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: 1169868
Sex: F
Age: 29
State: TX

Vax Date: 03/23/2021
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: nkda

Symptom List:

Symptoms: Patient stated feeling dizzy 1minute after sitting down in Post Vaccination. Pt felt sleepy, body felt heavy and she was about to fall. Pt did not fall but staff member stated her eyes rolled back. @ 2:20pm Pt is fully awake and feel back to normal now. Currently sitting in Post Vac eating and talking while being monitored by healthcare staff. Bp 122/76 Hr 66 O2 98 Patient stated that every time she gets vaccines and blood draws she feels this way related to anxiety of getting a vaccine. Patient is stable

Other Meds: none

Current Illness: no

ID: 1169869
Sex: M
Age: 66
State: PA

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: sulfa, cipro, lipitor, zocor, januvia, environmental allergies

Symptom List:

Symptoms: fever for 2 days, treated with Tylonol; headache for 4 days treated with Aleve or Tylonol; severe malaise for 3 days treated with bed rest; moderate to severe toothaches treated with Tylonol and Aleve; severe fatigue for 7 days treated with rest at first and then mild exercise; fatigue continues

Other Meds: zoloft, prilosec, crestor, metformin, tresiba, novolog, vitamin d3, allegra, guaifenesin, albuterol, neosporin, amlodipine, hydrochlorothiazide, aleve, meclizine, tylonal

Current Illness: lumbar pain, sinus infection, tachycardia

ID: 1169870
Sex: M
Age: 22
State: KY

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: nka

Symptom List:

Symptoms: I administered HPV and HepB vaccines and approximately 5 minutes later, patient fainted. He recovered quickly with no additional issues and left facility approximately 20 minutes later.

Other Meds: none

Current Illness: none

ID: 1169871
Sex: M
Age: 34
State: MI

Vax Date: 03/30/2021
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: Erythromycin, gabapentin

Symptom List:

Symptoms: Major swelling in nasal sinuses noticeable from exterior. Major pain along sinuses and jawline

Other Meds: Metformin, Xarelto, Metoprolol, lisonopril

Current Illness:

ID: 1169872
Sex: M
Age: 40
State: CA

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:

Symptom List:

Symptoms: dizziness and weakness 10 minutes post vaccination. observed patient for 20 more minutes while seated. called 911 for patient but patient refused service. patient was alert the entire time and able to converse coherently. Patient felt fine afterwards to drive home. Followed up with patient on 4/5/21. Patient stated that he's perfectly fine after reaching home with just a slight arm soreness which was resolved the next day.

Other Meds:

Current Illness:

ID: 1169873
Sex: F
Age: 55
State: KY

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

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

Lab Data:

Allergies: Gentamicin- anaphylaxis

Symptom List:

Symptoms: About an hour after receiving the vaccine I developed a large white hive just below the injection site. (hive approx 2 inches in diameter) I began to itch on rest of body/ no more hives just itch. I took 50mg of Benadryl. 4 hours later still itching so I took 50mg of Benadryl. Approx, 4.5 hours later, woke up with tightening feeling in throat, itching in throat and roof of mouth, itching tingling of tongue, and tingling sensation of lips. went to the emergency room. Was admitted and monitored, benadryl was administered. Duration of hospital stay 1 day.

Other Meds: Lisinopril, Januvia, Glipizide

Current Illness: None

ID: 1169874
Sex: M
Age: 52
State: CA

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: Patient experienced syncope w/a vasovagal reaction. Patient awoke after 10 seconds. Juice given. Patient observed for 30 minutes. symptoms resolved, patient discharged.

Other Meds:

Current Illness:

ID: 1169875
Sex: F
Age: 75
State: GA

Vax Date: 03/12/2021
Onset Date: 03/15/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Allergies Statin's: leg cramps - Side Effects Toprol XL: fatigue - Side Effects Crestor: abdominal symptons and leg cramps - Side Effects Norvasc: edema - Side Effects Zetia: increased flatulence - Side Effects Niacin: severe flushing - Side Effects Nasonex: headaches and dry eye - Side Effects epinephrine: tachycardia and near syncope - Side Effects

Symptom List:

Symptoms: spontaneous nose bleed

Other Meds: Multivitamins, Ibuprofen 200mg, Docusate sodium 100mg, Cherry Extract,Culturelle , Red Yeast

Current Illness:

ID: 1169876
Sex: F
Age: 25
State: MA

Vax Date: 03/24/2001
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: rash/swelling/hives on left calf, around navel, and on left hand

Other Meds: multivitamin

Current Illness: none

ID: 1169877
Sex: F
Age: 87
State: TX

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 04/05/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: 30 hours later , profound sensorineural hearing loss in right ear. Treated by steroid, hearing returned in one week . Black tarry stools INR increased from 2 to 12 ER visit , admitted to hospital on March 23. TIAs

Other Meds: Warfarin 5 mg OLM MED/AMLO/ 40/10/25 mg Metoprolol ER 50 mg Clopidogrel 75 mg Ezetimibe 10 Calcium 600 + D3 (2 daily) Apple Cider vinegar tablets 600 mg

Current Illness: None

ID: 1169878
Sex: F
Age: 43
State: NV

Vax Date: 02/22/2021
Onset Date: 02/26/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Vicodin

Symptom List:

Symptoms: I noticed right away that when she administered the shot it was much higher on my left shoulder than the first shot. The next couple of days I felt lousy so I didn't work out. When I started to work out again on Friday, Feb. 26th, I noticed I couldn't lift my arm across my body or directly above without severe pain. My range of motion was immediately impacted. It's been six weeks and I cannot put on a shirt or take it off without pain. I've had to modify my typical workout routine. The pain wakes me up at night when I shift positions.

Other Meds: Levothyroxine 88mcg

Current Illness: none

ID: 1169879
Sex: F
Age: 17
State: TX

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

Symptom List:

Symptoms: Pt began to complain of dizziness and then shortly thereafter said she could not see. I dialed 911 and while on the phone with 911, the patient said she was experiencing shortness of breath. I administered an EpiPen and waited for EMS to arrive. Pt was transported to hospital and later released

Other Meds:

Current Illness: none

ID: 1169880
Sex: F
Age: 58
State: AK

Vax Date: 02/25/2021
Onset Date: 02/26/2021
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: redness around injection site

Other Meds:

Current Illness:

ID: 1169881
Sex: F
Age: 16
State: GA

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: none

Symptom List:

Symptoms: patient said she started losing vision in one eye for few minutes, and started having numbness or tightness in arms. Paramedics were called and she felt fine after first few minutes

Other Meds: unknown

Current Illness:

ID: 1169882
Sex: F
Age: 60
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: aspirin, ibuprofen

Symptom List:

Symptoms: Patient complaining of itchiness around the face and all over her body. Denies any shortness of breath or difficulty breathing. Patient had this reaction 27 minutes after 1st dose of the covid vaccine. Patient was awake and alert. Benadryl 50 mg IM given on the left deltoid. Vital signs: B/P= 147/94, HR= 67, RR= 18, Oxygen sats= 98%.

Other Meds: Albuterol inhaler, anastrozole, tylenol, voltaren, claritin, flonase

Current Illness: none

ID: 1169883
Sex: F
Age: 58
State: AL

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

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

Lab Data:

Allergies: pencellian, motrin, advil, ibrophfen, glucafouge, shellfish

Symptom List:

Symptoms: I was unable to get email thorough to local health department and felt I should report to someone. I did not see a physician or dentist (was trying to wait a day or two in case it was in response to the vaccine), but reaction in the mouth seemed unusual to me so I wanted to report. I do not use vsafe, smartphones pointing to codes but felt like I needed to alert someone about unusual reactions to my second Merderna vaccine. My first vaccine was on 2/26/2021 at #013AZ1A. I only had a slight sore arm. No other symptoms. My second vaccine #028AZ1A on 3/26/2021 had severe reactions. On 3/27/2021 I had a sore throat, sore arm, migraine, but the scary thing was I developed severe swelling in my mouth. Gums where wisdom teeth had been extracted years ago had two huge abscesses. My gums were there were gaps in my teeth were swollen and coming up between my teeth. My mouth was sore and sensitive. I couldn't even bite down on jello. On the third day I began using Orajel and gargling in warm salt water. By the 4th day my mouth was back to normal but I have sensitivity in lower and upper right teeth but improving daily. I am able to bite, chew and see no swelling. I had no problems with my teeth prior to the vaccine. Migraine disappeared after two days. I did not take tynol. It was as though the vaccine was trying to attack what it might have thought to be a problem in my mouth. (Only able to sip warm broth for two days). Very scary.

Other Meds: n/a

Current Illness: none related

ID: 1169884
Sex: F
Age: 67
State: MA

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Bacitracin, Neosporin, all grains, paper tape

Symptom List:

Symptoms: Previous tendon pain at joint sites (from Lyme disease) returned full force (had been gone since 2012); Previous headache became constant (last headache was 1998); Memory issues and word-finding problems (previous Lyme symptoms which had been gone since 1995); Constant nausea (only alleviated partially by acupressure band on wrists) These symptoms are still ongoing...it's day 17 post 2nd vaccination.

Other Meds: Cequa eye drops, Wixela inhaler, Montelukast

Current Illness: asthma

ID: 1169885
Sex: F
Age: 42
State: TX

Vax Date: 03/29/2021
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: Allergic to penicillin

Symptom List:

Symptoms: On 4/5/21 my armpit started hurting and is swollen. The pain goes down into my arm and a little into my pec. Same side as injection site.

Other Meds: Allegra, zinc complex, b12, cod liver oil, vitamin c, tart cherry, celery seed

Current Illness: None

ID: 1169886
Sex: M
Age: 54
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: Unknown

Symptom List:

Symptoms: Nurse put vaccine/syringe (vanish point) into the patients arm, when needle disappeared some of the vaccine dripped down the patients arm. Unable to determine how much of vaccine went into the arm. Patient educated that we could not give another vaccine bc that may give hime too much vaccine at one time. Patient very understanding and verbalized understanding. Patient will return for 2nd dose in May.

Other Meds: Unknown

Current Illness: Unknown

ID: 1169887
Sex: M
Age: 37
State: CA

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: n/a

Symptom List:

Symptoms: briefly blacked out loss of bladder tingly sensation to fingers feet and face.

Other Meds: n/a

Current Illness: n/a

ID: 1169888
Sex: M
Age: 67
State: VA

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: None

Symptom List:

Symptoms: Both legs severe ache from hips to ankles. Rest and Acetaminophen 500 mg (2). Legs returned to normal the afternoon of 31 March 2021.

Other Meds: Gabapentin 300 MG, Acetaminophen 500 mg, Simvastatin 20 mg, Lisinopril 20 mg

Current Illness: None

ID: 1169889
Sex: M
Age: 38
State: OR

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

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

Lab Data:

Allergies: Hayfever, smoke induced asthma

Symptom List:

Symptoms: Injection site swelled up to size of golf ball, had severe arm pain and swelling would not go down for 5 days.

Other Meds: Flonase, cingulair, atrovent, patanol, zyrtec

Current Illness: None

ID: 1169890
Sex: F
Age: 26
State: AL

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: non

Symptom List:

Symptoms: Patient has a fear of needles. After her injection, she tried to stand up to tell me she does not feel good but fainted before getting to the counter. She hit her head at some point. We gave her some water and called the paramedics. After checking her out she was instructed by the paramedics to go to hospital. She went to the student health center and given information regarding head injury. She later return to collect her Vaccine record card.

Other Meds: birth control pills

Current Illness:

ID: 1169891
Sex: M
Age: 33
State: SD

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: Lexapro

Symptom List:

Symptoms: Hives to right arm and neck; Benadryl 50mg given

Other Meds: Xolair, Suprep, Pepcid, multivitamin, vitamin C, fiber, zyrtec

Current Illness:

ID: 1169892
Sex: F
Age: 47
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: Amoxicillin, Flagyl, Melon, Peanut, PCN, Albuterol, Benzoin, Celebrex, Iodine, Neurontin, Nortriptyline

Symptom List:

Symptoms: She reported feeling itchy in the lips. She took a Benydryl and started to have itchiness in the throat. She was placed in a wheelchair and taken to the ED. she was treated with epinephrine, steroids, Benadryl, Pepcid, and Zofran. To be observed for 4-6 hours, after 3 hours of observation she wanted to go home and her husband said he was comfortable to watch her.

Other Meds:

Current Illness:

ID: 1169893
Sex: F
Age: 60
State: GA

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:

Symptom List:

Symptoms: PER PATIENT AFTER SHE GOT HER SHOT SHE STARTED GETTING NUMBNESS OR TIGHTNESS IN HER OPPOSITE ARM

Other Meds:

Current Illness:

ID: 1169894
Sex: F
Age: 34
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: Eucalyptus, almonds, papaya, eggs, dairy, all animal derived products, latex,

Symptom List:

Symptoms: Sudden pixilated/blurred vision, primarily right eye peripherally. After 20-30 minutes of obstructed vision, onset of headache. Sharp pain in temples, and strain/tension in neck. No soreness/tenderness at injection site. Eyesight restored around 6:00pm, headache continued. I took 3 ibuprofen, drank 4oz of gatorade, at two clementines, and 5 ride crackers.

Other Meds: Na

Current Illness: Na

Date Died: 04/02/2021

ID: 1169895
Sex: M
Age: 67
State: OR

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: metoclopramide

Symptom List:

Symptoms: Death; 48 hours after vaccine

Other Meds: acetaminophen (TYLENOL) 325 mg, oral, EVERY 8 HOURS PRN ? albuterol sulfate 90 mcg/actuation inhaler 2 Puffs, inhalation, EVERY 4 HOURS PRN, FOR RESCUE ? amLODIPine (NORVASC) 2.5 mg, oral, DAILY, Managed by Dr. ? ARIPiprazole (ABILIFY) 30

Current Illness: LE edema, fatigue, joint pain, CKD3-4 with uremia

ID: 1169896
Sex: M
Age: 61
State: TN

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: n/a

Symptom List:

Symptoms: After 5 minutes post vaccine, patient started vomiting and became dizzy. patient symptoms were not resolving so paramedics were called.

Other Meds: n/a

Current Illness: n/a

ID: 1169897
Sex: F
Age: 41
State: IL

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: antibiotics: augmentin, cipro, nitro food: mango poison ivy sensitive skin generally - rashes from laundry detergent

Symptom List:

Symptoms: Day 1: Ten hours later: exhaustion, body ache, fatigue without being able to sleep, diarrhea, headache Day 2: Extreme body ached and headache Day 3: spaciness and exhaustion Day 4: Joint cracking with movement Day 5: Mild/nothing Day 6: Fever and chills

Other Meds: none

Current Illness: None

ID: 1169898
Sex: M
Age: 16
State: CO

Vax Date: 03/11/2021
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: receives allergy shots

Symptom List:

Symptoms: Mother of patient describes chills, fatigue, and kidney pain. Is being exclusively managed by PCP who has seen him multiple times. Given Jannsen at mass vaccination clinic by student nurse under preceptor supervision. Error not brought to attention of until 4/2/2021.

Other Meds: unknown

Current Illness: unknown

ID: 1169899
Sex: F
Age: 85
State: ME

Vax Date: 02/17/2021
Onset Date: 03/04/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Augmentin- vomiting

Symptom List:

Symptoms: Painful rash developed on palms of hands and fingers, including finger tips 2 weeks after 2nd vaccination. Conservative treatment with lab evaluation, supportive care and moisturizer to peeling skin. Improving over 4-5 weeks, still with mild symptoms. No systemic symptoms.

Other Meds: Synthroid, Daily multivitamin, PreserVision AREDS , Vitamin B12 cap, Vitamin D3

Current Illness: None

ID: 1169900
Sex: F
Age: 44
State: AK

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: multiple

Symptom List:

Symptoms: headache, low grade fever up to 100 degrees, chills ,nausea, itching

Other Meds: multiple

Current Illness: multiple

ID: 1169901
Sex: F
Age: 52
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:

Symptom List:

Symptoms: Janssen-Covid 19- EUA 53 yo Female who recieved single dose of Janseen lot # 180890 at approx 12:10 this morning. During observation pt had complaint of facial numbness shortly after vaccination Pt denied any sob,diff breathing. No signs of hives noted. no swelling in the mouth or difficulty swallowing.

Other Meds:

Current Illness:

ID: 1169902
Sex: F
Age: 70
State: CA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 04/05/2021
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Allergies: Multiple food allergies including: wheat, barely, fish, milk, garlic, green beans, sulfites History of drug reactions to demerol, iodine contrast dye, NSAID's

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Symptoms: Less than 24 hours after the first dose of Moderna COVID vaccine I experienced a severe exacerbation of sensory ganglionopathy (probably autoimmune) such that I could barely move. This condition involves sensory changes (paresthesia, dysesthesia) and burning pain that affects most of my body. It had been completely controlled by small doses of medication. Now, more than 2 months after the vaccine, I am continuing to have significant, life changing symptoms despite medication. I am unable to increase medication because of side effects.

Other Meds: pregabalin, duloxetine, dupilumab, allegra, symbicort, spiriva, montelukast, amlodipine, pepcid, pantoprazolemultivitamins, calcium,

Current Illness: None

ID: 1169903
Sex: F
Age: 22
State: CA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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Symptoms: Patient received the vaccine and felt fine, and then walked out to the observation tent. As soon as she sat down in the observation tent she started to feel dizzy and after 30 seconds her vision started to go black. Patient then fell out of the chair, and regained consciousness after 5 seconds. Patient was then helped into a wheel chair and taken to a cot and waited 30 minutes before leaving and is having a friend pick her up.

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Current Illness:

ID: 1169904
Sex: F
Age: 30
State:

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
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Symptoms: "While in observation patient began to feel dizzy. PMH for hypertension and anxiety. BP 184/96, HR 130, sat 98%. Heart-tachy, regular rhythm, Lungs-clear. Patient was given water and monitored. At 1:44pm she state that she felt better and no longer felt dizzy. BP 159/103, HR improved to 120. Cardiovascular: Tachycardia Actions/Interventions: Monitoring at vaccine site Cardiovascular: Tachycardia "

Other Meds:

Current Illness:

ID: 1169905
Sex: F
Age: 45
State: NJ

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

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Symptoms: None stated.

Other Meds: NP THYROID

Current Illness: None

ID: 1169907
Sex: M
Age: 34
State: IL

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

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Allergies: Shellfish

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Symptoms: Felt nauseous and out of breathe right away. Fainted and hit head on pavement within 15 minutes of shot. Admitted into ER with concussion and found bleeding in brain within 3 hours of shot.

Other Meds: N/a

Current Illness: None

ID: 1169908
Sex: M
Age: 79
State: TX

Vax Date: 03/05/2021
Onset Date: 03/08/2021
Rec V Date: 04/05/2021
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Allergies: N/A

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Symptoms: Fevers up to 102.8, chills, sweats and extreme fatigue including sleepiness .alternated between Tylenol 500mg and Ibuprofen for fever

Other Meds:

Current Illness: none

ID: 1169909
Sex: F
Age: 65
State: OR

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 04/05/2021
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Allergies: corn, soy, dairy, wheat/oats/rye/barley, diflucan, flu vaccine, chemical sensitivity

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Symptoms: Drive up clinic. Got shot and immediately the ringing in my ears got super loud, like a switch was flipped. I did not feel dizzy or lightheaded, just the loud noise. No treatment then as did not mention. Five days later firefighters took BP at 169/80 (normally 114/70). Suggested I see doctor, which I did. Doctor said it could be response but it should dissipate. Now 4/5/21 and still loud. Worried because strokes run on mom's side of family.

Other Meds: b vit, calc/mag/phosphorous/vit d, vit d

Current Illness: None

ID: 1169910
Sex: F
Age: 46
State: CA

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
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Symptoms: Dizziness w/headache BP: 146/96

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Current Illness:

ID: 1169911
Sex: M
Age: 76
State: NM

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/05/2021
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Allergies: NKDA

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Symptoms: Patient states that he felt "floaty" after receiving the vaccine today. It began within about 5 minutes. No chest pain. No shortness of breath. NO numbness or weakness. He does note he tends to be emotional and has been quite emotional about the vaccine. He has been under a lot of stress for the last ten years. Vital Signs HR 69 /min, 39 /min, BP 181/124, 195/126, Ht 59, RR 18, Oxygen sat % 95, 96, Oxygen Liter(s) Patient had EKG which showed bradycardia and flipped T waves inferiorly. He was sent to the ER where his blood pressure remained high. Pulse remained low initially but gradually improved. Cardiac work up was normal and patient was discharged to home.

Other Meds: Ondansetron HCl 8 MG Tablet 1 tablet Orally Twice a day as needed for nausea Triamcinolone Acetonide 0.1 % Cream Externally Chlorthalidone 25 MG Tablet 1 tablet in the morning with food Orally Once a day

Current Illness: None

ID: 1169912
Sex: M
Age: 42
State: DC

Vax Date: 03/15/2021
Onset Date: 03/01/2021
Rec V Date: 04/05/2021
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Allergies: None known

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Symptoms: Although I had symptoms of Erythromelalgia prior to the vaccine, flares have increased over last few weeks. Symptoms include daily: 1) Erythromelalgia flares (numbness, redness, searing heat from hands and feet, particularly in PM) 2) peripheral neuropathy (wrist, hands, knuckles, feet). 3)Joint pain, numbness, and swelling (knees, wrists, knuckles)

Other Meds: AM: Loratadine Phentermine Bupropion Vit B12 ; Vit D PM: Spironolactone Sertraline HCL Clindamycin 1% lotion Trazodone (occasional) Melatonin

Current Illness: Minor seasonal congestion

Date Died: 03/29/2021

ID: 1169913
Sex: M
Age: 77
State: TN

Vax Date: 03/13/2021
Onset Date: 03/26/2021
Rec V Date: 04/05/2021
Hospital: Y

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Symptoms: none noted or reported after the injection

Other Meds:

Current Illness:

ID: 1169914
Sex: F
Age: 73
State: CA

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

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Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA PM of immunization- started feeling icky; next day I felt like I was run over by a train; ran temp that night. Also had a large red area on arm of immunization --the red area was about 5" wide by 3" tall; area itched; temp went away; arm is still sore 5 days later, but redness is slowly going away. Immunization area is still a little itchy and reddish

Other Meds: metformin, blood pressure meds, statin

Current Illness: n/a

ID: 1169915
Sex: M
Age: 65
State: FL

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

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Symptoms: Patient became nauseated and lightheaded after receiving vaccine, symptoms were resolved after 5 minutes with no known re-occurrence at this time

Other Meds: BP and cholesterol medication

Current Illness: none

ID: 1169916
Sex: M
Age: 43
State: VA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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Symptoms: Patient passed out in their seat in waiting area. Struck back of his head on window behind him. Responsive after 20 seconds. Ambulance called to assess patient further. No treatment required and patient's wife drove him home.

Other Meds:

Current Illness:

ID: 1169917
Sex: M
Age: 61
State: CA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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Symptoms: Was administered second dose if Moderna 2 weeks early. Earliest dose would have been on 4/15/21..

Other Meds:

Current Illness:

ID: 1169918
Sex: F
Age: 71
State: IL

Vax Date: 03/23/2021
Onset Date: 03/27/2021
Rec V Date: 04/05/2021
Hospital: Y

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Allergies: No known allergies

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Symptoms: She developed symptoms of right lower leg pain 4 days after receiving the vaccine. It then progressed to right chest pain, tachycardia, and shortness of breath. She was diagnosed with a DVT and PE.

Other Meds: aspirin 81 mg daily calcium 500 mg daily

Current Illness: None

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm