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: 1029417
Sex: M
Age: 70
State: IN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Allopurinol,

Symptom List: Dysphagia, Epiglottitis

Symptoms: Lethargy, body aches

Other Meds: Cell Cept, Prednisone, Metoprolol, Nexium, biotin, vitamin c, Losartan, Nexium, Calcium, culturelle, vitamin E, Lexapro, Gabapentin, multivitamin, Preservision

Current Illness:

ID: 1029418
Sex: F
Age: 28
State: CA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Large red welt at injection site. 2 hrs post inj, 2/12, tissue around inj site started to become very firm - expected. 2/13 AM, woke up with a big red welt at inj site, hot to the touch, 1.5in x 2.5in. 2/14, 4in x 3in. It is hard, hot and feels a bit like cellulitis forming. Very sore and tender to touch. Seems to be spreading.

Other Meds: Lexapro Buspirone Welbutrin Advil Tylenol

Current Illness: None

ID: 1029419
Sex: F
Age: 29
State: VA

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Augmentin

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Shortness of breath, fatigue, body ache to left lower limb, fever 99.6F. Lasted approximately 8.5 hours.

Other Meds: Zoloft, Omega-3, NatureMade Prenatal, Vitamin B12, Vitamin D

Current Illness: N/A

ID: 1029420
Sex: F
Age: 65
State: NY

Vax Date: 02/08/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Developed Bells Palsy as possible side effect 4 days later.

Other Meds: Daily vitamins - No prescription meds.

Current Illness: None

ID: 1029421
Sex: F
Age: 59
State: CA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Had my shot at 7:05pm on 2/12/21. Woke the next morning with a sore arm at the shot site, slight lump and warm. Around 5:30pm after getting home from work i felt tired, went to lay down , immediatly fell asleep. Woke 2 hours later with shooting pains to both my knees. I have severe arthritis and with every heart beat I felt pain. I also had fever. Around 10pm I took 1 aleve and checked my temp 100.1. The last t time I had checked my temp and that was at midnight it was 99.7. The pain was still there but started to subside. I woke today 2/14/21 and the fever is gone, still feel achy in the knees. I can deal with that.

Other Meds: 2 Aleve 220 mg at 9am

Current Illness: None

ID: 1029422
Sex: F
Age: 23
State: IL

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: NO KNOWN DRUG ALLERGIES

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

Symptoms: This should of been administered into the deltoid muscle, however this was administered into the triceps muscle. The patient complained of pain, soreness, redness, swelling at the injection site beyond normal. It seemed that it was possible that capillaries may have been broken during administration that caused this.

Other Meds: I DO NOT HAVE ANY RECORDS OF THS BESIDES NITROFURANTOIN MONO/MAC 100MG BUT THIS COURSE SHOULD OF BEEN COMPLETED 3 DAYS BEFORE VACCINATION.

Current Illness: UTI

ID: 1029423
Sex: F
Age: 34
State: PA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Morphine-arrhythmia Demerol: full body red rash

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Body aches, nausea, vomiting, and fevers. Also severe left arm pain with associated weakness and radiating pain down my arm to 4th/5th fingers

Other Meds: Advair Singular Birth control GNC active woman vitapack Vitamin c Vitamin d Vitamin b Magnesium

Current Illness: Gastroenteritis

ID: 1029424
Sex: F
Age: 34
State: NY

Vax Date: 01/21/2021
Onset Date: 01/26/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Strawberries

Symptom List: Pharyngeal swelling

Symptoms: Moderna COVID-19 Vaccine EUA Morbilliform rash appeared within one week, spread and itch increased in second and third week, still present four weeks from injection - patient was first prescribed antibiotic cream that had no effect, then prescribed steroid when rash was identified as morbilliform.

Other Meds: Vitamin B Vitamin C Women's Daily Probiotic

Current Illness: HPV

ID: 1029425
Sex: F
Age: 56
State: OR

Vax Date: 01/30/2021
Onset Date: 02/05/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Developed rash at injection site about a week after vaccination then turned red and warm. Very mild itching. Fades for a bit but is then comes back, no itching just a pale redness and rashiness. Still there today. About 4 inches long and 3 inches wide.

Other Meds: 50mg metropolol

Current Illness:

ID: 1029426
Sex: F
Age: 82
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Left shoulder injury. Unable to reach behind back with left arm. Started approximately 2/4/21. Still have pain & hard to reach behind back on 2/14/21. Noticed small dime-sized red spot on left shoulder on 2/11/21. On 2/14/21 red spot had grown to approximately 3 1/2? long & 2 1/2? wide. Is warm to the touch, but doesn?t seem to be swollen & not painful. Intermittent problem finishing a sentence without taking an additional breath. Started about 2/5/21. Not sure if heart murmur is related.

Other Meds:

Current Illness:

ID: 1029427
Sex: M
Age: 19
State: IL

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: very tired, hard to stay awake

Other Meds: antihistamines, daily vitamin & fiber supplement

Current Illness: none

ID: 1029428
Sex: M
Age: 40
State: VA

Vax Date: 01/15/2021
Onset Date: 01/17/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Ampicillin

Symptom List: Rash, Urticaria

Symptoms: Chronic Headache for 3.5 weeks. No history of headaches. Three subsequent doctors visits to assess.

Other Meds: Benedryl

Current Illness: None

ID: 1029429
Sex: F
Age: 45
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Sulfa Naproxen NSAIDS Codeine

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Temperature 103 degrees F. since 7pm on 2/12/21. Vomited three times on 2/13/21. Uncontrollable chills. Lightheaded.

Other Meds: Skipped prescriptions at the time of vaccination.

Current Illness: No illnesses

ID: 1029430
Sex: M
Age: 85
State: AR

Vax Date: 01/02/2021
Onset Date: 02/05/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: penicillin

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

Symptoms: Shingles reactivated 2/6/2021, as of 2/11/2021 on course of acyclovir 800 mg tablets

Other Meds: Morning: Metformin 500 mg, Women's multivitamin, fish oil 1000 mg, Vitamin D3 25 mcg, Calcium 600 mg, CoQ10 100 mg, Zinc 50 mg, Vitamin C 500 mg: Evening: Rosuvastatin 5 mg, aspirin 81 mg, fish oil 1000 mg

Current Illness: None

ID: 1029431
Sex: M
Age: 69
State: WA

Vax Date: 01/27/2021
Onset Date: 01/31/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: IVP dye Erythromiacin Chlorhexidine

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

Symptoms: 4 days after the injection I had some raised red bumps on my right are in the ante-cub ital area. These went away in 2 days and did not itch. Over the following couple of weeks I started to have intermittent red bumps with flakey surfaces and intense itching on both arms . At this time I have several of these over both arms and my back with intense itching that I'm using hydrocortisone cream to treat. I am scheduled for the second shot on Tuesday Feb 16. Today, Feb 14, these spots are increasing in number and itching. I am going to contact my PCP to day to try to be seen tomorrow before the scheduled second dose.

Other Meds: Acyclovir 800 mg Amlodipine 5 mg Atovaquone 150 mg Finisteride 5 mg Pantoprazole 40 mg Xarelto 20 mg Tamsulosin 0.4 mg Thalidomide 50 mg Vitamin D 3

Current Illness: None

ID: 1029432
Sex: F
Age: 33
State: FL

Vax Date: 02/07/2021
Onset Date: 02/14/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Itchy rash on the arm I received the vaccine; warm to the touch but not painful.

Other Meds: Zyrtec

Current Illness: None

ID: 1029433
Sex: M
Age: 74
State: SC

Vax Date: 01/27/2021
Onset Date: 01/29/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Note: Shot was administered at Clinic . not Dr. office. Beginning on the evening of 1/29/21 I began experiencing Chills, a slight fever of 100.3 and extreme fatigue. These conditions continued for a period of 3 days. At that point I also began to experience shortness of breath and my O2 level dropped to 78%. I began using a nebulizer, spirometer, flutter valve and exercises at that point and over the next several days. Please note that I am a COPD patient and had completed a 16 day course of Prednisone on 1/25/21. On approximately 2/6/21 my breathing and O2 levels began to return towards normal, although even today I'm still not quite back to what's normal for me. I am continuing to use the nebulizer, spirometer and flutter value in preparation for shot #2 scheduled for 2/18/21.

Other Meds:

Current Illness:

ID: 1029434
Sex: F
Age: 62
State: IL

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: red patch at injection site 2.5" x 3.5", slightly hardened

Other Meds: ClaritinD12, Florastor, Calcium + Vitamin D, multivitamin

Current Illness: none

ID: 1029435
Sex: F
Age: 72
State: MD

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Shellfish, Iodine, Tramadol. sulfa. Levaquin. Anti fungal rx

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Triggered Migraine headache within 30 min. Within 6 hrs large red circle on upper arm. Within 11 hrs very large bullous areas appear and continue to grow over the following 12 hours Currently the several large blisters have joined into one very large one that is 2" long by 2" wide by 1/2 " high I would like to submit photos. Please let me know how I can do this.

Other Meds: Synthroid 75 mcg Lamotrigine 150 mg

Current Illness: None

ID: 1029436
Sex: F
Age: 57
State: NC

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: None known

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

Symptoms: Fever, swollen lymph glands, sore throat, fatigue, nausea, vomiting

Other Meds: Adderall 30mg taken daily, 1 Centrum Silver multi-vitamin

Current Illness: None

ID: 1029437
Sex: M
Age: 75
State: FL

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

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

Lab Data:

Allergies: None

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

Symptoms: No sleep at night, temp to 101F

Other Meds: Metformin, Diltiazem, Pioglitazone, Farxiga , Lisinopril, Repaglinide, Atorvastatin, Fenofibrate. Tresiba.

Current Illness: None

ID: 1029438
Sex: M
Age: 36
State: MA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Unevaluable event

Symptoms: Fever body aches fatigue

Other Meds: Celexa 10mg

Current Illness:

ID: 1029439
Sex: F
Age: 62
State: PA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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: 4 1/2 hours after the vaccine my arm got red, hot and felt a little swollen, the band aid placed got really tight. I got the chills and started shaking, I developed a fever of 102, chills and fever broke in 36 hours. I developed a cough, congestion and wheeze, had aches and pains all over, rolled around in bed for 36 hours. The fever broke by 7am on Sunday morning the aches and pains especially lower back still continue. I took Acetaminophen 1000mg twice during my 36 hours .Severe symptoms appear to be over.

Other Meds: none

Current Illness: none

ID: 1029440
Sex: F
Age: 77
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Chills, vomiting, diarrhea, sweats, tremors, dizzy, headache, unsteady gait, fever 101. Symptoms lasted for 24 hours and then I was feeling bad and in bed for 3 days. I took Tylenol for symptoms. I called my doctor and was advised to take Tylenol.

Other Meds: Sotolol, Fosamax,Methylprednisol, Potassium, Forosemide, Estradiol, Omega 3,

Current Illness:

ID: 1029441
Sex: F
Age: 66
State: CA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: None.

Symptom List: Injection site pain, Menorrhagia

Symptoms: I woke up at 2:30am the morning after receiving the first dose of the Moderna vaccine. My temperature was 107.2. I took 2 Extra-Strength Tylenol which lowered my fever to around 105 where it remained most of the day on 1/28/21. The next day, 1/29/21 my fever was in the 103-104 range. I took one dose of 2 Advil that day. The night of the 29th it went down to 102-103. The third day, 1/30/21 my fever broke.

Other Meds: Crestor

Current Illness: Had COVID 19 diagnosis 12/24/20.

ID: 1029442
Sex: F
Age: 47
State: PA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: There was no adverse event. This patient was given Pfizer vaccine #1 on 1/15/21. Pfizer lot # EL3249. She was then given a Moderna COVID vaccine for her second dose on 2/08/21. There are several safeguards in place to ensure the same brand of vaccine is given for first and second doses. The hospital is looking into this vaccination error to ensure this does not happen again. The patient did not have her vaccination card with her for her second dose.

Other Meds:

Current Illness:

ID: 1029443
Sex: F
Age: 22
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pain and soreness in arm through afternoon on 2/12 after getting vaccine. I started to get a small lump on my arm. That evening I had bad chills through the night and next morning. I took tylenol and got a low fever on 2/13. Lump was red and grew all day. Had low fever all day, increased to 101.6 in afternoon despite the Tylenol. Fatigue, headaches, and body aches. 2/14 I felt better in the morning. Headaches and fatigue still. Large red lump/swelling on arm (around 3 inches wide) at site of vaccination, arm still sore and painful to touch.

Other Meds: None

Current Illness: None

ID: 1029444
Sex: F
Age: 80
State: NC

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

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fly like symptoms, fatigue, chills, fluid cough more than usual, left side pain under navel

Other Meds: Too many to list

Current Illness:

ID: 1029445
Sex: F
Age: 68
State: GA

Vax Date: 12/11/2020
Onset Date: 12/11/2020
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: possibly sulfa, latex if left on skin greater than 24 hours, all topical antiobiotics

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

Symptoms: I had extreme burning when I received TDAP. She administered in it in top of arm and I don't remember her pinching skin. Soon after, I had reduced mobility in left arm and could not move shoulder well. I still have the reduced mobility and pain in arm, down to forearms, with achiness and discomfort.

Other Meds: Vit. D, Omega 3, probiotic align

Current Illness: none

ID: 1029446
Sex: F
Age: 68
State: KY

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: sulfur, epinephrine

Symptom List: Nausea

Symptoms: Within 45 minutes I had rapid heart palpitations and felt nauseas.

Other Meds: sertraline,estradial,lisinopryl,atenolol. vitamin, ebrta B, extra C

Current Illness: none

ID: 1029447
Sex: F
Age: 71
State: NY

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: Ceftin

Symptom List: Injection site pain

Symptoms: Terrible stomach spasms and cramping. Nausea, vomiting, and fever.

Other Meds: Gabapentin

Current Illness: UTI

ID: 1029448
Sex: F
Age: 49
State: OH

Vax Date: 12/22/2020
Onset Date: 01/04/2021
Rec V Date: 02/14/2021
Hospital:

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

Lab Data:

Allergies: acetaminophen, advocare, albuterol, aspirin, adhesive tape, Augmentin, Bactrim, bee sting, zipro, CT Scan dye, Demerol, diaconate, diclofenac, Entex, flexural, ibuprofen, enteral, lamictal, latex, Mestinon, mobic, MRI dye, Mucinex, naproxen, Neurontin, oxycodone, paxel, peanuts robitussen, theroquil, shellfish, sulfa, tophorol, trazadone, Zoloft

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

Symptoms: 12/22 Vaccination Unknown dates; around the holidays 1.5.2021 - missed 2 weeks of work. I started the propranolol. I ended up with extreme HA, vomiting, syncope, Stomach pain, couldn't keep anything down. Lasted for 2 weeks. *2nd shot - same symptoms

Other Meds: prednisone, keppra, lexapro, propranolol

Current Illness: n/a

ID: 1029450
Sex: M
Age: 81
State: MI

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/14/2021
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Allergies: NONE

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

Symptoms: total loss of strength. could not crawl on the floor, only roll at about 10:30pm on day of vaccination via ambulance to Hosp. ER

Other Meds: BABY ASPIRIN LEVOTHROXINE .075MG SIMVASTATIN 20MG CITALOPRAM 20MG

Current Illness: no

ID: 1029451
Sex: F
Age: 69
State: GA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/14/2021
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Allergies: Codine, Penicillin, Sulfur, Dairy, Wheat, MSG, Mold, Pollen

Symptom List: Tremor

Symptoms: Severe muscle pain, severe weakness, slight shortness of breath. Was unable to sleep because of severe muscle pain. I passed out when I went to the bathroom at 3:53 am from the pain I came to on the floor at approximately 3:57 and had hit my head just below my eyebrow on the sink counter. I was bleeding from a wound and sustained a black eye.

Other Meds: Liothyronine SOD 5 MCG Tab, Levothyronine 25 MCG Tab - one half dose, DHEA

Current Illness: None

ID: 1029452
Sex: F
Age: 45
State: VA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/14/2021
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Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: Malaise in the evening and woke up with chills, the next day had malaise and achy and significant soreness of arm three days following

Other Meds: none

Current Illness: no

ID: 1029454
Sex: M
Age: 70
State:

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 02/14/2021
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Allergies: Raw carrots

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Mild lower abdominal discomfort. May or may not have been associated with shot. Lasted about a day, then went away. Pain at injection site started later, that day, gone in a day or so. No treatment

Other Meds:

Current Illness:

ID: 1029455
Sex: F
Age: 57
State: CA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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Allergies: Amoxicillin Sulpha based drugs Coreg

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

Symptoms: Immediately upon receiving the injection I felt a tingle in my throat which grew into a lump resulting in a coughing attack where I could not catch my breath or stop coughing. It lasted for about 10 minutes but then subsided however the discomfort or feeling of something in my throat lingered for a couple of hours

Other Meds: Metformin Atorvostatin Lisinopril Sertraline Topamax Full Aspirin

Current Illness: None

ID: 1029456
Sex: F
Age: 29
State: IL

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/14/2021
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Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Soreness at injection site, fever (101.2), headache, chills

Other Meds: None

Current Illness: COVID 19 positive test 21 days prior to vaccination.

ID: 1029457
Sex: F
Age: 49
State: OH

Vax Date: 01/22/2021
Onset Date: 02/14/2021
Rec V Date: 02/14/2021
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Allergies: acetaminophen, advocare, albuterol, aspirin, adhesive tape, Augmentin, Bactrim, bee sting, zipro, CT Scan dye, Demerol, diaconate, diclofenac, Entex, flexural, ibuprofen, enteral, lamictal, latex, Mestinon, mobic, MRI dye, Mucinex, naproxen, Neurontin, oxycodone, paxel, peanuts robitussen, theroquil, shellfish, sulfa, tophorol, trazadone, Zoloft

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

Symptoms: 1/22 Vaccination chills, extreme fatigue, extreme HA. Slept all day and night. Didn't feel better all weekend. 1/29 went to dr. office. Pre-scheduled due to reaction from 1st vaccine.

Other Meds: prednisone, Keppra, Lexapro, Tylenol, propranolol

Current Illness: asthmatic, chronic kidney disease, hypertension, autonomic dysreflexia , seizure disorder, chronic migraines

ID: 1029458
Sex: F
Age: 80
State: MA

Vax Date: 02/06/2021
Onset Date: 02/12/2021
Rec V Date: 02/14/2021
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Allergies: Penicillin, sulfa

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: My left upper arm the site of the injection started to be itchy on Friday Feb. 12, 2021, six days after the shot. It has a rash of about an inch and a half radius. I put some cortisone on it and took a quarter of a Benadryl tablet today Sunday Feb 14, 2021 because the itch becoming more irritating. The itch did decline .

Other Meds: Diltiazem, HZTZ, pravastatin, fluoxetine, metoprolol, baby aspirin

Current Illness: None

ID: 1029459
Sex: F
Age: 57
State: NC

Vax Date: 02/02/2021
Onset Date: 02/06/2021
Rec V Date: 02/14/2021
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Symptom List: Pain in extremity

Symptoms: On 2/6/2021 in the morning I had numbness & tingling on my left hand. My arm was very sore & it was painful. I also had fever 99.2. My arm numbness and tingling is still going on that hasn't resolved and I've been seeing a doctor for it.

Other Meds: Azythromycin 250 mg every morning Metoprlo 75mg twice a day Lisinopril 20mg Loprzlie 20mg nlortirptyline 45mg tizanidie 2mg flonsie 50 Inhaler Montelukast 10mg musinex 600mg Fish Oil 1200mg Vitamin D Multi Vitamin Benzonatate 200mg

Current Illness:

ID: 1029460
Sex: F
Age: 79
State: MA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
Hospital: Y

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Allergies: aspirin bupvicaine azithromycin clindamycin codiene epinephrine fentanyl levoquin lidocaine metformin morphone penicillin

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

Symptoms: Patient started to experience chest tightness and then hypertension

Other Meds: atenolol atorvastatin diazepam keppra levothyroxine lisinopril omeprazole multivitamin prednisone

Current Illness: none

ID: 1029461
Sex: F
Age: 78
State: VA

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/14/2021
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Allergies: none

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: low grade fever, fatigue, headache, muscle aches, chills, pain at injection site these symptoms started around 9:00am 24 hours after injection of second dose.

Other Meds: glipizide 2.5mg aspirin [ low dose] 81mg lisinopril 10 mg atorvastatin 10 mg Jardiance 25 mg one-half tablet

Current Illness: Type 2 Diabetes

ID: 1029462
Sex: F
Age: 39
State: IA

Vax Date: 02/03/2021
Onset Date: 02/09/2021
Rec V Date: 02/14/2021
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Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Large rash on Legs and lower abdomen

Other Meds:

Current Illness:

ID: 1029464
Sex: M
Age: 66
State: CO

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

Symptom List: Vomiting

Symptoms: Chills beginning at 4:30 am., Fever/temp at 7 am 101.4. > 500 mg of Acetaminophen given. Fever at 10 am 100.4, Fever at 1:45 pm 101.7 > 500 mg Acetaminophen given. Called Hospital and told to call if climbs to 102.

Other Meds: Vitamin D

Current Illness: Surgery for Prostate Cancer on January 12, 2021

ID: 1029465
Sex: F
Age: 71
State: NY

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/14/2021
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Allergies: Codeine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Besides sore arm, started with dizziness, upset stomach, 99? fever, chills, headache and vomiting that would not stop abusing dehydration.

Other Meds: Synthroid Pregabalin Pravastatin Lisinopril Vitamin E Multivitamin

Current Illness: None

ID: 1029466
Sex: M
Age: 61
State: NC

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/14/2021
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Allergies: Shellfish Fish

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

Symptoms: Hives, Itchiness, Difficulty Breathing Benadryl and later when difficulty in breathing increased an Epipen Administered Symptoms Reduced, no further issues

Other Meds: lisinopril Oxybutynin metFormin sertraline

Current Illness:

ID: 1029467
Sex: F
Age: 4
State: CA

Vax Date: 02/22/2018
Onset Date: 02/24/2018
Rec V Date: 02/14/2021
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Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pain at the injection site along with tenderness, redness and swelling.

Other Meds:

Current Illness:

ID: 1029468
Sex: F
Age: 67
State: WI

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

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: One of our Greenfield patients called today (2/12/21) to discuss the adverse effects she experienced following her first dose of the COVID vaccine (received last Friday, January 29). The patient indicated that several hours after receiving her vaccine, she experienced pronounced dyspnea and tachycardia. She stated these symptoms lasted throughout the weekend and were severe enough to prevent her from conducting her daily activities. The patient mentioned that, at one point, she nearly passed out while showering from not being able to catch her breath. The patient reported that she contacted her PCP for guidance, who instructed her to visit the ER for a thorough workup; however, the patient stated she did not follow these orders due to concerns of having a high copay. When speaking with her today, the patient assured me that her symptoms have since resolved.

Other Meds: Metoprolol ER, Amlodipine, Trazodone, Atorvastatin

Current Illness:

ID: 1029469
Sex: F
Age: 42
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/27/2021
Rec V Date: 02/14/2021
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Allergies: Penicillin

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

Symptoms: COVID vaccine arm - redness, swelling, soreness, itching, 4-5? diameter. Center of swelling 4? south of injection site.

Other Meds: Asmanex; Albuterol

Current Illness: None

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am