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
88,334
AK1,815
AL6,133
AR3,993
AS45
AZ14,539
CA64,759
CO12,159
CT8,719
DC1,747
DE1,868
FL41,499
FM3
GA16,132
GU92
HI2,477
IA4,739
ID2,763
IL21,496
IN23,655
KS4,844
KY8,414
LA5,328
MA15,281
MD13,105
ME3,277
MH8
MI20,143
MN12,873
MO10,275
MP30
MS3,073
MT2,392
NC17,450
ND1,440
NE3,023
NH3,124
NJ19,456
NM4,089
NV4,600
NY36,525
OH20,140
OK6,525
OR8,918
PA24,920
PR2,483
QM2
RI2,092
SC6,952
SD1,243
TN10,038
TX38,745
UT4,482
VA15,477
VI62
VT1,780
WA15,487
WI11,573
WV2,461
WY894
XB5
XL1
XV2

ID: 1105562
Sex: M
Age: 1
State: GA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient given expired vaccine. Vaccine expired on 3/1/2021. No symptoms when checked on patient on 3/12 and 3/16

Other Meds: none

Current Illness: none

ID: 1105563
Sex: M
Age: 31
State:

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: dizzy, heart racing, lightheaded. Evaluated by EMS- Refusal to Transport.

Other Meds:

Current Illness:

ID: 1105564
Sex: F
Age: 27
State: MN

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Lidocaine, penicillin

Symptom List:

Symptoms: Loss of circulation/feeling in vaccinated arm, onset within 40 minutes, lasting two and a half hours. Nausea, onset within one hour, lasting 30 hours. Severe headache, onset within 18 hours, lasting 54 hours. Body aches, onset within three hours, lasting 60 hours. Fever of 99.7F, onset within two hours, lasting 48 hours. Rash on vaccinated arm, lasting 60 hours.

Other Meds: None

Current Illness: None

ID: 1105565
Sex: M
Age: 87
State: CA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pt was given 0.3mL of Moderna (second dose) instead of the recommended dosage 0.5mL of Moderna.

Other Meds:

Current Illness:

ID: 1105566
Sex: F
Age: 59
State: TX

Vax Date: 03/14/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Mercury

Symptom List:

Symptoms: I have MS. The reaction was like a full body flare. I couldnt walk up the stairs or get off the toilet. I couldnt think clearly. Fever 102. Body aches. But the reason i am filing this is the apparently inflammatory response

Other Meds: Multi vitamin Biotin Melatonin B12 Doxycozin Buproprion Sertraline Lasix Potassium Abilify Labetalol Nifedipine Telmisartan

Current Illness: None

ID: 1105567
Sex: F
Age: 45
State: MS

Vax Date: 03/05/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Toradol and Lisinopril

Symptom List:

Symptoms: Exactly one week after shot, I experienced pain at the injection site. Pain spread from injection site to middle of arm. Left index finger joint pain. Friday, the joint was just sore. Saturday it was swollen and very painful. Attempted compression and heat therapy unsuccessfully. Sunday pain reduced to soreness. Today pain and soreness from arm and joint have ceased. Index finger joint affected is the one above palm of hand.

Other Meds: HCTZ 12.5 mg once daily; Amlodipine 5 mg once daily; Zyrtec one pill daily; Vit D 2000 iu daily; Chewable Vit C 500 mg daily; Glucosamine Chondroitin two pills daily; multivitamin daily

Current Illness: Hypertension

ID: 1105568
Sex: M
Age: 28
State: ND

Vax Date: 03/04/2021
Onset Date: 03/11/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Localized rash, itching

Other Meds:

Current Illness:

ID: 1105569
Sex: F
Age: 49
State: NM

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Intense pain in right shoulder capsule/deltoid for 3 days. I could not raise my arm it was so painful. Almost 3 weeks out and I still have lingering pain in my left shoulder I never had until the shot. I have not received any treatment as I keep hoping it will just go away. If I have the same reaction when I go for the second shot I will go to my doctor.

Other Meds: Synthroid

Current Illness: none

ID: 1105570
Sex: F
Age: 59
State: AL

Vax Date: 01/21/2021
Onset Date: 02/20/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Coedeine, Darvocet

Symptom List:

Symptoms: Had second covid shot on February 18th. On February 20th while exercising on the treadmill I noticed my stamina was not the same. Felt like I just started an exercise program. I have been waling on treadmill for 20 years waling 4-6 miles at a time. Felt like I could hardly walk due to getting tired easily and very early in routine. Afterwards I am experiencing shortness of breath, smothering feeling, hard to take a deep breath, lightheadedness and palpatations. Have not been able to keep my normal exercise routine due to symptoms. Contacted my doctor about symptoms and he ordered a treadmill test. Did the treadmill test on March 16 and awaiting the results.

Other Meds: Vitamin D3 2000, Align, Magnesium

Current Illness: None

ID: 1105571
Sex: F
Age: 56
State: NC

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Chills, Fever, Diarrhea, Headache, Exhaustion, Joint Aches For 12-14 hours

Other Meds: None

Current Illness: Covid Jan 23-Feb 17

ID: 1105572
Sex: F
Age: 74
State: MN

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
Hospital: Y

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

Lab Data:

Allergies: Codeine Nausea And Vomiting ? Contrast Dye [Iodinated Contrast Media] Angioedema ? Darvon [Propoxyphene] Nausea And Vomiting Darvocet ? Depakote [Divalproex Sodium] Hallucinations ? Levo-Dromoran [Levorphanol] Hypotension ? Lyrica [Pregabalin] Dizziness ? Macrobid [Nitrofurantoin] Rash Fever and chills ? Miralax [Polyethylene Glycol 3350] Vomiting ? Neurontin [Gabapentin] Dizziness ? Nsaids (Non-Steroidal Anti-Inflammatory Drug) GI Upset ulcers ? Talwin [Pentazocine] Nausea And Vomiting and Dizziness ? Ultram [Tramadol] Dizziness ? Vicodin [Hydrocodone-Acetaminophen] Dizziness and Vomiting

Symptom List:

Symptoms: Initially had chills, fatigue for two days, then on 3/15 awoke with severe weakness in the right lower extremity. Presented to ER, MRI showed acute stroke ( Small acute infarction within the posterior left corona radiata). Admitted for stroke stabilization and rehab evaluation. Will be discharged to home with outpatient PT and OT

Other Meds: acetaminophen (TYLENOL EXTRA STRGTH) 500 mg tablet Take 2 tablets by mouth 3 times daily. Max acetaminophen dose: 4000mg in 24 hrs. acetaminophen-caffeine-butalbital (FIORICET) 325-40-50 mg tablet Take 1 tablet by mouth every 4 hours if

Current Illness:

ID: 1105573
Sex: F
Age: 76
State: NC

Vax Date: 02/02/2021
Onset Date: 02/09/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: I had a severe headache in the middle of the night and I have had headaches every night since for the last 5 weeks. It is a cluster headache. I used to have cluster headaches years ago.

Other Meds: Vitamin A, Vitamin B, Vitamin C, Vitamin D, Calcium, Zinc

Current Illness: No

ID: 1105574
Sex: M
Age:
State: IL

Vax Date: 03/16/2021
Onset Date: 03/09/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: The vaccine was given to the patient who was under the authorized age of 18 and up.

Other Meds: N/A

Current Illness: N/A

ID: 1105575
Sex: F
Age: 59
State: OH

Vax Date: 01/16/2019
Onset Date: 01/17/2019
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: sensitivities to Cipro, sulfa drugs allergic to bee and wasp stings (on shots for - many years)

Symptom List:

Symptoms: Next day - Restless Leg started. Had for at least one year. Didn't notice until did physical work house cleaning week or so later - muscles felt damaged - extreme soreness that would not go away. Went to gym couple months later and did very minor arm workout. Again, muscles extremely sore and would not heal. At this point, couldn't get to ground, walk well, walk any distance, reach overhead, lifting. In the past, was extremely active. Only regained halfway normal life after started Cymbalta after about a year and a half. Still very limited. Doctor I go to now said fibromyalgia, though have no other symptoms. Started right after Shingrix vaccine #1 (obviously didn't get 2nd). No doubt in my mind was from the vaccine. Too close timewise to be a coincidence. Still have the restless leg occasionally.

Other Meds: Atenolol - small dose 2x/day calcium/magnesium fish oil

Current Illness:

ID: 1105576
Sex: F
Age: 73
State: VA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: extensive allergies to many foods, soy, sulfa, tetracyclines, sulfite

Symptom List:

Symptoms: typical allergic reaction for patient (flushing within 30 minutes of shot, then within 1 hour developed jaw tightness, subjective difficulty swallowing). No SOB, difficulty breathing. tolerating secretions

Other Meds: synthroid

Current Illness: none

ID: 1105578
Sex: F
Age: 32
State:

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: dizziness, flushing. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1105579
Sex: F
Age: 37
State: WA

Vax Date: 01/03/2021
Onset Date: 01/10/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Animal dander

Symptom List:

Symptoms: About a week after vaccination a rash start on both arms. Big blotchy hives on my forearms which spread to my thighs and progressed to hives all over my body. The rash was itchy. At Urgent care they gave me an IV of Benadryl. I was discharged after about two hours. I took Benadryl and daily Zyrtec for a week and the hives went away. I followed up with my doctor and got some allergy tests which were negative for new allergy.

Other Meds: Zoloft Depo-every three months.

Current Illness:

ID: 1105581
Sex: F
Age: 56
State: TX

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Phenergan, cipro, bactrim

Symptom List:

Symptoms: nausea & vomiting, slight headache, b/p- 140/97; seen and cleared by EMS

Other Meds:

Current Illness:

ID: 1105582
Sex: F
Age: 67
State: WA

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: sulfa rocephin vancomycin clindamycin advil opioids strawberries oranges and orange juice warfarin eliquis

Symptom List:

Symptoms: nausea, dizziness and chest compression with in 15 minutes of shot. oxygen and laid supine flat. Itchiness within 60 minutes. Benadryl 25 mg. Resolution post shot 3 hours, released home. At 3 PM I experienced chest compression again and used my rescue inhaler with resolution of sx, also took another benadryl Note: I was premedicated with zyrtec and 50 mg of diphenhydramine at the time of the second shot

Other Meds: zyrtec diphenhydramine digoxin dulera premarin

Current Illness: none

ID: 1105583
Sex: F
Age: 19
State: WI

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient was given a 1mL dose instead of a 0.5mL dose, resulting in a sore arm. Pt was informed to seek medical advice in case of adverse effects.

Other Meds: Nuvaring, Clindamycin gel, Benzoyl Peroxide gel, multiple vitamin

Current Illness:

ID: 1105584
Sex: F
Age: 68
State: SC

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Tetracycline. Poison Ivy/Oak/Sumac/Mango sap (urushiol oil). No food allergies.

Symptom List:

Symptoms: Late on day of vaccine was cold/chilled. Next day Fever rose to 103 degrees at 7pm, chills, nausea, diarrhea, tired, dull headache all day. Took Tylenol/Motrin, slept, fluids. Knew these were possible side effects so next 2 days I rested & did nothing.

Other Meds: Lisinopril 5mg, simvastatin 10mg, allegra, flonase

Current Illness: None

ID: 1105585
Sex: M
Age: 72
State: FL

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
Hospital: Y

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

Lab Data:

Allergies: none known

Symptom List:

Symptoms: Lethargy, fatigue, cough, fever 103, pulse ranging from 43-149 adm dx: a-fib, pneumonia

Other Meds: levothyroxine and atorvastatin zinc, vitamin d, vitamin c, elderberry juice plus high concentration fruit veggie gummy

Current Illness: pneumonia in right lung (found after admission to ER later on 03/12/21) pulmonologist in hospital diagnosed as walking pneumonia

ID: 1105586
Sex: M
Age: 30
State: TX

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient stated that he felt dizzy and was sweaty. Patient was sitting on the floor. Patient had water and peanut butter crackers and stated to feel better after that. BP 126/88 and 54 HR

Other Meds:

Current Illness:

ID: 1105587
Sex: F
Age: 27
State: OR

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Prednisone (induces psychosis) Mangos & pistachios (causes rash and throat swelling) Metals (causes skin inflammation & infection ie earrings or medical staples)

Symptom List:

Symptoms: I noticed a very mild headache and slight coldness within 2 hours of my vaccine. Onset of my severe symptoms began around 10PM on 03/12/2021 with a stabbing headache (Felt like someone took an air pump and kept 'blowing up' my head. My eyes felt achy and heavy and every time I looked in a different direction I would get a zapping/electric feeling throughout my head that would cause my head and neck to spasm (longer duration) or twitch (quick jolt). This also caused dizziness). I got really cold and had intense shivering and shaking. Around midnight, my skin started feeling bruised all over my body (very sensitive to touch, including my bed sheets against my spine felt like rubbing up against a wound). At the same time, my joints (especially my neck, hips, and knees) got hot to the touch and were incredibly painful (induced tears). My muscles developed a deep ache that also caused significant pain. I felt very weak and confused. I didn't take my temperature until the early morning, and it was 102.9 at that time. I alternated taking Tylenol and Ibuprofen throughout the day, but my temperature stayed between 102 and 103.1 for about 24 hours, as did the previously noted symptoms. I noticed a gradual improvement of my symptoms over the next two days. On the evening of 03/14/2021, my headache worsened some, and I had an unexpected episode where I nearly passed out (dropped to the floor but stayed conscious). I also had intermittent foot tingling (very noticeable, not mild) over the course of a few hours. For 3 full days (but by far the most severe within the first 24 hours), I experienced some strange sound processing. Things like the sound of a car driving by or the ceiling fan felt like it echoed throughout my whole body and gave me an uncomfortable shivering feeling. As of today (03/16/2021), I am mostly recovered. I am still experiencing fatigue, a very mild headache, and some mild pain. My nausea has completely resolved, though that was never a chief complaint of mine. I realize that some of my symptoms are to be expected with this vaccine. But especially the level of pain I experienced throughout my entire body was very concerning and not something that I was aware could happen as a result of the vaccine.

Other Meds: These are my regularly scheduled daily medications, though most of these I hadn't taken yet on the day of my vaccination. Lithium Prazosin Propranolol Sertraline Trazodone Vitamins A, D, B6, & Magnesium

Current Illness: None

ID: 1105589
Sex: F
Age: 85
State: MA

Vax Date: 02/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: exactly 7 days out pt developed L upper arm redness swelling firmness itching, self resolved in 1wk

Other Meds:

Current Illness:

ID: 1105590
Sex: F
Age: 53
State:

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: dizziness, pre-syncopal. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1105591
Sex: F
Age: 44
State: NC

Vax Date: 01/03/2021
Onset Date: 01/11/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: It started out as a quarter size red mark at the injection site and grew to the size of a quarter dollar and was super itchy. It created MS hug, making it hard to breathe. The hug lasted about 2 1/2 weeks. My Dr prescribed a steroid cream and prescription Benadryl. After 24 hours from there the swelling and redness went down and there was a white hallow around my arm for about week.

Other Meds:

Current Illness:

ID: 1105592
Sex: F
Age: 50
State: KY

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: near syncope occurred about 25min after administering injection, patient reports she became flushed, felt lightheaded and slid down the wall to the ground, evaluated at site. transferred to ED for further evaluation. Discharged home from ED in good condition.

Other Meds:

Current Illness:

ID: 1105593
Sex: M
Age: 66
State: FL

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: Strong inflammation near to the neck of a strongly inflamed nodule. I don't know if it's an artery. But it is getting worse and worse.

Other Meds: None

Current Illness: High triglycerides

ID: 1105594
Sex: M
Age: 62
State: MA

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Fever of 101.0, lasted 12 hours. Sore arm and under arm for 24 hours. Headache 12 hours.

Other Meds:

Current Illness: nine

ID: 1105595
Sex: F
Age: 72
State: NJ

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Fentanyl, Ciprofloxacin, Metronidazole , Sulfonamide Antibiotics, contrast Dye, Strawberries

Symptom List:

Symptoms: The day after second vaccine I awoke with left underarm and neck lymph nodes swollen, tender, uncomfortable, with slight redness to area. Over course of next 5 days I felt more tired than usual as swelling subsided. After first vaccine I only experienced left arm soreness at injection site, mild headache and some tiredness for first 24-36 hrs.

Other Meds: Metoprolol Succinate ER, Olmesartan Medoxomil, Hydochlorothiazide, Vit D3

Current Illness:

ID: 1105596
Sex: F
Age: 62
State:

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: flushing, tongue tingling, redness chest, neck and cheeks. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1105597
Sex: F
Age: 35
State: CA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: Slumped over after receiving vaccine. Hx vasovagal with previous vaccines. Pt evaluated by MD & EMTs, DC home in stable condition.

Other Meds: None

Current Illness: None

ID: 1105598
Sex: F
Age: 40
State: KS

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
Hospital:

Vax Type:
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Symptoms: Progress Notes Expand AllCollapse All Patient: DOB: 4/11/1980 Date: 3/16/2021 MRN: Subjective Patient is a 40 y.o. female who was seen at COVID Vaccine Clinic today for her second 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 generalized weakness, "need for a quick snack". She denied rash, shortness of breath, difficulty swallowing or syncope 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 red flag findings ALLERGY REVIEW OF SYSTEMS Previous Reactions: none Objective Vitals Vitals: 03/16/21 0944 BP: (!) 158/103 Pulse: (!) 102 SpO2: 100% Physical Exam Constitutional: General: She is not in acute distress. Appearance: She is not ill-appearing or diaphoretic. Comments: Anxious on arrival to bay, "I think I just need a snack to feel better." HENT: Head: Normocephalic. Mouth/Throat: Mouth: Mucous membranes are moist. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Pulmonary: Effort: Pulmonary effort is normal. Musculoskeletal: General: Normal range of motion. Skin: General: Skin is warm and dry. Neurological: Mental Status: She is alert. Motor: No weakness. Psychiatric: Comments: Anxious affect Clinically, post injection anxiety related event. Elevated BP on arrival, improved with rest and granola bar. Salient anxious affect, post injection histamine response, requiring warm blanket, prolonged rest Ambulated with assist, additional snacks provided and pt discharged after 45" stay Assessment/Plan Treatment included: snacks 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)

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Current Illness:

ID: 1105599
Sex: M
Age: 72
State: ND

Vax Date: 03/12/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
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Symptoms: Complains of right hand pain, the meat part of the thumb. Says it is difficult to pick up heavy items and do daily activities. Aleve helps relieve the pain as does soaking the hand in warm water. He does take medication for Gout and also has arthritis in his back. Has not gotten any worse but not necessarily better. Has not seen a medical doctor.

Other Meds: Medication for Gout

Current Illness:

Date Died: 02/14/2021

ID: 1105600
Sex: M
Age: 99
State: TX

Vax Date: 01/11/2021
Onset Date: 02/14/2021
Rec V Date: 03/16/2021
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Allergies: Tetanus vaccine and toxoid, horse serum, ace inhibitors, Avelox (Moxifloxacin)

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Symptoms: Death on Feb 14, 2021

Other Meds: Carvedilol 3.125 mg: ? of 6.25mg twice a day Metformin 500 mg: 1 tablet twice a day Multivitamin: 1 tablet TruNature Vision Complex Lutein and Zeaxanthin 25mg / 5 mg: 1 tablet Glucosamine / Chondroitin: 1 tablet twice a day Aspiri

Current Illness:

ID: 1105601
Sex: F
Age: 33
State: TX

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/16/2021
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Allergies: animal dander, seasonal allergies

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Symptoms: Skin rash/hives first appearing on chest and back ~10 hrs following injection (3/11/21). Each day progressing in severity and spreading to upper arms, neck, head, waist. Went to dermatologist on 3/15/21 and received antihistamines and other topical creams. Skin rash remains severe.

Other Meds: Hydroxychloroquine, Clobetasol propionate 0.05%, steroid injection

Current Illness: Lichen planopilaris (LPP)

ID: 1105602
Sex: F
Age: 74
State: IL

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 03/16/2021
Hospital: Y

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Allergies: Augmentin

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Symptoms: 2/15-2/19 nightly headaches increasing in intensity each night. 2/20-2/25 nightly headaches with stabbing pain in left eye 2/26.. 2/22- saw Dr. /had CT. 2/24-returned to Dr. and was sent to ER due to high BP. Hospital admission that evening. 2/26 Steroid treatment stopped headaches and eye pain. 2/27 released from hospital after BP was <160. Diagnosis-migraines possibly triggered by vaccine. Pain/nausea elevated BP and decreased food intake which caused low blood sodium levels. IV treatments to increase sodium and lower BP. Dizziness from low sodium and high BP created fall risk, so bed had alarm. Bed confinement necessitated daily injections to prevent blood clots. Twice daily blood tests done to monitor sodium and potassium levels + kidney function.

Other Meds: Metatoprolol, Sertraline, Alendronate, Zyrtec, Calcium, Glucosamine, Fish Oil, Lutein

Current Illness:

ID: 1105603
Sex: F
Age: 77
State: CA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/16/2021
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Symptoms: Pt was given 0.3mL of Moderna (second dose) instead of the recommended dosage 0.5mL of Moderna

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Current Illness:

ID: 1105604
Sex: F
Age: 25
State: IL

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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Allergies: None reported.

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Symptoms: Pt received 2nd COVID vaccination at 1024. Once in observation area, pt became unresponsive shortly after sitting down. This provider was called over by staff to pt, which was noted to have dropped her water bottle and become unresponsive while sitting in the chair. Pt remained in the chair, did not fall or injure self. Upon arrival to patient, she was noted to have moderate pallor, with shallow, slow breathing, no cyanosis noted. Her head was aligned/adjusted to maintain an open airway. Pt noted to have some muscular rigidity and not verbally responsive. Another provider advised to call 911 due to unresponsiveness and seizure-like activity. 911 called @1027, meanwhile pt lifted and placed into a wheelchair and moved to treatment area where vitals were obtained, patient became verbally responsive @1034, responses/speech was clear but slow, pt was oriented to self, place, time and situation. Oxygen applied via facemask @4L. Pt provided staff with phone number to call her mother who was notified of daughter's condition @1032. FD Engine arrival @1033 report given and pt also became more responsive, eyes opened and stated clearly that she was feeling better. Pt color also improved. Pt denied any allergies, PMH or hx of seizure activity. Pt only reported a syncope many years ago. Ambulance arrival @1036, report provided to emergency staff and pt taken to ambulance for further evaluation @1039. Pt returned to vaccine clinic @1052, having declined ambulance transport. When asked about events, pt stated that upon sitting down she felt a sudden onset of moderate nausea and reached for her water bottle in her bookbag, pt states she could not recall or hear anything until she was moved to wheelchair, and did not recall how she came to be in the observation area (based on this information, suspected time unconscious was approx 6-12 seconds). Pt was educated regarding the many causes of syncope and the neccesity for further evaluation in the Emergency department. Pt discouraged from driving herself from the clinic and was able to obtain ride from her roommate. Pt urged again to obtain a ride to the hospital for further evaluation, understanding verbalized and agreed with plan of care.

Other Meds: None reported.

Current Illness: None reported.

ID: 1105606
Sex: F
Age: 54
State:

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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Symptoms: dizziness, lightheaded. Evaluated by EMS-Cleared

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ID: 1105608
Sex: M
Age: 49
State: MI

Vax Date: 03/09/2021
Onset Date: 03/11/2021
Rec V Date: 03/16/2021
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Allergies: None

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Symptoms: Developed Lichen Planus on scrotum 2 days after receiving the 1st dose of the vaccine. Swelling/bump appeared on scrotum. No pain associated. 1 week after 1st dose of vaccine and 5 days after first sign of swelling/bump I saw my PCP. Diagnosis of Lichen Planus made during visit. Doctor recommended steroid cream.

Other Meds: Atorvastatin, Lisinopril, Glyburide/Metformin, Januvia, multivitamin, niacin supplement.

Current Illness: None

ID: 1105609
Sex: F
Age: 22
State: ME

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/16/2021
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Symptoms: Sore arm: started several hours after the injection and was pretty mild, was very sore the next morning, almost gone if not completely gone by the following morning. No treatment Slight chills and shakiness the night of the vaccine (which was at noon), gone by morning. No treatment

Other Meds:

Current Illness:

ID: 1105610
Sex: F
Age: 50
State: OH

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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Allergies: Penicillin , sulfa drugs, amoxicillin

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Symptoms: 15 minutes after the injection I noticed that my heart was beating fast and I felt anxious. When I got up an started walking I felt slightly unbalanced. 15minutes later I felt like my lips were swelling and my throat felt tight. On route to the emergency room my lips , tongue and mouth felt numb and tingling. I arrived at ER at 0930 and was given IV Benadryl and prednisone by mouth by ER Dr.

Other Meds: aspirin, mondafinil, metoprolol, glipizide, nexium, metformin, atorvastatin,

Current Illness:

ID: 1105611
Sex: M
Age: 56
State: TX

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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Allergies: None

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Symptoms: Felt like passing out for 2 minutes. Patient states he was anxious because he don't like taking shot. He states he has history of passing out with shots. VSS: BP 92/61, Heart rate 86 bpm, 02 sat 97%, Blood Sugar 128

Other Meds: None

Current Illness: None

ID: 1105612
Sex: F
Age: 53
State: PA

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
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Allergies: none

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Symptoms: Severe chills, fever of 103, body aches, headache, fatigue, sore arm. Lasted for 48 hours

Other Meds: Eliquis

Current Illness: none

ID: 1105613
Sex: F
Age: 43
State: MO

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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Allergies: CORN, WHEAT

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Symptoms: pt was very anxious and claimed to have a scratchy throat, pt took zyrtec and felt better soon afterwards. Follow up with patient several hours later she claimed she was better.

Other Meds:

Current Illness:

ID: 1105614
Sex: M
Age: 84
State: NE

Vax Date: 03/05/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
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Allergies: No known allergies

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Symptoms: Patient received 2nd dose of Moderna vaccine on 3/5/21 to his left deltoid. On 3/14/21, he began to develop tender, swollen, and erythematous area of lymphadenopathy to his left axillary region. He presented to clinic on 3/16/21 with concerns for infection and was noted to have area of induration with surrounding erythema and swelling. Was treated for possible underlying cellulitis.

Other Meds: Apixiban, atorvastatin, carvedilol, gabapentin, glucosamine/chondroitin, norco, bengay cream, torsemide.

Current Illness: None

ID: 1105615
Sex: F
Age: 16
State: IL

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
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Allergies: none known

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Symptoms: No treatment needed, given outside FDA approved range

Other Meds: none

Current Illness: None

ID: 1105616
Sex: F
Age: 44
State: VA

Vax Date: 03/09/2021
Onset Date: 03/17/2021
Rec V Date: 03/16/2021
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Allergies: none

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Symptoms: Received vaccination on what would have been last day of menstral cycle. 24 hours after shot started cycle again but 30x worse ended up in the er and they said I should report to cdc as they are unsure if the shot is related but they had seen others with same issues.

Other Meds: sertraline, levothroxine, calcitril

Current Illness: none

Total 2021 VAERS Injuries: 679,999

Page last modified: 03 October 2021 5:28pm