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: 0931585
Sex: F
Age: 75
State: TN

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

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

Lab Data:

Allergies: raspberries, adhesive

Symptom List:

Symptoms: Moderate metallic taste in the back of mouth No treatment needed. Disappeared after about an hour.

Other Meds: Omeprazole, famotidine, Simvastatin, atenolol, amlodipine, low dose aspirin. acetominophen. Vitamin D3, multi vitamin, probiotic, tumeric, CoQ10, chelated magnesium

Current Illness: None

ID: 0931586
Sex: F
Age: 57
State: WI

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin

Symptom List:

Symptoms: Headache began about 5 minutes after injection and lasted until the next day. About 10 hours after receiving the vaccine, I was awakened by intense pain in the tragus of both ears, as if they were in a vice grip. I finally took acetaminophen which mostly resolved it, but I continued to have similar, intermittent pain over the next 2-3 days. It has now resolved.

Other Meds: Celebrex, Black cohosh, multivitamin

Current Illness: none

ID: 0931587
Sex: F
Age: 28
State: NY

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

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: myalgia, chills, headache, and fever

Other Meds: Junel

Current Illness: none

ID: 0931588
Sex: F
Age: 51
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: The vaccine was reconstituted and prepared in the syringe, and the expiration date and time was marked on the vaccine syringe. The vaccine was administered to the patient after the recommended beyond-use time.

Other Meds:

Current Illness:

ID: 0931589
Sex: M
Age: 58
State: MO

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Fatigue/malaise, aching joints, low-grade fever, slight headache--all began approx. 23 1/2 hours after vaccine. Chills began approx. 36 hours after vaccine. Extra-strength acetaminophen (2 tabs) taken approx. every six hours during daytime hours when symptoms began. Symptoms continued for approx. 50 hours after they initiated.

Other Meds: Daily multivitamin; Vit D3 1000IU daily

Current Illness: None, though did test positive for COVID-19 Oct 26, 2020.

ID: 0931590
Sex: F
Age: 35
State: NY

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Allergy to Lori tab

Symptom List:

Symptoms: Two days after I had a red hard raised hot lump. Treated with ice and Advil. Fully went away. Last night one week one day post I have a raised red itchy rash

Other Meds: Lisiopril. Lexapro. Birth control. Multi vitamins

Current Illness: Covid tested for symptoms 12/11. Negative

ID: 0931591
Sex: F
Age: 33
State: IN

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Benedryl

Symptom List:

Symptoms: Headache, extreme lethargy, full body hives, eyes swollen . Symptoms lasted for about 48 hours.

Other Meds: Sertraline

Current Illness: None

ID: 0931592
Sex: M
Age: 38
State: CA

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Gout like symptoms upon wakening. Swollen painful toes on right foot.

Other Meds: Statin

Current Illness: None

ID: 0931593
Sex: F
Age: 48
State: MD

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Cipro, Cymbalta.

Symptom List:

Symptoms: Dizzy Headache Nauseous

Other Meds: Lamictal, Trazadone, Trileptal, Synthroid, Trokendi, Oxycodone, Gabapentin, Modafinil, Motrin.

Current Illness:

ID: 0931594
Sex: F
Age: 53
State: WI

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Muscle pain, joint pain, fever, chills, shortness of breath, headache, fatigue, starting the morning after the vaccination that was provided around 4:30 in the afternoon, used Tylenol for the pain and fever. Better the next day but still not well. Missed work

Other Meds:

Current Illness: COVID positive December 13th

ID: 0931595
Sex: F
Age: 28
State: CA

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: Sore arm after IM injection surrounding injection site lasting 24 hours

Other Meds: None

Current Illness: None

ID: 0931596
Sex: F
Age: 34
State: OH

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Bactrium Keeflex Sulfa

Symptom List:

Symptoms: Arm was bruised and tender to the touch approximately 3-4 hours following vaccine. Started feeling dizzy around 8pm on 1/7/21. Took PM meds and went to bed. Awoke around 3am with a temp of 103, joint aches, muscle aches, chills, congestion, eyes very dry and itchy, severe headache/migraine with photosensitivity, fatigue on 1/8/21. Left arm was swollen, hot to the touch and very tender to move it. Took Tylenol and Benadryl to help relieve symptoms. Put a heating pad on injection site. Felt about the same all day so I rested. Went to bed around 10pm on 1/8/21. Woke up around 4am on 1/9/21 and my temp was 99.7 prior to taking any meds and after about 20 minutes of being out of bed. On 1/9/21 I still have arm tenderness and bruising, fatigue, headache, left eye redness to upper eyelid with swelling, temp has been running at 99.7 and it?s currently 4pm EST.

Other Meds: Biotin 10,000mg PO AM Potassium 90mcg PO BID Mag-ox 400mg PO BID MTV PO QAM Apple cider vinegar 400mg PO QAM Acidophilus PO BID Vit B12 1,000mcg PO QAM Vitamin B complex PO QAM Simethicone 80mg PO QID PRN Imitrex 50mg PO daily PRN (was not

Current Illness: No prior illness prior to vaccine.

ID: 0931597
Sex: M
Age: 66
State: FL

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: FEVER OF 101.3?

Other Meds: TIVICAY, PREZISTA, RITONAVIR, CRESTOR TRICOR, ZETIA, 84 MG ASPIRIN, NIACIN, B12, D3

Current Illness: HIV,

ID: 0931598
Sex: F
Age: 45
State: FL

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Documented no allergies to COVID vaccine, vaccine products, or other medications. No allergies disclosed at screening. At time of event stated that about June 2020 had swollen tongue after bee sting which lasted about 1 hour but did not seek medical care at time.

Symptom List:

Symptoms: At about 15 minutes post vaccination individual experienced a feeling tongue was swollen. Initial vital signs stable and she self-reported to vaccination staff. Provider was called, and 0.3 mg Epinephrine via Epi pen was given. On-base emergency response EMTs and command post activated. Symptoms were slight hoarseness, salivating, difficulty pronouncing words, and flushed. She felt her cheeks were starting to swell. After the one dose epinephrine she felt swelling start to resolve and symptoms improving. She was transported via EMS to hospital where she reports back to us IV hydration and is anticipating release with a clear airway and normal vital signs.

Other Meds: no medications disclosed

Current Illness: none

ID: 0931599
Sex: F
Age: 36
State:

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Staff RN was observing the above mentioned person and noted she was having splotchy looking non raised reddish rash on arms and neck area. I also noted she had it on her upper neck & back area. She was given 25mg of benadryl PO. She denied shortness of breath, throat swelling, difficulty swallowing or itching at this time. She also denied any other symptoms. She was verbalizing well and denied any allergies prior to taking her benadryl or vaccine. (Our observation room had equipment and medical emergency box available . Our ED is available also if needed) She was observed for about 1 hour. She did not have any continuation of rash or new symptoms. Fact Sheet for COVID vaccine already given &V-Safe.

Other Meds:

Current Illness:

ID: 0931600
Sex: M
Age: 63
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: The vaccine was reconstituted and prepared in the syringe, and the expiration date and time was marked on the vaccine syringe. The vaccine was administered to the patient after the recommended beyond-use time.

Other Meds:

Current Illness:

ID: 0931601
Sex: M
Age: 31
State: GA

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: No Known Allergies

Symptom List:

Symptoms: Member given Covid-19 Vaccine at approximately 10:38- member placed in observation room for 30 min observation time- at approximately 11:00 member appeared to be in a daze, slow to speak when asked questions- member unable to completely verbalize what he wanted to say- Vital signs stable- member asked what his birthday was and responded with "My body is fine". Member was able to transfer from observation chair to wheelchair, but needed assistance. Member transferred to the ACC for further evaluation

Other Meds: traMADoL (ULTRAM) 50 mg Oral Tab 15 tablet 0/0 12/14/2020 6/15/2021 Sig - Route: Take 1 tablet by mouth every 6 hours as needed for pain - Oral Ibuprofen (MOTRIN) 800 mg Oral Tab 90 tablet 0/0 11/22/2020 Sig - Route: Take 1 tablet by mouth

Current Illness: as of 1/9/2021 ICD-10-CM Priority Class Noted - Resolved MIGRAINE (Chronic) G43.909 2/12/2019 - Present MILD PERSISTENT ASTHMA (Chronic) J45.30 7/22/2020 - Present

ID: 0931602
Sex: F
Age: 31
State: PA

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

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

Lab Data:

Allergies: Coedine

Symptom List:

Symptoms: 10:47a went into a room to wait for 15 minutes directly after the injection. Began to feel somewhat dizzy right afterwards. Continued back to my office. Informed my supervisor that I was feeling dizzy but informed him that I had a couple bites of oatmeal, and a few cups of coffee and was going to try and eat something and hydrate and I?m sure I would feel better. I went back to work for about an hour (I work at a desk). For about an hour I continued to feel dizzy and noticed I was cloudy and was staring off. After an hour I really became dizzy and walked to my supervisors office and informed him. It felt as though I was walking on the moon to get to his office. I also felt like I had a uti. I sat down in his office and informed him of what happened. As I was talking to him I began to pass out. I did not go out the whole way but he began speaking to me more. After feeling a little better I walked back over to my office. I felt waves of dizziness and being hot and cold. My husband came and picked me up around 1:30p from work. I felt better after getting in the car and going home. Once I was home I ate and had began to feel better. Around 6:00p I began to go through another wave and was experiencing body aches, hot and cold sweats, loss of appetite, tingling all over my body but mostly in my legs and feet. At that point I went in and laid down in bed for the rest of the night. Probably around 9:00p I began to feel better. I attempted to fall asleep around 11:00p but when I closed my eyes I felt like they were racing back and forth. So I got back up and watched something in tv until I fell asleep maybe about 30 minutes later. I woke up the next morning around 8:45a. I tossed and turned most of the night, however I felt better. It was like I had the flu for a few days and on the last day I felt better but was under the weather. At this point in the morning I was fatigued. I was able to perform some tasks around the house. I then laid back down in bed for a few hours because I was beginning to feel dizzy and was experiencing hot and cold sweats. After a few hours I got up from bed and performed a few more tasks around the house. Then was able to sit down on the couch and watch some tv. At this point I?m still expediting tingling in my body at times. Still a little dizzy but able to focus and hot and cold sweats.

Other Meds: Protonics, d12, multivitamin, prenatal, valtrex, protonics, vitamin c

Current Illness: No

ID: 0931603
Sex: M
Age: 64
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: The vaccine was reconstituted and prepared in the syringe, and the expiration date and time was marked on the vaccine syringe. The vaccine was administered to the patient after the recommended beyond-use time.

Other Meds:

Current Illness:

ID: 0931604
Sex: F
Age: 43
State: TN

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

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: Started menstruation that afternoon. Off cycle... 1 week - 2 weeks early. Not typical for me... I'm very regular. Not on birth control but husband has vasectomy. Chance of pregnancy is extremely unlikely. Started with bad cramping in pelvis and aching legs. Cramps have lessened. Dark blood. Brownish in color.

Other Meds: Zoloft, wellbutrin, zertec, caffeine, vitamin c

Current Illness: No - sinus/ indoor allergies

ID: 0931605
Sex: F
Age: 46
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: The vaccine was reconstituted and prepared in the syringe, and the expiration date and time was marked on the vaccine syringe. The vaccine was administered to the patient after the recommended beyond-use time.

Other Meds:

Current Illness:

ID: 0931606
Sex: F
Age: 58
State: NJ

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

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

Lab Data:

Allergies: sometimes when eating fish or shellfish I get hives

Symptom List:

Symptoms: Approx 6 min after getting shot I felt a jab like a nerve tingle go up my left neck to the left side of my scalp where it felt odd (timgle) and i reported to Emt on site so i stayed an extra 15 and left. Approx 3hr later I felt left face cheek numbness that radiated to the left side of my scalp where i first felt the tingle. This sensation was not present the next day 1/9

Other Meds: Metformin levothyroxin lisinipril almodipine besylate multi vitimin vit d and calcium iron

Current Illness: none

ID: 0931607
Sex: F
Age: 71
State: IL

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Pain swelling/hardness, redness, of injection site approximately 2 inches in diameter when first noticed >1 week after injection. Contacted primary care physicians and instructed to take ibuprofen and use topical hrdrocortisone. Size increased to 3 inches the following day and experienced some chillls. No fever.

Other Meds: Atenolol, esomeprazole, vitamin D, Zyrtec

Current Illness:

ID: 0931608
Sex: F
Age: 64
State: NY

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, gadolinium

Symptom List:

Symptoms: Intense left arm pain awakening me from sleep, fever 101.4, unable to hold down food or water, slept for almost 24 hours, could not go into work on 1/8/21.

Other Meds: None

Current Illness: None

ID: 0931609
Sex: M
Age: 60
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: The vaccine was reconstituted and prepared in the syringe, and the expiration date and time was marked on the vaccine syringe. The vaccine was administered to the patient after the recommended beyond-use time.

Other Meds:

Current Illness:

ID: 0931610
Sex: F
Age: 33
State: AK

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Poultry, Fish, Seafood, Treenuts(almonds), Environmental

Symptom List:

Symptoms: Several minutes after getting the shot, my chest started to feel tight and I needed to use my rescue inhaler. I stayed at the Clinic until 30 minutes had been up. When I arrived home I needed to use my Albuterol Nebulizer Solution, and started to get slightly itchy. My chest didn't start to feel better until after 2am, and the next day I noticed my arm at the injection site was swollen and slightly red. It is still red to this day and it feels achy all the way to my wrist.

Other Meds: Daily Vitamin, Vitamin D, Advair, Ventolin Inhaler(albuterhol)

Current Illness: Cyst in armpit

ID: 0931611
Sex: F
Age: 23
State: WI

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient reported feeling like her tongue was tingling and felt larger than normal. She did not report having any difficulty breathing. 25mg of Benadryl was given orally. After 10 minutes she thought she was feeling a bit better, but then continued to say that she was having tingling and not "feeling normal". We decided to administer epinephrine instead of waiting for her to continue to get worse. I administered an epi-pen (0.3mg) about 30 minutes after she took the Benadryl and a nurse from the SNF called 911. Paramedics arrived and evaluated her. Her breathing sounded okay via the paramedic's stethoscope. Because she was still not reporting feeling "back to normal" and because she had epinephrine administered, she was transported via ambulance to the ER for continued monitoring.

Other Meds:

Current Illness:

ID: 0931612
Sex: F
Age: 46
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: The vaccine was reconstituted and prepared in the syringe, and the expiration date and time was marked on the vaccine syringe. The vaccine was administered to the patient after the recommended beyond-use time.

Other Meds:

Current Illness:

ID: 0931613
Sex: F
Age: 76
State: GA

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: None reported by patient

Symptom List:

Symptoms: Pt c/o having 'weird feeling/not feeling good' and increase heart rate about 7-8 minutes after receiving vaccine. Pt denied any shortness of breath at the time, no swelling of face, BBS clear and equal with equal rise and fall of the chest wall, alert and oriented X 4, able to speak in complete sentences. Progressed to report 'lips feeling like they are swelling approximately 18 minutes after the vaccine was administered. 911 was activated. Epinephrine 0.3 mg IM via epi autoinjector was administered to left thigh. Pt still c/o feeling that her lips were swelling 8 minutes after first dose of Epinephrine; therefore, another dose of 0.3 mg Epinephrine IM via epi autoinjector was administered to left thigh. Diphenhydramine 25 mg IV was administered 2 minutes after second dose of Epinephrine. IV fluids administered as well, while awaiting arrive of EMS. EMS arrived on scene approximately 30 minutes after called. Blood glucose was 120 mg/dl approximately 25 minutes after vaccine administration. Pt report feeling better after the 2nd dose of Epinephrine and Diphendydramine and 500 ml of Normal saline IV. Pt was transported via EMS to the ER for further evaluation and treatment.

Other Meds: Unknown

Current Illness: Unknown; no illness at time of vaccine administration

ID: 0931614
Sex: M
Age: 26
State: CO

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

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Chills, body aches, head aches, and general energy depletion

Other Meds: N/A

Current Illness: N/A

ID: 0931615
Sex: F
Age: 36
State: NY

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/09/2021
Hospital:

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

Lab Data:

Allergies: Naproxen

Symptom List:

Symptoms: Immediate: Dizziness, numb face, itching throat and nasal passage, itching tongue (slightly swollen) with lead like feeling, bruising on chest. 3 Days Later: Itching throat and nasal passage, itching tongue with lead like feeling and chest pain. 4 Days Later: Itching throat and nasal passage, itching tongue with lead like feeling and off-on chest pain.

Other Meds: Levothyroxine

Current Illness:

ID: 0931616
Sex: M
Age: 57
State: CA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/09/2021
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Allergies: None

Symptom List:

Symptoms: flu like symptoms , significant fatigue

Other Meds: Cialis 10mg, bupropion 150 mg, aspirin 81mg, lisinopril, xyzal,

Current Illness: None

ID: 0931617
Sex: F
Age: 34
State: PA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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Allergies: betadine-mild rash

Symptom List:

Symptoms: Vaccinated at 610am. Mild myalgias, pain at injection site, and headache starting around around 430pm when I woke up for work. Severe myalgias, fatigue, worsening headache, pain at injection site and chills noticed around 9pm on 1/8/21 continued until I went to sleep. I slept from 1am 1/9/21 to 230pm 1/9/21. Currently 4pm and experiencing mild generalized myalgias, mild headache, left shoulder and injection site pain and fatigue.

Other Meds: Escitalopram 10mg QD; Tri-Lo-Marzia QD

Current Illness: N/A.

ID: 0931618
Sex: F
Age: 52
State: ME

Vax Date: 12/24/2020
Onset Date: 01/03/2021
Rec V Date: 01/09/2021
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Allergies: no

Symptom List:

Symptoms: Hard lump developed 10 days after vaccine, then day 12-13 red elevated rash developed size of orange. improved by day 15.

Other Meds: levothyroxine

Current Illness: no

ID: 0931619
Sex: M
Age: 68
State: FL

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/09/2021
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Allergies: None

Symptom List:

Symptoms: 1. Mild soreness/ache at injection site, starting about 3 hours after injection, lasting for about 24 hours 2. Moderate fatigue, starting 4 hours after injection, ended by 9pm same day 3. Mild constipation, lasting 2 days

Other Meds: Atorvastatin Lipitor

Current Illness: None

ID: 0931620
Sex: F
Age: 36
State: GA

Vax Date: 12/27/2020
Onset Date: 01/05/2021
Rec V Date: 01/09/2021
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Allergies: none

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Symptoms: At the time of injection no issues other than sore arm. Day 9 post injection developed significant swelling, redness, warmth, and rash like irritation in left arm. Over the past 5 days there has been some decrease in swelling but the redness has formed a circle and has flare ups of rash, warm, and irritation. I have been taking benadyl, zyrtec, and cortisone cream to try and relieve symptoms.

Other Meds: Bystolic, Nexium, Advil, Benadryl

Current Illness: none

ID: 0931621
Sex: F
Age: 37
State: AZ

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/09/2021
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Allergies: NONE

Symptom List:

Symptoms: Aches, Chills, Nausea, vomiting, fatiuge - 48 hours. chest tightness- 6 hours

Other Meds: Albuterol Inhaler PRN for Asthma

Current Illness: NONE

ID: 0931622
Sex: F
Age: 38
State: IN

Vax Date: 12/16/2020
Onset Date: 12/17/2020
Rec V Date: 01/09/2021
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Allergies: None

Symptom List:

Symptoms: Muscle aches, nausea, fatigue, injecton site pain

Other Meds: Birth control

Current Illness: None

ID: 0931623
Sex: F
Age: 69
State: CA

Vax Date: 01/01/2021
Onset Date: 01/09/2021
Rec V Date: 01/09/2021
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Lab Data:

Allergies: Nine known

Symptom List:

Symptoms: Nausea Extreme tiredness Body Ache Chills Fever. 100f

Other Meds: Lisinopril /Hcz Lipitor Synthroid

Current Illness: None

ID: 0931624
Sex: F
Age: 32
State: MO

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/09/2021
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Lab Data:

Allergies: Clindamycin, Keflex, Lexapro, Naproxen

Symptom List:

Symptoms: 1352 - Pt reports upper lip swelling, unable to see on visual assessment, BP-141/92, 100% on RA, T - 98.1, HR - 91, RR - 16. Given 25 mg of oral benadryl per this RN per vaccination clinic standing order. 1403 - Pt reports feeling no change from initial report but does note "some finger tingling". 92% on RA, HR - 88. 1410 - Discussed taking a 2nd 25mg dose with patient. Will hold at this time, she states "my hands normally feel puffy when this gets worse but they feel normal now". Pt reports upper lip swelling feels "puffy" but unchanged from initial report. 1418 - Pt reports upper lip swelling increased, BP - 140/85, HR - 80, RR 16, 100% on RA, 25mg of oral benadryl given. 1423 - Pt reports upper lip "puffiness" with slight improvement, new c/o upper back itchiness, no rash or hives visualized on assessment 1428 - Pt reports improvement to feeling of "puffiness", back itchiness remains the same, and pt "feels sleepy" 1438 - Pt reports resolution of upper lip swelling and says "It feels like when I came in", slight back itchiness still present 1448 - Pt reassessed 30 min post 2nd dose of benadryl, pt reports complete resolution of all symptoms, BP - 135/79, T - 98.2, RR - 14, HR - 78, 100% on RA Discussed transportation with patient prior to providing 2nd dose of Benadryl, Pt home via private vehicle with mother (driver) and partner. Educated patient to call nurse on call number with any further concerns or if symptoms resume.

Other Meds:

Current Illness:

ID: 0931625
Sex: M
Age: 45
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
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Symptom List:

Symptoms: The vaccine was reconstituted and prepared in the syringe, and the expiration date and time was marked on the vaccine syringe. The vaccine was administered to the patient after the recommended beyond-use time.

Other Meds:

Current Illness:

ID: 0931626
Sex: F
Age: 52
State: GA

Vax Date: 12/17/2020
Onset Date: 12/19/2020
Rec V Date: 01/09/2021
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Allergies: no

Symptom List:

Symptoms: Left axillary pain for 3 days. Very sore left axilla. NO redness. no edema.

Other Meds: Celexa, Metformin, Vit D, Omega 3 Fatty Acid, Flonase, Astelin, Crestor,

Current Illness: I had COVID diagnosis on 10/22/20. I had a TdaP booster vaccine 24 hours prior to my COVID vaccine

ID: 0931627
Sex: M
Age: 41
State: IN

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/09/2021
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Allergies: None

Symptom List:

Symptoms: About 12 hours after admin; arm, shoulder, neck pain, progressed to generalized body aches, nausea, severe headaches, cough, mass weakness, diarrhea, joint pain. Symptoms started subsiding about 15 hours after onset. Minor cough still persist with minor shortness of breath.

Other Meds: Vit D3

Current Illness: None

ID: 0931628
Sex: F
Age: 24
State: MD

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/09/2021
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Allergies: Penicillin (skin reaction)

Symptom List:

Symptoms: awoke at 2 am with nausea, chills, generalized pain. Immediately felt myself start to pass out or have a seizure- I am not sure which. Family member reports my eyes were open with absent stare however I lost consciousness, <60s. My right calf was in a severe muscle spasm as soon as I became conscious which leads me to believe I had some convulsions. Nausea chills and generalized pain persisted throughout the rest of the morning. Stopped around 10 am and turned into pounding headache and fatigue. Additionally my left arm is in moderate to severe pain (not like the typical soreness I get with the flu shot). I am in significant pain moving my arm, but also changing body positions while keeping my shoulder still and close to my body (bending over, scooting over in bed).

Other Meds: GI probiotic, hormonal birth control

Current Illness: N/A

ID: 0931629
Sex: F
Age: 43
State: MA

Vax Date: 12/29/2020
Onset Date: 01/06/2021
Rec V Date: 01/09/2021
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Symptoms: Moderna COVID-19 Vaccine EUA 8 days after receiving my vaccine I experienced warmth, rednessness, mild itching and firmness at the injection site. At the largest, the area was approx 8 cm across. It lased for 4 days and seemed to improve with administration of steroid cream and taking claritin and benadryl. I had no other systemic effects.

Other Meds:

Current Illness:

ID: 0931630
Sex: F
Age: 46
State: LA

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/09/2021
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Allergies: Penicillin

Symptom List:

Symptoms: Fever, chills, night sweats, swollen glands under arm, swollen injection site, body aches, headache

Other Meds: Synthroid, Motrin

Current Illness: None

ID: 0931631
Sex: F
Age: 78
State: TN

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 01/09/2021
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Allergies: None

Symptom List:

Symptoms: Diarrhea, Fatigue.

Other Meds: None

Current Illness: None

ID: 0931632
Sex: F
Age: 18
State: NH

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/09/2021
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Allergies: N/A

Symptom List:

Symptoms: Skin rash around neck, hives Shortness of breath Swelling Nausea

Other Meds: Oral Contraceptive

Current Illness: N/A

ID: 0931633
Sex: F
Age: 26
State: AZ

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/09/2021
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Allergies: None

Symptom List:

Symptoms: Pt reports vomiting, fever, chills, headache, sore throat

Other Meds: Tylenol prn

Current Illness: Diagnosed with COVID on 01 Jan 2021, symptoms began 27 Dec 2020 and resolved except for loss of taste or smell.

ID: 0931634
Sex: F
Age: 29
State: RI

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/09/2021
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Allergies: Darvocet, Reglan

Symptom List:

Symptoms: Pt entered observation @ 1530. @ 1540 pt stated her throat felt "tingly", when this asked her if she felt ok. @ 1541 pt stated she felt a small lump. This nurse assisted pt to bed in vaccination clinic. Stated the lump felt "bigger". This nurse administered Epi 0.3mg to R thigh @ 1544. Pt stated s/s were better @ 1548. Cold compress was also applied. This nurse assisted pt to ER. Pt @ ER @ 1605. When this nurse left pt, she was being assisted by ER for registration. Denied any s/s of chest pain or SOB.

Other Meds: Cymbalta, Trazodone, IUD

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm