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: 0921074
Sex: M
Age: 7
State: RI

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: expired IPOL being administered to patient; with no AE; Initial information received on 23-Dec-2020 regarding an unsolicited valid non-serious case from a nurse. This case involves a 7 years old male patient who received expired IPV (VERO) [IPOL] (expired product administered). The patient's medical history, past medical treatment(s), vaccination(s) and family history were not provided. Concomitant medication was not reported. On 23-Dec-2020, the patient received a dose of suspect IPV (VERO) (with unknown strength, formulation, dose and frequency) (lot P1F541M and expiration date: 07-Dec-2020) via unknown route in unknown administration site for prophylaxis vaccination. It was a case of actual medication error due to expired product administered. At the time of report, no adverse event was reported. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in directive 2001/83/ec and module VI of the good pharmacovigilance practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds:

Current Illness:

ID: 0921075
Sex: F
Age:
State:

Vax Date: 08/01/2020
Onset Date: 12/23/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: dizziness; Initial information was received on 23-Dec-2020 regarding an unsolicited valid non-serious case from the patient. This case involves an 87 year old female patient who experienced dizziness, while he received INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE [FLUZONE HIGH-DOSE QUADRIVALENT]. The patient's medical history, past medical treatment(s), vaccination(s) and family history were not provided. The patient had not received other vaccine concomitantly. On an unknown date of August-2020, the patient received unknown dose of suspect INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE (injection, lot unknown and expiration date unknown) via an unknown route for prophylactic vaccination. On 23-Dec-2020, the patient developed non-serious dizziness, immediately following the administration of INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE. Details of laboratory data were not reported. It was not reported if the patient received any corrective treatment. At the time of reporting, the event outcome was unknown.

Other Meds:

Current Illness:

ID: 0921076
Sex: M
Age:
State: VA

Vax Date: 12/17/2020
Onset Date: 12/19/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: sick for 3-7 days; fever; aches; chills; Initial information regarding an unsolicited valid non-serious case was received from a pharmacist via Agency (Reference number- 00406450) and transmitted to Sanofi on 24-Dec-2020. This case involves a unknown age male patient who experienced fever (pyrexia), aches (pain), chills and was sick for 3-7 days (illness), while he received vaccine INFLUENZA QUADRIVALENT RECOMBINANT VACCINE [FLUBLOK QIV]. The patient's medical history, concomitant medication, medical treatment(s), vaccination(s) and family history were not provided. On 17-Dec-2020, the patient received a 0.5 ml dose of INFLUENZA QUADRIVALENT RECOMBINANT VACCINE (lot: QFAA2059; expiration date: 30-Jun-2021, strength-standard) once via intramuscular route in the left deltoid for prophylactic vaccination. On 19-Dec-2020, the patient experienced non-serious fever (pyrexia), aches (pain), chills and was sick for 3-7 days (illness), 2 days following administration of INFLUENZA QUADRIVALENT RECOMBINANT VACCINE. Relevant laboratory data not provided. It was not reported if the patient received a corrective treatment. At the time of reporting the event outcome was unknown for all events. It was reported as product was used and no product technical complaint.

Other Meds:

Current Illness:

ID: 0921077
Sex: M
Age: 0
State: CA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Urticarial rash on day 1, no progression on day 2.

Other Meds: None

Current Illness: None

ID: 0921078
Sex: F
Age: 40
State: CA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: pain, ache behind his right eye, that is still there fuzzy vision that lasted for 30 minutes warmth on top of head and around his ear

Other Meds:

Current Illness:

ID: 0921079
Sex: F
Age: 40
State: NY

Vax Date: 12/24/2020
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: n/a

Allergies: n/a

Symptoms: large 13-15 cm hive, itchy, tender, elevated and red

Other Meds: Accutane 40mg

Current Illness: n/a

ID: 0921080
Sex: F
Age: 63
State: NY

Vax Date: 12/30/2020
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: NONE

Allergies: None

Symptoms: Post vaccination x 1 week. Sight is reddened/mod swelling/terrible intching

Other Meds: Advil

Current Illness: Nothing

ID: 0921081
Sex: M
Age: 67
State: OH

Vax Date: 12/22/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Severe left Bell's palsy started 9 days after the 2nd Shingrix injection.

Other Meds: Aspirin, Metoprolol, Lisinopril, Amlodopine, Crestor

Current Illness: None

ID: 0921082
Sex: F
Age: 72
State: SC

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: weakness, headache, body aches, soreness at the injection site, warm injection site, dizziness, loss of appetite

Other Meds: none

Current Illness: None

ID: 0921083
Sex: M
Age: 36
State: MI

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Patient reported a "migraine headache at the back of the head within 5 minutes of receiving the Pfizer COVID 19 vaccine at 9:45am on 01/04/2021. Symptoms were quickly followed by itching of the head and ears. Within twenty minutes his tongue, lips, and throat felt tingly and numb. He stated he was taken by EMS to hospital where he was given Benadryl and monitored for 2 hours. Today he reports a mild headache, chills, soreness at the site of the injection with slight burning, and fatigue. He stated, "I'm fine." Infection Prevention specialist for hospital reports that patient chart indicated he had no evidence of tongue or lip swelling. His vitals at the ER were stable and he was observed for over an hour. He was given oral zofran, acetaminophen, and benadryl.

Other Meds: Multi-vitamin - Animal pac gabapentin - 300 mg 2x daily tylenol 4 - 300 mg every 6 hours methotrexate - 2.5 mg (6 tablets weekly) prednisone - 5 mg 2x daily pantaprazole - 40 mg 2x daily, simponi aria injection every other month - l

Current Illness: none

ID: 0921084
Sex: M
Age: 23
State: NJ

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

Lab Data:

Allergies: none

Symptoms: 23 yo male received COVID-19 Moderna vaccine at 11:04am , patient monitored x15 minutes, no complaint or adverse reactions noted, discharged at 11:19pm Patient returned at 11:30am after going to his car, patient stated "I went to my car and took a sip of coffee, I felt like there was something in my throat". Monitored Patient x 45 minutes, patient alert and oriented x 4, calm, skin color normal, no rash, BP 125/86, P 84, pulse ox 98, no complaint of worsening or change in condition. Spoke with patient's father x 2, requested father to pick up son, but father felt not necessary. Notified medical advisor, recommended discharge to immediate care or ED via self. Parent agreed with self transport to ED after speaking with patient. 911 transport refused by patient. Safety instructions reviewed with parent and patient, both verbalized understanding. Patient discharged to transport self to Emergency Room, parent aware.

Other Meds: none

Current Illness: n/a

ID: 0921085
Sex: F
Age: 58
State: PA

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: Patient went to Urgent care

Allergies: Methylene blue

Symptoms: Patient broke out in a rash and was diagnosed with shingles

Other Meds: Glimepiride, Metformin, Trulicity, Fenofibrate, Lopressor, Aspirin, Vitamin C, Vitamin B12, Vitamin D3, Calcium with Vitamin D

Current Illness: None

ID: 0921086
Sex: F
Age: 62
State: IA

Vax Date: 12/26/2020
Onset Date: 01/01/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: none

Allergies: none known

Symptoms: Developed itching at site and then in 24 hrs red area 9sunburn appearing color approx. 4 inch diameter circle below the injection site, reddened area spread to part of deltoid and into antecubital at its maximum. used ice packs and Ibuprofen initially and then took 1 dose Benadryl on 3rd day which has helped subside the spread and caused fading from sunburn red to very light red color. itching milder

Other Meds: Ibuprofen, and Benadryl and ice packs

Current Illness: none known

ID: 0921087
Sex: F
Age: 42
State: TX

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

Lab Data:

Allergies: ibuprofen, IV contrast allergy

Symptoms: Pt received COVID Vaccine at 1055, 1120 pt began coughing severely and could not stop, unable to speak. 1120 25mg Benadryl liquid given, Pepcid 20 mg given PO, cough worsening. 1122 second dose of Benadryl given, called for MD. Brought pt to Private room via wheelchair. Upon arrival, audible stridor noted. Epinephrine 0.3 mg IM given at 1126. IV started, placed patient on monitor and O2 via 1L NC. MD at bedside along with RT and pharmacy. 1134 Solumedrol 125 mg IV given, 1 puff of Ventolin given. Lungs clear. 1140 Coughing stopped, pt able to speak now. Vital signs: 1130 SPO2 99% Pulse 142 1135 99% pulse 106 BP 168/102 1140 sats 100% HR 93 BP 157/105 1145 sats 100% HR 97 BP 159/93 1200 sats 99% HR 103 155/97 114

Other Meds: lisinopril/HCTZ, albuterol MDI

Current Illness: no

ID: 0921088
Sex: F
Age: 53
State: CA

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: a day after vaccination, felt fatigue and "under the weather". 2 days after injection, experienced sharp pain in left ear radiating down to jawline and left shoulder and upper arm. Pain also caused severe headache relieved with high dose Tylenol. Symptoms lasted 24hrs. Headaches became mild lasted thru day of report reaction (1/4).

Other Meds:

Current Illness:

ID: 0921089
Sex: F
Age: 45
State: CO

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

Lab Data: None

Allergies: Allergic to Penacillin.

Symptoms: Began experiencing tachycardia, dizziness, headache, and started shaking about 5 minutes after receiving the vaccine. 50 mg Benadryl given IM to R deltoid at 1000. Symptoms began to resolve. Started experiencing some chest pain. Individual states she has a pacemaker, which felt like it was "combating" the tachycardia. Was monitored for 45 additional minutes and all symptoms subsided. Individual was able to return to work.

Other Meds: Humira (last taken on 1/3/21) and methotrexate (last taken 1/4/21).

Current Illness: None

ID: 0921090
Sex: F
Age: 77
State: MN

Vax Date: 12/23/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital: Y

Lab Data: on 1/4/2021: COVID-19 Pos ; D Dimer 243; BNP 400; Troponin 10; AST 47; ALT 42; INR 2

Allergies: Sulfa/Trimethoprim

Symptoms: Pt vaccinated on 12/23. PCP notified that SOB and fatigue getting worse on 1/4. Unable to keep pre-op Dental work planned prior to mitral valve surgery on 1/14/2021. PCP referred her to our ED where she was diagnosed with COVID-19 and transferred to facility, which is where her surgery was planned.

Other Meds: Apixaban, ECASA, Atorvastatin, Labetalol, Multivitamin w/minerals, Pantoprazole, Diltiazem, Meclizine

Current Illness: Mitral valve surgery (surgery planned within days)

ID: 0921091
Sex: M
Age: 54
State: NH

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital: Y

Lab Data:

Allergies: neomycin

Symptoms: Pt received vaccination and left after 15 min. observation symptom free. He drove a short distance away from the clinical site when he felt profuse sweating and had syncope (seconds) crashing into curb. He was aroused from impact and was able to stop car. He then developed profuse nausea and sudden urge to defecate. He went to restroom. Given these events he returned to the clinical site in another vehicle. Upon arrival he denied chest pain, shortness of breath or ongoing nausea or abdominal pain. He reported his AM blood sugar was 72 and does not take insulin. No history of coronary disease or syncope. EMS was activated and assumed care.

Other Meds: none related

Current Illness:

ID: 0921092
Sex: F
Age: 56
State: VA

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

Lab Data:

Allergies:

Symptoms: Vertigo, nausea, vomiting

Other Meds:

Current Illness:

ID: 0921093
Sex: F
Age: 56
State: WA

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: About 15 minutes after vaccination I started itching all over, became flushed, my throat and sore. I was taken to the ED where I was given non drowsy antihistamine and observed. At home I experienced severe fatigue, muscle aches and chills. At about 30 hours the symptoms went away

Other Meds: zoloft spirinolactone

Current Illness: no

ID: 0921094
Sex: M
Age: 49
State: TX

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Vertigo starting at 7pm the night of the vaccine. The next morning woke with continued vertigo and fatigue. Still in bed on 1/5/2021 at 12:30pm.

Other Meds: none

Current Illness: none

ID: 0921095
Sex: F
Age: 51
State: VA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: blood drawn- no results given todate.

Allergies: Oxycodone

Symptoms: "Moderna COVID-19 vaccine EUA"

Other Meds: Multi- vitamins, glucosamine chondroitin

Current Illness: L arm injury- bicep strain (10/30)

ID: 0921096
Sex: F
Age: 39
State: CA

Vax Date: 12/28/2020
Onset Date: 01/01/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient received the covid vaccine on 12/28/2020. c/o new onset of bil eyelid swelling with "greenish" discharge on 1/1/2021 and stomach pain (relieved with BM - "little diarrhea") on 1/2/2021. Diarrhea improved after 24 hours but the eye swelling persists. On 1/5/2021 new onset of headache, vomiting, "wet" cough, and nasal congestion. Denies fever, chills, or body ache. Covid test on 12/28/2020 was negative.

Other Meds:

Current Illness:

ID: 0921097
Sex: F
Age: 28
State: IA

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: none

Allergies: peanuts, shellfish

Symptoms: acute, mild but obvious, swelling of Right maxillary sinuses

Other Meds: trazodone, topimax, sertraline, zyrtec, loratadine, progesterone,

Current Illness: functional rhinoplasty

ID: 0921098
Sex: F
Age: 44
State: CA

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: FEVER, CHILLS, BODY ACHES, MALAISE

Other Meds:

Current Illness:

ID: 0921099
Sex: F
Age: 38
State: FL

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: None

Allergies: Bactrim, seafood

Symptoms: Fever up to 101, body aches, headache, chills

Other Meds: Cymbalta, propranolol, vitamin D, seroquel, clonazepam, rizatriptan, Fioricet

Current Illness: None

ID: 0921100
Sex: F
Age: 65
State: OR

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

Lab Data:

Allergies:

Symptoms: Patient had vaccine and about an hour later began experiencing symptoms of dizziness, light-headed, and "woozy." Was brought back to vaccine event by her manager. Was advised to go to the ED but refused.

Other Meds:

Current Illness:

ID: 0921101
Sex: F
Age: 1
State: IN

Vax Date: 12/22/2020
Onset Date: 12/27/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: sweet potatoes

Symptoms: Patient's mom called 01/05/2021 @1106 to report that "she developed fever Sunday 12/27/20 of 102 gave Tylenol for fever and would only go down to 101, took her to the Dr. (Pediatrician) 12/28/20 and then continued Tylenol to treat fever" "Thursday 12/31 fever decreased to 100 and stayed down after that" "and then last night (01/04/21) she got a rash "pinkish dots not really raised and were on her upper torso" Mom also reports, "she has decreased appetite and drinking in the last week" Mom denies any history of a vaccine reaction in the past. No complaints of nausea, vomiting or diarrhea; Mom also reports, "I called her doctor today but haven't heard back yet" 01/05/21 @1303 called Pediatrician Dr. regarding mom's concern "could she have reaction to measle vaccine?" LVM for the "Dr.'s nurse" @ 1330 Dr. Office nurse reports, "viral illness 12/28" they will follow up with mom.

Other Meds: None reported on the screening form.

Current Illness: denied illness

ID: 0921102
Sex: F
Age: 39
State: VA

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Dizziness, headache

Other Meds:

Current Illness:

ID: 0921103
Sex: M
Age: 41
State: NY

Vax Date: 12/23/2020
Onset Date: 12/27/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: Optho did OCT test

Allergies: NKDA

Symptoms: central serous retinopathy have small blurry spot in right lower quadrant visual field

Other Meds: none

Current Illness: none

ID: 0921104
Sex: F
Age: 64
State: CO

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

Lab Data: None

Allergies: Allergic to prilosec, iodine, eggs, sulfa, propofol, and metoprolol.

Symptoms: About 5 minutes after receiving the vaccine, she began to experience a dry cough and tickling in the back of her throat. Also reported some shortness of breath. 25 mg of Benadryl was given IM in the R deltoid. Her symptoms subsided after approximately 15 minutes and she was able to return home.

Other Meds: Antihypertensives and beta blocker

Current Illness: Reported that she was positive for COVID.

ID: 0921105
Sex: F
Age: 59
State: NY

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Woke up with redness to the left eye.

Other Meds:

Current Illness:

ID: 0921106
Sex: F
Age: 33
State: NH

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: latex (anaphylactic), eggs, environmental

Symptoms: Reported onset of sustained dizziness assoc w numbness and tingling of bilateral hands and change in sensation of thumbs 10 minutes after vaccine admin. She did not notify clinic staff, self administered Benadryl 50mg and waited until staff checked on her at 20 min mark to report. Upon assessment pt is sitting up, appears mildly anxious, denies SOB, CP or difficulty swallowing. Dizziness is persistent despite change in position and fluids, removal of N95 mask. VSS, b/p 106/68, p 68, RR 26. Pt encouraged to push fluids, recline in seat and take slow deep breaths. Hand sensation w/ mild improved but did not resolve after 10 minutes, dizziness unchanged. Pt and husband verbalized understanding of further care options.

Other Meds: Singulair, Adderall, azalastine, mometasone, Zyrtec, albuterol

Current Illness:

ID: 0921107
Sex: F
Age: 49
State: HI

Vax Date: 12/28/2020
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: None.

Allergies: Pet dander

Symptoms: On the evening of 01/04/2021, I developed hives at the site of the shot. (red welts) I took a Benadryl and went to bed. The swelling/hives went down the next morning, but it still feels itchy, thus I put hydrocortisone cream to see what happens.

Other Meds: Prolia, daily vitamins

Current Illness: None

ID: 0921108
Sex: F
Age: 42
State: NY

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

Lab Data:

Allergies: capers

Symptoms: Tingling and numbness in left hand

Other Meds: Centrum Multivitamin, CBD

Current Illness:

ID: 0921109
Sex: F
Age: 46
State: CA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: None

Allergies: sulfa, neogram

Symptoms: Left arm soreness and tenderness, onset approximately 6 hours after injection and lasting 4 days. Body muscle aches beginning about 6 hours after and progressing, lasting 3 days, but decreasing by day 2. Body chills beginning after about 11 hours and lasting for about 2 hours, resolving with Tylenol. Fever up to 101.1 beginning evening of injection and for full day following. General fatigue exacerbated day after injection and lasting 2 days(already experiencing some due to recent COVID infection). Mild nasal congestion day after injection and diminishing until resolved the day after beginning.

Other Meds: Levothyroxine, atorvastatin, allegra, pepcid, muti vitamin

Current Illness: COVID 19 positive with onset of 11/20/20 with some lingering symptoms

ID: 0921110
Sex: F
Age: 38
State: IN

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data: na

Allergies: none

Symptoms: urticaria generalized and involving soft palate

Other Meds: lexapro and birth control

Current Illness: covid 2 months before

ID: 0921111
Sex: F
Age: 52
State: VA

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Nausea, lightheadedness, headache, fatigue, sore/swollen arm

Other Meds:

Current Illness:

ID: 0921112
Sex: M
Age: 32
State: MS

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: I got my first dose 12/18/20, minimal symptoms, sore arm that lasted about 24 hours, consistent with every years flu shot. 2nd dose 1/4/21, completely different experience. I was forwarned that the first dose primes the immune system, 2nd can be worse, so I was taking 600 mg Motrin q6 hours. Despite that, my arm progressively hurt worse and worse until now I can?t lift it above my waist. Full body aches and pains. Horrible chills and so cold. 102.1 F is highest temp so far, but that?s on top of scheduled Motrin. Still glad that I got it, but man does it suck right now.

Other Meds: None

Current Illness: None

ID: 0921113
Sex: F
Age: 61
State: CA

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient describes feeling feverish, joint aches in elbows and knees, body aches, red rash at knees and elbows and arm pain at injection sites. This is the 2nd dose, patient reports no adverse reactions on the first dose.

Other Meds:

Current Illness:

ID: 0921114
Sex: F
Age: 34
State: TN

Vax Date: 12/28/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: Contact PCP

Allergies: None

Symptoms: No issue on date of vaccine. Minor muscle soreness in left arm the following day. No further issues following days. On 01/31/2020 at approximately 2130hrs, numbness and tingling of right side of face began while on work duty. Completed shift, drove home and went to bed. The following morning lips were covered in blisters, right cheek and under eye was extremely swollen. Attempted to drive to work and began experiencing brain fog and blurred vision. Returned home and facial swelling worsened along with severe headache and itchy dry skin. Took a bath and was unable to determine water temperature by touch. Intense leg muscle aches and nerve pain in right side of face. Remained calm and slept the following two days. Went to PCP as soon as possible on 01-04-2020 and was advised symptoms to be delayed adverse reaction to Moderna Vaccine. Patient was prescribed Alegra, Tylenol and methylprednisolone at this time. PCP advised inability to receive secondary dose on 01/28/2021 due to steroid treatment for allergic reaction to Moderna Vaccine. Swelling retreats and returns throughout the day following Dr visit. Voice changes occur during swelling (gurgled). The patient has no appetite but maintains a scheduled healthly diet. The patient has been unable to sleep for 24 hrs straight even after taking melatonin. There has been no shortness of breath however the patient experiences muscle spasms, dizziness and blurred vision while reading. The patient's right side of face has slower reaction timing than the left, the right eye closes frequently (not in tandum with the left) and is unable to smile. The patient has not experienced vomiting nor stool issues. The patient is unable to return to work until 01-11-2021 or until symptoms remain undetected for 48 hrs.

Other Meds: Zinc40mg (daily), Melatonin 10mg(nightly), Concerta 36mg(daily)

Current Illness: None.

ID: 0921115
Sex: F
Age: 45
State: VA

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: N/A

Allergies: Sulfa Drugs

Symptoms: I had flu like symptoms that lasted about 48 hours. I ran a fever of 102. The site of the vaccine on my left arm swelled up and wrapped all the way across my arm. Hot to the touch.

Other Meds: Avapro, Victosia, Levamir, Singular, Omepazole

Current Illness: N/A

ID: 0921116
Sex: F
Age: 49
State: KY

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: Anaphylaxis to Codeine, Morphine, Penicillin, Sulfa, Shellfish

Symptoms: Patient received Pfizer COVID vaccine and waited for 30 minutes after to observe for reaction. Within the 30 minute waiting period, she felt like her lips and tongue were tingling and her throat was scratchy. She denied shortness of breath, chest pain, difficulty swallowing or difficulty breathing. Vital signs were stable. Due to her history of anaphylaxis reaction with various medications and shellfish, she was taken to the ER. In the ER she received IV Solu-Medrol, Benadryl and Pepcid and her symptoms resolved. She was observed for 6 hours and then released to home.

Other Meds: Unknown

Current Illness: Unknown

ID: 0921117
Sex: F
Age: 36
State: OH

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: 30 hours after injection, she had diffuse redness and itching in her left upper arm and forearm(ipsilateral arm of injection) that was also on her chest and abdomen. She has photos on her phone. Right hand felt numb. Interestingly, the symptoms spared approximately 10 cm around the injection site. She had mild joint diffusely. No fever but had chills. She took 25 mg of Benadryl and her symptoms significantly improved after about an hour.

Other Meds: Dicyclomine prn

Current Illness: None

ID: 0921118
Sex: F
Age: 57
State:

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

Lab Data:

Allergies:

Symptoms: Patient received her vaccination then started to feel palpitations as she was waiting for 15 minutes. Then the patient felt dizzy and her BP was elevated (SBP ~135 mmHg) than her normal which is around 90/60 mmHg.

Other Meds:

Current Illness:

ID: 0921119
Sex: F
Age: 36
State: VA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever = 101.6F

Other Meds:

Current Illness:

ID: 0921120
Sex: F
Age: 56
State: IA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data: none

Allergies: Sonata for sleeping medication

Symptoms: Head ache, Body Ache, Chills, Low grade fever, swollen on injection site, upset stomach

Other Meds: Glipizide, metformin, multivitamins, Vitamin D3, Calcium, Fish oil

Current Illness: none

ID: 0921121
Sex: F
Age: 47
State: MO

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies: gluten, wheat rye barley, pertussis vaccine, sulfa drugs.

Symptoms: fever 100.4 for 36 hrs, then today 1/5 hives on administration side (arm)

Other Meds: OTC zyrtec, vitamin c vitamin B

Current Illness: none

ID: 0921122
Sex: F
Age: 47
State: CA

Vax Date: 12/31/2020
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Felt tired and cold Fever

Other Meds:

Current Illness:

ID: 0921123
Sex: F
Age: 50
State: PA

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

Lab Data: none

Allergies: Bactrim/Sulfa

Symptoms: BP; 170/110 mild SOB palpitation (HR 80bpm) hot flashes mild sweating Took Claritin, increase fluid intake, and extra Valsartan x 1.

Other Meds: Valsartan Calcium supplement

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm