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: 0959363
Sex: F
Age: 23
State: CA

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

Lab Data:

Allergies: None

Symptoms: 6 days later I noticed a rash around my injection site. The rash started getting much worse and became very red and my arm had hives all around the injection site. It burns and is very swollen. The rash has gotten bigger on my upper left arm.

Other Meds: Advair, Flonase, Allegra

Current Illness: None

ID: 0959364
Sex: F
Age: 50
State: NM

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

Lab Data: none

Allergies: Bactrim, garlic

Symptoms: perioral numbness with HA. Difficulty swallowing & breathing. Pt felt it was likely due to the N95 mask. Given procedural mask and reported improvement of symptoms. Rapid response contacted. No other intervention

Other Meds: levothyroxine 88mcg qam

Current Illness: unknown

ID: 0959365
Sex: F
Age: 32
State: NJ

Vax Date: 01/13/2021
Onset Date: 01/15/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Palpitations. When I check with my Apple Watch, it shows PVCs

Other Meds: None

Current Illness: None

ID: 0959366
Sex: F
Age: 53
State: IA

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

Lab Data:

Allergies:

Symptoms: When receiving the 2nd dose today, the patient commented that the Shingles vaccine she received within a week of her first dose of the COVID19 Pfizer vaccine was more painful. Patient had not disclosed she had received a vaccine within 14 days of her 1st dose.

Other Meds:

Current Illness:

ID: 0959367
Sex: F
Age: 0
State: NY

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

Lab Data:

Allergies: no allergies

Symptoms: Patient was vaccinated and within 10 minutes bilateral hands started swelling, chest tightness as well. Patient took 100mg benadryl po and within 15 minutes swelling decreased. Speaking with patient at 1654 patient denies any symptoms and hand swelling and chest tightness are completely gone.

Other Meds: flonase spray nostril daily. penicillin 500mg tid

Current Illness: positive for streptococcal on 1/11/21

ID: 0959368
Sex: F
Age: 49
State: NY

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

Lab Data:

Allergies: allergy to shrimp

Symptoms: Pt reported tongue feeling swollen 10 minutes after receiving vaccine. Physical exam normal, vital signs stable. Denies SOB, CP, NVD, difficulty swallowing. Monitored for 45 minutes, vital signs remained stable. Gave benadryl 50 mg, symptoms resolved.

Other Meds:

Current Illness:

ID: 0959369
Sex: F
Age: 45
State: MT

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

Lab Data:

Allergies:

Symptoms: Vomiting, Diarrhea, Fever, & Body Aches

Other Meds:

Current Illness:

ID: 0959370
Sex: F
Age: 39
State: TN

Vax Date: 12/24/2020
Onset Date: 12/25/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data: None.

Allergies: "NKDA"

Symptoms: Pt reports around day 1 or 2 after receiving 1st dose of Moderna, the injection site became irritated and began itching. Pt states on day 6 her symptoms resulted into cellulitis. Pt stated she called her PCP and informed him of symptoms. Pt stated she is a doctor and she did not go in to be seen by her PCP. Pt reports to taking Zertec and Benadryl and noticed relief of symptoms after 48 hours of taking medication.

Other Meds: "None"

Current Illness: "None"

ID: 0959371
Sex: F
Age: 25
State: CA

Vax Date: 01/07/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None.

Allergies: None.

Symptoms: 1/18/21, red and irritated, didn't feel anything. This morning 1/20/21 was inflamed, the area of the vaccine is red, irritated and size of her fist. From the area of the vaccine to her forearm, numb/tingling feeling. No treatment. Symptoms persist

Other Meds: Pregablin, Yazmine BC.

Current Illness: None.

ID: 0959372
Sex: F
Age: 27
State: NY

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: injection site itchiness, persistent at least a week after injection. 12 days after shot, noticed red raised skin around the area of injection (like hives), and skin temperature of the area was significantly warmer than the rest of skin. Other than arm soreness the day after injeciton, no other side effects noticed.

Other Meds: ZOLOFT 10mg Zyrtec Vitamin D Vitamin C

Current Illness: n/a

ID: 0959373
Sex: F
Age: 58
State: WI

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

Lab Data: Noe done.

Allergies: Family Hx of Malignant Hyperthermia

Symptoms: I started out with an itchy chin. The itch then went to my forehead, scalp, cheeks and left ear pinna. The tip of my tongue also became numb. Symptoms lasted for 45 minutes.

Other Meds: Levothyroxine, Paroxetine, Lisinopril, Metformin, Glipizide, Women's Multiple Vitamin

Current Illness: None

ID: 0959374
Sex: F
Age: 31
State: TX

Vax Date: 01/13/2021
Onset Date: 01/15/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: MRI

Allergies: environmental allergies

Symptoms: pt stated she started having body aches, headache, chills same day after vax. 3 days after vax pt started having extreme back muscle spasms. 4 days after vax pt had crushing feeling and sensation in back. 5 days after vax pt is not able to touch spot where she had her epidural and started having electrical shocking sensations down her back. pt visited a message therapist that said her back was inflamed and to see a chiropractor which did an adjustment and was told to keep back iced. pt has kept her PCP informed w/ symptoms so Dr. ordered her an MRI. Results did not show any reason to have electrical shocks so pt was told to take ibuprofen and keep back iced. On 1/19 pt is still having electrical shocks and stated she feels like her nerves are going haywire. Pt said her skin feels like bugs are crawling on her. Pt is in a lot of pain and was told to get a referral to see a neurologist in a week if not any better.

Other Meds: Humalog through pump, metformin, Zyrtec, Flonase, multivitamin, vitamin C, Vitamin D, Zinc, Calcium, Beist hormone replacement estrogen cream.

Current Illness: none

ID: 0959375
Sex: F
Age: 27
State: AR

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

Lab Data:

Allergies: no

Symptoms: 1/14 woke up with chills, fatigue, fever 101

Other Meds: Birth control

Current Illness: no

ID: 0959376
Sex: F
Age: 26
State: CA

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

Lab Data: N/A

Allergies: seasonal/environmental allergies

Symptoms: Had minor side effects the night of getting the injection (i.e. sore arm, headache) But on the morning of 1/19, a full week later, when waking up and rolling onto that arm, the injection site felt bruised suddenly. (Didn't have any arm soreness after day 2). It was a small solid bump that was slightly swollen, red, and occasionally itchy

Other Meds: norgestimate and ethinyl estradiol tablets (Daily) aller-tec nasacort

Current Illness: N/A

ID: 0959377
Sex: F
Age: 62
State: SC

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

Lab Data: n/a

Allergies: NO KNOWN ALLERGIES

Symptoms: Redness/Warmth at injection site

Other Meds: Nicotine Patch 24 Hour 14 MG/24HR Apply 1 patch transdermally one time a day for Smoking Cessation for 2 Weeks and remove per schedule Nicotine Patch 24 Hour 21 MG/24HR Apply 1 patch transdermally one time a day for Smoking Cessation for 2

Current Illness: N/A

ID: 0959378
Sex: F
Age: 47
State: CA

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

Lab Data: EKG 1/8/21 and 1/9/21 Event monitor 30 day in process. Echocardiogram 1/18/21.

Allergies: NKA

Symptoms: I received the vaccine in the afternoon of Jan 6th. Approximately 45 minutes to an hour later I felt lightheaded and like I was going to pass out. After a bit I felt a little better but remained dizzy and lightheaded. On the 7th I continued to feel dizzy and lightheaded throughout the day. I was sitting down on a call in the afternoon when my Apple watch vibrated and indicated my heart rate was below 50 for 10 minutes. I checked my heart rate and it was 38 - 48 BPM. On the morning of the 8th I reported my persistent symptoms to Dr. and an EKG was done showing a heart block. I have had bradycardia for the past year and likely the heart block but was not symptomatic until after I took the vaccine. See next pg

Other Meds: multivitamins

Current Illness: None

ID: 0959379
Sex: F
Age: 76
State: AL

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

Lab Data: not sure

Allergies: penn, codeine

Symptoms: Patient said she felt the meds going into her system after the vaccine was given and she became dizzy. Her vital signs were taken over a course of 30 minutes and her blood pressure kept getting higher and higher to 210/140/ Pulse 55 and O2 sat was 99%. Dr. was called and she recommended pt be taken to the ER by the ambulance. The ambulance was called but the pt ended up leaving in the car with her son. I called both Medical Center and Hospital but pt had not been admitted to the ER this afternoon.

Other Meds: blood pressure meds

Current Illness: high blood pressure

ID: 0959380
Sex: M
Age: 53
State: NY

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

Lab Data: None

Allergies: none reporred

Symptoms: Inadvertent and prematurely administered second COVID-19 vaccine of the incorrect manufacturer, resulting in no harm or adverse event. First dose of Moderna COVID-19 administered on 12/23/20 and second vaccine dose of Pfizer COVID-19 administered on 1/7/21.

Other Meds: none

Current Illness: none reported

ID: 0959381
Sex: F
Age: 37
State:

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

Lab Data:

Allergies: flagly and cephalexin, latex, carries epi pen.

Symptoms: patient complained of itching to throat and roof of mouth and tingling to tongue. Also had rash to chest and neck and itching. Patient complained of symptoms becoming worse and having to constantly clear throat, epi pen was used and patient transported to the ED via wheelchair.

Other Meds:

Current Illness:

ID: 0959382
Sex: F
Age: 32
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: Rash broke out after one week

Other Meds: no

Current Illness: no

ID: 0959383
Sex: F
Age: 41
State: NY

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

Lab Data:

Allergies: nka

Symptoms: Patient was vaccinated and within 10 minutes bilateral hands became swollen with chest tightness. Patient was given 100mg benadryl po and within 15 minutes her symptoms diminished. at 1700 when speaking with patient she denies any symptoms.

Other Meds: flonase penicillin 500mg tid

Current Illness: positive strep on 1/9/21

ID: 0959384
Sex: F
Age: 22
State: MD

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

Lab Data: N/A

Allergies: Dilantin

Symptoms: Felt faint, appeared pale, sweating. BP95/62, P69. Rested in chair, sweatshirt removed. Symptoms resolved. 2:40pm BP114/80, P69. Patient also reported slight metallic taste in mouth & slight tightness in chest with deep breath. Stated was "fine" @2:50pm & was talking & laughing w/fellow patient. Escorted ambulatory to car driven by co-worker.

Other Meds: BCP

Current Illness: None

ID: 0959385
Sex: F
Age: 45
State: MT

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

Lab Data:

Allergies:

Symptoms: Vomiting, Diarrhea, Fever, & Body Aches

Other Meds:

Current Illness:

ID: 0959386
Sex: M
Age: 53
State: OR

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: Redness, swelling, warm to touch, 2 inch diameter, feels muscle soreness in hand and wrist,

Other Meds:

Current Illness:

ID: 0959387
Sex: F
Age: 51
State: IL

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

Lab Data: Unknown- patient taken to Emergency Department for follow-up

Allergies: unknown

Symptoms: Patient presents back to the COVID clinic approximately one hour post vaccine with chief complaints of total body urticaria and light headed

Other Meds: unknown

Current Illness: unknown

ID: 0959388
Sex: F
Age: 49
State: NY

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

Lab Data:

Allergies: shrimp

Symptoms: Pt reported feeling like her tongue was swelling 10 minutes after receiving vaccine. Physical exam normal. Vital signs stable. Benadryl 50 mg PO administered. Vital signs remained stable. Pt monitored by physician, NP and EMS. Pt tolerating liquids. Pt denies chest pain, shortness of breath, numbness/tingling, difficulty swallowing, nausea/vomiting. Pt reported resolution of symptoms within 10 minutes after Benadryl administered.

Other Meds:

Current Illness:

ID: 0959389
Sex: F
Age: 35
State: MA

Vax Date: 12/26/2020
Onset Date: 12/26/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: nka

Symptoms: Staff member's left hand was noted to have a slight twitch about ten minutes after receiving the vaccine. The twitch became more pronounced and involving the entire left arm and within twenty minutes her fingers had become hyper-flexed and erect (looked like swan neck deformity). She tried pressing down and stretching the fingers to no avail. 12:40 she was asked to accompany this writer to another observation area for closer monitoring. When she stood up from the chair, she was frozen and unable to move her left leg on command and needed physical assistance from this writer to ambulate. She became weak and needed the assistance of another nurse to be laid on the stretcher. VS were taken 98/64,117,22. (VS prior to administration of the vaccine 124/89,130,18. At this time we offered to send her to ED for further evaluation but staff declined stating, "this has happened before, it will go away". It was agreed upon that if symptoms worsened or showed no improvement in 5 minutes EMS would be activated. 12:50 VS 130/83,89 , tremors dissipating, fingers back in normal position , she was able to move her left leg on command and stand unassisted. She continued to be monitored and all symptoms gone by 1:10 when she was able to leave the facility on her own.

Other Meds:

Current Illness:

ID: 0959390
Sex: F
Age: 75
State: CA

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

Lab Data:

Allergies:

Symptoms: After vaccination, complained of tongue feeling thick and being lightheaded. Benadryl 25mg PO administered and patient observed by onsite RN and paramedic. Pt improved and safely discharged home.

Other Meds:

Current Illness:

ID: 0959391
Sex: F
Age: 47
State: UT

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

Lab Data: N/A

Allergies: NKDA

Symptoms: Chills, left arm pain, stomach discomfort, low grade fever, body aches

Other Meds: vitamin D, progesterone

Current Illness: None

ID: 0959392
Sex: F
Age: 30
State: TN

Vax Date: 12/30/2020
Onset Date: 01/08/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None.

Allergies: Seasonal allergies, mild rash to neosporin (& all active components), sensitivity to serotonergic drugs (like zoloft, buspar, dextromethorphan, etc...) resulting in excess vasodilation and bleeding under skin/in joints after several days, developed mild small rashes on torso/limbs from taking lamictal about four days (still have occasional rashes appear when body under stress or when sick)

Symptoms: Mild rash, about 3.5 inches diameter, started on left deltoid around injection site, pink and raised 1cm splotches. Arose after hot shower. In about 1 hour, became one big rash, darker pink. Itched some/burned slightly. Felt in quality similar to lamictal rashes patient previously experienced. Rash lasted about 3 days and slowly expanded by about 2 inches in diameter, fading and itching less, until gone. Applied hydrocortisone cream after about 1 day to relieve itching. Rash otherwise resolved with no first aid/other attention.

Other Meds: Prescription of testosterone cypionate 200 mg/mL take 0.25 mL once every 2 weeks by intramuscular injection. Was taken exactly 1 week prior. Had taken for approximately 5 years with no issues.

Current Illness: None.

ID: 0959393
Sex: F
Age: 73
State: TX

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

Lab Data:

Allergies: Allergic to all antibiotics except zpack and most pain meds and muscle relaxants Allergic to coffee, tea, red wine

Symptoms: In 14 minutes facial cheeks,nose, lips tingling and num accompanied with dizziness-nurses evaluated with elevated blood pressure and very high heart rate-EMTS also evaluated & said I could go to hospital for observation but I refused. I remained for hour with unchanged symptoms-left took a Benadryl and it helped with tingling. For remaining 36 hours was short of breath and difficulty swallowing. Continued on Benydril for 2 days-olater symptoms were side effects fatigue headache, joint pain, chills, tenderness at injection but mild

Other Meds: ZyrtecD Armour thyroid Tylenol

Current Illness: No known illness

ID: 0959394
Sex: F
Age: 59
State: IL

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

Lab Data: none

Allergies: none

Symptoms: 48 hours after second vaccine I woke up with pain under my left arm (arm I got the vaccine in) lymph node. Sore and tenderness lasted 24 to 36 hours.

Other Meds: Levothyroxine 50mcg Hctz 50mg

Current Illness: no

ID: 0959395
Sex: F
Age: 24
State: IN

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Dairy sensitivity Latex sensitivity

Symptoms: -fatigue -severe muscle aches -headache -nausea -dizziness/syncope -hot flashes/chills

Other Meds: Sprintec

Current Illness: Unspecified respiratory virus

ID: 0959396
Sex: F
Age: 79
State: MN

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

Lab Data:

Allergies: Fentanyl, Rofecoxib

Symptoms: 1/19/21: ER visit for evaluation 1/20/21: Hospital admit due to increased confusion and possible sepsis. Principle Problem listed: Systemic inflammatory response syndrome (sirs) of non-infectious origin without acute organ dysfunction; Acute encephalopathy SIRS likely due to COVID-19 vaccine but no current evidence of acute infection. Her acute encephalopathy is likely due to her SIRS response in the elderly and does not require acute intervention other than support.

Other Meds: Aripiprazone, Atorvastatin, Clonazepam, Trazodone, Loperamide, Pilocarpine, Clopidogrel, Culturelle, Desvenlafax, Lisinopril, Modafinil, Vitamin B-12, Caltrate, Metformin, Methylphenid, Vimpat

Current Illness:

ID: 0959397
Sex: F
Age: 23
State: MT

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

Lab Data:

Allergies:

Symptoms: Headache & Nausea

Other Meds:

Current Illness:

ID: 0959398
Sex: F
Age: 38
State: FL

Vax Date: 12/23/2020
Onset Date: 12/30/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data: n/a

Allergies: n/a

Symptoms: Left axillary lymphadenopathy

Other Meds: n/a

Current Illness: n/a

ID: 0959399
Sex: F
Age: 75
State: WA

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

Lab Data: unknown. We were not notified of this event at the time it occurred (only recently did the patient's husband reach out to let us know) and it does not appear that they sought formal medical evaluation/treatment other than the hospice nurse (unclear who that was or what his/her evaluation was/revealed).

Allergies: latex, PCN

Symptoms: Patient confirmed she had no history of severe allergic reaction to a prior vaccine or any of the ingredients in the Moderna vaccine prior to vaccination which was performed 1/7/2021 without complications and she was observed for 15 minutes post vaccination without any adverse reaction. Her husband reported that she was well until the evening following her vaccination (1/08/2021) at which time she became agitated. The following day she became very fatigued and unresponsive, taking only sips of water. The only medical attention they sought at this time was a home health hospice nurse as the patient had been on hospice. Her condition spontaneously improved without treatment after 3 days and 6 days after her vaccination she was at her normal baseline.

Other Meds: Amantadine, Carbidopa, Entacapone, Sertraline, trazadone, TMP-Sulfa, vitamin D3

Current Illness: none disclosed at time of vaccination

ID: 0959400
Sex: F
Age: 38
State: IA

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

Lab Data: CT Scan 01/08/2021 Blood tests in ER on 01/08/2021 MRI 01/08/2021

Allergies: None

Symptoms: 12 hours after vaccination began experiencing fever, chills, body aches, slight head ache - lasted around 12 hours Had slight pain above eye prior to getting vaccination Saw PCP on 01/08/2021 due to eye pain - had CT scan for possible aneurysm, found 2 spots on brain, thought patient had shingles On 01/10/2021 shingles rash appeared

Other Meds: None

Current Illness: None

ID: 0959401
Sex: M
Age: 36
State: OK

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

Lab Data: EKG and Echo Covid tests negative on 1/13/2021 and repeat 1/14/2021 CT Chest - positive for multiple pulmonary embolus CXR US Doppler lower/upper limbs

Allergies: None

Symptoms: I was having episodes of dyspnea and non productive cough starting from 1/1/2021. On 1/13/2021 I experienced severe dyspnea and had loss of consciousness for 5 seconds and was found down. I was rushed to the hospital and diagnosed with multiple pulmonary embolus (about 9) which was treated with direct TPA via catheterization. I then recovered in the ICU and transitioned to oral anticoagulation and discharged home on 1/15/2021.

Other Meds: Multivitamin

Current Illness: None

ID: 0959402
Sex: F
Age: 54
State: MA

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

Lab Data: Chest x-ray at the ED 1/20/21 negative

Allergies:

Symptoms: Recipient reported waking with chest tightness, chills, heart racing, pulse- 124-126, shortness of breath chocking sensation and dry throat. Worried about her breathing, she went to the emergency department, blood pressure taken- 183/103. She was given IV fluids and recommended follow up with PCP.

Other Meds:

Current Illness:

ID: 0959403
Sex: F
Age: 45
State:

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

Lab Data: none

Allergies: none

Symptoms: "Moderna COVID-19 Vaccine EUA" Body aches and fatigue for 12-15 hours starting about 18 hours after injection. Sore arm for 72 hours starting 3 hours after injection.

Other Meds: Daily RX meds: Levothyroxine 75mcg, Liothyronine 10, Low Dose Naltrexone, progesterone, hydrocortisone 10mg Supplements: iron, multivitamin, A-drenal, fish oil, magnesium, vitamin D

Current Illness: none

ID: 0959404
Sex: M
Age: 29
State: CA

Vax Date: 01/06/2021
Onset Date: 01/09/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: CBC, Lipid. Contact the doctor may get a copy of the results.

Allergies: No known allergies before this event

Symptoms: Rash with itchiness in the face, neck, arms, groin, shaft of the penis, scrotum, swelling of the upper and lower eyelid and face. Denied any neurologic symptoms, cardiovascular or respiratory symptoms. the itchiness and the rash is intense. the rash can be notice from distance. Consulted the primary care Dr. and was prescribed a course of prednisone of 10 day taper starting at 50 PO mg/day.

Other Meds: Vitamin D3 generic. One tablet a day unclear the strength.

Current Illness: None. Report a good health status. Practicing keto diet at the time of the event

ID: 0959405
Sex: F
Age: 32
State: MT

Vax Date: 12/30/2020
Onset Date: 01/06/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Redness at injection site (without pain), approximately 2x3 inches. Appeared about a week after vaccination and lasted about a week. Also, slight pain in armpit (no swelling) that appeared and lasted the same amount of time.

Other Meds: Stelara, oral birth control

Current Illness: None

ID: 0959406
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: none.

Allergies: amlodipine, iodine and contrast

Symptoms: Globus feeling - feeling like "something caught in her throat", tingling lips, tongue felt "weird", tingling in legs. Patient was monitored for approximate one hour total in the clinic. Patient vital signs were stable at the beginning and continued to be stable. No other signs or symptoms of an allergic reaction.

Other Meds: sucralfate, cetirizine, fluticasone nasal spray, conjugated estrogens cream, hydrochlorothiazide, losartan, aspirin, levothyroxine, pantoprazole, meclizine, Zofran

Current Illness: recent visit for symptoms of unknown cause

ID: 0959407
Sex: F
Age: 50
State: MI

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

Lab Data:

Allergies: None

Symptoms: Swollen and very painful lymph nodes in neck, under arm, and upper chest swelling all on side of injection. All accompanied by the usual fever, body, and joint aches which subsided at 48 hours after injection. Swollen and very painful lymph nodes in neck, under arm, and upper chest swelling still present.

Other Meds: Celexa Atorvastatin Myrbetrique Mobic

Current Illness: None

ID: 0959408
Sex: F
Age: 63
State: SC

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

Lab Data:

Allergies: None

Symptoms: Diarrhea

Other Meds: Ozempic, sertraline, doxycycline

Current Illness: None

ID: 0959409
Sex: F
Age: 1
State: IA

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

Lab Data: N/A

Allergies: NA

Symptoms: Mother reported large red lump on L) thigh & fever on 1/14/2021. Lump remains on thigh when reassessed on 1/18/2021

Other Meds: NA

Current Illness: NA

ID: 0959410
Sex: F
Age: 52
State: AL

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

Lab Data: Dr. has ordered patch test for polyethylene glycol to be administered prior to dose 2. Patient tolerates AIMOVIG which also contains polysorbate 80.

Allergies: None

Symptoms: 11 days post vaccination, patient developed local skin reaction - rash, warmth, redness - at site of injection. Patient had experienced itching off and on since vaccination but noticed rash had developed in the AM on 1/20/21. Patient had appointment for allergy injections with allergist so discussed with Dr.

Other Meds: Aimovig 140 mg SQ monthly, nurtec 75 mg PO PRN, naratriptan 2.5 mg PO PRN, singulair 10 mg PO daily, zyrtec 10 mg PO daily, Junel 1/20 1 PO daily

Current Illness: none

ID: 0959411
Sex: F
Age: 31
State: ME

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

Lab Data: unknown

Allergies: Amoxicillin and Penicillin

Symptoms: Approximately 10 to 15 minutes post injection she started feeling hot, then patient began to become flushed . I gave her oral benadryl 50 mg and 40 mg of famotidine oral. The difficulty in breathing did not lessen. She began to use her accessory muscles. Her O2 sats were 99% via finger pulse oximeter. Breathing became increasingly labored. An Epi pen 0.3 mg was administered. An ambulance was called. Her breathing became less labored, she was transported to the hospital via ambulance to be checked out.

Other Meds: Unknown

Current Illness: unknown

ID: 0959412
Sex: F
Age: 47
State: NH

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

Lab Data:

Allergies: Amoxicllin

Symptoms: patient had experienced redness in upper chest and broke out into hives shortly after receiving the Vaccine. At 3:20 p.m. Five Minutes after receiving the vaccine the patient took 50mg of Benadryl that she had brought with her to the clinic. Heart Rate 120 and Blood Pressure 174/96 at this time Patient Heart Rate 100 and Blood pressure 150/90 at 3:40 p.m.

Other Meds: Amitriptylene 50mg, loratadine 10 mg

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm