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: 0966338
Sex: F
Age: 39
State: IL

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

Lab Data:

Allergies:

Symptoms: Patient began to complain of shortness of breath, tingling in left arm (in which she received the vaccine), dizziness, and "seeing spots" approximately 5 minutes after administration of COVID-19 vaccine. Patient was found to have low blood pressure of 86/58. A code blue was called by COVID clinic staff. Upon rechecking vitals, the patient's blood pressure had improved to 136/79 and her oxygen saturation on room air was 100%. The patient was advised to go to the emergency department for continued monitoring but refused.

Other Meds: naproxen, leflunomide, tocilizumab

Current Illness:

ID: 0966339
Sex: F
Age: 62
State:

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

Lab Data:

Allergies: Keflex influenza vaccine Clarithromycin Oxycodone Pregabalin Bactrim Coumadin

Symptoms: Facial swelling and asthma exacerbation

Other Meds:

Current Illness:

ID: 0966340
Sex: M
Age: 46
State: IL

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

Lab Data: EKG, Blood test to r/o clot, Patient declined chest x-ray on 1/15/21

Allergies: None

Symptoms: Chills, muscle aches, fatigue, headache, difficulty breathing

Other Meds: N/A

Current Illness: No

ID: 0966341
Sex: F
Age: 61
State: MA

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

Lab Data:

Allergies:

Symptoms: Female caller stated she received the Modernaa COVID vaccine on 1/20/2021 and then the next morning at work she began experiencing chills. The chills continued throughout the day and when she got home from work she had a temperature of 101.0 F. Caller instructed to recieve in person care per guidelines for Severe of Temperature = or >100.0 F. Caller verbalized understanding of recommendations 1/22/2021 @ 1611

Other Meds:

Current Illness:

ID: 0966342
Sex: F
Age: 59
State: MI

Vax Date: 12/28/2020
Onset Date: 01/03/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Six days after receiving the first dose of the Moderna COVID-19 vaccine, the site of the injection began intensely itching. A patch about 6 inches long and 4 inches wide around the injection site became red, a little bumpy and hot to the touch. The itch and redness intensified over the next two days, which is now seven and eight days post injection. The itch is non-stop; the redness has spread and it's still warm to the touch. On the ninth day post-injection, the itch has subsided, the warmth is gone and the redness has started to go away. By the tenth and eleventh day post-injection, all symptoms have subsided. I am scheduled for the second dose Jan. 25 and plan to get it in my left arm and will monitor to see if I get the same results.

Other Meds: Topomax, OTC Biotin, OTC Calcium with vitamin D

Current Illness: None

ID: 0966343
Sex: F
Age: 64
State: CO

Vax Date: 01/13/2021
Onset Date: 01/16/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: Penicillin, Bactrim and Sulfer all cause hives

Symptoms: On Saturday on the 16th I started itching all over my body and my head, dry mouth and my ears were itching as well. On Sunday I noticed the itching increased after taking my levothyroxine. The 18th I noticed the same pattern of itching increasing after taking the levothyroxine the dry mouth as continued. Have not been sleeping well. The 19th same pattern occurred. I also developed a slight headache. I have been using lots of lotion. The itching appears to worsens after taking the Levothyroxine and after showering. The 20th same thing, but the headache was worse so I took two aspirins. The 21st was a big change, my heart was racing the normal pattern but at 1pm in the afternoon while walking home I noticed a burning sensation on my rear-end. When I made it home I noticed an elongated redden area it was very red and I put some cream triple antibiotic cream on there. It was burning very badly. The evening I went back to work my body started itching again, I noticed the area where I received the vaccine was red and hard under the skin about 3inch diameter area. Took a shower and put antibiotic cream. Today after taking my pill in the morning itching came back, and the redden area at the injection site looks like hives now . The redden area on my bottom has improved. My heart was also racing again. I did called the hospital last night and was supposed to receive a return call which I have not received yet.

Other Meds: Levothyroxine 100 mg once a day, and Vitamin C at bedtime

Current Illness:

ID: 0966344
Sex: F
Age: 45
State:

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

Lab Data:

Allergies: none

Symptoms: severe rigors, myalgias, joint pain, headache, tachypnea to mid-30's.

Other Meds: none

Current Illness: none

ID: 0966345
Sex: F
Age: 43
State: AZ

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

Lab Data: None

Allergies: Mild to acetaminophen

Symptoms: First 24 hours-body aches and headache, resolved at 48 hours. 48-72 hours felt fine. 72 hours -onset of nausea and severe headache, quickly shifted into diarrhea and two rounds of heavy vomiting (patient rarely vomits even when sick)

Other Meds: Multi vitamin, vitamin D supplement, OTC allergy

Current Illness: None, tested negative for COVID 3 days before and no opportunity for exposure after that

ID: 0966346
Sex: F
Age: 39
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: redness, itchy, bump area where the shot was given.

Other Meds: Daily vitamin, speralactone

Current Illness: none

ID: 0966347
Sex: M
Age: 70
State: GA

Vax Date: 01/10/2021
Onset Date: 01/10/2021
Rec V Date: 01/22/2021
Hospital: Y

Lab Data: 01/12/2021: COVID test (negative), 01/12/2021 - 01/14/2021: "blood work" but no mention of what blood work or results. Patient would not discuss with me the results.

Allergies: Cyclobenzaprine, diclofenac, Keppra, Nyquil D, penicillin VK. Tried contacting the patient for a complete list, but he was not willing to talk to me.

Symptoms: A couple of hours after the vaccine, patient started to have a headache and body soreness. Later in the day, the patient started to have difficulty breathing, so much so that his albuterol nebulizer treatment was not having any effect. On 01/12/2021 at around noon time, patient went to the ER.

Other Meds: Unknown. Tried contacting the patient, but he was not willing to talk to me.

Current Illness: Unknown. Tried contacting the patient, but he was not willing to talk to me.

ID: 0966348
Sex: F
Age: 74
State: CA

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

Lab Data: None

Allergies: None

Symptoms: Some diarrhea the next day after my first vaccine.

Other Meds: Multiple vitamins, Estrace, Sertraline

Current Illness: None

ID: 0966349
Sex: F
Age: 37
State: OH

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

Lab Data: On physical exam, axillary lymph nodes are palpable and enlarged on side of vaccination. I have not consulted a doctor.

Allergies: None

Symptoms: Redness, swelling, and warmth within a 2 inch diameter circle at the site of injection. Significant pain at and around the site of injection. Began about 18 hours after the injection. That is similar, but higher in intensity, that the response I experienced after my first COVID vaccination. In addition, I also have significant pain and swelling in several axillary lymph nodes on the same side the vaccine was given. Pain is rated 6 out of 10 despite taking Ibuprofen 600mg q4 hours. Pain and swelling in the lymph nodes began about 36 hours after the 2nd vaccination. It has not yet resolved.

Other Meds: Rexulti, Escitalopram

Current Illness: Minor similar response to first dose of vaccine. Redness, swelling, warmth in 2 inch diameter circle at site of injection. Pain in the upper arm around site of injection.

ID: 0966350
Sex: F
Age: 46
State: NM

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

Lab Data: No

Allergies: egg white and yolk

Symptoms: difficulty swallowing and burping from increased gas that lasted until 11:00pm

Other Meds: None

Current Illness: none

ID: 0966351
Sex: F
Age: 68
State: MD

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: Penicillin, Sulfa

Symptoms: I immediately sat down for 1 hour, felt I had something , like i felt possible slight chest tightness. I say I was fine until 3-4 hours later, I had extreme headaches. At 430pm, I still had the headaches and I took Tylenol 500mg. At night my headache got worse and it felt like I had the flu. I then went to bed and when I woke up my left arm felt intense like hornets and it was swollen. I then took another Tylenol and Ibuprofen 600mg. At 4am, I felt awful and horrible. I had joint pain with aches, felt nauseated. I called my PCP and he told me to take Prednisone 10mg. My fever was 101.4F. By the night my fever was gradually coming down and it was 102F. By the next day I felt much better. I also had Covid-19 on March 2020 and also got tested for antibody test in July 2020. I spoke with my PCP and he is recommending I do not take the 2nd dose injection.

Other Meds: Olmensartan, Estrogen patch, Biaxin, Genomycin, Levaquin, (one hour after vaccine I took Benadryl 12.5mg and Tylenol 500mg)

Current Illness: I had a slight cold that vas very mild.

ID: 0966352
Sex: F
Age: 50
State: CO

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

Lab Data: none

Allergies: NKDA

Symptoms: 15 minutes after injection, itching in throat, anterior chest and neck. hive formation over itchy areas, transported to ED and given epi, Benedryl and Solumedrol. Throat swelling sensation gone after epi and within 30 min to 1 hour the itching gone. Sent home with epi-pen and Prednisone

Other Meds: Calcium 500 BID

Current Illness: none

ID: 0966353
Sex: F
Age: 29
State: SD

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/22/2021
Hospital:

Lab Data: Covid test on 12/28/20 - Positive

Allergies: amoxiciin

Symptoms: That night it was just a mild soreness similar to any other vaccine at the injection site. Monday the 28th I woke to go to work and I could not taste anything. Instead went to get tested for covid and the result was positive.

Other Meds: Cymbalta, Xyzol,

Current Illness: no

ID: 0966354
Sex: F
Age: 54
State: MD

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

Lab Data:

Allergies: None

Symptoms: Within 5 minutes patient with dizziness and fast heart rate (reported by patient as in the 80s). Patient also with worsening of her baseline essential tremor (R>L). No other signs of anaphylaxis or other symptoms. Vitals taken with BP 128/68, HR 68, RR 16. Patient observed for 30 minutes with no other side effects. Discarhge in stable condition with no medications administered.

Other Meds:

Current Illness:

ID: 0966355
Sex: U
Age:
State: AK

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

Lab Data: None

Allergies:

Symptoms: Red Rash that covers my upper left arm from just below the shoulder to just above my elbow. The rash is hot to the touch.

Other Meds:

Current Illness:

ID: 0966356
Sex: F
Age: 59
State: CA

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

Lab Data: na

Allergies: n/a

Symptoms: raised skin at injection site. swollen, hot, and itchy. 2inches x 2inches

Other Meds: losartan prozac

Current Illness: none

ID: 0966357
Sex: F
Age: 69
State: NY

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

Lab Data:

Allergies:

Symptoms: Fever, chills, acid reflux

Other Meds: Levothyroxine, Resuvastatin

Current Illness:

ID: 0966358
Sex: F
Age: 80
State: OR

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

Lab Data:

Allergies: none

Symptoms: swelling to face, cheek, eyes, lips. benadryl given. awaiting outcomes. monitoring.

Other Meds:

Current Illness:

Date Died: 01/20/2021

ID: 0966359
Sex: F
Age: 77
State: IN

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: Aleve

Symptoms: Headache, pain in the injection site, threw up. A few hours later she died.

Other Meds: Levothyroxine, Gabapentina, furosemide, Losartan, pravastatin

Current Illness: Diabetes, hyper tension

ID: 0966360
Sex: F
Age: 30
State: MD

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

Lab Data:

Allergies: augmentin cephalexin triclosan adhesive tape tramadol

Symptoms: 1 hour after receipt of booster vaccine, developed pruritis and difficulty breathing, throat tightness; Stridor evident in the ED, hypotension requiring epinephrine injections and eventual infusion.

Other Meds:

Current Illness:

ID: 0966361
Sex: F
Age: 43
State: ID

Vax Date: 12/16/2020
Onset Date: 12/23/2020
Rec V Date: 01/22/2021
Hospital:

Lab Data: Stool samples and inflammatory markers and blood cell count

Allergies: Sulfa medications

Symptoms: 7 days after shot lots of gas and diarrhea and 8-9 days

Other Meds: Lexapro 5mg

Current Illness: No

ID: 0966362
Sex: F
Age: 32
State: CA

Vax Date: 01/08/2021
Onset Date: 01/17/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 9 days after my 1st dose I woke up with a red blotch on my left arm where I got my Moderna vaccine, it was warm, a little painful and a little itchy. The next day my arm was tingly and slightly numb and over this past week the numbness and tingly feeling has spread to all of my arm and to my face, to my cheekbones and below. I can still feel and move my arm and face and control my muscles, but I feel that it's now spreading to my left leg .

Other Meds:

Current Illness:

ID: 0966363
Sex: M
Age: 37
State: OR

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

Lab Data: none as of yet. I plan to further follow up with my PCP in 2 days, after the weekend, if pain continues to persist.

Allergies: penecillin

Symptoms: Moderna COVID -19 Vaccine EUA Approximately 3 hours after vaccine, shoulder pain began to develop. Pain became significant, waking me in the middle of the night. The following day, I was unable to lift the arm I received the injection in no higher than about 80 degrees from my side. Pain increased despite taking OTC NSAIDS. By the second morning after vaccine administration, pain had worsened and right arm cannot be raised more than about 60 degrees without significant pain. Contacted PCP office about 12 hours after injection, they recommended NSAID dosages alternating ibuprofen and tylenol, and icing the shoulder. Pain impacts daily life activities, including caring for small children , lifting items that weigh more than a few pounds by the impacted arm, and significant difficulty reaching any object above the level of the shoulder. I have never previously experienced this kind of reaction to any other upper arm injection or vaccination.

Other Meds: omeprazole, OTC generic zyrtec, docusate, daily multivitamin, Qvar 40mcg 1x/daily

Current Illness: None

ID: 0966364
Sex: F
Age: 77
State: CO

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt received dose #1 Moderna COVID vaccine 12/28/20 @ Clinic. About 3 hours after had 30 minutes of rapid heart rate, and fluttering. Laid down, went to sleep, and it resolved. She didn't seek emergency care. Did not have chest pain or shortness of breath. Continued to have palpitations occasionally, fatigue, tachycardia. Presented to PCP on 1/7/21 for symptoms and was transferred to ED for additional cardiac workup and treatment after capturing SVT on EKG. Also diaphoretic, dizzy, nauseous, SOB with palpitations. Given IV metoprolol in ED with conversion to NSR. Per ED "Suspect that the vaccine may have been her trigger." Able to discharge without escalation of care. Entered for tracking.

Other Meds:

Current Illness:

ID: 0966365
Sex: M
Age: 64
State: TX

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient had an argument about some issues, so he got excited while he was waiting for observation in the post vaccination area. He had a complaint of feeling of light headed and anxious . No SOB, no chest pain, no headache, no dizziness, no visual problems. Vital signs: BP-142/90 HR-84 O2 Sat-99% He had good color, good O2 saturation and was alert and active, Oriented X3 in NAD. I told him to relax ,take deep breaths and was watching him for almost 30 minutes after he reported feeling light headed. Lungs was CTA and heart rate was normal. H/O HTN. Informed patient to relax gave him post vaccination care instructions and told him to drink enough fluids and take Advil or Tylenol PRN for pain relief.

Other Meds:

Current Illness:

ID: 0966366
Sex: F
Age: 42
State: IN

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

Lab Data:

Allergies: None

Symptoms: Swelling and thickening of the tongue and lips, irritation to the throat and roof of mouth. Benadryl administration on site and regime continued throughout the day at home. F/u with primary care 2 days later due to continued side effects of headache, stomach ache. Nausea and vomiting

Other Meds: Gabapentin, topiramate, trintellix, omeprazole, Vyvanse

Current Illness: None

ID: 0966367
Sex: F
Age: 50
State: NY

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

Lab Data: none

Allergies: seasonal allergies

Symptoms: One week later I have redness, swelling at the injection site and it is warm. I also had a small fever of 99.

Other Meds: multivitamin, vitamin d

Current Illness: none

ID: 0966368
Sex: M
Age: 56
State: FL

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

Lab Data: none

Allergies: None

Symptoms: headache, localized pain/swelling/erythema at injection site with swelling into anterior lateral chest and under left axilla. Symptoms persisting past 3 days, slow to improve. treatment: Tylenol and Ibuprofen PRN

Other Meds: Cialis PRN Clobetasol ointment PRN

Current Illness: None

ID: 0966369
Sex: F
Age: 0
State: HI

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

Lab Data: EKG - 1/19/21, normal. Chest xray- 1/19/21- normal.

Allergies: None

Symptoms: 4.5 hours after event while vigorously crying infant reportedly stopped breathing and became unresponsive x 30s. Dad performed chest compressions and she returned to baseline prior to EMS arrival. Transported to local hospital where diagnosed with BRUE (Brief Resolved Unexplaned Event) and Apnea.

Other Meds: None

Current Illness: None

ID: 0966370
Sex: M
Age: 58
State: WA

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

Lab Data:

Allergies: No known

Symptoms: No adverse event reported at this time- Patient given COVID 19 vaccine 10 days apart from tetanus vaccine instead of the recommended 14 days. Called, studies failed to identify whether there have been interactions with other vaccines at this time.

Other Meds: Unknown

Current Illness: No known

ID: 0966371
Sex: F
Age: 51
State: IL

Vax Date: 12/17/2020
Onset Date: 12/17/2020
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: penicillin

Symptoms: "after first I had a lot of stiffness in right arm. I couldnt move it"

Other Meds:

Current Illness:

ID: 0966372
Sex: M
Age: 78
State: AZ

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

Lab Data: None

Allergies: Sulfa

Symptoms: Received my 1st Covid shot yesterday at 11:45. No problem. Went home and went for a 4 mile walk. Still no problem. At about 2:00 AM this morning I woke up shivering. Added another blanked and turned up the heat. No improvement. Finally got up and woke up my wife. Temperature was 101.7? F. Blood pressure was 149/90. Took some ibuprofen and sat on the sofa with a heating pad on my chest for about two hours. Blood Pressure dropped back to its normal 125/75 (may have been high because I took it the moment I got up) but temp was the same. However, shivering had stopped, so I went back to bed. When I woke up this morning (about 8:00) temperature was 99.1? F, blood pressure was normal (125/71) and no other symptoms. My arm isn't sore either. It appears that the elevated temperature was my only reaction from the shot. It's interesting because during the entire time I did have COVID symptoms, I never had any elevated temperature.

Other Meds: Diovan 320 mg, Norvasc 5 mg, Atenolol 50mg x 2, Tamsulosin 0 .4 mg, Multi vitamin, Vitamin D3, Vitamin B12, Vitamin C

Current Illness: Tested positive for COVID-19 01/30/2021. Last symptom from COVID was 10 days previous (01/11/2021). Experienced no elevated fever during active symptoms, only cough, headache and tiredness.

ID: 0966373
Sex: U
Age: 48
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Starting 1/4 and continuing through 1/21- Arm very sore and swollen with "knots" near the injection site. Managed with low-dose ibuprofen and "voltaren cream". Saw PCP about ongoing symptoms-considered injection technique as potential cause

Other Meds:

Current Illness:

ID: 0966374
Sex: F
Age: 35
State: VA

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

Lab Data:

Allergies:

Symptoms: Pt received her vaccine. She was waiting in the waiting area for the 15 minutes. She approached the nurse and said she felt flushed and her tongue felt "heavy". Patient was seated in a chair and ice packs were applied to nape and face. Patient complained of pressure in her chest. Emergency response was called. Vital signs taken-HR 107; BP 144/78; Oxygen saturation 97% on Room Air. Taken to Emergency Department by 2 nurses via wheelchair.

Other Meds:

Current Illness:

ID: 0966375
Sex: F
Age: 32
State: MN

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

Lab Data: No

Allergies: Oxycodone 5mg liquid

Symptoms: Fever, body aches, chills, congestion,cough, head ache, nausea, exhaustion

Other Meds: Ibuprofen

Current Illness: No

ID: 0966376
Sex: M
Age: 52
State: CA

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

Lab Data: None

Allergies: None

Symptoms: Waves of fever with intermittent chills; headache/dizziness

Other Meds: None

Current Illness: None

ID: 0966377
Sex: M
Age: 81
State: ID

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

Lab Data: none

Allergies: nka

Symptoms: loose cough. coughing for about an hour

Other Meds: glipaside, metforman,janumet, larsorten, rosuvaststin.

Current Illness: no

ID: 0966378
Sex: F
Age: 59
State: OH

Vax Date: 01/13/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Seen in office today (1/22/2021). Patient with local ecchymosis, erythema, and warmth around injection site. Patient also complained of joint pain and mild headache. Recommended Benadryl 25-50 mg every 8hrs as needed, hydrocortisone cream, and cool compresses. Parameter of erythema marked with pain. Will treat with Augment if redness worsens.

Other Meds: Ajovy, aspirin, Avapro, Baclofen, Biotin, Cardizem, Fluticasone, Magnesium Oxide, Montelukast, Pepcid, Symbicort, Ventolin, Vitamin B2, Vitamin B12, Vitamin C, Vitamin D3

Current Illness: none

ID: 0966379
Sex: F
Age: 51
State: TX

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/22/2021
Hospital: Y

Lab Data: CMP AST Mypay CT scan ultrasounds - MRI

Allergies: Bactrim Lisinopril General Anesthesia

Symptoms: When I woke up the next morning I suffered from stomach pain .. Rushed to the hospital for an emergency surgery Diagnosed with Acute pancreatitis and had to have my Gallbladder removed Gal bladder was 13CM big Currently on Antibiotics

Other Meds: Metformin 100 Mg Jardiance 10mg Ezetimite 5Mg Spironolactone 100 Mg Topamax 25Mg Zyrtec 10Mg Rossubastatin 5Mg Multi Vitamin

Current Illness: NA

ID: 0966380
Sex: M
Age: 70
State: FL

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

Lab Data:

Allergies: none known

Symptoms: Fatigue for 12 hours after receiving vaccination at 9:15 am. Went to bed at 10:00 pm, slept all night, and felt fine the next morning. Slight discomfort (1 on a scale of 10) at injection site the next morning, which dissipated by noon.

Other Meds: omeprazole 40mg once daily tamsulosin 0.4mg once daily ferrex 150 iron supplement once per day Vitamin D 2000IU daily

Current Illness: none

ID: 0966381
Sex: F
Age: 21
State: NY

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

Lab Data: none

Allergies: penicillin, cephalosporin

Symptoms: pt reports she currently has 101.2 fever, headache, body aches, fatigue, and left arm (under arm and across chest ) is sore and injection site is sore and swollen.

Other Meds: Sertraline 50 mg, Sprintec, Tylenol,

Current Illness: none

ID: 0966382
Sex: F
Age: 25
State:

Vax Date: 12/29/2020
Onset Date: 01/06/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Left clavicle swollen lymph nodes

Other Meds:

Current Illness:

ID: 0966383
Sex: F
Age: 55
State: TX

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

Lab Data: None

Allergies: None

Symptoms: 1/21/21 received vaccination, 1/22/21 started having body aches, cold, flush feeling, fever as high as 101.4, sinuses inflamed, stuffy, arms hutting, weak, headache

Other Meds: None

Current Illness: None

ID: 0966384
Sex: F
Age: 63
State: NY

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Developed rash

Other Meds:

Current Illness:

ID: 0966385
Sex: F
Age: 48
State: CT

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

Lab Data: Vital Signs, EKG, Benadryl administered by Paramedic.

Allergies: Eggs, Red wine, wheat, chocolate, lactose. No anaphylaxis.

Symptoms: Pt was administered the Moderna COVID19 vaccine at approximately 3:20 PM. Pt sat in observation and after about 15 minutes she reported pain and a sensation of heat at the injection site. Pt denied other symptoms at the time. EMS arrived on scene. At the time the pt had broken out into a rash on the arm where the injection was given. Pt was evaluated by EMSA. BP 169/112 repeat 170/97. HR 115. Rash continued to spread to pt's chest, neck, and other arm. Pt agreed to be transported to Hospital. Paramedic administered IM Benadryl. Pt did not have any difficulty breathing or swelling at the time she left the clinic.

Other Meds: Junel FE, vitamins

Current Illness: No

ID: 0966386
Sex: F
Age: 34
State: CA

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 12 hours post vaccine, developed body aches, fever, severe arm and underarm pain radiating over to chest. Seen at clinic, then sent to ED for chest Ultrasound- but was not done. COVID tested- results-negative. Treated with Acetaminophen and Ibuprofen, rest off work x several days. Cleared to return to work on 1/21/21.

Other Meds:

Current Illness:

ID: 0966387
Sex: F
Age: 40
State: CA

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: none

Allergies: nickel

Symptoms: right abdominal vesicular rash with erythema, pruritits for 8 days turning into dry scaly skin (not painful)

Other Meds: zoloft, sipronolactone, buspar

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm