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: 0956277
Sex: F
Age: 64
State: NY

Vax Date: 01/14/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: Fresh Pineapples

Symptoms: Headache, body aches, headache, extreme fatigue

Other Meds: Jardiance, Folic Acid, Singular, Zetia,

Current Illness:

ID: 0956278
Sex: F
Age: 72
State: IN

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

Lab Data: Jan 5, 2021 platelets were 65 Jan 14, 2021 platelets were 45

Allergies: sulfa drugs

Symptoms: I have a chronic low platelet problem, the previous readings had risen to 65, but 5 days after injection they were down to 45. Does this vaccine affect platelets? ! ! Should I proceed with 2nd vaccination shot? !!

Other Meds: Furosemide 20mg/ potassium chloride 20meg / Pregabalin 50mg / Hydroxychloroquine 200mg / Levothyroxine 88mcg / Liothyronine 25mcg / Losartan 100mg / Bystolic 10mg / Isosorbide mononitrate 60mg / vitamin D / multi-vitam

Current Illness:

ID: 0956280
Sex: U
Age: 54
State: CT

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

Lab Data: NONE

Allergies: NO ALLERGIES

Symptoms: SHE FELT NAUSEOUS AND WAS VOMITING AND MUSCLE SORNESS ON INSIDE OF THE FOOT AND MUSCLE CRAMPING AND FEVERISH THAT AROSE 1 HOUR AFTER INJECTION. 12:45 INJECTION AND 1:45 SYMPTOMS STARTED.

Other Meds: NKA

Current Illness: NONE

ID: 0956281
Sex: F
Age: 90
State:

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

Lab Data:

Allergies:

Symptoms: PAIN AT SITE

Other Meds:

Current Illness:

ID: 0956282
Sex: F
Age: 36
State: FL

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

Lab Data:

Allergies: Peanuts

Symptoms: Nine days post vaccine I noticed redness, swelling, itchiness and mild pain at injection site.

Other Meds: Zoloft, Allegra, Multi vitamin, fish oil

Current Illness:

ID: 0956283
Sex: F
Age: 42
State: NJ

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/19/2021
Hospital:

Lab Data: None reported.

Allergies: NKDA

Symptoms: Right upper arm pain radiating to right shoulder and neck area. Unable to lift Right arm more than 45 degrees away from right side of body. Unrelieved with OTC pain medication.

Other Meds: None reported.

Current Illness: None reported.

ID: 0956284
Sex: M
Age: 73
State: AZ

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

Lab Data: TESTED Negetive

Allergies: None

Symptoms: Exposed to covid 19

Other Meds: Allopurinol. 300gm Cabapenten 300mg Metformin1000mg Coq10200mg PrevserVision Areds Ecotin 81mg Sudafed Sinus

Current Illness: No

ID: 0956285
Sex: M
Age: 38
State: VA

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

Lab Data: BP 142/87 pulse 90

Allergies: none disclosed

Symptoms: Pt received vaccine around 1:50pm. While sitting in observation post vaccine, pt felt dizzy and lowered his head. Nurse standing by told pt was having trouble breathing. Pt couldn't swallow, did not faint. Nurse gave epi pen 0.3mg at 1:54pm. At 1:58pm, BP was142/87 and pulse 90. EMS arrived at 2pm. Pt was responsive, a little dizzy but walked to stretcher.

Other Meds: unknown

Current Illness: none disclosed

ID: 0956286
Sex: F
Age: 37
State: FL

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

Lab Data: N/A

Allergies: N/A

Symptoms: Two hours after the injection I experienced increasing soreness in my left shoulder up through the left side of my neck and down through the forearm. I became slightly nauseous through that evening. The pain and tightness got to the point I could not perform regular functions with the left arm. It felt as if my muscles were tearing and prevented me from sleeping. I took ibuprofen in addition to alternating ice and heat to no avail. It hurt to lift my arm, grip to pull or push even a blanket. This continued for 48 hours before there was slight relief. Full range of motion returned four days after the injection. For brief periods throughout the days following, I also experienced occasional slight heart palpitations.

Other Meds: Tri-sprintec Iron 65mg

Current Illness: N/A

ID: 0956287
Sex: F
Age: 39
State: NJ

Vax Date: 01/04/2021
Onset Date: 01/12/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: amoxicillin

Symptoms: 1/12/21 at 08:00 am patient started having intense itching throughout body which worsens at night, rash to abdomen, chest, bilateral lower legs. Pt. states that she started taking zyrtec which helped patient sleep better. Pt. states that symptoms have not resolved and are still there.

Other Meds: denies

Current Illness: denies

ID: 0956288
Sex: F
Age: 35
State: MN

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

Lab Data:

Allergies: shellfish

Symptoms: Systemic: Headache-Severe, Systemic: Pateint experienced severe throbbing headache 5 minutes after the vaccine. She had shortness of breath due to walking before the vaccination. She had tightness on her chest 40 min latetr. 911 called; symptoms lasted 1 day

Other Meds:

Current Illness:

ID: 0956289
Sex: F
Age: 84
State: FL

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

Lab Data: None Known

Allergies: No Known Allergies

Symptoms: was seated and waiting for her 1:12 appointment. We administered the vaccine and approximately 2-3 minutes later she was turning red and calling me for help. I asked her what was going on and she said to help her, that she can't breathe, and that she thinks she is going to die. We administered a dose of Epinephrine and shortly after she said she was feeling better but she was shaky/jittery. EMS was called simultaneously and they arrived shortly after.

Other Meds: None known

Current Illness: None Known

ID: 0956290
Sex: F
Age: 58
State: KY

Vax Date: 01/15/2021
Onset Date: 01/17/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: sulfonamide antibiotics,

Symptoms: Patient noticed hives developing in middle of chest Sunday(1/17/21) evening. Next day (1/18/21) she presented at work (PCP office), and hives had spread throughout body, and patient did not feel well. Pt was prescribed a prednisone taper, triamcinolone 0.1% cream, Xyzal and diphenhydramine to manage symptoms.

Other Meds: Aspirin 81mg, Vitamin D3 2000 IU, fluconazole 150mg, glucosamine-chondroitin 250-200mg, Jardiance 25mg, lisinopril-HCTZ 20-12.5mg, meloxicam 7.5mg, metformin 1000g, pantoprazole 20mg, polyethylene glycol oral powder, rosuvastatin 20mg

Current Illness: COVID-19

ID: 0956291
Sex: F
Age: 37
State: PA

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

Lab Data:

Allergies:

Symptoms: PT RECEIVED VACCINE BY SUB Q . 3RD DOSE TO BE GIVEN

Other Meds:

Current Illness:

ID: 0956292
Sex: F
Age: 63
State: MD

Vax Date: 10/12/2020
Onset Date: 10/13/2020
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: Sulfa drugs

Symptoms: Following the injection (early morning of the next day), pain at site. This was followed by fever (up to 102 degrees) for one day, lower fever for several days afterwards, in concert with fatigue. There was also a slight rash along the arm. Of ongoing concern is pain at injection site more than three months after the vaccination.

Other Meds:

Current Illness: None

ID: 0956293
Sex: F
Age: 42
State: CA

Vax Date: 01/06/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: Theophylline, latex

Symptoms: Starting Wednesday January 13th I had severe lower leg cramps continued to upper leg lower back shoulders and arms through Thursday the 14. Then beginning Friday January 15th I had nasal congestion and all over body aches. Now as of Monday January 18th I have developed a circular rash with an outer diameter redness ring. I sent a photo to health clinic of my arm and they have sent me this vaers report to fill out. I still have a bruise from my shot and I have tested positive now for covid19 as of Saturday January 16th 2021. Thank you I am in contact with my MD and my work has been notified as well.

Other Meds: Atorvastatin, metformin and vitamin d

Current Illness:

ID: 0956294
Sex: F
Age: 69
State: IL

Vax Date: 01/13/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: sulfamethoxazole, tetanus, and keflex

Symptoms: Patient received first dose of COVID vaccination. Woke up 4 days after with eye redness and swelling.

Other Meds: atenolol, lipitor, cymbalta, hydrochlorothiazide.

Current Illness: None

ID: 0956295
Sex: F
Age: 91
State: FL

Vax Date: 01/05/2021
Onset Date: 01/09/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: BLOOD WORKS IN ER WERE NORMAL PER DAUGHTER. CARDIAC WORKOUT WITH NEGATIVE TEST RESULTS PER DAUGHTER.

Allergies: SULFA DRUGS, PENICILLIN, IBUPROFIN, CODEINE, VINEGAR

Symptoms: A 91 Y.O FEMALE RECEIVED COVID-19 VACCINE ON 01/05/21 AT 11:30AM. FOUR DAYS AFTER THE VACCINATION ON 01/09/21 AT 3:15 PM, SHE CALLED HER DAUGHTER AND TOLD HER THAT HER MOUTH WAS NUMB, LEFT SIDE OF THE MOUTH WAS DROOPING, SO AS HER EYLID. AT ABOUT 5 PM THAT DAY, PATIENT ARRIVED IN TMH ER VIA AMBULANCE. ER DOCTOR RULED OUT HEART ATTACK OR STROKE. PATIENT WAS DIAGNOSED WITH BELL'S PALSY. WAS SENT BACK TO WESTMINSTER OAKS THAT DAY WITH CORTICOSTEROID AND EYE OINTMENT THAT WAS PRESCRIBED BY THE DOCTOR. (INFORMATIONS REPORTED TO ME BY THE DAUGHTER AND THE PATIENT HERSELF) AS OF 01/19/21, PATIENT IS STILL RECOVERING. SPOKE WITH THE PATIENT TODAY 01/19/21, PATIENT STATE SHE STILL HAS THE SIGNS AND SYMPTOMS OF THE BELLS PALSY, BUT SHE SAID SHE'S GETTING BETTER. SHE ALSO STATES THAT TODAY IS THE LAST DAY OF HER CORTICOSTEROID TREATMENT.

Other Meds: FLONASE, KEPPRA, SYNTHROID, ATIVAN, PAXIL, COQVIT, VIT.D3, JEVITY VIA G-TUBE

Current Illness: NONE

ID: 0956296
Sex: F
Age: 49
State: KY

Vax Date: 01/07/2021
Onset Date: 01/14/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient complained of headache and sore throat that started after she received the vaccine and persisted for one week. She sought care at an immediate care center. Was tested for Covid, Flu and strep throat which were all negative. Instructed to hydrate, get rest, healthy diet and take Tylenol/Motrin as needed.

Other Meds:

Current Illness:

ID: 0956297
Sex: F
Age: 46
State: MO

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

Lab Data: None

Allergies: Multiple food allergies, multiple environmental allergies, multiple animals and insect allergies

Symptoms: I waited the 15 minutes. I walked to my car and drove to work. Got very busy with work, coughed here and there. Noticed my tongue felt swollen and tried to swallow some water and had difficulty, realized I was having a little anaphalxsis reaction. It started approximately it 12pm, maybe earlier, I was busy.

Other Meds: Zyrtec D, Lexapro, Wellbutrin, Clonazapam, Vitamin B12, Vitamin D

Current Illness: None

ID: 0956298
Sex: F
Age: 54
State: MD

Vax Date: 01/11/2021
Onset Date: 01/17/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: One week after shot/swelling, heat, itch in upper arm with flu like sypmtoms

Other Meds: calcium

Current Illness: none

ID: 0956299
Sex: F
Age: 49
State: IA

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

Lab Data:

Allergies:

Symptoms: Patient received Moderna (lot number 025J20-2A, left arm, on 12/29/2020). She came for a 2nd dose today and received Pfizer (lot number EL1283, left arm, on 1/19/2021). No adverse effects at this time.

Other Meds:

Current Illness:

ID: 0956300
Sex: F
Age: 81
State: FL

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

Lab Data:

Allergies:

Symptoms: Body rash, self treating with antihistamine. Still has 9 days later.

Other Meds: Meloxicam, Amlodipine Besylate, Levothyroxine, Elavil, Zegerid OTC, Latanoprost, Calcium, Multi vitamin, Vitamin C, Tylenol

Current Illness:

ID: 0956301
Sex: F
Age: 61
State: CO

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

Lab Data:

Allergies:

Symptoms: Headache, Body Aches, Given Tylenol - Sx Improving

Other Meds:

Current Illness:

ID: 0956302
Sex: F
Age: 37
State: OH

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: N/A

Allergies: PCN

Symptoms: vaccine 1/5/21, redness more so on 1/13/21, developed ring around injection site 1/18, ring around site is still there, but red "blob" has shown up under ring and is warm and slightly itchy

Other Meds: pantoprazole 40mg, citalopram 20mg

Current Illness: n/a

ID: 0956303
Sex: F
Age: 54
State: PA

Vax Date: 01/11/2021
Onset Date: 01/17/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Cold sweats, joint pain. fever, Arm soreness with redness, swelling warm to touch

Other Meds:

Current Illness:

ID: 0956304
Sex: F
Age: 51
State: CA

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: N/A

Allergies: Cephalexin (hives)

Symptoms: 2.5 days after Covid vaccine #2, I developed left leg stiffness, a recurrence of my symptoms associated with Stiff-Person Syndrome. I was originally diagnosed with SPS in 2013, and had complete resolution of all symptoms following a course of IVIG, with no symptoms since 2017. The same left leg stiffness which I had previously recurred two days after vaccine administration. I saw my neurologist, who thinks that the vaccine stimulated an immune response with an increase in antibody production, and since this condition is associated with elevated B cell antibodies (anti-GAD antibodies), this may be temporarily triggering symptoms.

Other Meds: Tamoxifen 20 mg

Current Illness: None

ID: 0956305
Sex: F
Age: 96
State: HI

Vax Date: 01/10/2021
Onset Date: 01/12/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: redness, and swelling to deltoid

Other Meds:

Current Illness:

ID: 0956306
Sex: M
Age: 25
State: PA

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

Lab Data: N/A

Allergies: N/A

Symptoms: 1/16/21 - 3:40 PM - Metallic taste in mouth 1/16/21 - 3:45 PM - Chills 1/16/21 - 3:50 PM - Neck / Back soreness 1/16/21 - 3:55 PM - Lightheadedness 1/16/21 - 6:45 PM Difficulty Breathing / Lung Pain, tiredness 1/17/21 - Arm / Body pain, difficulty sleeping, tiredness 1/18/21 - Arm / Body pain, difficulty sleeping, tiredness 1/19/21 - Full body aches, arm pain, lightheadedness, dizziness, tiredness

Other Meds: CVS Multi vitamin

Current Illness: N/A

ID: 0956307
Sex: F
Age: 32
State: FL

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

Lab Data: 1/11: CBC, CMP, CXR, EKG, COVID-19 PCR all WNL 1/13: retinal exam with blood vessel rupture

Allergies: NKDA

Symptoms: First night: awoken at night due to arm pain. Able to work following day 1/7: evening: low grade fevers 99.0. Tolerated with tylenol 1/8: ongoing low grade fevers 99.0. Tolerated with Tylenol 1/9: Fevers slowly increasing to 100, with chills, alternating with sweats. Began difficulty tolerating with Tylenol q6h 1/10: fevers increasing to 101. Chills and sweats ongoing. Not controlled with Tylenol q6h. Began adding ibuprofen q6h alternating. Arm pain continued with now noticing severe erythema, warmth and edema around incision site. Began with macular rash around trunk anterior and posterior 1/11: 1:30 am began having chest heaviness that was not subsiding. Tmax 103.4. Went to ED. EKG, CBC, CMP, UA, CXR all WNL. BC ordered - unknown results. COVID PCR negative. Rash continued spreading to limbs as day progressed. some now raised and tender on arms and flank. Given keflex QID. 1/12: Fevers and chills continue 103. Not controlled with Tylenol and ibuprofen alternating q6h. Now with canker sores/ulcer in mouth and several in genital region. Difficult to ambulate and to urinate secondary to severe pain from ulcers. 1/13: Fevers and chills continue. 103. Still not controlled but slightly improved. Rash appeared stable. Now with central blind spot in right eye. Went to see ophth and found to have had a blood vessel rupture. Ulcers continue to be severely painful requiring sitz baths to urinate 1/14: fevers slowly declining. Rash stable. blind spot unchanged 1/15-1/19. Fevers eventually resolved. Continuing keflex. Ulcers improving, though still somewhat painful. Able to ambulate. Blind spot unchanged.

Other Meds: Ortho Tri-cyclen Lo

Current Illness:

ID: 0956308
Sex: F
Age: 58
State: CA

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

Lab Data:

Allergies:

Symptoms: Light headedness for 4 hours Dizziness for 30 minutes Nausea for 3.5 hours

Other Meds:

Current Illness:

ID: 0956309
Sex: F
Age: 62
State: IA

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

Lab Data:

Allergies: Bandaids, adhesives

Symptoms: Reported PM post vaccine she had fever, malaise, headache, left axilla swelling, "pleurisy" feeling in chest. No sob. Early on 1/8/21 in the AM, had 2 runs afib, that responded to metoprolol. She reported the afib to her cardiologists. Called again on 1/19/21 to report continued fevers, fatigue, body aches, nausea, and chills that caused her to call off on 1/17/21. Ordered COVID-19 PCR.

Other Meds:

Current Illness:

ID: 0956310
Sex: F
Age: 39
State: CA

Vax Date: 01/09/2021
Onset Date: 01/13/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: EKG, orthostatics, MD checkup, labs, vitals

Allergies: N/A

Symptoms: ~2wks following first injection, noticed a left submandibular lymph node swelling/tenderness. Following first injection, had occasional transient headache, lightheadedness. ~4 days following the second injection, had an episode of elevated resting and active heart rate for ~1.5hrs. (Normal resting HR is 60-70s, during episode was 100-110s with increase to ~140 with short walk). Following second shot, also had axillary lymph node discomfort, transient on/off headache, lightheadedness, chills, fatigue. My submandibular lymph node has not resolved but HR issue has (why reported as ?no? below).

Other Meds: Occasional cranberry supplement, occasional turmeric tea

Current Illness: UTI, meds (Bactrim x6 days) completed 1/6/2011 Recently diagnosed with insufficient vitamin D

ID: 0956311
Sex: M
Age: 50
State: WI

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: Pt reports total spine MRI no compression.

Allergies:

Symptoms: Received fist Moderna Vaccine 12/30/2020. 01/07/2021 Started with bil leg numbness and weakness. By 1/15/2021 numbness constant both legs. Electric shock sensation at times down spine to feet. Weakness both legs started 1/18/2021. Neurologic injury being worked up for transverse myelith.

Other Meds: Unknown

Current Illness:

ID: 0956312
Sex: F
Age: 55
State: AK

Vax Date: 12/31/2020
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: None

Allergies: NKDA; no known food allergies

Symptoms: This is a 55 year old female who presents with a history of right shoulder, upper arm and upper back pain (mainly centering on the upper right scapula) that started on Saturday, Jan 16th. States that onset was sudden and limited her range of motion; when she turns her neck towards the left, the pain is exacerbated. She denies arm or hand weakness or sensory dysfunction (i.e. no tingling or numbness of the fingers). She does not note any fever or erythema of the shoulder. She has been treating with ibuprofen, which she states she has seen improvement of the pain. Two weeks ago, she received a COVID-19 vaccine in the right arm, although from the picture she took the vaccine appeared to be administered higher than the deltoid. Suspect this could represents shoulder injury related to vaccine injury. Other than synthroid she takes no other medications on a routine basis. She stated that she developed an iatrogenic hepatitis after taking either rifampin or INH, and was told not to take those medications; however, she reports no history of anaphylaxis to a drug or vaccine.

Other Meds: Synthroid 112 mcg

Current Illness: None

ID: 0956313
Sex: M
Age: 51
State: AK

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

Lab Data: UNKNOWN TO THIS REPORTER

Allergies: UNKNWON

Symptoms: APPROXIMATELY 5 MIN AFTER RECEIVING VACCINE, IN OBSERVATION, BEGAN TO HAVE A SEIZURE. FELL ONTO STAIRS IN THEATER-LIKE SEATING. CARE WAS IMMEDIATELY REDERED BY RNS, A CODE BLUE WAS CALLED. CODE TEAM ATTENDED TO PATIENT AND SUBSEQUENTLY TOOK TO THE EMERGENCY DEPARTMENT.

Other Meds: UNKNOWN

Current Illness: NONE

ID: 0956314
Sex: F
Age: 17
State: MN

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

Lab Data:

Allergies:

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 0956315
Sex: F
Age: 75
State: FL

Vax Date: 01/04/2021
Onset Date: 01/12/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: One week after being given the vaccine on Monday, January 4, 2021, my upper left arm has turned red, swollen, hot and itchy. This has now lasted 8 days after first noticing site area reaction and 2 weeks after vaccine given. I saw the doctor on Monday, January 18 and he recommended Benadryl every 4 to 6 hours. He also wanted me to report the site reaction and get your advice on receiving the 2nd vaccine.

Other Meds: Lisinopril Metoprolol Crestor generic Flonase

Current Illness: n/a

ID: 0956316
Sex: M
Age: 81
State: NY

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

Lab Data: CBC CT brain scan BP EKG

Allergies:

Symptoms: Slurred speech one day post vaccine. Lasted 20 seconds

Other Meds: Allopurinol Chlorthalidone Deferasirox

Current Illness:

ID: 0956317
Sex: F
Age: 57
State: CA

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

Lab Data:

Allergies: clinidine, codeine

Symptoms: On Day 4, pt called stated she went to ER for severe swollen arm with redness around the injection site. Pt also reported of swollen lymph nodes on her throat, in which she believed it was an anaphylactic shock. Pt then was prescribed antibiotics and Benadryl for the symptoms.

Other Meds: Amoxicillin, lasix, xanax, levothyroxine, metoprolol, chlorpromazine, Albuterol, Ibuprofen, Atorvastatin

Current Illness: N/A

ID: 0956318
Sex: F
Age: 59
State: KY

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

Lab Data: Positive Rapid Covid test 1/16

Allergies:

Symptoms: Headache - sore throat - fever- fatigue

Other Meds: Metformin, lisinopril , atorvastatin, synthroid, humalog insulin, Lantus insulin, victoza

Current Illness:

ID: 0956319
Sex: F
Age: 33
State: CA

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

Lab Data: N/A

Allergies: None

Symptoms: I was about 28 weeks pregnant when I got the Moderna COVID19 vaccine. This is my first pregnancy. My due date is 03/28/2021. About 10 hours after receiving the vaccine I noticed a round, 2-inch diameter spot on my arm about an inch away from the injection site. The spot was red, warm, swollen, and painful to the touch. My arm began hurting that night and hurt for a few days then the pain and the spot went away. Then, about 10 days later I noticed the red, swollen, warm spot had returned in the same place it was 10 days prior. The only difference was that upon it's return it did not hurt to the touch, but the color, swelling, and warmth was the same. I didn't ice the spot when it first appeared or when it appeared a second time. I haven't treated it in any way and have yet to inform my physician. I do want to know if it is safe for me to take the second dose of the vaccine--I'm scheduled to take it on 02/04/2021. I had an ultrasound appointment yesterday, 1/18/2021, and the technician told me the baby's current weight is 3 lbs. 8 oz., which is what would be expected at this stage (30 weeks, 1 day).

Other Meds: Synthroid 175 mcg, Buproprion SR 50mg TID, & pretnatal vitamins including Folate, Vitamin D, and Co-Q10

Current Illness: None

ID: 0956320
Sex: F
Age: 93
State: KY

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

Lab Data:

Allergies: Aricept

Symptoms: Rash around injection site. Small red, chicken pox like areas scattered on left arm, left side of neck, and breast. Some complaints of itching. Hydrocortisone cream was ordered. Resident states it is no longer itching. Area seems to be resolving.

Other Meds: Claritin Tablet 10 MG, Omeprazole Capsule Delayed Release 20 MG, Lipitor Tablet (Atorvastatin Calcium), Metoprolol Tartrate Tablet 25 MG, TRADJENTA 10X10, U-D 5MG TABLET, TORSEMIDE <> 20MG TABLET, ELIQUIS 2.5MG TABLET, LOSARTAN POTASSIUM

Current Illness:

ID: 0956321
Sex: F
Age: 64
State: AZ

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

Lab Data:

Allergies:

Symptoms: Covid 19 Vaccine

Other Meds:

Current Illness:

ID: 0956322
Sex: F
Age: 34
State: MI

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

Lab Data:

Allergies:

Symptoms: Arm is very sore and swollen around injection site

Other Meds:

Current Illness:

ID: 0956323
Sex: F
Age: 23
State: PR

Vax Date: 12/18/2020
Onset Date: 01/13/2021
Rec V Date: 01/19/2021
Hospital:

Lab Data: venous Doppler, Result: Normal X-Ray left leg, Result: Normal CBC, BMP, and CK- MB: All within normal limits

Allergies: Latex

Symptoms: Tingling sensation, tiredness, weakness, stiffness, inflammation, foot pain.

Other Meds: Meloxicam 15MG Daily Prednisone 5MG Daily Metothrexate 2.5MG 2 Tab Weekly Centrum Womens Multivitamins 1 Tab Daily

Current Illness: Foots pain

ID: 0956324
Sex: M
Age: 74
State: CO

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

Lab Data:

Allergies:

Symptoms: Body aches, Chills, low grade fever. Given Tylenol

Other Meds:

Current Illness:

ID: 0956325
Sex: M
Age: 70
State: IN

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

Lab Data:

Allergies: none

Symptoms: chills, fatigue, mild fever for about 12 hours

Other Meds: Zegrid

Current Illness: COVID 30 days prior

ID: 0956326
Sex: F
Age: 43
State: MN

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

Lab Data: none

Allergies: none

Symptoms: intermittent fevers, extreme muscle ache, Left axillary lymphadenopathy for over 24 hours. Took ibuprofen and tylenol which exacerbated stomach ache. Then took sucralfate and esomeprazole and tylenol supp.

Other Meds: levothyroxine, liothyronine

Current Illness: hypothyroidism

ID: 0956327
Sex: M
Age: 25
State: KY

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

Lab Data: POCT SARS-CoV-2 PCR - POSITIVE

Allergies: No known

Symptoms: Congestion and loss of smell day 6 from first COVID vaccine dose. Tested positive (PCR) for COVID 1/19/2021

Other Meds: none listed

Current Illness: None identified

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm