VAERS 2021 Database www.vaers.hhs.gov

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

Total Manufacturer

Incidents per State

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

ID: 1169358
Sex: F
Age: 74
State: OH

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Cortizone, steroids, percadine, demerol

Symptom List:

Symptoms: 2:30 am the next day, I woke up and I was shaking violently and I was freezing! I touched my cheek and I had a 104 temp. I couldn't move my limbs. I was immobile. Sick all night. Saturday I had diarrhea and vomiting and fever. Body aches. Large lump where I got the vaccine and it was hot and red to the touch at the injection site.

Other Meds: Hydrochlorothiazide, celexa, nexium, singulair, symbicort inhaler

Current Illness: No

ID: 1169359
Sex: M
Age: 28
State: CA

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Fatigue for 3 days. Fatigue subsided entirely after 3 days.

Other Meds:

Current Illness:

ID: 1169360
Sex: F
Age: 27
State:

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient states that she has tightening , chest tightening and swelling of the tongue. Patient was transported to the ER by ambulance.

Other Meds:

Current Illness:

ID: 1169362
Sex: F
Age: 44
State: MI

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Class A Steroids Penicillin Sulfa

Symptom List:

Symptoms: Body rashing started around 9 pm the day I received the shot in addition to hot and cold chills with shaking. The rash started on my hips and went down to my feet. It was a very hot burning rash that would come and go during the day but was terrible when trying to lie down. At certain points my hip knee and ankle joints were neon pink. As of Thursday I went to urgent care and was prescribed a dexamethisone steroid pack that I just started yesterday with Zyrtec twice a day and Benadryl every 4 to 6 hours. Rash is improving and cold chills are less frequent but still occurring. Too soon to know if it will resolve since I just started oral dexamethisone yesterday

Other Meds: Bus Par Klonopin Amitriptaline Hydroxychloraquin Collagen

Current Illness: Contact Dermatitis Cutaneous Lupus Anemia

ID: 1169363
Sex: F
Age: 75
State: NC

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Keflex

Symptom List:

Symptoms: slight dizziness, right arm weakness, weak all over, blood pressure elevated

Other Meds: Losartin

Current Illness:

ID: 1169364
Sex: F
Age: 69
State: IL

Vax Date: 03/24/2021
Onset Date: 03/29/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Sulfites, tetanus toxoid

Symptom List:

Symptoms: Rash on face, neck, and chest - 5 days treated zyrtec benadryl and topical cream from dermatologist

Other Meds: Topiramate, gabapentin, venlafaxine, losartan, diclofenac sodium, pantoprazole, zolpidem 10mg, synthroid, atorvastatin. Vit b 12, coenzyme Q 10, Cranberry 500 mg, Citracal 1200, Trubiotics, Lysine 1000mg.

Current Illness: Hypothyroidism

ID: 1169365
Sex: F
Age: 47
State: AK

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: achy, chills

Other Meds:

Current Illness:

ID: 1169366
Sex: F
Age: 40
State:

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List:

Symptoms: Injection site pain beginning same day and lasted for about 5 days. Trouble sleeping the same night. Headache, diarrhea, and general not feeling well began the day after and lasted for 2 days.

Other Meds: Microgestin, iron supplement, Benadryl, magnesium

Current Illness:

ID: 1169367
Sex: F
Age: 42
State: UT

Vax Date: 03/19/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: PCN

Symptom List:

Symptoms: Developed antibodies for Covid-19 while being on Copaxone after receiving her injections

Other Meds: Copaxone 40 mg three times per week Pfizer, Inc., and BioNTech: 26 Feb 2021 dose 1, 19Mar2021 dose 2

Current Illness: MS

ID: 1169368
Sex: M
Age: 66
State: TX

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: HEADACHE, BODY ACHES, INJECTION SITE RED, WARM, 7CM WHEEL, RAISED RASH ON FOREHEAD & HEAD ON DAY 3 & 4, DAY 5 HEADACHE & RASH REMAINS THE SAME WITH A NEW AREA ARISING. REDNESS TO ARM DECREASED, AREA HARD TO TOUCH. DAY 6 REMAINS THE SAME

Other Meds:

Current Illness:

ID: 1169369
Sex: M
Age: 55
State: MN

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Right foot pain worsening

Other Meds: lisinopril, metoprolol tartrate, amitriptyline. famotidine, cephalexin,allopurinol

Current Illness: none

ID: 1169370
Sex: F
Age: 44
State: NY

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient felt slight tingling in fingers. Called her back at 3:30pm and she said it seemed better but her hand and fingers still felt a little "weird". Vaccine definitely went into deltoid - took picture of site with pts phone and mine.

Other Meds:

Current Illness:

ID: 1169371
Sex: F
Age: 60
State: FL

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

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

Lab Data:

Allergies: NKFA

Symptom List:

Symptoms: Two hours after receiving vaccination had extreme nausea and diarrhea. Nausea and vomiting lasted until 8 pm. Vomiting at least 30 times. Diarrhea lasted into the next day, all day, until I took two ammonium.

Other Meds: Synthroid, metoprolol, lipitor, doxycycline, calcium, Vitamin C, magnesium, Areds, Culturale, Cranberry pills, Vitamin D3, multivitamin, metformin

Current Illness: No illness

ID: 1169372
Sex: M
Age: 33
State: CA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: headache turned migraine hasn't gone away and been over 2 weeks since vaccine fatigue nausea and sensitive to sound

Other Meds: Symbicort and nasal spray for allergies

Current Illness: none

ID: 1169373
Sex: F
Age: 37
State: OH

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List:

Symptoms: Patient heart rate was in the 40s and became dizzy and faint. Needed EMS transport off site. This occurred at a mass vaccination site and patient was transported off facility grounds. Resolved at clinic level, not monetary reimbursement.

Other Meds: unknown

Current Illness: unknown

ID: 1169374
Sex: F
Age: 35
State: NY

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Allergic to biaxin, allergic to pine trees

Symptom List:

Symptoms: Swollen lymph nodes in left armpit, sore lymph nodes, upper body (back, neck, shoulder, both arms) aches, low grade fever, chills. Soreness in left arm and painful to lift left arm. Lasted 24 hours, then just sore lymph nodes/sore arm for another 24 hours after that.

Other Meds: Birth control pills, daily multi vitamin

Current Illness: None

ID: 1169375
Sex: F
Age: 76
State: NH

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: All penicillin based antibiotics.

Symptom List:

Symptoms: Day 5 and still have symptoms. Leg spasms like charlie horses from my knees (both replacement knees) up through my thighs to my hips, pretty much 24/7. Chills, loss of apatite and some foods taste strange. have been unable to sleep through the night because of the pain.I do think that the antibiotic did not mix with the second shot even though the medical staff cleared me at the COVID clinic that I could have the shot.

Other Meds: Levothyroxine 150 MCG and Sulfamethoxazole 2 x a day for 10 days

Current Illness: Wound in left leg due to cellulite

ID: 1169376
Sex: M
Age: 71
State: NJ

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

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

Lab Data:

Allergies: none noted

Symptom List:

Symptoms: client is the doorman at the apartments ( building where a number of seniors reside). The Health Department was holding a COVID-19 vaccine clinic in the building. Client received his #2 Moderna vaccine about 10 :15 am, was observed x 15 mins, no reported side effects. the client was back at his desk in the area of the clinic, either sitting or standing in the area. Almost an hour after receiving the vaccine, the client was standing but fell to the floor, hit his head and began having a grand mal seizure. We turned him on his side, he was unresponsive and in a seizure x 5 mins, 911 was called and responded. The superintendent of the building said the client had a seizure disorder. Another co worker reported the client had had seizures at the building on 3 other occasions. We do not know what medication the client had taken that day. Client was in a postictal state and was transported by paramedics to the hospital.

Other Meds: not known

Current Illness: not known

ID: 1169377
Sex: F
Age: 38
State: CA

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

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

Lab Data:

Allergies: cashews

Symptom List:

Symptoms: Patient was discharged @ 1224 and reported feeling itchy on her face and needing to clear her throat. Dr. @ bedside for exam patient denies chest pain, shortness of breath all vital WNL. Zyrtec 10mg given by mouth @ 1240pm pt tolerated well. Discharged @ 12:55pm in no distress.

Other Meds: allergies and thyroid medication

Current Illness: none

ID: 1169378
Sex: F
Age: 28
State: OH

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: 4-5-21 2:30PM TC: PT STATES RT SIDE OF FACE NUMB UNTIL THE NEXT DAY. THEN HAD FEVER, CHILLS, DIARRHEA AND NAUSEA. TODAY SHE FEELS BETTER - JUST A HEADACHE. NO NEURO DIFICITS PT STATES.

Other Meds:

Current Illness:

ID: 1169379
Sex: F
Age: 34
State: VA

Vax Date: 03/27/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: ?COVID arm?. Welt, redness, warm to touch and slight itch.

Other Meds: Cynthroid

Current Illness: 5 weeks postpartum

ID: 1169380
Sex: F
Age: 67
State: TX

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List:

Symptoms: Tightness arm/ shoulder to ear like a swelling then got a metallic taste in mouth / gland felt swollen to about voice box area and had some dizziness for about 1 1/2 hours that just felt some tiredness rest of day. stated about 40 minn after vaccine. pt has not ever had any other vaccine in her life this was the first. other item she had a reaction to was Bactrim that had some facial swelling and inflamed eye. pt is not on meds to know

Other Meds: none known

Current Illness: unknown

ID: 1169381
Sex: F
Age: 56
State: WA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: isolated elevated heart rate, nausea, sore right arm muscle

Other Meds: metoprolol

Current Illness:

ID: 1169382
Sex: F
Age: 17
State: TX

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Administered vaccine to pt. off EUA recommendations

Other Meds:

Current Illness:

ID: 1169383
Sex: F
Age: 41
State: OR

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Hydrocodone

Symptom List:

Symptoms: Immediate fatigue and fever lasting 36 hours. Rheumatoid Arthritis Flare, Hashimoto's flaire, Thyroid Flare, Sever unexplained pain in right foot that I cannot bear weight on. X-ray at hospital revealed nothing.

Other Meds: Vitamin D

Current Illness: None

ID: 1169384
Sex: F
Age: 31
State: TX

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Allergic to hydrocodone

Symptom List:

Symptoms: Low-grade fever, feeling of being flushed, dizziness, headache, general malaise - came on the morning after the vaccine. Symptoms lasted approximately 4 hours although the malaise/fatigue lasted the rest of the day

Other Meds: Contraception, probiotic, Pepcid, multivitamin, fish oil

Current Illness: None

ID: 1169385
Sex: M
Age: 67
State: TX

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: ANXIETY

Other Meds: NONE REPORTED

Current Illness: NONE REPORTED

ID: 1169386
Sex: F
Age: 20
State: GA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient appeared to faint. She said everything became black and then she came to. She apparently passed out but recovered extremely quickly. This occurred within 5 minutes of receiving the immunization. We provided her orange juice and observed her for another 20 minutes.

Other Meds:

Current Illness:

ID: 1169387
Sex: F
Age: 39
State: AK

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: achy, dizzy

Other Meds:

Current Illness:

ID: 1169388
Sex: M
Age: 50
State: MI

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Levaquin, Bactrim

Symptom List:

Symptoms: Major joint pain. No fever, but full body aches for 1 day. Afterwards, most of pain went away except lower back which has always been a problem.

Other Meds: Simvastatin 20Mg, Meloxicam 7.5Mg, Omeprazole 20Mg, Lisinopril 5Mg

Current Illness: None

ID: 1169389
Sex: M
Age: 56
State: CT

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Participant reported waking up the next morning after his Pfizer vaccine with right facial paralysis and severe facial pain. Pt went to his primary care physician and was diagnosed with bell's palsy and instructed not to receive second dose of Pfizer.

Other Meds:

Current Illness:

ID: 1169390
Sex: F
Age: 44
State: OR

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: Within an hour of vaccine, I experienced fatigue and muscle aches and a headache all within that first hour. Also, redness and swelling at injection site and some heat. And all of the symptoms lasted and didn't dissipate for several days. The headache was debilitating to the point that I didn't want to let wait it out and I called the hospital line and got a recommendation for ibuprofen. I took ibuprofen. I never got a fever. I think the headache probably resolved within 3 or 4 days; muscle aches 4-5 days and I was fatigued for a week to 10 days. I was worried about my second dose and I had very few reactions to my second dose.

Other Meds: none

Current Illness: no

ID: 1169391
Sex: F
Age: 68
State: MD

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: ceclor, sulfurcaneted medications, i get hives and rash mold dust mites some southern grasses and trees

Symptom List:

Symptoms: Injection site: welt and hard lump , itchy, sore arm, elbow had sharp pain on movement to pick things up, could not bear weight., and lack of strength. Headache, fever 100.5, nauseous, profoundly weak, greatly fatigued, body aches, joint pain, chills, lack of Appetite and , motivation

Other Meds: bupropion 150 XL famotidine 40 mgs zrtex

Current Illness: urinary track infection

ID: 1169392
Sex: F
Age: 37
State: FL

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: The vaccine area is itchy, swollen, warm and redness. This started around 7:00 pm on 4/3/2021. Redness has increase and still warm and itchy.

Other Meds: Acetaminophen 500mg, Centrum multivitamin, Lisinopril 5mg.

Current Illness: None

ID: 1169393
Sex: F
Age: 16
State: OH

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pfizer 1st dose administered at COVID-19 Clinic. Client reported being diagnosed with COVID-19 during the last week of September 2020. Reviewed with client what to expect with side effects after receiving 1st dose. No questions or concerns voiced. Gave vaccine at 1505. Mother then stated after vaccine administered that client has history of syncopal episodes after vaccines. Provided water to client and recommended for client to be moved to a supine position. Client declined lying down. About 1506, client lost consciousness for 4 seconds. Client returned to consciousness without intervention and was alert and oriented x 4. Client had 10mL emesis after returning to consciousness. Recommended for client to lie down, client declined. Provided graham crackers and cycling floor fan. Client able to tolerate water and graham crackers. After 5 minutes, client stated feeling better. Mother elaborated that about 1 year ago had first vagal response to needles when having wisdom teeth removed. Happened again during IV initiation for tonsillectomy surgery and during flu vaccination 2020. Monitored client in clinic room for 20 minutes, no further reaction. Advised for client to state needing to lie down when returns for 2nd dose. Client and mother verbalize understanding. Mother escorted client from clinic to private vehicle.

Other Meds:

Current Illness:

ID: 1169395
Sex: F
Age: 54
State: CA

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Chills, Body Aches, Fever 100 F Saturday 4/4/2021. Took Advil one time around 8:00 pm, the symptoms were minimized by Sunday.

Other Meds: None

Current Illness: None

ID: 1169396
Sex: F
Age: 60
State: FL

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/05/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies: Penicillin Latex Thimerosal

Symptom List:

Symptoms: Cold Feet, Nausea, Vomiting, Diarrhea/abdominal cramps. The diarrhea and abdominal cramps/stomachache are still happening as I write this report today April 5, 2021.

Other Meds: Methylprednisolone 4MG Tablets Hydroxychloroquine 200 MG Diovan 320MG Metoprolol 50MG

Current Illness: None

ID: 1169397
Sex: F
Age: 43
State: IL

Vax Date: 03/19/2021
Onset Date: 03/24/2021
Rec V Date: 04/05/2021
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Allergies: NKDA

Symptom List:

Symptoms: Lymph node enlargement in throat beginning on day 5 and lasting until day 7 with underarm/breast involvement as well Fatigue on day 6 Body/joint aches on day 6, lasting until day 9

Other Meds: omeprazole norethindrone hydroxychloroquine azelastine gabapentin

Current Illness: None

ID: 1169398
Sex: F
Age: 48
State: DE

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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Allergies: NKDA

Symptom List:

Symptoms: Pt received her 1st dose of Pfizer vaccine in her left deltoid. Pt came to the first aid area asking for a new bandaid, and stated that the bandaid was not covering over the injection site. Client fainted and this nurse assisted patient to the floor. This nurse called for additional support of workers to help assist patient to the first aid lying area. Vital signs were obtained at 1405 and are as follows: 96.6, 63, 143/88, 18, patient denied any pain. Pt reported that prior to fainting she felt dizzy and lightheaded. Pt reported daily medications are vitamin D supplement PO daily and metoprolol PO 10mg daily. PMH includes HTN. Pt was observed in the first aid area for an additional 30 minutes. Vital signs rechecked at 1424 and are as follows 97.1, 72, 112/73, and 17, no pain. Pt was assisted to an upright sitting position and provided a bottled of water after stating that she no longer felt dizzy or lightheaded. Pt was accompanied by her daughter who will be driving the patient home. Nurse assisted patient to schedule her 2nd appointment for 4/26 at 1pm, and daughter stated that she will be coming with her mother for the 2nd appointment as well. Patient was assisted to a standing position slowly and patient denied having dizziness or lightheadedness while standing. Patient exited the facility accompanied by her daughter at 1433, vital signs prior were within defined limits.

Other Meds: Pt reported that she takes Vitamin D supplement PO daily and metoprolol 10mg PO daily

Current Illness: None

ID: 1169399
Sex: M
Age: 72
State: TX

Vax Date: 01/29/2020
Onset Date: 03/10/2021
Rec V Date: 04/05/2021
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Lab Data:

Allergies: Hay, Bactrim

Symptom List:

Symptoms: Sore joints, waking several times at night, tired during day

Other Meds: No

Current Illness: No

ID: 1169400
Sex: M
Age: 67
State: TX

Vax Date: 01/23/2021
Onset Date: 01/25/2021
Rec V Date: 04/05/2021
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Allergies: No

Symptom List:

Symptoms: Approximately 2 days after vaccine I developed minor case Shingles lower back. I contacted my PCP we did a Zoom visit she inspected the area. I was prescribed Valtrex after 4-5 days it was gone.

Other Meds: Flecainide, Metoprolol

Current Illness: No

ID: 1169401
Sex: F
Age: 26
State: MN

Vax Date: 12/27/2020
Onset Date: 03/29/2021
Rec V Date: 04/05/2021
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Symptom List:

Symptoms: Developed positive Covid-19: symptoms developed on 3/29/2021, test results on 4/1/2021

Other Meds:

Current Illness:

ID: 1169402
Sex: F
Age: 57
State: WA

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
Hospital:

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Lab Data:

Allergies: Dragon Fruit

Symptom List:

Symptoms: 4- 3-2021 at 9:00 am I suffered; body aches, joint pain, headache, swollen at injection site, pain and swelling , dry cough, fatigue, chills, fever 101.7 4-4-2021 all of the above symptoms with a fever of 100. 4-5-2021 all of the above symptoms with a lower fever 99.2

Other Meds: Vitamin C, Triamterene-HCTZ, Venlafaxine HCL, Losartan Potassium

Current Illness: None

ID: 1169403
Sex: M
Age: 56
State: NM

Vax Date: 03/26/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
Hospital:

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Lab Data:

Allergies: lisinopril, amoxicillin

Symptom List:

Symptoms: Patient received first COVID vaccine on 3/26 . On 4/1 developed left 3rd cranial nerve palsy.

Other Meds: Metformin, glipizide, losartan, atorvastatin, pantoprazole.

Current Illness: n/a

ID: 1169404
Sex: F
Age: 58
State: AZ

Vax Date: 04/04/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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Allergies: None

Symptom List:

Symptoms: Flu like symptoms with headache, body aches, hot and cold spells, nausea, just overall don't feel well

Other Meds: None

Current Illness: None

ID: 1169405
Sex: F
Age: 42
State: FL

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
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Allergies: None Stated

Symptom List:

Symptoms: 03 Apr 2021. - 0230: Woke up with facial pain - 1000: Noticed facial pain and intense swelling at the cheeks. - Rest of day: N/V/D, muscle aches, chills, headache, and fatigue 04 Apr 2021. - Same symptoms as day before. 05 Apr 2021. - Fatigue persisted, facial swelling present but improved with Diphenhydramine use.

Other Meds: None Stated

Current Illness: None Stated

ID: 1169406
Sex: F
Age: 27
State: WV

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/05/2021
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Lab Data:

Allergies: Vraylar(drug allergy), fusarium

Symptom List:

Symptoms: Excessive thirst, couldn?t get enough to drink. Mouth was extremely dry. Started the day of shot lasted about three days. There was also a dry cough. Started the day of the shot, it would come in fits, and it could be pretty bad. The second day had the worst coughing fit. After that the coughing went away. I drank a lot of water for that symptom. I did nothing really for the coughing.

Other Meds: Keppra, topamax, singular, geodon, buspar, qnasal, symbicort, aimovig, linzess, maxalt as needed, ashwagandha, Zyrtec, b-12, zinc, magnesium, biotin, vistaril, melatonin, turmeric, probiotic

Current Illness: Migraines on and off(have regular migraines and hormonal migraines)

ID: 1169407
Sex: F
Age: 53
State: CO

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
Hospital:

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Lab Data:

Allergies: Sulfamethoxazole

Symptom List:

Symptoms: received immunization on 4/2 approx 4pm. Late in the day on 4/3, started to have swelling of her cheeks, ear. Became itchy, warm. Denies any SOB, cough, wheezing, throat constriction. progressive symptoms over the course of sunday and into monday. called nurse line, advised to take Benadryl, Claritin. some improvement.

Other Meds: Climara Patch, Flonase allergy, Lisinopril, Medroxyprogesterone, Melatonin, Trazodone.

Current Illness: none reported.

ID: 1169408
Sex: M
Age: 37
State: CA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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Allergies: None

Symptom List:

Symptoms: Nurse at the monitoring area noticed the pt is pale and losing conciousness after he received vaccination. His SBP was 80 and stated that he does not feel alright. He stated that he does not have preexisting condition but he was afraid of the needle and it was painful when he received the injection. The nurse called 911 and the pt was taken to ER approximately 40 minutes after receiving the covid vaccine.

Other Meds: N/A

Current Illness: None

ID: 1169409
Sex: M
Age: 22
State: OH

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
Hospital:

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Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Patient became dizzy and in and out of consciousness. Patient was then taken to a private room where he had a 10 second seizure with no reported hx of epilepsy or other medical conditions (according to the patient) Needed EMS transport off site. This occurred at a mass vaccination site and patient was transported off facility grounds. Resolved at clinic level, not monetary reimbursement.

Other Meds: Unknown

Current Illness: UNKNOWN

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm