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: 1251947
Sex: F
Age: 48
State: OH

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Fever, chills, nausea, pain in arm, increased resting heart rate, heart palpatations, disoriented

Other Meds: Metoprolol, Buspar, Clonazepam

Current Illness: None

ID: 1251950
Sex: F
Age: 22
State: NY

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Post injection epileptic episode. Approx 10 minutes after receiving first dose of Modern vaccine: Tonic Clonic, Grand-mal seizure.

Other Meds: Keppra Sertraline

Current Illness: none

ID: 1251951
Sex: F
Age: 54
State: IL

Vax Date: 04/01/2021
Onset Date: 04/14/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Shingles (rash on the right side of abdomen, pain in the abdomen and in the back) valacyclovir

Other Meds: none

Current Illness: none

ID: 1251952
Sex: F
Age: 34
State: MD

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, indoor and outdoor allergies (i.e. cats, dogs, dust, grasses)

Symptom List:

Symptoms: 11:30pm: fever, chills, teeth chattering, achy. Lasted through the AM. Around 1pm the next afternoon nosebleed began.

Other Meds: Zyrtec (daily) - taken night before vaccine

Current Illness: None

ID: 1251953
Sex: F
Age: 58
State: IN

Vax Date: 04/12/2021
Onset Date: 04/14/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: All pain killers

Symptom List:

Symptoms: Still have a big lump at the injection site, still a little red and a little warm to touch

Other Meds: Atorvastat 10mg, Gabapentin 300mg, Xanax 1mg Amlodipine 5mg, Lamotrigine 100mg, Venlafaxine 150 mg, vitamins D3 and C

Current Illness: None

ID: 1251954
Sex: M
Age: 32
State: MD

Vax Date: 04/20/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: 96 hours after shot- nausea, vomiting, diarrhea, fever (highest 102.0F)

Other Meds: Prilosec OTC

Current Illness: N/A

ID: 1251955
Sex: F
Age: 50
State: CA

Vax Date: 03/05/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: SHELLFISH, GLUTEN

Symptom List:

Symptoms: EAR ACHES, TINNITUS, SORE THROAT (TINNITUS BEGAN AFTER SECOND SHOT); EAR ACHE BEGAN 20 DAYS AFTER SECOND SHOT; FATIGUE (NEED NAP IN AFTERNOON UNLIKE PRE-VACCINE);;BEGAN AFTER FIRST SHOT AND CONTINUES 20 DAYS POST SECOND SHOT

Other Meds:

Current Illness:

ID: 1251956
Sex: F
Age: 64
State: MN

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: fragrances, almost anything in the air fluoride

Symptom List:

Symptoms: Dizziness and weakness immediately upon standing up from the chair. I didn't think much of it at the time because I often get light-headed with needles. And the room was stuffy, alcohol scent. After the 15 minutes, I drove home. During the drive home I started to think I wanted to be in bed. I got home, was hungry, ate lunch, and went to bed. I got up around 5, still feeling weak but not tired. I went to bed again at my normal bed time but did not sleep well. In the morning I still felt weak, but was fine by early afternoon. Then the next day in the afternoon I got a pinpoint headache in the back right of my head. Also started feeling weak again. Today the headache is still there but not localized. Still feel weak.

Other Meds: Calcium, magnesium, zinc, VD3 V D3 fish oil protein powder estradiol

Current Illness: none

ID: 1251957
Sex: F
Age: 35
State: FL

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

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

Lab Data:

Allergies: UNKNOWN

Symptom List:

Symptoms: PT REPORTED SHE FELT LIKE SHE LOST CONSCIOUSNESS FOR A MOMENT AND LOST CONTROL OF HER BOWELS. PATIENT VISIBLY SOILED HERSELF IMMEDIATELY FOLLOWING VACCINE ADMINISTRATION.

Other Meds: UNKNOWN, BUT PT REPORTED TAKING MEDICATION FOR HIGH BLOOD PRESSURE AND DIABETES.

Current Illness: UNKNOWN

ID: 1251958
Sex: M
Age: 39
State:

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

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

Lab Data:

Allergies: No known allergies.

Symptom List:

Symptoms: Patient reports feeling nauseous and lightheaded. Patient appears sweaty, pale, and is vomiting. Assisted patient in to wheelchair and wheeled him to recovery area. Assisted patient to gurney. Vital signs at 1507: BP 122/88, P 74, O2 98%. No known allergies. Provided patient with granola bar and water. After 25 minutes, patient reports feeling back to baseline.

Other Meds:

Current Illness:

ID: 1251959
Sex: F
Age: 64
State: NJ

Vax Date: 04/01/2021
Onset Date: 04/18/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Complete loss of appetite

Other Meds: Atenolol Losartan Hydrochloride Atorvastatin

Current Illness: No e

ID: 1251960
Sex: F
Age: 63
State: CO

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Immediate pain upon injection. Burning sensation down left arm. Within a few minutes dizziness/disorientation. 3/19/21 at 1 AM wake to joint pain. Any injury, i.e. broken bone, sprain, etc. ever had was now inflamed & painful. Awake for 2 days due to pain. Overall muscle weakness. Attempted to "carry on" except the worst symptom appeared, BRAIN FOG. Could not remember words that started with s, sc, sh, etc. Would lose my car in parking lots. Couldn't finish sentences. Saw primary care physician on 3/26/21. Ordered MRI w/o contrast on 4/14with no acute process or findings to report. Saw masseuse on 3/26/21 & she wanted to know, "Why are you joints hot?" Symptoms began to subside around 4/19/21.

Other Meds: HRT Compound Biest 50/50

Current Illness: None

ID: 1251961
Sex: F
Age: 38
State: FL

Vax Date: 04/10/2021
Onset Date: 04/19/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: Hydrocodone and Shrimp flavor

Symptom List:

Symptoms: I became ill one week after my vaccination. I started out with a scratchy throat and coughing (April19th to April 15th) . By the next day, I was week and couldn't get out of bed. It felt as if I had the flu. I lost my appetite as well for a brief period.

Other Meds: Losartan, Tamoxifen, Acyclovir

Current Illness: None.

ID: 1251962
Sex: M
Age: 30
State: CA

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

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

Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: Patient is a 30 year old male A & O x4 with chief complaint of dizziness. 10 minutes after receiving the vaccine patient stated that he felt shaky and dizzy. Patient placed in a seated position, vital signs obtained and EMS called. Vital signs stable. Negative medical history, allergies or medications. Patient stated that the symptoms resolved and he felt much better. Negative chest pain, SOB, weakness, dizziness, numbness, tingling, with no signs of stroke or allergic reaction. Patient denied any other complaint. Fire Dept Medic Engine and ambulance arrived on scene and assumed patient care. Patient signed AMA and went home via private vehicle.

Other Meds: None

Current Illness: None

ID: 1251963
Sex: M
Age: 40
State: TX

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Moderna COVID-19 Vaccine EUA was received mid afternoon on Day 0. I woke the next day around 8AM (as personally typical) with significant dizziness. After an additional hour of rest and following a few anti-vertigo maneuver attempts, I was able to rise. More than three weeks later, I still experience moderate dizziness when waking and often if tilting my head back more than 45 degrees in the normal course of the day. No medical treatment has bee prescribed.

Other Meds: Vitamin C, Vitamin D, Calcium, Zinc, Turmeric, JuicePlus (Veggie, Fruit, Berry), Folic Acid

Current Illness: none

ID: 1251964
Sex: F
Age: 18
State: MA

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Symptoms began with a tingling sensation in the back corner of the mouth, which spread to the rest of the cheek. Pain similar to the tension of muscles was felt upon touching the left jaw and neck area. Soon it was noticed that left cheek/jaw area was swollen.

Other Meds: Vyvanse, Sprintec, Zyrtec

Current Illness: None

ID: 1251965
Sex: M
Age: 31
State: WA

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

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

Lab Data:

Allergies: UNK

Symptom List:

Symptoms: PATIENT RECIEVED FIRST DOSE PFIZER AFTER RECEIVING MODERNA. HEALTH RECORD INDICATES PATIENT RECEIVED FIRST AND SECOND DOSES OF MODERNA (2/15 & 3/12) HOWEVER PATIENT STATES THAT SHE ONLY RECIEVED ONE DOSE. SHE MARKED "NO" WHEN ASKED IF SHE EVER RECEIVED A COVID19 VACCINE. SHE ALSO RESPONDED NO WHEN VERBALLY ASKED PRIOR TO VACCINE BEING ADMINSTERED. I CALLED AND EMAILED THE PATIENT AND RECIEVED A TEXT RESPONSE.

Other Meds: UNK

Current Illness: UNK

ID: 1251966
Sex: F
Age: 54
State: IL

Vax Date: 04/13/2021
Onset Date: 04/20/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Fatigue for about 24 hours. One week later awoke at 3am with dizziness. Almost a vertigo type feeling except there was no nausea.

Other Meds: Sertraline 50 mg

Current Illness: none

ID: 1251967
Sex: M
Age: 61
State: NM

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

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

Lab Data:

Allergies: NA

Symptom List:

Symptoms: Certified Technician administered the vaccine to patient in the administration cubicle in front of the pharmacy. As he was administering the vaccine, some of the vaccine leaked out/sprayed out from the point at which the needle is attached to the syringe. Most of the vaccine was administered. The syringe used was a 1ml VanishPoint syringe, it comes with the needle already attached to it, the needle is non-removable but retractable. We pulled the rest of the syringes from that box and hazwasted them as a precaution/prevention for this happening again. Per CDC, since more than half of the dose was administered, we did not repeat the dose.

Other Meds: NA

Current Illness: NA

ID: 1251968
Sex: F
Age: 72
State: NY

Vax Date: 04/15/2021
Onset Date: 04/17/2021
Rec V Date: 04/24/2021
Hospital: Y

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

Lab Data:

Allergies: Bees

Symptom List:

Symptoms: Pt previously healthy other than controlled HTN received her 2nd moderna vaccine on 4/15- hospitalized on 4/18 (sxs starting 4/17) with a large L thalamic cryptogenic CVA/ sepsis/acute bacteremia/encephalopathy/lactic acidosis. carotid dopplers neg for acute pathology, echo normal and neg bubble study. Pt now with short term memory impairement, flat affect, and amnesia surrounding events of admission and hospitalization. She is a Lifelong non smoker. No past hx of atrial fibrillation- no atrial fibrillation noted on tele. PT/OT/speech path seen. ldl 108- started on lipitor, started on aspirin. aic 6.0, Gram negative bacteremia/e coli in cx- unclear GI source. Possibly diverticular. MRCP showed nothing acute. Home with a few more days of augmentin per ID dc home with home health services 4/22

Other Meds: Nortriptyline, HCTZ, Lisinopril

Current Illness: None

ID: 1251969
Sex: M
Age: 36
State: FL

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

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

Lab Data:

Allergies: no known allergies

Symptom List:

Symptoms: The patient came in for his shot. Once he received his shot, he sat down on the chair for observation. All of a sudden he got up and started sitting down on the floor asking to lay down. He felt dizzy, faint. He kept saying faint. He also was feeling hot. The patient drank water and was feeling better. He wasn't always answering right away. He laid there for less than 15 minutes and then was able to get up and sit on the chair for another 5-10 minutes before he left the store. He called his wife to let her know. The store manager was with the patient the whole time.

Other Meds: Dexmethylphenidate 10 mg

Current Illness: He had one episode of diarrhea in the morning.

ID: 1251970
Sex: F
Age: 39
State: UT

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

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

Lab Data:

Allergies: Latex, Kiwi

Symptom List:

Symptoms: Sharp tight pain in the middle of my chest with right jaw burning radiating from chin to right ear. First the nerve pain started about 1-2 mins after injection and then immediately after the nerve burning in my face was the chest tightness and sharp pain. Like it hurt to take a deep breath as well. The burning pain in my right side of my face passed after 20-30 mins and then the chest tightness and sharp pain passed a little longer about an hour.

Other Meds: Effexor, Metformin, Levothyroxine, Liothyronine

Current Illness: None

ID: 1251971
Sex: F
Age: 39
State: OK

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: Penicillin and Sulfa Drugs

Symptom List:

Symptoms: At 10 hours after the vaccine, I started to chatter my teeth uncontrollably, stuttering of speech, involuntary movements of my limbs and passing out. This lasted for 4 hours. I was transferred to the hospital via ambulance. Vitals were all stable and reactions continued. Once treated with Ativan I was released and remained in bed for 4 days from pure exhaustion.

Other Meds: Livothroxyin

Current Illness: None

ID: 1251972
Sex: M
Age: 44
State: GA

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Dizziness and flashes

Other Meds: None

Current Illness: None

ID: 1251973
Sex: M
Age: 53
State: WA

Vax Date: 04/14/2021
Onset Date: 04/20/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: fatigue, body ache, fever (101 F); pain/sensitivity in left arm pit, left shoulder

Other Meds: Lisinipril, Hydrochlorothiazide, Zyrtec

Current Illness: None

ID: 1251975
Sex: F
Age: 41
State:

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: Tegretol

Symptom List:

Symptoms: J&J COVID-19 Vaccine EUA. I experienced severe heartburn for 12 days following the Janssen vaccination. Heartburn was painful and continuous but exaggerated by certain foods. Normally I never have heartburn.

Other Meds: multivitamin, calcium supplement, probiotic

Current Illness: None

ID: 1251976
Sex: M
Age: 16
State: MI

Vax Date: 03/27/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List:

Symptoms: Family came into the COVID Vaccination clinic at because its been 4 weeks since his first dose - which he got Moderna. Spoke with Dr. and he approved getting the second dose as per CDC Administration and Errors COVID19 guidance report

Other Meds: unknown

Current Illness: unknown

ID: 1251977
Sex: M
Age: 23
State: PA

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

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: about ten minutes after injection was given Patient started to complain of a sore and scratchy throat. Brought back to med obvs at 11:36 and was alert and stable at that point in time. Initial VS were: HR: 48, BP: 117/69, SPO2: 99. Patient remained in med obvs with improvement in throat sensation, was able to tolerate drinking water, denied pain or swelling in throat just complained of it feeling dry. At 12:30 patient was stable and felt well enough to go home.

Other Meds: N/A

Current Illness: N/A

ID: 1251978
Sex: F
Age: 36
State: VA

Vax Date: 03/25/2021
Onset Date: 04/02/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Augmentin

Symptom List:

Symptoms: Eight days after receiving the Moderna COVID-19 vaccine, I developed a rash at the injection site, approximately 3 inches by 2 inches in size, accompanied by soreness. I took Benadryl, which reduced the rash. It went away on its own about three days later.

Other Meds: Benadryl; Calcium Magnesium Zinc Vitamin D supplement

Current Illness:

ID: 1251979
Sex: F
Age: 39
State:

Vax Date: 03/01/2021
Onset Date: 03/07/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: All over pain, neasous, felt on fire, migraine, colitis

Other Meds:

Current Illness:

ID: 1251980
Sex: M
Age: 23
State: FL

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

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: Felt nauseous within 5 minutes after receiving Moderna vaccine. Patient started feeling better after drinking some cold water and was stable approximately 10 minutes after. Patient was under pharmacist's observation for 30 minutes.

Other Meds: NONE REPORTED

Current Illness: NONE REPORTED

ID: 1251981
Sex: F
Age: 16
State: CA

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Underage for vaccination

Other Meds: None

Current Illness: None

ID: 1251982
Sex: M
Age: 39
State: GA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: chocolate and Keflex

Symptom List:

Symptoms: 4/10/21 - I took 4 low dose Bayer aspirin about 11:45 AM on 4/10/21. I received the Janseen COVID19 vaccine about 12:45 PM on 4/10/21. I cleared the 15 minute monitor period at 1:05 PM. About 8:00 PM on 4/10/21 I felt slight chills and left wrist was achy. About 9:00 PM on 4/10/21 chills persisted and I felt fatigued. About 9:45 PM on 4/10/21 I felt more body aches and took 4 low dose Bayer aspirin at 81 mg. About 10:15 PM I had a temp of 100.4 F and body chills. 4/11/21 - About 2:35 AM I had a body temp of 101.6 F with body chills and night sweats. About 11:25 AM body temp decreased to 99.9 F and had a headache. I took another dose of 4 low dose Bayer aspirin. I slept a total of about 3 hours from 10 PM on 4/10 to 10 AM on 4/11. About 9:00 PM body temp was 99.6 F. 4/12/21 - About 8:30 AM body temp was 97.9 and slept more than 5 hours with light to moderate night sweats. Experienced injection site pain from 4/10/21 to 4/13/21.

Other Meds: Bayer low dose aspirin 81 mg (4 tablets each dose time) 11:45 AM and 9:45 PM on 4/10/21 and 8:00 AM on 4/11/21

Current Illness: none

ID: 1251983
Sex: F
Age: 61
State: MI

Vax Date: 04/16/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
Hospital:

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

Allergies: no known allergies

Symptom List:

Symptoms: Giant hive like lesion mid arm 10x10 , warm with induration and also some erythema extending dorsally and distally occurring 8 days after administration. Initially no reaction noted by patient. The lesion began 2-3 cm distal to expected area of immunization on the 14th ( a standard deltoid IM immunization). Patient awoke with the lesion which worsened somewhat through the day and presented to the urgent care here after contacting the pharmacy and her PCP

Other Meds: Clonazepam,cyclobenzaprine,gabapentin,hydrochlorothiazide,Irbesartan,metoprolol tartrate,oxycodone/acetaminophen,keppra,pramipexole,symbicort inhaler

Current Illness: none

ID: 1251984
Sex: F
Age: 27
State:

Vax Date: 04/16/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
Hospital:

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Lab Data:

Allergies: latex fruit reaction

Symptom List:

Symptoms: approximately a week after vaccine, small raised area on arm at injection site. very slightly red color, feels like a hard lump/knot in muscle. tender to touch but not painful. mildly itchy (enough to notice, not unbearable or overwhelming)

Other Meds: sertraline 200mg/day

Current Illness:

ID: 1251986
Sex: M
Age: 24
State: CT

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
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Symptom List:

Symptoms: Pt report feeling clammy and "vision going like about to faint about 2 to 3 minutes after the shot. Pharmacist went over to check and found that patient is sweating. Patient also complained about nausea, hot and thirsty. Pharmacist did not find any rash or swelling on the face. Patient drank some water and did some slow, deep breathing. He reported feeling better after about 10 to 15 minutes. Pharmacy staffs called 911 when pharmacist first checking on the patient. EMR arrived in about 10 to 15 minutes and got blood pressure 125/76 heart rate 60 to 64. Patient said that he feels okay and EMR that he does not need to go to hospital. Patient agreed to check with MD and let pharmacy follow up next day.

Other Meds:

Current Illness:

ID: 1251988
Sex: F
Age: 67
State: AZ

Vax Date: 04/01/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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Lab Data:

Allergies: Strawberries Pollen OxyCodone Doxycycline Codiene

Symptom List:

Symptoms: Red, raised, hard, and tender lump on arm just below injection site. Not warm to touch.

Other Meds: Prolia Actemra Atorvastatin Temazepam Sertraline Metoprolol Pantoprazole Albuterol - rescue inhaler Vitamin D3 Nature Made - Multi For Her

Current Illness:

ID: 1251989
Sex: M
Age: 63
State: IN

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

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Lab Data:

Allergies:

Symptom List:

Symptoms: Chills, temp, fatigue

Other Meds:

Current Illness:

ID: 1251990
Sex: F
Age: 45
State: FL

Vax Date: 04/16/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
Hospital:

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Allergies: None

Symptom List:

Symptoms: Palpable, 2 inch diameter knot, warm to touch, appear on same arm as injection site 6 days after first dose of vaccine. knot is approximately 3.5 inches below injection site. No other side effects from vaccination until now.

Other Meds: Tylenol

Current Illness: Positive Covid Result on 03/27/2021 via Lumiradx SARS-COV-2 AG TEST - Mild symptoms only (low grade fever, headache and fatigue) Negative Covid Result on follow up 04/05/2021

ID: 1251991
Sex: M
Age: 37
State: WA

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

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Lab Data:

Allergies: NO

Symptom List:

Symptoms: PATIENT RECIEVED FIRST DOSE P AFTER RECEIVING M. HEALTH RECORD INDICATES PATIENT RECEIVED FIRST AND SECOND DOSES OF COVID (2/15 & 3/12) HOWEVER PATIENT WIFE STATES THAT HE ONLY RECIEVED ONE DOSE. HE MARKED "NO" WHEN ASKED IF HE EVER RECEIVED A COVID19 VACCINE. HE ALSO RESPONDED NO WHEN VERBALLY ASKED PRIOR TO VACCINE BEING ADMINSTERED. I CALLED AND EMAILED THE PATIENTS WIFE SENT A TEXT RESPONSE.

Other Meds: UNK

Current Illness: UNK

ID: 1251992
Sex: M
Age: 40
State: CA

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

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Lab Data:

Allergies:

Symptom List:

Symptoms: Pins and needles sensation through out my body, mainly in my feet

Other Meds:

Current Illness:

ID: 1251993
Sex: F
Age: 58
State: NY

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

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Lab Data:

Allergies: Ultracet , codeine, HTCZ, mucinex, amoxicillin, ibuprofen

Symptom List:

Symptoms: Redness, itching, swelling, feels feverish and hot.

Other Meds: Tylenol

Current Illness: None

ID: 1251994
Sex: F
Age: 28
State: NC

Vax Date: 04/12/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
Hospital:

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Lab Data:

Allergies: none

Symptom List:

Symptoms: Growth of mass on L trunk, tender. About 3x5 cm.

Other Meds: none

Current Illness: none

ID: 1251995
Sex: F
Age: 47
State: OH

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

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Lab Data:

Allergies: penicillin, vacomycin

Symptom List:

Symptoms: Patient complained of dizziness and lightheadedness about 10 minutes after receiving vaccine, had visible tremors. Requested a cool cloth, was feeling hot. No complaints of problems breathing or swelling. No 'racing heart.' No EpiPen given. EMS arrived and took her to local ER. Patient was conscious and oriented entire time.

Other Meds: unknown

Current Illness: remission for myeloid sarcoma

ID: 1251996
Sex: F
Age: 26
State:

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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Symptoms: Patient received the vaccine and felt fine. Had indicated no hx of fainting or dizziness, but felt nervous. Patient thought it wasn't as bad afterwards and indicated they felt fine. Patient had a seat in front of the pharmacy, started to feel dizzy but didn't tell anyone. Put her head between her knees, that didn't help and she figured she'd splash some water on her face, went to the bathroom and felt like she maybe needed to throw up, knelt over the toilet and next thing she knew she woke up on the floor.

Other Meds:

Current Illness:

ID: 1251997
Sex: F
Age: 57
State: CA

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

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Lab Data:

Allergies: contrast media, dupixent, erythromycin, gentamycin, iopamidol, trazadone, Xolair, alcohol, doxycycline, almond, amoxicillin, cantaloupe, clarithromycin, diltiazem, Macrobid, nickel, Omnicef, Moderna vaccine, Oxycodone, Rocephin, silicone, walnut, watermelon, cipro, Levaquin, penicillin, lopressor

Symptom List:

Symptoms: Pt had difficulty breathing, wheezing, shortness of breath, worsening voice hoarseness decrease in O2 saturation from 99% to 94%. Pt given 2 IM Epi injections, 25 mg oral Benadryl before being transferred into EMS care. They administered an additional 25mg IM Benadryl, placed pt on oxygen and transferred her to the E.D.

Other Meds: Tylenol, albuterol, Imuran, benralizumab, calcium carbonate, Zyrtec, Clobetasol, flexeril, voltaren gel, Benadryl, epi, Pepcid, breo-ellipta, guaifenesin, atarax, ketamine powder, Mobic, multivitamin, naloxone, Prilosec, lyrica, famotidine,

Current Illness: Cdiff., left suprascapular variant radiofrequency ablation 3/25, reaction to covid vaccine post first moderna vaccine (neck flushing, throat tightness lasting 3 days with treatment with prednisone, Benadryl and "regular antihistamines"), autonomic function testing,

ID: 1251998
Sex: F
Age: 71
State: NY

Vax Date: 03/28/2021
Onset Date: 04/19/2021
Rec V Date: 04/24/2021
Hospital: Y

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Lab Data:

Allergies: sulfa, tree nuts, buckwheat, pcn, Levaquin, clindamycin

Symptom List:

Symptoms: Pt recived her 2nd pfizer covid 19 vaccine on march 28th. hospitalized 3 weeks later with chest pain and possible new breast lesion and non specific lung nodules and elevated d dimer. -cardiac cause ruled out - seen by cardiology -Pt with tender pea sized nodule to 9 o clock position of left breast which reproduces her pain. ordered breast u/s of the area asap as out pt CT scan chest showing Non specific Multiple bilateral lung micro nodules, none measuring larger than 4 mm.

Other Meds: asa, vit d, lisinopril, metformin, omeprazole

Current Illness: none

ID: 1251999
Sex: M
Age: 32
State: FL

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

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Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient developed a headache & then had a seizure. Called 911, patient came out of seizure while paramedics were with him and was taken to the hospical

Other Meds: Dilantin

Current Illness: Epilepsy

ID: 1252000
Sex: F
Age: 62
State: CA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/24/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: Pollen, mold, dust, tannens, shell fish

Symptom List:

Symptoms: My tongue began to swell around 4pm. I took a Benadryl. The swelling did not resume until 8pm. I took a second Benadryl around 8:30 pm. By 9pm the swelling began to impede my breathing. Sought medical attention at hospital at 9:30pm where there was no ED. A security guard called 911 and paramedics transported me to a second Hospital ED arrived approximately 10-10:15pm. ED triage staff came to talk to me I sat upright on the gurney, vomited and my airways closed. I managed to say "I can't breathe!" and remember nothing until 36-48 hours later during sleep/wake cycle in ICU. I had to be intubated nasally upon admission. **See more on Continuation page** I had to be intubated nasally upon admission. Doctors said my airway was almost completely blocked with only a sharpie pen sized passage to insert the tube. I am still recovering from my IUC stay. Regaining endurance, strength, stamina as well as vocal range and strength.

Other Meds: See information on continuation page Prescription Medications Metoporolol 12.5 mg daily Trazadone 50-100 mg daily Hydorochlorothizaide 12.5 daily *ncreased to 25mg daily after this hospitalization Lisinopril 40 mg daily **discontinued** ?

Current Illness: Hypertension, Polymorphic Ventricular Tachycardia

ID: 1252001
Sex: F
Age: 47
State: CA

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

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Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: Patient is a 47 year old female with chief complaint of heart palpitations. Patient stated that she felt heart palpitations approximately 10 minutes after receiving the vaccine. Patient placed in a seated position and vital signs obtained. Patient denied any other complaint. Negative chest pain, SOB, weakness, dizziness and no signs of stroke or allergic reaction. Medic Engine 52 and AMR 452 already on scene were notified and assumed patient care. Patient left AMA with her husband via private vehicle.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm