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: 0959218
Sex: F
Age: 44
State: CO

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: Influenza vaccine, corn, peanuts, soybeans

Symptom List:

Symptoms: Patient received first Pfizer SAR COVID vaccine dose at 18:16 pm. Patient advised vaccination team of previous allergic reactions to H1N1 vaccine (anaphlyxis - swelling of mouth, lips and tongue) and flu vaccine (head to toe hives). Patient was counseled by lead pharmacist regarding risk and and data related to vaccine. Patient agreed to receive vaccine. Informed patient that we would monitor for potential reaction for 30 minutes, patient agreed to stay. Patient was observed by nursing. At approximately, 1850 patient reported that she felt her lips swelling, and noted to have difficulty in her speech. She has administered 50mg Benadryl suspension. Vital signs taken: 1900: 147/92; 82; 97% room air 1905: 132/101; 84; 97% room air 1910: 145/104; 84; 97% room air. 1915: 147/104; 81; 97% room air RN observer called vaccine physician on call at 1915 regarding patient status. Patient was then observed to have hives around her neck, upper chest and arms. RN then called again at 1924. Was advised to send patient to the ED. RN called ambulance and was advised to administer epinephrine. Pharmacist pulled up 0.3mL of epinephrine. Administered injection in right thigh at 1934. Ambulance called and arrived on site at 1936. Patient was assessed, IV access secured and transferred to ED for further observation. Observed for 4 hours with improvement in symptoms. sent home with prednisone. Patient contacted the next day and reported hives on arms, face, back, hands as well as swollen lips and fever to 101.6. Contacted again the following day and symptoms were resolving. Patient is tracking symptoms in VSAFE

Other Meds: Latisse eye drops, Pristiq, Pepcid, Synthroid, Singulair, phentermine, prednisone, retin-A, ambien

Current Illness:

ID: 0959219
Sex: F
Age: 21
State: MA

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: telephone call -itchy arm, neck, ED visit, RX benadryl, released after 1 hr, no resp/thrt, allergy consult; Incident rpt: - I had received the vaccine around 4:45pm and was there for the 15 min of observation then went off to the floor I was floated to. Next around 6.40-6:45pm I started feeling chills and felt extremely itchy on my arm (the one I received the vaccine) my neck, and my eyes felt so itchy and puffed up. Then, the charge nurse sent me down to the ED because I was experiencing an allergic reaction; is advised to get second vaccine in allergist office

Other Meds:

Current Illness:

ID: 0959220
Sex: F
Age: 33
State: ND

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: I had extreme headache and nausea for 24 hours.

Other Meds: Melatonin Tylenol Benadryl Birth Control Zoloft

Current Illness:

ID: 0959221
Sex: F
Age: 76
State:

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Extreme pain in arm (not just sore) and body aches, as if run over by a truck, chills (could not get warm), worst headache I can ever remember having, felt like ice picks thru my head, sensitive to light and noise, lasted from 2:00am until approx. 9:00pm on 1/19.

Other Meds: tylenol

Current Illness:

ID: 0959222
Sex: F
Age: 47
State: NM

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List:

Symptoms: Patient started feeling itchy at the injection site. Patient felt not okay, No SOB, lightheadedness, hives or numbness. Rapid Response was called and was advised extra observation time. No other intervention.

Other Meds: atorvastatin 20mg qday, fluoxetine 20mg qday, fluticasone 50mcg/inhalation 1 spray both nostrils qam, Mocronor 0.35mg oral contraceptive, omeprazole 20mg qday, rizatriptan 10mg oral prn migraine

Current Illness: none

ID: 0959223
Sex: F
Age: 76
State: TX

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Approximately 5 minutes post-vaccination patient called for staff saying she felt lightheaded. Staff arrived and moved patient to floor, head supported by patient's jacket. We placed her feet above head (in a chair). Upon questioning patient about her history with vaccines, patient stated she had had a similar reaction with blood draws, but not with a vaccine. Patient also stated she is borderline diabetic and had only eaten a small bowl of cereal this morning and not had lunch yet. Patient stated she was feeling better, we sat her up and she drank a bottle of orange juice. Patient monitored for another 15 minutes, felt well and was escorted to her to her apartment and she claimed she felt well. Patient instructed to call her PCP, 911, or go to the nearest emergency emergency room for any additional issues.

Other Meds:

Current Illness:

ID: 0959224
Sex: F
Age: 29
State: CO

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/20/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: 29-year-old female presented to the ED with complaints of nausea, vomiting, and fever. She received the COVID-19 vaccine yesterday. Initially, she felt well but around midnight she started having chills, fevers, and nausea/vomiting. She also complains of a headache with associated photophobia, with a headache described as a diffuse constant ache. She denies any abdominal pain or diarrhea. She denies any cough or cold symptoms. Prior to the onset of her symptoms around midnight, she felt fine.

Other Meds: dextroamphetamine-amphetamine 30mg levothyroxine 25mcg lisinopril 20mg lorazapam 0.5mg

Current Illness: NA

ID: 0959225
Sex: F
Age: 47
State: NC

Vax Date: 01/11/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List:

Symptoms: 8 days after vaccine, I started feeling very fatigued. My arm developed a rash, itching and some soreness at the injection site. Rash is also hot to the touch.

Other Meds: Lunesta 3mg as needed at bedtime for sleep Multivitamin daily Calcium daily Vitamin C daily Vitamin D daily

Current Illness: Shingles 2 weeks prior

ID: 0959226
Sex: F
Age: 26
State: CA

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: possible ibuprofen allergy

Symptom List:

Symptoms: Symptoms within first 6-24 hours of receiving 2nd dose: moderate pain at injection site, body/muscle aches, chills, intermittent headache and fatigue

Other Meds: N/A

Current Illness: N/A

ID: 0959227
Sex: F
Age: 92
State: GA

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: States got nauseated/vomited 24 hours after the vaccine Client went to her primary physician to be checked out on 1/20/21 at 1:00pm with her son who reported her adverse reaction to her doctor and the health department.

Other Meds:

Current Illness: Unexplained weight loss for past 6 months

ID: 0959228
Sex: F
Age: 0
State: IN

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Severe pain. Upper arm where injection was swelled a lot. Could not raise right arm because of pain. This is day three and pain and swelling still pronounced

Other Meds: Aspirin.calcium.flecanide.Ladin.levothyroinemetoprol.. omeprazole.simvastatin.. trandplapril

Current Illness: None

ID: 0959229
Sex: F
Age: 65
State: CA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: Tylenol Codeine Penicillin Eggs

Symptom List:

Symptoms: Chest Pain, High fever, chills, high blood pressure, high pulse, headache, weakness, stomach pain

Other Meds: Metoprolol 50 mg Potassium Citrate 5mg

Current Illness: kidney stones

ID: 0959230
Sex: F
Age: 68
State: FL

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: Penicillin. Soy Erythromycin Cipro Compazine Gadolineum Inteferon Avonex

Symptom List:

Symptoms: Bell?s Palsy left side face/ swelling in head/ brain Tele. Dr instructions antiviral if continues and visit in person

Other Meds: Montelukast Pepcid Multivit B complex Vit D3 200mg Tylenol Advil

Current Illness: MS IBS GERD/ hiatal hernia Asthma

ID: 0959231
Sex: M
Age: 52
State: AZ

Vax Date: 01/18/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: Anaphylaxis to poultry and eggs

Symptom List:

Symptoms: Fever 102.2 Paroxysmal Rigors Myalgia Fatigue (Lack of Lymphadenitis in affected arm this time) (Previously diagnosed with COVID-19 in July, 2020, Had active antibodies IgG and IgM at time of first vaccine done in December, 2020)

Other Meds: Telmisartan, Multivitamin, Aspirin

Current Illness: Moderna Vaccine for COVID-19 1 month prior

ID: 0959232
Sex: F
Age: 59
State: OH

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List:

Symptoms: 4 cm erythemic warm induration at injection site; low grade fever, myalgias

Other Meds:

Current Illness: none

ID: 0959233
Sex: F
Age: 53
State: NY

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: Lisinopril (coughing)

Symptom List:

Symptoms: Urticaria and angioedema starting within 3 minutes of the vaccine treated at hospital.

Other Meds: albuterol, certirizine, doclofenec, epipen

Current Illness: Unknown

ID: 0959234
Sex: F
Age: 88
State: NC

Vax Date: 01/11/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: IV dye

Symptom List:

Symptoms: red and swollen at site, warm to touch.

Other Meds: HCTZ Med for cholesterol

Current Illness: none

ID: 0959235
Sex: F
Age: 34
State: IN

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: Sulfa allergy

Symptom List:

Symptoms: High fever, muscle pain, joint pain, headache, chills, swollen Lymph nodes in the arm of injection (armpit)

Other Meds: N/A

Current Illness: N/A

ID: 0959236
Sex: F
Age: 73
State: FL

Vax Date: 01/06/2021
Onset Date: 01/10/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: First just arm pain then a few days later hot red and swollen at injection site. It is 2 weeks today and it has not gone away

Other Meds: Prednisone

Current Illness: None

Date Died: 02/07/2019

ID: 0959237
Sex: F
Age: 0
State: WA

Vax Date: 02/05/2019
Onset Date: 02/07/2019
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: My daughter was given 2 vaccines in her first 24 hours of life. We were released from the hospital at hour 28 of life, and she died at home at hour 39, due to "unknown causes" which they later diagnosed as SUIDS.

Other Meds: N/A

Current Illness: N/A

ID: 0959238
Sex: M
Age: 62
State: IN

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: Chills, muscle/ bone ache, headache, low grade fever

Other Meds: No

Current Illness: No

ID: 0959239
Sex: F
Age: 40
State: OR

Vax Date: 12/27/2020
Onset Date: 01/03/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: raised bump at injection site 1 week after vaccination

Other Meds:

Current Illness:

ID: 0959240
Sex: F
Age: 34
State: AZ

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List:

Symptoms: Tight and itchy throat, thick tongue- started approximately 5 minutes after vaccine administration and lasted for approximately 4 hours.

Other Meds: NA

Current Illness: NA

ID: 0959241
Sex: F
Age: 56
State: OK

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: None.

Symptom List:

Symptoms: Headache, nausea, dizziness and joint pain that started about noon 1/20/21. Took some Advil and laid down, headache has resolved, not feeling nauseous but still having joint pain in hands with stiffness, knuckles, and knee pain and hips.

Other Meds: Pantoprazole, Probiotic, Protandim multivitamin (NRF2 synergizer), Protandeim NRF1 synergizer, Azo.

Current Illness: None.

ID: 0959242
Sex: F
Age: 26
State: CA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: fever 103, hives on face , neck , back and chest,, dry throat , mild sob, mild lightheadedness

Other Meds: portia-28 oral contraceptive

Current Illness: none

ID: 0959243
Sex: F
Age: 47
State: NC

Vax Date: 01/11/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: codeine

Symptom List:

Symptoms: fatigue, redness, hotness, itching and soreness at injection site 8 days after vaccination

Other Meds: Lunesta multivitamin vitamin c vitamin d calcium

Current Illness: shingles 2 weeks prior

ID: 0959244
Sex: F
Age: 26
State: CT

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Injection site reaction - soreness, swelling, redness Headache, chills, fatigue

Other Meds: Apri

Current Illness: None

ID: 0959245
Sex: F
Age: 52
State: TX

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: Penicillian

Symptom List:

Symptoms: After day 1 my arm developed a half dollar sized red circle which was warm to the touch - circle continued to get larger a little bit each day and was itchy but resolved and cleared up by 1/10/21 - on 1/13/21, the redness returned and the itching returned and spread drastically over my upper arm and was swollen and hot to the touch. I went to my PCP and she determined that I had cellulitis due to bacterial skin infection over the injection site. Another doctor was brought in that confirmed the diagnosis. i was given a 7 day prescription of Bactrim and the arm started to clear up within 2 days of starting the antibiotic.

Other Meds: Armour Thyroid, Paroxatine, Chlorthalidone, Losartan Potassium, fish oil, vitamin C, Aspirin, Multi vitamin, Vitamin D

Current Illness: n/a

ID: 0959246
Sex: F
Age: 56
State: NJ

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient reports experiencing hypotension with blood pressure of 55/39. The onset was 12 hours after receiving the booster. Patient reports the symptoms lasted 12 hours.

Other Meds:

Current Illness:

ID: 0959247
Sex: F
Age: 38
State: ID

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Twenty minutes after injection patient noted left sided facial numbness (Same side as injection). Shortly after that she noted some tingling in her throat. She was given diphenhydramine 50mg and monitored for roughly 1 hour total after her injection before having complete resolution of the tingling in her throat and marked improvement in facial numbness.

Other Meds: Esomeprazole 40mg twice daily, albuterol PRN

Current Illness: None

ID: 0959248
Sex: F
Age: 53
State: CO

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Pt received dose #1 of Moderna COVID vaccine 1/18/21 Vaccine Clinic. 1/19/21 presented to urgent care for conjunctivitis. Per note "I discussed this may be a side effect of the vaccine or could truly be unrelated. I did discuss she should call the maternal [sic] hotline to discuss the symptoms." Per provider, potential vaccine reaction. Entered by PSS for tracking.

Other Meds:

Current Illness:

ID: 0959249
Sex: M
Age: 83
State: PA

Vax Date: 01/12/2021
Onset Date: 01/14/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: on 1/14/2021 out for appointment with family. Returned cold, clammy,m lethargic, thick tongue. POx = 84% on room air. pulse = 44, BP = 110/46. Blood sugar = 120. No fever. No signs/symptoms prior to this

Other Meds:

Current Illness:

ID: 0959250
Sex: F
Age: 59
State: PA

Vax Date: 12/17/2020
Onset Date: 12/19/2020
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: Sulfa - Anaphylaxis Azithromycin Lasix

Symptom List:

Symptoms: Within 1-2 days after COVID vaccine developed dysphagia and vise-like chest pain within a few seconds of swallowing.

Other Meds: Entresto Carvedilol Aspirin Restasis Vitamin D MVI

Current Illness: None

ID: 0959252
Sex: F
Age: 37
State: MD

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: PCN: Latex

Symptom List:

Symptoms: Initially experienced nausea & tingling in lower extremities. BP141/93,P73. Sat another 15minutes: LE's still not feeling right. Accompanied to ambulate outside for fresh air. Stated felt better afterwards but remained quiet & not feeling WNL as had felt before receiving the vaccine. Stated was "feeling fine now" @11:50am, & was ambulating & conversing WNL. Agreed w/plan discussed w/both site leaders to be transported by supervisor back to work@testing site where medical staff were present in event she had any further symptoms. Accompanied to ride.

Other Meds: Latuda

Current Illness: None

ID: 0959253
Sex: F
Age: 34
State:

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Vaccine Saturday morning, arm hurt later that day. Almost exactly 24 hours after vaccine on Sunday: sore throat, aches, fatigue in middle of the day, rested. Monday felt better in the morning, felt a little more tired than usual. Did a weight training work out, that afternoon started feeling funky and tired. Tuesday: felt sick, not as much as on Sunday, laid low.

Other Meds: Prenatal vitamin

Current Illness:

ID: 0959254
Sex: F
Age: 40
State: OR

Vax Date: 01/02/2021
Onset Date: 01/04/2021
Rec V Date: 01/20/2021
Hospital:

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

Lab Data:

Allergies: fruits

Symptom List:

Symptoms: itchy throat, next day chills at night woke with fever itchy throat, terrible r lung pain; lung pain still continues to occur throughout the day. Hurting when she breaths or exhales, runny nose. Sought treatment Urgent Care

Other Meds: N/A

Current Illness: N/A

ID: 0959255
Sex: F
Age: 20
State: KS

Vax Date: 01/03/2021
Onset Date: 01/04/2021
Rec V Date: 01/20/2021
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Symptoms: HEADACHE, SHORTNESS OF BREATH, CHEST PAIN

Other Meds:

Current Illness:

ID: 0959256
Sex: M
Age: 30
State: IN

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
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Allergies: Augmentin

Symptom List:

Symptoms: S/S started approx 16 hours after injection. It started with fatigue and headaches, by 1400 that same day I began to feel chills and the sensation of pressure on my chest grew. I'm currently writing this 48 hours after injection and still experiencing tiredness, muscle pain and slight chills.

Other Meds: Ibuprofen Acetaminophen One-a-day multi vitamin

Current Illness: N/A

ID: 0959257
Sex: F
Age: 38
State: MA

Vax Date: 01/07/2021
Onset Date: 01/16/2021
Rec V Date: 01/20/2021
Hospital:

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Lab Data:

Allergies: Bupropion, peanuts

Symptom List:

Symptoms: The day of, had arm soreness and fatigue, but had resolved after 4 days. However, after 10 days, had developed fatigue, tender lymph nodes in the axilla, and erythematous hive on the left arm where the vaccination was that resolved over the course of 4-5 days.

Other Meds: Prenatal vitamins

Current Illness: None

ID: 0959258
Sex: M
Age: 56
State: CO

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/20/2021
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Allergies: unknown

Symptom List:

Symptoms: On 1/9 and 1/10 had diarrhea plus headache and nausea. On 1/13 felt dizzy with continued headache. Called PCP on 1/11 and 1/13 and received medication for nausea and ibuprofen for headache. Felt better by 1/15 but was advised by PCP not to return to work until1/18. I request name of physician several days ago but he has not communicated that information. His PCP is strongly advising receiving second dose but wants to pre-medicate.

Other Meds: unknown

Current Illness: unknown

ID: 0959259
Sex: F
Age: 77
State: CA

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/20/2021
Hospital:

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Symptom List:

Symptoms: 5 minutes after vaccination started to feel "Funny" and "Distant". Treated with PO juice. Feeling continued x30 minutes, sent to Urgent Care and diagnosed with anxiety

Other Meds:

Current Illness:

ID: 0959260
Sex: F
Age: 58
State: KY

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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Lab Data:

Allergies: Dilantin, seizure disorder not requiring treatment

Symptom List:

Symptoms: Chills, seizure like activity, body aches, injection site soreness

Other Meds: HCTZ, Metoprolol, Motrin

Current Illness: None

ID: 0959261
Sex: F
Age: 56
State: MA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/20/2021
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Symptoms: Patient received vaccine @ 1735, after receiving vaccine patient reported "feeling funny" & tingling to lips. After 5 minutes of receiving vaccine patient then reported "feeling worse" & having a tightness to throat, Code Blue called, code cart & epi present. VSS, O2 sat 100%, BP 176/116, HR 88 bpm. ED code team arrived, patient stable and transported patient to ED via wheelchair for further evaluation.

Other Meds:

Current Illness:

ID: 0959262
Sex: F
Age: 56
State: NJ

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/20/2021
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Symptom List:

Symptoms: Patient reports experiencing hypotension, with blood pressure to 55/39. The onset was 12 hours after receiving the booster dose with the symptom lasting 12 hours.

Other Meds:

Current Illness:

ID: 0959263
Sex: F
Age: 46
State:

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 01/20/2021
Hospital:

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Symptoms: Staff reporting that 1st vaccine she doesn't have any reaction. 2nd vaccine on 01/11/2021 1pm. On 01/13/2021 noon time she started to feel extremely exhausted which last for 3 days. Staff was so tired that she didn't want to open her eyes. Staff said she is fine now. Denies COVID exposure.

Other Meds:

Current Illness:

ID: 0959264
Sex: F
Age: 38
State: TX

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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Lab Data:

Allergies: none

Symptom List:

Symptoms: Flushed to chest area

Other Meds: none

Current Illness: none

ID: 0959265
Sex: F
Age: 34
State: CA

Vax Date: 01/12/2021
Onset Date: 01/20/2021
Rec V Date: 01/20/2021
Hospital:

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Symptom List:

Symptoms: Circular rash around injection site Warm to touch

Other Meds:

Current Illness:

ID: 0959266
Sex: F
Age: 28
State: MA

Vax Date: 12/25/2020
Onset Date: 12/28/2020
Rec V Date: 01/20/2021
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Allergies: None reported

Symptom List:

Symptoms: On 12-28-2020, I felt pretty fatigued and developed a fever throughout the following day. I lost most of my appetite and had quite a bit of diarrhea for about 24 hours. I went to the ER urgent care on 12-29-2020 in the evening. I was in the ER room for that evening then I was discharged.

Other Meds: Norlyda 0.35mg for birth control, pre-natal

Current Illness: None reported

ID: 0959267
Sex: M
Age: 52
State: AZ

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

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Lab Data:

Allergies: Egg and Poultry

Symptom List:

Symptoms: received vaccine at 1300 on the Monday the 18th. At 0100 on the 19th side effects of fever 100.2, fatigue, taking Tylenol and Motrin to control fever. Adverse event is not as serve as the first dose. Symptoms are still occurring as of today. I did have COVID in July, in December when I got the first dose I did still have antibodies in the body.

Other Meds: Telmilsartan

Current Illness: Did have an adverse reaction to the 1st dose of Moderna

ID: 0959268
Sex: F
Age: 80
State: PA

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/20/2021
Hospital:

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Lab Data:

Allergies: no

Symptom List:

Symptoms: Got sick this morning, vomiting with some dry heaving.

Other Meds: no

Current Illness: no

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm