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: 0956177
Sex: F
Age: 25
State: AZ

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: MODERNA COVID 19 VACCINE EUA High fever, aches , pain, headache in bed had to take off work 3 days. Full body ichy rash stared 4 nd day, after fever aches went away. Went to my dr on 1/16 since rash did not go away, kept spreading getting worse all over my body. Dr diagnoised it as some areas posrisis other areas as eczema. I have never had either in my life, and have no allergies to anything. She told me it may go away, or i may have it for life, the moderna triggued an auto immunne disorder. she gave me a shot of predinsone, and scripted cream. Dr said I should not get the 2nd dose of vaccine, and to come back 3 times a year for the predisone shot to keep it under control

Other Meds: Prozac 40 mgs daily

Current Illness: none

ID: 0956178
Sex: M
Age: 43
State: PR

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

Lab Data: Unknown, patient indicated that his doctor identified elevated muscle enzymes.

Allergies: None

Symptoms: Patient could not open and close hand after the first day of vaccination. On the third day his arm turned purple and could not be moved and was numb. A week and a half after vaccine, arm hurt and was numb. Patient was hospitalized.

Other Meds: None

Current Illness: None

ID: 0956179
Sex: F
Age: 26
State: TX

Vax Date: 12/31/2020
Onset Date: 01/07/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: 1/19/21 - saw my dentist, x-rays and photos taken, teeth assessed, no signs of infection or dental issues that could be contributing the symptoms. One filling does need to be redone on the right side but that tooth was not as affected by pain and sensitivity as others were and would not be the cause of the widespread pain/sensitivity per my dentist.

Allergies: vancomycin - anemia/immunosuppression ranitidine - headaches

Symptoms: 1/7/21 - developed widespread tooth sensitivity to hot and cold food 1/11/21 - woke up in the middle of the night with severe tooth and jaw pain on the lower right side 1/12/21 and 1/13/21 - pain spread to include upper and lower jaw/teeth on the right side of my mouth 1/14/21 and 1/15/21 - pain resolved in right lower jaw, pain still present in right upper jaw 1/16/21 - pain isolated to upper right jaw and last molar, could not eat without pain 1/17/21 and 1/18/21 - pain still present but mostly resolved, hot and cold sensitivity recurred During this timeframe, pain was managed with acetaminophen 1000mg and ibuprofen 800mg as needed

Other Meds: montelukast 10mg QHS levocetirizine 5mg QHS fluticasone 50mcg 1 spray each nostril BID Blisovi FE 1.5mcg/30mcg daily famotidine 40mg daily albuterol inhaler 2 puffs as needed before exercise

Current Illness: No acute illnesses at the time of vaccine. Seasonal allergy flares resolved in October 2020.

ID: 0956180
Sex: F
Age: 58
State: IL

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

Lab Data:

Allergies: Shellfish Allergy, Lidocaine, Aspirin, Cefdinir

Symptoms: Patient was being observed after vaccine, about 20 min after vaccine started feeling hot and moved to patient room. Patient then had altered LOC, shortness of breath, swollen tongue. Called EMS who arrived within 5 min to transfer to hospital, at time of transfer patient was awake, on oxygen and still altered.

Other Meds: Acetaminophen (TYLENOL EXTRA STRENGTH PO) ACETAMINOPHEN-CAFF-BUTALBITAL 50-325-40 MG Capsule albuterol 108 (90 Base) MCG/ACT Aerosol Solution atorvastatin (LIPITOR) 40 MG Tablet cyclobenzaprine (FLEXERIL) 5 MG Tablet divalproex (DEPAKOTE ER

Current Illness: Unknown

ID: 0956181
Sex: M
Age: 21
State: ND

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

Lab Data: None

Allergies: None

Symptoms: Pt developed right-sided headache behind right eye with no associated visual disturbance or other symptoms. He reported mild pain only. He was sent home. He was evaluated again by his primary care provider the following day due to persistent headache and progressively worsening headache. He was sent home from work and given home care instructions.

Other Meds: None

Current Illness: None

ID: 0956182
Sex: F
Age: 60
State: TX

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

Lab Data:

Allergies:

Symptoms: Patient returned home after vaccination to experience normal adverse effects such as chills, weakness, and fever that was experienced with the first dose of Shingrix. Patient then fainted at home and hit their head which was also accompanied by ringing in the ears. Patient then began to feel contraction of their nerves and muscles for several hours after their fainting episode.

Other Meds: Estradiol, Meloxicam, Aldactone, Venlafaxine

Current Illness:

ID: 0956183
Sex: F
Age: 60
State: KY

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

Lab Data:

Allergies: ANSAIDS

Symptoms: WHEN I GOT TO WORK I DIDN'T FEEL AT MYSELF. I WAS DIZZY AND VERY SHAKEY AND DIDN'T FEEL RIGHT THE MAIN PROBLEM IS IF I CLOSE MY EYES AND GET REALLY DIZZY AND GET SICK AT MY STOMACH

Other Meds: ONE A DAY HEALTH FOR WOMEN

Current Illness:

ID: 0956184
Sex: F
Age: 63
State: CA

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

Lab Data: None

Allergies: No known allergies.

Symptoms: 10:00am - Vaccine given. 10:15am - client reported experiencing nausea & headache (pain scale: 8/10). BP - 172/85mmHg; Pulse - 94). 10:18am - BP - 176/93mmHg; Pulse - 104 10:20am - BP - 186/93mmHg; Pulse - 105, client reports the pain and nausea symptoms are the same. Client taken to an exam room and placed lying down on her left side, head slightly elevated. Client reported feeling a bit cold, covered with disposable gowns for warmth. Temperature taken at 10:34am - Temperature: 37 degrees Celsius. 10:43am - BP 130/60mmHg, Pulse - 92. Client reported that feelings of nausea is gone, however is still experiencing slight headache 4/10 pain scale. 10:57am - BP 124/64mmHg; Pulse - 88 10:59am - BP 174/89mmHg; Pulse - 99. Client reports that she feels a sharp pain on her abdominal area by the belly button (6/10). Also reports a mid-back pain (9/10 pain scale). 11:10am - BP 162/86mmHg; Pulse - 101 11:15am - BP 147/78mmHg; Pulse - 89. Client reports abdominal pain at 5/10, mid-back pain 8/10. 11:25am - BP 155/82mmHg; Pulse - 90. Client reports abdominal pain is aching at 5/10 pain scale, mid-back pain 7/10 pain scale.

Other Meds: Calcium + Vitamin D Supplement

Current Illness: none

ID: 0956185
Sex: M
Age: 55
State: DE

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

Lab Data:

Allergies: mild reaction to vaccines

Symptoms: I stayed for an extra 20 minutes or so just to be sure I was OK. When I got home, I had a slight headache, and a slight sore arm. Advil 400 mg and an ice pack handled that well. Friday morning, woke up and prepared for my day as normal, including a healthy fruit smoothie for breakfast

Other Meds: Advil

Current Illness: Fractured Jaw

ID: 0956186
Sex: F
Age: 58
State: NC

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

Lab Data: Evaluated by provider and sent to ED.

Allergies: Iodine Contrast/Causes nausea & rash

Symptoms: Late Entry 0952: Patient not feeling well. Reports shortness of breath, tongue tingling and has a rash to left upper arm. 0954: O2 sats 99%, HR 130 bpm, BP 150/90. Offered PO Benadryl per vaccine standing orders for adverse reactions. Patient refused PO Benadryl. O2 at 2L/NC applied at this time. EMS notified and in route. 1000: Patient remains very anxious and complains of dry mouth, dizzyness and tingling tongue. Attempted to administer EpiPen per vaccine standing orders for adverse reaction. Patient refused EpiPen. 1002: EMS on site. Patient continues to refuse EpiPen. O2 sats 99% on 2L/NC, HR 123 bpm, and BP 137/76. Patient ambulated with EMS personnel outside. After ambulating with EMS personnel, patient stated she felt better and refused to be transported to the hospital. Returned inside for follow up and monitoring. Late Entry 1025: Patient waiting to sign AMA form and had another episode in the hallway. Patient stated she did not feel right and squatted in the hallway. Staff assisted her to a chair. EMS notified and in route. Dr. notified. 1028: O2 sats 99%, HR 94 bpm and BP 138/102. Patient refused EpiPen at this time. Patient complains of feeling dizzy and short of breath. O2 at 2L/NC applied for comfort. 1032: O2 sats 98% on 2L/NC, HR 88 bpm, and BP 128/84. 1035: Dr. at bedside assessing patient. 1040: EMS here. Patient agreed to be transported to the local hospital for evaluation. O2 sats 98% on 2L/NC, HR 86 bpm, and BP 140/81.

Other Meds: None

Current Illness: None

ID: 0956187
Sex: F
Age: 34
State: MN

Vax Date: 01/08/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: 1/18/2021 punch biopsy, labs obtained

Allergies: bactrim, vicoden, pertussis vaccine

Symptoms: Symptoms began 1/16/2021, rash started around my breasts, abdomen and back that then spread to my groin, legs, feet, arms and hands. Target looking, redness and some blisters. Rash is severely itchy and burns.

Other Meds: levothyroxine, prenatal vitamin, xanax PRN

Current Illness: NA

ID: 0956188
Sex: F
Age: 61
State: MI

Vax Date: 01/13/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: feathers

Symptoms: vertigo, fatigue, malaise

Other Meds: wellbutrin, trazodone, desvenlafaxine, fish oil, multivitamins

Current Illness: none known

ID: 0956189
Sex: M
Age: 91
State: FL

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

Lab Data:

Allergies: none

Symptoms: Unusually high Blood sugar upon routine daily testing. The last several days since vaccine. No idea of related.

Other Meds: Glimipride4MG.Simvastatin10MG. Metformin 1000MG, Lisinopril 2.5MG Aspirin 81 MG

Current Illness: none

ID: 0956190
Sex: F
Age: 55
State: CA

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

Lab Data: None.

Allergies: Bees, wasps, and Brazil nuts.

Symptoms: Client reports that she started feeling a dry spot in the back of her throat that made it slightly difficult to breath around 1/2 hour following vaccine. She consulted with the nurse administering the vaccine and decided it would be okay to leave the vaccination site. She reported that the dry spot on the back of her throat became more prominent and it was more difficult to swallow around an hour after receiving the vaccine. She decided to go to the ER as a precaution because she lives far from the hospital. At the ER they gave her 75 mg of Benadryl and 15 mg of prednisone. Her symptoms resolved following the medications.

Other Meds: She takes allergy medication daily (had not taken medication for 3 days).

Current Illness: None

ID: 0956191
Sex: F
Age:
State: VA

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

Lab Data:

Allergies: NKDA

Symptoms: Pt. reported itchness on (L) side of chest ~ 15 minutes after inj. Redness size of grapefruit noted on (L) side of chest. Benadryl 25mg po x one cap. given at 9:20 am 10:40am T.C. w/pt. slight HA - x 30 -45 mins. 0 OTC needed. 0 (R) side itching - started but @ 10:40 AM no more itching. Feeling sleepy from Benadryl. 1/15/2021 - 4:25pm tc with patient who reports "she is ok" and feels her normal self now.

Other Meds: Numerous Rxs for RA

Current Illness:

ID: 0956192
Sex: M
Age: 45
State: AZ

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

Lab Data:

Allergies: N/A

Symptoms: None stated.

Other Meds: N/A

Current Illness: N/A

ID: 0956193
Sex: M
Age: 68
State: AZ

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: NA

Symptoms: Covid 19 vaccine

Other Meds:

Current Illness:

ID: 0956194
Sex: F
Age: 40
State: CA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/19/2021
Hospital:

Lab Data: Pt claims she saw her MD regarding the muscle pain

Allergies: NKA

Symptoms: Pt is claiming to still have muscle pain at the injections site as of 1/18/2021 from the injection given on 12/29/2020

Other Meds: unknown

Current Illness: unknown

ID: 0956195
Sex: M
Age: 30
State: MA

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

Lab Data:

Allergies:

Symptoms: Woke up feeling extremely cold. Called out and put on an electric blanket. Kept waking up throughout the night. Then started feeling overall pain when moving and exhaustion. Symptoms were gone by 1/13/2021

Other Meds:

Current Illness:

ID: 0956196
Sex: F
Age: 54
State: GA

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

Lab Data:

Allergies: Med Allergies / Sensitivities: ? Sulfa drugs ? Gabopentin ? Heparin SubQ (can use Heparin to flush an IV line) ? Antibiotics: Levaquin, Avelox, Biaxin (clarithromycin), Azithromycin, Minocycline, Augmentin ? Pain meds: Dilauted, Oxycodone, Morphine, Mobic ? Migraine meds: Cymbalta, Protriptylene, Topomax (but can take Trokendi without cognitive issues), Lamotrigine (cannot take generic ? but can take Lamictal? just not effective), Immitrex ? Adhesives ? Note: most cause severe headaches; dizziness, tremors, severe nausea, etc.

Symptoms: Felt similar to IV-DHE treatment... at around 3am I woke up, felt my whole body heat up really quickly - rapid flush - heart racing - chest constricted - difficult to breathe while laying down. Sat up, grabbed washcloth with cool water, applied to face and neck, popped pillows so could sleep partially upright. Whole episode lasted about 10 minutes and then I went back to sleep. Frightening but not life-threatening. would have been scarier had I not experienced something like this once before.

Other Meds: Daily Meds / Procedures: ? Cuvitru IG ? 5g SubQ ? 1x/week ? Trokendi XR ? 50mg ? 1x/ day ? Buproprion SR ? 150mg ? 2x/day ? Simvastatin ? 40mg ? 1x/day ? Adderall -5mg ? 1x/day (morning); ? Pantoprazole ? 40mg ? 1x/day ? Xanax - .25mg:

Current Illness: n/a

ID: 0956197
Sex: F
Age: 38
State: OH

Vax Date: 01/06/2021
Onset Date: 01/12/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: n/a

Allergies: Imitrex, mobic

Symptoms: I felt itching at the site and noticed 2 welts at the injection site. I about the size of a dime and the other half that size. Redness and warm to the touch at the site of my Left deltoid. An hour later, my left arm started to tingle all the way down to my left hand. About 2 hours later I started to get numbness from my left forearm to my hand (specifically the palm of my left hand). The tingling had subsided the next morning and I still had some numbness in the palm of my left hand in the morning. The numbness subsided late morning that day.

Other Meds: Xulane birth control patch. Excedrin migraine medicine.

Current Illness: none

ID: 0956198
Sex: F
Age: 39
State:

Vax Date: 01/08/2021
Onset Date: 01/11/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Employee states that she woke up Monday morning, stretched and had a "horrific" pain in arm where the vaccine shot was given. Pain persists in the arm for 5 days. Has taken Tylenol/motrin for pain without relief. Pain improved over the weekend and did not seek medical treatment.

Other Meds:

Current Illness:

ID: 0956199
Sex: F
Age: 59
State: WA

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

Lab Data:

Allergies: ace inhibitors, adhesives, morphine, oxycodone, percoset, Flu Flu vaccine, amlodipine,tape. Now I consider COVID-19 vaccine an allergy

Symptoms: None stated.

Other Meds: potassium supplement, atenolol, losartan, Triamterine/HCTZ, Ty tylenol, ibuprofen, venlafaxine, atorvastatin, mobig, baclofen

Current Illness: none

ID: 0956200
Sex: F
Age: 60
State: NJ

Vax Date: 01/05/2021
Onset Date: 01/12/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: None

Allergies: Seasonal allergies only

Symptoms: A week after my first vaccine my arm got itchy. The following day it was tender, warm, and swollen which prompted me to call my doctor. I saw him 3 days after my symptoms began (10 days after my vaccine). He felt is was an allergic reaction. It dissipated on its own 2 days after the doctor appointment.

Other Meds: Singulair Symbicort Vesicare Metformin Zyrtec Vitamin D

Current Illness: None

ID: 0956201
Sex: F
Age: 32
State: CA

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

Lab Data:

Allergies: None known

Symptoms: I had a 5in x3in bright red, hot, itchy rash on my left arm below injection site that appeared 7 days after I had received the shot. It has now been 2 weeks since I received the shot and I still have the rash. I reached out to my doctor's office, but have not been able to talk to my PCP yet. The rash remains the same size, hot, itchy and red.

Other Meds: Prenatal vitamins (I am currently breast feeding a 7 month old). labetalol 100mg 2x/day ibuprofin 600 mg/ as needed for tendinitis on left wrist *Not an illness, but I gave birth to my first daughter 06/2020 and I am currently breast feedi

Current Illness: High Blood Pressure tendinitis on left wrist since 06/2020 neck spasm on 01/02/2020

ID: 0956202
Sex: F
Age: 56
State: WI

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

Lab Data: None.

Allergies: Beta blockers (shortness of breath). Cat dander (itchy, watery eyes).

Symptoms: Headache, upper back and neck pain, chills, nauseated, dizzy. Patient woke up this morning to use the bathroom and had a syncopal episode with no known injury.

Other Meds: Cetirizine 10 mg tabs daily. Citalopram 30 mg tabs daily. Fish oil 1000 mg capsules. Levalbuterol 45 mcg/act 1-2 puffs every 4 hours as needed. Metronidazole 0.75% cream one application daily. Montelukast 10 mg tab daily. Multivitamin daily

Current Illness: No known illnesses.

ID: 0956203
Sex: F
Age: 24
State: IA

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

Lab Data:

Allergies: No

Symptoms: Systemic: chest tightness, twitching of arms and legs-Mild; symptoms lasted 1 day

Other Meds:

Current Illness:

ID: 0956204
Sex: F
Age: 52
State: CO

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

Lab Data: None

Allergies: NKDA Seasonal allergies/'hayfever'

Symptoms: I am reporting this simply for CDC data collection pruposes. I received my first dose on Dec. 23, 2020 - sore arm. No other adverse reactions. 2nd dose - Jan. 18th, 2021 at 0900. 7:30 yesterday evening, I crashed and burned. I don?t think that I have ever felt so unwell; uncontrollable shaking, chills, and body aches. I had such a bad headache that I could barely lift my head off of my pillow. This lasted all night. I had to sit on the floor of the shower this morning due to lightheadedness and nausea. I continue to feel general body aches,chills and malaise; though not nearly as bad as last night. The symptoms are slowly subsiding.

Other Meds: Daily multi-vitamin Probiotic Apple Cider Vinegar tabs Vitamin D

Current Illness: None

ID: 0956205
Sex: F
Age: 37
State: CA

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

Lab Data: None

Allergies: PCN

Symptoms: Initially I had swelling and soreness at the injection site and later experienced drowsiness. The drowsiness started approximately 8 hours after the injection and lasted approximately 36 hours. The soreness, swelling, and redness started approximately 6 hours after the injection and continued for approximately 5 days. Beginning on the second day and continuing for about 48 hours I had a fluttering heart/increased heart rate. I then had 1-2 days with no symptoms, but now my arm is swollen, red, warm, and itchy around the injection site. It has been this way for 2-3 days.

Other Meds: None

Current Illness: N/A

ID: 0956206
Sex: F
Age: 17
State: MI

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

Lab Data:

Allergies:

Symptoms: Patient was 17, underage for vaccine

Other Meds:

Current Illness:

ID: 0956207
Sex: F
Age: 35
State: IN

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: I had side effects from the COVID vaccine: headache, muscle pain, fever of 101, tachycardia, chills, insomnia

Other Meds: metroprolol, lisinopril, camrese, protonix, pepcid, claritin

Current Illness: none

ID: 0956208
Sex: F
Age: 29
State: MI

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

Lab Data:

Allergies: None

Symptoms: Fever, chills, body aches, fatigue

Other Meds: Junel birth control, PEPCID

Current Illness: Dec. 25-Jan. 1: sinus congestion. Tested negative for Covid-19

ID: 0956209
Sex: F
Age: 54
State: TX

Vax Date: 01/07/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: non

Allergies: Tramadol

Symptoms: My arm has gotten very red at the administration site and it was previously not red. It does not hurt but is the size of 2 half dollars. It has increased in size in the last 2 days.

Other Meds: Estradiol .5mg/day Escitalpram 20mg/day

Current Illness: none

ID: 0956210
Sex: F
Age: 54
State: IL

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

Lab Data: none

Allergies: Sulfa, Codeine

Symptoms: A fast heartbeat started on the evening the first shot. The next day I had the following symptoms, dizziness, weakness, fast heartbeat, pain in both arms, headache, muscle pain, joint pain, chills, nausea, diarrhea, fever. These symptom lasted for 3 days.

Other Meds: Vitamin C, Zinc, Vitamin D, Baby Aspirin, Setraline, Trazodone, Zoloft

Current Illness: none

Date Died: 01/12/2021

ID: 0956211
Sex: M
Age: 91
State: KY

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: Ct scan of abdomen, was COVID negative

Allergies: NKDA

Symptoms: patient passed away on 1/12 at 1800 from a ruptured colonic mass.

Other Meds: amiodarone (PACERONE) 100 mg Tablet ferrous gluconate (FERGON) 324 mg (38 mg iron) Tablet furosemide (LASIX) 20 mg tablet lidocaine (XYLOCAINE) 2 % Solution Melatonin 1 mg Tablet nystatin (MYCOSTATIN) 100,000 unit/mL suspension

Current Illness: known colonic mass, presumed malignant but no biopsy diagnosis.

ID: 0956212
Sex: F
Age: 80
State: NC

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

Lab Data: I did not report this since the antihistamine seemed to be working.

Allergies: petroleum products on open wound

Symptoms: Broke out w/mild hives on left inner arm approximately 10 hours after injection. Hives spread to torso and both arms. Took Q-Dryl antihistamine 25 mg and hour after the hives started. Relieved the situation but hives returned about 10 hours later. Hives were present on arms. torso, buttocks. Took another antihistamine a few hours later; hives returned on arms, left hand and torso; also felt nauseous Have had no hives since Monday, Jan 18th about 8:00 PM.

Other Meds: Metropolo, Valsartan 80 mg,Sertraline50 mg,Simvastin20 mg, D 3 1000 units, Centrum Silver, Osteo bi-flex, aspirin 81 mg Omeprazole 40 mg

Current Illness: none

ID: 0956213
Sex: F
Age: 45
State: NY

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: none

Allergies: ASA

Symptoms: next day area appeard red mild swollen and itchy. It stayed that way for 4-5 days and then disappeared. On 1/18/2021 the area was severely red and big hive was noted surrounding site of injection. Severe itchiness still present.

Other Meds: none

Current Illness: none

ID: 0956214
Sex: F
Age: 33
State: MA

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

Lab Data: None

Allergies: NKA

Symptoms: Started with sore arm and fever, chills, nausea, muscle and body aches, and dizziness. fever lasted until 1/14/2021. and every thing else lasted 1/15/2021.

Other Meds: None

Current Illness: COVID-19 October 28, 2020 and was sick until December 7, 2020

ID: 0956215
Sex: M
Age: 73
State: IN

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

Lab Data:

Allergies:

Symptoms: about 1 1/2 to 2 inch bright red rash, with a slightly raised hard core just above the right elbow (area of lymph node), there was about a 100 degree temperature limited to the rash site with normal temperature above and below site and general body temperature being normal. By morning it was fading away and within 24 hours rash was gone with slight lump that gradually faded away over the next 24 hours. There may have been a slight red flushing lower inner surface of the same arm that still seems to be there, but no elevated temperature, tenderness or significant redness compared to the original localized rash. The injection site never reddened but had a slight tenderness for 24-48 hours.

Other Meds: rosuvastatin, finasteride, fluticasone propionate, ipratropium bromide, loratidine, coQ10, ibuprofen, resveratrol, pterostilbene, vitamin D3, Areds 2 (Zinc), glucosamine, chondroitin with MSM

Current Illness: slight headache, tiredness with daytime sleeping for 2-3 days about 2 weeks before vaccination

ID: 0956216
Sex: F
Age: 40
State: TX

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

Lab Data:

Allergies:

Symptoms: Patient called to inform us that she got an infection at the site of injection 6 days after the shot and got treatment from her doctor.

Other Meds:

Current Illness: infection at site six day after shot

ID: 0956217
Sex: F
Age: 50
State: OR

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

Lab Data: None ***To clarify: I received the vaccination at a Public Health Center. However, my primary care physician.***

Allergies: Sensitive to wheat and gluten (headaches, stuffed up nose.) I do have issues with some antibiotics: Zithromax made me break out in severe hives which lasted more than a week. Augmentin gave me some hives, which stopped when I stopped taking it. Tetracycline gave me severe stomach cramps which stopped when I stopped taking it. I am also Lactose intolerant.

Symptoms: On the day of the shot (1/15/21), I had arm pain. Next morning (1/16/21), I still had arm pain and my left arm was not as flexible. By 5:00 p.m., I had chills, felt like a low grade fever, and ached all over. By 6:30 p.m., very chilled, lymph node swollen on left side, no energy. Fever of 100.4 at 8:00 p.m. Tylenol lowered fever to 99.9 at 9:15 p.m. On 1/17/21, normal temperature and chills gone. Still tired. By 9:45 p.m., rash from armpits to outside of breasts and around neck. It did not itch. On 1/18/21, rash still present at 7:00 a.m. Nausea started at 8:00 a.m. Still tired. By 9:30 pm., rash better but still present. Still nauseous. 1/19/21, rash better but still present. Still nauseous. Still tired - but a little more energy.

Other Meds: None. I usually take a multiple vitamin, but I didn't on the day of the vaccine. I may have taken Advil for a headache the night before.

Current Illness: None.

ID: 0956218
Sex: F
Age: 71
State: NJ

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

Lab Data: None

Allergies: Macrobid, sulfa antibiotics, levocin

Symptoms: 48 hours after vaccine my heart rate went to.80. Normally it is 60. Slight headache and I couldn't sleep.

Other Meds: Tiadylt, eliquis,telmisartan,metoprolol,simvastin

Current Illness:

ID: 0956219
Sex: F
Age:
State: AZ

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

Lab Data:

Allergies: None

Symptoms: None stated.

Other Meds: Fenofibrate, Fluticasone (occasionally), Glimepiride, hydroclorothiazide/lisinopril, Metformin, Rosuvastatin, Tresiba, Trulicity, low dose aspirin, Multivitamins.

Current Illness: None

ID: 0956220
Sex: F
Age: 49
State: PR

Vax Date: 12/17/2020
Onset Date: 12/17/2020
Rec V Date: 01/19/2021
Hospital:

Lab Data: None

Allergies: Penicillin, Iodine

Symptoms: The same night of vaccination patient experienced rash in both arms, hands and face. She took Benadryl and topical cream he had at home for dermatitis and problem resolved by noon the next day.

Other Meds: None

Current Illness: None

ID: 0956221
Sex: F
Age: 23
State: CA

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

Lab Data:

Allergies: Coconut, Latex, Bees, penicillin, clindamyosin, Cephlexon

Symptoms: Horrible body aches, fever, arm pain and swelling. Fatigue where I cannot get out of bed. I cannot sleep due to body aches. I have a high pain threshold and this is unbearable. I had Covid back in July 2020 and this is just as bad now as it was then.

Other Meds: Propranolol, Emgality, Effexor, Omeprazole, Buspar,

Current Illness: Refer below

ID: 0956222
Sex: F
Age: 77
State: TN

Vax Date: 01/05/2021
Onset Date: 01/17/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: none

Allergies: Aspirin, Codeine, all Mysians, Penicillin, Latex, band aides,Silvedin, Perch

Symptoms: Itching with rash around vaccination 1 week and 1 day later. Itching started a few days after getting the shot and rash appeared around 11 days after getting the vaccination.

Other Meds: Fosamax, Hydrochlorothiazide, Folate, B-12, Red Yeast Rice, D3, B complex, Biotin,

Current Illness: none

ID: 0956223
Sex: F
Age: 57
State: VA

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

Lab Data: NONE

Allergies: PCN

Symptoms: HIVES, IM BENADRL GIVEN

Other Meds: IM Benadryl

Current Illness: none

ID: 0956224
Sex: F
Age: 39
State:

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

Lab Data: none

Allergies: Some adhesives

Symptoms: *right arm sore the night of injection, resolved within 36hrs *dull headache behind eyebrows off & on starting 3-4 days post injection, still happening on day 9 post injection, have not taken anything to resolve it *red, raised, warm to touch, itchy hive on right, upper arm. started 8 days after vaccine given, going on day 2 will use hydrocortisone cream

Other Meds: Vitamin C, Vitamin B Complex, Vitamin D, Liposomal Glutathione, Digestive Enzymes, Cat's Claw

Current Illness:

Date Died:

ID: 0956225
Sex: M
Age: 82
State: CA

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

Lab Data:

Allergies: No known allergies

Symptoms: Systemic: Pt monitored by nursing for 30min after inj,pt was stable/no reaction.At ~1hr post inj pt was unresponsive.Pt was a hospice/dnr per director

Other Meds:

Current Illness:

ID: 0956226
Sex: F
Age: 45
State:

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

Lab Data:

Allergies:

Symptoms: 6 days after vaccination a large red area noted at vaccination site. Roughly the size of a baseball. Denies fever, states at times warm to touch.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm