VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer

Incidents per State

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

ID: 1110261
Sex: F
Age: 83
State: FL

Vax Date: 03/08/2021
Onset Date: 03/15/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Caller c/o of N/V/D beginning today every hour for 4 hrs., denies fever, shortness of breath, chest pain. Caller has no other symptoms, will attempt to drink water & eat bland foods. Advised to contact PCP if symptoms do not resolve. Spoke with caller, feeling much better, symptoms resolved, eating and drinking well -KLC

Other Meds: omeprazole atenolol "high cholesterol" medication

Current Illness:

ID: 1110262
Sex: M
Age: 74
State: VA

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lot:
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Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Significant painful recurring intermittently muscle spasm on chest wall that continued until 3/15/2021. It was so strong that I initially thought I was having a heart attack. However, other symptoms associated with such an event did not occur, that is no profuse sweating, rapdid heart beat, etc. On Monday, I visted my doctor who listened to my heart and took an EKG. The EKG was normal and she felt that the spasm was associated with the Moderna shot. I have had no further such events

Other Meds: Atenenol, Fluvastatin

Current Illness: None

ID: 1110263
Sex: M
Age: 67
State: IN

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Uncontrolable shaking Fever Overall flu (like) symptoms Vomiting

Other Meds: Metformin Rosuvastatin Losartan Levimer Trulicity

Current Illness: None

ID: 1110264
Sex: M
Age: 63
State: IN

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
Manufacturer:
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Vax Site:

Lab Data:

Allergies: No

Symptom List:

Symptoms: 100.5 fever, severe pain and body aches

Other Meds: Lisinopril, amlodipine , metoprolol, atorvastatin

Current Illness: None

ID: 1110265
Sex: F
Age: 57
State: CA

Vax Date: 01/20/2021
Onset Date: 01/01/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Tinnitus

Other Meds: None

Current Illness: None

ID: 1110266
Sex: F
Age: 67
State: OK

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Preservatives in apple juice, white bread, valium, garlic.

Symptom List:

Symptoms: Following the vaccine went to the grocery store and had her mask on, when she got home she was itching around the mask area/mouth area. It then kept itching, and that night she went to rub it and it was full of blisters that popped and oozed and continued like that. Now her skin feels like elephant skin, burning and itching, and feels like she has somebody burning her with a cigarette and stabbing her with a needle at the same time, and this is everywhere and extremely painful that continues to keep spreading. She has it from the top of her head, in her head, in her ears, and down to her feet to the arch of her foot. She went to the UC the morning of 3/11/21, and she told her that she needed to go to the ER, which she did. They sent her home with Benadryl cream, Benadryl tablets and put on Prednisone, a Z-Pak and nothing has helped. She went back to the ER on 3/12/21, and was put on Hydroxyzine. Her eye is so swollen right now that she can only see a small slit through it and the left eye is swollen shut and cannot take the pain and is going to go back to the ER one more time.

Other Meds: Bupropion, Buloxetine, Furosemide, Gabapentin, Pantoprazole, potassium, Pamidene, Losartan, Hydrocodone, Albuterol.

Current Illness: None.

ID: 1110267
Sex: F
Age: 51
State: IN

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Penicillin, erythromycin

Symptom List:

Symptoms: I experienced pain and swelling at the injection site within 12 hours of receiving the injection. About 24 hours later a headache started. After 36 hours I began experiencing tiredness, chills and a fever. The side effects have disappeared after 48 hours.

Other Meds: None

Current Illness: None

ID: 1110268
Sex: F
Age: 59
State: IN

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Chills. Took 3 ibuprofen went to bed fine the next Am

Other Meds: Metropol. Zoloft. Vit D. Multi vitamin and a 1000mg of Vitamin C

Current Illness: None

ID: 1110269
Sex: M
Age: 64
State: IN

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: none

Symptom List:

Symptoms: 4" x 6" swelling and redness around shot area generating temperature of 101 degrees two and three days after being administered, headache lasting 2 days, joint pain lasting one day

Other Meds: Lisinopril 20mg 1xdaily, Atorvastatin 20mg 1xdaily, , Levothroxine25 mg 1xdaily, Tamsulosin 0.4mg 1xdaily, Fluticasone Propionate spray 50mg 1xdaily, Azelastine HCI spray 0.1% 2xdaily,, Asprin 81mg 1xdaily, Vitamin C 1000mg 1xdaily, Vitam

Current Illness: common cold (6th day)

ID: 1110270
Sex: M
Age: 67
State: CT

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/18/2021
Hospital: Y

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

Lab Data:

Allergies: Tylanol, NSAIDs, Almonds, Apples

Symptom List:

Symptoms: Given shot in hospita, then within 15 minutes brought to Emergency Room, after I Became non-responsive, While in Emergency Room had following issues: large rash and itching on upper body, Bruise down arm from injection site, extreme Headache, High Blood Pressure, Loud Ringing in ears, shaking and body tremors. Benadryl given for rash and itching.

Other Meds: omeprazol, Lactulose, Diltiazem

Current Illness: Liver Cirrhosis, Heart (Pacemaker) Moderate Dementia

ID: 1110271
Sex: F
Age: 69
State: PA

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: environmental

Symptom List:

Symptoms: I had severe head ache, chills, nausea. I still have a slight head ache daily since the vaccine

Other Meds: Pravachol 10 mg 1xd Multi vitamin 1xd fish oil 1000 mg 1xd calcium 600 mg 1xd vitamin C 500 mg 1xd biotin 5000 mg 1xd vitamin D3 2000iu 1xd CoQ10 100 mg 1xd Loratadine 10 mg 1xd Ambien 5 mg 1xd as needed

Current Illness: none

ID: 1110272
Sex: F
Age: 73
State: FL

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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Lab Data:

Allergies: sulfa

Symptom List:

Symptoms: Pt. stated she started feeling a burning sensation 5 minutes after getting vaccinated, the burning sensation moved to her chest and then to her legs and it went away on its own. At 10:47 am pt. stated she is feeling OK and wants to go home.

Other Meds: Omeprazole

Current Illness:

ID: 1110273
Sex: F
Age: 65
State: FL

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/18/2021
Hospital:

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Symptom List:

Symptoms: Caller c/o headaches & dizziness since receiving the vaccine on 3/08/2021. Spoke with PCP who prescribed her meclizine, however she is still symptomatic.Spoke with caller who states that she is feeling much better, symptoms resolved as of yesterday.

Other Meds: metformin aspirin 81mg priamterene-hctz atenolol lisinopril pravastatin omeprazole meclizine

Current Illness:

ID: 1110274
Sex: M
Age: 46
State: KS

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
Hospital:

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Allergies: None

Symptom List:

Symptoms: Violent uncontrollable shaking (convulsions) for about 30 minutes in the middle of the night. Started around 2 am I believe. My wife had the same vaccine the day prior and a similar experience. Can't overemphasize how serious the shaking was and it was scary.

Other Meds: Daily multivitamin, daily Vitamin c, 1.5mg melatonin, sertraline 50 mg

Current Illness: None

ID: 1110275
Sex: F
Age: 75
State:

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/18/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: pt experienced dizziness & neck pain following the vaccination. pt. denies any other s/s. resolved with comfort & calming measures. BP: 152/75, HR: 81, RR: 18. Medic paresent.

Other Meds:

Current Illness:

ID: 1110276
Sex: F
Age: 60
State: PA

Vax Date: 03/08/2021
Onset Date: 03/16/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lot:
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Lab Data:

Allergies: None known

Symptom List:

Symptoms: On day 8, the injection site arm throbbed, got very swollen (probably an area of 6"x6") very red, hot and itchy.

Other Meds: Atenolol 25mg Atvorstatin 10mg

Current Illness: None

ID: 1110277
Sex: F
Age: 74
State: PA

Vax Date: 03/06/2021
Onset Date: 03/12/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Cats. Some shellfish - oysters, lobster. Codeine, maybe.

Symptom List:

Symptoms: The day of the vaccination March 6, 2021, I had just a sore arm. The tenderness lasted about 36 hours. A week later beginning the evening of March 13, 2021, my arm at the injection shot swelled to the circumference size of a tennis ball. The swollen area was very red, very warm, had hives and itched. The reaction has mostly subsided as of this date March 18, 2021. In the interval between March 6 and 13 I had other small patches of itchy rash across my shoulders and lower back that scabbed as they cleared up.

Other Meds: Calcium and vitamin D. Flaxseed oil. Estrace cream. Clindamycin lotion.

Current Illness: None

ID: 1110278
Sex: M
Age: 66
State: AZ

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies: Latex effects skin

Symptom List:

Symptoms: Chills and temperature increase which lasted for a couple hours.

Other Meds: Omeprazole 20mg, 81 mg aspirin, rosuvastatin 40 mg, levothyroxine 150 mcg, multiple vitamin.

Current Illness: No

ID: 1110279
Sex: F
Age: 24
State: MA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lot:
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Vax Route:
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Lab Data:

Allergies: Augmentin

Symptom List:

Symptoms: Sore throat, fever, cough, low pulse ox, headache, face flushing, fatigue, body aches

Other Meds: Celexa, qvar

Current Illness:

ID: 1110280
Sex: F
Age: 48
State: MD

Vax Date: 03/10/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Starting 24 hours after the injection, extreme fatigue for about 48 hours. Also, very slight soreness at the injection site. Starting the 7th day, injection site swelled, became firm, warm to the touch, and started itching.

Other Meds: Parnate, Multi-vitamins, Biotin

Current Illness: N/A

ID: 1110282
Sex: F
Age: 52
State: CA

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: migraine within 24 hours of 2nd vaccine, migraine 4 days after 2nd vaccine, migraine 5 days after 2nd vaccine

Other Meds: Lexapro 20mg, Vitamin D 4000IU

Current Illness: none

ID: 1110283
Sex: F
Age: 61
State: FL

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Temperature 100, Chills, mild headache

Other Meds: None

Current Illness: None

ID: 1110284
Sex: F
Age: 39
State: FL

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: headache, nausea, vomiting, fatigue and left arm soreness

Other Meds: None

Current Illness: NOne

ID: 1110285
Sex: F
Age: 58
State: FL

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: 03/13/2021 tired, arm swollen, red circle on arm, hot to touch 03/04 hives on the neck and went away within a few hours Recommendation cold compress to the area, you could call your PCP for any other recommendations but it sounds like your symptoms are subsiding from what you are stating

Other Meds: Zyrtec

Current Illness:

ID: 1110286
Sex: F
Age: 57
State: NY

Vax Date: 03/04/2021
Onset Date: 03/11/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: All forms of penicillin, shellfish trigger reactions, also lisinopril

Symptom List:

Symptoms: "COVID arm" - red raised "lump", about 2.5 by 3.5 inches around, like hives but more solid, hot, some pain but and itching but not severe. Started about 7 days after shot on 3/4/21.

Other Meds: Levothyroxin, Omeprazole, Atorvastatin, Metformin, Losartan HCTZ, pregnancy multivitamins with added A, C, and calcium (for low vitamin levels, not pregnant)

Current Illness: None

ID: 1110287
Sex: M
Age: 32
State: NY

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Fever, chills, joint pain, nausea, fatigue

Other Meds:

Current Illness:

ID: 1110288
Sex: F
Age: 59
State: MA

Vax Date: 03/03/2021
Onset Date: 03/16/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: No symptoms immediately after first shot except after 13 days later woke up with pain in arm (same arm as injection). Pain is still present after 3 days. Taking ibuprofen, ben-gay, and heating pad with essentially no effect. If I keep arm elevated the pain is slightly less. Not able to sleep due to discomfort on Day 2 and was able to sleep on Day 3 although woke up at 2am and put on ben-gay and heating pad. Constant pain limiting mobility in arm.

Other Meds: lisinopril

Current Illness: no

ID: 1110289
Sex: M
Age: 72
State: CT

Vax Date: 03/10/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Terazosin-HTN/Tachycardia HCTZ_urinary incontinence Quetiapine-Urinary incontinence Diphenhidramine-htn,anxiety,tachycardia Cipro-diarhea Metforin-diarrhea

Symptom List:

Symptoms: Patient has gastritis, fatigue, headache, unable to eat meals x 1 week.

Other Meds: ALPHA LIPOIC ACID CAP/TAB TAKE BY MOUTH EVERY DAY ASPIRIN 81MG EC TAB TAKE ONE TABLET BY MOUTH DAILY AZELAIC ACID 20% TOP CREAM (Status = EXPIRED) APPLY A SMALL AMOUNT TOPICALLY TWICE DAILY Last Released: 1

Current Illness: as below

ID: 1110290
Sex: M
Age: 63
State: IL

Vax Date: 03/12/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital: Y

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

Lab Data:

Allergies: nka

Symptom List:

Symptoms: 3/17/21 63 y.o. male who presents with sudden onset of chest pain and palpitations, which occurred while patient was exerting himself. Pain is substernal, radiated to the left arm, associated with lightheadedness. Denies diaphoresis or nausea. Per EMS there were short runs of nonsustained ventricular tachycardia 3/18: - remains inpatient admission as of 3/18/21 @ 0900 63 y.o. male with a past medical history of nonsustained ventricular tachycardia. He states he was lifting a couch yesterday and his heart started beating fast. He did not really have any chest pain, but felt a little bit lightheaded. He called an ambulance and they brought into the ER. In the emergency room his EKG did show some frequent PVCs. However, he did not really require any intervention. He was given 3 nitro, but it really did not make any difference in the way he was feeling. The patient denies multiple times that he actually had chest pain. He states he just felt like his heart was beating funny. The patient's most recent stress test was a nuclear stress test in May of 2019. Overnight, the patient has felt very well. He denies any significant chest pain. He denies any further heart palpitations. On the monitor he would occasionally going to bigeminy, which is not abnormal for him. EKG this morning was unremarkable. After speaking with the patient's wife, she told me that he has had a several month history of very limited exertion. She states every time he exerts he becomes extremely dyspneic and has heart palpitations and sometimes almost passes out. She states last night he was extremely diaphoretic and very nearly passed out.

Other Meds: Medications Administrations Status Frequency Start Date End Date metFORMIN (GLUCOPHAGE) tablet 1,000 mg Order Report Active 2 TIMES DAILY WITH MEALS 03/18/21 09/14/21 fish oil omega-3 fatty acids capsule 2,000 mg Order Report Active DAILY

Current Illness:

ID: 1110291
Sex: F
Age: 44
State: MN

Vax Date: 03/04/2021
Onset Date: 03/12/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Rash on left arm 8 days after vaccine. Minor rash, started as "couple of little dots" and spread to oval/rectangle; gone after a couple of days. Rash can no longer be seen and is either completely resolved or possibly very slightly itchy. Patient also submitted a VAERS report herself. She had a local reaction (redness, swelling, irritation) to a flu shot several years ago but gets the flu shot every year and has not had other reactions.

Other Meds:

Current Illness:

ID: 1110292
Sex: M
Age: 84
State: FL

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Lot:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Intermittent left-sided knee pain radiating down leg, spoke with physician who advised him to go to urgent care however he has not gone yet, took ibuprofen on Saturday which provided relief. Advised to follow up with PCP recs. -KLC Spoke with caller, has not yet seen PCP or gone to urgent care, however still c/o pain in leg radiating from knee to foot. Advised to contact PCP and follow recs -KLC

Other Meds: midodrine eye drops for glaucoma aspirin 81mg

Current Illness:

ID: 1110293
Sex: F
Age: 64
State: PA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: 1. Heart palpatations - didn't last long - seemed to subside after I drank water and did deep breathing 2. Woke next morning with pain between my shoulder blades - didn't last long either once I was up and moving

Other Meds: Lisinopril, Multi-Vitamin, Vitamin B12, Iron, Vitamin D, Vitamin C, Vitamin K, Fish Oil, Turmeric, Acetyl-L-Carnitine, Low Dose Aspirin, Calcium

Current Illness: N/A

ID: 1110294
Sex: M
Age: 17
State: NY

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Approximately 15 minutes after vaccination, recipient developed tightness in throat. Taken into ambulance by EMTs. Seen by doctor at 20 minutes post vaccine. Patient developed stridor and shortness of breath. Treated for anaphylaxis- IM epinephrine x2, IV dexamethasone, 250 mL normal saline bolus. Transported to emergency department by EMS.

Other Meds: Insulin

Current Illness: none

ID: 1110295
Sex: F
Age: 31
State: MO

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Latex sensitive

Symptom List:

Symptoms: Janssen COVID-19 Vaccine EUA Strong fatigue, brain fog, pain throughout body, strong flare up of fibromyalgia symptoms.

Other Meds: Cyclobenzaprine 10MG, Duloxetine HCL DR 60MG, Blisovi 24 FE, Pregabalin 150MG, Naproxen 250MG

Current Illness:

ID: 1110296
Sex: F
Age: 39
State: IL

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/18/2021
Hospital:

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Lab Data:

Allergies: None

Symptom List:

Symptoms: Vomiting Extreme weakness Day after (16th)broke out in hives/rash. Not in atm where administered but all over stomach, back, chest and neck. Not itching more burning. 18th- hives part is gone but redness is still all over. Feels like a sunburn.

Other Meds: Daily multivitamin Daily vitamin d Daily fiber Dicyclomine

Current Illness: None

ID: 1110297
Sex: F
Age: 41
State: NY

Vax Date: 02/25/2021
Onset Date: 03/08/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type:
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Vax Name:
Lot:
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Lab Data:

Allergies: Penecillin, Bactrum, Arythromicyn

Symptom List:

Symptoms: I got a rash on my torso (stomach and back) and upper arms (both arms). It's slightly itchy and has seemed to spread since it started. It started on day 8, 9, or 10 after receiving the vaccine, and has gotten a bit worse. I've now had the rash for about 10 days. A dermatologist told me to use a steroid cream on it, which hasn't helped. I'm seeing another dermatologist today. I'm unsure if I should receive the second vaccine, and trying to find out, but have not been able to get an answer. If someone could call me to let me know, I would appreciate it. My number is (number).

Other Meds:

Current Illness:

ID: 1110298
Sex: F
Age: 66
State: NY

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/18/2021
Hospital:

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

Allergies: Tramadol, Lyrica, codeine, Cymbalta, honey

Symptom List:

Symptoms: Swelling at injection site, itching, redness, throbbing, redness travelling toward elbow; treated with benadryl still taking it

Other Meds: Turmeric, Multivitamin, Glucosamine Chondroitin, Super Vitamin B, aspirin, Alpha lipoic acid, Magnesiummadol

Current Illness: none

ID: 1110299
Sex: M
Age: 18
State:

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: pt. experiencing lightheadedness/ dizziness, dry mouth & nausea. pt. denies any other s/s. Resolved with calming comfort measures. pt able to drink water & eat a snack.

Other Meds:

Current Illness:

ID: 1110300
Sex: F
Age: 47
State: NC

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/18/2021
Hospital:

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

Allergies: None

Symptom List:

Symptoms: Patient began having fever (101), chills, weakness, aches, headache, and vomitting/dry heaving for 72 hours (3/10/2021-3/13/2021). Patient took Tylenol at first and it was not helping ease symptoms. Symptoms started to resolve with Aleve and hydration (water). Symptoms resolved within 72 hours.

Other Meds: None

Current Illness: None

ID: 1110301
Sex: F
Age: 47
State: IL

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Tomato Wheat intolerance Wasp/bee

Symptom List:

Symptoms: Shot received at 7p on 2/26/21 Large welt appeared at injection site, raised, red, hot, painful to touch and arm was very sore on 2/27/21 at approximately 4p. Welt remained and became itchy over the course of the next week. Welt was gone by 3/3/21 Welt returned and was very sore and itchy on 3/6/21 Applied hydrocortisone cream and took a zyrtec to relive itching 3/6/21-3/7/21 Welt was gone again by 3/11/21 Arm is still painful to raise to the side in the injection area as of 3/18/21

Other Meds: B-12 Duloxine 25 mg daily

Current Illness: No

ID: 1110302
Sex: F
Age: 68
State: IN

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Sore arm, Fever, chills, headache beginning in the middle of the night. 3-17-21. Began to feel better around 6pm that night and aside from a sore arm, all symptoms were gone the next morning 3-18-21

Other Meds: Prozac (generic)

Current Illness: None

ID: 1110303
Sex: F
Age: 39
State: IN

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Pnc

Symptom List:

Symptoms: Migraine nausea and vomiting very tired and sore stiff arm

Other Meds: Tylenol

Current Illness:

ID: 1110304
Sex: F
Age: 52
State: SC

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: CODEINE

Symptom List:

Symptoms: started with tingling, numbness, and redness around the mouth and face. quickly progressed to hives and difficulty breathing. EMS administered benadryl, solumedrol, and epinephrine and transferred to ER. She responded to treatment quickly and was discharge from the ER same day.

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1110305
Sex: F
Age: 29
State: IA

Vax Date: 02/12/2021
Onset Date: 02/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to Cepro, Keflex, Prazosin. I am allergic to Sesame seeds and Peanuts.

Symptom List:

Symptoms: I have been having really severe migraines with auras, vomitting, numbness and tingling on my left side.

Other Meds: I take Dulera Inhaler, Singular, Guanfacine, Methalfenidate, Spriva, Retin A, Clendomycin topical lotion, Epi Pen, Samotidine, Hydrocortizone topical cream, Zoloft, Hydroxizine, Buspire, Clonipin, Respomat Inhaler, Sudafed, Linzest, Xolair

Current Illness: No

ID: 1110306
Sex: M
Age: 57
State:

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: PCN

Symptom List:

Symptoms: General muscle soreness around injection site, otherwise no other reaction

Other Meds:

Current Illness: None

ID: 1110307
Sex: F
Age: 34
State: NY

Vax Date: 03/12/2021
Onset Date: 03/15/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: one swollen lymph not on the left side under the clavicle

Other Meds:

Current Illness:

ID: 1110308
Sex: F
Age: 31
State: LA

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Janssen COVID-19 Vaccine EUA Body aches - pain level 10/10 from 3am - 7am, pain level 7/10 from 7am-12pm, pain level 4/10 from 12pm-7pm Chills/sweating/fever off and on from 3am-7pm Nausea, loss of appetite Took Tylenol and ibuprofen every 4-6 hours

Other Meds: Birth control Simvastatin Viibryd 20mg Adderall 20mg

Current Illness: None

ID: 1110309
Sex: F
Age: 57
State: IN

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: aspirin, sulfa

Symptom List:

Symptoms: Left side face drooping , worsening numbness in hands (lasted from afternoon of vaccine until next morning)

Other Meds: amitriptyline, atorvastatin, Flonase, gabapentin, losartan, spironolactone, valacyclovir

Current Illness:

ID: 1110310
Sex: F
Age: 52
State:

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: tingle in the right arm that the vaccine was given.

Other Meds:

Current Illness:

Date Died: 03/04/2021

ID: 1110311
Sex: M
Age: 91
State: MN

Vax Date: 02/09/2021
Onset Date: 03/04/2021
Rec V Date: 03/18/2021
Hospital:

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

Allergies:

Symptom List:

Symptoms: patient passed away within 60 days of receiving a COVID vaccine

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm