aches/pain, pain in legs for 18 hours

Other Meds: Synthroid, sudafed, maxide, lipitor, calcium with vit D, Simvastatin, neurontin, phentermine, losartin

Current Illness:

ID: 0942092
Sex: F
Age: 27
State: FL

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

Lab Data: None

Allergies: None

Symptoms: Blurry vision over long period of time - immediately after vaccination

Other Meds: Mometasone nasal spray; Cetirizine; Prenatal vitamin

Current Illness: No

ID: 0942093
Sex: F
Age: 51
State: OR

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

Lab Data: Hearing audiology test, 1/12/21 MRI to be scheduled after insurance approval

Allergies: Clindamycin, nickel, latex (sensitivity to latex on face only)

Symptoms: I had a mild headache the evening of the shot, I had a headache the next two days that was relieved by Advil. I had a very sore arm at the injection site Friday and Saturday after the shot was given. The arm pain was gone Sunday morning. I was very tired on Saturday especially and slept through the morning and early afternoon on and off until about 3:00 pm. On Friday during the day, I noticed my right ear starting to feel unusual and uncomfortable. On Saturday, the ear issue continued, I felt like I had some hearing loss and a constant buzzing and ear fullness feeling. On Sunday, the ear issued continued with the hearing loss, buzzing and fullness and has through today and hasn't stopped. I tried some nasal decongestant on Sunday afternoon, but it didn't have any effect. I made an appointment with the ENT doctor on Monday morning for Tuesday. I had a hearing test on Tuesday and saw the ENT doctor on Wednesday. He prescribed prednisone and ordered an MRI. I will be starting the prednisone later today (Wednesday) when the pharmacy has the prescription ready.

Other Meds: Junel, pantoprazole, vitamin B-12, vitamin D, loratadine, fluoxetine

Current Illness: none

ID: 0942094
Sex: F
Age: 35
State: FL

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

Lab Data:

Allergies: None

Symptoms: Tachycardia for >24 hours, no treatment, just monitored

Other Meds: None

Current Illness: None

ID: 0942095
Sex: F
Age: 31
State: HI

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 10 minutes after 1st dose of moderna vaccine, employee began experiencing palpitations. Examined by on-site physician. Denied chest pain, dyspnea, throat tigetening, angioedema, dizziness, nausea/vomiting, rash/hives. Employee did report warmth on roof of mouth without metallic taste. No acute distress or angioedema noted as time passed. Blood pressure (BP) 150s/100s, heart rate (HR) 120s, which dropped down to 100, then 96 during examination. By 12:31 PM palpitations and mouth warmth resolved. BP 125/86, HR 93. 12:45: BP 130/89, HR 80. Hypertension, tachycardia, mouth warmth resolved. Employee was observed for a full hour and was directed to continue to self-monitor. Employee was directed to see PCP for worsening or recurrence of symptoms.

Other Meds:

Current Illness:

ID: 0942096
Sex: F
Age: 38
State: KS

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

Lab Data: UNKNOWN

Allergies: after vaccination pt reported allergy to antibiotics

Symptoms: had tightness in the chest like an asthma attack with BP 158/98, P-103, O2SAT98%

Other Meds: unknown

Current Illness: none

ID: 0942097
Sex: M
Age: 4
State: TX

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

Lab Data: none

Allergies: nkda

Symptoms: Redness around injection site and mom advised us that she feels a lump

Other Meds: none

Current Illness: none

ID: 0942098
Sex: F
Age: 28
State: IN

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

Lab Data:

Allergies: Sulfa

Symptoms: Fever - began around 0500 the day after my second injection Severe fatigue - began 2 hours after my injection Muscle aches - began around 0500 Rigors - began around 1200 Treated with ibuprofen and sleep Symptoms resolved by the morning of 1/13 at 0700

Other Meds: Buproprion

Current Illness: none

ID: 0942099
Sex: F
Age: 60
State: IN

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

Lab Data: none

Allergies: none

Symptoms: About 22 hours after administration I had chills, headache,blood shot eyes, total body aches and extreme fatigue. I slept off and all day and at 3:00 am 1/13/2021 I woke up and felt much better. chills, headache and body aches all gone. Some fatigue still lingers. I did not have fever at any time.. My arm injection site was less sore than the first vaccine.

Other Meds: amlodipine, vit c, vit d, claritin, B complex.

Current Illness:

ID: 0942100
Sex: F
Age: 26
State: NJ

Vax Date: 01/06/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Cefdinir

Symptoms: Beginning 1/11/2020, I began experiencing an uncomfortable sensitivity in my left axilla. I have a history of inflamed lymph nodes that occurs 1-2 times a year under the arm and in the groin, and this felt similar to those episodes. The lymph node is hard to touch and the sensitivity continues today. Today (1/13/2020), I noticed an inflamed, red patch of skin that is hot to touch over the region where the injection occurred. Additionally, I have experienced diarrhea 1-2x/day for the past two days.

Other Meds: Tri-sprintec Spironolactone

Current Illness: N/A

ID: 0942101
Sex: F
Age: 30
State: MT

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

Lab Data:

Allergies:

Symptoms: Body aches, chills, fatigue

Other Meds:

Current Illness:

ID: 0942102
Sex: F
Age: 38
State: OH

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

Lab Data:

Allergies: Allergic to all seafood

Symptoms: Severe headache and nausea and possible fever (chills in the middle of the night)

Other Meds:

Current Illness:

ID: 0942103
Sex: F
Age: 26
State: IN

Vax Date: 01/03/2021
Onset Date: 01/10/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: 1 week after administration the injection site became red and swollen and itchy. Since then I have developed hives surrounding the area on my upper arm

Other Meds: Vitamin D

Current Illness: None

ID: 0942104
Sex: F
Age: 26
State: IN

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

Lab Data:

Allergies: None Reported

Symptoms: Became Faint, hypotensive and Diaphoretic. Right arm injection site clear. no redness or swelling. Initial BP 82/53 Pulse rate 147. Ate a granola bar and water. BP take again 124/80 Pulse rate 120. Patient became fatigued. Mom or dad picking up

Other Meds: None Reported

Current Illness: None Reported

ID: 0942105
Sex: F
Age: 44
State: CA

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

Lab Data:

Allergies: No known allergies

Symptoms: @0705 patient started to report slight swelling of lips and tight pressure in chest. No SOB. Also reporting numbness to lips as well. Same reaction to the initial dose. Patient stated it did not feel worse than the initial time. By 0735, symptoms resolved.

Other Meds: azelastine, fluticasone

Current Illness:

Date Died: 01/09/2021

ID: 0942106
Sex: M
Age: 54
State: CA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 54 y/o M with PMH of HTN, HLD, Alcoholic Cirrhosis, Aortic Valve Stenosis, and angina BIBA as a Medical Alert for cardiac arrest noted PTA. Per EMS, the patient called because he was having constant, diffuse abdominal pain x 1 day that radiated to his chest. On scene, the patient had a witnessed arrest with EMS starting CPR. He was given 3 rounds of epi without ROSC. Pt had no associated shockable rhythm. Of note, pt's wife, had noted pt had received covid vaccine the prior day.

Other Meds:

Current Illness:

ID: 0942107
Sex: F
Age: 41
State: NE

Vax Date: 01/06/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: 1/9/21: ER visit with EKG, labs, head CT taken at County Hospital.

Allergies: None

Symptoms: Received the vaccine on a Wednesday afternoon. That evening I developed body aches, which got progressively worse over the course of the following day. I developed a persistent headache on Thursday that stuck around until Sunday. On Saturday morning I woke up feeling ok, still had the dull headache, but was ok enough to be up and around. At approximately 10:30 Saturday morning I was hit with stroke symptoms. I had weakness in my left hand, tunnel vision, couldn?t understand words that were spoke to me and was aphasic with garbled speech. Went to local ER and was worked up for stroke. Symptoms resolved Within approximately 45 minutes. All tests, lab results ok.

Other Meds: Losartan 25mg PO at HS Vitamin D3 2000 iu daily Tylenol 1000 mg PO PRN body aches

Current Illness: Treated hypertension Low vitamin D level, recently started the supplement Active cold sore

ID: 0942108
Sex: F
Age: 61
State: TX

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

Lab Data: BP 158/84 P 100

Allergies: NKDA

Symptoms: Angina, palpitations and right arm numbness. Pt stated feeling was coming back.

Other Meds: Levothyroxine

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm