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: 0959613
Sex: F
Age: 48
State: IN

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

Lab Data: none

Allergies: NIL

Symptoms: left axillary swelling, febrile, chills, full body discomfort, headache mostly resolved after 24 hours

Other Meds: pristiq

Current Illness: none

ID: 0959614
Sex: F
Age: 38
State: WI

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

Lab Data: None

Allergies: grapes, blueberries, dust

Symptoms: Patient describes a tingling in her tongue, this is the same reaction she gets with exposure to her other allergens including: grapes, blueberries, and dust. The patient was given 50mg Benadryl and monitored for 1.5 hours. The patient did not report a gradual lessening of symptoms. Patient will be released with instructions for self monitoring and emergency planning if the symptoms get worse. She has had no history of EPI usage for an allergic reaction. She has gone for the

Other Meds: No medications

Current Illness: no past medical history

ID: 0959615
Sex: M
Age: 53
State: RI

Vax Date: 01/14/2021
Onset Date: 01/16/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: NONE

Allergies: MUCINEX

Symptoms: STARTING 48 hrs LATER PAIN RT HIP. THEN WEAKNESS RT LEG ONLY. LED TO 9 FALLS OVER THREE DAY PERIOD. IMPROVED AS OF 1/20/21 HEADACHE ON NIGHT ON VACCINE ONLY.

Other Meds: XARELTO, CLONIDINE, LOSARTAN

Current Illness: FEVER, CHILLS, DIARRHEA, SHAKES X 48hrs DEC 29TH-3 or 4

ID: 0959616
Sex: F
Age: 41
State: CO

Vax Date: 01/14/2021
Onset Date: 01/09/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: US soft tissue neck normal sized lymph nodes not considered pathologic in neck.

Allergies: NKDA

Symptoms: developed tender lymph nodes in neck and above (L) clavicle 1/9/2021 - palpable on exam as shotty Lymphadenopathy anterior cervical with slight rash at injection site

Other Meds: Topical retin A, Kyleena IUD

Current Illness: N/A

ID: 0959617
Sex: M
Age: 75
State: CA

Vax Date: 01/11/2021
Onset Date: 01/14/2021
Rec V Date: 01/20/2021
Hospital: Y

Lab Data: Blood tests, X-rays of right lower extremity and chest, and IV antibiotics were conducted and administered.

Allergies:

Symptoms: On 01/14/2021 patient developed fever and chills and had right leg pain similiar to previous episodes of leg infection, right lower extremity showed mild soft tissue swelling. Chest X-ray showed bilateral perihilar vascular congestion which was new since prior study. Patient's temperature was 40.12 C and blood pressure 193/85. Patient was admitted to Hospital at that time.

Other Meds:

Current Illness:

ID: 0959618
Sex: F
Age: 27
State: NY

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

Lab Data:

Allergies: sulfa antibiotics

Symptoms: Patient reports numbness & tingling with a heavy arm 10 minutes post vaccination. V/S taken WNL. BP-126/92, HR 80, SPO2 98%, RR-18. Patient given electrolytes for rehydration. Patient reports suffering from medical PTSD of 15 years ago. Pt observed for additional 15 minutes. Pt discharged at 1705. BP 126/92 HR 80 O2 Sat -98% Pt reports tingling & numb in (R) fingertips, arms heavy 5lb.

Other Meds: xanax Effexor Lorena Remeron Gralisse

Current Illness: Neck & back pain

ID: 0959619
Sex: F
Age: 44
State: WA

Vax Date: 01/08/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: no

Symptoms: Day 10 large lump appeared / not painful red, hot to touch, & itchy

Other Meds: Irbesartan, pantoprazole, nitrofurantoin

Current Illness: no

ID: 0959620
Sex: F
Age: 79
State: OK

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/20/2021
Hospital: Y

Lab Data: CT, EKG, X-ray, CBC/Chem labs were normal and ruled out acute stroke

Allergies: tamsulosin - unknown, ciprofloxacin PO and fluoroquinolones - throat closure, povidone - iodine -

Symptoms: Eleven hours after receiving COVID vaccine, client started experiencing stroke-like symptoms legs/arm weakness, couldn't speak, shortness of breath, and throat swelling. Hospital ruled out acute stroke but could not entirely exclude a cerebellar stroke due to her dizziness with vertigo and nystagmus (per hospital report). Client was in hospital 2.5 days, per hospitalist. note-all work up including MRI and tte were negative for acute findings- symptoms have resolved. Hospitalist noted symptoms may be worse following second shot. Spoke with client 1/19/21 and she reported feeling weak and tired only.

Other Meds: Atorvastatin 40MG PO DAILY, calcium 1200 MG PO BID, Vitamin D3 400 UNITS PO HS, Metoprolol SUCCINATE 37.5MG ORAL BID

Current Illness: none

ID: 0959621
Sex: F
Age: 34
State: MO

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

Lab Data:

Allergies: Stated had adverse reaction to Influenza vaccination

Symptoms: Patient stated begin 24 hours after initial vaccination experienced fatigue and headache which continued to worsen resulting in inability to function and sleep continuously. Developed Diarrhea 4 days after vaccination. Begin vomiting on Monday 1-18-21. Went to Urgent Care and had a COVID test which came back Negative on 1-20-21 Will see primary care physician this Friday 1-22-21. Still experience Diarrhea, fatigue, headaches and nausea as of 1-20-21. Patient been instructed to rest, drink plenty of fluids and treat symptoms until to be seen by primary care provider

Other Meds: None known

Current Illness: None known

ID: 0959622
Sex: F
Age: 34
State: MT

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

Lab Data:

Allergies: 0

Symptoms: sore arm 1st day felt like a bruise 3rd day - welt size of band aid 4th day - ballsized hard/red/hot lump ?afraid about infection 8th as it resolved she became fatigued/"body drawing! body aches no fever

Other Meds: steroid inhaler & rescue inhaler

Current Illness: menstrating at the same time

ID: 0959623
Sex: M
Age: 17
State: IN

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

Lab Data: No tests were needed/done.

Allergies: UNKNOWN

Symptoms: Vaccine was administered outside the FDA approved age range. There were no adverse events/reactions.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 0959624
Sex: F
Age: 17
State: IN

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

Lab Data: No tests were needed/done.

Allergies: UNKNOWN

Symptoms: Vaccine was administered outside the FDA approved age range. There were no adverse events/reactions.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 0959625
Sex: M
Age: 13
State: GA

Vax Date: 08/11/2020
Onset Date: 08/12/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: Mom reported on 8-13-20 via phone that child had rash on rash on right arm starting 8-12-20. Mom stated she gave oral benadryl. Mom stated 8-13-20 child's face swollen & c/o entire body itcjing. Stated she continued with benadryl. Referred child to MD or ER immed. mom stated child had improvement 8-13-20.

Other Meds: No

Current Illness: No

ID: 0959626
Sex: F
Age: 39
State: CA

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

Lab Data:

Allergies:

Symptoms: Fatigue, body aches, injection site pain, headache

Other Meds:

Current Illness:

ID: 0959627
Sex: F
Age: 39
State: NY

Vax Date: 01/08/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: Latex sensitivity

Symptoms: Typical mild symptoms 24-36 hours after injection (arm soreness, redness and minor swelling at injection site, myalgia, arthralgia, fatigue), all resolved within 73 hours. Day 11 post-injection, re-emergence of urticaria at injection site, red, warm, swollen, about 2 inches in diameter. Day 12/13 post-injection, increased diameter.

Other Meds: Escitalopram, lamotrigine

Current Illness: None

ID: 0959628
Sex: F
Age: 54
State: CA

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

Lab Data:

Allergies: Penicillin

Symptoms: Only had right arm soreness until around 10pm. Around 10pm had a headache, upset stomach and neck was achy. Woke up around 3am with chills off and on for about an hour, achy all on right side of my body, and had a bad headache.

Other Meds: Lisinopril 2.5mg/day

Current Illness:

ID: 0959629
Sex: F
Age: 74
State: MN

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

Lab Data: N/A

Allergies: Ambien Lisinopril Eggs-causes diarrhea when taken with Metformin

Symptoms: Diarrhea x 2 episodes

Other Meds: Aspirin 81mg take 1 tab po QD Calcium + Vit D 600mg/800units take 1 tab po BID Miralax 17gm mix 17gm in 8oz of H20 QD Vit D3 1000IU take 1 cap po QD

Current Illness: N/A

ID: 0959630
Sex: M
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: Medication Administration Error being reported per EUA Fact Sheet for Providers: Patient received Moderna COVID Vaccine as 2nd dose in series in error - First dose was Pfizer. Vaccinator inadvertently used incorrect vaccine and did not realize error until administered. Observation was carried out as per standard practice. No harm to patient. No further action taken or subsequent doses scheduled based on CDC guidance RE: errors with interchangeability (https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html)

Other Meds:

Current Illness:

ID: 0959631
Sex: F
Age: 49
State: GA

Vax Date: 10/21/2020
Onset Date: 10/21/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Chickens

Symptoms: Within 5 minutes of influenza vaccination, Pt came in itching + had facial Flushing. Pt has an allergy to chickens but stated she has never had any trouble with Flu vaccinations.

Other Meds: Benadryl every night

Current Illness:

ID: 0959632
Sex: F
Age: 39
State: CA

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

Lab Data:

Allergies:

Symptoms: Fatigue, body aches, injection site pain, headache

Other Meds:

Current Illness:

ID: 0959633
Sex: F
Age: 29
State: ND

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

Lab Data:

Allergies: Sulfa, amoxicillin, penicillin

Symptoms: Fever of 103.7, severe body aches, chills, vomiting

Other Meds:

Current Illness:

ID: 0959634
Sex: F
Age: 49
State: RI

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

Lab Data:

Allergies:

Symptoms: Pt entered observation @ 1645. @ 1704 states prickles felt on back and arm. States s/s had been going on about 10 mins before she said anything. Benadryl 25mg given @ 1705. Does have allergies to Flu Vaccine, MRI Dye, Vicodin, Buspar, Lisinopril, Suchycin. Celexa, Prev Pack, Lexapro, Penicillin, Hydrocodone, and Fluoxetine. Remains to voice s/s @ 1729. Red Blotchy areas noted to face and neck. Pt states this is normal for her when her anixety level is high. V/S were taken @ 1733 BP-193/105, P-74, R-18, 02-100% on L arm. V/S obtained on R arm @ 1731 BP-193/111, P-76, R-18, O2-100%. States that takes BP meds daily @ night, in which she hasn't taken her meds all day. Takes Amlodipine 5mg, Klonopin 0.5mg, Vit D 1000, MVI, Clartin 5mg, and Zantac 150mg. Stil continues to voice s/s @ 1739. BP remains elevated. Patient sent to ER @ 1740. Pt entered registration @ ER @ 1745. Pt continue to voice s/s of prickling noted to body. Denies SOB nor trouble w/ breathing.

Other Meds: Amlodipine, Klonopin, Vit D, MVI, Claritin, Zantac

Current Illness:

ID: 0959635
Sex: F
Age: 37
State: CO

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

Lab Data: none

Allergies: None

Symptoms: extreme immune? reaction, starting around 11 pm the same day of reaction, including high subjective fever, delirium, repeated episodes of syncope, extreme weakness lasting 2-3 hours. overall - flu like symptoms that lasted 36 hours post injection.

Other Meds: Amoxicillin 875 mg bid

Current Illness: tooth pain

ID: 0959636
Sex: M
Age: 29
State: CA

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

Lab Data:

Allergies: Amoxicillin- rash

Symptoms: Constant/On and off headache since second vaccine was given (over a week now). Headache more in the frontal section of the head and in between eyes; however, it migrates and intensifies around my head. The headache depresses my mood and had to call off work. Been in bed due to headache since second dose was given.

Other Meds: Celexa - general anxiety

Current Illness: None

ID: 0959637
Sex: F
Age: 46
State: TX

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

Lab Data: none

Allergies: none

Symptoms: 1/12/2021 fever 101.2 body aches chills fatigue still continue yesterday diarrhea symptoms lasted x2 days 11/20/2021 noted left arm with inches all around with bright red patches redness lt arm around injection site. Denies pain Taking Tylenol

Other Meds: none

Current Illness: none

ID: 0959638
Sex: F
Age: 40
State: NE

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

Lab Data:

Allergies:

Symptoms: DEVELOPED NECK PAIN (ALL AROUND), NOT COMPLETELY RESOLVED AT THIS TIME.

Other Meds:

Current Illness:

ID: 0959639
Sex: F
Age: 52
State: MI

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

Lab Data: As it has not progressed, waiting. Planning to get MRI if worsens. Overall feeling fine except for problem on left side of face, arm and fingers.

Allergies: Shrimp Unknown wool

Symptoms: Fever, chills, myalgias, arthralgias, fatigue, dizziness, headache, nausea, injection site pain -started about 8 hrs after vaccination and lasted for about 2 days. About 40 hours after vaccination developed decreased sensation, numbness over left side of the scalp and in next few hours had numbness of left side of face, arm and fingers with some weakness in grip and fine motor movements. Has been the same since then. Fe hours later started having

Other Meds: Lisinopril/Hydrochlorothiazide Paroxetine

Current Illness:

ID: 0959640
Sex: F
Age: 52
State: GA

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

Lab Data: n/a

Allergies: Sulfur

Symptoms: Pain at the injection site started in the evening of 1/12/2021. It went away after 2-3 days. Redness and itchiness started on 1/14/2021. Applied hydrocortisone cream for 3 days then resolved. However, the redness and itchiness returned on 1/20/2021. Possibly caused by irritation form blood pressure monitor cuff or slept on the left side of body in the previous night.

Other Meds: Vitamin A, B, D

Current Illness: none

ID: 0959641
Sex: F
Age: 75
State:

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

Lab Data: n/a

Allergies: unk

Symptoms: pt reported getting the moderna vaccine lot number 025L20A on Jan 14th 2021 and then on the 15th she had diarrhea during the day, then chills later in the evening, then a horrible burning pain from stomach to throat that night til about 4am. Pt stated she has not had the symptoms again since but she did also delay her copaxone shot by about 3 days because of that. pt stated md is aware and ok with getting 2nd dose of series.

Other Meds: unk

Current Illness: unk

ID: 0959642
Sex: F
Age: 27
State: NY

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

Lab Data:

Allergies:

Symptoms: Patient was administered potentially undiluted vaccine- stayed for observation period of 15 minutes, no adverse reactions. Pt notified of administration later in the day via phone call.

Other Meds:

Current Illness:

ID: 0959643
Sex: F
Age: 75
State: CA

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

Lab Data: none

Allergies: None

Symptoms: Pain of injection site, fatigue, headache for about 36 hours, after all systems but injection site gone. After 48 hours injection site was not painful. Mild signs as expected.

Other Meds: Premarin 0.3, Losartan 50, Simvastatin 40, vitamins D & E, Biotin 3000, Nexium 24 hour

Current Illness: None

ID: 0959644
Sex: F
Age: 49
State: FL

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

Lab Data: N/A

Allergies: Pineapple allergy, environmental allergies

Symptoms: 2? raised, hard, warm welt at site of injection

Other Meds: Triamcinalone ointment, Motrin, Benedryl

Current Illness: N/A

ID: 0959645
Sex: F
Age: 25
State: MN

Vax Date: 01/07/2021
Onset Date: 01/15/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: I started having cramps Friday night and Saturday morning I started bleeding, by Saturday evening I was passing clots and tissue. ER doctor and nurses did tests and found I was having a miscarriage.

Other Meds:

Current Illness: I was unaware I was pregnant at time of vaccine. Turns out I was, I had a miscarriage a week later at about 4-5 weeks.

ID: 0959646
Sex: F
Age: 69
State: CA

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

Lab Data:

Allergies:

Symptoms: Patient describes Soreness at injection site, later experienced body aches, headache, fever that is rising and hoarseness in voice

Other Meds:

Current Illness:

ID: 0959647
Sex: F
Age: 16
State: MD

Vax Date: 08/13/2020
Onset Date: 08/14/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: NONE KNOWN

Symptoms: 0N 8/14/2020 PATIENT'S MOM CALLED OUR OFFICE CONCERNED ABOUT POSSIBLE SHOT REACTION. LARGE RED AREA AROUND SITE AND HOT TO TOUCH. AN APPOINTMENT FOR EVALUATION WAS SCHEDULED. PT CAME IN 8/14/2020 AND WAS DIAGNOSED WITH ADVERSE EFFECT OF OTHER BACTERIAL VACCINES (BEXSERO LOCAL REACTION, WITH ERYTHEMA, SWELLING, AND PAIN) AFTER THIS APPOINTMENT THERE WERE NO CALLS BACK FROM PATIENT WITH WORSENING CONDITIONS. PATIENT RECIEVED HER SECOND BEXSERO VACCINE ON 10/14/2020.

Other Meds: NONE

Current Illness: NONE

ID: 0959648
Sex: F
Age: 30
State: CA

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

Lab Data:

Allergies:

Symptoms: Patient with h/o hives from first dose (12/26/20) became lightheaded and dizzy 20-30 minutes after second dose. Received 25 mg Benadryl and Epi-Pen before being sent to the ED.

Other Meds:

Current Illness:

ID: 0959649
Sex: F
Age: 32
State: TX

Vax Date: 11/24/2020
Onset Date: 11/27/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data: n/a

Allergies:

Symptoms: Three days post vaccination, patient complained of numbness to entire arm. She states this only occurs when she is laying down. It used to wake her up at night. Now, she gets minimal numbness and tingling sensation every 2 or 3 days.

Other Meds:

Current Illness:

ID: 0959650
Sex: F
Age: 40
State: CA

Vax Date: 01/12/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: not established.

Allergies:

Symptoms: My left arm is welted, really swollen and bruised. In the same exact area the area is really hot, and it itches alot! The symptoms have just recently surfaced, it has been 1 week.

Other Meds:

Current Illness:

ID: 0959651
Sex: F
Age: 93
State: MN

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

Lab Data: N/A

Allergies: Oxycodone

Symptoms: 3 episodes of emesis "a couple" episodes of diarrhea

Other Meds: Tylenol 500mg take 1 tab po TID

Current Illness: N/A

ID: 0959652
Sex: M
Age: 32
State: MI

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

Lab Data: unknown

Allergies: seasonal allergies, Lamictal, Gabapentin, Topomax

Symptoms: Patient complained of "throat thickening" at 0931. Patient with history of "reaction to some infusion" done at clinic requiring IV Benadryl/steroid/?epi. Treated with 0.3 mg Epi IM at 0937, reported symptoms resolved by 0838. Patient transported to local hospital via EMS at 0950.

Other Meds: Albuterol, Diclofenac, omeprazole, Flexeril, Zyrtec prn

Current Illness: none

ID: 0959653
Sex: M
Age: 90
State: TX

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

Lab Data:

Allergies: NKDA

Symptoms: Patient reported fever, dizziness and lightheadedness, as well as low blood pressure to this nurse by phone. This nurse requested patient to be seen by provider as soon as possible. Patient agreed and came to clinic soon after phone call. Dr notified this nurse that patient was advised to be seen by provider in ER for possible IV fluids and lab work due to symptoms. Pt refused and went home.

Other Meds: amlodipine 5 mg tablet Take 1 tablet by mouth once a day as directed. Aspir-81 (aspirin) 81 mg tablet,delayed release (DR/EC) Take 1 tablet by mouth once a day as directed. carvedilol 25 mg tablet Take 1 tablet by mouth twice a day a

Current Illness: None reported by patient

ID: 0959654
Sex: M
Age: 28
State: OH

Vax Date: 12/23/2020
Onset Date: 12/31/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Local injection site warmth edema, pruritis, blanching erythema progressing from 3x3 cm to 10x8 cm maximum extent over the course of 24 hours on injection day #8. Resolved spontaneously over 3 days. Worse with muscle manipulation. No weakness. No fevers, chills, constitutional symptoms. No other symptoms.

Other Meds: Pantoprazole

Current Illness: None

ID: 0959655
Sex: F
Age: 33
State: GA

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

Lab Data:

Allergies: Soy

Symptoms: Left arm joint pain 4 hours after shot. Chills. Nausea. Muscle aches. Headache. Fatigue. Stomach ache. Remaining started that night continuing now.

Other Meds: Prenatal Multi DHA vitamins

Current Illness: No

ID: 0959656
Sex: F
Age: 73
State: NH

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

Lab Data:

Allergies: non known

Symptoms: fever, aches, tired

Other Meds: metrolol, atorvastatin, clopidogrel, losartan potassium, trazadone, claritan,

Current Illness:

ID: 0959657
Sex: M
Age: 29
State: VA

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

Lab Data: Drug screen negative CMP sent out

Allergies: none listed

Symptoms: Patient had seizure like activity- Has seizure disorder meds were stopped 1-6-2021

Other Meds: Strattera 25mg 2 twice daily/Lipitor 10mg 1 in the evening/Advil 200mg 3 twice daily/Remeron 15mg in the morning and Remeron 45mg in the evening. Tegretol was stopped 1-6-21 per inmate request Tegretol was restarted today at 200mg twice da

Current Illness: Cyst removal

ID: 0959658
Sex: F
Age: 56
State: TX

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

Lab Data:

Allergies: NA

Symptoms: Woke up at 4:30 A.M 1/19/2021 Rt. Arm feeling heavy, swollen, red, and hot.

Other Meds:

Current Illness: NA

ID: 0959659
Sex: F
Age: 62
State: ID

Vax Date: 01/09/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Patient on 1/18/21 patient reports that they saw swelling and red raise area. Over the course of the 2 days it has become more red and raised with some itching present.

Other Meds: multivitamin by natures bounty

Current Illness: none

ID: 0959660
Sex: F
Age: 43
State: MA

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

Lab Data:

Allergies: None

Symptoms: Soreness in left upper arm and neck. The next day also had a 100.2 temperature with fatigue and nausea.

Other Meds: Sertraline Propanolol

Current Illness: Noneanx

ID: 0959661
Sex: F
Age: 65
State: NY

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

Lab Data:

Allergies: Antibioties (Bactrim, Augmentin, Macrodantin, Erythomycin) Benedryl All Anti-Depressants - they think I was allergic to the binding agent in the pills rather than the active ingredient. Is the same ingredient used in the vaccine???

Symptoms: Anaphylactic Shock - Dizziness at about 18 minutes after shot. Tongue swelled / Throat swelled Two Epi Pens given by pharmacist Taken by ambulance Given IV steroids (not sure if other meds) in ambulance. Stayed in Emergency Room for several hours. Discharged w/ Epi Pen and steroid pills.

Other Meds: Lexythyroxine Prilosec

Current Illness: none

ID: 0959662
Sex: M
Age: 80
State: NC

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

Lab Data:

Allergies: Penicillin-Lidocaine

Symptoms: Red area on the left side under the arm pit severe burn like a hot iron stating to heal 01/20/2021 pealing

Other Meds: Atorvastatin,Citalopram,Metformin,Januvia,Carvedilol,Amlodipine,Eliquis,Lisinopril/Hydrochorotha,Vit C,Mutivitamiin,Vit. E,Asprin 81MG,Omega3

Current Illness: Heart Decease, Diabetes-bladder cancer

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm