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: 1184783
Sex: M
Age: 55
State: TX

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Dysphagia, Epiglottitis

Symptoms: 1ST COVID VACCINE GIVEN 03/18/2021 2ND DOSE GIVEN 4/8/2021 GIVEN TOO SOON

Other Meds: N/A

Current Illness: N/A

Date Died: 02/08/2021

ID: 1184784
Sex: M
Age: 79
State: MN

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 04/09/2021
Hospital: Y

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

Lab Data:

Allergies: Ambien, Codeine, Morphine, Zolpidem

Symptom List: Anxiety, Dyspnoea

Symptoms: Approximately 3 hours after vaccine administration, patient experienced the following: Nausea, Vomiting, Abdominal pain, and the following day: Bloody Bowel Movements. Patient went to the emergency department the day after vaccine administration. Patient was made NPO, started on IVF and Zosyn. Patient was seen by GI who agreed with supportive management of ischemic colitis. Around 1730 on 2/6, patient unresponsive and rapid response was called. Patient responded to Narcan. On 2/8/2021, 0358, patient was seen as not breathing and code blue was called. Interventions were unsuccessful and patient was pronounced dead at 0439am.

Other Meds: Androderm, Aspirin, Atorvastatin, Renal Vitamin Caps, Calcium Acetate, Carvedilol, Cyanocobalamin, Dulcolax, Gabapentin, Hydromorphone, Lidocaine-prilocaine topical cream, Losartan, Polyethylene glycol, Ropinirole, Temazepam, Trazodone, Tri

Current Illness: Diabetes Mellitus Type II, Coronary Artery Disease, Ischemic Colitis, Hypertension, Restless legs syndrome, Anemia, End Stage Renal Disease-on dialysis, Peripheral Artery Disease, Hyperlipidemia, Primary Insomnia, Back pain, 2nd degree AV block, Leg wound

ID: 1184785
Sex: M
Age: 35
State: OH

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies

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

Symptoms: Approximately 15 minutes following receipt of first Pfizer COVID-19 vaccination, patient began feeling "out of it." He became dizzy and lightheaded and experienced a vasovagal episode. He did not lose consciousness. His vital signs were BP 94/57; HR 67; O2 sat 95% on room air; respirations 14 and regular. Auscultation of lung sounds were clear bilaterally. His apical pulse was regular and between 54-67 beats per minute. Patient was able to consume oral fluids and began to feel much improved. He was observed for 30 minutes and stated he felt "100% better" afterwards.

Other Meds: No medications

Current Illness: None reported

ID: 1184786
Sex: M
Age: 46
State: OH

Vax Date: 03/20/2021
Onset Date: 03/25/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Ringing in both ears for over 2 weeks now

Other Meds: Vitamin D, B-12, Omega 3

Current Illness: none

ID: 1184787
Sex: F
Age: 37
State: CT

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 04/09/2021
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: quick and intense (started 30 minutes after injection) arm pain that radiated from under ear, all through neck, through arm, down to wrist. migraine that began one hour after injection and lasted 3 days chills and fever for 5 days that started 3 hours after injection covid rash that appeared one week after first injection and lasted a week (red, hot, lacy surface rash that looks like hives. I would get this rash due to covid back in october and november) confusion and brain fog on and off 2 weeks after 1st injection. vertigo on and off for a month that started 2 weeks after 1st injection.

Other Meds: Trisprintec oral birth control

Current Illness: post covid syndrome pleurisy

ID: 1184788
Sex: F
Age: 59
State: FL

Vax Date: 03/24/2021
Onset Date: 04/01/2021
Rec V Date: 04/09/2021
Hospital: Y

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

Lab Data:

Allergies: NA

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

Symptoms: Sudden Severe Colitis onset with undetermined cause a week after vaccine

Other Meds: Entresto, Coreg, Crestor, fish oil, D3, CoQ10

Current Illness: none

ID: 1184789
Sex: F
Age: 55
State: MI

Vax Date: 04/06/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Right when I got the vaccine i had a chilling effect to my body my arm was sore, headaches, body aches, chills, then Wednesday was worse headache chills body aches and queasy stomach started yesterday then last night the cramping was so bad on the right side that I could hardly get my breath, then this morning I lost control of my bowels with cramping and having a hard time being active. I still have a headache.

Other Meds: 200mg Perperimate, Vit C, Green powdered vegetables

Current Illness: no

ID: 1184790
Sex: F
Age: 51
State: TX

Vax Date: 04/04/2021
Onset Date: 04/04/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Pharyngeal swelling

Symptoms: Increased tiredness and fever beyond 3 days

Other Meds: Tylenol, Aleve

Current Illness: N/A

ID: 1184791
Sex: M
Age: 53
State:

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: No allergies

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Dizziness

Other Meds: No medication s

Current Illness: None

ID: 1184792
Sex: F
Age: 42
State: TX

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: About 24 hours after the vaccination, I started feeling tired and achy. A few hours later my throat became sore and I developed red splotches all over my face and neck. The splotches were gone when I awoke the next day but I was sick for about 1 week with fatigue, muscles aches, sore throat, chills. On the 7th day, I awoke with a terrible headaches and had to stay in bed most of the day. On the 8th day, I finally felt better but there was redness on my arm where I received my shot.

Other Meds: None

Current Illness: None

ID: 1184793
Sex: F
Age: 71
State: MI

Vax Date: 03/23/2021
Onset Date: 03/25/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Shortness of breath,sweatsupset stomach headaches

Other Meds: Skyrixi,hydrochlorothiazide,Zetia,B12,D3Pdoriatic

Current Illness: Psoriayic arthritis

ID: 1184794
Sex: M
Age: 33
State: MN

Vax Date: 01/25/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Completed Covid 19 Vaccine Series on 01/25/2021, now has Covid 19

Other Meds:

Current Illness:

ID: 1184795
Sex: F
Age: 30
State: NC

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: NO

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

Symptoms: 102.1 FEVER REPORTED AT 1:45AM, ACHES, CHILLS, TOOK acetaminophen AT 2:15AM WENT BACK TO SLEEP AND WOKE UP AT 6:30AM WITH FEVER REDUCED TO 99.7, WENT TO WORK AT 8:00AM TEMPERATURE BACK DOWN TO 97.4. STILL HAD ACHES AND FELT LETHARGIC AND TIRED. TOOK ANOTHER ACETAMINOPHEN AT 10:15AM. CURRENTLY 10 WEEKS 4 DAYS PREGNANT DUE ON NOV. 1.

Other Meds: METOPROLOL, ASPIRIN

Current Illness: NONE

ID: 1184796
Sex: M
Age: 57
State: GA

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Redness, slight-swelling, warmth, and pain in left knee. No previous injury, diagnosed RA, or other known issue with left knee. Mentioned to physician during routine check-up, but he made no recommendations. Knee no longer swollen, red, or warm, but is tender when pressure is applied.

Other Meds: Levothyrozxine 50mcg QAM Metoprolol ER 50mg QD Apixaban 5mg BID Diltiazem CR 240mg QHS ASA 325mg QHS Losartan-HCTZ 100-12.5mg QOD

Current Illness: None

ID: 1184797
Sex: F
Age: 48
State: IN

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Redness and pain at the injection site, muscle aches, fever of 99.2 to 102.0, fatigue.

Other Meds:

Current Illness:

ID: 1184798
Sex: M
Age: 72
State: NV

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

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

Lab Data:

Allergies: N/A

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

Symptoms: after receiving the J&J vaccine, patient admitted to RN in having one dose of the Pfizer prior (DATE UNKNOWN)

Other Meds: N/A

Current Illness: N/A

ID: 1184799
Sex: F
Age: 27
State: NY

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Very mild headache and mild chills that began around 3pm and got progressively more noticeable starting around 7pm. I took advil around 9pm. I woke up the this morning (4/9/2021) and feel completely better.

Other Meds: Flora Adult Probiotic

Current Illness: N/A

ID: 1184800
Sex: F
Age: 74
State: IN

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: PENICILLIN, REGLAN, VICODIN, BATRIN

Symptom List: Ear pain, Hypoaesthesia

Symptoms: FIRST REACTION BUT NOT BOTHERSOME WAS SLIGHT SORE ARM. WITHIN 22 HRS OF RECEIVING THE SHOT, I STARTED WITH. A SLIGHT FEVER 99.9 FATIGUE & CHILLS. FOR THE NEXT 36 HRS, MY TEMP STAYED IN THE RANGE OF 100.3 TO 102.1. I TOOK TYLENOL EVERY 6 HRS. FINALLY TEMP WENT BACK TO NORMAL & CHILLS STOPPED. HOWEVER , THE TIREDNESS/FATIGUE LASTED ANOTHER 24 HRS. TODAY 4/9, I FEEL FINE WITH NO SIDE EFFECTS. THANK YOU FOR LISTENING.

Other Meds: RX: PLAVIX, CRESTOR , FUROSIMIDE, POTASSIUM. CARVEDILOL, AMPLODIPINE,ZETIA OTC: 81 ASPIRIN, TYLENOL, VIT D, MULTI VITAMIN

Current Illness: HEART DISEASE

ID: 1184801
Sex: M
Age: 19
State: TN

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: seasonal allergies only

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient called the day after recieving his vaccine reporting vomiting. He states that the evening after receiving his vaccine he started to feel like he was being "placed under laughing gas" then around 12 am experienced stomach pain and felt nauseous but did not throw up until 1am. Spoke with him at 1130 the day after receiving his vaccine and he feels "off" and has a headache but is no longer vomiting

Other Meds: montelukast

Current Illness: Tested positive for covid ~ 1 month ago but was asymptomatic

ID: 1184802
Sex: F
Age: 51
State: IL

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: Severe allergy to pork mild/moderate allergies to NSAIDS corn soy banana melon rice

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

Symptoms: Severe fatigue, severe muscle aches, vivid dreams. Tylenol and rest. Much better after 48 hours, but persistent muscle aches.

Other Meds: T3/T4 Combination therapy Lexapro Protonix Bupropion Zyrtec Multivitamin Vitamin D3 Iron

Current Illness:

ID: 1184803
Sex: F
Age: 69
State: OH

Vax Date: 03/29/2021
Onset Date: 04/05/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient reported a sore arm for a few days post injection that went away and then reappeared as a hot/tender arm with a bump at the injection site "about 4 days ago."

Other Meds:

Current Illness:

ID: 1184804
Sex: F
Age: 64
State: PA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: Prednisone, Penicillin

Symptom List: Unevaluable event

Symptoms: Sore arm, fever, aches, headache, nausea, diarrhea, severe joint aches, sneezing, coughing, 3 to 4 days and counting

Other Meds: Tylenol, multi vitamin, garlic, vitamin C

Current Illness: none

ID: 1184805
Sex: F
Age: 49
State: TX

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: Benzoyl peroxide

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

Symptoms: Exactly 12 hours after vaccination I had the following reactions at 3:00am the following morning: Fever in excess of 102.5, muscle spasms, jaw clamped tight, extreme chills, shortness of breath, could not breathe lying down (felt like diaphragm was suppressed), and broken blood vessels in right eye. Had to sleep sitting up for fear of not being able to breathe. Lasted a couple hours. Now I just have a lingering low grade fever.

Other Meds: Synthroid, estrogen, medroxyprogesterone

Current Illness: Non

ID: 1184806
Sex: F
Age: 63
State: AZ

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Headache, chills, exhaustion.

Other Meds: Pepcid

Current Illness: None

ID: 1184807
Sex: F
Age: 62
State: OH

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Injection site pain, Menorrhagia

Symptoms: Extreme Pain in arm, swelling. Pain goes from arm to shoulder. Fingers on left hand tingle and numb.

Other Meds: Multi vitamin, vitamin A - B. Hair Skin & Nails vitamin. Baby asprin, trelogy, bata blocker

Current Illness:

ID: 1184808
Sex: M
Age: 43
State: FL

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient recieved vaccine on Monday 3/29/21 around 9:30am, he started to feel itchy same day around belly button but as the week went by the rash increased (looks like bumps and no puss), looks like a hives rash some places looks worse than others and looks patchy. He also c/o bilateral swelling in hands/fingers. No c/o fever, bodyaches, chills, headache, sob. As of 4/7/21 @3:45pm swelling has subsided but the itchyness and rash is not getting better. Patient took Benadryl, and applied Triamcinolone cream, and also took Xyzal. Advised patient to continue with the Benadryl/Xyzal to help with the allergic reaction. He may also apply benadryl cream and hydrocortisone cream to help. Informed patients wife that if he experiences any fever/body aches/chills to take Tylenol or Ibuprofen but if he experiences any SOB or chest pain then proceed to the Urgent Care or ER. The brother in law is a Dermatologist which he prescribed him the Triamcinolone cream. 4/9-Follow up: Patients wife called back and stated that patient is still itchy (almost 2 weeks) but it's drying up now. She stated he is still taking benadryl and applying the triamincinolone cream. Advised to continue with the Benadryl/Xyal and benadryl cream. Will follow back up on 4/12/21.

Other Meds: Wellbutrin Vitamin D Probiotics Fish oil Men's Multivitamin

Current Illness:

ID: 1184809
Sex: F
Age: 50
State: GA

Vax Date: 04/06/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: narcotics, venifor, iron dextrose

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: pt says she got the flu like symptoms but then developed a raised, red itchy rash on her arms, legs, and chest. Pretty much all over her body. She is taking Benadryl which seems to help but as soon as it wears off the rash comes back. Pt will contact her PCP if her symptoms do not subside.

Other Meds: ibuprofen, benadryl

Current Illness:

ID: 1184810
Sex: M
Age: 50
State: NY

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: Penicillin- anaphylaxis

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Due to pt's PCN allergy, pt monitored for 30 minutes after receiving the 1st dose of the Covid vaccine. 15 minutes into monitoring, pt developed a throbbing HA and described feeling like his lower extremities had weights tied to them. Pt's BP 140/90. Pt denied any cardiac or neuro. EMS called for further evaluation. While waiting for EMS, pt developed tingling sensation in both hands and had vision changes. Pt transported to hospital upon EMS arrival. Called pt to f/u 4/9. Stated that he was monitored at Hospital ER for several hours. Was given Fioricet for HA and Reglan for stomach. No scans done. Stated that he was feeling much better and was released from the ER the same day. Has a f/u appointment with PCP, on 4/15.

Other Meds: Unknown

Current Illness: None

ID: 1184811
Sex: M
Age: 18
State: NJ

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Red swollen itchy blotch on arm

Other Meds: Fluoxetine, alprazolam, risperidone, ibguard, vit d3

Current Illness: Asthma

ID: 1184812
Sex: M
Age: 16
State: WI

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Nausea

Symptoms: PHN supervisor was notified by state that this patient was below the age requirement to receive this vaccine. PHN contacted the patient's mother and notified her of this information. Patient's mother states that the child appears without any complaints or complications.

Other Meds: unknown

Current Illness: unknown

ID: 1184813
Sex: M
Age: 40
State: TN

Vax Date: 04/06/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: 3 days sustained fever over 102, cardiac arrest Thursday night, back & chest pain, vomiting, difficulty breathing. Went to ER, admitted to ICU, currently in ICU at hospital.

Other Meds:

Current Illness:

ID: 1184814
Sex: M
Age: 60
State: TX

Vax Date: 01/22/2021
Onset Date: 01/24/2021
Rec V Date: 04/09/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: On 01-24-2021, I went into the hospital because I had fever and chills. I also experienced soreness in my left arm with body aches in my joints. Lab work was performed at the hospital. I stayed at the hospital 7 days.

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Current Illness:

ID: 1184815
Sex: F
Age: 43
State: NC

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
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Allergies: Penicillin

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

Symptoms: Ichy, felt hot all of sudden, eyes watery and blurry, side of neck (injection side) felt thick/hot.

Other Meds:

Current Illness:

ID: 1184816
Sex: F
Age: 54
State: NY

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/09/2021
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Allergies: na

Symptom List: Tremor

Symptoms: complaint of "ball like sensation" to throat and itching to bilateral forearm and redness. Benadryl 50 mg administered orally Patient observed for additional 45 mins Pt symptoms resolved. ER precaution Pt verbalized understanding

Other Meds: na

Current Illness: na

ID: 1184817
Sex: F
Age: 37
State: NY

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/09/2021
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Lab Data:

Allergies: Levaquin

Symptom List: Erythema, Pruritus

Symptoms: within minutes felt an intense systemic response. broke out in a sweat clammy sweat above upper lip tingle/prickly feeling over body in fingers and toes dizzy heart palps gumby/jelly like limbs face muscles around mouth affected eye floaters splitting headache that started at base of skull and wrapped around to top of head and temples As response progressed extremities started to tremble teeth chattered fatigue nausea 4-8 in the evening (over 24 hrs later) intense sweating difficulty swallowing brain fog

Other Meds: prenatal vitamin

Current Illness: standard cold three weeks prior (young daughter who was also sick tested negative for COVID-19)

ID: 1184818
Sex: F
Age: 34
State: WI

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/09/2021
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Allergies: None

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

Symptoms: within 10 minutes of the injection, my vision blurred and I felt like I was going to faint. the next day, I had severe anxiety attacks due to the overwhelming sensation of fainting. I never lost consciousness or fainted, but I feel that I was very close to it.

Other Meds: Tylenol, Ativan

Current Illness: None

ID: 1184819
Sex: F
Age: 51
State: NE

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/09/2021
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Allergies: none

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

Symptoms: slight tingling in hands and feet, off and on shortly after vaccination. tingling and muscle tremor in left cheek 12 hours after vaccination

Other Meds: multivitamin, simvastatin, losartan

Current Illness: none

ID: 1184820
Sex: M
Age: 33
State: IA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
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Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: After vaccine he reported being nauseous and dizzy. He got very pale and about 5 minutes after the vaccine he passed out. He came back after about a minute. EMT was called to check patient. Vitals were stable.

Other Meds: Unknown

Current Illness: Unknown

ID: 1184821
Sex: F
Age: 16
State: KY

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
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Allergies: none

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

Symptoms: Mother of patient made an appointment for Moderna COVID vaccine clinic. 16 yr old received Moderna vaccine. No s/s or adverse reactions at this time.

Other Meds: No known

Current Illness: none

ID: 1184822
Sex: F
Age: 39
State: NJ

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/09/2021
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Allergies: No

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

Symptoms: On monday evening she started feeling bad. she had a sore throat and a dry cough and body aches. the next morning she had a sore arm, fever(100.7), chills, shooting pain in her hands and hips, and shortness of breath. By thursday 4/8 she developed a migraine that has continued along with all of these side effects. She took Tylenol to help with fever and pain.

Other Meds: No

Current Illness: In February she felt nauseous and exhausted. She got tested for Covid and it was negative. she thinks its possibly an Epstein Barr flare up.

ID: 1184823
Sex: F
Age: 25
State: TX

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/09/2021
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Allergies: Penicillin

Symptom List: Pain in extremity

Symptoms: - got my phizer vaccine in my left arm - walks to 10-15 min waiting room - sits down and is looking at my phone for 3-5 mins - slight nausea hits and I start feeling dizzy - my eyes start going black snd I feel really hot - I tell the lady watching everyone that I don't feel good. A nurse and another woman come and put me in a wheelchair so I don't fall out of a chair if I faint - my eyes are going more black and I'm profusely sweating all over my body - I faint and convulse for 5 seconds - I wake up from passing out and my hands and feet are extremely tingly and feel like they have a million pins in them - my hands started cramping really bad and I can almost not open them for 5 minutes - over the next 15 mins the tingleynes and hand cramps completely fade away and I feel normal

Other Meds: Zinc, Allegra, lysine

Current Illness: N/A

ID: 1184824
Sex: F
Age: 72
State: NC

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 04/09/2021
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Allergies: none

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

Symptoms: Day after first shot both of my thighs felt sore like I had done lunges/squats when I had not exercised. I told the person giving the 2nd shot about the soreness and said I should report to my primary Dr. I did and was told if not gone in 2 weeks call back. I had 2nd shot Wednesday 2/10/21. I started feeling worse on the 28th. Tuesday 03/02/2021 had great difficulty getting out of bed and great difficulty walking also my upper arms hurt. I saw the Dr. that morning and she thought I had polymyalgia rheumatica PMR and took a blood sample. I also had a fever. The results came back positive for PMR and put on prenisone 15mg for 3 weeks. I am now on 4 weeks of prednisone tapering down from 10mg to .5mg. I do not tolerate

Other Meds: alprolasam, vitiman D, omega 3

Current Illness: none

ID: 1184825
Sex: F
Age: 58
State: IN

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/09/2021
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Allergies: Teslon pearls Hydracodone

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

Symptoms: Swollen red injection site, extreme tired, stomach cramps, neck and back spasms/pain(like a Charlie horse in neck)still swollen hurting 4 days later neck still hurting 4 days later

Other Meds: Annuity Elipta, Benazapril HCTZ 10- 12.5 METPROLOLSUCC ER 50MG ATORVASTATIN 20 MG Omeprazole 20mg

Current Illness: Seasonal allergies

ID: 1184826
Sex: M
Age: 44
State: OH

Vax Date: 03/19/2021
Onset Date: 03/26/2021
Rec V Date: 04/09/2021
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Allergies: No

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

Symptoms: I went to be that night feeling fine, and woke up the next morning around 8:30 to testicles being extremely swollen and sore, to the point where I held an ice pack on them each night before going to bed. This lasted one entire week.

Other Meds: Aspirin, Tylenol

Current Illness: No

ID: 1184827
Sex: F
Age: 30
State: NE

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
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Allergies: None

Symptom List: Vomiting

Symptoms: Night of (4/8/21, 8:00pm), I experienced notable fatigue. Day after (4/9/21, beginning 9:30 AM), began to feel dehydrated, dizzy, hot flashes, and nauseated.

Other Meds: Insulin (Novolog), Synthroid, Vyvanse

Current Illness: None

ID: 1184828
Sex: F
Age: 38
State: IN

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
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Allergies: aleve - eyes swell shut Omnicef/Cefdinir - rash all over Cetritide - headache, itchy at injection site Codine - anxious, jittery, cant sleep Steroids - hangry, can't stop eating, weight gain Soy sauce coconut

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Tired Headache Very sore arm/shoulder Some nausea

Other Meds: levothyroxine monteleukast multivitamin benadryl allergy shots every 4 weeks saline nasal spray

Current Illness:

ID: 1184829
Sex: M
Age: 53
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/09/2021
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Allergies:

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

Symptoms: At 12:45pm, patient began to have headache. No blurry vision. No N/V/SOB. 7/10 in pain, known to have headaches in medical history. Vitals stable 117/52, HR 74, O2 97%, FS 100

Other Meds:

Current Illness:

ID: 1184830
Sex: M
Age: 63
State: MI

Vax Date: 03/17/2021
Onset Date: 04/07/2021
Rec V Date: 04/09/2021
Hospital: Y

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Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Hospitalized 4/7 for covid pneumonia. Still hospitalized 4/9/2021

Other Meds:

Current Illness:

ID: 1184831
Sex: F
Age: 73
State: WA

Vax Date: 03/27/2021
Onset Date: 03/01/2021
Rec V Date: 04/09/2021
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Allergies:

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

Symptoms: pt was vaccinated 5 days early

Other Meds:

Current Illness:

ID: 1184832
Sex: M
Age: 52
State: CA

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/09/2021
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Allergies: None

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

Symptoms: Headache and body ache followed by severe leg cramps.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am