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: 0959914
Sex: F
Age: 50
State: HI

Vax Date: 12/18/2020
Onset Date: 01/11/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: MRI Brain 1/11/2021.

Allergies:

Symptoms: Optic Neuritis, MRI confirmed, treated with IV steroids with resolution.

Other Meds:

Current Illness:

ID: 0959915
Sex: F
Age: 44
State: IN

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

Lab Data:

Allergies: None

Symptoms: Headache, pain in left arm, fever, chills, body aches, nauseous, fatigue

Other Meds: Metform, Prozac, wellbutrin, creator, aspirin, b12, d3, gabapentin, melatonin, allergy medicine

Current Illness: None

ID: 0959916
Sex: M
Age: 51
State: CA

Vax Date: 12/17/2020
Onset Date: 12/30/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: palpitation (likely PACs)

Other Meds: Fosinopril

Current Illness: None

ID: 0959917
Sex: F
Age: 59
State: OH

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

Lab Data: None

Allergies: Carboplatin chemotherapy Shellfish

Symptoms: Moderna COVID-19 Vaccine EUA. Red, irritating (itchy) rash on forearms, calves, neck, chest, stomach, and back.

Other Meds: Multi-vitamin and Calcium w/Vitamin D

Current Illness: None

ID: 0959918
Sex: M
Age:
State: AZ

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

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0959919
Sex: M
Age: 39
State: CA

Vax Date: 12/22/2020
Onset Date: 12/26/2020
Rec V Date: 01/20/2021
Hospital:

Lab Data: 12/26- Ultrasound of the left eye 12/27- Retinal Scan and MACOCP

Allergies: No per pt.

Symptoms: received the vaccine on 12/22/2020. Took a nap on 12/26/2020 around 1400 and woke up and noticed that left eye had blurry vision. He washed it and it was still blurry. After 1 hour, he decided to go to the ED- was worried about possible stroke in his eye or retinal detachment. No retinal detachment found in ED; was discharged from the ED, not admitted into the hospital. Followed up with ophthalmologist as instructed on 12/27/2020. Retinal scan done and found no retinal detachment but the doctor found fluid found behind the retina. MD recommends rest, less stress at work. Unknown if related to vaccine per MD - mentioned no data is available to compare.

Other Meds: Allopurinol Multivitamin

Current Illness: No per pt.

ID: 0959920
Sex: F
Age: 23
State: MA

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

Lab Data: None

Allergies: NKDA

Symptoms: Patient reported lightheadedness immediately after vaccine given. Transported to recliner via wheelchair. BP reading 108/80, given PO fluids and symptoms resolved shortly after. Assessed by the physician on site and cleared for release.

Other Meds: Unknown

Current Illness: No current illness

ID: 0959921
Sex: M
Age: 74
State: CA

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

Lab Data: N/A

Allergies:

Symptoms: N/A

Other Meds:

Current Illness:

ID: 0959922
Sex: F
Age: 56
State:

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

Lab Data: Sat 100%

Allergies: Latex

Symptoms: Bitter taste and itching (General) Received Benadryl 50 mg and improved

Other Meds: methylPREDNISolone (MEDROL DOSEPAK) 4 mg tablet albuterol HFA (PROVENTIL HFA, PROAIR HFA, VENTOLIN HFA) 90 mcg/actuation inhaler SUMAtriptan (Imitrex) 100 mg tablet codeine - butalbital - aspirin - caffeine (Butalbital Compound W/Code

Current Illness:

ID: 0959923
Sex: F
Age: 42
State: PA

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

Lab Data:

Allergies: Berries Latex Avocados Penicillin Amoxicillin Zithromax Macrobid

Symptoms: 5 mins: mild site itching 15mins: whole body itching mod 20 mins: tongue swelling, coughing 25 mins: difficulty swallowing, tight breathing Pt was given 2nd round of 25 mg benedryl, epinephrine, Prednisone, albuterol breathing treatment and monitored for 3 hours. Sent home on 5 day course or prednisone

Other Meds: Benedryl Advil Buspar

Current Illness: None

ID: 0959924
Sex: F
Age: 33
State: AK

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

Lab Data:

Allergies: SULFA,MONTELUKAS

Symptoms: Tenderness, swelling 7 days after covid vaccine

Other Meds: BCP, BENEDRYL

Current Illness: Patient left arm swollen 7days after covid vaccine

ID: 0959925
Sex: M
Age: 28
State: WA

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

Lab Data:

Allergies: Chocolate

Symptoms: Received vaccine at 18:45 on 01/19/2020 Woke up at 10:00 01/20/2021 after approx 8-9 hours of sleep with symptoms: Nausea Headache Dizziness Dry Cough Chest/Lung Tightness Full Body Aches Fatigue/Lethargy

Other Meds: Citrizine Hydrochloride, 10mg (10:00am 01/19/2021)

Current Illness:

ID: 0959926
Sex: F
Age: 77
State: CA

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

Lab Data:

Allergies:

Symptoms: Hives - received Benadryl 50 mg and Epi-Pen

Other Meds:

Current Illness:

ID: 0959928
Sex: F
Age: 49
State:

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

Lab Data:

Allergies:

Symptoms: Agitation, BlurredVision, Confusion, Anaphylaxis, UrticariaPruritus, Syncope, Pt experienced reaction three days PRIOR to first vaccine - event documentation only. Narrative: Pt has history of likely environmental allergies resulting in 4-5 mild reactions annually. Has seen allergist-immunologist in the community and has epi-pens, ranitidine and diphenhydramine. Had reaction three days PRIOR to first covid vaccine dose. She did NOT experience any untoward reaction to either dose of vaccine.

Other Meds:

Current Illness:

Date Died: 01/19/2021

ID: 0959929
Sex: M
Age: 69
State:

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

Lab Data:

Allergies:

Symptoms: Narrative: Patient seen in ED 1-17-21 with c/c of "bloated with epigastric pain". Patient with complicated medical history including stage 1B pancreatic cancer (was currently on chemotherapy mFOLFIRINOX), and a leadless permanent pacemaker implantation on 1-11-21 for long episodes of SR with complete heart block following symptoms of syncope (other cardiac history: CAD s/p CABG 2009, PAF, and HTN). Regarding ER visit for epigastric pain, nothing notable was found on workup and patient was to discharge home to rest. There were available doses of COVID-19 Vaccine following a vaccine clinic that same day, and patient was offered and agreed to a dose of vaccine. Patient was monitored for 15 minutes post vaccine with no notable issues. The following day, Monday 1-18-21, patient's caregiver called facility at 22:30 to report he had a fever of 102.8 degrees and that he had been "feeling kind of bad all day". Patient was advise to seek urgent medical care and reported back to ED on 1-19-21 at 00:55. Patient wasd admitted for SIRS (tachycardia and febrile) -- patient also reported diffuse myalgia. WBC WNL, CXR unremarkable for infection, UA neg for bacteria, LFTs WNL, blood cultures negative. Procalcitonin elevated at 17.8 -- suggesting inflammatory response. Patient initially reported feeling better on the morning of 1-19-21, but around 13:00 began rapidly declining (confusion, unable to walk) and started experiencing EKG changes (9 beats of SVT). Patient then coded and resuscitation was attempted for approximately 30 minutes. Patient did not survive the code. Coroner has been notified and family is considering autopsy at time of this report.

Other Meds:

Current Illness:

ID: 0959930
Sex: F
Age: 48
State: FL

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

Lab Data: CBC, CMP (WNL)

Allergies: ALLERGY TO PENICILLIN, HISTORY OF ALLERGY VACCINE ONCE A WEEK UNTIL 13 YEARS OLD

Symptoms: HEADACHE, TIRENESS, ITCHING, BURNING SENSATION OF THE SKIN, MILD FINE, GENERALIZED SYMETRICAL RASH, WORSE IN ARMS, CHEST AND ABDOMEN. NOW NO HEADACHE/PAIN IN INJECTION SITE, BUT CONTINUES WITH RASH, BURNING SENSATION AND ITCHING DESPITE SOLUMEDROL INTRAVENOUS ON 10/13/2020 AT DOCTOR'S OFFICE, HYDROXYZINE 25 MG THREE TIMES A DAY, BETAMETHOSNE CREAM SINCE 01/13/2020 AND PREDNISONE 50 MG BY MOUTH DAILY SINCE 1/18/2020

Other Meds: N/A

Current Illness: N/A

ID: 0959931
Sex: F
Age: 34
State: NY

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

Lab Data:

Allergies: None

Symptoms: Developed cellulitis. Put on antibiotics.

Other Meds:

Current Illness:

ID: 0959932
Sex: M
Age: 31
State: CA

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

Lab Data:

Allergies:

Symptoms: Hives, tightness of throat

Other Meds:

Current Illness:

ID: 0959933
Sex: F
Age: 34
State: OH

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

Lab Data:

Allergies: Penicillin

Symptoms: Vaccine was administered very high, presumably in the joint space, rather than the deltoid. Patient experienced intense pain in the entire shoulder area for 24 hours following administration. After initial 24 hours, pain remained more localized in the joint itself. Pain is intensified when moving out of the neutral position.

Other Meds: Escitalopram, Tri-Lo-Marzia, Restasis, melatonin, Multivitamin, probiotic

Current Illness: None

ID: 0959934
Sex: F
Age: 25
State: MA

Vax Date: 01/07/2021
Onset Date: 01/16/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: Cephalexin (minor rash)

Symptoms: 1/7 - Got vaccine, minor soreness in arm at injection site. 1/8 - Soreness in arm at injection site, no discoloration nor lump. Sore back and abdominal muscles. 1/9 - Some minor soreness remaining, resolved by end of day. 1/10-1/15 - No soreness, discoloration, lump, nor other symptoms of any kind. 1/16 - Suddenly noticed a hard lump at injection site, apx. 2" diameter. Lump was minorly itchy and sore to touch, and area was red and hot. 1/16-1/20 - Lump gradually reduced in size, itch and pain resolved. Redness remains. 1/20 - Redness at inj. site has progressed to a bullseye pattern. There's a center red spot apx. 1" diameter, surrounded first by a ring of normal skin, then by a ring of redness. Diameter of outer red ring apx. 2".

Other Meds: Kyleena IUD

Current Illness: None

ID: 0959935
Sex: F
Age: 95
State: CA

Vax Date: 01/14/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: Shrimp

Symptoms: Swelling and redness at injection site; itching

Other Meds: Pantoprazole, Eliquis, Fosamax, Potassium chloride, furosemide, amlodipine,

Current Illness: None

ID: 0959936
Sex: F
Age: 56
State: CA

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

Lab Data:

Allergies: none

Symptoms: had itching and tingling the next day. with in 2 days hives all over chest and arms.

Other Meds:

Current Illness: none

ID: 0959937
Sex: F
Age: 66
State: IN

Vax Date: 01/06/2021
Onset Date: 01/14/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: observation and symptoms to make diagnosis

Allergies: Ultram, Sudafed, Codeine

Symptoms: Red, Blotchy rash appeared on right lower abdomen, Starting about 2 inches from umbilicus wrapping around intermittently to back 1 inch to right of spine. Rash was very painful-stabbing, searing burning pain, itching, tingling. rash was various sizes with fluid filled blisters.

Other Meds: Ramipril 10 mg BID, Albuterol HFA 90mcg inhaler prn, Carvedilol 25 mg BID, Chlorthalidone 25 mg QD, Effexor225 mg QHS, Oxybutinin 15 mg QD, Adderall 45 mg QAM, Iron OTC QD, metformin 500 mg QAM, omeprazole 40 mg QD, tamoxifen 20 mg QD

Current Illness: Gallbladder attack 12/22/2020

ID: 0959938
Sex: M
Age: 58
State:

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

Lab Data: normal C4, normal tryptase

Allergies: none

Symptoms: significant facial/lip angioedema first noted ~20 hours post vaccination, leading to intubation in ED due to concern for airway protection. extubated and discharged in 2 days

Other Meds: ibuprofen ~8 hours prior to symptoms

Current Illness: COVID-19, symptomatic end of December, positive early January, and positive upon admission

ID: 0959939
Sex: F
Age: 41
State: CA

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

Lab Data:

Allergies: n/a

Symptoms: After over a week post vaccination I have noticed redness under the vaccination site that was warm to touch. Also noted significant discomfort and soreness in the armpit are and around the shoulder of the vaccinated arm. After palpating, I could locate several enlarged lymph nodes that were tender. The arm still has swelling and redness, however, lymph nodes are less tender although still sore.

Other Meds: Zinc, multivitamin

Current Illness: n/a

ID: 0959940
Sex: F
Age: 33
State: AZ

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

Lab Data:

Allergies:

Symptoms: Body aches, chills, headache. Treated with Tylenol for 24 hours and symptoms have started to subside

Other Meds:

Current Illness:

ID: 0959941
Sex: F
Age: 70
State: AK

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

Lab Data: none

Allergies: NONE

Symptoms: none

Other Meds: SYNTHROID

Current Illness: Patient developed redness on 9th slight increase5mm of redness from injection site.

ID: 0959942
Sex: F
Age: 37
State: CA

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

Lab Data: None

Allergies: Doxycycline

Symptoms: Sore arm and injection site x 48hrs and fatigue, following vaccination. After 48hrs, swollen lymph node and pain under left underarm developed. Left underarm continues to be painful on the 3rd day of vaccine, as well as fatigue.

Other Meds: Probiotics

Current Illness: H pylori

ID: 0959943
Sex: F
Age: 41
State: GU

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

Lab Data: Basic Metabolic panel (normal except glucose over 300) CBC (normal) Urine HCG: negative Lipase normal

Allergies: Shrimp allergy: causes hives and itchy throat

Symptoms: On Jan 12, the patient developed positional vertigo and nausea as well as sore arm. Vertigo resolved when she fell asleep. Vertigo returned on Jan 16 and17. Diarrhea occurred 6 times on Jan 17. The patient noticed significant diffuse loss of hair from January 16 to 19. She continues to have some nausea.

Other Meds: Metformin 1000mg bid Omega 3 capsules Vitamin C Vitamin D3 Multivitamins

Current Illness: Acute: none

ID: 0959945
Sex: F
Age: 58
State: NY

Vax Date: 01/10/2021
Onset Date: 01/12/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: none

Allergies: allergy to bee stings, azithromyacin

Symptoms: On Tues, 1/12 I started feeling like I was getting a cold because I got the chills when I got home, but not the flu because I had my flu shot in Oct.2020 Wednesday 1/13 I left work because I started with vomiting, diarhhea , a light headache and my arm was real sore. That continued on through that night and into the next morning. So I had to call in at work that morning 1/14. I finally started feeling better by friday night, 1/15. The headache was gone and the chills were only slight and I could finally keep some toast down. Before that I could only slightly keep liquids down.

Other Meds: metformin, lisinopril, atorvastatin, methocarbamol, 81 mg aspirin, claritin, pantaprazole

Current Illness: none

ID: 0959946
Sex: F
Age: 33
State: CT

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

Lab Data: None

Allergies: None

Symptoms: Patient developed lip swelling, facial numbness and area of hives on the thigh. Symptoms started day after the vaccine and resolved after 24 hours.

Other Meds: Zyrtec Ergocalciferol Labetalol NIfedipine Nexium

Current Illness: None

ID: 0959947
Sex: F
Age: 45
State: OH

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

Lab Data: none

Allergies: Bactroban, fresh pineapple, cinnamon gum

Symptoms: No adverse reactions until day 8 at the injection site. Red, swelling, warm to the touch, and itching. Also, tenderness in the armpit

Other Meds: Azurrett - Low dose birth control Advil as needed

Current Illness: none

ID: 0959948
Sex: F
Age: 75
State: OR

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

Lab Data:

Allergies: Maybe dairy?

Symptoms: Headache, fatigue, chills following day, symptoms subsided the following day

Other Meds: Calcium, Vit D, fish oil, b complex vitamins, turmeric, probiotic

Current Illness: None

ID: 0959949
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: Itching, burning, rash, swelling (mostly at ankles)

Other Meds: Celexa B12 Vitamin D levothyroxine glimepiride metformin Lipitor aspirin vitamin c centrum silver biotin

Current Illness:

ID: 0959950
Sex: F
Age: 28
State: CA

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

Lab Data:

Allergies: None

Symptoms: Vaccinated on 1/11/21 and on 1/18/21 I developed redness, warmth, and itchiness at the vaccine site, worsened the next day, applied topically hydrocortisone cream and redness and itchiness decreased 1/20/21

Other Meds: Blisovi Fe 1.5/30

Current Illness: None

ID: 0959951
Sex: F
Age: 35
State: CA

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

Lab Data:

Allergies:

Symptoms: Day one, diarrhea, sore arm, headache, fatigue . Day 2 sore arm, fatigue day 3 fatigue day 4 headache day 5 headache day 6 swollen neck lymph nodes as well as armpits and body aches

Other Meds: Synthroiid and gammagaurd

Current Illness: Hypogammaglobulinemia

ID: 0959952
Sex: F
Age: 34
State: OR

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

Lab Data: N/a

Allergies: Cipro, sulfa, macrobid

Symptoms: Delayed redness, swelling, hot to touch 48+ hours after injection

Other Meds: Multivitamin, cal-mag-D, fish oil, B Complex

Current Illness: N/a

ID: 0959953
Sex: F
Age: 63
State: NJ

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

Lab Data: None yet

Allergies: None

Symptoms: felt warm, slight fever, headache, very sore arm. Dizzy.

Other Meds: BUPROPION HCL XL 150MG

Current Illness: Overweight

ID: 0959954
Sex: F
Age: 40
State: PA

Vax Date: 01/15/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: 4 days after receiving vaccine , I broke out in hives (raised itchy rash all over my body). I cannot rule out if this was due to a new soap product that I started using on Jan 19th or because of vaccine or other environmental factor. I have been treating the rash with Benadryl and cortisone 10 cream purchased OTC.

Other Meds: Herbal serum for allergies (small doses of allergens) taken once daily. 3 pumps.

Current Illness: None

ID: 0959955
Sex: F
Age: 49
State: NY

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

Lab Data:

Allergies: NONE

Symptoms: The back of my knee has a bulge; my calf is swollen; my knee makes a noise as I go up the stairs; it is uncomfortable to walk/climb stairs

Other Meds: Lithium

Current Illness: NONE

ID: 0959956
Sex: F
Age: 85
State: NJ

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

Lab Data:

Allergies:

Symptoms: Moderna COVID-19 Vaccine EUA 1 hour after injection, vomiting ensued and persisted through the evening. Low-grade fever (treated with Tylenol). Also experiencing weakness and fatigue.

Other Meds: mirtazapine

Current Illness:

ID: 0959957
Sex: M
Age: 72
State:

Vax Date: 12/31/2020
Onset Date: 01/07/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Rash on injection arm started 7 days after injection. Rash fully cleared up after 14 days from onset of rash, which was 21 days after injection.

Other Meds:

Current Illness:

ID: 0959958
Sex: F
Age: 58
State: IL

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

Lab Data: N/A

Allergies: NKDA

Symptoms: Left Axcillary pain and swelling with, moderate lymph node tenderness. Pain Grade 7/10. Discomfort developed during the late night following injection.

Other Meds: Tylenol, HCTZ, atorvastatin, norvasc

Current Illness: None

ID: 0959959
Sex: F
Age: 76
State: MI

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

Lab Data: NA

Allergies: duloxetine, sulfa drugs

Symptoms: Patient states that she started experiencing symptoms on 1/16/21 morning. Patient notes that she had a fever of 103.9. She notes weakness and wasn't able to get out of bed. Fever, weakness, chills, fatigue, unresponsiveness. Patient states at one point she became unresponsive per her daughter. EMS was called to patient's home and patient appeared not alert and wasn't able to answer EMS questions. Patient states that her fever has since broke and denies any current fevers. Patient states that she continues to feel very weak. Patient states that she has been resting in bed and increased her water intake. Patient did test positive for COVID on 10/20/20. Patient inquiring if she should receive second COVID vaccine due to symptoms she experienced with first vaccine.

Other Meds: Tylenol, albuterol, allopurinol, vitamin C, aspirin, atorvastatin, chlorthalidone, cholecalciferol, coenzyme Q10, diclofenac 1% gel, gabapentin, lisinopril, metformin, multivitamin, tiotropium

Current Illness: Pt was in hospital with COVID released 10/30/2020.

ID: 0959960
Sex: F
Age: 41
State: IL

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

Lab Data: Please consult medical record at hospital.

Allergies: Allergist reported possible positive reaction to shellfish test but I can consume shellfish without limit with no reaction.

Symptoms: Admitted in Hospital for Anaphylaxis.

Other Meds: 100mg Topiramate

Current Illness: No.

ID: 0959961
Sex: F
Age: 30
State: CA

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

Lab Data: None

Allergies: Nka

Symptoms: Itchy back, dizziness, nausea, groggy

Other Meds: Vitamin D, ginger, zinc, vitamin C

Current Illness: Had Covid 3 weeks prior

ID: 0959962
Sex: F
Age: 39
State:

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

Lab Data:

Allergies:

Symptoms: itching

Other Meds:

Current Illness:

ID: 0959963
Sex: F
Age: 44
State: AK

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

Lab Data:

Allergies: Kiwi, hummus, medications inthe penicillin family

Symptoms: Patient was 22 minutes into her 30 minute monitoring period after receiving Moderna COVID-19 Vaccine and complained of itching around her neck. Visible rash around her neck. Generalized rash on her trunk, left arm, and redness in both ear lobes. EMS was called. Pt ambulated to cot. BP at 05:15pm was 140/90. One dose of 0.5mg/(0.5mL) epinephrine administered to right anterolateral thigh. BP at 05:23pm was 160/110. Pt began to shiver and was cool to the touch, blanket placed. EMS arrived at 05:30pm and left with Pt at 05:38pm. Pt talking/laughing throughout event. Pt taken to hospital. Benadryl was given and was observed for 2 hours then discharged.

Other Meds:

Current Illness:

ID: 0959964
Sex: F
Age: 57
State: CO

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

Lab Data: un known

Allergies: un known

Symptoms: Pt. broke out in hives immediately after receiving Moderna vaccine. No SOB, face or tongue swelling and no other complaints. Pt. was observed in the vaccine clinic and evaluated by the clinic physician. Hives persisted and started to itch. Pt. was taken to UTC accompanied by an RN. Pt. did not want to take Benadryl because she stated it would make here sleepy.

Other Meds: un known

Current Illness: un known

ID: 0959965
Sex: F
Age: 25
State:

Vax Date: 01/09/2021
Onset Date: 01/16/2021
Rec V Date: 01/20/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Starting 01/16/2021, there was itchiness and a cluster of red papules/wheals that showed up on my right back. The rash continued to spread the next few days with increasing papules and itchiness. The rash is localized to my torso. Most are on my right abdomen and right back but is now spreading to my left side and upper back. There are also a few under and on my right breast and below both my armpit areas. The rash is still erythematous, with some that are papular and some appearing like vesicles. There is still itchiness and some stinging sensation. I am currently on Hydroxyzine 25MG at night and Zyrtec OTC during day but it has only been 2 days since I started the meds. The itch does wake me up at night time. So far the antihistamines have helped a bit with the itch. At the same time, I appear to have a sore throat though it feels more like a mild swelling of my throat as whenever I swallow it feels sore.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm