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
30,609
AK1,116
AL2,490
AR1,629
AS31
AZ7,656
CA29,793
CO5,715
CT3,932
DC777
DE796
FL16,357
FM3
GA6,458
GU49
HI1,077
IA2,429
ID1,323
IL9,702
IN14,777
KS2,412
KY3,191
LA2,225
MA7,121
MD6,104
ME1,601
MH6
MI8,794
MN5,956
MO4,653
MP10
MS1,270
MT1,320
NC7,777
ND700
NE1,539
NH1,630
NJ7,901
NM2,014
NV1,831
NY16,388
OH9,662
OK2,593
OR3,948
PA10,337
PR1,115
QM1
RI1,091
SC2,871
SD697
TN4,166
TX16,089
UT2,246
VA7,388
VI26
VT949
WA6,704
WI5,618
WV1,241
WY444
XB4
XL1
XV1

ID: 1002208
Sex: F
Age: 50
State: MD

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Starting the evening of the vaccine, the patient experienced fever, chills and body aches.

Other Meds:

Current Illness:

ID: 1002209
Sex: F
Age: 50
State: CA

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Raised rash bumps, particularly on extremities, mostly found on finger joints, elbows, knees , and to area of injection. Symptoms occurred approximately 1 week after vaccination

Other Meds: None

Current Illness: None

ID: 1002210
Sex: F
Age: 44
State: WI

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Allergic to Penicillen

Symptom List:

Symptoms: Within 5 minutes, I felt weird and light headed. My blood pressure spiked, temperature spiked to 101, heart rate was elevated and continued to be elevated for about 12 hours, and there was a rash across my chest and upper arms. On 1/14, I was extremely tired. On 1/15, I had a sore throat, headache, and still slightly tired. As the days went on, the cold symptoms got progressive worse. Extremely congested, runny nose, extremely painful headache, coughing up pflegm, sore throat, etc. On Wednesday, 1/20 I had a fever of 101. I had these cold symptoms for a week and a half and that was when I called my doctor. She gave me an antibiotic. I was on the antibiotic 1/26 - 1/30. Today is 2/4 and I'm still coughing. Something weird also happened, smells changed. My coffee smelled awful and other things seemed extremely strong.

Other Meds: Deblitane 0.35 Mg Women's One a Day Multivitamin

Current Illness: None

ID: 1002211
Sex: F
Age: 32
State: NJ

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Tiredness, headache, muscle pain, chills, fever, body aches, injection site swelling, feeling unwell.

Other Meds:

Current Illness:

ID: 1002212
Sex: F
Age: 81
State: AZ

Vax Date: 01/31/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: 3 hours of Vomiting and Diarrhea for aprox 48 hours

Other Meds: Valstartin, glucosamine hci, Metoprolo, Levothyroxine, Lioythyronone, Simvastatin, adult asprin,

Current Illness: NONE

ID: 1002213
Sex: F
Age: 78
State: NC

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Ace inhibitors, amlodipine, amoxicillin, Coreg, cozzarr, Augmentin, diltiazem, fosopril, hydrochloride, metro polo, isosorbide monotrate, zerapromil, dioxicilin, prednisone,

Symptom List:

Symptoms: On the 4th hour I was sleepy and fatigue, 3pm, went to bed at 11pm, woke up at 2am extremely dizzy and the room was fiercely spinning and couldn?t get up. I tried going back to sleep and when trying to move the room spined drastically slowly sat up and went to the bathroom and laid back down and it started again, each duration lasted 10 seconds and it caused me to have 3 BMs in the next3 hours, couldn?t sleep but I have a tightness around my head and sleepiness and last event was 7am, when got up I had diarrhea and and had dry heaves that lasted 5 minutes and now fatigued and hot feeling around my eyes. My stomach feels stressed and tired and weak

Other Meds: D3 500mg, Magnesium 400mg, Warfarin 6mg, Furosemide 80mg, Alopurinol 300mg, B12 100mcg

Current Illness: HTN,

ID: 1002214
Sex: F
Age: 43
State: ID

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin and Sulfa

Symptom List:

Symptoms: Rash two days after the vaccine

Other Meds: norethindrone-ethinyl estradiol (NORTREL 1/35, 28,) 1-35 mg-mc

Current Illness: Unknown

ID: 1002215
Sex: F
Age: 58
State:

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Chills, sweats, headache, fatigue and abdominal pain

Other Meds:

Current Illness:

ID: 1002216
Sex: F
Age: 37
State: WA

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 02/04/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Received the Moderna Vaccine (Lot# 025L20A) on 1/11/21. 1/13/2021 had swelling and pain to my left upper arm near and around site of injection. The swelled area was the the whole with of my arm. The injection site was also warm to the touch with some itching associated. On 1/14-16/2021 I had extreme exhaustion including irritability. On 1/17/2021 woke up feeling good, the arm pain went away and had no other symptoms. On 1/18/2021 at night I noticed a bump feeling like a cyst at the cite of injection and the itch reappeared. 1/19/2021 around 11am I visited a health clinic to show them my arm after asking fellow colleagues if any of them had the same reaction. At the health clinic we looked at the injection site and there was a red rash covering part of my upper arm and the nurse looked closer and said she saw puss granulars.'

Other Meds:

Current Illness:

ID: 1002217
Sex: F
Age: 31
State: NJ

Vax Date: 01/26/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List:

Symptoms: Moderna COVID-19 Vaccine Approximately 7 days after I received dose 1, I started having symptoms at the injection spot. This included inflammation, a bright red rash, and pain to the touch.

Other Meds: NA

Current Illness: NA

ID: 1002218
Sex: F
Age: 59
State: CA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: PAIN & SWELLING AT INJECTION SITE THEN DEVELOPED CHILLS AND BODY ACHES HAPPENED ALL OF A SUDDEN, HAD A MILD HEADACHE, THE BODY ACHES LASTED FROM FRIDAY EVENING THROUGHOUT THE FOLLOWING DAY SATURDAY, ON SUNDAY A.M. I STARTED TO FEEL LIKE MYSELF. UP UNTIL YESTERDAY I DO HAVE MILD SENSIVITY ON THE INJECTION SITE WITH ITCHING.

Other Meds: Blood pressure medication

Current Illness:

ID: 1002219
Sex: F
Age: 58
State: MN

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Unknwon

Symptom List:

Symptoms: Client presented for first dose Moderna Covid Vaccination. 30 minutes after receiving vaccination rash developed in midriff area. States this occurred a number of times with flu vaccine and was advised not to take that again. Rash is very difficult to see. It is very fine an very slightly pink, barely raised. States itch is minor. Historically the flu rash became very itchy and burned somewhat After 30 more minutes rash had not worsened. Client felt comfortable leaving, stating resources she would access if symptoms worsened. BP 140/88. Pulse 82. States she is under treatment for Hypertension.

Other Meds: Unknown

Current Illness: Unknown

ID: 1002220
Sex: F
Age: 70
State: FL

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: Intestine discomfort, multiple bowel movements (no diarrhea), chills, feverish (but no fever), muscle aches. I'm reporting this 24 hours after getting the 2nd Pfizer shot. Reaction started overnight. Don't know at this time how long this will last. Have not called doctor. Taking Tylenol.

Other Meds: Vitamin D 1000mg, Vitamin B12, Tylenol

Current Illness: Reaction to first dose of Pfeizer Covid-19: On day 13, big area of left arm (where shot given) became red. Lasted for about 5 days.

ID: 1002221
Sex: F
Age: 77
State: CA

Vax Date: 01/25/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Had swollen inflamed are around injection site a day after injection, which the disappeared after a couple of days. However, it reappeared 10 days later and I still have it.

Other Meds:

Current Illness: none

ID: 1002222
Sex: F
Age: 43
State: WI

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Swelling of lymph node in right armpit originally. Swelling and fluid spread - filling right side of body, across right collar bone, halfway down torso and slightly around the back. It also spread down the right arm halfway to elbow. The on-call nurse originally thought it could be cellulitis but after being told there was no redness or itchiness, she was unsure of the diagnosis and suggested to talk with the on-call doctor or go to the ER. The on-call doctor really had no idea as to what was going on. Once at the ER, the doctor checked with other doctors and read as much as he could about this type of reaction. Nothing he read matched up exactly with what was going on. He did note some swelling of lymph nodes had been reported but not to this extent. With all this being new, he suggested to go home and watch the swelling and come back if things got worse. For several days, there continued to be no redness or itchiness. The discomfort was only in the lymph node in the right armpit, with some slight pressure from the skin tightening around the fluid on the arm. Within a week, the welling was completely gone and the lymph node discomfort lasted a couple days more. I feel it necessary to note that I don't believe the shot was given in the correct location. As soon as the needle entered the skin, my thought was 'that is too high' and there was a pain like I have never felt with a vaccine before. That pain subsided shortly after the injection but it was several days before the injection site felt better. Now, two weeks later, I have a constant pain in my shoulder, slightly down my arm and into my collar bone area. There are also times when the pain throbs or shoots through as well. I believe this pain may be due to the placement of the shot, and not necessarily from the vaccine itself.

Other Meds: None

Current Illness: None

ID: 1002223
Sex: F
Age: 30
State: IL

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Pregnant: due June 9th. Found out at 20 week ultrasound- succenturiate placenta with velamentous cord insertion. My first dose of vaccine was only at 18 weeks though. After first dose of vaccine only sore arm and a knot in the arm that was visible but pain free for 1.5-2 weeks. After second dose of vaccine: next am started with nausea, progressed to stomach cramps, body aches, headache, then fever 100.1. this lasted the whole day into the PM. Went to sleep. Woke up the next morning perfectly fine. All symptoms had resolved.

Other Meds: Prenatal Vitamins

Current Illness: none

ID: 1002224
Sex: F
Age: 36
State: MI

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

Symptom List:

Symptoms: Patient developed a rash on both arms, neck and chest after vaccination. Rash was erythematous but not hives. Patient received benadryl, pepcid, and transported by EMS to nearest ED.

Other Meds: alprazolam, atenolol, welbutrin, cleocin topical, flonase, inflectra, birth control, loratadine, minocycline, multivitamin, tumeric root extract

Current Illness: none

ID: 1002225
Sex: F
Age: 60
State: MA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Allergic: Penicillin [hives], Lisinopril [lips swelling]

Symptom List:

Symptoms: With dose #1 of Moderna Covid-19 vaccination developed cellulitis at left arm injection site. Treated with Dicloxacillin 100 mg twice daily. Improvement noted within 5 days With dose #2 of Moderna Covid-19 vaccination developed cellulitis at right arm injection site. 4 days after the injection developed enlarged neck lymph nodes. Treated with Dicloxacillin 100 mg twice daily. Arm improved within 4 days, but that was when lymph enlargment was noted. Remains on antibiotics at time of reporting. Site continues to be swollen.

Other Meds: Benacart

Current Illness: Injection site cellulitis Left arm 1st covid-19 vaccination. Treated with Dicloxacillin.

ID: 1002226
Sex: F
Age: 74
State: OK

Vax Date: 01/04/2021
Onset Date: 01/14/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Penicillin (mild)

Symptom List:

Symptoms: 10 days after the Moderna 1st shot I developed a red rash on the arm that received the shot, just above the injection site. About the diameter of a tennis ball. Very red, warm to touch, moderately itchy. Because it was so long after the shot, and because I found nothing in the information about side effects, I was not sure it was connected. It disappeared after a few days ( I did take Benadryl twice). On 2-1-2021, I had the second shot of Moderna in the same arm. (Lot number 042L20A). On Feb 3rd I began to devolve the same type of rash, again on the arm the injection was on. By happenstance, someone else mentioned a similar side effect, and said it was mentioned in on line information. I checked and saw that there was a post about an arm rash on some recipients, but that few had been reported, so I decided I should go ahead and report. The rash is still with me(note only been a day since developed) but it is not severe and I am not particularly concerned about it. I?m going to answer yes on item 20 because the original rah resolved.

Other Meds:

Current Illness: None

ID: 1002227
Sex: F
Age: 59
State: OH

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List:

Symptoms: Around 7p 2/2 felt a little different. I went to bed awoke at 3am to such terrible body aches, left arm felt like it weighed 100 lbs,and it hurt to walk and my head fell forward. i experienced these symptoms severe till about 2pm 2/3 felt alot better. i returned to work on 2/4 still experiencing symptoms in left arm and shoulder back of neck area. I also had a lilttle bleeding at the site and bruising. with all this being said i would do it again. Thank You doctor

Other Meds: Celexa,Align probiotic

Current Illness: none

ID: 1002228
Sex: M
Age: 40
State: VA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: Received Moderna COVID-19 Vaccine EAU. Second round. Fine at time of injection until approximately 00:30 on Feb 3. Woke up restless and stiff. Feel back to sleep around 01:00 and awoke again at 03:30 restless and stiff. Unable to fall asleep. Soreness in back and shoulders began to increase with mild headache. Fatigue began to set in and feel asleep at approximately 07:00 on Feb 3. Work up to chills, muscle soreness throughout, no appetite or desire to drink, and extreme headache at 10:30. Restless periods of sleep while fighting body aches and chills continue through the entire day. Waking periods for remainder of the day occurred between 10:30 - 11:30, 12:30 - 15:00, and 14:00-18:30. Suffered from intense headache, muscle stiffness, no appetite, and chills during all of the waking periods. Upon awakening 05:45 on Feb 4 all symptoms had subsided but low energy due to lack of hydration and low food intake from previous day.

Other Meds: None

Current Illness: None

Date Died: 02/03/2021

ID: 1002229
Sex: M
Age: 77
State: MN

Vax Date: 01/22/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: spontaneous death, found unresponsive in cell after normal morning activities

Other Meds: unknown

Current Illness: none known

ID: 1002230
Sex: F
Age: 67
State: MO

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Trimethoprim

Symptom List:

Symptoms: She states "I sat down to get my shot and the next thing I knew everyone was standing over me". EMS on scene reported that her syncopal spell lasted about 15 minutes after which she was found to be bradycardic and hypotensive.

Other Meds: Potassium Chloride 20 meq daily

Current Illness:

ID: 1002231
Sex: F
Age: 46
State: MO

Vax Date: 01/20/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: MILD ALLERGY TO AUGMENTIN AND LORTAB

Symptom List:

Symptoms: WOKE UP WITH TERRIBLE MIGRAINE THAT MADE ME NAUSEOUS AND BODY ACHES WITH EXTREME FATIGUE. MIGRAINE LASTED CLOSE TO 10 HOURS. BODY ACHES AND FATIGUE LASTED 2 DAYS.

Other Meds: SERTRALINE, HYDROXYZ PAM, AND METFORMIN

Current Illness:

ID: 1002232
Sex: F
Age: 26
State: MN

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs Mangoes Almonds

Symptom List:

Symptoms: Vaccination at 3:00 PM on 1/28/2021. Woke up at midnight on 1/29/21 ( 9 hours later) aching all over with oral temp of 102.8 F. and aching all over. Took acetaminophen. The morning of 1/29 her left side hurt very bad and she still had a fever. At noon here temp was 100.6 oral and at 6:00 PM it was 101.7 oral. Continued achy and tired. On 1/30/21 continued with being tired with sore arm. Better by 1/31/21.

Other Meds: Prenatal vitamin

Current Illness: No

ID: 1002233
Sex: F
Age: 65
State: IN

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Chills, headache, fever

Other Meds:

Current Illness:

ID: 1002234
Sex: F
Age: 63
State: WI

Vax Date: 01/27/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: NKA NKFA All environmental eg molds pollen cats evergreens

Symptom List:

Symptoms: Left lower lid eye edema,itching and hives on body. Slight wheeze. Took a 25mg Benadryl p.o. Used my Proventyl inhaler. Relief within 30-45 minutes. NOTE; I had been to my beauty salon to have highlight treatments to my hair that day also. (2/02/21.)I have had this reaction in the past after my salon treatment but not the hives before. I strongly feel this was related to the chemicals used on my hair but felt I needed to report it.

Other Meds: 0lmesartan 10mg. Metropolol 50mg. Omeprazole 20mg Lexapro 5mg Aspirin 80mg Zocor 20mg

Current Illness: No

ID: 1002235
Sex: F
Age: 63
State: AZ

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Fever 101, required 4L of oxygen, Lungs sounded coarse. Administered oxygen and started weaning down on 2/4 to 3L. Fever resolved after administering tylenol and ibuprofen last night. However, resident is in a home that has had recent covid positive employees and residents so this may simply be related to actual covid 19. She was tested yesterday and we are awaiting the lab results.

Other Meds:

Current Illness:

ID: 1002236
Sex: F
Age: 38
State: IA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: penicillen tongue swelling to sequential flu vaccines

Symptom List:

Symptoms: swelling of tongue improved with benedryl

Other Meds:

Current Illness:

ID: 1002237
Sex: F
Age: 59
State: IN

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Shrimp, watermelon, IVP dye, Zpack ,Erythromycin, Tramadol,

Symptom List:

Symptoms: Headache, extreme fatigue, nausea cough, shortness of breath, body aches,

Other Meds: Metoprolol , Tylenol, Calcium with D, Hydrochlorothiazide, Omeprozole, Levothyroxine,Meloxicam,Citalopram, BabyAsprin, Gabapentin, Nortriptoline Atorvistaton

Current Illness: None

ID: 1002238
Sex: F
Age: 41
State: CA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: body aches fever chills

Other Meds:

Current Illness:

ID: 1002239
Sex: F
Age: 44
State: CA

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/04/2021
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Allergies: Fish; seafood; opiates;Welbutrin

Symptom List:

Symptoms: 3:00 am, I woke up because I started having a migraine style headache - some fever and chills and achiness; but the headache was the worst and it kept me down for 36 hours. I took ibuprofen 800 mg every six hours - it helped the headache be less severe.

Other Meds: Protonix - for acid reflux every day; multi-vit; probiotic; magnesium

Current Illness: no

ID: 1002240
Sex: F
Age: 67
State:

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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Allergies: SIDE EFFECTS drug (side effects) that I have tried but do not take: Fosamax = brittle bones- ineffective, but was taken simultaneously with Pantoprazole/ Omaprozole Raloxifen Hcl 60 mg = weight gain Fluticasone propionate = ab pain Simvastatin (10 mg) = pounding heart Atorvastatin = muscle weakness Lipitor (10 mg) = muscle weakness Crestor = Ab pain and palpitations Claratin = Insomnia Sudafed = light headed Montelukast sodium = insomnia Omaprozole ? ineffective Pantoprazole Sod Dr ? ineffective = allergies (sinus congestion), C. Diff, bone fractures, possibly impares concentration, possibly insomnia (stopped on 7/22/20) Divalproex sod er = occasional shaky hands, irritable, melancholy (past), blurred vision (double vision), dry mouth, lack of coordination, unsteady walk (but this was also before taking it), redness of inner eyelid, dry eyes & mouth

Symptom List:

Symptoms: PfizerpBioTech Covid19 Vaccine EuA awakened in night with fast heartbeat of 93-96

Other Meds: Vitamins taken: Balance B-100 (100-400 mg per ingredient) 1 per day CoQ10 (200 mg) 1 per day Omega3 (500 mg) 1 per day D3 3000 IU 1 per day Multi 1 per day Longvida optimized curcumin extract 400 mg 1 per day

Current Illness: none

ID: 1002241
Sex: F
Age: 43
State: OH

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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Symptoms: Fever of 106, extreme swelling of arm at injection site, tinnitis, shortness of breath, tachycardia, headache.

Other Meds:

Current Illness:

ID: 1002242
Sex: F
Age: 29
State: AK

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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Allergies: None

Symptom List:

Symptoms: Woke up with a fever of 101.2 at 2:30am on 2/3/21. Extreme headache, nausea and body aches.

Other Meds: None

Current Illness: None

ID: 1002243
Sex: F
Age: 42
State: CA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/04/2021
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Allergies: No known medication allergies

Symptom List:

Symptoms: 13 minutes into the vaccination she developed rash on her neck and face that was itchy. She was given epinephrine and IM diphenhydramine. She was sent to the ED where upon arrival she developed throat tightness and difficulty in swallowing. She was given solumedrol in the ED and observed. She did well on therapy

Other Meds: No

Current Illness: No

ID: 1002244
Sex: F
Age: 45
State: WI

Vax Date: 01/27/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
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Allergies: Bupropion Hcl Morphine

Symptom List:

Symptoms: She is here complaining of electrifying pain and numbness in her left axilla, underneath the arm to the elbow, sometimes traveling down to the hand. She received her 2nd COVID vaccine on 1/27/21 in the left arm. She was fatigued on Saturday and Sunday was feeling better. Her arm pain started on Monday 2/1/21. She is unable to abduct her arm past 90 degrees. She is having trouble lifting and moving her arm. Her strength is equal in BUE. She has taken ibuprofen, tried warm packs and ice packs without relief. She is not having any neck pain, chest pain, SOB or pain that radiates to her jaw. There is no swelling in LUE/axilla. There is no rash present.

Other Meds: SYNTHROID 200 mcg tablet metFORMIN 500 mg extended release tablet

Current Illness: Blunt trauma to abdomen 1/18/2021

ID: 1002245
Sex: F
Age: 72
State: TX

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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Allergies: PCN

Symptom List:

Symptoms: Headache, Chills, Extreme Pain in right arm, Swollen, Red Spot approximately the size of 2 quarters, Fever 99.8

Other Meds: Tylenlol, Pristiq, Levothyroxin, Benicar, Primidone, Rosuvastatin, Aspirin, Multivitamin, Zyrtec, B12, Benardryl, Trazodone

Current Illness: No

ID: 1002246
Sex: F
Age: 58
State: HI

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/04/2021
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Lab Data:

Allergies: Mango and almonds

Symptom List:

Symptoms: Participant was vaccinated at 11:18 am. At 11:48 c/o difficulty swallowing "I can only feel the left side of my throat". Vitals at 11:50: BP 120/84, HR 62, RR 18, lungs CTA, temp 98.2F. A&O x 3. Stated that on 12/30/20 rcvd Moderna first dose;had hives on flank and elbows the next day. Informed her PCP who referred her to allergy specialist; Allergist stated it was OK for her to return to this vaccine POD for 2nd dose. Monitored by EMS . No medications were given. At 12:42 participant stated that she felt better, no symptoms. She was released from post-vaccination area.

Other Meds: Lantanoprost (for eyes)

Current Illness:

ID: 1002247
Sex: F
Age: 68
State: CA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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Allergies: none

Symptom List:

Symptoms: 9:12 onset of nausea & dizziness, awake & oriented x4, skin tone normal for ethnicity, T 99.2, B/P 120/76, HR 55, 02 99% on room air, respirations 18, lungs clear to all, no signs/symptoms of respiratory distress. Patient and niece state that she hasn't has anything to eat this morning and does receive chemotherapy every 21 days, next dose due March 10th. Within 3 mins patient nausea & dizziness resolved. Patient states she feels fine and is drinking small amounts of water. Lead nurse notified and assessed patient. Patient discharged home with niece. Patient did get doctor ok to receive Covid vaccine.

Other Meds: Atorvastatin; Amlodipine; Chemo drug

Current Illness: none

ID: 1002248
Sex: M
Age: 53
State: IL

Vax Date: 01/07/2021
Onset Date: 01/28/2021
Rec V Date: 02/04/2021
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Allergies: None

Symptom List:

Symptoms: Developed Bell Palsy after receiving shot.

Other Meds: 6,000 Units vitamin D Multiple vitamins men over 50

Current Illness: None

ID: 1002249
Sex: F
Age: 51
State: TX

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 02/04/2021
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Allergies: Celecoxib, Iodine, Naproxen, Vioxx

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Symptoms: Patient described that the next day after receiving the vaccine (01/01/21) she had fatigue, headache, and nausea. The next day (01/02/21) she reported that she was fine and had no symptoms other than soreness. The day after that (01/03/21) she had exhibited symptoms of her rheumatoid arthritis flare ups with pain in her joints, and swelling on her left side (arm and torso). The patient went to her rheumatologist the next day (01/04/21) and was treated with prednisone for two weeks thereafter. The rheumatologist said that she should be fine to receive the second dose, but to have the event reported.

Other Meds: Xeljanz XR

Current Illness: Rheumatoid arthritis, vitiligo

ID: 1002250
Sex: M
Age: 81
State: IN

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
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Allergies: none

Symptom List:

Symptoms: We gave patient his second vaccinate at day 17 and not day 28. Patient was an inpatient in room, the clinic received request that his attending MD had approved him to receive a Covid vaccine. The RN up to the unit to vaccinate patient, she was not able to find patient in the system, and believed he may be a first dose, before vaccinating him she confirmed with the charge nurse he did need the vaccine, which the charge nurse did confirm. Nurse vaccinated patient and returned to the clinic to finish her system documentation . We were notified on 2.2.2021 that we had 2nd dose vaccinated patient sooner than recommended.- his first vaccine was on Jan 14th 2021,

Other Meds: none

Current Illness: none

ID: 1002251
Sex: F
Age: 26
State:

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/04/2021
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Symptoms: arm weak, warm and rash at injection site

Other Meds:

Current Illness:

ID: 1002252
Sex: M
Age: 45
State: MS

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 02/04/2021
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Allergies: None Known

Symptom List:

Symptoms: Could not walk. Extreme pain. Contracted muscles in lower back, thighs, leg tendons, hip joints.

Other Meds: Atorvastatin 40 mg, Isosorbide mono 30 mg, Triam/ HCTZ, Carvedilol 3.125 mg, Aspirin 81 mg, Famotidine 20 mg, Cetirizine HCl 10 mg

Current Illness: None apparent, no symptoms

ID: 1002253
Sex: F
Age: 26
State: WV

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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Symptoms: Fever of 103?F, chills, body aches, nausea, fatigue and headache for 12 hours starting 6 hours after receiving the vaccine

Other Meds:

Current Illness:

ID: 1002254
Sex: F
Age: 31
State: NJ

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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Lab Data:

Allergies: Biactin

Symptom List:

Symptoms: Pounding headache, nausea, full body aches, joint pain

Other Meds: Prozac, Buspar, Klonopin

Current Illness:

Date Died: 01/28/2021

ID: 1002255
Sex: F
Age: 76
State: FL

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/04/2021
Hospital: Y

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Symptoms: Death

Other Meds:

Current Illness:

ID: 1002256
Sex: F
Age: 74
State: CA

Vax Date: 01/26/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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Allergies: cipro, adhesive tape, multaq, amiodarone, bacitracin, digoxin, mold

Symptom List:

Symptoms: on day 8, redness and warmth near injection site, approx. 1.5 x 2 cm in size. No pain, minimal itch

Other Meds: Basa, atorvastatin, furosemide, levothyroxine, magnesium, metoprolol, potassium, vitamin D

Current Illness: none

ID: 1002257
Sex: F
Age: 40
State: HI

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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Allergies: Unknown

Symptom List:

Symptoms: Vaccine Administered: 1344hrs Reported Reaction: 1355hrs While in post-vaccination area, pt suddenly stood up and complained of feeling light headed and had some tightness in her chest. Ambulated outside of classroom for fresh air. Stated she felt better with fresh air. Chair made available for pt but would sit and then stand. She did this twice until just standing. Vital signs taken - stable. Water offered but refused. Chair offered but sat only for a little due to wanting to stand. Monitored until symptoms resolved. Discharged at 1413hrs.

Other Meds: Unknown

Current Illness: Unknown

Total 2021 VAERS Injuries: 298,524

Page last modified: 03 October 2021 5:28pm