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: 0966035
Sex: F
Age: 40
State: NM

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None as of yet

Allergies: None

Symptoms: No symptoms or reactions immediately. Injection site was very sore the following day. Followed by body aches, chills, headache, muscle and joint pain. Tired.

Other Meds: Women's Multivitamin Vitamin C Xanax 0.5mg

Current Illness: None

ID: 0966036
Sex: M
Age: 69
State: FL

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient received his covid-19 vaccine and during observation period experienced syncope and unconsciousness

Other Meds:

Current Illness:

ID: 0966037
Sex: F
Age: 74
State: CO

Vax Date: 01/14/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Redness and slight swelling

Other Meds: Vitamins (multi). Vitamin D and fish oil

Current Illness: None

ID: 0966038
Sex: F
Age: 28
State: NJ

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: camera down nose to view his trachea and vocal cords

Allergies: none

Symptoms: five minutes after vaccine developed tingling in left shoulder. ten minutes after vaccine felt tightness in throat, fifteen minutes after vaccine had difficulty swallowing

Other Meds: none

Current Illness: none

ID: 0966039
Sex: F
Age: 45
State: CA

Vax Date: 01/09/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: almost two weeks after injection a really red spot showed up with welts on it. The spot is also warm to touch.

Other Meds:

Current Illness:

ID: 0966040
Sex: F
Age: 43
State: OK

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: NA

Allergies: She had an anaphylactic reaction to a chemotherapy medication 7 years ago

Symptoms: Burning/ Scratchy throat that progressed to a feeling of throat swelling, rash on throat, tongue edema, ears "clogged". She was taken via ambulance to hospital. Received epi/ benadryl/ steroids and was released a short time later.

Other Meds: Unknown

Current Illness: Unknown

ID: 0966041
Sex: F
Age: 44
State: CT

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

Lab Data: echocardiogram (2) heart ultrasound bloodwork cardiac enzymes chest xray results all normal. Heart rate still in the 170's/180's. Beta blocker was administered intravenously.

Allergies: none

Symptoms: 1 hr and 15 minutes after receiving the shot I had a wave of dizziness come over me. Suddenly, my heart rate increase to over 180 beats per minute. I laid on the couch for an hour to relax and try to get it to slow down. Heart rate did not. Checked heart rate multiple times on a blood pressure machine and it was in the 180's. After an hour I went to the ER.

Other Meds: Tamoxifen

Current Illness: none

ID: 0966042
Sex: F
Age: 56
State: PA

Vax Date: 01/08/2021
Onset Date: 01/18/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: Imitrex

Symptoms: Erythema, swelling, warmth, tenderness

Other Meds: Metoprolol, metformin, lisinopril, vit D3, rosuvastatin, multivitamins

Current Illness: None

ID: 0966043
Sex: F
Age: 53
State: KY

Vax Date: 12/28/2020
Onset Date: 01/13/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: n/a

Allergies: penicillin, erythromycin,demerol,plavix

Symptoms: inlarged lymphnodes discovered under left arm . One is pea sized the other is smaller.

Other Meds: atenelol, avapro,pantoprazole,tylenol,vitamin c,zinc,vitamin d, b6,zrytec,ambien,eye drops, restasis, estradiol

Current Illness: n/a

ID: 0966044
Sex: F
Age: 49
State: MN

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Sore arm began within an hour of vaccine. Chills began 5 hours later. Overnight arm was painful. By 5:00 a.m. I was clammy and feverish with body aches and strong headache. By noon that day the fever went away but headache and body aches persisted until later that evening. By next a.m. I felt fine with no side effects at all.

Other Meds: none

Current Illness: none

ID: 0966045
Sex: F
Age: 46
State: MA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/22/2021
Hospital:

Lab Data: C-Diff-neg

Allergies: VIcidon

Symptoms: Shortly after the vaccination I got a burning warming sensation up and down my left leg which still presist today. I had a fever for one day but had diarrhea for about a week.

Other Meds: Zaralot, Topomax, Nexium, Bisoprolol Fumarate, Tizanidine, Colestipol

Current Illness: no

ID: 0966046
Sex: M
Age: 45
State: CT

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

Lab Data: none

Allergies: none

Symptoms: right shoulder soreness for the first dose for 1-2 days. left shoulder soreness after second dose, then approximately 8-10 hours later, I developed headache, neck ache, and by the morning, had skin sensitivity especially noticeable in touching my hair and genitals in the shower which was approximately 15 hours later. By 18 hours later my headache had worsened and i began to get light-headed. i drank tons of water and had no urination. I got hot and almost fainted. I had extreme uncontrollable shivering by 20 hours after injection. i nearly passed out at work. I also had nausea and burping. By the next day(more than 24 hours after injection), I was completely fine.

Other Meds: vit D, C, E

Current Illness: none

ID: 0966047
Sex: F
Age: 66
State: AZ

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

Lab Data:

Allergies: Penicillin

Symptoms: After vaccination patient started having pain in her left arm to the point that she can not lift her left arm. She went to the doctor on 01/22/21 and received pain medication. Her doctor told her that may be the muscle bundle fiber is injured and gave her pain medication. As of 01/22/21 she still can not lift her arm and when she tries she gets too much pain. She has not left the sensation.

Other Meds: none

Current Illness:

ID: 0966048
Sex: F
Age: 31
State: IL

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: Heavy Head / headache Queasy / waves of nausea Chills ** for 5 days post vaccine

Other Meds: prenatal vitamin

Current Illness: n/a

ID: 0966049
Sex: F
Age: 51
State: WV

Vax Date: 01/14/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: REDNESS AND HOT TO TOUCH - LOCAL REACTION STARTED ONE WEEK AFTER INJECTION

Other Meds:

Current Illness:

ID: 0966050
Sex: F
Age: 41
State: MI

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

Lab Data:

Allergies: Iodine - Topical Only Morphine Penicillin Propofal Flagyl Shellfish Eggs (Yolk and White) Dust, Mold , Pollens, Trees, Grass

Symptoms: Hives started on my chest, they were very sensitive, first noticed when my chest felt raw from my shirt. Hives went up from my chest to my neck and eventually to my face. About 30 mins after hives started, my breathing became labored. I took 3 Benadryl and was preparing to give my self an EpiPen injection. Benadryl was enough to slowly bring everything back to normal. This began around 6:00 pm, Benadryl was taken around 6:45, by 9:00pm I was completely normal for bed.

Other Meds: Singular 10 mg 1x/day Cefuroxime 500 mg 2x/day Prilosec 20 mg 1x/day Metaxalone 800 mg 3x/day Advil PM OTC 1x/day Ibuprofen 400 mg 1x/day Vitamin D3 5,000 IU 1x/day Cymbalta 60 mg am / 30 mg pm Tramadol 50 mg am / 100 mg pm Amitriptyline 25

Current Illness: N/A

ID: 0966051
Sex: F
Age: 84
State: MD

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: Unknown

Symptoms: Pt developed heavy chest and SOB sensation with pain behind her left ear. All self resolved after approx 10 mins.

Other Meds: Unknown

Current Illness: Known

ID: 0966052
Sex: F
Age: 0
State: MI

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: She reacted to Shingle shot about three months ago.

Symptoms: She experienced a loss of taste and soon had nausea.

Other Meds: Not aware

Current Illness: Not aware

ID: 0966053
Sex: F
Age: 58
State: WV

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Sick to stomach, migraine head ache

Other Meds:

Current Illness:

ID: 0966054
Sex: M
Age: 0
State: NJ

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
Hospital: Y

Lab Data: 1/21/2021 - abdominal ultrasound demonstrating small bowel on small bowel intussusception 1/22/2021 - Viral PCR negative for common viral causes of enterocolitis, positive for rotavirus. 1/22/2021 - Bacterial cultures still pending. clinical suspicion for bacterial enterocolitis is low.

Allergies: Soy and Dairy allergies

Symptoms: Patient developed bloody diarrhea and NBNB vomiting later in the day after receiving his rotavirus vaccination. Patient was brought to the ED 2 days after vaccination as his symptoms were not improving. Abdominal ultrasound demonstrated small bowel on small bowel intussusception. Patient was admitted to the general pediatrics service of the hospital and treated with IV fluids and acetaminophen for supportive care. Viral PCR came back negative for common viral causes of enterocolitis but positive for Rotavirus. At this time, bacterial cultures are still pending and the patient will remain in supportive care in the hospital.

Other Meds:

Current Illness: none

ID: 0966055
Sex: F
Age: 65
State: NY

Vax Date: 12/18/2020
Onset Date: 12/19/2020
Rec V Date: 01/22/2021
Hospital:

Lab Data: Mone

Allergies: Flagyl Cantelope, plums, peaches Preservatives

Symptoms: First: headache for 6 days. Body aches and low grade temp intermittently. Itching on day 8? Second: chills and low grade temps x 10 days. Joint pain x 10 days. Itching on day 13. Intermittent headaches and brain fog x 10 days.

Other Meds: Bystolic Livalo Xanax Lexapro Aspirin Vitamin C Lutein

Current Illness: None

ID: 0966056
Sex: F
Age: 44
State: KY

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: No known drug allergies

Symptoms: Lightheadedness, faintness, fatigue the night of receiving 2nd dose. Morning following second dose patient passed out while taking a shower and injured her arm. Contusion and bruising was prominent

Other Meds:

Current Illness: None

ID: 0966057
Sex: F
Age: 80
State: NY

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: EKG, blood drawn, head CT, heart monitor

Allergies: None

Symptoms: Extreme cramping in both legs, fainting

Other Meds: Amlodapin, klonapin, raloxifen, vitamin D, multi vitamin, baby aspirin

Current Illness: None

ID: 0966058
Sex: F
Age: 50
State: NV

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: No

Allergies: No

Symptoms: I had fatigue, fever, body aches and constant headaches. I had a rash that showed up after four or five days.

Other Meds: I take vitamins and lorsarten

Current Illness: No

ID: 0966059
Sex: F
Age: 89
State: TX

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: N/A

Allergies: SULFA ANTIBIOTICS

Symptoms: RED, FEVERISH, AND ITCHING FROM SHOULDER TO ELBOW. SOLID RED AND ITCHED. HAD PROBLEMS SLEEPING. HYDROCORTISONE CREAM OTC DID NOT HELP. RUBBING ALCOHOL APPLIED TO AREA PROVIDED RELIEF. PATIENT APPEARED TO SHOW ME AND HER ARM AND ITLOOKED FINE AND SHE SAID SHE WAS NOT HAVING ANY ISSUES AS OF 01/22/21. PATIENT DID NOT SEE A PHYSICIAN.

Other Meds: XANAX, LEVOTHYROXINE, BREO ELIPTA, PRO-AIR, CARTIA XT 120MG,

Current Illness: N/A

ID: 0966060
Sex: F
Age: 63
State: LA

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: Angioedema in November 2019. Supposedly to Lisinopril. All available allergy tests negative.

Symptoms: I was okay during the 30 minute observation period, and was discharged. Between 1 and 1:30 am, about 15 hours after receiving the vaccine, I woke up from my sleep suddenly, with an acute episode of chest tightness, cough, severe running nose and lacrimation. I did not have hives or lip/throat itching or swelling. I felt a little warm in the face. I took Ventolin inhaler two puffs twice 30 minutes apart + Aller-flo nasal sprays. I began to feel a bit better and then took Benadryl 25 mgms (because of my history of Angioedema) around 2:30 am. I feel better now, which is 12 hours after onset of episode, but had to take Ventolin inhaler this morning for a bit of chest tightness. I do not have a history of asthma, but have had seasonal allergies in past years. But if this is seasonal allergy, it is very unusual, since I have never had an acute episode like this without any early milder symptoms. And I haven't needed Ventolin in a couple of years. I am now concerned about taking the second dose.

Other Meds: Insulin, diabetic medications. Allegra 180 mgm night before vaccination, and another 180 mgm 30 minutes before vaccination, as advised by allergist

Current Illness: None

ID: 0966061
Sex: F
Age: 65
State: WV

Vax Date: 01/07/2021
Onset Date: 01/15/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: HEAD COGESTION, FEVERISH AND ACHY STARTED 12-36 HOURS POST INJECTION

Other Meds:

Current Illness:

ID: 0966062
Sex: F
Age: 61
State: NJ

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: NONE

Symptoms: SEVERE HEADACHE, BODY ACHES, LOW GRADE TEMP (99-100) LASTED ABOUT 24 HRS. TOOK EXTRA STRENGTH TYLENOL Q 4 H

Other Meds: BYSTOLIC 5MG-OD; MULTI-VIT

Current Illness: NONE

ID: 0966063
Sex: F
Age: 40
State: CA

Vax Date: 01/14/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Exactly 7 days after I received the vaccine my injection site starting itching. The itching turned into hives. When I woke up on the 8th day the injection side was red, hot, grew to the size of my fist & is very swollen underneath in my muscle. It is hot, red, & itchy.

Other Meds: Generic aleve, butran patch, nortriptyline, vit D, elderberry, zinc, vit c

Current Illness: None

ID: 0966064
Sex: F
Age: 39
State: OH

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

Lab Data: None

Allergies: None

Symptoms: High Fever >102, dizziness, fatigue, body aches, back pain, headache, numbness in fingertips and toes

Other Meds: Lexapro, Prevacid, Multivitamin

Current Illness: None

ID: 0966065
Sex: F
Age: 55
State: MI

Vax Date: 01/14/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: Pecans Buckwheat

Symptoms: One week after receiving the injection I have developed a rash about an inch away from the injection site. It is itchy, red, and raised. This began at approximately 8 PM at night and has lasted for 19 hours so far.

Other Meds: Effexor Trazodone Buspirone Budesonide

Current Illness: None

ID: 0966066
Sex: F
Age: 35
State: MS

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: nkda

Symptoms: She reports body aches, nausea, diarrhea, headache & fatigue

Other Meds:

Current Illness:

ID: 0966067
Sex: F
Age: 46
State: IN

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever, chills, body aches, joint pain

Other Meds:

Current Illness:

ID: 0966068
Sex: F
Age: 76
State: TX

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

Lab Data:

Allergies: none known

Symptoms: Delayed rash on arm at injection site. On the 8th day following vaccination, I developed a circular red rash, slight swelling, hot, vaguely itchy. The circle was about 2 inches diameter. Over the next two days, although the swelling abated, the rash expanded down and around my arm. I am now in my third day of having the rash. Now , the rash is about 6 inches down my arm Like her, I am wondering whether I should have the second dose of the vaccine.

Other Meds: losartan 50 mg parvastaton 40 mg aspirin 81mg vit D ARED II Multivitiman

Current Illness: none

ID: 0966069
Sex: F
Age: 31
State: PA

Vax Date: 01/15/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: Day after injection redness,warmth, painful to touch at injection side. Next day gone. One week from the day I received the vaccination Red and warmth at injection site and sore under left armpit same side injection given on.

Other Meds:

Current Illness:

ID: 0966070
Sex: F
Age: 39
State: IN

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

Lab Data: None

Allergies: None known

Symptoms: Extreme pain in entire L UE, nausea, fatigue, chills, hot flashes, headache, dizziness, brief and mild SOB, itchy rash over entire torso worse on L side. Pain in UE gone in ~30 hours from injection, headache from 12 hours to 36 hours, rash 30 hours to 54 hours.

Other Meds: Vitamin C 125mg

Current Illness: None

ID: 0966071
Sex: F
Age: 66
State: NJ

Vax Date: 01/12/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: none

Allergies: penicillin IM as a child

Symptoms: one week post vaccine ..hypersensitivity reaction ...large hive , red indurated warm and itchy about the size of an orange, three days later , less red but now no longer circumscribed

Other Meds: omlesartan, hctz, effexor, crestor vitamin d lamictal

Current Illness: none

ID: 0966072
Sex: F
Age: 75
State: MI

Vax Date: 01/12/2021
Onset Date: 01/15/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: NKDA

Symptoms: Several days after first dose of Covid-19 vaccine, she developed shingles of her left frontal face.

Other Meds: glipizide, lantus, metformin, vitamin D

Current Illness: None

ID: 0966073
Sex: F
Age: 40
State: CA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: Citrus, pineapple

Symptoms: Twelve minutes after receiving the vaccine injection, patient reported tingling in both arms and across her upper back. She had taken a dose of Benadryl, 50 mg p.o. prior to coming to the clinic, due to her prior history of allergies. Her blood pressure was checked in left arm, 134/94. She denied chest pain, SOB or feeling of swelling in tongue or face. After the tingling sensation, she began to experience pruritus of her arms, back and scalp. Visual inspection revealed no visible rash or hives. When she began rubbing on her left arm to relieve the itchy sensation, the area of rubbing became erythematous. She was observed for 45 minutes after the injection. Symptoms did not progress and she was discharged from the clinic. Phone follow-up 24 hours later: pruritus has resolved. She took 2 more doses of Benadryl 50 mg p.o. yesterday, at 2 p.m. and 11 p.m. Only symptom reported today is sleepiness.

Other Meds: Benadryl

Current Illness: Mild URI 4 weeks prior

ID: 0966074
Sex: U
Age: 0
State: IL

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

Lab Data:

Allergies:

Symptoms: While a nurse was preparing to reconstitute a COVID-19 vaccine, the vial was dropped and broken. This error did not reach any patients and did not cause any adverse events.

Other Meds:

Current Illness:

ID: 0966075
Sex: F
Age: 50
State: NV

Vax Date: 12/18/2020
Onset Date: 12/19/2020
Rec V Date: 01/22/2021
Hospital:

Lab Data: No

Allergies: No

Symptoms: I felt tired and then after 5 days I had a rash on my breast and it lasted for almost 3 weeks. I went to Urgent Care.

Other Meds: I take vitamins and losartan.

Current Illness: No

ID: 0966076
Sex: F
Age: 31
State:

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: Advair, formaldehyde

Symptoms: chest tightness

Other Meds:

Current Illness:

ID: 0966077
Sex: F
Age: 69
State: FL

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: o Patient received Moderna vaccine IM to left arm. Patient reports the area is red and itchy. Patient stated she does not have a history of allergies to medication or food. Vitals sign taken BP 154/76 P 72 o2 sat on room air 99% at 10:40 am. 10:55 am VS BP 143/73 P 72 o2 sat 98% on room air. Patient denies any SOB ,dizziness, chest pain or severe headache. Patient transferred via ambulation to clinic for further evaluation. o Patient transferred via ambulation to clinic for further evaluation. Patient will be evaluated for further treatment by staff.

Other Meds:

Current Illness:

ID: 0966078
Sex: F
Age: 38
State: PA

Vax Date: 01/14/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: no

Symptoms: Pt. received 1st dose of moderna vaccine to left arm on 1/14/21 at 08:30 am, and developed itching, redness, and swelling, lump, warm to touch on 1/20/21 at 1800 pm. Pt. states that redness and lump are a little bigger than a quarter size. Pt. denies taking anything for it. Pt. states that her symptoms are not getting worse but are also not improving.

Other Meds: yes

Current Illness: no

ID: 0966079
Sex: F
Age: 25
State: MO

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: PT stated she felt funny. Began assessment. PT lost pulse, began CPR. PT regained pulse, was transferred via EMS to hospital

Other Meds: None

Current Illness: None

ID: 0966080
Sex: M
Age: 45
State: NY

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: undisclosed

Symptoms: Vaccine administration error. It is suspected that a 1/2" needle syringe was used instead of a 1" needle syringe.

Other Meds: Undisclosed

Current Illness: undisclosed

ID: 0966081
Sex: F
Age: 42
State: IN

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

Lab Data:

Allergies: Aspartame, Wellbutrin, Vicodin

Symptoms: On Wednesday 01/20/21 approximately 8 days post vaccination a large area of my upper arm began to hurt and become hot , red, and swollen near the injection site. Today the pain and swelling are slightly better but it is still red and hot to the touch and has not shrunk in size any at all. Reminder, I had only the normal reactions of pain and a small knot

Other Meds: Pristiq, Adderall

Current Illness: None

ID: 0966082
Sex: F
Age: 62
State: TN

Vax Date: 01/20/2010
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: noe

Allergies: Avalox

Symptoms: first 24 hrs --only sore arm one day, post injection: chills, fever (100.5), headache, weakness, nausea (symptoms were like what I experienced the first days of Covid (Dec 4) except with Covid I ran little low and infrequent fever.

Other Meds: Diltiazem, Lisinopril, Montelucast, zyrtec, Ruvostatin, Sertraline, Advair, Potassium, Vit B and D, Caltrate, Caltrate

Current Illness: Asthma, heart bp,

ID: 0966083
Sex: F
Age: 37
State: MD

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: Not applicable, transported to ed

Allergies: Seasonal allergies only. No history of anaphylaxis

Symptoms: Dizziness approximately 10 minutes after vaccination. Flushing, itching and swollen tongue, itching inner ears and forearms

Other Meds: Prn albuterol inhaler

Current Illness: Asthma only

ID: 0966084
Sex: M
Age: 31
State: OH

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Fever, chills, joint pain, body aches, fatigue, headache

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm