VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer

Incidents per State

State Total
33,148
AK1,168
AL2,646
AR1,711
AS32
AZ8,055
CA32,151
CO6,206
CT4,222
DC854
DE841
FL17,604
FM3
GA6,882
GU49
HI1,149
IA2,607
ID1,400
IL10,364
IN15,917
KS2,546
KY3,340
LA2,338
MA7,738
MD6,604
ME1,746
MH6
MI9,455
MN6,426
MO4,924
MP10
MS1,337
MT1,375
NC8,278
ND741
NE1,628
NH1,754
NJ8,443
NM2,114
NV1,985
NY17,530
OH10,263
OK2,706
OR4,271
PA11,318
PR1,171
QM1
RI1,180
SC3,050
SD717
TN4,501
TX17,103
UT2,359
VA7,909
VI27
VT1,026
WA7,274
WI6,007
WV1,305
WY477
XB4
XL1
XV2

ID: 0979212
Sex: F
Age: 39
State: ME

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: 24 hours after receiving the vaccine I developed a rash on my face, minor swelling to face and peri-orbital edema. 48 hours later the rash and swelling were worse 72 hours later rash and swelling same as 48 hours but now with itching, resolved the next day. benadryl taken all 3 nights.

Other Meds: Wellbutrin, vit c.

Current Illness: Two weeks prior I had low grade fevers for a few days-99.5-100, fatigue, headaches. COVID tested and negative during that illness, ended up delaying vaccine.

ID: 0979213
Sex: M
Age: 55
State: WI

Vax Date: 01/09/2021
Onset Date: 01/15/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Sulfa (get a rash), Gluten and diary

Symptom List:

Symptoms: It started abruptly, i experienced brain frog and super weak, globally with al muscles and was very fatigues and malaise. I had access to a blood pressure cup the reading was 148/92, usually my BP is 100/60. Once they took my BP, then i went to the ER. As time went on, I got more sleepy and tired. The first ER visit they did lab work, CBC panel which was normal, thyroid test which was normal, EKG and aniongap which were negative. They gave me no medications to take and was probably there in the ER for about 6 hours. which was on 01-15-2021. The second time, it was around 11:45am on 01-21-2021. While sitting at the edge of my bed, I felt a total sadness and despair and feeling of being alone. I then went to work felt normal in the morning and as i went to type some notes after a minute i felt the same symptoms happening again, my BP 140/88 and went to the ER. I was really tired and could of fallen asleep, felt oriented but took me a while to process things. I also had trouble moving my entire body. They placed an IV, gave me fluids, did an EKG again which was normal. They did a CT scan, CTA to my chest and neck and CT perfusion, had to inject contrast, exams were both normal. The doctor came in and told me if I was okay to drive home and I drove home. On the third episode. 01-25-2021 it occurred around 9am, the symptoms came back but with less intense. I lied down and rested., could feel my heart racing just like the other two episodes. This symptom lasted for about two hours and kind of lingered all day but i could still function. i felt like I had the flu, moderate malaise with brain fog.

Other Meds: Methylphenidete ext release 40mg QAM, Albilify 2mg every three days, Multi-vitamin, vitamin D, Focus factor supplement

Current Illness: None

ID: 0979214
Sex: F
Age: 68
State: VA

Vax Date: 01/15/2021
Onset Date: 01/24/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: no allergies to meds or food. only reported hayfever.

Symptom List:

Symptoms: Pt states approximately 1 week after vaccine her upper arm became very itchy. Reports taking OTC benadryl to control the itching. Pt came into the office, left upper arm red and slightly swollen. Pt instructed to see PCP for recommendations other than benadryl. Pt states she is going there when she leaves here.

Other Meds: none known

Current Illness: none known

ID: 0979215
Sex: F
Age: 42
State: ME

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: phenergen, morphine,

Symptom List:

Symptoms: Systemic: tight throat was given 50 mg of benadryl and water and recovered with an hr; symptoms lasted 1 day

Other Meds:

Current Illness:

ID: 0979216
Sex: F
Age: 59
State:

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: injection site pain, right arm numbness and pain, ulnar nerve distribution nerve pain, thoracic outlet area pain, right breast pain, fever, chills, myalgia, severe headache, across chest pressure, nausea, dizziness

Other Meds: None

Current Illness: None

ID: 0979217
Sex: F
Age: 32
State: OH

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: HEADACHE, BODY ACHES, CHILLS

Other Meds:

Current Illness:

ID: 0979218
Sex: F
Age: 34
State: CA

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: s/p vaccine c/o tingling in both arms, burning in chest, dizziness, lightheadedness, felt like something stuck in her throat, dry mouth, felt like throat closing

Other Meds:

Current Illness:

ID: 0979219
Sex: F
Age: 55
State: RI

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Blurry vision while trying to read paperwork about 5 minutes after vaccine

Other Meds:

Current Illness:

ID: 0979220
Sex: F
Age: 36
State: MT

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Itching of chest and arms, Redness at injection site, Lightheaded 15min after vaccine

Other Meds:

Current Illness:

ID: 0979221
Sex: M
Age: 74
State: NC

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: penicillin,ativan,keflex

Symptom List:

Symptoms: Next day, diarreah, vomiting

Other Meds: meyoprolol, pantoprazole,multi-vitiman,vit.D,zinc,glucosemine,vit.C,coumidin

Current Illness: none

ID: 0979222
Sex: F
Age: 25
State: IN

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None.

Symptom List:

Symptoms: Severe body/muscle aches, headache, extreme fatigue, fever up to 101.1 and chills

Other Meds: Zoloft 50mg, Ventolin inhaler, Dulera inhaler, Melatonin, Mirena IUD

Current Illness: None

Date Died: 01/22/2021

ID: 0979223
Sex: M
Age: 77
State: CA

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Patient developed SOB but reported good O2Sats. Instructed on going to ER if worsening symptoms. Patient eventually expired on 1/22/21

Other Meds: Pravastatin 40 mg, KCL ER 10meq, Metoprolol 25 mg, losartan 100 mg, glyburide 2.5 mg, furosemide 40 mg, ASA 81 mg, amlopidine 10 mg, allopurinol 300 mg

Current Illness: CHF, hypertension, type 2 DM

ID: 0979224
Sex: F
Age: 88
State: MN

Vax Date: 01/07/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Ambien and cyclobenzoprine

Symptom List:

Symptoms: Pt. with weakness and GI bleed. Admitted to hospital after being seen in the ER

Other Meds: Too many to list.

Current Illness: None other than chronic illness

ID: 0979225
Sex: F
Age: 25
State: NY

Vax Date: 01/14/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: no known allergies

Symptom List:

Symptoms: The patient developed a red welt on arm right below injection site approximately 2 weeks after the vaccine. They reported some bruising on outside of the welt, it appears red, and feels hot and hard to touch, tender and itchy. The welt has not worsened. The patient reports her husband accidentally elbowing her in the arm preceding the adverse event.

Other Meds:

Current Illness:

ID: 0979226
Sex: F
Age: 41
State: AK

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient developed a quarter sized lump at injection site the days after receiving the injection. This was raised and red according to patient's report. It persisted for 4 days and resolved on its own. Patient also developed muscle aches, fatigue, and slight headache. These persisted for 1.5 days.

Other Meds:

Current Illness:

ID: 0979227
Sex: M
Age: 57
State: ME

Vax Date: 01/24/2021
Onset Date: 01/24/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Exhaustion, Systemic: described by the EMT as a vasovegal reaction. patient passed out and had seizure like reactions. was unresposive and given epi pen. after EMT arrived, patient was monitored and allowed to leave; symptoms lasted 1 day

Other Meds:

Current Illness:

ID: 0979228
Sex: F
Age: 21
State: CA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: Per witness, patient "fainted", falling out of chair shortly after arriving to recovery area. Upon writer arrival patient was diaphoretic, A&Ox4 , V/S WNL (121/80, HR 99, O2 100%, Resp. 18), patient reports hx of anxiety and untreated syncopal episodes. EMS activated. Upon EMS arrival, VS 117/62, HR 116, Resp. 18, O2 100%, finger stick blood sugar 96. Patient transported to ED by EMS at own request.

Other Meds: Paxil 10mg qHS unknown birth control pill

Current Illness: none

ID: 0979230
Sex: F
Age:
State: WA

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: severed headache, dizziness, low grade fever. staying home from work.

Other Meds:

Current Illness:

ID: 0979231
Sex: F
Age: 32
State: OH

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: HEADACHE, CHILLS , BODY ACHES

Other Meds:

Current Illness:

ID: 0979232
Sex: F
Age: 58
State: CA

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Penicillin, Cephalosporins, Sulfonamides

Symptom List:

Symptoms: extremely sore at the injection site. I had overnight chills starting at 9pm on 1/21/2002 through morning. I took my temp on 1/21 at 9am and it was normal. (98.4) Body aches, and nausea most of the day on 1/21/2021. treatment: Ibuprofen 600mg BID X 2 days.

Other Meds: none

Current Illness: none

ID: 0979233
Sex: F
Age: 59
State: TX

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: ACE inhibitors, Red onions, IVP Dye

Symptom List:

Symptoms: After receiving the injection I experienced slight soreness at the injection site, which was expected. later that evening I experienced swelling in the left axilla lymph nodes. The swelling in that area was extreme on 01/20/2021 throughout the night and has continued until day of reporting on 01/27/2021. The pain and swelling involved the entire underarm and pain could be felt deep in the tissue. On pain scale of 1-10 with 10 as extreme, I would rate pain as a 9 on days 1-5. Pain has gradually diminished in severity on subsequent days and is a 2 today. Measures to reduce the pain included elevation of arm and shoulder during the night, discontinuation of deodorant during period of discomfort and application of warm and cold compresses to decrease pain and swelling. Initially contemplated seeking emergency room evaluation and treatment for evaluation , but decided against because there is no way to remove the vaccine and treatment would probably include measures already implemented.

Other Meds: Otezla, Metformin, Nifedipine, Duloxetine, Celebrex, Black Elderberry, Zinc, Vitamin D,

Current Illness: Psoriasis, HTN, Type II Diabetes, Osteoarthritis

ID: 0979234
Sex: M
Age: 69
State: AK

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: Sore injection site Unusual fatigue 24 hours after injection

Other Meds:

Current Illness: None

ID: 0979235
Sex: F
Age: 66
State: MT

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Sulfa, Percocet Pistachio nuts

Symptom List:

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA Vagal Near-Syncope

Other Meds: Metformin Januvia Armour Thyro Atorvastatin CoQ 10 Vitamin D3 Vitamin E

Current Illness: none

ID: 0979236
Sex: F
Age: 55
State: FL

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: No

Symptom List:

Symptoms: fever 100.3 & 101.6, chills & body aches. Next day symptoms were gone.

Other Meds: atorvastatin 40 MG tablet, citalopram 20 MG tablet, losartan 25 MG tablet, hydrochlorothiazide 12.5 MG tablet, NORETHINDRONE AC-ETH ESTRADIOL ORAL

Current Illness: No

ID: 0979237
Sex: F
Age: 24
State: CA

Vax Date: 12/26/2020
Onset Date: 12/31/2020
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: When I was eating chips I wanted to lick my fingers and my mouth felt funny. I looked in the mirror and my face looked fine. The following day I noticed half of my face was paralyzed and I went to urgent care. The Dr. diagnosed me with Bells Palsy and put me on antibiotics for 10days. I asked for more because it wasn't healing, but hey didn't me anymore. Maybe a week after I did a phone visit and asked If I should get more medicine and they said no. Maybe a week ago from today 1/27/21 I seen my PCP and she contacted the Neurology department at medical center regarding my situation. After about 3 weeks of having this im about 90% better.

Other Meds: Birth Control Fiber Gummy

Current Illness:

ID: 0979238
Sex: M
Age: 38
State: PA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: amoxicillin

Symptom List:

Symptoms: Anxious feeling Heart racing Feeling hot BP 157/103, HR 114. Snack and juice given. BP repeated 161/94, HR 71. Reported feeling better and okay to leave. Went home.

Other Meds: unknown

Current Illness: unknown

ID: 0979239
Sex: M
Age: 46
State: ID

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Ammoxacillin

Symptom List:

Symptoms: Arm swelling , Soreness, pain. the following day(s) nausea, labored breathing, funny feeling like a heavy chest. dizziness ( still happens occasionally seven days after vaccination) fatigue still happening to date.

Other Meds: Lisinopril, Metropolol , Rosuvastatin, Aspirin. Vitamin b12.

Current Illness: none

ID: 0979240
Sex: F
Age: 49
State: MD

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: n/a

Symptom List:

Symptoms: 3 1/2 hours after receiving 2nd dose. Extreme abdominal pain that lasted 1 1/2 hours. I had the same pain after the 1st dose-but it happened 6 days after receiving the dose. Exactly the same pain and lasting 45 minutes.

Other Meds: Cymbalta 30mg OD

Current Illness: n/a

ID: 0979241
Sex: F
Age: 77
State: TN

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Resident started vomiting and diarrhea

Other Meds:

Current Illness:

ID: 0979242
Sex: F
Age: 61
State: PA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Codeine

Symptom List:

Symptoms: itching, slight heaviness in chest with cough, very tired went to sleep as so as I arrived home after the shot, red welt on arm around area of injection when awoke in morning.

Other Meds: Gabapentin, Effexor XR, Omeprazole, Zyflamend, Turmeric, Magnesium , Vit D3, Fish Oil, Stress B, Albuterol

Current Illness:

ID: 0979243
Sex: F
Age: 60
State: AZ

Vax Date: 01/14/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: 1 week after first Moderna covid 19 dose she had sudden onset of shortness of breath and subsequently some chest pain, She was seen in ER, had elevated D dimer. She had negative CTA for pulmonary embolism and negative cardiac workup that included ekg and cardiac enzymes. She was dishcharged home and returned in 2 days with similar symptoms and no cause found . She has had recurrent chest heaviness lasting about 1 hour episodically since that time, about 3 times, and has cardiology follow up scheduled.

Other Meds: Dexilant multivitamin trulance tramadol

Current Illness: none

ID: 0979244
Sex: F
Age: 34
State: CA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: sumatriptan

Symptom List:

Symptoms: within 15 minutes started feeling nauseous, bad headache minutes after. Got dizzier, brain fog. At home later progressed to fever, chills, sore throat. The next day the SOB returned, chest pain/pressure Now almost 2wks later still feeling very short of breath

Other Meds: Mirena IUD, Arnuity Ellipta inhaler, flonase nasal spray, albuterol

Current Illness: Residual lung damage after COVID infection 6/2020, mild persistent dyspnea on exertion that had been gradually improving

ID: 0979245
Sex: F
Age: 35
State: IN

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Red dye #40 Sulfa Latex

Symptom List:

Symptoms: Beginning the morning after my second vaccine dose, I experienced body aches, joint pain, nausea, diarrhea and fatigue. By 24 hours post-vaccine, I developed a fever of 100.8, a headache, and swollen lymph nodes. By 36 hours, my fever broke, diarrhea discontinued, and the headache subsided. The body aches, nausea, fatigue, and swollen lymph nodes continue to inhibit my ability to perform ADLs and I was unable to work today.

Other Meds: Carvedolol Trintellix Cyproheptadine Rousuvistatin Fish oil Folate Singulair

Current Illness: None

ID: 0979246
Sex: F
Age: 65
State: ND

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: chills, body ache, fever (missed a day of work)

Other Meds:

Current Illness:

ID: 0979247
Sex: F
Age: 80
State: TX

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: Rash (other than injection site)-Mild

Other Meds:

Current Illness:

ID: 0979248
Sex: F
Age: 47
State: CA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Iodine: stated after reaction of the vaccine

Symptom List:

Symptoms: 47 yo female received Moderna vaccine via IM L/upper arm (Deltoid) at 10:54AM. Itching started 10:54Pm. Pt reported at 11:07 AM. Pt states late report was to see if itching will stop. So far itching on L/upper arm and chest. At 11:am pt was itching all over. 11:20 AM Benadryl 25mg via IM given. EMR medical staff contacted. Pt refused to go to E.R. On advice of EMR. Pt will go home and continue with Benadryl for itching. Reports no shortness of breath. Pt was discharged at 12:00 non when a family member picked her up on a private vehicle. 11:15 V/S: B/P 158/96, P 8, RR 20, O2 sat 99%.

Other Meds: Synthroid 150mcg and Keppra

Current Illness: Seizure, Hx of Thyroidectomy

ID: 0979249
Sex: F
Age: 24
State: KS

Vax Date: 01/24/2021
Onset Date: 01/24/2021
Rec V Date: 01/27/2021
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Allergies: Cantaloupe

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Symptoms: Uvulitis, Treatment: cough drops, numbing throat spray. lasted 12 hours Rash and swelling at vaccine site, Treatment: Ice and heat, still present, reducing in size Fatigue, Treatment: Rest, Still present, but recovering Fever, Treatment: Fever reducer (Tylenol), lasted 48 hours

Other Meds: Bupropion, Lexapro, Omeprazole

Current Illness:

ID: 0979250
Sex: M
Age: 64
State: VA

Vax Date: 01/14/2021
Onset Date: 01/16/2021
Rec V Date: 01/27/2021
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Symptoms: Chillis,congestion etc

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Current Illness:

ID: 0979251
Sex: F
Age: 33
State: NY

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/27/2021
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Allergies: Sensitivity to Milk, eggs and Moxifloxacin. Gastrointestinal side effects.

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Symptoms: My period was scheduled to come 1/14/2021, the day after my 1st dose of the Moderna vaccine. My periods are very predictable and I am not sexually active. The evening I received the vaccine, twice I had sharp pains in my uterus. It lasted for a few seconds and went away. It happened one more time in the middle of the night, jolting me out of sleep. My period has not come since I took the shot. It?s been two weeks. This is very unusual.

Other Meds: Singulair, Zyrtec and Aleve.

Current Illness: Nasal cautery.

ID: 0979252
Sex: M
Age: 55
State: WI

Vax Date: 01/09/2021
Onset Date: 01/15/2021
Rec V Date: 01/27/2021
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Allergies: Sulfa (get a rash), Gluten and diary

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Symptoms: First episode 01-15-21, started 10am, i was at work, started feeling weak and brain fog so i sat down and another therapist came into the office and told her how i was feeling, they checked my BP 148/92, went to the ER. They took some blood work, CBC panel were negative, thyroid test, normal, anaiongap, normal, glucose reading, normal and an EKG normal. 2nd episode 01-21-2021 started 11;45am, that morning when i woke up i felt really strong feelings of sadness and despair. At 11;45a i was about to eat and i started to feel again brain fog, total body weakness, elevated BP, they took my BP again and it was 144/88 so i went to the ER again. I could not keep my eyes open. They did a EKG again with a CTA and a CT with perfusion both were normal. They gave me fluids, sodium fluids. Agian it was transient my BP slowly went down and went home. Third episode 01-25-2021 started about 9am, i was at home did not have access to a BP cup, symptoms were same but less intense, i could feel my heart pounding, brain fog and body aches and this lingered throughout the day. It felt like I had the flu. No elevated temperature on all three of my episodes.

Other Meds: Methylphenidete ext release 40mg QAM, Albilify 2mg every three days, Multi-vitamin, vitamin D, Focus factor supplement

Current Illness: None

ID: 0979253
Sex: F
Age: 31
State:

Vax Date: 01/25/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
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Symptoms: raised red rash from injection site and down 2 inches

Other Meds:

Current Illness:

ID: 0979254
Sex: F
Age: 65
State: OH

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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Symptoms: FATIGUE, CHILLS, HEADACHE, BODY ACHES,

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Current Illness:

Date Died: 01/19/2021

ID: 0979255
Sex: M
Age: 65
State: CA

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/27/2021
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Allergies: none; + bee allergy listed in records

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Symptoms: Patient received COVID 19 vaccine the morning of 1/18/21 at Public Health COVID-19 vaccine clinic. I (person completing this report) work for PH. Later that night while in bed, patient reported difficulty breathing to his wife, then turned blue, and became unresponsive. Family report pt was without any symptoms prior to event. 911 called; CPR started by family member 15 min. after pt became unresponsive. EMS performed resuscitation for about 30-40 minutes with multiple defibrillation for V-fib. Between EMS and Medical Center ER, pt had 9 rounds of epi, CPR w/ LUCAS machine, given 2 doses of amiodarone (150 mg and 300 mg). Patient had 3 EKGs, which did not show STEMI, but did show nonspecific conduction delay and sinus arrest with junctional escape vs sinus bradycardia (HR 50's). Pt had return of spontaneous circulation. Pt intubated, and started on Levophed. Pt transferred to ICU, and had central line placed. Family decided to make patient DNR. Pt went into coarse VFib again, and as per wishes of family, code blue not called. Patient expired at 01:53 on 1/19/21.

Other Meds: per hospital list: Nitrostat 0.4 mg SL prn, famotidine 10 mg, ASA 81 mg, atorvastatin 20 mg, benazepril 5 mg, carvedilol dose unspecified

Current Illness: unknown; family report pt without symptoms prior to event

ID: 0979257
Sex: F
Age: 65
State: KY

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
Hospital: Y

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Symptoms: Notified by a secondary source the following information. Patient was admitted to the hospital for a stroke. The hospital discovered the patient had a stroke a week prior to vaccination. Patient pace maker had been faulty and patient INR may have been lower than therapeutic. Unable to speak directly to patient at this time to confirm these events. Actual progression unknown. Understood patient is improving.

Other Meds: Warfarin, Levothyroxine, Zocor, Losartan, B12 1,000, Lopressor, Flecainide

Current Illness: unknown

ID: 0979258
Sex: F
Age: 51
State: PA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
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Allergies: sulfa

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Symptoms: ONE HALF HOUR POST INJECTION, I FELT A TINGLING SENSATION IN THE BACK OF MY LEFT SHOULDER AND DOWN MY SPINE. FOLLOWING THAT I EXPERIENCED CONFUSION THAT LASTED APPROXIMATELY ONE HOUR. I HAD A METALLIC TASTE IN MY MOUTH FOR THE ENTIRE DAY. I HAD EXTREME FATIGUE ALL DAY.

Other Meds: levothyroxin multi vitamin

Current Illness: none

ID: 0979259
Sex: F
Age: 82
State: FL

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/27/2021
Hospital: Y

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Allergies: None

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Symptoms: At 8:00 P.M. that night she used her walker to go to the bathroom. After 5 minutes I went in and found her walker at the comode,and she was standing 20 ft. away at the bed mumbling O.K. o.k. and that was all she said. I called 911 and she was taken to The Hospital where she is currently in ICU on a respirator.

Other Meds: Tylenol

Current Illness: Lung Cancer and Biopsys done on Tues Before

ID: 0979260
Sex: F
Age: 33
State: FL

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
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Allergies: none

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Symptoms: Around 11pm approximately 15 hours or so after the injection, I began with severe arm pain at the sight of injection (could not raise arm), body aches, fatigue, fever, and I ended up fainting. I fainted after trying to sit up, for maybe a few seconds, before coming to. Then proceeded with shaking and cold sweats through the night. Next day is better, but still body aches, fatigue and very small fever of 99.5

Other Meds: Alprazolam- .25mg Berberine 500mg

Current Illness: none

ID: 0979261
Sex: F
Age: 48
State: CA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/27/2021
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Symptoms: Systemic: cheek numbness, resolved with 25 mg of benadryl

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Current Illness:

ID: 0979262
Sex: F
Age: 52
State: IL

Vax Date: 12/30/2020
Onset Date: 01/16/2021
Rec V Date: 01/27/2021
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Allergies: environmental

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Symptoms: Bell's Palsy

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Current Illness:

ID: 0979263
Sex: F
Age: 55
State: VA

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
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Allergies: Avelox family of antibiotics.

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Symptoms: Awoke with body aches, muscle spasms to the point my body felt like it was having a seizures. Chills, pain in joints and muscles. I constantly felt like I had to stretch my body out. Jerking movements for close to two hours. Husband gave me ibuprofen, which did help. Nausea close to the end of the second hour, but never vomited. No HA. Started approx. 12:22 am and started to feel better approx 2:00 am. Did not go to work today as I was tired and sore. Slept most of day. Seem better now, 3:30 pm.

Other Meds: Allegra Prozac 10 mg

Current Illness:

Total 2021 VAERS Injuries: 319,999

Page last modified: 03 October 2021 5:28pm