VAERS 2021 Database www.vaers.hhs.gov

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

Total Manufacturer

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1159852
Sex: F
Age: 78
State:

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Allergic to Demerol and had Adverse reaction to N/V medication Ondansetron felt sick Prozac and zoloft combo also made her sick to stomach

Symptom List:

Symptoms: Everything aches, arms, shoulders, legs, and low grade fever.

Other Meds: Preservision Pantoprazole Cadawid Vitamin C Vitamin Aspirin 81 mg 1/2 alprazolam prn

Current Illness:

ID: 1159853
Sex: M
Age: 23
State: MI

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Starting around 6 pm I started having aches and chills. At about 11 pm, those chills and aches got more severe and I had a fever of 101 degrees for about two hours.

Other Meds:

Current Illness:

ID: 1159854
Sex: F
Age: 37
State: CA

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: seasonal allergies, sensitive skin, mild tree nut allergy

Symptom List:

Symptoms: Injection site bleeding, bruising, redness, swelling, stiffness- onset immediate to a few hours after, lasting 9+days (still experiencing bruising, swelling, redness) Tinnitus in ear on same side as injection- onset 30 min after, lasting 4 hours Headache- onset 1 hour later, lasting 2 days Fatigue, muscle soreness, muscle stiffness- onset 1 hour later, lasting 4 days Head rushes, Dizziness, Vertigo- onset 1 hour later, lasting 4 days Lymph node swelling- onset 6th day, lasting 3+days (still present) Low grade fever (98.8-99.5 degrees F)- onset paired with lymph node swelling onset, lasting 3 days Large red swelling area surrounding injection site, warm to touch, "Covid Arm"? - onset days 7-9+ (still present)

Other Meds: Adderall, Liletta IUD, B-12, lion's mane mushroom, Omega7

Current Illness: no known acute illness

ID: 1159855
Sex: F
Age: 36
State:

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Employee received .2 cc of Pfizer instead of .3 cc which was inadvertently administrated by vaccine nurse. NO ADVERSE REACTION, just reporting medication error. Our Vaccine Task Force, after speaking with CDC and DOH, decided to offer the employee an additional COVID-19 vaccine dose. Thanks.

Other Meds:

Current Illness:

ID: 1159856
Sex: M
Age: 32
State:

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Chills, aches, arm pain, joint pain

Other Meds:

Current Illness:

ID: 1159857
Sex: F
Age: 32
State: OH

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Eggs - mild reaction \ intolerance

Symptom List:

Symptoms: High fever (103.1) + Fever reducing medicine (Acetaminophen) Chills, Lethargy, Severe Headache (treated with Ibuprofen), Blurred vision, loss of appetite on Day 2, increased thirst, sore throat, minimal pain to injection site

Other Meds: Prenatal Vitamin D & B12

Current Illness:

ID: 1159858
Sex: F
Age: 63
State: HI

Vax Date: 03/24/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Severe vertigo/dizziness, Headache, Feeling nauseous, Sensitivity inner ear to loud noises.

Other Meds:

Current Illness:

ID: 1159859
Sex: F
Age: 23
State: OR

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Moderna COVID-19 Vaccine Eua Moderate soreness and stiffness in injection arm - started 8pm 03/31/2021, reduced to mild 8am 04/02/2021 Fever between 99.6-101 fahrenheit - started 8pm 04/01/2021, reduced to 99.6 but still present as of 9am 04/02/2021 Nausea, loss of appetite - 04/01/2021 Took ibuprofin to manage fever and arm pain at 9pm 04/01/2021, reduced arm pain but fever remained above 100 degrees

Other Meds: Welbutri, buspar, limotrigin, cyred eq oral contraceptive

Current Illness:

ID: 1159860
Sex: M
Age: 57
State: LA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Patient presented to ED via ambulance with fatigue weakness, poorly controlled Diabetes, hyperglycemia and abdominal pain. still in hospital on this date

Other Meds:

Current Illness: CHF, poorly controlled DM, AKI, elevated troponin, hyperglycemia on admission

ID: 1159861
Sex: M
Age: 72
State: OR

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Right after leaving the clinic son called stating recipient vomited; returned to clinic. RN from clinic went out to car and assess patient who was dizzy all day and had just vomited. Denied chest pain, dyspnea, fever. Recommended being seen in ED for evaluation and offer to call EMS declined but family decided to go to ED and son drove/EMS not called.

Other Meds:

Current Illness:

ID: 1159862
Sex: M
Age: 69
State: PA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Hay fever, tree pollen

Symptom List:

Symptoms: Woke up the next morning with muscle aches all over. Not very severe but I did end up taking some ibuprofen to lessen them. I did NOT have any fever or other symptoms. When I woke up the following morning, I still have very mild muscle aches which got less as the day went on. Also had mild tenderness at the vaccine site on left arm.

Other Meds: Atorvastatin 20 mg Omeprazole 20 mg Lisinopril 5 mg Vitamin D-3 1,000 IU

Current Illness: None

ID: 1159863
Sex: F
Age: 67
State: IL

Vax Date: 03/31/2021
Onset Date: 04/02/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Ativan

Symptom List:

Symptoms: Immediate bruise at injection site when received, moderate nose bleed 48 hours after vaccine. Bleeding stopped. No medical attention needed.

Other Meds: Aspirin 81 mg, 1 per day, daily vitamin.

Current Illness: No

ID: 1159864
Sex: M
Age: 82
State:

Vax Date: 02/19/2021
Onset Date: 03/17/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: chest tightness

Other Meds:

Current Illness:

ID: 1159865
Sex: F
Age: 70
State: KY

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Slight ringing in ears began 28 hours following receiving the vaccination, and the ringing is still present. The ringing is not bothersome, but a retired doctor friend suggested that I report this side effect. I am able to sleep soundly. This is the only possible side effect experienced following the 2nd dose.

Other Meds: Synthroid; Metoprolol; Vitamin B12

Current Illness: None

ID: 1159866
Sex: F
Age: 33
State:

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Employee received .2 cc of Pfizer instead of .3 cc which was inadvertently administrated by vaccine nurse. NO ADVERSE REACTION, just reporting medication error. Our Vaccine Task Force, after speaking with CDC and DOH, decided to offer the employee an additional COVID-19 vaccine dose. Thanks.

Other Meds:

Current Illness:

ID: 1159867
Sex: F
Age: 59
State: FL

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient experienced sharp pain at a specific spot on head the evening after vaccination. Loud ringing in the right ear was also observed. Patient had a headache that lasted 3 days. There was redness under the injection site that went down the arm. Patient has been taking acetaminophen to help with symptoms.

Other Meds:

Current Illness:

ID: 1159868
Sex: F
Age: 34
State:

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: One hive over left eye. denies swelling, SOB, tingling, and itching. benadryl given, symptoms improved

Other Meds:

Current Illness:

ID: 1159869
Sex: F
Age: 65
State: CA

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: At 3:00 woke up with headache and slight nausea and sore arm. Felt constipated and went back to sleep. Woke up at 9am felt nausea and was constipated but went to bathroom and small amount of stool. Then within another hour went to bathroom fine but still felt sore arm and stomach felt nausea. Then in 30 min around 10am after getting into bed again I got up and went to bathroom again and had slight diarrhea of soft stool and mash potatoes stool. Also I felt my lymph nodes under my chin and they were a bit swollen more than normal and still felt headachy and a bit of nausea but never felt like throwing up. Then ate breakfast and felt better but dull headache was on and off all day so took acetaminophen every 6 hours and then went to sleep and was good the next day no headache but swollen under the chin lymph nodes 9 days now. No other symptoms. No more sore arm unless I rub it I only feel it slightly n stomach is fine and no nausea after that first day.

Other Meds: None

Current Illness: None

ID: 1159870
Sex: F
Age: 60
State: AZ

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Dupixent, Demerol, Levaquin

Symptom List:

Symptoms: Severe Psoriatic arthritis flare, red swollen, painful joints, hands and feet.

Other Meds: Cosentyx, Otezla

Current Illness:

ID: 1159871
Sex: F
Age: 62
State: FL

Vax Date: 03/24/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Bee stings, gluten intolerant

Symptom List:

Symptoms: Wednesday after Wednesday getting shot, injection site started to feel pain and itchy. Thusday, very itchy like five mosquitoe bites barely see pink 2 inch by 1 (6 pm) . Friday, extreme itchiness, 4 inch by 2.5 reddish spot (noon). Had to apply OTC cortisone in hopes of easing itch. First time using Cortisone in over 20 years.

Other Meds: Pepcid Complete, Tums, Famotidine tablets 20 mg

Current Illness: None

ID: 1159872
Sex: M
Age: 52
State: FL

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Fatigue, uncontrollable shaking, fever, chills, loss of appetite (ongoing),

Other Meds: Uniquenol, prebiotics, vitamin C,

Current Illness: Unknown diagnosed virus

ID: 1159873
Sex: F
Age: 22
State: NY

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Chills for about 2 hours Exhaustion for 4 hours Slight fever for 2 separate 3 hour instances

Other Meds: Vitamin D Supplement 2000IU B12 2500mcg Vitamin C 1000mg

Current Illness: Food Poisoning March 13-20

ID: 1159874
Sex: F
Age: 28
State: LA

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

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

Lab Data:

Allergies: penicillin

Symptom List:

Symptoms: injection site extremely sore, knot at injection site, nausea, body aches, fever, headache, runny nose

Other Meds: Lexapro, vitamin D, Womens Multi vitamin

Current Illness: none

ID: 1159875
Sex: F
Age: 28
State:

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Employee received .2 cc of Pfizer instead of .3 cc which was inadvertently administrated by vaccine nurse. NO ADVERSE REACTION, just reporting medication error. Our Vaccine Task Force, after speaking with CDC and DOH, decided to offer the employee an additional COVID-19 vaccine dose. Thanks.

Other Meds:

Current Illness:

ID: 1159876
Sex: F
Age: 16
State: OH

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient was given a Moderna shot but did not qualify by age to be given the Moderna vaccine. The patient was monitored after the shot for any adverse reactions and did not display any.

Other Meds: None

Current Illness: None

ID: 1159877
Sex: F
Age: 60
State: IL

Vax Date: 03/06/2021
Onset Date: 03/09/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: I was doing my HIIT workout as always (I am 60 and in good physical conditioning) and got bad hip pain on my left side. I stopped and saw my chiropractor and just took it easy from doing HIIT for awhile.

Other Meds: Spironolactone, Lisinopril, Doterra Life Long Vitality pack (vitamins)

Current Illness: None

ID: 1159878
Sex: F
Age: 36
State: NJ

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Azathioprine cozar doxycycline haldol celexa compozine ursidial

Symptom List:

Symptoms: Itching , throat swelling. Burning palms ,hot flashes, chest discomfort

Other Meds: Zyrtec azathioprine astagraf xl metoprolol levathyroxine pre natal vitamin. Calcium, calcitriol sodium bicarbonate

Current Illness: None

ID: 1159879
Sex: F
Age: 23
State:

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: syncopal episode post vaccination. pt lowered to ground by spouse. hx anxiety with blood draws and vaccines. did not eat today. nauseated. brought to observation, monitored, sent home

Other Meds:

Current Illness:

ID: 1159880
Sex: F
Age: 37
State: NY

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Left arm pain, body aches, 103.6 fever, headache, nausea

Other Meds: Famotidine 40mgx2

Current Illness: None

ID: 1159881
Sex: M
Age: 61
State: FL

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Iodine, Shellfish & TB scratch test positive result (at approximately age 10years old), later blood test negative.

Symptom List:

Symptoms: On 3/18/21 was providing vaccinations for its employees I was asked if I wanted to take advantage of the extra vaccine. I did and got the 1st vaccination Pfizer EN6208. On 3/19/21 Shortly after arrival at work 08:00 I began to feel numbness/ tingling of both my feet. The numbness/tingling had moved up to my knee?s by Noon and once at home at approximately 6:00pm while at home the numbness/ tingling had moved up to my waist. The numbness/ tingling remained from the waist down. In addition my groin and rectum region also have the numbness/ tingling. When I sit down it feels like I am sitting on a gel pad, kind of squishy. On 3/22/21 had an appointment my vitals were checked a couple of physical tests were done and he recommended a full panel of blood work.

Other Meds: none

Current Illness: none

ID: 1159882
Sex: F
Age: 23
State: KY

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient stated she felt short of breath, developed chest tightness, became diaphoretic immediately after vaccine administration. Patient also reported light-headedness. 50 mg oral diphenhydramine was given and patient was sent to the emergency room for further evaluation.

Other Meds:

Current Illness:

ID: 1159883
Sex: F
Age: 29
State: OH

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: 15 minutes after receiving her vaccination, she experienced lightheadedness. She was taken to a private section of the arena and monitored.

Other Meds: Flexeril

Current Illness: None

ID: 1159884
Sex: M
Age: 41
State:

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Employee received .2 cc of Pfizer instead of .3 cc which was inadvertently administrated by vaccine nurse. NO ADVERSE REACTION, just reporting medication error. Our Vaccine Task Force, after speaking with CDC and PA DOH, decided to offer the employee an additional COVID-19 vaccine dose. Thanks.

Other Meds:

Current Illness:

ID: 1159885
Sex: F
Age: 56
State: CA

Vax Date: 03/22/2021
Onset Date: 03/26/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Penicillin. Benadryl/compozine

Symptom List:

Symptoms: I got all over on me an allergic skin reaction redness burning, very itchy and painful sensation

Other Meds: Warfarin 3mgs. Oxicodone 10/325mgs take at night time after 6pm

Current Illness:

ID: 1159886
Sex: M
Age: 37
State: IL

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Milk

Symptom List:

Symptoms: Vaccine was administered at 10:25am. Patient walked over to the waiting area and as he was walking he passed out and fell to the ground. Vitals were taken at about 10:28am: B/P 132/74 HR 70 RR 18, glucose 120. Patient was able to state his name and where he was located, but kept his eyes closed and kept stated he felt "confused and dizzy" and was apologetic. EMS was called at 10:30AM and when EMS was here pt was noted to have another syncopal episode. Patient was transported to Hospital via ambulance.

Other Meds: No medications

Current Illness: None

ID: 1159887
Sex: F
Age: 55
State: WA

Vax Date: 03/22/2021
Onset Date: 03/26/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Slight swelling at site of facial dermal fillers that lasted about 2-3 days. Swelling of lymph node under left arm that started about 1 week after injection and lasted about 5 days

Other Meds: Dextro-Amp, Bupropion, Vitamin D, Vitamin C

Current Illness: none

ID: 1159888
Sex: F
Age: 38
State: MD

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: I exp red bump around the injection site for 24 hours.

Other Meds: Vyvanse 20 mg

Current Illness: No

ID: 1159889
Sex: F
Age: 19
State: TN

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient sustained a vasovagal syncope event about 3 to 4 minutes subsequent to vaccine administration. Struck back of head on chair with fall to ground. Evaluated by medical staff and referred to medical center via ER non-emergent transport. Subsequent to ER staff evaluation for syncope and head injury, she was treated and released from the ER without need for further work-up or imaging.

Other Meds: N/A

Current Illness: N/A

ID: 1159890
Sex: M
Age: 35
State: TX

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 04/02/2021
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Lab Data:

Allergies: none

Symptom List:

Symptoms: Fever of 102, Fatigue, severe headache, chills, body aches

Other Meds: NAC 600 mg, 1000 mg's Vitamin C, 5000 IU Vitamin D

Current Illness: none

ID: 1159891
Sex: F
Age: 68
State: NC

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 04/02/2021
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Lab Data:

Allergies: MSG

Symptom List:

Symptoms: Beginning with nausea, followed soon after with all over body aches, low grade fever, chills, sweats, headache, for just over 2 days. I accept this as price to pay for not getting or dying of Covid!

Other Meds: Trazadone, simvastatin, atenolol, gabapentin, celecoxib, lisinopril

Current Illness: None

ID: 1159892
Sex: M
Age: 38
State: WI

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

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Lab Data:

Allergies: no known allergies

Symptom List:

Symptoms: Patient had a vasovagal response. Patient observed another person feeling anxious and then he fainted. Patient immediately recovered without any further concerns.

Other Meds: N/A

Current Illness: no known illnesses

ID: 1159893
Sex: F
Age: 60
State: FL

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/02/2021
Hospital:

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Symptom List:

Symptoms: pt came to clinic in w/c 1155am c/o dizziness, SOB, SpO2 RA 96%, BP176/98 P76 1200 drinking water 1206 BP 147/80 P67 - better 1208 pt and husband, walked with staff (RN) to car

Other Meds:

Current Illness:

ID: 1159894
Sex: F
Age: 52
State:

Vax Date: 02/18/2021
Onset Date: 02/27/2021
Rec V Date: 04/02/2021
Hospital:

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Symptom List:

Symptoms: left side facial numbness with facial droop

Other Meds:

Current Illness:

ID: 1159895
Sex: M
Age: 67
State: NY

Vax Date: 03/31/2021
Onset Date: 04/02/2021
Rec V Date: 04/02/2021
Hospital:

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Lab Data:

Allergies: Mild allergy to Aspirin

Symptom List:

Symptoms: Some fatigue for a few days after injection. Swollen Lymph nodes in armpit of the arm receiving the injection. Swelling has not subsided yet.

Other Meds: Multi Vitamin, Losartan Potassium, Simvastatin, Methotrexate, Folic Acid

Current Illness:

ID: 1159896
Sex: F
Age: 63
State: KS

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
Hospital:

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Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Developed itchy red rash/hives on both fore arms(slowly fading out), headache(about 2 hours after shot for 20-30 minutes) and nausea(within 10 minutes of receiving shot and lasting about 15 minutes).

Other Meds: Lithium, Allopurinol, Omeprazole, Escitalopram, vitamin C, Pramipexole, Triamterene, Famotidine, Metoprolol, vitamin D3, multi-vitamin, Oxybutynin

Current Illness: sarcoidosis

ID: 1159897
Sex: M
Age: 70
State: IL

Vax Date: 03/28/2021
Onset Date: 03/30/2021
Rec V Date: 04/02/2021
Hospital:

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Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: Pt developed outbreak of herpes Zoster approximately 36 hours after receiving the 2nd Moderna vaccine. Location- R LE.

Other Meds: Allopurinol, Atorvastatin, Pantoprazole, Flomax, MVI

Current Illness: None

ID: 1159898
Sex: F
Age: 45
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: Arm soreness began night of injection. Next day I experienced fatigue, low-grade fever, muscle aches, nausea. By second day I was feeling fine/all symptoms abated.

Other Meds: None

Current Illness: None

ID: 1159899
Sex: F
Age: 66
State: GA

Vax Date: 03/09/2021
Onset Date: 03/23/2021
Rec V Date: 04/02/2021
Hospital:

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Lab Data:

Allergies: Anything in the onion family (onions, garlic, scallions, chives, shallots).

Symptom List:

Symptoms: Extreme sore throat, cough, low grade fever, stuffy nose, tiredness.

Other Meds: Rx Trazodone (since 1987 for migraines). None other.

Current Illness: None.

Date Died: 03/03/2021

ID: 1159900
Sex: F
Age: 92
State: MO

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

Vax Type:
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Allergies:

Symptom List:

Symptoms: CVA (stroke) around 2:00 p.m., was immediately transported to hospital. Meds were given (I believe Alteplase, but would need to confirm.) 3 brain bleeds after medications. Patient passed away at 5:40 p.m.

Other Meds:

Current Illness: none

ID: 1159901
Sex: F
Age: 56
State:

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

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Lab Data:

Allergies: Penicillin, sulfa, tetracycline, keflex

Symptom List:

Symptoms: Fever (102), aches, headache

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm