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: 1388525
Sex: M
Age: 12
State: IA

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Went to scan vaccine and it expired

Other Meds:

Current Illness:

ID: 1388526
Sex: F
Age: 43
State:

Vax Date: 03/17/2021
Onset Date: 05/25/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: I received the vaccine in February and March 2021 with limited adverse reaction. I had flu like symptoms the day after the 2nd dose. On May 25, 2021 I noticed itching and discomfort in my left pinky toe. When I looked at the toe a few days later, it had a cluster of purple rashes and was swollen. It has remained this way for over 2 weeks. I have seen 2 physicians this week (internal medicine and dermatology) and neither could identify what the issue was. I now know of 3 other people who received vaccines around the same time as me and are having similar symptoms on their toes. Based on what I've read, it sounds consistent with "Covid toes". I never tested positive for Covid and I believe this is a delayed reaction to the vaccine.

Other Meds: None

Current Illness: None

Date Died: 06/10/2021

ID: 1388528
Sex: F
Age: 69
State: IL

Vax Date: 05/26/2021
Onset Date: 06/08/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: cephalexin (reaction unknown)

Symptom List:

Symptoms: Only reporting to VAERS as patient received covid-19 vaccination under EUA and was hospitalized and is now deceased from illness deemed UNRELATED to prior covid-19 vaccination. She was a 69 yr old female who was transferred to hospital on 6/8 at 0141 from outside hospital with severe shock, acute hypoxemic respiratory failure, who had a cardiac arrest on arrival here for 5 mins, during arrest CPR was done and 2 doses of epinephrine were administered prior to ROSC and targeted temperature management was initiated. She was found to have a massive PE, alteplase was given and a heparin continuous infusion was started on 6/8 at 0154 and 0345, respectively. She later underwent a thrombectomy on 6/8 at 1640. She showed signs of poor neurological status. Went into MSOF despite aggressive supportive care. Family requested to make her comfortable and the patient expired on 6/10 at 0449.

Other Meds: atenolol 25 mg twice daily fluticasone propionate 50 mcg/act nasal spray 2 sprays in each nostril daily hydrochlorothiazide 50 mg daily losartan 100 mg daily paroxetine 40 mg daily trazodone 200 mg daily

Current Illness: unknown and unable to assess

ID: 1388529
Sex: F
Age: 67
State: CA

Vax Date: 02/12/2021
Onset Date: 02/26/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: She developed severe leukocytoclastic vasculitis that is ongoing. We have found no other clear cut explanation for her severe vasculitis. She has had an EBV viremia that is thought to represent reactivation as opposed to being the primary process. She remains on imuran, prednisone at this time.

Other Meds: ativan, zoloft, valtrex, hyzaar, ursodiol, imitrex

Current Illness: ILI in January 2021 - covid-19 testing was negative at that time

ID: 1388530
Sex: F
Age: 25
State: OR

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: NSAIDS

Symptom List:

Symptoms: parasthesia in injected arm, blindness in right eye, intense weakness and lethargy.

Other Meds: sertraline

Current Illness: none

ID: 1388531
Sex: F
Age: 72
State: IN

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Augmentin, Sulfa Drugs, and Penicillin

Symptom List:

Symptoms: Patient stated she received here 2nd COVID-19 Vaccination on 06/07/2021. Patient stated that she received her vaccination at 10:00am. Patient stated that right away she started feeling burning, soreness, weakness in arm, rash, and hot to the touch. Patient stated later in the day she started having elevated blood pressure, stiff arm, super fatigue and sleeping to much, anxious, palpitation, slightly elevated heart rate at 99, and lower grade fever. Patient stated today (06/10/2021) that her arm is still very sore, red, swollen, fatigue, and stiff arm.

Other Meds: Patient currently takes Vitamins but did not take anything before Vaccination.

Current Illness: No other illnesses or vaccination done prior to COVID vaccination.

ID: 1388532
Sex: F
Age: 57
State: CA

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Bacitracin Zinc + Neomycin Sulfate + Polymyxin B Sulfate Skin Rash and/or Hives Medium 6/1/2010 Sulfa (sulfonamide Antibiotics) Skin Rash and/or Hives, Other Medium Allergy 6/1/2010 Facial swelling Codeine Phosphate Skin Rash and/or Hives, Asthma and/or Shortness of Breath Not Specified 11/4/2003 hyperactivity Methadone Class Not Specified 11/6/2015 itching

Symptom List:

Symptoms: Patient received in RN observation area, post-COVID vaccination administration, as recommended per CDC guidelines and policy on post-vaccination RN monitoring. Patient ambulating in door way and grabbed the door, stating, "I'm dizzy, I feel like I'm going to pass out". Patient helped to bench outside and then to the gurney. Patient reporting lightheadedness, dizziness, and blurred vision. Denies Hx of anaphylactic reaction to first vaccine. Patient denies adverse reactions to vaccinations in past. Medical history as stated in patients chart. Patient does report diabetes. Last Blood glucose was 189 per patient at 0630 on 6/10/2021. 09:19 : Vitals: BP: 143/76, P: 86, Resp: 18, SpO2: 98%. RRT called at 09:20, and responded promptly, RRT, Dr. Almond and nurse leader updated on patient status. 09:23 Patient reported chest tightness, and a "massive headache". Vitals at that time were: BP 133/78, Pulse: 82, SpO2: 99%. Patient transported to ER with RRT with all belongings.

Other Meds: Omeprazole (PRILOSEC) 20 mg Oral CPDR SR Cap Take 1 capsule by mouth 2 times a day - MAY TAKE UP TO 2 CAPSULES TWICE DAILY Clindamycin HCl (CLEOCIN HCL) 300 mg Oral Cap Take 1 capsule by mouth every 8 hours until gone Chlorhexidine Gluco

Current Illness: tooth infection

ID: 1388533
Sex: M
Age: 31
State: IL

Vax Date: 03/30/2021
Onset Date: 05/01/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Swollen lymph nodes across right side of body. Lymph nodes of shoulder, chest and traps were swollen and body movement was severely restricted due to these swollen lymph nodes. I only got one of the vaccines. Did not get the second one.

Other Meds: cannabis and caffeine with OTC brand for seasonal allergies

Current Illness: none

ID: 1388534
Sex: F
Age: 15
State:

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient presented to the observation room with her mother to schedule 2nd appointment and be observed after vaccination. Patient lost consciousness and was caught by the observation staff and lowered into a chair. Staff states patient lost consiousness for approximately 30 seconds. Once patient came to she knew her name, where she was, and the date. She still felt very dizzy. Patient's pulse and O2 saturation were immediately taken showing a pulse of 45 and O2 sat of 100%. Unable to get pulse up, lead of operations called for ER support. Patient was gray in color, very weak, and still complaining of dizziness when ER staff arrived. Unable to walk due to weakness, patient was transferred to cart and taken to ER

Other Meds:

Current Illness:

ID: 1388535
Sex: M
Age: 30
State: KY

Vax Date: 05/07/2021
Onset Date: 05/31/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: TESTED POSITIVE WHEN PARTIALLY VACCINATED

Other Meds:

Current Illness:

ID: 1388536
Sex: F
Age: 19
State:

Vax Date: 05/13/2021
Onset Date: 05/19/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: R07.89 - Other chest pain

Other Meds:

Current Illness:

ID: 1388537
Sex: M
Age: 15
State: MD

Vax Date: 06/09/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Food allergies to crabs, shrimps, peanut butter, Tilapia fish.

Symptom List:

Symptoms: On June 10, 2021 around 1:20am, child woke me up and stated that he has a headache. After feeling his head, he felt very warm with a temperature of 102.3 using both a digital and under the tongue thermometers. I had child to take a Tylenol pill with something to drink. At approximately 4:45am took the child's temperature again and it was 99.6 degrees and I had the child to take another Tylenol pill at that time, so that the temperature wouldn't spike up. Around 9:30am, after allowing him to sleep, he woke up and stated that he felt better. Then, I was able to go to work.

Other Meds: None

Current Illness: None

ID: 1388538
Sex: F
Age: 19
State:

Vax Date: 04/17/2021
Onset Date: 04/30/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: H54.62 - Unqualified visual loss, left eye, normal vision right eye

Other Meds:

Current Illness:

ID: 1388539
Sex: M
Age: 58
State: WA

Vax Date: 05/09/2021
Onset Date: 05/30/2021
Rec V Date: 06/10/2021
Hospital: Y

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

Lab Data:

Allergies: None.

Symptom List:

Symptoms: Mother reporting. He got his vaccine, approximately 3 weeks later he came home from work, was not feeling good, laid down, went to sleep and when he woke up he was not able to walk, paralyzed on left side. He called 9-1-1 and was taken to the ER. In the ER he was diagnosed with a stroke, and is still in the hospital undergo rehab. They are hoping that he is going to make a full recovery. He is still totally paralyzed on his left side. He was initially admitted to the Hospital, and then transferred to rehab unit at Rehabilitation Hospital since 6/5/21.

Other Meds: Vitamin B12, BP medicine.

Current Illness: None.

ID: 1388540
Sex: F
Age: 36
State: WA

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Cranberry (anaphylactic), codiene, percaset, vicadin, morphine, pediazole

Symptom List:

Symptoms: Felt fine for 8 hours, then woke up with 101 degree fever, intense sweating, joint inflammation (extreme pain), intense fatigue, 4 days straight of these symptoms. Unable to work for that entire time. Took tylenol for fever (did not go below 99 for the 4 days), intense chills when the fever spiked, normally never cold (but freezing the entire time), spasms/shivers. Did not feel fully recovered for a week and a half. Called the number for the clinic (because it was early in the pandemic).

Other Meds: Testosterone, pantopricil (heartburn), wellbutrin, zyrtec (allergy), vitamin D, vitamin B12, truvada (prep, not HIV positive), flonase (allergy), zoloft

Current Illness: N/A

ID: 1388541
Sex: F
Age: 37
State: NJ

Vax Date: 05/01/2021
Onset Date: 06/02/2021
Rec V Date: 06/10/2021
Hospital: Y

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

Lab Data:

Allergies: n/a

Symptom List:

Symptoms: stroke

Other Meds: birth control

Current Illness:

ID: 1388542
Sex: M
Age: 68
State: ME

Vax Date: 04/22/2021
Onset Date: 05/10/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List:

Symptoms: Large oblong Lump on right side of face. Approx. 3 inches by 2 inches, 1 to 2 inches thick and growing.

Other Meds: none

Current Illness: non known

ID: 1388543
Sex: M
Age: 32
State: CA

Vax Date: 05/16/2021
Onset Date: 05/16/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: I got my second dose of the Covid vaccine on 5-16-21 and my right arm is still sore weeks after and it has gone away as of today 6-10-21. I can?t lift anything heavy with out it hurting.

Other Meds: No

Current Illness: No

ID: 1388544
Sex: F
Age: 21
State:

Vax Date: 04/12/2021
Onset Date: 06/08/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: PETIENT TESTED POSITIVE FOR COVID 19 AFTER BEING FULLY VACCINATED

Other Meds:

Current Illness:

ID: 1388545
Sex: M
Age: 22
State: MA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: No Known Allergies

Symptom List:

Symptoms: Patient received first dose of COVID 19 vaccine at 1:30 pm on 5/4/21, at 11:00 pm on 5/4/21 patient was at home sitting on couch when his body went stiff, eyes rolled into the back of his head, legs began shaking for about 20 seconds, once patient came to he was extremely nauseous and vomited. Patient did not seek medical attention that evening, called his PCP next day and was advised to follow up. Two days later patient still experiencing some headaches and nausea, advised to go to local ED (hospital) patient had labs drawn and received a CT scan, reported all were unremarkable. Patient is in the process of following up with Neurology and undergoing and EEG for suspected seizure.

Other Meds: Patient is not prescribed any medications

Current Illness: N/A

ID: 1388546
Sex: F
Age: 46
State: TX

Vax Date: 01/05/2021
Onset Date: 02/28/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: No Allergies to medications, food, or other products.

Symptom List:

Symptoms: My chromes medicine became ineffective and it developed antibodies. Due to my medication being ineffective because of the vaccine I and to switch medication.

Other Meds: Yes I was taking remicade.

Current Illness: No Other illnesses at the time of vaccination and up to one month prior.

ID: 1388547
Sex: F
Age: 43
State: VA

Vax Date: 04/26/2021
Onset Date: 05/10/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Exactly two weeks after I developed severe chills, and a horrible headache. Around this time I also developed a rash on the right/back side of my midsection I thought was poison Ivy because I spend a lot of time outdoors exercising. I am not allergic to poison Ivy however, and it was not very itchy (just a little). I took a picture. Then developed a small painful rash on the front of my right/back midsection with little pustules. The headache got worse over days and severe lower back pain and gas. When I laid down I could hear blood pumping in my ears. I missed two and a half days of work despite working from home and needing to be present online. The whole thing lasted a week, but I have a mark from the second rash still on me despite that is it is a month or so later.

Other Meds: None

Current Illness: None

ID: 1388548
Sex: F
Age: 20
State:

Vax Date: 03/25/2021
Onset Date: 04/16/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: R00.0 - Tachycardia, unspecified chest pain

Other Meds:

Current Illness:

ID: 1388549
Sex: F
Age: 17
State: IL

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Peanut butter flavoring agent, shellfish containing products

Symptom List:

Symptoms: Pt reported that she felt dizzy and sleepy and endorsing weakness after covid vaccine. Pt was sent to the emergency department. Pt felt better after eating and was able to ambulate with no dizziness or weakness. Pt stated she "feels better" and left.

Other Meds: etonogestrel (Nexplanon) 68 mg subdermal implant

Current Illness:

ID: 1388550
Sex: F
Age: 33
State:

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Rash to neck area- Benadryl 25mg IM X1 administered as ordered. Rash resolved.

Other Meds:

Current Illness:

ID: 1388551
Sex: F
Age: 48
State: CA

Vax Date: 06/09/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Body aches, weakness, headache, injection site pain.

Other Meds:

Current Illness:

ID: 1388552
Sex: F
Age: 14
State:

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: EOA called in to report an adverse event. Attendee, DOB 05/28/2007. W/in 60 secs of receiving shot, she looked pale, felt dizzy, reported feeling lightheaded. Mom was there and reported this happens when she receives injections. Didn't have time to get her to observation, so laid her down over 3 chairs w/head in mom's lap. First vitals:3:15p, BP 110/70, HR 86, resp 19, O2 100% room air, temp 98F. Kept an eye on her, w/in time she took vitals she was feeling better. 2nd vitals 3:20p, BP 102/70, HR 71, resp 16, O298% room air, temp 98.3. 1st dose of Pfizer, lot EW0217. Shot in L arm. Patient's sx subsided, she was released w/her mother, no further issues.

Other Meds:

Current Illness:

Date Died: 05/21/2021

ID: 1388553
Sex: F
Age: 82
State: AZ

Vax Date: 05/19/2021
Onset Date: 05/21/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Venlafaxine

Symptom List:

Symptoms: Death

Other Meds: Acyclovir, Citalopram, Dexamethasone, Eliquis, Lipitor, Metoprolol, Pantoprazole, Calcium, Chondroitin-Glucosamine, Vitamin B Complex

Current Illness: Multiple Myeloma

ID: 1388554
Sex: F
Age: 73
State: DE

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: The same day after after receiving the vaccine I noticed while I was doing yard work my leg was swollen, and so I shook it off as if it was nothing. Later on I realized that it didn't get smaller my leg started to get bigger. So I called the doctor and they advised me to come in immediately to do an ultrasound. They later on told me that the swelling was due to a blood clot that formed and they prescribed Xarelto 15 mg 2x day and with that prescription I didn't see any improvement so they prescribed me to do 20mg 1x day and I'm just now seeing results now.

Other Meds: U-10 100 mg 2xday, Metoprolol 25mg 2x day, Pantoprazole Sod 40mg 1xday, Atorvastatin 40mg 1x day only half, Vitamin D-3 2000mg 1x day

Current Illness:

ID: 1388555
Sex: F
Age: 20
State:

Vax Date: 04/07/2021
Onset Date: 04/28/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: R07.9 - Chest pain, unspecified DIZZINESS CHEST PAIN SHORTNESS OF BREATH

Other Meds:

Current Illness:

ID: 1388556
Sex: F
Age: 66
State: NY

Vax Date: 03/27/2021
Onset Date: 03/31/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to sulfur drugs.

Symptom List:

Symptoms: I had lymph nodes in the front of my neck were swollen to the size of a grape.

Other Meds: Omeprazole, Albuterol, Montelukast sodium, Alendronate sodium

Current Illness: No illnesses at the time of vaccination.

ID: 1388557
Sex: F
Age: 32
State: MN

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: latex (delayed hypersensitivity), sulfa antibiotics, allergic rhinitis (dander, pollens, dust mite)

Symptom List:

Symptoms: Red splotchy rash developed on both legs approximately 18 hours after vaccination. Rash was on tops of feet, around ankles, extended up calves and was also present on upper thighs. Rash did not itch. Treated by taking zyrtec every 12 hours and benadryl every 6-8 hours. Rash resolved 4/3/21.

Other Meds: loratadine (10 mg), famotidine (20mg), ibuprofen ( 400 mg taken at 8pm on 3/31/2021), woman's daily vitamin (vitafusion), vitamin D (vitafusion)

Current Illness: none.

ID: 1388558
Sex: F
Age: 18
State:

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 06/10/2021
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Allergies: Amoxicilli & bee stings

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Symptoms: patient's father requested for medical staff to assist his 18yo daughter. Patient c/o light headedness without any accompanying symptoms. per patient she "passed out", according to father, patient did not completely lose consciousness, but became weak and minimally responsive. per pt and father, patient has a significant history of "passing out' associated with medical procedures and the sight of blood. Patient reports having already eaten. Upon initial assessment, no acute distress noted, patient was slightly pale, AOx4, verbal, able to make needs know, and answers questions appropriately. Respiration even and unlabored, lung sound clear to auscultation. after approx 1 minute, noted patient's skin pink, dry warm, & intact. Respiration remained even and unlabored, lung sound clear to auscultation. no sx/sx of allergic reaction. Patient?s father reported that patient has a history of anxiety. Denies any significant past medical history, or allergies.

Other Meds: Benadryl as needed for allergies

Current Illness: denies

ID: 1388559
Sex: M
Age: 47
State: WA

Vax Date: 05/26/2021
Onset Date: 06/02/2021
Rec V Date: 06/10/2021
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Allergies: None

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Symptoms: Bell's palsy 6 days after vaccine, mild to moderate, unresolved at this time

Other Meds: None

Current Illness: None

ID: 1388560
Sex: M
Age: 67
State: FL

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
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Allergies: NO

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Symptoms: PATIENT WAS ASKED IF HERE FOR COVID SHOT SAID YES . HE FILLED OUT PAPER WORK AND SIGNED . GIVEN VSAFE AND PFIZER INFO. AFTER GETTING VAC TOLD US HE HAD THAT SHOT ALREADY AND WANTED A SHINGLES SHOT.

Other Meds:

Current Illness: UNKNOWN

ID: 1388561
Sex: F
Age: 71
State: AZ

Vax Date: 03/25/2021
Onset Date: 04/10/2021
Rec V Date: 06/10/2021
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Allergies: Evista, Niacin, and Spriva

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Symptoms: Extremely high blood pressure and high heart rate and low oxygen levels. Incidents have happened 4-10-21, 4-28-21, 5-22-21 & 6-1-2021

Other Meds: Atenolol, Lisinopril, Omperzole, Methocaramol, Ropinrole, Celecolix, Solifenacin, Metformin,Rosuvastin, Venalaxine, Mutli-Vitamin, Glucosamine, Chrondrotin & MSN, Calcium, Fiber, Omega 3 Salmon oil, Cinnamon,& Baby Asprin

Current Illness: None

ID: 1388562
Sex: M
Age: 79
State: LA

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 06/10/2021
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Allergies: None

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Symptoms: 3/10/21 experienced fever, body aches, sore arm. 3/17/21 bilateral hand weakness 4/8/21 2nd injection. 4/9/21 fever, body aches, pain in shoulders, elbows, wrists - very intense felt like on fire. 4/18/21 seen in local ER - joint pain over a month. given toradol and prednisone by PCP. 5/18/21 Returned to ER with complaints of bilateral arm, shoulder and wrist pain since COVID vaccines. Given prednisone. His primary care physician has done complete work up and feels patients complaints are due to vaccine. 6/10/21 Spoke to patient still has weakness bilateral hands and arms and constant muscle aches.

Other Meds: Prilosec, Glipizide, Lisinopril

Current Illness:

ID: 1388563
Sex: M
Age: 62
State: KS

Vax Date: 04/29/2021
Onset Date: 04/01/2021
Rec V Date: 06/10/2021
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Symptoms: 42 days post immunization, pt still experiencing sore shoulder with a swollen "bump" at injections site

Other Meds:

Current Illness:

ID: 1388564
Sex: F
Age: 20
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 06/10/2021
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Symptoms: O20.0 - Threatened abortion PELVIC PAIN VAGINAL BLEEDING R07.89 - Other chest pain CHEST PAIN

Other Meds:

Current Illness:

ID: 1388565
Sex: M
Age: 25
State: CA

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/10/2021
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Allergies: NKDA

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Symptoms: Patient received the 2nd COVID vaccine (Pfizer, lot # ER8736, use by 07/04/21) at 0950. The client told EMT, " am feeling a little light-headed and dizzy" at 1000. The client was immediately assisted to the anti-gravity chair and placed in a semi-fowler's position. The client appeared mildly diaphoretic. RN arrived on scene and assessed the client who was A & O x 4. The client was offered Benadryl and stated, " I think I will hold off on Benadryl and see how I feel in a few minutes." Vital signs were taken at 1003, BP- 132/84, HR-74, RR-14, oxygen saturation- 98%. The client was given juice and a granola bar. The client no longer appeared diaphoretic, denied feeling flushed, itchy, shortness of breath, difficulty breathing, angioedema, or chest pain. The client is currently taking Turmeric, denied any chronic medical conditions, or drug allergies. Vital signs taken at 1008, BP- 138/84, HR- 69, RR-14, oxygen saturation at 98%. The client stated, " I'm feeling better and the light-headedness is better." Vital signs taken at 1013, BP- 139/88, HR- 69, RR-14, oxygen saturation- 99%. The client was assisted to a Fowler's position by EMT. Vital signs taken at 1015, BP- 136/86, HR- 69, RR-14, oxygen saturation-98%. Patient stated " I'm just feeling tired", denied shortness of breath, difficulty swallowing, itching or swelling. Vital signs taken again at 1025 BP- 141/86, HR-66, RR-14, oxygen saturation 99%. Client stated, " The light-headedness and dizziness is gone, my mouth is just a little dry." The patient then drank water which relieved the mouth dryness. Last vitals taken at 1030 BP-139/82, HR-66, RR-14, oxygen saturation 99%. The client slowly stood up and denied any dizziness, headache, SOB, or chest pain. RN educated the client about follow-up precautions with his PCP, Emergency Room precautions, and educated the client about V-safe. The client had a steady and even gait when walking to his vehicle at 1034.

Other Meds: Turmeric Supplement, dosage unknown

Current Illness: N/A

ID: 1388566
Sex: F
Age: 35
State: MO

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 06/10/2021
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Allergies: midodrine penicillin syfonamite sulfur

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Symptoms: i had arm pain went down to the hand. The allergic reaction was with my neck it was tight and it was hard for me to breath. i was really tired and i didn't take any medicine and had not eaten that dat. I had an itch and at the night time was the worst i had itch all over my body. Joint pains

Other Meds: armodaphinal cydonil metrophil singuler and proair inhaler and lovance phedermine pentin birth control

Current Illness: none

ID: 1388567
Sex: F
Age: 32
State: AR

Vax Date: 03/23/2021
Onset Date: 03/29/2021
Rec V Date: 06/10/2021
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Allergies: I am allergic to blood pressure medication Perindopril.

Symptom List:

Symptoms: On my arm where I got the vaccine it was very tender and I got a rash. My shirt being against this arm even caused discomforted. I also had body aches , pain , and chills. This was for a couple of days. I was on antibiotics for a week to get rid of the rash on my arm.

Other Meds: I was taking migraine medication.

Current Illness: None.

ID: 1388568
Sex: M
Age: 12
State: NC

Vax Date: 06/09/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
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Allergies: None

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Symptoms: Patient woke up at 5 am the morning after receiving the shot and was talking about things that weren?t there. He was asking for ammo and saying everything was moving so fast and that we were all in a line and no one would give him ice water. His heart was beating really fast. His temperature was 98.4. He was shivering and sweating. This lasted about 2 hours and then he fell asleep. Today he remembers everything that he said and that happened.

Other Meds: None

Current Illness: None

ID: 1388569
Sex: F
Age: 26
State: IL

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 06/10/2021
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Allergies: no known allergies

Symptom List:

Symptoms: Pt felt dizzy, shaky, hot (sweating), and had ringing in the ears. Pt reported she felt like she would pass out. Pt checked her blood glucose and it was 93. Pt had some water and orange juice and felt better after about 30 minutes.

Other Meds: ergocalciferol 1250 mcg (1 capsule every sunday), insulin glargine (inject 23 units every evening), novolog flexpen U-100, inject 14-20 units three times a day with meals.

Current Illness:

ID: 1388570
Sex: F
Age: 43
State: AZ

Vax Date: 05/28/2021
Onset Date: 05/30/2021
Rec V Date: 06/10/2021
Hospital: Y

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Allergies: none

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Symptoms: Fever , Headache , Elevated LFT , Thrombocytopenia , Renal Failure

Other Meds: none

Current Illness: none

ID: 1388571
Sex: M
Age: 54
State: MA

Vax Date: 05/04/2021
Onset Date: 05/07/2021
Rec V Date: 06/10/2021
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Allergies: Penicillin

Symptom List:

Symptoms: 3 days after receiving the 2nd Pfizer shot, the pt began experiencing numbness in both feet and toes as well as R hand. A week later R thigh tingling followed by bilateral leg pain. Spread to calf region then knee caps toward the end of May. Then, balance became difficult, feeling like he was falling to the right. Was admitted to medicine service. Over course of week continued to decline and no longer can walk, needs bed lift to use the bathroom. Currently on day 1 of 5-day IVIG treatment. Due to possible tick exposure has also been receiving Abx for Lyme.

Other Meds: Escitalopram Sildenafil Magnesium oxide Trazadone Truvada Fish oil Multivitamin

Current Illness: None

Date Died: 06/08/2021

ID: 1388572
Sex: F
Age: 61
State: GA

Vax Date: 06/07/2021
Onset Date: 06/08/2021
Rec V Date: 06/10/2021
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Allergies: codeine, ertapenem

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Symptoms: At around 5:30 a.m. on the day after 2nd Moderna dose, resident was found non-responsive with no vital signs. CPR was performed. Time of death 6:20 a.m. There were no acute illnesses or changes in condition noted prior to receiving vaccine.

Other Meds: vitamin C, zinc, santyl, pantoprazole, chlorhexidine, apixaban, levetiracetam, humalog, metroprolol, docusate, duoneb, dakins, tramadol, hydroxyzine

Current Illness: dysphagia, hypertension, CHF, COPD, Acute respiratory failure with hypoxia, sepsis, cerebral infarction, COPD, PUD, seizures

ID: 1388573
Sex: M
Age: 46
State: WA

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
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Allergies: Zonisamide, Haloperidol

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Symptoms: Patient started to feel throat contractions and nausea within 5 minutes of the vaccine. He then started throwing up profusely. Patient was given 25 mg of Promethazine IM within 10 minutes of start of the reaction. He was held in the clinic for 30 minutes and checked on every 5 minutes.

Other Meds: albuterol sulfate amoxicillin-pot clavulanate baclofen cephalexin epinephrine hydrocodone-acetaminophen levetiracetam M-Natal Plus multivitamin with folic acid Narcan ondansetron ondansetron HCl pantoprazole polyethylene glycol 3350 prazosi

Current Illness:

ID: 1388574
Sex: F
Age: 16
State: FL

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 06/10/2021
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Symptoms: Systemic: Dizziness / Lightheadness-Mild, Additional Details: Pt fainted after receiving the shot. BP was stable. Pt was conscious and responsive and rested on the floor for a while and then went home with father.

Other Meds:

Current Illness:

ID: 1388575
Sex: F
Age: 63
State: IL

Vax Date: 04/23/2021
Onset Date: 05/05/2021
Rec V Date: 06/10/2021
Hospital: Y

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Allergies: nifedipine, sulfa, erythromycin, nickel

Symptom List:

Symptoms: biopsy confirmed leukocytoclastic vasculitis developed within 2 weeks of 2nd Pfizer Shot; required hospitalization, prolonged course of steroids

Other Meds: Lisinopril started the day of the adverse event. also taking omeprazole 20mg, ozempic 0.25mg q week, Xarelto 20mg qd, bupropion 100mg bid, Symbicort 2 puffs bid

Current Illness: none

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm