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: 0954766
Sex: F
Age: 39
State: PR

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: NO

Allergies: SEAFOOD MANGO CIPRO PENICILLIN

Symptoms: TICKLING IN THE LOWER LIP, WHICH IS SLIGHTLY INFLAMMED

Other Meds: no

Current Illness:

ID: 0954768
Sex: F
Age: 30
State: MA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Patient experienced heart racing and felt the color from her face go pale. Patient was brought to EMS area. Vital signs monitored. Adverse feelings resolved within 15-20 minutes

Other Meds: None

Current Illness:

ID: 0954769
Sex: F
Age: 54
State: VA

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Very bad arm pain for 36 hrs. very bad body aches for 36 hrs very bad joint pain for 36 hrs no energy for 36 hrs *Heart palpitations continuing to date

Other Meds: Euthyrox 75 mg daily Lisinopril 20 mg daily Rosuvastatin 40 mg daily Clopidogrel 75 mg daily Metoprolol tartrate 25 mg twice daily Isosorbide mononitrate 30 mg daily Aspirin 81 mg daily

Current Illness:

ID: 0954770
Sex: F
Age: 58
State: MI

Vax Date: 01/04/2021
Onset Date: 01/11/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: None

Allergies: PCN Sulfa Tamiflu

Symptoms: Red, raised, extremely itchy rash on left upper arm x 2-3 days. Rash resolved. Intermittent itching persists.

Other Meds: Calcium D3 MVI

Current Illness: None

ID: 0954771
Sex: F
Age: 39
State: OH

Vax Date: 01/10/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: na

Allergies: No

Symptoms: Redness around injection area. I marked the redness, next day redness is moving outside of the border.

Other Meds: Levothyroxine

Current Illness: No

ID: 0954772
Sex: F
Age: 27
State:

Vax Date: 01/11/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: NONE

Symptoms: Arm pit sore - to injection site, warm to touch, red area, tender to touch, swollen denies any fever Started on abx - cephalexin

Other Meds:

Current Illness: NONE

ID: 0954773
Sex: F
Age: 62
State: FL

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: None

Allergies: NONE

Symptoms: Fever up to 102; headache; severe malise; itching and redness at injection site - treated with Alleve, rest & fluids

Other Meds: Alleve

Current Illness: None

ID: 0954774
Sex: F
Age: 42
State: IN

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: Had Covid test on Thursday 1/14 which came back negative

Allergies: Flagyl

Symptoms: Developed myalgias on 1/12 which lasted until Friday and developed loss of sense of smell and taste on Tuesday which lasted until Thursday

Other Meds: Cymbalta Pregabalin Amlodipine/Benazepril Imodium Depakote Lorazepam Fluoxetine Rosuvastatin

Current Illness: No

ID: 0954775
Sex: F
Age: 41
State: MI

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: Non

Allergies: Unknown

Symptoms: Patients states felt lump in throat, able to swallow, denied shortness of breath or difficulty in breathing. Able to manage secretions. , Respirations 24, heat rate 102, skin warn and dry. Diphenhydramine 50 mg IM left gluteus maximums. Monitored for 30 min. Husband arrived to escort home. Refused transport or advice to seek medical attention. States "I am a ER nurse, and I am OK now". Respirations 18 heart rate 84. Patient left with husband following.

Other Meds: Unknown

Current Illness: Unknown

ID: 0954776
Sex: F
Age: 47
State: IL

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: Iodine shell fish

Symptoms: Tip and edge of tongue feels on fire, white scabs and very painful. No swelling occurred. I have not seen a Dr about this. I called the location of where I got the vaccine to see if I could speak to a Dr and they gave me a email to send questions.

Other Meds: Levothyroxine, ketones

Current Illness: None

ID: 0954777
Sex: F
Age: 21
State: OH

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: red itchy swollen knot at vaccine site , ongoing swollen lymph node in armpit

Other Meds: pristiq, syeda

Current Illness: N/A

ID: 0954778
Sex: F
Age: 38
State: MA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: I started feeling lightheaded, heart started beating fast, and I briefly felt like I might pass out. I raised my hand to tell the nurse, and she asked if I wanted to see the EMTs which I replied yes. I was able to walk to the EMTs with no issue, as the lightheadedness had subsided (felt lightheaded for maybe 1-2 min total time). The EMTs took my blood pressure and it was 160/100, with a high heartrate (they didn't tell me what that was). They gave me some water and I sat for a few minutes, starting to relax and feel better shortly thereafter. They took my blood pressure again, and it was down to 140/84 and they mentioned that the heartrate had gone down significantly as well. At that time I felt fine, and they felt I was ok to go home.

Other Meds: Loryna (birth control pill)

Current Illness: None

ID: 0954779
Sex: F
Age: 36
State: GA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Started with fever of 101.3, aching all over-hurt to touch skin, extreme fatigue, headache all that started about 12 to 15 hours after injection was given and lasted about 12 hours. I'm not sure if this next part has anything to do with the vaccine but I have an IUD(birth control) and I have not had a mensal cycle in over 4 years and about 48 hours after my injection I started with a lite mensal cycle. It's just very strange that I have not had anything in over 4 years and started this after the vaccine and that's the only thing I have done or changed.

Other Meds: None

Current Illness: None

Date Died: 01/13/2021

ID: 0954780
Sex: M
Age: 82
State: MI

Vax Date: 01/05/2021
Onset Date: 01/13/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: None.

Allergies: Shellfish/Seafood

Symptoms: On 1/13/2021, resident had sudden emesis. Immediately following emesis he was noted without a pulse and pronounced deceased. No acute symptoms noted prior to this episode. Resident does have a significant cardiac history.

Other Meds: Norvasc 10mg daily Multivitamin daily Vitamin C 500mg twice daily Folic Acid 1mg daily Aspirin 81mg daily Thiamine 100mg daily Coreg 6.25mg twice daily Ativan 0.5mg three time daily Cymbalta 30mg daily ProStat 30ml three time daily D

Current Illness: None

ID: 0954781
Sex: F
Age: 32
State: MA

Vax Date: 01/15/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: No

Allergies: Penicillin

Symptoms: 3 days after shot starting getting nauseous and very hot. Then an hour later I started getting foggy and the top my head and forehead is numb. I had a low grade fever that night and my body feels very heavy like it?s sleeping.

Other Meds: Acid reflux medication

Current Illness: No

ID: 0954782
Sex: F
Age: 77
State: NY

Vax Date: 01/12/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: Coedine, penicillen

Symptoms: Six days after vaccination, itching, rash, area warm, slightly swollen. No treatment

Other Meds: Lipitor, warafin, atenenol,lisinopril

Current Illness:

ID: 0954783
Sex: M
Age: 54
State: NJ

Vax Date: 01/06/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: N/a

Allergies: No

Symptoms: Left upper arm rash with reaness which growing every day and itching

Other Meds: Enalopril, semastatin, vitamin C, zinc, aspirin

Current Illness: No

ID: 0954784
Sex: F
Age: 37
State: MI

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: Being tested for covid at 2:10 pm recommended by occupational health today

Allergies:

Symptoms: 12 hours after shot I got extreme chills and fever once fever broke I was dripping in sweat and very hot to touch this happened 3 times in the full 20 hours than ended around 10:30 pm Sunday than Monday at 4 pm had the chills and fever again this happened two times last fever was 9:30 pm

Other Meds: Doxycycline, zoloft 75mg, albuterol

Current Illness: Lymphedema

ID: 0954785
Sex: F
Age: 52
State: MD

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: lymphadenitis on axilla of injection site with swelling/ erythema into the L breast.

Other Meds: vitamin d, mvi, fiber, metronidazole topical cream

Current Illness: none

ID: 0954786
Sex: M
Age: 79
State: PA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: none

Allergies: ALLERGIES: LESCOL XL 80MG TAB, ZOCOR, SULFA DRUGS, PENICILLIN

Symptoms: received moderna covid 19 1/14/21 12 noon. 1600 hours developed severe sharp 7/10 peri umbilical abdominal pain that did not radiate, no associated signs/symptoms. Pain persisted until 2300 hours, took one tab acetaminophen, went to sleep. Upon arising in AM pain resolved. Has not recurred. Upon arising did experiencing more typical side effects including fatigue and thought he had fever, no thermometer to check, these symptoms subsided over 1-2 days. No recurrence of any above symptoms.

Other Meds: Active Medications Status 1) FERROUS SULFATE 325MG TAB TAKE ONE TABLET BY MOUTH EVERY DAY ACTIVE SAME AS IRON (SUBSTITUTE FOR NU-IRON 150MG TABLET) 2) FINASTERIDE 5MG TAB TAKE ONE TABLET

Current Illness: none

ID: 0954787
Sex: F
Age: 43
State: OH

Vax Date: 12/28/2020
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Bell's palsy, diagnosed by patient's physician on January 16, 2021.

Other Meds:

Current Illness:

ID: 0954788
Sex: F
Age: 43
State: VA

Vax Date: 01/02/2021
Onset Date: 01/09/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: none, telehealth visit with primary doctor with inspection of area.

Allergies: none

Symptoms: Axilla pain and swelling (lymph node), L arm/shoulder reaction at site and below with redness, itching and swelling. Present for 1 week after initiation of symptoms with 2-3 days of pain and swelling and then improved over 3-4 days after that.

Other Meds: probiotic

Current Illness: none

ID: 0954789
Sex: M
Age: 50
State: MA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: Codeine, latex

Symptoms: C/O felling numbness in the back of his head and some tingling in left arm. Seen By EMT. BP-131/91,76. O2 Sat 98%. TEl./EKG SR.

Other Meds: None

Current Illness: None

ID: 0954790
Sex: F
Age: 27
State:

Vax Date: 01/07/2021
Onset Date: 01/12/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: Left axillary and clavicle lymphadenopathy, large, painful, and erythematous

Other Meds: Birth control

Current Illness: None

ID: 0954791
Sex: F
Age: 37
State: OH

Vax Date: 01/11/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: 1/18: Urgent care visit. No labs

Allergies: Penicillin

Symptoms: Injection site reaction. Started 1 week after injection. Redness, hot to touch, large hard spot underneath injection, itching, throbbing. 5cmx9cm area

Other Meds: Birth control pill Multivitamin Calcium with vit D

Current Illness: N/a

ID: 0954792
Sex: M
Age: 65
State:

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: none

Other Meds: none

Current Illness: none

ID: 0954793
Sex: F
Age: 43
State: NY

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: Aspirin/penicillin/codeine/oxycodone/latex/trulicity

Symptoms: patient reported her hands itching 20 minutes after receiving vaccine no other complaints Benadryl 25 mg cap x 1 dose given to patient resolved / discharged After being monitored for 45 minutes

Other Meds: Basaglar/farxiga/prozac/hydroxyzine/levothyroxine/omeprazole/spironolactone

Current Illness:

ID: 0954794
Sex: M
Age: 64
State: TX

Vax Date: 12/24/2020
Onset Date: 12/26/2020
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: seasonal allergies

Symptoms: had most side effects listed for vaccine - headaches, body aches, cough, runny nose, malaise.

Other Meds: simvastatin, metoprolol, vit d, vit c, multivitamin, flonase, claritin, restoril

Current Illness:

ID: 0954795
Sex: F
Age: 64
State: NC

Vax Date: 11/28/2020
Onset Date: 11/29/2020
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: flare up of her acid reflux / reflux was really bad; flare up of her acid reflux / reflux was really bad / had silent reflux for several years but it has been well controlled in the last 6 months; Exhausted; Body aches; nausea; bloating; This case was reported by a consumer and described the occurrence of esophageal acid reflux in a 64-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Concurrent medical conditions included silent reflux. On 28th November 2020, the patient received the 2nd dose of Shingrix (intramuscular). On 29th November 2020, 1 days after receiving Shingrix, the patient experienced esophageal acid reflux, condition aggravated, exhaustion, general body pain, nausea and bloating. On an unknown date, the outcome of the esophageal acid reflux was not recovered/not resolved and the outcome of the condition aggravated, exhaustion, general body pain, nausea and bloating were unknown. The reporter considered the esophageal acid reflux, condition aggravated, exhaustion, general body pain, nausea and bloating to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. Patient has had silent reflux for several years but it has been well controlled in the last 6 months. Patient reported that she received the 2nd dose of Shingrix vaccine on Saturday 28th November 2020 and on sunday 29th November 2020 experienced flare up of her acid reflux in night and stated the reflux was really bad also patient was exhausted and had body aches with nausea and bloating. The reporter did not consent to follow up.

Other Meds:

Current Illness: Reflux gastritis

ID: 0954796
Sex: F
Age: 66
State: CO

Vax Date: 07/01/2020
Onset Date: 07/01/2020
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: vomiting; chills; dehydration; elevated blood pressure; slow heart beat; dizziness; shortness of breath; localized abdominal pain; This case was reported by a consumer via call center representative and described the occurrence of vomiting in a 66-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. In July 2020, the patient received the 1st dose of Shingrix (intramuscular). In July 2020, 2 days after receiving Shingrix, the patient experienced vomiting, chills, dehydration, increased blood pressure, heart rate decreased, abdominal pain localized, dizziness and shortness of breath. On an unknown date, the outcome of the vomiting, chills, dehydration, increased blood pressure, heart rate decreased, abdominal pain localized, dizziness and shortness of breath were recovered/resolved. It was unknown if the reporter considered the vomiting, chills, dehydration, increased blood pressure, heart rate decreased, abdominal pain localized, dizziness and shortness of breath to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. It was reported that the female patient received the 1st dose of Shingrix in July 2020, and 2 days after the vaccination patient experienced vomiting, chills, dehydration, elevated blood pressure, slow heart beat, which lasted 2- 3 days and resolved. The patient reports localized abdominal pain, which lasted for 1 week and resolved. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 0954797
Sex: F
Age: 81
State: AR

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

Lab Data:

Allergies:

Symptoms: Tiredness; This case was reported by a consumer and described the occurrence of tiredness in a 71-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 1st December 2020, the patient received the 2nd dose of Shingrix (intramuscular). On an unknown date, unknown after receiving Shingrix, the patient experienced tiredness. On an unknown date, the outcome of the tiredness was unknown. It was unknown if the reporter considered the tiredness to be related to Shingrix. Additional details were provided as follows: It was reported that patient received the dose of Shingrix and experienced tiredness. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 0954798
Sex: M
Age: 0
State: IN

Vax Date: 12/03/2020
Onset Date: 12/03/2020
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: inadvertently injected an 8.5 week old with BEXSERO; This case was reported by a other health professional via call center representative and described the occurrence of wrong vaccine administered in a 8-week-old male patient who received Men B NVS (Bexsero) (batch number ABXA93AA, expiry date 28th February 2022) for prophylaxis. Co-suspect products included meningococcal B recom vaccine + aloh + omv pre-filled syringe device (Bexsero Pre-Filled Syringe Device) injection syringe for prophylaxis. On 3rd December 2020, the patient received Bexsero (intramuscular) .5 ml and Bexsero Pre-Filled Syringe Device. On 3rd December 2020, unknown after receiving Bexsero and Bexsero Pre-Filled Syringe Device, the patient experienced wrong vaccine administered. On an unknown date, the outcome of the wrong vaccine administered was unknown. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional information was provided as follows: The medical assistant mentioned that, she inadvertently injected an 8.5 week old with Bexsero instead of Hepatitis B in the left thigh, which led to wrong vaccine administered. No further information was provided. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 0954799
Sex: M
Age: 72
State: PA

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: feeling fatigued; arm pain in the injected arm; This case was reported by a consumer and described the occurrence of fatigue in a 72-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. The patient's past medical history included rib fracture. Concomitant products included codeine phosphate, paracetamol (Acetaminophen + Codeine). On 21st December 2020, the patient received Shingrix (intramuscular). On 21st December 2020, 1 hr after receiving Shingrix, the patient experienced pain in arm. On 22nd December 2020, the patient experienced fatigue. On 23rd December 2020, the outcome of the fatigue and pain in arm were recovered/resolved. It was unknown if the reporter considered the fatigue and pain in arm to be related to Shingrix. Additional details were provided as follows: The patient reported for himself. The patient experienced arm pain in the injected arm. The reporter did not consent to follow-up. The lot number was not available.

Other Meds: Acetaminophen + codeine

Current Illness:

ID: 0954800
Sex: F
Age: 59
State: ME

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: not applicable

Allergies: Bee venom, 10/09/2012, Anaphylaxis; Oxycodone, 06/13/2014, Hives, Shortness of Breath, Itching; Vancomycin, 05/13/2013, Shortness of Breath, Itching, wheezing; Ace Inhibitors, 01/20/2011; Bee Pollen, 02/17/2014; Celebrex 01/20/2011, itching, hives; Diltiazem, 01/20/2011, Hives whole body, hospital; Erythromycin, 06/13/2014, Info entered from paper chart; Fentanyl, 01/20/2011, Hives, itching; Lisinopril, 02/18/2014; Macrolides and Ketolides, 02/18/2014; Methacholine, 01/20/2011, Itching, lost voice, tight throat; Morphine, 01/20/2011, Edema, Hives, Itching; Nutritional Supplements, 01/20/2011; Penicillins, 01/20/2011, Convulsions/Can't breathe; Perfume (nic), 02/17/2014; Ponstel, 01/20/2011, Edema, Admit to Hospital; Pronestyl, 06/13/2014, Info entered from paper chart; Prozac, 01/20/2011, Tried to control vagus nerve-caused major depression; Tetanus Toxoid, 03/25/2013, "huge knot" at site; Vancomycin Hcl, 02/18/2014; Wellbutrin, 01/20/2011, /EES - Itching

Symptoms: Patient received first COVID vaccine given at 3:10 pm approximately. Patient monitored closely at approximately 3:40pm began experiencing itching on left arm by injection site and up in hairline. Noted red patches, no hives, Provider on site made aware of patient itching. No issues with breathing, swallowing able to talk in complete sentences. She was eating a snack and drinking juice without issue 3:45 pm itching both arms and upper back plus up in hairline, complained of chest being heavy. Provider assessed lung sounds lungs clear per provider 4pm this writer notes red patches under chin and on side of face, noted patient scratching their back. Checked shoulder areas hives noted. Provider over to assess. Adult Anaphylaxis Kit accessed and guidelines followed Per Provider, Dr, IM Benadryl given 25mg from Anaphylactic kit. Injection given in Right deltoid no issues noted. Per provider Epinephrine pen 0.3mg given in right upper thigh. Oxygen saturation is 99% and heart rate 121. 4:05pm Patient noted to be shaking she states "this is normally what happens after the Epi Pen" Blood pressure checked and was 121/71 4:15 shaking has subsided she states breathing better 4:17pm reported to RN that breathing normal and patient reports minimal itching. 4:20pm Provider spoke with patient advised to go home and rest Patient understands not recommended to have second shot. Patient was driven back to her work location by employer to get her vehicle. Provider cleared patient to drive home. Patient symptoms had resolved speaking clearly with no issues

Other Meds:

Current Illness:

ID: 0954801
Sex: F
Age: 54
State: GA

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: None

Allergies: Ceclor

Symptoms: Moderna COVID-19 vaccine Received shot 8am on a Thursday morning. Friday at 3am Began having chills about 16 hrs after injection and fever4 hours later of 102. Also had headache and leg pains. Fever lasted until 8am Saturday morning. Then just had fatigue for 2 days. I took Tylenol and ibuprofen alternating.

Other Meds: Protonix Losartan/hctz Claritin Zinc Vitamin D3 Probiotic Whole Foods multivitamin

Current Illness: None

ID: 0954802
Sex: F
Age: 24
State: OH

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Hives, sore arm, fatigue

Other Meds: Montelukast, birth control, escitalopram

Current Illness: None

ID: 0954803
Sex: F
Age: 58
State: KY

Vax Date: 01/15/2021
Onset Date: 01/01/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: none at this time

Allergies: sulfer and adhesive tape

Symptoms: the first couple of days just soreness in arm from elbow up the back of head. On Sunday 1/18 has a small rash on chest in the evening. had a welp on wrist when I woke up still had small rash. as the day went on the rash spread and became whelp from head down to top of legs. when I got up at 12:30 am Tuesday morning due to itching I also had something like a hot flash and felt sick to my stomach. I spoke with the doctor in the office on Monday. was directed to take Benadryl at night and xyzal 5 mg in the morning. also was given a Rx for triamcinolone acetonide cream USP 0.1%. which does help with the itch when it is applied. the rash/hives are still spreading.

Other Meds: pantoprazol, rosuvastatin, jardiance, lisinopril, metformin, stool softener, miralax, vitamin D3, C, Zinc, diflucan,

Current Illness: was positive for COVID 12/28/20

ID: 0954804
Sex: F
Age: 48
State: MA

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/19/2021
Hospital: Y

Lab Data: Blood work, chest x-ray, leg ultrasound and CT scan

Allergies: Acetaminophen

Symptoms: Started with severe chills, body aches and feverish. The. Slight leg pain which worsened with time , swelling on the right leg calf, warm to touch and difficulty breathing. Got hospitalized on 1/16 21 with multiple clots in my right leg and clot in the lung. Still in the hospital now.

Other Meds: Mvi and vitamin C

Current Illness: None

ID: 0954805
Sex: F
Age: 47
State: LA

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: 30-40 minutes after the vaccine administration, began to have a decreased sensation to left side of face to include jaw, lip and tongue.

Other Meds: Toprol, Flecainide, Estrogen, Progesterone

Current Illness: none

ID: 0954806
Sex: F
Age: 58
State: MA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: PCR test 01/13/21-negative-missed 2 days of work

Allergies: Lisinopril(cough) seasonal allergies-pollen, dust, smoke, aerosol cleaning products

Symptoms: Received first dose of Moderna Covid-19 vaccine on Monday 01/11/21 @10;30 AM. Had fever and chills,102-104.9, severe myalgia, joint pains(felt like run over by the truck), transient mild headache, severe muscle ache both arms(worse on left upper arm at vaccine site), fatigue and malaise. Before vaccination, I had taken Alkaseltser, Nyquil and Naproxen.

Other Meds: Vitamin D, Losartan, Pravastatin, Metformin, Glipizide, Meloxicam, Aspirin, magnesium, omeprazole

Current Illness: None

ID: 0954807
Sex: F
Age: 40
State: NC

Vax Date: 01/08/2021
Onset Date: 01/14/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: UTC visit for diagnosis now on valtrex and pain medication

Allergies: hydrocodone - rash

Symptoms: I started to get a painful rash on my left torso and at first thought it was a bug bite but then after 48 hrs it got worse and more painful and I realized it was shingles. I have never had shingles and I am healthy and young and so I thought it might be related to getting the vaccine- Maybe COVID vaccine induced it or made me susceptible. I am nursing a 4 month old to give more information.

Other Meds: vit D levothyroxine prenatal

Current Illness: none

ID: 0954808
Sex: F
Age: 58
State: NH

Vax Date: 01/05/2021
Onset Date: 01/14/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: Allergic to sulfa drugs

Symptoms: Injection site became very red, hot, hard and swollen, nine days after receiving the vaccine. Applied ice off and on the entire day. Made no difference. Saw a medical provider on 1/18/2021, have been put on Cephalexin 500 mg, once capsule by mouth three times a day for 10 days.

Other Meds: Zoloft, multi-vitamin, red yeast rice, turmeric curcumin complex, coq-10, vitamin D3, aspirin 81 mg

Current Illness:

ID: 0954809
Sex: F
Age: 43
State: KY

Vax Date: 01/05/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: METFORMIN

Symptoms: Cellulitis at injection site. Treatment: Keflex 500 mg QID x 7 days. Site measures 13 cm x 9 cm. Warmth and erythema at site. worsening over 24 hours.

Other Meds:

Current Illness: DIABETES, LEFT SHOULDER SURGERY

ID: 0954810
Sex: M
Age: 76
State: NY

Vax Date: 01/11/2021
Onset Date: 01/19/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: 3 cm redness at vaccination site

Other Meds: Eliquis

Current Illness: None

ID: 0954811
Sex: F
Age: 35
State: NC

Vax Date: 01/13/2021
Onset Date: 01/19/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: NONE

Allergies: NONE

Symptoms: SIGNIFICANT UPPER LIP SWELLING 6 DAYS LATER

Other Meds: TRIAMTERINE/HCTZ ORAL CONTRACEPTIVE

Current Illness:

Date Died: 01/16/2021

ID: 0954812
Sex: F
Age: 86
State: NY

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: She had the first dose of Pfizer vaccine at the Campus on Friday 1/15 at 4:30 pm. After the vaccine, she had no new symptoms or signs of vaccine reaction and MD friend reports that he checked her pulse which was not elevated from baseline. On 1/16, she awakened and continued to feel at her recent baseline. However, in the early afternoon, she complained of headache, nausea/epigastric pain, and chest heaviness. These apparently were not unusual symptoms for her to feel intermittently. Per her niece, who has a home O2 sat device, her 02 sat that morning was 97 with a HR of 87 irregularly irregular. She was afebrile. (continue on page 2)

Other Meds: apixaban, levothyroxine, prednisone, diltiazem, (cont page 2)

Current Illness: Unknown

ID: 0954813
Sex: F
Age: 50
State: PR

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: More than 24 hours of Shivering, Excruciating headache, muscle, articulations pain and mild fever.

Other Meds: Anti-dipressants Wellbutrin 400mg, Prozac 80mg and Synthroid 0.125mcg

Current Illness: No

ID: 0954814
Sex: F
Age: 49
State: NY

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: migraine and rash

Other Meds: metformin Glipizide Albuteral motrin 800

Current Illness: diabetic Asthma

ID: 0954815
Sex: M
Age: 24
State: IN

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Intense headache and chills. Had a fever of 103 at it?s highest. Had to go to urgent care.

Other Meds:

Current Illness:

ID: 0954816
Sex: F
Age: 24
State: OH

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: None

Allergies: Sulfa

Symptoms: Chills, sore arm, fatigue, muscle pain, joint pain, headache

Other Meds: Montelukast, escitalopram, birth control

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm