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
63,479
AK1,562
AL4,914
AR3,110
AS44
AZ12,730
CA54,886
CO10,464
CT7,347
DC1,568
DE1,561
FL33,514
FM3
GA12,508
GU74
HI2,078
IA4,130
ID2,361
IL18,091
IN22,023
KS4,061
KY6,276
LA4,395
MA13,121
MD11,272
ME2,858
MH8
MI16,697
MN10,689
MO8,360
MP30
MS2,487
MT2,035
NC14,437
ND1,184
NE2,562
NH2,717
NJ16,033
NM3,532
NV3,784
NY30,921
OH17,029
OK5,673
OR7,479
PA21,111
PR1,959
QM2
RI1,833
SC5,601
SD1,087
TN8,048
TX31,896
UT3,791
VA13,180
VI48
VT1,592
WA13,026
WI9,856
WV2,120
WY754
XB5
XL1
XV2

ID: 0952498
Sex: F
Age: 38
State: VA

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 01/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: nitrous oxide

Symptom List:

Symptoms: headache, nausea, dry heaves. swollen lymph node under arm, pain and itching at injection site. lymph node under arm was painful and swollen for 1 week. Out of work on 1/12 due to inability to lift arm and use as node was very painful. fully resolved as on 1/15/21

Other Meds: none

Current Illness: none

ID: 0952499
Sex: M
Age: 17
State: NJ

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: NONE

Symptom List:

Symptoms: NONE

Other Meds: NONE

Current Illness: NONE

ID: 0952500
Sex: F
Age: 55
State: FL

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/18/2021
Hospital:

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

Allergies: shellfish

Symptom List:

Symptoms: 15 minutes after vaccine- itchy all over- took benedryl severe fatigue starting the next day vaccine and lasting for 7 days Arm tender for first 48 hours 9 days AFTER vaccine- area where vaccine given very red, swollen , hot to touch and itchy

Other Meds: Wellbutrin Losartin

Current Illness:

ID: 0952501
Sex: F
Age: 28
State: IN

Vax Date: 01/06/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
Hospital:

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

Allergies: Sulfa, Clindamycin, Erythromycin, Cephalexin

Symptom List:

Symptoms: A week after my vaccine woke up my arm was swollen, red, hot to touch, sore, and very itchy. The swelling has decreased but is still there. The swelling has moved around. Redness has spread to other area's of my arm. Still very itchy, but is no longer hot to touch. Arm is only sore when its touched.

Other Meds: Zyretc, Levothyroxine, Wellbutrin, Buspar, Vitamin D, Singulair, Falmina, Nexium

Current Illness: None

ID: 0952502
Sex: F
Age: 65
State: CT

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/18/2021
Hospital:

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

Allergies: Sulfa

Symptom List:

Symptoms: 12 hours after receiving the second vaccine I developed a temp of 103 that lasted approximately 36 hours. I also developed a rash on my forearms 24 hours after the vaccine which lasted approximately 24 hours

Other Meds: Metoprolol, Airborne, Zyrtec

Current Illness: none

ID: 0952503
Sex: F
Age: 74
State: KY

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies: Penicillin, Bactrim, Cardizem, Codeine, Levaquin, iv contrast

Symptom List:

Symptoms: 20 minutes after vax, started having a headache, feeling hot, BP was 51/37, nausea, severe pain in lower back, felt paralyzed, couldn't stand up, diarrhea, collapsed on bathroom floor. Took Zofran for nausea. went to lie down in bed and after a while, BP went back to normal.

Other Meds: Synthroid

Current Illness: n/a

ID: 0952504
Sex: F
Age: 29
State: OH

Vax Date: 12/18/2020
Onset Date: 12/19/2020
Rec V Date: 01/18/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
Dose Series:
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Lab Data:

Allergies: ciprofloxacin, cephalexin

Symptom List:

Symptoms: Twelve hours after receiving vaccine patient began experiencing chills & body aches. The next morning (24 hours post-vaccine) the patient had a very bad migraine, chills, and body aches. Upon standing felt nauseous & dizzy, then saw black dots and vision went black for several minutes and fell to floor. Relative called 911 and vision had returned by the time medics arrived. Vitals were normal, except for low blood pressure. She took Advil and felt better by the evening.

Other Meds:

Current Illness:

ID: 0952505
Sex: F
Age: 67
State: AZ

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Horrible headache for 30 hours Bad body aches

Other Meds:

Current Illness:

ID: 0952506
Sex: M
Age: 69
State: MO

Vax Date: 01/10/2021
Onset Date: 01/11/2021
Rec V Date: 01/18/2021
Hospital:

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

Allergies: baclofen, keflex, sulfa, vytorin

Symptom List:

Symptoms: Tremors, elevated BUP and Heart Rate, Elevated temperature of 100.6 that continued to rise to 101.6 despite tylenol being administered. Altered Level of consciousness.

Other Meds: Sevelamer, Eliquis, Fluoxetine, Lasix, Renal-Vite, Finasteride, Rivastigmine patch, carvedilol, amlodipine, florastor, citrucel, protonix, flomax, rosuvastatin

Current Illness: Pulmonary Embolism, acute respiratory failure with hypoxia, Chronic diastolic (congestive) heart Failure

ID: 0952513
Sex: U
Age: 35
State: UT

Vax Date: 12/16/2020
Onset Date: 12/16/2020
Rec V Date: 01/18/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: the patient has not complained of any adverse reactions; a dose of MMRII or VARIVAX mixed with a non Merck diluent; This spontaneous report as received from a registered nurse refers to a 35-year-old patient of unknown gender. The patient's medical history, concurrent conditions and concomitant medications were not reported. On 16-DEC-2020, the patient was vaccinated with a dose of measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (M-M-R II) 0.5 ml or varicella virus vaccine live (oka/merck) (VARIVAX) 0.5 ml (lot #, expiration date and route of administration were not reported for both) for prophylaxis that was reconstituted with an improper diluent. The diluent used was for zoster rgE vaccine (mammalian) (SHINGRIX) (reported as SHINGREX) and read "Asolb mono phospholipid lipid a qs-21 natural compound extracted from the soap bark tree, combined in liposomal formulation". The patient had not complained of any adverse reactions. This is one of two reports received from the same reporter.; Sender's Comments: US-009507513-2101USA001793:

Other Meds: sterile diluent

Current Illness:

ID: 0952514
Sex: U
Age:
State: OH

Vax Date: 12/07/2015
Onset Date:
Rec V Date: 01/18/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Postherpetic neuralgia, vision problems and neurological issues; Postherpetic neuralgia, vision problems and neurological issues; Postherpetic neuralgia, vision problems and neurological issues; Information has been received from a lawyer regarding a case in litigation, referring to a currently 65 year old patient of unknown gender. Information regrading the patient's pertinent medical history, concurrent conditions, known allergies and concomitant medications was not provided. On or about 07-DEC-2015, the patient was vaccinated at a clinic with zoster vaccine live (ZOSTAVAX) (strength, dose, route of administration, lot # and expiration date were not provided),for the long-term prevention of shingles and zoster-related conditions. Subsequently, on an unknown date, the patient was treated by a provided for the following injuries: post herpetic neuralgia, vision problems (visual impairment) and neurological issues (nervous system disorder). The patient claimed damages as result of injuries to themselves and economic losses. At the time of the report, the outcome of post herpetic neuralgia, nervous system disorder and visual impairment was unknown. The lawyer considered post herpetic neuralgia, nervous system disorder and visual impairment to be related to Zoster Vaccine Live (ZOSTAVAX).

Other Meds:

Current Illness:

ID: 0952515
Sex: M
Age:
State: TX

Vax Date: 05/01/2019
Onset Date: 05/01/2019
Rec V Date: 01/18/2021
Hospital: Y

Vax Type:
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Lab Data:

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Symptom List:

Symptoms: Sore throat with excessive saliva / diagnosed with Epiglottitis; excessive saliva; Tuesday had a sore throat / received IM anti-biotic / Thursday still had a very bad sore throat; This case was reported by a nurse via sales rep and described the occurrence of epiglottitis in a 68-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. The patient's past medical history included shingles. In May 2019, the patient received the 1st dose of Shingrix .5 ml. In May 2019, 1 day after receiving Shingrix, the patient experienced sore throat. On an unknown date, the patient experienced epiglottitis (serious criteria hospitalization and GSK medically significant) and saliva secretion excessive. The patient was treated with antibiotics nos (Antibiotic (Details Unknown)). On an unknown date, the outcome of the epiglottitis, sore throat and saliva secretion excessive were recovered/resolved. It was unknown if the reporter considered the epiglottitis, sore throat and saliva secretion excessive to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The patient received Shingrix .5ml dose on a Monday around May 2019. The next day on Tuesday, this patient had a sore throat, on Wednesday he received an IM anti-biotic, on Thursday still had a very bad sore throat with excessive saliva so went to hospital and diagnosed with Epiglottitis. This patient's condition eventually resolved with no further issues. The patient never received a second Shingrix immunization. Supposedly this patient did experience a case of Shingles the year before he received the Shingrix vaccine. This nurse wanted to know if the patient could receive a COVID vaccine. The reporter did not know if there was any causal relationship with the vaccine so she never reported.

Other Meds:

Current Illness:

ID: 0952516
Sex: U
Age:
State: NY

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

Vax Type:
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Vax Name:
Lot:
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Lab Data:

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Symptom List:

Symptoms: flu like symptoms; This case was reported by a nurse via call center representative and described the occurrence of influenza-like symptoms in an unknown number of patients patients who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced influenza-like symptoms. On an unknown date, the outcome of the influenza-like symptoms was recovered/resolved. It was unknown if the reporter considered the influenza-like symptoms to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not applicable for this report. The reporter had a few patients that reported a severe reaction following Shingrix, flu like symptoms that lasted several days. The reporter consented to follow up. No additional details available. The case has been linked with the case US2020244472 reported by same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2020244472:same reporter

Other Meds:

Current Illness:

ID: 0952517
Sex: U
Age:
State: NY

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

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: generalized burning sensation; paresthesia / abnormal skin sensation; This case was reported by a nurse via call center representative and described the occurrence of burning sensation in an unknown number of patients who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced burning sensation and paresthesia. On an unknown date, the outcome of the burning sensation and paresthesia were unknown. It was unknown if the reporter considered the burning sensation and paresthesia to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not applicable for this report. The reporter stated that couple of patients experienced generalized ,burning sensation, paresthesia, abnormal skin sensation following Shingrix administration. The reporter consented to follow up. No additional details available.; Sender's Comments: US-GLAXOSMITHKLINE-US2020244470:same reporter

Other Meds:

Current Illness:

ID: 0952518
Sex: F
Age: 60
State: NJ

Vax Date: 12/01/2020
Onset Date:
Rec V Date: 01/18/2021
Hospital:

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

Allergies:

Symptom List:

Symptoms: diagnosed with breast cancer / right breast / 2 cm. in size; received the injection / hurt / as being bit by a Jersey mosquito; This case was reported by a consumer via call center representative and described the occurrence of breast cancer in a 60-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 1st December 2020, the patient received the 1st dose of Shingrix. On an unknown date, less than 2 months after receiving Shingrix, the patient experienced breast cancer (serious criteria GSK medically significant) and injection site pain. On an unknown date, the outcome of the breast cancer and injection site pain were unknown. It was unknown if the reporter considered the breast cancer and injection site pain to be related to Shingrix. Additional details were provided as follows: The patient reported that she received her first dose of Shingrix and she was diagnosed with breast cancer around the same time. The patient could not recall the exact date of her diagnosis and she couldn't confirm if the diagnosis occurred before or after the vaccination. The patient claimed that the breast cancer was in her right breast and was 2 cm. in size. The patient planned to undergo chemotherapy. She also reported that when she received the injection, it hurt which she described as being bit by a mosquito. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 0952519
Sex: F
Age: 48
State: TN

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/18/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Body aches; Fever 99.8F; Chills; Entire left arm muscle is in pain on movement; Choking in the throat; Facial Flush; Blurred vision; Dizziness; Confusion; I had no emotions; A spontaneous report was received from a pharmacist concerning a 48-years old, female patient who received Moderna's Covid-19 vaccine (mRNA-1273) and experienced choking, flushing, vision blurred, dizziness, confusional state, emotional disorder, body aches, pyrexia, chills and limb discomfort. The patient's medical history included migraines and a hysterectomy. Products known to have been used by the patient, within two weeks prior to the event, included sumatriptan, naratriptan hydrochloride, and galconezumab. On 02 Jan 2021, prior to the onset of events, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025L20A) in the left deltoid intramuscularly for prophylaxis of COVID-19 infection. A pharmacist called stating she received the Moderna COVID-19 vaccine on 02 Jan 2021 at 9:45am in her left deltoid. Immediately after receiving the vaccine, she had facial flushing, blurred vision, dizziness, confusion and choking in the throat that lasted 20 minutes. After a few hours, she stated confusion would come and go, and she had no emotions. The next morning, the confusion was gone. On 03 Jan 2021, she reported having body aches and a fever of 99.8 degrees Fahrenheit. She reported chills, body aches, and a lot of pain in the left arm. If she tried to move her left arm, the entire muscle in the left arm hurt. Treatment for the events included acetaminophen and an antihistamine. Action taken with mRNA-1273 in response to the events was withdrawn. The events, choking, flushing, vision blurred, were considered resolved on 02 Jan 2021. The events, confusional state, emotional disorder, and dizziness, were considered resolved on 03 Jan 2021. The events, body aches, pyrexia, chills, and limb discomfort, were not considered resolved.; Reporter's Comments: This case concerns a 48 year old female patient with medical history of migraines, who experienced a serious unexpected event of Choking, non-serious unexpected events of Flushing, Vision blurred, Dizziness, Confusional state, Emotional disorder, Pain, and Limb discomfort, and non-serious expected events of Pyrexia and Chills. The events of Choking, Flushing, Vision blurred, Dizziness, and Confusional state occurred immediately after administration of their first of two planned doses of mRNA-1273 (Lot number: 025L20A). The event of Emotional disorder occurred on the same day when the patient received mRNA-1273. The events of Pain, Pyrexia, Chills, and Limb discomfort occurred on the next day of mRNA-1273 administration. Very limited information regarding the events has been provided at this time. Based on temporal association between the use of the product and the onset of the events, a causal relationship cannot be excluded.

Other Meds: IMITREX [SUMATRIPTAN]; AMERGE; EMGALITY [GALCANEZUMAB]

Current Illness: Migraine

ID: 0952521
Sex: F
Age:
State:

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

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

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Symptom List:

Symptoms: Swelling; Scratcky tongue; Scratchy mouth; This spontaneous case was received on 21-Dec-2020 from nurse via Agency (reference number: SEQW20-05868) and concerned a female patient of an unreported age. The patient's medical history and concomitant medications were not reported. On an unspecified date in 2019, the patient was vaccinated with Flucelvax Quadrivalent (influenza vaccine, subunit influenza virus vaccine polyvalent, dose, route of administration and anatomical location: not reported) for flu prevention. The batch number was not reported. On an unspecified date in 2019, an unknown amount of time after receiving Flucelvax Quadrivalent, the patient developed scratchy tongue, swelling and scratchy mouth. The outcome of the events was not reported. The reporter did not provide a causality assessment. This case as assessed as non-serious. Company comment: A patient of an unreported age was vaccinated with Flucelvax Quadrivalent. An unknown amount of time after receiving Flucelvax Quadrivalent, the patient developed scratchy tongue, swelling and scratchy mouth. Causal role of the suspect vaccine is unassessable, due to lack of information regarding temporal relationship, diagnostic findings and corrective treatment.; Sender's Comments: A patient of an unreported age was vaccinated with Flucelvax Quadrivalent. An unknown amount of time after receiving Flucelvax Quadrivalent, the patient developed scratchy tongue, swelling and scratchy mouth. Causal role of the suspect vaccine is unassessable, due to lack of information regarding temporal relationship, diagnostic findings and corrective treatment.

Other Meds:

Current Illness:

ID: 0952523
Sex: M
Age:
State:

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

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

Allergies:

Symptom List:

Symptoms: Vascular dementia; Had a reaction; This spontaneous case was received on 06-Jan-2021 from a pharmacist via Health Authority (reference number: SEQW21-00057) with additional information received on the same date (reference number: SEQW21-00058) (being processed together) and concerned an elderly, male patient. At the time of this report, the patient was an 84-year-old. The patient's medical history and concomitant medications were not reported. On an unknown date in 2018, the patient was vaccinated with Fluad (TIV) (influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, mf59, dose: 0.5 ml, route of administration and anatomical location: not reported) for flu prophylaxis. The batch number was not reported. On an unspecified date in 2018, unknown amount of time after receiving Fluad (TIV), the patient had a reaction at that point, but the reporter did not know what kind of reaction. On an unknown date, the patient was diagnosed with vascular dementia that got worse and was now in a nursing home. The reporter did not provide causality assessment. The reporter stated patient was diagnosed with vascular dementia, but they were not sure if this was related to the vaccine. At the time of initial reporting on 06-Jan-2021, the patient had not recovered from the event of vascular dementia. The outcome of event 'adverse reaction' was not reported. The event of vascular dementia was considered to be medically significant by a Physician within Seqirus' Pharmacovigilance and Risk Management Department. Company comment: A 84-year-old male patient experienced adverse reaction unknown amount of time after administration of Fluad (TIV). Vascular dementia was diagnosed on an unknown date. The patient's medical history and concomitant medications were not reported. Causality is unassessable for both events due to low narrative data.; Reporter's Comments: The reporter stated patient was diagnosed with dementia, but they were not sure if this was related to the vaccine.; Sender's Comments: A 84-year-old male patient experienced adverse reaction unknown amount of time after administration of Fluad (TIV). Vascular dementia was diagnosed on an unknown date. The patient's medical history and concomitant medications were not reported. Causality is unassessable for both events due to low narrative data.

Other Meds:

Current Illness:

ID: 0952524
Sex: F
Age:
State: AZ

Vax Date: 10/24/2020
Onset Date: 10/24/2020
Rec V Date: 01/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Blood pressure: 219/173, 186/97; Don't feel well- palpitation, cold and hurt around neck; Don't feel well- palpitation, cold and hurt around neck; Don't feel well- palpitation, cold and hurt around neck; Swelling 2r:1 inch right a way as the needle out; Don't feel well- palpitation, cold and hurt around neck; This spontaneous case was retrieved on 06-Jan-2021 from Vaccine Adverse Event Reporting System (VAERS) (reference number: 900434-1), reported by other health professional and concerned a 75-year-old female patient. The patient's concurrent conditions included hypertension, hypercholesterolemia, osteoporosis. The patient's concomitant medications were not reported. On 24-Oct-2020, the patient was vaccinated with Fluad Quadrivalent vaccine (influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, mf59; dose reported as one, route of administration: intramuscular, anatomical location: left arm and indication: not reported). The batch number reported was 279820. On the same day, after receiving Fluad Quadrivalent, the patient developed swelling '2r' (as reported):1 inch, right away as the needle was out. After around 10 minutes, the patient did not feel well, had palpitation, was cold and hurt around the neck. Pharmacist gave two tablets of Benadryl (diphenhydramine hydrochloride) at dose of 25 mg by mouth. The blood pressure was monitored: 219/173 - 70 and five minutes after 186/97 - 70 (units were not reported). The patient asked to call 911. No further details were provided. On an unspecified date in 2020, the patient recovered from all events. The reporter did not provide a causality assessment. The event of 'hypertension' was considered to be medically significant by a Physician within Seqirus' Pharmacovigilance and Risk Management Department. Company comment: A 75-year-old patient was vaccinated with Fluad Quadrivalent. On the same day, after receiving Fluad Quadrivalent, the patient developed hypertension, palpitations, swelling, neck pain, malaise, vaccination site swelling and feeling cold. The patient's concurrent conditions included hypertension, hypercholesterolemia, osteoporosis. Causality was highly confounded for hypertension and palpitations, cannot be totally excluded due to plausible chronology. Causal role of the suspect vaccine is unassessable for hypertension and palpitations, due to lack of information regarding concomitant medications and treatment compliance. Causal role of the suspect vaccine is assessed as possibly related for swelling, neck pain, malaise, vaccination site swelling and feeling cold.; Sender's Comments: A 75-year-old patient was vaccinated with Fluad Quadrivalent. On the same day, after receiving Fluad Quadrivalent, the patient developed hypertension, palpitations, swelling, neck pain, malaise, vaccination site swelling and feeling cold. The patient's concurrent conditions included hypertension, hypercholesterolemia, osteoporosis. Causality was highly confounded for hypertension and palpitations, cannot be totally excluded due to plausible chronology. Causal role of the suspect vaccine is unassessable for hypertension and palpitations, due to lack of information regarding concomitant medications and treatment compliance. Causal role of the suspect vaccine is assessed as possibly related for swelling, neck pain, malaise, vaccination site swelling and feeling cold.

Other Meds:

Current Illness: Hypercholesterolemia; Hypertension; Osteoporosis

ID: 0952530
Sex: F
Age: 38
State: MO

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/18/2021
Hospital:

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

Lab Data:

Allergies: PCN

Symptom List:

Symptoms: Became flushed from head to toe, rapidly, and became "very hot."

Other Meds: UNK

Current Illness: None

ID: 0952531
Sex: F
Age: 44
State: PR

Vax Date: 01/07/2021
Onset Date: 01/10/2021
Rec V Date: 01/18/2021
Hospital:

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

Lab Data:

Allergies: CRAPS

Symptom List:

Symptoms: 7 DAYS OF SINSTOMES,PAIN ON IJECTION SITE,SWELLING ON INJECTION SITE PAIN AND SWELLING ON RIGHT ARM PIT (GANGLIOS INFAMATION )

Other Meds: NONE

Current Illness: NONE

ID: 0952532
Sex: F
Age: 28
State: MA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Right arm numbness/tingling. Decreased to 2 fingers after 30 minutes of monitoring. 01/14/2021 starting having sporadic HA until today 01/18/2021.

Other Meds: None

Current Illness: None

ID: 0952533
Sex: M
Age: 45
State: NJ

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/18/2021
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Lab Data:

Allergies: Pollen (ragweed)

Symptom List:

Symptoms: Excruciating pain (9 on scale of 0-10; unable to move arm), chills, low fever (94 degrees F). Pain started a few hours after injection and continued for approximately 24 hours unabated, after which pain subsided somewhat. For the next 24 hours pain was still extreme (8 on scale of 0-10) though the range of motion in my arm increase a bit. After approximately 48 hours pain was dramatically reduced, and by day 3 I was near 100%. The magnitude of pain (9 out of 10) is why I thought it would be useful to report the event. The pharmacist said I should expect a lot of pain, but a complete in ability to move my arm due to searing pain seemed exceptional. The pain was so intense it caused dizziness and nausea as well.

Other Meds: Multi-vitamins, calcium supplement, Atenolol, Hydrochlorothyazide, Flowmax, Potasium citrate

Current Illness: None

ID: 0952534
Sex: F
Age: 55
State: CA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/18/2021
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Lab Data:

Allergies: denied

Symptom List:

Symptoms: Pt. C/O blurred vision peripherally in both eyes. She denied Hx of migraines, did not have any headache. No other symptoms

Other Meds: Vitamin D

Current Illness: denied

ID: 0952535
Sex: F
Age: 32
State: NJ

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/18/2021
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Lab Data:

Allergies: NKA

Symptom List:

Symptoms: 1/8/21 DURING DAY: FATIGUE AND HEADACHE STARTED; DURING EVENINGS: CHILLS, BODYACHES, JOINT PAIN, SORE THROAT, AND FEVER (100.9 WHILE ON EXTRA STRENGTH TYLENOL). SATURDAY MORNING: RED, HOT, WELT (ITCHY AT TIMES) AND STOMACH ISSUES. TOOK ADVIL AND EXTRA STRENGTH TYLENOL.

Other Meds: NONE

Current Illness: NONE

ID: 0952536
Sex: F
Age: 24
State: CO

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
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Lab Data:

Allergies: No Known

Symptom List:

Symptoms: Pt. states she has had swelling, itching and redness around injection site.

Other Meds: No Known

Current Illness: No Known

ID: 0952538
Sex: F
Age: 37
State: NY

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
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Allergies: None

Symptom List:

Symptoms: Within minutes of receiving the injection, I developed a metallic taste in my mouth. I also felt a bit light-headed and woozy. I informed the staff at the site that I felt this way and they asked me to remain for additional monitoring. Over the next 15 minutes, my tongue began to swell. 15 minutes later my jaw began to stiffen and I had difficulty swallowing. After another 15 minutes the staff asked the EMS personnel to screen me and check my vitals. All were normal. After another 30 minutes of monitoring by EMS the symptoms began to subside and I went home. At home, I began to feel weak and went to bed. My body began to ache and I took ibuprofen to ease the pain. Within 15 hours of receiving the dose, I had a 100.9-degree fever and chills. The fever lasted the next day. I could not get out of bed for the next day. When I tried to sit up and watch TV I had back pain so severe it left me in tears. I went back to bed and stayed there until the following morning. All told, I could not get out of bed for 36 hours.

Other Meds: Losartan 75 mg

Current Illness: POTS

ID: 0952539
Sex: F
Age: 50
State: NC

Vax Date: 01/04/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
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Allergies: Iodine

Symptom List:

Symptoms: Red Bull?s eye erythemic area ~ 8cm x 4cm; initial warmth & swelling, noted on day 9. Erythema & warmth continues with mild itching.

Other Meds: Celexa 40mg po qd; diclofenac 75mg po qd; Wellbutrin SR 150 mg po qd; protonix 40 mg po qd; vitamin D3

Current Illness: None

ID: 0952540
Sex: F
Age: 38
State:

Vax Date: 12/24/2020
Onset Date: 12/28/2020
Rec V Date: 01/18/2021
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Lab Data:

Allergies: NONE

Symptom List:

Symptoms: Left armpit lymph node pain and swelling

Other Meds: MULTI-VITAMIN VITAMIN B-12 1000MCG BIOTIN 10 MG FERROUS SULFATE 325MG

Current Illness: NONE

ID: 0952541
Sex: F
Age: 66
State:

Vax Date: 12/18/2020
Onset Date: 12/24/2020
Rec V Date: 01/18/2021
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Symptoms: Developed Covid on 12/24.

Other Meds:

Current Illness:

ID: 0952542
Sex: F
Age: 32
State: OH

Vax Date: 01/08/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
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Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: Moderna

Other Meds: Duloxetine HCI 60mg Propranolol HCI ER 60MG Aimovig 70mg Pantoprazole sodium 20 mg

Current Illness:

ID: 0952543
Sex: M
Age: 48
State: NY

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 01/18/2021
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Symptoms: During 15 minute observation period post vaccine individual became slightly diaphoretic and felt weak. He does comment that he has not had much to eat or drink. Was offered juice and a snack which he tolerated and improve his symptoms. Vital signs were taken stable with slight tachycardia that improved at second set of vitals. Seen by provider on site and physical exam was benign. No medication intervention was needed. Left observation on own recognizance

Other Meds:

Current Illness:

ID: 0952544
Sex: F
Age: 66
State:

Vax Date: 12/18/2020
Onset Date: 12/24/2020
Rec V Date: 01/18/2021
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Symptoms: developed Covid on 12/24

Other Meds:

Current Illness:

ID: 0952546
Sex: F
Age: 73
State: CA

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 01/18/2021
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Allergies: Sulfa

Symptom List:

Symptoms: mild facial swelling, especially around mouth. I had general aching at my hips and knees, fatigue

Other Meds: lycinopril, omeprasol, atenolol, asa, align probiotic, vit c

Current Illness: none

ID: 0952547
Sex: F
Age: 46
State: VA

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
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Symptoms: Pt developed left arm pain, shooting pain down the left arm and up in the the shoulder/ neck. Severe pain and did to to urgent care for pain management on 1/16/21. 1/17/21, did develop a rash and is consistent with shingles.

Other Meds: synthroid 100mcg po qam, celexa 10mg po qd

Current Illness:

ID: 0952548
Sex: F
Age: 40
State: NJ

Vax Date: 01/08/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
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Allergies: NKDA

Symptom List:

Symptoms: Moderna COVID vaccine Injection was administered in the left gl?teas medius: A week after vaccine noticed at site of injection a 3 diameter of induration w itchiness , w 0.5 diameter having redness in addition. The whole left upper side of my dorsalgluteal side and hip are notably swollen. Pain 3-4/ 10 when indurated site is touched.

Other Meds: Zinc, vit D3, multi vit, B12

Current Illness:

ID: 0952549
Sex: F
Age: 55
State: MI

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/18/2021
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Allergies: Imitrex Compazine Reglan Phenergan

Symptom List:

Symptoms: I received the vaccine on Jan. 8, 2021. 48 hours later, I was suffering from diarrhea, abdominal pain and fatigue. The s/s continue but are less severe until the present (1/18/2021.) No treatment except lots of fluids and gut rest.

Other Meds: abilify 10mg daily Vyvanse 50mg daily Lexapro 40mg daily trazadone 100mg daily Estradiol .1 mcg patches Ajovy q 3 months

Current Illness: none

ID: 0952550
Sex: F
Age: 53
State: MI

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
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Lab Data:

Allergies: Multiple allergies to antibiotics, shellfish

Symptom List:

Symptoms: C/o Nausea, fatigue, achiness, chills on next day. That evening developed nausea and has had since. Having palpitations since vaccination coming and going which is not normal for patient. Also getting hot flashes.

Other Meds: Zoloft Atenolol

Current Illness: No

ID: 0952551
Sex: M
Age: 48
State:

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
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Symptom List:

Symptoms: Headache, Fever 101.0, sore at injection site. Treated with Tylenol. Headache lasted all day. Fever lasted 2 hours.

Other Meds:

Current Illness:

ID: 0952552
Sex: F
Age: 81
State: FL

Vax Date: 01/10/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
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Lab Data:

Allergies: No known allergies, adverse reaction to Celebrex on file

Symptom List:

Symptoms: Patient called and stated they were having itching and small rash with moderate pain at injection site. Advised patient to contact Dr. if worsened conditions. Advised treatment with ice pack to sore area and Benadryl to calm the itching and small rash. Patient did not notify of advancement of rash or allergic reaction past localized area.

Other Meds: Meloxicam

Current Illness: None that the patient recalls. Flu in the fall.

ID: 0952554
Sex: F
Age: 40
State:

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/18/2021
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Symptom List:

Symptoms: Starting the evening January 14th I experienced a high fever of 102.3 which responded to Tylenol however, was persistent for 48hours; in conjunction I experienced significant body aches, migraines, diarrhea, chills, and fatigue. Fever broke by Sunday morning however continuance of body aches and fatigue lasted through the weekend.

Other Meds:

Current Illness:

ID: 0952555
Sex: F
Age: 65
State: CT

Vax Date: 11/05/2020
Onset Date: 11/05/2020
Rec V Date: 01/18/2021
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Lab Data:

Allergies: None documented

Symptom List:

Symptoms: Patient felt significant tachycardia lasting for approximately 12 hours. She also felt short of breath.

Other Meds: unknown

Current Illness: unknown

ID: 0952556
Sex: M
Age: 25
State: NY

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 01/18/2021
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Symptom List:

Symptoms: During 15 minute observation period patient noted a headache and a general feeling of weakness. Denied SOB, rash, feeling of throat swelling. Was offered water and a snack which overall improved symptoms. Vital signs all stable. No medication intervention was used. Patient left clinic feeling well and on recognizance

Other Meds:

Current Illness:

ID: 0952557
Sex: F
Age: 59
State: MO

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
Hospital:

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Lab Data:

Allergies: Fish

Symptom List:

Symptoms: Became hot and nauseated

Other Meds: UNK

Current Illness: None

ID: 0952559
Sex: F
Age: 48
State:

Vax Date: 01/08/2021
Onset Date: 01/12/2021
Rec V Date: 01/18/2021
Hospital:

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Lab Data:

Allergies: Pineapple, aspirin

Symptom List:

Symptoms: On Tuesday (1/12/21) night face and neck started itching and burning. Face was starting to swell and neck was red and had small bumps on it. Took some Benadryl and went to bed woke up this morning and eyes were swollen and face was a little worse. No record that patient sought medical attention or visited the ED. Patient reported swelling and itching went resolved the weekend of 1/16/21.

Other Meds:

Current Illness:

ID: 0952560
Sex: F
Age: 46
State:

Vax Date: 12/21/2020
Onset Date: 12/30/2020
Rec V Date: 01/18/2021
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Symptoms: patient developed Covid 9 days after vaccine

Other Meds:

Current Illness:

ID: 0952561
Sex: F
Age: 63
State: OR

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
Hospital:

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Lab Data:

Allergies: sulfa, tetracycline

Symptom List:

Symptoms: CHILLS, FEVER 102, COUGH, HEADACHE, MUSCLE AND JOINT PAINT, FATIGUE, LARGE RASH UPPER LEFT ARM AT INJECTION SITE, ITCHY ON UPPER LEFT ARM.

Other Meds: Messalamine, Estradiol, Aleve, Atomic Iodine, Calcium, B12

Current Illness: Got the virus on 1/1/2021, Only had muscle aches for a couple of days and a mild cough.

ID: 0952562
Sex: M
Age: 63
State: NJ

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/18/2021
Hospital:

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Lab Data:

Allergies: PENNICILLIN; SEASONAL ALLERGIES

Symptom List:

Symptoms: LOW GRADE FEVER, JOINT AND MUSCLE ACHES, PAIN AT INJECTION SITE, SLEEPINESS FROM LATE EVENING ON 01/07 TO EVENING OF 01/08. ABOUT 22 HRS TOTAL. TOOK EXTRA TYLENOL. ONE PILL TAKEN TWICE DURING REACTION TIME.

Other Meds: METROPROLOL; ATORVASTATIN

Current Illness: NONE

ID: 0952563
Sex: F
Age: 59
State: FL

Vax Date: 01/08/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
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Allergies: Codeine

Symptom List:

Symptoms: Patient's left arm at the site became increasingly itchy and week later hot and red wheel 2 inch in diameter was visible and on January 15 th site developed a hot and hard lump. The lump has gone down but still red and itchy. Advised not to scratch or irritate the siye further.

Other Meds: Vitamin D 5000 IU daily

Current Illness: None

ID: 0952564
Sex: F
Age: 53
State: KY

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/18/2021
Hospital:

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Lab Data:

Allergies: Sulfa, Zomig, Topiramate

Symptom List:

Symptoms: Previously had Covid 19 Nov 9, 2020. Developed same exact symptoms that i had then. 24 hours later, developed headache, severe sore throat, fever, and aches that have continued into day 4. Felt like I had Covid all over again

Other Meds: Venlafaxine, Armour thyroid, spironolactone, metoprolol, Multivitamin, Vit C, Vit D, Magnesium, Cetirizine, Vit B complex

Current Illness: None

Total 2021 VAERS Injuries: 559,999

Page last modified: 03 October 2021 5:28pm