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: 1213538
Sex: F
Age: 48
State: NV

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Plugged ears with pressure. Like when on an airplane

Other Meds: Bupropion 150 mg 2x day, Trintellix 20 mg 1x day, Rosuvastatin 5 mg 1x day, OMEGA-3 ETHYL ESTERS 1 GM CAP- 1 2x day, Zyzal 1-1x day, Allegra 1-1x day

Current Illness: Auto immune - vitiligo possible start of RA

ID: 1213539
Sex: M
Age: 0
State: MI

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: IODINE

Symptom List: Anxiety, Dyspnoea

Symptoms: BACK IN FEBRUARY PATIENT WAS IN A NURSING HOME. HE IS HOME NOW AND HIS MOM BROUGHT HIM IN FOR WHAT SHE THOUGHT WAS HIS 1ST COVID VACCINATION. HE DIDN'T REMEMBER RECEIVING THE 1ST DOSE BUT IT IS DOCUMENTED IN THE DATA BASE. THE FAMILY UNDERSTANDS HE HAS HAD 2 SHOTS OF DIFFERENT MANUFACTURERS AND THE SERIERS IS COMPLETE.

Other Meds:

Current Illness:

ID: 1213540
Sex: F
Age: 32
State: CT

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Rash behind knees and waist on the sides of the body.

Other Meds: birth control

Current Illness: Cavity filled at 7am on the date of vaccination

ID: 1213541
Sex: F
Age: 26
State: CO

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Extreme headache, lethargy, and fatigue morning after vaccine. Pale clammy skin, cold-sweats, diarrhea, nausea, vertigo, dizziness, fainting, lightheadedness, muffled hearing, and blurred vision, later that afternoon. Pale, clammy skin, cold-sweats, vertigo, fainting, lightheadedness, muffled hearing, and blurred vision spells 1-2x/day since vaccine 1 week ago.

Other Meds: None

Current Illness: None

ID: 1213542
Sex: F
Age: 61
State: TX

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

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

Lab Data:

Allergies: caffeine Lortab

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

Symptoms: Slight rash after 1st dose, severe rash after 2nd dose with body aches, headache, tiredness.

Other Meds: Losartan Potassium 50 mg (1Xday); Ezetimibe 10 mg (1Xday); Metoprolol 50 mg (1/2 2 X day); Tramadol 50 mg (as needed)

Current Illness:

ID: 1213543
Sex: F
Age: 57
State: CA

Vax Date: 03/18/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: Horse serum

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

Symptoms: Flu symptoms: chills, fever, aches/pains

Other Meds: Metoprolol 100 mg Sertralina 100mg Sintrocid .100 mg Ezetimiba/Arora statin 10/20

Current Illness: None

ID: 1213544
Sex: M
Age: 60
State: TN

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Chills, fever, body ache, headache, sweating, teeth/gums sore and sensitive.

Other Meds: Blood Pressure, Allergies

Current Illness: none

ID: 1213545
Sex: M
Age: 50
State: GA

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

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Within 2-3 hours , felt achy, and fatigued (mild) Next 24 hours felt about the same 36-48 hours later achy, fatigue , Temp 99.4 By 4/10/21 symptoms were more intense Sinusitis began with sneezing, nasal congestion. 4/11/21 still fatigued, muscle aches, nasal congestion wax and waned 4/11/21 rest seemed to help but noticed fatigue through the day, and more nasal congestion 4/12/21 symptoms still about the same. Moderate to severe 4/13/21 lethargy 4/14/21 seemed better but tired easily with activity (nasal congestion. Moderately controlled with DayQuil/NyQuil generic product 4/15/21 Nasal Swab tested for COVID awaiting results Still mod / severe signs of fatigue, muscle aches, nasal congestion , weakness, shortness of breath(at times) Moderate cough of sputum

Other Meds: Vit C 500 mg / day Vit B complex Vit D 3000 -5000 IU/day Amlodipine 10 mg / day

Current Illness: None

ID: 1213546
Sex: F
Age: 30
State: NJ

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: Pineapple

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Heavy Menstrual Flow

Other Meds: Xyzal, Monolukast, JUNEL FE 1 MG-20 MCG TABLET

Current Illness: None

ID: 1213547
Sex: M
Age: 60
State: NC

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: Lisinopril, clindamycin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient 1st dose of COVID 19 Vaccination was March 12, 21 of Moderna COVID-19 Vaccine 0.5 ml IM in Left Deltoid Lot#; MOD; 026A21A; 08/26/2021. Patient reported for scheduled visit on April 9, 2021 and received Pfizer Vaccine in left Deltoid Lot#: ER8727 07/31/2021. Chief of Primary Care and assigned Team Provider notified. No adverse reactions noted. F/u with patient the next day. No issues verbalized.

Other Meds: Metformin, Omeprazole, Atorvastin, Amlodipine, Sildenafil

Current Illness:

ID: 1213548
Sex: F
Age: 34
State: IL

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
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: By 6pm there was severe pain in my arm and head. Fatigue. Symptoms worsened the next day, followed by fever, chills, body aches, and pain in the shoulder, neck, and head by the 2nd day. Fever of 103.1 that persisted for 10 hours before breaking. Migraines and stomach upset still persisting. It is 13:10 on day 2.

Other Meds:

Current Illness:

ID: 1213549
Sex: M
Age: 69
State:

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: 10:53 client reported chest / pain 2/10 and was diaphoretic. Was brought to lay down Pso2 97% pulse 78 right arm b/p 158/74. no improvement. 11:02 was taken to the ER for evaluation. 2pm follow up call made no answer.

Other Meds:

Current Illness:

ID: 1213550
Sex: F
Age: 79
State: FL

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Date and time adverse event started: 3/18/21 - 1PM Adverse events experienced and are they still occurring now: 3 HOURS POST MODERNA VACCINE ON 3/18/21 PATIENT BEGIN FEELING TINGLING/NUMB IN HER LIPS AND A HOT "WEIRD SENSATION THROUGH THE BODY" THAT RESOLVED WITHIN 3 MINUTES. What happened as a result of the adverse event? RESOLVED SPONTANEOUSLY

Other Meds: SYNTHROID IS THE ONLY ONE SHE COULD RECALL

Current Illness:

Date Died: 02/06/2021

ID: 1213551
Sex: M
Age: 73
State:

Vax Date: 01/27/2021
Onset Date: 02/06/2021
Rec V Date: 04/15/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: DEATH, ABDOMINAL DISTENTION, CHF EXACERBATION. Narrative: Pt died after completion of COVID vaccine series. Pt in CLC at time of both vaccinations. Hospitalized for CHF exacerbation 01/05 COVID vaccine dose #1 01/01 c/o abdominal distention, diarrhea 01/08 c/o increased SOB and continued diarrhea/abdominal distention, sent to ED, low potassium, borderline elevation troponin, gaseous distention on CT, admitted to hospital, states SOB and leg swelling for a few weeks now (likely unrelated to vaccine) 01/21 discharged from hospital to CLC; during course, found to have severe hypokalemia and renal failure, abd ileus, treated for electrolyte imbalance 01/26 admitted to hospital with c/o coffee ground emesis & abdominal distention 01/27 COVID vaccine dose #2 moved to critical care mid hospitalization with like aspiration PNA and numerous complications 02/06 patient passed away after withdraw of care Unlikely that vaccine contributed to death but death likely due to comorbidities and advanced age. Patient did not have acute specific ADR at time of vaccine or between vaccinations and date of death that could be attributed to vaccine. Hospitalized prior to and after vaccinations. Numerous comorbidities including acute on chronic HF and kidney failure pre-disposed patient to death.

Other Meds:

Current Illness:

ID: 1213552
Sex: M
Age: 53
State: FL

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
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: Fever up to 101.8, chills, aches.

Other Meds:

Current Illness:

ID: 1213553
Sex: F
Age: 33
State: NY

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Tachycardia-Medium, Additional Details: Patients blood pressure, pulse and O2 levels were fine. 130/87... 48 and 100%... patient wanted 911 called. they came and took her. No loss of consciousness

Other Meds:

Current Illness:

ID: 1213554
Sex: F
Age: 26
State: CA

Vax Date: 04/07/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Delayed hypersensitivity reaction: erythematous rash of left deltoid/injection site starting on day 8 (4/15/21)

Other Meds:

Current Illness:

ID: 1213555
Sex: F
Age: 39
State: FL

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

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Red splotch on arm at injection site, beginning about a week after the injection itself. Warm, some swelling and tenderness, occasionally itchy.

Other Meds: None

Current Illness: None

ID: 1213558
Sex: F
Age: 51
State: GA

Vax Date: 04/11/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Monday: General muscle body pain. Some congestion and stomach discomfort. Pain and swollen area where shot was administrated. Tuesday: Better but same symptoms. Wednesday: Better but still stomach discomfort , some muscle pain all over body, swollen, red and hard on area where shot was administrated. Tired. Today: Still same as Wednesday, some light head, need to rest, feel some nausea or some stomach disconfort.

Other Meds: antihistamine 20mg

Current Illness: none. only allergic to pollen

ID: 1213559
Sex: F
Age: 41
State:

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 1025 Pt. complains of intense itchiness on upper body. Dizzy when standing. No shortness of breath. Mouth, tongue and throat all feel normal. 1028 Pt. given 50mg Benadryl per Dr. order. 1032 BP 120/80, HR 73. 1101 Pt. feeling better and released per physician

Other Meds:

Current Illness:

ID: 1213560
Sex: F
Age: 46
State: NJ

Vax Date: 03/29/2021
Onset Date: 03/31/2021
Rec V Date: 04/15/2021
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, Lymph node pain, Lymphadenopathy

Symptoms: Both lymph nodes under both arms been swollen for last two weeks but producing much burning pain and spasm in muscles in chest. And shivering inside at night in particular. Some shooting muscle pain in legs early on. Fading last day a bit. Had to get muscles relaxants and strong antiinflamatory but getting batter last day on just Tylenol. Had to get heart and chest X-ray but all looks normal. Saw doc twice. Believing it will get better soon as doc said it should subside bc had to postpone second shot til a week later April 26.

Other Meds: Ju birth control. Probiotic Certizine allergy. Turmeric Vitamin D3. Ashwonga Zinc B

Current Illness: None

ID: 1213561
Sex: F
Age: 56
State: FL

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

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

Lab Data:

Allergies: None.

Symptom List: Unevaluable event

Symptoms: She got her vaccine and the arm had swollen up, red and hot to the touch and then after a couple of hours she could not lift it to move it, she could not move it backwards. This then moved up her arm, across the shoulders and to the neck on the right side. She took Ibuprofen. The arm feels fatigued, but she can move it, but the range of motion is not as easy as it used to be. It still feels swollen, but there is nothing that you can see.

Other Meds: Vitamin D3.

Current Illness: None.

ID: 1213562
Sex: M
Age: 43
State: MD

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Body aches, joint pain, bone pain, headaches, soreness at injection site

Other Meds: Pentasa, lanzoprazole, sertraline, busperone, finasteride, B-12 sublingual, multivitamin with iron, Zyrtec

Current Illness: None

ID: 1213563
Sex: F
Age: 66
State: PA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Severe rash on right forearm, even more severe rash with swelling and bumps at lower left leg above Achilles heal, rash on upper right thigh and right midriff.

Other Meds: Gabapentin 300 mg (1 tab), Women's Daily Multi Vitamin, B12 1000 mg (1 tab)

Current Illness: None

ID: 1213564
Sex: M
Age: 77
State: CA

Vax Date: 01/01/2021
Onset Date: 03/03/2021
Rec V Date: 04/15/2021
Hospital: Y

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

Lab Data:

Allergies: PCN, motrin

Symptom List: Injection site pain, Menorrhagia

Symptoms: The patient was admitted to hospital from 2/24/2021 until 3/6/2021 for AMS, diagnosed with UTI. He had an MRI on 3/3/2021 that incidentally showed a nonocclusive thrombus in the right dural venous sigmoid sinus, which extends to the right jugular vein. He is being treated with apixaban. It is unclear if this is coincidental or somehow related to the vaccine.

Other Meds: APAP 650mg tid, baclofen 10mg tid, cetrizine 10mg daily, vitamin D 1000U daily, marinol 2.5mg bid, flonase nasal spray, atrovent nasal spray, Ocean nasal spray prn, melatonin 6mg qhs prn, Norco q8hrs prn, laxatives

Current Illness: UTI

ID: 1213565
Sex: M
Age: 20
State: NC

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: Seafood Anti-inflammatory

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

Symptoms: Hives , nausea, body aches, fiver

Other Meds: Allegra Probiotic (culturelle)

Current Illness:

Date Died: 03/09/2021

ID: 1213566
Sex: M
Age: 72
State:

Vax Date: 02/03/2021
Onset Date: 03/09/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: death Narrative: Patient received his COVID #1 Moderna vaccine on 2/3/2021. On 2/9/21, he reported to our ER with severe upper back pain x 2 weeks, notes indicate that he fell 12/2020 and sustained a fracture to T5, he denied shortness of breath but did report a cough. He was given morphine 10mg IM x 1 dose, ondansetron 4mg SL x 1 dose and an outpatient RX for Norco and discharged. On 2/11/21, his wife reported that he fell out of bed and he was taken to a facility via EMS. No records from that visit are available. On 3/9/2021. it was reported that he passed away. No autopsy reports available. 34 days from time of vaccine to date of death.

Other Meds:

Current Illness:

Date Died: 03/01/2021

ID: 1213567
Sex: F
Age: 85
State:

Vax Date: 02/08/2021
Onset Date: 03/01/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Narrative: On 1/11/21, patient received Moderna COVID vaccine #1 and on 2/8/21, she received dose #2. No notes record any adverse events to vaccine. There is a scanned document from 2/24/21 where patient agreed to home hospice care. Date of death is recorded as 3/1/21. No documentation of any events from time of vaccines to date of death. No autopsy results reported. 21 days from date of vaccine #2 and date of death.

Other Meds:

Current Illness:

Date Died: 03/20/2021

ID: 1213568
Sex: M
Age: 75
State:

Vax Date: 02/26/2021
Onset Date: 03/20/2021
Rec V Date: 04/15/2021
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: death Narrative: Patient received Moderna covid vaccine # 1 on 2/26/21. Per scanned records on 3/18/21, he presented to the ER with reports of shortness of breath and was subsequently admitted and treated for acute CHF, NSTEMI and sepsis (ceftriaxone and azithromycin). He later developed AKI and surgery was consulted for placement of a Trialysis catheter. After placement of this catheter, he developed increasing respiratory distress and confusion and was transferred to the ICU where he received vasopressors, intubation and unsuccessful resuscitation after a code blue. Autopsy reports not available. 22 days from date of vaccine to date of death.

Other Meds:

Current Illness:

Date Died: 02/24/2021

ID: 1213569
Sex: M
Age: 80
State:

Vax Date: 02/04/2021
Onset Date: 02/24/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: death Narrative: Patient received COVID vaccine #1 on 2/4/21. On 3/1/21, it was reported to the facility that patient had passed away on 2/24/21. No notes on file with respect to what happened around the time of his passing. No autopsy results available. 20 days from time of vaccine to date of death.

Other Meds:

Current Illness:

Date Died: 03/21/2021

ID: 1213570
Sex: M
Age: 82
State:

Vax Date: 02/12/2021
Onset Date: 03/21/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: death Narrative: Patient received Moderna Covid vaccine #1 on 2/12/21. On 2/17/21, his son contacted the clinic social worker to inquire about home health services as he thought Patient had had a stroke (no longer able to walk and slurred speech). Patient refused to go to the hospital and son agreed to not have him admitted for fear that he would die alone in a hospital. Patient receives primary care from a provider and social worker suggested that he contact his PCP regarding home hospice services. No further notes of what occurred after that conversation and his date of death is reported as 3/21/21. No autopsy results available. 37 days from date vaccine to date of death.

Other Meds:

Current Illness:

Date Died: 03/25/2021

ID: 1213571
Sex: M
Age: 74
State:

Vax Date: 03/01/2021
Onset Date: 03/25/2021
Rec V Date: 04/15/2021
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Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Death. Narrative: Patient received Moderna COVID vaccine #1 on 3/1/21. On 3/17/21, he was admitted to a facility for a CABG. Per notes, after his CABG, he developed Pseudomonas pneumonia, AKI requiring dialysis and ultimately became oliguric. He required epinephrine, dobutamine, dopamine, amiodarone and went through two code blues prior to pronouncement of death on 3/25/21 at 2305. No autopsy reports available. 24 days from time of vaccine to date of death.

Other Meds:

Current Illness:

Date Died: 02/28/2021

ID: 1213572
Sex: M
Age: 84
State:

Vax Date: 02/01/2021
Onset Date: 02/28/2021
Rec V Date: 04/15/2021
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Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: death Narrative: Patient received COVID vaccine #1 on 12/30/20 and #2 on 2/1/21. He was an inpatient in the facility and had been under hospice care since 12/9/20. No adverse events to vaccine found per notes. On 2/27/21, he began to have short and rapid respirations and was unresponsive. He was given morphine, atropine sublingual, lorazepam and nebulizers per hospice care orders and was determined to be imminent. On 2/28/21 at 2230, he passed. No autopsy results available. 27 days from date of vaccination to date of death.

Other Meds:

Current Illness:

ID: 1213935
Sex: F
Age: 86
State: NC

Vax Date: 04/09/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
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Symptom List: Tremor

Symptoms: PATIENT PRESENTS WITH 4 DIME SIZE RED MARKS, ALMOST WELT LIKE ON VACCINATION FOREARM AND RIGHT ABOVE ELBOW AND STATES THEY ITCH ON AND OFF. ADVISED PT TO TRY SOME HYDROCORTISONE CREAM AND FOLLOW UP WITH MD IF NEEDED

Other Meds:

Current Illness:

ID: 1213936
Sex: F
Age: 88
State: NJ

Vax Date: 04/07/2021
Onset Date: 04/11/2021
Rec V Date: 04/15/2021
Hospital: Y

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Allergies: Turkey - reaction nausea

Symptom List: Erythema, Pruritus

Symptoms: Patient presented to the ED on 4/11/21, which was 4 days after her 2nd Moderna COVID-19 Vaccine, with bilateral hip pain that patient reports started after getting the vaccine. The bilateral hip and thigh pain was very severe and she was unable to ambulate and perform her ADLs like usual. Vaccine received on 4/7/21.

Other Meds: fluticasone-vilanterol, ergocalciferol, diclofenac topical, cetirizine, ammonium lactate topical, albuterol

Current Illness: Well controlled asthma

ID: 1213938
Sex: M
Age: 46
State: WA

Vax Date: 04/05/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
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Allergies: None

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

Symptoms: Headache everyday for 3 days upon waking up. Typically around 8:45am

Other Meds: Triumeq

Current Illness:

ID: 1213939
Sex: F
Age: 86
State: AZ

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/15/2021
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Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Patient received COVID Moderna on 03/15/2021 by PCP office. On 04/09/2021, received a COVID Pfizer vaccine. Report created per RN, for documentation purposes in case of any future symptoms, due to different brands were administrated.

Other Meds:

Current Illness:

ID: 1213940
Sex: M
Age: 53
State: IL

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
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Allergies: Aspirin, ibuprofen, penicillin, ampicillin, tetanus shot, fresh water fish and clams

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Face numbness on right side. I started feeling numbness in the right corner of my mouth within minutes of receiving the shot. Within a couple of hours it had spread to a larger area. From just below my eye to my chin including my lips on that side and inside my mouth and cheek. Symptoms were still there the next morning so I contacted my doctor. I was instructed to go to the emergency room. The ER doctor determined that it wasnt a stroke and said it was most likely a reaction to the covid shot. They also said it resembles a minor case of Bell Palsy but was most likely not Bell Palsy. It was probably an inflammation of the nerves in my face due to the shot. I was prescribed a steroid to use if the symptoms did not stop in a couple of days.

Other Meds: Omega 3/fish oil pills

Current Illness: None

ID: 1213941
Sex: F
Age: 27
State: MN

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 04/15/2021
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Allergies: No allergies

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

Symptoms: I don't know if this is an adverse event, but I wanted to report symptoms I'm experiencing. 2 days after receiving the second injection for the Pfizer COVID-19 vaccine, I noticed a tender lump above my collarbone on the left side; the lump was not immediately visible, but I could feel it with my fingers and move it around. After examining the site of the lump, it appeared to be swollen when compared to my collarbone on the right side. The lump on the left side is the same side I received the injection. After researching, it appears that the tender lump may be a swollen lymph node(s) near my collar bone related to the Pfizer vaccine. It has now been present for 5 days, but appears to be reducing in size and sensitivity as time goes on. I have contacted my primary care provider who has instructed me to monitor the lump and follow up in person after a few weeks if it has not subsided.

Other Meds: Lexapro, Adderall, Vitamin D supplement, Vitamin B12 supplement, Zyrtec

Current Illness:

ID: 1213942
Sex: F
Age: 74
State: OH

Vax Date: 04/07/2021
Onset Date: 04/09/2021
Rec V Date: 04/15/2021
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Allergies: None

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

Symptoms: Bumps on palms of hands and fingers that are sore Rash on tops of both hands Started on 4-9-2021 and persist yet on 4-15-2021

Other Meds: No

Current Illness: None

ID: 1213943
Sex: M
Age: 53
State: MI

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
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Lab Data:

Allergies: latex,nickel,adhesives, tomatoes,codein

Symptom List: Pain in extremity

Symptoms: Pt became blotchy and itchy. Had itchiness in the mouth. No difficulty breathing or shortness of breath.

Other Meds: albuterol symbicort flonase vitamin D

Current Illness: none

ID: 1213944
Sex: M
Age: 29
State: CO

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

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Allergies: No

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

Symptoms: Patient was looking pale a minute after the shot, I asked how he was doing, he responded by saying he felt very dizzy. I asked him to take slow deep breaths, gave him some water. About after 1 more minute he passed out (very unresponsive but still breathing, pupils very dilated) pulse was slow but still palpable. Tried ammonium smelling salts, that did not bring patient around. Called 911. Tried patting patient and talking to patient to bring them back to consciousness. After about a minute or two patient was able to respond to me. He knew his name and date of birth and where he was. Asked him to wait for ambulance to check vitals. Patient said he still felt very dizzy. Kept his head down and eyes closed. Once EMS arrived they checked his vitals, determined BP was low (they did not tell me a number). They monitored patient's vitals for 10-15 minutes. BP did not "bounce back" per EMS so they took him to the hospital for IV drip possibly.

Other Meds: Unknown

Current Illness: None

ID: 1213945
Sex: F
Age: 25
State: GA

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

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

Symptoms: Systemic: Seizure-Severe, Additional Details: pt had seizure approximately 5 minutes after receiving vaccination,was sitting in waiting are,stood up,passed out,hit head,then seized.was short.called 911.pt apparently has history of seizures with vaccination.was cleared by ems. worker called pt at 6 pm and pt was fine..

Other Meds:

Current Illness:

ID: 1213947
Sex: M
Age: 55
State: AZ

Vax Date: 03/23/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
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Allergies: None

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

Symptoms: Lower leg swelling from below knee to top of foot at ankle. Very angry red and swollen. Causing fever shakes and fatigue. Taking Amoxik Clav 875-125 tab. Nort. Began talking on Tuesday for 3 days with slight improvement.

Other Meds: Synthroid .125mcg Cyclobenzaprine HCI 10mg Bariatric Advantage ultra solo w/iron BakeBro edibles 20mg THC

Current Illness: None

ID: 1213948
Sex: M
Age: 38
State: FL

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/15/2021
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Allergies: Epogen

Symptom List: Vomiting

Symptoms: Patient stated that he got hives around the injection site and later it spread to other parts of his body - this is now resolved Patient stated that he felt a tightness in his chest on the evening he got vaccinated and that it has persisted until now. Patient refused to go to the hospital for evaluation

Other Meds: Clonidine Sevelamer Coreg Gabapentin Nifedipine Colace

Current Illness:

ID: 1213950
Sex: F
Age: 48
State: IN

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
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Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fatigue occurring 18 hours post injection. Nausea, fever occurring 24 hours post. Hives occurring Thursday morning 4/15/21.

Other Meds: birth control

Current Illness: None

ID: 1213951
Sex: F
Age: 29
State: IN

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
Hospital:

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Allergies: No

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

Symptoms: Fatigue a couple hours after vaccine, I took Acetaminophen 1g at ~8pm High fever (my guess is ~103F) and shivering overnight. At least a few hours, I wasn?t conscious enough to get up and take my temperature nor more medicine. In the morning fever was down to 100F and shivering was gone, I felt a lot better comparatively. Took another 1g Acetaminophen. Intense fatigue and 98.6F temperature until aprox 24h after the vaccine. I had some chills in the evening, but very mild. Note: I had diagnosed COVID19 last week of October 2020. Then I had 100F fever for 2 days and cold like symptoms starting on day 3 for about 5 days.

Other Meds: Birth Control

Current Illness: No

ID: 1213952
Sex: F
Age: 77
State: OH

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 04/15/2021
Hospital:

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Allergies: no

Symptom List: Injection site swelling, Limb discomfort

Symptoms: iST INJECTION WEAK NAUSEA RIDE CIRCLE UNDER INJECTION SITE LASTED ABOUT 4 DAYS TOOK WATER & TYLENOL 2ND INJECTION WEAK NAUSEA DRY HEAVES EXTREME PAIN IN ALL JOINTS CHILLS CIRCLE BELOW INJECTION SITE UNABLE TO FUNCTION ON MY OWN FOR 5 DAYS WEAK AND NSUSEA LASTED 4 DAYS MORE TOOK tYLENOL AS SUGGESTED BY STAFF WHEN RECEIVING INJECTION

Other Meds: Progestrian daily multi vitamin vitamin D estrogen

Current Illness: no

ID: 1213953
Sex: M
Age: 34
State: CA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/15/2021
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Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: S: Syncope/vasovagal after COVID vaccine while in observation lot. B: Staff responded to honking horn - pt reported he has just come to from passing out- had been on the phone with partner while event happened and she reported the same. Diaphoretic, lightheaded and out of it. Pt laid flat and treated with ice and supportive care. Vitals stable. History of vagal response around shots previously. A: Syncope after vaccine R: Appropriate care provided.

Other Meds:

Current Illness:

ID: 1213954
Sex: F
Age: 59
State: CO

Vax Date: 03/29/2021
Onset Date: 03/31/2021
Rec V Date: 04/15/2021
Hospital:

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Allergies:

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

Symptoms: hard to breathe. I am allergic to cats; the outcome when I'm around cats has always been difficulty breathing. Consequently, I make it a point to stay away from cats. Post the Moderna COVID vaccine dose #1, my breathing is labored, and my lungs feel congested and heavy with wetness. 6 days ago, I came into contact with a cat, which sent me into a hyper state of difficulty breathing 5 days ago, which lasted for a full 24 hours. Post that episode, my breathing continues to be labored, and my lungs continue to feel congested and heavy with wetness. I can go about my day, but I'm not at 100%, like I was before I took dose 1 of the vaccine.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am