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: 0919393
Sex: F
Age: 28
State: PA

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

Lab Data:

Allergies: Latex, Aspirin, dilaudid, percocet

Symptoms: Hot flash and dizzy next thing she knew she was in a stretcher. Gave her an ice pack and elevated feet. Went to ED, per patient did not receive any medications, just had an EKG.

Other Meds:

Current Illness: Covid + 12/13/20

ID: 0919394
Sex: F
Age: 57
State: ND

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: None

Allergies: Sulfa Drugs

Symptoms: Vaccine was administer too high on the arm and infiltrated the bursa sack around the shoulder joint of the left arm. The patient alternated ice and heat on the shoulder joint, self administered ibuprofen, and exercised the arm for 48 hours. The patient was unable to lift the arm more than 20 degrees, in front or to the side. The pain resolved in about 60 hours. She has no residual affects.

Other Meds: Unknown

Current Illness: None

ID: 0919395
Sex: F
Age: 33
State: IN

Vax Date: 12/20/2020
Onset Date: 12/21/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: High fever, headache, tenderness at injection site.

Other Meds: Tylenol as need Vitamin c 500mg twice a day Vitamin d 4000 IU once a day 100mg zinc once a day Augmentin twice a day for 10 days

Current Illness:

ID: 0919396
Sex: F
Age: 57
State: KS

Vax Date: 12/17/2020
Onset Date: 12/18/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: Sunday 12/20 Retinologist did collect cultures prior to treating me with antibiotics.

Allergies: Penicillin, cephalosporin

Symptoms: Took covid shot Thursday 12/17. On Friday 12/18 had avastin shot to right eye. That afternoon had EXTREME inflammation, irritation, tearing, pain and light sensitivity. Vision became "whited out". Saw Dr. sunday 12/20, received two antibiotic shot and steroid shot all to right eye. Prescribed Levaquin po and antibiotic and steroid eye drops. Followed up with retinologist again today 1/4/21, symptoms fairly resolved but vision is still blurry. Hoping to completely regain my sight.

Other Meds: Lisinopril, simvastatin, zyrtec. Had an avastin shot in my right eye 12/18/2020

Current Illness:

ID: 0919397
Sex: F
Age: 53
State: MA

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: Sulfa, Percocet

Symptoms: Employee told nurse she felt lightheaded and "shaky". Given water and asked to stay extra 15 minutes. Seen by EMT's for blood pressure check: 130/80, Pulse 77, 100%.

Other Meds: Albuterol inhaler Possibly others which patient declined to disclose

Current Illness:

ID: 0919398
Sex: F
Age: 59
State: TX

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: extreme pain in arm with injection site, inability to move arm, insomnia due to pain in arm.

Other Meds:

Current Illness:

ID: 0919399
Sex: F
Age: 44
State:

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Employee received MODERNA vaccine on 12/28/2020 and had no symptoms on first day, then on 12/29/2020-2nd day employee experienced body aches, fatigue, nausea, and low grade fever-99.4, with no chills. Then on 12/30/2020-3rd day employee had body aches, and mild nausea only, by the 4th day employee feeling much better with no further symptoms.

Other Meds:

Current Illness:

ID: 0919400
Sex: F
Age: 54
State: MS

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

Lab Data: N/A

Allergies: morphine and related

Symptoms: localized itching at injection site. Benadryl 50mg capsules given. itching decreased- got better.

Other Meds: unknown

Current Illness: None

ID: 0919401
Sex: F
Age: 48
State: AZ

Vax Date: 12/19/2020
Onset Date: 12/19/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: 12/19/2020 EKG: Sinus rhythm with ventricular rate of 64. No acute ST segment elevation or depression noted. Nonspecific ST wave changes noted. QRS interval normal 84 ms. QTc interval mildly prolonged 528. No electrolyte abnormalities.

Allergies: ciprofloxacin - rash fexofenadine - unknown reaction

Symptoms: employee getting Pfizer COVID19 vaccination. about 10 min post injection developed feeling of flushing and ?"prickliness" on skin. no resp distress no swelling or rash seen. VS taken and hypertension noted 170s/90s. normal O2sat and HR- NO prior medical hx of hypertension. Monitored for 30 min in vaccination clinic persistent hypertension. Referred to ED for ongoing monitoring-still hypertensive but eval neg referred to primary care provider for follow up

Other Meds: None obtained from this facility

Current Illness:

ID: 0919402
Sex: F
Age: 40
State:

Vax Date: 12/26/2020
Onset Date: 12/26/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: local- soreness systemic/local-urticaria

Other Meds: Levothyroxine 50 mcg

Current Illness: none

ID: 0919403
Sex: M
Age: 23
State: ME

Vax Date: 12/26/2020
Onset Date: 01/02/2021
Rec V Date: 01/04/2021
Hospital:

Lab Data: N/A

Allergies: Penicillin

Symptoms: I received the vaccine through my employer. 7 Days after the vaccination event, my left deltoid muscle became significantly swollen, stiff and tender. There was pain when I tried to elevate the arm laterally. The site was very warm to the touch. I experienced periods of malaise and fatigue at random intervals throughout the week after which I received the vaccine. On day 8, a red rash began to appear on the vaccination site. It was slightly itchy. The area was still stiff and swollen, and painful to move past a certain angle. This night I felt especially fatigued. On day 9 I woke up to see the swelling was mostly subsided, however the rash had spread down the arm to roughly the elbow. The site was no longer warm. It was still slightly irritable. As the day is progressing (this is written on day 9), the rash is starting to fade.

Other Meds: N/A

Current Illness: N/A

ID: 0919404
Sex: F
Age: 32
State: OH

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

Lab Data: None

Allergies: Celiac disease. Codeine. PCN.

Symptoms: C/O heaviness and warmth to neck, shoulder, and back. C/O heart racing- HR 112. BP 143/99. ER diagnosed with allergic reaction- minor. Continue to report warmth and heaviness to mid-upper back.

Other Meds: None

Current Illness: hx Celiac disease.

ID: 0919405
Sex: F
Age: 42
State: WI

Vax Date: 12/26/2020
Onset Date: 12/30/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: bees

Symptoms: Patient received a dose of vaccine that may be less than effective due to storage conditions. No adverse effects noted.

Other Meds:

Current Illness:

ID: 0919406
Sex: F
Age: 27
State: TX

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: Penicillin, amoxicillin

Symptoms: Extreme right arm soreness- painful to palpation and to lift arm Low grade fever evening of 12/20/20 ranging from 99.4-100.4

Other Meds: Zyzal, birth control, flonase, spirnolactone

Current Illness: seasonal allergies

ID: 0919407
Sex: M
Age: 44
State: PR

Vax Date: 12/26/2020
Onset Date: 01/04/2021
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: In the area where the vaccine was applied I have it irritated and warm

Other Meds: N/A

Current Illness: N/A

ID: 0919408
Sex: F
Age: 35
State: NY

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

Lab Data: none

Allergies: no known allergies

Symptoms: Patient was given vaccine at 1515 and told to wait at facility until 1530. Patient called cf clinic at 1630 stating she had hives. Patient spoke with RN and stated that her hands were itchy on the ride home and she noticed they were swollen. She stated that she developed hives on her chest and hands. Patient denies any chest heaviness or shortness of breath at this time. Doctor consulted and advised patient take benadryl for reaction. Patient was advised if she developes shortness of breath or any further symptoms to come in and seek emergency treatement and she understood. Patient did complete v safe today and reported on there as well.

Other Meds: gabapentin , metformin, omega 3

Current Illness: none.

ID: 0919409
Sex: F
Age: 37
State: SC

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: Watermelon, cantaloupe, no med allergies

Symptoms: Dizziness post vaccine, came back to clinic and ate snack bc she had not eaten that morning. BP 130/80, felt better with food. 2 similar episodes the following day, no further epidose after 48h.

Other Meds: Wellbutril XL 150mg daily Ibuprofen prn migraine

Current Illness: na

ID: 0919411
Sex: F
Age: 40
State: MO

Vax Date: 12/22/2020
Onset Date: 12/23/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: widespread itching, localized itching at injection site, swelling/welting at injection site, red area about the size of an orange around injection site, darkened discoloration like bruising persisting 2 weeks following first inection . Reported to Employee Health

Other Meds: levonorgestrel and ethinyl estradiol tablets, once daily Linzess once daily

Current Illness: N/A

ID: 0919412
Sex: F
Age: 32
State:

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Arm very sore at injection site a few hours after vaccination, and for about 2-3 days afterward. Moving the arm helped alleviate the soreness. Also took a bath and ibuprofen.

Other Meds:

Current Illness:

ID: 0919413
Sex: F
Age: 69
State: PR

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: Aspirin

Symptoms: swelling , itching, pain ,redness, hot area. Started Xyzal and Prednisone 5 mgs, Panadol 500 mgs, cold compresses for about 3 days. then in January 1, started antibiotic Augmentin bid, because it became worst. Now with redness , hot area, but improving>I am a Doctor. Moderna Vaccine

Other Meds: VitaminD 10,000U, Glucosamina, Caltrate 600 mgs, Tumeric,

Current Illness: Hypertension, Osteoporosis

ID: 0919414
Sex: F
Age: 48
State: NH

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

Lab Data: none

Allergies: Phenergan, Tylenol, Peanuts, Tree nuts

Symptoms: headache (base of skull) and neck pain (back of neck)

Other Meds: Losartan, HCTZ, Singulair

Current Illness: Hypertension

ID: 0919415
Sex: M
Age: 54
State: WI

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: Treated for earache with antibiotic on 1/4

Allergies: Ciprofloxin

Symptoms: Body aches and joint pain, swollen lymph node on right armpit, temperature of 101'F starting on 1/1

Other Meds: Albuterol, Amlodipine, Atenolol, Atrovastatin, Gemfibrozil, Insulin, Jaridiance, Losartan, Metformin, Omega 3, Omeprazole, Sitagliptin, Spirolactone

Current Illness: Ear ache

ID: 0919416
Sex: F
Age: 40
State: WI

Vax Date: 12/26/2020
Onset Date: 12/30/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: penicillins

Symptoms: Patient received a dose of vaccine that may be less than completely effective due to storage conditions. No adverse effect noted.

Other Meds:

Current Illness:

ID: 0919417
Sex: F
Age: 46
State: OR

Vax Date: 12/26/2020
Onset Date: 12/27/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: none

Allergies: Sulfa drugs

Symptoms: On day two I noticed a golf ball sized lump at injection site. It was there until day 4 or 5 when it started to go away, but never went away completely. It was sore, but not very painful. On day 10, I noticed it was more sore and now there is a lot of redness over injection site. The lump is a little bigger, but not as big as it was originally.

Other Meds: Avapro, HCTZ, Prilosec, Wellbutrin, Multivitamin, Vitamin C, Melatonin

Current Illness: none

ID: 0919418
Sex: F
Age: 48
State: CT

Vax Date: 12/24/2020
Onset Date: 12/24/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: PCN (anaphylactic) Erythromycin (hives) Peanuts (anaphylaxis)

Symptoms: Patient developed shortness of breath and tachycardia/palpitations in the evening after receiving the vaccine, as well as "pins and needles" sensation over her torso.

Other Meds: acyclovir

Current Illness: None

ID: 0919420
Sex: F
Age: 50
State: GA

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: 103 fever on and off x 2 days; dizziness x 1 1/2 day; swollen/painful lymph nodes x 4 days; body aches/fatigue x 2 days

Other Meds: Estradiol 5mg 1cc monthly; Lisinopril 10mg daily

Current Illness: none

ID: 0919421
Sex: F
Age: 38
State: UT

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: EKG showed NSR Labs, CBC And chemistries all within normal values Chest x-ray showed not cardiopulmonary disease CT of brain showed no acute findings

Allergies: Tamiflu

Symptoms: Employee started having symptoms 5 hours after administration of vaccine. Had headache and chills. Slept through the night. Woke with fever, chills, body aches and tics, chest pain, headache, nausea, difficulty breathing, lethargy and decreased level of responsiveness. Was admitted to the ED on 12/29/2020 at 11:37 am. Temp 37.7, HR 88, RR 22, BP 122/86, SaO2 98%. Glasgow coma score was 15. She was oriented to person, place and time but responses were short and slow. Work up in the ED included, EKG, chest x-ray, CT of brain, and Labs(CBC & chemistries). She was also given Acetaminophen 650mg for head ache, Ketorolac 30 mg for pain, Ondansetron 4mg for nausea, and 2 liters of LR. Observed for 5 hours with some improvement in symptoms and discharged at 5:10 pm

Other Meds:

Current Illness: Tested Covid positive on 12/10/2020

ID: 0919422
Sex: F
Age: 30
State: KY

Vax Date: 12/23/2020
Onset Date: 12/31/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: EKG clear, no blood clots detected, X-ray of chest normal.

Allergies: Erythromycin, penicillin

Symptoms: A week after receiving the COVD19 vaccine, red patches of skin started appearing around the injection site. Patches were not itchy. Armpit area (lymph nodes) was painful, as well as general pain in left arm. The next day the rash had gotten larger and left arm started tingling. Arm pain persisted. On the third day the rash was larger still, with prolonged arm tingling and left chest area pain. I went to the ER as no one could answer why these problems were arising a week after the vaccine. ER advised taking Benadryl and watching out for shortness of breath. Arm is currently tingling and eyesight seems fuzzy.

Other Meds: Magnesium chelate, allergy shots (not taken that week), cetrizine HCl taken daily, oral birth control, Viibryd

Current Illness:

ID: 0919423
Sex: F
Age: 46
State: NY

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: none

Allergies: Penicillin, Shellfish, Mold, Aged Cheese

Symptoms: Turned red and flushed within 5 minutes of vaccine administration. Lasted for about 60 minutes. No issues breathing.

Other Meds: Bystolic, Amlodipine

Current Illness: None

ID: 0919424
Sex: M
Age: 39
State: KS

Vax Date: 12/17/2020
Onset Date: 12/18/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Left eye swollen 24 hours later, took Benadryl in ED and resolved right away

Other Meds:

Current Illness:

ID: 0919425
Sex: F
Age: 53
State: WI

Vax Date: 12/26/2020
Onset Date: 12/30/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: meperidine

Symptoms: Patient received a dose of vaccine that may be less than completely effective due to storage conditions. No adverse effect noted.

Other Meds:

Current Illness:

ID: 0919426
Sex: M
Age: 63
State: GA

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 01/04/2021
Hospital:

Lab Data: None

Allergies: Pineapples

Symptoms: Patient reports having a 1 cm x 1.5 cm " blister- like " lesion at his injection site since 01/03/2021 at 7:00 pm.

Other Meds: Omeprazole , Zyrtec

Current Illness: Patient denies.

ID: 0919427
Sex: F
Age: 32
State: OH

Vax Date: 12/31/2020
Onset Date: 01/02/2021
Rec V Date: 01/04/2021
Hospital:

Lab Data: Chest X-ray was normal

Allergies: Adhesive

Symptoms: Moderna vaccine on 12/31/2020. The next day, Friday she had a sore left arm, that was it. No redness or swelling at the injection site.. On Saturday she had a dry cough with deep inspiration, chest tightness, and shortness of breath and left shoulder pain requiring aleve and heating pad. Saturday she used her rescue inhaler a few times, Sunday she used it 2-3 x and one time today. Ongoing chest tightness . Got order for 5 days of steroids and epi pen prescription

Other Meds: albuterol HFA 90 mcg/actuation inhaler Prn amitriptyline 75 mg tablet Po daily Amphetamine-Dextroamphetamine 30 mg tablet buPROPion XL 300 mg 24 hr tablet Cholecalciferol (Vitamin D3) 50 mcg (2,000 unit) Cap clobetasol 0.05 % cream ELURYN

Current Illness: None

ID: 0919428
Sex: F
Age: 58
State: TX

Vax Date: 12/26/2020
Onset Date: 12/30/2020
Rec V Date: 01/04/2021
Hospital: Y

Lab Data: Angiogram 12/31/2020 Troponin levels 12/30/2020 <0.02; 12/31/2020 1.7 PER PATIENT

Allergies: nka

Symptoms: Felt slight warmth throughout body about 5 minutes after vaccine. Disappeared 2 minutes later. Arm started to feel sore as the day went on and was very sore by nighttime. Next day, arm started to feel better and over the next 3 days was no longer sore. On the morning of the 30th, woke up feeling fine, took a 3.5 mile walk and felt fine. Around 12:30 pm, experienced sudden pain and a burning sensation in the chest and both upper arms. Thought it was possibly heartburn ; took a Prilosec. The discomfort (mild but steady) continued so checked blood pressure which was 141/91. Called cardiologist and went to emergency room per instruction, around 1:30. Admitted overnight with the diagnosis of a mild heart attack and performed a heart catheterization where they found no major blockage. One artery noted 30% blocked but that overall heart function looked good. Discharged on 12/31/2020. -reported by patient via email, on 1/3/2021 @ 4:49pm

Other Meds: clopidogrel lisinoprel carvedilol rosuvastatin aspirin symbicort melatonin mvi vitamin d3

Current Illness: none

ID: 0919429
Sex: F
Age: 39
State: OR

Vax Date: 01/04/2020
Onset Date: 01/04/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: None

Allergies: Penicillins, Sulfas, Erythromycin, Lavender oil

Symptoms: Vomiting

Other Meds: Nexplanon, Ibuprofen as needed, Imitrex as needed, recent cortisone shot, CBD balm

Current Illness: Frozen shoulder

ID: 0919430
Sex: F
Age: 55
State: CA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: N?A

Allergies:

Symptoms: 12/29/20 Headache, dizziness. Woke at midnight with headache, flushed face, could not get warm. Heart rate 95, respiratory rate 25. At approximate 2:00 am woke with HEADACHE, flushed face, Temp 101.1. 12/30/2020 Continues to c/o of dizziness, Huge headache, Ibuprofen not effective

Other Meds:

Current Illness:

ID: 0919431
Sex: M
Age: 72
State: PA

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 01/04/2021
Hospital:

Lab Data: Ophthalmic Exam

Allergies: No known Allergies

Symptoms: Anterior Uveitis in the Left Eye; blurry vision, injected sclera in left eye started on 1/3/21; evaluated for and diagnosed with Anterior Uveitis of Left Eye at Hospital Emergency Department on 1/4/21, and prescribed topical steroids upon same-day discharge.

Other Meds: Metformin, Sitagliptin, Pioglitazone, Azetimibe, Atorvastatin, Ramipril, Hydrochlorothiazide

Current Illness: No Illnesses at time of vaccination

ID: 0919432
Sex: F
Age: 39
State: WI

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: Positive COVID test result received 12/30 from 12/28 test, after 12/29 vaccination

Allergies: Codeine, morphine, Demerol, environmental allergies such as grasses, trees, dander, mold

Symptoms: Severe headache, vomiting, chills within one hour of vaccine, full body rash and itching 12/29 through ongoing, swollen feet resulting in inability to walk 1/4/2021 (PCP suggests erthyema nodosum); treated with Claritin

Other Meds: None

Current Illness: Had routinely tested for COVID on 12/28 as required by employer but had no symptoms,got positive results of test on 12/30

ID: 0919433
Sex: F
Age: 57
State: GA

Vax Date: 12/22/2020
Onset Date: 12/25/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: none to report

Allergies: NO KNOWN ALLERGIES

Symptoms: patient reports arm pain and unable to move arm without discomfort

Other Meds: UNKNOWN

Current Illness: NO KNOWN ILLNESS

ID: 0919434
Sex: F
Age: 21
State: SC

Vax Date: 12/27/2020
Onset Date: 12/29/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: Covid test on January 3rd 2020

Allergies: None

Symptoms: On Sunday, December 27, I had the injection. I was fine. Monday the 28th, I was in pain in my arm. December 29 to currently ( January 4 2021) I am sick. I believe I got it from the vaccine. I have been out of work for two weeks. I will not go get the other vaccine. I thought I was protecting myself but find out I am not. I am currently laying in bed sick as a dog. I have shortness of breath, cough, sneezing,sore throat, and bodyaches. I am in severe pain

Other Meds: None

Current Illness: None

ID: 0919435
Sex: F
Age: 24
State: TN

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

Lab Data:

Allergies: Doxycycline

Symptoms: My arm has not stopped twitching since I have received the vaccine 2.5 hours ago. I can still use it. It is a localized twitch on the back side of my arm an inch above my left elbow (same side as injection).

Other Meds: Adderall

Current Illness:

ID: 0919436
Sex: M
Age: 29
State: IL

Vax Date: 12/29/2020
Onset Date: 01/01/2021
Rec V Date: 01/04/2021
Hospital: Y

Lab Data: Full bloodwork, CT, MRI as part of inpatient hospitalization 1/2/2021-1/3/2021 at Medical Center.

Allergies:

Symptoms: Bell?s palsy, right side of face is numb, with difficulty closing eyes, smiling, raising eyebrows, eating, drinking, swallowing.

Other Meds:

Current Illness: Strained neck resulting in numbness in extremities. This and facial numbness prompted me to see my PCP who urged me to go to the ER immediately. I went to Medical Center's ED, after which I was admitted to the neuro ICU for a possible brain bleed, which after an MRI was determined to be a cavernoma.

ID: 0919437
Sex: F
Age: 37
State: WV

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

Lab Data:

Allergies: Tramadol hydrochloride

Symptoms: Started having tingling in her mouth, post nasal drip, and feeling like her skin in her mouth was sloughing off an hour later.

Other Meds:

Current Illness:

ID: 0919438
Sex: F
Age: 54
State: KS

Vax Date: 12/18/2020
Onset Date: 12/20/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 48 hours later bilateral eyes swollen. Saw dr. in office and treated with steroid cream and allergy meds resolved without difficulties

Other Meds:

Current Illness:

ID: 0919439
Sex: F
Age: 33
State: WI

Vax Date: 12/26/2020
Onset Date: 12/30/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: levonergestrel, cymbalta

Symptoms: Patient received a dose of vaccine that may be less than completely effective due to storage conditions. No adverse effects noted.

Other Meds:

Current Illness:

ID: 0919440
Sex: F
Age: 39
State: IN

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/04/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Severe anterior right shoulder pain associated with very limited ROM due to pain. No pain at injection site. No swelling or erythema at injection site. Pain is in anterior shoulder and radiates down right arm. Pain is constant but worse with movement. Pain started the night that vaccine was given 1/2/2021 and has been persistent since then making it difficult to work. Pain not relieved with tylenol or ibuprofen. Pain is more severe that what would be expected from needle trauma. Of note, vaccine was given particularly high near subdeltoid bursa.

Other Meds: none

Current Illness: none

ID: 0919441
Sex: F
Age: 58
State: GA

Vax Date: 12/23/2020
Onset Date: 01/03/2021
Rec V Date: 01/04/2021
Hospital:

Lab Data: saw MD, no tests or labs done

Allergies: none

Symptoms: Moderna COVID-19 Vaccine EUA reddness at injection site - noticed 10 days past injection; no itching or pain

Other Meds: Allegra Singular Mirlax

Current Illness: none

ID: 0919442
Sex: F
Age: 55
State: FL

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: COVID19 test 1/3/2021; result negative

Allergies: none

Symptoms: Day of vaccine approximately 30 minutes later patient experienced warm sensation in chest, progressed to muscle aches, swelling of foot/ankle. On 1/3/2021 patient still complains of muscle/body aches, joint pain, swelling of foot. On oral steroid for foot swelling. >10days with no improvement.

Other Meds: none

Current Illness: none

ID: 0919443
Sex: F
Age: 58
State: GA

Vax Date: 12/28/2020
Onset Date: 01/04/2021
Rec V Date: 01/04/2021
Hospital:

Lab Data:

Allergies: Lortab & Morphine

Symptoms: S: Employee received Covid vaccination on 12/28/20. Employee reported noticing "itching all over my body". The following day she experienced nausea and moderate joint pain. She then also experienced redness on forehead, ears and "felt like they were on fire." B: Covid vaccination on 12/28/20. Employee contacted advice nurse and was instructed to report to ACC A: Employee reported to ACC on 12/29/20 and received solumedrol shot R: Reporting for tracking purposes

Other Meds: Outpatient Medications at End of Encounter on as of 12/28/2020 Disp Refills Start End Cephalexin (KEFLEX) 500 mg Oral Cap 14 capsule 0/0 12/4/2020 12/4/2021 Sig - Route: Take 1 capsule by mouth 2 times a day for 7 days for infection - Ora

Current Illness: ICD-10-CM Priority Class Noted - Resolved MENOPAUSAL HOT FLASHES (Chronic) N95.1 5/14/2012 - Present MENOPAUSAL SYMPTOMS (Chronic) N95.1 9/12/2012 - Present MIGRAINE (Chronic) G43.909 9/12/2012 - Present VARICOSE VEINS OF BILAT LEGS W INFLAMMATION I83.11, I83.12 9/12/2012 - Present HIGH DENSITY LIPOPROTEIN DEFICIENCY (Chronic) E78.6 9/28/2012 - Present VITAMIN D DEFICIENCY E55.9 9/28/2012 - Present HX OF TOTAL HYSTERECTOMY W HX OF BENIGN DISEASE (Chronic) Z90.710, Z87.898 11/14/2012 - Present FHX OF COLON POLYP Z83.71 6/18/2013 - Present INSOMNIA G47.00 6/21/2013 - Present CARDIOVASCULAR STRESS TEST NEGATIVE FOR ISCHEMIA ADMIN CODE 8/21/2013 - Present Overview SLEEP APNEA (Chronic) G47.30 10/11/2013 - Present ADJUSTMENT DISORDER W ANXIETY F43.22 11/27/2013 - Present PREDIABETES (Chronic) R73.03 8/6/2014 - Present HX OF LASIK Z98.890 1/9/2015 - Present BILAT DRY EYE SYNDROME H04.123 1/9/2015 - Present PRESBYOPIA H52.4 1/9/2015 - Present BRONCHITIS J40 9/15/2015 - Present ACUTE SINUSITIS J01.90 9/15/2015 - Present HYPERLIPIDEMIA (Chronic) E78.5 1/25/2016 - Present ABNL LIVER FUNCTION STUDY R94.5 5/16/2016 - Present RIGHT BUNDLE BRANCH BLOCK I45.10 8/30/2016 - Present ADULT OBSTRUCTIVE SLEEP APNEA (Chronic) G47.33 2/22/2017 - Present MAJOR DEPRESSIVE DISORDER, RECURRENT EPISODE (Chronic) F33.9 9/4/2018 - Present

ID: 0919444
Sex: F
Age: 34
State: NY

Vax Date: 12/21/2020
Onset Date: 12/29/2020
Rec V Date: 01/04/2021
Hospital:

Lab Data: 12/30 - ct cspine

Allergies: None

Symptoms: 12/21 had covid vaccine (dose 1). On evening of 12/29 had sudden onset of mild neck pain and significant weakness and numbness of left arm, weak hand grip, clumsiness in hand . Did not improve after trying to shake arm/move around , and took prednisone 40mg oral. Went to ER and had CT Cspine which did not show evidence of cervical pathology. Continued with corticosteroids, sought consultation with PMR and neurology specialists, and steroid dose increased to 60mg/day. Some improvement in strength , but still have diminished sensation and strength in left hand/arm. Unable to perform full job tasks as I am left hand dominant. Likely brachial neuritis / parsonage turner syndrome per both specialists seen. Continuing with corticosteroids at this time, pending bloodwork and OT evaluation

Other Meds: Balziva ( birth control )

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm