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: 0947967
Sex: F
Age: 41
State: NY

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

Lab Data:

Allergies: Penicillin, Sulfa antibiotics

Symptoms: Patient with redness to chest and abdomen and hoarseness to voice.

Other Meds:

Current Illness:

ID: 0947968
Sex: F
Age:
State: NY

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

Lab Data: Test Date: 20210107; Test Name: Heart Rate; Result Unstructured Data: Test Result:140s; Comments: 2 hours later Heart Rate in 140s; Test Date: 20210107; Test Name: Heart Rate; Result Unstructured Data: Test Result:normalized; Comments: HR normalized 6 hours later

Allergies:

Symptoms: generalized body aches; chills; heart rate in 140s; diaphoretic; dizzy; fatigue; This is a spontaneous report from a contactable healthcare professional. A 65-year-old female patient started to receive bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number EL3246), via an unspecified route of administration from 07Jan2021 13:30 to 07Jan2021 13:30 at a single dose for an unspecified indication. Medical history included covid (COVID prior vaccination: Yes). Concomitant medication included valacyclovir and vitamin d3. The patient previously took ampicillin, Keflex and metronidazole; the patient had allergies with all. Historical vaccine included first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) on 17Dec2020. It was reported that 9-hours post second vaccine, the patient had generalized body aches, chills, 2 hours later Heart Rate in 140s, diaphoretic, chills and dizzy. HR normalized 6 hours later. Diaphoresis lasted 10 hours. No treatment was received for the events. The patient also reported to have extreme fatigue. The outcome of the event heart rate abnormal and diaphoretic was recovered on 08Jan2021 while recovering for the other events.

Other Meds: VALACYCLOVIR [VALACICLOVIR]; VITAMIN D3

Current Illness:

ID: 0947969
Sex: M
Age: 51
State: OR

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

Lab Data: NA

Allergies: PCN

Symptoms: I have a red bump on my arm that is a knot and tender to the touch or painful when touched. It is very itchy and had a headache for the past few days

Other Meds: omeprazole, aspirin

Current Illness: NA

ID: 0947970
Sex: F
Age:
State: CA

Vax Date: 12/18/2020
Onset Date: 12/21/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data: Test Date: 20201219; Test Name: Nasal Swab; Test Result: Negative

Allergies:

Symptoms: Shingles dash developed within 3 days of the vaccine; This is a spontaneous report from a contactable nurse (patient) reported that a 42-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: Ek5730, expiration date: not reported), via an unspecified route of administration on the left arm on 18Dec2020 16:45 at single dose for COVID-19 immunization. The patient medical history was not reported. The patient was not pregnant. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included cyanocobalamin-tannin complex (B12 [CYANOCOBALAMIN-TANNIN COMPLEX]), ginkgo biloba and colecalciferol (VITAMIN D [COLECALCIFEROL]). Within 3 days of the vaccine, on 21Dec2020, the patient developed shingles rash with outcome of recovered. As treatment, patient received antiviral medication for 7 days. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on 19Dec2020. Since the vaccination, the patient has not been tested for COVID-19. No follow-up attempts are possible; information about lot number was already obtained.

Other Meds: B12 [CYANOCOBALAMIN-TANNIN COMPLEX]; ; VITAMIN D [COLECALCIFEROL]

Current Illness:

ID: 0947971
Sex: M
Age: 84
State:

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

Lab Data:

Allergies:

Symptoms: No adverse event reported. Only reporting administration of vaccine in possible temperature excursion

Other Meds:

Current Illness:

ID: 0947972
Sex: F
Age:
State: NY

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

Lab Data:

Allergies:

Symptoms: R arm pain--at site of injection; significant nausea; headache; body aches; chills; fatigue; This is a spontaneous report from a contactable Physician (patient). A 51-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) (lot number EL6142), via an unspecified route of administration on 07Jan2021 14:45 at single dose for covid-19 immunization. Vaccine location was right arm and it was the first dose. The facility type vaccine was hospital. Medical history included hypothyroidism, hx of Hodgkins from 1994, breast cancer from 2005. Concomitant drug included levothyroxine sodium (SYNTHROID). The known allergies included Bactrim, bacitracin, non-ionic contrast. Patient was not diagnosed with COVID-19 prior to vaccination nor tested for COVID-19 since the vaccination. The patient didn't receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient experienced Right arm pain - at site of injection, significant nausea, headache, body aches and chills. fatigue on 07Jan2021 20:00 with outcome of recovering. Patient didn't receive treatment for the adverse events. The events were reported as non-serious.

Other Meds: SYNTHROID

Current Illness:

ID: 0947973
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: Chills; headache; diarrhea; vomiting; body ache; received second dose BNT162B2(lot number EI1283) , intramuscular at Arm Left on 08Jan2021; received second dose BNT162B2(lot number EI1283) , intramuscular at Arm Left on 08Jan2021; This is a spontaneous report from a contactable Nurse(patient). A 36-Year-old female patient received second dose BNT162B2(lot number EI1283) , intramuscular at Arm Left on 08Jan2021 19:00 at the 36 years old at single dose for COVID-19 immunization. The medical history included Asthma and Dm(Diabetes mellitus). The patient was not Allergies to medications, food, or other products. There were concomitant medications but unspecified. The patient previously took first dose BNT162B2 (lot numberEJ1685) on 21Dec20200 6:30 PM at 36 years old Intramuscular at Left arm for COVID-19 immunization. The patient experienced Chills, headache, diarrhea, vomiting, body ache on 09Jan2021 02:30 AM. It was unknown if there was treatment received for the adverse events Chills, headache, diarrhea, vomiting, body ache. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. The outcome of the events was unknown. The information on the batch number has been requested.

Other Meds:

Current Illness:

ID: 0947975
Sex: F
Age:
State: MN

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

Lab Data:

Allergies:

Symptoms: Body aches, chills, headache, nausea - emesis x1; Body aches, chills, headache, nausea - emesis x1; Body aches, chills, headache, nausea - emesis x1; Body aches, chills, headache, nausea - emesis x1; Body aches, chills, headache, nausea - emesis x1; This is a spontaneous report from a contactable nurse. A 27-year-old female patient received the second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiry date not reported), via an unspecified route of administration on 07Jan2021 14:00 at a single dose on left arm for COVID-19 immunization. The patient's medical history was not reported. No known allergies. Concomitant medication included drospirenone, ethinylestradiol (YASMIN) for birth control. The patient previously received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiry date not reported), via an unspecified route of administration on 21Dec2020 08:00 at a single dose on left arm for COVID-19 immunization. The patient experienced body aches, chills, headache, nausea - emesis x1 on 08Jan2021 02:00. No treatment received for adverse event. The outcome of the events was recovering. The events were assessed as non-serious. Facility type vaccine was Hospital. No other vaccine received in four weeks. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. Information on the lot/batch number has been requested.

Other Meds: YASMIN

Current Illness:

ID: 0947976
Sex: M
Age:
State: NC

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

Lab Data: Steroids, ABX - thought was bronchitis

Allergies: NKDA

Symptoms: Headache, body aches, cough - began 1/10/21 - 3 day s/p Pfizer 1st dose vaccine WAS NOT TESTED for COVID - his dr said not necessary - "his wife had it, he had it!"

Other Meds: Metformin, lisinopril, metoprolol, glipizide, fenofibrate

Current Illness: DM, HTN

ID: 0947977
Sex: F
Age:
State:

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

Lab Data: Test Date: 20201221; Test Name: Nasal Swab; Test Result: Negative

Allergies:

Symptoms: severe head ache; body ache; This is a spontaneous report from a non-contactable healthcare professional (patient). A 36-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, expiry date EJ1685), intramuscular on left arm at 21Dec2020 07:30, intramuscular at a single dose for Covid-19 immunization. The patient has no medical history. Concomitant medication included sertraline hydrochloride (ZOLOFT). The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On an unspecified date, the patient experienced severe headache and body ache during the first dose. The patient underwent lab tests and procedures which included nasal swab with negative result on 21Dec2020. There was no treatment received for the adverse events. Outcome of the events was recovered. No follow-up attempts are possible. No further information is expected.

Other Meds: ZOLOFT

Current Illness:

ID: 0947978
Sex: F
Age: 65
State:

Vax Date: 12/31/2020
Onset Date: 01/09/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Delayed injection site reaction.

Other Meds:

Current Illness:

ID: 0947979
Sex: F
Age:
State:

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

Lab Data: Test Date: 20201221; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Negative

Allergies:

Symptoms: Minor itching of face and neck; This is a spontaneous report from a non-contactable healthcare professional (patient). A 36-years-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, expiry date EL1284), intramuscular on left arm at 07Jan2020 07:30, intramuscular at a single dose for Covid-19 immunization. The patient has no medical history. Concomitant medication included sertraline hydrochloride (ZOLOFT). The patient previously took bnt162b2 as first dose for Covid-19 immunization and experienced severe headache and body ache. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 07Jan2021 at 7:45, the patient experienced minor itching of face and neck during the second dose. The patient underwent lab tests and procedures which included nasal swab with negative result on 21Dec2020. There was no treatment received for the adverse events. Outcome of the events was recovered in Jan2021. No follow-up attempts are possible. No further information is expected.

Other Meds: ZOLOFT

Current Illness:

ID: 0947980
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: one had to get their wits about them before driving an hour home because they weren't confident about their driving abilities after getting the vaccine; This is a spontaneous report from a contactable consumer. A female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number and expiry date were not reported), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. The patient's concomitant medications were not reported. The patient was the one who had to get their wits about them before driving an hour home because they weren't confident about their driving abilities after getting the vaccine on an unspecified date. The outcome of the event was unknown. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0947981
Sex: M
Age: 19
State: KS

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

Lab Data:

Allergies:

Symptoms: Immunization 1/15/2021 COVID Vaccine Clinic Need for vaccination +1 more Dx Medication Reaction ; Referred by MD Reason for Visit Progress Notes APRN (Nurse Practitioner) ? ? Nurse Practitioner Cosign Needed Expand All Collapse All COVID VACCINE CLINIC 1/15/2021 Subjective Patient is a 19 y.o. male who was seen at COVID Vaccine Clinic today for his first dose of the COVID 19 vaccination. He denied any history of previous adverse reactions to vaccines. He was given the Moderna vaccination in the left deltoid muscle. During his 15 minute waiting period after the injection, the patient began to experience tired and stomach upset. He denied rash, hives, welts, difficulty breathing, difficulty swallowing, wheezing, throat tightness, hoarseness, stridor, itching, lightheadedness, dizziness, facial swelling, lip swelling and tongue swelling. This provider was notified of patient reaction and he was then assessed in the emergency bay area. Monitored patient for severe reaction symptoms, including but not limited to abdominal pain, blood pressure abnormality , chest pain, collapse, drooling, hypotension, increased swelling, rapid progression of symptoms, respiratory distress, skin changes, tongue swelling and vomiting. ALLERGY REVIEW OF SYSTEMS: Patient complains of malaise/fatigue and dizziness Patient denies chills, fever, vomiting and abdominal pain Nausea: Previous Reactions: Reports similar symptoms with other vaccines in the past but no major reactions. Objective Vitals Vitals: 01/15/21 1334 BP: 126/89 Pulse: 75 SpO2: 99% Patient ate about 15-20 Minutes prior to coming to appointment Physical Exam Constitutional: Appearance: Normal appearance. He is not ill-appearing. Cardiovascular: Rate and Rhythm: Normal rate. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Abdominal: General: There is no distension. Tenderness: There is no abdominal tenderness. Skin: General: Skin is warm and dry. Neurological: Mental Status: He is alert and oriented to person, place, and time. Assessment/Plan Treatment included: no therapy. Follow up response to treatment: good. Patient discharge: Stable to go home and follow up with PCP. Overall stable. Patient states he has this same reaction with other vaccines including his annual flu vaccine. Feels nauseous and really tired. States he generally goes home and is able to "sleep it off". Declines Pepcid today. Overall he feels stable. No progression of symptoms and nausea has actually improved after drinking some water. APRN Electronically Signed 1/15/2021 1:42 PM

Other Meds:

Current Illness:

ID: 0947982
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: guillain barre syndrome; Initial information regarding an unsolicited valid serious courtesy case received from a pharmacist via Pfizer Pharmaceuticals (Reference number: 2021003640) on 06-Jan-2021. This case involved an adult patient of an unknown gender who experienced Guillain Barre syndrome, after receiving influenza vaccine. Medical history, medical treatment(s), vaccination(s), concomitant medication(s) and family history were not provided. On an unknown date, the patient received a dose of suspect influenza vaccine (other details unknown) produced by unknown manufacturer (lot number and expiry date were not reported) via an unknown route in an unknown administration site for prophylactic vaccination. On an unknown date (unknown latency), the pharmacist asked information on Pfizer coronavirus infectious disease (COVID-19) vaccine. Pharmacist asked if Pfizer coronavirus infectious disease (COVID-19) vaccine could be administered to any person who had a positive history of developing Guillain Barre Syndrome after receiving an influenza vaccine (Guillain Barre syndrome). Final diagnosis was Guillain Barre syndrome. No relevant laboratory details were provided. The event of Guillain Barre syndrome was assessed as medically significant as per the important medical event list. It was not reported if the patient received a corrective treatment. Outcome of the event of Guillain Barre syndrome was reported as unknown. There will be no information available on the batch number for this case.; Sender's Comments: This case involved an adult patient of an unknown gender who presented with Guillain Barre syndrome after receiving influenza vaccine (produced by unknown manufacturer). Time to onset is unknown. Although, medical history, comorbidities, concomitant medications, additional information on investigations ruling out other etiologies would be needed for complete assessment of the case. Based upon the reported information, the role of the vaccine cannot be assessed.

Other Meds:

Current Illness:

ID: 0947983
Sex: F
Age: 46
State: IL

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

Lab Data:

Allergies: None

Symptoms: Woke this morning to redness, slight swelling, warmth to the touch at the injection site; area is about 2" in diameter. Had no similar symptoms prior to this morning. No pain or itching or irritation. No additional side effects at this time.

Other Meds: Reds/Greens/Multivitamin/Iron/BCAAs

Current Illness: None

ID: 0947984
Sex: F
Age: 47
State: NY

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

Lab Data: tomorrow scheduled for COVID PCR

Allergies: shrimp

Symptoms: 6pm- fatigue 9pm myalgia and joint pain 12am- fever 101.3, rigors, myalgia. took tylenol 6am- fatigue, fever 100.5 took tylenol

Other Meds: Breo, zyrtec, flonase, azelastine, multivit, vitamin D

Current Illness: none

ID: 0947985
Sex: F
Age: 42
State: NY

Vax Date: 01/04/2021
Onset Date: 01/11/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: Walnuts

Symptoms: Moderna Covid-19 Vaccine EUA Red patch, itchy on the injection site

Other Meds: Vit. C

Current Illness: None

ID: 0947986
Sex: M
Age: 44
State: DC

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

Lab Data: None

Allergies: none

Symptoms: Client complained of dizziness. He reported to have eaten an apple pie before getting vaccinated. He stated that he forgot to take his Xanax this morning. BP at 2:40p 144/106 pulse 108, encouraged to rest. BP repeated at 03:05 136/99 pulse 103 . Client felt better. Encouraged to rest at home and contact PCP in case of adverse reactions.

Other Meds: Xanax

Current Illness: none

ID: 0947987
Sex: F
Age: 68
State:

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

Lab Data:

Allergies:

Symptoms: No adverse event reported. Only reporting administration of vaccine in possible temperature excursion

Other Meds:

Current Illness:

ID: 0947988
Sex: F
Age: 22
State: IN

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

Lab Data:

Allergies: Penicillin, morphine

Symptoms: Red streaks on R arm. Hives on chest

Other Meds:

Current Illness:

ID: 0947989
Sex: M
Age: 42
State: ME

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

Lab Data:

Allergies: Contrast Dye, Bee stings

Symptoms: 15 minutes post vaccination starting with shaking, feeling hot and flushed, and sensation of throat closing. Brought to ER. Treated with IV benadryl and PO Tylneol. EE refused epi-pen injection. Discharged from ER aprox 3 hours post vaccination

Other Meds:

Current Illness:

ID: 0947990
Sex: F
Age: 24
State:

Vax Date: 12/28/2020
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Delayed onset of regional lymphadenopathy.

Other Meds:

Current Illness:

ID: 0947992
Sex: F
Age: 41
State: CA

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

Lab Data:

Allergies: Sulfa Tree nuts

Symptoms: About 10 minutes after getting my vaccine I noticed the roof of my mouth itching as well as my tongue and back of my throat. I waited to see if it would go away and then a couple minutes later noticed my lips started itching and swelling and from there it just got worse. I told the nurse practitioner that I think I was having a reaction, she had me take a seat told her my entire mouth throat & lips felt swollen and itching and she looked and said it was full blown anaphylaxis reaction. Administered EpiPen, benadryl and called ambulance where they took me to medial emergency department.

Other Meds: Armour thyroid 120mg, seasonal birth control, Allegra 180mg, Singulair 10mg, Protonix 40mg, Midodrine 2.5mg, Trokendi XR 200mg, Gabapentin 300mg, Benadryl 50mg, Vitamin B121ML/week, B6 50mg daily, D3 5,000 daily, apple cider vinegar gummies

Current Illness:

ID: 0947993
Sex: M
Age: 21
State: IA

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

Lab Data:

Allergies: Cats

Symptoms: I have just had a fever ever night since I got the vaccine.

Other Meds: NA

Current Illness: NA

ID: 0947994
Sex: F
Age: 63
State: VA

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

Lab Data: None

Allergies: Thimersol, sulfa, Lisinopril, Dilaudid, Phenergan

Symptoms: Fever, chills, headache, body aches, nausea, generalized weakness

Other Meds: Metoprolol, Lexapro, Nexium, Amlodipine, Levothyroxine, Buspirone, iron.

Current Illness: None

ID: 0947995
Sex: F
Age: 43
State: AK

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

Lab Data:

Allergies: reported food allergies, unknown what

Symptoms: Began with hives, itching. Quickly progressed to difficulty breathing. Brought to ER, IM Epi given in ER triage. Caregiver given racemic Epi and another dose of IM Epi in ED. Further care please refer to ED MD

Other Meds: unknown

Current Illness: Unkniown

ID: 0947996
Sex: F
Age: 21
State: OK

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

Lab Data:

Allergies: Sulfa drugs

Symptoms: 1/13/21: received second dose of COVID-19 vaccine. One hour later experienced sensation of arm numbness, resolved within hours. Later in evening experienced a sensation of burning in entire right arm. 1/14/21: woke at 2 a.m. with sensations of shortness of breath. At 5:30am developed muscle spasms in form of twitches in right arm and diffuse muscle discomfort. Additionally describes chest pain in substernal location with radiation to right rib cage. Chest pain reproduced and accentuated by direct pressure. Developed fever of 99.9 degrees and was turned away when going to work. Returned home and recorded temperature slightly above 100 degrees. 1/14/21: experienced continued muscle discomfort and right arm twitches. Remains short of breath but seems to be improving. 1/15/21: continued complaints of chest pain radiating from middle of chest to right side, continued shortness of breath, and whole body pain.

Other Meds: Lomotil 2.5 - 0.025 mg, 1 tablet four times daily PRN, hyoscyamine 0.125 mg 1 tablet every 4 hours PRN, ondansetron ODT 8 mg 1 tablet by mouth every 4 hours PRN, birth control

Current Illness: Patient reported none at time of vaccine. Husband diagnosed with COVID on 1/1/21. Patient has not been isolating from husband. Received COVID-19 test on 1/15/21 with results pending.

ID: 0947997
Sex: F
Age: 28
State: CA

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

Lab Data:

Allergies:

Symptoms: BODY ACHES, CHILLS, TEMP 101.5, HEADACHE

Other Meds:

Current Illness:

ID: 0947998
Sex: F
Age: 38
State: FL

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

Lab Data: none

Allergies: penicillin - rash

Symptoms: Took second dose shot at 9am on 1/13/21 - by 5pm the same day I started to experience flu like symptoms - no fever but had muscle aches, chills, jittery/restless/insomnia, fatigue - these symptoms continued until 10pm on 1/14. Took four doses of ibuprofen between 6pm on 1/13 through 6pm on 1/14. The ibuprofen was eith ineffective or slightly effective for a short period of time but all symptoms returned within 3-4 hours after taking ibuprofen. All symptoms resolved upon waking at 6am on 1/15/21.

Other Meds: none

Current Illness: none

ID: 0947999
Sex: F
Age: 60
State: TN

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

Lab Data: Heart rate and respiratory rate WNL; declined to have blood pressure checked or to be evaluated outside of vehicle

Allergies: None

Symptoms: 10 minutes after receiving vaccine pt. c/o severe itching on face and neck. No hives, shortness of breath or distress noted. Pt. declined to take Benadryl or Epinephrine - requested to go to hospital for evaluation.

Other Meds: Unknown

Current Illness: Unknown

ID: 0948000
Sex: F
Age: 56
State:

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

Lab Data:

Allergies:

Symptoms: No adverse event reported. Only reporting administration of vaccine in possible temperature excursion

Other Meds:

Current Illness:

ID: 0948001
Sex: F
Age: 29
State:

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

Lab Data:

Allergies:

Symptoms: chest pressure, SOB, scratchy throat, light headedness, hoarse voice 12/29 - about 15 min after receiving the vaccine employee reported mild chest pressure/pain, hoarse voice, SOB, light-headedness, and scratchy throat. (She was given the vaccine in the ED because of a history of anaphylaxis with taking antibiotics). Her physical examination and vital signs were normal. No evidence of swelling to lips, tongue or throat. No treatment was required. Employee was observed for 4 hours and discharged to home. She was diagnosed with a minor allergic reaction.

Other Meds:

Current Illness:

ID: 0948002
Sex: F
Age: 48
State: MD

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

Lab Data: None

Allergies: NKA

Symptoms: Flushed 15-20 min. after vaccination; monitored for additional 15-20 min.

Other Meds: Ventolin

Current Illness: N/A

ID: 0948003
Sex: F
Age: 55
State:

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

Lab Data:

Allergies:

Symptoms: Tachycardia, SOB and throat tightness day after injection.

Other Meds:

Current Illness:

ID: 0948004
Sex: F
Age: 47
State:

Vax Date: 12/26/2020
Onset Date: 12/27/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Agitation, Headache, Abdominal cramps, pain at injection site Narrative: Patient received Covid vaccine on 12/27. Noted myalgias in the middle of the night. The following morning she awoke with abdominal cramps, headache, pain at injection site, tachycardia and anxiety. Seen in ED, given IV fluids and Rocephin.

Other Meds:

Current Illness:

ID: 0948005
Sex: F
Age: 28
State: NY

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

Lab Data:

Allergies: None

Symptoms: The night of receiving the vaccine, I developed chills and myalgia that progressively got worse into the morning. Then I developed a fever of 38.6

Other Meds: Oral contraceptive

Current Illness: None

ID: 0948006
Sex: F
Age: 26
State: OR

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

Lab Data: None

Allergies: Sulfa antibiotics / seasonal allergies

Symptoms: Day of- sore arm. Day 2- painful and hard to move left arm. Lethargy/sore throat/cough/headache and then spiked a fever of 100.4 starting at 10pm that lasted until 2-3am until I took Tylenol. Day 3- woke up and fever resolved. Still have cough, muscle aches, and slight headache

Other Meds: None

Current Illness: Hashimoto?s Disease /ovarian cyst

ID: 0948007
Sex: F
Age: 48
State: CA

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

Lab Data:

Allergies:

Symptoms: RRT called for numbness and tingling sensation report by patient (employee) after receiving Pfizer COVID-19 Vaccine. Vaccine administered at 10:48am and approximately 15 minutes later starting reporting numbness and tingling sensations. All VSS stable, neuro exam completed with no other findings appreciated. MDs at bedside encouraging patient to go to the emergency department but patient refused. Encouraged to go if symptoms persist and/or worsen. Patient endorses she will take Benadryl when she gets home.

Other Meds:

Current Illness:

ID: 0948008
Sex: F
Age: 68
State: FL

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

Lab Data:

Allergies: No known allergies

Symptoms: Patient received vaccine at 1:48 pm then approximately 5 minutes afterwards fainted and fell to the floor while sitting in a chair. I went over and rolled patient over having her lay face up and then proceeded to ask her questions. We had a staff member called 911 while I was helping her. I asked her how she felt and she responded and said she felt "hot all over and dizzy." Her pulse was low (~40 bpm). 911 informed us to lie her down on the floor until EMS arrived which we already had been doing at the time. After getting off the phone with 911, she started feeling better and her pulse returned to a normal rate (~80 bpm). EMS still took her to the hospital for further evaluation.

Other Meds: n/a

Current Illness: n/a

ID: 0948009
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: BlurredVision, Dizziness, NauseaVomiting & HYPOtension Narrative: Patient had nausea and dizziness within one minute of vaccine. BP was relatively low when we checked it in clinic and the patient was sent to the ED.

Other Meds:

Current Illness:

ID: 0948010
Sex: F
Age: 33
State: TX

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

Lab Data:

Allergies:

Symptoms: Symptoms ? EE reports she woke up on 1/14 with body aches, chills and fatigue. + fever (Tmax 100.1) and advil taken. EE reports she called off of work yesterday due to feeling ill. EE reports today improvement in symptoms but still with mild HA and fatigue. Temp 99.4 today, advil taken at 13:15.? Last day of work and shift ? today Home remedies? - rest and Advil Any improvement? - yes Recommendation? EE encouraged to continue to monitor her symptoms and to contact the Vaccine support line with additional questions and concerns. EE reports she called off work yesterday and heading to work at time of call. EE educated on Illness in the Workplace Policy and to notify her manager if she needs to leave work and go home. EE verbalized back understanding and denied further questions at this time.

Other Meds:

Current Illness:

ID: 0948011
Sex: M
Age: 27
State: NY

Vax Date: 12/22/2020
Onset Date: 01/10/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Moderna Covid-19 Vaccine EUA Rashes on both arms and (L) side of the body

Other Meds: Unknown

Current Illness: None identified

ID: 0948012
Sex: M
Age: 57
State:

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

Lab Data:

Allergies:

Symptoms: No adverse event reported. Only reporting administration of vaccine in possible temperature excursion

Other Meds:

Current Illness:

ID: 0948013
Sex: F
Age: 39
State:

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

Lab Data:

Allergies:

Symptoms: perioral, numbness/tingling Employee reports peri-oral numbness/tingling 15 mins after vaccine administration. Employee immediately escorted to ED for airway evaluation. On arrival to ED, all VSS. No airway compromise. Given 50mg PO benadryl and 10mg PO zyrtec and then d/c'd home.

Other Meds:

Current Illness:

ID: 0948014
Sex: F
Age: 25
State: WI

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

Lab Data: N/A

Allergies: Gantrisin (broke out when I was a baby and haven't taken since)

Symptoms: -Redness at injection site has spread into about a 3 inch circle (length and width). Started as about a 1 inch circle. -The area is hot to the touch -Swelling and hardness I have iced the area on and off, it does not seem to help. Benadryl does not seem to help.

Other Meds: -Junel birth control -Great Value brand Benadryl for seasonal allergies (taken at night)

Current Illness: N/A

ID: 0948015
Sex: F
Age: 69
State: OR

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: Aspirin, St. John's Wart

Symptoms: At 48 hours I developed a rash and itching from head to toe. Mild. Benedryl helped. Then at 72 hrs, I developed chronic sneezing. All reactions have resolved as of today, 1/15/21.

Other Meds: Ropinerol, ezetimibe, HCTZ, Potassium, Levothyroxin, Pepcid, Loridadine, Fish Oil, Magnesium/Calcium, Vit. E and Vit D3, Multi-vitamin, glucosamine., ibuprofen, Coqu10, MCI, Vagifem

Current Illness: None

ID: 0948016
Sex: M
Age: 38
State: IL

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

Lab Data:

Allergies: Oxybutynin

Symptoms: C/O headache this morning; received PRN Tylenol.

Other Meds:

Current Illness:

ID: 0948017
Sex: F
Age: 63
State: MI

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

Lab Data: none

Allergies: Azithromycin, codeine, sulfa, tetracycline, sodium oxabate

Symptoms: Swelling/Itching of Injection site area beginning 8 days after vaccine was given. Sudden onset 9 days after vaccine and it was erythematous warm and measuring 5 x 7 cm

Other Meds: none

Current Illness: none

ID: 0948018
Sex: F
Age: 41
State: MN

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

Lab Data: None

Allergies: Valtrex

Symptoms: fever, chills, body/muscle aches, headaches, fatigue for approximately 24 hours. Mild improvement with Tylenol.

Other Meds: multivitamin, calcium, Vitamin C, Biotin

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm