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: 0966691
Sex: F
Age:
State: CT

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

Lab Data:

Allergies:

Symptoms: On January 21, 2021 at the Clinic, a PA was administering vaccinations during the morning for a four-hour shift, 8 AM to noon. At the end of her shift, she handed off her vaccines to another vaccinator. The PA had three doses of vaccine drawn up at that time, in syringes, on her desk. When the nurse inspected the syringes, she found 0.4mL of vaccine had been drawn into those syringes rather than the required 0.3mL. The nurse then alerted the APRN, who escalated the situation to the manager. The manager then contacted Quality. The concern was that the PA had been vaccinating patients all morning with an inappropriate dose of vaccine, 0.4mL. After thorough internal investigation, we found that the PA drew up 38 vaccine doses and administered 35 of them. Additionally, based on vial usage for the day and total number of vaccines administered, we have concluded that it is highly unlikely that excess vaccine was administered. This was a near miss event and is being reported out of an abundance of caution.

Other Meds:

Current Illness:

ID: 0966692
Sex: F
Age: 71
State: CA

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

Lab Data:

Allergies:

Symptoms: Headache Shortness of breath achiness tired

Other Meds:

Current Illness:

ID: 0966693
Sex: F
Age: 19
State: MA

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

Lab Data: none

Allergies:

Symptoms: Patient reported light headedness, feeling faint immediately after vaccination , BP 100/60, given Gatorade and water, symptoms resolved shortly after, monitored for 30 minutes.

Other Meds:

Current Illness:

ID: 0966694
Sex: F
Age: 65
State: IN

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

Lab Data:

Allergies: Sulfa drugs

Symptoms: Chills for 1.5 hours beginning approx 2 hours following injection

Other Meds: Metaprolol Tartrate 75 mg (Loptessor) 1xday AM Metaprolol Tartrate 50mg (Lopressor)1xday PM Amlodipine Besylate 5mg (Norvasc) 2xday AM and MIDDAY Sertraline 100mg (Zoloft) 250mg 1xday AM Modafinil 100mg (Provigil) 1xday upon rising

Current Illness: None

ID: 0966695
Sex: M
Age: 41
State: NY

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

Lab Data: n/a

Allergies: n/a

Symptoms: fatigued ,no appetite, no fever,

Other Meds: n/a, vitamins

Current Illness: n/a

ID: 0966696
Sex: F
Age: 88
State: AK

Vax Date: 01/13/2021
Onset Date: 01/17/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: 1-16: Cant take deep breath, 1-17-18: R hand swollen, painful - Advil, 1-21-23: Extreme pain in L wrist, Swollen. Advil pm, Advil, immobilized with stretchy bandage

Other Meds: None

Current Illness: None

ID: 0966697
Sex: M
Age: 80
State: CT

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

Lab Data:

Allergies:

Symptoms: On January 21, 2021 at the Clinic, a PA was administering vaccinations during the morning for a four-hour shift, 8 AM to noon. At the end of her shift, she handed off her vaccines to another vaccinator. The PA had three doses of vaccine drawn up at that time, in syringes, on her desk. When the nurse inspected the syringes, she found 0.4mL of vaccine had been drawn into those syringes rather than the required 0.3mL. The nurse then alerted the APRN, who escalated the situation to the manager. The manager then contacted Quality. The concern was that the PA had been vaccinating patients all morning with an inappropriate dose of vaccine, 0.4mL. After thorough internal investigation, we found that the PA drew up 38 vaccine doses and administered 35 of them. Additionally, based on vial usage for the day and total number of vaccines administered, we have concluded that it is highly unlikely that excess vaccine was administered. This was a near miss event and is being reported out of an abundance of caution.

Other Meds:

Current Illness:

ID: 0966698
Sex: M
Age: 87
State: CT

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

Lab Data:

Allergies:

Symptoms: On January 21, 2021 at the Clinic, an PA was administering vaccinations during the morning for a four-hour shift, 8 AM to noon. At the end of her shift, she handed off her vaccines to another vaccinator. The PA had three doses of vaccine drawn up at that time, in syringes, on her desk. When the RN inspected the syringes, she found 0.4mL of vaccine had been drawn into those syringes rather than the required 0.3mL. The RN then alerted the APRN who escalated the situation to the manager. The manager then contacted the Quality. The concern was that the PA had been vaccinating patients all morning with an inappropriate dose of vaccine, 0.4mL. After thorough internal investigation, we found that the PA drew up 38 vaccine doses and administered 35 of them. Additionally, based on vial usage for the day and total number of vaccines administered, we have concluded that it is highly unlikely that excess vaccine was administered. This was a ?near miss? event and is being reported out of an abundance of caution.

Other Meds:

Current Illness:

ID: 0966699
Sex: F
Age: 38
State: KY

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

Lab Data:

Allergies: Nka

Symptoms: Just redness, warmth, swelling, and soreness at the site of injection for 2 days and minimally on day 3.

Other Meds:

Current Illness:

ID: 0966700
Sex: F
Age: 45
State: CA

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

Lab Data:

Allergies:

Symptoms: Injection site pain, muscle aches, chills

Other Meds:

Current Illness:

ID: 0966701
Sex: F
Age: 74
State: FL

Vax Date: 01/09/2021
Onset Date: 01/13/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: No medical or laboratory tests were taken

Allergies: None, although I have had a sensitivity to sulfa and usually avoid medications with sulfa.

Symptoms: Red rash on face. At first, 1/13/21, I didn't think it was related to the vaccine. It spread and worsened over the next four days and then the injection site became red also that was when I related it to the vaccine, 1/18/21. I sent a picture to my doctor, a friend, who retired, and he said to take Benadryl and Pepcid AC, which I did for 3 days (1/18/21 - 1/10/21). I now have just a little roughness to my face and a very pale red mark by the injection site.

Other Meds: Rosuvastatin 5mg, Metoprolol ER 50 mg, Oxybutynin 5mg Calcium+D 600 mg, CoQ-10 100mg, Cranberry +C. Benefiber, Milk Thistle 250mg, Biotin 5,000 mcg, Folic Acid 800 mcg.

Current Illness: None

ID: 0966702
Sex: M
Age: 37
State: GA

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

Lab Data:

Allergies: Penecillin

Symptoms: After a night of being up with flu like symptoms, when I got out of bed at 7 am to start my day, I had a precipitous fall in body temperature. At this time, I also had profuse cold sweats, my limbs started getting cold, I could not see or hear and had ?stars? like I was about to pass out. My wife helped me downstairs and after some water and Tylenol, symptoms reversed themselves in about 15 minutes. My body temperature was not recognized by the thermometer and then registered 93.4

Other Meds: Tylenol

Current Illness: N/A

ID: 0966703
Sex: F
Age: 69
State: CT

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

Lab Data:

Allergies:

Symptoms: On January 21, 2021 at the Clinic, an PA was administering vaccinations during the morning for a four-hour shift, 8 AM to noon. At the end of her shift, she handed off her vaccines to another vaccinator. The PA had three doses of vaccine drawn up at that time, in syringes, on her desk. When the nurse inspected the syringes, she found 0.4mL of vaccine had been drawn into those syringes rather than the required 0.3mL. The nurse then alerted the APRN, who escalated the situation to the manager. The manager then contacted Quality. The concern was that the PA had been vaccinating patients all morning with an inappropriate dose of vaccine, 0.4mL. After thorough internal investigation, we found that the PA drew up 38 vaccine doses and administered 35 of them. Additionally, based on vial usage for the day and total number of vaccines administered, we have concluded that it is highly unlikely that excess vaccine was administered. This was a near miss event and is being reported out of an abundance of caution.

Other Meds:

Current Illness:

ID: 0966704
Sex: F
Age: 38
State: MA

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

Lab Data: None

Allergies: NKDA

Symptoms: 10 mins after vaccine administration became very dizzy and 10 sec. loss of consciousness, then nauseated with dry heaving. VSS: 142/86-86 O2 sat 97%. Administered Ondansetron 4mg x 2 at 4:30pm, with some relief, Continued complaint of dizzy feeling nad nausea declined ED eval. Administered 500ml of NS, VS at 545pm: O2 sat 100% pulse 80 BP 153/99 discharged home with Zofran 4mg 2 4hours as needed

Other Meds: Amlodepine 2.5mg daily

Current Illness: No

ID: 0966705
Sex: U
Age: 78
State: CT

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

Lab Data:

Allergies:

Symptoms: On January 21, 2021 at the Clinic, a PA was administering vaccinations during the morning for a four-hour shift, 8 AM to noon. At the end of her shift, she handed off her vaccines to another vaccinator. The PA had three doses of vaccine drawn up at that time, in syringes, on her desk. When the nurse inspected the syringes, she found 0.4mL of vaccine had been drawn into those syringes rather than the required 0.3mL. The nurse then alerted the APRN, who escalated the situation to the manager. The manager then contacted Quality. The concern was that the PA had been vaccinating patients all morning with an inappropriate dose of vaccine, 0.4mL. After thorough internal investigation, we found that the PA drew up 38 vaccine doses and administered 35 of them. Additionally, based on vial usage for the day and total number of vaccines administered, we have concluded that it is highly unlikely that excess vaccine was administered. This was a near miss event and is being reported out of an abundance of caution.

Other Meds:

Current Illness:

ID: 0966706
Sex: F
Age: 67
State: FL

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

Lab Data:

Allergies: NONE

Symptoms: General malaise with burning sensation inside the body, no fever registered; inflammation of right arm and hand/wrist, migratory joints pains, muscle pain, stabbing pains sudden, neuralgic pain in the extremities. Pain was so severe that cause limitation for walking around the house. The last event on the 7th day was inflammation of the right foot and ankle with severe pain with no history of sprain or trauma.

Other Meds: Acetominophen 500 mg Zinc, Vitammin D

Current Illness: NONE

ID: 0966707
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: had 2nd covid vaccine Tuesday, then at 2:30 am woke from sleep with severe arm pain where she got the shot, then progressed to her left back, hip , shoulder, neck, headache, chills, took hot shower and got severely nauseated and dry heaving, and diarrhea and dizzy, then from the back of her neck to her arms she went numb and both hands started spasming, had trouble speaking

Other Meds:

Current Illness:

ID: 0966708
Sex: F
Age: 30
State: TX

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

Lab Data: Flu test Covid Test

Allergies: Amoxicillin Penicillin

Symptoms: Around 4-5pm I did not feel well. About 6-7pm I started shivering and a fever of 102. I had muscle pain, just pain all over, I continued with a fever for two day. I took Tylenol for two days and called out of work. I had a migraine as well, I was hot/cold and sweating through my clothes. I seen my doctor, and she ran a Covid and flu test both came back negative.

Other Meds: Multi vitamin Vitamin D

Current Illness: Covid in August 2020

ID: 0966709
Sex: F
Age: 30
State: ND

Vax Date: 01/16/2021
Onset Date: 01/18/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: Sulfa drug

Symptoms: Hives covering entire body for 3 days

Other Meds: Adult multi vitamin

Current Illness:

ID: 0966710
Sex: M
Age: 95
State: CT

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

Lab Data:

Allergies:

Symptoms: On January 21, 2021 at the Clinic, an PA was administering vaccinations during the morning for a four-hour shift, 8 AM to noon. At the end of her shift, she handed off her vaccines to another vaccinator. The PA had three doses of vaccine drawn up at that time, in syringes, on her desk. When the nurse inspected the syringes, she found 0.4mL of vaccine had been drawn into those syringes rather than the required 0.3mL. The nurse then alerted the APRN, who escalated the situation to the manager. The manager then contacted Quality. The concern was that the PA had been vaccinating patients all morning with an inappropriate dose of vaccine, 0.4mL. After thorough internal investigation, we found that the PA drew up 38 vaccine doses and administered 35 of them. Additionally, based on vial usage for the day and total number of vaccines administered, we have concluded that it is highly unlikely that excess vaccine was administered. This was a near miss event and is being reported out of an abundance of caution.

Other Meds:

Current Illness:

ID: 0966711
Sex: F
Age: 35
State: WA

Vax Date: 01/11/2021
Onset Date: 01/15/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: PENISILLEN.

Symptoms: when I got the vaccine it was puff for 4 days. On the 5th day I noticed that the injection site was red and plump. I also had a burning itch like a mosquito bite. It got to the size of a tennis ball. I tried to refrain from touching the area as well as scratching the area to not spread.

Other Meds: NONE

Current Illness: NONE

ID: 0966712
Sex: F
Age: 69
State: CA

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

Lab Data:

Allergies: YELLOW #5, BEE STINGS

Symptoms: PT C/O L SCAPULA PAIN W/ FEELING OF SWOLLENESS AFTER RECEIVING MODERNA VACCINE. PT WAS BEING MONITORED FOR 30 MINS, D/T PAST ALLERGIC REACTION TO YELLO #4 AND BEE STINGS. AFTER 30 MINS PT'S R SHOULDER AREA SHOWED SWELLING TOWARDS NECK. 911 RESPONSE WAS INICIATED, VITALS WERE WNL. PT WAS TRANSPORTED TO THE HOSPITAL.

Other Meds: UNKNOWN

Current Illness: TREATED FOR LOW K RECENTLY

ID: 0966713
Sex: F
Age: 33
State: OR

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

Lab Data:

Allergies: Seasonal allergies

Symptoms: Numbness and tingling sensation with tongue, lips, and around lip area.

Other Meds:

Current Illness:

ID: 0966714
Sex: F
Age: 43
State: NJ

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

Lab Data: No lab work was done

Allergies: None that I know of

Symptoms: 20 minutes following vaccine I suddenly experienced tingling in mouth and throat, muscle twitches in hands, rapid heartbeat, and rash. I returned to vaccine clinic and was referred to ER. I was observed for several hours and symptoms resolved.

Other Meds: Multivitamin and probiotics

Current Illness: None

ID: 0966715
Sex: F
Age: 78
State: CT

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

Lab Data:

Allergies:

Symptoms: On January 21, 2021 at the Clinic, a PA was administering vaccinations during the morning for a four-hour shift, 8 AM to noon. At the end of her shift, she handed off her vaccines to another vaccinator. The PA had three doses of vaccine drawn up at that time, in syringes, on her desk. When the nurse inspected the syringes, she found 0.4mL of vaccine had been drawn into those syringes rather than the required 0.3mL. The nurse then alerted the APRN, who escalated the situation to the manager. The manager then contacted Quality. The concern was that the PA had been vaccinating patients all morning with an inappropriate dose of vaccine, 0.4mL. After thorough internal investigation, we found that the PA drew up 38 vaccine doses and administered 35 of them. Additionally, based on vial usage for the day and total number of vaccines administered, we have concluded that it is highly unlikely that excess vaccine was administered. This was a near miss event and is being reported out of an abundance of caution.

Other Meds:

Current Illness:

ID: 0966716
Sex: F
Age: 39
State: CA

Vax Date: 01/11/2021
Onset Date: 01/16/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Redness/swelling, cellulitis of arm requiring antibiotics

Other Meds:

Current Illness:

ID: 0966717
Sex: F
Age: 78
State: CT

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

Lab Data:

Allergies:

Symptoms: On January 21, 2021 at the Clinic, a PA was administering vaccinations during the morning for a four-hour shift, 8 AM to noon. At the end of her shift, she handed off her vaccines to another vaccinator. The PA had three doses of vaccine drawn up at that time, in syringes, on her desk. When the nurse inspected the syringes, she found 0.4mL of vaccine had been drawn into those syringes rather than the required 0.3mL. The nurse then alerted the APRN, who escalated the situation to the manager. The manager then contacted Quality. The concern was that the PA had been vaccinating patients all morning with an inappropriate dose of vaccine, 0.4mL. After thorough internal investigation, we found that the PA drew up 38 vaccine doses and administered 35 of them. Additionally, based on vial usage for the day and total number of vaccines administered, we have concluded that it is highly unlikely that excess vaccine was administered. This was a near miss event and is being reported out of an abundance of caution.

Other Meds:

Current Illness:

ID: 0966718
Sex: F
Age: 80
State: LA

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

Lab Data: None

Allergies: Penicillin, Sulfur, Cortisone, Tylenol, Chocolate, Sweet Potatoes, Wheat, Cabbage, Oranges, Grape Fruit, Coconut,

Symptoms: lip swelling, left arm pain, hand pain/tightness

Other Meds: Eliquis 5 mg, Pantoprazole 40 mg, Aripiprazole 20 mg, Divalproex 500 mg, Atorvastatin 20 mg, Metoprololtartarte 25 mg , Benadryl as needed, Miralax as needed

Current Illness: None

ID: 0966719
Sex: F
Age: 40
State: WA

Vax Date: 12/31/2020
Onset Date: 01/10/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: Keflex, cephalexin, sulfa drugs

Symptoms: Seems like shingles.

Other Meds: Wellbutrin, Adderall, propranolol, estradiol birth control, vitamin D3

Current Illness: None

ID: 0966720
Sex: F
Age: 40
State: NY

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

Lab Data:

Allergies: None

Symptoms: Within a few minutes I felt like my throat was getting tight, constricted, and maybe even the description would be inflamed. I was still able to breathe okay and swallow with only some restriction so I didnt say anything. I felt a little foggy and shaky as well for about another 2 hours and then was fine.

Other Meds: Multi-vitamins

Current Illness: None

ID: 0966721
Sex: F
Age: 76
State: WV

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

Lab Data: None

Allergies:

Symptoms: After 5 min, patient experienced sharp left deltoid area to left neck with ?fuzzy headache?

Other Meds: Unknown

Current Illness: None

ID: 0966722
Sex: F
Age: 51
State: CA

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

Lab Data:

Allergies:

Symptoms: Injection site pain, headache. Resolved.

Other Meds:

Current Illness:

ID: 0966723
Sex: M
Age: 79
State: CT

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

Lab Data:

Allergies:

Symptoms: On January 21, 2021 at the Prospect COVID 19 Vaccine Clinic, an orthopedic PA was administering vaccinations during the morning for a four-hour shift, 8 AM to noon. At the end of her shift, she handed off her vaccines to another vaccinator (a RN). The PA had three doses of vaccine drawn up at that time, in syringes, on her desk. When the RN inspected the syringes, she found 0.4mL of vaccine had been drawn into those syringes rather than the required 0.3mL. The RN then alerted the lead APRN, who escalated the situation to the operations manager. The operations manager then contacted the Chief Quality Officer. The concern was that the PA had been vaccinating patients all morning with an inappropriate dose of vaccine, 0.4mL. After thorough internal investigation, we found that the PA drew up 38 vaccine doses and administered 35 of them. Additionally, based on vial usage for the day and total number of vaccines administered, we have concluded that it is highly unlikely that excess vaccine was administered. This was a ?near miss? event and is being reported out of an abundance of caution

Other Meds:

Current Illness:

ID: 0966724
Sex: M
Age: 74
State: CT

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

Lab Data:

Allergies:

Symptoms: On January 21, 2021 at the Clinic, an PA was administering vaccinations during the morning for a four-hour shift, 8 AM to noon. At the end of her shift, she handed off her vaccines to another vaccinator. The PA had three doses of vaccine drawn up at that time, in syringes, on her desk. When the nurse inspected the syringes, she found 0.4mL of vaccine had been drawn into those syringes rather than the required 0.3mL. The then alerted the APRN, who escalated the situation to the manager. The manager then contacted Quality. The concern was that the PA had been vaccinating patients all morning with an inappropriate dose of vaccine, 0.4mL. After thorough internal investigation, we found that the PA drew up 38 vaccine doses and administered 35 of them. Additionally, based on vial usage for the day and total number of vaccines administered, we have concluded that it is highly unlikely that excess vaccine was administered. This was a near miss event and is being reported out of an abundance of caution.

Other Meds:

Current Illness:

ID: 0966725
Sex: F
Age: 34
State: MO

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

Lab Data:

Allergies: nkda

Symptoms: patient states severe swelling at injection site

Other Meds:

Current Illness:

ID: 0966726
Sex: F
Age: 66
State: CA

Vax Date: 01/15/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: none

Allergies: nuts sulfa drugs cipro

Symptoms: 4 days after vaccine reported - headache, diarrhea, itchy rash

Other Meds: BENZONATATE CAP,ORAL 100MG prn MONTELUKAST TAB 10MG TAKE ONE (1) TABLET BY MOUTH QD TO PREVENT ASTHMA ATTACKS CETIRIZINE TAB 10MG TAKE ONE (1) TABLET BY MOUTH EVERY DAY FOR SEASONAL

Current Illness: asthma hypothyroidism type II DM hyperlipidemia seasonal allergies

ID: 0966727
Sex: F
Age: 67
State: IL

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

Lab Data:

Allergies: none known

Symptoms: 2 1/2 to 3 inch area at injection site that is red firm and warm to touch , no fever or other problems

Other Meds: Hydrochlorothiazide, Amlodipine, Ibuprofen , multivitamins and airborne

Current Illness: none

ID: 0966728
Sex: F
Age: 12
State: WI

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: Patient presents today via virtual visit for rash. Virtual appointment has been arranged since we are in the middle of COVID-19 pandemic. Mother and patient were the historians. Patient had Gardasil, influenza, meningococcal MCV for PE, and Tdap vaccination on 1/5/2021. Patient went to the emergency room on 1/10/2021 for a rash that developed on 1/8/2021. The rash developed on bilateral lower extremities. It started on the feet and has been ascending up the legs and is now located on the lower abdomen according to the ED notes. In the ED note the rash was painful and pruritic. According to the ED note the rash itself was very characteristic for Henoch Schoenlein purpura. Patient does not have any abdominal pain but she does have bilateral knee arthralgia. Patient had labs completed which showed mild leukocytosis. Her electrolytes and LFTs were within normal limits. Inflammatory markers including sed rate and CRP were both minimal. UA were worse without any evidence of UTI. There was no proteinuria. She has microscopic hematuria. In the ED she was mildly tachycardic. She received 1 L of IV fluids and her heart rate trend went back to normal. Patient then had follow-up appointment with her doctor on 1/11/2021. Patient had urine analysis completed in the doctor's office which showed trace ketones and trace leuks. Patient's CMP was within normal limits. Patient's CRP was minimal. Patient's sed rate was within normal limits at 15. Patient clinically looks well nontoxic. Mother reports that patient also had leg edema along with a rash which started to go down since the ED visit, however 3 days ago that the leg swelling came back. The rash has not worsened, but it has persisted. It continues to be painful and pruritic. They have not been doing any treatments. Patient denies fever, shortness of breath, dry cough, chills, shaking repeatedly with chills, muscle pain, headache, nausea, vomiting, diarrhea, sore throat, or new loss of taste or smell. 1. Henoch-Schonlein purpura -Detailed education done about the manifestation and treatment -Educated that it is a self-limiting eruption -Educated about taking Tylenol or ibuprofen for arthralgia, plain -Educated about trying Benadryl for itchiness -We will send dermatology consult for biopsy -Patient was advised to have close follow-up with her doctor -Educated about going back to the emergency room for worsening symptoms

Allergies: NKDA

Symptoms: Patient presents today via virtual visit for rash. Virtual appointment has been arranged since we are in the middle of COVID-19 pandemic. Mother and patient were the historians. Patient had Gardasil, influenza, meningococcal MCV for PE, and Tdap vaccination on 1/5/2021. Patient went to the emergency room in on 1/10/2021 for a rash that developed on 1/8/2021. The rash developed on bilateral lower extremities. It started on the feet and has been ascending up the legs and is now located on the lower abdomen according to the ED notes. In the ED note the rash was painful and pruritic. According to the ED note the rash itself was very characteristic for Henoch Schoenlein purpura. Patient does not have any abdominal pain but she does have bilateral knee arthralgia. Patient had labs completed which showed mild leukocytosis. Her electrolytes and LFTs were within normal limits. Inflammatory markers including sed rate and CRP were both minimal. UA were worse without any evidence of UTI. There was no proteinuria. She has microscopic hematuria. In the ED she was mildly tachycardic. She received 1 L of IV fluids and her heart rate trend went back to normal. Patient then had follow-up appointment with her doctor on 1/11/2021. Patient had urine analysis completed in the doctor's office which showed trace ketones and trace leuks. Patient's CMP was within normal limits. Patient's CRP was minimal. Patient's sed rate was within normal limits at 15. Patient clinically looks well nontoxic. Mother reports that patient also had leg edema along with a rash which started to go down since the ED visit, however 3 days ago that the leg swelling came back. The rash has not worsened, but it has persisted. It continues to be painful and pruritic. They have not been doing any treatments. Patient denies fever, shortness of breath, dry cough, chills, shaking repeatedly with chills, muscle pain, headache, nausea, vomiting, diarrhea, sore throat, or new loss of taste or smell.

Other Meds: none

Current Illness: none

ID: 0966729
Sex: M
Age: 42
State: IL

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

Lab Data: Unaware of what hospital would have done

Allergies: sulfa (hives)

Symptoms: Approximately 5 minutes after vaccination, while pt was in our waiting area in front of pharmacy, he started to feel light headed/dizzy. He stated he was tachycardic. I had pt sit down immediately. We called 911. I took his blood pressure which was considerably elevated (235/107). Pt had no other signs of an allergic rxn. Paramedics arrived and took pt to the nearest hospital.

Other Meds: none disclosed by the patient

Current Illness: none disclosed by the patient

ID: 0966730
Sex: F
Age: 48
State: MA

Vax Date: 01/11/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: See by a doctor on 1/22/21.

Allergies: Latex

Symptoms: arm pain day 1-2, day 2 fatigue and migraine, day 3-4 migraines and fatigue and joint pain, day 8 itching and swelling on arm around injection site and difficulty breathing, day 9 to present arm injection site swelling continues to grow in size on arm continues to be itchy and breathing is more difficult as day progresses. Right back of knee swelling and pain also beginning day 8, which gets worse as the day progresses.

Other Meds: Trokendi, levothyroxine, zomig, Fiornal,

Current Illness: none

ID: 0966731
Sex: M
Age: 81
State: CT

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

Lab Data:

Allergies:

Symptoms: On January 21, 2021 at the Clinic, an orthopedic PA was administering vaccinations during the morning for a four-hour shift, 8 AM to noon. At the end of her shift, she handed off her vaccines to another vaccinator. The PA had three doses of vaccine drawn up at that time, in syringes, on her desk. When the nurse inspected the syringes, she found 0.4mL of vaccine had been drawn into those syringes rather than the required 0.3mL. The nurse then alerted the APRN, who escalated the situation to the manager. The manager then contacted the Quality. The concern was that the PA had been vaccinating patients all morning with an inappropriate dose of vaccine, 0.4mL. After thorough internal investigation, we found that the PA drew up 38 vaccine doses and administered 35 of them. Additionally, based on vial usage for the day and total number of vaccines administered, we have concluded that it is highly unlikely that excess vaccine was administered. This was a near miss event and is being reported out of an abundance of caution.

Other Meds:

Current Illness:

ID: 0966732
Sex: F
Age: 75
State: CT

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

Lab Data:

Allergies:

Symptoms: On January 21, 2021 at the Clinic, a PA was administering vaccinations during the morning for a four-hour shift, 8 AM to noon. At the end of her shift, she handed off her vaccines to another vaccinator. The PA had three doses of vaccine drawn up at that time, in syringes, on her desk. When the nurse inspected the syringes, she found 0.4mL of vaccine had been drawn into those syringes rather than the required 0.3mL. The nurse then alerted the APRN, who escalated the situation to the manager. The manager then contacted Quality. The concern was that the PA had been vaccinating patients all morning with an inappropriate dose of vaccine, 0.4mL. After thorough internal investigation, we found that the PA drew up 38 vaccine doses and administered 35 of them. Additionally, based on vial usage for the day and total number of vaccines administered, we have concluded that it is highly unlikely that excess vaccine was administered. This was a near miss event and is being reported out of an abundance of caution.

Other Meds:

Current Illness:

ID: 0966733
Sex: F
Age: 45
State: TX

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

Lab Data:

Allergies:

Symptoms: Patient reports flushing, lightheaded, dizzy, symptoms lasted about 3 minutes, she was seen and cleared by EMS. V/S; BP 152/87, HR 87, Spo2 100%

Other Meds:

Current Illness:

ID: 0966734
Sex: F
Age: 27
State: OR

Vax Date: 01/13/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None, treated at home. Would have gone to urgent care if symptoms were present today.

Allergies: Aloe vera and most fruit or plant extracts.

Symptoms: Severe headache began on 1/20/21 at 9 PM. I took Benadryl, Tramadol, and ibuprofen for relief and to sleep, asleep by 11 PM. Had a very restless sleep and woke up with severe sweating around 3 AM. Woke up at 9:30 AM with severe, pounding headache. Attempted to walk around at 10 AM, pounding headache was a 10/10 pain scale when upright. Nausea set in as soon as I was standing, ran to lay down to avoid vomiting. At 10:30 AM I sat up attempted to drink water and the vomiting began. Severe vomiting for about 30 minutes, then intermittent vomiting throughout the day until 6 PM. Headache did not let up all day, no response to medication (acetaminophen, ibuprofen, rizatriptan, magnesium). Headache subsided around 8 PM and I was able to sleep. No symptoms today 1/22/21.

Other Meds: Rx: Metoprolol Tartrate, Cromoyln solution, Spironolactone, low dose Naltrexone, Xulane patch, rizatriptan, sudafed. Over-the-counter: nasal decongestants, Alegra, Claritin, Xyrtec, benadryl, Flonase. Supplements: Vitamin D3, Iron, L-theani

Current Illness: none

ID: 0966735
Sex: F
Age: 55
State: CO

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

Lab Data: N/A

Allergies: N/A

Symptoms: Pt developed diarrhea, nausea, vomiting, dizziness and diaphoresis, pallor

Other Meds: N/A

Current Illness:

ID: 0966736
Sex: F
Age: 74
State: AZ

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

Lab Data: Had covid test today 1-22-2021. Tested positive.

Allergies: PCN, Sulfa

Symptoms: Chills, muscle ache, headache.

Other Meds: Multivitamins, vit E, Krill oil, vit D

Current Illness: None

ID: 0966737
Sex: F
Age: 0
State: FL

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

Lab Data:

Allergies: Clindamycin

Symptoms: Staff worker reported shortness of Breath/Labored breathing, lightheadedness/dizziness after approximately 7 minutes of receiving vaccine. Patient received Epipen injection and paramedics were called to transport her to hospital.

Other Meds: VItamin D; Levothyroxine

Current Illness:

ID: 0966738
Sex: M
Age: 67
State: TX

Vax Date: 01/07/2021
Onset Date: 01/18/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: Biopsy taken of lesions. no results at this time.

Allergies: None

Symptoms: On January 18, 2021, vaccine administration site started to itch, then by the next day, there was urticaria throughout the entire body. Patient took benadryl, with little effect. Went to outpatient clinic, was given cetirizine with better results.

Other Meds: Ezetimibe, Cetirizine, citalopram, lisinopril, Tadalafil, empagliflozin, metformin, testosterone.

Current Illness: Diabetes, HTN, depression, anxiety, fatigue.

ID: 0966739
Sex: M
Age: 81
State: AZ

Vax Date: 01/17/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: none

Allergies: Penicillin

Symptoms: Wednesday morning he started to feel a lot of muscle soreness in the back of his neck and shoulders and could not put his head back to drink water. Wednesday evening put muscle rub on achy areas and took a couple of Aleve. Thursday morning was feeling better and Thursday evening a lot better. Friday just a slight tight feeling to remind him it is still there.

Other Meds: Amlodipine, Digoxin, Eliquis, Atenolol, Losartan, Requip, B12, Multiple Vitamin

Current Illness: gastritis from December 22nd, 2020 to December 28th 2020

ID: 0966740
Sex: F
Age: 53
State: CA

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

Lab Data:

Allergies:

Symptoms: Headaches Sevier body aches tired runny nose

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm