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: 0962375
Sex: F
Age: 45
State: NE

Vax Date: 01/13/2021
Onset Date: 01/18/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: anitigen 1/18/2021 negative PCR 1/19/2021 negative

Allergies: Vistaril

Symptoms: Migraine, exhaustion x 48hrs, nausea

Other Meds: Gabapentin Tylenol Multi-Vitamin

Current Illness:

ID: 0962376
Sex: M
Age: 67
State: TX

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: Vitals 199/92

Allergies: NKDA

Symptoms: ?Moderna COVID-19 Vaccine EUA? Patient states that 5 minutes after receiving the vaccination he started to develop HIVES, and SOB and lightheadness. Patient admits he was given Benadryl IM at vaccination drive thru clinic and was transported to ER.

Other Meds: ATORVASTATIN 40 MG METFORMIN HCL 1000 AMLODOPINE PIOGLITATZONE METOPROLOL

Current Illness: no

ID: 0962377
Sex: M
Age: 43
State: OH

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: none in the facility

Allergies: Aspirin, Sulfa

Symptoms: Patient reported tongue pain located on the edges of the tongue, dizziness, shortness of breath. Initial vital signs 108- HR 99% Pulse OX room air- 220/100

Other Meds: valacycovir, prednisone, promethazine, Symbicort albuterol

Current Illness: none reported

ID: 0962378
Sex: F
Age: 54
State: VA

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

Lab Data:

Allergies: Eggs, contrast medium, latex, other foods and products.

Symptoms: Injection site pain, headache, tiredness, muscle pain, chills, nausea, feeling unwell, sweating, dizziness. After 45 minutes it subsided enough, except the nausea, so that I could go to the recovery area where I remained for a few more minutes. I then felt well enough to drive myself home.

Other Meds: Hydroxychloroquine, tizanidine, topimirate, levomefolate-algal, alpha lipoic acid, magnesium citrate, D3, B-complex, dulera.

Current Illness: None

ID: 0962379
Sex: F
Age: 39
State: LA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: None

Allergies: Sulfa

Symptoms: Patient was given the injection (right deltoid) on 13 January 2001 and noticed pain under that arm on 16 Jan 2001. On January 19th, she noticed itching to the deltoid area and then on the 20th, a red rash appeared. It was warm to the touch and 21 Jan she stated the area of redness was warm and hard to touch. I examined the patient and did not find any induration but agree with warm to touch and an irregular shaped area with noticeable erythematous area measuring 5cm X 7 cm. Gave her an injection of Clindamycin 300mg and a prescription of Cephalexin 500mg four times a day for ten days. Will re- evaluate in 24 hours. No other symptoms to report.

Other Meds: Sprintec (BC)

Current Illness: None

ID: 0962380
Sex: F
Age: 47
State: IN

Vax Date: 01/18/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: Covid negative - 19Jan2021

Allergies: Pitted fruit and Peanuts

Symptoms: First dose without incident. 18Jan2021 6:40am 2nd dose - 12hr later felt blah, 24hrs later extremely dizzy with moderate headache and body aches. then at 4am 20Jan2021 (right around 48hrs), I had erythema with a blister on left lateral side around rib region 8-10 with itching and burning. This improved to no erythema and this morning (21Jan2021) only 3 blisters with mild discomfort.

Other Meds: None

Current Illness: none

ID: 0962381
Sex: F
Age: 56
State: TX

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: Vs @ 1254 & 1310

Allergies: codeine

Symptoms: Flushing Elevated BP @1254 BP152/95, P93, R20, T98.3, Spo2 99%RA Nausea

Other Meds: Amoxicillin qid, Benacar qday Levothyroxine qday Cymbalta qday

Current Illness: Tooth abscess

ID: 0962382
Sex: F
Age: 78
State:

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/21/2021
Hospital: Y

Lab Data:

Allergies: NKA

Symptoms: Admitted to hospital 1/14/2021 with acute mental status changes, hypoxia, pneumonia (previous positive COVID 12/18/2020) ICU 1/14/2021-1/16/2021, currently hospitalized PCU level of care

Other Meds:

Current Illness: COVID-19 positive 12/18/2020

ID: 0962383
Sex: F
Age: 77
State: TX

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: None

Allergies: Metormin- -Asprin - -Streptomycin- -Bactrim- -Augmentin- -Avandia - -Norvasc- - Actos - -Indocin- -Atorvastatin

Symptoms: Approx 1 hour after injection (arm ok) top of head near crown on left side felt pressure extreme soreness to touch and like nerves were tingling. Did not have any of this before injection. This went on for rest of evening , all next day. Next morning was back to normal. Never any severe pain just pressure and soreness. Got inj. At 3:35 on Tuesday 1-19 2021 started feeling apps 4:30 same day into night. All next day Wednesday 1-20-2021 into night. Next morning Thursday 01-21 it was gone. Could not stand to touch that area on top of head.

Other Meds: Levothyroxine 75mcg- -Metoprolol ER 50 mg- -Glimepride 2 mg- -Pravastatin 40 mg - -Olmesartan 40 mg- -Omeprazole 20 - -Buspar 5 mg- -Toujeo Solostar 50 units - -vitiamins: D3, 5000- -B Complex ZBEC.

Current Illness: Bronchitis, strep throat

ID: 0962384
Sex: M
Age: 86
State: SD

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: None

Allergies: NKA

Symptoms: 55 minutes (12:00pm) after receiving 1st dose of Moderna COVID-19 vaccine resident was shaky all over. States he's had panic attacks but it "doesn't feel like that". Denies chest pain. Denies shortness of breath. Visibly shaking. Facial Hx of diabetes and had just finished lunch. Blood sugar 189. 02= 98% on room air, BP 140/70 Pulse 106. At 12:07 complains that tongue feels numb and throat feels tight. 12:08 pm, Epi-pen administered to left outer thigh. 12:16pm states he's feeling better. Shaking has subsided. Tongue numbness almost gone. 12:31pm T= 98.3 02 = 98% P=80 BP= 114/72

Other Meds: amlodipine, metformin, paroxetine, potassium chloride, simvastatin, terazosin naproxen sodium PRN, nexium PRN, nitroglycerin PRN

Current Illness: None

ID: 0962385
Sex: F
Age: 68
State: NJ

Vax Date: 12/28/2020
Onset Date: 01/06/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: none

Allergies: seasonal allergies, drug-propofol

Symptoms: Took a nap and woke up with a black eye, left side. Occurred approximately 1430 on 01 January 2021. Black Eye continued to spread downward to the check bone. Visited Urgent Care on 1/11/2021 and they said it was due to a broken blood vain. I have never had this incident in the past.

Other Meds: ibuprofen, gabapentin, levothyroxine, simvastin, loratadine, sertaline, calcium/vit D, fish oil caps, multivitamin, milk thisle

Current Illness: none

ID: 0962386
Sex: F
Age: 78
State: VA

Vax Date: 01/13/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: none

Allergies: nortriptyline

Symptoms: Round red itchy rash around the injection site. Likely been there since injection and still noticeable on day 9 post vaccination

Other Meds: lisinopril, Vit D, simvastatin, sertraline,

Current Illness: None

ID: 0962387
Sex: F
Age: 46
State: PA

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

Lab Data:

Allergies:

Symptoms: Systemic: Anaphylaxis-Severe

Other Meds:

Current Illness:

ID: 0962388
Sex: F
Age: 31
State: FL

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: None

Allergies: NKA

Symptoms: Had arm soreness on the day of the vaccine. The following day continues to have soreness of the arm but noticed a firm hard small lump in her left neck. Left neck lump persists. Non painful

Other Meds: None

Current Illness: None

ID: 0962389
Sex: F
Age: 87
State: FL

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: I thought I had covid and I went this morning to get the covid test and it was negative.

Allergies: novicaine, honey dew melon

Symptoms: about 1 hour after shot, I got very cold and chilled, then that night or following day, I felt like I had a cold and sore throat and congested. Each day it got a tiny bit worse, I was soo sick but lethargic and unwell. It got a tiny bit worse the next day but I am hoarse and my throat feels annoyed and I don't feel like me. Even though all this happened I would go through with it again. The injection site hurt the next day and it went away.

Other Meds: daily losartan, Lipitor, omeprazole dr, diritive of Synthroid, amlodipine, metrothrolo er, aspirin, isosorbide monolith er tb, protein X, vitamins, airborne, inhaler Anoraelpita, eye drops that I take at night Latanoprost for glaucoma

Current Illness: no illness

Date Died: 01/16/2021

ID: 0962390
Sex: M
Age: 81
State:

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

Lab Data:

Allergies: ASPIRIN

Symptoms: Admitted to hospital after vaccination with Acute hypoxemic respiratory failure, Septic shock; Aneurysm of arteriovenous dialysis fistula; expired 1/16/2021

Other Meds:

Current Illness: intestinal adhesions with obstruction; Intestinal adhesions with partial obstruction; S/P colon resection; SBO (small bowel obstruction)

ID: 0962391
Sex: F
Age: 61
State: MO

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Global myalgia, chills, high fever, significant arm pain. Excedrin used. Symptoms mostly resolved.

Other Meds: lisinopril and simvistatin generic excedrin prn

Current Illness: None

ID: 0962392
Sex: F
Age: 23
State: FL

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: NONE

Allergies: None

Symptoms: Headache (one day post vaccine), Fatigue (one day post vaccine)

Other Meds: Lexapro 10mg Adderal 5mg Vitamin D 5000UI, Elderberry

Current Illness: Common Cold 30 days before vaccination

ID: 0962393
Sex: M
Age: 83
State: AZ

Vax Date: 01/15/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: none

Other Meds: sinemet

Current Illness: none

ID: 0962394
Sex: F
Age: 48
State:

Vax Date: 01/05/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: 1/20/21 Positive for Covid

Allergies:

Symptoms: 1/20/21 HA, fever, sinus pressure/pain, ear pain, congestion, sore throat, chills *Positive for Covid

Other Meds:

Current Illness:

ID: 0962395
Sex: M
Age: 53
State: HI

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Hives on chest, back, legs and groin

Other Meds: None

Current Illness: Gallbladder stones

ID: 0962396
Sex: F
Age: 30
State: IL

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

Lab Data: n/a

Allergies:

Symptoms: Received vaccine 1/20/2021 Awoke 1/21/2021 with chills, temp of 100.5, arm is sore

Other Meds: OTC allergy medication

Current Illness:

ID: 0962397
Sex: F
Age: 80
State: NC

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: None

Allergies: Sulfa drugs, Bee stings, "Any thing with D"

Symptoms: Morning after receiving vaccine (01/14/2021), woke up and was having chills, weakness, "head felt like it did when having covid, dizziness, light-headed". Urinary incontinence and memory loss, and hallucinations on 01/14/2021. Blue color to left deltoid started 01/13/2021 in PM and on 01/14/2021 when waking up, left upper arm was blue and redness noted down to elbow. "I have laid on the couch and that's basically all I've done since getting the shot."

Other Meds: Pravastatin, "nerve pill" (unknown name), "Happy Pill" 20mg capsule (Unknown name), Meclizine

Current Illness: Covid+ 11/01/2020. Hospitalized with Covid "about 6 days" in November 2020.

ID: 0962398
Sex: F
Age: 91
State:

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

Lab Data:

Allergies: NSAIDs

Symptoms: Dizziness

Other Meds:

Current Illness:

ID: 0962399
Sex: M
Age: 43
State: IL

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

Lab Data:

Allergies:

Symptoms: Body aches, headache, chills

Other Meds:

Current Illness:

ID: 0962400
Sex: F
Age: 34
State: NC

Vax Date: 01/12/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: redness and itching over injection site

Other Meds: Mirena IUD

Current Illness: none

ID: 0962401
Sex: M
Age: 31
State: IL

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data:

Allergies: Penicillin, nuts, peanuts

Symptoms: Patient received the Moderna Covid-19 vaccine and during the observation the patient was observed to experience a reaction. Approximately 5 minutes after the vaccine patient experienced warmth, dizziness, weakness, confusion, vision blurred, labored breathing, hypotension, mild nausea. Blood pressure was dropping after first reading from 96/60 to 86/42 at which point a single dose of epi-pen was administered. The patient BP stabilized at 105/83 at the time paramedics arrived and took the patient.

Other Meds: None

Current Illness: Asthma

ID: 0962402
Sex: F
Age: 77
State: TX

Vax Date: 01/08/2021
Onset Date: 01/18/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: blood work- just for being at the dr.

Allergies: Plaquenil, gabapentin,

Symptoms: on the 18th i was in the Dr office and went to take my blood pressure i got up to get my weight and went to walk to the scale IN front of me and instead i was walking backwards instead of forward. i stopped myself but i couldn't make myself forward only going backward. my brain wasn't telling me to walk back but my feet were moving backward. Finally stopped and was able to make myself move forward. i was fully aware of what was happening but just couldn't stop it.

Other Meds: Centrum Silver, Vitamin D3, Zinc 50, Vitamin C 1000 units a day, Vitamin E 800 unites a day, Novolog, Victoza 0.6 mg, Prozac 10 mg , Hydroxyurea 1000mg daily, Celbrex 200 mg- twice a day, Crestor 20mg, Prilosec 20mg twice a day, Zyrtec, 10M

Current Illness: Headaches and dizziness- haven't felt good since July

ID: 0962403
Sex: F
Age: 76
State: TX

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

Lab Data: None

Allergies: None

Symptoms: Pain at injection site.

Other Meds: Amlodipine, atorvastin, cozaar, cyclobrnzaprine, fenofibrate nanocrystallized, gabapentin, glimepiride, lancets, lumigan, polyethylene, tamsolosin

Current Illness: Diabetes, cholesterol, high blood pressure

ID: 0962404
Sex: F
Age: 36
State: UT

Vax Date: 01/05/2021
Onset Date: 01/07/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Two days post vaccination patient began having itching, redness, swelling and hot to the touch at injection site. has traced the redness with pen and states redness is expanding. states about 3 in in diameter, states some redness after injection with a small lump but the last 3 days redness has grown and expanded. Encouraged to apply ice pack, may take Tylenol/Anti Itch medication for sxs. Continued to expand. Went to Urgent Care 1/17/21. Rx Cephalexin.

Other Meds:

Current Illness:

ID: 0962405
Sex: F
Age: 25
State: AZ

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: None.

Allergies: Betadine/iodine, penicillin, Chlorhexidine, tramadol

Symptoms: Extreme body aches started 01/20/21 at 06:00am as well as headache and fever. This has continued to today 01/21/21 with body aches, fever, congested nose. Taken IBU and Tylenol with little relief

Other Meds: Ibu, linzess 290mg, vitamin C

Current Illness: None.

ID: 0962406
Sex: F
Age: 57
State: AZ

Vax Date: 01/15/2021
Onset Date: 01/18/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data:

Allergies: noe

Symptoms: On the monday following my vaccination is very suddenly developed SEVERE chills. It took me three hours in a bed with electric blankets to get warm. Headache and body aches and tiredness. That day was the worst. And here is is 4 days later and I am still not out of the woods. I am still taking tylenol and advil for the body aches and chills and I have no energy

Other Meds: noe

Current Illness: none

ID: 0962407
Sex: M
Age: 56
State: AZ

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: N/A

Allergies: penicillin

Symptoms: Patient was sitting in chair and fainted, would not respond to sternal rub or name. Called rapid response and was taken to ED. Patient was not responding for 2 minutes, proceeded to take vitals and gave him some orange juice in case low sugar. Took vitals and patient had low BP, felt cold, all other vitals were WNL. Taken to ED after about 15 minutes where they ran tests and made sure patient was okay.

Other Meds: unknown

Current Illness: unknown

ID: 0962408
Sex: F
Age: 80
State: IL

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: Influenza Test Negative

Allergies: No allergies

Symptoms: Fever 102 x 1 - Droplet Isolation implemented

Other Meds: Amlodipine 5mg daily, Breo Ellipta 1 puff daily, Claritin 10mg daily, Donepezil 10mg daily, Famotidine 20mg daily, Lasix 20mg daily, Losartan 100mg daily, Metoprolol Tartrate 12.5mg BID, Montekulist 10mg daily, Potassium Chloride 10mEq 2 ca

Current Illness: COPD, Hypertension, GERD, Obesity, PVD,

ID: 0962409
Sex: F
Age: 22
State: OH

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

Lab Data:

Allergies: Gluten and lactose intolerance

Symptoms: Moderna COVID?19 Vaccine EUA Nausea, vertigo, headache, joint and muscle ache, increased skin sensitivity, fever

Other Meds: Cymbalta, loestrin, topimax

Current Illness: Sinusitis

ID: 0962410
Sex: F
Age: 17
State: AL

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Per dad, 2 hours after getting the vaccine the patient started laughing and crying inappropriately at the same time. This episode lasted around 4 hours. Patient then fell asleep and when she woke up she was fine. Patient has not had any problems or episodes since that day.

Other Meds: Cetirizine 5mg/5mL-Take 1 tsp every night

Current Illness: None

ID: 0962411
Sex: F
Age: 27
State: FL

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: None, informed PCP today, was told to take antinflamatory and monitor over next few days.

Allergies: Nickel

Symptoms: Swelling in underarms (at where armpit meets chest), more significant in left armpit (side of vaccine) but present on both sides. Noticed as soon as arrived home from clinic. Currently persistent still 9 days later. Not worsening but not improving. Some discomfort from this swelling. No swelling or redness of actual injection site at any point. Also had headache, arm and body aches and pains of muscle/bone, and fatigue but these resolved within a few days. Only swelling in armpits persists.

Other Meds: None, occasional multivitamin

Current Illness: None

ID: 0962412
Sex: F
Age: 55
State: PA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccine recipient received injection low in the arm (8 finger breadths below the AC). She was concerned this was not in the deltoid muscle itself. Upon review, the vaccine was not injected in the appropriate location for a deltoid IM injection.

Other Meds:

Current Illness:

ID: 0962414
Sex: F
Age: 29
State: MN

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: Full body red raised spotted rash with bloches of large red patches on the the upper arms. Itchy Treated with steroids and H2 blockers

Other Meds: n/a

Current Illness: n/a

ID: 0962415
Sex: F
Age: 56
State:

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient received second dose 1 day too early.

Other Meds:

Current Illness:

ID: 0962416
Sex: F
Age: 41
State: ND

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

Lab Data: none

Allergies:

Symptoms: Body aches and chills 10 hours after second vaccine. Lasted 12 hours.

Other Meds:

Current Illness:

ID: 0962417
Sex: F
Age: 88
State: FL

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

Lab Data: none noted

Allergies: Cipro, Actonel, Accupril

Symptoms: Pain/discomfort in left shoulder and neck.

Other Meds: unknown

Current Illness: none noted

ID: 0962418
Sex: F
Age: 32
State: NY

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data:

Allergies: Bananas. No drug allergies.

Symptoms: Developed hives all over the body, difficulty swallowing, itchiness, tingling, SOB, mild chest tightness 9 min following the first dose of the vaccine on 01/11/21and was treated with IV Benadryl, Pepcid and Hydrocortisone. Since the vaccine on 01/11 patient c/o prolonged fatigue and intermittent episodes of palpitations, chest tightness resolving without intervention. (2-3 episodes ) 01/20 patient reported symptoms of chest tightness, full body shaking requiring medical attention and d/c from care.

Other Meds:

Current Illness:

ID: 0962419
Sex: M
Age: 42
State: PR

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: OXYGEN VIA NASAL CANNULA

Allergies: NONE

Symptoms: DRY MOUTH, PAIN OF SITE OFVACCINATION, INCREASE OF BLOOD PRESSURE

Other Meds: Vitamin D3

Current Illness: NONE

ID: 0962420
Sex: F
Age: 41
State: KS

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: n/a

Allergies: none

Symptoms: arm soreness at the site of injection for about 3-4 days following the injection

Other Meds: allegra, flonase, multivitamin, vitamin B, calcium with Vit D

Current Illness: yeast infection (prior month)

ID: 0962421
Sex: F
Age: 67
State: CA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data:

Allergies:

Symptoms: stated verbalized dizziness at 1007 patients stated "perfectly normal" dcd home

Other Meds:

Current Illness:

ID: 0962422
Sex: F
Age: 80
State: NC

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: None

Allergies: Sulfa drugs, bee stings, "Anything with D"

Symptoms: Left deltoid began turning blue evening of 01/13/2021. After awakening on 01/14/2021, left upper arm was blue and red to elbow. Voices that "head felt like it did when I had covid, light-headed, dizziness", hallucinations, urinary incontinence, weakness, memory loss.

Other Meds: Pravastatin, "happy pill, 20mg" (Doesn't know name of medication, "nerve pill 1/2" (unknown name), Meclizine

Current Illness: Covid+ with hospitalization 11/2020.

ID: 0962423
Sex: F
Age: 55
State: MA

Vax Date: 01/12/2021
Onset Date: 01/14/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data: COVID 19 negative tested 1/17/21

Allergies: none

Symptoms: Initial tenderness at injection site 1/13/21 then red and warm 1/14/21 Joint pain 1/14 and muscle aches started 1/15 and continued along with headaches for 3 days. Went for a COVID test and negative. Injection site left arm is indurated and warm 1 inch area and pruritic at times for past 3 days to present .

Other Meds: Sertraline 100 mg Advil pm at night

Current Illness: none

ID: 0962424
Sex: F
Age: 20
State: AZ

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

Lab Data: none

Allergies: NKDA

Symptoms: fever of 102.4 body aches, upset stomach

Other Meds: Birth Control- norgestimate 0.25mg-ethinylestradiol 35 mcg

Current Illness: none

ID: 0962425
Sex: F
Age: 78
State: NY

Vax Date: 01/09/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: I had my moderna vaccine on January 9th at Public Health, and had a mildly sore arm for one day. I checked in with vsafe each day when prompted and noted no reactions. Ten days later, January 19th, I had a blood test in the same arm. That night, my arm, at the vaccination site, became itchy, swollen , sore and red. I am advising you of this. Do I need to be concerned. COVID-19 Moderna Modernatx, Inc., Lot# 012L20A, exp: 7/6/2021

Other Meds: Arnnuity Ellipta, Estradol, cholesterol medicine, levothyroxine, gelatin tablets, Vitamin D, calcium, zinc, Prolia shot December 2020 I received a blood test in the same arm 1/18/2020

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm