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: 0958905
Sex: F
Age: 37
State: WI

Vax Date: 01/07/2021
Onset Date: 01/13/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: Day 1: sore arm Day 2: sore arm Day 6: entire upper arm was red, hot, sore, extremely itchy; took benadryl Day 7: more localized to injection site with about a 3" diameter, hard/hot/red/itchy. Went to PCP, started me on antibiotice incase it was cellulitis, continued benadryl Day 8: spreading from day 7 so PCP started me on 2nd antibiotic, continuing benadryl. still spreading by the end of the day Day 9: spreading continued; not hard, still hot, itchy, red. taking 2 antibiotics and benadryl Day 10: not spreading anymore, had to stop 1 antibiotic due to nausea while on it. continued the other antibiotic and benadryl Day 11: redness is pretty much gone, not hard, not really sore, still slightly itch. Can't take benadryl during the day, still taking 1 antibiotic. Day 12: taking 1 antibiotic and no benadryl during the day. it is slightly itchy but doesn't hurt, not hot, not red, not swollen, but it feels like something is there. I don't know how to explain it.

Other Meds: N/A

Current Illness: N/A

ID: 0958906
Sex: F
Age: 51
State: SC

Vax Date: 01/17/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Urticaria over arms, abdomen, neck, face, back

Other Meds: Cetirizine, Zegerid, Nexium, Lo Estrin, vitamin D, fish oil

Current Illness: None

ID: 0958907
Sex: F
Age: 66
State: MI

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

Lab Data:

Allergies: Codeine, Narcotics

Symptoms: adverse reaction to the COVID-19 vaccine. She states that she got the motor in a vaccine approximately 1.5 hours prior to arriving to clinic. As she was driving home, she felt that her bottom lip on the right side was becoming mildly swollen as well as having the sensation that her throat was closing up. She has been able to breathe comfortably and swallow without difficulty. She states that currently her throat feels ?thick.? She also states that she has a ?flushed? sensation. Has had adverse reaction in the past to the the 2nd shingles vaccine. Denies any adverse reaction at the injection site. No recent dietary/medication changes. Denies fever/chills, syncopal episode, severe shortness of breath, numbness/tingling in the extremities or muscular weakness.

Other Meds: Aspirin, atorvastatin, multivitamin, calcium/vitamin-D, elderberry, famotidine, glucosamine/chondroitin, Claritin-D, Fish Oil, Zinc

Current Illness: Denies

ID: 0958908
Sex: F
Age: 26
State: NY

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

Lab Data: unknown

Allergies: pt denies any allergies

Symptoms: Pt received the vaccine dose 2 and was sitting in the observation area when she stated that she was feeling lightheaded and felt like she was going to pass out. This reaction occurred within 15 minutes of receiving the vaccine. Pt was pale, sweaty, diaphoretic, hypotensive and had bradycardia. Pt's systolic BP was in the 60s and her diastolic was in the 30s. Pt was offered food but refused. Pt was immediately brought to the ER where her care was transferred to an ER nurse.

Other Meds: unknown

Current Illness: unknown

ID: 0958909
Sex: F
Age: 61
State: MI

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

Lab Data: NONE

Allergies: Sulfa drugs, Morphine, sulfates in food, gluten, dust mites, grass, pine trees, Night shade family of plants

Symptoms: Second, dose 1/16/21 Pfizer LOT: EL3248 Saturday 11:30 am ? Side Effects started about 1.5 - 2 hours after injection (I took 2 Tylenol and took a 3 hour nap) o Tired o Left Eye twitch o Blurred double vision o Headache o Nauseous ? Side Effects started about 5 - 6 hours after injection (I took 2 Tylenol a Benadryl and used my Ventolin inhalator) o Tired o Watering eyes o Sore tongue o Headache o Nauseous o Heavy feeling in chest ? Side Effects started some time during the night after injection o Muscle cramping in both legs and opposite arm of injection site o Low fever 100.3 Sunday side Effects (I took 2 Tylenol and took a 3-4 hour nap) o Tired o Left Eye twitch o Watering eyes o Sore tongue o Excessive thirst o Swollen neck glands o Nauseous (only after eating) o Muscle cramping in both calves o Blurry vision in the evening o Runny nose Monday side Effects (Went to work) o Tired o Left eye lid twitch o Swollen neck glands o Nauseous o Runny nose o Achy body o Diarrhea Tuesday side Effects (Went to work) o Left eyelid twitch o Swollen neck glands o Runny nose o Sore throat o Diarrhea BLOODY Wednesday side Effects (went to work) o Swollen neck glands o Runny nose o Sore throat Note: I have several Allergies that require me to take an allergy pill every day. I also use an inhaler as needed. My symptoms were not any worse than when I have a bad allergic reaction, I have received shots of Epinephrine for my allergies and did not feel one was necessary.

Other Meds: loratadine , Bupropion , Simvastatin sertraline

Current Illness: NONE

ID: 0958910
Sex: F
Age: 51
State: PA

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

Lab Data: None

Allergies: Seafood, cat scan dye

Symptoms: Back pain,fever,chills,muscle aches, headache, diarrhea, upset stomach , nausea, severe head fog , Disiness, feels like electrical currents in head and ears. These symptoms have been all 7 days.

Other Meds: Atenolol, Alprazolan

Current Illness: No

ID: 0958911
Sex: F
Age: 43
State: IN

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

Lab Data: Only saw my doctor afterwards to get her opinion. Appointment was in 1/20/2021. No further testing as she feels it was vasovagal.

Allergies: None that I am aware of

Symptoms: 8 mins after receiving first dose, I became very dizzy, my heart rate increased and I started sweating. I never passed out and remained sitting. The episode lasted 1-2 minutes. I did not need assistance. Then 2 -3 hours later I had the exact same episode and reported it to the downtown clinic and they only urged me to self monitor or report to ER if needed. Those were the only 2 episodes. My blood pressure was elevated that afternoon but was very low for 3 days and I did not take my atenolol for those days.

Other Meds: Atenolol

Current Illness: None

ID: 0958912
Sex: F
Age: 42
State: AZ

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

Lab Data: None

Allergies: NKDA

Symptoms: Immediate arm and neck soreness/12 hours later joint pain , Back pain, muscle aches, headache, rapid heart rate, metallic taste in mouth. weakness, fatigue, Symptoms still current after 2 weeks post vaccine.

Other Meds: Liquid Iron 10-20ml QD , D-3 K-2 drops QD , B12 SL QD, Dexilant 60mg 1 PO QD

Current Illness: Anemia symptoms Low hemoglobin

ID: 0958913
Sex: M
Age: 61
State: MN

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

Lab Data: Labs done 1/15/21 WCB 9.6 HGB 16.2 MCV 86 PLT 230 SODIUM 137 POTASSIUM 4.2 CHLORIDE 101 CO2TOTAL 26 BUN 16 CREATININE 1.09 GLUCOSE 124 CALCIUM 9.8 ALBUMIN 4.4 BILITOTAL 0.8 BILLIDIRECT 0.3 ALT 15 AST 16 PROTEIN 7.8

Allergies: NKA

Symptoms: Resident became lethargic, general weakness outside baseline, unable to walk, bumbled speech. Elevated HR and Temp of 105.2F

Other Meds: Vitamin B1 1000MG PO DAILY, Vitamin D3 2000 UI PO Daily, Levothyroxine 50mcg PO Daily, Trazodone 50MG Po HS daily, Tamsulosin 0.4MG PO DAILY, Ramipril cap 2.5mg daily, Quetiapine 150mg Po twice a day, Melatonin 5mg Po at HS. Olanzapine 10m

Current Illness: UTI, was taking Cipro

Date Died: 01/15/2021

ID: 0958914
Sex: F
Age: 87
State: GA

Vax Date: 12/30/2020
Onset Date: 01/15/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: Death on 1/15/2020

Other Meds: Melatonin, Sertraline, Omeprazole, Resperidone, Depakote ER, vitamin E, multi vit, ASA, Lasix, gabapentin, potassium, Imodium, Zofran, Buspar, benztropine.

Current Illness:

ID: 0958915
Sex: F
Age: 28
State: PA

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

Lab Data: N/A

Allergies: Penicillins

Symptoms: Chills, nausea, body aches, joint pain, muscle aches, headache, swollen lymph nodes in neck

Other Meds: Tylenol taken before vaccination. Prescriptions: Cymbalta, buspar, Adderall ER, Adderall IR, vitamin D 1000 IU, Flintstone complete chewable, calcium citrate max.

Current Illness: N/A

ID: 0958916
Sex: F
Age: 54
State: AZ

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

Lab Data: none

Allergies: compazine

Symptoms: On day eight after vaccine I awoke to find my left deltoid stiff, red, warm and swollen. These symptoms continued for two days.

Other Meds: fosinopril, hydrochlorothiazide, vitamin d, multi-vitamin

Current Illness: none

ID: 0958917
Sex: F
Age: 46
State: MA

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: Penicillin, Sulfa, Quinolones, Cephalosporin, Tetracycline

Symptoms: On 1/9 noticed 2 medium size hives on right lower area near elbow, 1/10 additional hives on left lower area near elbow. Over the next few days several more hives appears on bilateral forearms. On 1/16 both arms were covered with hives that were itchy. On 1/17 both arms and legs covered with hives that were itchy. 1/18 went to PCP as hives increased in number and size and were itchy. Started on prednisone for allergic reaction

Other Meds: Omeprazole 20mg BID, Zyrtec 10mg QD, Valsartan 160mg BID, Vitamin D3 1000 IU daily, Diltiazem 180mg QD, Singular 10 QD, Reclipsen QD, Clonidine 0.1mg QD

Current Illness: none

ID: 0958918
Sex: F
Age: 66
State: AZ

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

Lab Data: None yet

Allergies: Sulfa

Symptoms: Headache, fever, chills, body aches.

Other Meds: Levetheroxine, Celexa, Metformin, Ropineral ,Mucinex

Current Illness: None

ID: 0958919
Sex: F
Age: 38
State: KY

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

Lab Data: None yet, advised to go to ER.

Allergies: PCN, Doxycycline

Symptoms: Patient called to report headache beginning 1 hour after vaccination followed by lips, tongue and right side of face numb and tingling. Advised patient to go to ER department for further evaluation.

Other Meds: Keto shakes, Cipro finishing for sinus infection 2 weeks ago.

Current Illness: sinus infection

ID: 0958920
Sex: F
Age: 72
State: NY

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

Lab Data:

Allergies: Bees, omperazole, penicillin, Eletriptan, iodixanol, Naproxen,

Symptoms: Patient entered monitoring area at 9:26 am. She had been pre-medicated with Benadryl 50 mg 30 minutes before vaccine administration due to hx of anaphylatic reactions to medications in past. Patient had also taken her routine Allegra 180 mg this morning. At 9:36 am patient c/o itching in the neck & arm areas, some redness present. Patient denied SOB, wheezing, lip/tongue swelling or light headedness or abd. pain. O2 sats 97%, pulse 72. Patient given Zyrtec 10 mg at 9:45 am and at 9:55 am itching improved, O2 sat at 98%, B/P=163/99, pulse 72 and patient states feeling much better. Given famotidine 20 mg and VS 179/76, pulse 68, O2 sat 96% and states feeling betted. One hour post injection, patient feels safe

Other Meds: Melatonin,Allegra, Pepcid, Albuterol, Levothyroxine, xarelto,

Current Illness: none

ID: 0958921
Sex: F
Age: 48
State: CO

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

Lab Data: none

Allergies: Peas, Pineapple, Watermelon, Sulfa, Penicillins, prednisone, tetracycline, tuberculin ppd, influenza vaccine

Symptoms: This may be a duplicate report, as primary care notes state the process has been initiated. However, out of an abundance of caution, and as the facility the event was reported to, I wanted to enter this report for completeness due to the unusual events. Patient received 1st dose of moderna covid vaccine at an outside facility and (per patient) had a seizure at that site immediately following the injection (history of seizures due to past meningitis, no seizures in past 3 months per patient). No medications were given, 911 was not called, patient not instructed to go to ED (per patient). Patient went home. Once home, patient reported "stroke like symptoms" on her right side (weakness and inability to close right eye for 30 minutes, numbness in R thigh and heel). Then weakness moved to left side (numbness/tingling in L hand and eye, numbness in L lower leg) along with some swelling to face/tongue. Had back pain but no chest pain or difficulty breathing. Extreme dizziness. No additional seizures. The next day she called our nursing line to report these symptoms and was instructed to go to the ED and also scheduled a visit with primary care provider the next morning. Patient stated she was feeling better and apparently did not go to the ED, instead choosing to see PCP next morning. On presentation to PCP, injection site was red and swollen, itching and swelling in hands, itching in bottom of feet, widespread joint pain. No visible rash, no dysphagia, no difficulty breathing. Other symptoms had largely resolved. Patient was prescribed benadryl (no steroids due to allergy to prednisone), cold compresses for injection site and sent home with instructions to go to ED if symptoms reappeared. Also recommended making an appointment with a neurologist for additional follow up as patient currently does not see a neurologist for seizures and is treating with CBD/THC only.

Other Meds: Symbicort inhaler, albuterol inhaler and nebs, Mirena IUD, Epipen prn, CBD oil, THC

Current Illness: chronic asthma, history of seizures due to past meningitis (last seizure >3 months prior to this one)

ID: 0958922
Sex: F
Age: 33
State: NJ

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

Lab Data:

Allergies: None

Symptoms: Around 2 inch large rash on left arm where shot was given. Itchy sensation, redness, pains on applying pressure on vaccine shot area.

Other Meds: Metformin, Omega-3, Vitamin D3

Current Illness: None

ID: 0958923
Sex: F
Age: 27
State:

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

Lab Data:

Allergies: none

Symptoms: throbbing arm pain, lasted for 36 hours, used Advil as needed.

Other Meds: nothing

Current Illness: none

ID: 0958924
Sex: F
Age: 46
State: CA

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

Lab Data:

Allergies:

Symptoms: Fever, chills, body aches

Other Meds:

Current Illness:

ID: 0958925
Sex: F
Age: 55
State: OH

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

Lab Data: unknown at this time - will follow up with patient this evening

Allergies: Morphine and taxotere (anaphylaxis to both)

Symptoms: Patient experienced heart palpitations, increased heart rate (100) and increased Blood pressure (210/120) - patient sent to ER via ambulance

Other Meds: unknown

Current Illness: unknown

ID: 0958926
Sex: F
Age: 56
State: RI

Vax Date: 01/03/2021
Onset Date: 01/07/2021
Rec V Date: 01/20/2021
Hospital: Y

Lab Data: MRI showed enhancement of the right facial nerve and an incidental meningioma. She was started on valacyclovir and prednisone.

Allergies: NKDA

Symptoms: Patient developed right facial numbness and facial droop on 1/7/21. She came to the TMH ED and was admitted. She was afebrile; neurologic exam was consistent with a peripheral facial palsy on the right.

Other Meds: Amlodipine 5 mg daily ASA 324 mg daily Atorvastatin 80 mg daily

Current Illness: None

ID: 0958927
Sex: F
Age: 55
State: NJ

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

Lab Data:

Allergies: NONE

Symptoms: STINGING HEADACHE FROM 1/8 TO 1/10. CHILLS ALL DAY ON 1/9. TOOK TYLENOL EVERY 4 HRS

Other Meds: TERNORMIN .25; LEXAPRO .5

Current Illness: NONE

ID: 0958928
Sex: F
Age: 69
State: VA

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

Lab Data: None

Allergies: None

Symptoms: Red rash appeared on upper arm, itchy. Second day rash lessened.

Other Meds: Irbesartan 150 mg Atorvastatin 20 mg Latanaprost 0.005% 81 mg aspirin Calcium 600 mg

Current Illness: None

ID: 0958929
Sex: F
Age: 34
State:

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

Lab Data: None

Allergies: I am allergic to Penicillin.

Symptoms: 24 hours after the shot I had minor redness and swelling near the injection site which went away with in 24 hours. 8 days after the injection I had more severe swelling and redness about the width of a soft ball, the area was also warm to the touch and felt hard. With in 6 hours of the second reaction the swelling had decreased to about half of what it was from the time I had noticed it. By the next day the swelling was gone and the area was no longer hard and by the thrid day the redness had completely gone away.

Other Meds: None

Current Illness: None

ID: 0958930
Sex: F
Age: 57
State: GA

Vax Date: 01/05/2021
Onset Date: 01/14/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: NONE

Allergies: NONE

Symptoms: QUARTER SIZE INDURATION--RED , ITCHY, WARM

Other Meds: LEVOTHYROXINE VITAMIN D AFRIN ZYRTEC

Current Illness: NONE

ID: 0958931
Sex: F
Age: 54
State: NY

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

Lab Data:

Allergies:

Symptoms: Reported nose bleed,fever, chills, enlarged lymph node

Other Meds:

Current Illness:

ID: 0958932
Sex: F
Age: 61
State: NY

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

Lab Data: none

Allergies: Shellfish (rash), strawberries (hives); sulfites (itching); clarithromycin (itching); fish; iodine, levoflozacin (hives); methylprednisolone (itching); penicillins (rash); ARBs (angioedema)

Symptoms: Due to hx of allergic reactions, pt was told to wait for 30 minutes in observation prior to vaccination. At 1208 on 1/20/2021 pt received 2nd dose of COVID Pfizer vaccine. Immediately after vaccination, pt experienced unusual taste in mouth, flushing, and feeling of heat in chest. At 1232, pt noticed flushing on arms and feelings of heat and pins and needles in both arms, hands, chest, both feet, and back. Sensation was persistent, so at 1301, 50 mg of IM Benadryl administered to RD by NP. By 1320 flushing on arms and chest subsided, feeling of pins and needles persisted but was not as severe as initial reaction. By 1345 flushing on arms returned, pins and needles sensation worsened again in all locations noted prior, spread to scalp, and tingling sensation occurred on lips. Pt communicated with Dr advised to stay under observation, but transfer to ED not medically necessary. At 1415, pt was advised to go home with supervision of partner and monitor symptoms from there.

Other Meds: Claritin 10 mg once a day; Prevacid 30 mg once a day; Pepcid AC 20 mg once a day; Pulmicort 80 mcg, 2 puffs, once a day; Singulair 10 mg once a day; Zyrtec 10 mg once a day; 2000 mg Vitamin D

Current Illness: none

ID: 0958933
Sex: F
Age: 63
State: AS

Vax Date: 12/29/2020
Onset Date: 01/08/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headaches started 01/08/2021 and would come and go during the day. The last two days not as much.

Other Meds:

Current Illness:

ID: 0958934
Sex: M
Age: 82
State: GA

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

Lab Data: NA

Allergies: NA

Symptoms: MODERNA COVID-19 VACCINE EUA Patient reports approximately 24 hours after receiving vaccine , he came in from a doctor's appointment and remembers opening the door and then woke up in the floor and there was blood on the floor. Patient had no other adverse reactions other than soreness in his arm. No follow-up treatment required per patient.

Other Meds: HYDROCODONE . LISINOPRIL AND METFORMIN

Current Illness: NONE

Date Died: 01/20/2021

ID: 0958935
Sex: F
Age: 92
State: NC

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

Lab Data:

Allergies: Penicillin

Symptoms: Sudden Death within 24 hours of vaccine

Other Meds: Aspirin, Biotin, Levothyroxine, melatonin, Namenda, Zyprexa, Trazodone, B12, B6, Vit D, Xanax

Current Illness:

ID: 0958936
Sex: F
Age: 27
State: NY

Vax Date: 12/31/2020
Onset Date: 01/08/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Hives at injection site 8 days after vaccine was administered. Redness and slight irritation remained at site for an additional week before clearing up.

Other Meds: Oral contraceptive- Junel Fe

Current Illness: none

ID: 0958937
Sex: F
Age: 63
State: AS

Vax Date: 12/29/2020
Onset Date: 01/08/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headaches started 01/08/2021 and would come and go during the day. The last two days not as much.

Other Meds:

Current Illness:

ID: 0958938
Sex: F
Age: 71
State: PA

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

Lab Data: None to date

Allergies: None known

Symptoms: After 15 minutes I had tightness in my chest, headache, and felt my senses were hypersensitive (visual, focus); felt "speedy". I checked my pulse and it was normal (80)

Other Meds: Levothyroxin 50 mgm daily Probiotic daily Azo cranberry urinary tract health tablets daily

Current Illness: None known

ID: 0958939
Sex: M
Age: 50
State: MI

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

Lab Data:

Allergies: NKDA

Symptoms: Left eye swelling and red, itchy, tearing, blurry, warm.

Other Meds: Simvastatin, celexa, neurontin

Current Illness:

ID: 0958940
Sex: M
Age: 87
State: NJ

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data: Chest Xray: negative, Labaratory: Lab results within baseline for resident, Covid POC rapid test: negative

Allergies: Corticosteroids

Symptoms: According to staff present, patient was found nonresponsive. Nurse Practitioner and RN entered room too assess resident. He was slow to respond, but appropriate. He was very warm to touch. Temp was 100.4, BP taken manually 158/78. Spo2 95% on room air. received 1st dose of vaccine yesterday 12/29/2020 at approximately 1230 pm.Chest X-ray and STAT labs were ordered. After a few minutes pt was awake and alert and oriented to person, place, and time and back to his baseline. Resident was given acetaminophen for fever.

Other Meds: Trazadone HCl Tablet 50 mg at bedtime, Ditropan XL tablet ER 1

Current Illness:

ID: 0958941
Sex: F
Age: 40
State: CA

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

Lab Data:

Allergies:

Symptoms: headaches, chills, mild fatigue. didn't take temp.

Other Meds:

Current Illness:

ID: 0958942
Sex: F
Age: 28
State: NY

Vax Date: 01/11/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: no side effects after shot other than sore arm until 8 days later when the injection site became red, warm and a little swollen. Appears less red today than yesterday but still warm and swollen. No other symptoms and feeling healthy otherwise.

Other Meds: probiotic

Current Illness: none

ID: 0958943
Sex: F
Age: 62
State: NY

Vax Date: 01/11/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: lactose, hydrocodone (Vicodin), codeine, diphenhydramine (Benadryl), penicillin, clindamycin, erythromycin, vancomycin, molds/mildew

Symptoms: Day 8 after vaccine, the injection site was swollen, firm, and itchy. By Day 9, itching is gone, but swelling and firmness remain. No color change. In the weeks prior to the vaccination, I had been experiencing muscular pain in my back which was treated by acupuncture. After the vaccination, the muscle pain returned and continues.

Other Meds: bupropion, vortioxetine, losartan/HCTZ, oxybutynin, estriol, vitamin C, d-Mannose

Current Illness:

ID: 0958944
Sex: F
Age: 49
State: FL

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

Lab Data: no

Allergies: no

Symptoms: Redness around the site and only notice after she took the collegen

Other Meds: Collegen

Current Illness: no

ID: 0958945
Sex: F
Age: 50
State: WA

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: no tests, just cut open hemrrohids and drained blood clots

Allergies: none

Symptoms: tried to use a cream Dr prescribed for hemrrhoids, had to have them surgically cut, drained of blood clotts, sent home. went back to urgent care 4 day later still in a lot of pain, was given a surgical consult, waiting for a appointment. Rash Dr prescribed prednisone and topical cream 2x daily on rash, still having rash issues spreading.

Other Meds: vitamins B,D, Potasium, Magnesium, collegen, fiber gummy, stool softner, probiotic

Current Illness: had a rash when I woke up the next morning, continues to spread (now 1/20/21) also had a BM and ended up with external thrombosis hemrrohids. have seen drs for both, have been seen in urgent care 2 times, have a surgical consult next month. never had these issues before the vaccine. not allergic to anything

ID: 0958946
Sex: F
Age: 43
State: MA

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

Lab Data:

Allergies:

Symptoms: Patient received 2nd dose Pfizer @ 1549, after 10 minutes of monitoring patient c/o of tightness & felt "slow swelling" in her throat. Also reporting "slow swallowing sensation" Patient brought out to back triage area, vitals stable, NO SOB, no wheezing, no lip or tongue swelling noted. 167/95, 63, 99% RA. Reporting feeling anxious. Only allergy or similar event patient reports is medication, ephedrine during delivery which was treated w/ O2 during her delivery Repeat vitals 134/90, 59, 99% Allergy MD on call notified of event, per MD continue to monitor for additional 30 minutes and call back w/ any further symptoms 136/93, 60 & 99% After 30 minutes, patients vitals stable, sensation has resolved & felt well enough to go home 127/92, 59 & 99%

Other Meds:

Current Illness:

ID: 0958947
Sex: F
Age: 38
State: IN

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

Lab Data:

Allergies: NKA

Symptoms: Woke up at 7 am on the 19, Feeling extreme fatigue, body aches, low grade temp. I called the virtual IU Health line to report symptoms. I spent all day in bed till symptoms started to subside which was around 4:30pm 01/19/2021. I was completely symptom free by 01/20/2021 at 0930 am.

Other Meds: Phentermine, IB profin, Vitamin B12

Current Illness: no

ID: 0958948
Sex: F
Age: 55
State: ME

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

Lab Data:

Allergies: IVP contrast dye >25 years ago

Symptoms: Transient numbness and tingling of left cheek lasting 7 minutes. No allergic signs or symptoms.

Other Meds: none

Current Illness: none

ID: 0958949
Sex: F
Age: 49
State: IA

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

Lab Data:

Allergies: NKA

Symptoms: Extreme fatigue Moderate pain in the injection arm Moderate to severe headache. Still there even after ibuprofen. Mild nausea only lasted about an hour about 6 hours post injection. Body aches treated with ibuprofen and rest

Other Meds: sertraline 25 mg low estrogen birth control

Current Illness: None

ID: 0958950
Sex: M
Age: 38
State: NY

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

Lab Data:

Allergies: NKDA

Symptoms: D/w patient after covid vaccine slight headache - elevated bp 143/102 Now symptoms resolved employee feels better and wants to go home. Encouraged patient to come back if symptoms get worse.

Other Meds: No active meds

Current Illness: None

ID: 0958951
Sex: F
Age: 27
State: OR

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

Lab Data:

Allergies: Allergy to amphetamines - severe anxiety, breathing problems

Symptoms: I had fatigue and body aches after about 2 hours following the injection. I also had severe muscle and joint pain in the arm I received the injection in for about 2 days following the injection. I could not sleep on my arm, had difficulty lifting it over my head, and still experience some tenderness when I rub my upper arm. I have never experienced this much pain following a vaccination in my entire life.

Other Meds: Ashlyna (birth control) Bupropion XL 300 mg Fluoxetine 80 mg Loratadine 10 mg Hair, skin, and nails supplement Vitamin B12

Current Illness: None

ID: 0958952
Sex: F
Age: 71
State: PA

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

Lab Data: Positive covid test 1/18/2021

Allergies: None

Symptoms: Cough dysponea fever

Other Meds:

Current Illness: None

ID: 0958953
Sex: F
Age: 30
State:

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

Lab Data:

Allergies:

Symptoms: Started with itchy mouth and itchy soft palate. Progressed to itchy throat. Gave 50mg of Benedryl with no relief, progressed to difficulty breathing, and increased throat itching. Gave EPI pen and sent to ER

Other Meds:

Current Illness:

ID: 0958954
Sex: F
Age: 72
State: VI

Vax Date: 01/09/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Patient presented to office with erythemous patch on left arm 5 cm x 10 cm, 2cm below vaccine injection site

Other Meds: Premarin

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm