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: 1107754
Sex: F
Age: 27
State: NC

Vax Date: 03/01/2021
Onset Date: 03/14/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: Eramyicin, Z packs

Symptom List: Dysphagia, Epiglottitis

Symptoms: Within 8 hours of receiving the vaccine, I started to feel weak and began to develop a fever. By that night I had a 102f fever. My muscles were very achey, and my heart was racing. I was slightly nauseous but still able to eat a little. By 24 hours after the shot my fever was down to 99f. I started to get diarrhea beginning the second day and has lasted until now the third day after vaccination day.

Other Meds:

Current Illness:

ID: 1107755
Sex: F
Age: 70
State: IN

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Anxiety, Dyspnoea

Symptoms: 12 hours after shot, shaking and cold. Leg cramps. Little sleep. However, I went throughout my day with no issues and symptoms ended around 6pm the next day.

Other Meds: rosuvastatin soft stool

Current Illness: none

ID: 1107756
Sex: F
Age: 68
State: NM

Vax Date: 03/07/2021
Onset Date: 03/16/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Swelling and redness in arm at vaccination site.

Other Meds: Levothyroxin Calcium Vitamin D Vitimin B12 Areds2

Current Illness: None

ID: 1107757
Sex: M
Age: 74
State: VA

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Approximately two days after first injection I developed two red bumps on right forearm which were extremely itchy. Benadryl Extra Strength gel relieved itching for a few hours. Red bumps spread to upper arms legs, feet and back over a period of two to three weeks. Saw dermatologist weekly for past three weeks. He prescribed antibiotic pills and topical cream including permethrin lotion which had no affect. Biopsy of one of the bumps on leg was done on 10 February which concluded the bumps were result of either a bite or allergic drug reaction. The rash/bumps are all over my body and itch intensely. Continuing to see physician in hope of finding a resolution to problem.

Other Meds: Artovastin 80mg, Chlorthalidone 25 mg, Amlodopine 10 mg, Klor-Con 10 mg, Fish Oil 2400 mg, Mulitvitamin Equate Men 50+,

Current Illness: None

ID: 1107758
Sex: F
Age: 51
State: TX

Vax Date: 02/10/2021
Onset Date: 02/22/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Report severe hair loss. Treatment: PCP visit Outcome: All test were normal except vitamin D was low and placed on vitamin D supplements. Scheduled to see a dermatologist.

Other Meds:

Current Illness:

ID: 1107759
Sex: F
Age: 54
State: NY

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: None known

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

Symptoms: I received the shot at 9:00am Friday March 12, 2021. I woke at 3:08am Saturday March 13th, 2021. I woke in a pool of sweat. The bed sheets were actually wet. I began throwing up, and severe diarrhea, and an intense headache. After several hours, my right leg started to cramp for about 30 minutes. I was sick for about 12 hours, and I could not keep any food down until 4:00pm Saturday March 13th, 2021. It was a miserable and scary night.

Other Meds: None. I did take an Ibuprofen at 10:00am Friday March 12, one hour after my vaccination.

Current Illness: None

ID: 1107760
Sex: F
Age: 55
State: CA

Vax Date: 03/08/2021
Onset Date: 03/15/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: Hazel Nuts

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I?m suffering from right arm pain that began a week after my first injection. I?m currently in a lot of pain, unable to use my arm. I?m taking Aleve and Tylenol intermittently.

Other Meds: Rosuvastatin, Levothyroxine, Bupropion, Trintellix, B12, B6, D

Current Illness:

ID: 1107761
Sex: F
Age: 36
State: IL

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: HEADACHE, CHILLS, AND SORE THROAT

Other Meds:

Current Illness:

ID: 1107762
Sex: F
Age: 66
State: CA

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 03/17/2021
Hospital:

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

Allergies: statins, sorbitol

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: patient reported severe neuropathy bilateral legs and feet, dizziness, nausea very similar to 3 years ago when she was on chemotherapy for breast cancer. Neuropathy had resolved.

Other Meds: none

Current Illness: none

ID: 1107763
Sex: M
Age: 57
State: MA

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

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

Lab Data:

Allergies: Penicillin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Chills, shivering, low fever, aches, headache

Other Meds: Amlodopine, Losartan

Current Illness: none

ID: 1107764
Sex: F
Age: 69
State: PA

Vax Date: 03/09/2021
Onset Date: 03/16/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Began to itch at vaccine site a week after receiving shot.

Other Meds:

Current Illness:

ID: 1107765
Sex: F
Age: 74
State: IL

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: penicillin sulfa

Symptom List: Rash, Urticaria

Symptoms: headache, fever, bone and muscle pain, general body ache

Other Meds: levothyroxine atenolol omeprazole spironolactone ipratroplum/albuteral furosemide multiivitamin glucosamine sulfate b6 folic acid aspirin 81mg magnesium

Current Illness: none

ID: 1107766
Sex: F
Age: 45
State:

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: Latexs, shellfish, nuts, sulfa drugs

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

Symptoms: Tingling back of throat and tip of nose. Dizzy on standing.

Other Meds:

Current Illness:

ID: 1107767
Sex: F
Age: 61
State: CO

Vax Date: 03/11/2021
Onset Date: 03/13/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: woke up with nausea 36 hours after getting the shot. After vomiting I was able to go back to sleep. The entire next day I didn't feel well. Weak, slightly nauseous. All the symptoms lasted approximately 24 hours then I was back to normal. In case it matters. I believe I had Covid last February but it was prior to public knowledge and test availability.

Other Meds: Fosamax, Collagen peptides

Current Illness: none

ID: 1107768
Sex: M
Age: 12
State: TN

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: After vaccine was administered it was reported that child was not of age to receive the vaccine. Our member contacted the guardian to inform child was not eligible to receive this vaccine. No adverse effects reported.

Other Meds: Not known

Current Illness: Not known

ID: 1107769
Sex: F
Age: 31
State: NC

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 1125- c/o "my tongue feels funny". No obvious swelling noted. BP 154/72, resp 20 Pulse ox 100% Takes pepcid AC daily for "stomach problems". States "my friend made me anxious before my shot" 1130 - Benadryl 25mg po given per standing order. 1140 BP 127/71 pulse 60 resp 18 pulse ox 100% 1145 - denies further c/o tongue feeling funny. 1155 - BP 120/80 Pulse 58 resp 18 pulse 100% 1200 Denies further feeling in tongue. Escorted ambulatory with steady gait to car. Instructed friend to drive.

Other Meds:

Current Illness:

ID: 1107770
Sex: M
Age: 61
State: IN

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/17/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: NKA

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

Symptoms: 23 HOURS AFTER VACCINE DEVELOPED LIP SWELLING , BODY PRURITIS, AND BILATERAL BLOTCHY HANDS. ABDOMINAL PERIUMBILICAL PAIN. SYMPTOMS LASTED 12 HOURS. STARTED ON OZEMPIC 7 WEEKS AGO AND HAD SAME ABDOMINAL PAIN 3 WEEKS AGO BUT NONE OF THE OTHER SYMPTOMS. THIS ABDOMINAL PAIN MAY NOT BE RELATED. IMPRESSION: PROBABLE ALLERGY TO MODERNA. PCP WAS NOTIFIED BY VACCINE CLINC. PATIENT ADVISED TO SEE ALLERGIST IF HE CHOOSES TO PROCEED WITH SECOND DOSE OF MODERNA.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1107771
Sex: F
Age: 68
State: OK

Vax Date: 03/03/2021
Onset Date: 03/11/2021
Rec V Date: 03/17/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Got COVID shot March 3, then had some alteration of taste around March 8 or so, then L facial paralysis consistent w Bell Palsy on March 11.

Other Meds: amitriptyline, vitamin D, fluoxetine, Norco, Basaglar, levothyroxine, lorazepam, losartan, metformin, pantoprazole, rosuvastatin, triam-HCTZ

Current Illness:

ID: 1107772
Sex: F
Age: 68
State: IN

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe arm pain - could not lift arm for 2 1/2 days, injection site bruise, 101 temp first 36 hours, 100.2 next 24 hours, extreme fatigue (slept 18 hours day after injection).

Other Meds: Rouvastatin 10, hydrocodone-acetam 5-325, allopurinol 300, hydralazine 25, omeprozole 20, gabapentin 200, valsartan 320, vitamin D2 1.25, alendronate sodium 70

Current Illness: None

ID: 1107773
Sex: U
Age:
State: AZ

Vax Date:
Onset Date:
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Approximately 3 hours after receiving the injection, I developed chills, body aches, joint pain and extreme fatigue (and a sore arm at injection site). No fever. The only symptoms remaining upon waking the next morning were slight fatigue and a sore arm. All symptoms were gone the next day.

Other Meds:

Current Illness:

ID: 1107774
Sex: F
Age: 69
State: FL

Vax Date: 02/06/2021
Onset Date: 03/07/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: Raw shell oysters and clam. Raw only. I tolerate cooked shellfish.

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

Symptoms: Lips, tongue and inside mouth are swollen. Tastebuds are overly active. Feels like I?ve eaten hot food and burned my mouth. Tongue and lips have a tingle sensation

Other Meds: Keppra, losartin, tricor, eliquis , Crestor

Current Illness: None

ID: 1107775
Sex: F
Age: 68
State: MD

Vax Date: 02/25/2021
Onset Date: 03/15/2021
Rec V Date: 03/17/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: 03/15/2021: Presented to the emergency department with left flank pain. The patient was admitted with an obstructing kidney stone with associated hydronephrosis. The patient had a ureteral stent placed and discharged the next day with outpatient follow up.

Other Meds:

Current Illness:

ID: 1107776
Sex: F
Age: 42
State: WV

Vax Date: 02/25/2021
Onset Date: 03/05/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: 7 days after injection: 1. large swollen red patch, itchy, resolved within 36 hours. 2. mild headaches, headaches continues and increased in intensity as time went on. 14 days after injection: dizzyness and mild motion sickness, headaches. mostly resolved by 3/17/21

Other Meds: levothyroxine, vitamin D

Current Illness: None

ID: 1107777
Sex: F
Age: 71
State: PA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: strawberries, possible reaction to contract dye- anapylactic reaction

Symptom List: Injection site pain, Pain

Symptoms: pt was experiencing extreme anxiety prior to vaccination today, high bp following initial dose with dizzy spells, pt is alert and stable, resting comfortably, pt bp returned to wnl after spending time in the observation tent, observed pt walking- pt is steady, no dizziness, pt felt comfortable to drive herself home.

Other Meds: eliquis, asthma inhaler, famodadine

Current Illness: asthma

ID: 1107778
Sex: F
Age: 66
State: CA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: Unk

Symptom List: Injection site pain, Menorrhagia

Symptoms: Injection was apparently given in the bicep area as opposed to the deltoid. Patient complained of soreness and swelling thereafter (which is improving by the time she comes in for her second vaccination,) but she still has some limitations in range of motion which inhibits her work as a sign language interpreter. She has had no distal paresthesias or weakness, just soreness surrounding the site which she indicates to be the left inferolateral bicep area where there is a minute reddish (presumed) puncture site and underlying induration.

Other Meds: Unk

Current Illness: Unk

ID: 1107779
Sex: M
Age: 69
State: NJ

Vax Date: 03/06/2021
Onset Date: 03/15/1921
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: Mold

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

Symptoms: Small Pox vaccination scar has swollen and itches

Other Meds: None

Current Illness: None

ID: 1107780
Sex: F
Age: 64
State:

Vax Date: 03/01/2021
Onset Date: 03/11/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: severe insomnia

Other Meds: vitamins D, C, B, 5HTP

Current Illness:

ID: 1107781
Sex: F
Age: 35
State: IL

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: HEADACHE, CHILLS, AND SORE THROAT

Other Meds:

Current Illness:

ID: 1107782
Sex: F
Age: 57
State: MI

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Patient was sitting in waiting area post vaccination. A pharmacist from the vaccination area was called over to her because she was not feeling well. As the pharmacist was speaking with her patient fainted. Pharmacist was holding on to her to keep her from falling. I went over and took her BP which was 65/44, pulse 53. After a few minutes patient regained consciousness and was able to give us her information. 911 was also called. Patient reports a history of severe reaction to Penicillin. Patient reports history of syncope at eye doctor's office. Her BP was taken again at 10:20am and was 98/72, pulse 70. 911 arrived and patient chose to be taken to hospital.

Other Meds:

Current Illness: none reported

ID: 1107783
Sex: M
Age: 45
State: NC

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: Numbness and tingling in (L) arm shot taken, and face.

Other Meds: daily vitamin Prescribed hctz/lisinopril but hadn't taken it yet for the day Prescribed sertraline but hadn't taken it yet for the day

Current Illness: none

ID: 1107784
Sex: F
Age: 58
State: MI

Vax Date: 01/09/2021
Onset Date: 01/11/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: demerol - rash penicillin - rash stadol - rash

Symptom List: Injection site pain

Symptoms: Received first dose of Pfizer vaccine 1/9/2021. On 1/11/2021 developed headache, body ache, sore throat, nasal congestion. PCR positive for COVID-19.

Other Meds: B-complex vitamin, cholecalciferol, estradiol, krill-om-3-dha-epa-phospho-ast, progesterone

Current Illness: chronic fatigue

ID: 1107785
Sex: F
Age: 63
State:

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Dizzy, headache. Left chest pressure. Said she has an appointment with cardiologist this week. She was seen in Emergency room last week with same complaint and was told it was bone or muscle, not heart. All symptoms resolved when she left.

Other Meds: Prednisone and inhaler for asthma

Current Illness:

ID: 1107786
Sex: M
Age:
State: IN

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Chills, headache, fever, joint pain, muscle pain, zero energy, lack of appetite.

Other Meds: Cosopt, lumigan, estemide, metoprolol, losartan

Current Illness: First vaccine shot reaction lasted 30 hours.

ID: 1107787
Sex: M
Age: 44
State: NC

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: Hx of anaphylaxis to Haldol.

Symptom List: Tremor

Symptoms: Moderna vaccine dose 1 was administered at around 1:40 PM. Pt reports itchiness, N/V,and dizziness about 10 minutes after injection. Epinephrine 0.3 mg administered IM LVG 15 minutes post vaccine. S/S resolved for about 5-10 minutes. S/S returned including SOB, with throat/tongue/lip swelling and tingling. Started PT on 2 L O2 via NC. Administered another 0.3 mg of epinephrine IM LVG. S/S did not resolve so another 0.3 mg of epinephrine was administered IM LVG. Patient still reported SOB, generalized itchiness, and throat swelling. 125 mg of Solumedrol was then administered IM RVG. 50 mg of diphenhydramine was administered IVP in the left forearm. EMS was called and patient refused transport to hospital. S/S resolved.

Other Meds: Fluoxetine, Seroquel, and Singulair taken on 03/11/2021.

Current Illness: Patient reports no illness within the past month.

ID: 1107788
Sex: M
Age: 66
State: IN

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/17/2021
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Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Mild flu-like feeling, very tired, no appetite, only wanted to rest and sleep. I check my blood pressure often and during the day after my shot my pressure was high all day, at one point was 160 over 90. As of today, the 17th of March, my pressure has gone down to normal. My symptoms lasted just over 30 hours.

Other Meds: None

Current Illness: None

ID: 1107789
Sex: M
Age: 55
State:

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/17/2021
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Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Fever, chills, nausea, vomiting, diarrhea, body aches

Other Meds:

Current Illness:

ID: 1107790
Sex: F
Age: 66
State: KY

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 03/17/2021
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Allergies: None

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

Symptoms: 2 weeks sore at injection site and limited shoulder movement.

Other Meds: Multi vitamin

Current Illness: None

ID: 1107791
Sex: F
Age: 61
State: NY

Vax Date: 03/14/2021
Onset Date:
Rec V Date: 03/17/2021
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Allergies: unknown

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: brief swelling at injection site, gave patient loratadine, swelling then started to decrease. Patients son (nurse) claimed to have seen this before and said it was a mild allergic reaction. Called patient next day, said she was fine just a little sore.

Other Meds: unknown

Current Illness: unknown

ID: 1107792
Sex: M
Age: 28
State:

Vax Date: 02/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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Allergies: None

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

Symptoms: Cold, fever, chills, body ache, no energy. Felt as though patient had a cold. Fever was very high to the point body was sweating. Took Tylenol( one tablet of 500mg) few hours after onset of symptoms. Fever went down after taking Tylenol and was able to sleep well after. Getting better throughtout the day after.

Other Meds: None

Current Illness: None

ID: 1107793
Sex: F
Age: 31
State:

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/17/2021
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Allergies: Allergic to Gabapentin

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

Symptoms: Headache for 72 hours after injection. Low grade fever, chills, and weakness 24 hours after injection lasting approximately 16 hours.

Other Meds: Oral contraceptive, Lexapro, antihistamine, multivitamin, magnesium, Vitamin D

Current Illness: None

ID: 1107794
Sex: F
Age: 55
State: WV

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/17/2021
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Allergies: Penicillin

Symptom List: Pain in extremity

Symptoms: after about 45 minutes, both wrists starting to rash and itch. It spread to my chest, neck, back and stomach. The itch was kind of a stinging itch and my palms were hot. I called the facility and they asked me to come by so they could look at it. They said it was a reaction but not severe enough for an epi pen. They told me to go to my Dr, which had left for the day so I went to MedExpress. My bp on arrival was 150/98. They gave me a shot of Decadron. My bp went down to 120/80 before leaving and my itch had eased a little. They prescribed 5 days of Prednisone and Zyrtec. The next morning, I had a severe headache and could not concentrate, I felt a little itchy and tired. Today, no rash or itch just nervousness on the inside from the prednisone and my hands are still hot sometimes.

Other Meds: Centrum Silver Multivitamin

Current Illness: none

ID: 1107795
Sex: F
Age: 68
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/27/2021
Rec V Date: 03/17/2021
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Allergies: sulfa

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

Symptoms: pt stated that both hands and arms started itching. She took Zyrtec and Allegra on them which did not help. She developed a rash on the palms of her hands, bottoms of her feet, upper right arm and right thigh. She contacted her doctor and was told to use Benadryl. This helped very little. Pt went to the doctor where she was given a steroid shot and prescribed a steroid cream to use for 1 week. She was not advised not to get the 2nd dose. She had an annual appt to see her Dermatologist and they drained a cyst that had developed on her back. The doctor thinks this developed from the infection from the rash her body was fighting but was advised to get the 2nd dose. The skins on her hands and feet peeled off so she went back to her PCP. She was referred to an allergist and prescribed her more steroid cream. Pt went to allergist which did a scratch test for 75 different foods and a blood test for blueberries (these were eaten about the time the rash appeared) which were both negative. Pt took the 2nd dose of the covid vax where she only had a little itching and a minor rash. She applied triamcinolone acetonide which helped. Pt says she no longer has any of these symptoms.

Other Meds: Lisinopril, metformin, sertraline, Januvia, rosuvastatin, famotidine, B complex, ginkgo-biloba, multiitem, Vegan glucosamine sulfate,

Current Illness: no

ID: 1107796
Sex: F
Age: 28
State: VA

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/17/2021
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Allergies: none

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

Symptoms: dizziness normal vital signs

Other Meds: none

Current Illness: none

ID: 1107797
Sex: M
Age: 58
State: MD

Vax Date: 03/07/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: severe muscle pain on injection site 10 days after getting dose. i could barely move my left arm

Other Meds: telmisartan/amlodipine turmeric

Current Illness:

ID: 1107798
Sex: M
Age: 27
State: GA

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/17/2021
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Allergies: Soy

Symptom List: Vomiting

Symptoms: Fever starting roughly 12 - 16 hours after injection, lasting at least three days. Soreness and fatigue. Occasional nausea

Other Meds: Antihistamine tablets daily for allergies Tylenol prior to vaccination

Current Illness:

ID: 1107799
Sex: F
Age: 66
State: MD

Vax Date: 03/08/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Developed a rash around injection area in left arm 9 days after injection.

Other Meds: Levothyroxin 112 mcg, atenol/chlor 50-25, gabapentin 300 mg 2 tab 3 x day, 81 mg aspirin

Current Illness: no

ID: 1107800
Sex: F
Age: 43
State: IN

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/17/2021
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Allergies: no

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

Symptoms: day after i had nausea and fatigue some dizziness. later in the evening i started to develpo a rash on my forarms. The right arm seems to be worse i took a benadryl and have not noticed any improvment. Itching seems to be spreading.

Other Meds: numbatone, xanaflex ,synthroid, valium

Current Illness: had a sinus cold a few weeks prior

ID: 1107801
Sex: F
Age: 73
State:

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/17/2021
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Symptom List: Injection site swelling, Limb discomfort

Symptoms: Extreme arm pain (9 out of 10 on pain scale), hip pain (7 out of 10 on pain scale), and pain in the joints of the fingers (10 out of a 10 on pain scale)...could not bend fingers and woke her up several times throughout the night

Other Meds:

Current Illness:

ID: 1107802
Sex: F
Age: 78
State: TN

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 03/17/2021
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Allergies: Codin

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

Symptoms: 3 days after vaccine experienced fever, extreme muscle pain, extreme bone pain, head ache, chills. 13 days after vaccine experienced extreme swelling in glad under left ear and down the neck under chin. Ear ache in both ears but worse in the left ear. Visited physician next day and was prescribed an antibiotic. Was better in 14 days.

Other Meds: Methotrexate, Hydroxychloroquine, Pantoprazole, Folic Acid, Fish Oil, Calcium , Vitamin D3

Current Illness: Arthritis

ID: 1107803
Sex: F
Age: 37
State: KY

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 03/17/2021
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Allergies: allergic to cipro

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

Symptoms: Dizziness, numbness in left arm, heart palpitations, nausea, blurred vision. Began within the hour of the dose. Dizziness, arm numbness, blurred vision lasted less than 24 hours. Heart palpitations lasted 3 days. Breastfed twins also fussy, irritable, trouble sleeping, smaller appetites for three days.

Other Meds: prenatal vitamins

Current Illness: na

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am