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: 0946698
Sex: M
Age: 37
State: CA

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

Lab Data: N/A

Allergies: N/A

Symptoms: I recognized about 24 hours after my 1st COVID vaccine I had hives spanning flank to flank, across my abdomen, as high as my arms pits and low as my waistline.

Other Meds: N/A

Current Illness: N/A

ID: 0946699
Sex: F
Age: 68
State: PA

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: NONE

Symptoms: HAD RAISED SKIN AT SITE OF INJECTION/ 7 DAYS LATER HAD A LARGE RED MARK AT INJECTION SITE AND 102 FEVER CONSULTED MD GIVEN RX FOR AUGMENTIN

Other Meds: NONE

Current Illness: NONE

ID: 0946700
Sex: F
Age: 29
State: TN

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

Lab Data:

Allergies: none

Symptoms: Injection site soreness, Fever 101, body aches - both aches and fever lessened with Tylenol

Other Meds: none

Current Illness: none

ID: 0946704
Sex: U
Age: 2
State: IL

Vax Date: 12/07/2020
Onset Date: 12/07/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Caller reported temperature excursion / Caller reported multiple administrations of both products / Temperature -13.3 C; This spontaneous report was received from a registered nurse and refers to a 2-year-old patient. No information regarding the patient's pertinent medical history, drug reactions or allergies and concomitant therapies was provided. On 07-DEC-2020, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck) (VARIVAX) lot # T017688, expiration date 21-MAY-2022, 0.5 milliliter for prophylaxis (anatomical location and route of administration were not reported). Digital Data logger was involved. The vaccine was stored at the temperature that was reported as 13.3 degrees of Celsius for 4 hours and 15 minutes. There was no previous temperature excursion reported. This is one of several reports received from the same reporter.; Sender's Comments: US-009507513-2012USA013093: US-009507513-2012USA013532: US-009507513-2012USA013501: US-009507513-2012USA013524: US-009507513-2012USA013533: US-009507513-2012USA013539: US-009507513-2012USA013584: US-009507513-2012USA013585: US-009507513-2012USA013592: US-009507513-2012USA013594: US-009507513-2012USA013596: US-009507513-2012USA013598: US-009507513-2012USA013603: US-009507513-2012USA013601: US-009507513-2012USA013501: US-009507513-2012USA013095:

Other Meds:

Current Illness: Prophylaxis

ID: 0946705
Sex: U
Age:
State: AZ

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

Lab Data:

Allergies:

Symptoms: No adverse event; Patient received a dose of VAQTA on 01-JAN-2021 and it had expired on 06-JAN-2021; This spontaneous report was received from an other reporter regarding a patient of unknown age and gender. The patient's concurrent conditions, pertinent medical history, drug reactions, allergies, and concomitant therapies were not reported. On 07-JAN-2021, the patient was vaccinated with a dose of Hepatitis A Vaccine, Inactivated (VAQTA) one dose, 0.5 milliliter, lot number: T001419, expiration date: 06-JAN-2021 (route of administration was not reported), and it was a expired dose (Expired product administered). The Hepatitis A Vaccine, Inactivated (VAQTA) had never undergone a temperature excursion. No adverse event reported.

Other Meds:

Current Illness:

ID: 0946706
Sex: U
Age:
State: NY

Vax Date: 10/14/2020
Onset Date: 10/14/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: syncope; I've experienced right eye pain; right arm muscle / right leg muscle / pain; right arm / right leg / joint pain; Fatigue; Swelling at injection site; leakage to injection site.; Rhinitis; insomnia; coughing,; dizziness; This case was reported by a nurse and described the occurrence of syncope in a adult patient who received Flu Seasonal QIV Dresden (Fluarix Tetra 2020-2021 season) for prophylaxis. Co-suspect products included flu seasonal qiv dresden pre-filled syringe device (Fluarix Tetra Pre-Filled Syringe Device) injection syringe for prophylaxis. On 14th October 2020, the patient received Fluarix Tetra 2020-2021 season and Fluarix Tetra Pre-Filled Syringe Device. On 14th October 2020, less than a day after receiving Fluarix Tetra 2020-2021 season and Fluarix Tetra Pre-Filled Syringe Device, the patient experienced syncope (serious criteria GSK medically significant), eye pain, muscle pain, joint pain, fatigue, injection site swelling, injection site leaking, rhinitis, insomnia, cough and dizziness. The patient was treated with paracetamol (Acetaminophen) and ibuprofen. On an unknown date, the outcome of the syncope, eye pain, muscle pain, joint pain, fatigue, injection site swelling, injection site leaking, rhinitis, insomnia, cough and dizziness were unknown. It was unknown if the reporter considered the syncope, eye pain, muscle pain, joint pain, fatigue, injection site swelling, injection site leaking, rhinitis, insomnia, cough and dizziness to be related to Fluarix Tetra 2020-2021 season and Fluarix Tetra Pre-Filled Syringe Device. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional details were provided as follows: The patient age group was not reported but it was captured as per qualification (nurse) of the patient. The age at vaccination was not reported. The nurse reported that, he or she experienced right eye pain, right arm muscle and joint pain, right leg muscle, joint pain, fatigue, swelling at injection site, leakage to injection site, rhinitis, insomnia, coughing, syncope and dizziness. The reporter had all these lovely things didn't have before this flu shot.

Other Meds:

Current Illness:

ID: 0946707
Sex: U
Age:
State:

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

Lab Data: Test Date: 202012; Test Name: Body temperature; Result Unstructured Data: (Test Result:101,Unit:degree F,Normal Low:,Normal High:)

Allergies:

Symptoms: Fever of 101; terrible headache; muscle aches and more; This case was reported by a consumer via interactive digital media and described the occurrence of fever in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. Concurrent medical conditions included idiopathic thrombocytopenic purpura. In December 2020, the patient received the 1st dose of Shingrix. On an unknown date, less than a day after receiving Shingrix, the patient experienced fever, headache and muscle pain. Shingrix was discontinued. On an unknown date, the outcome of the fever, headache and muscle pain were unknown. It was unknown if the reporter considered the fever, headache and muscle pain to be related to Shingrix. Additional information was provided as follows: The age at vaccination was not reported. The age group was captured as an adult as per vaccine indication. The patient had an Idiopathic thrombocytopenic purpura (ITP). The patient received Shingrix injection a week and a half before reporting, within 12 hours he/she began with fever of 101 degree F, terrible headache, muscle aches and more. The patient's primary said he/she should not take the second vaccine.

Other Meds:

Current Illness: Idiopathic thrombocytopenic purpura

ID: 0946708
Sex: F
Age:
State: GA

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

Lab Data:

Allergies:

Symptoms: anaphylactic reaction; This case was reported by a consumer via call center representative and described the occurrence of anaphylactic reaction in a female patient who received Flu Seasonal QIV Dresden (Fluarix Tetra 2019-2020 season) for prophylaxis. Co-suspect products included flu seasonal qiv dresden pre-filled syringe device (Fluarix Tetra Pre-Filled Syringe Device) injection syringe for prophylaxis. On an unknown date, the patient received Fluarix Tetra 2019-2020 season and Fluarix Tetra Pre-Filled Syringe Device. On an unknown date, less than a year after receiving Fluarix Tetra 2019-2020 season and Fluarix Tetra Pre-Filled Syringe Device, the patient experienced anaphylactic reaction (serious criteria GSK medically significant). On an unknown date, the outcome of the anaphylactic reaction was recovered/resolved. It was unknown if the reporter considered the anaphylactic reaction to be related to Fluarix Tetra 2019-2020 season and Fluarix Tetra Pre-Filled Syringe Device. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional details were reported as follows: The case was reported by patient's parent. The age at vaccination was not reported. The patient received Flarix vaccine in fall of 2019 and had an anaphylactic reaction. The reporter did not consent to follow-up. This case was linked with case US2020AMR229295, reported by same reporter.

Other Meds:

Current Illness:

ID: 0946709
Sex: F
Age: 72
State: NY

Vax Date: 12/26/2020
Onset Date: 12/26/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: tingling sensation side of jaw; tingling sensation inside the mouth; tingling sensation inside toungue; blood pressure went up; pulse went up; A spontaneous report was received from a nurse who was also a 72 years old, female patient who experienced the serious events of a tingling sensation in the side of her jaw, inside her mouth, and tongue, and also had an increase in blood pressure and pulse rate. The patient's medical history was not provided. Concomitant product use was not provided/unknown by the reporter. On 26 Dec 2020, approximately 5 minutes prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Lot number 039K20A) intramuscularly in the left deltoid for prophylaxis of COVID-19 infection. The patient reported she received the Moderna vaccine on 26 Dec 2020 and after 5 minutes, she experienced tingling in the side of her jaw, inside of her mouth, and tongue. She described it as "like getting a Novocain injection." She was rushed to the ER and then suddenly her blood pressure and pulse went up. A CT scan of the brain was performed, and per the patient, symptoms were somehow resolved. She was advised by her primary care physician that she cannot get the second dose of the vaccine based on her reactions. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was not provided. The events, tingling sensation in the side of her jaw, inside her mouth, and tongue, and had an increase in blood pressure and pulse rate were considered resolved on 26 Dec 2020.; Reporter's Comments: This case concerns a 72 years old, female subject, who experienced a serious unexpected event of jaw disorder, paraesthesia, paraesthesia oral, and non-serious unexpected event of blood pressure increased and heart rate increased. All the events occurred after 5 mins of mRNA-1273 (Lot# 039K20A) vaccine administration. The subject was treated in ER (details not provided). Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 0946710
Sex: U
Age:
State: IN

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

Lab Data:

Allergies:

Symptoms: allergy to adacel; Initial information regarding an unsolicited valid non-serious case received from the nurse and other healthcare professional. This case involves a patient of unknown demography who had allergy to adacel (Allergy to vaccine), when the patient received DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL]. Medical history, past medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included ACETYLSALICYLIC ACID (ACETYLSALICYLIC ACID); and CODEINE (CODEINE) (reported as patient has allergy to these products as well). On an unknown date, the patient received a dose of suspect DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE (lot number, expiration date not reported) via an unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, the patient had allergy to adacel (allergy to vaccine) (latency unknown) following the administration of DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE. No relevant laboratory tests were reported. It was not reported if the patient received a corrective treatment. At the time of report, event outcome was Unknown for allergy to vaccine. There will be no information regarding batch number for the case.

Other Meds: ACETYLSALICYLIC ACID; CODEINE

Current Illness:

ID: 0946711
Sex: F
Age:
State: DC

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

Lab Data:

Allergies:

Symptoms: delayed reaction at the injection site on her upper arm, itchy papule reaction; Initial information regarding this unsolicited valid non-serious case received from a physician and transmitted to Sanofi on 04-Jan-2021. The case involved a female patient of unknown age who had a delayed reaction at the injection site on her upper arm, itchy papule reaction (vaccination site papule), while she received vaccine INFLUENZA QUADRIVAL A-B VACCINE [FLUZONE QIV]. Relevant medical history, past medical treatment, vaccination details, concomitant medications and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA QUADRIVAL A-B VACCINE (lot number and expiry date not reported) via unknown route in the upper arm for prophylactic vaccination. On an unknown date, the patient developed a non-serious delayed reaction at the injection site on her upper arm which was a was a localized itchy papule reaction (vaccination site papule), unknown latency following the administration of INFLUENZA QUADRIVAL A-B VACCINE. It did not spread to the entire body. It persisted for days. The patient wanted to gather information on one ingredient in the vaccine. Ingredient name was Octyl phenol ethoxylate, it was related to Polyethylene-glycol. She was an essential worker and needed Covid 19 vaccine. Given the concern of allergic reaction she would like to know if that ingredient was concerning or not. Relevant laboratory test was not reported. It was not reported if the patient received a corrective treatment. At the time of reporting, the outcome was unknown for the reported event. There would be no information available on batch number for this case.

Other Meds:

Current Illness:

ID: 0946712
Sex: F
Age: 71
State: CO

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

Lab Data:

Allergies:

Symptoms: During introduction of myself to patient and her husband who both wanted to receive vaccine, patient verbalized anxiousness related to inability to bring mother in with her to receive a vaccine as well. I educated on how they could get the mom an appointment or come to a clinic that we host and patient was then calmed down and relieved that the was more opportunity in future for vaccination. Discussed all registration paper work, V safe paper importance, and EUA form for the Covid 19 vaccination. I then proceeded to vaccinate patient after she verified and verbalized authorization to administer. I then did the same process with husband. After receiving vaccination, patient was escorted to the observation room for 15 minute waiting period to be monitored for any reactions. After patient sat down with husband who was also vaccination I verified they felt fine and reiterated the importance of notification of any side effects to monitor for, pointed them to the medics in the room and both patient and husband verbalized understanding. A conversation of signing up mom and other family members to receive vaccine through our notification system online was also talked about for an additional 2-3 minutes and then I said my goodbye, thanked them, and left the observation room. After leaving the observation room to accept my next vaccine appointment patients husband notified the EMS medics that his wife, the patient, didn't feel well. The EMS medics took over and called for an ambulance.

Other Meds:

Current Illness:

ID: 0946713
Sex: F
Age: 55
State: VA

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

Lab Data:

Allergies: Has had reaction to every vaccine she's ever had, such as fever, headache. No breathing problems.

Symptoms: About 20 minutes after vaccination, felt tingling throughout body. Slight headache, followed by feeling dizzy and wobbly. Must hold onto something to walk. Has some trouble focusing, "like a fog".

Other Meds:

Current Illness: No

ID: 0946714
Sex: F
Age: 68
State: FL

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

Lab Data:

Allergies: None

Symptoms: Moderna Vaccine Much higher blood pressure than normal beginning 1/10/21 thru 1/14/21. Headaches and fatigue 1/10/21-1/13/21.

Other Meds: Losartan/HCTZ50; Estradiol; Vitamin D3

Current Illness: None

ID: 0946715
Sex: F
Age: 71
State: CA

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

Lab Data:

Allergies:

Symptoms: Sore throat swollen lymph nodes on neck

Other Meds:

Current Illness:

ID: 0946716
Sex: F
Age: 50
State: CA

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

Lab Data: None

Allergies: None

Symptoms: 1/12/2021 @ 1045hrs - Received vaccine in left arm. 1/12/2021 @ 2200hrs - Vaccination site tenderness, body/muscle aches. 1/12/2021 @ 2300hrs - Body/muscle aches, chills. 1/13/2021 @ 0300hrs - Body/muscle aches, chills, fever 99.0, general malaise. 1/13/2021 @ 0600hrs - Body/muscle aches, chills, general malaise, no energy. Did not report to work. 1/13/2021 @ 1000hrs - Symptoms continued. Took Advil 600mg PO. Slept from 1030-1230hrs. 1/13/2021 @ 1230hrs - No energy, very tired, rested the entire day. Took Advil 600mg every 4 to 6 hours. 1/13 to 1/15/2021 - Left arm site tenderness with raised, hard area at injection site. Left armpit soft tissue swelling, possibly lymphadenopathy. 1/15/2021 - Reported symptoms to provider, awaiting appointment.

Other Meds: None

Current Illness: None

ID: 0946717
Sex: F
Age: 29
State: IA

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

Lab Data:

Allergies:

Symptoms: I received Moderna vaccine on 01/06/2021. Normal pain at the injection site occured with little concern. Pain in armpit began 01/08/2021. I did not think anything of it, believing the pain to be from an ingrown hair caused by shaving or just something with the vaccine. I ignored it to spend time with family. On 01/12/2021 I noticed the pain had not subsided and deepened into the armpit causing pain to radiate from the area when lifting or moving heavy items. I palpated the area and felt a pea sized lump. It moved freely. I could not locate it again. I continued to palpate into the top of my shoulder and discovered a large lump in the clavicle area. It is painful to apply pressure. I knew these areas to be part of the lymphatic system. I also did research on side effects of the Moderna vaccine but observed most people to have lymph node symptoms for only 24-48 hours within three days of receiving the vaccine then they subside. I made an appointment that same day, 01/12/2021, with Dr. at clinic to be examined. At first, Dr was dismissive of my symptoms. Dr did physically examine my areas of complaint and scheduled an ultrasound for 01/15/2021 at Hospital. On 01/13/2021 I noticed the injection site began to ache again. On 01/14/2021 I awoke from a nap at 6pm. I began showering for work when I felt a burning, itchy sensation on my inner left bicep. I observed two red spots on my inner left bicep close to my armpit with a red rash below the two red spots. I palpated the red spots to find a large and slightly smaller lump under the skin corresponding with the red spots. The rash itches. As of 01/15/2021, the ultrasound had to be rescheduled by the hospital as their ultrasound technician cannot make it into work because of a blizzard. I now have two lumps in the clavicle area that alternate swelling and reducing in size. I've been taking tylenol every four hours when I'm awake to control the pain. The ones in my clavicle now cause tension in the left side of my neck. I've also applied warm compresses on the affected sites. It helps lessen the swelling for a bit but does come back.

Other Meds: Citalopram and Yaz

Current Illness:

ID: 0946718
Sex: F
Age: 50
State: NY

Vax Date: 01/07/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: Codeine

Symptoms: Red, swollen, warm area at the site of injection 7 days after vaccine.

Other Meds: None

Current Illness: Unknown

ID: 0946719
Sex: F
Age: 39
State: MN

Vax Date: 01/06/2021
Onset Date: 01/10/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Moderate Bilateral jaw pain with moderate headaches; started about 3-4 days after shot, persistent, constant- despite ice and ibuprofen. Pain is intense but manageable to go to work. I am getting really worried about this pain. No problem increased pain with eating, but or talking

Other Meds: None

Current Illness: None

ID: 0946720
Sex: F
Age: 56
State: CO

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

Lab Data:

Allergies: No known medication or food allergies. Some seasonal allergies

Symptoms: 3 Hours after vaccine: PATIENT STATES SHE EXPERIENCES NAUSEA, VOMITTING, DIZZINESS,FATIGUE, WEAKNESS, ATAXIA RESULTING IN A FALL, PALLOR, AND FORGETFULNESS THE DAY AFTER THE VACCINE WAS ADMINESTERS SHE CONTINUED TO HAVE FATIGUE AND WEAKNESs She rested the day after, no medical treatment needed.

Other Meds:

Current Illness: When she was contacted about the adverse reaction she stated she wasn't feeling well when she received the vaccine. As an agency we do screen before administering the vaccine and she was asked if she was feeling sick that day and stated she was not.

ID: 0946721
Sex: F
Age: 48
State: IL

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

Lab Data:

Allergies: Banana Blueberry Avacodo

Symptoms: "11p that night I had a 101 -102 temp, chills, headache, hard shakes"

Other Meds:

Current Illness:

ID: 0946722
Sex: F
Age: 73
State: TX

Vax Date: 01/07/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: none

Allergies: penicillin

Symptoms: red swollen itchy rash

Other Meds: spanisertib, 0simertinib, xarelto, motropolol

Current Illness:

ID: 0946723
Sex: F
Age: 50
State: PA

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: None known

Symptoms: 50 year old female presents due to reaction to her first Moderna Covid 19 vaccine done 12/30/20. 24 hours after receiving her first vaccine she developed hives on her waste and trunk. She then developed itchy bilateral forearms and hands. No rash seen on arms. The hives resolved in 24 hours and the pruritis resolved after 5 days. She took Benadryl and Pepcid with relief at that time. Denies any shortness of breath, chest pain, palpitations, wheezing, throat itching or swelling. She was taking Amoxicillin for a tooth abscess at the time and her last dose was the same day as the Covid 19 vaccine. She has no known allergies. No problems or reactions to any medications or vaccines in the past.

Other Meds: She was taking Amoxicillin for a tooth abscess and took her last dose on the same day as her first Moderna Covid 19 vaccine on 12/30/2020

Current Illness: treated for tooth abscess

ID: 0946724
Sex: M
Age: 39
State: TX

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

Lab Data:

Allergies:

Symptoms: fever, body sore, cold chills, cold sweats

Other Meds: Humalog, Meloxican, Rosuvastatin, Ozempic, Omeprazole, Toujeo, Sildenafil, Motelukas, Jardiance, Azelastine, Losartan, Vitamin D, Biotine

Current Illness:

ID: 0946725
Sex: F
Age: 39
State: IN

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

Lab Data: I and D 01/12/2021

Allergies: pyridium

Symptoms: Woke up on 01/10/2021 with tender left breast, under the breast was red and hard. Had to have area drained and packed

Other Meds: none

Current Illness: none

ID: 0946726
Sex: F
Age: 61
State: MA

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

Lab Data: rapid covid swab, negative result

Allergies: Penicillin

Symptoms: Fever, severe headache, nausea, fatigue symptoms lasted from 1/08/2021 at 3:30 am to approximately 1/13/2021 11:00 PM.

Other Meds: Lisinopril 10-12.5 mg, 2 tab day Atorvastatin 40 mg, 1 tab at bedtime Calcium 1 tab a day

Current Illness:

ID: 0946727
Sex: F
Age: 64
State: MI

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

Lab Data: none

Allergies: Morphine

Symptoms: Injection site sore, with redness, warmth, and swelling. Continued to expand in size becoming at least 2 inch firm lump. Remains red, warm to touch. Itching began on 1/14/21. Took Benadryl 25 and Aleve 200 on 1/14/21 at 2130. Some symptom abatement in am of 1/15/21. Some decrease in swelling. Remains hot, red and itchy. Applied hydrocortisone cream and notified PCP.

Other Meds: Acetaminophen 500 mg on 1/8/2021 & 1/9/21 Benadryl 25 mg with Aleve 200 mg on 1/14/21 at 2130

Current Illness: None

ID: 0946728
Sex: M
Age: 37
State: CA

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

Lab Data: NA

Allergies: NA

Symptoms: About 24 hours after my 1st COVID vaccine dose I noticed hives from flank to flank across my abdomen, and as high as my arms pits and as low as my waistline.

Other Meds: NA

Current Illness: NA

ID: 0946729
Sex: F
Age: 27
State: GA

Vax Date: 01/14/2021
Onset Date: 01/14/1921
Rec V Date: 01/15/2021
Hospital:

Lab Data: na

Allergies: unknown

Symptoms: Patient received COVID 19 vaccine on 1/14/21 at approx 1428 without any complications. Patient was escorted to observation holding area for 15 minute observation post injection. Patient held from 1430-1445 without any difficulties experienced by patient. Patient speaking frequently during observation period with another stakeholder. Patient left at 1445 after observation was complete. Patient returned at 1500 stating her throat felt strange and she was having difficulty swallowing water. Patient escorted to bay for monitoring. Vital signs BP 150/101, HR 70, O2 sat 99% on room air. Per physician order patient given 50 mg Benadryl PO and 10 mg Zyrtec PO. Vital signs at 1509 were BP 148/87, HR 72, RR not documented, pt breathing on room air. Pt held and monitored. At 1610, pt stated "I feel something in my throat". Pt has no difficulty swallowing water. 1610 vital signs BP 138/92, HR 70, O2 Sat not recorded, breathing on room air.

Other Meds: unknown

Current Illness: unknown

ID: 0946730
Sex: F
Age: 44
State: NY

Vax Date: 12/23/2020
Onset Date: 12/25/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data: all labs and imaging are pending

Allergies: cephalosporins- erythema multiform as a child

Symptoms: Left supraclavicular lymphadenopathy started Dec 25th and still present, unchanged. Rash started on abdomen Jan 11th and progressive. worsening. Mildly itchy, spreading to back/arm/legs. Blanching. Fix eruption. Looks like pityriasis rosea

Other Meds: Imitrex prn. none taken around the time of vaccination though

Current Illness: none

ID: 0946731
Sex: F
Age: 63
State:

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None. I hope to get a COVID test on Monday 1/18/21 to see if it is COVID rather than the Vaccination. If symptoms don't go away by Monday. I'll check in with my primary care physician.

Allergies: penicillin, sulfates

Symptoms: within 24 hours vaccination shots, I had intermittent low grade fever, constant chills, and mild VERTIGO (that was the worst). Re the Vertigo, I didn't fall but experienced it whenever moving. I was bumping into walls and was dizzy whenever I moved position (e.g. sitting to standing & vice versus). These symptoms lasted 5-7 days after they began (both shots).

Other Meds: Tylenol & prilosec

Current Illness: same symptoms /side effects after 1st vaccination (12/28/20)

ID: 0946732
Sex: F
Age: 51
State: NY

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

Lab Data: none

Allergies: none

Symptoms: Rash, swollen tongue and 2 seizures. Admitted to hospital with diagnosis of seizure and allergic reaction.,

Other Meds: unknown

Current Illness: none

ID: 0946733
Sex: F
Age: 48
State: IA

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: nka

Symptoms: large area of reddness to injection site

Other Meds:

Current Illness:

ID: 0946734
Sex: F
Age: 67
State: TX

Vax Date: 12/29/2020
Onset Date: 01/02/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: none

Allergies: no known drug allergies

Symptoms: Acute anterior uveitis, right eye Patient given Tobradex (steroid-antibiotic drops) from PCP on 1/2/21 She then saw me, her ophthalmologist on 1/5/21. She was noted to have significant nongranulomatous anterior chamber reaction (2+ cell). There was no hypopyon or keratic precipitates. She was symptomatic with pain and light sensitivity in the right eye only. (Of note, the left eye was quiet. It had undergone cataract surgery and recently discontinued postoperative steroid drops). I discontinued the Tobradex and start Durezol drops every 2 hours. Of note, she has no history of uveitis. I saw her again 1/12/21 with complete resolution of the inflammation. She is currently tapering down on the topical steroid. I will see her again on 1/26/21 while taking Durezol 1x/day. This should be about 3 days from her second vaccination

Other Meds: Gleevec 300 daily Aspirin 81 daily Benadryl 50 QHS Olmesartan 20 daily Furosemide 40 daily Potassium 30 daily Trelegy Ellipta daily Albuterol sulfate nebs 2-4x/day Home O2 Azithromycin 250 3x/week

Current Illness: none

ID: 0946735
Sex: F
Age: 28
State: MI

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

Lab Data: None

Allergies: No known allergies to ingestible products as an adult. VERY slight hypersensitivity to large amounts of tropical fruit as a child. Last reaction >15 years ago.

Symptoms: I was awoken from sleep with violent chills and an sensation of severe cold. My chills became violent and coarse rigors, severe enough to contract the spine into hyperextension if I kept my body in a neutral position. I could still activate each muscle group to keep in a fetal prostration pose. I was knowledgeable of the event, did not loose any bowel, bladder, or smooth muscle function, and the intensity of the rigors was focused on the most developed skeletal muscles (thighs, calves, upper arms, forearms, paraspinal muscles, hands, respectively). Jaw and muscles of the head/face seemed unaffected. Fingers and toes not distinctly affected. I was not sweating at this time and there were NO other symptoms to report; I remained lucid and able to self-reflect the entire time. Home temperature is kept to consistent 66F, no malfunctions to thermostat. No recent changes to bedding (sheet and quit on top of mattress); it is even optimized for me as I tend to overheat as I sleep. At 50 minutes, I felt "less frozen" and confident enough to stand/ambulate for 220mg naproxen + 500mg APAP , cautiously and successfully swallowed. Robe was donned over existing pajamas and thick comforter was pulled from hallway closet. Rigors continued, but it appeared that intentional activation of the muscle groups could still overpower the rigors for safe (but shaky) ambulation. Greatest risk was coarsely shaking hands a bringing cup to mouth to swallow pills. Above activity was completed in 5 minutes. I then sat upright in bed under layers above. I could feel the muscles calm and relax, with episode completely ending in 5 minutes. Total time of event: 60 minutes. Post-event details: There was a mild sensation of muscle tension in the posterior cervical spine akin to whiplash, but no residual symptoms. I debriefed with my husband shortly thereafter (he has been in another room the whole time) and fell asleep by 23:30. Awoke to alarm at 05:00 and able to stretch, accomplish 30 min run, vacuum/mop the floors, and present to work by 08:00am without deficit. Time of documentation: 11:22 am 1/15/2021

Other Meds: Vitamin D-3 4,000IU

Current Illness: None

ID: 0946736
Sex: F
Age: 62
State: IL

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

Lab Data:

Allergies:

Symptoms: "100.1 fever by that night, aches, pains"

Other Meds:

Current Illness:

ID: 0946737
Sex: F
Age: 63
State: FL

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: N/A

Allergies: none

Symptoms: She reports that on 1/7/21 (8 days following vaccination) the injection site became red and itchy and she had a hive like rash at the site x 48 hr. She reports no treatment was necessary and all symptoms have resolved.

Other Meds: asprin, selenum, alphalipoic acid, co-Q 10, miralax

Current Illness: none

ID: 0946738
Sex: F
Age: 33
State: TX

Vax Date: 01/06/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: The first day I received my shot I had no symptoms. on 1/14/2021 around 1:00 pm I started to get hives around the area i received my vaccine. Today on 1/15/2021 the hives are gone and I am left with a big red circle that is very hot, to touch.

Other Meds: adderall

Current Illness: n/a

ID: 0946739
Sex: M
Age: 31
State: NC

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

Lab Data:

Allergies: None

Symptoms: Chills, headache, body aches. Fever to 100.5 F. Fevers/chills/body aches started about 21 hours after receiving dose. Headache about 26 hours after. Measured fever about 31 hours after receiving shot. Headache resolved with tylenol. Subsquent day 36+ hours after, felt back to normal at baseline.

Other Meds: None

Current Illness: None

ID: 0946740
Sex: F
Age: 42
State: MD

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

Lab Data:

Allergies: Penicillin Bee sting Red meat

Symptoms: Swollen lymphnode approx 1 inch in diameter with swelling around the node approximately 2 inches in diameter. Pain. Was directed by my PCP,s walk-in clinic to report.

Other Meds: Contrave Multivitamin Amlodipine B12 im injection Advil

Current Illness: Sinus infection

ID: 0946741
Sex: F
Age: 44
State: PA

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: nonne

Allergies: none

Symptoms: 7 days after has a 3" raised bump at injection site

Other Meds: none

Current Illness: none

ID: 0946742
Sex: F
Age: 47
State: MA

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

Lab Data:

Allergies: crab

Symptoms: Pt arrived to vaccine clinic in doctors conference room at approx. 11am. Pt read over covid vaccine consent and screening questions. Pt stated she had an allergy to crab and I advised pt to stay for full 30mins instead of 15mins. Pt vaccine was adminstered and pt sat in chair for observation. At approx 11:10am pt stated she felt "tingling and numbness around mouth" 25mg benedyrl and a RRT was activated. RRT responsed and escorted pt to ED.

Other Meds:

Current Illness:

ID: 0946743
Sex: F
Age: 62
State: TN

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

Lab Data:

Allergies:

Symptoms: She said she received her First Covid vaccine on 12/22/2020. She said on 1/4/2021 she worked that evening and started having severe pain in calf of her left leg no redness ,no heat, just hurt to work 1/8/2021 She had surgery on her left leg. 2nd Covid Vaccine received on 1/12/2021 She said she had PT on her right leg with severe pain in her left calf She said she did not have any therapy on her left leg. Two ? three hours later she developed chills, temp 100.1 took temp again later is was 99. She had ultrasound that showed a large blood clot She said the PA told her the blood clot could be from receiving the Covid vaccine

Other Meds:

Current Illness:

ID: 0946744
Sex: F
Age: 35
State: MT

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Fever chills vomiting

Other Meds: N/A

Current Illness:

ID: 0946745
Sex: F
Age: 28
State: FL

Vax Date: 12/28/2020
Onset Date: 01/05/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: N/A

Allergies: shellfish, bees

Symptoms: 1/5/21 symptoms began. She reports swelling, itching, warmth and burning at the injection site and surrounding area. Patient is still having the same symptoms.

Other Meds: no

Current Illness: no

ID: 0946746
Sex: F
Age:
State: AZ

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

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0946747
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: Woke up with low grade fever 99.9. Felt low back pain, chills, arm pain, and fatigue. Took Tylenol 1000 mg and Naproxen 440mg. Symptoms decreased around 5pm and fever subsided around 9pm.

Other Meds:

Current Illness:

ID: 0946748
Sex: F
Age: 50
State: WI

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

Lab Data:

Allergies: none

Symptoms: I woke up at 12:39am feeling nauseous and with a pounding heartbeat. I also had a headache and severe body aches, and chills, but no fever. I drank some water and sat up in bed for a while. The pounding heartbeat settled down in about half an hour. I did not take Advil or anything else because of the nausea. Later in the morning I had some nasal congestion. Symptoms persisted but slowly waned until 6:00pm that day. After that, fatigue was the only symptom that lasted until about the 48 hour mark.

Other Meds: none

Current Illness: none

ID: 0946749
Sex: F
Age: 91
State: FL

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

Lab Data: Covid19-negative; medical test taken - all normal, pt cannot specify which test completed

Allergies: sulfa, nitrofuran

Symptoms: 7:00PM fatigued, burning up fever 100., ibuprofen/tylenol dose; Sunday afternoon nausea, loss control of body, anxious, feeling of fainting, unable to move-paralyzed, pressed button for medical help, ambulance arrived, pt transported to ER -- 102. temp ambulance, RN at hosp temp 98., pt was shaky, 8:30PM erratic heartbeat per admitting doctor - pt admitted. Pt PCP/Cardiologist contacted, kept on heart monitor, pt discharged Monday afternoon. 1/14/21 chest pain, nausea, 102. fever. symptoms

Other Meds: N/A

Current Illness: N/A

ID: 0946750
Sex: M
Age: 33
State: FL

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

Lab Data: N/A

Allergies: No

Symptoms: Body aches, felt cold, night sweats, headaches, Started 1/09/21, resolved by 1/10/21

Other Meds: No

Current Illness: No

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm