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: 1155906
Sex: M
Age: 44
State: SC

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

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

Lab Data:

Allergies: EGGS OR EGG BYPRODUCTS, FISH, SHELLFISH

Symptom List: Dysphagia, Epiglottitis

Symptoms: Nnurse was called to assist a patient that had left the monitoring area. Upon arrival, patient was sitting in mall with back leaning on wall. Patient was AAAx3. He was pale and diaphoretic. Patient stated he waited his 15 minutes and felt fine. Patient received dose 1 of Pfizer Covid Vaccine (Lot #EN6207, Exp 5/31/21). When he was walking back to his car he "blacked out" and fell to the floor. Patient stated he hit his head on the ground. No visible injury to back of head was observed. Patient reported he did not eat or drink anything prior to coming. He stated it was warm in the mall and he was having difficulty breathing with the mask on. Patient was instructed to take his mask off. VS were assessed: 98/68, HR 82, pulse ox 98% room air. Patient was given water and some chocolate. Patient stated he started to feel better. Patient was assisted into wheelchair and continued to be observed. Patient stated he initially started to feel better, but then felt lightheaded again. VS reassessed @ 0948 BP 92/64, HR 72, pulse ox 98% room air. This nurse advised patient EMS should be called for further evaluation. Patient refused and stated he did not want to go to the hospital. Nurse again advised that his blood pressure remained low and he should be further evaluated. Patient continued to refuse. Patient was advised to call someone for a ride home as it was advised he should not drive at this time. Patient called his father for transport home. Patient was given a sprite to drink while waiting for his ride. Patient was accompanied by monitor until ride arrived. Patient was picked up and left without further incident.

Other Meds:

Current Illness:

ID: 1155907
Sex: F
Age: 21
State: NY

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1155908
Sex: F
Age: 59
State: ME

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

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

Lab Data:

Allergies: PCN

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

Symptoms: 10 min after vaccination developed mild arm soreness, slight diaphoresis and 5/10 headache. Normal BP and pulse. Looked fine. No arm erythema/swelling. No hives. No respiratory symptoms. Treated with water/hydration and noted improvement.

Other Meds: None

Current Illness: None

ID: 1155909
Sex: M
Age: 17
State: WI

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

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

Lab Data:

Allergies: none listed on form

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: GIVEN BEFORE AGE 18 YEARS

Other Meds: unknown

Current Illness: unknown

ID: 1155910
Sex: F
Age: 77
State:

Vax Date: 02/08/2021
Onset Date: 02/17/2021
Rec V Date: 04/01/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Chest pains

Other Meds:

Current Illness:

ID: 1155911
Sex: F
Age: 21
State: NC

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

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

Lab Data:

Allergies:

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

Symptoms: At around 10:30pm on the day of the vaccine until I feel asleep after 2:00am, my heart hurt, my whole body ached, I was so cold my skin was red. My head hurt. I felt like I would pass out. Today, 4/1, I feel better but go from hot to cold and still feel aches with my head hurting earlier.

Other Meds: Tri Lo Marzia, GI-synergy (K-64) by Apex Energetics, Methyl-SP (K-14) by Apex Energetics, PM soothee by Xymogen, GI Revive by Designs for Health, BioDoph-7 Plus by Biotics Research, Liqua-D (K-87) by Apex Energetics

Current Illness:

ID: 1155912
Sex: M
Age: 53
State: IN

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Soreness at injection site, low fever, headache, muscle ache, lethargy for about 24 hours

Other Meds: Metformin, simvastatin

Current Illness: None

ID: 1155913
Sex: F
Age: 39
State: MI

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

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

Lab Data:

Allergies: Vicodin.

Symptom List: Pharyngeal swelling

Symptoms: She got her vaccine, had pain at the injection site that moved up her arm. She was having chills. She took a nap and when she woke up she could not lift her arm at all. Had pain in the neck, wrist, arm. She had pain/feelings in that arm. She woke up sometime after midnight sitting up because she woke up and had a tingling sensation in her throat and felt as if her throat was going to close on her. She did not go back to sleep fearing this. She took 600 mg of Tylenol, as well as 600 mg today. She has been better today, and thinks that she had the swelling and pain due to the way that the woman gave her the injection. She has not notified her doctor. She is not having any chills, and her arm is just sore right now, but able to use is otherwise. When she lifts the arm it hurts, as well as shoulder/ball of her arm hurts.

Other Meds: Cymbalta.

Current Illness: None.

ID: 1155914
Sex: F
Age: 29
State: MA

Vax Date: 03/20/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: Mild sulfa allergy

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Red mark appearing at site of injection 12 days after vaccine, slightly itchy, 1.5inches wide, 1 inch long.

Other Meds: Spironolactone, Escitalopram, Vyvanse, Pantoprazole, Zyrtec, Levothyroxine, Birth Control (Apri), Vitamin D, Vitamin B12.

Current Illness:

ID: 1155915
Sex: F
Age: 71
State: PA

Vax Date: 03/04/2021
Onset Date: 03/11/2021
Rec V Date: 04/01/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient stated she suffered a stroke about 1 week after getting the vaccine. The patient went to the hospital and was successfully treated. The patient is now on plavix and pravastatin for further prevention.

Other Meds:

Current Illness:

ID: 1155916
Sex: F
Age: 24
State:

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: - erythema at injection site - feeling of throat closure 7 hrs after injection

Other Meds:

Current Illness:

ID: 1155917
Sex: F
Age: 28
State: IL

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

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

Lab Data:

Allergies: None known

Symptom List: Rash, Urticaria

Symptoms: March 31, 2021: 12:30pm: Headache and sore arm 3:30pm: Nausea and severe headache 4:30pm: Pain in joints and swelling in hands + headache continuing 7pm: Severe chills with temperature at 100.3 F + headache continuing 8:30pm: Abdominal pain and continuation of chills + headache. Quite a bit of abdominal gas April 1, 2021: 12:30am: Chills subsided and temp raised to 100.5F. Joints still still and sore. 6:30am: Sore joints but body temp back down to 98.3F and body aches not as bad 8am: Minor traces of blood in stool 10am: Took 2 advil for headache and other body pains 12pm: No more traces of blood in stool 11am: Headache minimized and body aches greatly reduced

Other Meds: 1. Nuva Ring 2. Calcium Magnesium supplement 3. Daily women's multi-vitamin 4. Probiotic 5. Fish Oil

Current Illness: None known

ID: 1155918
Sex: M
Age: 79
State: WI

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

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

Lab Data:

Allergies: Bee Venom Penicillin G

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

Symptoms: Patient received first covid vaccination today, at around 1140 Volunteer monitoring patients noted that individual scooted down in his chair. She asked if he was okay and stated he was feeling dizzy. Vaccination clinic staff responded. Patient was able to assist to floor. Feet were elevated. He was provided water and ice pack. Patient did not appear to lose responsiveness at any point. He was able to state he was at the hospital as well as his name, DOB and where he was from, but patient was slow with answers. Patient then stated he was starting to feel better. He denies SOB or chest pain. As staff continued to interact with him, he was slower to respond again. He shared he had nobody in attendance with him and no family in the area. A code medical was called. BP cuff arrived BP was 164/110. ER nurse began assessment. Patient was able to get to standing position with staff assistance. He was taken to ER via stretcher for evaluation.

Other Meds:

Current Illness: Unknown

ID: 1155919
Sex: M
Age: 28
State: PA

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

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

Lab Data:

Allergies: None

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

Symptoms: Patient has a history of syncope after vaccinations (last occurred with a vaccination 10 years ago) but did not state this prior to receiving his first COVID-19 vaccine. About 1 minute after sitting down in the observation area, he fell to the ground and briefly lost consciousness. Multiple staff members came immediately to assess, rolled him over, and he immediately came to and was alert and oriented. He was taken to a medical area and laid down on a cot. He had unremarkable vitals and was breathing normally. He initially endorsed feeling lightheaded, but denied any other symptoms. He was given crackers and water given that he had not had much to eat or drink before the vaccination. He had a normal neurological exam. He was noted to have a superficial abrasion above and below the left eye (lower forehead and upper cheek), and a small Bandaid was placed on the forehead. Fire rescue on site called EMS, who assessed him. There were no immediate concerns and he refused transportation to a hospital for further assessment. After 1 hour had passed, the patient confirmed that he was feeling normal and he was allowed to leave. He was able to walk out of the facility of his own volition and did not have further symptoms when standing. His wife verified that she would drive him home. Prior to leaving, he was given strict instructions of reasons to seek immediate medical care should he have any new or worsening symptoms. The patient indicated understanding. Communication was performed via a Language Line medical interpreter.

Other Meds: None

Current Illness: None

ID: 1155920
Sex: F
Age: 52
State: MA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: Dairy, Gluten, Cats

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

Symptoms: 30 minutes after injection- right side of face and head went numb 90 minutes after injection- uncontrollable laughing 5 hours after- body aches 7 hours after- high fever, intense upper back pain, joint pain, aches, headache, chills, incredible thirst, nausea Uncontrollable laughing lasted about 5 minutes and happened at 2 separate times High fever lasted 24 hours Low grade fever lasted 72 hours Nausea and thirst lasted 7 days Numbness is still present to date

Other Meds:

Current Illness:

ID: 1155921
Sex: F
Age: 26
State: CA

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: None Known Allergies

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

Symptoms: Patient experienced rash, itch, swelling on bilateral hands. Vital signs were stable feeing dizziness after 10 minutes of vaccination. Benadryl 50mg IM were given and monitoring over one hour. Continued stable, no SOB, itchy and rash went away.

Other Meds: Vitamin D, Cetirizine

Current Illness: None

ID: 1155922
Sex: M
Age: 34
State: HI

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Feeling faint, on the verge of fainting-Mild, Systemic: Flushed / Sweating-Mild

Other Meds:

Current Illness:

ID: 1155923
Sex: F
Age: 21
State: TX

Vax Date: 03/30/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: Bactrim

Symptom List: Ear pain, Hypoaesthesia

Symptoms: localized pain, redness, and swelling.

Other Meds: Escitalopram, Abilify

Current Illness: none

ID: 1155924
Sex: M
Age: 33
State: UT

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Client cancelled the original booster dose appointment which was scheduled 28 days after prime dose due to being out of town. He was rescheduled to receive the boost dose 23 days after the first dose. He received the second dose 5 days prior to the 28 day required time frame.

Other Meds: None

Current Illness: None

ID: 1155925
Sex: F
Age: 61
State: OK

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: sulfa drugs, amoxicillin, demerol, codeine, diuretics

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

Symptoms: 2 hours after getting the vaccine itching began on stomach, face, legs and arm. I took an antihistamine and it subsided.

Other Meds: estradoil, calcium, losartan, vitamin D,

Current Illness:

ID: 1155926
Sex: F
Age: 39
State: WI

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

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

Lab Data:

Allergies:

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

Symptoms: Lost consciousness for approximately 2 seconds immediately following vaccination. BP was 64/36, pulse 51, and O2 was 99%. By 1140 am BP was 82/60. Patient recovered and was able to walk out of facility without assist.

Other Meds:

Current Illness:

ID: 1155927
Sex: F
Age: 66
State: WI

Vax Date: 03/03/2021
Onset Date: 03/12/2021
Rec V Date: 04/01/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Hospitalization within 6 weeks after receiving vaccine

Other Meds:

Current Illness:

ID: 1155928
Sex: F
Age: 39
State: MI

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

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

Lab Data:

Allergies: Cymbalta

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

Symptoms: She got her vaccine, had pain at the injection site that moved up her arm. She was having chills. She took a nap and when she woke up she could not lift her arm at all. Had pain in the neck, wrist, arm. She had pain/feelings in that arm. She woke up sometime after midnight sitting up because she woke up and had a tingling sensation in her throat and felt as if her throat was going to close on her. She did not go back to sleep fearing this. She took 600 mg of Tylenol, as well as 600 mg today. She has been better today, and thinks that she had the swelling and pain due to the way that the woman gave her the injection. She has not notified her doctor. She is not having any chills, and her arm is just sore right now, but able to use is otherwise. When she lifts the arm it hurts, as well as shoulder/ball of her arm hurts.

Other Meds:

Current Illness: None

ID: 1155929
Sex: F
Age: 48
State: MI

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: Penicillin-reaction unknown ( age 3)

Symptom List: Injection site pain, Pain

Symptoms: Tachycardia ranging from 100 bpm to 120bpm ( possibly higher around 3-4AM 2/28/21) from 2/28 1AM continuing through 3/1/21 approximately 10:00pm.

Other Meds: Vitamin D 500mcg, Concerta 18mg

Current Illness: Moderna Vaccine 1st dose:1/29/2021

ID: 1155930
Sex: F
Age: 16
State: WY

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

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

Lab Data:

Allergies: no known

Symptom List: Injection site pain, Menorrhagia

Symptoms: patient passed out 10 minutes after receiving the Pfizer covid vaccination

Other Meds: unknown

Current Illness: unknown

ID: 1155931
Sex: M
Age: 59
State: CA

Vax Date: 03/26/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: penicillin

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

Symptoms: 3/26/21 11:00 a.m. - 3/28/21 9:00 a.m.: soreness and tenderness at the injection site - RESOLVED 3/30/21 queasiness 3/31/21 3:30 p.m. - 7:30 p.m. severe headache over right eye (ameliorated with tylenol) 3/31/21 to present: moderate to mild nausea 4/1/21 8:30 a.m. to present: intermittent diarrhea

Other Meds: testosterone cypionate (injectable biweekly), anastrozole (Arimidex), vitamin D

Current Illness: none

ID: 1155932
Sex: M
Age: 39
State: NY

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: UNKNOWN

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: MRN 1998862 - Occurrence Date: 03/11/2021. At 17:01, following Covid-19 vaccine administration at the vaccine POD, patient stated that he felt his heart racing. V/S taken at 17:05: BP: 140/103, HR: 105, 02 Sat: 100%, and RR: 18. Patient stated that he was diagnosed with high blood pressure 6 years ago in , but has not had a physical since then, and also stated that he is not taking any blood pressure medication. V/S retaken at 17:35: BP: 135/105, HR: 70, 02 sat: 99%, and RR: 16. Patient was advised to go to the ER, but declined.

Other Meds:

Current Illness:

ID: 1155933
Sex: M
Age: 34
State: GA

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: None (Pollen)

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 2nd dose received 40 days after 1st dose. Within first 24 hours: Fever/Chills next morning. Stomach/body pain. Head pain. Pain radiating to testicles. Entire body aching. Couldn't find comfortable position to sit/stand/walk. Worse than any illness I've had, but without the brain fog Within next 48 hours: Armpit swollen on right arm (same as vaccine arm). Pain in head persisting. Pain behind ears. Dizzy/lightheaded feeling. Third Day after vaccine: Armpit is still swollen. Headache persists. Ache in muscles and joints seem to be re-emerging. But, overall, I'm fine and can work today. Note: Pollen count high - and I typically do get headaches from pollen - so, headaches could be attributable to pollen, but timing is suspicious.

Other Meds: None

Current Illness: None

ID: 1155934
Sex: F
Age: 75
State:

Vax Date: 02/13/2021
Onset Date: 02/23/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient had a stroke. Did not have any side effects leading up to the stroke event.

Other Meds:

Current Illness:

ID: 1155935
Sex: F
Age: 33
State: GA

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: Ceclor

Symptom List: Nausea

Symptoms: By the following evening I was breaking out in hives all over my body, Sunday morning I was covered in an itchy rash that looked like a sunburn all over my body, in my ears and hair.

Other Meds: Vitamin D, Singulair

Current Illness: UTI a few weeks beforehand

ID: 1155936
Sex: M
Age: 70
State: NJ

Vax Date: 02/24/2021
Onset Date: 03/22/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: I have painful swollen glands under my neck area. I went to my primary doctor, ran a cbc and came back negative but my glands are painful, mostly on the right side where the vaccine was administered.

Other Meds: none

Current Illness: none

ID: 1155937
Sex: F
Age: 62
State: IN

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
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Allergies: Yes allergy to penicillin and other medicines

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

Symptoms: I felt my face swelling and at the same time when I started to eat something found it hard to swallow. Also had side effects of extremely tired fever nausea and cold chills

Other Meds: Spironalactone metformin glipizide

Current Illness: High blood pressure

ID: 1155938
Sex: F
Age: 25
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: chest pain, 4/10, eyes tingling. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1155939
Sex: F
Age: 62
State: FL

Vax Date: 03/29/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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Allergies: none

Symptom List: Tremor

Symptoms: vasovagal syncope after getting up in the night to use the bathroom , momentary blackout with spontaneous recovery

Other Meds: Walgreens multivitamin

Current Illness: none

ID: 1155940
Sex: M
Age: 43
State: TX

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Tinnitus

Other Meds: None

Current Illness: None

ID: 1155941
Sex: F
Age: 66
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Called to obs area ~25 minutes after receiving injection, patient stayed longer due to an issue after first injection where she felt a little light-headed when she was driving to her office afterwards. Patient stated that she had started to feel that her neck was weak, no ShOB, throat tightness, N/V, diaphoresis. BP 164/92, HR 82, O2 98%, HRRR no murmur, CTAB. No palpable abnormality in the neck. Patient took fexofenadine last night, I did give her diphenhydramine 25 mg to take and provided water to take that with as well. Patient requested to use the restroom and I walked her in to the office building, she did not appear to have any issues with ambulation, though she did state she felt less steady than normal. Extended her observation time for 10 minutes after my exam (total 40 minutes obs time) and patient had no further issues.

Other Meds:

Current Illness:

ID: 1155942
Sex: F
Age: 35
State: MN

Vax Date: 01/14/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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Lab Data:

Allergies: Pollen, Cat Dander

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

Symptoms: tested positive by PCR for COVID 19 on 3/31/21, completed series of Pfizer COVID vaccine on 1/14/21. Known exposure to household contacts with COVID 19. Patient had N/V, abd pain.

Other Meds: Neurontin, Singulair, Celexa, Ferrou Sulfate, Duo-Neb, Proventil, Flonase

Current Illness: None

ID: 1155943
Sex: F
Age: 56
State: AL

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/01/2021
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Allergies: Pcn, iodine, ivp dye, strawberries, tropical fruit, which is pineapple, mango, kiwi,

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Ha,malaise, body aches, nausea , vomiting,diarrhea,, bilateral ear aches, swollen glands under chin,

Other Meds: 900 am Effexor,sterra, magnesium,hyzaar, pericolace Neurotin,vistarel, excedrin

Current Illness: None

ID: 1155944
Sex: M
Age: 27
State: AL

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
Hospital:

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Allergies:

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

Symptoms: patient complains of having nerve numbness and tingling from elbow down on same arm that he received his vaccination

Other Meds:

Current Illness:

ID: 1155945
Sex: F
Age: 69
State: OH

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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Allergies: imitrax,latex,ppd,miralax,aspartame, saccharin

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

Symptoms: Pt was given Pfizer vaccine at 1254 pm in right deltoid , went to observation and began experiencing numbness and tingling at 100pm. Assessed by nursing staff 121/70. Pt experiencing slurred speech. 911 called at 106pm, arrived at 115pm. 111pm VS: 136/83, 888 pox:99%. Paramedics here transported to ER at 118pm.

Other Meds: Effexor,tylenol, vitamin C, aromasin,monodox,neurotin, Cymbalta,topamax,pepcid,potassium, ASA 81mg, MVI

Current Illness: HTN,breast CA,migraine,GERD, stroke

ID: 1155946
Sex: F
Age: 19
State: OH

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/01/2021
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Allergies: NA

Symptom List: Pain in extremity

Symptoms: Extreme Brain Fog, Lapses in time, episodes of stuttering and slurred speech, difficulty with cognitive thinking.

Other Meds: Lexapro 10millagrams per day taken at 9pm

Current Illness: NA

ID: 1155947
Sex: M
Age: 39
State: IN

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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Lab Data:

Allergies: None

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

Symptoms: Arm soreness, fatigue

Other Meds: None

Current Illness: None

ID: 1155948
Sex: F
Age: 70
State: CA

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/01/2021
Hospital:

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Allergies: Erythromycin, Darvon, Lactose Intolerant

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

Symptoms: pain, tenderness and swelling, fatigue, right shoulder joint pain, fever. Took Aleve for fever. Used Lidocaine patches for right arm/shoulder pain. Symptoms lasted approximately 29 hours

Other Meds: None

Current Illness: None

ID: 1155949
Sex: F
Age: 23
State: SC

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 04/01/2021
Hospital:

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

Symptoms: After injection, upon standing up, patient became light headed. Assisted to chair. Patient immediately went limp, clammy, and unresponsive. 911 called. Assisted to floor. Legs raised. Became active at about 15 seconds, speaking to nurses. Began recovering. Pulse 96 BP 98/56 Pulse 52 Repeated vital signs when standing up, 72/47 Pulse 51 became slightly lightheaded again. Returned to laying position on floor, continued to talk to nurses. EMS arrived and took over assessment. Declined to go to hospital. Return to chair with no issues. Stood with no issues. To recovering area for further observation before leaving. In recovery area Participant lying on monitor cot post EMS departure. 1619 BP 88/56, P 65, O2 Sat 99%. Voiced lighted headedness better and mother at side. 1622 Assisted to sitting position BP 84/62. Encouraged to sit and continue hydration. 1625 Participant and mother voiced readiness to leave. Educated to monitor closely for p.m. and call 911 for s/s return and or resp. distress. Both voiced will return to urgent care / hospital if any issues. 1625 Participant stood with minimal assist. BP 90/47, P 57. Ambulating without c/o. At time participant departed Howard vaccine site via private car.

Other Meds:

Current Illness:

ID: 1155950
Sex: F
Age: 50
State: TN

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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Allergies:

Symptom List: Vomiting

Symptoms: following vaccination patient c/o sudden HA with 3/10 pain level. Writer assessed patient. Denies shortness of breath, denies tongue tingling/swelling. Denies itching. Denies nausea or symptoms of anaphylaxis. Patient declined further medical attention offered. VS 118/78, 88, 20, 98% RA. After waiting 30 minutes patient reports HA now 1/10 and she feels ok to leave site.

Other Meds: N/A

Current Illness:

ID: 1155951
Sex: M
Age: 18
State: WI

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 04/01/2021
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Allergies: sulfa and cefzil medications

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: High fever started 6 hours after injection along with shaking/chills. Intense headache as well. 1,000mg Tylenol brought fever down to about 103.6. After talking with doctor, placed in cold shower and also gave 400mg advil. He calmed down and fell asleep for 7 hours. Woke and no fever but achy and tired for remainder of the day. Woke up the following day (so about 36 hours later) and felt much better. All is fine now.

Other Meds: none

Current Illness: none

ID: 1155952
Sex: M
Age: 38
State:

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 04/01/2021
Hospital:

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Allergies:

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

Symptoms: Later on in the afternoon of the vaccine day I had chills, fevers, headaches, & a lot of sweet It was really bad flue symptoms it was worst the covid this lasted for 24hrs.

Other Meds:

Current Illness: Tested Positive for covid 2 days after 1st vaccine 1/22/2021

ID: 1155953
Sex: M
Age: 17
State: WI

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

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Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 2 minutes after vaccination patient felt "warm, dizzy, lightheaded, nausea "and c/o tingling in hands and feet. Provided cooling measures and food and drink. Resolved within 15 minutes.

Other Meds:

Current Illness:

ID: 1155954
Sex: F
Age: 56
State: MN

Vax Date: 12/21/2020
Onset Date: 01/06/2021
Rec V Date: 04/01/2021
Hospital: Y

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Allergies:

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

Symptoms: Hospitalization within 6 weeks after receiving vaccine

Other Meds:

Current Illness:

ID: 1155955
Sex: F
Age: 15
State: IL

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

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Allergies: none

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

Symptoms: Patient is 15 years old and received the first dose of the Moderna vaccine. The Moderna vaccine is authorized for people age 18 and older. According to the patient's mother, they did not realize this until after vaccination. Patient was advised not to receive the second dose until 18 years of age. Patient reported redness and swelling at the injection site. No other adverse effects reported.

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am