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: 0958262
Sex: F
Age: 60
State: FL

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: covid 19 swab 2/14/21, negative

Allergies: penicillin, bee stings

Symptoms: chills, headache, body aches, loss of taste, flush, red eyes, extreme fatigue

Other Meds: Triamterene/HCTZ, Topamax, Inderal, Bentyl, folic acid, Synthroid, Vytorin, Asa, Xegerid, Acidophilus, multivitamin, calcium +D,B12, zinc, elderberry

Current Illness: none

ID: 0958263
Sex: F
Age: 46
State: GA

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

Lab Data: N/A

Allergies: Zofran, Penicillian, Keflex, Compazine, Levquin, Sulfer

Symptoms: I have had a headache since injection was given on the day of I did have. Diarrhea the day of. And also neck stiffness for three days after vaccine

Other Meds: Amolodipine

Current Illness: N/A

ID: 0958264
Sex: F
Age: 37
State: AR

Vax Date: 01/06/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient had local skin site reaction 12ish days post vaccination.

Other Meds:

Current Illness:

ID: 0958265
Sex: M
Age: 45
State: AL

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

Lab Data:

Allergies:

Symptoms: lightheadedness; tingling, slslight numbness right arm andd face. informed patient that if it continues to go to ER. Pataient leeft with understanding above.

Other Meds:

Current Illness:

ID: 0958266
Sex: F
Age: 0
State: WA

Vax Date: 01/04/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Due to mistake, child received HIB vaccine twice in the same visit, once by itself, an a second time in the combination vaccine.

Other Meds: None

Current Illness: None

ID: 0958267
Sex: F
Age: 67
State: NY

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

Lab Data:

Allergies: Sulfa

Symptoms: Headache, stomach ache, myalgias

Other Meds: Prozac 20 mg Simvastatin 20 mg

Current Illness:

ID: 0958268
Sex: F
Age: 67
State: TX

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: SULFA

Symptoms: 1. My fingertips were numb, all day on the day after I received the vaccine, and for a while on day two 2. Inside my mouth and lips was very irritated and red

Other Meds: Thyroid Cymbalta, lamictal, Prednisone, Losartan, Arthrotec,

Current Illness: None

ID: 0958270
Sex: M
Age: 57
State: AZ

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

Lab Data: None

Allergies: No

Symptoms: Sore arm where shot was in Minister for 2 days.

Other Meds: Advil, Vitamin D

Current Illness: No

ID: 0958271
Sex: M
Age: 62
State: OH

Vax Date: 01/07/2021
Onset Date: 01/11/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: Penicillin Cautions with NSAID use

Symptoms: Patient with intellectual disability received his vaccine on 1-7-2021 in his right deltoid. On 1-11-2021 it was noted that he was developing a rash on his right ear/cheek area and a raised red rash near the sight of his vaccine by the attending nurse on 1-12-2021. is unable to verbalize his symptoms, an anatomical diagram was completed by his nurse on 1-12-2021, noting continued redness on the right side of his face and his right upper arm. Photos were also taken to archive this. His PCP was notified and an order was received to give a dose of diphenhydramine at approximately 1:30 PM on 1-12-2021. By 1-15-2021, the arm and facial redness had resolved per patients nursing notes.

Other Meds: ASA 325 mg. by mouth once daily Depakote 1,000 mg. by mouth twice daily Colace 100 mg. once daily Luvox 100 mg. by mouth twice daily Januvia 100 mg. by mouth daily every morning Metoprolol ER 25 mg. by mouth daily at bedtime Niacin 500 mg.

Current Illness: No Acute illnesses known

ID: 0958272
Sex: M
Age: 21
State: OK

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

Lab Data:

Allergies: codeine

Symptoms: nausea, sweats, weakness and feeling "out of it" for approx. 1 hour following

Other Meds: gabapentin, hydroxyzine, multivitamins, fluticasone, vitamin d3, fluoxetine, famotidine, Zyrtec, fluoxetine

Current Illness:

ID: 0958273
Sex: F
Age: 57
State: KY

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

Lab Data: None

Allergies: IVP dye, tetracycline

Symptoms: 15 minutes after initial injection, dizziness and dry mouth began. Lasted approximately one hour. 3 hours after injection, broke out with rash and began itching, throat became tight. I called my PCP who suggested a solumedrol injection along with Benadryl. I choose to take 20 mg Zyrtec and call 911 if respiratory effect declined. Had extreme lethargy all day. Presently, short of breath, aches and such similar to side effects mentioned.

Other Meds: Lamictal, voltaren, Pepcid

Current Illness: None

ID: 0958274
Sex: F
Age: 33
State: NJ

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: FROM 1/8 3AM TO 1/8 7PM: CHILLS AND BODY ACHES. TOOK IBUPROFEN EVERY 4- 6 HRS.

Other Meds: IBUPROFEN

Current Illness: NONE

ID: 0958275
Sex: F
Age: 38
State: WA

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

Lab Data:

Allergies: sulfa (hives), shellfish (anaphylaxis), peanuts (mouth feels fuzzy), mango, other exotic fruits

Symptoms: 11 minutes after receiving shot, scalp on head started itching, tongue started swelling, area around tonsils felt like it was swelling. Pt received epi, and lips/tongue/throat continued to swell and itching spread to different parts of face.

Other Meds: Citalopram, hydroxyzine prn, sumatriptan, dicyclomine

Current Illness: none

ID: 0958276
Sex: F
Age: 18
State: GA

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

Lab Data: 1/19/2021: Vital signs, Telemetry monitor, chest x ray: Impression normal chest. , oxygen, IV saline lock

Allergies: NKA

Symptoms: Received the Moderna Vaccine at 1549. Presented to the ED at 1635 with c/o localized swelling, lip swelling with right facial swelling.

Other Meds: None

Current Illness: None

ID: 0958277
Sex: F
Age: 30
State: CA

Vax Date: 01/14/2021
Onset Date: 01/17/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: N/A

Allergies: NKA

Symptoms: Three days after vaccination pt had a red spot with itching at injection site.

Other Meds: None

Current Illness: Positive Covid19 (month prior)

ID: 0958278
Sex: F
Age: 93
State: KY

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

Lab Data:

Allergies: none known

Symptoms: Systemic: Anaphylaxis

Other Meds:

Current Illness:

ID: 0958280
Sex: F
Age: 61
State: WI

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

Lab Data:

Allergies:

Symptoms: Patient developed pain in the arm a few hours after the injection. Pain significantly worsened over the rest of the day to the point that she could not move the arm for 2-3 days. Symptoms then improved for a few days, but have worsened again in the last 48 hours. No swelling or erythema.

Other Meds:

Current Illness:

ID: 0958281
Sex: M
Age: 34
State: OR

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Arm was sore the first day and injection site was red for 5 days and went down on day 8 I woke up and injection site was red and hot to the touch. It has now gone down but a bruise looks like it is forming and still a little red.

Other Meds: Allergy meds, vitamin D, Vitamin C, Super B vitamin

Current Illness: N/A

ID: 0958282
Sex: F
Age: 46
State: NY

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

Lab Data: none

Allergies: NKDA

Symptoms: Reports feeling a little achy the next day but unsure if had encountered a viral infection prior to the vaccine administration. Developed rash to neck, upper chest/back lateral and between breasts

Other Meds: Keflex, Flonase, Tri-Legest-Fe

Current Illness: ? viral illness prior to vaccine

ID: 0958283
Sex: F
Age: 38
State: GA

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

Lab Data:

Allergies: no allergies

Symptoms: Patient received vaccination at 7:35pm, and about 10 minutes later, the patient reported burning in her throat, and a feeling of lumpiness in her throat. The patient was administered Benadryl 50mg po as one dose. Symptoms improved within 30 minutes. No other side effects reported or observed.

Other Meds:

Current Illness: none

ID: 0958284
Sex: M
Age:
State: AZ

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

Lab Data:

Allergies: None

Symptoms: None stated.

Other Meds: Multiple Vitamin, D3 Vitamin B Sublingual, Calcium Chew, Duloxetine 20 mg. Metformin HCL XR 500 mg, Dutasteride .5mg Bacalutamide 50 Mg., Xgeva,

Current Illness: Stage 4 Prostate Cancer - Metastized.

ID: 0958285
Sex: F
Age: 40
State: NJ

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

Lab Data:

Allergies: Pollen, mold, dermatographia (rubber, adhesive and cardboard)

Symptoms: Headache, extreme fatigue, nasal congestion, soreness at injection site, brain fog.

Other Meds: Trazadone Zoloft Zyrtec Prazosin Nexplanon implant

Current Illness:

ID: 0958286
Sex: M
Age: 32
State: TX

Vax Date: 01/11/2021
Onset Date: 01/14/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: 14th Jan-lump left-groin-lymph node, he feels it, body aches, 15th Jan-feeling better-slept-all day 16th Jan-lay in bed 15 & 16th Jan till noon-holiday week-end 17th Jan-lay in bed 18th Jan-lay in bed 19th Jan- lump in left neck-lymph node he says-enlarged-he feels it-hoarse like sound in his voice 20th today-Jan-better today-feels like he is getting to FLU-nose runny

Other Meds: anti-inflammatory & flexeril

Current Illness: none

ID: 0958287
Sex: M
Age: 34
State: CA

Vax Date: 12/31/2020
Onset Date: 01/16/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: No adverse medical response.

Allergies: None.

Symptoms: Second dose of vaccine was inadvertently administered to patient 1 day earlier than recommended. He received the 2nd dose on day 16, instead of day 17 or later as recommended.

Other Meds: None.

Current Illness: None

ID: 0958289
Sex: F
Age: 20
State: IN

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

Lab Data:

Allergies:

Symptoms: Fever (100.0), body aches, chills, cold sweats, headache, fatigue. Ibuprofen and tylenol for treatment.

Other Meds: Linzess, Prozac, Culturelle

Current Illness:

ID: 0958290
Sex: F
Age: 49
State: CA

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

Lab Data: None

Allergies: None

Symptoms: Headache, Body Aches, Chills, Fever, Lethargy - Approx. 48 hours duration

Other Meds: Wellbutrin XL

Current Illness: None

ID: 0958291
Sex: F
Age: 38
State: MI

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Fever, chills, weakness. Pain, redness, swelling, hard and hot to the touch at injection site. Pain in injection site got increasingly worse throughout the day. By about 10 pm of the night of injection (Friday) fever and chills set in and lasted throughout the night and the next day. Symptoms decreased with the help of Motrin 600 mg but came back after the Motrin wore off. By late Sunday night symptoms were almost fully gone.

Other Meds: Metformin, Ozempic, Vitamin D3, Levothyroxine, Losartin/Hct, Vitamin B12

Current Illness: December 19, 2020 test positive for COVID-19.

ID: 0958292
Sex: F
Age: 56
State: PA

Vax Date: 01/09/2021
Onset Date: 01/17/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None.

Allergies: Latex over-exposure.

Symptoms: I am experiencing localized inflammation around the injection site that is raised and itchy, red and hot. It is red at the cite and a raise circle around the injection site. It has grown in the days since it has began. It started like a 1 inch redness and is now about 3 inches. It appears to continue to get larger. The course of it began around the 18th of January and 3 or 4 days later it remains and is getting bigger. I have a low grade fever of 99 but no aches or any other discomfort.

Other Meds: Iron, Vitamin C, Drenatrophin, Cod Live Oil, Proenzol Sugar/Startch DigestEnz, Boswelia Complex

Current Illness: Cholesterol high.

ID: 0958293
Sex: M
Age: 35
State: MN

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

Lab Data:

Allergies: no known allergies

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 0958294
Sex: F
Age: 22
State: MI

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

Lab Data: N/A

Allergies: None

Symptoms: 100.5 fever Servere body aches Extreme neausea And throwing up Headache

Other Meds: Buspirone 30 mg Protonex20mg Levothyrovine50mcg

Current Illness: None

ID: 0958295
Sex: F
Age: 38
State: GA

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

Lab Data:

Allergies: no allergies

Symptoms: Patient received vaccination at 7:35pm. 10 minutes later, patient reports burning in throat and a feeling of lumpiness in throat. Patient was given Benadryl 50mg orally as one dose. Symptoms improved within 30 minutes. No other side effects reported or observed.

Other Meds:

Current Illness:

ID: 0958296
Sex: F
Age: 56
State: PA

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

Lab Data: None

Allergies: Ketek

Symptoms: Rash and Itching of upper left arm

Other Meds: None

Current Illness: None

ID: 0958297
Sex: F
Age: 29
State:

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

Lab Data:

Allergies:

Symptoms: Fever, body aches, head aches, fatigue and chills.

Other Meds: None

Current Illness: None

ID: 0958299
Sex: F
Age: 42
State: KY

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

Lab Data:

Allergies:

Symptoms: APPROXIMATELY 8 MINUTES AFTER RECEIVING MODERNA #2 VACCINATION, CLIENT DEVELOPED DIZZINESS, SHORTNESS OF AIR, PERIPHERAL TREMORS/NUMBNESS. CLIENT BECAME PALE AND DIAPHORETIC. CLIENT STILL ALERT AND ORIENTED X3. BENADRYL 25 MG ORAL GIVEN FOLLOWED IMMEDIATELY WITH EPI PEN ADULT DOSE @ 10:56 AM. VITAL SIGNS @ 10:54 WITH BP: 146/72, P: 131, REPIRATIONS 30, SKIN PALE/DIPHORETIC PRIOR TO ADMINISTRATION OF EPI. 2ND SET VITAL SIGNS @ 11:00 150/74, P: 119, R: 30 SKIN PINKINING/IMPROVING DIAPHORESIS STILL REPORTS PERIHERAL NUMBNESS/VISUAL PERIPHERAL TREMORS STILL PRESENT/REDUCED. 3RD SET VITAL @ 11:13 AM BP:136/68, P: 100, R: 26 REPORTS HER TONGUE FEELS THICK. TRANSFERRED TO ER FOR CONTINUATION OF CARE @ 11:20 AM VIA WHEEL CHAIR.

Other Meds:

Current Illness:

ID: 0958300
Sex: F
Age: 67
State: AL

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

Lab Data: None. Should I have allergy testing?

Allergies: Sulfa (parental report about taking this as a child) Codeine (sensitive) Clindamycin (caused c-diff) Flagyl (rash)

Symptoms: Flush/warm face followed by dry mouth/tongue and then shakes/jitters. Flush went away but dry mouth/tongue and shakes/jitters continued. The monitoring staff kept me under observation for 1.5 hours, and then I left after symptoms mostly subsided. I've never had any adverse reaction to a vaccine or other medication ... although I tend to be medication sensitive so I avoid it if possible. My only allergies are seasonal/pollen (outdoor) and some indoor (mold, etc.) What was my reaction? Can I take the 2nd dose or not?

Other Meds: None on the morning of vaccination. But, regular supplements include: Betaine HCL + pepsin - with each meal Digestive enzyme - before each meal Cal/Mag/D3 - daily B12 - daily l-Glutamine - after breakfast and dinner Probiotics - daily on

Current Illness: Sinus and respiratory virus 3 weeks prior

ID: 0958301
Sex: F
Age: 66
State: NY

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

Lab Data: NA

Allergies: Bacitracin / Gentamycin / Amoxicillin

Symptoms: Received vaccination @ 11:19 am 11:32 am noted red blotchiness on (L) neck by observer, pt denied SOB itchiness, lightedheadeness, nausea given Claritin 10mg tab orally observation extended to 30 min blotchiness resolved, no further symptoms

Other Meds: metformin atarvastatin vitamins lisinopril levothyroxine B12 multivitamin

Current Illness: None

ID: 0958303
Sex: F
Age: 60
State: KY

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

Lab Data:

Allergies:

Symptoms: Pt was seen @ urgent care on 1/14/2021 after vaccine @ 1:30 PM that same day. She reported that ~ 45 mins after receiving the vaccine her lips began tingling & burning. She did 0 have any swelling or SOA.

Other Meds:

Current Illness:

ID: 0958304
Sex: F
Age:
State: MD

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

Lab Data:

Allergies:

Symptoms: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient received COVID vaccine on December 31.

Other Meds:

Current Illness:

ID: 0958312
Sex: F
Age: 34
State: IN

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

Lab Data:

Allergies: none

Symptoms: ~ 6 hrs after vaccination, headache started ~18 hrs after vaccination, still had headache and also felt malaise ~24 hrs after vaccination, still had headache and malaise, and started feeling total body aches/soreness ~36 hrs after vaccination, all other symptoms resolved but now had swollen and tender lymph node under R arm. Approaching 48 hrs from vaccination and the swollen lymph node has not resolved. Of note - I am currently breastfeeding. I did not have any decrease in my breastmilk supply and noted no changes in my infant either.

Other Meds: multivitamin

Current Illness: none

ID: 0958313
Sex: F
Age: 46
State:

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

Lab Data: None notes

Allergies: None noted

Symptoms: Patient felt dizzy and weak approximately 20 minutes after vaccination and passed out when walking out of the clinic. Patient given one round of Epi and offered supplemental oxygen. Patient was monitored after resolution of symptoms and released to home care.

Other Meds: Daily Aspirin, and Hypertension meds

Current Illness:

ID: 0958314
Sex: F
Age: 38
State: AZ

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

Lab Data:

Allergies: Latex

Symptoms: Nausea , dizziness body aches

Other Meds: Trulance Lasix Probiotic IBU

Current Illness:

ID: 0958315
Sex: M
Age: 98
State: CO

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

Lab Data:

Allergies: NKA

Symptoms: Systemic: Approximately 1 hr after injection 98 y/o pt became unresponsive. He had a strong pulse, cold extremeties. Did not admin epi. Nurse director felt it was coincidental to injection (hydration/nutrition)-Severe

Other Meds:

Current Illness:

ID: 0958316
Sex: F
Age: 52
State:

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

Lab Data: None

Allergies: Amoxicillin

Symptoms: Client was instructed to wait for 15 minutes after vaccine. At 1725 client reported that felt itchy all over. Client was assessed by EMT and RN. Client denied any trouble breathing, itchy throat but indicated that her entire body was itchy, client was scratching all over. Her blood pressure was 140/68, client declined EMS services and indicated that she does not wish to go to the hospital. She indicates that she had a previous similar episode in the past after taking amoxicillin for an ear infection. Client was advise to purchase Benadryl, she indicates that medication makes her sleepy and she is driving. She was asked to stay another 15 minutes and was monitor in case of worsening symptoms. Client remains in the same state and indicates that she will be okay to drive and wishes to leave the facility. Client verbalizes understanding that if she was to feel worst to starts to have trouble breathing she is to call 911.

Other Meds: None

Current Illness: None

ID: 0958317
Sex: F
Age: 25
State: CA

Vax Date: 12/31/2020
Onset Date: 01/16/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: NO adverse medical issues reported.

Allergies: None

Symptoms: Patient received second dose of vaccine one day earlier than recommended. The patient received the second dose on day 16, instead of the recommended 17 days or later.

Other Meds: None

Current Illness: None

ID: 0958318
Sex: M
Age: 84
State: CT

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

Lab Data:

Allergies: n/a

Symptoms: At 4am this morning woke up with headache, chills, nausea, slight fever, joint pain, muscle pain. Had COVID and bacteria pneumonia back in October Spoke with doctor this morning and said the symptoms were not unexpected. Doctor encouraged to file VAERS report.

Other Meds: Alfuosin 10mg once a day, Pravastatin 20 mg once a day, hydrochlorothiazide 25 mg twice a day, Hydroxyzene 25 mg 3 times a day, Gabapentin 300mg twice a day, Aspirin 81 mg once a day, Centrum multi vitamin once a day, Vitamin D3 2000 mg

Current Illness:

ID: 0958319
Sex: M
Age: 60
State: IL

Vax Date: 01/07/2021
Onset Date: 01/11/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Lower abdominal pain consistent with colitis flair >7 days duration. Treated with ibuprofen and heating pad. Pain continues at 2-3/10.

Other Meds: balsalazide, atorvastatin, mometasone nasal spray, vitamin d3, MVI, lansoprazole

Current Illness: cold-negative COVID test 1 week prior to vaccine

ID: 0958321
Sex: M
Age: 59
State:

Vax Date: 01/05/2021
Onset Date: 01/11/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: NKA

Symptoms: Rash, itching left are (same arm as vaccine). spread for 2-3 days then subsided

Other Meds: None

Current Illness: None

Date Died: 01/19/2021

ID: 0958322
Sex: M
Age: 62
State: FL

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

Lab Data: Was sent to ER

Allergies: None

Symptoms: Shaking and then became unresponsive

Other Meds: ASPIRIN ASPIRIN EC 325 MG TABLET TAKE 1 TABLET BY MOUTH DAILY ATORVASTATIN 40 MG TABLET LIPITOR 40 MG TABLET TAKE 1 TABLET BY MOUTH IN THE EVENING AT 5PM OLANZAPINE 10 MG TABLET ZYPREXA 10 MG TABLET TAKE ONE-HALF (1/2) TABLET BY MOUTH TWICE

Current Illness: Hyperlipidemia, Head Trauma, Hx of Seizures, Unspecified Psychosis, Depression, Mood Disorder, Substance Abuse

ID: 0958323
Sex: F
Age: 51
State: NY

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: peanuts, beta blockers, shrimp

Symptoms: Abnout 5 minutes after getting her vaccine she began to feel short of breath, tightness, and palpitation. In the ED, patient was given IM epi x 1, IV benadryl & solumedrol. Patient states that she felt better. Patient has had a similar allergic rxn in the past to shrimp, beta blockers and lisinopril (cough). Pt has never had to use epinephrine for her allergic reactions in the past. Patient has an epi-pen at home for her son (peanut allergy).

Other Meds: chlorthalidone, omeprazole, telmisartan, epipen

Current Illness: None

ID: 0958324
Sex: F
Age: 53
State: AZ

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data: Don't know if they did lab work.

Allergies: Phenergan - get a rash;hives Toradol - get a rash; hives tomatoes Cantaloupe

Symptoms: Around 7:00 pm I started to get sick and my body started to hurt. Joints hurt. Tried to take Tylenol - it didn't take it away - maybe slowed it down but then it came back. Thursday morning - I woke up really sick - joints hurt, hot and feverish and I called ambulance. My temp was over 100 degrees. They took me to ER. They took my temp there and it was 101.6. The Dr. requested morphine and I was given that for the pain. They observed me for awhile and sent me home with Tylenol with Codeine (300 mg). The morphine helped and I came home and I went to sleep and the next day my pain was not as bad as it was the day before. I was able to start moving around even though I was still achy. By third day I was feeling better. By fourth day, I was doing a lot better and the pain had gone back down. Felt shortness of breath when I first got symptoms and was using my inhaler. My shortness of breath lasted a little longer - for about a week. Had a Telehealth visit with doctor to refill meds if I needed it.

Other Meds: Cetirizine 10 mg - daily; take Vit D pill (Ergocalciserol 1250 mcg - one time a week) Levothyroxine 125 mcg - daily Oxybutynine 5 mg - daily Duloxetine 20 mg- daily Pantopravole 40 mg - daily

Current Illness: no

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm