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: 0959312
Sex: F
Age: 36
State: MO

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

Lab Data: NA

Allergies: NA

Symptoms: Red, swollen, painful, injection site beginning the evening after the second dose. Fatigue a few hours after the second dose. The fatigue continued through the second day after the dose. Headache the day after the second dose. All symptoms were treated with ibuprofen.

Other Meds: Celexa, MVI, oral contraceptive, Zyrtec

Current Illness: NA

ID: 0959313
Sex: M
Age: 58
State: OR

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

Lab Data: none

Allergies: None

Symptoms: sore arm, headache, whole arm intense itching, hives and swelling (had to remove all rings)

Other Meds: None

Current Illness: none

ID: 0959314
Sex: F
Age: 43
State: NM

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

Lab Data: none

Allergies: no known allergies

Symptoms: Patient started feeling numbness of left hand and fingers after 10 minutes. Pain on forearm (Pressure feeling) Patient was monitor for 15 more minutes, no other interventions

Other Meds: unknown

Current Illness: unknown

ID: 0959315
Sex: F
Age: 60
State: IA

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

Lab Data: none

Allergies: none

Symptoms: severe joint pain

Other Meds: Atorvastatin, venlafaxine

Current Illness: none

ID: 0959316
Sex: F
Age: 22
State: MT

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

Lab Data:

Allergies:

Symptoms: Headache, Fatigue, Injection Site Pain

Other Meds:

Current Illness:

ID: 0959317
Sex: F
Age: 34
State: MA

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

Lab Data: None

Allergies: Sesame Seed, Sesame Oil

Symptoms: Headaches, Arm Pain, Armpit Glands Sore/Swollen, Injection Site Red/Painful/Raised

Other Meds: Epi-Pen as needed

Current Illness: None

ID: 0959318
Sex: F
Age: 58
State: WA

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

Lab Data:

Allergies:

Symptoms: Had small red area initially after vaccine was given. 12 days later it increased to baseball size and is itchy. States she had similiar rxn with pneumonia vaccine in past.

Other Meds:

Current Illness:

ID: 0959319
Sex: F
Age: 41
State: CT

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

Lab Data: Covid-19 test on 01/16/2021 with a negative result

Allergies: N.K.A

Symptoms: Body aches, head aches, chills, nausea, vomiting, 103+ fever ( comes and go) for 4 days

Other Meds: None

Current Illness: None

ID: 0959320
Sex: M
Age: 74
State: WA

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

Lab Data: none needed

Allergies: none

Symptoms: Moderna COVID-19 Vaccine EUA Slight dizziness and fatigue one hour after shot, lasting 30 minutes Very mild soreness around site of vaccine, starting several hours after shot and still noticeable two days later

Other Meds: diclofenac losartan baby aspirin Prevacid

Current Illness: none

ID: 0959321
Sex: M
Age: 75
State: AL

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

Lab Data: None

Allergies: None listed

Symptoms: Patient was given his vaccine from a full vial prior to reconstituted with Normal Saline. Treatment: Patient was observed at the clinic for one hour after vaccination. Patient had no complaints prior to leaving the clinic. Dr placed a Follow up call to patient two hours after he was released from the clinic. Pfizer was consulted. Pfizer reported the patient may experience increased arm pain. Pfizer approved patient to receive second vaccine on his due date. Follow up instructions given to the pt per Dr. Pt advised of date for second vaccine. Patient contacted again 1/20/21 per Dr. Patient doing well and voiced no complains

Other Meds: Unknown

Current Illness: None Listed

ID: 0959322
Sex: F
Age: 49
State:

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

Lab Data:

Allergies:

Symptoms: chills, low-grade fever (99.6 F), injection site pain

Other Meds:

Current Illness:

ID: 0959323
Sex: F
Age: 48
State: IA

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

Lab Data:

Allergies: codeine, sulfa

Symptoms: Lump, red, warm to the touch

Other Meds:

Current Illness: none

ID: 0959324
Sex: F
Age: 58
State: KS

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

Lab Data:

Allergies: bactrim

Symptoms: developed redness, swelling,,,soreness, in arm where the vaccine was given a week later. Warm to touch

Other Meds: Synthroid, Premarin, Celexa

Current Illness:

ID: 0959325
Sex: F
Age: 30
State: OR

Vax Date: 12/28/2020
Onset Date: 01/07/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Sulfa Hayfever Melons Avacodo

Symptoms: Left Arm pain and redness, extending to neck and sternum, Treated with antibiotics.

Other Meds:

Current Illness:

ID: 0959326
Sex: F
Age: 56
State: NJ

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

Lab Data:

Allergies:

Symptoms: Patient reports tingling in hands, nausea, and sweating with the first dose.

Other Meds:

Current Illness:

ID: 0959327
Sex: M
Age: 53
State:

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

Lab Data:

Allergies: none

Symptoms: Shingles. Open weeping sores on L side of head. Received prescription for 7 day course of Valtrex (anti viral). Sores scabbed over by end of 7 day prescription. Shingles vaccine had been received 2 years prior.

Other Meds: none

Current Illness: none

ID: 0959328
Sex: F
Age: 59
State: PA

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

Lab Data: none

Allergies: Unknown

Symptoms: Person receiving the vaccine developed a tingling in her mouth. Not short of breath or itchy, no hives. Vital signs 156/90, Pulse 72, SPO2 97. Gave her water and candy, sat her in recliner with feet up. She remained with us for over 30 minutes. Felt better after water. Vital signs before leaving were 147/90, pulse 73, SPO2 97

Other Meds: Unknown

Current Illness: unknown

ID: 0959329
Sex: F
Age: 55
State: MO

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

Lab Data: Chest x-ray, COVID molecular rapid test with a negative result.

Allergies: Shrimp

Symptoms: Per patient she began experiencing shortness of breath and tightness in her chest a few minutes after vaccine administration. Pt reports using her inhaler and nebulizer treatments with relief in symptoms. Symptoms have persisted for 24 hours.

Other Meds: Amlodipine, atorvastatin, Breo Ellipta, Ergocalciferol, HCTZ, Ibuprofen, Metformin, Quetiapine, Terbinafine, Topiramate

Current Illness: N/A

ID: 0959330
Sex: F
Age: 61
State: CA

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

Lab Data:

Allergies: demerol, fentanyl, penicillin

Symptoms: Received first dose of Moderna vaccine in left deltoid. went to car with family and began vomiting. No SOB with chest issues. Called 911. Gave one aspirin per 911 call. Pulse in normal limits. Patient did not get transported to ED via ambulance.

Other Meds:

Current Illness:

ID: 0959331
Sex: F
Age: 45
State: IN

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: I developed a red rash on my torso area that I call a viral rash 48 hours after administration of first vaccine. The rash was not painful or itchy and resolved within 48 hours.

Other Meds: Miralax , Linzess, Ibuprofen, melatonin, Benadryl

Current Illness: No

ID: 0959332
Sex: F
Age: 94
State: SC

Vax Date: 01/08/2021
Onset Date: 01/14/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: n/a

Allergies: SULFA ANTIBIOTICS

Symptoms: Bruise/knot/warmth at the injection site. Cool compress/massage.

Other Meds: Ensure afterment; HydrOXYzine HCl Tablet 25 MG Give 1 tablet by mouth every 6 hours as needed for Itching; Lasix Tablet 20 MG (Furosemide) Give 1 tablet by mouth one time a day for edema; Sotalol HCl Tablet 120 MG Give 1 tablet by mouth two

Current Illness: INFECTION TO RLE/TREATED WITH AUGMENTIN X 5 DAYS/PROBIOTIC X 7 DAYS

ID: 0959333
Sex: M
Age: 12
State: CA

Vax Date: 05/01/2019
Onset Date: 05/01/2019
Rec V Date: 01/20/2021
Hospital:

Lab Data: influenza negative

Allergies: none

Symptoms: Acute onset fever up to 103 degrees - difficult to control with antipyretics x several days Body aches mild abdominal pain slight cough No other concomitant illness to explain the fever; influenza negative

Other Meds:

Current Illness: none recorded

ID: 0959334
Sex: F
Age: 31
State: CA

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

Lab Data: All normal

Allergies: None

Symptoms: Day 2-4 soreness, tired, chills, severe fatigue. Day 7 Swelling and pain in arm pit area. Felt like I had a golf ball in under my arm pit. Felt like a pinch nerve by my neck , resolved nu day 14.

Other Meds: None

Current Illness: None

ID: 0959335
Sex: F
Age: 37
State: MT

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

Lab Data:

Allergies:

Symptoms: Rash on chest and arms-started a week after vaccine

Other Meds:

Current Illness:

ID: 0959336
Sex: F
Age: 42
State:

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

Lab Data:

Allergies:

Symptoms: severe arm pain later that night and half of next day

Other Meds:

Current Illness:

ID: 0959337
Sex: F
Age: 46
State: NJ

Vax Date: 01/08/2021
Onset Date: 01/15/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Latex

Symptoms: Vaccine recipient received vaccine on 1/8/2021. She reported that on 1/15/2021 around 3-4 pm noticed that she had left eye weakness. Over the weekend 1/16/2021 ? 1/17/2021, she noticed that the left eye weakness/droop was more pronounced when she was tired. On 1/18/2021 she went to see a neurology specialist and had an MRI done. Vaccine recipient reported that the MRI findings were normal. On 1/18/2021 she developed a migraine and took propranolol and Aleve. She is waiting on pending blood work and results.

Other Meds: Calcium/Vitamin D, Vitamin C, Echinacea, Synthroid, Prilosec, Tums, Botox (cosmetic) injection on 12/5/2020

Current Illness: None

ID: 0959338
Sex: M
Age: 63
State: CO

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

Lab Data:

Allergies: Furinol

Symptoms: Within 45 minutes, started feeling flushed, lightheaded and a little dizzy.

Other Meds:

Current Illness: Sinus Infection

ID: 0959339
Sex: F
Age: 85
State: IL

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

Lab Data: None

Allergies: penicillin, sulfa, miacalcin, Vitamin B 12, levoxyl, codiene, elocon cream, phosamax, estrogen patch, clindamycin, fulforyl-loop-, cephelosprins, meloxicam, voltaren.

Symptoms: Patient had an immediate reaction following the 1st Moderna COVID-19 Vaccine administration on 01/18/2021. S/S began immediately following the injection, and were scratchy, dry throat, dry cough, slight wheezing in upper bilateral lobes. Treated with 50 mg Benadryl, monitored for 30 minutes which included vital signs. Patient recovered- home with husband. Advised patient to follow up immediately with urgent care or primary care physician.

Other Meds: Synthroid Aleve prn

Current Illness: None

ID: 0959340
Sex: F
Age: 56
State: NJ

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

Lab Data:

Allergies: PENICILLIN, SULFA - RASH

Symptoms: PATIENT REPORTS TINGLING IN HANDS, NAUSEA, AND SWEATING WITH THE FIRST DOSE

Other Meds:

Current Illness:

ID: 0959341
Sex: F
Age: 52
State:

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

Lab Data:

Allergies: None known

Symptoms: Swelling of lymph nodes in right neck and axilla within one week of vaccine, rash on right arm and neck 2-3 weeks after vaccine

Other Meds: vitamin C, Airborne

Current Illness: Dental work 12/31.

ID: 0959342
Sex: F
Age: 57
State: MA

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

Lab Data: None

Allergies: Seasonal

Symptoms: Soreness/Pain in the injection site and not able to lift the arm for almost 75 hours.

Other Meds: None

Current Illness: None

ID: 0959343
Sex: F
Age: 63
State: TX

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

Lab Data: N/A

Allergies: N/A

Symptoms: 12 hrs after vaccine headache,nausea,achy,sore arm 24 hrs after vaccine fever 100.2, bad chills,headache,body aches,very sore arm 36 hrs after vaccine swollen lymph nodes under rt arm, temp 99.8

Other Meds: metoprolol, calcium, vitamin D, biotin, coQ10

Current Illness: N/A

ID: 0959344
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: After vaccination, complained of tingling on lips and tongue. Legs felt heavy; fatigued. Treated with PO Benadryl and observed by onsite RN and paramedic- much improved. Follow-up call to patient 24 hours later and she is feeling much better.

Other Meds:

Current Illness:

ID: 0959345
Sex: M
Age: 23
State: KS

Vax Date: 01/03/2021
Onset Date: 01/04/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: HEADACHE, SHORTNESS OF BREATH

Other Meds:

Current Illness:

ID: 0959347
Sex: F
Age: 26
State: WI

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

Lab Data: Scheduled to see her doctor on Friday, January 22nd.

Allergies: NKA

Symptoms: Hives noted the following morning that were described as red, hot and itchy. Located on chest, head, hands and arms, side of right hip. Used Claritin and ice packs with some relief. Also experienced numbness on her left shoulder and left chest to navel which subsided by mid day. No breathing issues or any additional signs or symptoms.

Other Meds: None

Current Illness: Planning pregnancy

ID: 0959348
Sex: F
Age: 48
State: IL

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

Lab Data: None

Allergies: NKA

Symptoms: Left arm moderate pain, mild swelling, severe headache, fever 101.6, chills, fatigue, muscle aches and joint pain. Treatment- alternate acetaminophen and ibuprofen - reduce chills, fever and severe headache. Muscle aches, fatigue and joint pain remain

Other Meds: Birth Control, multi vitamin

Current Illness: None

ID: 0959349
Sex: F
Age: 56
State: OK

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

Lab Data: Have called hospital and personal physician. I haven't gone to hospital yet and hope not to have to.

Allergies: Penicillin

Symptoms: Severe, painful abdominal cramping, sweating, and pooping. Felt like childbirth. So painful it was difficult to hold back tears or regulated my breathing. A lot like a severe "spastic colon attack". 2 1/2 hrs later, a dozen or so toilet flushed and it's not over with yet!

Other Meds: Did not take meds this morning. Omeprazole 20g 1daily Oxybutin (bladder) 5mg 2x daily A________ (blood pressure) 5mg 1x daily

Current Illness: Prior bladder infection couple of weeks before.

ID: 0959350
Sex: F
Age: 25
State: MT

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

Lab Data:

Allergies:

Symptoms: Fever

Other Meds:

Current Illness:

ID: 0959351
Sex: M
Age: 55
State: WA

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

Lab Data:

Allergies: N/A

Symptoms: Within 24 hours, patient reported uncontrolled blood glucose levels above 200. Patient previously had blood glucose within normal limits and was well controlled for some time. These elevated blood glucose levels lasted approximately one week. He had no other dietary/medication changes during this timeframe. The only change was that he received the vaccine. He also experienced headache, fatigue and severe injection site pain, peaking at 24 hours post injection.

Other Meds: Long-acting and short-acting insulins

Current Illness: None

ID: 0959352
Sex: F
Age: 27
State: MO

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

Lab Data: None

Allergies: NKDA

Symptoms: 1410 Client became light headed and reported to obs desk. Unassisted descent to floor upon turning to go to a 30 min obs seat. Did not strike head, sat on buttocks and propped self with left arm; No medical Hx. BP 140/100 P 96 R 12 SpO2 100%; LOC A&O x3, did not lose consciousness; skin warm pink and sweaty; hot at back of neck; HR regular; Resps unlabored; Lungs clear; assisted to a supine on floor and legs elevated; ice pack for comfort; EMS notified 1420 BP 152/104 P 70 R 12 SpO2 99% Resps continued unlabored; EMS arrived; Handoff report given; EMS assessed; client sitting; ; client offered transport to local ED and declined 1430 Client moved back into chair; BP 136/94 P 94 R 12 SpO2 99% 1440 Client stated she was starting to feel light headed again. Moved to floor and legs elevated again. BP 140/90 P 87 R10; Resps unlabored; A&O x3; skin cool pink dry; 1445 BP 136/108 P 85 R 10 ; continues supine with legs elevated; requested that client find someone to drive her home rather than drive self; client contacting boyfriend 1450 BP 140/108 Client states she feels fine but would like to remain on the floor sitting up. 1500 Client moved to chair for further observation; VS assessment discontinued 1530 Client remains in obs and waiting for ride

Other Meds: None

Current Illness:

ID: 0959353
Sex: F
Age: 45
State:

Vax Date: 01/11/2021
Onset Date: 01/17/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Amoxicillin

Symptoms: 6 days after vaccine she developed recurrent soreness in the arm where she got the shot and hives on her legs. These resolved within 24 hours without intervention.

Other Meds: None

Current Illness: None

ID: 0959354
Sex: F
Age: 64
State: TX

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

Lab Data: None

Allergies: Sulfa

Symptoms: 1/19/2021- Sore left arm at injection site 1/20/2021- Fever (100.2), aches, chills, strong headache, occasional nausea

Other Meds: Atenolol, L-Thyroxine, Valacyclovir, Fluticosone, multi-vitamin, Cetirizine, Biotin

Current Illness: None

ID: 0959355
Sex: F
Age: 41
State:

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

Lab Data: none taken or necessary.

Allergies: none

Symptoms: tingling tongue immediately after but checked by medics and nothing serious. told to take an antihistamine. later that eve itchy eves and the next day a bad mood and my tongue peeled a little, briefly. all pretty mild though.

Other Meds: vitamins c, d, b, 5mthf, coq10, red marine algae, selenium, zinc, magnesium, parsley, echinacea, elderberry, glucosamine and chondroitin, also am on hrt, took valciclovir for cold sores a week or so before

Current Illness: none

Date Died: 01/14/2021

ID: 0959356
Sex: F
Age: 89
State: MN

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

Lab Data: unknown

Allergies: n/a

Symptoms: Pt passed away the day after the vaccine was given.

Other Meds: N/A not a resident at the living center.

Current Illness: n/a

ID: 0959357
Sex: F
Age: 23
State: TX

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

Lab Data: None

Allergies: NKA

Symptoms: Staff member reported symptoms started 5 hours after receiving her vaccination on 1/19/2021. She reported fever 102.1F took 1,000mg Tylenol and temperate went down 99F. Currently 98F without medication. She also headache, body aches and chills and continues to feel symptoms but headache is improved.

Other Meds: multi-vitamin

Current Illness: None

ID: 0959358
Sex: F
Age: 76
State: CA

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

Lab Data: None

Allergies: Shellfish Penicillin

Symptoms: On January 18th at 1:00 am, I had a fever, headache, and horrible body aches in every joint and part of my body. I had Covid in June 2020, and 10 days prior to the test on the 17th, I was tested for antibodies, and I still had them 6 months later. Presently, my fever has subsided, headache persist, and my aches are not as bad.

Other Meds: None

Current Illness: none

ID: 0959359
Sex: F
Age: 40
State: CA

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

Lab Data: Went to Emergency Department on 1/10/21

Allergies: None

Symptoms: Delayed anaphylaxis after receiving the vaccine. Symptoms including hives, shortness of breath, and felt like her throat was closing. Her initial symptoms included hives which began 6 hours after receiving the vaccine. This eventually progressed to anaphylaxis and she went to the ED 2 days later.

Other Meds: Albuterol HFA inhaler

Current Illness: None

ID: 0959360
Sex: M
Age: 56
State: CA

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

Lab Data:

Allergies:

Symptoms: Body aches, headache

Other Meds:

Current Illness:

ID: 0959361
Sex: M
Age: 52
State: CA

Vax Date: 12/31/2020
Onset Date: 01/02/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Non-stop ringing in ears

Other Meds: Rosuvastatin 10mg

Current Illness: N/A

ID: 0959362
Sex: M
Age: 88
State: CO

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

Lab Data:

Allergies: Penicillin

Symptoms: Day 8 after injection icing and redness

Other Meds: New script starting 1/14//2021 Minocycline 100mg cap once a day

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm