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: 1003515
Sex: F
Age: 64
State: WY

Vax Date: 01/14/2021
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: NKA

Symptom List: Dysphagia, Epiglottitis

Symptoms: 01/14/2021-approximately 4pm, approximately 5 hrs. post vaccination, Ct started experiencing a 'vibration sensation' inside legs and hips. Ct was driving at the time, thought something was wrong with her car got out and realized it was her body. By 6pm she had 'internal tremors' throughout whole body. Described vibrations at bedtime as quite violent. Reported to Heath Department via V-safe. Was going to go to the ER but didn't, next morning, 9am, tremors started to subside and were gone within 24 hrs. of the vaccine.

Other Meds: Corzaar 50mg/day, supplements-Vit D, Calium, Magnesium

Current Illness: none

ID: 1003516
Sex: F
Age: 31
State: MO

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: Anxiety, Dyspnoea

Symptoms: Swelling and tenderness of dermal filler (chin) after the 2nd Moderna vaccine

Other Meds: None

Current Illness: None

ID: 1003517
Sex: F
Age: 36
State: AZ

Vax Date: 01/19/2021
Onset Date: 02/01/2021
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: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: very lethargic on Sunday. Felt hot (no fever) all day Monday, with headache, also lethargic. In the evening I was changing my shirt and I noticed there was a large raised, hot welt on my left arm around the injection site. Called a family member who is a nurse and they told me to go to Urgent care. Went to Urgent care that night around 5:30pm, the Physicians Assistant (did not get her name) told me it looked like a delayed reaction to the covid 19 vaccine and she told me not to get the second shot. She also told me to report the side affect.

Other Meds: fluoxetine, buspirone, womens vitamin

Current Illness: none

ID: 1003518
Sex: F
Age: 45
State: OK

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

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

Lab Data:

Allergies: Shellfish Latex

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient waited approximately 20 minutes after receiving vaccine as is standard. Patient began to drive home when she started to notice tingling in her lips, feeling flushed, and then as though her throat was closing. She contacted 911 and they responded road side. Patient was initially being monitored only, then her BP dropped. Decision was made to transport patient to ED. En route she received epinephrine and was placed on O2 by way of non-rebreather mask. Upon arrival to the ED patient continued to be dyspneic. She was given solumedrol, benadryl, Pepcid, and mag. Patient was stabilized and no additional epi was required. Patient was admitted to hospital in observation status. She was stable overnight. She did have one episode of itching and nausea, she was given diphenhydramine and Zofran and these symptoms resolved. Patient was monitored until around 1PM the day after event and was released to home in stable condition.

Other Meds: Albuterol

Current Illness: None

ID: 1003519
Sex: M
Age: 37
State: IN

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: Banana

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: I began having what felt like was nerve and joint pain along my left side of my face and arm. I developed a headache and was also nauseous. It went away after about 48 hours.

Other Meds: Hydrochloride, daily men?s vitamins

Current Illness: None

ID: 1003520
Sex: F
Age: 39
State: OR

Vax Date: 01/26/2021
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: N/A

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: 4 inch round area with swelling, redness, itching around injection site. Began at 1300 on 2/3/2021 continues today.

Other Meds: N/A

Current Illness: N/A

ID: 1003521
Sex: M
Age: 68
State: IN

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: Pyrexia, White blood cell count decreased

Symptoms: Extreme fatigue Fevers of up to 103.5F Could not get warm Body/joint aches (even knuckles on both hands)

Other Meds: Tamsulosin Atorvastatin

Current Illness:

ID: 1003522
Sex: M
Age: 41
State: MA

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: N/A

Symptom List: Pharyngeal swelling

Symptoms: Right Arm rash, hard, warm-to-touch, 2-3cm below injection site, area enlarged each day (two days)

Other Meds: Lexapro 20mg, Prevacid 30mg, Multi-Vitamin, Zrytec, Probiotic

Current Illness: N/A

ID: 1003523
Sex: M
Age: 45
State: WA

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: No

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Body pain Fever Chills Fatigue Abdominal bloating

Other Meds: No

Current Illness: No

ID: 1003524
Sex: F
Age: 70
State:

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: Sulfa

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Rash presenting one week later at injection site, approximately 4 inches by 5 inches. Red, itchy, hard.

Other Meds: None

Current Illness: None

ID: 1003525
Sex: F
Age: 42
State: PA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Sore arm, gi upset, diarrhea, head ache

Other Meds: Topamax

Current Illness: Headaches Depression (past) Seizures (none in over 2 years)

ID: 1003526
Sex: F
Age: 48
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: Shellfish

Symptom List: Rash, Urticaria

Symptoms: Allergic Reaction had to be taken to The ER. Treatment Benadryl IV and monitored

Other Meds: No

Current Illness: No

ID: 1003527
Sex: F
Age: 46
State: IN

Vax Date: 01/13/2021
Onset Date: 01/17/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: 4 days post 2nd vaccine I started vaginal bleeding. Lasted 2 weeks. Bleeding stopped for a few days then I started my regular period on my regular schedule

Other Meds: Cymbalta Singulair imitrex vitamin D Lmethylfolate Topamax

Current Illness: None

ID: 1003528
Sex: F
Age: 75
State: LA

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: PATIENT EXPERIENCED HIVES ON TORSO, ARMS AND LEGS; CHILLS

Other Meds:

Current Illness:

ID: 1003529
Sex: F
Age: 72
State: CA

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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: two days after initial shot, red and swollen arm at site. 3 days after, cold and flu feeling aches for 1 day, 7 days after itching all over body 20 days later flu feeing aches

Other Meds: none

Current Illness: none

ID: 1003530
Sex: F
Age: 43
State: NY

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: Bees, wasps -anaphyaltic

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Dose 1: Light headed, asthmatic light breathing after 10 mins. mild headache within 1 hour. Extreme Headache lasted 4 days intensified after first full day, arm tenderness 5 days Dose 2: Light headed, extreme nausea, heat flush, redness in face within 5-15 mins of shot. Continuous nausea, no appetite for 18 hours; first evening sever fatigue full body aches, low mobility in legs, serve chills and extreme headache; second day nausea improved, fatigue, body aches, chest tightening, intermittent headache - treated with Advil. Evening fatigue, chest tightening, chills

Other Meds: 150mcg Synthroid 2000 units Vit D

Current Illness: Thyroid disease, hypothyroidism

ID: 1003531
Sex: F
Age: 88
State: CA

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: Not aware

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Sleepy on the evening of shot, sleepy and weakened arm and leg strength , slurred speech, complains of headache and dizziness (difficult to validate)

Other Meds: Simply 12.5mg hydrochlorothiazide , omeprazole and vitamins

Current Illness: Recovered from Covid and released from ?watch?

ID: 1003532
Sex: F
Age: 29
State: NV

Vax Date: 01/21/2021
Onset Date: 01/24/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Latex, mango, various skin products, fragrances, adhesives

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Mid to low grade fever (99.5-101) from 3 days to 2 weeks following vaccine, nausea from 3 days to ~12 days after vaccine

Other Meds: Multivitamin, vitamin d, loratadine

Current Illness: N/A

ID: 1003533
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: Tetracycline

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever, tired, loss of appetite, sleepy, achey

Other Meds: Citalopram, levothyroxine, rusivastatin, metformin, vitamin, d3, fiber gummies,

Current Illness:

ID: 1003534
Sex: M
Age: 65
State:

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: n.a.

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: About 12 hours after the vaccination I had diarrhea and then again about 3 hours later.

Other Meds: lisinopril, hctz, metoprolol, eliquis, lipitor, amlodipine, predisone

Current Illness: diverticulitis

ID: 1003535
Sex: F
Age: 73
State: AK

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: Advil, Robitussin, Naprosyn, Paroxetine, Sulfa

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: Generalized itching, runny nose since time of injection. On day 6 develop raised warm area over site of injection, 8 cm, 4 cm x 1 mm

Other Meds: None

Current Illness: None

ID: 1003536
Sex: F
Age: 66
State: CA

Vax Date: 01/26/2021
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: Penicillin Nitroglycerin Bee stings

Symptom List: Unevaluable event

Symptoms: Red swollen itchy patch or hive at injection site starting on day 8 after the first dose

Other Meds: Calcium tablet Vitamins B-12, C, D3 Biotin

Current Illness: None

ID: 1003537
Sex: F
Age: 63
State: OH

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: None

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Extreme muscle pain at injection site within three hours of inoculation, headache within seven hours and general achiness all over body and fever of 101 x 6 p.m.

Other Meds: None

Current Illness: None

ID: 1003538
Sex: F
Age: 22
State: NJ

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: Injection site pain, Pain

Symptoms: Began to feel fatigued around 4:00 pm, got severely cold at 6pm, teeth were chattering, temperature was 101?. I fell asleep at about 8 pm because I was so fatigued I couldn?t keep my eyes open. Chills when I was trying to sleep. I was up a few times throughout the night sweating. The next morning I felt nauseous and had a bad headache and my body aches. I felt like this the whole next day and am still completely fatigued.

Other Meds: Zoloft 25 mg Hydroxyzine 25mg

Current Illness:

ID: 1003539
Sex: M
Age: 62
State: IL

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient had wife call 2 days ago asking if they should be concerned about his arm still hurting. He said he had limited range of motion, and pain is helped by ibuprofen or acetaminophen but returns when medicine wears off. He said this week is better compared to last week. His wife received same vaccine on same day, but had only soreness for a few days.

Other Meds:

Current Illness:

ID: 1003540
Sex: F
Age: 51
State: IN

Vax Date: 01/09/2021
Onset Date: 01/30/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Sensitive to adhesive

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: After first vaccine about 25 mins after the shot, the tip of my tongue and lips went numb. I had general fatigue the remainder of the day. The day following I was aching, bad headache and pain down my neck, my stomach was upset along with fatigue. These feelings came and went throughout Sunday 10, Monday 11, and Tuesday 12. I felt better on Wednesday Jan 13th. On Sunday January 23rd I started feeling very fatigued, achy and had a fever of 100 F. This lasted through Monday Jan 24

Other Meds: Vitamin C, Vitamin B1, Iron, Zinc, Vit D3 +K2, and Fluticasone Propionate Nasal Spray

Current Illness: None

ID: 1003541
Sex: M
Age: 53
State: HI

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Lots

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: After both shots, the second on 1/27/21, I got a severe migraine within 2 hours that lasted 5 days. After day 5 the symptoms went away. During the time of the migraine I treated it with 2 doses of rizatriptan ODT per day.

Other Meds: Lots

Current Illness:

ID: 1003542
Sex: F
Age: 63
State: CA

Vax Date: 01/24/2021
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: doxycycline and sulfa antibiotics, reactions unknown

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: local redness, swelling, itching, discomfort at injection site (L deltoid region), onset 4 days after vaccination.

Other Meds: budesonide (entocort) 9mg daily

Current Illness: microscopic colitis

ID: 1003543
Sex: F
Age: 60
State: CA

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: Unknown

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Hypertensive with BP=203/98; Paulse =120; Temperature =101.3. Patient given comfort measure, 911 called, and transported to ER for higher level of care.

Other Meds: Unknown

Current Illness: Unknown

ID: 1003544
Sex: F
Age: 89
State: WY

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: ct stated "too many to list", states she is allergic to alot o

Symptom List: Nausea

Symptoms: During screening for the vaccine at a clinic, ct said she had 'too many allergies' to list. RN escorted client to the local hospital and gave her the COVID vaccine there so she could be monitored there. Two hours after client received vaccine when she was at home she became very itchy, was uncomfortable for 4 days, stated this happens to her all the time. Then was ok. 02/03/2021-ct reported PCP told her not to get the second dose of Moderna to wait until the Johnson/Johnson vaccine was available then get it since it will only be one dose.

Other Meds: Hydroxyzine, Zyrtec, Benadryl, Singular antihistamine

Current Illness: allergies all the time, limited diet

ID: 1003545
Sex: F
Age: 42
State: PA

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

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Injection site pain

Symptoms: Injection site sore, fever of 103.6, chills, headache, foggy feeling, muscle aches, light headed lasted 4 days

Other Meds: Topamax

Current Illness: Headaches Depression (past) Seizures (none in over 2 years)

ID: 1003546
Sex: F
Age: 67
State: AZ

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: None known

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: After leaving the site after over 15 minutes, noticed splotchy area on neck. It went away on the 2-hour drive home. Today I am feeling some itchiness in random areas. The mild pain at the injection site is gone.

Other Meds: Centrum Silver vitamin for women 50+

Current Illness: Not I'll at time of vaccination. Stopped Advil January 28, 2021. Had a stomach ache the week prior to vaccination.

ID: 1003547
Sex: F
Age: 59
State: HI

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: iv contrast dye

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Patient reported itching/hives and an "itchy throat" during observation period post COVID vaccine. Denied throat swelling, SOB or respiratory distress. Patient was immediately given epi and IM Benadryl. Patient observed for 30 min. Vital signs were stable the entire observation period. Rash improved at discharge.

Other Meds: glucophage, prinzide/zestoreic, wellbutrin, escitalopram

Current Illness:

ID: 1003548
Sex: F
Age: 46
State: IN

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: Klonopin

Symptom List: Tremor

Symptoms: Fever, chills, body aches, swollen red warm painful arm at injection site, fatigue

Other Meds: Prozac, Xanax, Prilosec, vitamin d, c, b1, b12,, magnesium, calcium, multivitamin,

Current Illness: No

ID: 1003549
Sex: M
Age: 41
State: CA

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: No known allergies

Symptom List: Erythema, Pruritus

Symptoms: Patient received 2nd dose of Pfizer-BioNTech COVID-19 Vaccine EUA at 2:04pm , <5 minutes after vaccine administration he developed hypotension with loss of consciousness for few seconds. He was sitting in a designated chair for the protocol 15 min observation and fell from the chair to the ground, hitting the right side of his temporal - redness noted around area with skin intact. Clinic staff immediately moved patient to be lying down on the ground with cervical spine precaution and lifted his legs up on a chair. Vitals: HR 78 and BP 118/72 taken in supine position on ground with legs elevated. Patient was transported by EMS to the ED at 2:45pm. ED note: Patient has Hx of vasovagal syncope in the past with similar symptoms after blood draws..Exam and workup shows well-appearing young man, nonfocal neuro exam, normal gait, cardiopulmonary exam unremarkable, no signs of trauma other than a small hematoma to the right forehead. After evaluation, their Canadian Syncope Risk Score is -3 indicating very low risk for 30 day serious adverse events (<1%). Telemetry monitoring during their ED stay has not captured any events. Discussed next steps with patient: given their low risk for 30 day serious adverse events (including death, serious arrhythmia, MI, PE, ICH), they would prefer to be discharged to continue their workup as an outpatient, rather than admission for observation. Patient was deemed stable to discharged from the ED at 5:57pm with counseling to follow up with PCP in the next 2 days and to return to the ED with any persistent or worsening symptoms.

Other Meds: Not listed in medical chart

Current Illness: Not listed in medical chart

ID: 1003550
Sex: F
Age: 87
State: WV

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Client was given Pfizer as second dose COVID 19 vaccine after having Moderna for first dose. Cleint was monitored for 30 minutes post vaccine. No adverse reactions noted.

Other Meds:

Current Illness:

ID: 1003551
Sex: F
Age: 55
State: OH

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

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: at 1010 am I began to feel extreme fatigue, headache, pain in all of my joints, severe headache, nausea and dizziness. I have a golf ball size swelling in my right arm pit with pain to my red breast. It is now 9pm on 2/4/21 and the swelling has not decreased and the pain is getting worse. I am able to stand up, but still having severe headache and nausea. will be making doctor visit to check this swelling in my right arm pit.

Other Meds: none

Current Illness: none

ID: 1003552
Sex: M
Age: 43
State: MS

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
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Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Excruciating pain in right shoulder; zero mobility. Patient said, this is the worst pain I have ever experienced in my entire life. Improved slightly over 72 hours.

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Current Illness:

ID: 1003553
Sex: F
Age: 53
State: MI

Vax Date: 12/21/2020
Onset Date: 01/02/2021
Rec V Date: 02/04/2021
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Allergies: Mortphine

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Arm was getting sore and stiffing and as days went on till after second shot was seen by ED, and PT have not Frozen shoulder Shot was close to Shoulder capulituits . I have received yesterday 2/3/2021 a cortisone shot to the shoulder and will receive PT

Other Meds: Ibprophen, Tylenol , Excedrin, Cortisone shot to the shoulder, Lidicin patches 4%

Current Illness: None

ID: 1003554
Sex: F
Age: 87
State: WV

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Client was given Pfizer as second dose COVID 19 vaccine after having Moderna for first dose. Cleint was monitored for 30 minutes post vaccine. No adverse reactions noted.

Other Meds:

Current Illness:

ID: 1003555
Sex: M
Age: 36
State: UT

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

Symptom List: Pain in extremity

Symptoms: Malaise, generalized arthralgia, headache, nausea (no vomiting), fatigue

Other Meds: Bupropion 100 mg TID Propranolol ER capsule 60 mg daily

Current Illness: Canker sore in mouth for 3 days prior to receiving the second dose of the vaccine

ID: 1003556
Sex: F
Age: 74
State: AZ

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 02/04/2021
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Allergies: keflex sulfa penicillin bees wasps

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: Severe burning up the left side of my neck, head, and face. This lasted a few days...now just intermittent swelling and achiness.

Other Meds: cipro synthroid cytomel levathyroxine omeprazole rovastatin

Current Illness: bladder infection

ID: 1003557
Sex: F
Age: 47
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/04/2021
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Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: 3 days after 1st dose- discharge from left nipple. 2nd dose vaccination: muscle pain and chills, memory loss, brain fog and (hallucinations, behaving like a 1o year old as per family)

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Current Illness:

ID: 1003558
Sex: F
Age: 40
State: MD

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

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Nausea, fever, chills, severe joint pain, myalgia, headache, lack of appetite from 2/3/2021 2am until 2/4/2021 at 2pm

Other Meds: Nortriptyline 10mg at night

Current Illness: None

ID: 1003559
Sex: F
Age: 48
State: MT

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
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Allergies: None noted on COVID Vaccination Record. Sulfa - unknown reaction on EMR.

Symptom List: Vomiting

Symptoms: Medical status of Sarcoidosis discussed prior to immunization and counseled that there are limited data and benefit of vaccine would outweigh the risk of COVID infection. Observed for 15 minutes. Patient started to leave the facility and felt dizzy. Then her entire face became numb around mouth and cheeks. She did not have difficulty breathing or feel her windpipe swell. Patient chose to go to her vehicle in parking lot and called her Mom. In that process her cell phone battery needed charged. She drove home. Her face, mouth, and cheeks remained numb and dizziness subsided. Family and friends contacted EMS Ambulances to look for her when it was determined she did not elected to go to the ED. A friend of patients Mom called the Hospital switchboard operator to report the situation at 2:45 pm. The operator went to the Medical Staff member oversee for Vaccination Clinic ,CRNP, and informed her of the concern and potential reaction to COVID vaccine. CRNP called the patient and spoke with her at 3pm. She identified no dizziness, no airway or breathing problem and lessening numbness of face. She stated she felt better and did not elect to return to ED. A buddy system of family, neighbors and her husband (out of town) continued to check on her. CRNP did a second phone call 5pm where patient stated she had very mild left cheek numbness. Total Estimated time of Facial Numbness is 4 hours. Patient was counseled to have followup with PCP for possible Bell's Palsy if numbness returned, and go to ED or call EMS with difficulty breathing.

Other Meds: None

Current Illness: None

ID: 1003560
Sex: F
Age: 82
State: CA

Vax Date: 01/26/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
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Allergies: Cipro, Sulfa, Reglan, Benadryl, Percocet

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Area where injection was given is hot, red and sore to touch.

Other Meds: Chewable vitamin, Vit. B12, Vit D3, Probiotic, Plavix, Estradiol, Amlodopine, Cymbalta, Pantoprazole, Lasix, Mucinex, Biotin, Prevaststin, Mirapex, Melatonin, Equate, Xanax,Milk of Mag.

Current Illness: None

ID: 1003561
Sex: F
Age: 37
State:

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
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Allergies: Seasonal allergies (i.e. pollen)

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: 30 mins after injection of second dose a metallic/medicinal taste was discovered in my saliva. Four hours after dose began feeling nausea. Day 2 nausea and metallic/medicinal taste in saliva continued. Metallic/medicinal taste in saliva stopped mid morning of day 2. Day 2 experienced chills, headaches, elevated body temperatures, severe night sweats, and stiff body. Day 3 headaches and stiff neck. Also injected arm was very sore during the two day experience.

Other Meds: Desonide cream, 0.05 (topical cream for dry skin)

Current Illness: None

ID: 1003562
Sex: F
Age: 66
State: CA

Vax Date: 02/04/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
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Allergies: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Tingling to both lower extremities that subsided after walking for a few minutes.

Other Meds: Multi Vitamins, Tylenol

Current Illness: None

ID: 1003563
Sex: M
Age:
State: MI

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
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Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Patient came in for covid 19 vaccine. When administering the vaccine the serum leaked out the syringe at the needle attachment. The patient was given a full second dose and instructed to stay in facility for 30 minutes.

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Current Illness:

ID: 1003564
Sex: F
Age: 36
State:

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

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Redness, itching, lump at vaccination site. Noticed about 8 pm 2/4/21

Other Meds:

Current Illness: No

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am