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
14,483
AK632
AL1,127
AR910
AS16
AZ3,667
CA13,327
CO2,413
CT1,595
DC221
DE328
FL6,586
FM1
GA2,729
GU32
HI514
IA1,095
ID635
IL3,934
IN5,377
KS1,111
KY1,536
LA881
MA3,125
MD2,509
ME775
MH3
MI3,544
MN2,383
MO1,890
MP7
MS557
MT767
NC2,891
ND342
NE804
NH727
NJ3,218
NM1,023
NV764
NY7,122
OH3,828
OK1,145
OR1,856
PA4,343
PR637
RI495
SC1,040
SD342
TN1,598
TX6,813
UT936
VA3,039
VI13
VT425
WA2,882
WI2,344
WV635
WY199
XB1

ID: 0946149
Sex: F
Age: 26
State: NY

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: 45 min after vaccination I got the chills. Throughout the night (within a few hours of vaccine) I had chills and extreme soreness to arm. Next morning I woke up with chills, terrible headache/migraine, high fever up to 103.3, cough, aches, neck and back pain, nausea, and vomited one time. No Tylenol or Motrin would break my fever all day long.

Other Meds: None

Current Illness: None

ID: 0946150
Sex: M
Age: 58
State:

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Fatigue, sore arm, headache, chest pain (intense heartbeat), malaise

Other Meds:

Current Illness:

ID: 0946151
Sex: F
Age: 26
State: UT

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: 4:30pm on 1/13/21 my arm started to get sore, but not bad, just normal vaccine sore. Then by the next day it had gotten worse and throughout the day it just kept getting worse and spread to the left side of my chest. I can't lift my arm and most movement hurts.

Other Meds: Nortrel 1/35

Current Illness: No

ID: 0946152
Sex: M
Age: 27
State: IL

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: motrin, dust mites

Symptom List:

Symptoms: Around 7 pm I started feeling really anxious. I checked my HR on my smart watch and it said that around 12pm my HR was 157bpm which was right after getting the vaccine when I started walking home. My resting HR is usually 47-52bpm. I am a very active person. I have been waking up in the middle of the night multiple times in night sweats and it feels like my heart is contracting very hard. I notice that my HR jumps up right when I start to be more active, but more than normal. On the 11th my average walking HR was 140. Today at work my HR was 134 at the highest around 9am and the lowest was 56bpm around 7am when I was getting ready for work. Additionally to the increased HR I have SOB when I walk and talk. I did have a sore arm as well the first day, but nothing more than any other injection I have had before.

Other Meds: Vyvanse, tylenol, descovy, finasteride, lexapro

Current Illness: none

ID: 0946348
Sex: F
Age: 85
State: MN

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: Alendronate, Atorvastatin, Calitonin, Fluvastatin, GLutein protein, Simvastatin, Triamteren, HCTZ

Symptom List:

Symptoms: Lump to injection site. Redness to Left arm 8 cm x 12 cm 1/13/21 Redness spreads 12cm x 14cm 1/14/21 Bright red spots, fragmented developed. Area is warm to touch. Body temp 97.8 degrees F Patient's son, has set up an appointment with primary MD to be seen

Other Meds: Not known

Current Illness: 11/24/2020 tested Covid 19 positive

ID: 0946898
Sex: M
Age: 40
State: KS

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: Ceclore

Symptom List:

Symptoms: About 1 minute after receiving vaccine, pt fainted while on the way to recovery area. Pt was standing in entryway when he started to fall down but was caught on the way down by a nurse. While on the floor the pt was asked his name and responded with correct answer, EMS was called and then pt was placed in wheelchair and transferred to cot after. the BP and pulse was taken (63/46, pulse 51) Glucose gel was provided orally. EMS arrived shortly after BP was take but pt refused stating that he was feeling better and he waited out the remainder of his recovery time laying in cot with no other incidents.

Other Meds: 0

Current Illness: 0

ID: 0946899
Sex: U
Age: 32
State: MO

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

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

Lab Data:

Allergies: 0

Symptom List:

Symptoms: Client was sitted in the chair and started rolling his eyes stretching his feet and twitching like he was having a seizure. Was helped on the floor gained consciousness. Stood up and sat on the wheelchair wheeled to the cot area and was place on the cot. V/P 133/96 HR - 54 - 78 O2Sat 97% B/S - 111 glucose gel EMS was called Client was stable Had lost conciousness and disoriented when he woke up. Client started he felt light headed and had vision event

Other Meds: Escitalopram, Buprion XL

Current Illness: Depression, Anxiety

ID: 0947218
Sex: M
Age: 96
State:

Vax Date: 01/04/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: INJECTION SITE SWELLING

Other Meds:

Current Illness:

ID: 0947220
Sex: F
Age: 68
State: GA

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: Stomach (Abdominal pain); Nausea, headache, feverish, but no temp; minor Body aches. Began around 9:00 A.M. (2 hrs After injection). Nausea & other symtoms gone by A.M. 12-29-20.

Other Meds: Inderal, chloresteramine; prevacid, Allergy 4

Current Illness: None

ID: 0947221
Sex: F
Age: 45
State: OH

Vax Date: 12/22/2020
Onset Date:
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: latex - eggs

Symptom List:

Symptoms: chest tightness - heaviness light head facial swelling-hurting dizzy severe left arm pain to fingers range of motion lost. coughing more astma - using inhaler more on daily rash on face - chest - pain to touch

Other Meds: Armour - thyroid

Current Illness: Cold?

ID: 0947222
Sex: F
Age:
State: NH

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

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

Lab Data:

Allergies: Latex, other allergies, none to vaccine components, none to po

Symptom List:

Symptoms: Good Evening, I have attached the VAERS form that I had trouble uploading to the VAERS. I have also quoted it below because the tablets we have on site will not allow me to type in those areas of the PDF. The adverse reaction occurred around 12:45 pm on 01/06/2021. Symptoms ceased within 3 hours after visit. On follow up, she said her symptoms felt like indigestion and anxiety. Thank you for your time and understanding. The note is as follows, Vaccine recipient came to the vaccination site at 12:45. She informed us of her medical history. She had one instance of anaphylactic shock as a baby. She has not had a reaction since. She has an allergy to latex, and two others that are no longer viewable in database. No one on site has access to her file now that she has successfully been vaccinated, so the following history was obtained from patient verbally. I did verify that she is not allergic to polyethylene glycol. Recipient has taken miralax before with no reaction. This morning before arrival, recipient took her normal dose of levothyroxine, and mesalamine. She also took one lorazepam before her appointment to treat the anxiety she was feeling leading up to her vaccination. She ate a normal amount for her, including nuts, crackers and three 16 oz bottles of water. Before her injection, medic reviewed all medical history and allergies. We discussed risks, and the expected positive outcome of getting the moderna vaccine. She verbalized her anxiety, but attested that she very much wanted the vaccine. After vaccination, recipient was speaking clearly, feeling okay, and she was instructed to wait for 30 minutes of observation. She told personnel on site that she was having chest pain. She pointed to her sternum describing a 3/10 pain that felt like pressure. She said it radiated to her right breast. She said it felt like indigestion, and she took 1 dose of her own pepsid in her car while she was waiting her 30 minute period. Vitals: SPO2 98%, pulse 55 bpm steady, strong. She was offered EMS, and she declined. Medical staff recommended calling her pcp ASAP and scheduling a virtual urgent care visit to mitigate her COVID concerns in hospital settings. Patient then said that she felt ready to go home, and she was advised to lay with her feet up, sip water, eat crackers, and use ice or head to alleviate pain and reduce anxiety. Recipient felt confident in heading home. Patient information listed below.

Other Meds: Levothyroxine, mesalamine, lorazepam, pepsid

Current Illness: Ulcerative colitis, thyroid condition

ID: 0947396
Sex: F
Age:
State:

Vax Date:
Onset Date: 12/31/2020
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Dizziness Narrative: employee said her heart was low, so she laid on the floor C/o sweaty, diziness, lying on floor felt better. PMH of vascular response, taking beta blocker had juice felt better. Vss. 115/76 bp pulse 65. Recheck b/p 103/69 65 pulse, 101/68 pulse 69 oxygen sats room aire were 100. initial pulse was 43 b/p 115/76. Resolved after rest elevated legs, and fluids. Employee left about after and hour walking well, with no further c/o symptoms all seemed to resolved She was instructed to go the emergency room any further symptoms. She verbalized back the plan.

Other Meds:

Current Illness:

ID: 0947408
Sex: F
Age: 61
State:

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Myalgia & NauseaVomiting

Other Meds:

Current Illness:

ID: 0947643
Sex: F
Age: 46
State: ME

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: flagyl

Symptom List:

Symptoms: 1/6/21 injection site discomfort, which lasted approximately 2-3 days. 1/13/21 injection site redness, itchy, hard, warm to touch - no change in symptoms at this time and no worsening symptoms, monitoring

Other Meds: methotrexate

Current Illness:

ID: 0947646
Sex: F
Age: 57
State: IA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: tingling and numbness in Right hand (5 min) sweating and anxiety felt foggy 20 min.

Other Meds:

Current Illness:

ID: 0947647
Sex: F
Age: 1
State: CO

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: N/K

Symptom List:

Symptoms: Cellulitis - Red, swollen, hot to touch no D/C noted L leg > R leg L thigh oval shaped 2 1/2 x 1 3/4 inch & R thigh round 1 inch area.

Other Meds: N/K

Current Illness: N/K

ID: 0947648
Sex: M
Age: 52
State: MN

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/14/2021
Hospital: Y

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

Lab Data:

Allergies: Adhesives

Symptom List:

Symptoms: Pt. with dizziness, then Afib with RVR, then massive cerebral hemorrhage Pt. non oriented & unable to give history - History provided by S.O and daughter

Other Meds: Multiple

Current Illness: No Acute only chronic

ID: 0948039
Sex: F
Age: 59
State: AZ

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

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

Lab Data:

Allergies: vancomycin, metformin, latex, sulfa

Symptom List:

Symptoms: rash, "burning" to throat, skin, anxiety Pt got vaccine at 1430, was monitored x30 min. She left hospital to go eat then started drive home. Pt turned around & came back to hospital after symptoms began at 1515.

Other Meds: shingrex vaccine 12/30/20

Current Illness: DMII

ID: 0948053
Sex: F
Age: 60
State: NY

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

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

Lab Data:

Allergies: Sulphur

Symptom List:

Symptoms: Upper lip feeling numb/numbness resolving @ 925 AM vs 138/77 P 66 O2 sat 100% RA

Other Meds: Vit C. and Zinc

Current Illness: N/A

ID: 0948059
Sex: F
Age: 52
State: MS

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Pt noted rash on (L) knee, progressed to both thighs, lower back and both arms. Now also on bith arms, upper back and ears, and both legs. Very itchy.

Other Meds: B Complex

Current Illness: N/A

ID: 0948063
Sex: F
Age: 31
State: MI

Vax Date: 12/31/2020
Onset Date: 01/06/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: Macrobid - Ciprofloxin

Symptom List:

Symptoms: Initially - localized discomfort. Redness days after - swelling at sign of injection, fatigue, strong stomach pain on 1-6-21 further discomfort and swelling two inches distal of injection site.

Other Meds: Valacyclovir - Rizatriptan - Ondansetron Prenatal vitamins - Tylenol - Motrin

Current Illness: None

ID: 0948067
Sex: M
Age: 22
State: IL

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient given expired Varivax vaccine. Pt does not report any ADRs

Other Meds:

Current Illness:

ID: 0951117
Sex: F
Age: 1
State: NC

Vax Date: 11/13/2019
Onset Date: 11/13/2019
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient received routine vaccines at 15 month visit as listed above. Approximately 3 months later, in Feb 2020, parents noted several lumps in R thigh where shots had been given. U/S showed nonspecific hypoechoic nodules. Biopsy showed dermal granulomous inflammation around necrobiotic debris. Pt had testing through the allergist and was strongly reactive to aluminum. Allergist believes the nodules may represent a delayed hypersensitivity reaction to aluminum. Patient also subsequently developed similar nodules in L thigh in the area where the other shots listed above were given at the 15 month visit.

Other Meds: Multi-vitamin

Current Illness: None

ID: 0951175
Sex: F
Age: 64
State: RI

Vax Date: 01/08/2021
Onset Date:
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Bilateral Axilla, dominant on vaccinated arm rash, itch Redness, Swelling

Other Meds: Afluria, cyclobenzaprine, fluticasone propionate, losartan, meloxicam, montelukast, omeprazole, Symbicort, zinc, Zyrtec,

Current Illness:

Date Died: 01/04/2021

ID: 0963167
Sex: M
Age: 88
State: DE

Vax Date: 01/02/2021
Onset Date: 01/04/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Narrative: Symptoms: & Cardiac Arrest; Death Treatment: EPINEPHRINE

Other Meds:

Current Illness:

ID: 0963168
Sex: M
Age: 79
State:

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/14/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: shaking, altered consciousness Narrative: One day after pt received his first covid vaccine, pt experienced upper extremity shaking leading to ED visit and subsequent hospitalization with concern for seizure. Examination and labs were not consistent with seizure. He had features of lewy body disease and parkinsonism. Labs were significant for leukocytosis, but pt had no other signs/symptoms of infection or findings to indicate a source of infection. Pt referred to Neurology.

Other Meds:

Current Illness:

Date Died: 01/05/2021

ID: 0967754
Sex: F
Age: 66
State:

Vax Date: 12/21/2020
Onset Date: 01/05/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Death - unknown cause, no reported side effects Narrative: Unknown cause of death

Other Meds:

Current Illness:

ID: 1279607
Sex: F
Age: 42
State: ME

Vax Date: 12/31/2020
Onset Date: 01/09/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient report she received the 1st Moderna vaccine lot number 039K20A in her right arm on 12/31/2020 at 0856 at the vaccine clinic. Patient reports her arm was sore for a couple of days. Patient reports on 1/9/2021 she noted itching, redness, and swelling at injection site. Patient is improving today.

Other Meds: Methotrexate, Folic acid, Palquinil, synthroid, Diflucan, vit

Current Illness: denies

ID: 1279608
Sex: F
Age: 71
State: ME

Vax Date: 12/31/2020
Onset Date: 01/07/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: PCN, Sulfa

Symptom List:

Symptoms: Patient reports she received the Moderna covid 19 vaccine lot number 039K20A on 12/31/2020 on her left arm. She received it at the a physicians building. Patient reports the vaccine was lower on her arm. She reports she had pink irritation which resolved. Patient reports on 1/7/2021 she noted increased redness and swelling. Patient reports she went to the ED and was advised to monitor. Patient reports she was started on Keflex and treated for cellulitis. Patient reports the redness an inflammation is resolving. VAERS completed.

Other Meds: Vitamin supplements

Current Illness: denies

ID: 1279609
Sex: F
Age: 50
State: FL

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: CATS/DOGS/POLLEN/SHRIMP->CAUSES PRURITUS

Symptom List:

Symptoms: FATIGUE/HEADACHE/BODY MALAISE ONE HOUR AFTER 2ND DOSE OF COVID 19 VACCINE. NOW C/O L ARM PAIN RADIATING TO GIRON/R LEG PAIN/DIZZINESS/DIRPHORESIS WEAKNESS TO L LOWER EXTREMITY.

Other Meds: CRANBERRY/XIGDOU/EZETIMAB/PRAVASTATIN/FLOUXETIN/MVI/FISH OIL/OSETO BIFLEX/MG GLUCONATE

Current Illness: DM/HYPERLIPIDEMIA/O/A/HEADACHE/DEPRESSION/ANXIETY

ID: 1279612
Sex: F
Age: 47
State: CA

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Headache (migraine), nausea, Body Aches, fatigue, chills

Other Meds: None

Current Illness: None

ID: 1279613
Sex: F
Age: 33
State: ME

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient reports she received 1st Moderna Covid 19 vaccine lot number 039K02A on 1/7/2021 at 1450 in the center in her left arm. She reports she noted dizziness at 2000 that evening lasting until 1400 on 1/08/2021. She reports she also developed shaking chills and headache which ended at 1100 on 1/8/2021. Patient reports she called out of work due to chills on 1/8/2021. Patient reports her symptoms have resolved other than some mild arm soreness.

Other Meds: albuterol as needed

Current Illness: denies

ID: 1279614
Sex: F
Age: 35
State: GA

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: Peniccillin & Ceclor

Symptom List:

Symptoms: Fatigue, Coughing, body aches all over, Headache, Chills, no fever

Other Meds: Celexa, Amitriptyline,Hrdochlolrothiazide, Ptotonix

Current Illness: None

ID: 1279615
Sex: F
Age: 54
State: CA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: see attached

Other Meds:

Current Illness: 1/13/21 @ 1255 - Patient at my vaccine station and during vaccination screening questions, patient stated she has history of anaphylaxis reaction to flu vaccine in 2017. Has not had since, and was hospitalized for asthma in nov, 2020, she also was noted to carry her own epi pen and albuterol MDI. Pharmacy was called to station to consult and stated it was safe to proceed. approx. 24 min into her 30 min recovery, she Sts she became short of breath and was escorted to the "cot" area. She was give (1)25mg Benadryl P.O by pharmacist, prior to my arriving in the room. when I came in, patient was tachypnic with audible wheezes but able to speak a full sentence telling me her home address. Skin color WNL, Warm and dry to touch. SPO2 95 % AND HR 110. Patient advised to use her albuterol MDI which was noted to be expired 9/2020- patient used a total of 4 puffs and was given and additional 25 mg P.O Benadryl @ 1350. Patient recovered an additional 30 minutes and was discharged with no increase WOB, RR 18, HR 98 SPO2 98% advised to follow up with PMD. Also Pharmacy stated it's not recommended to receive second dose if a reaction occurs in the first (4)hours patient verbalized understanding, and left with her co-worker who sts. she would follow her home.

Date Died: 01/07/2021

ID: 1349711
Sex: M
Age: 77
State: TN

Vax Date: 12/22/2020
Onset Date: 01/07/2021
Rec V Date: 01/14/2021
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Symptoms: Symptoms: & cardiopulmonary arrest Treatment: EPINEPHRINE 8 MG Unknown during code

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Current Illness:

ID: 1349712
Sex: M
Age: 82
State:

Vax Date: 01/04/2021
Onset Date: 01/09/2021
Rec V Date: 01/14/2021
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Symptoms: Narrative : Symptoms: SkinRash& SWOLLEM GLANDS UNDER JAW-SORE. BLISTERS DEVELOPED WHERE THE RASH WAS ON PTS KNEE Treatment:

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Current Illness:

ID: 1349713
Sex: M
Age: 64
State: KS

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/14/2021
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Symptoms: Narrative : Symptoms: Headache, Fever & Temp of 102.5 w/ chills Treatment:

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Current Illness:

ID: 1349774
Sex: M
Age: 72
State: MO

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/14/2021
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Symptoms: Narrative : Symptoms: & abdominal pain Treatment:

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Current Illness:

ID: 1349844
Sex: M
Age: 87
State:

Vax Date: 12/22/2020
Onset Date: 12/23/2020
Rec V Date: 01/14/2021
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Symptoms: Narrative : Symptoms: & lethargic, low grade temperature Treatment:

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Current Illness:

ID: 1349846
Sex: F
Age: 43
State:

Vax Date: 12/29/2020
Onset Date: 12/31/2020
Rec V Date: 01/14/2021
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Symptoms: SkinRash, UrticariaPruritus, orbital edema Narrative:

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Current Illness:

ID: 1349851
Sex: F
Age: 40
State:

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/14/2021
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Symptoms: Fever flu like symptoms Narrative: Approximately 5 hours after vaccine administration she began to have flu like symptoms

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Current Illness:

ID: 1349852
Sex: F
Age: 38
State:

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/14/2021
Hospital:

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Symptoms: Headache, Myalgia, Fever, chills Narrative:

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Current Illness:

ID: 1349853
Sex: F
Age: 53
State:

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/14/2021
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Symptoms: Headache, Myalgia, Arthralgia, Diarrhea, NauseaVomiting, Fatigue,achy,stomach pain,Told to follow up with primary care Narrative:

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Current Illness:

ID: 1349854
Sex: F
Age: 42
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/14/2021
Hospital:

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Symptom List:

Symptoms: Dizziness, Headache, Myalgia, Arthralgia & NauseaVomiting Narrative:

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Current Illness:

ID: 1349855
Sex: F
Age: 35
State:

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/14/2021
Hospital:

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Symptoms: Headache, Myalgia, Fever, NauseaVomiting, fatigue Narrative:

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Current Illness:

ID: 1349856
Sex: F
Age: 50
State:

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/14/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: malaise, chills, injection site redness and swelling Narrative:

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Current Illness:

ID: 1349857
Sex: F
Age:
State:

Vax Date:
Onset Date: 01/07/2021
Rec V Date: 01/14/2021
Hospital:

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Lab Data:

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Symptoms: Headache, Myalgia & Fever Narrative:

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Current Illness:

ID: 1349858
Sex: F
Age: 60
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/14/2021
Hospital:

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Lab Data:

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Symptom List:

Symptoms: Myalgia aches, pain, fatigue Narrative:

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Current Illness:

ID: 1349859
Sex: F
Age: 43
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/14/2021
Hospital:

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Symptoms: Headache, Myalgia, Fever, CHILLS, FATIGUE Narrative: RESTING AT HOME AND TAKING IBUPROFEN, INCREASED FLUIDS

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Current Illness:

ID: 1349860
Sex: M
Age: 41
State:

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/14/2021
Hospital:

Vax Type:
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Symptoms: Headache, Myalgia & Fever Narrative:

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Current Illness:

Total 2021 VAERS Injuries: 128,185

Page last modified: 03 October 2021 5:28pm