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: 0942510
Sex: F
Age: 28
State: NY

Vax Date: 11/19/2020
Onset Date: 11/29/2020
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: penicillin: hives

Symptom List:

Symptoms: Left arm/shoulder pain persisting beyond 11 days after the vaccine was given Concern for SIRVA despite the clinician recalling the location of the injection as being properly placed

Other Meds: none

Current Illness: none

ID: 0942872
Sex: F
Age: 32
State: CA

Vax Date: 01/05/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: N/a

Symptom List:

Symptoms: Aside from the bruising at my injection site on my left upper arm, I have developed a reddned area below. The area is warm to touch, can feel a bump inside, slight soreness. It is not painful.

Other Meds: N/a

Current Illness: None

ID: 0942873
Sex: F
Age: 23
State: OR

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: The first day 1/07/21 I started with a pain on my throat , my throat felt really sore however I was still able to eat . The following day 1/08/21 I still had a sore throat I was able to eat , but at the end of the night I got a fever me temperature was 102.0 . I knew all these symptoms were normal but being that on 1/09/21 It was painful for me to swallow I went to immediate care where they said I still had a fever and told me I had a swollen tonsil on the left side of the mouth which is also the side I received the vaccine on. I still continued to have a fever . Saturday night I noticed I had gotten some small sores on my mouth also on the left side . On Sunday I had loose stool , but I have been eating very soft foods because of my throat . Which then I went to go see a dentist and she said they appeared to be fever blisters , those popped I have a couple on my tongue as well . As of today my throat pain feels to be getting better .I did start a oral mouth rinse also for the sores

Other Meds: None

Current Illness: None

ID: 0942874
Sex: F
Age: 39
State: NM

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: Darvocet, seasonal allergies and dogs.

Symptom List:

Symptoms: Patient had the initial Pfizer COVID vaccine on December 18th. She started to having arthralgias, myalgias, fever, fatigue and weakness starting on December 20th. The patient continuously had arthralgias, myalgias and weakness for the next few weeks. Patient follow up with physical therapist once a week to work on muscle weakness. The patient continuously had arthralgias and myalgias until January 10th. Primary care provider on January 7th orders CBC, autoimmune and thyroid panel since patient was having ongoing myalgias and arthralgias. Patient postpone 2nd dose because side effects from previous vaccine were ongoing. Patient got 2nd dose vaccine on January 12th at 4:30pm. On January 13th at 11am the patient initially had nausea and arthralgias. Patient took Zofran 4mg ODT about 11:15am. 30mins later the patient tongue swelled. No lips swelling and no SOB. Patient immediately took liquid Benadryl 50mg to 75mg PO. Patient immediately drove to ED. Patient was observed until 2pm for signs and symptoms of allergic reaction. Patient was discharge and advised to take Benadryl 25mg to 50mg every 4 to 6 hrs prn allergic reaction, Patient took famotidine 20mg at 4pm along with 25mg of Benadryl PO. Tongue swelling began to decrease. Patient also had fever, myalgia and arthralgias at 4:30pm. Took Tylenol 1,000mg and symptoms subsided (fever, myalgia and arthralgias).

Other Meds: Bupropion SR 100mg 1PO QD, Aldactone 50mg 1PO QD, Bio-identical therapy testosterone 100mg pellet SQ every 4- 5 months, Zinc 50mg 1PO QD, Quercetin 500mg 1PO QD, L-glutamine 500mg 1 PO QD, Fexofenadine 180mg 1PO QD Medication to manag

Current Illness: Patient was having ongoing myalgia, arthralgias and weakness starting on December 20th. Symptoms seems to have gotten better by January 10th.

ID: 0942875
Sex: F
Age: 38
State: AZ

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: Gluten Latex

Symptom List:

Symptoms: nauseous , weakness, fever, racing heart. All symptoms started about 5 hours after vaccination. Fever highest so far at 101.6 , heart rate 132 at highest taken.

Other Meds: Xarelto Lexapro

Current Illness: none

ID: 0942876
Sex: F
Age: 34
State:

Vax Date: 12/16/2020
Onset Date: 12/18/2020
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Vertigo and headache for 8 days

Other Meds: None

Current Illness: None

ID: 0942877
Sex: M
Age: 74
State: OH

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/13/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: I received the Johnson and Johnson vaccine for covid 19 on December 9, 2020 as a participant in the study program. I am a board crtified family physician. Beginning about 12 hours after the Moderna vaccine, I became fatigued, feverish (99.1) , ached in the thighs and calves, and had a 2-3 hour salty taste triggering thirst. The injection site became very tender but there was no inflammation nor rash. All symptoms resolved on awakening 9:00 am 1/8/21.

Other Meds: crestor,zetia, niacin, finasteride, vit d, zinc

Current Illness: none

ID: 0942878
Sex: F
Age: 47
State:

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: Allergic to Sulpher medications

Symptom List:

Symptoms: Metallic taste in mouth all times and tongue tingles all the time

Other Meds: Synthroid, Vitamin D

Current Illness: None

ID: 0942879
Sex: M
Age: 53
State: HI

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital: Y

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

Lab Data:

Allergies: PEANUTS, OXYCODONE, PCN, PRAZOSIN, AMIDE CLASS ANESTHETICS

Symptom List:

Symptoms: Received 2nd vaccination in series on 11 JAN 21. By next morning started to experience some muscle and joint symptoms. By afternoon of 12 JAN 21 experienced sudden onset loss of bladder control for first time in his life, followed a few hours later by blurry vision, vertigo, motion sickness, emesis and cold sweats that drenched his clothes. Taken to ER by paramedics, and admitted for further observation and evaluation for underlying neurologic vs. cardiogenic problems. Given positional treatments by PT for possible otoliths. Feels much improved on afternoon of 13 JAN 21, but symptoms not fully resolved. Will likely be discharged from hospital on 14 JAN 21 if problems continue to resolve.

Other Meds: LIPITOR, CYMBALTA, 81 MG ASA

Current Illness: N/A

ID: 0942880
Sex: F
Age: 32
State: NJ

Vax Date: 01/03/2020
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Throbbing glands on both sides of neck and sublingual, causing tightness in throat and difficulty swallowing beginning about 5 days after injection, continuing into present (10 days after injection)

Other Meds: Fluoxetine 50mg Clonazapam 0.5mg

Current Illness: None

ID: 0942881
Sex: F
Age: 26
State:

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Immediately after receiving the shot my left arm started to become numb and tingly, it felt like it was falling asleep. This went away after an hour. Then during the night at 1 a.m. I woke up and the same feeling of numbness was happening in both my left arm and leg. This then shifted to my right side, then just to my hands and feet. During this I was also experiencing the noted Covid vaccine side effects of fever, chills, headache, body ache, weakness, and nausea.

Other Meds: Mesalamine Days (birth control) VSL#3 Probiotic Vitamin B12 Vitamin D3 Face acne treatment (Zinc Pyrithione, Niacinamide, Azelaic Acid)

Current Illness:

ID: 0942882
Sex: F
Age: 56
State: NJ

Vax Date: 01/04/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: Pollen allergies

Symptom List:

Symptoms: Patient started to have redness and swelling at the injection site on day 8 after the injection. Getting worse today. Immediately after the injection, patient only experienced minimum discomfort at the injection site, including very mild pain and minimum swelling. Those symptoms resolved 3 days after the injection. No systemic adverse reactions.

Other Meds: Zyrtec, vit. c, vit. D, zinc, vit. E

Current Illness:

ID: 0942883
Sex: F
Age: 64
State: CA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: Pen Levaquin bee stings

Symptom List:

Symptoms: The day of vac 1/8/2021 at 5:00pm got a bloody nose about 6:00pm the chills went to bed about 9 pm with mild headache. No arm pain 1/9/2021 sat night at 1:30 am nose bleed 1/10/2021 3:00 pm another nose bleed All events held pressure..I can't tell you the last time I had a nose bleed!

Other Meds: metoprolol baby aspirin

Current Illness:

ID: 0942884
Sex: F
Age: 42
State: OR

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: compazine, contrast dye medium for ct scans

Symptom List:

Symptoms: About ten minutes after administration I began to feel prickly, burning on my arms which gradually got worse over the next 20 minutes and spread to my hands, sides, back and legs. Arms were very red. Informed clinic medical provider who took vitals. blood pressure was 186/116 o2 sat were normal. was given an im shot of benedryl and water, vitals were continued to be monitored and blood pressure came down to 145/84. Prickly burning sensation and redness continued. Went home and examined body and did have several hives on back and upper arm. slept due to benedryl, woke up to a very sore arm, achy joints but the prickly burning had mostly resolved. next day still feel tired and achy in joints but burning is gone.

Other Meds: levothyroxine, metformin, hydroxyzine, omeprazole, tylenol

Current Illness: none

ID: 0942885
Sex: F
Age: 35
State: CO

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: Sulfa antibiotic

Symptom List:

Symptoms: Very bad body aches and fatigue that lasted 48 hours

Other Meds: Omeprazole 20mg daily and synthesis 100mcg daily

Current Illness: None

ID: 0942886
Sex: M
Age: 84
State: PA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/13/2021
Hospital: Y

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

Lab Data:

Allergies: Atorvastatin Iodinated Diagnostic Agents Metrizamide Nsaids All statins Tolmetin

Symptom List:

Symptoms: Admission Note: ? Weakness - Generalized Patient reports feeling weak prior to dialysis, but demanded clinic to perform dialysis. Had full tx done and brought to ER. Reports still feels weak after dialysis. 84 year old male comes in today after completing dialysis for evaluation of generalized weakness x 5 days. He has also lost his voice. He tells me he received his COVID vaccine yesterday, but he is concerned he may have COVID. He denies any fevers, cough, sore throat, NVD, abd pain. Transfer Note: HOSPITAL COURSE: Patient is a 84 y.o. male who presented with shaking chills and was found to have Gram-negative rods in the blood. The source of infection was unclear. Initially it was thought that it could possibly be cholecystitis but imaging was negative for that. There was concern that it could be UTI but the patient is on dialysis and is an uric and therefore no urinalysis could be got. Early this morning when I saw the patient the patient did have significant pain and tenderness in the right knee and is not able to put weight on that. I.e. Consulted Dr. Today with per lumbar from Orthopedics who said that it would be in the best interest of the patient for him to be transferred to hospital where he could decide on aspiration and or washout of the right knee. Transfer center has been called and we are trying to finalize a transfer of the patient hospital at this point of time Please see problem list listed below. REASON FOR ADMISSION/ ADMISSION DIAGNOSES Sepsis cause unclear

Other Meds: Medication List As of 1/6/2021 11:25 AM amLODIPine Besylate 5 mg Oral Apixaban 5 mg Oral 2 times daily Aspirin 81 mg Oral Daily Cholecalciferol 10,000 Units Oral 2 times weekly cloNIDine HCl 0.1 mg/day Transdermal Weekly Clopidogrel B

Current Illness:

ID: 0942887
Sex: F
Age: 40
State: TX

Vax Date: 01/04/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: On day 9 post-vaccine, my right arm become swollen, warm, indurated. erythematous, pruritic, and tender to touch. Area becomes progressively worse. On day 10 post-vaccine, area on arm continues to spread but is less swollen and indurated while remaining to be warm, pruritic, and tender to touch. Erythema continues but isn't quite as angry. I become fatigued with a horrible migraine, feeling feverish but no fever, and had chills.

Other Meds: None

Current Illness: None

ID: 0942888
Sex: F
Age: 46
State: NC

Vax Date: 01/10/2021
Onset Date: 01/10/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Right after I received the vaccine, like 2 minutes latter, I started feeling dizzy, then I had a shocking sensation around my throat then I had some palpitation.I better about 20 minutes latter. I had prednisone at home, so I took 40mg and Benadryl and PepciI felt I had some sensation of throat tightness the day after that but it went away after few hours.

Other Meds: None

Current Illness: None

ID: 0942889
Sex: F
Age: 46
State: IL

Vax Date: 12/28/2020
Onset Date: 01/04/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Swollen and painful lymph nodes in jaw and neck. Myalgia in neck. Right side greater than left. Tingling around area of right ear and hearing changes on right side. Numbness in arms/fingers. Symptoms presented about 6 days after 1st vaccine , worsened. Persisted for about 5 days.

Other Meds: None

Current Illness: None

ID: 0942890
Sex: F
Age: 32
State: FL

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, bactrim, penicillin

Symptom List:

Symptoms: Pain behind right ear and into the jawline (24 hours after), numb tongue on right side (36 hours after), facial paralysis of the right side of face (48 hours after), bruise-like feeling on right side of face (1 week after). Diagnosed with Bell?s Palsy 48 hours after.

Other Meds: Motrin for pain after giving birth, prenatal vitamin

Current Illness: Pregnant - induced and delivered

ID: 0942891
Sex: F
Age: 47
State: TX

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Shortly after injection, pain at site; continued pain in arm today. Some fatigue yesterday and today. Major headache today, not all day just part of day.

Other Meds: None

Current Illness:

ID: 0942892
Sex: F
Age: 68
State: AL

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Lower extremity muscle cramping (not near the site of injection) approximately 18 hours post-vaccination.

Other Meds:

Current Illness:

ID: 0943606
Sex: F
Age: 52
State: VA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: Peaches

Symptom List:

Symptoms: -Tingling in roof of mouth without swelling then pt stated back of throat feeling numb & swollen

Other Meds: HCTZ Vitamin E, D ceterozin omeprazole zine Flonase

Current Illness: HTN - Acid Reflux - Environmental induced allergies

ID: 0943624
Sex: M
Age: 57
State:

Vax Date: 01/11/2021
Onset Date: 01/06/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Anaphylaxis tongue swelling and throat soreness Narrative: developed throat pains and tongue swelling 1/6/21 whereas mRNA vaccine Covid 19 Pfizer was given at Hospital. Advised not to taken 2nd dose until etiology of tongue swelling and throat pains identified. His 1/6/2021 covid 19 test (biofire- which include Covid 19 infection and all possible viral etiology was negative.

Other Meds:

Current Illness:

ID: 0943803
Sex: M
Age: 58
State: CA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: About an hour after the vaccine I went out for lunch and was eating some radishes and felt sensitivity on my tongue. It passed in about 5-minutes. I noticed the sensation because I was hypervigilant about any sensations I might be feeling after the vaccine.

Other Meds: omezeprole; terbinafine (generic Lamisil)

Current Illness: no

ID: 0943817
Sex: F
Age: 40
State: ME

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: PCN,-hives, angioedema, cantalope, trees, grass, cashews, Cas Caesin from milk

Symptom List:

Symptoms: Following day patient developed fever 103, chills, vomiting, 48 hours after vaccine patient developed diarrhea which lasted 2 days. She was covid tested 1/9/2021 which was negative.

Other Meds: Birth control, Advair, Albuterol

Current Illness: denies

ID: 0943842
Sex: M
Age: 58
State: IA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: coedine, bee stings

Symptom List:

Symptoms: Vacianted at 12;45pm, 4pm arm began to hurt, 12midnight skin started to feel like it was burning, took cold shower. 12/31/2020 - 6am-woke up large knot on arm at injection site, arm hurt, arm felt heavy, rash from elbow to fingers on both arms. Fever -102/7, took 50mg Benadryl, 20 mg Pepcid AC, Tylenol for fever, Albuterol breathing treatment. Went back to sleep. Awoke around 2pm- felt better, arm continues to be sore. No rash, no burning of skin, no itching. Discussed s/s to look for and advised if symptoms reoccur and get worse, call 911. He stated he is a nurse and knows what to do. I asked him did he sign up for V-Safe , encouraged him to sign up and record his information. He stated he would - RN

Other Meds: albuterol for asthma

Current Illness: no

ID: 0943903
Sex: F
Age: 42
State:

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: HYPERtension chest pain (mild), anxiety

Other Meds:

Current Illness:

ID: 0943910
Sex: F
Age: 76
State: TN

Vax Date: 01/02/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Had small, hard, painful knot at injection sight after shot that lasted 3 days and went away Itches, slightly tender to palpation, red 16.5 cm X 8.5 cm on R arm, anterior lateral aspect Treatment: Steroid injection - Cephalexin, Claritin, Famotidine, steroid cream - Triamcinolone, Salonpas liquid lidocaine

Other Meds: Cephalexin Cap 500 mg, Famotidine Tab 20 mg, Levothyroxine Sodium Tab 100 MCG, Meloxicam Tab 15 mg, Omeprazole Cap delayed rel 20 mg sig, Triamterene-HCTZ tab 37.5/25 mg, Xanax Tab 0.5 mg, Biotin Cap 5000 MCG, Vitamin B-12 Sublingual Tab Su

Current Illness: See attached

ID: 0944436
Sex: F
Age: 46
State: MN

Vax Date: 01/06/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: Latex gloves, Amoxillion

Symptom List:

Symptoms: chills, Fever, body aches, my coughing came back I think from covid Fine now

Other Meds: N/A

Current Illness: Covid

ID: 0944440
Sex: F
Age: 62
State: MN

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Had a Headache - missed a day of work Took Tylenol all Day.

Other Meds:

Current Illness:

ID: 0944446
Sex: F
Age: 31
State: KS

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies: pneumovax-23

Symptom List:

Symptoms: Patient started to have a local injection site reaction on 1/10/21 at around 9:10am. The injection site had some redness and swelling. By the afternoon on 1/10/21 the red and swelling increased and by 1/12/21 the redness was the size of a half dollar and swelling just beyond the redness. The area is warm to touch. Pt also had symptoms of nausea, fatigue, and muscle pain. Pt was instructed to take Zyrtec BID & pepcid. When I talked to the patient on 1/13/2021, the injection site remains the same and still feels nauseated.

Other Meds: Amlodipine, buspirone, ergocalciferol, fluconazole, Fluoxetine, hydrochlorothiazide, ivermectin, levothyroxine, metformin, wellbutrin XL

Current Illness: Na

ID: 0944466
Sex: F
Age: 55
State: MN

Vax Date: 01/06/2021
Onset Date: 01/10/2021
Rec V Date: 01/13/2021
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Lab Data:

Allergies:

Symptom List:

Symptoms: chills, bad headache

Other Meds:

Current Illness:

ID: 0944471
Sex: M
Age: 1
State: MO

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies: No

Symptom List:

Symptoms: Vomiting/fever - within 24 hours given zofran and tylenol satisfactory outcome

Other Meds: No

Current Illness: No

ID: 0944481
Sex: F
Age: 38
State: PA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies: No

Symptom List:

Symptoms: Patient presented to Facility MD Experiencing Flushing, HA, elevated BP, Faint with Rapid HRT Beat. She was given water, Juice and laid down. After 30-40 minutes sxs subsided. Spoke to pt said she was Feeling much Better. Spoke to nurse at Rehab center. Pt reported she was Feeling much better By 5pm on 1-12-21.

Other Meds:

Current Illness:

ID: 0944487
Sex: F
Age: 33
State: PA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies: cherry/penicillin/tetracycline

Symptom List:

Symptoms: had moderna covid vaccine yesterday at hospital 9 am states nurse was aware she had covid in december but talked to nurse and who reportedly talked ot cdc personnel who gave approval to give moderna vaccine saying if patient felt ok then ok to receive so was given following vaccine had arm pain and this lasted several hours last nite had trouble sleeping and woke up disoriented body hurts felt chills diarrhea and then on way to work vomited multiple times bilious now nausea no rash no fever but + chills and feels out of it right arm itchy red tender has headache confusion but denies sob advised will do Vaers and hold on second dose right now and work note Vaccine was given at Hospital on 1-12

Other Meds: buproprion/ocp/clonazepam/metformin/sertraline/sprionolactone/

Current Illness: covid 19 infection december 9-2020

ID: 0944492
Sex: M
Age: 27
State: AL

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: A few hours after my second dose on 1/08/2021, I had some adverse reactions that worried me, including arm numbness, tingling around my mouth and cheeks, a splitting headache/blurry vision, joint and muscle pain and dizziness. I called e-medicine and had a video call with a E-Medicine provider who told me to keep monitoring my symtoms and go to the ER if they got worse (fortunately they didn't); however there are some lingering effects. Currently I still am experiencing headaches (around my ears and temple area) with joint pain/body aches and occasional tingling/burning sensations in my fingers and feet.

Other Meds:

Current Illness:

ID: 0944498
Sex: F
Age: 64
State: NY

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies: PCN, Bactrim, Contrast DYE

Symptom List:

Symptoms: Patient reports generalized warmth throughout her body, w/a metallic taste and a fever of 102, 24 hours post vaccination. She also reports extreme fatigue. With the administration of (2) doses of Tylenol 500mg the symptoms were relieved. Patient sought no medical treatment. Patient advised to take Tylenol prior to second series of Moderna vaccine requirement.

Other Meds: Brilinta, Metoprolol, Lipitor, MVI

Current Illness: N/A

ID: 0944514
Sex: F
Age: 61
State:

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: Dizziness, Headache, Palpitations, HYPERtension, anxiety and stated SOB Narrative:

Other Meds:

Current Illness:

ID: 0944518
Sex: F
Age: 33
State: WV

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0944521
Sex: F
Age: 64
State: CA

Vax Date: 12/31/2020
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies: Effexor, Relafen, Robaxin, Duloxetine, Gabapentin, nortriptyline, pravastatin, Motrin

Symptom List:

Symptoms: Shingles, antiviral given, pain resolved but still has HA. Has followed up w/PCP.

Other Meds: Bacolen, aspirin, HCTZ, atenol, vit C, turmeric cranberry, Apple cider, potassium, mag, multivitamins, B complex

Current Illness: COVID 19 12/15/20

ID: 0944540
Sex: F
Age: 37
State: CA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies: Hydromorphone, Bee sting, CoNtrast, PeaNuts, VaNcomycin

Symptom List:

Symptoms: Patient calls 911 w/ anaphylactic reaction 45 MiNs s/p Moderna Covid-19 vaccine. x 4 0.3 mg Epi peNs given prior to ED arrival. Airway patent but difficulty speaky. Further ED treatments included IV MedicatioNs & breathy treatment.

Other Meds: Albuterol, BupropioN, Diphenhydramine, EPI Pen, Advair, ONdaNsetroN, Sertraline

Current Illness:

ID: 0944548
Sex: F
Age: 53
State: TX

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: left arm vaccine site. Red swollen, Hot. Feels like a ball inside

Other Meds: Vitamins

Current Illness:

ID: 0944553
Sex: F
Age: 22
State: OR

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: itchy throat, gave Benadryl 50mg - resolved. Then patient sxs returned + she went to ER (pharmacy staff not notified until after)

Other Meds:

Current Illness: N/A

ID: 0963165
Sex: M
Age: 94
State:

Vax Date: 01/07/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: 1/11 asymptomatic COVID Positive test Narrative:

Other Meds:

Current Illness:

ID: 1279606
Sex: F
Age: 30
State: ME

Vax Date: 12/30/2020
Onset Date: 01/06/2021
Rec V Date: 01/13/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: none allergies continued: Caesin from milk

Symptom List:

Symptoms: Patient reports she received the 1st covid 19 Moderna vaccine lot number 039K20A on 12/30/20 in her left arm in the vaccine clinic. patient reports on the day after her arm was sore. She reports she noted on 1/6/2021 lymph node swelling on the left side axillary and at clavicle. she reports she also had joint pain for. She reports on 1/7/2021 she had a fever of 101.8 with headaches . Patient reports on 1/8/21 she noted red swollen hot painful left arm on 1/8/2021 for a couple of days then resolved. Symptoms of fever lasted 24 hours. patient reports she was OOW 1/7/2021, and 1/08/2021 due to fever and had a negative covid test. patient reports her lymph nodes are less swollen and all other symptoms are resolving.

Other Meds: none

Current Illness: denies

ID: 1326285
Sex: M
Age: 56
State:

Vax Date: 12/22/2020
Onset Date:
Rec V Date: 01/13/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: sore throat, fever 101 on 12/29,

Other Meds:

Current Illness:

ID: 1326286
Sex: F
Age: 61
State:

Vax Date: 11/08/2020
Onset Date: 11/24/2020
Rec V Date: 01/13/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: ear pain, pressure, jaw numbness, diagnosis of bells palsy

Other Meds:

Current Illness:

ID: 1326287
Sex: M
Age: 57
State:

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/13/2021
Hospital:

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

Allergies:

Symptom List:

Symptoms: None Stated.

Other Meds:

Current Illness:

ID: 1349811
Sex: M
Age: 58
State:

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Myalgia Fatigue Narrative:

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm