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: 0946113
Sex: F
Age:
State: TX

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Mild headache (Day 2); Injection site soreness (Day 1 and Day 2); This is a spontaneous report from a contactable other healthcare professional (patient herself). A 53-year-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection; lot number: EK5730, expiration date was unknown), intramuscularly on the left arm on 18Dec2020 at 13:15 at a single dose for COVID-19 immunization administered at the hospital. The patient had no medical history. The patient had no known allergies; she had no allergies to medications, food, or other products. Concomitant medication included cetirizine hydrochloride (ZYRTEC). The patient was not pregnant at the time of vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 18Dec2020 at 16:00, the patient experienced injection site soreness (day 1 and day 2) and mild headache (day 2) on 19Dec2020. The reporter assessed the events as non-serious. The patient did not receive any treatment for the adverse events (AE). The patient recovered from both the events on an unspecified date.

Other Meds: ZYRTEC [CETIRIZINE HYDROCHLORIDE]

Current Illness:

ID: 0946114
Sex: F
Age:
State: KY

Vax Date: 01/06/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: red blotches on my arms and upper chest; This is a spontaneous report from a non-contactable other health care professional. A 44-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection; lot number: EK9231), via an unspecified route of administration on 06Jan2021 at single dose at arm left for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On 08Jan2021, the patient experiencing red blotches on my arms and upper chest. The patient did not receive treatment for the adverse event. The outcome of the events was not recovered. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 0946115
Sex: M
Age:
State: MI

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Nausea; shortness of breath; tiredness; stiffness at the injection site; stiffness at the injection site; This is a spontaneous report from a contactable consumer. A 33-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) Solution for injection (lot numbers and expiry dates were unknown) via an unspecified route of administration on 08Dec2020 for the first dose and on 08Jan2021 for the second dose, both administered in the right arm at a single dose for COVID-19 immunization. The patient had no medical history and no concomitant medications. The patient had no known allergies to medications, food, or other products. The patient did not receive any other vaccines within 4 weeks prior to BNT162B2 and did not receive any other medications within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 09Jan2021, the patient experienced nausea, shortness of breath, tiredness, and stiffness at the injection site. No therapeutic measures were taken in response to the events. Outcome of the events at the time of last observation was recovered. The report was considered as non-serious; the events did not result in death, were not life threatening, did not caused/prolonged hospitalization, were not disabling/ incapacitating, and did not caused any congenital anomaly/birth defect. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0946116
Sex: M
Age:
State: NM

Vax Date: 12/21/2020
Onset Date: 12/24/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Suprascapular lymphadenopathy noted 3 days after vaccination, unilaterally on the same side as the administration; This is a spontaneous report from a contactable nurse (patient himself). A 24-year-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EJ1685, expiry date not reported), intramuscular in the left arm on 21Dec2020 18:45 at single dose, and then second dose (lot number: EL0142, expiry date not reported), via an unspecified route of administration in the left arm on 11Jan2021 at single dose for COVID-19 immunisation. Medical history was none. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient was not diagnosed with COVID-19 prior to vaccination. Since the vaccination, the patient has not been tested for COVID-19. The patient had no allergies to medications, food, or other products. Concomitant medications were not reported. The patient experienced suprascapular lymphadenopathy noted 3 days after vaccination, unilaterally on the same side as the administration on 24Dec2020 09:00. No treatment was received for the adverse event. Clinical outcome of the event was not recovered.

Other Meds:

Current Illness:

ID: 0946117
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: I was never sick until the year I got the flu shot then I was sick the entire season; Initial information received on 14-Dec-2020 regarding an unsolicited valid non-serious case received from a consumer (patient) via social media. This case involves an unknown age patient who was never sick until the year, patient got the flu shot then patient was sick the entire season (illness), while he/she received vaccine Influenza Vaccine. The patient's past medical history, medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On an unknown date, the patient received a dose of suspect Influenza Vaccine produced by unknown manufacturer lot number not reported via unknown route in unknown administration site, for Prophylactic vaccination. On an unknown date, it was reported that the patient was never sick until the year, patient got the flu shot then patient was sick the entire season (illness) (Unknown latency) following the administration of Influenza Vaccine. Every season every year for the next several years. It was at least 10 years or longer before I got the shot again. patient would not have gotten it then, but his/her employer required it. And once again he/she became sick for the entire season. Went a few years without it and was not sick at all but then her/his employer insisted he/she get it and was sick the entire season afterwards. had not it the past 3 years and have not been sick any. So it may not affect some but it sure makes he/she sick so would not get them again. Final diagnosis was the patient was never sick until the year, patient got the flu shot then patient was sick the entire season. No laboratory data was reported. It was not reported if the patient received a corrective treatment. The event outcome was reported as Unknown. No further information was reported.

Other Meds:

Current Illness:

ID: 0946118
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/15/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Allergic reaction; This spontaneous case was received on 05-Jan-2021 from other non-health professional (consumer) via Agency (reference number: NUS2020US193921) and concerned a female patient of unreported age. The patient's medical history and concomitant medications were not reported. On an unknown date, the patient was vaccinated with influenza virus vaccine monovalent (brand not specified; indication, dose, route of administration and anatomical location: not reported). The batch number was not reported. On an unknown date, an unknown amount of time after receiving influenza virus vaccine monovalent, the patient experienced allergic reaction. On an unknown date, the patient was hospitalized due to the event for seven days. The outcome of the event of allergic reaction was not reported. The reporter did not provide a causality assessment. The event of allergic reaction was considered to be serious due hospitalization. Company comment: A female patient experienced hypersensitivity an unknown amount of time after administration of influenza virus vaccine monovalent. The patient's medical history and concomitant medications were not reported. Causality is unassessable due to lack of reported information.; Sender's Comments: A female patient experienced hypersensitivity an unknown amount of time after administration of influenza virus vaccine monovalent. The patient's medical history and concomitant medications were not reported. Causality is unassessable due to lack of reported information.

Other Meds:

Current Illness:

ID: 0946126
Sex: U
Age:
State:

Vax Date: 09/17/2020
Onset Date: 09/17/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: appeared on my back / small itchy sp[ots on the left side of my back; This case was reported by a consumer and described the occurrence of pruritus in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On 17th September 2020, the patient received the 1st dose of Shingrix. On 17th September 2020, less than a day after receiving Shingrix, the patient experienced pruritus. On an unknown date, the outcome of the pruritus was unknown. It was unknown if the reporter considered the pruritus to be related to Shingrix. Additional details were provided as follows: The age group was not reported but was selected as per the vaccine indication. Within the day or two, very itchy was appeared on back, directly across on the left side from where the shot was given. The patient still getting small itchy spots on the left side of my back. The patient asked should get the 2nd shot.

Other Meds:

Current Illness:

ID: 0946127
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: erythema 3" by 3" raised and red hot.; erythema 3" by 3" raised and red hot.; erythema 3" by 3" raised; This case was reported by a consumer via interactive digital media and described the occurrence of erythema in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced erythema, feeling hot and swelling. On an unknown date, the outcome of the erythema, feeling hot and swelling were unknown. It was unknown if the reporter considered the erythema, feeling hot and swelling to be related to Shingrix. Additional details were provided as follows: The patient received 1st dose of Shingrix immunization caused a raised area of erythema which was quite hot and measured about 3" by 3". The patient inquired that could he get the 2nd dose of Shingrix after 2 months or it was considered as an allergic reaction or normal reaction. The information regarding consent to follow up was not reported. No further information was available.

Other Meds:

Current Illness:

ID: 0946128
Sex: M
Age: 74
State: GA

Vax Date: 09/10/2020
Onset Date:
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: rash on his forehead; This case was reported by a consumer via call center representative and described the occurrence of rash in a 74-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. On 10th September 2020, the patient received the 1st dose of Shingrix (intramuscular). On an unknown date, less than 4 months after receiving Shingrix, the patient experienced rash. On an unknown date, the outcome of the rash was not recovered/not resolved. It was unknown if the reporter considered the rash to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The patient experienced rash spread on his face to his cheeks. The rash was unresolved. This case has been linked with case US2020AMR249090, reported by the same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR249090:same patient

Other Meds:

Current Illness:

ID: 0946129
Sex: F
Age: 63
State: NY

Vax Date: 05/02/2018
Onset Date: 05/02/2018
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Arm pain in her left arm / never resolved / still ongoing; This case was reported by a consumer via call center representative and described the occurrence of pain in arm in a 63-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 2nd May 2018, the patient received the 2nd dose of Shingrix. On 2nd May 2018, less than a day after receiving Shingrix, the patient experienced pain in arm. On an unknown date, the outcome of the pain in arm was not recovered/not resolved. It was unknown if the reporter considered the pain in arm to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The patient she developed arm pain in her left arm, that has never resolved and was still ongoing. The reporter did not consent to follow up.; Sender's Comments: US-GLAXOSMITHKLINE-US2020248587:same reporter US-GLAXOSMITHKLINE-US2020248574:Same reporter US-GLAXOSMITHKLINE-US2020248580:Same reporter US-GLAXOSMITHKLINE-US2020248583:Same reporter

Other Meds:

Current Illness:

ID: 0946130
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: makes me sick so no i dont get it; Initial information received on 23-Nov-2020 regarding an unsolicited valid non-serious case from a consumer (patient). This case involves a patient of unknown demographics who makes him sick so no the patient dont get it (Illness), while the patient received vaccine Influenza Vaccine. The patient's medical history, past medical treatment(s), vaccination(s) and family history were not provided. Concomitant medication was not reported. On an unknown date, the patient received influenza vaccine (Strength, formulation, dose, frequency, route, batch number and expiry date were unknown) for prophylactic vaccination. On an unknown date (unknown latency), after started therapy with suspect vaccine, makes the patient sick so the patient did not got it (Illness). Action taken with the suspect drug was not applicable. It was not reported if the patient received a corrective treatment. The event outcome was reported as unknown.

Other Meds:

Current Illness:

ID: 0946131
Sex: F
Age: 0
State: ME

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: pediatric patient was given Pentacel with only diluent with no adverse event; Initial information regarding an unsolicited valid non-serious case received from the other healthcare professional via phone at a call center as a Medication Inquiry on 11-Jan-2021. This case involved a 9-month old female patient who was given DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE (PENTACEL) with only diluent with no adverse event (Product preparation issue). It was an actual medication error due to inappropriate reconstitution technique. Medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included hepatitis B vaccine for prophylactic vaccination. On 28-Dec-2020, the patient received a dose of suspect DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE 0.5 mL (lot number: U6842DA, expiry date: 05-Jul-2021) via intramuscular route in the right thigh for prophylactic vaccination. On 28-Dec-2020, it was reported that pediatric patient was given Pentacel with only diluent with no adverse event (Product preparation issue). At the time of reporting, the patient did not experience any adverse event. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holders compliance with the requirements set out in Directive 2001-83-EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds: HEPATITIS B VACCINE

Current Illness:

ID: 0946153
Sex: F
Age: 36
State: CO

Vax Date: 12/30/2020
Onset Date: 01/01/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: 12/31/20 at Emergency Room EKG, labs, IV, CT scan of head 1/6/21 seen by Primary care, MRI ordered & EEG 1/12/21 seen by Neurologist 1/15/21 MRI to be done

Allergies: None

Symptoms: Woke up with sore left arm and headache. As day progressed headache continued and had several episodes of feeling hot, sweaty, and nauseous. At approximately 8 pm I had another episode of feeling unwell. I sat down on couch and had a seizure. Arms went straight out from body, legs got tense, loud noise from mouth, then was slumped over on couch. Husband got me to the pickup and drove me to the emergency room.

Other Meds: Pepcid 40mg

Current Illness:

ID: 0946154
Sex: M
Age: 67
State: FL

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: 30 years ago, I had hives once after eating scallops. Haven?t ingested scallops since then, nor have I had any other allergic reactions.

Symptoms: Very minor swelling of my nose along with some redness. No pain or shortness of breath. Symptoms dissipated with 24 hours.

Other Meds: Rosuvastatin Calcium 10 mg Vitamin C 1000 mg Vitamin D3 5000iu Super B Complex Vitamin Adult Mature MultiVitamin Aspirin 81mg GlucosamineHCI 1500 mg with MSM 1500 mg Fish Oil 1000 mg CoQ10 400 mg

Current Illness: None

ID: 0946155
Sex: F
Age: 34
State: NY

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: n/a

Allergies: seasonal

Symptoms: severe nausea, vomiting, diarrhea, headache, fevers, dizziness, arm pain and abdominal pain.

Other Meds: synthroid, zyrtec

Current Illness: n/a

ID: 0946156
Sex: F
Age: 26
State: OR

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Severe nausea, with vomiting, which started approximately 9 hours after the injection. This also included body aches, chills, mild fever, and dizziness. Vomiting lasted for approximately 2 hours, but nausea persisted for approximately 2 days. A significant migraine occurred approximately 6 hours after the injection, and lasted approximately 6 hours.

Other Meds: Nexplanon

Current Illness:

ID: 0946157
Sex: F
Age: 43
State:

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Called to see pt in drive up lane 7 min post vaccination. She immediately felt after the vaccination, numbness and tingling in L face on the buccal side and her L arm. She felt like her L side of the face and eyelids were swelling. She was agitated and worried. Past medical history of breast cancer and axillary swelling. Initial examination lungs CTA, regular tachycardia. Pt moved to observation area. Initial vitals: BP: 154/82, HR 129, 97% O2 Benadryl 25 mg po given at 10:25am EMS notified and first injection 3mg Epi pen injection given at 10:41am; 911 called. BP 154/82, 136, RR 20, O2 sat 99% 10:43am. Second epinephrine 3mg injection given at 10:44am. BP 162/84, HR 131, RR 22, O2 sat 100% at 10:49am. At 10:49am, she suddenly was short of breath, general mailais, delayed ear swelling, and was put on a stretcher and 10L non rebreather. She was brought to Medical Ctr at 10:54.

Other Meds:

Current Illness: Past medical history of breast cancer and axillary swelling.

ID: 0946158
Sex: F
Age: 47
State: MS

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None at this time

Allergies: Latex Tape Adhesive Bactrim DS Kiwi fruit

Symptoms: Debilitating lower back pain beginning mid-morning on the day following the vaccine administration. It came on quite suddenly. I left work early due to the pain. It feels like a deep twisting pain that seems to decrease strength in the back area.

Other Meds: Armour Thyroid Rosuvastatin Ambien Tylenol Phentermine

Current Illness: None

ID: 0946159
Sex: F
Age: 25
State: MO

Vax Date: 01/05/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Rash about 3 inches in size. Noticed after it started itching. Itches occasionally, then goes away. Started a week after first dose of vaccine. Currently on day 2 of the rash. Tried Zyrtec, Benadryl, and Hydrocortisone ointment with some itching relief, but rash hasn?t decreased in size or has gone away yet.

Other Meds: Ibuprofen, tri lo sprintec, and multivitamins

Current Illness: Possible tendinitis in left leg

ID: 0946160
Sex: F
Age: 33
State: CA

Vax Date: 12/20/2020
Onset Date: 12/20/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: Cipro, bactrim, macrodantin, orange food coloring, possibly betadine or late blood transfusion reaction,

Symptoms: 12/20: 10 mins after the injection my arm started hurting so I was moving it around and suddenly a felt a tickle in my throat, swallowed and felt like I swallowed the wrong way and was coughing to the point of feeling like I was going to vomit. Per everyone around I was bright red and I looked weird. The ER nurse said my heart rate was 125 and my systolic BP was elevated at 130s (normally in the 110s). After sitting for 45 mins heart rate was back to 60s. Still felt like I was in a fog but felt ok. Once I walked to my car I felt alot of nausea again and was on and off the rest of the day. In the middle of the night I woke up short of breath laying on my back had to lay on my side. 12/21. I was moving pavers and got short of breath. Checked my heart rate and it was 100. O2 sat was 99%. If I sat and didn't move I was fine as soon as I started moving it started again. Also felt nauseating all day. I was having a hard time concentrating and my husband was getting frustrated that I wasn't understanding what he was saying. My left arm hurt really bad all day 12/22 By the afternoon felt more normal except my arm still hurting really bad. 12/26 was shoveling dirty and suddenly my arm where I got the injection started hurts and I got very nauseated again. On 12/29 the cdc called me because I did the vsafe program. They were wondering if I was actually going to get the second vaccination because they said my reaction is a severe reaction. 12/30 my arm started itching had chills and temp right after 1/1 rapid test was negative for covid 1/2 pcr was negative

Other Meds: Tirosint, multiple vitamin, garlic, vitamin c, zinc, vitamin D, probiotics, d mannose

Current Illness:

ID: 0946161
Sex: F
Age: 0
State: TX

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Headache day of vaccine, itchy skin and hives developed on arms and legs day after vaccine, lasting 2 days. Swollen, painful lymph node in armpit started the day after vaccine and continues to present, nearly a week post-injection.

Other Meds: Metformin, bupropion

Current Illness: No e

ID: 0946162
Sex: M
Age: 29
State: WA

Vax Date: 01/02/2021
Onset Date: 01/10/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: Covid 19 test conducted on Tuesday, 12 January. Result negative on Wednesday, 13 January

Allergies: Cefaclor Sulfa Drugs

Symptoms: Onset of severe pompholyx and uriticaria on hands and feet. Prescribed famotidine, prednisone and hydroxyzine. Pompholyx on hands developed into blisters 4 days after onset of symptoms

Other Meds: None

Current Illness:

ID: 0946163
Sex: F
Age: 38
State: HI

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None. Didnt go in

Allergies: None

Symptoms: Im having sime pretty aggressive chills and nausea

Other Meds: None

Current Illness: None

ID: 0946164
Sex: F
Age: 23
State: TX

Vax Date: 12/11/2020
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None--cannot get appt with dermatologist for 4 wks and no emergent symptoms to date at this time

Allergies: NKA

Symptoms: Vaccines received in series on 12/11/20 and 1/11/21. Three days before due date for second COVID vaccine, started severely itching and experiencing hive-like rash all over body, especially to hands and head; mostly relieved by benadryl but wore off every 6 hours. Contacted PCP (listed in form) who suggested taking zyrtec and using a moisturizing lotion. This helped for the day of receiving the vaccine. Thinking it was something unrelated due to the time elapsed from the vaccine, despite no changes in consumption or products/environment encountered, I went ahead and got the second vaccine. Day 1 after vaccine, I experienced the usually reported side effects, including slightly elevated temp, chills, and body aches. Itching and hives continued but not as noticeable due to other side effects. The next morning, hives and itching were significantly worse; any time I scratched (or something touched my skin more than lightly), large, red welps would nearly immediately develop, and often had raised bumps within the irritations. To date, this is continued, slightly relieved by allergy medications, but not entirely and must be taken around the clock or severe symptoms will begin again.

Other Meds: Protonix Sprintec

Current Illness: N/A

ID: 0946165
Sex: F
Age: 41
State:

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Staff had 2nd vaccine yesterday 01/13/2021 at 11:20. At night 3 am woke up with bodyache, lower back pain, fever 103, could not sleep. Took Tylenol. Today at 12 noon staff feels chill, fever 102. Now ok. W

Other Meds:

Current Illness:

ID: 0946166
Sex: M
Age: 33
State:

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccine at 8:30am in the morning. Around 4 pm started feel warm, weakness. Took Tylenol 1000 mg. Helped a little bit. Today still having bodyache and chills.

Other Meds:

Current Illness:

ID: 0946167
Sex: M
Age: 43
State:

Vax Date: 01/09/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 2nd vaccine on Saturday. Sunday, burning feet, leg, thigh. Went to ER to check if it was cause by diabetes, was told its probably not Gulliam Barre. Still having the symptoms. Worsen when laying down, better with movement.

Other Meds:

Current Illness:

ID: 0946168
Sex: M
Age: 47
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: In the evening 01/12/2021 started having bodyache, fatigue, chill 99.8. Took sick day yesterday and slept most of the time. Feeling fine today.

Other Meds:

Current Illness:

ID: 0946169
Sex: F
Age: 44
State:

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 01/11/2021: Same day at 8 pm started to have body ache, headache, a little fever 100.1 and very tired. Took Tylenol. Got up next day at 12:30 a lot better. Today ok but not 100%.

Other Meds:

Current Illness:

ID: 0946170
Sex: F
Age: 37
State:

Vax Date: 01/05/2021
Onset Date: 01/10/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: NA

Allergies: Na

Symptoms: Disclosure: I do not have a severe side effect- I want to report this do it can help science. Hope it helps. Minor adverse event - 1. Bull's eye Rash on the vaccine site. I have taken a photo if ever needed. 2. Swollen lymph nodes. I wanted to emphasize on the bull's eye rash which started after 5 days after vaccination. it's itchy and swollen. No pain or other discomfort. I never noticed lymph nodes before the peculiar rash. I am overall health and has no other contra indications.

Other Meds: Vitamin D3 - CVS brand 1000 IU

Current Illness: Sniffling due to cold weather - when our in cold.

ID: 0946171
Sex: F
Age: 41
State: LA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: No medical tests, went to Urgent Care on Monday, January 11, 2021.

Allergies: Phenergan

Symptoms: *Rash ,whelps and swelling on bilateral arms from the shoulder area to hands. *Rash ,whelps and swelling on bilateral legs from upper thighs down to feet *Severe Itching Received the vaccination on Wednesday, January 6, 2021. Symptoms started on Saturday, January 9, 2021 around 1pm. Symptoms intensified as the days went by. Went to Urgent Care on Monday, January 11, 2021.

Other Meds: None

Current Illness: None

ID: 0946172
Sex: F
Age: 54
State: MI

Vax Date: 01/12/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Lymphadenopathy under left clavicle 2 days post injection. Also had minor headache 1 day post vaccination which resolved by day 2. No medical treatment needed at this time.

Other Meds: None

Current Illness: None

ID: 0946173
Sex: F
Age: 28
State: CA

Vax Date: 01/03/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: covid: vaccination clinic S: At 1557 patient c/o tongue swelling and itchiness. Given 25mg PO benadryl at 1557 O: Patient alert and oriented, airway patent. BP 129/88 HR 74 O2 98% 1617 Repeat O2 sat 98% HR 59. Patient c/o persistent tongue swelling. A/P: 28 F with history of nut allergy with tongue swelling after Pfizer vaccine. EMS notified 1620. Patient evaluated by EMS and declined further treatment by EMS and stated that she would walk over to ED for further evaluation. Further return to ED precautions discussed with patient.

Other Meds:

Current Illness:

ID: 0946174
Sex: F
Age: 67
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: NA

Allergies: SULFONAMIDE ANTIBIOTICS

Symptoms: Patient reports pain at the injection site lasting from 01/12/21 at time of administration until the morning of 01/14/21. Patient reports heart palpitations during the evening of 01/13/21 and hives/rash that developed on 01/13/21 starting on the upper back and has now spread to abdomen and both armpits. Patient took Benadryl on 01/14/21 around 8pm and itching/sensitivity is lessened. Patient reports fatigue on 01/13/21. Patient reports headache on 01/12/21 which subsided with the use of acetaminophen. Patient states headache returned on 01/13/21 to a lesser degree and resolved on its own. Patient denies continued heart palpitations.

Other Meds: Levothyroxine 75 MCG

Current Illness:

ID: 0946175
Sex: F
Age: 62
State: MD

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data: EKG, CBC, Chem7, and troponin all normal from ED eval of 23 Dec 2020.

Allergies: None reported

Symptoms: As per Emergency Dept note of 23 Dec 2020: "Syncope, related to getting the vaccine. Normal ECG, no evidence of arrhythmia, normal H/H, no evidence of ACS, CHF clinically. Normal nonfocal exam. Symptoms resolved. Home with reassurance." As per follow-up note of 04 Jan 2021: "62yo female s/p first dose of Pfizer-BioNTech vaccine on 12/23/2020 who experienced syncope, hypertension (200/100) within minutes after receiving the vaccine. She was then transported to the ED where she was given IV fluids, anti-emetic and discharged a few hours later. She reports the onset of fever, chills, anorexia, malaise, and emesis 4 hours after receiving the vaccine. The malaise, chills and anorexia persisted for 4 days at which point she started feeling better. COVID test was reportedly negative. She wants to decline 2nd dose of vaccine."

Other Meds: None reported

Current Illness: None reported

ID: 0946176
Sex: M
Age: 32
State: CO

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: none

Allergies: no known drug allergies

Symptoms: 12 hour post-vaccination- shivering and body aches 20 hours post-vaccination- angioedema/tongue swelling

Other Meds: Levocetirizine 5 mg daily omeprazole 20 mg daily

Current Illness: no other illnesses at time of vaccination

ID: 0946177
Sex: F
Age: 35
State: WA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: N/A

Allergies: Penicillin

Symptoms: Large red circle around site with large swelling and pain

Other Meds: Claritin, Montelukast, Symbicort, Albuterol

Current Illness: N/A

ID: 0946178
Sex: F
Age: 59
State: CA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None done at vaccination site.

Allergies:

Symptoms: 59 y/o female experienced right distal arm and hand paresthesias about 10-15 minutes after receiving the Moderna Covid-19 vaccine in the same arm. She stated that this was atingling and burning sensation and indicated the dorsal hand, middle three fingers with some lesser extension on he palmar side of same. After a few minutes more she noted this in a circular palmar zone and along the radial aspect of the wrist, extending about 3 inches up the radial aspect of the arm from the wrist. She laater on questioning of other symptoms stated that she had a mild pain in the mid right abdomen and a mild pain under the left eye / lower lid. She was monitored for an hour. No "treatment" was given. She was allowed to proceed home and was instructed to inform her primary care provider.

Other Meds: Fluoxetine, Celebrex, Trazadone, Metformin, Glimiperide, Methocarbamal , Atorvastatin

Current Illness: None

ID: 0946179
Sex: F
Age: 42
State: PA

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: Hydrocodone sensitivity, Laytex sensitivity, mild Grapefruit allergy and Lactose Intolerance

Symptoms: I felt very heavy (especially my limbs) and had a slight headache on Thursday (the day after receiving the vaccine). This feeling continued into Friday morning when I nearly passed out (blacked out and collapsed for a split second) as I was crouched position for approximately 10 minutes at work. I felt dizzy and slow moving for the next several hours. My blood pressure was rated as normal, blood oxygen normal, and pulse slightly low by a nurse on staff who took my vitals after the episode. My temperature, which had been 97.8 prior to the event that morning (typical for me) was elevated during this time to 100.2 and returned to normal after approximately 4 hours without medication. I was fatigued, so I slept for approximately 4-5 hours that afternoon and began feeling better the following day (Saturday).

Other Meds: Women's Multivitamin, Ginkgo Biloba, Meloxicam, Glucosamine & Chondroitin, Tumeric, Folic Acid

Current Illness: None

ID: 0946180
Sex: F
Age: 48
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: n/a

Allergies: Sulfa, penicillin, reglan injection (could be the carrier), bee stings, cat dander

Symptoms: Lightheaded briefly at about 15 minutes. Lips tingling and red, chest and neck hot and very flushed at about 25 minutes. Feeling winded at about 30 minutes, lips very slightly blue-ish. Vitals were all normal and no treatment was given. Approx six hours later I experienced a "lump in my throat" for about two to three hours - took Benadryl, which resolved it. Also around five or six hours later ordinary side effects began - fatigue, aches, headache, sore arm. These all resolved by the following morning.

Other Meds: multivitamin, Vitamin D

Current Illness: n/a

ID: 0946181
Sex: F
Age: 40
State: OK

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: Dairy, kiwi

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA. Facial numbness and tingling beginning aproximately 40-45 minutes after injection. Resolved approximately 2-3 hours later.

Other Meds: Time-Release Iron, Vitamin D, Prenatal vitamins, Flaxseed Oil, Cetirizine, zinc, Phentermine

Current Illness: none

ID: 0946182
Sex: F
Age: 42
State: CA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: Doctor visit via phone. With pictures of dermatitis sent via email.

Allergies: N/A

Symptoms: Itchy dermatitis.

Other Meds: Nuvaring

Current Illness: N/A

ID: 0946183
Sex: F
Age: 37
State: ND

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None, patient identified late at night. Benadryl 25mg PO taken at 0022 1/15/21

Allergies: Sulfa Sensitive to soaps/scents Copper (in Paraguard IUD)

Symptoms: ~10pm, tickle in throat ~ Midnight dry cratchy cough related to tickle in throat ~10pm, itchy wrists, bilaterally, progressed to back of neck, insides of arms, lower legs, tops of feet, upper chest, under breasts, and splotchy face. ~10-midnight - rash in all same areas of itchiness

Other Meds: Vyvanse 60mg QD Benicar 20 mg QD Famotidine 40mg QD

Current Illness: None

ID: 0946184
Sex: F
Age: 44
State: CA

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: Sulfa

Symptoms: Rash/hives, itching, fever, body aches Treating with Motion and Benadryl Fever and body aches resolved after 24 hrs Rash/hives and itching continue

Other Meds: None

Current Illness: COVID positive 12/14/2020

ID: 0946185
Sex: M
Age: 79
State: NC

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: none

Allergies: Codine, Latex , Paprica , oil of Oregano, Penicilin

Symptoms: Dizzy, Motion imbalance

Other Meds: levothyroxcin 175mcg: Lantus 130 unit/D: Lisinoplil 40mg: Vitimins D3, C 6000 mg.: Probiotic 30Mill X 3: Milkthisle, Sawpomentle, zinx, Omega3: Felt dizzy at first 8Hrs. ..Synuses ache came on thru the6-12th hour,dizzness grow more s

Current Illness: Plastic Proceces Knee, Penis Implant. Operation: neck-lower/back fussions , galbladder/removed, wrist op June 2020:

ID: 0946186
Sex: F
Age: 31
State: MN

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: EKG normal 1/14/21 Troponin Normal 1/14/21 Chest X-ray normal 1/14/21 Blood pressure normal 1/14/21

Allergies: Sea food, amoxicillin, wool, mucinex

Symptoms: I developed atypical chest pain 3 days after the shot. Chest pain that was sharp as intermittent and has been on going since 9/8/21.

Other Meds: Multi vitamin and vit C/zinc gummies Ibuprofen, voltaren

Current Illness: None

ID: 0946187
Sex: F
Age: 28
State: MD

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Severe atm soreness, headache 2 hours after. Watery eyes and fatigue 6 hours later.

Other Meds:

Current Illness:

ID: 0946188
Sex: F
Age: 23
State: OH

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: Singulair; Mynocycline

Symptoms: Moderna COVID-19 Vaccine EUA Extreme tiredness: sleeping 12+ hours and still feeling like I have not slept Migraine: I do get chronic migraines so I am unsure 100% if the migraine is related to the vaccine or not Fever: under 100.0?F Night sweats Chills

Other Meds: Omeprazole; Zoloft; Zyrtec

Current Illness: Gastroenteritis (3 weeks prior)

ID: 0946189
Sex: F
Age: 29
State: OH

Vax Date: 01/07/2021
Onset Date: 01/10/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: Covid test done on 1/11/21, came back positive

Allergies: Amoxicillin Doxycyclin Peanuts

Symptoms: 1/7/21 PM sore left arm at injection sight 1/10/21 PM severe congestion, headache, sinus pressure 1/11/21 AM severe headache, vertigo, shortness of breath, cough 1/11/21 AM went to get covid test due to being symptomatic, tested positive. I had a negative weekly (required by work) test done on 1/5/21 prior to getting vaccine.

Other Meds: Lexapro Ativan

Current Illness: None

ID: 0946190
Sex: M
Age: 37
State: WA

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: Evaluated today, 1/14/21, by urgent care provider. No tests or diagnostics performed as of yet.

Allergies: N/A

Symptoms: Redness, swelling, hot, itchiness still present after 8 days. Urgent Care provider started me on oral Keflex. Very swollen lymph nodes to left axilla and near left clavicle. Moderate to severe shoulder pain. Unable to sleep on my left side. Inflammation to left shoulder.

Other Meds: Bupripion, adult mens multivitamins, biotin, ibuprofen, diphenhydramine, vitamin e, vitamin d, vitamin c

Current Illness: Shingles about 10 days prior

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm