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: 1173367
Sex: F
Age: 24
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: Unknown

Symptom List:

Symptoms: While uncapping a clean needle to administer vaccine, community health worker (CHW) reports that something hit her glove but she didn't think anything of it. CHW then proceeded to vaccinate patient with same needle without her preceptor's ( Name, NP) knowledge of possible finger stick. Per (Name), NP she also observed CHW push on the plunger before contact with patient's skin and vaccine leaked onto patient's arm. NP feels that patient received less that half a dose and feels that patient needs to have her dose repeated. After administering vaccine, CHW removed her gloves and realized that she had a small puncture to her left pointer finger. CHW then went to the bathroom, washed her finger, and made her preceptor aware that she had a needle stick. CHW and NP made clinical lead and pod manager aware of incident. Clinical lead observed CHW to have a small puncture wound to her left pointer finger with no blood or fluids visible. Attempted to find patient to make her aware of needle stick with dirty needle, but she had already left clinic. After checking the system and narrowing down patients by vaccinator it was determined that (Name) was correct patient. TC to patient x 2, left message to return call to clinical lead ASAP. 4/6/21- Clinical lead called patient back and she came in to repeat her second dose. Patient has a scheduled appointment with her PMD for blood work today at 1:30 PM.

Other Meds: Unknown

Current Illness: Unknown

ID: 1173368
Sex: M
Age: 49
State: FL

Vax Date: 03/31/2021
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: None

Symptom List:

Symptoms: Fever, muscle aches, exhaustion

Other Meds: None

Current Illness: None

ID: 1173369
Sex: F
Age: 55
State: CA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
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: Per triage record documented by provider on site. Patient presenting with complaint of throat itch and anxiety. Provider assessed patient administered single dose epi 0.3mg IM. S/S improved patient sent home.

Other Meds: none

Current Illness: none

ID: 1173370
Sex: F
Age: 61
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: none

Symptom List:

Symptoms: nausea, fatigue, chills, sweats, muscle aches. No treatment. Cleared up on its own

Other Meds: none

Current Illness: none

ID: 1173371
Sex: F
Age: 74
State: VA

Vax Date: 03/16/2021
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:

Symptoms: Bell's Palsy on the L side of face on 4/4/2021.

Other Meds: Atorvastatin, Paxil, Seroquel, Multivitamin, Vitamin D, Omega 3, Omeprazole, oxybutinin, botulinum toxin A 100iu

Current Illness: None

ID: 1173372
Sex: F
Age: 55
State: MO

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

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

Lab Data:

Allergies: most antibiotics - penicillin, amoxicillin (anaphaxis), sulfa . . . .others

Symptom List:

Symptoms: Enlarged and painful lymph nodes under arm / in left arm pit for approximately 5 days following the vaccine. Significant enough that it was uncomfortable for arm to hang at side when standing and would awaken me from sleep if arms was not held out from side.

Other Meds: Vitamin D loratadine lisinopril

Current Illness: Some sinus congestion/drainage - not sure if a sinus infection or seasonal allergies

ID: 1173373
Sex: M
Age: 38
State: OH

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: Patient was give an expired dose of vaccine. No symptoms reported. Patient was called back to get active dose less than 12 hours later. Again, NO symptoms reported from either vaccine administration. Second shot was given in opposite arm.

Other Meds:

Current Illness:

ID: 1173374
Sex: F
Age: 29
State: KY

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: Codiene, latex, lamictal

Symptom List:

Symptoms: Shortness of breath, dizziness, tingling hands and feet, headache, wheezing

Other Meds: Multivitamin, vitamin c, vitamin d, protonix, tylenol, ibuprofen

Current Illness: None

ID: 1173375
Sex: F
Age: 42
State: VA

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: None

Symptom List:

Symptoms: Severe chills, fever, fast heartbeat

Other Meds: Calcium and Vitamin D supplement

Current Illness: None

ID: 1173376
Sex: M
Age: 49
State: WV

Vax Date: 10/09/2020
Onset Date: 10/09/2020
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: PCN

Symptom List:

Symptoms: Patient reports no known time or cause of any shoulder injury prior to or after Flu Vaccine. Right Shoulder pain within hours after injection, increasing daily pain for several months until increased pain with loss of motion. Treatment for pain required by PCP. Ortho referral made and completed. SIRVA explained and suspected.

Other Meds: Warfarin 4mg qd

Current Illness: None

ID: 1173377
Sex: F
Age: 51
State: NC

Vax Date: 03/24/2021
Onset Date: 03/26/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: allergic to codeine and cephlus-based antibiotics

Symptom List:

Symptoms: Itchy rash on whole body. Rash developed roughly 2 days after injection on 3/24. Went to doctor on 4/5 and was prescribed prednisone.

Other Meds: birth control pills, vitamin C, probiotic, vitamin D, zinc monomethionine, fish oil

Current Illness: none

ID: 1173378
Sex: F
Age: 59
State: NV

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: NO

Symptom List:

Symptoms: Fever, shaking chills, lower back pain, headache and pain in joints; Ibuprofen; felt better in 36 hours with only stiffness in fingers and full headache; completely better within 72 hours

Other Meds: 80 mg Bayer, Zyrtek, Alive Women's Vitamin and B Complex Vitamin

Current Illness: None

ID: 1173379
Sex: F
Age: 36
State: CA

Vax Date: 03/01/2021
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: Rash around Covid vaccine injection. When I first noticed, my arm felt really itchy and then I Noticed two lumps around the size of a nickel each. Less than an hour later itchiness subsided and my arm started to hurt and feel soar like when I first got the Covid vaccine.

Other Meds:

Current Illness:

ID: 1173380
Sex: F
Age: 44
State: NC

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: Within a few minutes of injection pain at injection site began. Within 2 hours of injection pain was significant and could not lift arm above shoulders. Treatment was massage of arm until pain was too much to take any pressure. After that avoiding touching and avoiding lifting arm was only way to avoid pain. No medication was taken. Pain lasted 48 hours from time of injection.

Other Meds: None

Current Illness: None

ID: 1173381
Sex: F
Age: 23
State: CO

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: Events: Injection site pain (mild) occurred at time of vaccine administration. Headache (moderate), chills (severe), fever (moderate), and fatigue (moderate) happened about 10 hours afterward, continued for about 14 hours, and caused disruption in sleep and normal activities. Treatment: Water and Tylenol. Outcomes: Everything resolved by 24 hours after vaccine administration except for mild pain in the vaccinated arm.

Other Meds: Vitamin C, Vitamin D, Zinc, Iodine, Vitamin B12, Vitamin A

Current Illness:

ID: 1173382
Sex: M
Age: 55
State: MI

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: Pain in upper arm and neck for close to a week. Got shot on Wednesday and felt sore throughout body especially around upper arm and neck. By Friday had biting pain around neck. Could barely move it on Saturday and Sunday. Monday the biting pain left and neck pain started to let up. Tuesday seems like pain is getting better.

Other Meds: Telmisartan, Simvastatim, Ezetimibe, Omeprazole

Current Illness:

ID: 1173383
Sex: F
Age: 65
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: 12:25 "sudden pressure to face" x 15-20 seconds. Took pt to triage via wheel chair. EMT & MD at side. Vitals 140/63, 114, 20 02 98% RA Pt husb states hx extreme anxiety Pt DC home stable

Other Meds: Verapamil, Plaquenil

Current Illness:

ID: 1173384
Sex: F
Age: 16
State: ID

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 fainted within 5~10 seconds after the vaccine; not responding to conversations, not responding to calling her name during the fainting. Patient woke up approximately 5 minutes after fainting, and reported that she started to feel much better. Patient was seated on chair under direct help of pharmacist at the time. No observable injury, did not fell to the floor. EMS was called and arrive, and patient care handed over to EMS.

Other Meds: unkown

Current Illness: unkown

ID: 1173385
Sex: M
Age: 70
State: CA

Vax Date: 01/15/2021
Onset Date: 02/20/2021
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: Around the time of the 1st dose of Pfizer Covid-19 vaccine, noticeable deteriorating hearing loss, more rapidly in right ear. Then 2 weeks after 2nd dose, sudden profound hearing loss in left ear occurred.

Other Meds: Novartis, Valsartan, Nicameta, Dipyradamole, Triamcinolone Acetonide

Current Illness:

ID: 1173386
Sex: F
Age: 22
State: CO

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: None

Symptom List:

Symptoms: Fever, muscle pain, headache, nausea - started 12 hours after vaccine and continuing for >12 hours

Other Meds: Mili, levothyroxine, isotretinoin, buspirone, escitalopram, vitamin D

Current Illness: None

ID: 1173387
Sex: M
Age: 26
State: VA

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:

Symptoms: Passed out 18 hours after vaccine, very low heart rate and blood pressure. Called 911 for ambulance to give saline solution through IV. Was taking to the emergency room and discharged 6 hours later after receiving two bags of saline solution.

Other Meds: None

Current Illness: None

ID: 1173388
Sex: F
Age: 52
State: CO

Vax Date: 03/09/2021
Onset Date: 03/16/2021
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: Client came today for 2nd Covid shot with husband and explained she got "frozen shoulder" with her 1st dose that began 1 week after the shot was administered. Client had told me she was having physical therapy on the right arm, but would prefer the shot in that arm so she could sleep on the other side. I did not ask more about the injury. Today. 4.6, she told me her shoulder tendon had been loose which was causing her muscle to be loose in that shoulder, so the inflammation could have gone into the bursa causing capsulitis or something similar. The client was not complaining, but did inform me so I can report the adverse effect. Her husband got the shot the same day at the same time and did fine.

Other Meds:

Current Illness:

ID: 1173389
Sex: F
Age: 73
State: WI

Vax Date: 03/22/2021
Onset Date: 03/23/2021
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: Had flue like symptoms, extreme fatigue and lost balance and fell out of bed

Other Meds:

Current Illness:

ID: 1173390
Sex: F
Age: 94
State: CA

Vax Date: 02/19/2021
Onset Date: 02/27/2021
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:

Symptoms: 2 severe nosebleeds (have never had a nosebleed in 94 yrs = first on 27 - second on Mar.3

Other Meds: Lipitor - Norvasc -Atenol = magnesium = potassium = digoxin - Co10 - multiple vit. D C [ EVOA eye vit. 2 baby aspirin-pepcid

Current Illness: none

ID: 1173391
Sex: F
Age: 29
State: GA

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: I started feeling tired and achy around 6pm. My left arm is really sore. I have a temperature or 99.6 and a Headache

Other Meds: Prenatal vitamins Vitamin c tablets

Current Illness:

ID: 1173392
Sex: F
Age: 68
State: CA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
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: Nausea, chills, fever lasting 3 days. Joint Pain and malaise for one week, believed to be an RA flare from vaccine

Other Meds: Armour Thyroid , Trulicity, Enbrel

Current Illness:

ID: 1173393
Sex: F
Age: 23
State: TX

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: Vancomycin

Symptom List:

Symptoms: Patient received her 1st dose of the vaccine and I had her sit down, within 10 minutes she comes to the consultation window and she says she is having a hard time breathing. I take her to the IMZ room and sit her down and she says her throat is closing up. She is struggling to breathe so I give her a dose of an epipen. She starts to fill better. she says she is itching and her chest is a little read and has some bumps so I gave her some Benadryl.

Other Meds: Keppra and Vimpat

Current Illness: has seizures, but hasn't had them in awhile

ID: 1173394
Sex: M
Age: 86
State: PR

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: N/A

Symptom List:

Symptoms: Both cheekbones swollen

Other Meds:

Current Illness: High pressure, vision, circulation, muscle aches

ID: 1173395
Sex: F
Age: 30
State: TX

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Seasonal allergies

Symptom List:

Symptoms: I woke up around 2am and although I was covered in blankets, I was freezing. I also had a fever, was nauseated, had joint and muscle pain, and my heart was racing. My heart rate was 154, so I started doing breathing techniques and got it down to 118, then 111. I was so fatigued that I just fell asleep. Called out of work and slept most of the day next day. I stayed in bed on Sunday. I went to work Monday and then Tuesday, I was sitting at the computer and my heart started to race and pound again. My pulse ox was 132. My BP was 154/92. I had tingling down my arm and I felt weak. I was taken to the ER and they did an EKG and some labs. I saw a doctor around 6:20 that evening and I was discharged around 7 with instructions to follow up with a cardiologist two days later. The first one didn't even get close to me, so I ended up seeing Dr. . He put an event monitor on me. He instructed me to come back if this continues or gets worse and he would put me on meds. I've never had heart issues before and I'm not sure if everything has been resolved.

Other Meds: Zyrtec - as needed

Current Illness:

ID: 1173396
Sex: F
Age: 41
State: KY

Vax Date: 03/18/2021
Onset Date: 03/18/2021
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:

Symptoms: Vaccine was administered in drive thru. I pulled out after and into one of the waiting spots. About 10 minutes after I was suddenly drenched in sweat and started to see black. My left side of body started to feel a burning sensation. I had been told to honk and put on flashers if anything went wrong. I did and waited more than 30 minutes. No one ever came to check me. After about 10 more minutes I started to feel better but was still pale and my face looked slightly puffy. I never saw anyone so I eventually drove home, drank a ton of water, ate some saltines and then slept a little. Had chills off and on that day and remained tired the next day. Felt fine by day 3

Other Meds: Crestor

Current Illness:

ID: 1173397
Sex: F
Age: 51
State: OK

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: Tetracycline Latex

Symptom List:

Symptoms: 2nd dose symptoms: dragging/low energy, chills, upset stomach, onset of sudden constipation, stomach swelling, runny nose, constant taste of a chemical, uncomfortable/not a pain in throat, and sore arm. About 4:00 PM, I felt pains in my chest and I could not hear. My ears felt very hot and then became so dizzy I fell to the ground.

Other Meds: LISINOPRIL 20 MG HYDROCHLOROTHIAZIDE 25MG

Current Illness: None

ID: 1173398
Sex: F
Age: 57
State: TX

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: Sulfa, Penicillin, Iodine, pollen and other environmental allegies

Symptom List:

Symptoms: Headache (more of a migraine), chills, vomiting, body aches

Other Meds: Jardiance 25 mg/ Zyrtec 10mg/ Vit B12/ Vit D3/ Mongelukast Sodium 10mg/ Vit C 500mg

Current Illness:

ID: 1173399
Sex: M
Age: 48
State:

Vax Date: 03/19/2021
Onset Date: 03/26/2021
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: acid reflux and possible acute pancreatitis

Other Meds:

Current Illness:

ID: 1173400
Sex: F
Age: 62
State: NY

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: propolis

Symptom List:

Symptoms: fever, chills, fatigue, jaw and face pain. Took Tylenol and slept, feeling better 12 hours later

Other Meds: Ofev

Current Illness:

ID: 1173401
Sex: F
Age: 39
State: AL

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: Pt is working at vaccine site. 1 hour 1 15 post vaccine pt states she felt hot in her face and hands. Came to Triage 1 where evaluated by EMT & MD. BP 118/55, HR 52, Resp 20, 02 100% RA. Pt stayed for 10 mins and then said she was fine and went back to work.

Other Meds: NONE

Current Illness: NONE

ID: 1173402
Sex: F
Age: 34
State: GA

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: None

Symptom List:

Symptoms: Half dollar sized rash on top of right hand with secondary quarter sized rash splotch on right wrist

Other Meds: Melatonin and trazadol

Current Illness: None

ID: 1173403
Sex: F
Age: 38
State: IL

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: Nausea, headache, body aches, fever

Other Meds: Levothyroxin, zetia

Current Illness: None

ID: 1173404
Sex: F
Age: 37
State: NH

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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Symptoms: Patient fell off chair, appeared to be having a seizure. Patient was very pale, clammy and reported nausea. Patient was given cold compress to back of neck, blood pressure and pulse monitored. 911 was called and arrived approx 10 minutes after event. Patient was conscious and aware when EMS arrived. Patient reported history of fainting and appearing to have seizures in the past.

Other Meds:

Current Illness:

ID: 1173405
Sex: F
Age: 70
State: PA

Vax Date: 03/14/2021
Onset Date: 03/16/2021
Rec V Date: 04/06/2021
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Lab Data:

Allergies: Bee Venom, Fragrances, Wool, Milk, Egg, Lactase, Soy, Propoxphene

Symptom List:

Symptoms: Fatigue and tingling lasted 2 days. Diarrhea has been ongoing since 03/16/2021. Have returned to the eating from the Autoimmune Paleo Diet plan with no success to date

Other Meds: Atorvastatin 40mg, Oxybutynin 10mg, Aspirin 81mg, Magnesium 200mg, Vit B Complex, Vit C 500mg, MultiVit,Calcium Citrate w/Vit D, Probiotic

Current Illness:

ID: 1173406
Sex: F
Age: 22
State: OH

Vax Date: 04/01/2021
Onset Date: 04/03/2021
Rec V Date: 04/06/2021
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Allergies: None known

Symptom List:

Symptoms: Headache and Fever (Friday) On Saturday, vaginal pain worsening into multiple vaginal ulcers, very painful and some itching Given antiviral and lidocaine for pain Improved in around three days

Other Meds: Birth Control (Lo Lestrin Fe), daily vitamin

Current Illness: None known

ID: 1173407
Sex: F
Age: 21
State: IL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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Lab Data:

Allergies: NKDA;Seasonal allegeries

Symptom List:

Symptoms: Vomit Dizziness

Other Meds: clonidine, fluvoxadine, buspesore, estorilla

Current Illness: No Known

ID: 1173408
Sex: F
Age: 20
State: IL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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Allergies: none

Symptom List:

Symptoms: PT STATED NOT FEELING WELL AND SHE SAID SHE IS NOT ABLE TO SEE. PT FELT DIZZY AND FAINTED. SHE FELT BETTER AFTER ELEVATING FEET AND WAITED 30 MIN FOR OBERVATION.

Other Meds: n/a

Current Illness: noe

ID: 1173409
Sex: F
Age: 20
State: CO

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

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Lab Data:

Allergies: Bees

Symptom List:

Symptoms: Awoke in the middle of the night to mild/moderate anaphylaxis - tingling throat and tongue, swelling of throat and tongue, difficulty breathing, nausea, gagging, diarrhea - lasting for about 30 minutes - all symptoms occurred at the same time

Other Meds: Kariva

Current Illness: N/A

ID: 1173410
Sex: F
Age: 73
State: WI

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 04/06/2021
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Symptom List:

Symptoms: She had fever and muscle aches for 2 days and she had headache and stomach upset for 5 days after vaccine given

Other Meds:

Current Illness:

ID: 1173411
Sex: F
Age: 28
State: CA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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Allergies: Latex

Symptom List:

Symptoms: Pt arrived to observation area post first pfizer covid vaccination. Pt. Presented in observation with no symptoms and sat down in chair. At 2:12 pm patient raised hand for assistance. At that time patient stated that she was "dizzy." When asked if she felt going to pass out she replied, yes. Patient was placed on the floor with her head down and feet up. Patient continued to complain of dizziness and numbness in her feet. Placed pulse ox on Patient. HR 53 O2 93, Patient continued to be alert, but was having difficulty remembering her age and previous symptoms persisted and she stated she initially felt itchiness in her mouth and throat. At 2:18 EPIPEN was given IM 0.3mg Left anterolateral thigh (Lot #0GM229 EXP 12/21). Ambulance was called. 2:20 BP 110/68 HR 78 02 95. Patient began to state her symptoms were improving still complaint of tingling in fingers and legs. Able to answer questions appropriately. She was returned to sitting in the chair. 2:23 BP 100/70 HR 85 o2 100%. Patient remained alert and oriented Heart rate and pulse remained stable. 2:30p Paramedics arrived, Patient was taken to hospital via ambulance.

Other Meds:

Current Illness:

ID: 1173412
Sex: F
Age: 45
State: OR

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

Symptom List:

Symptoms: Drowsiness, pain in arm and up shoulder. Chills and fatigue 10-13 hours after shot. Felt better 24 hours after shot except for arm tenderness, which lasted an additional 24 hours.

Other Meds: Chromium Picolinate Thyroid Support Fermented Ginseng Menopause Support Spirulina Herbal Rest Melatonin 3mg Omega 3 w/ BioCurc? Daily Probiotic Foundational Multivitamin Aloe plus

Current Illness: None

ID: 1173413
Sex: F
Age: 43
State: FL

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: sore muscles fatigue diahrea chest pain red wealt at injection site

Other Meds: propanolol meloxicam b-12 injections

Current Illness: tacycardia, hypertension

ID: 1173414
Sex: F
Age: 25
State: CA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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Allergies: animals

Symptom List:

Symptoms: Client c/o tingling in throat 15 minutes after vaccination. Observed and symptoms resolved. VS stable. Discharged home at 12:28p.m.

Other Meds: Unknown and not reported by client.

Current Illness: Unknown and not reported by client.

ID: 1173415
Sex: F
Age: 59
State: TX

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

Symptom List:

Symptoms: anaphylaxis response Swelling of neck/face/eyes, difficulty in breathing

Other Meds: MEDICATION Baclofen 20mg 1 q 6 20mg Meloxacom 7.5 mg prn 2 times a day Oxycontin 10mg CR every 12 hours daily long acting pain medication Oxycodone 10 mg 4 times daily for pain control Diazepam 10mg prn only severe muscle spasms and cram

Current Illness: None

ID: 1173416
Sex: F
Age: 54
State: IL

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

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Symptom List:

Symptoms: reh hives on left and right forearm from wrist to elbow

Other Meds: levothyroxine,

Current Illness:

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm