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
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 0981872
Sex: F
Age: 31
State: ME

Vax Date: 01/22/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List:

Symptoms: Day 1 & 2: chills, fully body muscle aches, headache. Day 6: full body hives

Other Meds: Nexplanon

Current Illness: None

ID: 0981874
Sex: M
Age: 52
State: LA

Vax Date: 01/11/2021
Onset Date: 01/16/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: generalized itching, maculopapular rash, lips, face, neck, tongue swelling, difficulty of swallowing, left wrist swelling, generalized weakness, fatigue. 2nd dose of vaccine received on 01/11/21, first was on 12/22/20. Symptoms started on 01/16/21 between 1 and 2 am. First day symptoms were mild resolved after taking allegra and benadryl. On 01/17/21 between 2 and 3 am started again, and got worse, did not improve after taking allerga and zyrtec. Later in the day started on prednisone daily, allegra daily and one dose of benadryl. Symptoms lasted for few more days

Other Meds: none

Current Illness: none

ID: 0981875
Sex: F
Age: 56
State: NY

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Tenderness under arm, - lymph node association, mid to lower back, site swelling Ibuprofen 400 mg relieved symptoms

Other Meds:

Current Illness:

ID: 0981876
Sex: F
Age: 30
State: IA

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Fever; joint pain; muscle pain; feels like got hit by a bus

Other Meds:

Current Illness:

ID: 0981877
Sex: M
Age: 51
State: MO

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Injection site pain, body aches, headache, chills, fever to 100. Symptoms relieved with Aleve.

Other Meds: Omeprazole, Aleve, statin, Finasteride

Current Illness: None

ID: 0981878
Sex: M
Age: 63
State: PA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Joint and muscle pain

Other Meds:

Current Illness: None

ID: 0981879
Sex: F
Age: 53
State: FL

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: Percoset; Latex

Symptom List:

Symptoms: 1/26 - fever; swelling - tylenol 650 1/27 - fever; swelling - tylenol 650 1/28 - swelling - 2 tylenol; 200 mg aspirin; ice pack

Other Meds: Losartan; Vitamin C; baby aspirin; /ocuvite; b-12; calcium; fish oil;magnesium with zinc; Vitamin E and D

Current Illness: n/a

ID: 0981880
Sex: F
Age: 77
State: FL

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: I received my injection on 1/25/2021 I had my second COVID shot, everything went well, I just had a little pain and swelling and was fine. About 7 hours later i got up from chair and i was dizzy and my balance was off and i almost fell into table. I didn't feel right. I went and sat back down and i was very tired and i started getting headache. I called my daughter and a nurse she knows told me to take extra strength Tylenol 500 mg take 2 every 6 hours. I started at 730 and went until 130. I slept on and off and got up Tuesday and my arm was still hurting. I was very tired and had no energy. When i got up later in the afternoon i had extreme chills. It was 83 degrees in Florida nd i turned heat up to 84 and i was still shaking. I got under covers and had a fever it was 100.8. Went to sleep that night and fever broke. Got up Wednesday and felt a little better, still had headache and tired. Decided to take a shower. I noticed my left arm where the injection was was all red. 6-7 inches long and about 5 inches wide which i never saw before. after shower I called my PCP I contacted the nurse said she thought it was normal and if there was no change to call her back on Friday. my arm is still red and warm i went to sleep but couldn't sleep. I saw an article about COVID arm rash seen after Modern vaccine and now i know that's what I had. I feel better after I read it in the magazine today and it said it will only last a week. This should be listed as a side effect so nobody else wonders what it is. I drank so much water because it said to drink plenty of water and i tried to use arm as much as possible.

Other Meds: Levothyroxine and 2 Advil

Current Illness: No

ID: 0981881
Sex: F
Age: 16
State: SC

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: no known allergy

Symptom List:

Symptoms: Error: Too Young for Vaccine

Other Meds:

Current Illness:

ID: 0981882
Sex: F
Age: 70
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Approximately 29 hours (5. PM Tuesday) after I received the 1 st Moderna vaccine, I developed a redness and swelling at the injection site. My arm became painful all around the shoulder and halfway down my upper arm. I was unable to lift my arm without major discomfort. I applied ice packs to the site every hour and took ibuprofen every 8 hours through Thursday morning. My arm was better and although I still had some discomfort I was able to move my arm more freely. The redness was gone and the swelling was down.

Other Meds:

Current Illness: None

ID: 0981883
Sex: F
Age: 29
State: FL

Vax Date: 01/01/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Delayed redness/warm to touch around injection site worsening on Day 8 post vaccine with itchiness. 2.25 inches by 2 inches in size

Other Meds: Portia birth control

Current Illness: None

ID: 0981884
Sex: F
Age: 58
State: MI

Vax Date: 01/01/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: Cocoa, Salmon, protamine, thermamit, carbonite, ethylene oxide, bees,

Symptom List:

Symptoms: Had this 24 hours after first vaccine and again with second. Didnt report first time but did notify my department manager and OR educator. Bloody nose, dripping like a runny nose. Last 3 days after first vaccine. Just starting again with second vaccine. Not as severe but still bloody when I blow it.

Other Meds: Levothroxin, Vit. D, Calcium, Boysenberry

Current Illness: None

ID: 0981885
Sex: F
Age: 21
State: VA

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

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

Lab Data:

Allergies: Sulfa drugs

Symptom List:

Symptoms: 101.9F fever onset 12 hours after second dose vaccination with associated myalgias. Lasted 8 hours

Other Meds: Zoloft 50mg, Adderall Salts 20mg

Current Illness: Urinary Tract Infection 3 weeks prior

ID: 0981886
Sex: F
Age: 74
State: VA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Sore arm.

Other Meds:

Current Illness:

ID: 0981887
Sex: M
Age: 75
State: MA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Minor difficulty staying warm, Felt a bit of fog.

Other Meds: Copd inhalers

Current Illness: o none

ID: 0981889
Sex: F
Age: 51
State: KY

Vax Date: 01/19/2021
Onset Date: 01/23/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: o food alleriges drugs sulfa zithromax augmentin

Symptom List:

Symptoms: Started with an ocular migraine( I have had these in the past but not for a couple of years) on Thursday the 21st 2 days after vaccination, On Friday, still had dull headache. Woke up Saturday with a slight fever. It progresssed until Sunday and I became very weak, horrible headache, extreme dizziness. This is still going on. The fever left yesterday. But am still weak and having severe dizziness and fullness in my head. I have had labrinthitis in the past but haven't had any major issues for 6 years when I had the flu. Went to doctor yesterday. Flu was negative. She thought maybe another an upper respiratory virus which I question because I only go to work with a small group and come home and no one at my work has been sick. I also always start out with a sore throat when I have some sort of URI and I never had this. I do not have any congestion to speak of. I am a rule follower and always wear my mask and to be honest wear gloves if I have to touch anything. but I do not go anywhere except for work. I was exposed to covid the day after vaccination but have tested negative 2 times. I had the RT-PCT test. I am just trying to take it one day at a time

Other Meds: Baclofen 10 mg 2 times a day lexapro 10 mg 1 per day colace stool softeners 4 per day

Current Illness: 0

ID: 0981890
Sex: F
Age: 66
State: NY

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pt complains of mild itchiness on the left arm at 10: 45am, assessment was done pt. had slight erythema on the left arm, no rash was found on the torso. pt. was offered a Benadryl but she refused. she also refused additional 15 mins.

Other Meds:

Current Illness:

ID: 0981891
Sex: M
Age: 68
State: NC

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Severe weakness, shortness of breath dizziness, very elevated blood pressure and heart rate for about 4 hours Had to be transported from clinic via ambulance to Medical Center; Doctor attending in ED Symptoms continued for 6 days

Other Meds: Atorvastain 10 mg; Aspirin 81 mg; Lansoprazole 15 mg; Ranolazine ER 500 mg;

Current Illness: none

ID: 0981892
Sex: F
Age: 64
State: SC

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: Penecillin

Symptom List:

Symptoms: Fever, chills, body ache

Other Meds: Lisinpril 5 mg Tamoxifen 20 mg

Current Illness: Covid on 12/18/20 with pneumonia

ID: 0981893
Sex: F
Age: 30
State: MO

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Initial itching around the collarbone progressing up the neck. while in route to ED she started complaining of a scratchy throat. Seen in ED. no further information provided

Other Meds:

Current Illness:

ID: 0981894
Sex: F
Age: 37
State: VA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: chills, body aches, joint pain - MS symptoms amplified

Other Meds: Lexipro, Adderall, Prevacid, Baclofen, Ocrevus

Current Illness: sinus infection

ID: 0981895
Sex: F
Age: 48
State: OR

Vax Date: 01/20/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: latex

Symptom List:

Symptoms: Right arm started to ache around 2:30 pm while writing on the board (I am a teacher). It also started to itch. By the time I got home the injection site swelled. It was in an oval shape 2 inches long by 1 inch wide. The area became progressively hot and feverish feeling, sore and swelled so that it felt like a knot under the skin. I took ibuprofen and iced it. I was eventually able to sleep. Today, which is the next day at 8:30 am, I am very tired. The swelling has gone down and it is still quite warm.

Other Meds: sertraline, busipar, lisinopril, hydroxyzine

Current Illness:

ID: 0981896
Sex: F
Age: 37
State: PA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: Bactrim, Sulfa, Phenergan, Tetracycline, Tygacil

Symptom List:

Symptoms: The vaccine recipient received the Moderna COVID-19 Vaccine on 12/29/2020. Then, inadvertently was given the Pfizer COVID-19 vaccine on 1/27/2021. No treatment required.

Other Meds: Unsure

Current Illness: Denied

ID: 0981897
Sex: F
Age: 57
State: ME

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List:

Symptoms: had nausea chills headache and weakness lasted for 12 hours

Other Meds: none

Current Illness: none

ID: 0981898
Sex: F
Age: 37
State: CA

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

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

Lab Data:

Allergies: Latex gloves - flares up eczema prone hands

Symptom List:

Symptoms: 5 minutes post vaccination- in observation location and left hand & forearm starting to feel numb & tingling - This continued for days and progressively improved about 10 minutes post vaccination - headache sharp, right side. Moved to observation chair for further assessment and vitals check. Upon getting up to go to the new chair, was lightheaded. Vital signs taken and revealed tachycardia and increased BP beyond normal values. Prior symptoms persist. Healthcare workers continue to monitor me while sitting on chair. Oral Tylenol for headache was given. Approximately 30-45 minutes in I feel chest palpitations and an uneasy 'anxious' type of feeling even though I am just sitting down and staying calm. Due to all these symptoms plus the BP and HR remaining high they gave me Benadryl 25mg IM to the right arm as well. The BP started to slowly go down after about 2 hrs as well as HR. Allowed to leave hospital vaccination clinic, while BP and HR still high, was better than the first 2 hours. New symptoms on day 2, pain left arm at injection site and muscles, fatigue and some intermittent nausea. The symptoms continued for 3-4 days post vaccination. I monitored Vitals at home. BP finally stabilized to my normal range around the 4th day.

Other Meds: Tylenol PRN - last dose was 48+ hours ago Albuterol PRN - last dose greater than 3 months Vitamin C prn Multi-vitamin - prn Claritin/allergy med daily

Current Illness: No illness

ID: 0981899
Sex: F
Age: 74
State: IN

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Hives/Rash. Various places on my arms, legs, neck, vaginal area. Itchy. Took Benadryl even 6 hours. Lasted 3 days Tingling in arm in the exact area shot was given started on 3 day after injection. Nausea and diarrhea started on 3rd day after injection

Other Meds: Xanax, vitamin D, calcium with D, biotin, magnesium citrate, cranberry with vitamin C, fosamax, omega 3

Current Illness: Had an eardrum infection and was taking an antibiotic ( amoxicillin)

ID: 0981900
Sex: F
Age: 33
State: OR

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: I initially had chills fatigue, muscle aches, joint pain, flank pain lower back pain , I urinated blood the AM of the 30th of Dec and went to my doctor which resolved the next day. I had a on and off headache. My symptoms lasted a total of 3 days. I only took ibuprofen

Other Meds: melatonin daily

Current Illness: no

ID: 0981901
Sex: F
Age: 46
State: NY

Vax Date: 01/08/2021
Onset Date: 01/22/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Two weeks after the vaccine , sudden onset of vertigo , head very light, super exhausted

Other Meds: womens one a day

Current Illness: none

ID: 0981902
Sex: F
Age: 39
State: NC

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: Penacillin levaquin kiwi tree nuts Adhesive in tape and bandaid

Symptom List:

Symptoms: Pt experienced redness, swelling, and small round patches that look similar to ringworm with white crust. Flat and smooth. No itching but sorness and tenderness in shoulder and up into neck area. Arm warm to the touch intermittently; neck and left ear feel hot. Started 24 post vaccination. Taking benadryl q6 hours until symptoms resolve. Has contacted pcp for further intructions.

Other Meds: Gabapentin Birth Control Pill (unsure of name) Hydrocodone PRN Synthroid Zinc Vit D Vit C

Current Illness: Ear infection - 5 weeks prior

ID: 0981904
Sex: M
Age: 76
State: TX

Vax Date: 01/15/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: Raised red bumps in a rash all over the abdomen, arms & legs. First noticed at 6 pm, majority of rash gone the next morning except. Under arms and upper legs.

Other Meds: Montelukast, aspirin, tamulosin hcl, spironolactone, amlodipine, metformim, metoprolol, simvastatin,losartsan, vitamin D3, turmeric curcumin

Current Illness: None

ID: 0981905
Sex: F
Age: 29
State: IA

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Fever; chest discomfort; dizzyness; headache Seen a physician due to chest discomfort and was released.

Other Meds:

Current Illness:

ID: 0981906
Sex: F
Age: 54
State: GA

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

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

Lab Data:

Allergies: No reported allergies

Symptom List:

Symptoms: The above pt. called on Monday 01/25/2021 and reported having what she intepreted as a severe reaction to the EUA Moderna Covid-19 vaccine that she received on 01/21/2021. She states that the evening after receivng shot that she experienced headache, tingling in hands, swelling of the face and feelings of shortness of breath. States that she has sisters who are nurses and she took benadryl and an injection of epi pen that she had at home and recovered without any other issues. Denies going to the hospital or seeing her private doctor after incident. Pt. did not report the use of Epi pen injections nor listed any history of reactions on questionaire during visit.

Other Meds:

Current Illness:

ID: 0981907
Sex: F
Age: 33
State: AZ

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: Codine

Symptom List:

Symptoms: Starting about 11-12 hrs after receiving the vaccination I developed a fever, fatigue, headache, nausea, diarrhea, & my entire body ached. This lasted about 24 hours.

Other Meds: Tri-sprintec

Current Illness: N/A

ID: 0981908
Sex: F
Age: 56
State: TX

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/28/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Patient returned to observation area after going to car. She is having an anxiety attack thinking what to do if she has a reaction (per patient). Patient denies chest pains, shortness of breath, trouble breathing. Panic button activated and staff including Doctor responded. No hives, rash noted. After being observed and breathing checked with stethoscope, it was determined patient didn't have a reaction. After waiting 30 minutes, patient left without any symptoms of reaction to vaccine. Patient instructed to go to ER if any problems.

Other Meds: N/A

Current Illness: N/A

ID: 0981909
Sex: F
Age: 39
State: IN

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
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Allergies: Erythromycin

Symptom List:

Symptoms: 1/26/21: Fever of 102F, bad chills, body aches in almost all muscles (did not exercise), headache, mild nausea and muscle continuously twitching in one leg for a few hours. 1/27/21: Fever of 101F, chills, body ache (did not exercise), mild nausea and headache.

Other Meds: Centrum multivitamin for women

Current Illness: None

ID: 0981910
Sex: F
Age: 34
State: UT

Vax Date: 12/30/2020
Onset Date: 01/25/2021
Rec V Date: 01/28/2021
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Allergies: unknown

Symptom List:

Symptoms: called to report to her supervisor/employer that while she was at the gym working out she started to not feel well, she felt she was hyperventilating and then her left arm went numb and although she was awake, she not able to respond. The paramedics was contacted and came. She reported that once she was in the emergency department all her tests were clear, including her CT scan. The MD felt it was most likely a "mini TIA". She has fully recovered and denies any other symptoms at this time, but was instructed by her MD to contact the facility that administered her MODERNA covid vaccine.

Other Meds: unknown

Current Illness: NONE

ID: 0981911
Sex: F
Age: 41
State: PA

Vax Date: 01/15/2021
Onset Date: 01/24/2021
Rec V Date: 01/28/2021
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Allergies: None

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Symptoms: Delayed reaction at injection site. Slightly sore, swollen, hot to touch, red circle about 2inches in diameter at the injection site. Faded over next 12 hours, no other symptoms just slightly red the next day, faded and now a slightly discolored no other symptoms.

Other Meds: None

Current Illness: No

Date Died: 01/27/2021

ID: 0981912
Sex: F
Age: 67
State: CA

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/28/2021
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Allergies: none

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Symptoms: Patient presented to the Emergency Department complaining of chest pain, pale, cool diaphoretic, and hypotensive. The patient was discovered to have a large saddle pulmonary embolism, went into cardiac arrest and expired. Of note, the patient received her second Moderna COVID vaccine on 1/23, which would place her first one approximately 12/25 if she received them at the appropriate interval. This information is from the patient's daughter and the ED record, the information is not available in CAIR. Per the daughter, the patient started feeling ill on 1/21, improved on 1/25, and then acutely worsened on 1/27, resulting in the ED visit.

Other Meds: albuterol, fluticasone nasal spray, hydrochlorothiazide, losartan

Current Illness:

ID: 0981913
Sex: F
Age: 57
State: NY

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
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Allergies: Nickel, Bacitracin

Symptom List:

Symptoms: fever 100.8. joint pain, headache

Other Meds: Multi vitamin, Lipitor, Omeprazole, vitamin C, vitamin D

Current Illness: None

ID: 0981914
Sex: M
Age: 53
State: GA

Vax Date: 01/11/2021
Onset Date: 01/20/2021
Rec V Date: 01/28/2021
Hospital: Y

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Allergies: NKDA

Symptom List:

Symptoms: Moderna COVID?19 Vaccine EUA Dr. received Covid-19 vaccine on January 11, 2021 in his office. Dr. reported complaints of abdominal discomfort to his staff starting on January 13 or 14th. Pain and condition worsened. By January 19th, running fever 103.9 F, oral. Labs showed elevated white count. On January 20th, follow up labs and KUB done. Elevated white count and Appendicits diagnosed. Also on January 20th, emergency consult done and emergency surgery done to remove appendix. Reports of Appendicitis noted on follow-up research. Even though reports stated unknow correlations between Covid-19 vaccine and Appendicitis, VAERS report done as precaution.

Other Meds: None known

Current Illness: None reported.

ID: 0981915
Sex: F
Age: 38
State: CA

Vax Date: 12/19/2020
Onset Date: 12/19/2020
Rec V Date: 01/28/2021
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Symptoms: Complex migraine with neurological symptoms: numbness to R upper extremity, trouble speaking. Patient presented to Emergency Dept. Sxs resolved in one hour.

Other Meds:

Current Illness:

ID: 0981916
Sex: F
Age: 27
State: CA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/28/2021
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Allergies: None reported

Symptom List:

Symptoms: Patient reports ~10 minutes post vaccine becoming sweaty, experiencing blurry vision, and muffled hearing. Writers assessment at 12 minutes , no longer diaphoretic, reports clear vision, slight headache, still slightly muffled hearing. Report no past medical history or allergies, and states last meal was ~20 hours ago. Assessment at 20 minutes - patient reports ?weak neck?, continued headache, vision/hearing returned to normal. Provided with education to seek care of physician if conditions continue or worsen, left site with boyfriend.

Other Meds: None reported

Current Illness: None reported

ID: 0981917
Sex: F
Age: 59
State: WV

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/28/2021
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Allergies: Crab meat ( no other shell fish)

Symptom List:

Symptoms: Headache within first 15 minutes, treated with OTC medication, lasted 3 days 1st day- headache, dizziness, nausea 2nd day- stomachache, headache, joint and muscle soreness, sinus congestion 3rd day- severe headache, mild soreness in muscles, sinus drainage cough 4th day- very mild headache 5th day- increased sinus congestion and drainage scratchy throat 6th day- same, plus mild headache 7th- 10th day- symptoms mostly resolved some lingering drainage and fatigue

Other Meds: Fish oil, lisinopril, atervastin, Vit D, multi vitamin

Current Illness: None

ID: 0981919
Sex: F
Age: 67
State: NC

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
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Allergies: Cefuroxime Itching High Glucosamine Swelling High Iodine Swelling High Shellfish Containing Products Swelling High Metoclopramide Other (Shakes, confusion) Medium Penicillins Rash, Medium Apixaban Rash Codeine Nausea

Symptom List:

Symptoms: On 01/26/21, 67 yo F with anemia, asthma, Afib (on rivaroxaban), fibromyalgia, DM2, HLD, and osteoarthritis was administered COVID-19 Moderna vaccine 0.5 mL in left deltoid (Lot #011J20A, Exp: 05/11/21). Pt has numerous documented allergies including iodine (hives, facial swelling), Shellfish Containing Products (Hives, facial swelling) and penicillin (edema). Pt initially tolerated injection without incident and was sent for post-injection observation. Within 10 minutes, pt developed acute SOB, increased WOB, wheezing, and cough. Pt also reported itching skin and scratchy throat. Provider notified and exam found pt in respiratory distress with increased work of breathing, bronchospasm and wheezing. Pt had no rash, lip swelling or vomiting. Vitals assessed as O2 sats >96%, BP 140-150s/60s, HR 70-80s. Pt was administered albuterol 2.5 mg via nebulization x 2, diphenhydramine 50 mg IM and epinephrine 0.3 mg IM. Pt was subsequently transported to ED. By time of arrival, pt's symptoms had significantly improved. Pt administered famotidine 20 mg IV and prednisone 60 mg PO and placed on continuous cardiac and pulse oximetry monitoring. After complete symptom resolution, pt was discharged in stable condition. Pt's allergy profile was updated to include Moderna Covid-19 Vaccine (eua) (rxn: Anaphylaxis; severity: High).

Other Meds: Unknown

Current Illness: anemia, asthma, Afib (on rivaroxaban), fibromyalgia, DM2, HLD, and osteoarthritis

ID: 0981920
Sex: F
Age: 36
State: MI

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/28/2021
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Allergies: WHEAT AND GLUTEN LATEX, SULFASALIZINE, TORADOL, REGLAN , OMEPRAZOLE, ALOTRIPTINE (MIGRAINE MEDS INDOMETHACINE).

Symptom List:

Symptoms: LEFT ARM NUMBNESS AND TINGLING THROAT FELT THICK BENADRYL 50MG IM GIVEN

Other Meds: EMBRIEL, PLAQUENIL, PREDNISONE 3MG, BABY ASA, ZRYTEC, SINGULAR, FOLIC ACID, PRENATAL VIT, PROGESTERONE, VIT D, MAGNESIUM.

Current Illness: NO, COVID IN DECEMBER

ID: 0981921
Sex: M
Age: 29
State: NY

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/28/2021
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Allergies: NKDA

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Symptoms: Prior to vaccination, Client was clinical evaluated and clinically cleared by medical consultant, to receive vaccine. Vaccine administered and 2 minutes later client states "I don't feel well". Paramedic assessed, monitored and client eventually cleared to go home.

Other Meds: Client states he took Tylenol one hour prior to vaccination = 1330

Current Illness: Nasal Congestion

ID: 0981922
Sex: F
Age: 1
State: TX

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/28/2021
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Allergies: N/A

Symptom List:

Symptoms: Patient broke out in hives on face, stomach, back and chest. Very swollen and red on face area and around the eyes. Decardron 4ml was administered to the patient. The redness got somewhat better that evening and the swelling finally went away 2 days after steroid was given.

Other Meds: N/A

Current Illness: N/A

ID: 0981923
Sex: F
Age: 54
State: IA

Vax Date: 01/19/2021
Onset Date: 01/21/2021
Rec V Date: 01/28/2021
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Symptoms: Exhaustion; Shortness of breath; fatigue . Seen a physician due to history of COPD

Other Meds:

Current Illness:

ID: 0981924
Sex: F
Age: 70
State: PA

Vax Date: 01/19/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
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Symptoms: Developed a rash around the injection site that spread around my deltoid area. It itches slightly, but is not painful.

Other Meds: Diltiazem, Chlorthalidone, spironolactone, calcium, vitamin D

Current Illness:

ID: 0981925
Sex: F
Age: 29
State:

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/28/2021
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Allergies: none

Symptom List:

Symptoms: 1 hour after vaccine received, patient experienced itching, initially she felt it could have been related to something else, however after going home and showering, itching persisted and involved the entire body. Injection site developed bumps that looked like hives per report and spread the entire arm. The patient took a dose of diphenhdyramine however itching and hives continued into the night and could not sleep, another diphenhdyramine dose was taken and she was able to sleep for a few hours. She went to see her PCP who deemed this an allergic reaction to the vaccine, gave her oral steroid along w topical cream. The bumps and hives subsides within 24 hours of steroid use, and the itching resolved after 2 days of initiating steroid (3 days post vaccine) . Steroids were started 1 day post vaccine. PCP recommended patient sees an allergist for further investigation and refrain from second dose of vaccine

Other Meds:

Current Illness: asthma

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm