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
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

Date Died: 02/03/2021

ID: 1080932
Sex: F
Age: 87
State: KY

Vax Date: 01/12/2021
Onset Date: 01/23/2021
Rec V Date: 03/08/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Dysphagia, Epiglottitis

Symptoms: DIAGNOSED WITH COVID 1/21/21; RECIEVED BAMLANIVUBAM INFUSION; HOSPITAL ADMISSION 1/23/21 WITH ACUT RESPIRATORY FAILURE DUE TO COVID. INTUBATED X 10 DAYS

Other Meds:

Current Illness: HYPERTENSION, COPD, NON-SMALL CELL CANCER RIGHT LUNG

ID: 1080933
Sex: F
Age: 71
State: IN

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Skin reaction to betadine

Symptom List: Anxiety, Dyspnoea

Symptoms: chills, headache, body aches, somewhat nauseated

Other Meds: Rosuvastatin 10 mg./day, Sertraline 100 mg./day, multi-vitamin

Current Illness: headaches

ID: 1080934
Sex: F
Age: 27
State: TX

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Allergies to bee stings (anaphylaxis) Allergy to hydrocodone

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

Symptoms: Fever, chills, headache for approx 24 hours. Onset approx 24 hours after vaccine Pain, redness, and swelling in arm for 5 days.

Other Meds: Memantine Vitamin B2 Vitamin B complex Seasonique Magnesium Naratriptan

Current Illness: None known

ID: 1080935
Sex: M
Age: 36
State: CO

Vax Date: 02/26/2021
Onset Date: 03/01/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Moderna COVID-19 Vaccine EUA body aches, chills, sore throat, cough, fever, running rose

Other Meds: Multi-Vitamins Lisinopril HCTZ Allopurinol

Current Illness: none

ID: 1080936
Sex: F
Age: 72
State: VA

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Flushing with CT IV Contrast dye.. Face flushing when corticoid steroid injections for knees / spinal stenosis L4 L5 x ray guided meds Bacterium ,, face flushing sometimes when I drink some red or white wines or beer.

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

Symptoms: aprox 5-7 mins after injection I notice that the right side of my tongue and lips felt different. They seemed to tingle. I called the nurse and she had the attending Dr come to me. Dr checked my airway and said it looks beautiful but wanted me to go next door to the ED. We walked over and checked in. I think my BP was 180/100 and elevated heart rate. Nurse took me to examine room. Dr listened to my heart, checked for rash and looked in my mouth. O2 sat was constant between 96-99%. Heart rate was elevated. Right side of face was a little more flushed than left side. Sensation continued to subside and was gone within the 90 minutes the Dr wanted to contain me. BP was down and HR lower when we left the ED, but not my normal BP No other events. Arm sore at site of injection.

Other Meds: (1) 500 MG Tylenol aprox 8:45 AM Prior to leaving home not taken on day of vaccination Powdered Collagen Vit D/ Vit C.. occasional Omeprazole

Current Illness: NA

ID: 1080937
Sex: F
Age: 52
State: PA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 1/2 hour after receiving the vaccine she felt like her she felt like her throat was swelling and scratchy. She said it scared her , and she ended up stopping at a store and took Benadryl and then she was ok. She?s doing better today but her Lymph nodes are swollen under her arm.

Other Meds:

Current Illness:

ID: 1080938
Sex: F
Age:
State:

Vax Date:
Onset Date: 02/27/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I had a large red area on my arm (aprox. 3" x 2") in between my shoulder and my elbow, that was very itchy...it is now 10 days after my shot and the area is just almost gone...but it took 10 days for it to fade

Other Meds:

Current Illness:

ID: 1080939
Sex: F
Age: 31
State: TX

Vax Date: 02/26/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Red rash around injection. Area feels warms.

Other Meds:

Current Illness:

ID: 1080940
Sex: F
Age: 66
State: VT

Vax Date: 12/21/2020
Onset Date: 01/05/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: One week after I started a rash that was itch. The following morning I started getting small itchy blisters on my ankle and wrist. I would get a new batch of blisters everyday. They weren't going away so I went to see a Dr. to see if it was from the vaccine. She said it looked like a allergic reaction but I have not done anything different. So I got a prescription cream and it helped, about three weeks later they stopped occurring. I got my second dose but not no allergic reaction.

Other Meds:

Current Illness:

ID: 1080941
Sex: F
Age: 34
State: TX

Vax Date: 02/27/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Mobic

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fatigue, headsache, warm itchy hard rash at injection site with onset of rash 3/8/21

Other Meds: Lisinopril, metaprolol, detrol la, omepraole, pyridium

Current Illness: Uti

ID: 1080942
Sex: F
Age: 68
State: IN

Vax Date: 02/25/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: sufa drugs

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

Symptoms: hard pink knot around injection sight

Other Meds: double x vitimins

Current Illness: none

ID: 1080943
Sex: F
Age: 75
State: IN

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Extreme Body Aches, headache . . . . low-grade fever (99.7 was highest recorded

Other Meds: B12 - 1000 mcg daily D3 - 2000 IU (25 mcg) daily C - 1000 mg lisinopril - HCTZ 10/12.5 MG daily Prolia - shot every 6 months

Current Illness: None

ID: 1080944
Sex: M
Age: 70
State: IN

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None that I know of

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

Symptoms: Fever (101?), chills, muscle aches, moderate discomfort at injection site, but that was minor compared to all the other. Lasted almost 2 whole days, better by Sunday (felt guilty for not going to church). SIDE NOTE, when I described my side effects to my brother he went ballistic saying that the government is lying to us, the vaccine was not suppose to contain live virus and me getting sick was proof that it did. I explained that my symptoms were a result of my immune system gearing up for a fight once it had been given the instructions as to how it should fight the battle, but no explanation would convince him otherwise (he falls for every conspiracy theory that comes along).

Other Meds: Diltiazem hydrochloride -240mg Lisinopril - 60mg Montelukast - 10mg Potassium Chloride - 60MEQ Hydrochlorothiazide - 25mg Spironolactone - 12.5mg

Current Illness: none

ID: 1080945
Sex: M
Age: 73
State: TX

Vax Date: 03/01/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Saturday developed cough and chills, and tired continued into Sunday. Still have dry cough Monday morning

Other Meds: BP med, cholesterol drug, diet, quercetin, immunity md, vit c, berberine

Current Illness: None

ID: 1080946
Sex: F
Age: 70
State: KS

Vax Date: 02/11/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient states that lymph nodes are swollen, red, and tender to the touch under both arms

Other Meds:

Current Illness:

ID: 1080947
Sex: F
Age: 39
State: MD

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: "This is a 39 yo woman who states she works , received second dose of Covid 19 vaccine on 02/23/21: was achy and nauseated which resolved with Tylenol. Denies cough, runny nose, sore throat, SOB, wheezes, lack of smell or taste. Denies exposure to Covid19 patient or suspected. Works in person."

Other Meds: None

Current Illness: None

ID: 1080948
Sex: M
Age: 49
State: TX

Vax Date: 02/12/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Penicillin

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

Symptoms: 03/06/2021 Tested posted with Rapid swab test at pharmacy. Had second test that did a saliva test and those were negative

Other Meds:

Current Illness:

ID: 1080949
Sex: F
Age: 76
State: CA

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: sulfa, tetracyclines, betadine, doxycycline, benadryl, multaq, clindamycin,

Symptom List: Ear pain, Hypoaesthesia

Symptoms: swelling of L arm's inner aspect; tenderness in entire arm especially around the inside elbow; some red areas that have diminished; fatigue. continues.

Other Meds: Vitamin D, Vitamin C, OTC allergy pill, Estradial .5mg, metoprolol 25mg./daily divided into 2 doses, Lotemax eye drops, valtrex (finished that day)

Current Illness: none

ID: 1080950
Sex: F
Age: 52
State: FL

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: At 9am on 3/4/21 I development tachycardia. It lasted about 10 minutes. Around 5pm on 3/4/21 I developed tachycardia again it was continuous and it lasted until 11pm. On 3/5/21 and 3/6/21 I experience two more episodes that lasted 10 minutes each time. On 3/4/21 I started experiencing episodes of my blood pressure suddenly rising. It would go from mid 130?s to 160?s for 10-15 minutes and then fall back down into the 130?s again. This did seem to correspond with the tachycardia episodes. At 9am on 3/4/21 I developed ringing in my ears, it intensified during the day and seemed to peak from 5pm-11pm. I am still currently experiencing ringing in my ears. It is not continuous and does seem to be getting better each day. On 3/4/21 I developed swelling in my body. I especially noticed it in my hands and face. It went away by 3/6/21.

Other Meds: None

Current Illness: Just my reaction to the first dose on 1/29/2021

ID: 1080951
Sex: F
Age: 21
State: IL

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies:

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

Symptoms: Janssen COVID-19 Vaccine EUA fever of over 101?F, dry cough, shortness of breath, chills, muscle aches, weakness, headache

Other Meds:

Current Illness:

ID: 1080952
Sex: M
Age: 56
State: CA

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

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

Symptoms: Severe itching and hives, scalp, face

Other Meds: Loratadine, clonidine, atorvastatin, hydralazine, amlodipine, asa

Current Illness: ER visit 1 month prior for right leg pain and hypertension

ID: 1080953
Sex: F
Age: 70
State: MN

Vax Date: 03/03/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None that I know of.

Symptom List: Unevaluable event

Symptoms: Severe hives/rash gradually developed over my body. Starting in my groin area, under my breasts, under my belly fat, on my scalp, on my back Started on March 5 and still going on today March 8!

Other Meds: Venlafaxine 225 mg per day Simvastatin 10 mg per day Multiple vitamin Probiotic 2 x per day Vitamin e. 1000

Current Illness: UTI in early February! Finished antibiotic before the vaccine

ID: 1080954
Sex: F
Age: 29
State:

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Fatigue, body aches, fever, chest pain, chest tightness (lasted 5 days), dizziness.

Other Meds: Ibuprofen

Current Illness: None

ID: 1080955
Sex: F
Age: 88
State: KS

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Progress Notes APRN (Nurse Practitioner) ? ? Family Medicine Pt called to follow up on covid-19 vaccine done on 02/26/21. She states she did develop chills, fatigue and blood pressure was up and down (from baseline, "not of any concern"). Slight elevation of temp, under 100 F. This was on Friday. Then over the weekend, she slept a lot. Today she feels well and "ready to get dose #2". Denies any further questions or concerns. Pt is appreciative of phone call. APRN Progress Notes APRN (Nurse Practitioner) ? ? Family Medicine Cosigned by: MD at 2/28/2021 7:37 AM Expand AllCollapse All COVID VACCINE CLINIC 2/26/2021 Patient: DOB: Date: 2/26/2021 MRN: Subjective Patient is a 88 y.o. female who was seen at COVID Vaccine Clinic today for her first 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 headache. She denied rash, hives, welts, difficulty breathing, difficulty swallowing, wheezing, throat tightness, hoarseness, stridor, itching, lightheadedness, dizziness, facial swelling, lip swelling, tongue swelling and weakness face, arms/legs. 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 blood pressure abnormality , chest pain and rapid progression of symptoms. PMH: Past Medical History: Diagnosis Date ? Allergy year round ? Cardiac pacemaker in situ 10/26/2017 ? Chronic kidney disease, stage III (moderate) (HCC) 7/17/2020 ? Coronary artery disease ? Diverticulosis ? Esophageal reflux ? Esophageal stricture ? Hearing loss ? Hiatal hernia ? Hypothyroid ? Osteoarthritis ? Palpitations ? Perennial allergic rhinitis 5/22/2017 ? Postablative ovarian failure ? Proteinuria Hypertensive ? Rheumatic fever ? Rotator cuff tear, left Nonsurgical treatment ? Sciatica ? Skin cancer nose X2 ? Unspecified cataract removed ? Unspecified essential hypertension ALLERGY REVIEW OF SYSTEMS: Patient complains of headaches Patient denies chills, fever, malaise/fatigue, facial swelling, ear pain, sinus pain, sinus pressure, frequent throat clearing, eyes itching, puffy eyes, eye redness, cough, chest tightness, shortness of breath, wheezing, rash, hives, eczema, itching of skin, abdominal pain, muscle aches and dizziness Denies vision changes. L eyelid with droop. Chronic. Unchanged. : Previous Reactions: none Objective Vitals Vitals: 02/26/21 1408 02/26/21 1414 BP: (!) 156/66 (!) 145/56 Patient Position: Sitting Pulse: 60 SpO2: 99% Physical Exam Vitals and nursing note reviewed. Constitutional: General: She is not in acute distress. Appearance: Normal appearance. She is well-developed. She is not ill-appearing, toxic-appearing or diaphoretic. Eyes: Comments: Slight drooping of L eyelid, chronic, unchanged per pt and pt's granddaughter, Otherwise no facial drooping or asymmetry. Neck: Thyroid: No thyromegaly. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Pulses: Normal pulses. Heart sounds: Normal heart sounds. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No wheezing. Musculoskeletal: Cervical back: Neck supple. Skin: General: Skin is warm and dry. Capillary Refill: Capillary refill takes less than 2 seconds. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Gait: Gait (walks with steady gait. ) normal. Psychiatric: Mood and Affect: Mood normal. Thought Content: Thought content normal. Judgment: Judgment normal. Assessment/Plan Treatment included: water Follow up response to treatment: excellent. Patient discharge: Stable to go home and follow up with PCP. Differential Diagnosis: Red flag symptoms (CP, SOB, NVD, Visual/Neuro concerns) Pt monitored for approx 30 minutes. She has improvement of bp on observation along with headache has subsided. She is encouraged to monitor her bp at home and follow up with pcp if bp stays above 140/90. Granddaughter had requested pt to be evaluated. She is appreciative of this evaluation. APRN Electronically Signed 2/26/2021 2:47 PM

Other Meds:

Current Illness:

ID: 1080956
Sex: M
Age: 66
State: OH

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Unknown

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient received 2nd dose of Pfizer COVID-19 vaccine earlier than the recommended timeframe. First dose was given on 02/17/2021, 2nd dose was given on 03/05/2021.

Other Meds: Unknown

Current Illness: Unknown

ID: 1080957
Sex: F
Age: 46
State: KS

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Red rash at injection site that looked like a bug bite had radiated outward. About 2 inches in diameter. A little bit itchy, but no other concerns. This happened a few days after the first injection too. Faded on it's own after a couple days.

Other Meds: Multi-vitamin. Fiber supplement.

Current Illness: None

ID: 1080958
Sex: M
Age: 74
State: WA

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin (at age 4)

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Sore upper arm; sore neck; tired and a little "fuzzy" Gone in 36 hours No treatment

Other Meds: atorvastatin levothyroxin nabumetone amlodipine besylate B-12 multivitamin psyllium husk caps

Current Illness:

ID: 1080959
Sex: F
Age: 23
State: IN

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient was given a COVID-19 vaccine on 07MAR21 at 0930. She complained of numbness of her tongue and lips. She was given Benadryl 25 mg po by one of our registered nurses. She was monitored for an additional 30 minutes.

Other Meds:

Current Illness:

ID: 1080960
Sex: F
Age: 85
State: MO

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: tetracycline,

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

Symptoms: pt stated after she got home from taking the covid vax that she started having severe chills, cold hands and feet. She said she could feel the medicine from the vax moving down her arm and stopping in her fingers with a tingling sensation. She was nauseated, sinus pain and headache. The next day the symptoms seem to be improving. By 3/7/2021 she was feeling back to normal.

Other Meds: levothyroxine 75mg, metoprolol ER 75mg x 2 daily, calcium 600 x 2 daily, Premarin cream 1 gm x 2 weekly, potassium 10meq, multivitamin, Prese vision 2 gels daily, Xarelto 20mg, diltiazem ER 180 mg, furosemide

Current Illness: no

ID: 1080961
Sex: F
Age: 45
State: KY

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Rash on palm, neck, and face

Other Meds:

Current Illness:

ID: 1080962
Sex: F
Age: 70
State: IN

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulpha

Symptom List: Injection site pain

Symptoms: Low grade fever, 99.6. Aches, headache, lasted for about 24 hours. Called to see if I could take Excedrin. I took 2 extra strength to relieve the symptoms. Had a little soreness around the injection site. NOTE: I didn't have any side affects after the 1st injection.

Other Meds: Hormone replacement therapy Gappapenten for shingles Lisiniprel for blood pressure Hashimoto's disease Cosyntex

Current Illness: Shingles

ID: 1080963
Sex: F
Age: 60
State: OH

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Codeine

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

Symptoms: Eight hours after the shot, I quickly became very chilled with total body aches and pains and extremely tired. My mouth became very dry. This lasted most of the night. The next morning approaching 24 hours after the shot, the initial side effects were gone but I then had a headache and a bit of nausea. Again was extremely tired and pretty much rested all day. All side effects were gone the next day. I felt no need to call my healthcare provider and did not take any over the counter pain medication.

Other Meds: EyePromise multi-vitamin; Magnesium Citrate 250 mg; Viactiv Calcium plus D; Potassium Chloride ER 20MEQ

Current Illness: none

ID: 1080964
Sex: F
Age: 61
State: CT

Vax Date: 03/07/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

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

Symptoms: Received vaccine 6pm. By 5AM next morning, conjunctivitus in both eyes. No other COVID-19 symptoms or side effects from the vaccine

Other Meds: pantaprozole

Current Illness:

ID: 1080965
Sex: M
Age: 24
State: VA

Vax Date: 02/28/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Tremor

Symptoms: Painful swollen lymph node in left armpit. Tenderness in left pectoral. Onset was approximately 5 days after vaccination.

Other Meds: Zoloft 125mg

Current Illness: none

ID: 1080966
Sex: F
Age: 70
State: MN

Vax Date: 03/04/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa drugs, Paclitaxel, Chlora Prep, AC (doxorubicin + cyclophosomide), Bacitracin cinnamon, mint dust, mold, pollen, gold

Symptom List: Erythema, Pruritus

Symptoms: I woke up the day after receiving the vaccine with vertigo (I have had this before) and nausea. I couldn't keep any food down all day. I did not have a fever and my blood pressure was normal. There were no symptoms the day of the vaccine (Thursday) and Saturday all symptoms had resolved without taking any medication.

Other Meds: Lisinopril, Amlodipine, Balanced B-50 Tabs, Vitamin D3 2,000 IU, Letrozole, Bayer Low Dose aspirin, Calcium Citrate, Zometa

Current Illness:

ID: 1080967
Sex: F
Age: 66
State: FL

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: none

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Fever onset approx 4 hours and have had high grade and low grade fevers since. Taking tylenol every 4-6 hours.

Other Meds: lisinopril 5mg, breo 100 mcg/25 mcg

Current Illness: none

ID: 1080968
Sex: M
Age: 34
State: NY

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Feel cold, head ache, body ache

Other Meds:

Current Illness:

ID: 1080969
Sex: F
Age: 65
State: FL

Vax Date: 02/26/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa, penicillin, feldene, compazine, gadolinium,

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Redness and sore arm appeared unexpectantly on the 9th day after receiving my 1st injection of Covid-19 vaccine. Still red and sore today.

Other Meds: Synthroid 50 mg, gabapentin 300mg, nortriptyline 20mg, Flax oil, Rameltoin 8mg, Lysine, Vitamin C, Zinc

Current Illness: None

ID: 1080970
Sex: F
Age: 38
State: VA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: unknown

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

Symptoms: 2/10/2021 during my lunch break I still was not feeling better so I took a nap at 12:30 woke up at 12:50 because I was having chest pains and my mouth bottom row left side from my lip to my ear felt like someone had hit me in the face with a hammer, on 2/11/2021 I called into my supervisor stating I would need to go to urgent care, my mouth and face was in awful pain and had swollen, I went to Urgent care and they sent me to Hospital for a possible stroke. While I was there, I was given Tramodal of pain observed for several hours then told that my impending facial paralysis was just a allergic reaction to the shot, to take Tylenol and Motrin for pain. For 2 more days my face continued to swell and I suffered in pain , I went back to the urgent care , where I was provided something for the ?supposed allergic reaction? pain and to help with the swelling, well a few days the new meds t last Thursday my mouth gushed with this fluid of Blood and puss mixed , very thick. I went back to the urgent care and they could not tell if this was coming from my jaw or my gum( also I have braces only on my top teeth and I went to the orthodontist the same day I received the shot, I go every for weeks) I was given more meds to take with the ones that I was already prescribed and told to contact my orthodontist because even though my face has gone down I have a hard knot in it that possibly holds infection.

Other Meds: unknown

Current Illness: unknown

ID: 1080971
Sex: F
Age: 70
State: PA

Vax Date: 02/04/2021
Onset Date: 02/07/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Plaquenil (Hydroxycloquine)

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

Symptoms: I went into full blown arthritis which affected most of my joints.

Other Meds: Vitamins D, E, B12, Milk Thistle, PreSerVision, calcium, tumeric and cumin powder.

Current Illness: Nash (controlled by diet)

ID: 1080972
Sex: F
Age: 71
State: IN

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Mostly grasses, pollen No meds at this time

Symptom List: Pain in extremity

Symptoms: About 30 min after injection, tendon in my neck, left side began to warm, then, the warmth rose to the base of scull. I started rotating neck, but continued for about 30 minutes. My neck on that side became stiff and painful. I continued throughout the pm to exercise my neck . By bedtime, it was no longer warm. Still slightly stiff, next morning, a bit stiff. By 36 hr, totally back to normhe, I am an RN, retired & daughter is RN, active, didn't see reason to contact Dr.

Other Meds: Atorvastin, Ibestatan, Advair, Albuterol Sulfate HFA, Aspirin, Betamethazone cream, Gabapentin, Hychlorothiazide, Fluticasone nasal spray, Tizanidine

Current Illness:

ID: 1080973
Sex: F
Age:
State: NJ

Vax Date: 03/06/2021
Onset Date: 03/01/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Sulfa

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

Symptoms: Nausea, uncontrollable chills, bone pain through out entire body, tired, sore arm, stomach cramps, headache

Other Meds: Xeloda, xgeva, glucosamine, vitamin D, lorazepam

Current Illness: Metastatic cancer

ID: 1080974
Sex: F
Age: 63
State: IN

Vax Date: 02/24/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: bee/wasp stings

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

Symptoms: The vaccine is the only variable that could have caused this reaction. Started mid-morning with a deep flushing in my face, and then spread to arms(bright red elbows) and chest and upper thighs. Raised bumps but not large lesions, very itchy. Onset was this morning, so I do not know how long this may last. Ongoing two hours later. No other reactions.

Other Meds: milk thistle, vitamin D, B-12 and multi-tab

Current Illness: none

ID: 1080975
Sex: F
Age: 61
State: NE

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: severe headache chills diarrhea tired hives/rash

Other Meds: Arimidex 1MG, Crestor 40MG, Original Hemp emergy 750MG Calcium 600mg, Centrum Silver women 50+, D-3 5000IU, Benadryl 25MG.

Current Illness: No illnesses at the time of vaccinations , previous illness, 2005 Breast cancer, 2009 Acute Promyeloctic Leukeimia, 2013 Melanoma. 2019 breast cancer, 2019 basel cell carcimoma.

ID: 1080977
Sex: F
Age: 61
State: CO

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Ampicillin, Spetra, Keflex, macrobid. Had a reaction (bad headache and fever) from tetnus shot 20+ years ago.

Symptom List: Vomiting

Symptoms: Rapid heart rate for several hours (about 10). Bad headache which is now a sinus headache on the right side.

Other Meds: Symbicort, cranberry pill, vitamin D, multivitamin

Current Illness: None

ID: 1080978
Sex: F
Age: 93
State: FL

Vax Date: 02/28/2021
Onset Date: 03/01/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Grand mal tonic-clonic seizure, pt put in bed on 2 l oxygen , postictial sleep x 2 days

Other Meds: ASA,Bupropion,Colace,Eliquis,Nu-Iron,Lasix,Levothyrixine,Latanoprost,metprolol,Protonix,Timolol,

Current Illness:

ID: 1080979
Sex: M
Age: 30
State: MI

Vax Date: 01/19/2021
Onset Date: 02/18/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Lactose intolerance, banana anaphylactic, penicillin anaphylactic

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

Symptoms: Pityriasis rosea of trunk

Other Meds: Zyrtec 10 mg nightly.

Current Illness: None

ID: 1080980
Sex: F
Age: 32
State: FL

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Chills, sweating, loss of appetite Slept for about 10-11 hours cold sweats throughout out the night and lingering feeling afterwards

Other Meds: Citalopram 20mg

Current Illness:

ID: 1080981
Sex: F
Age: 64
State: GA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: shellfish

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

Symptoms: At 10:45 5 minutes after receiving vaccine patient complained of itching at the left upper arm rash and redness noted.

Other Meds: Unknown

Current Illness: unknown

ID: 1080982
Sex: F
Age: 50
State: NC

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Latex Sulphate eye drops Pork Milk Gluten Cat Horse epithelia Feather mix Fescue grass Timothy grass Sweet vernal grass English plantain Ragweed Sheep sorrel Birch trees Ash trees Walnut nuts Candida Cladosporium Epicoccum Mugwort American dust European dust Epidermophyton Fusarium

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

Symptoms: Roughly 20 to 25 minutes after receiving the vaccine I felt my entire jaw swell which for me is an allergic reaction to the the shot I have a long list of allergies and when beginning allergy shots to help deal with those allergies and finding the correct dose to begin with the swelling of the jaw and tightness was an allergic reaction for me I recognized it right away and took OTC generic Benadryl when I got home with a low dose-400mg ibuprofen for site pain. Continued OTC generic Benadryl roughly every 5 hrs. Did this for roughly 24 hrs Jaw still feels slightly swollen-most likely the lymph nodes around the jaw but am not taking extra meds at this point This leads me to acknowledge that for the next dose, which usu has more of an affect on the body, that I will possibly need my epipen that I carry with me

Other Meds: Synthroid 137 mcg. I do not have a thyroid Montelukast sodium 10 mg Simvastin 20 mg Aspirin 81 mg Meloxicam 7.5 mg Turmeric and curcumin 2 capsules Super B complex Daily vitamin OTC Allegra Had allergy shots 2 days before( get 1 in each a

Current Illness: I catch colds and viruses easily, no thyroid Have had 1 or 2 colds/virus?s in past month-no fever, no doctor visit

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm