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: 1228266
Sex: F
Age: 27
State: OH

Vax Date: 04/11/2021
Onset Date: 04/13/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: Suprax, Rocephin

Symptom List:

Symptoms: 4/13- itching began in perineal area. 4/14- blisters appeared. Burning and itching. 4/15- more blisters, more burning and itching. 4/16- ER trip. Tested for herpes and other STIs. Given Valtrex and Lidocaine. - set f/up appointment with OB/GYN ()on Wed 4/21/21 4/17- area slightly improved. 4/18- Negative results on tests. Area slightly improved.

Other Meds: Lo loestrin Fe

Current Illness: N/a

ID: 1228267
Sex: F
Age: 39
State: VA

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Strong body aches starting 7 hours after shot lasting 24 hours, mild body aches for following 36 hours Night sweats for 3 nights following shot Heartburn starting 24 hours after shot, ongoing

Other Meds: Trazadone, Lexapro, Rosuvastatin, Flonase, daily vitamin

Current Illness: None

ID: 1228268
Sex: F
Age: 33
State: IN

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: headache, body ache, chills, fever

Other Meds: None

Current Illness: None

ID: 1228269
Sex: M
Age: 58
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228270
Sex: F
Age:
State: NE

Vax Date:
Onset Date: 03/07/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: LOCAL PAIN; NECK, BACK, AND SHOULDER STIFFNESS; This spontaneous report received from a patient via a company representative concerned a 44 year old female. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 06-MAR-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow up to request batch/lot numbers. No concomitant medications were reported. On 07-MAR-2021, the subject experienced local pain. On 07-MAR-2021, the subject experienced neck, back, and shoulder stiffness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from local pain, and neck, back, and shoulder stiffness on 09-MAR-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1228271
Sex: F
Age: 30
State: IL

Vax Date: 03/20/2021
Onset Date: 04/16/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

Symptom List:

Symptoms: Patient has been having left arm pain. Developed acute, partially occlusive left subclavian deep vein thrombosis found on duplex on 4/16/21. She was started on lovenox and will have further work-up.

Other Meds: buspirone, fexofenadine, mometasone, natazia, verapamil, ondansetron, sumatriptan

Current Illness: none

ID: 1228272
Sex: M
Age: 56
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228273
Sex: F
Age: 55
State: PA

Vax Date: 03/31/2021
Onset Date: 04/02/2021
Rec V Date: 04/19/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin Aspirin Motrin Ibuprofen

Symptom List:

Symptoms: Within days of receiving vaccine started feeling mild discomfort on right side of lower abdomen while doing light abdominal exercises. This continued for about 10 days and then flu-like symptoms started - bloating, continual abdominal discomfort, back pain, lack of appetite for 3 days. On Friday, April 16, I went to doctor who sent me to the ER for further tests which showed appendicitis resulting an appendectomy on Saturday, April 17 at 7:30 AM.

Other Meds: Hydrochlorothiazide 25ng once/day Vitamin D-3 1000 IU once/day Vitamin K-2 45 mcg once/day

Current Illness: None

ID: 1228274
Sex: F
Age: 86
State: MI

Vax Date: 03/31/2021
Onset Date: 04/08/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: 86-year-old spanish speaking female brought into the ED with concerns of slurred speech and confusion that was noted at 3 PM on 4/8. Patient's last known well was at 10 AM on 4/8. GCS on arrival 15. NIH SS 2 recorded at 18: 12 (for mild right-sided facial droop and mild dysarthria). In the EMS blood glucose was 122, no meds were given. Patient is not on any anticoagulation. Patient's blood pressure was elevated at 233/78. Patient denying any headaches, nausea, vomiting. Per the family no focal neurologic deficits noted except for dysarthria which was improved during the ED visit. Neurology contacted in the ED for stroke code. Patient outside of TPA window. CT head was negative. CT head negative for acute intracranial infarction. Chest x-ray negative for any acute cardiopulmonary findings. Patient was started on nicardipine drip in the ED with the blood pressure reduced to 145/70, then turned off. CBC showed mild leukocytosis (14.8) likely reactive. CMP unremarkable. PT/INR was also obtained. After discussion with neurology given the CT head and CTA head and neck, CTP negative are reassuring for low concern of stroke. ASA 325 once was given. However neurology does recommend an admission for further evaluation with an MRI for notably rule out stroke. After discussion with family and the physicians the patient refused admission. Upon reexamination no further worsening of her initial symptoms, blood pressure controlled. Patient was discharged in a stable condition. She was discharged AMA. Patient was thoroughly explained the risks and benefits of leaving AMA. Patient said she understood and was advised to come back if the symptoms worsen. Patient was discharged with aspirin, Plavix and atorvastatin. Recommended to follow-up with the PCP tomorrow soon as possible. Also advised to return to the ED if any of the symptoms return.

Other Meds:

Current Illness:

ID: 1228275
Sex: M
Age: 43
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228276
Sex: F
Age: 54
State:

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: 04/18/2021 Typical symptoms... Fever 102-103, headache, nausea, fatigue... NonTypical symptoms.... left side of face by mouth felt numb (like getting numbing at dentist); Slept all day but kept waking up because left arm, right arm, left leg fell asleep or numb. 04/19/2021 Today Fever Broke and just feel fatigued. Numbness and limbs falling asleep seems to have gone away.

Other Meds: multivitamins

Current Illness: none

ID: 1228277
Sex: M
Age: 43
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228278
Sex: M
Age: 53
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228279
Sex: F
Age:
State: WV

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: HEADACHE; BODY ACHE; LOW GRADE FEVER; This spontaneous report received from a parent concerned a female of unspecified age. The patient's height, and weight were not reported. The patient's past medical history included heart transplant, and concurrent conditions included no alcohol use, and non smoker, and other pre-existing medical conditions included the patient had no known allergies. The patient did not have drug abuse or illicit drug usage. The patient was previously treated with tacrolimus for heart transplant, and mycophenolate sodium for heart transplant. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805031, expiry: UNKNOWN) dose was not reported, administered on 10-MAR-2021 08:30 for prophylactic vaccination. No concomitant medications were reported. On 10-MAR-2021, the patient experienced headache, body ache and low grade fever. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache, body ache, and low grade fever on 11-MAR-2021. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker

ID: 1228280
Sex: M
Age: 59
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228281
Sex: F
Age: 23
State: DC

Vax Date: 04/10/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List:

Symptoms: On Sunday 4/18 starting at 4:15pm, my vaccine site began to itch, developed a red rash, and became swollen. It is still itchy and swollen, however it is not as extreme as it was when symptoms abruptly began.

Other Meds: Lexapro - 20mg daily Bupropion - 150mg daily

Current Illness: n/a

ID: 1228282
Sex: F
Age: 56
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228283
Sex: F
Age: 52
State:

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: Ceclor

Symptom List:

Symptoms: Chills, body aches, pain at injection sight

Other Meds: None

Current Illness: None

ID: 1228284
Sex: F
Age: 40
State: NJ

Vax Date: 03/28/2021
Onset Date: 03/30/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Cognitive impairment, lower brain function, confusion, memory impairment and other impairments related to overall brain function.

Other Meds: None

Current Illness: None

ID: 1228285
Sex: F
Age: 34
State: TN

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

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

Lab Data:

Allergies: Codine , Hydrocodone

Symptom List:

Symptoms: I was given the vaccine at 11:10am and by 5:30pm I was beginning to feel tired and unwell. At 6:45 I had a fever, body aches, pain in my arm, headache, and chest pain. These symptoms continued for three days and my fever reached 102.7. After three days the fever and body aches subsided but the fatigue and chest pain continued. The chest pain has continued with increased heart rate during small bursts of activity. I called the clinic that administered my shot on April 9th and was told chest pain was normal up to 10 days and if it continued to be a problem to go to the ER. After 11 days of chest pain I went to the ER on April 13th and they did an EKG, CT with contrast, and blood work. They concluded I was fine. I was told it could be esophagitis so to take 2 15mg Prevacid a day which I have done with no relief. I was also informed it could be muscle related so I have iced, taken anti-inflammatory medication, and have not exerted myself. It is now April 19th and I am still experiencing chest pain and racing heart rate with minimal exertion.

Other Meds: Flonase, Xyzal, Vitamin D-3 & MK-7, Womens Multivitamin

Current Illness: None

ID: 1228286
Sex: M
Age: 25
State: FL

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: nka

Symptom List:

Symptoms: 10:48am Passed out, sweating and urinated. No reaction at site.

Other Meds: Vit C

Current Illness:

ID: 1228287
Sex: F
Age: 49
State: IN

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: Day after injection:Fever, headache, chills, body aches, tired, no energy and exhausted. Had extreme sweats that night. My arm swelled up the size of a softball at the injection site. My arm is stiff, hot, red and very sore. 2 days after: headache, tired and out of breath and am still very swollen and very sore. 3rd day: is the same as day 2

Other Meds: None

Current Illness: None

ID: 1228288
Sex: F
Age: 47
State: MI

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: Allergic to codine

Symptom List:

Symptoms: Scratchy Throat for 14 hours after dose 1 Fever at 4:30am after dose 1 Arm pain at injection site lasted for 36 hours after dose 1 Rash on left hand at 4:30am after dose 1 Diarrhea 12 hours later after dose 1

Other Meds: Zyrtec for seasonal allergies

Current Illness: n/a

ID: 1228289
Sex: F
Age:
State: WA

Vax Date:
Onset Date: 03/08/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: HIGH FEVER; ACHY; This spontaneous report received from a patient via a company representative concerned a female of unspecified age. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 08-MAR-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow -up to request batch/lot numbers. No concomitant medications were reported. On 08-MAR-2021, the subject experienced high fever. On 08-MAR-2021, the subject experienced achy. Laboratory data included: Body temperature (NR: not provided) 102.3 F. Treatment medications included: ibuprofen. On 09-MAR-2021, Laboratory data included: Body temperature (NR: not provided) 100.6 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from high fever, and achy. This report was non-serious.

Other Meds:

Current Illness:

ID: 1228290
Sex: F
Age: 28
State: NJ

Vax Date: 04/10/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Swelling in the arm, and hand. Also little dots on both hands

Other Meds: Birth control

Current Illness: Upper respiratory infection

ID: 1228291
Sex: F
Age: 44
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228292
Sex: M
Age: 60
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228293
Sex: U
Age: 46
State: KY

Vax Date: 04/12/2021
Onset Date: 04/14/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: compazine

Symptom List:

Symptoms: Patient is a 46 yr/o female who presents with vaginal bleeding, started 3 to 4 days ago, states she is used 3-4 tampons this morning in the last 4 hours, states seems to be better currently, but waxes and wanes. She has had some clotting. Last. She believes was 1 week later than normal, around the first of this month. Denies sexual activity in the last 10 months, denies concern for STIs. No dysuria or flank pain. No fever or chills. Thought she could be anemic secondary to her fingers tingling earlier today. She does have an OB/GYN but has not seen them for a couple of years. Did have uro-Guynn surgery last year. Diffuse lower abdominal pain, fairly constant. No treatment prior to arrival. Denies weight gain or concern for pregnancy.

Other Meds: adderal, Tenormin, flexeril, Cymbalta, relpax, Neurontin, ibuprofen, cortisproin, trileptal,

Current Illness:

ID: 1228294
Sex: F
Age: 78
State: VA

Vax Date: 04/12/2021
Onset Date: 04/16/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: Iodine

Symptom List:

Symptoms: Rash one week after second shot

Other Meds: Develop rash around the injection side 5 days after the second Covid Shot.

Current Illness: Had a TAVR procedure done on 3/11/2021 (Valve Replacement procedure)

ID: 1228295
Sex: M
Age: 22
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228296
Sex: F
Age: 47
State: MA

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: penicillin, codeine

Symptom List:

Symptoms: 103. fever began 12;30 Saturday morning , body aches, headache felt like my head was going to explode. fever of 102 continued into Sunday morning severe arm pain at sight of injection also underarm tenderness. all of my armpit glands are swollen around inside of my arm near left breast. fever finally subsided Monday morning.

Other Meds: vitamin c, multi vitamin

Current Illness: none

ID: 1228297
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: SORE ARM; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown) .5 ml, start therapy date was not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On an unspecified date, the subject experienced sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of sore arm was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1228298
Sex: M
Age: 39
State: NY

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: penecillin family, arythromicin family

Symptom List:

Symptoms: re-occuring hives on hands , feet and scalp daily and randomly through out body

Other Meds: crestor, avapro

Current Illness: none

ID: 1228299
Sex: F
Age: 46
State: OR

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies: amoxicillin

Symptom List:

Symptoms: severe facial rash along dermatome on left side of face - red, itchy, oozing bumps that eventually blistered and scabbed, lasted 7-9 days

Other Meds: none

Current Illness: none

ID: 1228300
Sex: F
Age: 53
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228301
Sex: M
Age: 51
State: MN

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/19/2021
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Allergies: Amoxicillan

Symptom List:

Symptoms: Body aches, fever, chills, headache. Came on approximately 6 hours after vaccination, subsided approximately 24 hours after vaccination.

Other Meds: Zyrtec

Current Illness: None

ID: 1228302
Sex: F
Age: 80
State: NC

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/19/2021
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Allergies: ciprofloxacin, levofloxacin, penicillin

Symptom List:

Symptoms: Patient developed pruritic rash on her legs five hours after receiving the moderna vaccine. Patient was seen by physician and given topical steroid and OTC antihistamine for symptom relief.

Other Meds: carbidopa, citalopram, fluconazole, gabapentin, metformin, metoprolol, myrbetriq, omeprazole, triamcinolone

Current Illness: NA

ID: 1228303
Sex: F
Age: 50
State: PR

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 04/19/2021
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Allergies: None reported

Symptom List:

Symptoms: She started to have heavy vaginal bleeding. On 04/14/2021 she started to have back pain that radiated to the left leg and anterior abdomen.

Other Meds: Ativan, Abiem, Pretiq, UDI progesterone

Current Illness: None reported

ID: 1228304
Sex: F
Age: 62
State: PA

Vax Date: 03/16/2021
Onset Date: 03/19/2021
Rec V Date: 04/19/2021
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Allergies: None

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Symptoms: I was ill with diarrhea, sick to stomach, blood clots coming out of my rectum for 24 hrs., body aches.

Other Meds: Propranolol

Current Illness: None

ID: 1228305
Sex: F
Age: 66
State: MI

Vax Date: 02/10/2021
Onset Date: 02/17/2021
Rec V Date: 04/19/2021
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Allergies: none known

Symptom List:

Symptoms: swelling and tenderness in right leg in the area of my knee. it occurred approx. 1 week after 1st dose

Other Meds: lisinopril ,alprazolam

Current Illness:

ID: 1228306
Sex: F
Age: 30
State: FL

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/19/2021
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Allergies: none

Symptom List:

Symptoms: Experienced soreness to the injection site and pain under armpit about 12 hours after injection. Also experienced fatigue. No following day experienced itching to injection site was well as redness. By 04/19/2021 symptoms have subsided This is my first pregnancy. Estimated delivery date Sept 22, 2021.

Other Meds: prenatal vitamins

Current Illness: none

ID: 1228307
Sex: M
Age: 56
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
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Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228308
Sex: F
Age: 45
State: NY

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/19/2021
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Allergies: Tetnus, Erythromycin, Morphene, Sulfa

Symptom List:

Symptoms: My arm from shoulder to finger tips started tingling, then pins and needles, then going numb. My face started to feel tight like you feel with a bad sunburn. Then my face started tingling with pins and needles, my lips went numb, I started getting red splotches across my face spreading down my neck. I quickly got home and took Benadryl for the next 24 hours.

Other Meds: Vitamin D, Fentermine, Zyrtec, Multi Vitamin

Current Illness:

ID: 1228309
Sex: F
Age: 50
State: NC

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/19/2021
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Allergies: Motrin, Coffee, Coco, Cats, Cigarettes, Pollen, Dust, Latex

Symptom List:

Symptoms: Abdominal cramping and both legs ache down to knees. A small red, blood-filled, blister appeared on bottom of abdomen. These symptoms started about a week ago and they are ongoing.

Other Meds: Tylenol, Multi Vitamin with Iron & Calcium, Vitamin D 5000 IEU, Amovij monthly injection, Xanax, Propanol, Inderal

Current Illness: Seasonal Allergies

ID: 1228310
Sex: F
Age: 23
State: NY

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/19/2021
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Lab Data:

Allergies: NA

Symptom List:

Symptoms: Syncopal episode due to patients response to needles.

Other Meds: NA

Current Illness: NA

ID: 1228311
Sex: F
Age: 51
State: RI

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/19/2021
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Allergies: Allergy to raspberries and latex in the past

Symptom List:

Symptoms: Pt received dose 1 of Pfizer vaccine on 4/15/21 at approx. 3:46pm at a clinic due to past allergies. While being monitored for 30 minutes post vaccine, pt complained of slight wheeze, pain in throat and tongue feeling heavy. Only visible sign was small red blotches on upper chest. BP was 159/95, pulse 75 and pulse ox was 97%. 25 mg Benadryl po given at approx. 4:16pm. Pt remained at clinic to be monitored. At 4:50pm, patient left with husband feeling much improved: throat pain gone, wheeze gone, tongue feeling normal, swallows easily and red areas on chest visible, but diminished in size. Patient called on 4/16/21 and no further complaints. Felt much improved once home and no further symptoms. Encouraged to let staff know about incident when receiving dose 2 and to stay longer than 30 minutes for monitoring.

Other Meds:

Current Illness: Asthma

ID: 1228312
Sex: F
Age: 52
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
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Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1228313
Sex: F
Age: 62
State: TX

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/19/2021
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Symptoms: Patient in observation. Patient experienced syncope for approximately 10 seconds. Patient awakens. Patient vital signs BP-179/79 HR-76 T-98.6. When patient awaken, AOx3 and she began drinking a bottle of water. Patient monitored. Patient husband and daughter in car. Patient monitored. Vital signs retaken BP-138/78 HR-64 R-16. Patient verbalizes feeling better and anxiety has decreased. Patient and family educated on worsen symptoms and when to seek medical attention.

Other Meds:

Current Illness:

ID: 1228314
Sex: M
Age:
State: IN

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/19/2021
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Lab Data:

Allergies: Typical spring allergies

Symptom List:

Symptoms: Metal taste in mouth within 30 minutes of injection., similar to injection 1. I otherwise felt fine and had a normal day of moderate physical activity. I awoke in the middle of the night with chills and body aches and a strong feeling of anxiety. I was able to fall back asleep and woke up as normal a few hours later. I had a very strong head ache centered behind my sinuses, body aches in my pelvis and legs, and hot flashes mixed with chills. Aches were manageable with Tylenol. As the day progressed those continued and I was very fatigued. I went to bed earlier than normal and after a full night's sleep symptoms subsided.

Other Meds: Levothyroxine

Current Illness: Spring Allergies

ID: 1228315
Sex: F
Age: 59
State: MI

Vax Date: 04/11/2021
Onset Date: 04/12/2021
Rec V Date: 04/19/2021
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Allergies: none

Symptom List:

Symptoms: Extreme fatigue lasting 4 days, foggy brain (inability to make decisions, concentrate)

Other Meds: Basis, multivitamin (Centrum for women), omega-3, B12, famotidine 20 mg

Current Illness: none

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm