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: 1172412
Sex: F
Age: 55
State: MN

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

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: After the dosage, I had pain for 10 minutes in my left foot 25 mins later, then pain for 10 mins in my right foot after that, then my arm started to hurt at 7pm, I did not laying on that side when I slept that night it was so painful. Next day I started to get Lethargy as the day went on and fever of 100.8. When I woke up Sunday the fever was gone, but I suffered with Chills all day on the 3rd day, on the fourth day, I woke up and my lungs hurt when I took a deep breathe and every joint hurt when I moved, and I had a Migraine headache and still severe lethargy. I spent most of day 3 & 4 sleeping. When I woke on the 5th morning I had some lung pain, but every other side affect was gone.

Other Meds: Trazadone, Women's Alive 50+ multi-vitamin, Benadryl, High Absorption Magnesium.

Current Illness: allergies - season, pollen and flowers

ID: 1172413
Sex: F
Age: 53
State: MO

Vax Date: 03/30/2021
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: Penicillin

Symptom List:

Symptoms: Developed a itchy red rash at injection site a week following my 1st COVID-19 vaccine. The rash is about 1-2" diameter, raised about 1-3mm. Currently experiencing this rash, will continue to monitor and seek treatment if it worsens.

Other Meds: None, only daily women's multi-vitamin

Current Illness: None

ID: 1172414
Sex: M
Age: 33
State: MA

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:

Symptoms: PT received covid vaccine and immediately experience vasovagal syncope, showing signs of clammy skin. EMS responded to vaccination table to evaluate and treat. Pt was hypertensive as well. EMS treated PT at vaccination table until PTs condition improved and PT was able to get up on his own and walk to observation area to continue the duration of his observation period. PT declined transport.

Other Meds:

Current Illness:

ID: 1172415
Sex: F
Age: 61
State: NH

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Medications: Allergic to clindamycin, possible allergy to penicillin. Foods: Possible allergies to wheat, seafood, and shellfish. I am gluten free by necessity but no allergy has been proven. Allergic to wool, dust, and various things in nature. I have cold urticaria. I am also lactose intolerant.

Symptom List:

Symptoms: Almost immediately I could feel the vaccine moving down my arm into my hand first affecting my elbow and then affecting my 4th and 5th fingers. Next, my throat became irritated and I started coughing if I tried to speak. After the irritation subsided I realized that I was breathing more easily too, so I do think my breathing was somewhat affected. Next I felt fatigued, very tired. This was followed by my forehead feeling warm to the touch. My temperature was normal and my heart rate also checked out fine. Then my face turned very red and the skin on my face was puffy. I stopped at a clinic but they had a long line so I went home and took 10 mg of loratadine. The redness on my face and the puffy appearance resolved soon after taking the allergy medicine. All of those symptoms resolved within about an hour and maybe 15 or 20 minutes from getting the shot. The red, puffy skin on my face is what concerned me the most. Nothing in particular was swollen, just the skin looked a bit puffy.

Other Meds: Magnesium supplement, Vitamin D supplement

Current Illness: None

ID: 1172417
Sex: M
Age: 14
State: PA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: While entering data into the database, our team member noticed that the patient was only 14 years old. He registered using our automated scheduling system with the date of birth of 3/20/1947. Upon arrival, the patient's date of birth is documented on the consent as 4/12/2006. We checked in and there is no patient listed with a birthdate of 3/20/47. The 14-year-old is in the database with an extensive vaccination history. His mother appears as if she completed the paperwork and signed the consent for him. Patient scheduled for 2nd on 4/2 but didn't arrive. We were going to discuss the incident with the guardian.

Other Meds:

Current Illness:

ID: 1172418
Sex: F
Age: 35
State: ID

Vax Date: 03/25/2021
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: NKDA

Symptom List:

Symptoms: At injection site, a red oblong welt has raised up. It is painful to touch, and looks like hives. No other reactions noted.

Other Meds:

Current Illness: None

ID: 1172419
Sex: F
Age: 33
State: CA

Vax Date: 04/04/2021
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: No

Symptom List:

Symptoms: Nausea, vomiting, chest pain

Other Meds: OTC Multi-vitamins

Current Illness: No

ID: 1172420
Sex: F
Age: 57
State: CA

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:

Symptoms: Flushing/sweating. Vitals wnl/stable, given water and orange juice.

Other Meds:

Current Illness:

ID: 1172421
Sex: F
Age: 55
State: VA

Vax Date: 04/03/2021
Onset Date: 04/03/2021
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:

Symptoms: Pt had covid vaccine #2 at approx 9 am. Within 10 min had roof of mouth swelling and skin crawling, ear itching. No airway compromise. Declined epi pen administration Benadryl given at 932 Sx began resolving within 10 min. OBJECTIVE: Alert nad 125/82 95% 16 pulse 94 Initially sl flushed no hives. Op clear Voice indicated soft tissue swelling No respiratory distress. CV: Regular rate and rhythm, no murmurs. Pulm: Bilaterally CTA no wheezing. repeat vitals at 950 119/71/88/98% By 10:20 sx improving 119/71/, 88, sat 98% By 1030 near complete resolution of symptoms, throat swelling improved, minimal itching. Repeat prior to discharge at 101/66 80, 98% 1045 pm Epi pen ordered for emergency use, Husband picking up at clinic.

Other Meds: unknown

Current Illness: none.

ID: 1172422
Sex: M
Age: 74
State: NC

Vax Date: 03/06/2021
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: Zylopren, pollen, cat hair, Ciprofloxacin

Symptom List:

Symptoms: Burning all over, sores on legs got worse, confusion and balance problems

Other Meds: Metformin, Lantis, Glipazide, Tramadol, Asprin

Current Illness: none

ID: 1172423
Sex: F
Age: 44
State: PA

Vax Date: 03/25/2021
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:

Symptoms: The day after the vaccine on 03/25, had some mild pain left arm where vaccination received that went away after 2-3 days. Today, on day 12 I've started experiencing significant pain in my left arm, radiating down from shoulder and numbing my fingers, and where and RED RASH that are also itchy, several spot on left arm.

Other Meds: birth control pills

Current Illness:

ID: 1172425
Sex: F
Age: 36
State: OH

Vax Date: 03/24/2021
Onset Date: 04/02/2021
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:

Symptoms: Small raised lump in arm more than a week after injection. Lump was warm and itchy. Started Friday and into Saturday. By Sunday it stopped itching. By Monday, no more issue.

Other Meds: Zoloft, melatonin, magnesium,

Current Illness: n/a

ID: 1172426
Sex: F
Age: 32
State: FL

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- Swelling and Hives.

Symptom List:

Symptoms: Patient is a 32 year old female who presented to community Center for her first dose of the Pfizer vaccine. She admits to a history of newly diagnosed Hypertension. She currently states she takes a combination of 2 high blood pressure medications, but she is unsure of the names of her meds. She denies taking her blood pressure medications today and said she normally takes them in the evening. Patient received her first dose of Pfizer in her left arm. During observation she asked for her BP to be assessed due to c/o a pounding headache. VS were taken and the first reading was 179/120 HR 109, followed by a second BP reading of 200/120, HR 106, then final HR was 84. It was explained to the patient that she is currently in a hypertensive crisis and should be taken to ER STAT for further treatment. Patient agreed with medical advice and paramedics was called and she was taken to the ER. Patient denies diplopia, dizziness, N/V, weakness, syncope or any symptoms of COVID-19. Patient notified observation staff at 1403 hours and EMS & patient out time 1425 hours.

Other Meds: 2 meds for Hypertension; Unsure of names but states it is a combination; possibly a calcium channel blocker with ace inhibitor.

Current Illness: N/A

ID: 1172427
Sex: M
Age: 63
State: CA

Vax Date: 03/30/2021
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:

Symptom List:

Symptoms: FOR 3 DAYS KNOW I HAVE SEVERE HEAD ACHE , NAUSEA AND LOST APETITE

Other Meds:

Current Illness:

ID: 1172428
Sex: F
Age: 63
State: LA

Vax Date: 04/02/2021
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: NKA

Symptom List:

Symptoms: Patient describes symtoms related to "Covid Arm" . Redness, swelling, and itchy in three different areas at or below injection site down to elbow. Advised patient to apply topically benadryl and if necassary also take oral benadryl. Also told if condition worsened or signs of lips swelling, throat swelling, or wheeze; go to er or urgent care immediately. But, Covid arm is one of the possible side effects and should subside in 5-10 days.

Other Meds: Atorvastatin, Alendronate, Losartan

Current Illness:

ID: 1172429
Sex: F
Age: 33
State: FL

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:

Symptoms: Pt notified RN that she vomited following influenza vaccine, but still wants to get the Pfizer vaccine. Following administration, pt felt nauseated and EMS notified. Blood sugar 121. Pt monitored by medical provider and EMS for 45 minutes. During that time, pt vomited once. No meds given. Pt stated she felt better and left with family in good condition.

Other Meds:

Current Illness:

ID: 1172430
Sex: M
Age: 31
State: TX

Vax Date: 04/05/2021
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: N/A

Symptom List:

Symptoms: Chills, fever, body aches, disoriented

Other Meds: N/A

Current Illness: N/A

ID: 1172431
Sex: F
Age: 50
State: CA

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: Peanuts Mango Gynetomycin Keflex Sulfa Metrogel

Symptom List:

Symptoms: 1. Rash developed about 90 minutes after the vaccine across my neck, up onto my left side of my jaw, and up through my left temple area. The rash also started to appear in the middle of my back. This rash started to feel tight and felt my throat tightening. 2. 26 hours after the vaccine-I spiked a fever. My regular temperature is 97.4. My temperature climbed to 99.9 for 6 hours. 3. The redness on my neck, face, and middle of my back. The bumps have not reduced after 6 days. I have a burning sensation all over my face, neck, back, and now my legs and arms. It is spreading.

Other Meds: Xarelto Lisinopril Dyclomine Prevacid Metoprolol Flecanide

Current Illness: none

ID: 1172432
Sex: M
Age: 63
State:

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: sever chills and shakes approximately 10hrs after vaccination lasting 4-6hrs followed by fever with body aches within 24 hrs symptoms subsided by 48 hrs after vaccination 3 200 mg tabs ibuprofen taken

Other Meds:

Current Illness:

ID: 1172433
Sex: F
Age: 48
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:

Symptoms: Within 10 minutes, developed SOB and diaphoresis and malaise Monitored patient for 30 minutes. Took vital signs.

Other Meds:

Current Illness:

ID: 1172434
Sex: F
Age: 61
State: KS

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: .Avocado, Cantaloupe, Adhesive, Latex

Symptom List:

Symptoms: MS worsened greatly. Unable to function without significant help.

Other Meds: Baclofen, Cymbalta, Synthroid, Estradiol, Valium, Linzess, Tylenol, D3, Multiple Vitamin, Zinc, Calcium

Current Illness: None

ID: 1172435
Sex: F
Age: 21
State: FL

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Started with a headache 5 hours after the vaccine. Got worse and worse and got dizziness, weakness, fever (got worse and worse up to 103), and nausea.

Other Meds:

Current Illness:

ID: 1172437
Sex: F
Age: 50
State: CT

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

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

Lab Data:

Allergies: penicillin, asprin, sulfur

Symptom List:

Symptoms: sore arm for 3 days

Other Meds: 5mg amlodepene/20mg benezole

Current Illness:

ID: 1172438
Sex: F
Age: 58
State: MD

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

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

Lab Data:

Allergies: Motrin, PCN, Lyrica

Symptom List:

Symptoms: Severe swelling at the site, lump, hives forming, tender to the touch, aches, chills, extreme fatigue

Other Meds: Lisinopril, Vit D, Fiber, Vit C, Hair/Nails/Skin supp, Hydrochlorot, Metphormine, Prastatine, Aspirin

Current Illness: None

ID: 1172439
Sex: M
Age: 72
State: ND

Vax Date: 03/31/2021
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: Wool skin issue

Symptom List:

Symptoms: Within a couple a hours after receiving vaccination left eye became blurred and had double vision. Has not been relieved at this time.

Other Meds: Concerta, Wellbutrin, Seroquel, Amlodipine, levothyroxine, Lipitor, many supplements

Current Illness: none

ID: 1172440
Sex: F
Age: 26
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: Penicillin, Latex

Symptom List:

Symptoms: facial burning / itching, itching redness of ears, face, palms of hands and soles of feet. Trouble breathing. Epinephrine was offered but declined, benadryl 25mg was given, symptoms did not subside.

Other Meds: Bystolic 10mg OCP

Current Illness: none

ID: 1172441
Sex: F
Age: 78
State: NY

Vax Date: 04/02/2021
Onset Date: 04/03/2021
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:

Symptoms: Received Covid vaccine on 4/2 and then starting 4/3 starting experiencing nocturnal chest pain. Found to have bilateral pulmonary embolism on evening of 4/5.

Other Meds:

Current Illness:

ID: 1172442
Sex: F
Age: 60
State: TX

Vax Date: 03/11/2021
Onset Date: 03/29/2021
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:

Symptoms: Rash over most of the trunk area, head and neck.

Other Meds: Goli

Current Illness: none

ID: 1172443
Sex: F
Age: 54
State: OK

Vax Date: 04/04/2021
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:

Symptom List:

Symptoms: Rash

Other Meds:

Current Illness:

ID: 1172444
Sex: F
Age: 73
State: MO

Vax Date: 03/31/2021
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: penicillin

Symptom List:

Symptoms: Day after vax: arm ache from site to wrist Day2 fatigue, feeling unwell Day3 swollen at site, bright red Day4 " " " Day5 arm ache, swollen, bright red

Other Meds: tramadol lexapro lisinipril amlodopine vitamin c and d zinc b-12

Current Illness: crohn's flare

ID: 1172445
Sex: F
Age: 30
State: VA

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: sulfa medicines

Symptom List:

Symptoms: Pregnant - 13 weeks and 6 days- due date is October 1, 2021. Around 6 pm the night of my shot on April 1 I started with a headache, that progressed into a migraine, chills, fever. Tylenol was not helping. The next morning I called my doctor because the tylenol was not helping and they prescribed fioricet to bring my fever down and take the migraine away. Migraine went away later that night April 2, 2021 but felt weak that night into the next day.

Other Meds: prenatals

Current Illness: none

ID: 1172447
Sex: M
Age: 81
State: AZ

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Shingles

Other Meds:

Current Illness:

ID: 1172448
Sex: F
Age: 67
State: FL

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Codeine, fragrances, family fragrances and oils; astors Turpentine

Symptom List:

Symptoms: Within 1/2 hour of shot breasts got sore and glands hurt. I took 1 Tylenol 3/25 and 1 on 3/26. One week later 4/1/2021 I had a visual migraine in my left eye while looking at computer screen very intense at near 2pm , 4/2 visual migraine (lighter shorter duration), 4/3 visual migraine 11 am with 10 minute duration field much smaller. Visual migraine was followed by a mild headache.

Other Meds: Zyrtec, Sensimist, Hawthorn,

Current Illness: None

ID: 1172449
Sex: M
Age: 62
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:

Symptoms: Patient reported feeling lightheaded and his ? heart felt like it was racing? Patient seen by medical team and provided water Patient?s symptoms resolved and refused medical transport and signed AMA form Patient will be driven home by spouse

Other Meds: None

Current Illness: None

ID: 1172450
Sex: F
Age: 58
State: NY

Vax Date: 04/02/2021
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: corn

Symptom List:

Symptoms: swollen lip, multi blisters, pain

Other Meds: armor thyroid, CBD oil tincture

Current Illness:

ID: 1172451
Sex: F
Age: 28
State: IN

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Lab Data:

Allergies: Seafood

Symptom List:

Symptoms: Fever, Swelling of face

Other Meds: N/A

Current Illness: N/A

ID: 1172452
Sex: M
Age: 49
State: NY

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/06/2021
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Allergies: No known allergies

Symptom List:

Symptoms: Patient received Johnson&Johnson COVID vaccine in the afternoon on 3/31/21. Patient reported having right arm pain, diaphoresis, chills, nausea, and muscle aches/pain in upper leg/lower back at 5:30am the following morning. Patient took 2 tablets of 500mg naproxen in the morning and in the afternoon. Symptoms did not resolve and patient had to leave work early. Upon getting home patient took 2 tablets of 650mg tylenol and symptoms resolved within 48 hours. On 4/3/21 patient reported mild to severe pain in heel of left foot. The following day the patient went to WellNow urgent care to get his heel examined. During examination provider noticed patient's lesions and patient stated more lesions have appeared since getting the vaccine. 1 on his stomach, 1 on the dorsum of his left foot, 1 on his back, 1 on his left elbow, in between his toes of his left foot, and in between the fingers of his right hand. Patient stated that these lesions cause a burning sensation and can become itchy. Patient was sent to Hopsital ED as provider at urgent care was concerned patient may have purpura. Patient was seen and discharged on 4/4/21 from the ED. The heel pain was determined to be plantar fascitis which was treated with at home exercises with a heel cup. The patient was given clotrimazole for his lesions. The patient had a follow-up visit with his primary care provider at hospital on 4/6/21 in which he explained the clotrimazole only made his lesions worse. Patient was referred to follow up with dermatology on 4/8/21. Primary care provider believes progression of the lesions since getting the vaccine leads to concern of an underlying autoimmune exacerbated by vaccine.

Other Meds: Naproxen 500mg tablet BID

Current Illness: No other ilnesses at the time of vaccination or within 1 month of vaccination

ID: 1172453
Sex: F
Age: 68
State: AZ

Vax Date: 03/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/06/2021
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Allergies: cipro, xanax, cats

Symptom List:

Symptoms: Patient developed a rash on both arms, and her right breast and right lower abdomen.

Other Meds: clotrimazole cream, omeprazole, zofran, methocarbamol, atenolol, heparin, silver sulfadiazine, vitamin e, multivitamin, atorvastatin, acetaminophen, oxycodone, miralax, oxybutynin, dulaglutide.

Current Illness:

ID: 1172454
Sex: F
Age: 69
State: IN

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/06/2021
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Allergies: cephalosporins

Symptom List:

Symptoms: General malaise, weakness, urticaria & pruritus mainly on injection arm, but proceeding to other parts of body. The pruritus is awful & wakes me up at night.

Other Meds: fluoxetine, bupropion, furosemide, trazadone, Ca++, Vit D, alendronate, Mg++, multivitamin,

Current Illness: osteoporosis

ID: 1172455
Sex: F
Age: 66
State: KY

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 04/06/2021
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Symptoms: c/o of feeling light headed.

Other Meds:

Current Illness:

ID: 1172456
Sex: F
Age: 35
State: AR

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/06/2021
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Allergies: NKDA

Symptom List:

Symptoms: Numbness, tingling, HA, body aches, shingles vesicles next day

Other Meds: Multivitamin

Current Illness: None

ID: 1172457
Sex: M
Age: 44
State: TX

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 04/06/2021
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Allergies: N/A

Symptom List:

Symptoms: 03/08/2021 11:31 am Patient C/O feeling light headed and dizzy. Patient also noted pale and clammy and laid himself on the floor. Patient stated that he ate a granola and coffee for breakfast. V/S 97.4 temp. BP 101/60, R 18, Pulse 48. Snacks and water offered, water taken only. Patient then stated that he feels sick and cannot sit up on his own, close monitory in progress. 11:34 am Wife called and notified. 911 rescue called. 11:50 am Rescue arrived and assessed patient declined going to the hospital. 12:00 pm. Patient VS 97.7 temp, BP 110/64, Pulse 56, R 16.. Patient left facility with wife.

Other Meds: N/A

Current Illness: N/A

ID: 1172458
Sex: F
Age: 55
State: OK

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/06/2021
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Allergies: None

Symptom List:

Symptoms: Painful lymph node swelling under collarbone and above in neck.

Other Meds: Tylenol. Norvasc. Bystolic. Prevacid

Current Illness: Ulcer Triple Therapy 14 days prior.

ID: 1172460
Sex: F
Age: 45
State: ND

Vax Date: 02/27/2021
Onset Date: 03/09/2021
Rec V Date: 04/06/2021
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Lab Data:

Allergies: IV Contrast Cipro Sulfa

Symptom List:

Symptoms: I started experiencing swelling and pain in my ankle and right leg.

Other Meds: Eliquis Macrobid Sanctura

Current Illness: None

ID: 1172461
Sex: F
Age: 57
State: MI

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/06/2021
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Allergies: Codeine, Valium

Symptom List:

Symptoms: I woke up at 2:00 am 4/3 with extreme physical discomfort. At 11:00 am the fatigue was incredible and I was running a fever. By 14:00 my fever was 101.9 I was suffering incredible body aches and chills. (reminded me of day 4 of covid last March) The itching on the back of my neck was noticeable by 7:00 am 4/4, but the fever was gone. The body aches were improving. at 17:00 4/4 I felt human again and was able to eat. The itching has continued and I have a rash on my chest; lower back; back of neck; and the groin area. It reminds me of roseola and may just be a reaction to the sudden intense high fever? However at 3:00 4/6 my arms , thighs and face are starting to itch as well. Monitoring, if swelling starts I will see doctor.

Other Meds: multi-vitamin, Ca+, Fish oil

Current Illness: none

ID: 1172462
Sex: F
Age: 40
State: MI

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/06/2021
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Allergies: NONE KNOWN

Symptom List:

Symptoms: NUMBNESS AND TINGLING OF LEFT ARM, SHOULDER, FACE, AND TONGUE. NO SWELLING DIAPHORESIS, CHILLS, SOME ITCHING AT 5:10 PM

Other Meds: NONE KNOWN

Current Illness: NONE KNOWN

ID: 1172463
Sex: F
Age: 41
State: MO

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/06/2021
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Allergies: None

Symptom List:

Symptoms: Immediately felt a sense of being off followed by brain fog, headache, and fatigue which last for approximately 5 hours. Then 9 hours after injection, onset of uncontrollable chills for 1 hour then a fever for approximately 4-6 hours. All adverse events were gone within 24 hours of injection.

Other Meds: None

Current Illness: None

ID: 1172465
Sex: M
Age: 29
State: CA

Vax Date: 03/31/2021
Onset Date: 04/02/2021
Rec V Date: 04/06/2021
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Allergies: N/A

Symptom List:

Symptoms: I started noticing chicken pox-like bumps on my back, shoulders, elbows, ear, and nose by Friday night/Saturday morning. They continued to spread and I began to feel flu-like symptoms on Monday the 5th (5 days after the injection) I saw a doctor virtually and sent her pictures and she believes I have contracted chicken pox from the vaccine as I have not been in contact with anyone that has had chicken pox

Other Meds: N/A

Current Illness: N/A

ID: 1172466
Sex: F
Age: 17
State: VA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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Allergies: Dodocyl gallate, povidone iodine, and thimerosol (preservatives)

Symptom List:

Symptoms: About ten minutes after injection, face and ears became flush and throat became itchy. Complained of mild dizziness and growing lump in her throat. Medical staff checked throat, blood pressure, O2, laid her down on cot with feet elevated. After 20 minutes of stable BP called the chief of immunology who recommended she go to Urgent Care for follow up. While waiting at Urgent Care for 30 minutes, her face, tongue, and throat became swollen, hives developed on face, and had increased difficulty in swallowing and felt short of breath. She was taken to a patient room, IV started and Epi-shot was given. Additional allergy meds were given (Benadryl and Solu-Medro). She the. Slept for the next 90 minutes. Swelling decreased and throat felt better. Monitoring for a couple hours and sent home.

Other Meds: None

Current Illness: None

ID: 1172467
Sex: U
Age: 82
State:

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

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Symptom List:

Symptoms: Pt received Moderna on 3/1/21 and 3/30/21. Pt was found to be COVID+ 4/6/21. Pt hospitalized on 4/6/21 for nonCOVID related issues.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm