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: 1263667
Sex: F
Age: 68
State: AZ

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: Sulfa, Neomycin, Atarax, parabens, Leeks, adhesive on bandages

Symptom List: Dysphagia, Epiglottitis

Symptoms: 1. These symptoms occurred after my 2nd COVID vaccine: A bad headache several hours after the 2nd vaccine. Headaches in places I don't get a headache, such as the top of my head (I can feel the exact spot), forehead, both temples, behind my eyes, back of my head. Sometimes the headaches last 5 minutes or less (top of my head), other times it could last several hours if located at the back of my head or at temples. This is still occurring since my vaccination on 3/17/21. I take an Advil liquid gel for the more intense headaches, which does help. 2. Tinnitus since the 2nd vaccine dose. It is still occurring all day and night, despite drastic cutback on caffeine (as of 4/2) and vitamins/supplements (4/20).

Other Meds: Cevimeline, Hydroxychloroquine, Levothyroxine, Vit. D, B, C

Current Illness: Recovering from Covid-19 infection in January.

ID: 1263668
Sex: M
Age: 57
State: TN

Vax Date: 04/12/2021
Onset Date: 04/26/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Achiness, chills, fatigue

Other Meds: Diphenhydramine, OTC NSAIDS

Current Illness:

ID: 1263669
Sex: F
Age: 64
State: MA

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/27/2021
Hospital:

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Allergies: hydrocodone makes me nauseous, allergic to bees

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

Symptoms: vaccine at 4:30 pm wednesday. next day at 10:00 am, bad headache, ached all over, overwhelming tiredness. did not want to eat or watch tv or read. I either slept, or lay there with my eyes open or shut. slept all night. next day appetite back, less tired but still so fatigued. third day all better.

Other Meds: centum silver, caltrate, acidophilous, magnesium malate

Current Illness: 2 weeks before this second dose, had a bad cold.

ID: 1263670
Sex: M
Age: 35
State: IN

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

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Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Started feeling extremely fatigued and breathless just 10 min after the shot, it lasted just one minute and felt better after that 1 min. Later in the day felt chills and very light feverish and fatigue.

Other Meds:

Current Illness:

ID: 1263671
Sex: F
Age: 24
State: CA

Vax Date: 04/21/2021
Onset Date: 04/23/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: None

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

Symptoms: Full body hives, Benadryl, hives persist

Other Meds: None

Current Illness: None

ID: 1263672
Sex: F
Age: 53
State: CO

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies:

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

Symptoms: Shingles

Other Meds: Acyclovir Antibiotics Novocain

Current Illness:

ID: 1263673
Sex: F
Age: 30
State: MA

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

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Lab Data:

Allergies: No known allergies

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient reported symptoms of tachycardia and dizziness around 10 minutes after receiving the dose. She also reported blurry vision. An ambulance was called to the scene and EMS took her blood pressure, pulse, and blood sugar. All came back within normal limits. Patient was given water and EMS offered to take her to the hospital. Patient refused to be taken to the hospital. She was advised to stay for at least another 15 minutes. When she left the pharmacy she said she was feeling better. I called her at 2:30 pm to check on her and she stated she was feeling fine and "back to normal". I advised her to call the pharmacy if she has any questions and to seek medical help if symptoms come back.

Other Meds: no known medications

Current Illness: n/a

ID: 1263674
Sex: M
Age: 74
State: OH

Vax Date: 03/03/2021
Onset Date: 03/13/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: Dilation Seizure medication - unsure which one

Symptom List: Pharyngeal swelling

Symptoms: 1 week after receiving 1st vaccine patient developed rash on back of neck under hairline that radiated down his back through to upper thigh area. Rash was itchy. Wife applied lantiseptic cream QOD in AM after shower and applied calmoseptime QOD in AM after shower. Wife started applying this cream 1 week after the rash appeared. This rash is continuous through today. Wife states rash "goes away" in one place and reappear in another place.

Other Meds: Vimpat 100mg 1/2 in AM 1 in PM, Losartan 100 mg 1 in AM, Furosimide 40 mg 1 in AM, Aspirin 81 mg daily, Sertraline 25 mg in AM, Potassium 10 meq 1 daily, Spironolactone 25 mg 1 daily, Amlodipine 10 mg 1/2 daily; Diazepam 2 mg PRN, Tylenol

Current Illness: None

ID: 1263675
Sex: F
Age: 70
State: WI

Vax Date: 02/27/2021
Onset Date: 04/20/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: None in file

Other Meds:

Current Illness:

ID: 1263676
Sex: F
Age: 52
State: NY

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

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Lab Data:

Allergies: adhesives

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Redness and Hives from hand to elbow of right arm of the injection site / feeling hot on right side of body / infection on back from a cyst that was removed 2yrs prior / severe itchiness at arm and back

Other Meds: vitamin C / iron / multi vitamin / B-12 / D-3 / Prevcaid / Caltrate

Current Illness: None

ID: 1263677
Sex: M
Age: 57
State: AZ

Vax Date: 03/30/2021
Onset Date: 04/07/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: sulfa

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: a psoriatic plaque emerged on right shin, about 2.5 cm diameter, 4.7.2021, and another emerged left shin around 4.14.2021, never had psoriatic plaques before. Although I am reporting as a patient, I am also a physician

Other Meds: None

Current Illness:

ID: 1263678
Sex: F
Age: 55
State: SC

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

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Lab Data:

Allergies: NKA

Symptom List: Rash, Urticaria

Symptoms: rash at injection site- getting smaller but now itching- has not taken Benadryl yet Pt will start taking Benadryl now and will , ER if s/s worsen or do not improve

Other Meds: Tylenol taken day 1 and rash better now - itching more today has noT taken any Benadryl yet.

Current Illness: none

ID: 1263679
Sex: F
Age: 35
State: MN

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: NA

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

Symptoms: Fever, lethargy, chills, muscle aches, sore arm lasted 24 hours after receiving the 2nd shot. Developed "Covid Arm" once those resolved. Itchy, red, lump at injection site.

Other Meds: Levothyroxine, Carvedilol, Nifedipine, Sertraline, Buspirone, Hydroxyzine, Zyrtec

Current Illness:

ID: 1263680
Sex: F
Age: 55
State: WI

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 04/27/2021
Hospital:

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Allergies: Unknown

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

Symptoms: Employee woke up with triggered trigeminal nerualgia (previously diagnosis), and double vision, causing vertigo and nausea. Her vision was better if she closed one eye. She was vomited throughout the day on 4/24/21, 4/25/21 - with the nausea, double vision and vertigo getting better on 4/26/21 and completely resolved on 4/27/21. On 4/27/21 employee reports aching, sore arm and fatigue. States she feels like she did when she had COVID 19 which she reports having in January 2021. Messaged her provider to see if she should get dose 2 of the COVID 19 vaccine.

Other Meds: Unknown

Current Illness: Unknown

ID: 1263681
Sex: F
Age: 58
State: MN

Vax Date: 03/27/2021
Onset Date: 03/29/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: Season environmental allergies(ragweed, dust, pet dander)

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: itchy neck - 6 hours later (continued until present- now is red and chapped) uncontrollable nosebleeds 40 hours later and 7 days later (2 ER visits) ENT Specialist followup - no known cause for these nosebleeds! elevated aPTT level - will see Hematologist anxiety (can't sleep at night) Never had this in my life! CT scan Sinuses

Other Meds: simvastatin, calcium, 81mg aspirin, vitamin d, vitamin c, Plexus natural supplements( slim drink, multivitamin, biocleanse, probio 5 probiotic)

Current Illness: none

ID: 1263682
Sex: F
Age: 53
State: IL

Vax Date: 10/05/2020
Onset Date: 10/05/2020
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: Penicillin

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

Symptoms: Right arm/shoulder shooting pain with reaching/extension, lasting 15-20 seconds at a time. This happened initially when needle was removed, and then began happening with the movements described above 2 days later. She first saw her primary care physician in January 2021 and has been attending physical therapy since then with minimal improvement. States she completely limited her use of the right arm due to the pain, causing decreased range of motion in the shoulder ("frozen shoulder"). She now has been seen in clinic and was referred to an orthopedic physician.

Other Meds: none

Current Illness: none

ID: 1263683
Sex: M
Age: 29
State: NY

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

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Allergies: None

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

Symptoms: Provider attempted to administer the covid vaccine in the LD. Once the needle was inserted, as soon as the provider applied pressure to the plunger, the needle malfunctioned and sprayed solution on the patients arm while the needle was still inserted. Under 0.1ml of solution was actually injected into the patient. The needle was removed and the needle was put in a kidney tray. The provider called and told his supervisor. The supervisor talked to a doctor. The doctor said it was okay to administer a full dose into the RD. The provider administered a full dose to the patients RD.

Other Meds: None

Current Illness: None

ID: 1263684
Sex: F
Age: 60
State: FL

Vax Date: 04/06/2021
Onset Date: 04/08/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: nkda

Symptom List: Ear pain, Hypoaesthesia

Symptoms: weak, loss of Appetite called 911 transported to Hospital 4/21-patient still having issues with eating , patient was dehydrated . went to hospital , got out now

Other Meds:

Current Illness:

ID: 1263685
Sex: M
Age: 72
State: FL

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

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Lab Data:

Allergies: Unknown

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: strong side effects as pain( muscular, joint)headacche , chills , nousea , vomiting and high fever ( 92-94);

Other Meds: lozatrin aspirin

Current Illness: High blood presure

ID: 1263686
Sex: M
Age: 26
State: NJ

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

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Lab Data:

Allergies: unknown

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

Symptoms: Situation: patient was administered 1st dose of COVID-19 (Pfizer) by certified tech. Post-administration, patient was instructed to sit for observation. Technician stated that approximately 2 min or so after patient sat down, he came up to her at the window to state that he was feeling lightheaded and weak. Consequently, while in conversation with her, patient gently collapsed onto the floor. He was alert and conscious the entire time; temp was 97; patient was noted to be pale and sweating profusely. Patient was provided water, ice pack and orange juice. Ambulance was offered and he was taken by paramedic for further evaluation.

Other Meds: none

Current Illness: none

ID: 1263687
Sex: M
Age: 82
State: WA

Vax Date: 04/10/2021
Onset Date: 04/13/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: none known

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: Patient has been very stable on anticoagulation with warfarin. On same dose since 2016 with only rare very mild excursions in INR. He had appointment for routine INR check which happened to fall 3 days after his vaccine, and INR was found to be 4.1. There were no other identified explanations for the unusually high INR in him. He did not have any symptoms of bleeding or thromboembolism. He did have some arm pain so took a few doses of ibuprofen (which should not cause the increase in INR and he has been using ibuprofen prn the duration of his anticoag therapy) He was asked to hold 2 doses and returned 1 week later, which was 10 days after vaccine. At that time INR came down to 3.0 and CBC was ordered which came back normal for him. He still did not have any symptoms of bleeding or thromboembolism.

Other Meds: warfarin, metoprolol, lisinopril, simvastatin, ibuprofen as needed

Current Illness:

ID: 1263688
Sex: F
Age: 25
State: MN

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: latex

Symptom List: Unevaluable event

Symptoms: Had the worst cold sore/ herpes outbreak ever. it spread to my genitals, went to doctor and confirmed its still HSV1 and not HSV2. also spread to the inside of my mouth and nose. skin was sloughing off the inside of my nose and the roof of my mouth.

Other Meds: bupropion XL, Gabapentin, duloxitine DR

Current Illness:

ID: 1263689
Sex: F
Age: 48
State: OK

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

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: Patient reported to pharmacy about 1hour after receiving her Moderna vaccine. Patient stated the was feeling itchy all over her body and was starting to get red splotches. We gave her 25mg of diphenhydramine by oral route and she reported it was starting to resolve about 30 minutes later.

Other Meds:

Current Illness:

ID: 1263690
Sex: F
Age: 60
State: MD

Vax Date: 04/25/2021
Onset Date: 04/26/2021
Rec V Date: 04/27/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Extreme headaches, nausea, vomiting, chills, fever, muscle aches and joint pain Symptoms started at 11 am on 4/26 and are ongoing into 4/27, treatment with Acetaminophen and trying to rehydrate

Other Meds: Talz

Current Illness:

ID: 1263691
Sex: F
Age: 25
State: IL

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

Vax Type:
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Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Nausea, throwing up, aching body, fever, chills Lasted approximately 20 hours

Other Meds: None

Current Illness: None

ID: 1263692
Sex: F
Age: 37
State: NY

Vax Date: 03/12/2021
Onset Date: 03/26/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: Sulfa drugs

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

Symptoms: Exactly two weeks after administration of the first dose - Friday, March 26 - developed tinging in both hands and all 10 fingers. Immediately ceased Cipro (prescribed in the ER for a prospective UTI) after only four days of a ten day regimen due to possibility it was a side effect. Received the second vaccine on schedule despite symptoms. Condition progressed to include tinging in both feet, then both legs started "falling asleep." Sensations are never the same from one day to the next - changing from tingling to pins and needles to numbness/falling asleep to twitching to compression. Cannot track a pattern as to which limbs fall asleep when and for how long (is it positional, food/drink related, is there a specific length of time, symmetrical, etc) but it's systemic, diffuse and bilateral. On the date of the filing of this report (April 27, 2021), I have experienced a 50-75% decrease in the intensity and frequency of the symptoms but they have not yet completely resolved. It is 6 1/2 weeks since my first dose, 3 1/2 weeks since my second. No presence of any other neurological symptoms - no weakness, no loss of sensation (even with feeling of numbness), no loss of strength, no cognitive impairment, no falling, no blurry vision. No pain. No indications of any nerve damage whatsoever, so it seems to be uncomfortable and annoying but not dangerous. Saw a neurologist six days after onset of symptoms and he ran several tests (listed below). While I understand it is impossible to track whether this is definitively vaccine-related, especially with an adjacent emergency room visit, the timing seemed too coincidental to completely dismiss as a possibility. I have not had any neurological symptoms prior to this point in time, and they seem to be dissipating over time without any intervention. I file this report with the hopes that with this new vaccine, any information is helpful and if there is a chance this is a rare severe side effect, perhaps others have reported the same and risk factors can be tracked.

Other Meds: Prescriptions - Pentasa (4g daily), Klonopin (.05mg only as needed), Cipro Supplements - daily multivitamin

Current Illness: Stomach virus of unknown origin that resulted in ER visit for IV fluids a week after the the first vaccination (symptoms started PRE-vaccine). Bloodwork was normal. Tested positive for a UTI and was given Cipro.

ID: 1263693
Sex: F
Age: 49
State:

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/27/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: Cyclobenzaprine

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 03/04/2021: Abdominal pain which required evaluation in the ER ER physician ordered urinalysis (normal), she reported that the ER did an ultra-sound and blood draws. CBC lymphocytes slightly low 22.5 %all other in normal range Normal Serum glucose, Renal and hepatic function tests. Discharged with tylenol, diagnosis of inflamed GI system. 04/08, Pain irradiated to ?right shoulder? just below the clavicle, ?shortness of breath? . ER second visit testing : COVID-19 PCR, Hemogram, arterial gases, Blood chemistry. Results: Hemogram WNL Glicemia: 96mg/dl Kidney function tests WNL Arterial gases: pH 7.46, pCO2: 32.7mmHg pO273.3mmHg SO2 95.4% HCO3 22.50mmol/L FiO2 0.21 COVID-19 PCR negative April 16, 2021: continued pain in right upper chest, radiating to mid-breast. Hurts to breathe deeply. No fever, no other signs/symptoms, referral consultation with Internal Medicine, specialist ordered VES, CRP, COVID-19 PCR, Abdomen and pelvis CT scan, Abdomen ultrasound, chest CT scan, these were performed on 4/20 On 4/24 Pain in chest continues, specialist ordered D-dimer. On 4/25 Dr. ordered arterial gases a Chest angio CT, abdomen doppler ultrasound and lower limb bilateral doppler ultrasound. Currently patient hospitalized, receiving treatment with blood thinners.

Other Meds: Prozac 40mg QD

Current Illness: Polycistic kidneys and liver PTSD

ID: 1263694
Sex: M
Age: 33
State: MS

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

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Lab Data:

Allergies: NONE GIVEN

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: PATIENT ARRIVED FOR HIS 2ND DOSE OF PFIZER. (1ST DOSE GIVEN 4/6/21, WITHOUT ANY REACTIONS NOTED). NURSE SCREENED PATIENT AND FORM COMPLETED WITHOUT ANY NOTED REACTIONS OR REASONS NOTED TO HOLD VACCINE. INTERVIEW WITH PT WHO SAID HIS LEFT ARM STARTED TO CRAMP BEFORE THE SHOT WHEN HE WAS REMOVING HIS SHIRT. PT RECEIVED HIS PFIZER VACCINE AT 1205PM, THEN TO 15MIN WAITING. HE SAID HE FELT FLUSHED, AND SEEN SPOTS. ASSISTED BY EMERGENCY PERSONEL WITH VS TAKEN. EP SAID THE PT WAS DIAPHORETIC AND PALE WHEN HE MADE IT TO THE CAR AT 1215 AND CALLED THE AMBULANCE MONITORED EKG BY EP AND ASSESSED BY THE AMBULANCE PERSONEL. PT REFUSED TO GO TO THE ER, SAID WOULD GO TO HIS PRIMARY PHYSICIAN WITH HIS WIFE, WHO WAS PRESENT AND DRIVING THE CAR. LEFT WITHOUT ANY ACUTE SYMPTOMS AND SAID WAS FEELING BETTER.

Other Meds: NONE GIVEN

Current Illness: NONE GIVEN

ID: 1263695
Sex: F
Age: 21
State: CA

Vax Date: 03/17/2021
Onset Date: 03/19/2021
Rec V Date: 04/27/2021
Hospital: Y

Vax Type:
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Lot:
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Lab Data:

Allergies: Advil (Motrin): anaphylaxis, hypotension, rash

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Patient with a history of anaphylactic reaction to Advil developed a possible biphasic allergic reaction to Pfizer Covid vaccine (lot EN6208) given on 3/17. Patient initially had urticarial rash on 3/19 and it was treated with Benadryl and Solu-medrol. Patient was discharged on daily prednisone. However, patient returned on 3/21 with facial swelling, chest and throat tightness and shortness of breath. Prior to ED arrival, patient self-treated with EpiPen. At the ED, Benadryl, Pepcid, and Solu-medrol were given and continued for 2 days during hospitalization. No further respiratory distress developed, but the patient still had intermittent itching and rash. Patient was discharged on tapered prednisone, Benadryl as needed and Pepcid.

Other Meds: Benadryl 50 mg PRN for allergic symptoms Levonorgestrel-ethinyl estradiol 0.1 mg/20 mcg tab

Current Illness: None

ID: 1263696
Sex: F
Age: 55
State:

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

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Allergies:

Symptom List: Nausea

Symptoms: 4/27/2021 was observed post Covid-19 immunization for 15 minutes . During the observation period, she experienced an adverse reaction with the following symptoms: Reports itching to the upper chest.. Assessment : Time of assessment 0945. Urticaria. No visible signs of rash or hives noted, complained of itching to upper chest. Actions taken: Vitals sign taken VAERS form obtained and completed by RN. VS at 0945- BP- 140/101, P- 65, 99%, recheck at 0959- BP- 139/83, P- 61, O2- 99%, 1015- BP- 125/88, P- 63, O2- 98%, water given, reports itching has stopped at 0959. Medications administered: Loratadine (Claritin) 10 mg by mouth. Time: 0949. Administered by RN. Famotidine (Pepcid) 20 mg by mouth. Time: 0949. Administered by RN. Disposition: Reports no further symptoms of adverse reaction after observation for 45 minutes. Discharged home. Instructed to call 911 for trouble breathing, rapid heart rate, dizziness, swelling of tongue or throat. Immunizations Administered Name Date Dose VIS Date Route Pfizer COVID-19 Vaccine 4/27/2021 9:29 AM 0.3 mL 2/25/2020 Intramuscular Manufacturer: Pfizer, Inc

Other Meds:

Current Illness:

ID: 1263697
Sex: F
Age: 76
State: AZ

Vax Date: 04/07/2021
Onset Date: 04/14/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: Sulfa, penicillin, NSAIDS, acetaminophen

Symptom List: Injection site pain

Symptoms: Noticed bright red disc-type spots on right leg - counted eight Area appeared swollen and was painful to touch Contacted my physician who looked at them Spots faded 2 days later

Other Meds: Losartan Armour Thyroid

Current Illness: none

ID: 1263698
Sex: F
Age: 11
State: CA

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

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Lab Data:

Allergies: No known drug allergies

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

Symptoms: Pt had her HPV vaccine during her office visit then she was leaving with her mom, she fainted and hit her head on the floor. No bleeding or bruising noted. Pt was then put on bed laying supine. Pt was anxious and crying. After she relaxed, her blood pressure was 121/78. Pt complained of a headache. Dr. assessed pt and she had no hematoma. Called mom the next day and mom reported that pt was feeling fine and no complaints of any headaches.

Other Meds: Chewable Multiple Vitamins

Current Illness: None

ID: 1263699
Sex: F
Age: 56
State: FL

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/27/2021
Hospital:

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Allergies:

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: severe coughing , hoarse voice, SOB, still has coughing ; went to ER

Other Meds: wellbutrin gabapentin

Current Illness:

ID: 1263700
Sex: M
Age: 55
State: MI

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: NONE

Symptom List: Tremor

Symptoms: 3:50 PT C/O EYES BURNING FACE FLUSHED, BP 240/132 HR 112 SKIN MOIST NO SHORTNESS BREATH , PT ASATES HX HTN BUT HE STOPPED MEDS A YEAR AGO BECAUSE THEY WERE NOT WORKING. 3:55 HR 104 4:00 PM BP 216/142 REFERRED TO ER- AMBULANCE CALLED 4:05 BP 240/132- TURNED OVER YTO AMBULANCE STAFF = 4:45 AMBULANCE STAFF OBSERV ED PT TIL BP RET'D NORMAL AS PT REFUSED TO GO TO ER

Other Meds: NONE

Current Illness:

ID: 1263701
Sex: F
Age: 61
State: MN

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/27/2021
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Lab Data:

Allergies: Ibuprofen

Symptom List: Erythema, Pruritus

Symptoms: Angry Arm My arm turned beet red and it lasted for about 36 hours.

Other Meds: Lisinopril; Amitriptyline;Hydroxyzine; Methocarbomol;Norco 325

Current Illness: None

ID: 1263702
Sex: F
Age: 47
State:

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies:

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

Symptoms: Seizure.

Other Meds:

Current Illness:

ID: 1263703
Sex: F
Age: 22
State: NC

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 04/27/2021
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Allergies: None

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: I received my J&J vaccine at around 3:00pm. By 10:00pm, I was feeling very tired and achey and went to bed. I woke up at 2:00am with a fever of 102.5, a terrible headache and unbearable body aches. I took some ibuprofen and tried to go to bed but began vomiting. This lasted for 3-4 hours and I was unable to sleep. The next day I began to feel better in the afternoon but by 6:00pm the fever and aches worsened again and I began vomiting uncontrollably, about every 10 minutes. I couldn?t keep anything down, even water. I had a virtual urgent care visit and the doctor ordered me to go to the emergency room. At the ER, the doctors determined I was severely dehydrated. I received 2 bags of IV fluid, nausea medicine and pain medicine. I spend about 3 hours in the ER before I was sent home. I had to keep taking nausea medicine to prevent vomiting for the next day or so.

Other Meds: Citalopram 20mg Zyrtec Mili birth control Flonase

Current Illness: Unknown illness (diagnosed as likely a sinus infection, tested negative twice for covid) about 2 weeks before vaccine.

ID: 1263704
Sex: M
Age: 35
State: TX

Vax Date: 04/20/2021
Onset Date: 04/22/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Swollen supraclavicular lymph nodes for one week after 2nd dose.

Other Meds: None

Current Illness: Was diagnosed with COVID-19 two weeks after first does and two weeks prior to second dose.

ID: 1263705
Sex: M
Age: 51
State: FL

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: none

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

Symptoms: Client received vaccine and began to feel a tingling sensation on his left hand and believed it looked blue. Assessed client. Vitals all wnl. no further evaluation needed. Client released at 1:15pm.

Other Meds: none

Current Illness: none

ID: 1263706
Sex: F
Age: 63
State: AZ

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies:

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

Symptoms: second dose of vaccine given before 24 days

Other Meds:

Current Illness:

ID: 1263707
Sex: M
Age: 50
State: IL

Vax Date: 04/19/2021
Onset Date: 04/23/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: The lymph nodes in my neck have swollen. I have been experiencing a very sore throat. It is hard to swallow. I was diagnosed today with strep throat and prescribed amoxicillin-clavulanate to address the strep throat.

Other Meds: None

Current Illness: None

ID: 1263708
Sex: F
Age: 19
State: TX

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

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: Body aches, cold sweats, vomiting, nausea, and headaches

Other Meds:

Current Illness:

ID: 1263709
Sex: F
Age: 52
State: NY

Vax Date: 04/08/2021
Onset Date: 04/15/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: None

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

Symptoms: Benign paroxysmal positional vertigo occurring 7 days after vaccine #2.

Other Meds: Hormone replacement therapy

Current Illness: Migraine

ID: 1263710
Sex: M
Age: 34
State: CA

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

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Lab Data:

Allergies: penicillin

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

Symptoms: fainted

Other Meds: none

Current Illness: none

ID: 1263711
Sex: F
Age: 39
State: SC

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

Vax Type:
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Lab Data:

Allergies: Penicillin

Symptom List: Vomiting

Symptoms: Severe swollen arm at injection site, burning, hot to the touch, lasted 1 week

Other Meds: Tramadol-50 mg

Current Illness: None

ID: 1263712
Sex: F
Age: 73
State: KS

Vax Date: 03/12/2021
Onset Date: 03/15/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: Bee Sting Cephradine(Velosef) - rash on back, syncope. **This is a discontinued 1st generation cephalsoporin.** Cefazolin - severe asthma reaction - vivid nightmares - night terrors Chlorhexidine and Hexachlorophene, skin breaks open and bleeds. Chromic Gut Suture - tissue broke ..down where it contacted suture and I "unzipped" Depo-Provera - swelling, discoloration, pain Dulera (mometasone fumarate/fomoterol fumarate dihydrate) sinusitis, headache, profuse thick mucus production Flovent HFA (Fluticasone) Asthma inhaler sore throat, ear ache Lovastatin - Elevated liver enzymes + fatty liver Seldane - vertigo Shingrix vaccine - rash Trulicity - rash

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: First few days after vaccination had sore arm and headache. By the 4th day the headaches had substantially increased into full-blown migraines. Extreme, debilitating fatigue. Body aches that kept me from sleeping. Pain on right side of head behind ear that felt like I had been hit. Could not do normal housework. April 1 I went to the emergency room where they gave me IV Toradol which alleviated the pain for 2 or 3 days. April 21 I got in to see my PCP. She prescribed a Medrol Dose Pack. Today is my last day of that.

Other Meds: amlodipine 5 mg before bed hydrocortisone 10 mg in am, 5mg at noon, 2.5mg at bedtime levothyroxine .075 mcg before bed NP Thyroid 60 mg 2x/day 81 mg aspirin in am Biotin 5000 mcg 1000 mg vitamin C cetirizine 10 mg Vitamin D3 4000 IU 5 mg

Current Illness: None

Date Died: 04/01/2021

ID: 1263713
Sex: F
Age: 59
State: PA

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

Vax Type:
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Lab Data:

Allergies: NKDA

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

Symptoms: 3/30/2021 Patient received 1st dose of Moderna vaccine at 11:35AM and subsequently discontinued dialysis treatment 58 minutes early due to being cold. 3/31/2021 Patient went to hospital at 2:28PM with admitting diagnosis of acute encephalopathy due to intra-cranial hemorrhage. 4/1/2021 Patient expired at 3:35AM with cause of death reported as intra-cranial hemorrhage.

Other Meds:

Current Illness:

ID: 1263714
Sex: F
Age: 69
State: IL

Vax Date: 01/20/2021
Onset Date: 01/26/2021
Rec V Date: 04/27/2021
Hospital:

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Lab Data:

Allergies: Multiple food allergies due to digestive difficulties with small bowel (SIBO and colitis diagnosis), including gluten, dairy, peanuts, garlic. onion to name a few. Med allergies: Reglan, Pradaxa, Actonel

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I had a marked increase in number and severity of heart palpitations starting 1 week after my first dose (above info) and continuing for 2 1/2 weeks after my second Moderna shot on 2/18/2021. In other words an increase in my symptoms of AFib.

Other Meds: Propafenone; Xarelto: Metoprolol; MTV; Vit D3; Magnesium; Ginger; Tumeric; 3 Probiotics; magnesium

Current Illness: No acute illness but got accessed tooth 1 week after first vaccine that may have been brewing earlier

ID: 1263715
Sex: F
Age: 78
State: CA

Vax Date: 04/13/2021
Onset Date: 04/21/2021
Rec V Date: 04/27/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: none

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Adverse events: unstable, too dizzy to walk, through-up, double vision. Treatment: wait for the symptoms to pass.. The symptoms have lessened but are still with me.

Other Meds: Elderberry and several vitamins

Current Illness: none

ID: 1263716
Sex: M
Age: 34
State: NH

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

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

Allergies: seasonal

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

Symptoms: Patient experienced what appeared to be a vasovagal event. regained consciousness within a few minutes. diaphoretic and expressed fatigue. Patient declined further evaluation by hospital staff. Observed for an extended amount of time until symptom free and patient departed.

Other Meds: n/a

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am