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: 0945548
Sex: F
Age: 50
State: TX

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: None

Allergies: Shellfish, Gluten, Floroquinolone antibiotics

Symptoms: 15 minutes after receiving the vaccine I felt like I was going to faint and then called out somone?s name and she came and caught me as I fainted. They called for Rapid Response Team. They put me on a stretcher, asked what happened, and took some vital signs - I was tachycardic, BP was 184/108 pulse ox 97 and they also saw nystagmus only in my left eye which I?ve never had before.

Other Meds: Propranolol, Hydroxychloroquine, Adderall, Lansoprazole, Creon, Gastrocrom (cromolyn sodium oral), Quercetin

Current Illness: Ehlers Danlos Syndrome, Mast Cell Activation Syndrome, Dysautonomia with Postural Orthostatic Tachycardia Syndrome, Lupus (SLE), chronic gastritis, IBS, CCI, cervical spinal stenosis with herniated discs, PCOS

ID: 0945549
Sex: F
Age: 42
State: MN

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

Lab Data:

Allergies: Prochlorperazine: nausea and vomiting

Symptoms: Patient developed tight feeling in throat, difficulty swallowing, diaphoretic, clammy skin and facial swelling around eyes.

Other Meds:

Current Illness:

ID: 0945550
Sex: F
Age: 43
State: CA

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

Lab Data:

Allergies: Azythromicin

Symptoms: Difficulties breathing within 5 minutes of getting the vaccine, Lightheaded, fast heartbeat, pain on the arm of injection. Within 1 hour: headache, tiredness, swelling on the site of the injection.

Other Meds: Riboflavin 400mg Pepcid Biotin

Current Illness: Seasonal allergies

ID: 0945551
Sex: M
Age: 69
State: OK

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

Lab Data: None

Allergies: None known

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA. Provider preparing vaccine diluted it using a smaller volume of diluent (1.5mL) than recommended (1.8mL). She injected 0.3 mL as indicated. Pt. was observed for 15 minutes and reported no adverse reaction. Consultation with Pfizer Safety Reporting revealed that this volume dilution would produce a concentration within the therapeutic range.

Other Meds: none reported

Current Illness: None reported

ID: 0945552
Sex: F
Age: 46
State: CA

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

Lab Data:

Allergies: Penicillin

Symptoms: Swollen face, wheezing

Other Meds:

Current Illness: None

ID: 0945553
Sex: F
Age: 56
State: NJ

Vax Date: 01/08/2021
Onset Date: 01/11/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: Did not seek medical care.

Allergies: None

Symptoms: Except for mild soreness in arm, felt perfectly fine for f, s and sun.Then, Awoke at 3 AM dizzy, difficulty balancing, severe vomiting and diarrhea. Felt like food poisoning with a horrible hangover. I felt like I wanted to die. For 90 min, My head was on the toilet seat or agsainst the floor. No one else in my house got sick snd we all ate the same meal. Couldn?t hold my head up. Felt terrible next day, vomiting had stopped, but diarrhea and dizziness/ lightheaded persisted. Missed full day of work on mon, 1/2 day on tues. I?m 90%better, but still with residual lightheadness snd feel off balance when I move my head or change position quickly. Had covid back in March - no respiratory sxs, just HA, congestion, sore throat, snd no sense of taste or smell for 6 weeks

Other Meds: Multivitamin, vitamin D, vitamin C and probiotic

Current Illness: None

ID: 0945554
Sex: F
Age: 47
State: MO

Vax Date: 01/06/2021
Onset Date: 01/08/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: have not had any yet have appointment with surgeon on 01/18/2021 which then i will fing out when biopsy is

Allergies: Sulfur

Symptoms: Lymph Node on my right side by my coller bone had swollen went to PCP, PCP sent me to have a ultra sound done, then a CT scan , then got sent to a oncologist, that referred me to a surgeon which I see on 01/18/2021 to get a biopsy/remove it and send it off to pathology all happened in one week,

Other Meds: Metoprol Tar 100mg, Indapamide tab 1.25mg,Bupropn HCL 300mg,Verapamil 240mg ER, B12 2500mcg, Phentermine tab 37.5

Current Illness:

ID: 0945555
Sex: F
Age: 54
State: NC

Vax Date: 01/04/2021
Onset Date: 01/11/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: None

Allergies: Allergic reaction once to Sporanox oral medication

Symptoms: My left shoulder was moderately sore for about 3 days after the injection. The soreness didn't interfere with activities but did interfere with my sleep. Other than that I had no immediate reaction. However, early on day 7 (01/11), I developed itching at the injection site and as the day progressed I developed redness, irritation, hotness, and continued itching. It began as a small area about the circumference of a golf ball and spread, over the course of the day, to about the size of a grapefruit. The symptoms lasted about 2 days (01/11-12). By the evening of day 9 (01/13), hives began to appear, mostly on my arms and legs, with minimal bumps also on my torso and neck. I'm submitting this report on the evening of day 10 and the hives are still present. The hives itch and are easily irritated.

Other Meds: Methylsulfonylmethane powder

Current Illness: None

ID: 0945556
Sex: F
Age: 35
State: CA

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

Lab Data: Given BENADRYL 50 mg PO x 1

Allergies: None

Symptoms: Patient experiences L posterior elbow urticaria and L arm and lower extremities swelling. No facial swelling. No drooling. Able to speak in full sentences.

Other Meds: None

Current Illness: None

ID: 0945557
Sex: M
Age: 19
State: NY

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

Lab Data: N/A

Allergies: CARPENTER ANTS AND WALNUTS

Symptoms: HEIGHTENED BLOOD PRESSURE AND HEART RATE, ALTERED MENTAL STATUS. EMS REQUESTED AND AIDED TRANSPORTED TO MEDICAL CENTER.

Other Meds: ADEROL, LEXIPRIL, BENZOTROPHIN

Current Illness: NONE

ID: 0945558
Sex: F
Age: 51
State: NJ

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: 1.11.2021-EKG while in the ER along with fluids, benadryl, Steroid, Pepcid.

Allergies: Demerol, Allegra, Contrast Dye (visapaque).

Symptoms: About 20 minutes after receiving vaccine, back sides of tongue with swelling, hives and rash on face, chest. received Benadryl 25 mg, and epi -taken to ER rec?d additional benadryl, steroid, Pepcid and fluids-monitored and able to go home. Continued Benadryl at home and steroids. 30 hours after vaccine had severe nausea and vomitting that resolved after a couple of hours. Left arm extremely sore. Day 3 after vaccine felt much better. Followed up with PCP and will not get the 2nd dose.

Other Meds: Valsartan/HCTZ, Xyzal, Singulair, Omeprazole, Biotin, hysoscyamine, vitamin A, Vitamin B12, Vitamin D3, Xiidra, MVI.

Current Illness: None.

ID: 0945559
Sex: F
Age: 53
State: TX

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

Lab Data: NA

Allergies: N/A

Symptoms: The day of the vaccine I was very sore for three days. On day 8th I got a really bad reaction. Redness, itchy and burning sensation.

Other Meds: N/A

Current Illness: High blood pressure

ID: 0945560
Sex: M
Age: 65
State: FL

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

Lab Data: None

Allergies: None known

Symptoms: Redness, swelling and pain at the injection site that subsided after 5 days. Redness and swelling returned at at day 8 following the initial injection and are still present at day 14.

Other Meds: Multi Vitamin, 500 mg Vitamin C, 200 mg Magnesium, 100 mg CoQ10, 80 mg Aspirin, 500 mg Valtrex.

Current Illness: None

ID: 0945561
Sex: F
Age: 48
State: CO

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: None

Allergies: Un know however, pt. brought her own epi-pens.

Symptoms: Post injection x 5 min. sitting in chair, friend stated pt. was having a reaction, nurse was notified, pt. stated "I am having a seizure", pt. was placed on floor, MD on site for clinic examined pt. Pt. responded to base line and placed on chair. Water provided. After observation, MD stated pt. to call her PCP and was able to go home with friend.

Other Meds: Un known

Current Illness: Un known

ID: 0945562
Sex: M
Age: 84
State: UT

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

Lab Data:

Allergies: none

Symptoms: None stated.

Other Meds: pain pills

Current Illness: pace maker

ID: 0945563
Sex: F
Age: 49
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data:

Allergies: no known food or drug allergies

Symptoms: heart palpitations and tachycardia, mild resolved within 9 hours of administration; after that, fever and myalgia x 6 hours; next day, general myalgia only

Other Meds: none

Current Illness: treated for possible UTI

ID: 0945564
Sex: M
Age: 0
State: AZ

Vax Date: 05/01/1953
Onset Date:
Rec V Date: 01/14/2021
Hospital:

Lab Data:

Allergies: NONE

Symptoms: NONE

Other Meds: BUMEX 2MG BID

Current Illness: NONE

ID: 0945565
Sex: F
Age: 41
State: MO

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

Lab Data: None

Allergies: None

Symptoms: Extreme hot flash that felt like needles all over the body, knees felt like they were on fire, lips and tounge were tingling, bad taste in mouth, elevated blood pressure and heart rate, and dizzy. Dissipated after about 30 minutes, and left a headache.

Other Meds: None

Current Illness: None

ID: 0945566
Sex: F
Age: 29
State: MS

Vax Date: 01/05/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data:

Allergies: Nsaids

Symptoms: Redness after injection for 3 days, sore arm Cellulitis diagnosed 1/14/2021

Other Meds:

Current Illness:

ID: 0945567
Sex: F
Age: 21
State: CA

Vax Date: 01/05/2021
Onset Date: 01/11/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: 1/11/2021- noticed red erythematous, itchy severely rash to Left forearm. Improved with otc antihistamines 1/11/2021- received 3 additional vaccines from PCP - MMR, Tdap and HPV- later that same evening rash developed to left arm where one vaccine provided our of 3. Resolved by 1/12/2021.

Other Meds: none

Current Illness: none

ID: 0945568
Sex: F
Age: 33
State: LA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: None

Allergies: Phenergan

Symptoms: Approx 15 mins post vaccination began having chills, slight dizziness. Continued. Approx 2hr post vaccination began having chest tightness. Approx 8hrs post vaccination began having intense joint/bone and muscle pain , rapid heart rate, shortness of breath at times. All of these symptoms continued until 1/14/21 until approx 8am. Still experiencing slight dizziness and headache.

Other Meds: Lo loestrin fe a HS Xyzal 5mg q HS Zeita 10mg q HS Aspirin 81mg q HS Lexapro 10mg q HS

Current Illness: Sinus infection

ID: 0945569
Sex: F
Age: 65
State: AL

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

Lab Data: Refer above: Ems did blood glucose and not sure if value but it was normal They did BP and it was low: systolic was around 110 and diastolic was around 66

Allergies: NKA

Symptoms: Patient received the second shingrix shot and her first pneumonia shot of prevnar 13 She got her shingrix was perfectly fine Did her pneumonia in right arm. She felt lightheaded within 1 minute and had to sit down. Said she had never felt dizzy like this before and was very hot. We asked if she needed anything she said no. Her husband standing next to her watching her and I as the pharmacist checked in every 2-3 minutes to see if she was ok. Suddenly she dropped her head and went unconscious and had labored breathing. Called ems immediately. Patient was unresponsive for 30 seconds and she came back. Had epi and Benadryl ready to give within 1 minute. However she was recovering from what seemed like syncope. Ems arrived within 5 minutes. They took her BP and her diastolic was 66ish (she had measured before in our automated machine and it was around 76ish). So they said she had syncope most likely and they monitored her and she refused to go on ambulance and went home as she?s a retired nurse and knew how she was feeling. She had some orange juice while ems was here and we turned on the fan in front of her and that seemed to help her.

Other Meds: Not sure she does not fill with us she only gets her shots with us

Current Illness: NA

ID: 0945570
Sex: F
Age: 71
State: AL

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Started with itching at injection site in the evening one week post injection. Today with erythemic, slightly raised area approximately 2 cm, circular. Extreme itching. Until this, no issues beyond a sore arm the first two days.

Other Meds: Estradiol Citerizine Multivitamins Calcium

Current Illness: None

ID: 0945571
Sex: F
Age: 36
State: CA

Vax Date: 12/21/2020
Onset Date: 01/11/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: None

Allergies: NKDA

Symptoms: Pfizer-BioNTech COVID-19 Vaccine Patient described immediate jaw clenching/tightness within first 10 minutes after vaccine, that only now subsided about 72-80 hrs later. Along with this severe body aches, soreness, chills.

Other Meds: Lexapro 10mg Zoloft 50mg

Current Illness: No current illnesses, currently breastfeeding

ID: 0945572
Sex: F
Age: 70
State: KS

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: none

Allergies: sensitive to thimerosal.

Symptoms: 01/08/21: Fatigue in the evening (no specific time given) 01/09/21: around noon trunk of body felt like it was in a vice squeezing, headache, nausea, sore throat, chills, and extreme fatigue that lasted a solid 5 hours. Patient reports taking 2 tablets of 200mg ibuprofen and symptoms eased up leaving her extremely tired. Patient reports taking 2 650mg tablets of acetaminophen around noon with no relief. 01/10/21: soreness in the arm of the injection 01/11/21: fatigue, body cramps (occasionally) decreased appetite, numbness in arm of injection

Other Meds: multivitamin with minerals

Current Illness: COVID-19 positive 11/04/20

ID: 0945573
Sex: F
Age: 75
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: none

Allergies: Tetracycline

Symptoms: 1/12: Nausea, mild vomiting (reflux), pain at injections site 1/13: More pain at injection site, nausea, mild vomiting, fever 99.7F, headache, sleeplessness 1/14: Less pain, no more nausea or fever

Other Meds: Metoprolol, Crestor, aspirin, Joint meds (Glucosamine, Chondroitin, MSM, Turmeric), cod liver oil

Current Illness: no new illness

ID: 0945574
Sex: F
Age: 50
State: MD

Vax Date: 01/06/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: None

Allergies: Formaldehyde and formaldehyde releasing agents.

Symptoms: Rash at injection site developed after 9 days. Itchy and red area about the size of a half dollar.

Other Meds: Metoprolol, birth control, multi-vitamin, vitamin c, zinc, echinacea, and glucosamine chondroitin.

Current Illness: None

ID: 0945575
Sex: F
Age: 60
State: MO

Vax Date: 01/06/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Raised area at the site of the injection (swollen) and itching. Started today, 1-14-21

Other Meds: None

Current Illness: None

ID: 0945576
Sex: F
Age: 48
State: CA

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

Lab Data: Blood Pressure and heart rate: 1/14/21 at 1:22pm, 1:25pm and 1:30pm.

Allergies: She said she has no known medical conditions.

Symptoms: Patient arrived for her appointment around 1:05 pm. She received the vaccine after reviewing the pre-vaccination questions. She received her vaccination without incident around 1:10pm and waited in her car for the prescribed 15 minutes. Around 1:20, she honked her horn, indicating she was experiencing something not normal. Nurse responded immediately. When nurse got to the car, patient appeared anxious and diaphoretic. Nurse took her BP and pulse. Her first reading was 160/104 with a heart rate of 104. Client was now calm and had caught her breath by 1:22pm. Patient said she had this happen before when she was pregnant years ago. She said she was light-headed and had tingling feet. Patient stated she had not taken medication and had no known medical conditions. Her BP was taken again at 1:25, and it was 158/92 with a heart rate of 72. The nurse monitored these tests again at 1:30, and the BP went to 144/84 and heart rate was still 72. Client said she was able to drive and return to work. She said she worked 10 minutes away. Our nurse recommended she call work to tell them she was coming. The client was no longer in any distress according to our nurses observation.

Other Meds: Said taking no medication.

Current Illness: None stated.

ID: 0945577
Sex: M
Age: 66
State: AZ

Vax Date: 11/25/2020
Onset Date: 11/25/2020
Rec V Date: 01/14/2021
Hospital:

Lab Data: no

Allergies: earth plant

Symptoms: ARM sore for 24 hours

Other Meds: Bacterium

Current Illness:

Date Died: 01/11/2021

ID: 0945578
Sex: F
Age: 72
State: KS

Vax Date: 01/02/2021
Onset Date: 01/10/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: No reactions immediately after vaccine was given. Resident has dementia, has had multiple hospitalizations related to a renal stone recently. Had a tooth that was bothering her, went to see her dentist and it was extracted on 1/6/21. On 1/10 they noted feet and ankles are dark purple with white splotches appears to be mottling. Minimally responsive to voice and touch. Not eating. Compassionate visit with family. Family did not want hospice, did not feel it was needed, said, what more could they do for her than you're already doing? On 1/11 at 1950 was determined to be deceased.

Other Meds: Aspirin 81 mg, metformin, namenda, effexor XR, donepezil, potassium chloride, Vitamin B12, Brillinta, clonzepam, flomax, ultram, oxybutynin chloride, sucralfate, ferrous sulfate, protonix, percocent, metoprolol succinate ER, senna Colace, n

Current Illness: Had a tooth extraction done on 1/6/21. Was on amoxicillin for 7 days and it caused diarrhea. Changed to Keflex.

ID: 0945579
Sex: F
Age: 58
State: NY

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data:

Allergies: Penicillin, Sulfa

Symptoms: Soreness, redness/inflammation

Other Meds: Rosuvastatin

Current Illness:

ID: 0945580
Sex: F
Age: 82
State: IN

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

Lab Data:

Allergies: sulfa drugs, PCN

Symptoms: Pt started feeling short of breath about 20 minutes after vaccine was administered. Husband honked horn from parking lot as instructed if any adverse reactions. Initial assessment: pt SOB, flushed, able to communicate, calm. 911 called and paramedics on scence in 1 minutes (we were at Firehouse for vaccine clinic). BP 179/68, HR 88, RR 28, Ox 99%. After monitoring, paramedics cleared patient to go home. Patient started feeling better after a few minutes of paramedics arriving. Encouraged by them to take Benadryl/Tylenol for any effects and to call 911 if she started to feel SOB again or had any other concerning symptoms. Husband and pt both verbalized understanding.

Other Meds:

Current Illness: bronchiectasis

ID: 0945581
Sex: F
Age: 72
State: IL

Vax Date: 01/05/2021
Onset Date: 01/12/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data:

Allergies: Penicillin, Ceclor, CT scan dye, shrimp

Symptoms: on 1/12/21 I woke up with a 3 inch by 5 inch red, raised, itchy rash at site of injection. Noted on 1/14/21 rash less red and itchy, no decrease in size.

Other Meds: Losartan 100 mg, Atorvastatin 10 mg, Vitamin D 2000 units, Preservison

Current Illness:

ID: 0945582
Sex: F
Age: 32
State: TX

Vax Date: 12/27/2020
Onset Date: 12/30/2020
Rec V Date: 01/14/2021
Hospital:

Lab Data: None.

Allergies: NKDA

Symptoms: Supraclavicular lymphadenopathy three days after vaccine. Bilateral upper arm arthralgia six days after vaccine. Severe fatigue and nausea 16 days after vaccine.

Other Meds: Adderall 20mg PO PRN

Current Illness: None

ID: 0945583
Sex: F
Age: 23
State: CA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever 101.7, chills, body aches, headache,

Other Meds:

Current Illness:

ID: 0945584
Sex: M
Age: 27
State: CA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data:

Allergies:

Symptoms: At 11:00 PM awoke with severe full body chills and subjective fever that lasted about an hour. Woke again at 1:30 AM drenched in sweat with pounding frontal headache and eye aches, got up to use restroom and had vasovagal syncope while standing in front of the toilet.

Other Meds: acetaminophen 1000 mg, ibuprofen 200 mg, fish oil 1000 mg, vitamin D3 50 mcg (2000 IU)

Current Illness: SARS-CoV-2 infection diagnosed via nasopharyngeal swab on 12/29/20

ID: 0945585
Sex: F
Age: 49
State: AZ

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: None

Allergies: NKA

Symptoms: left arm swollen and 2.5 cm X 4 cm redness at injection site. Patient stated, "it started swelling yesterday, and it was warm to tough." No worsening symptoms noted. patient was given instructions about comfort measures, and was advised to seek medical interventions if symptoms worsens or failures to resolve.

Other Meds: anxiety medications

Current Illness: None

ID: 0945586
Sex: F
Age: 31
State: IL

Vax Date: 01/06/2021
Onset Date: 01/11/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: Treated for cellulitis unclear if infection due to how vaccine was injected or a delayed allergic reaction. Prescribed antibiotics and close monitoring.

Allergies: Bactrim

Symptoms: Swelling, redness and tenderness, warmth to the area that is spreading, started on 5th day after the injection

Other Meds: Citalopram Duloxetine Seroquel

Current Illness:

ID: 0945587
Sex: F
Age: 30
State: TN

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/14/2021
Hospital:

Lab Data:

Allergies: Penicillin, amoxicillin

Symptoms: Bp 190/150. Sever nausea puking feeling faint. Exhausted

Other Meds: N/a

Current Illness: N/a

ID: 0945588
Sex: F
Age: 61
State: NY

Vax Date: 01/08/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: Covid 19 Vaccine

Allergies: none

Symptoms: For 2 days I had a huge welt on vaccine site. Then, on day 5, I developed low grade fever, cough, pain and soreness in muscles.

Other Meds: Zoloft, Wellbutrin, atavastin.

Current Illness: Covid 19 long hauler. Dx late March 2020

ID: 0945589
Sex: F
Age: 50
State: TX

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

Lab Data:

Allergies:

Symptoms: One(1) hive on the right side of face, hair & ear itchiness, client seen & cleared by EMS

Other Meds:

Current Illness:

ID: 0945590
Sex: F
Age: 56
State: NH

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

Lab Data:

Allergies: None

Symptoms: "Pfizer-BioNTech COVID-19 Vaccine " I, the client sitting 5 minutes after receiving vaccine began to feel dizzy and drank the provided bottled water. The dizziness lasted for 2 hours. Within 10 minutues I also started having numbness and tingling from my right elbow to my hand, anterior and posterior. This continued throughout the day. After being observed by staff, after 30 minutes I was given Benadryl tablet25 mg by mouth. The adverse event has also been reported to my manager and employee health.

Other Meds: None

Current Illness: None

ID: 0945591
Sex: F
Age: 26
State: PA

Vax Date: 01/08/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: Nothing has been done as of yet

Allergies: Bactrim

Symptoms: Soreness of injection site about 10 hours after injection time lasting about 2 days. 5 days after, severe pain in the underarm area 6 days after, severe pain in the underarm area in addition to pins and needles running from armpit to finger tips, sore neck and a runny nose began.

Other Meds: Daily vitamin- women's

Current Illness: N/A

ID: 0945592
Sex: F
Age: 42
State: AK

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

Lab Data:

Allergies: penicillins reports an allergy to something else- but unsure what it is, last year had some lip and eye swelling from something

Symptoms: Patient came into Public Health Clinic for 1st dose of COVID-19 Vaccine. Patient completed COVID-19 vaccine screening checklist for contraindications. Patient reported that she had a penicillin allergy-hives and had a reaction to an unknown agent that caused eye and lip swelling. Form reviewed by Dr who verbally screened risks for patient. Patient made educated decision to get vaccine knowing risks of allergic response. Patient received Moderna Lot # O11J20A in left deltoid administered by Indigo RN. Patient observed in clinic for 15 minutes after vaccine given. No reactions reported at that time. Patient waited longer due to significant other also receiving the vaccine and having to wait for observation. At 1054 patient reported to pharmacist of her lips feeling tingly and her tongue feeling heavy. She reported to, RN and informed Dr. of patient's status. Upon physical assessment of oral mucosa, no tongue swelling, throat soreness, redness or swelling noted on physical exam, vessels under bottom lip looked slightly dilated. Patients lips also within normal limits, no swelling noted. Vital signs of 98.3F tympanic, O2 sats 100% on room air, heart rate 91, respiratory rate 16. BP R. arm 164/104, L. arm 165/112, manual on R. arm 164/98. Patient states she took hydrochlorothiazide for BP at 12:30, right before coming into clinic. Patient still feeling like her lips are tingly and tongue is heavy, Per Dr. would prefer to assess patient in the ER. Instructed patient to go to Health Center ER with husband for further assessment. Per chart review from ED, Pt monitored in ED for 1 hr. without recurrence or development of symptoms. She states that she feels normal and is ok with going home. Return precautions discussed. No interventions.

Other Meds: Hydrochlorothiazide-for hypertension patinet reports taking that medication at 12:30 Vitamin D supplement- took this AM; Apple cider Vinegar

Current Illness:

ID: 0945593
Sex: M
Age: 83
State: AZ

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

Lab Data:

Allergies:

Symptoms: none

Other Meds:

Current Illness:

ID: 0945594
Sex: F
Age: 35
State: GA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Progressively worsening chills, myalgias, headache, fatigue peaking at 24 hours post vaccine. All mild. Did not need medication.

Other Meds: none

Current Illness: none

ID: 0945595
Sex: F
Age: 65
State: FL

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

Lab Data:

Allergies: sulfa drugs, preservatives

Symptoms: Reaction at vaccine injection site 1 week later

Other Meds: multi vitamin, probiotic, fish oil, vitamin d, turmeric, calcium

Current Illness: none

ID: 0945596
Sex: F
Age: 41
State: CT

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital: Y

Lab Data: BM

Allergies: None

Symptoms: Anaphylaxis- throat tightness , nausea , rash , pruritis , chest tightness, wheezing . 9-11 called epinephrine x 2 , decade on , IV Benadryl , duo-nebs, famotidine, admission to icu high dose prednisone , nebulizers , zofran , duo-neb nebulizers

Other Meds: Albuterol HFA TRELEGY ELLIPTA nexium 40mg Lexapro 20mg

Current Illness: None

ID: 0945597
Sex: F
Age: 55
State: VA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
Hospital:

Lab Data: None

Allergies: tequin, levaquin, cipro antibiotic, and nickel , and seasonal (dogs, oak, dust mites, mold)

Symptoms: During the early morning following my second Covid vaccination, I started having fever and chills, muscle aches, and a headache. I woke up about 230 am and my stomach was hurting. I thought I would have to have a bm in a little while but was able to go back to sleep. About an hour and a half later, I again woke up with stomach pain, maybe some bloating. I decided to go into the bathroom and I sat on the floor beside the toilet and began vomiting. I vomited 5 times and had one dry heave. The vomitus was clear in color, thin with some small pieces of food. I had felt very hot before vomiting, but was unable to check my temperature due tp nausea and vomiting. I checked my temperature a little while later and it was 100.2 F. I was able to go back to sleep for a while and kept checking temperature during the day. It was between 99.1 and 99.8 for most of the day.

Other Meds: Vitamin D, airborne, release (berberine supplement), osteo-bi-flex, multivitamin, vitamin C, lisinopril HCTZ, zetia, zyrtec, singulair, sinus tylenol

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm