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: 0957912
Sex: M
Age: 23
State:

Vax Date: 12/30/2020
Onset Date: 01/11/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: negative covid and normal EKG

Allergies:

Symptoms: fever, chills and fatigue 12 days after vaccine, lightheadedness and mild chest discomfort of day 21. did not receive second dose yet. unclear if related. Pfizer-BioNTech COVID-19 Vaccine EUA

Other Meds:

Current Illness:

ID: 0957913
Sex: M
Age: 90
State: AZ

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: NO

Symptoms: None stated.

Other Meds: NO

Current Illness: NO

ID: 0957914
Sex: F
Age: 59
State: FL

Vax Date: 11/02/2020
Onset Date: 12/02/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Restless sleep the first night. Fever 102. and fatigue the following day. Sore arm on right and left. Swelling at sight of injection for the influenza shot.

Other Meds: atenolol, fish oil, calcium with D, turmeric, magnesium, Potassium, Naproxen, Omeprazole

Current Illness: none

ID: 0957915
Sex: F
Age: 63
State: NJ

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: 1/15 FELT TIRED DURING THE DAY, CHILLS AND NOT FEELING WELL. STARTED APPRX 6PM. CHILLS, FATIGUE AND LOW GRADE FEVER (100.1) STARTED IN THE EVENING OF TH 15TH, CHILLS AND FEVER WERE GONE IN THE MORNING, FATIGUE AND NOT FEELING WELL LAST ALL DAY SATURDAY. WOKE UP FEELING FINE ON SUNDAY THE 17TH. TOOK A TYLENOL ON SATURDAY.

Other Meds: NONE

Current Illness: NONE

ID: 0957916
Sex: M
Age: 49
State: IN

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: Chills for about 2 hours duration starting at hour 10 after dose. Headache, fatigue, and moderate arm pain at injection that lasted from about hour 12-36 on and off, requiring some acetaminophen and ibuprofen and rest. By 48 hours after vaccine dose, asymptomatic other than arm pain that lingered for 5 days total. I had no symptoms after dose 1.

Other Meds: omeprazole, vitamin D

Current Illness: None

ID: 0957917
Sex: M
Age: 48
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: Unknown

Allergies: Pt stated allergy to cats

Symptoms: Pt received vaccine after reporting an allergy to cats. It was decided to place pt on a 30 minute observation period. About 20 minutes after receiving the vaccine, pt c/o "tickle in throat" which progressed to "feeling like something is stuck in my throat when I swallow". EMT on site evaluated pt. SPO2 was 99% on RA, RR- WNL, lungs clear to auscultation, and pt was able to carry on a normal conversation. Pt continued to c/o "feeling like something is stuck in my throat" and "restrictions when swallowing". No s/s of distress noted. Offered pt 50 mg of Benadryl per protocol, but informed pt that he would need to have someone come to drive him home. Pt refused Benadryl, stating that he didn't have anyone to drive him home. PHN called Dr. , pt's PMD to see if Dr. wanted to see the pt in his office. Dr. stated to send pt to Hospital ER for evaluation. Pt informed of order from Dr. Sent to ER.

Other Meds: Unknown

Current Illness: None reported

ID: 0957918
Sex: F
Age: 40
State: IN

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: Tetanus toxoid

Symptoms: Initial symptoms on the evening of dose were just really sore arm, swelling of lymph nodes in underarm and body aches. Overnight I was restless and unable to sleep well, body aches and hot and then chilled and cold. By morning my arm was so sore and swollen it was difficult to move it, continued with all over body aches, fatigue to the point of unable to sit up, no fever but alternated chills/cold and hot/sweat. I did take ibuprofen every 4-6 hours throughout the day. This is the same type of reaction I had to tetanus when a teen.

Other Meds: Lexapro 10mg PO daily, Protonix 40mg PO daily, Claritin 10mg PO daily

Current Illness: None

ID: 0957919
Sex: M
Age: 33
State: CO

Vax Date: 01/11/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: Sore arm from 11 Jan improved until 18 Jan when it became sore again. Developed a rash 18 Jan that has slowly spread from site of injection (left arm). Rash is warm to the touch and itchy. Have experienced elevated temperatures at night but unsure if this is due to a reaction of the shot.

Other Meds: None

Current Illness: None

ID: 0957920
Sex: M
Age: 43
State: GA

Vax Date: 01/15/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: On Monday, February 18th, around 08:25 in the morning, I noticed an itchy rash broke out around the back of my neck. I attempted to treat the rash with Triamcinolone Acetonide Cream USP, 0.5%. On Tuesday, February 19th, I noticed the rash had spread from the back of my neck to the front and down and across my chest. The rash also began appearing on the sides of my face and above my eyebrows.

Other Meds: Amlodipine 2mg

Current Illness: Tested positive for COVID-19 on 12/8/2020, with first symptoms appearing on 12/7/2020 at 09:00 PM (Fever).

ID: 0957921
Sex: M
Age: 79
State: AZ

Vax Date: 01/20/2020
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds: Xarelto

Current Illness:

ID: 0957922
Sex: F
Age: 32
State: NY

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: chills, sweating, severe body aches (comparable to birth contractions), joint pains, lethargy. started at 12:30 am 1/19/21 until 3:00pm that day. Then just the body aches continued with a low grade temp of a 100 until 10:30 pm that night.

Other Meds: synthroid, charlotte 24FE

Current Illness: none

ID: 0957923
Sex: F
Age: 57
State: VA

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: Performed a swab test SARSCOV2NAA (01-07-2021)

Allergies: None reported

Symptoms: On the next day i started feeling like allergy symptoms come on, had a terrible headache and started coughing. I also had a runny nose uncontrollably and was coughing as well which lasted four days then eventually it stopped. I started to feel better as the days went by.

Other Meds: Prednisone 10mg (3 pills for thee days then drop medication down), Avithlomycin 250mg (2 tablets by mouth OD), Guailenesin-codeine (cough suppressant), Brito and Albuterol (use 4 times a day)

Current Illness: None reported

ID: 0957924
Sex: F
Age: 74
State:

Vax Date: 01/12/2021
Onset Date: 01/21/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient received Moderna vaccine IM to left deltoid. 10:20 AM Patient reported dizziness and nausea. Patient denies any chest pain, SOB, severe headache. BP 107/89 P 80 o2 sat 97% on room air. Patient transported via wheel chair to Walkin Clinic for further evaluation. Patient transported via wheel chair to Walkin Clinic for further evaluation and treatment.

Other Meds:

Current Illness:

ID: 0957925
Sex: F
Age: 39
State: IN

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Walnuts, pecans, bananas

Symptoms: Headache, fatigue, fever (102), chills, body aches, joint pain

Other Meds: Metformin, synthroid, cyclobenzaprine, xarelto, topiramate, acetazolamide, nurtec

Current Illness: None

ID: 0957926
Sex: F
Age: 43
State: IL

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None other than vitals

Allergies: shellfish, red dye, and latex (reactions are hives)

Symptoms: received the vaccine at 8:30 am. At 8:43 am, she reported to the vaccine administrators that she was feeling dizzy. Staff noticed some facial redness. At 8:45 am, she started having hives on her neck which radiated down to her chest. At that time, we administered benadryl 50mg PO x 1. Vitals were taken (pulse ox = 98%; HR 92; and BP 160/102). Patient was wheeled to emergency department after that.

Other Meds: Cetirizine 10 mg daily; vilazodone 20 mg daily

Current Illness: None

ID: 0957927
Sex: F
Age: 47
State: IL

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: Done at hospital- 1/15/2021- CBC/CMP- results normal I was told

Allergies: Phenergan, Compazine, Reglan, Diflucan, Tobramycin, Squash foods, Bleach

Symptoms: Sore arm- could not raise arm above shoulder, 106 fever, muscle/joint/body aches for 3 days, seen in ER after 24 hours of symptoms. Fatigue for 1 week post vaccination.

Other Meds: Valsartan-HCTZ 160-12.5mg, Zetia 10mg, Cyclobenzaprine 5mg, Morphine ES 5mg, Estradiol 0.1mg

Current Illness: None

ID: 0957928
Sex: F
Age: 23
State: PA

Vax Date: 01/12/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Moderna COVID-19 Vaccine EUA Raised around injection site, itching/redness

Other Meds: None

Current Illness: None

ID: 0957929
Sex: F
Age: 55
State: MN

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: hydrocodone, codeine, tramadol

Symptoms: I received the shot at approximately 5 pm and my arm was almost instantly sore. About 3 hours later starting getting pain behind my left eye and left side of my face felt numb. I had a headache until Tues. and arm pain is pretty much gone today (wed). I was extremely fatigued on Tues but less so today. The numbness in my face is pretty much gone today too. I did let my doctor know at my physical on Monday.

Other Meds: armour thyroid

Current Illness: none

ID: 0957930
Sex: M
Age: 24
State: IN

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Peanuts

Symptoms: Left shoulder soreness - still present Chills - approximately 5 hours Severe body aches - approximately 12 hours

Other Meds: None

Current Illness: N/A

ID: 0957931
Sex: M
Age: 48
State: NY

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fever chills body ache

Other Meds:

Current Illness:

ID: 0957932
Sex: F
Age: 42
State: NC

Vax Date: 01/18/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: none as of yet

Allergies: none

Symptoms: fever

Other Meds: none

Current Illness: none

ID: 0957933
Sex: F
Age: 61
State: FL

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: After getting this vaccine I start feeling dizzy, headache, fatigue, tachycardia and body aches

Other Meds: None

Current Illness: None

ID: 0957934
Sex: F
Age: 34
State: NJ

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever of 103 C, chills, body ache, severe headache, nausea, metallic taste in the mouth 2nd dose of vaccination given at 11 am 1/14/2021. Pain at the injection site . Then body ache started. Midnight 1/14/2021 - chills started, fever 103, severe headache- Fever, body ache and headache continued till Monday(1/18/2021) Strong Metallic taste in the mouth, nausea, dizziness- still continuing.

Other Meds:

Current Illness:

ID: 0957935
Sex: M
Age: 56
State: KS

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: High fever, headache, body aches, chills

Other Meds: None

Current Illness: None

ID: 0957936
Sex: F
Age: 48
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Chills, Muscle and joint pain, Loss of Appetite, Extreme fatigue, headache and fever (up to 103.5 even when on Advil). Had low grade fever up till 4 days after vaccine Fatigue has persisted a week later

Other Meds: Nortriptyline, Propranolol, Xanax, Emgality, Magnesium, B-Complex, Baby Aspirin, Prenatal Vitamin, Vitamin D3, Colace

Current Illness: None

ID: 0957937
Sex: F
Age: 26
State: IN

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Chills, low grade fever, joint pain, fatigue, lasting about 10 hours

Other Meds: Multivitamin, Effector, Xanax XR, Zyrtec, Propranolol, Gabapentin, Velivet,

Current Illness:

ID: 0957938
Sex: F
Age: 54
State:

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: body ache, headache, cough. called in sick to work.

Other Meds:

Current Illness:

ID: 0957940
Sex: F
Age: 43
State: NJ

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: PERSISTENT BODY ACHES, HEADACHES AND CHILLS LASTING FROM AROUDN MIDNIGHT THROUGH MOSST OF THE FOLLOWING DAY, EASING OFF IN THE EVENING. TEMP AS HIGH AS 99.3. HEATING PAD TO LOWER BACK, ONE EXTRA STRENGTH TYLENOL TAKE ~4 HRS AFTER ONSET OF SYMPTOMS.

Other Meds: VIT B COMPLEX AND CALCIUM+D

Current Illness: NONE

ID: 0957941
Sex: F
Age: 78
State: AZ

Vax Date: 01/09/2021
Onset Date: 01/12/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: Loratadine histamine for allergic reaction And RX for hydrocodone 2.5%

Other Meds: Rash at the injection site Prescribed histamine and hydrocortisone 2.5% to apply 3-4 daily. Just started medications Jan 20

Current Illness: None

ID: 0957942
Sex: F
Age: 38
State: GA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: Rapid SARS Covid test, 01/12/2021, Negative test result

Allergies: None

Symptoms: Sore, swollen arm at injection site (12hrs post injection) Nausea, diarrhea (14hrs post injection) ended 36hrs post injection Chills, sweating, fever (14hrs post injection) ended 48hrs post injection Body and joint aches and inflammation (14hrs post injection) ended 55hrs post injection

Other Meds: Vitamin-C, Zinc, Omega-3,6, 12, Vitamin D, Multi-Vitamin

Current Illness: Sinus Infection

ID: 0957943
Sex: F
Age: 35
State: AR

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Cleocin

Symptoms: Patient reported within 5 minutes of injection arm was tingling and numb and felt it was beginning to swell. Patient was given dose of oral benadryl and monitored for additional 15 minutes. Patient started to complain of stomach pain and heaviness in chest. Was sent to ER where she complained of difficulty swallowing, increased heaviness in chest, and arm tingling. Patient reported ER gave her a dose of a steroid. She was released to pharmacy with prescriptions for EpiPen and steroids.

Other Meds: None

Current Illness: None

ID: 0957944
Sex: M
Age: 72
State: TX

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: 6 hours after injection I started itching all over, turning red, had a rash, my chest got tight, no difficulty breathing. I went to sleep and woke up very hot, some sweating. Had to get out from under the cover, cooled off in a few minutes. Eyes are burning, some redness, rash like on arms.

Other Meds: Amlodipine 5mg, Alleve

Current Illness: Hypertension

ID: 0957945
Sex: F
Age: 21
State: AL

Vax Date: 01/12/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Received vaccine on 1/12/21. On 1/19/21, I woke up to a red splotchy rash on my left arm where I received the vaccine. I put cortisone cream on it, and that night I noticed it is now raised and more red. It does not itch or hurt.

Other Meds: Macrobid 100mg started 1/12/21 at 2100

Current Illness: None

ID: 0957946
Sex: F
Age: 38
State: NE

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: seasonal

Symptoms: day after felt "strange". Waves of hot flashes that targeted mainly my face, literally dripping sweat. Mild nausea. Mild aches. Little out of it feeling. This was pretty much done by 1/1/21. 1/7/21 one week and a day after injection, injection site became raised, hard, inflamed looking and was itchy. Site was visibly red and raised and had approximate 3 in diameter. Previously mentioned symptoms began again (waves of hot flashes, nausea, aches). This lasted at least until bedtime. Next day, 1/8/21 felt better and injection site, though still hard and red, reduced down to size of quarter. No further symptoms BUT injection site now as of 1/20/21 still looks like a quarter sized bruise.

Other Meds: omeprazole lisinopril metformin birth control (pill) female multivitamin gummy

Current Illness:

ID: 0957947
Sex: F
Age: 33
State: TX

Vax Date: 01/07/2021
Onset Date: 01/15/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: rash at the injection site, some swelling, redness, itch and skin warm to touch. Used pain reliever, benedryll and ice pack to relieve symptoms

Other Meds:

Current Illness:

ID: 0957948
Sex: F
Age: 77
State: FL

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: dry cough, chills, sweating, fatigue, headache, pulse ox lower than normal

Other Meds: Tylenol, multivitamins , Vitamin B complex

Current Illness: none

ID: 0957949
Sex: F
Age: 28
State:

Vax Date: 01/12/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: One week after receiving the first dose of the Moderna COVID vaccine my upper arm developed an oval shaped rash around the vaccine injection site. The next day it had grown in size and was itching.

Other Meds: Birth Control

Current Illness: N/A

ID: 0957950
Sex: F
Age: 34
State: CA

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: hand swelling headache body pain general GI upset

Other Meds:

Current Illness:

ID: 0957951
Sex: F
Age: 61
State: ME

Vax Date: 01/07/2021
Onset Date: 01/12/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: Clindimycin

Symptoms: adverse affect was on 1/12 and was diagnosed by her PCP with Shingles. Today, 1/20, remains with Shingles, with rash, itchy and pain.

Other Meds: None

Current Illness: Denies

ID: 0957952
Sex: F
Age: 40
State: PA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: 1/14/2021: Cardiac Monitor CBC/Diff/Platelets Comprehensive Metabolic Panel CT Chest/Thorax w/ Contrast PE exam EKG 12 Lead-Chest Pain HCG w/Titer Infuser- insert Pulse Ox Monitor Troponin 1 hs UA w/culture if indicator Urinalysis POC

Allergies: latex, fish, onion, penicillin

Symptoms: Severe pain in left arm (still in pain 1/20), unable to move arms above head (lasted 5 days for both arms), Chest pain and squeezing sensation in chest and both arms (lasted 6 days), altered heart rate (lasted 2 days), internal swelling (was told this is what was causing the "squeezing" sensation)

Other Meds: allergy OTC, 81mg aspirin, multi-vitamin

Current Illness: nothing

ID: 0957953
Sex: F
Age: 62
State: IN

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: latex

Symptoms: Severe burning sensation to left arm pit area

Other Meds: daily vitamin

Current Illness: none

ID: 0957954
Sex: F
Age: 35
State: NY

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: Nurse assessed, vitals obtained. NP notified. Epi pen 0.3mg adminstered at 09:57am. Benadryl 50 mg IM adminstered at 10:00am. Vitals: HR 120, BP 178/110, Pulse Ox 100%, Temp 37.1. Second dose of Epi pen 0.3mg given as per MD given at 10:03am. Vitals: HR 107, BP 153/96, Pulse Ox 100%. Patient transported to ED as per protocol.

Allergies: None

Symptoms: Patient was instructed to be monitored for 30 mins due to prior allergic reactions. The patient complained of throat itchiness around 25mins into observation.

Other Meds: Benadryl PO

Current Illness: Lupus

ID: 0957955
Sex: M
Age: 60
State: IN

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: NONE

Allergies: Allergies: cephalosporins, codeine sulfate, Keflex, morphine, NSAIDS (Non-Steroidal Anti-Inflammatory Drug), Penicillins, Sulfonamides (Sulfa), tuberculin purified protein de, Tape

Symptoms: MODERATE BODY ACHES

Other Meds: Prescription acetaminophen [OTC] suppository; 650 mg; amt: one suppository = 650 mg; rectal Spec. Inst: Insert one suppository rectally every 4 hours prn pain/fever Prescription baclofen tablet; 10 mg; amt: one tablet = 10 mg; oral 01/20/

Current Illness:

ID: 0957956
Sex: M
Age: 30
State: NM

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data: N/A

Allergies:

Symptoms: Patient only received half the dose on lot EJ1685. Pfizer was called and advised it was okay to administer a full dose which lot was EL1284 @1821

Other Meds:

Current Illness:

ID: 0957957
Sex: F
Age: 55
State: UT

Vax Date: 01/11/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: sulonamides

Symptoms: Redness at injection site on Jan 11 and over 2 days has increased in size extending from shoulder to antecubital fossa

Other Meds:

Current Illness: She had received Tdap vaccine January 7 of this year

ID: 0957959
Sex: F
Age: 80
State: AZ

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0957960
Sex: F
Age: 3
State: AZ

Vax Date: 01/01/1950
Onset Date: 01/01/1950
Rec V Date: 01/20/2021
Hospital:

Lab Data: unknown

Allergies: Gabapentin

Symptoms: hives

Other Meds: none

Current Illness: none

ID: 0957961
Sex: M
Age: 64
State: TX

Vax Date: 01/12/2021
Onset Date: 01/14/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: 1/18/21-negative COVID antigen test

Allergies: none

Symptoms: Pt complained of fever and body aches

Other Meds: xanax, zyrtec and tramadol all PRN

Current Illness: none

ID: 0957962
Sex: F
Age: 63
State: TX

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: LARGE RED, HARD AREA THAT HAS GROWN OVER THE LAST 3 DAYS AT THE SITE OF INJECTION

Other Meds:

Current Illness:

ID: 0957963
Sex: F
Age: 54
State: KS

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: NKA

Symptoms: Patient states that the day after she received the vaccine she felt exhausted, had a sore arm where the vaccine was administered, a headache, neck stiffness, and an asthma exacerbation. Patient states that she also had numbness and tingling along the same path that she experienced when she was diagnosed with shingles a few years ago. Patient states that this path started in her lower left abdomen, traveled into the left side of her face, and down her neck into her left shoulder.

Other Meds: unknown

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm