VAERS 2021 Database www.vaers.hhs.gov

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

Total Manufacturer

Incidents per State

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

ID: 1126648
Sex: M
Age: 43
State: MI

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: Day 1 none 3/21/21 at approx 8pm Dizziness Nausea Joint pain Light fever Dehydrated Insomnia 3/22/21 all day Joint pain Dizziness Nausea Vertigo Foot pain Insomnia

Other Meds: Adderall losartan-hydroCHLOROthiazide 100-25 potassium chloride 20 mEq CR tablet amLODIPine 10 mg tablet carvediloL 12.5 mg tablet

Current Illness: None

ID: 1126649
Sex: F
Age: 63
State: TN

Vax Date: 03/21/2021
Onset Date: 03/23/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: only seasonal allergies listed

Symptom List:

Symptoms: Patient came in complaining that she was having weakness and dizziness. She was having trouble standing up from seated position. She was also having trouble walking in a straight line. Her husband was with her and drove her to the ER after leaving the pharmacy.

Other Meds:

Current Illness:

ID: 1126650
Sex: M
Age: 33
State: TX

Vax Date: 03/01/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Delayed swelling at injection site

Other Meds: None

Current Illness: None

ID: 1126651
Sex: M
Age: 69
State: MI

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Sore arm, tiredness, nausea, dizziness day of injection and today, the day after

Other Meds: Multiple vitamin Lisinopril Metoprolol Er Atrovastatin

Current Illness: None

ID: 1126652
Sex: M
Age: 35
State: NC

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: 3/19 Resting Pulse 105-120, Walking Pulse 120-140, Pulse Ox: 95, Temp: 100.0 3pm ,101.1 4pm. Throbbing on and off head aches in Parietal, and Frontal Lobes, started at 5-6PM. Upper body Pain in joints and lymphatic system. Lower Body pain in Right knee at 8pm. Renal/Flank pain most likely due to dehydration. Memory confusion and General Confusion, dizziness, foggy memory. Swollen Right Deltoid, subcutaneous heat at the injection site that can be felt through a polo shirt. 3/20- Flank and Kidney Pain. Memory confusion and General Confusion and Foggy memory still remains . Swollen Right Deltoid, subcutaneous heat at the injection site that can be felt through a polo shirt. 3/22- Memory confusion and General Confusion and Foggy memory still remains. Swollen Right Deltoid, subcutaneous heat at the injection site that can be felt through a polo shirt still present. 3/20- Memory confusion seems to be improving but foggy memory still remains. Swollen Right Deltoid, subcutaneous heat at the injection site that can be felt through a polo shirt still present.

Other Meds: Paxil, Rosuvastatin, Vitamin C, Vitamin B, Zinc

Current Illness: NA

ID: 1126653
Sex: F
Age: 57
State: NY

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Fatigue x 1 week and ongoing nausea vomiting diarrhea 2 days pruritus rash x1 week and ongoing

Other Meds: Biotin

Current Illness: None

ID: 1126654
Sex: M
Age: 74
State: AZ

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List:

Symptoms: chills, fever, tiredness, headache, sore muscles,swelling at injection site lasted4 days

Other Meds: amlodipine 5mg atorvastatin 10mg

Current Illness: none

ID: 1126655
Sex: F
Age: 50
State: OH

Vax Date: 03/20/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: left ring finder tender on Monday 03/22/21, Woke up Tuesday, 03/23/21 finger swollen, as the day has gone on it has gotten redder Called and spoke with a Teladoc doctor, said to take ibuprofen and ice, watch for 24/48 hours if gets redder or hot go and have it checked out for possible infection

Other Meds: Imodium

Current Illness: None

ID: 1126656
Sex: F
Age: 35
State: CA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: I started feeling really nauseous at 08:00 pm and had low energy all day. Vomiting followed by chills and body aches that evening and into the next morning. I was vomiting that morning but it stopped after about 12 hours. The next day, I was tired until 07:00 pm. No treatment. Estimated date of delivery - Due July 5, 2021; first pregnancy.

Other Meds: prenatal vitamins

Current Illness: no

ID: 1126657
Sex: M
Age: 1
State: MA

Vax Date: 06/21/2017
Onset Date: 06/21/2017
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: With in 6 hours of vaccination the child developed fever, lethargy, and diarrhea. Patient developed eczema. Diarrhea continued for 2 years post vaccination. Patient begins to stim and has speech regression in weeks following vaccination. Pt continues to loss skills for up to 12 months post vaccination

Other Meds: None

Current Illness: None

ID: 1126658
Sex: F
Age: 59
State: IN

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Continuous daily chills, sore throat and lethargic for 11 days after 2nd vaccine

Other Meds: Armor Thyroid, Lexapro, multi vitamins, vitamin B12 complex

Current Illness: None

ID: 1126659
Sex: M
Age: 49
State: IN

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: I went into atrial fibrillation/flutter within hours after the shot. I was totally fine and in sinus rhythm prior to the shot.

Other Meds: Metoprolol 50 mg 1 day Amlodipine 5 mg 1 day Eliquis 2 X day Amiodarone 1 X day

Current Illness: NONE

ID: 1126660
Sex: F
Age: 49
State: IL

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Mango, Egg white

Symptom List:

Symptoms: Approximately 40 mins mouth/tongue started tingling. Then an hour I developed a rash lower part of my face and hives on chest. I'm still exp symptoms taking Benadryl.

Other Meds: CLaritin D 24 hr,Levothyroxine

Current Illness: No

ID: 1126661
Sex: M
Age: 49
State: TX

Vax Date: 03/09/2021
Onset Date: 03/21/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Kiwi

Symptom List:

Symptoms: Dizziness start on Sunday, 3/21/2021 and has been present every day since so far. This is abnormal for me. Prior to that, I have been having some problems breathing after getting the vaccine and have been using my Ventolin more often after the vaccine. Also noticed shortly after getting the vaccine, a feeling of liquid in my right ear. the liquid in the ear did go away a day before the dizziness started. Did not consider the ear or breathing issues as possible side effects as I do have asthma and figured the ear was congestion. Not sure if the dizziness and the feeling of liquid in my right ear are related and/or related to the vaccine.

Other Meds: Lexapro. Ventolin as needed.

Current Illness: none

ID: 1126662
Sex: M
Age: 38
State: WI

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Sore neck

Other Meds: N/A

Current Illness: N/A

ID: 1126663
Sex: F
Age: 63
State: MA

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: 102.2 degree Fever, chills, allover muscle aches, exhaustion lasting from Sunday 3/21/21 - 11:00 am through Monday 3/22/21- 12:00 noon. As of Monday 12:00 noon, no symptoms remain.

Other Meds: Daily: fluoxetine 20 mg/day, multivitamin, fish oil, Vitamin D

Current Illness: none

ID: 1126664
Sex: F
Age: 82
State: GA

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

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

Lab Data:

Allergies: Tramadol

Symptom List:

Symptoms: Intense itching right side of face then moved to palmar surfaces. She then devoloped a macular-papular rash on her legs, then torso. Bottoms of feet itch at night. Pt was RX'd Prednisone and HYdroxyzine.

Other Meds: Vit. D3, Protonix,Cozaar,Fosamax, Baby ASA,

Current Illness: none

ID: 1126665
Sex: F
Age: 63
State:

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: lightheadedness. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1126666
Sex: F
Age: 37
State: IL

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: Janssen COVID-19 Vaccine EUA

Other Meds: Infliximab, D-3, B-12

Current Illness: None

ID: 1126667
Sex: F
Age: 49
State: TX

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Sulfa Allergy

Symptom List:

Symptoms: bumps in mouth on first day, face turned read on second day and bumps went away, third day lips became raw and almost wind burned and chapped then fourth and fifth day lips swelled up very large as well as chin and lower face and cheeks. Benadryl, claritin given together as well as epi pen for emergency use.

Other Meds: Synthroid, Cytomel, Symbalta, spironlactone,

Current Illness:

ID: 1126668
Sex: F
Age: 61
State: GA

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, tetracycline, Cipro, Levequin,

Symptom List:

Symptoms: Pfizer-BioNTech Covid 19 vaccine The night of the vaccine March 11th , I had fever of 100.8, chills, headache, muscle aches, sore throat, joint pain that lasted until Tuesday morning, March 16th. I had no symptoms on Tuesday & Wednesday, but developed hives on my ankles Thursday afternoon exactly one week after the Covid 19 vaccine. When I got up Friday morning I was covered in hives on my legs, arms and abdomen. The whelps were raised and itchy and appeared to be spreading. I went to my HCP and they administered an intramuscular steroid shot and advised me to take Benadryl as needed

Other Meds: Crestor 10mg - 2 tablets per week

Current Illness: UTI

ID: 1126669
Sex: F
Age: 65
State: NH

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Morphine and Codeine (anaphylaxis), root vegetables (anaphylaxis), steroids, egg whites.

Symptom List:

Symptoms: Immediately after receiving the vaccine she experienced a very strong, pungent and sharp taste and smell, which passed within 5 minutes. In those 5 minutes the next thing was tingling in her face, cheeks, lips and her sinuses which were not clogged up at the time cleared, which stayed that way until Saturday morning. She did have tingling and numbness in her fingers, but nothing in her feet, and did not extend beyond her face and cheeks. Then 20 minutes later at 1:55 PM her tongue became sort of thick and a little numb, but did not swell. The area between her tongue and mouth tightened and her jaw tightened but nothing swelled. No itching in the throat. She had some sort of aching like menstrual cramps but has had a hysterectomy. She did also have a headache, took a Tylenol at 2:15 and went to sleep. When she woke up had fatigue, sore arm, and everything else had passed other than the lips feeling prickly and numb. The tongue was no longer tight or in the jaw. Just still had the open sinuses and the headache. The most significant thing was the thickness and lack of feeling of her tongue. By Saturday she was fine other than the normal side effects, soreness of arm, no red rash, but had been moving it around.

Other Meds: Nabumetone, Valtrex, vitamin B complex, Sotalol. Cranberry concentrate.

Current Illness: UTI took Ciprofloxacin for 10 days from 3/1/21 to 3/10/21.

ID: 1126670
Sex: F
Age: 32
State: CA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: many - chocolate flavor, lanolin, wool, levofloxacin, morphine, aripiprazole, pregabalin, codeine, fluoxetine

Symptom List:

Symptoms: felt flushed, chills and itching lips within 30 minutes of vaccination

Other Meds: client on many medications - trazodone, tacrolimus, pyridostigmine, prednisone, oxycodone, odansterone, omeprazole, metoclopramide, methadone, liraglutide, gabapentin, famotidine, duloxetine, cyanocobalamin

Current Illness: no acute illness

ID: 1126671
Sex: M
Age: 64
State: FL

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Client verbalized feeling of anxiety after receiving the vaccine. Full assessment done by Paramedics. Client was released for home at 4:33 pm. Per paramedics no further evaluation needed. Symptom resolved.

Other Meds: none

Current Illness: none

ID: 1126672
Sex: F
Age: 55
State:

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: shaking. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1126673
Sex: F
Age: 77
State:

Vax Date: 03/20/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Caller stated she got Moderna vaccine on Saturday and was fine. She stated yesterday she had a few side effects, ie fever, headache, fatigue, which she stated are gone. She stated when she woke up today she was fine but then noticed her eyes were a little bit swollen. She stated she has history of eyes swelling when she eats alot of salt. No Lot number available at the time of this notification.

Other Meds:

Current Illness:

ID: 1126674
Sex: F
Age: 56
State: GA

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Allergic to sulfa and pyridium drugs

Symptom List:

Symptoms: About 15-17 minutes after the shot I was driving home and all of a sudden felt hot, my heart started racing, my hands started shaking, and I felt dizzy and lightheaded and my hands also felt numb. The worst of it probaby only lasted 5 minutes. I felt well enough to drive home but was still lighthead and shaky for about 45 minutes. An hour later, I feel ok except for a little lightheadedness.

Other Meds: Synthroid, Cimetidine, Zyrtec, vitamin D , Florastor Probiotic , Kerotin hair growth formula, T3 Conversion Booser

Current Illness: Seasonal allergies

ID: 1126675
Sex: M
Age: 65
State: NM

Vax Date: 03/19/2021
Onset Date: 03/19/2012
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1126676
Sex: F
Age: 48
State: TX

Vax Date: 02/11/2021
Onset Date: 02/15/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Allergic to melon's and egg whites

Symptom List:

Symptoms: After the shot, I had the "typical" reaction - sore arm, a bit of a head ache, but nothing concerning. Then on the 4th night after my shot, I started feeling bad and got in bed. That night I couldn't sleep due to not feeling well. The next morning I was very dizzy, agitated, nauseous and had a weird head ache behind my eyes. I started feeling like I was going to throw up anytime I looked at anything for more than about a minute. (my phone, a book, a puzzle, the tv). I laid by the toilet most of the day with a wash cloth over my eyes. Around 6pm that night I started throwing up a TON, major headache, body aches, shivers, but no fever. These symptoms lasted for the next two days. (as a side note, this was during the freeze, so I was not able to call my doctor, etc...). I started feeling better on day 4 but I had a headache for about two week - that still lingers on most days. (headaches are unusual for me). This was, without a doubt, the sickest I have ever been in my life! I decided not to get the 2nd shot because I was afraid of feeling worse after the 2nd shot.

Other Meds: zyrtek, B-12 vit, Vit D, Vit C, and Pristiq

Current Illness: No

ID: 1126677
Sex: F
Age: 18
State: FL

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: Loss of consciousness, vomiting, turned pale and unresponsive at times.

Other Meds: No

Current Illness: No

ID: 1126678
Sex: M
Age: 81
State: WI

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/23/2021
Hospital: Y

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

Lab Data:

Allergies: Tramadol, Rosuvastatin, Penicillins, Atorvastatin

Symptom List:

Symptoms: Patient developed COVID-19 symptoms and tested positive on 3/21/2021 after getting vaccinated on 3/20/2021. Patient has a history of COVID - he tested positive on November 16 of 2020. Patient's records also list "Acute respiratory failure with hypoxia (*) likely secondary to COPD exacerbation secondary to COVID-19 vaccine reaction" - this was listed as a Problem in his chart on 3/21/2021. - This is his listed prinicpal problem at admission to the hospital on 3/21/2021.

Other Meds: Prednisone, albuterol, Eliquis, atorvastatin, PriLOSEC

Current Illness: Coronary atherosclerosis,

ID: 1126679
Sex: M
Age: 26
State:

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: headache. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1126680
Sex: F
Age: 72
State: KY

Vax Date: 02/26/2021
Onset Date: 03/23/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Sulfamethoxazole-trimethoprim

Symptom List:

Symptoms: PNEUMONIA DUE TO COVID-19 VIRUS

Other Meds: ALBUTEROL HFA INHALER, NORVASC, COREG, LASIX, HYDRODIURIL, LANTUS PEN, HUMALOG KWIKPEN, KLOR-CON, ZINCATE

Current Illness: C-DIFF COLITIS, SEVERE SEPSIS, MULTIFOCAL PNEUMONIA, HTN, HYPERLIPIDEMIA, TYPE 2 DIABETES, UTI, ELEVATED BILIRUBIN, HYPONATREMIA, ACUTE RESPIRATORY FAILURE

Date Died: 02/04/2021

ID: 1126681
Sex: M
Age: 64
State: KY

Vax Date: 01/20/2021
Onset Date: 02/04/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Family notified facility of death when we contacted to confirm second dose appointment

Other Meds:

Current Illness:

ID: 1126682
Sex: F
Age: 72
State: MN

Vax Date: 03/11/2021
Onset Date: 03/13/2021
Rec V Date: 03/23/2021
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Allergies: contrast dye

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Symptoms: Had usual symptoms on March 12, the day after the vaccine -- headache, sore arm, temperature of 99.5, achy muscles.. On Saturday, March 13, I had a rash on my trunk (stomach, chest, neck, parts of my back, and some on inside of arms and front of legs). Took a Benadryl on the advice of a nurse at about 10:00 AM and another Benadryl again at about 10:00 PM. The rash was gone on Sunday, March 14.

Other Meds: Hydroxyurea 500 mg every other day Famotidine 20 mg twice a day

Current Illness: None

Date Died: 03/02/2021

ID: 1126683
Sex: M
Age: 81
State: IL

Vax Date: 01/26/2021
Onset Date: 03/02/2021
Rec V Date: 03/23/2021
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Allergies: Motrin

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Symptoms: Death within 60 days of vaccination. Tested positive for COVID-19 2/8/2021, admitted outpatient to Hospital 2/8-2/10 readmitted 2/13-2/14 with transfer to Medical Center in with death on 3/2/2021.

Other Meds: Unknown

Current Illness: Unknown

ID: 1126684
Sex: F
Age: 27
State: PR

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/23/2021
Hospital: Y

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Allergies: None

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Symptoms: One day after vaccine developed diarrhea with nause and vomiting. She also reported general malaise similar to "Influenza like symptoms". She stay at bed and improved from the general malaise symptoms but persisted with nausea and vomiting. On day 3, she reported at night that her pulse Ox dropped to 88% and was taken to ER. She was admiited with suspected atelectasis of left lower lobe abd possible pneumonia which is difficult to evaluate due to her chronic lung condition. She had improved and is no longer having vomiting or general malaise and expected to be discharge home soon.

Other Meds: None

Current Illness: She reported after being vaccinated that she eat shrimps the day before and had some gastric discomfort.

ID: 1126685
Sex: F
Age: 40
State: FL

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
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Allergies: Seafood (fish and shrimp)

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Symptoms: Patient stated she felt her throat tightening and had trouble swallowing within 5 min or so of vaccination. History of shrimp anaphylaxis.

Other Meds: Not known

Current Illness: Not known

ID: 1126686
Sex: F
Age: 70
State: CA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
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Allergies: Iodine

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Symptoms: "Moderna COVID-19 Vaccine EUA" Severe headache, body ache through out entire body including my right ear, could not be touched because of the pain, chills, weakness, fever

Other Meds: simvastatin 20 mg 1 tablet every evening, metoprolol tartrate 25mg 1tablet twice a day, hydrochlorothiazide 12.5mg 1 capsule every morning, D3 2000IU 50 mcg, B-Complex , Magnesium 500mg

Current Illness: none

ID: 1126687
Sex: F
Age: 82
State: WA

Vax Date: 03/15/2021
Onset Date: 03/17/2021
Rec V Date: 03/23/2021
Hospital: Y

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Symptoms: L shoulder abscess/septic joint. Underwent debridement. Started antibiotics, plan for 4-6 weeks

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ID: 1126688
Sex: M
Age: 32
State: MD

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/23/2021
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Allergies: non reported

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Symptoms: While giving the second dose in the Moderna Covid19 series, the entirety of the vaccine came out of the base or hub of the syringe. The needle was not tightened securely to the syringe. The patient was given his second dose using a new syringe from a new box of BD needles and the connection was secured before insertion in the arm

Other Meds: unknow

Current Illness: unknown

ID: 1126689
Sex: F
Age: 43
State: PA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 03/23/2021
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Allergies: Cypro

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Symptoms: After receiving the first shot, I had a taste of metal in my mouth. I sat down and in the next 30 minutes passed out. For the next three weeks, I had migraines more frequently than my usual migraines and a new pain behind my eye. After receiving my second doses, I felt extremely tired and within 3 hours of receiving got shooting pain on left side of my face. I was diagnosed with Trigeminal Neuralgia by Dr on March 22, 2021. This pain has been constant since receiving the second dose on March 8.

Other Meds: Lexapro 5mg and Levothyroxine

Current Illness: None

ID: 1126690
Sex: M
Age: 49
State:

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/23/2021
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Symptoms: dizziness, nausea. Evaluated by EMS-Cleared

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ID: 1126691
Sex: F
Age: 51
State: LA

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
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Allergies: Penicillin, Zofran, Darvocet

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Symptoms: Patients throat began swelling approximately 4 min after injection was given. Patient was given 0.3 mg epi pen in left outer thigh. EMS was contacted and came to pharmacy. EMS evaluated patient. Patient was stable when leaving by ambulance to go to emergency room . We spoke with the patient today (3/23/2021) at 1:45 pm, and she said she was doing fine.

Other Meds: Clonazepam, Adipex, Norco, Nexium, Trazodone, Levocetirizine

Current Illness:

ID: 1126692
Sex: F
Age: 68
State: VA

Vax Date: 02/14/2021
Onset Date: 02/20/2021
Rec V Date: 03/23/2021
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Allergies: Penicillin; latex

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Symptoms: Soreness that does not resolve. Stiffness and inability to use full range of motion. After a month my arm still aches and makes routine movement difficult.

Other Meds: Amlodipine Besylate 10mg 1x; Atenolol 25mg 1x; Atorvastatin 10mg 1x; Lisinopril 20 mg 1x; Metformin ER 500 mg 3 tablets 1x; Aspirin 81mg 1x; Eye Promise Restore Supplement 1x; Vit D3 Supplement 2000iu

Current Illness: None

ID: 1126693
Sex: F
Age: 55
State: PA

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/23/2021
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Allergies: mycin family

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Symptoms: Chills for one hour at 4:00am on 3/21/21; Fever from 100.5-102.0 from 6pm - 11:30pm 3/21/21; Advil

Other Meds: Sertraline 50mg, Lisinopril 10mg, Amlodipine Besylate 5mg, Vitamin D 2000

Current Illness: N/A

ID: 1126694
Sex: M
Age: 48
State: CA

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

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Allergies: NKA

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Symptoms: His clinic gave him Johnson and Johnson COVID vaccination and the next day, he developed abdominal pain, nausea, vomiting and dehydration. It got progressively worse, so he came to the ED. He has been admitted, rehydrated, given antiemetics and feels somewhat improved.

Other Meds: MIRTAZAPINE 15 MG PO QHS, ZOLOFT 200 MG PO DAILY, SEROQUEL 100 M PO BID, SYMTUZA (UNKNOWN DOSE)

Current Illness: His clinic gave him Johnson and Johnson COVID vaccination and the next day, he developed abdominal pain, nausea, vomiting and dehydration.

ID: 1126695
Sex: M
Age: 47
State: NC

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/23/2021
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Symptoms: Patient reports feeling "weird" and "rushing in chest", tingling and numbness near trachea

Other Meds:

Current Illness:

ID: 1126696
Sex: F
Age: 77
State: TX

Vax Date: 02/06/2021
Onset Date: 02/10/2021
Rec V Date: 03/23/2021
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Allergies: none

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Symptoms: Hives on various areas, mostly on forearms. A few on neck, legs, back, hands, wrists. The bumps range in size from marble size to quarter size and severely itch. I take Benadrel orally and apply Calamine lotion on bumps. I am currently still having hives.

Other Meds: Trazadone/Celexa/simvastin/B12/multi vitamin/Tumeric/ProbioticTylenol

Current Illness: none

ID: 1126697
Sex: F
Age: 52
State: CT

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/23/2021
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Allergies: paraphenylenediamine

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Symptoms: March 12, 2021: 10:30am vaccine administered; 10:40am light headed and dizzy for a few min; 10:50am saw stars. Remained seated and was observed and had some apple juice. 1:30pm began flu like symptoms began: 1) dizzy, 2) headache, 3) chills, 4) body aches, 5) joint pain, 6) exhaustion. March 23, 2021 still have flu like symptoms and not getting better: 1) dizzy, 2) headache, 3) body aches, 4) joint pain, 5) exhaustion.

Other Meds: birth control pill

Current Illness: N/A

Total 2021 VAERS Injuries: 679,999

Page last modified: 03 October 2021 5:28pm