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: 0920807
Sex: F
Age: 21
State: NY

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: None

Allergies: No known allergies

Symptoms: Night of vaccine, red raised itchy rash around injection site, foggy head feeling, left arm pain. All of these effects went away in 2 days. 8 days following administration of first Moderna dose (1/5/2020), the raised, red rash around injection site had returned (same size as before), with nausea and vomiting. Slight headache.

Other Meds: None

Current Illness: None

ID: 0920808
Sex: F
Age: 29
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: sore arm at injection site, fever/chills, tachycardia

Other Meds:

Current Illness:

ID: 0920809
Sex: F
Age: 22
State: IL

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: Tested for Covid 19 at 0845 on 1/5 with a negative result.

Allergies: NKA

Symptoms: Fever 101.2, severe body aches

Other Meds: Vitamin D weekly, B12 supplement and fish oil daily

Current Illness: No

ID: 0920811
Sex: F
Age: 54
State: NJ

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: none

Allergies: NKA

Symptoms: fever ,chill and achiness

Other Meds: tylenol

Current Illness: NONE

ID: 0920812
Sex: F
Age: 28
State: WA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: Offered prescription for Zofran, but declined

Allergies: NONE

Symptoms: Extreme nauses

Other Meds: NONE

Current Illness: None reported

ID: 0920813
Sex: F
Age: 47
State: WI

Vax Date: 12/28/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: Covid test done 1/2/2021 - Negative result

Allergies: Sulfa, Topiramate, Sumatriptan Succinate

Symptoms: 12/28 - 2 hours after injection - terrible arm pain. Could not raise arm and felt like a pulled muscle from my neck all the way down arm. This went on for 4 days. The pain woke me up at night for 2 nights. Just took Ibuprofen. This pain has resolved. 12/29 - body aches, chills, joint pain, fatigue, SOB on exertion, runny nose, and sneezing. These symptoms went on for 5 days. Mostly resolved - still some fatigue and SOB on exertion, runny nose, and sneezing. Again, treated with ibuprofen and rest. 1/31 - Extreme nausea, aggitatation, and fatigue. Took Zofran and went to bed at 7pm and slept until 9am. Felt much better. 1/2 - Completed a virtual visit. Advised to come in to clinic for covid test only. Not seen by physician. Negative results, and no F/U from a provider. 1/5 - All symptoms resolved except some fatigue and SOB on exertion, runny nose, and sneezing.

Other Meds: Ibuprofen, Norethindrone, Alprazolam, Escitalopram, Famotidine Atenolol, Levothyroxine, Lansoprazole

Current Illness: None

ID: 0920814
Sex: F
Age: 38
State: CA

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: None

Allergies: BACTRIM oral Ceftriaxone

Symptoms: She received the Moderna vaccine on 12/28. She then started to feel some itching in her throat within 5 minutes. It then started to get worse and then she started to cough. Vital signs show blood pressure 152/89 with pulse 72 oxygen saturation 100% with respiratory to 16. She was given liquid Benadryl and the coughing and itchiness in her throat lasted for three hours. She went to sleep as the Benadryl caused her to be drowsy. When she awoke she had no symptoms. She then had a fever later in the day. she had no hives, lip swelling, tongue swelling, shortness of breath or presyncope associated with these symptoms.

Other Meds: levonorgestrel/ethin.estradiol (Portia 28) 0.15-0.03 mg Oral Tab

Current Illness: None

Date Died: 01/04/2021

ID: 0920815
Sex: F
Age: 58
State: KY

Vax Date: 12/30/2020
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: Lisinpril, Codeine, Latex , environmental (hay fever)

Symptoms: Found deceased in her home, unknown cause, 6 days after vaccine.

Other Meds: unknown

Current Illness: unknown

ID: 0920816
Sex: F
Age: 64
State: TX

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: n/a

Allergies: penicillin allergy, latex allergy, suffa

Symptoms: Client experienced, itchy throat, and slight headache five minutes after injection was given at vaccine site. Client alerted staff, the EMT checked vitals, symptoms cleared before EMT spoke with patient. Client was clear to leave site. No medications administered.

Other Meds: n/a

Current Illness: n/a

ID: 0920817
Sex: F
Age: 51
State: IL

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: NONE

Allergies: NONE

Symptoms: JOINT PAIN, BODY MALAISE, HEADACHE, SWOLLEN INJECTION SITE

Other Meds: XARELTO, Hydrochlorothiazide

Current Illness: NONE

ID: 0920818
Sex: M
Age: 35
State: CA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: unknown

Symptoms: A few moments after vaccination individual complained of throat numb and tingling and felt like it was swelling shut. Epinephrine was considered but condition resolved within about 20 minutes with no epinephrine given.

Other Meds: unknown

Current Illness: unknown

ID: 0920819
Sex: F
Age: 45
State: OH

Vax Date: 12/22/2020
Onset Date: 12/26/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: Blood work 1/5/2021

Allergies: Latex

Symptoms: Pain and and severe weakness in arms and legs. Joint pain. Numbness in feet and hands. Increased blood pressure.

Other Meds: Had flu vaccines 12 days prior in same arm

Current Illness:

ID: 0920820
Sex: F
Age: 31
State: NY

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: About 12 hours after receiving the vaccine the resident developed temperature 101 F, headaches, vomiting and fatigue. Responded to Tylenol 1gm PO. Resident instructed to leave shift and go home to rest about 12 hours after that she was improved .

Other Meds:

Current Illness:

ID: 0920821
Sex: F
Age: 40
State: FL

Vax Date: 01/03/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: None, going to hospital now.

Allergies: None

Symptoms: Intially started as lip numbness, then tongue, lasting for about 10-15 minutes. It went away, then about 10 minutes later her Right arm became numb, then it returned to her lips on the Right side of her mouth, and then feeling wobbly, weakness on the Right leg. Elevated blood pressure, 182/112. Got medication prescribed and is lowerin blood pressure now, within an hour of taking medication, but numbness remains.

Other Meds: None

Current Illness: None

ID: 0920823
Sex: F
Age: 49
State: TN

Vax Date: 12/19/2020
Onset Date: 12/20/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: bee stings

Symptoms: Woke up to an enlarged tongue - could not close mouth or eat

Other Meds:

Current Illness:

ID: 0920824
Sex: F
Age: 62
State: HI

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: Shingles vaccine, IV contrast, shellfish

Symptoms: Five minutes after vaccine patient had itchiness around eyes, itchy throat and mild shortness of breath. Later, patient reported swelling around eyes and lips.

Other Meds:

Current Illness:

ID: 0920825
Sex: M
Age: 40
State: CA

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Pins & needles/tingling sensation and numbness located throughout the body including the throat, mouth and tongue. Gradually diminished over 24 hours and has now resolved.

Other Meds: Lisinopril

Current Illness: None

ID: 0920826
Sex: M
Age: 39
State: CA

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Weakness on the first day Diarrhea, weakness, chills, and weight loss the day after and ever since

Other Meds:

Current Illness:

ID: 0920827
Sex: M
Age: 62
State: KS

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Low fever, chills, 24 hrs. Headache Myalgia lasting 48 hrs. Arthralgia lasting 36 hrs.

Other Meds: Atorvastatin. Verapamil. Losartan

Current Illness: none

ID: 0920828
Sex: F
Age: 36
State: TN

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: NA

Allergies: NKA

Symptoms: The patient called stating she received the COVID vaccine yesterday at 11:30 AM. She reported that she had the usual sore arm. She woke up at 1:00 AM with 102.0 temperature and then start excessive vomiting at 1:30 AM. She also complained of vertigo and dizziness. She reports that she lost consciousness about 3:30 AM. Advised to go to the ER if symptoms continue.

Other Meds: Unknown

Current Illness: Unknown

ID: 0920830
Sex: F
Age: 41
State: NM

Vax Date: 12/17/2020
Onset Date: 12/17/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: mefoxin , Phenergan, trazadone, adhesive

Symptoms: 20 Minuets after injection hot air, red , moved across face, neck. 1 hour after injection. high BP chest heavy face and nose itchy @ 3:15 pm Benadryl 25 mg IM + difficulty swallowing.

Other Meds: Clonazapam, Rizotiptan, Bacfofen, Wellbutrin , Adderal, Celexa, propranolol, Gabepetin.

Current Illness:

ID: 0920831
Sex: F
Age: 64
State: TX

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: None.

Allergies: Doryx antibiotic. Gluten & dairy sensitive.

Symptoms: Severe muscle pain in neck, nausea, headache, fatigue, weakness, nerve pain which developed into shingles outbreak 5 days later, with continued malaise.

Other Meds: Armour Thyroid Wixela 1 puff/daily Multi- vit/mineral

Current Illness: None.

Date Died: 01/04/2021

ID: 0920832
Sex: F
Age: 104
State: NY

Vax Date: 12/30/2020
Onset Date: 01/01/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccine 12/30/2020 Screening PCR done 12/31/2020 Symptoms 1/1/2021 COVID test result came back positive 1/2/2021 Deceased 1/4/2021

Other Meds:

Current Illness:

ID: 0920833
Sex: M
Age: 44
State: MI

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Severe arm pain, (9-10/10) with movement and loss of range of motion.

Other Meds: Prilosec

Current Illness: none

ID: 0920834
Sex: F
Age: 18
State: NY

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

Lab Data: sent to ED

Allergies: PCN, peanuts, pomegranate, strawberry

Symptoms: Generalized flushing, increase body temp

Other Meds:

Current Illness:

ID: 0920835
Sex: F
Age: 31
State: TN

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

Lab Data:

Allergies: NONE

Symptoms: hot and cold sweats legs are really sore

Other Meds: NONE

Current Illness: NONE

ID: 0920836
Sex: F
Age: 35
State: NY

Vax Date: 12/28/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: No

Allergies: iodine contrast solution causes anaphylaxis, seasonal allergies

Symptoms: Estimated delivery date 05/09/2021. I had extreme fatigue and I had some trouble walking it flared my osteoarthritis. I decided to stay home and work from home since I was having trouble walking, the next day I felt fine.

Other Meds: Prenatal vitamins, 81mg of aspirin nightly

Current Illness: no

ID: 0920837
Sex: F
Age: 53
State: TX

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: Yes - PT states she had a previous severe allergic reaction but it is unknown to what she reacted to

Symptoms: Delayed allergic reaction that included facial swelling, severe abdominal pain. Patient states she self medicated with Benadryl 50mg PO and is no longer symptomatic. PT instructed to speak with primary care physcian

Other Meds:

Current Illness:

ID: 0920838
Sex: F
Age: 25
State:

Vax Date: 12/29/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: COVID-19 swab, Flu Swab, Strep test all done at ER on 01/03/2021 all NEG

Allergies: NKA/NKDA

Symptoms: since 12/31/2020 experiencing Dizzy, Lightheaded, Chest tightness, nausea, Diarrhea , dry mouth, dry throat, chills, swollen lymph nodes, symptoms progressing

Other Meds: Vitamin C and elder berry viatamins

Current Illness:

ID: 0920839
Sex: M
Age: 40
State: MN

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: Lab tests on 12/31/20: WBC 5.2 RBC 5.15 hemoglobin 16.4 hematocrit 47.2 MCV 92 MCH 31.8 MCHC 34.7 RDW 12.7 platelet 172 sodium 138 potassium 4.0 chloride 101.9 CO2 27.3 anion gap 13 glucose 110 BUN 15 creatinine 0.86 GFR greater than 60 calcium 9.3 total bilirubin 0.5 alk phos 69 ALT 56 AST 37.1 protein 7.6 albumin 4.7 CRP less than 5.0 pro time 11.3 INR 1.0 PTT 32.9 Sed Rate 6.

Allergies: None

Symptoms: Pleasant 40-year-old male comes in the emergency room with concern related to allergic reaction. Patient had received his COVID-19 vaccination approximate 60 minutes ago, at approximate 45 minutes after vaccination he developed flank pain left greater than right rated a 3 out of 10 extending down to his thighs he also noted a scratchy type sensation in the back of his throat feeling as if he needed to frequently clear his throat. The symptoms have been ongoing now for the past 15 to 30 minutes with no increasing or change in symptoms. Has never had allergic reaction in the past, unsure of previous Covid 19 infection though he describes in February of last year having upper respiratory illness which time he lost his sense of taste and smell. Currently denies any fevers, chills, nausea or vomiting. Denies any diarrhea. Denies cough or shortness of breath. Denies any swelling of the lips, face, eyes or nose. Denies any rash. Upon presentation emergency room patient was seen, evaluated, treated following standards of care given. Given patient's presenting symptoms and the recent COVID-19 vaccination will treat patient as adverse allergic reaction. Patient was given 50 mg of Benadryl IV, 20 mg of Pepcid IV, 10 mg of Zyrtec p.o. and 125 Solu-Medrol IV. Patient was observed in the emergency room for minimum of 2 hours, with complete resolution of symptoms. Patient was discharged home on Zyrtec to take 10 mg by mouth daily as well as Pepcid 20 mg by mouth twice daily for minimum of next 14 days, prednisone 20 mg 1 by mouth daily x5 days. Patient was given a prescription for EpiPen should his symptoms return or progress, recommend he call 911 and return immediately. Risks and warnings were discussed in detail, all questions were answered, patient verbalized understanding agreement plan of care.

Other Meds: None

Current Illness: None

ID: 0920840
Sex: F
Age: 62
State: WA

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Severe headache from 12/30 0400 to 1/3/21, extreme fatigue, and excessive thirst

Other Meds: Armour Thyroid, Estradiol

Current Illness:

ID: 0920841
Sex: F
Age: 43
State: WA

Vax Date: 12/29/2020
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: amoxicillin; mussells(maybe?)

Symptoms: Moderna EUA; moderate swelling and itching and pain lifting arm at injection site occured 7 days after injection. This swelling and pain is more severe than the initial reaction I had in the three days following the injection.

Other Meds:

Current Illness:

ID: 0920842
Sex: F
Age: 36
State: ID

Vax Date: 12/18/2020
Onset Date: 12/22/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: CBC; a B12 test; and a COVID antibody (IGG antibody); SED rate

Allergies: dicloxacillin

Symptoms: I worked the night of 18th and 19th (night shift nurse) - night of 18th - arm very sore (dominant arm where shot was taken) by end of night arm was sore; continued for several days. (Got my period either the night of 18th or morning of 19th). About 36 hours after vaccine; stood up to attend an alarm and felt very ill at patient's bedside and had to sit down: nauseous (felt similar to co-vid) - took Motrin an hour later; the day of 20th - slept all day; 21st - no appetite; mild headache - nauseous - period at same time of vaccine; 22nd - felt bleh; didn't eat much food - period going away but I was feeling worse; feel like I have the return of internal vibrations (can sit in my hands when I'm trying to do something for a patient that needs done quickly) back in July when I had Co-Vid (when I was out of work out of month - and had to see a cardiologist - two months until normal (neural and cardiac symptoms that went away with time) - so was returning of buzzing/etc. 23rd: could feel like I had internal vibrations sensations; nauseous - increased - got a refill from an old dental prescription - started Zofran; headache pressure (head pressure); a vertigo-ish feeling - felt like I just walked off a boat; at that point - called out of work - COVID hotline hospital call - did a rapid test that was negative (on 24th) and on 24th: had still all the same symptoms - nausea was worse and felt a bit more dizzy occasionally and called out of work again but could take care of myself (laid around) - " it felt like baby covid" 25th - work wanted me to get tested again; 26th - Panther Co-vid test - which was also negative. 27th and 28th - dizziness better; still taking Zofran one time /day (for nausea); was able to go to work on 29th - still had some nausea but didn't have to lie down all day anymore - still had internal vibrations - feels like I should be having a tremor but can't see it externally; 30th finally able to see primary care Dr and she ordered lab work: Dr wasn't certain it was an adverse effect vs. me feeling my own immune response to spike protein; Initial covid symptoms in July were similar to this; and she will see how things go; SED Rate was 1 so not concerning; CBC was fine and B12 was fine. Not much as changed since then: returned to work; can go about things in every day; stopped taking Zofran on 31st; I still had nausea but it was mild enough that I didn't need to take it and Dr said it would be best to stop due to it's on effects. Yesterday, was first day with no nausea (1/4/2021); still have internal vibrations sensation but it has gone down quite a bit - now more of a mild buzzing electric current sensation - like insides are buzzing super fast ; when I noticed when not occupied with other things which is how it faded out with original illness.

Other Meds: Aldactone - 50 mg daily every morning; metformin 1500 mg/ once a day; magnesium 250 mg daily; multi-vitamin; creatine - 5 grams a day;

Current Illness: nothing

ID: 0920843
Sex: F
Age: 44
State: NH

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: PCN, Sulfa, Cephalosporins...all cause rash

Symptoms: 7 days post vaccine enlarging erythematous, warm, tender circular skin lesion(6cm x 5 cm); reactive lymphadenopathy L axilla

Other Meds: None

Current Illness: None

ID: 0920845
Sex: F
Age: 37
State: TX

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: n/a

Allergies: n/a

Symptoms: pulling sensation on left arm to neck. took ibuprofen for discomfort. 1/4/21 began to get painful. feels a lump in neck area that has movement. sharp pain in neck, hurts to turn head. Rotating hot/cold presses to site. Using a topical cream Voltaren for pain on neck/arm.

Other Meds: Claritin, ibuprofen

Current Illness: n/a

ID: 0920846
Sex: F
Age: 28
State: NY

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

Lab Data: n/a

Allergies: sulfa, H1N1 vaccine

Symptoms: developed a red non-raised rash on one side of vaccination site, occurred 15 post vaccine, and resolved 1/2 hour later

Other Meds: birth report

Current Illness: none

ID: 0920847
Sex: F
Age: 45
State: OH

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: Shellfish, nuts, legumes (reaction lip swelling, throat tingling - no difficulty breathing or anaphylaxis)

Symptoms: ?Moderna COVID- 19 Vaccine EUA? - Patient received Moderna vaccine 12/23/20, developed rigor and low grade temperature 99.8 degrees F, pain at injection site same day as injection. 12/27/2020 developed worst headache of life for 5-6 hours, vomiting, welts and hives on face, bruising of upper thighs, itching of legs. Patient considered going to emergency department due to severe headache and vomiting but improved after 5-6 hours. As of 1/5/2021, patient still has welts and hives on face and healing bruises on thighs, has been taking diphenhydramine with little improvement.

Other Meds:

Current Illness:

ID: 0920848
Sex: F
Age: 40
State: IL

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever of 100.8, body aches, and headache...this was after the first dose

Other Meds: Advair 50/100

Current Illness:

ID: 0920849
Sex: F
Age: 48
State: TN

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Chest and arms red and warm; metallic taste in mouth; no signs of distress when monitoring discontinued. Proceeded to PCP office the following day due to face, neck and arm stiffness, edema in hands, legs, and face, continued metallic taste, and elevated BP (160/100). PCP prescribed oral steroids, antihistamine, and Epi-Pen.

Other Meds:

Current Illness:

ID: 0920850
Sex: F
Age: 28
State: GA

Vax Date: 12/21/2020
Onset Date: 12/22/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Chills, Body Aches, Temp 99.3, fatigue resolved within 48 hours from onset

Other Meds: Topamax,BCP

Current Illness: migraine headaches

ID: 0920851
Sex: M
Age: 49
State:

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: none

Allergies:

Symptoms: about 3 minutes after receiving vaccine, heart rate jumped to extremely high. Patient did not report until today so we were not able to get actual heart rate. This lasted for about 30 seconds, then went back to normal.

Other Meds:

Current Illness:

ID: 0920852
Sex: F
Age: 64
State: OK

Vax Date: 12/18/2020
Onset Date: 01/01/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: none

Allergies: tobrex

Symptoms: headache,nausea and vomiting ,chills

Other Meds: multi vitamin,vit d3,vit E

Current Illness: osteopenia ,occasional sinus headache

ID: 0920853
Sex: F
Age: 27
State:

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: mild numbness left side of face, starting day of vaccination; no f/u info available at this time. discussed with local health office.

Other Meds:

Current Illness:

ID: 0920854
Sex: F
Age: 47
State: NJ

Vax Date: 12/28/2020
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: Erytrhomycin

Symptoms: Hard painful lump post injection (day 1), itching and redness 7 days post injection.

Other Meds: Lexapro 5 mg daily, Tumeric daily, vitamin d, calcium, b complex

Current Illness: None

ID: 0920855
Sex: F
Age: 32
State:

Vax Date: 12/28/2020
Onset Date: 01/02/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: N/A

Allergies: N/A

Symptoms: Clusters of cold sores around mouth and in nose after 3 years of not having any. I take a daily dosage of Valtrex (1gm).

Other Meds: Valtrex

Current Illness: N/A

ID: 0920856
Sex: M
Age: 45
State: HI

Vax Date: 12/28/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Chills and fever for one night and pain at injection site for three days

Other Meds:

Current Illness:

ID: 0920857
Sex: F
Age: 31
State:

Vax Date: 12/20/2020
Onset Date: 12/20/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient came to our vaccination clinic to receive the COVID-19 vaccine and test. Administration was provided by LVN and patient was directed to our post-vaccination observation area to wait the 15 minutes. During those 15 minutes the patient became symptomatic and per the NP was having tachycardia, chest tightness and hypertension symptoms. NP made the decision to call EMS. EMS arrived at approximately 1515 and triaged patient, EMS then transported the patient to the ED. Husband was called and went with patient to the ED. Husband was escorted by security to ED.

Other Meds:

Current Illness:

ID: 0920858
Sex: F
Age: 34
State: CA

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

Lab Data:

Allergies: None

Symptoms: Developed numbness in left hand then subsequently, sharp burning pain in left upper chest, upper arm radiating to back. Also felt vertigo type symptoms

Other Meds: None

Current Illness: None

ID: 0920859
Sex: F
Age: 59
State: CA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: As she was getting the shot, her upper back teeth had pressure throat started to burn 15 minutes after shot, she was losing her voice 4 hours later she started to wheeze fatigue headache hour later, she started getting hives on her right side of her forhead

Other Meds:

Current Illness:

ID: 0920860
Sex: F
Age: 37
State: TX

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: None stated.

Other Meds: Claritin, ibuprofen

Current Illness: n/a

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm