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: 1310616
Sex: M
Age: 75
State: MN

Vax Date: 03/19/2021
Onset Date: 04/19/2021
Rec V Date: 05/12/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Guillain Barr? syndrome

Other Meds:

Current Illness:

ID: 1310617
Sex: F
Age: 39
State: GA

Vax Date: 03/31/2021
Onset Date: 04/20/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: decrease range of motion of the left arm (arm that received vaccination).

Other Meds: N/A

Current Illness: N/A

ID: 1310618
Sex: F
Age: 45
State:

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: None stated.

Other Meds: Anxiety, panic attack, she request BP check: pulse 74 respiration : 16; SPO2: 97 BP: 118/78; She felt better after 10 minutes , given water

Current Illness:

ID: 1310619
Sex: F
Age: 60
State: MN

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 05/12/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient hospitalized within 6 weeks of receiving COVID vaccination. First admission occurred on 4/15/2021 and the next was on 4/20/2021.

Other Meds:

Current Illness:

ID: 1310620
Sex: F
Age: 77
State: WA

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: After receiving the J&J vaccine 6 weeks ago and started getting stomach cramps that lasted a week, after that it subsided but has never stopped, now I can hardly eat anything. I went to the ER two weeks ago but there was no concern because there were no blood clots. Now my bowel is restricted and I've had auto-immune issue about a year and a half ago. Now just cramps and bloating. I also have a tooth that's come loose and I have a strange taste in my mouth since having the vaccine. I saw the doctor and they just called and the doctor stated that I've continue to have problems I should consider having an ultrasound of my stomach. Also, in the past, I went to Hospital.

Other Meds: Calcium, Vit D, Multivitamin and CQ10

Current Illness: No

ID: 1310621
Sex: F
Age: 67
State: AZ

Vax Date: 02/12/2021
Onset Date: 05/09/2021
Rec V Date: 05/12/2021
Hospital: Y

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

Lab Data:

Allergies: none

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

Symptoms: Renal Infarct (blood clots to both kidneys)

Other Meds: pravaststatin, levothyroxine

Current Illness: none

Date Died: 04/27/2021

ID: 1310622
Sex: M
Age: 48
State: OH

Vax Date: 01/06/2021
Onset Date: 04/26/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Developed symptoms around 4/25, presented to ED with complaints of chest pain and something being stuck in his throat. Subsequently died on 4/27.

Other Meds: Unknown

Current Illness: None

ID: 1310623
Sex: F
Age: 35
State: ME

Vax Date: 05/01/2021
Onset Date: 05/11/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: A dose of 0.3 ml was thought to be injected into left deltoid; however, syringe drawn up in advance by a pharmacy staff and double checked by lead pharmacist at the vaccination center acted as if it were "empty" with no vaccine in the syringe with plunger at 0.3 ml location. There was uncertainty about whether there had been vaccine in the syringe. Syringe behaved atypically when injected and no observable bubbles or solution as it was injected but vaccinator was uncertain whether there had been solution in the vaccine administered. Patient was in second trimester of pregnancy. The patient was observed for 48 hours to be sure no expected delayed local or systemic symptoms post suspected empty injection occurred and there were none. She had experienced arm soreness and some malaise after her initial dose 1 of Pfizer on 4/10/21 and confirmed that she did not have any symptoms or arm soreness with the planned second dose on 5/1/21. She was brought back to vaccination site for additional dose 2 after review of risks and benefits on 5/4/2021

Other Meds:

Current Illness:

ID: 1310624
Sex: M
Age: 24
State: IA

Vax Date: 04/13/2021
Onset Date:
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: He had previously received the Janssen on 3/10 in the community and no documentation was provided at intake. He never mentioned having the vaccine.

Other Meds:

Current Illness:

ID: 1310625
Sex: F
Age: 51
State: CA

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I felt nauseated and tired on day 2 (4/10), better on day 3 (4/11) but had serious vertigo on day 4 & 5 (4/12 & 4/13). I couldn't lift my head off the pillow without almost falling on 4/12. Had steady improvement on 4/13, and was walking around by end of day. By 4/14, I felt back to normal and went back to work. I have had vertigo in the past, but never such a severe case and unrelated to a migraine

Other Meds: Metformin, Advair, Prevastatin, Omeprazole, Nortryptyline, Amlopidine

Current Illness: None

ID: 1310626
Sex: F
Age: 48
State: MI

Vax Date: 05/08/2021
Onset Date: 05/12/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: I am a 48 year old Female been in Menopause for 3years ( no cycle for 24plus months), 4 days after receiving the vaccine I have now started to have stomach cramps an light bleeding as if I were on my period. I have not had any symptoms of this in three years. After my first shot day 14 i had very tender breasts , That has since subsided and now i am dealing with bleeding. would love to know how many other women are going thru this

Other Meds: N/A

Current Illness: N/A

ID: 1310627
Sex: F
Age: 50
State: NC

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Muscle spasms, TIGHT muscles, esp neck and head. Headache.

Other Meds: Birth control

Current Illness:

ID: 1310628
Sex: M
Age: 80
State: SC

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Severe bruising to bilateral hands (thumb and forefinger area). Pt notes no injury. Bruising began to develop the day after vaccination and steadily worsened over the next several days. Bruising is still apparent 6 weeks later.

Other Meds: METFORMIN TAMSULOSIN GLIPIZIDE LISINOPRIL ROSUVASTATIN METOPROLOL CLOPIDOGREL CLOTRIMAZOLE-BETAMETHASONE CREAM FLONASE ASPIRIN

Current Illness: NONE

ID: 1310629
Sex: F
Age: 59
State: MA

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

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

Symptoms: Fatigue, muscle pain,headaches since second COVID shot Condition improving

Other Meds: multivit-min/ferrous fumarate (MULTI VITAMIN ORAL) Instructions: Take by mouth. Documented by Historical Provider, MD on 8/20/2019 cholecalciferol (VITAMIN D3) 1,000 unit tablet Instructions: Take 1,000 units by mouth daily. Documented by H

Current Illness:

ID: 1310630
Sex: F
Age: 32
State:

Vax Date: 04/08/2021
Onset Date: 04/29/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: pulmonary embolus

Other Meds:

Current Illness:

ID: 1310631
Sex: F
Age: 34
State: MN

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: 20 weeks pregnant when vaccine was given. 5 hours after vaccine was given the patient complained of numbness and tingling on the left side of her face. Within days the numbness and tingling radiated down her left side. No facial drooping noted. Went to the Emergency Room on 4/11/21.

Other Meds: Vitamins, Folate, Prenatal Vitamin, Synthroid

Current Illness: Tickle in the throat 1 week prior.

ID: 1310632
Sex: F
Age: 85
State: MI

Vax Date: 02/19/2021
Onset Date: 05/09/2021
Rec V Date: 05/12/2021
Hospital: Y

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

Lab Data:

Allergies: Flu vaccine Pneumococcal vaccine Tb

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

Symptoms: DIAGNOSIS at time of disposition: 1. COVID-19 virus detected 2. Fall, initial encounter 3. Traumatic rhabdomyolysis, initial encounter (HCC) 4. Hypothermia, initial encounter 5. Atrial fibrillation with rapid ventricular response (HCC) 6. Pneumonia due to COVID-19 virus

Other Meds: Vitamin C Calcium multivitamin

Current Illness: none known

ID: 1310633
Sex: F
Age: 49
State: UT

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: crabfish

Symptom List: Ear pain, Hypoaesthesia

Symptoms: paralysis of my face for 2 days and severe migraines intermittent for the last 5 months that are invalidating

Other Meds:

Current Illness:

ID: 1310634
Sex: M
Age: 76
State: WA

Vax Date: 05/01/2021
Onset Date: 05/07/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: Some antibiotics

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: chills, sweats, fatigue & very unpleasant convulsive diarrhea.

Other Meds:

Current Illness:

ID: 1310635
Sex: F
Age: 53
State:

Vax Date: 02/02/2021
Onset Date: 05/09/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: No symptoms noted.

Other Meds:

Current Illness:

ID: 1310636
Sex: F
Age: 31
State: NY

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt presented for 2nd dose and stated that she developed hives ~ 72 hours after receiving fist dose. She never reported to MD. Take Zyrtec QD, so did not take Benadryl. Called Dr. who stated she should stay for 30 minutes observation. During this time, she reported feeling tingly, a ?strange feeling?, thought she was going to faint and had some chest tightness. She was observed for 45 minutes and was without complaint when she left.

Other Meds: Vitamins, folic acid

Current Illness:

ID: 1310637
Sex: F
Age: 78
State: TX

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: She had labored breathing in her chest and rib cage hurt for 36 hours post vaccination. She also had a urinary tract infection at the time and felt her heart flutter. In the past, she reported a history of reaction to any vaccine, including polio.

Other Meds:

Current Illness: UTI at the time of receiving vaccine

ID: 1310638
Sex: F
Age: 0
State: CA

Vax Date: 05/10/2021
Onset Date: 05/11/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: First time seizure after routine 6 month vaccines at primary clinic

Other Meds: Tylenol

Current Illness: None

ID: 1310639
Sex: F
Age: 24
State: NJ

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: symptoms of lethargy, feverish, muscle and joint aches, cold sweat

Other Meds: Tri-sprintec birth control

Current Illness:

ID: 1310640
Sex: M
Age: 24
State: IN

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Felt weird and feverish but did not have actual fever. Also felt nauseous.

Other Meds: Alprazolam

Current Illness: N/a

ID: 1310641
Sex: M
Age: 25
State: CA

Vax Date: 05/09/2021
Onset Date: 05/09/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Lightheaded, itchy, heart palpitations, breathing distress. Sent to UC transferred to ED.

Other Meds:

Current Illness:

ID: 1310642
Sex: M
Age: 47
State: WA

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: " I received the dose in my left arm and immediately after I was escorted from the treatment room to the waiting area I noticed a metallic taste in my mouth. I sat down to wait for my 15 minutes to be up as requested by the pharmacist. Within a minute of waiting my tongue started feeling numb on my left side and the left side of my face started tingling (cheek and region just below my eye). I also felt like my throat was tight and felt like I needed to clear my throat. I started researching "face tingling moderna" as I was getting concerned. I waited in the chairs for 20 minutes or so and no one came out of the pharmacy. My symptoms had not worsened but were not all the way gone with the face tingling remaining the longest. I decided to do some shopping as planned and would report my symptoms to the pharmacy if they didn't go away. All in all my symptoms lasted 25-30 minutes with the most intensity in the first 15 minutes."

Other Meds: Maca, Ginseng, Grapeseed extract, nettles, vitamin d

Current Illness: None

ID: 1310643
Sex: F
Age: 46
State: OR

Vax Date: 05/07/2021
Onset Date: 05/12/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: first 24 hrs ? 1) numbness and tingling in fingers and arm of vaccinated arm 24-56 hrs ? 1) slight facial paralysis on left side of face causing muscle twitching when I tried to smile 2) pain, inflammation and redness at the exact site of a scar from a childhood vaccine approx 2-3 inches from Pfizer injection 3) fatique

Other Meds: none

Current Illness: none

ID: 1310644
Sex: F
Age: 66
State: WI

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: This was 2nd dose. Within an hour I experienced a metal taste. It is now 1 month of a 24 hour taste.

Other Meds: Levothyroxin - 1 a day Multiple vitamin,, Macuguard ,,fish oil, Turmeric, Calcium, Glucosamine w/ MSM complex

Current Illness: none

ID: 1310645
Sex: M
Age: 48
State: NY

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Since my J&J vaccine, I have limited mobility on my left shoulder, at the injection site, still sore and can not lift my left arm to full extent.

Other Meds:

Current Illness:

ID: 1310646
Sex: F
Age: 40
State: CO

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Injection site pain

Symptoms: Patient reports Right arm pain radiating to right leg, 1 hour post injection. States symptoms subsided within 24 hours. Reports "lump" at right neck area starting 4/14 and currently still present, lympadenopathy has not subsided. No other complaints, no signs/symptoms of allergic reaction. Did not require treatment/medical intervention. Patient was provided PCP & FQHC contact list to follow-up with a PCP.

Other Meds: None per patient

Current Illness: None.

ID: 1310647
Sex: F
Age: 52
State: MD

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Headache, body aches, chills

Other Meds: Triameterine HCTZ, OTC multi- vitamins, calcium, vitamin D

Current Illness: None

ID: 1310648
Sex: M
Age: 73
State:

Vax Date: 03/10/2021
Onset Date: 04/07/2021
Rec V Date: 05/12/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient presented to the ED and were subsequently hospitalized within 6 weeks of receiving COVID vaccination. Diagnosis was NSTEMI.

Other Meds:

Current Illness:

ID: 1310649
Sex: M
Age: 24
State: NJ

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: No known Allergies

Symptom List: Tremor

Symptoms: Moderna Covid 19 Vaccination dose #2 given 8 days after receiving dose # 1. No adverse symptoms were noted

Other Meds: Mirtazapine

Current Illness: None noted

ID: 1310650
Sex: F
Age: 34
State: PA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/12/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Erythema, Pruritus

Symptoms: Pt was admininstered her first pfizer vaccine at approximately 3:11pm on 5/11/21. She was waiting 15 min following injection. I went to tell her the 15 minutes was up when she reported that she felt "tightness" across her upper chest. I asked her to stay a little longer so another nurse and myself could monitor her. She agreed. After just a few more minutes she reported a small itch on her left cheek and left neck. The other nurse and myself did not observe any bumps or hives. While I stayed with the patient, the other nurse went to the pharmacy and got #2 25mg oral benadryl and gave to the patient with water. She waited an additional 15 minutes and stated she was feeling ok and left. The following day, 5/12/21, we noticed her appt that was scheduled for 6/02/21 was cancelled. I called the patient to see if she cancelled or if it was an error on my part. She confirmed that she did cancel the appointment and she did not want the second dose. She reported that approximately 4-5 hours after she left our facility and the benadryl wore off, she got hives all over her abdomen and arms and started having difficulty breathing. She went to the emergency room and states she was treated with benadryl and pepcid. She was feeling better when I spoke to her on 5/12/21, however, due to the reaction she is declining the second dose of the pfizer vaccine.

Other Meds: unknown

Current Illness: unknown

Date Died: 05/06/2021

ID: 1310651
Sex: F
Age: 69
State: CO

Vax Date: 03/02/2021
Onset Date: 04/13/2021
Rec V Date: 05/12/2021
Hospital: Y

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Allergies: carisoprodol - rash, adhesive tape, lisinopril - cough

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

Symptoms: Patient received Moderna vaccine 3/2/2021 0.5 ml LD IM Lot: 029L20A and Moderna vaccine 3/30/2021 0.5 ml LD IM Lot: 019B21A. The patient was exposed to an infected person with Covid about 1 week after her second vaccine. She was admitted to the ICU with severe covid on 4/13/21. She was eventually transitioned to comfort care and died on 5/6/2021.

Other Meds: alirocumab 75 mcg/ml, 1 ml q14 days, apixaban 2.5 mg po BID, aspirin 81 mg po daily, atorvastatin 80 mg po daily, calcium, estradiol vaginal cream, ferrous sulfate 325 mg po daily, fluoxetine 40 mg po daily, gemfibrozil 600 mg po BID, levo

Current Illness: - EColi UTI - New Praluent prescription

ID: 1310652
Sex: F
Age: 44
State: IN

Vax Date: 05/10/2021
Onset Date: 05/11/2021
Rec V Date: 05/12/2021
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Allergies: Topamax

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

Symptoms: Fever, extreme fatigue, muscle pain, weakness

Other Meds: Pregabalin, hydrocodone/acetaminophen, escitalopram, levothyroxine, carbamazepine, propranolol, trazodone, tizanidine,

Current Illness:

ID: 1310653
Sex: F
Age: 60
State:

Vax Date: 03/15/2021
Onset Date: 03/19/2021
Rec V Date: 05/12/2021
Hospital:

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Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Beyond the fatigue, I experienced dizziness that began decreasing two months after onset. It is still not fully resolved. It made teaching online a challenge.

Other Meds:

Current Illness:

ID: 1310654
Sex: M
Age: 27
State: MD

Vax Date: 05/10/2021
Onset Date: 05/11/2021
Rec V Date: 05/12/2021
Hospital:

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Allergies:

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

Symptoms: pt says he has dry cough, shivers, chills, nausea, body aches, headache, fatigue and right arm is still sore. He has taken ibuprofen for his symptoms on the first day. On 5/12/21 he still has a dry cough and fatigue.

Other Meds:

Current Illness:

ID: 1310655
Sex: F
Age: 35
State:

Vax Date: 03/31/2021
Onset Date: 05/11/2021
Rec V Date: 05/12/2021
Hospital:

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Allergies:

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

Symptoms: New sore throat, New muscle aches

Other Meds:

Current Illness:

ID: 1310656
Sex: F
Age: 72
State: MI

Vax Date: 03/31/2021
Onset Date: 05/05/2021
Rec V Date: 05/12/2021
Hospital: Y

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Lab Data:

Allergies: Sulfa drugs

Symptom List: Pain in extremity

Symptoms: complaint of shortness of breath and fevers, which she had been experiencing for the past few days but significantly worsened as of that morning - she is came from residence brought by her daughter. Pt has a history of COPD and is a former smoker, for which she uses a pulse oximeter at home and reports that her levels were as low as the 70s. She says for the past week she had been feeling significant fatigue and shortness of breath, needing to stop to rest even when walking between rooms at home. Pt had tested positive for COVID-19 antibody previously in Feb 2021, and her COVID PCR tested positive in the ED. Chest Xray and CT Angiogram were done showing ground glass appereance consistent with COVID-19 and ruled out pleural effusion, and pulmonary embolism

Other Meds: Xanax Prozac Lasix albuterol

Current Illness: None known

ID: 1310657
Sex: F
Age: 52
State: WA

Vax Date: 04/26/2021
Onset Date: 05/08/2021
Rec V Date: 05/12/2021
Hospital:

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Allergies: All nuts, chamomile, rag weeds, penicillin, demeol, legumes, molds, pollin

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

Symptoms: Develop a severe rash that is raises all over my body

Other Meds: Tramadol 50mg 2 times daily Allegra over counter 1 time day Zantac 40mg 1 time day

Current Illness: None

ID: 1310658
Sex: M
Age: 57
State:

Vax Date: 05/04/2021
Onset Date: 05/05/2021
Rec V Date: 05/12/2021
Hospital:

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Allergies: penicillin

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

Symptoms: fever, sore muscles, lack of appetite, weight loss, fatigue,

Other Meds:

Current Illness: allergies

ID: 1310659
Sex: F
Age: 52
State: VA

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 05/12/2021
Hospital:

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Allergies: Sulfa Bees

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

Symptoms: Abnormal involuntary muscle movement Felt like I was having seizures while being conscious and alert

Other Meds: Aimovig Autoinjector 140mg/mL Amphetamine-Dextroamphetamine 20mg Cyclobenzaprine 10mg Desmopressin 0.1mg ESomeprazole40mg

Current Illness: Rheumayoid arthritis

ID: 1310660
Sex: M
Age: 66
State:

Vax Date: 03/16/2021
Onset Date: 04/09/2021
Rec V Date: 05/12/2021
Hospital: Y

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Allergies:

Symptom List: Vomiting

Symptoms: Patient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination. Diagnosis was COVID 19

Other Meds:

Current Illness:

ID: 1310661
Sex: F
Age: 67
State: NE

Vax Date: 04/21/2021
Onset Date: 04/29/2021
Rec V Date: 05/12/2021
Hospital: Y

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Lab Data:

Allergies: Sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt. was transferred to local ED after accidently fell off barstool at home and landed on her left side. Pt. was c/o severe left hip pain. After x-ray found to have Left femoral shaft fracture. Pt. was transferred to higher level of care for ortho. In the ER record there is no documentation of pt. having any s/s or c/o's following the 2nd Covid vaccine.

Other Meds: Xanax, Amitriptyline, Multiple Vitamins, Adderall, Tylenol #3, Vitamin B-12, Cymbalta, Ferrous Sulfate, Flovent Inhaler, Lasix, Plaquenil, Levothyroxine, Omeprazole, Pravachol, Ropinirole, Trazodone, and Lamotrigine

Current Illness: None that aware of

ID: 1310662
Sex: M
Age: 72
State: PA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 05/12/2021
Hospital:

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Allergies: None

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

Symptoms: Had fever, muscle aches and fatigue. Continues to have fatigue since getting second shot on 4/10. Fatigue varying in intensity but new since getting vaccine.

Other Meds: acidophilus, aspirin, iron, losartan potassium, lutein, metformin hcl, multivitamin, Tamsulosin hcl, trazodone hcl, vitamin d3

Current Illness: None

ID: 1310663
Sex: M
Age: 58
State: PA

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/12/2021
Hospital:

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Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: PHARMACIST REPORTED ON BEHALF OF PT LIFTING BLOCKS 5/12/21 24 HOURS POST FIRST MODERNA SHOT FOR THE FIRST "FEW" HOURS PT REPORTED HE WAS FINE. PT REPORTED SHARP STABING PAIN AND FEELING OF NUMBNESS.PT DESCRIBED 'ARM WENT DEAD"PT DID NOT SEEK MEDICAL HELP. PT LEFT WORK AND WENT HOME. PT CLAIMED UNRESOLVED AND DID NOT TAKE ANY MEDICATION. +

Other Meds:

Current Illness:

ID: 1310665
Sex: F
Age: 35
State: IN

Vax Date: 05/10/2021
Onset Date: 05/11/2021
Rec V Date: 05/12/2021
Hospital:

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Allergies: None

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

Symptoms: extreme chills, fever, nausea and vomiting

Other Meds: None

Current Illness: None

ID: 1310666
Sex: M
Age: 55
State: CO

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/12/2021
Hospital:

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Allergies:

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

Symptoms: This inmate was vaccinated initially on 3/25/2021, then again on 4/26/2021 and again on 5/11/2021. He has not had a reaction but received a third dose in error.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am