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: 0992516
Sex: F
Age: 77
State: IL

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Almost all antibiotics and codeines and opiates

Symptom List:

Symptoms: My vision in both eyes went blurry. I could not read even with my usual reading glasses and a magnifying glass. I could not see anything more than 5 feet away clearly even though my right eye is 20/20 vision. My eyes ached. By the next evening all blurriness had cleared up. No repeat problem.

Other Meds: Lantus, Metformin, Simvastatin, Etodolac, Prozac, zinc, magnesium, potassium, acetaminophen, glucosamine-chondroitin, baby aspirin, multi-vitamin, Co-Q 10, Preservision, Vitamin D3,

Current Illness: None

ID: 0992517
Sex: F
Age: 0
State: OK

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Alpha gal Topomax Ceclor Pepto bismol Onions Juniper Augmentin

Symptom List:

Symptoms: I had a full arm rash and all over itching including some in my throat shortly after taking the vaccine. We knew I was allergic so I had taken medication in advance. Once rash started, two medications were taken- Vistaril and Zyrtec. This seemed to help it go away some though I am still experiencing it. I have alpha gal and I believe that is what made me have a reaction to the vaccine.

Other Meds: Tylenol, zyrtec, singulair, vistaril, cyclobenzaprine, trazodone, celexa, losartan hydrochlorothiazide, pre natal vitamin, b complex, potassium, famotidine, latuda, metformin

Current Illness:

ID: 0992518
Sex: M
Age: 73
State: CA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: nkda

Symptom List:

Symptoms: I have a history of previous parox. at. fibrillation but none for the last year. A few hours after 2nd covid injection, along with mild myalgias/prodromal sx., I went into atrial fib., with mild tach. but no other problems. The arrythmia persisted for ~24 hr.s then converted back to sinus rhythm-- and fine since. This event is more of an interesting observation than an "adverse event" but as the spike protein binds to ACE2 receptors, I thought the two events might be related and possibly of interest to you.

Other Meds: losartan/hctz, bystolic, viibryd rosuvastatin, asa, diphenhydramine

Current Illness: hypertension, dyslipidemia mild mdd

ID: 0992519
Sex: F
Age: 44
State: KY

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: NONE KNOWN

Symptom List:

Symptoms: Allergic reaction, initial encounter Left arm heavy numb to wrist Throat numb felt as if swelling Face numb eye pain floating spots nausea headaches Cold Rapid heart beat monitor breathing and BP rates Went to hospital via EMS

Other Meds: BENICAR TOPRYL

Current Illness: NONE

ID: 0992520
Sex: F
Age: 39
State: TN

Vax Date: 01/14/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Rash noted to trunk of body 1/29/21 and then to neck and jaw line by evening. Zyrtec taken and that evening and Benadryl with no changes. Doses repeated filling day with no changes. To urgent care on 1/31/21 with covid and Flu negative and Strept also returned negative to be told likely viral and covid send off also obtained.

Other Meds: None

Current Illness: None

ID: 0992521
Sex: F
Age: 81
State: NJ

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: NKA reported

Symptom List:

Symptoms: 11:30 Reports throat dryness s/p vaccination, during 15 minute monitoring; "throat feels restricted" w/no additional complaints Po hydration/ water given, 02 via NRM applied, continued monitoring; NAD, respirations unlabored; BP 140/90 P 65 RR 14 O2SAT 99%RA 11:45 "feels better"; BP 140/89 P 63 RR 14 O2 SAT 98% RA; released from facility w/ daughter

Other Meds: Losartan

Current Illness:

ID: 0992522
Sex: F
Age: 80
State:

Vax Date: 01/21/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: cat-gut suture

Symptom List:

Symptoms: right arm redness, swelling, increasing since injection- cellulitis- keflex

Other Meds: ASA, celexa, lisinopril, multivitamin, cultruelle

Current Illness:

ID: 0992523
Sex: F
Age: 31
State: CA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Fifteen minutes after vaccination, pt began to feel dizzy with nausea. Pt assisted to lay down where symptoms persisted. Pt reported feeling that her eyes felt like they wanted to roll back and she could not focus them. No vision changes and no loss of consciousness. Pt hypertensive and tachy. EMS activated. Paramedics on scene initiated IV and administration of Zofran, with relief of nausea. Care transferred to ambulance and patient transported to local hospital.

Other Meds: None

Current Illness: None

ID: 0992524
Sex: F
Age: 72
State: SC

Vax Date: 01/20/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List:

Symptoms: Itching swelling (4 inches across), redness

Other Meds: Premarin, Zoloft,Neurotin, Zyrtec, Caltrate, Ambien, albuterol inhalant,

Current Illness: None

ID: 0992525
Sex: F
Age: 34
State: CT

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Arm pain, headache, fever, severe pain in all body muscles for more than four hours, which did not decrease after two capsules of naproxen sodium 220mg and 28 oz of water.

Other Meds: None

Current Illness: None

ID: 0992526
Sex: M
Age: 60
State: MA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: topomax

Symptom List:

Symptoms: After second Moderna shot, Pt developed nausea, headache, extreme fatique, and bad back and leg cramps/spasms to the point where he couldn't walk. These symptoms lasted for 48 hours and gradually subsided. His wife (me) was so frightened that I will not be getting the Moderna series since it's so dangerous and will caution friends and family as well.

Other Meds: lisinopril, omeprazole, nortriptyline, pregabalin

Current Illness: none

ID: 0992527
Sex: F
Age: 87
State: OH

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: bee sting

Symptom List:

Symptoms: About half an hour of vaccination, patient complaint of numbness of lips and tongue felt cotton dry. Patient stated that she has had reaction to bee sting before, but the reaction was immediate. I gave patient 2 tablets of 25mg Benadryl and kelp an eye on her. She felt fine after half an hour of observation. She then went to her room.

Other Meds: none

Current Illness: nk

ID: 0992528
Sex: F
Age: 46
State: IN

Vax Date: 01/26/2021
Onset Date: 02/17/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: 12 hours after receiving #2 shot, woke up with chills/body aches & pain to injection site, shoulder & neck with fatigue & body aches. The pain worsened to site, shoulder neck. The evening on Thursday, Lymph Nodes in neck were inflamed. Friday a doctor visit occured with a diagnosis of Reactive Lymphadenopathy. Motrin suggested every 8 hours. Monday 2/1/21- Neck and shoulder still very tender/sore & lymph enlarged. Physician would like a follow-up in 2 weeks if not resolved.

Other Meds: Vitamin D Multivitamin

Current Illness: none

ID: 0992529
Sex: F
Age: 51
State: MT

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Body aches and Chills

Other Meds:

Current Illness:

ID: 0992530
Sex: M
Age: 60
State: TX

Vax Date: 01/01/2021
Onset Date: 01/01/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: iodine and clorhexadine, arythromyacin

Symptom List:

Symptoms: Second shot vaccine was end of Jan 2021 chills that lasted 48 hours, I lost appetite the next day for 24 hours, I continued working, I started getting headaches and ringing in ears I perceived this as hypertension and it lasted 2-3 weeks, losartan 12mg per day, I checked it and it was high it?s never been that high so I took 24mg instead. I took 50mg total of losartan and it?s taken until now to get down to 25mg daily. I may have been exposed in Jan of 2020.

Other Meds: Losartan, amlodipine

Current Illness: no

ID: 0992531
Sex: F
Age: 27
State: WI

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Allergies ? Latex HIVES ? Benzocaine SHOCK ? Blue Dyes ANAPHYLAXIS ? Cayenne ANAPHYLAXIS ? Cephalexin ANAPHYLAXIS ? Clindamycin ANAPHYLAXIS ? Green Dyes ANAPHYLAXIS ? Levofloxacin ANAPHYLAXIS ? Lidocaine ANAPHYLAXIS ? Nystatin ANAPHYLAXIS ? Red Dye ANAPHYLAXIS ? Terbinafine ANAPHYLAXIS ? Yellow Dye ANAPHYLAXIS ? Verapamil MALAISE and WEIGHT GAIN

Symptom List:

Symptoms: ?Pfizer-BioNTech COVID-19 Vaccine EUA? Pt had red streaking to arm near injection site approximately 10 minutes after injection, then also had chest tightness and felt like her voice had changed. Was given 50mg of benadryl by EMS with near immediate improvement of her symptoms but pt referred to ED. Pt arrived at ED and felt improved, no redness noted to site, no hives or rash noted on exam. Discharged home

Other Meds:

Current Illness:

ID: 0992532
Sex: F
Age: 89
State: OH

Vax Date: 01/23/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: very itchy red arm that started exactly 7 days after first dose

Other Meds: unknown; pt just kept stating she doesn't have a medical doctor she is a healthy person

Current Illness: type II diabetes documented on her vaccine form

ID: 0992533
Sex: F
Age: 89
State: MI

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Synthroid

Symptom List:

Symptoms: 1/21/2021 started feeling achy joints and restless at HS, reported feeling chilled 1/22/2021 Reports fatigue, states "slept all day" 1/23/2021- 1/26/2021 reports face "puffy", continues with muscle aches Reports used Tylenol to treat symptoms. Not able to recall date/time of initial dose.

Other Meds: O2, Levoxyl, BP med (name not reported)

Current Illness: denies

ID: 0992534
Sex: F
Age: 54
State: MI

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: latex, antibiotics, plaquenil ,

Symptom List:

Symptoms: Patient felt dizzy after injection(1513 admin time). given juice and crackers, feet elevated and vitals taken , elevated BP 169/99, otherwise stable. Monitored for 30 minutes and dizziness and vitals improved. Patient escorted walking on her own to exit.

Other Meds:

Current Illness: recent back surgery, Sjogrens disease,

ID: 0992535
Sex: F
Age: 55
State: TX

Vax Date: 12/26/2020
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: On the third day I got a nasty smell in my urine. I went to the Doctor and they told me I started to get an UTI, she gave me medicine. She told me the smell, I would have to drink a lot of water. She told me the smell may have been from t he vaccine but she couldn't tell me for sure.

Other Meds: Thyroid( prescription med (unknown)

Current Illness:

ID: 0992536
Sex: F
Age: 24
State: WI

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List:

Symptoms: Shaky, throat felt different, felt hear beat fast and then not

Other Meds: Unknown

Current Illness: Unknown

ID: 0992537
Sex: F
Age: 70
State: WI

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Patient reported feeling drips of vaccine on her arm following the injection. Patient reports that there was no blood on the band aid when removed and she was not aware of any bleeding at the time of injection. There was no pain at the time of the injection and she is not experiencing any tenderness following. There is concern that a portion of the dose did not enter the muscle as intended and the dose was not adequate. The vaccine was administered at a mass clinic by a volunteer.

Other Meds: NA

Current Illness: NA

ID: 0992538
Sex: F
Age: 28
State: MT

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Injection Site Pain & Headache

Other Meds:

Current Illness:

ID: 0992539
Sex: F
Age: 73
State: CA

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Flagyl

Symptom List:

Symptoms: Approximately 39 hours after receiving the shot, I experienced severe diarrhea. It continued for four hours. Upon waking in the morning the symptoms had ceased and I felt well. While I have Ulcerative Colitis, I do not believe this event was related to it. It was not food related. Also, as I have had a C.diff problem in the past and am taking Vancomycin daily, it did not appear to be related to that.

Other Meds: Xeljanz Famotdine Vancomycin Alendronate Sodium Tablet Simvistatin, Adult Vitamin

Current Illness:

ID: 0992540
Sex: F
Age: 42
State: IN

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Zithromax Darvocett

Symptom List:

Symptoms: Extreme dizziness, things pulsating with my vision, feeling of blacking out, feeling of blood rushing in and out of my head,

Other Meds: Tylenol 1000mg Aleve 220mg Meclizine 25mg Protonix 40mg Metformin 500mg

Current Illness: Diabetes Fibromyalgia Arthritis Ankylosis spondylitis Vertigo Migraines

ID: 0992541
Sex: F
Age: 73
State: SC

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Hydrocodone, Codeine, Morphine, Contrast iodine, Sulfa, Nickle, Sudafed

Symptom List:

Symptoms: Pinpoint itchy rash on arms, back, chest and abdomen, Noticed at 2:00 AM, 14 hours after shot given. Very tired feeling. Went to ER for treatment on Sat AM, Was told to take Zyrtec and/or Benedryl and make appt with PCP. Rash gone on Monday 02/01/21. Have appt with Dr , PCP, Wed 02/03/21 for follow up. Will discuss having second shot??

Other Meds: Multi Vitamin, Vitamin C, Vitamin D3, Lisonpril, Sertraline, Rosuvastatin, Benefiber

Current Illness: None

ID: 0992542
Sex: F
Age: 38
State: TX

Vax Date: 01/21/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Redness, itching, swelling, and mild pain at the injection site that didn't appear until 9 days after the injection. Redness and swelling was about 2 inches in diameter. Symptoms improved with topical analgesic and resolved within 2 days.

Other Meds: Safyral, Vitamin D supplememt

Current Illness: None

ID: 0992543
Sex: M
Age: 40
State:

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: fever, bocy aches 14 hours fever last 24 hours

Other Meds:

Current Illness:

ID: 0992544
Sex: F
Age: 53
State: VA

Vax Date: 01/25/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Pollen and dust

Symptom List:

Symptoms: Left arm at injection site is swollen, painful and itching a week after the injection. It had been fine for the last 5 days.

Other Meds: Losartan/hctz Potassium Fenofibrate Loratadine

Current Illness: None

ID: 0992545
Sex: M
Age: 80
State: SC

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Pt. received Moderna vaccine at 10:45a.m. ten minutes later pt. started complaining of pain behind both ears. Pt. denied chest pain, SOB at the time. Pt. remained in the office. Approximately thirty minutes later, pt. developed chest pain on the left side. EKG was attempted but could not be performed due to pt. stated it was his chest was hurting when he laid back. Pt. was given 2 liters of Depo Medrol IM and placed call to 911. EMS arrived within fifteen minutes. Pt. was transported to ED.

Other Meds: none

Current Illness: None

ID: 0992546
Sex: F
Age: 69
State: VA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Started with fatigue and body aches the evening after vaccination, which continued for 3 days. Developed rash all over body 3 days post-vaccination.

Other Meds:

Current Illness:

ID: 0992547
Sex: F
Age: 55
State: TX

Vax Date: 01/23/2021
Onset Date: 01/25/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: I started to feel kind of weak and I took two Advil's and I was sweating at night. I woke up the next day fine like nothing happened. The the next Monday I got the bad urine smell again, but I didn't go to the Doctor. I just drank water about 2-3 bottles.

Other Meds: Thyroid (prescription )

Current Illness:

ID: 0992548
Sex: F
Age: 37
State: IN

Vax Date: 01/02/2021
Onset Date: 01/09/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Left arm rash week after vaccine administration; localized to large area of injection site

Other Meds: None

Current Illness: None

ID: 0992549
Sex: F
Age: 65
State: MI

Vax Date: 01/22/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: Stated on 1/27/21 she had 3 "bumps" on her right shoulder. The bumps gradually multiplied and moved down arm to wrist. She stated there are approximately 20 bumps ( some are in 2 "welted areas" or groups of 4 or 5). She stated the "bumps or welts" now are painful and some are "crusted". She stated she has pain and "burning" in underarm area and bra-line under her breast, although there are no bumps in that area. She states the pain is not improving. She stated that the nurse at her physician's office told her to call the Health dept to report it, but they have not seen her yet. I told her I would do the report but recommended she evaluated by her PCP due to not improving.

Other Meds: Amlodipine, Sertraline, Hydrochlorothiazide, Glucosamine, Vitamin B12, Vitamin D3, Atorvastatin, Losartan, ProAir inhaler, BREO inhaler

Current Illness: Denies other illness

ID: 0992550
Sex: M
Age: 76
State: PR

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
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Allergies: SALICYLATES

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Symptoms: PATIENT WOKE UP WITH RIGHT EYE REALLY RED SWOLLEN. ALSO FACE WAS SWOLLEN. TOOK BENADRYL WHICH HELPED TO ALLEVIATE AND BRING DOWN SWOLLEN FACE.

Other Meds: BENADRYL. IRBESARTAN, CARVEDILOL, FENOFIBRATE

Current Illness:

ID: 0992551
Sex: F
Age: 83
State: MO

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
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Allergies: Sulfa drugs..& dalaudid

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Symptoms: On day of vaccine I went to lie down(3:15 pm.) and the room started spinning. I sat up and turned to the other side, and again the room started spinning. I got out of bed and phoned my Doctor. She said to hydrate. I took 1/2 bonine and drank all evening. At 10:15, going to bed, again the room started spinning. I felt unsteady all evening.

Other Meds:

Current Illness:

ID: 0992552
Sex: F
Age: 53
State: NY

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
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Allergies: No

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Symptoms: Fever, pain on left arm, body aches, back pain Used Tylenol , fever subsided on 1/30 pm but back pain continued lightly and constant throughout 1/31/21. Flank pain (moderate) began on 2/1/21, consistent/current

Other Meds: No

Current Illness: None

ID: 0992553
Sex: F
Age: 69
State: MI

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
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Allergies: allergies to grasses and dusts

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Symptoms: About an hour and a half after my injection I felt like I was getting an allergic reaction in my nose and body. My upper lip started swelling until big and swollen. I could feel tingling in my face and itchiness and pain from the swelling. I took Benadryl at home and went to sleep. The next day, Thursday, my left lip had swollen over the night and my face also swelled, particularly on my left cheek. It persisted throughout the day. I continued with the Benadryl. The net day I had an appointment with Dr., a dermatologist previously scheduled for something else. I showed him the photo I had taken that Friday morning and he said it was getting better but I should contact my doctor. My doctor said I

Other Meds: Lisinopril, Lyrica, Atorvastatin, Vitamins, Vitamin D,

Current Illness: none

ID: 0992554
Sex: M
Age: 91
State: FL

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 02/01/2021
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Allergies: doxycycline

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Symptoms: Approximately 36 hours after first dose, he developed generalized hives, no angioedema, no anaphylaxis. He did go to urgent care and was given oral steroids prior to my visit with him, hives had mostly resolved at my visit on 1/27/21-- although he remained dermatographic. He has no prior h/o hives or allergies

Other Meds: Metoprolol Atorvastatin

Current Illness: none

ID: 0992555
Sex: F
Age: 40
State: TX

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
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Allergies: iodine

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Symptoms: Second dose High fever- 106 degrees Farenheight. Severe body aches, severe headache

Other Meds: Progesterone 200 mg and Divigel 1mg- HRT Syntroid- 50 mg

Current Illness: No

ID: 0992556
Sex: M
Age: 42
State: ND

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
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Allergies: Bee Stings, Watermelon, Penicillin

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Symptoms: Received vaccine on 1/26/2021. 1/27/21 at 7:30 pm developed diarrhea. GI symptoms continued on 1/28/21 in the morning. At approximately 1:20pm on thursday. employee had a syncopal episode. Pale and diaphoretic. Then had episode of vomiting. Treated for dehydration with IV fluids. Given script for zofran. Treated as outpatient.

Other Meds: None

Current Illness: Tested positive for Covid 12/14/2020. Released from isolation 12/24/2020

ID: 0992557
Sex: F
Age: 22
State: WA

Vax Date: 01/29/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
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Allergies: None

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Symptoms: Severe pain in shoulder, causing nausea, started around 1:30 am and is still persisting.

Other Meds: None

Current Illness: None

ID: 0992558
Sex: F
Age: 50
State: WY

Vax Date: 01/20/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
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Allergies: Demerol, Inapsine, Imitrex

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Symptoms: I had a shingles outbreak which started 6 days after receiving the 2nd COVID-19 vaccine.

Other Meds: Venlafaxine, Atorvastatin, Levothyroxine

Current Illness: none

ID: 0992559
Sex: F
Age: 39
State: WY

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
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Allergies: unknown

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Symptoms: 15 minutes after her vaccine she complained that she had blurred vision. She did report that she had a latex allergy so I removed the band aid even though the band aides are labeled latex-free. I checked her vitals and Her b/p was 114/85 pulse was 84 and respirations 16. Her pulse ox was 95% She was in no apparent distress. The blurred vision resolved in 5 minutes and her vitals remained stable for 30 minutes. I discharged her with no symptoms.

Other Meds: unknown

Current Illness: unknown

ID: 0992561
Sex: F
Age: 16
State: TX

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 02/01/2021
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Symptoms: PATIENT WAS VACCINATED AT AGE 16. AGE REQUIREMENT FOR MODERNA IS 18 AND OLDER.

Other Meds:

Current Illness:

ID: 0992562
Sex: F
Age: 34
State: MN

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 02/01/2021
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Allergies: Amoxicillin (hives reaction).

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Symptoms: 1-2 days after 2nd dose Pfizer covid vaccine administered, developed significant hives reaction on torso and right leg. Right leg rash biopsied at dermatology visit on 1/21/21 with biopsy results urticarial tissue reaction. Given topical steroid with improvements and started on Zyrtec. Rash finally started improving on Day 11 (1/24/21). Hives rash nearly resolved but then new rash started shortly after on right hip/buttocks. Saw provider in clinic and diagnosed with shingles on 1/28/21. There had been no new changes other than vaccine during time of start of rash (for example no changes in usual lotions, soaps, laundry detergents, new clothing, etc and no new foods had been introduced).

Other Meds: Sumitriptan Multivitamin

Current Illness: None

ID: 0992563
Sex: F
Age: 37
State: NM

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
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Allergies: None

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Symptoms: Light headedness, ongoing (started ~1 hour ago). I don't know if it's related to vaccine; I regularly experience presyncope with various triggers.

Other Meds: No medications taken today. Last night ~10:00pm, took citalopram norethindrone(heather), and Zyrtec/cetirizine hydrochloride

Current Illness: None

ID: 0992564
Sex: F
Age: 82
State:

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
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Symptoms: Left arm developed an itchy rash on 1/30/21

Other Meds:

Current Illness:

ID: 0992565
Sex: F
Age: 53
State: NC

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
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Allergies: N/A

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Symptoms: Moderna COVID?19 Vaccine EUA--extreme body aches, all joints hurt, extreme tiredness, nausea, headache, loss of appetite. Aches were so severe that any pressure hurt, including lying down with blankets on. No fever was presented. Symptoms lasted about 24 hours. Migraine headache remained an additional 12 hours

Other Meds: Armour Thyroid, Vit D, probiotic

Current Illness: N/A

ID: 0992566
Sex: F
Age: 66
State: OR

Vax Date: 01/21/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
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Allergies: Sulfates

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Symptoms: Erythema and induration @ the site the size of a silver dollar. Mild pain. A week later erythema and an induration increased and the size increased times two. Lasted only a couple days still some mild pain but nothing serious

Other Meds: Mesalamine, Vitamin D, Lipoic Acid, aloe Vera, probiotics, hair and nail supplement, protein collagen, mushroom supplement

Current Illness: Ulcerative colitis

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm