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: 0959463
Sex: F
Age: 30
State: CA

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

Lab Data: n/a

Allergies: Latex allergy, pineapple food allergy

Symptoms: Lethargy/fatigue, chills, soreness at injection site. Soreness and lethargy lasted approximately 3 days after the vaccine was administered. Chills lasted just the first day that the vaccine was administered.

Other Meds: Prenatal vitamins, Zyrtec, Flonase

Current Illness: n/a

ID: 0959464
Sex: F
Age: 21
State: CA

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

Lab Data:

Allergies: None.

Symptoms: Day of Vaccination (1/12): immediate headache, fatigue 1/13: Severe fatigue, headache, fever, severe body ache, inflammation where shot was administered (large, red circle - extremely itchy - left arm ) 1/14: fatigue, headache, severe body ache, rash and itching to injection site (left arm) 1/15: fatigue, headache 1/19: rash to upper left arm, extremely itchy 1/20: rash to upper left arm, extremely itchy

Other Meds: None.

Current Illness: None.

ID: 0959465
Sex: F
Age: 48
State: MI

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

Lab Data: unknown- client taken to hospital by EMS.

Allergies: sensitivity to avocado

Symptoms: Client received vaccine at end of our clinic day around 4:05 pm. No history of severe allergies, only prior sensitivity to Avocado. During clients 15 minute wait she stepped outside complaining of being hot. A nurse provided water for client, as well as juice. She stated she felt better. Nurse accompanied her back in side, and went over other signs and symptoms of anaphylaxis. Client stated she was not experiencing any of those symptoms and that she felt better. When her wait was complete, she walked to the coat room with other employees, and her throat and ears began to itch, and she was coughing to help itch her throat. At this time the vaccine director was alerted and anaphylactic protocol was initiated. EMS was called- the time was 4:37 pm, pulse was 80, blood pressure was 178/108. 4:39- client refused epi, so 1mL/50Mg, IM Benadryl was given in the right deltoid. Simultaneously, a tourniquet was placed above the vaccine site on the left deltoid. Distal pulses monitored in left arm every 5 minutes. 4:41 itching and coughing increased, client agreed to Epi. 0.3 mg Epi pen given in right thigh. EMS arrive and transported client to hospital for observation.

Other Meds: unknown

Current Illness: unknown

ID: 0959466
Sex: F
Age: 31
State: MT

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

Lab Data:

Allergies:

Symptoms: Fever, Body Aches, Vomiting

Other Meds:

Current Illness:

ID: 0959467
Sex: F
Age: 29
State: TX

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

Lab Data:

Allergies:

Symptoms: client reported tingling sensation down the left arm approximately 15 minutes after vaccination; seen & cleared by EMS. B/P-125/75, P-87

Other Meds:

Current Illness:

ID: 0959468
Sex: F
Age: 45
State: AR

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

Lab Data: 1/20/2021 Sought medical attention from PCP. Was prescribed steroids and was recommended to not take the booster shot due to the adverse reaction of the first shot.

Allergies: None

Symptoms: 1/17/2021 2:00pm Vaccine administered, abiding by the CDC and ADH guidelines for safe distancing and masks. Looked at injection site and it looked normal, just a little red dot where the needle was directed to administer the vaccine. 7:00pm arm started to itch at injection site. Looked at site and it was a large red spot, warm to touch and had a large knot under the red injection site. Itching continued through the night isolated primarily to my upper extremities (arms, chest, face) region. Did not take Xyzal that night for fear of some type of interaction. 1/18/2021 6:00am awoke to more facial itching and took a shower. Noticed red splotches in the T zone of the face. More isolated around my eye lids, a section on my forehead, on the right side of the bridge of my nose, and my laugh lines on my face from the bottom of the nostrils down both sides of my mouth to my chin. Arm was sore, which I had expected and the spot was more red than the previous day, still warm to touch, and knot was still present. 7:30am Got to work and my took a 1/2 tablet of Xyzal since I can't function on a whole dose of that or Benadryl for a work day. Itching subsided for about 4 hours. 1:00pm Took another 1/2 tablet of Xyzal. Lasted another 4 hours. 6:00pm Itching was back bad enough I took my normal nightly dose of 1 Xyzal table. It seemed to help until morning. Massaged knot on arm and tried to help lessen the soreness of the area. It was tender to touch, but not painful. 1/19/2021 5:30am Awoke to itching, spot still red, knot gone down compared to previous day. Took shower. Noticed that heat seems to bring out the redness in my face and makes the itching start again. Hot showers were not helping apparently. 7:00am Took 1/2 Xyzal, since itching was continuing. Lasted again for about 4 hours. 12:00pm Took 1/2 Xyzal and lasted an additional 4 hours. Thought the itching should be going away. 6:30pm Took normal dosage of Xyzal. Knot still present but not as prominent as previous days. Injection site still red. 1/20/2021 7:30am Went to local PCP for medical opinion and assistance. He gave me a steroid shot and gave me a Prednisne DosPak with a total of 21 steroid tablets to start administering on 1/21/2021. Was advised to not take the second booster of the Moderna Vaccine and to see advice as to the recommend course for vaccination of Covid-19 since I had an allergic reaction to the vaccine.

Other Meds: Tamoxifen 20mg 1X daily; Venlafaxine ER 75mg 1X daily; Xyzal 5mg 1X Daily; Vitamin E, Vitamin D-3

Current Illness: None

ID: 0959469
Sex: F
Age: 31
State: IA

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

Lab Data: Dopplers, Ultrasound, CT scan

Allergies: NKA

Symptoms: Employee received her 2nd Pfizer vaccine on 1/12/2021. Twelve hours later she developed a fever with a T-max of 102 degrees. The fever lasted 18 hours. She also complained of severe malaise and fatigue lasting 36 hours. On day 3 she developed left lower extremity pain that persisted over the weekend. She was seen in Urgent Care today where she was diagnosed with a thrombosis. She also came to the ETC and was ruled out for a PE The employee does have a family history of antiphospholipid in her mother. She has a follow up with her PCP and will also receive a work up in hematology as she had never been tested for any genetic coagulation conditions after her mom's diagnosis.

Other Meds:

Current Illness:

ID: 0959470
Sex: F
Age: 72
State: MI

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

Lab Data: D-dimer 4.10 at 1500 on 1/20/21 Troponin neg. at 1500 on 1/20/21 Lipase 199 at 1500 on 1/20/21 BNP 18 at 1500 on 1/20/21 INR 1.0 at 1500 on 1/20/21 CMP and CBC - within normal limits CT results pending, ordering diagnosis : suspected PE s/p LTKA, +D-dimer, acute onset chest pain

Allergies: NKDA

Symptoms: Patient seated in observation area after vaccination at 1412. At 1422 patient reported feeling heaviness in chest rated at 7/10 pain scale, mandibular pain, appeared diaphoretic and fatigued, skin grey/pale, though remained alert and responsive to questions appropriately. Patient also communicates she was having some chest pain prior to the immunization today, though she indicated on her forms that she was feeling well today. Vital signs assessed, P72 R16 O2 99, patient denied difficulty breathing. Rapid response protocol initiated, applied 2L O2 via NC, transferred patient to wheelchair and taken to ED for evaluation by response team. ED assessment reveals calf tenderness and patient reporting TKA x 2 weeks ago, elevated D-Dimer, CT results pending at this time.

Other Meds: CELEBREX 200 MG ONE DAILY PRN PERCOCET 5/325 MG ONE -TWO TABS Q 4-6 HRS PRN VITAMIN D 2000 UNITS DAILY ZINC 50 MG DAILY CYMBALTA 60 MG DAILY

Current Illness: TOTAL KNEE REPLACEMENT X 2 WEEKS AGO

ID: 0959471
Sex: F
Age: 25
State: TX

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

Lab Data:

Allergies:

Symptoms: Low Heart Rate Low Blood Pressure Dizzy/Faint Sweaty

Other Meds:

Current Illness:

ID: 0959472
Sex: F
Age: 71
State: CA

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

Lab Data:

Allergies: seasonal allergies

Symptoms: My left upper arm (non-dominant arm) hurts. The problem is that I cannot lift it above my head freely. I must do it very slowly and carefully

Other Meds: simvistatin CoQ10 multi-vitamin fish oil

Current Illness:

ID: 0959473
Sex: F
Age: 47
State: FL

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

Lab Data: None

Allergies: NKDA

Symptoms: During injection, there was leakage either from the syringe or injection site.

Other Meds: None known

Current Illness: None Known

ID: 0959474
Sex: F
Age: 40
State: CA

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

Lab Data:

Allergies:

Symptoms: Patient received her second Pfizer dose and began to complain of stomach cramps, feeling flushed and itchiness in her hands. Patient received 50mg of Benadryl IM and was transported to the hospital via ambulance.

Other Meds:

Current Illness:

ID: 0959475
Sex: F
Age: 56
State: ID

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

Lab Data: None, they were not severe enough to be seen by a medical provider

Allergies: statins, Celiac-intolerance to gluten, intolerance to soy

Symptoms: At first nothing but muscle soreness at the site, but I woke up soon after going to bed feeling nauseated almost threw up, also felt drunk (balance, lack of clear thinking, a little weak, etc). That lasted from about 8 hours after the shot (when it started) to 20 hours after the shot was administered.

Other Meds: My morning meds were taken earlier not at same time; Levothyroxine, Vitamin D, Vitamin C, Multivitamin

Current Illness: none

ID: 0959476
Sex: F
Age: 35
State: NY

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

Lab Data: None

Allergies: Gluten, pseudoephedrine family

Symptoms: Around 30 minutes after vaccine, I started to feel dizzy and light headed As the day went on, I started to get a headache and get very tired. Then around 5 I started to feel intense: Headache Chills/cold Dizzy/light headed/almost fell over several times Muscle weakness, could not carry anything or lift Muscles in face felt like they were melting down/stroke sensation Exhaustion Sore/achy everywhere Tender left arm where shot was Could not think/memory was gone/could not put together a sentence Tightness chest/hard to breath Could not keep eyes open Had to lay down and sleep with long pants long sweater, jacket and 3 blankets I woke up the next morning and some of my symptoms were gone except I still felt tired and had some achy ness, pain and left arm hurt and had shooting pain in joints Shooting severe pain in each joint, laster for 3 days, most severe in joints where I received vaccine but also in wrists, shoulder, elbows, hips, knees, ankles At day 5 my left arm is still sore including muscles around injection site

Other Meds: None I take a multivitamin

Current Illness: None

ID: 0959477
Sex: F
Age: 68
State:

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

Lab Data:

Allergies:

Symptoms: Patient reported an "itchy throat" and she said she "felt like my throat has something caught in it." Patient endorsed difficulty swallowing. Patient also endorsed dizziness and a headache that quickly subsided. EMTs on site took a set of vitals, vitals remained stable and within normal limits. Liquid Benadryl was given (20mL -- 25mg). Patient had an occasional dry cough that subsided after bendryl. Reported "not getting worse" and eventually feeling better. Vitals were retaken while sitting in a secluded room to ensure privacy.

Other Meds:

Current Illness:

ID: 0959478
Sex: F
Age: 76
State: MN

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

Lab Data: N/A

Allergies: Morphine

Symptoms: Client had diarrhea x 2 on 1/17/21. Client had extreme fatigue but was afebrile

Other Meds: Calcium 500/Vit D 400 take 1 tab po BID

Current Illness: N/A

ID: 0959479
Sex: F
Age: 38
State: SC

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

Lab Data: none

Allergies: Rashes - Levaquin

Symptoms: general fatigue (sleepiness), muscle aches, headache, left arm sore - 2-3 days and then the symptoms resolved

Other Meds: Multi Vitamins

Current Illness: none - except adverse event symptoms from Pfizer Dose 1

ID: 0959480
Sex: F
Age: 73
State: FL

Vax Date: 01/05/2021
Onset Date: 01/15/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: One week after vaccination developed elevated itchy rash about 3 inches in diameter has persisted for 6 days

Other Meds:

Current Illness: Atorvastatin , amlodipine

ID: 0959481
Sex: F
Age: 31
State: MT

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

Lab Data:

Allergies:

Symptoms: Fever, Body aches, & Vomiting

Other Meds:

Current Illness:

ID: 0959482
Sex: F
Age: 48
State: VA

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

Lab Data: n/a

Allergies: Penicillin Sulfa

Symptoms: body rash, lip swelling and tingling

Other Meds: unknown

Current Illness: none

ID: 0959483
Sex: F
Age: 43
State: CA

Vax Date: 01/11/2021
Onset Date: 01/16/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: SEA FOOD

Symptoms: VACCINE WAS GIVEN 1/11/2021. WAS SEEN BY ME WITH CELLULITIS OF THE LEFT ARM 1/19/2021 AT EXER-RHE BY ME. GIVEN IM ROCEPHIN AND KEFLEX PO, AS WELL AS AN INJECTION OF DECADRON. GOT NO BETTER REFERRED TO ER , HOSPITAL ON 1/20/2021,

Other Meds: NONE

Current Illness: NONE

ID: 0959484
Sex: F
Age: 31
State: TX

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

Lab Data: NONE

Allergies: NONE

Symptoms: SWELLING AT INJECTION SITE, RUE, 1 WEEK POST VACCINATION. WENT TO ER AND DIAGNOSIS OF CELLULITIS

Other Meds: NONE

Current Illness: NONE

ID: 0959485
Sex: M
Age: 94
State: CO

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

Lab Data: C&S

Allergies: NKA

Symptoms: Low Back Pain - Assessed by, PA on 1/19/2021 and treated for UTI with Doxycycline 100mg, po, bid X 10 days.

Other Meds: Adult daughter of patient call on 1/19/2021 to report that her father was having low back pain that was only moderately relieved with ibuprofen/acetaminophen, leaving him very uncomfortable. She questioned the timing of S&S onset with rece

Current Illness:

ID: 0959486
Sex: F
Age: 33
State: CA

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

Lab Data:

Allergies:

Symptoms: Lightheaded, SOB, HA; Epi-Pen given and resolved

Other Meds:

Current Illness:

ID: 0959487
Sex: F
Age: 71
State: AZ

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

Lab Data: None. I am going to call my doctor for advice/appointment since I still hope to get the second injection in three weeks since, due to my age and preexisting lung situation, I would likely be at great risk if I contracted covid. Q. Will ask about possibly getting an epi pen? Q. If it?s ok to get the second injection in three weeks, monitoring for only 15 minutes will be inadequate. Q. Is a parking lot distribution site adequate for my second dose?

Allergies: Torsemide, Lyrica, Gabepentin, Cymbalta, Cefdiner and possibly Penicillin

Symptoms: I felt fine while monitored in the parking lot for 15 minutes following injection. On my way home at 25 minutes post injection I had an over-all body wave-type feeling (somewhat similar to a sustained hot-flash) and over-all disconcertingly odd feeling. This lasted about 4 minutes and was followed by shakiness that lasted about 5 minutes (total time a bit less than 10 minutes). Took my bp, pulse, O2 as soon as I got home (approximately 5 minutes post symptoms) and the readings were fine.

Other Meds: Fluconazole 200 mg

Current Illness: I take fluconazole for chronic Valley Fever which is currently dormant.

ID: 0959488
Sex: F
Age: 57
State: NY

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

Lab Data: none

Allergies: Penicillin

Symptoms: She has a history of "severe allergic reaction to the PCN family" - so she took a Benadryl 25 mg prior to receiving the vaccine on 1/15/21. About 15 minutes later she noticed pins and needles sensation on the left side of her face and "in my left ear", denies rash/hives/throat tightness/angioedema/respiratory distress/etc. Patient states it lasted "for awhile" was mild and never evolved into anything more serious. However after I asked her about any other symptoms she states the left side of her face is still numb to a "very mild extent".

Other Meds: none reported

Current Illness: none reported

ID: 0959489
Sex: F
Age: 24
State: NH

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

Lab Data: none

Allergies: Singulair

Symptoms: VR described a brief syncopal episode several minutes after injection. VR feels almost entirely back to normal after event. She has a history of syncope with injections. She improved without any treatment.

Other Meds: Norgestimate and ethyenyl estradiol (OCP)

Current Illness: none

ID: 0959490
Sex: F
Age: 31
State: IA

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

Lab Data: 1/13/2020: COVID-19 PCR negative 1/20/2021: glucose 104, albumin 2.9, ALP 52, ALT 13, AST 24, total bili 0.5, total protein 7.5, Na 139, K 4, Cl 107, CO2 27, Ca 9.3, BUN 5, Cr 0.6. INR 1. WBC 6.1 (52.6% neutrophils, 37.3% lymphocytes, 10.1% mixed cells), Hgb 13.4, Hct 41, Platelets 313. 1/20/2021 d-dimers 2.42 Vascular venous lower extremity duplex: acute total obstruction in the left posterior tibial vein from mid calf to proximal calf CT angio: 1. Pulmonary emboli are not present. 2. Other significant findings: - Focal ground-glass focus is seen in the left apex likely representing a pulmonary arteriovenous malformation. 3. Additional incidental findings as above.

Allergies:

Symptoms: Fever (max 102 degrees Fahrenheit) after 12 hours of the vaccine, lasting for approximately 18 hours total. Accompanied by chills, malaise, myalgias. Continues with mild tiredness and shortness of breath on exertion over the next few days. COVID-19 test done on 1/13/2021 due to severity of symptoms, was negative. 3 days later (1/15/2021) left calf pain with mild edema, subsequently diagnosed (1/20/2021) as a left posterior tibialis complete vein occlusion (DVT). Chest CT done to rule out pulmonary emboli. Anticoagulation prescribed (xarelto).

Other Meds: birth control pill

Current Illness:

ID: 0959491
Sex: F
Age: 60
State: CA

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: unknown

Symptoms: Day 1-3: had headache, generalized itching and swelling of the right side of the face and eyelid. Took Tylenol Day 6: diagnosed with Bells Palsy by PCP 1/8: went to doctors for evaluation by PCP of symptoms currently patient still experiencing swelling of the right side of face and slight itching

Other Meds: unknown

Current Illness: unknown

ID: 0959492
Sex: F
Age: 31
State: IA

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

Lab Data: CT, Doppler, Ultrasound, Labs

Allergies:

Symptoms: Employee received her 2nd Pfizer vaccine on 1/12/2021. Twelve hours after her vaccine she developed a fever with a T-max of 102 degrees. The fever lasted 18 hours. She also complained of severe malaise and fatigue lasting 36 hours. On day 3 (Friday, January 15, 2021) she developed left lower extremity pain that persisted over the weekend. She was seen in Urgent Care today where she was diagnosed with a deep vein thrombosis of the proximal vein. She also came to the ETC and was ruled out for a PE. The employee does have a family history of antiphospholipid in her mother. She has a follow up with her PCP and will also receive a work up in hematology as she had never been tested for any genetic coagulation conditions after her mom's diagnosis.

Other Meds:

Current Illness:

ID: 0959493
Sex: F
Age: 88
State: MN

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

Lab Data: NONE

Allergies: SEASONAL

Symptoms: FEVER, AGITATION, BODY ACHES, FATIGUE

Other Meds: Medications Schedule Med days Assigned Amlodipine 1O MG by mouth 09:00 AM Started: 11/4/19 3:00 PM Daily 1 x a day MC LCM Atrovent 0.06% both nostrils 03:00 PM Started: 11/4/19 3:00 PM Daily 1 x a day Self Benazepril 40MG by mouth 09:00 AM

Current Illness: NONE

ID: 0959494
Sex: F
Age: 28
State:

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Large area of induration, redness and tenderness at site of injection that began 1 week after the dose, lasted about 2-3 days. No fevers, no systemic signs.

Other Meds:

Current Illness:

ID: 0959495
Sex: F
Age: 37
State: CA

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

Lab Data: None

Allergies: NA

Symptoms: Severe body aches, chills, fever 103, fatigue dizziness, headache - symptoms lasted 2days, the third day I had diarrhea and nausea.

Other Meds: Humira, Ativan, multivitamin

Current Illness: Seronegative spondyloacropathy- auto immune disorder

ID: 0959496
Sex: M
Age: 81
State: NC

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

Lab Data:

Allergies: Lisinopril

Symptoms: Patient felt anxious and felt that heart rate was irregular. Patient has a history of afib.

Other Meds: none

Current Illness: none

ID: 0959497
Sex: F
Age: 39
State: MT

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

Lab Data:

Allergies:

Symptoms: Severe Dizziness

Other Meds:

Current Illness:

ID: 0959498
Sex: M
Age: 65
State: CA

Vax Date: 01/11/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None so far

Allergies: penicillin. bee stings

Symptoms: I received the Moderna vaccine on Monday 1/11/21. There was swelling and pain at the injection site which lasted about 4 days. There was NO redness or rash at the injection site for a week. On 1/18/21 in the evening, suddenly a rash appeared which was warmer than the surrounding area. It was tender and about the size of a half dollar. It rapidly grew in size, on 1/20/21 it is now about 3x3.5 inches across and is still growing. I have called the Public Health Dept where I got the vaccination, without getting a response (3 times). I called Moderna, and was given a case Number: MOD21-09316. Batch number was 025J20-2A. They were not able to tell me anything beyond what I could read online. (It is odd that my injection site reaction was delayed a week.) I emailed my doctor and attached a photo. I am waiting to hear back.

Other Meds: synthroid, omeprazol, premarin, doxycycline

Current Illness:

ID: 0959499
Sex: F
Age: 61
State: NJ

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

Lab Data: Covid 19 swab - negative

Allergies: None

Symptoms: Tooth sensitivity Mouth sores - gums, palate, lips, tongue swollen with sores. On and off since vaccination. Lasts several days then dissipates. 3 episodes so far - lasting 2 days. Dental sensitivity has been constant. I have been treating with mouthwashes with some relief.

Other Meds: Synthroid Metformin XR Victoza I have a shingles vaccine 2 weeks prior.

Current Illness: None

ID: 0959500
Sex: M
Age: 1
State: TX

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

Lab Data: NONE

Allergies: None

Symptoms: Clusters of macular splotchy erythmatous rash and existing congestion 6 days after MMR, VARICELLA, HEPATITIS A vaccines. No txt indicated.

Other Meds: None

Current Illness: None

ID: 0959501
Sex: F
Age: 68
State:

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

Lab Data:

Allergies:

Symptoms: Patient reported an itchy throat and like she had something in her throat. Endorsed having trouble swallowing. Patient reported dizziness and headache which subsided. EMTs took set of vitals, remained stable and within normal limits. Patient still reporting throat itchiness. Liquid Benadryl given (20 mL -- 25 mg). Patient had occasional dry cough that subsided. Vitals retaken at 1350. Throat itchness subsided and patient left.

Other Meds:

Current Illness:

ID: 0959502
Sex: F
Age: 78
State: FL

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

Lab Data: none

Allergies:

Symptoms: Extremely sore arm - much more than flu shots and STILL very sore. Ice and Ibuprophen 400 did not help. Chills and shaking so much I put on flannel pj's. Very tired next day. Did almost nothing and took 2 naps. Was still some tired today but better

Other Meds: Benezapril, altorstatin, methotrexate

Current Illness: none

ID: 0959503
Sex: M
Age: 61
State: NY

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

Lab Data: none

Allergies: PCN

Symptoms: rigors, shaking chills, high fever 101.4 to 103 F

Other Meds: losartin 50mg bid

Current Illness: none

ID: 0959504
Sex: F
Age: 89
State: LA

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

Lab Data: None

Allergies: Cortisone, Promethazine, MRI Contrast Dye

Symptoms: 1/20 at 9 Vaccinated--1//20 at 4 patient started feeling--Dizziness, Weakness-Patient took Aleve

Other Meds: Olmesartan 20mg twice daily one tablet morning, half afternoon, Olmesartan 40 mg once daily, Sotalol HCL 80 mg half tablet morning half afternoon, hydrochlorochiazide 12.5 mg once daily, Doxepin 25 mg twice daily, Rosuvastatin 5 mg once eve

Current Illness: None

ID: 0959505
Sex: F
Age: 48
State: CA

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

Lab Data:

Allergies:

Symptoms: Anaphylaxis - received Epi-Pen x 2 and Benadryl 50 mg - resolved.

Other Meds:

Current Illness:

ID: 0959506
Sex: F
Age: 61
State: OR

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

Lab Data:

Allergies: unknown

Symptoms: Headache different than usual headache. Given epi by alternate provider and she said she felt better.

Other Meds: unknown

Current Illness: unknown

ID: 0959507
Sex: M
Age: 25
State: NJ

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

Lab Data: None yet

Allergies: None

Symptoms: Low grade fever presented about two hours after vaccination (99.7- 100.3) Fever went away by next morning, but by noon (15 hours after vaccine) pain in the low back started. No fever but intense pain in back. We believe the vaccine may have triggered a sickle cell crisis.

Other Meds: N/a

Current Illness: None

ID: 0959508
Sex: F
Age: 52
State: FL

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

Lab Data:

Allergies: shellfish nkda

Symptoms: Pt reported feeling light headed and reports swelling of the tongue. Initial BP upon report of complaint is 156/74, repeated BP at 1024 and 134/91 with 97%sp02. Initial spo2 was 97%. Patient received Benadryl 25mg and continued to be observed. Patient was released to home after 30 additional minutes of observation with some symptom relief.

Other Meds: Zyrtec Lo Loestrin Acyclovir 400mg

Current Illness: n/a

ID: 0959509
Sex: F
Age: 80
State: MN

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

Lab Data: N/A

Allergies: NKA

Symptoms: Emesis x 2, diarrhea episodes (unknown number of episodes)

Other Meds: Tylenol 325mg take 2 tab o TID Calcium Citrate + Vit D 315mg/200IU take 1 tab po BID Prilosec 20mg take 1 cap po QHS Senna S take 1 tab po BID Magnesium Chloride 64mg take 1 tab po BID

Current Illness: N/A

ID: 0959510
Sex: F
Age: 40
State:

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

Lab Data:

Allergies:

Symptoms: Patient felt "dizzy and like I am going to pass out." EMTs evaluated and moved patient to a secluded classroom. Patient endorsed feeling better when moved. Patient did lay down on stretcher. Blood pressure was taken and was within normal limits. Increased patient wait time.

Other Meds:

Current Illness:

ID: 0959511
Sex: F
Age: 67
State: MT

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

Lab Data:

Allergies:

Symptoms: Nausea, Injection Site Pain, Swollen Arm

Other Meds:

Current Illness:

ID: 0959512
Sex: F
Age: 33
State: IA

Vax Date: 12/30/2020
Onset Date: 01/02/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: A few days after receiving my vaccine I developed a markedly swollen and tender lymph node above my collarbone on the same side as my vaccine administration (left). I also had some tenderness in my underarm which I blame on a lymph node but was never able to feel a swollen one there. Both my underarm and collarbone area remained tender/sore for about two weeks. No systemic symptoms.

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm