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: 1247668
Sex: F
Age: 56
State: MI

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital:

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Lab Data:

Allergies: multiple allergies

Symptom List:

Symptoms: Client felt Flushed after injection of vaccine; B/P 152/88, 99% O2 sat on RA, HR 104 at 9:40am; B/P 132/88, O2 sat 99% on RA, HR 84 at 10:00am. Rested on couch, used the restroom, then left after feeling better. Stated she would have friend check on her that day.

Other Meds: multiple meds

Current Illness: unknown

ID: 1247669
Sex: M
Age: 36
State: MI

Vax Date: 01/24/2021
Onset Date: 04/12/2021
Rec V Date: 04/23/2021
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Allergies: none

Symptom List:

Symptoms: Received 2nd dose of Pfizer COVID vaccine on 1/24/2021. On 4/12/2021 the patient developed body aches, cough, headache, and nasal congestion. Positive for COVID.

Other Meds: multivitamin

Current Illness: none

ID: 1247670
Sex: F
Age: 74
State: VA

Vax Date: 03/04/2021
Onset Date: 03/05/2021
Rec V Date: 04/23/2021
Hospital:

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Lab Data:

Allergies: Tetracycline

Symptom List:

Symptoms: Subjective low grade fever, chills and feeling like she had the "flu" the day after the vaccine. Also noted body aches and that her skin on right thigh felt more "sensitive" the day after the vaccine. A few days later herpes zoster rash developed on right thigh where the skin sensitivity was located.

Other Meds: Aspirin, Atorvastatin, Diovan, Calcium, HCTZ

Current Illness: none

ID: 1247671
Sex: M
Age: 39
State: CA

Vax Date: 01/21/2021
Onset Date: 02/19/2021
Rec V Date: 04/23/2021
Hospital:

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Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Member got first COVID Vaccine and report to ER with "Kidney Pain". Member received second COVID Vaccine and was diagnosis with MONO. Pt was informed that COVID Vaccine can reactive Mono. Pt had mono in the past.

Other Meds: Unknown

Current Illness: None

ID: 1247672
Sex: F
Age: 19
State:

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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Symptom List:

Symptoms: Syncope, flushing, sweating, dizziness. Water given. BPs 90/38 (pulse 78), 120/64 (pulse 82).

Other Meds:

Current Illness:

ID: 1247675
Sex: M
Age: 63
State: GA

Vax Date: 04/20/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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Lab Data:

Allergies: none

Symptom List:

Symptoms: Constant "tingling" from below elbow down to thumb and hand. I have not reported this to my doctor. Planning to "wait and see" if it clears soon.

Other Meds: Acebutolol 400 mg = Aspirin (2) 81 mg = Cyclobenzaprine 10 mg = Atorvastatin 10 mg = Emgality 120 mg injection = Finasteride 5 mg = Gabapentin 300 mg = butalbital 50 mg-acetaminophen 300 mg-caffeine 40 mg-codeine 30 mg

Current Illness: none

ID: 1247676
Sex: M
Age: 28
State: MI

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/23/2021
Hospital:

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Lab Data:

Allergies: unknown

Symptom List:

Symptoms: Patient felt dizzy after shot. Client states long history of similar reactions after injections. Patient was moved via wheelchair to a cot and laid down briefly and then felt better. stayed for 30 min and then left with wife. BP was 120/78, temp was 98.6, pulse was 60 and O2 sat was 97% on RA. Patient states no allergies and taking levothyroxin.

Other Meds: unknown

Current Illness: unknown

ID: 1247677
Sex: F
Age: 74
State: FL

Vax Date: 04/08/2021
Onset Date: 04/19/2021
Rec V Date: 04/23/2021
Hospital:

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Symptom List:

Symptoms: PATIENT DEVELOPED SHINGLES WITH SX. APPEARING ON 04/19/2021 AND DIAGNOSED BY DR ON 04/22/2021

Other Meds:

Current Illness:

ID: 1247678
Sex: F
Age: 69
State: CA

Vax Date: 03/15/2021
Onset Date: 03/18/2021
Rec V Date: 04/23/2021
Hospital:

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Lab Data:

Allergies: dilation eye drops

Symptom List:

Symptoms: I had severe bells palsy in 2014 & since then I have had deep crease above the length of right eye brow & forehead & eye brow were frozen. on 3rd day of 2nd vaccine (3/18) , I had 3 short wrinkles lines above inside of eyebrow & 1 long ling wrinkle from eyebrow to forehead which lasted till next day. Following week, I noticed the solid line/wrinkle since 2014 was half it size. As week went on I could slightly raise eyebrow , fine line appeared on forehead that matched the left side and I could slightly frown. Eyebrow'/forehead are still evolving with slight swelling (like a welt w/out redness) from arch of eyebrow to end of eyebrow toward hairine. I have already reported previous unusual symptoms.

Other Meds: lisenopril, multi vitamin, vit b complex, vit c, coenzyme q10, calcium magnesium supplement

Current Illness: none

ID: 1247679
Sex: F
Age: 32
State: OH

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Patient experienced extreme anxiety, believed she couldn't breathe. Had a high heart rate and pulse. Went with emt to be checked.

Other Meds: N/A

Current Illness: N/A

ID: 1247680
Sex: M
Age: 50
State: TX

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/23/2021
Hospital:

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Allergies: None

Symptom List:

Symptoms: Moderna COVID-19 Vaccine. I got a rash all over my body (legs, back, eye brows, arms, pelvic area. Very itchy, redness and some swelling. After 11 days it is mostly receding, but still itches some.

Other Meds: Amlodipine Besylate 10mg; Atorvastatin 20mg

Current Illness: None

ID: 1247681
Sex: M
Age: 44
State: MN

Vax Date: 01/13/2021
Onset Date: 03/05/2021
Rec V Date: 04/23/2021
Hospital:

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Symptoms: Received Pfizer vaccines on 12/21/20 and 1/13/21 Tested positive for COVID by PCR on 3/5/21 Onset of symptoms 3/2/21; unknown symptoms

Other Meds:

Current Illness:

ID: 1247682
Sex: M
Age: 89
State:

Vax Date: 02/19/2021
Onset Date: 03/20/2021
Rec V Date: 04/23/2021
Hospital: Y

Vax Type:
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Symptom List:

Symptoms: Patient had ED visit / hospitalization within 6 weeks of receiving COVID vaccine

Other Meds:

Current Illness:

ID: 1247683
Sex: F
Age: 62
State: CA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/23/2021
Hospital:

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Allergies: None known

Symptom List:

Symptoms: Described earlier on form but,... Severe left knee and hip pain since waking on morning after first pizer vaccine.

Other Meds: NONE

Current Illness: Charcot Marie Tooth Disease a hereditary Neuro Muscular disease.

ID: 1247684
Sex: M
Age: 47
State: PA

Vax Date: 01/08/2021
Onset Date: 03/19/2021
Rec V Date: 04/23/2021
Hospital:

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Allergies: none

Symptom List:

Symptoms: I myself a healthy physician with no prior medical illnesses received Pfizer COVID19 vaccine first on 12/18/20 and second dose on 1/8/21 both doses at Hospital , ( they have the information of the lots)- Then on March 19th I started to develop an acute ascending sensory symptoms first in feet and then arms ; also involved torso . Sensory symptoms consisted of pins and needles and paresthesias . They persists on even today but less intense . Also had temperature dysregulation of the feet when shoes worn. There seem to have also some changes in my sweat gland activity. Saw my PCP and neurologist with working diagnosis of acute sensory neuropathy of unclear etiology. Though this could be idiopathic but like to check out if any association with COVID19 vaccine as this only association i could think about in healthy patient ie myself with no medial issues or any acute illness recently nor any systemic disorders to account for symptoms ; wanted to report so that you are aware and I personally wanted to see if this is being recognized in other vaccine recipients and might help me to arrive at a diagnosis.

Other Meds: none

Current Illness: none

ID: 1247685
Sex: F
Age: 43
State: PA

Vax Date: 03/19/2021
Onset Date: 03/23/2021
Rec V Date: 04/23/2021
Hospital:

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Allergies: none

Symptom List:

Symptoms: History of chronic migraine, completely stable at the time of vaccination (no migraine x 3 months). Severe migraine started a few days after the first dose of the Moderna vaccine. This migraine was different in severity and quality than my typical migraines. It was VERY severe (average 8/10) and didn't subside for six weeks (daily, severe, intractable migraine), at which time I was two weeks post second dose. At that time, it started to subside and respond to treatment and about three weeks after the second dose it went away completely. I was seen my neurologist's office and the emergency room multiple times for migraine infusions and developed Cushing's syndrome as a result of the multiple high doses of steroids I required to treat the migraine. My primary care doctor attributed this 6-week string of very severe migraines to the vaccine.

Other Meds: duloxetine, verapamil, buspirone

Current Illness: none

ID: 1247686
Sex: M
Age: 32
State: MN

Vax Date: 04/18/2021
Onset Date: 04/19/2021
Rec V Date: 04/23/2021
Hospital:

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Allergies: None

Symptom List:

Symptoms: 15 hours after vaccine - headache, mild fever, severe body aches 39 hours after vaccine - period of extreme exhaustion 42 hours after vaccine - all prior symptoms subsided 80+ hours after vaccine - body covered in itchy rashes and hives (current symptom)

Other Meds: None

Current Illness: None

Date Died: 04/23/2021

ID: 1247687
Sex: M
Age: 52
State: VT

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital:

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Lab Data:

Allergies: ether, varenicline

Symptom List:

Symptoms: Patient presented early this morning with increasing shortness of breath, chest tightness and associated chills. Treated with laboratory studies, xray and CT for PE studies, EKG x2, BIPAP, decline in status, intubated, CPR , expired.

Other Meds: None

Current Illness:

ID: 1247688
Sex: M
Age: 19
State: CA

Vax Date: 04/09/2021
Onset Date: 04/13/2021
Rec V Date: 04/23/2021
Hospital:

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Symptom List:

Symptoms: moderna vaccine and 6 days later positive for covid

Other Meds:

Current Illness:

ID: 1247689
Sex: M
Age: 45
State:

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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Allergies:

Symptom List:

Symptoms: Patient notes knot in throat and feeling like her throat is being coated. Given Benadryl and monitored for 45 minutes. She felt better and left in stable conditions.

Other Meds:

Current Illness:

ID: 1247690
Sex: M
Age: 40
State: NJ

Vax Date: 04/08/2021
Onset Date: 04/15/2021
Rec V Date: 04/23/2021
Hospital:

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Lab Data:

Allergies: Childhood penicillin allergy

Symptom List:

Symptoms: Pain around injection site on the left arm one week after covid vaccine, with shingles developing at the same time on the left side of my neck chest and neck.

Other Meds: Lexapro 20mg

Current Illness: None

ID: 1247691
Sex: M
Age: 77
State: AL

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 04/23/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: Propiomazine, Crestor, Topamax, Oxycodone

Symptom List:

Symptoms: Started experiencing a bad headache behind the right eye on Wed 1/27 at night, and on Feb. 7th could not get out of bed, his left shoulder blade became so painful went to the ED Feb. 8. Sent home the next day. The pain was so bad he thought he was having a heart attack. Took NTG did not help. Returned to ED on the 10th - stayed in in hospital for 8 days. Specialists were seen and nothing could help with the pain. Consulted with cancer doctors, and neurologists, doing tests to diagnosis. Dr. gave a nerve block and a week later the pain started to get better a week later on a holiday. Pain still comes and goes. Pain Started getting worse today 4/23/21. Must lie down on right side to get any relief. Has lost 50 pounds is very weak and getting weaker every day. and it is very painful to walk 40 steps to the garage. The TENS unit is not helping with the pain. Getting a spinal test.

Other Meds: Metformin 500mg, Triamcinolone 0.1% cream, Hydrocodone/Acetaminophen 10mg/325mg, Praluent, Eliquis, EC Aspirin 81mg, Coreg 25mg, Nitroglycerine 0.4mg spray, Protonix 40mg, Selenium 200mcg, Amiodarone 200mg.

Current Illness: Treated for Pneumonia on Dec. 30th- Jan. 6th

ID: 1247692
Sex: F
Age: 43
State: MA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 04/23/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Date of office visit: 4/22/2021 2:15 PM Intake done by: LPN Reason for today's visit: New Patient 30 minutes HR: 80, regular rate & rhythm BP: 136/78 (prehypertension) weight: 195 lbs 88.6 kg temperature: 98.5 F height: 5 ft 6 inch (measured) body mass index: 31.5 Obesity Classification: Class I, Simple obesity Progress Note xxxxx 4/22/2021 Patient is a 43-year-old female referred to me for management of hemorrhage into her pituitary gland. February 9, 2021 11 AM she received Moderna vaccine. by 7 PM she had a severe headache, leg numbness, severe arthralgias in her knees, global paresthesias, pressure behind her eyes, she describes her head is very heavy and pressurized was very painful. Symptoms lasted for three days and gradually remitted. To a lesser degree the headache persisted longer but resolved March 10, 2021 received Moderna vaccine. On same day she developed headache, chest pain, back pain, leg numbness. She states that when she walked it exacerbated chest pain and headache and she had to walk very gently on her toes. She tried Tylenol, ibuprofen without effect. The symptoms persisted. She started taking two aspirin a day. March 14 she worked third shift as usual (despite symptoms) March 15, the symptoms were bad enough that she felt she had to go to the emergency room. March 15, 2021 18:56 CT Head or Brain C-: 7 mm rounded hyperdensity within the pituitary gland which may represent a hyperdense pituitary mass lesion. Associated hemorrhage is not excluded. March 15, 2021 22:34 MRI Brain C-/C+: There is 0.6 x 0.6 x 0.7 cm round structure in the anterior pituitary gland with high T1 signal, dark T2 signal, susceptibility artifact and no enhancement. This likely represents a hemorrhage within the microadenoma. Advise neurosurgical consult and follow-up MRI in 6 months. ________________ 3/17/2021 I was consulted (while she was in hospital, chart review only. Patient not seen at that time) I wrote... PITUITARY ACTH Patient had ACTH stimulation test yesterday. Assuming she has received no steroid Rx during this admission prior to the ACTH stimulation test (as I have been told), then these results confirm that her adrenal gland has the ability to respond to ACTH and thus there is no reason to believe the underlying pituitary abnormality had resulted in chronic ACTH deficiency from the pituitary lesion that resulted in hemorrhage. 3/16/2021 4:32 PM .Cort 30 min Stim Cortisol 30 Minutes Post ACTH 19.3 mcg/dL Cortisol 60 Min 27.6 mcg/dL As the pituitary hemorrhage was an acute event, it is possible the pituitary currently does not have the ability to make adequate amounts of ACTH, despite the normal ACTH stim test, but the situation is too acute to cause the adrenal to atrophy (as a result of chronic ACTH deficiency) and she still could have secondary adrenal insufficiency. When there is a chronic ACTH deficiency of sufficient duration, the adrenal gland will eventually atrophy and the patient will then develop primary adrenal insufficiency as well and then the ACTH stim test will become abnormal. As we do not know if her pituitary can make ACTH appropriately, I think it would be prudent to treat the patient with PREDNISONE 2.5 mg qAM for now even thought we do not know for certain whether her pituitary can make ACTH. After discharge, she should be evaluated by endocrine to assess for ACTH deficiency. She should be advised to seek medical attention if she develops symptoms of adrenal insufficiency like nausea, emesis, abd pain, orthostatic symptoms. PITUITARY TSH 3/15/2021 11:47 PM T3 Total 83 (normal: 60-181) nGm/dL T4, Total 7.3 (normal: 4.5-13.3) mcg/dL TSH, 3rd gen 2.160 (normal: 0.358-3.740) mclU/ml I think, based on above admission TFTs, she should also be treated with LEVOTHYROXINE 100 mcg qAM even though we do not know for certain if she has central hypothyroidism. This too should be reassessed in the future. PITUITARY LH/FSH If she acutely or recently developed secondary amenorrhea and FSH is not c/w menopause, then that would suggest the lesion or hemorrhage has causes hypogonadotrophic hypogonadism. This situation would increase the probability she has central adrenal insufficiency and central hypothyroidism. If menses remains normal henceforth, the it is more likely her ability to make TSH and ACTH are normal. _______________ Patient was discharged on levothyroxine 100 ?g in the morning and prednisone 2.5 mg daily. She's also on iron pills. Past medical history: Iron deficiency anemia. Treatment was an IUD, after which she's gained a lot of weight. Medicines: IUD, Levothyroxine 100 mcg QAM, prednisone 2.5 mg QAM, ferrous sulfate 325 mg daily Allergies: none No cigarette use, alcohol abuse or drug use Family social history: patient has three children. High school educated. Healthcare worker. REVIEW OF SYSTEMS: overall health is good. She feels well. No headache. No nausea. No nocturia Physical exam: Extraocular muscles intact. VF full Lungs are clear. Cardiac exam regular. Impression: hemorrhage into pituitary gland Temporarily, symptoms correlate with covid vaccination in a women who previously was (reportedly) dx with covid infection. Maybe the pituitary hemorrhage was the result of the coronavirus vaccination or the aspirin she was taking. At this point she's feeling well. It's been about one month since the event. I'd like to wait another month and then proceed with testing of a pituitary gland to try to figure out if she really needs to remain on levothyroxine and prednisone and reimage the pituitary. On the day of the testing she will take neither medicine in the morning. Will then measure LH, FSH, estradiol, TSH free T4 and cortisol and renal panel. Patient will then receive ACTH 0.25 mg IM and have cortisol measured at 30 minutes and 60 minutes. I will follow-up with her by phone. She scheduled to see Dr. April 26. I would like to do another MRI but I would prefer to wait another month as she is clinically doing well and I want to allow the pituitary more time to "heal"/stabilize. No follow-up is scheduled with me, if Dr. does not order an MRI and I will after I received next blood test. M.D. 4/22/2021 3:40 PM Electronically signed by: M.D. on 4/23/2021 2:47 PM

Other Meds: IUD

Current Illness: COVID in November 2020 (per patient)

ID: 1247693
Sex: F
Age: 42
State: NV

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
Hospital:

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Lab Data:

Allergies: Penicillins

Symptom List:

Symptoms: Patient presented tot he clinic for 2nd dose on 4/22/2021,patient stated she received the 1st dose at our location. We have been in administering Moderna at this location. Second dose administered to patient after verbalizing her first dose was received at least 28 days prior. Patient was administered Moderna on 4/22/2021. I was notified by Data Entry the morning of 4/23/2021 that 1st dose was not documented in EMR. The information received indicated that first dose of Pfizer was given at HD on 1/22/2021. Supervisor and ordering physician notified, incident report completed and VAERS report submitted

Other Meds: Paxil 10mg, oral

Current Illness: None

ID: 1247694
Sex: F
Age: 32
State: SC

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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Lab Data:

Allergies: unknown

Symptom List:

Symptoms: In the computer system that we use for patients, if the syringe next to the patient's name is a green color, that means the patient is cleared for vaccination. If it is red, I carefully review the questionnaire with the patient. Patient told me before the vaccination that she doesn't do well with vaccines. I vaccinated her. She said the vaccine hurt her and the first vaccine did not hurt her. She needed to sit on her chair where she was vaccinated for a little while after. She turned yellow, was snoring and fell off the chair. I turned her to her side and called for help. We fanned her and she was given water. She put her head down on the chair while sitting on the floor and she asked for a trash can and she threw up. She also told me that she felt disoriented after waking up. She has a previous history of this reaction to vaccines(but with no vomiting)..also I don't think she experienced these reactions to vaccines the past few years. She never vomited after a vaccine. She also said she had no problem with the first Pfizer vaccine. We brought a nurse to assist her. I checked on her after 15 minutes and she was cold and sweaty. I seated her for an additional 15 minutes. I asked her if she wanted me to call 911. I also advised her that if she still did not feel well after she left the pharmacy, that she can go to the Emergency Room. Her husband was with her.

Other Meds: unknown

Current Illness: unknown

ID: 1247695
Sex: F
Age: 68
State: NM

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 04/23/2021
Hospital:

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Lab Data:

Allergies: none

Symptom List:

Symptoms: I received he first vaccine and had no symptoms but the following day I had a scaley not itchy rash on face "like a fish". the rash stayed for the 3 weeks. then i got the second maderna vaccine and the same day told to go into the hospital evaluation area but released same day. and i was okay the day of but the followin day i started feeling dizzy and could not walk and needed help from family. I felt tired and worn out for three days. the rash appeared again the day after on my face and on my arms; it was dark red his time and started to peel off a week after. i still have a rash but it is lighter in appearance.

Other Meds: contact dialysis clinic

Current Illness: none

ID: 1247696
Sex: F
Age: 29
State: TX

Vax Date: 04/09/2021
Onset Date: 04/16/2021
Rec V Date: 04/23/2021
Hospital:

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Vax Route:
Vax Site:

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Experienced "COVID arm" rash 7 days after the vaccine was administered. Rash progressed in size, redness and itchiness over the course of the first two days. The inner part of the rash faded by day 3, leaving a red ring. Faded completely by day 5. Sunlight seemed to irritate the rash. One week later a similar red, itchy rash developed on the right side of the face; unknown if related, but no prior history of skin conditions.

Other Meds: Hormonal birth control pill, Claritin D, Flonase

Current Illness: N/A

ID: 1247697
Sex: M
Age: 63
State: CA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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Allergies: None

Symptom List:

Symptoms: Rush ( red and swollen skin rush ) around the stomach area, under groin area, and down the inner parts of the legs all the way to the knees; warmth and very itchy.

Other Meds: TAMSULOSIN HCL 0.4 MG

Current Illness: None

ID: 1247698
Sex: F
Age: 45
State: MI

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/23/2021
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Allergies: dust mites , mold

Symptom List:

Symptoms: left upper arm at site of vaccination with 3-4 cm circular indurated erythematous swelling with no significant tenderness, fluctuance or surrounding edema.

Other Meds: centrum multivitamin

Current Illness: none

ID: 1247699
Sex: M
Age: 24
State: FL

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/23/2021
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Allergies: Ibuprofen, mold

Symptom List:

Symptoms: Client received vaccine and started to feel lightheaded, dizzy and nauseous. Client exited car for fresh air and symptoms worsened. Client lowered himself to the ground to prevent falling. Fire Rescue arrived to evaluate patient. Client diaphoretic, pale, but A+Ox3. Vitals all wnl, symptoms began to resolve as client rested and hydrated. Client was able to ambulate independently back to his vehicle where he continued to recover. Client declined transport for further evaluation and stated he felt better. Per Fire Rescue no further evaluation needed at scene. Client released at 10:45am.

Other Meds: none

Current Illness: none

ID: 1247700
Sex: F
Age: 45
State: CO

Vax Date: 04/07/2021
Onset Date: 04/17/2021
Rec V Date: 04/23/2021
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Symptoms: Shortness of breath for several days, feeling fatigue and week, pain in right elbow Diagnosed Apr. 17 in ER setting: acute segmental and subsegmental pulmonary embolism without acute cor pulmonale Acute thrombosis of superficial vena basilica right arm

Other Meds: Synthroid 100, Estarylla 0.25-35mg-mcg, started November 2020

Current Illness:

ID: 1247701
Sex: M
Age: 32
State: MA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/23/2021
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Allergies: n/a

Symptom List:

Symptoms: Enlarged lymph nodes in the left neck area. Duration: 30 days

Other Meds: n/a

Current Illness: n/a

ID: 1247702
Sex: F
Age: 41
State: OR

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/23/2021
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Allergies: none

Symptom List:

Symptoms: The patient left the vaccine clinic after the 15 minute observation period. While driving home, about 25 minutes post vaccination, the patient developed what she described as "tongue and throat felt funny and stuffy.' She drove to her PCP clinic and was evaluated by a physician. Vitals were normal/baseline (BP=96/68, HR=79, SpO2=100%, RR=14). She was treated with diphenhydramine 25mg by mouth, and Solu-Medrol 40mg intramuscular. Symptoms resolved following treatment and observation. The provider recommended that patient could proceed with 2nd dose.

Other Meds: Isibloom

Current Illness:

ID: 1247703
Sex: F
Age: 53
State: NJ

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/23/2021
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Allergies: No known drug allergies

Symptom List:

Symptoms: Myalgia, nausea, vomiting, chills, weakness/fatigue, dizziness and difficulty ambulating secondary to fatigue Tylenol for myalgia with no significant improvement and hydration Patient had a telehealth visit 4/23/21 and was advised to go to the ED for further assessment for possible dehydration

Other Meds: Azathioprine, Protonix, Plaquenil, Prednisone, Methotrexate, Pregabalin, Alendronate, Duloxetine, Vasculera, Folic acid

Current Illness: None

ID: 1247704
Sex: F
Age: 41
State: CA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/23/2021
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Symptoms: 1330: Rec'd first Covid vaccine 1342: Pt c/o itchy, red chest, rash on back; Benadryl 25 mg IM rt deltoid given 1351: BP 121/82 HR 72 SpO2 100% 1357: Benadryl 25 mg IM rt deltoid repeated 1418: Pt left facilty in her own car, self-driven

Other Meds:

Current Illness:

ID: 1247705
Sex: M
Age: 27
State: MA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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Allergies: amoxicillin (GI upset)

Symptom List:

Symptoms: Pt presented to clinic Moderna vaccine administered at around 11:55 AM; pt. stated no prior history of issues receiving vaccines. At around 12:03 PM pt. felt severely nauseous/lightheaded and attempted to stand and tell staff but immediately fainted, falling to the ground and hitting the front right side of his face on the ground. Pt. was unconscious for about 30-45 seconds. Pt. regained consciousness and able to verbalize name, DOB, location, etc. Vitals at the time taken include: BP 136/73 mmHg, O2 sat 94%, & HR 51 bpm. Called 911 and EMS arrived within about 5 mins. EMS arrived by 12:11 PM, vitals taken O2 Sat 100% & HR 68 bpm. Pt. refused transport to ED and insisted on driving himself home. Left on his own by 12:15 PM after being escorted by EMS to his car.

Other Meds: unknown

Current Illness: none

ID: 1247706
Sex: F
Age: 17
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/23/2021
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Allergies: N/A

Symptom List:

Symptoms: 17 y/o, believed to be and self described as 18 y/o, given Moderna Vaccine

Other Meds: N/A

Current Illness: N/A

ID: 1247707
Sex: F
Age: 60
State: CA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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Allergies: Co-trimxazole, sulfa, nuts, crab

Symptom List:

Symptoms: patient started to feel itching and swelling of tongue. 25mg Benedryl give and monitored for additional 30 min

Other Meds:

Current Illness:

ID: 1247708
Sex: F
Age: 0
State: FL

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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Allergies: NONE

Symptom List:

Symptoms: AS SOON AS THE SHOT WAS ADMINISTERED PT RIGHT ARM BEGAN TO SWELL IMMEDIATLEY, FELT A TINGLING BURNING SENSATION AND SLIGHT PAIN. LASTED UNTIL PT LEFT THE STORE AFTER 15 MINUTES OF OBSERVATION.

Other Meds: NONE

Current Illness: NONE

ID: 1247709
Sex: F
Age: 17
State:

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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Symptom List:

Symptoms: Dizziness, itching, sore arm, vitals WNL. Apple juice, water, crackers.

Other Meds:

Current Illness:

ID: 1247710
Sex: F
Age: 30
State: CA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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Symptoms: Patient received second dose covid vaccination today at 0930, patient complained of dizziness and hot flushes at 0957, Code Assist was called. VS-T-36.8 P-92 BP-98/76 O2 SAT-98%. at 0957. Blood Sugar-76 mg/dl At 1002 VS- P-72 BP 108/70 O2 sat 100%. Awake, alert and oriented. Patient went home with Mom at 1008.

Other Meds:

Current Illness:

ID: 1247711
Sex: F
Age: 22
State: KY

Vax Date: 04/15/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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Allergies: NKDA

Symptom List:

Symptoms: Patient has Cellulitis to left arm, at site of reported COVID vaccine, vaccine was administered at the Health Department, I do not have record to review at this time to confirm lot number of vaccine. Patient was prescribed Keflex, unsure of outcome as visit occurred today and patient has yet to start treatment.

Other Meds: Zoloft Omeprazole

Current Illness: Unknown

ID: 1247712
Sex: F
Age: 23
State: MI

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/23/2021
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Allergies: unknown

Symptom List:

Symptoms: Patient c/o tingling in her throat about 10min after receiving her 2nd dose of Pfizer vaccine. Patient states that she feels very warm and then 10 min later feels cold. Lungs were clear. O2 was 99% on RA. Pulse was 74. Patient given 2.5 tsp of Children's Benadryl. Observed for 25 min and then she left with boyfriend to go to Hospital for further evaluation.

Other Meds: unknown

Current Illness: unknown

ID: 1247713
Sex: F
Age: 63
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/23/2021
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Symptoms: Patient received first dose of Moderna COVID-19 vaccine on 4/7/2021. Vaccine given at 0935. In the observation lot, patient noted clear colorless fluid accumulating under bandage. Fluid did not appear serous or bloody. The fluid appeared to be uninjected vaccine. We agreed to re-vaccinate patient in right deltoid. Dose given 0942. Patient observed for additional 15 min and no reactions noted.

Other Meds:

Current Illness:

ID: 1247715
Sex: F
Age: 60
State: NY

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 04/23/2021
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Allergies: Very mild reaction to some shellfish; has never required medical care. Mild seasonal and dust allergies.

Symptom List:

Symptoms: Severe aches in joints (hips, knees) for two to three days. Nausea any time I moved injection arm even slightly for several days -- more like what you would expect from a break than a shot. Redness and slight swelling around injection site. Dizziness. Complete loss of appetite for two and a half days. Nausea for two days. Slight vomiting, mostly bile. Extreme fatigue for two to three days; lesser fatigue for another two. Liquid, nearly clear diarrhea morning of 3/29. Had the sense that I was running a fever but thermometer was in storage, so no proof.

Other Meds: Lisinopril 40 mg x 1 a day; Creon DR 24,000 units x 6 a day. B-Complex, Biotin, Omega-3 Fish oil, Multivitamin (for ages over 50), Vitamin D, Vitamin A: all every day. At the request of the practitioner who administered the vaccine, I did

Current Illness: None.

ID: 1247716
Sex: M
Age: 74
State: NC

Vax Date: 03/23/2021
Onset Date: 03/29/2021
Rec V Date: 04/23/2021
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Allergies: Penicillin Pollen

Symptom List:

Symptoms: Events: Fever (100.2); chills, short of breath; fatigue, brain fog, no appetite, nausea, vomit (bile), body aches and pains. Treatment: Sleep, Tylenol, Vitamin C, and Zinc. Time course: 14 days

Other Meds: Low dose Aspirin Atorvastatin (Lipitor) Losartan (Cozaar) Men's 50+ Multivitamin Synthroid Vitamin C Zoloft Vitamin D3

Current Illness: None

ID: 1247717
Sex: F
Age: 37
State: NC

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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Allergies: None.

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Symptoms: I have never had the flu, but I would suspect flu-like symptoms at 12:30am on 4/22/21. Chills (I could not get warm), then hot, aching, fever of 101 when I awoke at 6:30am. I took 3 Tylenol, but symptoms persisted the entire day on 4/22/21. I took another dose of Tylenol around 4pm. I was very tired as well, and felt weak. Then on 4/23, I awoke, feeling much better but when I got out of bed I almost fell over. I was dizzy. The dizziness has continued all day (it is now 3:09pm). I will take a dramamine when my workday is over. I have not had to throw up, nor have I felt nauseated to that point. But it is like a vertigo, when I am sitting still, I feel like I am tilting over. (but I have never had vertigo, so I am only guessing) I plan to call my doctor if this dizziness persists, but I am hoping the dramamine will help.

Other Meds: No medications taken at the time of the vaccine, or within 12 hours leading up. I am not currently on any prescribed medications.

Current Illness: I had hives on my face the week before, and took 2 10mg prednisone at that time, but it had resolved by the time I had my vaccine.

ID: 1247718
Sex: F
Age: 51
State: FL

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/23/2021
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Symptoms: localized reaction to injection site, erythematous circular area

Other Meds:

Current Illness:

ID: 1247719
Sex: F
Age: 26
State: WI

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

Symptom List:

Symptoms: The patient contacted public health, via interpreter, approximately 30 min after vaccination to report a rash started on her face and has now spread to her trunk and arms. Rash was reported as red and very itchy. The client returned to the clinic approximately 3 hours after vaccination and received a dose of diphenhydramine and written instructions on continued use. We then consulted with Dr., volunteer advisor to Public Health COVID Vaccine clinics. Dr spoke with the client and then submitted this situation to Dr., with the following information: "a 26 yo woman without any prior hx/o of allergy or atopy developed a pruitic rash 30 minutes after

Other Meds: Vitamin B12 injection about 2 wks prior

Current Illness: None

ID: 1247720
Sex: F
Age: 44
State: IL

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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Lab Data:

Allergies: latex, inion and humus

Symptom List:

Symptoms: Patient c/o itching ears, scratchy throat, some swelling under her eyes. No SOB, No respiratory distress. The patient was transported to the ER for observation.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm