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: 1059049
Sex: F
Age: 71
State: WI

Vax Date: 02/08/2021
Onset Date: 02/16/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Red circle, rash, itch around injection site. Known as Covid Arm.

Other Meds: Ibandronate Sodium (Boniva) - 150 mg/month Crestor - 10 mg/day Multi-vitamin - 1/day

Current Illness: None

ID: 1059050
Sex: F
Age: 23
State: NY

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

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

Lab Data:

Allergies: NKDA

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient Name: Date: 2/24/21 Vaccine:Moderna The response was to which dose?First Approximately how long after the administration the reaction started? 23min Major signs and symptoms: ill-appearing with drooped posture, tingling lips, throat hives Medication(s) given: 50mg PO Benadryl Vitals: 11:35pm HR99, O2 98% 11:37pm BP 128/107, HR78, RR18. 50mg PO Benadryl given 11:41pm lungs clear to auscultation. O2 98%, BP 126/79, HR79 11:46pm 120/73, HR72, O2 sat 98%, RR16. Hives visibly improving, tingling of lips resolving. 11:52pm 127/78, RR16, HR76, O2 99% 11:57pm good affect, hives/tingling nearly fully resolved. Other Interventions: water Outcome: Patient discharged with mother to home.

Other Meds: Hizentra 10 GM/50ML Soln

Current Illness: Per patient: Peripheral neuropathy due to infection, herpes simplex virus six, immunocompromised

ID: 1059051
Sex: F
Age: 71
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Sore arm; swollen and itchy.

Other Meds: Primidone, Digoxin, Atenolol, Citalopram, Levothyroxine, Warfarin, Alendronate Sodium (generic of Fosamax), Estradial

Current Illness:

ID: 1059052
Sex: F
Age: 38
State: LA

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

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

Lab Data:

Allergies: Sulpha and penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Symptoms showed.the morning after my second vaccine. Fever, chills, body aches, joint pain, headache and nausea. Second day after the vaccine I had headache, loss of appetite and joint pain. Third day joint pain. Fourth day no symptoms.

Other Meds:

Current Illness: None

ID: 1059053
Sex: F
Age: 42
State: CA

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:
Vax Route:
Vax Site:

Lab Data:

Allergies: unknown

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

Symptoms: Complained of chest tightness, flushed and palpitations, self resolved

Other Meds: unknown

Current Illness: unknown

ID: 1059054
Sex: M
Age: 63
State: GA

Vax Date: 02/14/2021
Onset Date: 02/16/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Joint pain in shoulders, elbows, hands, knees, ankles, feet and toes. Malaise, nausea, chills, headaches, and fatigue.

Other Meds: Plaquenil, Sodium Diclofenac, Ritalin, Prozac, Lorazepam, Ambien Ibuprofen, Asper-cream, Mira-lax, Senna, Psyllium fiber, Multi Vitamin, Vitamin D and B12

Current Illness: Rheumatoid Arthritis, IBS

ID: 1059055
Sex: F
Age: 19
State: CA

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:
Vax Route:
Vax Site:

Lab Data:

Allergies: nka

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: none

Other Meds: n/a

Current Illness: n/a

ID: 1059056
Sex: F
Age: 59
State: NV

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List: Pharyngeal swelling

Symptoms: chills, headache, body/joint ache, cough, chest pain

Other Meds: Omeprazole, Multivitamin, Vitamin C, Vitamin D, Calcium

Current Illness: GERD, IBS

ID: 1059057
Sex: F
Age: 77
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient reported dizziness and unsteady gait after receiving vaccine. BP 121/57 (pulse 69), O2 sat 98%. Followup: 129/68 (pulse 64), 98% O2 sat.

Other Meds:

Current Illness:

ID: 1059058
Sex: F
Age: 73
State: CT

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

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

Lab Data:

Allergies: Avelox antibiotic

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Red oval lesion at injection site about 4" high X 2" wide. Warm to touch. Somewhat sensitive. This report is being filed two days after the lesion first appeared (8 days after injection). The lesion is still present at this filing.

Other Meds: 81mg aspirin daily, atorvastatin, Vitamin D supplement

Current Illness: None

ID: 1059059
Sex: M
Age: 66
State: NC

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

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

Lab Data:

Allergies: Sulfa drugs

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

Symptoms: Fever Muscles Ached Rash on Deltoid at injection site measuring 5x8 cm Aleve prior to vaccine, again at bedtime Wed. Thursday Aleve in the morning and at bedtime.

Other Meds: Rosuvastatin 5 MG Vit C 1000 mg

Current Illness: None

ID: 1059060
Sex: M
Age: 33
State: CA

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

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

Lab Data:

Allergies: NKA

Symptom List: Rash, Urticaria

Symptoms: 10 mins after receiving vaccine pt became diaphoretic, pale, light headed, had abd pain, placed supine on cot, had change in vs (hr 40, bp 76/60), but pulse ox 99% on RA. Ambulance called, pt treated with epi x1. Felt better in 5 mins Ambulance arrived 5 mins after that and assessed pt. Ambulance released pt and he was taken to urgent care by a family member for further evaluation

Other Meds: NA

Current Illness: NA

ID: 1059061
Sex: F
Age: 53
State: CO

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:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Patient received her second dose of the COVID-19 vaccination and within 14 minutes began to have sensation of throat tightness, itchiness to the top of the palate, chest tightness, dizziness, and nausea. She was taken to the emergency department where she received treatment including cetirizine 20 mg PO, diphenhydramine 25 mg IV, epinephrine 0.3 mg IM, famotidine 20 mg IV, methylprednisolone 125 mg IV, and IV fluids. She recovered and was sent home in stable condition.

Other Meds:

Current Illness:

ID: 1059062
Sex: F
Age: 66
State: AZ

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

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

Lab Data:

Allergies:

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

Symptoms: At 9pm went to bed early. Just felt crummy. Slept poorly. Temperature at 3:30 am on 2/25/2021 was 101.4. F. Took one 500mg Tylenol. Slept better. Fatigue all day. By 2/26/2021 I?m feeling back to normal.

Other Meds: Lisinopril htcz Metoprolol Levothyroxine

Current Illness:

ID: 1059063
Sex: M
Age: 42
State: CA

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

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

Lab Data:

Allergies: nka

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

Symptoms: none used 5/8 inch syringe

Other Meds: n/a

Current Illness: n/a

ID: 1059064
Sex: M
Age: 25
State: WA

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

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

Lab Data:

Allergies: Penicillins

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

Symptoms: Patient became light-headed, pale immediately following covid vaccine injection. He then stated he's always had trouble after vaccines. Cold compress applied. No loss of consciousness noted. Water given, seat reclined. Slowly raised head to upright over the course of 30 minutes. Monitored VS every 5-10 minutes.

Other Meds: unknown

Current Illness: unknown

ID: 1059065
Sex: F
Age: 68
State: FL

Vax Date: 02/18/2021
Onset Date: 02/21/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: Vancomysen, aspirin

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

Symptoms: high fever, swollen face, rash in face, headache, nausea, swollen lymph nodes, joint pain, chills, weakness, overall feeling not well.

Other Meds: 1) Tacrolimus .5 mg & 1 mg, 2) Minocycline 100mb, 3) Xifaxan 550 mg, 4) Ursodiol 300 mg, 5) Furosemide 40 mg, 6) Glimepiride 4 mg, 7) Metoprolol 25 mg, 8) Florastor, 9) Calcium + D3 600 mg/10 mcg, 10) Omega-3 1000 mg, 11) Prilosec.

Current Illness:

ID: 1059066
Sex: F
Age: 48
State: CO

Vax Date: 02/22/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: eurythromyacin, codine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Chills, fever, full body sweat, nausea 1 day

Other Meds: Citalapram

Current Illness: none

ID: 1059067
Sex: M
Age: 46
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pt c/o tennis ball diameter sized lump in his left armpit (same side as the shot) about 36 hours after the Moderna immunization. Pt took OTC ibuprofen to reduce swelling and pain, which did help (about 50% reduction) He called the pharmacy to report the adverse effect on 2/26 and I advised him to contact his PCP to evaluate the lump.

Other Meds:

Current Illness:

ID: 1059068
Sex: F
Age: 47
State: MO

Vax Date: 01/15/2021
Onset Date: 01/25/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

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

Symptoms: Shot #1 12/18, Shot #2 1/15. 2 white lesion appeared on tongue on 1/25. No associated loss of taste, smell, ulceration, pain, fever. Remained unchanged. Perhaps increased tongue sensitivity. 2/17 photos evaluated by Derm colleagues, concern for COVID tongue, recommended ENT evaluation. 2/18 dentist full oral exam, concern for lichen planus, recommended ENT evaluation. 2/19 evaluated by ENT, concern for lichenoid reaction d/t vaccine. Oral topical steroids started (dexamethasone swish and swallow). Today is day 7 of 9 day course. Appreciable near resolution of lesions. Resolving tongue hypersensitivity.

Other Meds: Vitamin C, Probiotic

Current Illness: None

ID: 1059069
Sex: M
Age: 23
State: CO

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

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

Lab Data:

Allergies: None

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

Symptoms: Baseball sized rash at site of injection

Other Meds: None

Current Illness: None

ID: 1059070
Sex: F
Age: 66
State: IN

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

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

Lab Data:

Allergies: Lactose sensitivity. Environmental allergies, i.e. mold, dust, tree & weed pollen, etc.

Symptom List: Unevaluable event

Symptoms: I experienced tenderness, sensitivity to touch, swelling, and numbness (ALL SLIGHT) to the left side of my face, including around my eye, jaw, and lips.

Other Meds: Multivitamin, green tea extract, turmeric curcumin w. bioperene, alpha lipoic acid, vitamin D3, vitamin B12, krill oil, vitamin C, zinc, collagen w. vitamin C + biotin.

Current Illness: None, except noted in Item 12.

ID: 1059071
Sex: F
Age: 69
State: WA

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:
Vax Route:
Vax Site:

Lab Data:

Allergies: Biaxin, Augmentin, Sulfamethoxazole, Phenazopyridine, Dust, mold, pollen, pet hair

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

Symptoms: Started with headache and tired, then chills, then left breast itchy, then arm and armpit became sore, body aches and backache all night. I took Bismuth 525mg at 9am, acetaminophen 1000mg at 11am, felt better for a few hours, took acetaminophen 500mg at 6pm.

Other Meds: Citalopram 10mg, Flovent 220mcg, Olopatadine .2%, cetirizine 10mg, Levothyroxine 50mcg, Metformin 500mg, Oxybutynin 5mg, acetaminophen 500mg, multi-vitamin

Current Illness: 1/24/21 bloody urine from exercise

ID: 1059072
Sex: F
Age: 44
State: TX

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

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Pain to shoulder of injection site approximately 15 min post vaccination. Pain radiate to neck and feels numbness and as if swelling. Md in for assessment observation Vitals obtained, monitored an additional 15 mins. Symptom improved and discharged with post vaccination instructions and EC precautions.

Other Meds: Jardiance, Prinivil, Lisinopril, Metformin, Lipitor

Current Illness: None

ID: 1059073
Sex: F
Age: 86
State: GA

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Large round red area below vaccination site

Other Meds: Mobic

Current Illness:

ID: 1059074
Sex: F
Age: 42
State: AL

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

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

Lab Data:

Allergies: ?

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

Symptoms: AT 17:40 -PATIENT STATES SHE HAS SMALL AREA RASH AND ITCH ON RIGHT ARM. NO APPARENT DISTRESS. AT 17:50 LEFT ARM NOW ITCHES, BUT STILL NO LIPS, TONGUE OR THROAT DIFFICULTIES. AT 18:00 RASH AND ITCH HAS NOT INCREASED. PATIENT HAS BENADRYL AND ZANTAC AT HOME INSTRUCTIONS GIVEN. PATIENT REFUSED TO GO BY DCH ER, BUT WILL STOP AT ER OR MEDCENTER NORTH IF WORSENS BEFORE SHE GOES HOME. NO APPARENT DISTRESS UPON DISCHARGE

Other Meds: ?

Current Illness: ?

ID: 1059075
Sex: F
Age: 74
State: NY

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/26/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Hives and red rash developed about 3 half hours after vaccination starting with legs and continuing over entire body. took Benadryl & used Ventolin HFA and went to ER at Hospital . There treated with more Benadryl, famotidine & prednisone (last dose 8:31 pm). released. follow up with primary 2/17/20 continued with hives and rash . Took Benadryl 5-6 times daily first several days. Day 13 only needed one. Also using still Cortizone 10 Cr?me . Day 15 still have red rash and hives starting to go down.

Other Meds: multi vitamin VENTOLIN HFA as needed ergocalciferol 1.25 mg weekly

Current Illness: potential autoimmune disorder

ID: 1059076
Sex: M
Age: 84
State: CA

Vax Date: 02/10/2021
Onset Date: 02/13/2021
Rec V Date: 02/26/2021
Hospital: Y

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

Lab Data:

Allergies: None known

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: February 11, 2021 ? Arm pain ? He starts taking Tylenol as prescribed on day of Vaccination. February 13, 2021 ? Stabbing pain on the left side of the head (above his ear) ? Poor sleep the next 2 days February 14, 2021 ? Spoke to Dr ? He ordered a CT Scan and recommended for him to take Tylenol Extra Strength. The headache continues to escalate. February 15, 2021 ? He is taken to ER (Hospital) February 16, 2021 ? He is released with pain/insomnia medication February 20, 2021 ? He is confused, disoriented, repeats things, forgets things, has difficulty functioning normally and sleeping February 21, 2021 ? He has difficulty standing, he falls, he has difficulty swallowing. He is taken to ER (Hospital) February 21-26 - He is still at the Hospital. Was diagnosed with Viral Meningitis/Shingles

Other Meds: See end of form for complete listing. Lisinopril 10miligrams Pravastatin 20miligrams Terazosin HCL 10miligrams metFormin HCL (850 miligram) Aspirin 81mg Gingko Biloba 120mg Calcium 600 with vitamin D3 PreserVision (eye vitamin)

Current Illness: None

ID: 1059077
Sex: M
Age: 65
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Patient presented to pharmacy that he had just come from visiting with his doctor due to fact that arm immunized 2 days prior was swollen and red. Doctor prescribed antibiotic for patient as preventative and told patient to come to pharmacy to tell of condition of arm and pick up antibiotic.

Other Meds: methocarbamol metoprolol

Current Illness:

ID: 1059078
Sex: F
Age: 28
State: FL

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

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: 4.5 inch diameter warm red itchy welt appeared day 8 after vaccination at injection site.

Other Meds: None

Current Illness: None

ID: 1059079
Sex: F
Age: 57
State: NM

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

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain

Symptoms: Chills, muscle aches, fatigue for 36 hours

Other Meds: Estradiol, doxycycline

Current Illness: bladder infection

ID: 1059080
Sex: F
Age: 69
State: TX

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

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

Lab Data:

Allergies: Vicadin SulphA Penicillin

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

Symptoms: Vomiting 104 temp Loss of strength couldn?t sit up and couldn?t stand. Fell. Could pull myself up for hours Uncontrolled pee

Other Meds: Synthroid Prozac Ibuprofen Zyrtec Vitamin

Current Illness:

ID: 1059081
Sex: F
Age: 35
State: IL

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

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

Lab Data:

Allergies: Allergic to pineapple, kiwi, raw walnuts/almonds

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

Symptoms: Chest pressure developed in the evening Elevated heart rate developed in the evening (resting at 90bpm - normally 65-70bpm) Minor arm pain Heat at the site and up the side of my neck on the side of the injection

Other Meds: None. I have a mirena IUD

Current Illness: None

ID: 1059082
Sex: F
Age: 44
State: AZ

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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Allergies: penicillin, hep B and TB

Symptom List: Tremor

Symptoms: Patient was wellness director who helped going thru rounds and getting residents and staff to get vaccine, around 20 minutes after the shot when patient stood up, patient got lightheaded and had some tingly sensation in her mouth and around the top area of her face. patient mentioned she had anxiety, patient was given Benadryl, bottle of water, soda and orange juice. her friend helped her do breathing exercises to calm down her anxiety, patient was fine afterwards.

Other Meds: nothing, was given Benadryl after

Current Illness: unknown

ID: 1059083
Sex: F
Age: 52
State: TX

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

Symptom List: Erythema, Pruritus

Symptoms: approximately 15 min post vaccine nausea and pain. VS WNL gave water and snack. Md in for assessment, Symptoms improved after observation for additional 15 minutes.

Other Meds: Neurontin, Tradjenta, jardiance, metformin, trico

Current Illness: none

ID: 1059084
Sex: F
Age: 26
State:

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Lightheaded, nausea, patient refused transport by EMS

Other Meds:

Current Illness:

ID: 1059085
Sex: F
Age: 50
State: NY

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

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

Symptoms: Moderna COVID-19 Vaccine EUA I had a fast heartbeat about a couple minutes after the vaccine, then shortness of breath, dizziness and shakiness. I received Epinephrine then I had some itching and received Benadryl.

Other Meds: Cellcept Buproprion Calcitriol Cinacalcept Clonidine Colace Melatonin Prednisone Lipitor Magnesium Oxide Amlodipine Famotidine Prograf Propranolol Ambien

Current Illness:

ID: 1059086
Sex: M
Age: 24
State: CA

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

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: On Friday morning 2/26/21, we had a 24 yo male patient who had an anaphylactic reaction after his first dose of Pfizer COVID vaccine. He was instructed to wait on the chair, but had stood up at some point but was still in the pharmacy waiting area. A team member noticed he had fainted and called for help. The pharmacist on duty and immunizing tech came immediately to help him to a chair. At that point, he was conscious and talking. Then within a few seconds he started convulsing on the chair and lost consciousness. His eyes were open and head tilted back. A team member immediately called 911 and pharmacist administered 0.3mg Epipen to the thigh. We removed his face mask to check his breathing and also to allow him to breathe more easily. We also adjusted his head more forward and he started coughing. After about 15 seconds, he regained consciousness and could answer questions. EMT arrived soon after and took over. Patient does not have allergies or any history of anaphylaxis/ severe reaction from vaccinations. He did express some fear of needles and did not eat breakfast yet.

Other Meds: Unknown

Current Illness: None stated

ID: 1059087
Sex: F
Age: 55
State: IN

Vax Date: 02/17/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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Allergies: None

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

Symptoms: Firm Swelling and redness at injection site with itching just noticed on 2/26/21.

Other Meds: Raloxifene, calcium, vitamin D, multivitamin, vaginal estrogen

Current Illness: None

ID: 1059088
Sex: F
Age: 36
State: TX

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
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Allergies: Eggs; Xylitol; dairy sensitivity; maybe wheat

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

Symptoms: Swelling at the injection site; redness; heat; pain; itching; COVID arm? 4 in by 3 in red mark slightly purplish in center. Soreness in armpit area.

Other Meds: Vitamin D - 50mcg daily; Vitamin B-12 500 mcg twice weekly; Sertraline HCL 100 mg daily; Montelukast sod 10 mg daily; Cetirizine 10 mg daily

Current Illness: Seasonal allergies suspected

ID: 1059089
Sex: F
Age: 48
State:

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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Symptom List: Pain in extremity

Symptoms: Palpitations, rapid breathing, difficulty breathing, refused transport by EMS

Other Meds:

Current Illness:

ID: 1059090
Sex: F
Age: 53
State: WA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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Allergies: no known allergy

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

Symptoms: No adverse event identified. Immeasurable amount leaked from luer lock.

Other Meds: unknown

Current Illness: none reported

ID: 1059091
Sex: M
Age: 40
State: NY

Vax Date: 02/01/2021
Onset Date: 02/22/2021
Rec V Date: 02/26/2021
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Allergies: No

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

Symptoms: On day 2, twitching began in right calf. Then in left calf. Now all over.

Other Meds: Xanax

Current Illness: No

ID: 1059092
Sex: F
Age: 73
State: AL

Vax Date: 02/17/2021
Onset Date: 02/24/2021
Rec V Date: 02/26/2021
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Allergies: Penicillin; Codeine

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

Symptoms: At injection site, hard red lump, headache for three days; tired. On the 24th of February, my injection site started itching and a rash like a lot of mosquito bites under the skin. It was very red with a hard lump. Then I started itching under my arm in the right arm pit. Both the injection site and the arm pit have been itching for 3 days now. The lump is more pronounced in size. I feel like I'm itching to death. It is now just past 8:30 pm on Friday the 26th of February.

Other Meds: Valsartan 80mg; Gemfibrozil 600mg x2; Pantoprazole 40mg; Aspirin 81mg, Multivitamin; Centrum Silver

Current Illness: No

ID: 1059093
Sex: F
Age: 58
State: AL

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

Symptom List: Vomiting

Symptoms: PATIENT FEELS NAUSEATED. CHECK BLOOD SUGAR, ADDITIONAL 15 MINUTES ADDED TO TIMER. NO APPARENT DISTRESS. FINGERSTICK BS IS 65. A COKE AND CHEESE CRACKERS WAS GIVEN TO PATIENT. PATIENT IS BETTER WITH NO NAUSEA. DAUGHTER IS A NURSE WHO WILL RE-CHECK BLOOD SUGAR AT HOME. TEN MINUTES PATIENT WANTED TO LEAVE.

Other Meds: ?

Current Illness: ?

ID: 1059094
Sex: F
Age: 57
State:

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Dizziness, vision changes, cleared by EMS

Other Meds:

Current Illness:

ID: 1059095
Sex: F
Age: 55
State: OR

Vax Date: 02/23/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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Allergies: Hazelnut

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

Symptoms: Day 7 after the first vaccine which was on 1/26/21 a blotchy red circle formed around the injection site. It got larger over the course of a few days. I have less feeling in this area due to my spinal cord injury so it didn?t itch or hurt. It eventually went away. I received second vaccine dose on 2/23/21 and on 2/25/21 that same circle returned in the same spot even though the new injection site is well above the first one. Today 2/26/21 it?s larger and more red

Other Meds: Oxytrol patch, sudafed, vitamin C, D, probiotics, multi vitamin, D Mannose, calcium, Enemeez plus enemas

Current Illness:

ID: 1059096
Sex: F
Age: 33
State: IL

Vax Date: 02/17/2021
Onset Date: 02/22/2021
Rec V Date: 02/26/2021
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Symptom List: Injection site swelling, Limb discomfort

Symptoms: Five days after the initial dose, I noticed swollen lymph nodes near the armpit of my left arm. I received the injection in my left arm. The lymph nodes were tender and I experienced pain in the armpit area. Seven days after the initial dose, I woke up in the middle of night feeling like my body was on fire with pain on my left side. I took my temperature and it was 99.3. Upon waking up in the morning one week after the initial dose, the swelling was gone in lymph nodes. However, a red rash appeared near the injection site on my left arm. The rash was tender and warm to the touch. My left arm was tight and painful. As of day nine after the injection, the rash is itchy and has moved slightly down my arm. Pain has diminished but there is still tightness in my upper left arm.

Other Meds: Aurovela (birth control)

Current Illness:

ID: 1059097
Sex: F
Age: 55
State: MI

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 02/26/2021
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Allergies: Nickel, codeine, keflex latex

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

Symptoms: I had a 103 degree temperature for 9 hours, was hallucinating, chills, headache and I could not feel my fingers. They were numb. Hands pain.

Other Meds: Synthroid, MS Contin, cytomel

Current Illness: Tbi due to car accident 12-1-20 , ptsd

ID: 1059098
Sex: F
Age: 38
State: WA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 02/26/2021
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Allergies: Spiriva, ambien, atrovent. Nuts(all nuts) cherries Environmental

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

Symptoms: 11:00AM had vaccine, 2:30 yesterday had abdominal distention with URQ pain. Which can happen when I am fighting something. Became very tight requiring nebulizer treatments. And have needed about every 2 hrs since. Fever 103.2 starting about 7AM for about four hours.. nausea and vomiting (x2) around 11:00 AM. Massive headache. Liver pain and burning sensation in lungs. Which would come and go. Now at 5:00 having muscle aches starting. Been absolutely horrible feeling

Other Meds: Duloxetine Albuterol- inhaler and nebulizers Advair 500/50 Zinc Milk thistle in and off(for liver)

Current Illness: None

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am