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: 1171773
Sex: F
Age: 27
State: NJ

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

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

Lab Data:

Allergies: Mone

Symptom List: Dysphagia, Epiglottitis

Symptoms: Rapid heart rate starting 30 minutes post-injection, lasting roughly 4 hours. Fever starting about 12 hours after the injection, still ongoing as of now (30 hours post infusion), arm pain at injection site (still ongoing as of yet, 30 hours post injection) chills and weakness (still ongoing as of 30 hours post injection)

Other Meds: None

Current Illness: None

ID: 1171774
Sex: F
Age: 42
State:

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: lightheaded, dizziness, "salivating" like she going to throw up. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1171775
Sex: F
Age: 40
State: CA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: beer

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

Symptoms: patient reported feeling hot in the observation area and was brought to the EMS room H2O given allowed to rest discharged in no distress @ 935.

Other Meds: allegra, lexapro, estogen progesterone patch vitamin D and calcium

Current Illness: premature ovarian failure, allergies

ID: 1171776
Sex: F
Age: 16
State: NY

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: PCN - stomach upset; seasonal allergies

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient is a 16yo seen for her first dose of the COVID-19 vaccine. She was seated in the back seat of the car. Shortly after receiving her vaccine (within a few minutes), she chose to move to the front passenger seat of the car, and after sitting in the passenger seat she became lightheaded and lost consciousness. Syncopal event was witnessed and lasted a few seconds. She spontaneously regained consciousness, and complained of some lightheadedness and tunnel vision. No significant confusion was noted, her responses to questions were appropriate. Initial pulse was thready and heart rate initially difficult to auscultate. Pale color noted on the face. Initial pulse approximately 50bpm. Breath sounds clear with good air exchange. Patient was placed in a reclined position with feet on the dash. She quickly recovered and repeat heart rate was auscultated at approximately 70bpm, stronger pulse noted. She was noted to have improvement and she was then driven out of the vaccine site after obtaining consent from her mother (who was the driver) and parked beside EMS. BP was 100/50 and HR 68-72, SaO2 97%. Lightheadedness resolved and she was feeling well, at her baseline. She was monitored for 30 min then allowed to leave with her mother, she was at her baseline at last evaluation. Per history review with her mother, she has had 2 prior episodes of syncope with pin removal from hand after surgery and IV placement.

Other Meds: Singulair

Current Illness: None known

ID: 1171777
Sex: M
Age: 29
State: NY

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Pt was sitting in waiting area after receiving #1 injection of Pfizer Covid vaccine. He bagan to feel faint and presented to EMS Vitals taken BP 70/40 HR 40 O2 100% Blood sugar 96. Pt diaphoretic. No difficulty breathing.

Other Meds: none

Current Illness: none

ID: 1171778
Sex: F
Age: 50
State: CA

Vax Date: 01/07/2021
Onset Date: 01/16/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: I could not work but my knees hurt so bad. I had an arthritis pain in my joints, wrist knee and my fingers. I was in a lot of pain and limping at the end of the day. I went to the ER and they did tests. A few days later I developed a rash on my thighs and when it started to spread to the other thigh. It looks like hives and it is was very itchy. The rash then appeared on my buttock and then to the other side. It proceeded to spread in patches in different areas of my body and then spread to the contralateral side of the same body area. I had swelling in my right hand on two fingers. A month after vaccination I also got a fever. All tests were negative except my CRP was elevated each time. I was prescribed Prednisone, but the rash still appears periodically, and my joints still hurt after 12 weeks. The rash is not as itchy when it appears. I have had another course of Prednisone after seeing the immunologist.

Other Meds: Pepsid; Vitamin D

Current Illness:

ID: 1171779
Sex: M
Age: 19
State: AZ

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

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: low bp , dizzy

Other Meds:

Current Illness:

ID: 1171780
Sex: F
Age: 29
State: PA

Vax Date: 04/01/2021
Onset Date: 04/05/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: Day of I was dizzy off and on, day after my arm was very sore which I felt was normal. 4/5 I woke up with a very bad headache. 4/6 i woke up with chills, body aches, dizzy

Other Meds: liletta IUD

Current Illness: none

ID: 1171782
Sex: F
Age: 63
State:

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient came for second Covid vaccine. She stated that she was here for her Moderna. . Her fist covid vaccine was a Pifizer .I gave Moderna and did not note it was given in error until after vaccine given. Charge nurse and pharmacist and patient notified. Patient counseled on normal side effect and adverse side effects. Her adult son is coming to stay with her as this was prearranged.

Other Meds:

Current Illness:

ID: 1171783
Sex: F
Age: 38
State: MI

Vax Date: 12/31/2020
Onset Date: 01/05/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I noticed swelling upper right eye lid initially then little whitish bumps (2 small) on the lower eye lid.My doctor thought it was a growth gave me a antibiotic. I exp some drainage from eye and bumps lasted 3 weeks.

Other Meds: No

Current Illness: No

ID: 1171784
Sex: F
Age: 38
State: UT

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Patient was sitting in chair while person giving vaccine was standing at elevated level. Pain Immediately injection sight once given, Nerve was hit by needle Right arm/shoulder: pins/needles, numbness, muscle spasms/twitching Right Face: Pins and needles

Other Meds: Spironolactone, Ibuprofen, Fluoxetine, Buspirone, Adderall

Current Illness: N/a

ID: 1171785
Sex: F
Age: 44
State: NY

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: PT STARTED XOLAIR OVER A YEAR AGO & STARTED WORKING WELL FOR HER W/IN 2 DOSES & WAS CONTROLLING HIVES UNTIL ABOUT NOV/DEC 2020. AT THAT TIME SHE STARTED NOTICING VERY MINIMAL HIVES COMING BACK. PT RECEIVED 1ST PFIZER COVID VACCINE ON 3/11. NO CHANGES TO HIVES, STILL MINIMIAL. RECEIVED 2ND DOSE OF VACCINE ON 4/1. THAT DAY/EVENING SHE HAD ARM PAIN & FATIGUE (EXPECTED OF VACCINE). SHE WOKE UP OVERNIGHT W/ SEVERE ITCHING. FRIDAY AM HIVEALL ALL OVER BODY & SEVERE ITCHING. SAT/SUN THE HIVES STARTED RAISING & STILL ITCHING. MONDAY THE SX WERE SO SEVERE SHE WAS NAUSEOUS. MD STARTED HER ON TOPICAL CORTISONE & 5 DIFFERENT ANTIHISTAMINES. CORTISONE HELPS FOR ABOUT 15 MINUTES & ANTI-HISTAMINES DON'T SEE TO RESOLVE ITCHING. PATIENT IS TO FOLLOW-UP WITH MD FOR TREATMENT OF HIVES & POTENTIAL OF COVID VACCINE CAUSING SUCH AN IMMUNE RESPONSE THAT IT OVERWHELMED THE XOLAIR'S EFFECTS AND CAUSED THE HIVES TO OUTBREAK SEVERELY.

Other Meds: Xolair PFS

Current Illness:

ID: 1171786
Sex: M
Age: 53
State:

Vax Date: 02/17/2021
Onset Date: 04/05/2021
Rec V Date: 04/06/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: VTE- PE and DVT dx on 4/5/21

Other Meds:

Current Illness: hyperlipidemia, L inguinal hernia, seasonal allergies, colon polyps

ID: 1171787
Sex: F
Age: 18
State:

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: dizziness, nausea. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1171788
Sex: M
Age:
State: MD

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Allergic to all statins Flow max

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

Symptoms: Since receiving the vaccine experience chronic muscle pain in my back and neck and shoulders along with frequent headaches. When I go to the gym I can only lift have to wait so I normally do

Other Meds: None

Current Illness: None

ID: 1171789
Sex: F
Age: 68
State: CA

Vax Date: 02/10/2021
Onset Date: 03/10/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Patient developed cold like symptoms on 3/10- nasal congestion, cough that progressed to left lung ache/pressure, cough worsened, chest congestion, sore throat. On day 3/17 and 3/18 patient became SOB, malaise, chills/sweats, achy, tired, nausea, emesis, anorexia, "heart tightness' with ambulation, presyncope. Right leg started to feel tight and painful behind the knee, tachycardia.

Other Meds: Levothyroxine, Ibuprofen

Current Illness: None

ID: 1171790
Sex: F
Age: 63
State: AL

Vax Date: 03/24/2021
Onset Date: 03/31/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Mildly allergic to wheat and garlic; mild skin irritation to prolonged use of latex.

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

Symptoms: Redness near injection site, 3 x 1 with a bit of heat. Did not materialize until a week or more later, or I only noticed it later. In having my routine mammogram earlier today the technician noticed it and felt the heat. As I understand it I have a mild case I f Covid arm. A non-issue to this happy recipient!

Other Meds: ImmuneCalm Herbal capsules, Apple Cider Vinegar capsules, D3, Melatonin, magnesium, Manuka Royal Honey capsules, B Complex and Sublingual B12

Current Illness: None

ID: 1171791
Sex: F
Age: 57
State:

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

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

Lab Data:

Allergies: Dexlansoprazole; Hydromorphone; Meperidine; IV dye; Pfizer Covid vaccine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient received her first Pfizer COVID-19 vaccine. Approximately 25 minutes later she developed a feeling of throat swelling, hoarse voice and difficulty swallowing. She was unable to swallow water. She was treated in the ED with EpiPen, Solumedrol and Benadryl. Patient was admitted to ICU for airway monitoring.

Other Meds:

Current Illness:

ID: 1171792
Sex: M
Age: 30
State: CA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient came in for second dose of Vaccine. Upon injection, the hub of the syringe became faulty and vaccine leaked out. Per the nurse, the patient received approximately 0.2mL of the vaccine. Pharmacist notified and aware of the situation; she gave the okay for the nurse to redose the patient. Patient aware of the situation and was comfortable with a redose.

Other Meds:

Current Illness:

ID: 1171793
Sex: F
Age: 39
State: IA

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

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

Lab Data:

Allergies: Amoxicillin

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

Symptoms: Light headed, runny nose, sore throat, tiredness, watery eyes. Started to get a sore throat about 11 pm on 4/5 and by the time I woke up at about 6:30 am on 4/6 turned into "cold-like" symptoms. Seems to be getting worse throughout the day.

Other Meds: None

Current Illness: None

ID: 1171794
Sex: F
Age: 78
State:

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/06/2021
Hospital: Y

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

Lab Data:

Allergies: Amoxicillin, sulfa, azithromycin

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

Symptoms: Pt developed stroke like sx the morning after second COVID vaccine including weakness and numbness of R extremities. PCP ordered MRI the following Monday that showed an acute lacunar infart of the L periventricular white matter between the caudate nucleus and thalamus, likely embolic from untreated afib and CHADS-VASC 4.

Other Meds: Amlodipine, atorvastatin, diltiazem, aspirin 81 mg, lisinopril, HCTZ, levothyroxine

Current Illness: n/a

ID: 1171795
Sex: F
Age: 44
State: TX

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

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Flank pain: left and right kidney.

Other Meds: None

Current Illness: No

ID: 1171796
Sex: F
Age: 58
State: MI

Vax Date: 04/01/2021
Onset Date: 04/04/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Gluten sensitivity, iodine sensitivity,

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

Symptoms: Red itchy rash at point of injection started around 6 am on 4-4-21. Put topical benedryl on. Fine right now. Migraine on 4-5-21 started at 9:45 am. Slept and took 2 Advil. Headache on 4-6-21 and feeling congestion in head. Took 2 Advil. I wanted to report this because I tested positive for Covid on 10-21-20 and thought you should have this information on file. I had the Moderna COVID-19 Vaccine EUA.

Other Meds: Cod Liver Oil, vitamin D, B12, B6

Current Illness: none

ID: 1171797
Sex: F
Age: 54
State: FL

Vax Date: 03/29/2021
Onset Date: 04/05/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: RASH one week after that itches at the spot on the arm where they inserted the needle.

Other Meds:

Current Illness:

ID: 1171798
Sex: F
Age: 37
State: MD

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Fish and PCN

Symptom List: Injection site pain, Menorrhagia

Symptoms: After 35 min: Right side facial itching and "hives" on side of face. Back itching and "hives" reported on arrival to mother's house (about 5-10 minutes away). Took Benadryl PO and reports "relief." No airway issues (denied). Reported High blood pressure of "154 over 12...Something." Reports fever of 101 and chills for three days afterwards. Also reports "red ring around injections site from the 2nd week up until 3/22/21."

Other Meds: Amlodipine daily, Metoprolol daily, Albuterol HFA (PRN)

Current Illness: none

ID: 1171799
Sex: M
Age: 60
State: NV

Vax Date: 03/26/2021
Onset Date: 04/02/2021
Rec V Date: 04/06/2021
Hospital: Y

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

Lab Data:

Allergies: No

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

Symptoms: On 4/2/2021 my dad feel headache and nausea. no power right side arm and leg

Other Meds: Asprin. Insulin. Dipyridamole . use them everyday

Current Illness: Diabetes only

ID: 1171800
Sex: M
Age: 35
State: CA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pt received vaccination to left deltoid. Soon after shot pt had a syncopal episode with jerking movement. Was assisted to floor with help of nursing staff. Placed on left side. A/Ox3. V/s obtained with b/p 136/68 Hr 48 O2 98% on RA. RR18 even and unlabored. EMS notified. No acute distress noted, Father was contacted and at pt side. EMS arrived with full assessment of pt. He refused to go to hospital. V/S obtained again with HR 66 b/p 110/71. Pt went from side lying position to a standing position. Ambulated to waiting area with steady gait. Waited 30 min before leaving with father at his side. After 30 min pt was free to go. Denies any problems before leaving. V/s 134/64 HR 61 O2 100% on RA.

Other Meds: none

Current Illness: none

ID: 1171801
Sex: F
Age: 52
State: TX

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I have an irregular red splotch about 1.5 inches at the site of injection. I have another irregular red splotch about 1 inch under the other red splotch that measures about 2 inches. The red splotches feel warm to the touch, they do not itch but the area is a little sensitive to the touch but not painful. The red splotches went away after 3 days but returned on the 10th day after receiving the vaccine.

Other Meds: None

Current Illness: None

ID: 1171802
Sex: M
Age: 37
State: WA

Vax Date: 03/21/2021
Onset Date: 03/22/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: prolonged (2.5 weeks currently) pain and loss of range of motion in SHOULDER.

Other Meds: vitamin D

Current Illness: none

ID: 1171803
Sex: F
Age: 55
State: MI

Vax Date: 03/10/2021
Onset Date: 03/12/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: vaccine administered at mass vaccination clinic on 3/10/21 by EMT. client reports two days later severe headaches started that progressed to facial drooping, face and neck swelling, tongue and nose numbness all on left side, and dry mouth on the 6th day 3/17/21. she was admitted for observation to HCP on 3/18/21 and was told by a neurologist that her diagnosis was Bell's Palsy and that she should not receive a 2nd dose of covid vaccine. she reports that swelling and facial drooping have improved some but are still present today 4/6/21.

Other Meds:

Current Illness:

ID: 1171804
Sex: F
Age: 69
State: MD

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

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

Lab Data:

Allergies: Demerol, causes hallucinations, Droperidol (inapsine). caused hyperawarness and agitation.

Symptom List: Injection site pain

Symptoms: This was my first vaccine. Received it a 12:10pm. Started having symptoms around 5:30pm that evening 3/2/21. Extremely tired, everyday , as if someone drained all my energy. Symptoms lasted about 2 1/2 weeks. Got a little better, but still extremely tired. Had to take naps almost every day. I am a very healthy 70yr old but after this first vaccine, not my same self. Mild nausea, sore arm but only lasted 1 day.

Other Meds: Yes, Levothyroxine .88mcg, take one tablet per day. Paroxetine 40mg, take one tablet per day. herbal supplements : Red Rice Yeast with CoQ10, take this for high cholesterol 1,200mg Red rice yeast and 100mg CoQ10, 100mg this amount per

Current Illness: None

ID: 1171805
Sex: M
Age: 65
State: IN

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

Vax Type:
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Lab Data:

Allergies: codeine, statin drugs (for cholesterol) chocolate

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

Symptoms: pt states that the next day after taking the vax he felt like he had a severe flu. He was shaking badly, he had body aches, pains, chills and 101.4 fever. He had a rapid heart beat. His O2 level went down to 86. Today 4/6/2021 he is feeling exhausted and his back hurts. He is taking Tylenol for his symptoms.

Other Meds: Zetia, Lasix, medicine for his immune system, Vitamin D, K, and multivitamin.

Current Illness: non

ID: 1171806
Sex: F
Age: 27
State: MI

Vax Date: 03/29/2021
Onset Date: 04/05/2021
Rec V Date: 04/06/2021
Hospital:

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Lab Data:

Allergies: Seasonal only

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

Symptoms: Large rash at injection site. Seems harmless.

Other Meds: Birth control

Current Illness:

ID: 1171807
Sex: M
Age: 21
State: AZ

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

Vax Type:
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Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: low bp , dizzy,faint

Other Meds:

Current Illness:

ID: 1171808
Sex: F
Age: 54
State: NY

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

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Lab Data:

Allergies: None.

Symptom List: Erythema, Pruritus

Symptoms: Woke up in the middle of the night, around 3 a.m., with all my joints feeling stiff, most pronounced in my hands. After getting up several hours later, around 7:30, and moving around the stiffness faded away.

Other Meds: None.

Current Illness: None.

ID: 1171809
Sex: F
Age: 36
State: NC

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

Vax Type:
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Lab Data:

Allergies: No

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

Symptoms: fatigue, joint pain, chill and fever (99.5 to 101.5), rash, itchiness, and bruise on the same arm, swallowed and painfully lynph under the armpit on the same arm. The symptoms started 8 hours after the injection and last for 50 hours.

Other Meds: fluoxetine 40 mg

Current Illness: No

ID: 1171810
Sex: F
Age: 57
State:

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 04/06/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: compazine doxycycline tetracycline

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

Symptoms: eosinophilia

Other Meds: alprazolam

Current Illness: none

ID: 1171811
Sex: F
Age: 76
State: OH

Vax Date: 02/19/2021
Onset Date: 03/11/2021
Rec V Date: 04/06/2021
Hospital:

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Lab Data:

Allergies: NKA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient was hospitalized from 3/11-3/15 for mental status changes. No obvious etiology found. On admission she was found to be + for SARS-Co-V2. She had no respiratory symptoms and was not treated. She was discharged to

Other Meds: albuterol MDI 2 puffs QID prn SOB allopurinol 300mg QD amlodipine 10mg QD ascorbic acid 500mg QD ASA 81mg QD atorvastatin 40mg QD baclofen 10mg QHS Ca/Vit D3 250-125 BID carvedilol 6.25mg BID dabigatran 2.5mg BID valproic acid 250mg BID don

Current Illness: Patient was hospitalized 2/20-2/21 Female patient seen MD with PMH of COPD, CHF, dementia presented with encephalopathy on 2/20. Patient has baseline dementia with mild confusion at baseline, but she was noted to be more confused then usual by family. Stroke alert was called on pt. CT head was nonacute. Stroke neurologist did not recommend tPA. Patient was having elevated BP with SBP in the 200s a few days prior to arrival to the ED. Patient also endorsed having taking her 2nd covid vaccine prior to arrival. Pt's infectious w/u was unremarkable with negative blood cx. Her BP has been controlled during this admission. She is alert and conversational. She is able to talk about her dog and her kids. Patient states she is back to her baseline and is safe for discharge. Recommend f/u with her pcp to monitor her BP

ID: 1171812
Sex: F
Age: 55
State: KY

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/06/2021
Hospital:

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Lab Data:

Allergies: Penn

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

Symptoms: Shot was in right arm, when I woke up at 4:00 am I was shivering and very tired. Both of my shoulders hurt, after 24 hours my left shoulder and arm (which 5 years ago underwent a shoulder repair) continued to hurt and continues to hurt to date. Constant throbbing, burning going down my arm into my elbow that also hurts which also had surgery repair about 6-7 years ago. Icing helps briefly but the pain is immense.

Other Meds: Phenofibrate

Current Illness: None

ID: 1171813
Sex: M
Age: 50
State: CA

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

Vax Type:
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Lab Data:

Allergies: N/A

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

Symptoms: Had flu like symptoms, feverish, chills, aches and pains was painful to move and had no energy

Other Meds: N/A

Current Illness: N/A

ID: 1171814
Sex: F
Age: 66
State: GA

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 04/06/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: sulfa drugs, levaquin, cipro

Symptom List: Pain in extremity

Symptoms: my knees started hurting worse than they ever had before! all my joints started hurting, neck and shoulder especially. I also got a numbness in my left hand that came and went for a few days and then it stayed and it is still numb. This nurse that I have worked with before told me I could come in get the shot. She told me that I should come on Friday around 3pm if I am there and they have vaccinated all the people with appointments I could get one if there was one left. I was turned away so I called around and finally found someone (he was a CEO or something) and he told me to come in to get the vaccine. He left just as I got there to go inside and get the vaccine. When I made it inside I told them he had told me to come and get the vaccine and the nurses told me I couldn't get it without an appointment. I was persistent and they finally took me back to get the vaccine. I hope they did not give me something expired or bad.

Other Meds: yes, but choose not to list them.

Current Illness: No

ID: 1171815
Sex: F
Age: 57
State: IL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

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Lab Data:

Allergies: NKA

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

Symptoms: Dizziness, diaphoretic, lightheaded. Patient described "Feeling high". Nurse sat with for approximately 40 minutes. Took vitals twice and were within normal range. Patient relaxed and drank water. Patient reported feeling good. Vitals were taken again and was good.

Other Meds: Lomotrigine 150 mg

Current Illness: NKA

ID: 1171816
Sex: F
Age: 27
State: CA

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

Vax Type:
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Lab Data:

Allergies: None

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

Symptoms: About 4 hours after getting the first shot, I experienced itching on my lower back and continued to get rashes all over my body for the next few days and still am now. Very small part of my lip swelled and watery eyes.

Other Meds: None

Current Illness: None

ID: 1171817
Sex: F
Age: 55
State:

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: 4/6/2021 Patient was observed post Covid-19 immunization for 30 minutes based on pre-vaccination screening . During the observation period, she experienced an adverse reaction with the following symptoms: Anxiety and panic attack. Assessment : Time of assessment 1010 Alert and oriented and Anxious. Actions taken: Vitals sign taken VAERS form obtained and completed by RN. 1010 : bp-127/65, p- 80, O2- 92%, 1038- bp- 133/71, p- 72, o2- 98% Medications administered: No medication administered. Disposition: Reports no further symptoms of adverse reaction after observation for 30 minutes. Discharged home. The Patient was provided with Vaccine Information Sheet and instruction to access the V-Safe system. Immunizations Administered Name Date Dose VIS Date Route Pfizer COVID-19 Vaccine 4/6/2021 10:01 AM 0.3 mL 12/11/2020 Intramuscular Manufacturer: Pfizer, Inc Lot: ER8729

Other Meds:

Current Illness:

ID: 1171818
Sex: M
Age: 28
State: IL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

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Lab Data:

Allergies: NKA

Symptom List: Vomiting

Symptoms: Light headed, faint, weak, hot, sweating. Complained about throat tight and difficulty breathing. Provided patient with ice pack for back of neck and wrist. Due to patient complaining of difficulty breathing, 911 was called and he was assessed by EMS personnel.

Other Meds: None known

Current Illness: None known

ID: 1171819
Sex: F
Age: 17
State: NJ

Vax Date: 04/04/2021
Onset Date: 04/04/2021
Rec V Date: 04/06/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: none - gave to 17.5 yo

Other Meds:

Current Illness:

ID: 1171820
Sex: M
Age: 30
State: CA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: nkda

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

Symptoms: patient became diaphoretic and disoriented at vaccination station, brought to EMS given H2O and allowed to rest. Monitored vital signs until WNL, discharged in no distress with wife @ 920am

Other Meds: denies

Current Illness: denies

ID: 1171821
Sex: M
Age: 57
State: WI

Vax Date: 03/18/2021
Onset Date: 03/22/2021
Rec V Date: 04/06/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: No knowledge of any

Symptom List: Injection site swelling, Limb discomfort

Symptoms: About a week after receiving the shot from the hospital, I starting having itching in my elbows then calves and inner thighs and back sides of my knees. It started as blotches in areas. The ones on my arms seemed to have gone away. We have confirmed I am using the same soap, same laundry detergent and same deodorant. It was the worst on 4/4/21. So I have started to bathe in epson salt each day and not only shower. 4/5/21 it was high on my thighs. Trying to minimize itching. I also tried to apply a 1% hydrocortisone anti itch cream the last last few days. The redness has been reduced today. I have pictures of it growing. I think getting better.

Other Meds: Losartan

Current Illness: None

ID: 1171822
Sex: M
Age: 46
State: NC

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

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Lab Data:

Allergies: shellfish, bees, sulfa

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

Symptoms: lips and facial swelling.

Other Meds: albuterol,buproprion , buspirone, famotidine, hydroxyzine, lisinopril, lamotrigine, quetapine, tamsulosin, temazepam.

Current Illness: none

ID: 1171823
Sex: F
Age: 46
State: NY

Vax Date: 03/31/2021
Onset Date: 04/02/2021
Rec V Date: 04/06/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies: None

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

Symptoms: Several days after the J&J Vaccine I had a rash on my face and my lips became very swollen and turned a blueish gray color. Under my top lip there were several large dark red marks that were tender and swollen.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am