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
72,296
AK1,638
AL5,339
AR3,412
AS44
AZ13,316
CA58,147
CO11,002
CT7,824
DC1,626
DE1,670
FL36,235
FM3
GA13,429
GU82
HI2,195
IA4,332
ID2,473
IL19,261
IN22,568
KS4,284
KY6,945
LA4,714
MA13,886
MD11,901
ME2,997
MH8
MI17,865
MN11,345
MO8,919
MP30
MS2,676
MT2,147
NC15,401
ND1,273
NE2,732
NH2,859
NJ17,232
NM3,702
NV4,071
NY32,763
OH18,072
OK5,940
OR7,954
PA22,457
PR2,104
QM2
RI1,911
SC6,055
SD1,133
TN8,691
TX34,122
UT4,023
VA13,944
VI49
VT1,661
WA13,811
WI10,395
WV2,220
WY805
XB5
XL1
XV2

ID: 1058346
Sex: F
Age: 73
State: IN

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/26/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Voltarin, Codiene

Symptom List:

Symptoms: Chills, Body aches, Headache

Other Meds: Olmesartan Medox/HCTZ, Est Estrgn Methtest, Famotidine, Simvastatin, Tramadol, Omeprazole, CoQ10, Reacted Zinc, Vitamin D, Multi-Vitamin, Curcumin, Lutein Zeaxanthin, Bayer Low Dose Aspirin, Tylenol, Glucosamine Chondrotin, Fish Oil

Current Illness: None

ID: 1058347
Sex: F
Age: 65
State: PA

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

Vax Type:
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Lab Data:

Allergies: none

Symptom List:

Symptoms: fever 101.5, aches, joint pain, headache

Other Meds: Atorvastatin 40 mg, chewable baby aspirin , iron, carbonyl 45 mg Tab,omega-3 fatty acids-fish oil 340-1,000 mg cap capsule fluticasone propionate 50 mcg/actuation nasal spray, coenzyme Q10 10 mg capsule, ascorbic acid (vitamin C) 250 MG tab

Current Illness: none

ID: 1058348
Sex: F
Age: 69
State: CA

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: After booster: Chills, Fever, severe headache, severe body aches, foggy thinking, unable to walk, slept all day, very weak, couldn?t remember what happen rest of day after booster (2-24) or then next day during sever reaction.(2-25) Day of shot arm hurt for several hours then went away. Day 3 still listless, tired, headache, foggy.

Other Meds: Nortryptaline. Cynthroid MultiVitamin Niacin B-1

Current Illness: None

ID: 1058349
Sex: F
Age: 58
State: CA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/26/2021
Hospital:

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Symptom List:

Symptoms: After the second vaccination employee experienced minor symptoms on day 1 and day 2 with headaches, feeling hot/cold alternating, arm pain, muscle aches. Day 3-5, employee became more sick with mild intermittent chest pains, extreme exhaustion, muscle aches and spasms, dizziness, headaches, feeling hot and cold alternating, but no fevers noted. Day 7, employee started to feel better, but symptoms continued with fatigue which persisted for a several days until she was back to baseline

Other Meds:

Current Illness:

ID: 1058350
Sex: F
Age: 88
State: AL

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
Hospital:

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Symptom List:

Symptoms: PFIZER-BIONTECH COVID-19 VACCINE EUA. ADMINISTRATION ERROR: Resident documented as receiving 3 doses of vaccine. First dose of Pfizer COVID-19 vaccine on 1/12/21. Second dose documented on 2/2/21. Resident was vaccinated on 2/23/21 with paperwork showing only had 1 dose previously. Patient has no adverse reactions reported to date.

Other Meds:

Current Illness:

ID: 1058351
Sex: F
Age: 32
State: NY

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

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Symptom List:

Symptoms: Ten minutes post 2nd Pfizer vaccine patient complained of chest uneasiness and tachycardia. She also complained of diaphoresis and dizziness.

Other Meds:

Current Illness:

ID: 1058352
Sex: F
Age: 58
State: KS

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital:

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Symptom List:

Symptoms: Progress Notes (Nurse Practitioner) - - Family Medicine Attempt to call patient for follow up via phone. No answer. Progress Notes APRN (Nurse Practitioner) - - Family Medicine Cosign Needed Expand AllCollapse All COVID VACCINE CLINIC 2/24/2021 Patient: Date: 2/24/2021 MRN: 1356120 Subjective Patient is a 58 y.o. female who was seen at COVID Vaccine Clinic today for her first dose of the COVID 19 vaccination. She was given the Pfizer vaccination in the left deltoid muscle. During her 15 minute waiting period after the injection, the patient began to experience tip of tongue tingling/burning. She denied rash, difficulty breathing, difficulty swallowing, wheezing, throat tightness, hoarseness, stridor, itching, lightheadedness, dizziness, facial swelling, lip swelling and tongue swelling. This provider was notified of patient reaction and she was then assessed in the emergency bay area. Monitored patient for severe reaction symptoms, including but not limited to drooling, rapid progression of symptoms, respiratory distress, tongue swelling and vomiting. Pt reports that she may have burned the tip of her tongue this am after eating hot oatmeal. She wanted to be evaluated to be sure if that was the issue and not an allergic reaction. PMH includes HTN: takes 10 mg of Lisinopril ALLERGY REVIEW OF SYSTEMS: Patient denies chills, malaise/fatigue, facial swelling, sore throat, frequent throat clearing, cough, chest tightness, shortness of breath, wheezing, rash, cysts, muscle aches, dizziness and headaches Previous Reactions: none Objective Vitals Vitals: 02/24/21 0912 02/24/21 0920 02/24/21 0927 BP: (!) 144/79 126/82 132/71 Pulse: 75 67 SpO2: 99% 100% Physical Exam Vitals and nursing note reviewed. Constitutional: General: She is not in acute distress. Appearance: Normal appearance. She is well-developed. She is not diaphoretic. HENT: Mouth/Throat: Mouth: Mucous membranes are moist. Pharynx: Oropharynx is clear. Comments: No visible burn noted to tip of tongue. No swelling or discoloration noted. Eyes: Conjunctiva/sclera: Conjunctivae normal. Pupils: Pupils are equal, round, and reactive to light. Neck: Thyroid: No thyromegaly. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Heart sounds: Normal heart sounds. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No wheezing. Skin: General: Skin is warm and dry. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Psychiatric: Mood and Affect: Mood normal. Behavior: Behavior normal. Thought Content: Thought content normal. Judgment: Judgment normal. Assessment/Plan Treatment included: water Follow up response to treatment: good. Patient discharge: Stable to go home and follow up with PCP. Differential Diagnosis: Vaccine-Related Anxiety (include misc mental health) Encouraged to monitor symptoms at home. She is aware of f/up care with ED if she does progress in symptoms of allergic reaction. This time I think she has the burnt tip of her tongue sensation. F/up with pcp otherwise. APRN Electronically Signed 2/24/2021 9:40 AM

Other Meds:

Current Illness:

ID: 1058353
Sex: F
Age: 65
State: NC

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 02/26/2021
Hospital:

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Lab Data:

Allergies: Sulfa, ampicillin, opiates.

Symptom List:

Symptoms: Following the vaccine her arm was sore to the touch for a couple of days. Then around the 15th in the morning she got up and noticed a small bump on her arm, and it started to spread. It looks like a reaction from a TB positive shot. Yesterday it started itching, 2/25/21, started to put some cortisone cream on it, and it has turned redder since then. She continues to have the itching. The area has spread more on her arm, but nothing else has changed. She is going to call her doctor today as she is still having the symptoms.

Other Meds: Amlodipine, Deloxepin, Trulance.

Current Illness: None.

ID: 1058354
Sex: F
Age: 32
State: NJ

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

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Lab Data:

Allergies: KIWI

Symptom List:

Symptoms: progressive soreness diffuse erythema around injection site rigors/chills

Other Meds: NA

Current Illness: NA

ID: 1058355
Sex: F
Age: 72
State: WI

Vax Date: 02/02/2021
Onset Date: 02/06/2021
Rec V Date: 02/26/2021
Hospital:

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Lab Data:

Allergies: ampicillan

Symptom List:

Symptoms: Hair loss starting February 6, 2021 and continuing. Approximately 40% of the hair on my head has fallen out. I am taking Biotin and Hair, skin, & nails pills to help correct this.

Other Meds: Lansoprazole, Simvastatin, Trazodone, Olopatadine HCL, Vit D3

Current Illness:

ID: 1058356
Sex: F
Age: 45
State: OH

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
Hospital:

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Lab Data:

Allergies: Codeine

Symptom List:

Symptoms: Soreness at injection site Headache Fever (100.9) Chills Body aches

Other Meds: 80mg propranolol 150mg bupropion Women's One A Day 3000mcg B12 1000IU D3 500mg C

Current Illness:

ID: 1058357
Sex: M
Age: 62
State: GA

Vax Date: 01/29/2021
Onset Date: 02/05/2021
Rec V Date: 02/26/2021
Hospital:

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Lab Data:

Allergies: Shrimp

Symptom List:

Symptoms: One week following second dose, I experienced a urticarial reaction to a meal. I have never had allergies prior to this type of reaction. Upon allergy testing after this event on 2/19/21, an allergy to shrimp was noted. This report is intended to document a brand new food allergy that occurred one week after receiving second dose of COVID vaccine. Treated with one tablet of Benadryl and reaction subsided thereafter.

Other Meds: Heliocare Advanced and Finasteride

Current Illness: None

ID: 1058358
Sex: M
Age: 77
State: WI

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: 2/24/2021 admitted to hospital with hypoxia, lethargy, rash, altered mental status with HA. Altered mental status with HA, could be due to metabolic encephalopathy and reaction to COVID-19 vaccine. Will check ABG, CT head. Hold gabapentin. Check depakote level. Rash, likely due to allergic reaction to COVID-19 vaccine, hx of reaction to first COVID-19 vaccine with fever needing hospitalization. Start patient on Solu-Medrol and Pepcid. Benadryl p.r.n. Suspected right lower extremity cellulitis, start patient on Ancef. Check MRSA, will rule out right DVT Abn CXR, Bilateral LE edema, CXR seems stable to me, clinically no pneumonia. He does not have "hypoxia" when I was in room, however assisted living reporte 2/24/2021 admitted to hospital with hypoxia, lethargy, rash, altered mental status with HA. Altered mental status with HA, could be due to metabolic encephalopathy and reaction to COVID-19 vaccine. Will check ABG, CT head. Hold gabapentin. Check depakote level. Rash, likely due to allergic reaction to COVID-19 vaccine, hx of reaction to first COVID-19 vaccine with fever needing hospitalization. Start patient on Solu-Medrol and Pepcid. Benadryl p.r.n. Suspected right lower extremity cellulitis, start patient on Ancef. Check MRSA, will rule out right DVT Abn CXR, Bilateral LE edema, CXR seems stable to me, clinically no pneumonia. He does not have "hypoxia" when I was in room, however assisted living reported he was hypoxic this AM, wife said he was wheezy on Sunday could be due to acute on chronic diastolic congestive heart failure, IV Lasix x1. reeval in AM. Echo TTE is pending Abdominal pain and distension, CT abdomen without contrast to rule out other etiology that can cause altered mental status Hx of COVID-19 pneumonia, history of CVA with dense right hemiplegia and expressive aphasia, chronic atrial fibrillation, depression, Will reorder home meds after pharmacist reconciles medication list Generalized weakness, PT/OT DVT prophylaxis warfarin and SCD

Other Meds: Coumadin 3 mg PO HS, Vitamin C 1000mg PO daily, Cholecalciferol 125mcg PO daily, Lasix 10 mg PO daily, Protonix 40mg PO HS, Zincate 220(50Zn) one tablet PO daily, Pramoxine (Sarna Sensitive) 1% lotion apply topically 2 times daily after usi

Current Illness: COVID positive 12/30/2020

ID: 1058359
Sex: F
Age: 82
State: SC

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

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Lab Data:

Allergies: sulfa, Celebrex, Depakote, Dilantin, minocin

Symptom List:

Symptoms: lethargy, numbness in legs, nausea, headache

Other Meds: furosemide, baclofen, hydromorphone, tizanidine, levothyroxine, myrbetriq, gabapentin

Current Illness: None

ID: 1058360
Sex: F
Age: 68
State: NJ

Vax Date: 02/15/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital:

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

Allergies: No

Symptom List:

Symptoms: Nine days after my initial shot I noticed a big red rash on my arm, 3x3, very itchy and warm to the touch. The next day it looked a little bigger and today its even bigger. Not itchy today but very sore. Sent my doctor an email and doctor said it sounds like COVID arm.

Other Meds: No

Current Illness: No

ID: 1058361
Sex: M
Age: 60
State: LA

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

Vax Type:
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Vax Name:
Lot:
Dose Series:
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Lab Data:

Allergies: Lisinopril, wheat

Symptom List:

Symptoms: Fever 100.6, nausea, headache

Other Meds: Eliquis, pantrazole sodium, amlodipine besylate

Current Illness: DVT, PE

ID: 1058362
Sex: F
Age: 59
State: CO

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/26/2021
Hospital:

Vax Type:
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Vax Site:

Lab Data:

Allergies: None known

Symptom List:

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA: patient presented to the emergency department two days after receiving second dose of vaccine with persistent nausea and vomiting. Symptoms started the evening of the day the vaccine was administered. Vital signs within normal ranges. Patient observed in emergency department, adminstered intravenous fluids, diphenhydramine, and ondansetron which improved symptoms, and discharged to home stable.

Other Meds: amitripyline, duloxetine, fluconazole, lorazepam, prochlorperazine, rivaroxaban, trazodone, fam?trastuzumab deruxtecan, granisetron

Current Illness: metastatic breast cancer (undergoing chemotherapy)

ID: 1058363
Sex: F
Age: 59
State: WA

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Penicillin(rash)

Symptom List:

Symptoms: Chills and 104F fever for four hours. Pain in left arm and down left side to waist for 48 hours.

Other Meds: Multi-vitamin, calcium, vitamin D, Finasteride 1mg

Current Illness: None

ID: 1058364
Sex: F
Age: 39
State: NY

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/26/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Fever, sore arm, joint pain, confusion and disorientation, fatigue and sleepiness, malaise, weakness

Other Meds:

Current Illness:

ID: 1058365
Sex: F
Age: 68
State: NY

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

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

Lab Data:

Allergies: penicillin

Symptom List:

Symptoms: complained of blurred vision

Other Meds:

Current Illness:

ID: 1058366
Sex: F
Age: 56
State: NC

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

Vax Type:
Manufacturer:
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Lab Data:

Allergies: Ethanol, Wasps, bees

Symptom List:

Symptoms: 15 minutes after receiving shot, extreme fatigue, blurry vision, bp 250/200. ON the medic transport to ER, Left side weakness, loss of speech. Er evaluated for sudden onset left sided weakness, facial droop.Code stroke was called CT angiography was unremarkable and patient admitted for bp control. Bp normalized with Clonidine , neurological exam is stable. Md felt that thus was a combination adverse reaction to vaccine in combination with Wellbutrin. Discharge after 24 hours

Other Meds: Chlorthalidone 25 mg, Losartan 100 mg, vitamin D, MVI, Potassium Chloride 10 meQ, Wellbutrin150 mg

Current Illness: none

ID: 1058367
Sex: F
Age: 50
State: IN

Vax Date: 02/17/2021
Onset Date: 02/21/2021
Rec V Date: 02/26/2021
Hospital:

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Lab Data:

Allergies: PHENERGAN - JUST EPS SYMPTOMS. NOTHING LIFE THREATENING.

Symptom List:

Symptoms: Entire body aches terribly. extreme nausea and a headache not relieved by OTC medication. Full blown malaise.

Other Meds: SERTRALINE 200MG QD

Current Illness: N/A

ID: 1058368
Sex: F
Age: 53
State: NJ

Vax Date: 02/12/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies:

Symptom List:

Symptoms: 3" raised, itchy rash at injection site.

Other Meds: Tamoxifen 20 mg Vitamin D3 25 mcg

Current Illness:

ID: 1058369
Sex: F
Age: 35
State: TX

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 02/26/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: I had horrible body aches, chills, fever (100.8).It felt impossible for me to move around. I was in early stage of my pregnancy took a test on 1/7. My first doctor appt was 2/1 was told 8 weeks pregnant had a ultrasound didn't show any yoke or fetus. I had multiple ultrasounds done that week to enI had to have a DNC on 2/10 done and I'm still waiting on my DNA chromosomes to come back (plasenta show abnormality).(estimated date of delivery Pt stated around Sept 2021)

Other Meds: Zyrtec (per diem)

Current Illness: No

ID: 1058370
Sex: F
Age: 54
State: KY

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

Vax Type:
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Lab Data:

Allergies: sulfa

Symptom List:

Symptoms: Have been having random low grade fevers (99-100 degrees) my normal temperature is 96.8 and headaches when I wake up in the morning. After a week the headaches are starting to ease. The fevers continue.

Other Meds: Synthroid 200mcg, birth control, shatavari, neem, ashwaghanda, vitamin D, magnesium, multi-vitamin, zinc, CBD 40mg, tumeric 1000mg, probiotic

Current Illness:

ID: 1058371
Sex: F
Age: 65
State: PA

Vax Date: 02/13/2021
Onset Date: 02/17/2021
Rec V Date: 02/26/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Developed pruritic rash 4 days after second COVID vaccine injection that continued to progress for the next week despite the use of Benadryl

Other Meds: Levothyroxine 125 mcg daily

Current Illness: None

ID: 1058372
Sex: M
Age: 80
State: IL

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital:

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Lab Data:

Allergies: morophine

Symptom List:

Symptoms: Received second dose of Moderna instead of Pfizer vaccine.

Other Meds: calcitriol 0.25 mg 1 tab qd Vit D3 5000U 1 tab qd duloxetine DR 60 mg 1 tab qd spironolactone 50 mg 1 tab qd ASA 325 mg 1 tab qd K 10 meq 2 tab qd multivit 1 qd Zinc 50 mg 1 qd calcium 600 mg 1 qd Vit C 1000 mg 1 qd gabapentine 100 mg tid

Current Illness: UTI /sepsis Was in rehab after kidney stone/UTI/sepsis. Was on vent part of this admission

ID: 1058373
Sex: F
Age: 40
State: MO

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/26/2021
Hospital:

Vax Type:
Manufacturer:
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Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: extreme dizziness ringing in ears vomiting elevated heart rate elevated blood pressure headache itching sensation under skin nystagmus transported by ambulance from home to the emergency room treated via IV, benadryl, meclizine, anti-nausea medication

Other Meds: Mirena (IUD)

Current Illness: none

ID: 1058374
Sex: F
Age: 65
State: WI

Vax Date: 02/01/2021
Onset Date: 02/12/2021
Rec V Date: 02/26/2021
Hospital:

Vax Type:
Manufacturer:
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Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: Temperature, chills, extreme body ache, nausea, fatigue ,headache , extreme muscle pain

Other Meds: Multi vitamin Vitamin D3

Current Illness: None

ID: 1058375
Sex: F
Age: 78
State: AR

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/26/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies: NO

Symptom List:

Symptoms: my arm was black and blue, I woke up with head hurting diarrhea for 4 days, then I started having whelps all the way to my ears and down my chest and today Feb 26 I still have them but not as bad. Is it ok to take my 2nd shot March 8th ?

Other Meds: bby ASPIRIN, ATORVASTATIN, CARVEDILOL, CLOPOGREL, FAMOTIDINE, LOSARTAN, MULTIVITAMIN, FUROSEMIDE, NIFEDIPINE, ZINK , VIT D,

Current Illness: I had a pneumonia shot 13 days before my virus shot.

ID: 1058376
Sex: M
Age: 71
State: MO

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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Symptoms: Resident was given a third Moderna COVID19 vaccine on 2/23. The others were given 12/30/20 and 1/27/21. No adverse events have been reported to date.

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Current Illness:

ID: 1058377
Sex: M
Age: 76
State: NC

Vax Date: 02/16/2021
Onset Date: 02/22/2021
Rec V Date: 02/26/2021
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Allergies: none

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Symptoms: Woke to pool of blood from blood blister on scrotum. Bleeding stop with direct pressure. NEVER had blood blisters, especially on my scrotum. Remembered that Nurse questioned me about "blood thinning medication". I said "No, just a baby aspirin (81mg)", she gave me a questioning look and vaccinated me. I have stopped the baby aspirin and the blood blisters are fading slowly.

Other Meds: aspirin - 81 mg carvedilol (coreg) - 3.125 mg (beta blocker) aspirin - 81 mg carvedilol (coreg) - 3.125 mg (beta blocker) rosuvastatin (crestor) - 20 mg pantoprazole (protonix) - 40 mg dutasteride (avodart) - 0.5 mg tamsulosin (flomax) - 0.

Current Illness: none

ID: 1058378
Sex: M
Age: 76
State: CA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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Allergies: NKDA

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Symptoms: 77 year old male presents with SOB x "2 minutes" after vaccination. Pt has multiple comorbidities and poly pharmacy. Pt. is accompanied by 2 daughters who states that he is late with taking medication. Pt is currently "feeling better" and has refused emergency medical transport, .

Other Meds: Janvia, Singulair, Albuterol, Isosorbide

Current Illness: UNK

ID: 1058379
Sex: M
Age: 86
State: KY

Vax Date: 02/23/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
Hospital: Y

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Allergies: Motrin

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Symptoms: 1st dose vaccine 2/23/21; EMS called after pt fell at home 2/25/21; taken to ED and admitted to hospital DX: 1. Right-sided nontraumatic intracerebral hemorrhage, unspecified cerebral location (CMS/HCC) I61.9 431 2. Long term (current) use of anticoagulants Z79.01 V58.61 3. Sensory neglect (left sided) R41.4 781.8 currently still admitted to hospital at the time of this report

Other Meds:

Current Illness: Multiple; see chart

ID: 1058380
Sex: F
Age: 38
State: VA

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
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Allergies: None

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Symptoms: 101.7 degree fever for around 3 hours, the next day around 6pm.

Other Meds: Buspar, Lexapro, gummy vitamins

Current Illness: None

ID: 1058381
Sex: F
Age: 79
State: OH

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/26/2021
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Allergies: Wellbutrin Fosamax

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Symptoms: Tiredness, queasy, itching/rash, feeling of not being well. On days 9 & 10, arm was painfully itchy and a rash developed on my stomach and breasts. Exhaustion lasted 3 weeks.

Other Meds: Armour Thyroid , Xarelto, Metoprolol, Gabapentin, Prolia D3, Magnesium, B-12, B-1

Current Illness:

ID: 1058382
Sex: F
Age: 52
State: KS

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
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Symptoms: Progress Notes (Nurse Practitioner) Pt called for follow up s/p covid-19 vaccine done on 02/24/21. She reports doing well and better today. She still has a sore arm where the injection site is. No redness or swelling nor fever. She also states that her cotton mouth sensation is gone. She is overall well. Pt is appreciative for the phone call. Denies any other concerns. Progress Notes (Nurse Practitioner) Attempt to reach patient for follow up. No answer. Progress Notes (Nurse Practitioner) Cosign Needed Expand AllCollapse All Date: 2/24/2021 Subjective Pt is a 52 y.o. female who was seen at COVID Vaccine Clinic today for her first dose of the COVID 19 vaccination. She was given the Pfizer vaccination in the right deltoid muscle. During her 30 minute waiting period after the injection, the patient began to experience chills/shaking "as if my internals are trying to come out.". She also reports of R arm pain "as if someone socked me in the arm" at injection site. She denied rash, difficulty breathing, difficulty swallowing, wheezing, throat tightness, hoarseness, stridor, itching, lightheadedness, dizziness, facial swelling, lip swelling and tongue swelling. This provider was notified of patient reaction and she was then assessed in the emergency room area. Monitored patient for severe reaction symptoms, including but not limited to blood pressure abnormality , chest pain, collapse, hypotension, rapid progression of symptoms, respiratory distress, skin changes, tongue swelling and vomiting. PMH: depression/PTSD, recovered alcoholic and pill user x 8 years come this April. Currently on Zoloft, Abilify, Wellbutrin. ALLERGY REVIEW OF SYSTEMS: Patient complains of chills, muscle aches (R arm pain where injection site was) and headaches (she developed a headache later while she was in the bay about 15 minutes into her visit. Rates pain at 8/10) Patient denies fever, malaise/fatigue, facial swelling, ear pain, itching in ears, sore throat, frequent throat clearing, eyes watering, eyes itching, puffy eyes, eye redness, cough, chest tightness, shortness of breath, wheezing, rash, hives, eczema, itching of skin and abdominal pain She reported about 15 minutes into her visit with me of "Sudden onset of dry mouth.": Previous Reactions: when she was younger, she had an adverse reaction, unable to recall what, to the chicken pox vaccine. She's only been able to get one shot. She's tolerated other vaccines w/o issues. Objective Vitals Vitals: 02/24/21 0907 02/24/21 0926 02/24/21 0943 02/24/21 1000 BP: 135/84 128/71 120/73 101/71 BP Location: Left arm Left arm Patient Position: Sitting Sitting Pulse: 93 82 68 SpO2: 97% 100% Physical Exam Constitutional: General: She is not in acute distress. Appearance: Normal appearance. She is well-developed. She is obese. She is not diaphoretic. Comments: intially appeared fatigued, not as alert. After drinking water, eating a granola bar. She started to come around HENT: Mouth/Throat: Mouth: Mucous membranes are moist. Eyes: Extraocular Movements: Extraocular movements intact. Conjunctiva/sclera: Conjunctivae normal. Pupils: Pupils are equal, round, and reactive to light. Neck: Thyroid: No thyromegaly. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Heart sounds: Normal heart sounds. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No wheezing. Musculoskeletal: Cervical back: Neck supple. Skin: General: Skin is warm and dry. Comments: R arm inspected. Warm, no erythema, swelling nor rash. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Psychiatric: Mood and Affect: Mood is anxious. Affect is flat. Comments: initially flat/anxious. Pt was able to have normal mood by end of visit. Assessment/Plan Treatment included: water, snacks and ibuprofen for headache Follow up response to treatment: excellent. Patient discharge: Stable to go home and follow up with PCP. Differential Diagnosis: Vaccine-Related Anxiety (include misc mental health), Local reaction (arm pain, bleeding/bruising, mechanical irritation, localized rash) and Red flag symptoms (CP, SOB, NVD, Visual/Neuro concerns) Doing well after observation. She has a ride. She was able to ambulate out to the front with co-worker. She is aware of precautions to watch for. Advised to place warm compress or ice to R arm. F/up with pcp as needed. Electronically Signed 2/24/2021 12:50 PM

Other Meds:

Current Illness:

ID: 1058383
Sex: F
Age: 65
State: MI

Vax Date: 02/18/2021
Onset Date: 02/22/2021
Rec V Date: 02/26/2021
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Allergies: Levaquin

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Symptoms: Red rash about the size of a half dollar, slightly raised with itching over the vaccine injection site

Other Meds: Breo, singular, Flonase, gentamicin sinus rinse, folic acid, vitamin D

Current Illness: None

ID: 1058384
Sex: F
Age: 41
State: GA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/26/2021
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Allergies: Gluten, mollusks, nuts, seasonal allergies

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Symptoms: Migraine, head pressure, ringing ears, dizziness. Now I have Vestibular migraines, I am off balance. Still have dizziness, and head pressure. Headache comes and goes. First 2 days I also had inside vibration and energy zap in my whole body.

Other Meds: Famotidine 40 mg 2x a day Ibuprofen 400 when needed

Current Illness: Celiac

ID: 1058385
Sex: M
Age: 83
State: CA

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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Allergies: none

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Symptoms: At 8:30am, 2/26/21, He was asleep on chair in dining room. Very hard to wake him up! I got him to a recliner, but then he had to throw up. He said he was "foggy" and went to sleep when he got back to the recliner. At 11:45am, his blood pressure was 66/47, then 71/48 in his left arm. In his right arm, 74/51. He did have some top ramen soup and was feeling better. I took his temperature earlier and it was 96.1.

Other Meds: Finasteride 5mg 1/day; Tamsulosin 0.4mg 2/day; Lisinopril 40mg 1/day; Triam/HCTZ 37.5/25, 2/day; Atorvstatin 10mg, 1/day; HydrAlazine 50mg, 2/day; Labetalol 200mg, 2/day; Eliquis 5mg, 2/day; Fluticasone Propionate 50mcg, as needed; PreserV

Current Illness: none

ID: 1058386
Sex: F
Age: 60
State: CT

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
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Allergies: no known drug allergies

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Symptoms: Patient called to report that approximately 12 hours after receiving her second dose of SHINGRIX, she experienced feeling feverish (did not take a temperature to confirm), chills, and later felt sweaty and fainted. No injuries were sustained. Patient went back to bed and when she awoke, all of the symptoms were gone and she felt back to normal, no fever.

Other Meds: unknown, not disclosed

Current Illness: none disclosed

ID: 1058387
Sex: F
Age: 57
State: VA

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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Allergies: amoxicillin

Symptom List:

Symptoms: Facial, neck, and chest flushing, hypertensive, tachycardia, dizzy, nausea, anxious. EpiPen administered at 1128.

Other Meds: Prednisone, Hydroxychloroquine, Citalopran, clonazepam, ruvastatin, valtrex,

Current Illness:

ID: 1058388
Sex: F
Age: 68
State: MO

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
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Symptoms: Patient went to the restroom after her vaccine and when she came out, she was walking to her seat and had mid-sternal chest pain.

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Current Illness:

ID: 1058389
Sex: M
Age: 93
State: MD

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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Allergies: NKA

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Symptoms: Originally patient received 0.1ml dose of Moderna vaccine. Patient called and returned to the vaccination site where they were administered 0.5 ml of Moderna vaccine (as instructed) in patient's left arm. This was his second dose.

Other Meds: None disclosed

Current Illness: None disclosed

ID: 1058390
Sex: F
Age: 69
State: OH

Vax Date: 02/18/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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Allergies: None that I?m aware of

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Symptoms: Six days after getting the vaccine I started itching in my armpits and the next day I got a large rash around my injection site. This area is hard and itchy and is a bit swollen.

Other Meds: Vitamin D and zinc

Current Illness: None

ID: 1058391
Sex: F
Age: 0
State: PA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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Allergies: none

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Symptoms: There was no reaction from shots but the 4th dose of DTaP, PCV and IPV and Rotavirus were administered @ 8 months 3rd dose of Hib was given. She had Pentacel on 7/28/2020 and 10/2/2020. PCV - 7/28/2020, 10/2/2020, 12/18/2020 and 2/25/2021 Rotavirus - 7/28/2020. 10/2,2020, 12/18/2020. 2/25/2021 DTaP- Hep B- IPV- 12/18/2020, 2/25/2021 DTaP-Hib- IPV- 7/28/2020, 10/2/2020 Spoke with mom today and Patient is doing good. No symptoms

Other Meds: Polyvitamin/Fl

Current Illness: none

ID: 1058392
Sex: F
Age: 69
State: OH

Vax Date: 02/14/2021
Onset Date: 02/23/2021
Rec V Date: 02/26/2021
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Symptoms: Nine days after vaccination a red baseball size area (circumference) with hive/welts within the area around the injection site. Three days later hives/welts are gone but a red rash is visible.

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Current Illness:

ID: 1058393
Sex: F
Age: 27
State: NC

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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Symptoms: Chest tightness, warm throat, chills

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Current Illness:

ID: 1058394
Sex: F
Age: 56
State: NC

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
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Allergies: No

Symptom List:

Symptoms: Extreme nausea and vomiting. Barely able to keep water down yesterday. Doing a little better today.

Other Meds: No

Current Illness: No

ID: 1058395
Sex: F
Age: 68
State: GA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 02/26/2021
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Allergies: Grass Pollens. Diary products, except Yogurt. Mylantin a drug removed from the market in the 1960's.

Symptom List:

Symptoms: Nausea. Overall muscle aches. Migraines that responded to the 2 different drugs lists, but manifested repeatedly such that the nausea and very severe head pain woke me. My response was to take a different drug in each 24 hour period. Using sumatriptan first and then 24 hours later after the pain ceased and then reestablished itself, using Migrainol, and so on. The drugs worked, but the projectile vomiting and head pain consistently came and went. Injection #1 was a bit shorter and slightly less intense, but the last time I experienced projectile vomiting due to migraines was in 1999.

Other Meds: Gabapentin Migrainol Sumatriptan Biotin Compound Testosterone 10/ DHEA 10/Preg 50 Capsules Compound Estrao.75/Prog160 Capsules Levothyroxine Gabapentin Centrum Silver 88 mg Aspirin Chelated Magnesium Brown Seaweed Extract

Current Illness: No other illnesses.

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm