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: 1036034
Sex: U
Age:
State:

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

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: sick; Initial information was received on 07-Feb-2021 regarding an unsolicited valid serious case received from Health Authorities via consumer or non healthcare professional [under reference number: US-SA-SAC20210210001019]. This case involves an adult patient who experienced sick (illness), while the patient received INFLUENZA VACCINE. Medical history, medical treatment, vaccination, concomitant medication and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer [lot number and expiry date not reported] via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient was sick (illness) unknown latency following the administration of INFLUENZA VACCINE. This event was assessed as medically significant. Details of laboratory data were not reported. It was not reported if the patient received a corrective treatment. At the time of reporting, the event outcome is unknown. There will be no information on batch number for this case.; Sender's Comments: This case involves an adult patient who experienced sickness after vaccination with INFLUENZA VACCINE (produced by unknown manufacturer). The time to onset was unknown. Further information regarding concurrent condition during vaccination, previous vaccination and tolerance, laboratory investigations excluding alternative etiologies for the reported event are needed to fully assess this case. Based upon the reported information, the role of the suspect vaccines cannot be assessed.

Other Meds:

Current Illness:

ID: 1036035
Sex: U
Age: 90
State:

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

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

Allergies:

Symptom List:

Symptoms: Chills, nausea, body aches, temperature

Other Meds:

Current Illness:

ID: 1036036
Sex: M
Age: 73
State: WY

Vax Date: 02/10/2021
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: no

Symptom List:

Symptoms: Client reports symptoms of severe abdominal cramping and nausea started around midnight following afternoon immunization with Moderna Covid vaccine. Cramping would come and go and were severe. Client states he did what he could to put up with the pain until Monday Feb 15th. He went to local ER. Client was unable to tolerate CT contrast oral liquid (caused immediate diarrhea) so an abdominal CT scan was not completed and he was discharged. Symptoms still persist and client states he lost 16 lbs so far. He has reached out to follow up with his regular HCP- VA clinic. He is waiting for a call from them today.

Other Meds: unknown

Current Illness:

ID: 1036037
Sex: M
Age: 1
State: MI

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

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

Lab Data:

Allergies: no known allergies

Symptom List:

Symptoms: pateint was given the Hep A (adult) 1 single dose of the vaccine 50u/1-mL syringe by the Medical Assistant. Doctor had ordered the Hep A (ped/adol) dose of the vaccine 25u/0.5mL syringe. Wrong dosage was given. Parent was notified the following morning when error was discovered by myself, site supervisor of health facility. Parent stated patient has not had any side effects or symptoms from the vaccines given on 2/16/2021. Parent will monitor patient for symptoms.

Other Meds: N/A

Current Illness: N/A

ID: 1036038
Sex: M
Age: 19
State: GA

Vax Date: 02/15/2021
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: N/A

Symptom List:

Symptoms: Patient received vaccine outside recommended parameters. Verified with Moderna VAERS is required

Other Meds: N\A

Current Illness: N/A

ID: 1036039
Sex: F
Age: 48
State:

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

Vax Type:
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Allergies:

Symptom List:

Symptoms: Second vaccination given on the 02/12/2021 at 07:35. Began to have symptoms at 16:30 on 2/12/2021. Body aches, weakness, fever, chills, headache, and sore arm at injection site. These symptoms lasted until Monday 2/15/2021. I took Acetaminophen for the above symptoms. I left work early Friday night and called employee health Monday morning.

Other Meds:

Current Illness:

ID: 1036040
Sex: M
Age: 72
State: AZ

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

Vax Type:
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Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: Started runny nose the following evening after receiving vaccniation also felt a little stuffy. Next few days felt fine during the day but had a runny nose in the evening. Wednesday (day 4) felt front head stuiffiness and fogginess similar to a head cold. Want to know if this is a side effect I didn't see listed or the possiblility of coincidentally acquiring the virus. I had no symptoms prior to the injection.

Other Meds: Valsartan HCT 180/25; 81 mg Aspirin AM; Simvastatin 20 mg PM

Current Illness: None

ID: 1036041
Sex: F
Age: 52
State: ID

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

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Lab Data:

Allergies: Sulfa Adhesive tape

Symptom List:

Symptoms: Patient experiences numbness and tingling on left side of face 3-4 hours after vaccination. She mentioned it felt like going to the dentist and having numbing medicine. She states it lasted for 3 days without medical intervention. Shed stated that on Monday the 8th she went in for estrogen and testosterone "pellets", Symptoms of numbness and tingling returned on Saturday the 13th with numbness, tingling on left side of her face and roof of her mouth. On Sunday the 14th she started getting a rash on the left side of her face and jaw line. She called today to report these symptoms and will be speaking with her PMD tomorrow.

Other Meds: Progesterone Fluoxetine Armor Thyroid Omeprazole Testosterone and Estrogen pellet on Monday the 8th of Feb pellets

Current Illness: None

ID: 1036042
Sex: F
Age: 78
State:

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Body aches, chills

Other Meds:

Current Illness:

ID: 1036043
Sex: M
Age: 28
State: MI

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

Vax Type:
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Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Patient felt dizziness and giddiness after the vaccine . Onsite EMS was called vitals were taken BP 122/91 96% O2 room air HR 101. Patient refused evaluation/care. Left aginst medical advice.

Other Meds: Lisinopril

Current Illness:

ID: 1036044
Sex: F
Age: 75
State: CA

Vax Date: 01/26/2021
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: unknown

Symptom List:

Symptoms: EMT observer reports that client states she was "feeling dizzy." EMT assisted client to zero-gravity chair and assessed her pulse to be 75 BPM and BP 138/80. Client stated sitting in chair made her "feel better." EMT observed her for approx. 10 more minutes. EMT offered and client accepted a water bottle. She was informed to contact her physican if symptoms persis or worsen and to call 911 for any emergency. This summary is based on report written by EMT observer

Other Meds: unknown

Current Illness: unknown

ID: 1036045
Sex: F
Age: 76
State:

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

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

Allergies:

Symptom List:

Symptoms: fall, sore throat, malaise

Other Meds:

Current Illness:

ID: 1036046
Sex: F
Age: 42
State:

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

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies: Sudafed

Symptom List:

Symptoms: Panic attack

Other Meds: Vit C

Current Illness: No

Date Died: 01/24/2021

ID: 1036047
Sex: M
Age: 74
State: NY

Vax Date: 01/16/2021
Onset Date: 01/24/2021
Rec V Date: 02/17/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: penicillin diazepam

Symptom List:

Symptoms: Short version The patient has long-standing health issues. The patient received the first dose of Moderna COVID-19 vaccine on 1/16/2021 (unknown location). The patient suffered an event in his home on 1/24/2021. CPR and treatment was begun and he was transported to the ED. He was pronounced dead in the ED at 0846. Long version 70-year-old male with past medical history of CAD with pacemaker, A. fib, COPD, hypertension/hyperlipidemia presenting in cardiac arrest. 911 call at 0724. Per EMS, patient was witnessed by family to have seizure-like activity and then collapsed and became unresponsive. Patient was noted by family to be pulseless and CPR was started right away. Patient received two doses of epi by police were on scene first (AED defibrillation x2) and six doses of epi (plus 6 more AED shocks) by EMS when they arrived. Patient had CPR performed for 45 minutes prior to arriving at the hospital. On route, patient had episodes of paced rhythm and V. fib. Patient received one amp of bicarb and one amp of calcium en route. Patient also received 300 mg of amiodarone en route. Arrived in ED at 0810 Patient received ongoing compressions, shocks and additional medications (epinephrine x6, lidocaine IV, sodium bicarbonate) until time of death called at 0846 in the ED.

Other Meds: acetaminophen (TYLENOL) 325 MG tablet Apixaban (ELIQUIS) 5 MG TABS tablet atorvastatin (LIPITOR) 40 MG tablet B-Complex TABS cetirizine (ZYRTEC) 10 MG tablet Chlorhexidine Gluconate (BIOPATCH PROTECTIVE DISK/CHG) (Dressing) MISC Cholecalcif

Current Illness: Hospitalized 12/20 - 12/24/2020 Discharged to home with home care services Hospital Course 12/20 - 12/24/20: 74-year-old male with multiple medical problems presented to the ED with sudden shortness of breath and some palpitations. He was seen in the emergency room after being transported to the ED on CPAP was found to be febrile to 101 tachycardic tachypneic put on BiPAP in ED. EKG showed atrial flutter with left bundle branch block no ST segment elevations COVID-19 was negative RSV and flu was negative chest x-ray showed pneumonia in the right lower lobe. Subsequent chest x-ray showed bilateral lower lobe airspace disease consistent with pneumonia Patient also had a CT abdomen in the ED showing left pleural effusion . The CT report is attached which also showed a right renal cyst with calcification and needs to be followed up in 6 months with a renal protocol CT rest of it was negative. He was started on supplemental oxygen IV antibiotics. Patient was started on Rocephin and azithromycin is significantly improved but off the oxygen and is very eager to leave today patient also had an echocardiogram which revealed an EF of 55 to 60% LV wall motion was normal left atrium was severely dilated. Status post bioprosthetic aortic valve replacement which was in place. He was continued on Eliquis During his hospital course there were no complications. Discharged home today with follow-up. I have elected to send him home on 5-7 days of Levaquin patient reports he is does not tolerate Augmentin well

ID: 1036048
Sex: F
Age: 84
State: NY

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

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

Allergies: no

Symptom List:

Symptoms: temp to 102 severe back and hip pain obtunded

Other Meds: metoprolol, hydrochlorothiazide, meclizine

Current Illness: none

ID: 1036049
Sex: M
Age: 68
State: IL

Vax Date: 02/07/2021
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: dogs and cats

Symptom List:

Symptoms: while sleeping experienced what was described as a seizure taken to hospital by ambulance CT scan on arrival showed no indication for the seizure later in day EEG and MRI performed, no abnormalities found keppra (500 mg, twice per day prescribed) waiting for follow up appointment

Other Meds: simvastatin 20 mg/dy lisinopril 40 mg/day Xarelto 20 mg/dy omeprazole 20 mg/day Vitamin D 2000 units/day azelastine 205.5 mcg/spray, one spray/nostril twice/day

Current Illness: none

ID: 1036050
Sex: F
Age: 75
State:

Vax Date: 02/16/2021
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: Sore arm, swelling at injection site

Other Meds:

Current Illness:

ID: 1036051
Sex: F
Age: 70
State: SC

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: 01/27/2021 at 1514 Particpant c/o of fast heart beat, possible difficulty breathing and hand tingling. Assessed & noted p - 109, O2 sat 97%, skin warm / clammy with no discoloration at left upper arm injection site. Allergies verified and noted as Sulfur, Levaquin and PCN. Participant remained sitting and encouraged to deep breathe. At 1518 B/P 153/100, HR 102, O2 sat 98% with continued c/o. EMS activated at 1518 and pt moved to monitoring area; declined lying down, sat in chair for care. Post move to chair O2 sat drop to 90% then returned to 96%, HR 111. 1522 Administered Benadryl 50 mg IM right upper arm with no resp distress / rash noted. At 1554 participant voiced feeling better already with arrival of EMS noted

Other Meds: n/a

Current Illness:

ID: 1036052
Sex: M
Age: 36
State: NJ

Vax Date: 01/04/2021
Onset Date: 01/21/2021
Rec V Date: 02/17/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: S&S: "not 100%", leg pains, lumbar pain, stiff neck, short-term memory loss; Vital signs were stable; denies vision changes, H/A (nonretractable to meds), balance changes, weakness, speech abnormalities. Tx: Patient educated on post COVID-19 syndrome, Tylenol for pain, pseudoephedrine for congestion, labs for Liver enzymes, discussed possible neurology referral, follow-up w/ PCM on 2/4/2021 (14 days after initial visit).

Other Meds: Simvastatin 40mg daily Multi Vitamin Vitamin C Fish Oil Tylenol

Current Illness: COVID-19 positive (6Dec2020)

ID: 1036053
Sex: F
Age: 42
State: WI

Vax Date: 02/16/2021
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: anaphylaxis during previous source due to unknown source, allergies to multiple medications with resulting rash/pruritus lasting 4+ days

Symptom List:

Symptoms: about 8 minutes post vaccination client presented to monitoring staff with erythema in cheeks and possible erythema on chest. Client invited into ambulance stationed for monitoring for additional assessment. Initially just facial erythema and a 2"x2" section of redness on left chest wall. Vital signs normal at this time. No itching. in less than 5 minutes the redness progressed to full facial, neck, and chest erythema with some redness on right shoulder as well. Client reported itchy face, then upper body, then buttocks and abdomen in less than 5 more minutes. EMS was called, Benadryl 50 mg given PO. Vitals remained stable. EMS arrived, however client declined transport. Husband of client agreed to drive client to ER, and notify us on arrival. at 6:03 PM we received notification of arrival at ER and were able to speak with staff onsite as well. Per ER dose of steroid was given , no epinephrine given, pruritus resolved.

Other Meds: topiramate 75 mg, allegra 1 tab every AM, omeprazole 40 mg

Current Illness:

ID: 1036054
Sex: F
Age: 56
State: MN

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: Sulpha antibiotics

Symptom List:

Symptoms: Mild tenderness similar to regular flu shot until day 8 (2-11-21) Upper part of left arm swelled up became hot and tender to the touch. It itched. No noticeable redness. I used warm water in the shower and then cold pack on and off for about 2-3 days. The 4th day (Sunday) it got better and the swelling subsided.

Other Meds: Atenolol, Lantus, Metformin, Rosuvastatin, Vitamin D, aspirin, multivitamin, magnesium, vitamin B Complex.

Current Illness: none

ID: 1036055
Sex: F
Age: 53
State: RI

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: latex TYPE 1 hypersensitivity

Symptom List:

Symptoms: Numbness and tingling around mouth. Benadryl 25mg given at 1054am v/s at 1058am 145/82 p 74 r18 96% v/s 131/71 68 16 97% numbness and tingling resolved at 1122am

Other Meds: sertraline , zolpidem, atorvastatin, osphena, levothyroxine

Current Illness: n/a

ID: 1036056
Sex: F
Age: 67
State: FL

Vax Date: 02/04/2021
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: none

Symptom List:

Symptoms: Starting late 2/4 Body Ache, Tightness in Chest. Body Ache went away 2/6, tightness in chest improved. 2/1o Tightness in Chest came back. Went to Dr. Was given steroid shot, zpac, and breathing treatments. EKG was done. Returned to Dr, 2/12. Breathing better. Another EKG was done, little change. Went to Cadiologist on 2/15. Will have nuclear stress test on 2/18. Cardiologist feels that this is not heart or lung related based on consultation, thinks that it is Covid related.

Other Meds: Omeprazole,Rosuvastatin,AmLODLPine,OxybutyninER,Topiramate

Current Illness: Tested positive for Covid on 1/21 after 1st shot on 1/7

ID: 1036057
Sex: F
Age: 77
State:

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: thiazides, sulfonamides

Symptom List:

Symptoms: Patient's left middle finger became swollen and had a hard lump

Other Meds:

Current Illness:

ID: 1036058
Sex: F
Age: 50
State: KS

Vax Date: 01/20/2021
Onset Date: 01/20/2021
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: the evening of the second vaccine, patient had significant soreness and stiffness in her knee. In addition she had an elevated temperature for 2 days with fatigue, malaise and body aches. The knee issue progressed to require surgery for infection. On 2/12 she woke up with significant swell in in the area of the right temple and visual changes. this is the area of her cranial plate from prior brain surgery.

Other Meds: losartin, synthroid

Current Illness: none

ID: 1036059
Sex: M
Age: 70
State: IN

Vax Date: 01/08/2021
Onset Date: 01/08/2021
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: I believe the injection of the Moderna vaccine was made too high in my left upper arm resulting in a brachial neuritis. Commonly known as SIRVA. shoulder injury related to vaccine administration I had pain within 6 hours of the injection that was severe and was unable to sleep for control of pain for a good 48 hours. I had loss of strength of my arm on abduction and continued to have pain and weakness in my left arm nearly 6 weeks from the first injection. I have had my second Moderna vaccine subsequently at 28 days.

Other Meds: Olmesartan

Current Illness: none

ID: 1036060
Sex: F
Age: 94
State: TX

Vax Date: 01/26/2021
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:

Symptom List:

Symptoms: New onset seizure

Other Meds:

Current Illness:

ID: 1036061
Sex: F
Age: 55
State: WI

Vax Date: 02/10/2021
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:

Symptom List:

Symptoms: Received 2nd COVID vaccine on 02/10/2021. Healthcare provider received phone call on 2/15/21 from patient stating that her arm is red, warm to the touch and itchy. No respiratory issues.

Other Meds:

Current Illness:

ID: 1036062
Sex: F
Age: 69
State: CO

Vax Date: 02/09/2021
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: NKDA

Symptom List:

Symptoms: Shingles rash from stress of the vaccine

Other Meds: Prescriptions: Atenolol 25 mg tablet twice a day, Aspirin 81 mg one tab daily, citalopram 20 mg tablet once daily, losartan 100 mg tablet once daily, simvastatin 40 mg tablet once daily.

Current Illness: No illnesses

ID: 1036063
Sex: F
Age: 62
State: MI

Vax Date: 01/05/2021
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: n/a

Symptom List:

Symptoms: joint pain

Other Meds: mobic

Current Illness: n/a

ID: 1036064
Sex: F
Age: 71
State:

Vax Date: 02/15/2021
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: Penicillin, Levaquin, Cipro, Iodine, Lobster, shrimp, Walnuts, Eggplant Sensitivities to Eggs, Tomatoes,

Symptom List:

Symptoms: Moderna COVID-19 Vaccine EUA SIDE EFFECTS EXPERIENCED: Immediate burning at injection site Within an hour of injection and continuing for 24/36 hours: redness/rash for about 3 inches around injection site, mild headache, mild stomach upset, sore arm and soreness extended to back & under arm, general malaise. At 12 Hours plus: Rash on chest that only lasted for a few hours At 36 hour point: nausea, arm still sore

Other Meds: Olmesarten HZTZ 20 12.5

Current Illness:

ID: 1036065
Sex: F
Age: 73
State: OR

Vax Date: 02/10/2021
Onset Date: 02/13/2021
Rec V Date: 02/17/2021
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Allergies: NA

Symptom List:

Symptoms: severe vomiting and diarrhea for 4 days, could only consume clear liquids in very small amounts all over body aches

Other Meds:

Current Illness:

ID: 1036066
Sex: M
Age: 36
State: TX

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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Allergies: unknown

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Symptoms: Male neglected to inform staff that he had received first dose of pfizer covid vaccine in between his first and second dose of moderna covid vaccines.

Other Meds: unknown

Current Illness: unknown

ID: 1036067
Sex: F
Age: 77
State: MD

Vax Date: 01/30/2021
Onset Date: 02/08/2021
Rec V Date: 02/17/2021
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Allergies: Sulphur

Symptom List:

Symptoms: "COVID Toe" about 1 week after vaccination. Sympotom subsided after about 5 days, but resurfaced again after about 5 days.

Other Meds: Carbidopa-Levodopa 10-100MG Levothyroxine Sodium 75 MCG Fish Oil, Vitamin D-3, Vitamin B Complex Alpha Lipoic Acid (stopped taking about two months before vaccination)

Current Illness: Neuropathy

ID: 1036068
Sex: F
Age: 59
State: FL

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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Allergies: Latex, penicillin, gluten

Symptom List:

Symptoms: Hour 1-3 Intense nausea and chills Hour 2-5 Headache pain at injection site Hour 3-7 Intense Headache and pain radiated up trapezius into neck and side of head Hour 7 Took 400mg Ibuprofen, symptoms decreased significantly except for pain and restriction of movement in left arm and moderate headache.

Other Meds: Tirosint

Current Illness:

ID: 1036069
Sex: F
Age: 52
State: GA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/17/2021
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Allergies: Penicillin, Voltaren

Symptom List:

Symptoms: sore arm, hard and hot to the touch, extreme/severe vomiting, chills and high fever (102+), elevated heart rate for extended period (130+), blood oxygen levels fell 10 91-92. Low shallow breathing with dry intermittent cough. 2nd day extreme fatigue, shallow breathing. sore neck at the base of my skull with pain in eyes and sensitivity to light, accompanied with fluid sensation in years. lack of appetite. 3rd day, sore chest and rapid heart rate, and sore chest cavity, prickly rash on chest and torso. fatgue

Other Meds: N/A

Current Illness: N/A

ID: 1036070
Sex: M
Age: 63
State: TN

Vax Date: 01/30/2021
Onset Date: 02/05/2021
Rec V Date: 02/17/2021
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Allergies: amoxicillin

Symptom List:

Symptoms: I have developed a rash over my upper part of my body.

Other Meds: rbesartan tabs 150mg Fluticasone prop nasal spray 50mcg Atorvastatin 20 mg montelukast sod 10 mg

Current Illness: none

ID: 1036071
Sex: F
Age: 35
State: MD

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 02/17/2021
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Symptoms: Muscle pain, Joint pain in fingers/wrist/elbow, fatigue, low grade fever, diarrhea, pain in injection site, headache

Other Meds: Allegra Folate Fish Oil Motrin

Current Illness:

ID: 1036072
Sex: M
Age: 79
State:

Vax Date: 02/08/2020
Onset Date: 02/08/2021
Rec V Date: 02/17/2021
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Symptoms: Patient became dizzy and hypotensive 70's systolic after receiving his 1st PFIZER COVID-19 MRNA VACCINATION. Patient was taken to the ER.

Other Meds:

Current Illness:

ID: 1036073
Sex: F
Age: 43
State: LA

Vax Date: 02/04/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
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Allergies: None known

Symptom List:

Symptoms: About 8 days after injection, injection site became sore again. I had a knot at injection site and it was red and hot. Redness spread to about 3 inches in diameter and was warm to the touch. Very mild itching at injection site. This lasted 2-3 days, then began to subside. I didn?t go to the doctor and I didn?t take any medication for it either orally or topically.

Other Meds: OrthoTriCyclen Lo

Current Illness: None

ID: 1036074
Sex: F
Age: 50
State: MI

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

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Allergies: Allergy status to penicillin

Symptom List:

Symptoms: Patient had an allergic reaction after the vaccine . Onsite EMS was called vitals were taken BP 162/88 99% O2 room air HR 86. Patient was treated, Transported by the EMS to the hospital.

Other Meds:

Current Illness:

ID: 1036075
Sex: F
Age: 78
State: MN

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
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Symptoms: Red area surrounding injection site. has been increasing in size each day, taking up most of the upper area of her left shoulder. Is itchy and warm to the touch. Slightly swollen at direct inject site.

Other Meds:

Current Illness:

ID: 1036076
Sex: M
Age: 66
State: NH

Vax Date: 02/12/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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Allergies: Penicillin

Symptom List:

Symptoms: Afib initiation

Other Meds: Carvedilol, Simvastatin, Eliquis

Current Illness: None

ID: 1036077
Sex: F
Age: 67
State: MI

Vax Date: 01/19/2021
Onset Date: 01/29/2021
Rec V Date: 02/17/2021
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Allergies: pencillian

Symptom List:

Symptoms: 1/29/21 rash at injection site on left arm, feverish, looked blistered, itchy, rash at baseline of neck, rash on right arm from top to below elbow crease inside of arm, very itchy but no blisters. Used benadryl cream on rash & took benadryl tabs at night. Severe itching lasted about 5 to 6 days. No longer needed tabs after that, continued cream about 10 days

Other Meds: advil cold & sinus, miralax, flonase spray, stool softener, citracal slow release, B12, prilosec OTC, osphena, myrbetriq, hydrochloride, losartan pot, metoprolo tartrate

Current Illness: none

ID: 1036078
Sex: M
Age: 70
State: CO

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/17/2021
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Allergies: None

Symptom List:

Symptoms: Possible delayed reaction to Pfizer first dose resulting in rash and hives that have continued for eleven days (and counting). Hives appear on all areas of body except site of injection, soles of feet, knees and mid-chest and mid-back areas. Hives have gradually spread over last four days.

Other Meds: Amlodipine, Montelukast, Symbicort

Current Illness: None

ID: 1036079
Sex: F
Age: 32
State: IL

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
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Allergies: None known

Symptom List:

Symptoms: A week after the vaccination (Friday), I developed a red welt at the injection site. It was itching, red, and hot to the touch. The next day (Saturday), it continued to be itchy and grew in size. Around 6:00pm, I took benadryl. By Sunday morning, the redness had lessened and it did not grow in size. I took benadryl throughout the day on Sunday. By Monday, it was completely gone and no longer needed benadryl.

Other Meds: None

Current Illness: None

ID: 1036080
Sex: M
Age: 70
State: FL

Vax Date: 01/31/2021
Onset Date: 02/01/2021
Rec V Date: 02/17/2021
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Allergies: Penicillin as a child

Symptom List:

Symptoms: Numbness in fingers and wrists; painns in shoulder, pectoral and scapula areas.

Other Meds: Vitamins D, C, Zinc, B12

Current Illness: None

ID: 1036081
Sex: F
Age: 30
State: IL

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

Symptom List:

Symptoms: Chills, fever 103.0 , muscle and joint ache, headache, nausea, vomiting, sore left arm at injection site and lump in under left armpit

Other Meds: Tylenol 500 mg

Current Illness: N/A

ID: 1036082
Sex: F
Age: 62
State: RI

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
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Allergies: food unknown

Symptom List:

Symptoms: c/o of hands itching at 1125am Benadryl 25mg given at 1125am bp 169/95 p 69 99% r 18 1133am itching decreased bp 159/92 p 73 r 18 1150am vitals at 135/83 70 16 98% itching resolved and sent home.

Other Meds: metform

Current Illness:

ID: 1036083
Sex: F
Age: 49
State: CA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
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Allergies: none

Symptom List:

Symptoms: Had the shot in my left arm. Felt normal "after vaccination soreness" but as the night progressed I had a lot of pain radiating from my left elbow to my left thumb. Felt like a broken bone. Pain was definitely radiating from the bone that extends from my thumb to elbow. Finally took 2 tylenol and that worked wonders. Just haven't heard anything about bone pain and wanted to make sure to report it. I also felt a small amount of pain in my left breast but that didn't last long.

Other Meds: Losartan and Cozar

Current Illness: none

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm