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: 1035814
Sex: F
Age: 49
State: AR

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: About 3am the next morning I woke up to a loud ringing in both my ear. When I sat up I was very very dizzy. I got up and showered and my feet swelled very bad. I did not feel well but I went to work but the feelings never got better. So on 1/10 Sunday I went to the medical center because I jjust didnt not feel well. The swelling in the lower legs was still there so I was prescribed 20 mg of presnisone for 5 days. The sound changed during the time of the antibotics but after I stopped taking the prednisone the ringing sound came back, my left foot is still numb and my eyes are constantly red and burning even after putting drops in my eyes, I still suffer from headaches and if I turn my head too far left or right I get dizzy still to date. On 1/14 I was given a 60 mg dose of tapered predinosone for 2 week to help elevate the symptoms but it did not work. On 2/12 I saw an ENT specialist who performed a hearing test which did produce minor hearing loss and was diagnosed with having Tinnitis.

Other Meds: no

Current Illness: no

ID: 1035815
Sex: F
Age: 75
State: OH

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Sulfa allergy

Symptom List:

Symptoms: As a result of the Moderna coronavirus vaccine, I had redness, itchiness, and swelling on 2/12/21 for a few days. At its peak, it resembled a bee sting 2" in diameter, and was accompanied by muscle swelling near the injection site and soreness.

Other Meds: Prolia injection on 12/28/2020

Current Illness: None

ID: 1035816
Sex: F
Age: 65
State: GA

Vax Date: 02/08/2021
Onset Date: 02/15/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Citrus fruits Tomatoes Poison ivy

Symptom List:

Symptoms: Rash, itching around injection site about 5 to 8 days after injection - has continued- over 24 hours - "Covid arm"

Other Meds: Multivitamins Probiotic Calcium, magnesium, zinc

Current Illness: None

ID: 1035817
Sex: F
Age: 73
State: DC

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: 20 min after shot, warmth and flushing which lasted 2 min; soreness at injection site Soreness/swelling at site continued to present- 3rd day Redness at site started 8 hours after injection and continued to present Beginning 17 hours after shot and continued for 18 hours(shot+35 hrs): Muscle and joint aches Lethargy Temp maxed out 101 No headache, no chills After 35 hrs, temp normal, aches and lethargy faded quickly; normal by 42hrs. Soreness, swelling and redness at site continued at 68 hrs

Other Meds: Synthroid Multi vitamin

Current Illness: None

ID: 1035818
Sex: F
Age: 80
State: FL

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Sensitive to many foods, histamine reactions. Reaction to Tamiflu, Rifaxamin, questionable if she had reaction to Sulfa, adhesive tape.

Symptom List:

Symptoms: Immediate reaction was the headache at the time of the vaccine, and has had headaches on and off but nothing like the initial one. Started to get dizzy and felt weird on the ride home from the vaccine. The headache lasted a fairly long time and got tired by the evening and the next morning. The headache has still continued a little off and on until now, 2/17/21. The dizziness has gone away, the feeling "out of it" feeling has gone away, does not feel well about the concentration. The tiredness and fatigue started the day after the vaccine and has gotten worse, has to drag herself through the day and by 1:00 PM is done through the day due to the fatigue. Some days can go to 4:00 but most days only lasts until 1:00. She gets up at 7:30 and today at 10:37 has the feeling of tiredness. The gland under her arm a couple of weeks ago was swollen, which is still sensitive but not as bad as it was. The fatigue is the main thing that continues to bother her. She has not taken anything for these reactions. She has seen her doctor, and is supposed to get some blood tests today, 2/17/21.

Other Meds: Prolia, Fluticasone, Hycosamine, Ondansetron. ExtraC vitamin, Lutein, Zinc, pediatric vitamin/mineral powder, Elglutamine powder, optimagneuro, Bingdaling herb, 5 MTHS plus B12, Tums for calcium, pepcid complete.

Current Illness: None.

ID: 1035819
Sex: F
Age: 82
State: CA

Vax Date: 02/08/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: No side effects until 9 days after vaccination. No sore arm or no feeling bad. On the 9th day my arm at the vac. Site (right arm) got very swollen and very itchy. Headache and diarrhea also. Feeling very tired.

Other Meds: Multi-vitamin. Calcium. Magnesium Zinc and Vit.D. No prescriptions

Current Illness: None

ID: 1035820
Sex: F
Age: 82
State: NC

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List:

Symptoms: The night after my second vaccine, I started experiencing burning pain in my left hip area. I had a total left hip replacement on June 1st and had no pain in that hip prior to the second vaccine.

Other Meds: Losartan , amlodipine, carvedilol ,centrum, vitamin C, calcium/Vit D,aspirin 81mg,gabapentin, probiotic, ropinirole

Current Illness: none

ID: 1035821
Sex: F
Age: 39
State: TN

Vax Date: 12/20/2020
Onset Date: 12/26/2020
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Sulfa - angioedema Erythromycin - rash Codeine _ angioedema PCN - rash

Symptom List:

Symptoms: Symptoms consistent with flare of Ulcerative Colitis: defecation urgency, blood in stool, loose stools. I notified my GI doctor about symptoms, we agreed to increase my dose of Balsalazide to 3 grams PO BID. Symptoms had not resolved prior to my receiving second dose of vaccine. I had not had a flare in 2 years, and had a colonoscopy 6 months prior which showed complete resolution including normal biopsies. I continue to have symptoms 2 months later, I'm scheduled for follow up with GI in March. I realize this may just be correlation and not causation but felt it was important to report in case they are related.

Other Meds: Zoloft 100 mg PO once daily Balsalazide Disodium 1500 mg PO BID Spironolactone 50 mg PO once daily Levothyroxine 100 mcg PO once daily Vitamin D3 1000 IU once daily

Current Illness: none

ID: 1035822
Sex: F
Age:
State:

Vax Date: 03/01/2016
Onset Date: 05/01/2016
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: inflammation of spinal cord + in brain (Multiple Sclerosis was diagnosed a few months later)

Other Meds:

Current Illness:

ID: 1035823
Sex: M
Age: 47
State: AZ

Vax Date: 02/10/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pt reported that he received the 1st Pfizer dose on Feb. 10, on the 13th he reported fever, chills and feeling unwell. On Feb 14th, the pt went to his local doctor and was tested for COVID-19, on the 16th he was notified the COVID-19 test was positive. Pt was instructed to quarantine for the next 14 days, he understands the instructions he was given and will continue to monitor his health.

Other Meds:

Current Illness:

ID: 1035824
Sex: F
Age: 51
State: LA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: sulfa drugs

Symptom List:

Symptoms: Facial tic (lasted less than 24 hrs) Scalp Rash ( red spots\dots on scalp that were initially pruritic) Extreme fatigue lasting less than 24 hrs.

Other Meds: meloxicam vitamins

Current Illness: none

ID: 1035825
Sex: F
Age: 86
State: PA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, sulfadiazine, lactose, biaxin, ceftin, Vioxx and tetracycline

Symptom List:

Symptoms: overnight non stop Cough (first night) , "out of it feeling" , brain fog,, low blood pressure, leg weakness, nausea, dizziness, mouth ulcers outbreak, face flushing , this happened during the week following the Monday vaccination...?.still have some mouth sores and face flushing

Other Meds: Atenolol 25 , Femotidine, Levothyroxine, atorvastatin, asperin 81mg, centrum silver multi vit, , Vit D3, Amino-magnesium, mega red, (omega 3) Krill oil,

Current Illness:

ID: 1035826
Sex: F
Age: 30
State: MD

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List:

Symptoms: Fever of 101 degrees fahrenheit from 3am on 2/10/21 to 8pm on 2/10/21. Migraine headache, muscle aches, nausea, extreme fatigue, and dehydration, on 2/10/21. 2/15/21 large itchy bright red rash appeared on right arm. Has gotten less itchy and red, but still present on 2/17/21.

Other Meds: Duloxetine 40mg, Neurotin 100mg, Pregabalin 150mg, Mylan 3mg, Allegra 180mg

Current Illness: n/a

ID: 1035827
Sex: F
Age: 55
State: MO

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: NSAIDS

Symptom List:

Symptoms: Body aches, severe nausea, GI upset on 2-13-21 Next day still had severe nausea, GI issues, stomach pain 3rd day, still severely nauseated, frequent stools, pains in stomach even with sips of water. My stomach is still very sore, headache and nauseated, but getting better.

Other Meds: Cymbalta 90mg a day Metoprolol 25mg a day Vitamin D 50,000 iu 2 x week

Current Illness: None

ID: 1035828
Sex: F
Age: 52
State: AZ

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

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

Lab Data:

Allergies: sulfa, mesalamine

Symptom List:

Symptoms: Sore injection site; fatigue; headache; aches/pains; low grade fever

Other Meds: Daily vitamin, D3, Calcium

Current Illness: n/a

ID: 1035829
Sex: F
Age: 53
State: OH

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

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

Lab Data:

Allergies: bees, latex

Symptom List:

Symptoms: patient reports shaking and feeling like she can't breath (more like panic attack not anaphylaxis)

Other Meds:

Current Illness:

ID: 1035830
Sex: F
Age: 44
State: IN

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

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

Lab Data:

Allergies: SULFA, PCN

Symptom List:

Symptoms: Dose 1: Axillary lymph node swelling & pain Dose 2: 12 hours after dose; fever; neck & back pain; chills - lasted 12 hours

Other Meds: Pristiq, topamax

Current Illness: none

ID: 1035831
Sex: F
Age: 54
State: NV

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List:

Symptoms: Approximately 10 am 2/11 headache Approximately 3 pm 2/11 chills, fever, body aches, worsening headache x36 hours Continued daily headaches. 2/17/21 6 am intense vertigo with mild headache and nausea

Other Meds: Synthroid, paroxetine, miv

Current Illness: None

ID: 1035832
Sex: M
Age: 68
State: FL

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: ANTS

Symptom List:

Symptoms: PATIENT'S WIFE REPORTS THAT, "IT FELT LIKE HIS THROAT WAS CLOSING X 7 HOURS, THEN CLEARED UP". PATIENT DID NOT TAKE ANY MEDICATIONS FOR HIS SYMPTOMS. DID NOT GO TO AN ED OR DOCTORS OFFICE. PATIENT'S WIFE CALLED THEIR PCP, AND REPORTED TO A NURSE THERE. SHE WAS THEN TOLD TO CALL HEALTH DEPARTMENT AND REPORT IT TO US. PATIENT'S WIFE REPORTS THAT HE DOES HAVE AN ALLERGIC REACTION TO ANTS SOMETIMES, BUT NOTHING ELSE.

Other Meds:

Current Illness: NONE KNOWN

ID: 1035833
Sex: F
Age: 50
State: CO

Vax Date: 01/06/2021
Onset Date: 02/03/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Quarter size bruise looking area on Left breast. No known trauma to area. Was not there the night before, notice after shower. Had PA look at it and confirmed it was not a rash.

Other Meds:

Current Illness:

ID: 1035834
Sex: F
Age: 66
State: ND

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: My arm was sore for a day or two. it was red but small and It was going away. I noticed it come back on 02/16 and it was raised and bumpy and the size of a hand now. it itches a little.

Other Meds: Eliquis metoprolol Lisinopril furosemide digoxin presa vision multivitamin

Current Illness: no

ID: 1035835
Sex: F
Age: 51
State: GA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: SULFA

Symptom List:

Symptoms: PT STATES SWELLING UNDER EYES BEGAN 10 MINS AFTER VACCNIE ADMINISTERED. NO SIGNS OF DISTRESS NOTED. PT DENIES SOB, CHEST PAIN, DIZZINESS. ADMINISTERED BENADRYL 25MG PO X 1 DOSE. PT OBSERVED X 60 MINS AFTER MEDICATION ADMINISTERED. PT STABLE AND SWELLING REDUCED UNDER EYES.

Other Meds: Singular, Inhaler, Losartan

Current Illness:

ID: 1035836
Sex: M
Age: 73
State: WI

Vax Date: 02/06/2021
Onset Date: 02/08/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Extreme gout-like inflammation of left leg from hip and groin to foot. (Vaccination was administered in left arm.)

Other Meds: Uloric, Atorvastatin, Ramipril

Current Illness: CKD

ID: 1035837
Sex: M
Age: 31
State: NH

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 02/17/2021
Hospital: Y

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

Lab Data:

Allergies: Reactions to statin? drugs

Symptom List:

Symptoms: The day of the vaccine everything was fine sore arm. On the following morning notice rash on the right side of the mouth was flare of shingles on day 7 rash had crusted over. Around 2 more weeks still exp nerve pain right side of the mouth.

Other Meds: No

Current Illness: No

ID: 1035838
Sex: F
Age: 34
State: KY

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: All tree nuts Codeine Demirel

Symptom List:

Symptoms: With both shots I experienced the following: Migraine -3 days Extreme fatigue Dehydration Nausea Chills Hot flashes Nose bleeds with the 2nd shot. After the nose bleeds I back every tired and had a slight headache.

Other Meds: Wellbutrin

Current Illness: None

ID: 1035839
Sex: F
Age: 88
State: VA

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: codeine

Symptom List:

Symptoms: Onset approximately 4am Sunday Feb 14 I experienced extreme fatigue, nausea with dry heaves. Stayed in bed ll day, only rising to urinate or for dry heaves. Did not eat or drink anything until 5am Feb. 15 when I had 2 cups of tea. Nausea gone, able to eat. However to date Feb. 17 I am extremely weak, shaky. , afraid to shower for fear of falling.

Other Meds: Prednisone, nexium, neurontin, stool softener, probiotice, fish oil, Vitamin C with D3, tylenol

Current Illness: none

ID: 1035840
Sex: F
Age: 72
State: NC

Vax Date: 01/30/2021
Onset Date: 02/06/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Developed Covid 19 7 days after receiving 1st vaccine. Sore throat, chills, fever, body aches, headaches.

Other Meds: Euthyrox 5 mcg, Vit. D 4000IU daily, Mag/Cal

Current Illness: none

Date Died: 02/08/2021

ID: 1035841
Sex: F
Age: 84
State: IL

Vax Date: 02/03/2021
Onset Date: 02/08/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Gluten; NSAIDS; Penicillin; Sulfa

Symptom List:

Symptoms: Death on 2/8/2021 unknown signs and symptoms at time of death; multiple co-morbidities

Other Meds: Home Medications Current 2/3/2021: Albuterol-Ipratropium as needed; Allopurinol daily; Aspirin 81mg daily; B complex plus vitamin C daily; Budesonide as needed; Calcitriol 4 times per week; Diphenoxylate-Atropine as needed for diarrhea; Eut

Current Illness: Diarrhea with Cdiff etiology, seen in the Wound Center on 2/3/2021 for a pressure ulcer; Seen in ER on 1/14 with diarrhea, fatigue, cough and shortness of breath labs revealed BUN 20; Cr 1.68; GFR 29; Alk Phos 152.

ID: 1035842
Sex: F
Age: 47
State: MD

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient received her vaccine and the vaccinator noted the dose did not get administered in the patients arm in was dripping down the patients arm. Pharmacy team on sight and myself made aware of the faulty needle/ syringe and the vaccine was readministered to the patient.

Other Meds:

Current Illness:

ID: 1035843
Sex: F
Age: 72
State:

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List:

Symptoms: HIVES near injection site. Started evening of day after shot. Gone by following morning. No biggie just thought I'd let you know.

Other Meds: Xarelto metoprolol

Current Illness:

ID: 1035844
Sex: F
Age: 86
State: FL

Vax Date: 02/02/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: none reported

Symptom List:

Symptoms: patient developed rash, redness, soreness at/around injection site 2 weeks post vaccination event

Other Meds: unknown

Current Illness: unknown

Date Died: 02/11/2021

ID: 1035845
Sex: F
Age: 74
State: WI

Vax Date: 02/03/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: We were informed by EMS that the patient was found deceased on 2/11/2021 at her home. EMS states she was dead for some time, no medical care given.

Other Meds: Unknown

Current Illness: Not sick at time of vaccination, unknown prior.

ID: 1035846
Sex: F
Age: 65
State: MN

Vax Date: 02/06/2021
Onset Date: 02/13/2021
Rec V Date: 02/17/2021
Hospital:

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

Lab Data:

Allergies: Sulpha

Symptom List:

Symptoms: It began with itching on 2/13 at and around the injection site. 2/14-17 some hardness developed, then it turned into a rash and became quite tender.

Other Meds: Ranitidine, Paxil, omeprazole, acyclovir

Current Illness: None

ID: 1035847
Sex: F
Age: 70
State: MI

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies: Allergy status to other drugs, medicaments and biological subs

Symptom List:

Symptoms: 70 year old patient felt funny after shot. EMS was called vitals were taken BP 174/80 99% O2 room air HR 78. Chest Pain, Non-Cardiac but patient refused additional evaluation and care. Released against medical advice.

Other Meds:

Current Illness:

ID: 1035848
Sex: F
Age: 49
State: NY

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/17/2021
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Symptoms: Severe arm pain lasting almost two weeks

Other Meds:

Current Illness:

ID: 1035849
Sex: M
Age: 48
State: OR

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/17/2021
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Allergies: none

Symptom List:

Symptoms: I awoke from sleep freezing cold. Colder than I have ever felt. violent shakes. So much that I was worried my muscles would begin to sieze up and cramp. I had warm clothes and 5 blankets and could not get warm for over 2 hours. Elevated heart rate and breathing. Nothing warmed me. Eventually (and with ibuprofen) the incident subsided. I felt weak and just "off" with slight body aces and fatigue for the next day and a half.

Other Meds: none, other than a probiotic and multivitamin and vitamin d

Current Illness: none

Date Died: 02/13/2021

ID: 1035850
Sex: M
Age: 67
State: NC

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/17/2021
Hospital: Y

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Allergies: Aspirin Erythromycin

Symptom List:

Symptoms: Patient woke up on the morning of 2/6 with symptoms of a stroke. Rushed to hospital where clot found in brain. Recovered from initial stroke but then had another major stroke on 2/8 and never recovered.

Other Meds: Advair 250-50mcg Allegra-D 24 hour 180-240mg Amlodipine 2.5mg Buspirone 10mg Carvedilol 12.5mg Montelukast 10mg Prednisone 20mg Albuterol Zoloft 100mg Spiriva Nasacort AQ

Current Illness: Sinus Infection being treated with steroids and antibiotics

ID: 1035851
Sex: F
Age: 86
State: OH

Vax Date: 02/12/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
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Allergies: sulfa

Symptom List:

Symptoms: pt has 2" red spot around the injection site.

Other Meds: furosemide 20mg, levothyroxine 25mg, oxybutynin 5mg, atorvastatin 80mg, Eliquis 2.5mg, metoprolol 50mg, lisinopril 5mg, risperidone 0.5mg, spironolactone 25mg,

Current Illness: irregular heartbeat - admitted to hospital from 1/25-29/2021

ID: 1035852
Sex: F
Age: 70
State: IL

Vax Date: 02/09/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
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Symptom List:

Symptoms: Soreness and tenderness in breast.

Other Meds:

Current Illness:

ID: 1035853
Sex: M
Age: 57
State: WI

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 02/17/2021
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Allergies: lisinopril

Symptom List:

Symptoms: approximately 53 hours after shot, developed fever of 101.5 which broke overnight. Noticed red raised rash at injection site about the same time. rash is in shape of the band-aid administered and was left on for 48 hours. Rash is still present on arm now in the 5th day after injection. Soreness in arm developed within 24 hours and persists now, as well, 5th day following. Soreness is a mild ache, noticeable when touched or when raising arm above head.

Other Meds: janumet, aspirin, trulicity, omeprazole, glyburide, atorvastatin, farxiga, losartan, tamsulosin, amlodipine

Current Illness:

ID: 1035854
Sex: M
Age: 76
State: FL

Vax Date: 01/29/2021
Onset Date: 02/08/2021
Rec V Date: 02/17/2021
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Allergies: NIL

Symptom List:

Symptoms: Bleeding gums , painless bruises of back, Started about 10 days after vaccine, has now 02/16/21 stopped

Other Meds: Atenolol 50mg daily, Melatonin 10mg nocte

Current Illness: None, have not been ill for over 30 years, no doctor, dental, hospital visits over 30 years. Only cataract surgery

ID: 1035855
Sex: F
Age: 24
State: CO

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/17/2021
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Allergies: septra cefdinir

Symptom List:

Symptoms: Rash/hives appeared across upper abdomen/below breasts roughly 8 hours after injection. Growth of redness, swelling, and pain at injection site for up to 48 hours after injection. Ibuprofen and benadryl taken for 48 hours post injection. Redness/swelling/pain at injection site improved 72 hours post injection. Rash/hives improved 4 days post injection.

Other Meds: birth control - Junel Fe 1/20 tab trazodone 50mg QHS

Current Illness: None

ID: 1035856
Sex: F
Age: 31
State: VA

Vax Date: 12/15/2020
Onset Date: 12/18/2020
Rec V Date: 02/17/2021
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Allergies: None

Symptom List:

Symptoms: Patient experienced bruising size of orange for 1 week along with sore arm, neck muscles and back muscles for an entire week. Had difficulty completing activities of daily living for one week because of arm discomfort.

Other Meds: Lamictal 100 mgm daily Synthroid daily Fish oil capsules daily Folic Acid daily Vitamin C daily

Current Illness: Bi Polar disorder Hypothyroidism

ID: 1035857
Sex: M
Age:
State: IN

Vax Date: 02/14/2021
Onset Date: 02/14/2021
Rec V Date: 02/17/2021
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Symptoms: Patient arrived at Clinic for second dose of Moderna. Patient was checked in by CCMA. Patiient was assigend to a Pfizer bay. RN administered Pfizer vaccine to patient. Patient had provided vaccination card and Pfizer label placed on it. Upon check out it was noticed that patient had received Pfizer as oppossed to receiving his second dose of Moderna. DNP Supervisor was notiifed by RN charge for 2/14. I communicated with patient that there was no need to receive an additional dose of Moderna : that it was not ideal that he received the 2 different vaccines but that it shouldn't be harmful; that the vaccines are similar and that he should receive optimal immunity effacacy.

Other Meds:

Current Illness:

ID: 1035858
Sex: F
Age: 70
State: KS

Vax Date: 02/02/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
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Allergies: None that I am aware of.

Symptom List:

Symptoms: The arm the vaccine was given in developed slight tenderness, small bumps, some redness, itches and a has a hard area on or just below the injection site. These conditions did not begin until approximately 10 days after the vaccine. I visited with a nurse at our local health clinic. She, ironically, developed the same symptoms and said hers lasted almost until her second shot. Other than Benadryl cream to alleviate the itching, no treatment was recommended. I have had the above symptoms for five days and although they are slightly improved, they are not gone.

Other Meds: Omeprazole, Metformin, Primidone, Metoprolol XL, Olmesartan, Glimepiride, Atorvastatin, Januvia, low dose aspirin, B12 tablets, monthly B12 shot, Multivitamin

Current Illness: None

ID: 1035859
Sex: M
Age: 30
State: MI

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/17/2021
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Allergies: seafood

Symptom List:

Symptoms: Woke up 2 days post vaccination with hives, was take to urgent care and given steroids

Other Meds: Celexa, Propranolol, Risperidone, levothyroxine, dilantin, desmopressin,

Current Illness: none

ID: 1035860
Sex: F
Age: 61
State: MN

Vax Date: 02/08/2021
Onset Date: 02/15/2021
Rec V Date: 02/17/2021
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Symptom List:

Symptoms: Patient's arm at site of injection is inflammed, red, and is itching.

Other Meds:

Current Illness:

ID: 1035861
Sex: M
Age: 78
State: VT

Vax Date: 02/04/2021
Onset Date: 02/09/2021
Rec V Date: 02/17/2021
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Allergies: none that I am aware of

Symptom List:

Symptoms: Have constant pain in right upper arm shoulder, have taken Ibuprofen 800mg per day reliefs pain for about 12 hours. My arm movement seems to be good and is not painful when I move it. I have to elevate my arm in a sling type position as the day goes on it gets more painful otherwise. I have called my doctor but have not heard back from him, I am expecting him to call me today, so I can get his opinion on what might be wrong with my shoulder. I have my second virus short scheduled for Feb. 25,2021 at 9:30 am at the same place.

Other Meds: glucosomine

Current Illness: none

ID: 1035862
Sex: M
Age: 82
State: MD

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/17/2021
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Allergies: shellfish

Symptom List:

Symptoms: Pt had initial dose of vaccine 2/13/21 and noticed being short of breath/feeling bad the following day. He did not attend rehab on Monday, 2/15/21, as scheduled 2/2 SOB exhaustion. He did attend today, 2/17/21< but 3 minutes into exercise on treadmill he was unable to continue. He recovered quickly, refused clinic visit, and went home.

Other Meds: tylenol, amiodarone, plavix, colace, jardiance, glimepiride, atorvastatin, losartan, aspirin, lananoprost, levothyroxine, metformin, metoprolol, eliquis, potassium chloride, furosemide

Current Illness: PE 1/19 > elequis

ID: 1035863
Sex: F
Age: 50
State: IA

Vax Date: 01/23/2021
Onset Date: 01/28/2021
Rec V Date: 02/17/2021
Hospital: Y

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Allergies: NKDA

Symptom List:

Symptoms: Moderna COVID- 19 Vaccine EUA Pt received Dose 1 of Moderna COVID series 1/23/21. Pt developed difficulty breathing, cough, respiratory problems on 1/28/21. Pt tested positive for COVID 2/1/21. Pt had progressively worsening symptoms such as coughing fits which make her feel like she cannot breath until pt presented to ED 2/5/21. Initial pulse ox was 88% on room air. Pt was started on 2 L nasal cannula oxygen. Pt endorsed fever, chils, SOB, minimally productive repetitive harsh cough, diffuse body aches, fatigue, nausea, vomiting, diarrhea, mild generalized abdominal pain, loss of smell, loss of taste, no skin rash. Pt admitted to hospital. 2/6/21: Pt feeling better than day before. States oxygen is helping. Fever resolved. Continues to feel weak and tired. Recieved convalescent plasma in AM. Started remdesivir in PM. Continued on empiric ceftriaxone for bacterial superinfection coverage. Holding off on dexamethasone due to oxygen requirements of 2 L but plan to start if has increased oxygen needs. Enoxaparin started for DVT prophylaxis. Breo continued. 2/7/21: Pt continued to have significant cough. Pt did not like formulary Breo and pt's daughter brought in her home Symbicort for in-hospital use. Cough improved with benzonatate and dextromethorphan. Requiring 1 L of oxygen. Continued remdesivir, enoxaparin, benzonatate, detromethorphan. No evidence of bacterial pneumonia. 2/8/21: Discharged home with Genesis COVID Safe At Home telehealth program.

Other Meds: Aspirin 81 mg PO QD Atorvastatin 20 mg PO QD Budesonide-formoterol 160-4.5 mcg/inh 2 puffs BID Dexlansoprazole 60 mg PO QD Telmisartan 80 mg PO QD

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm