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: 1176865
Sex: F
Age: 46
State:

Vax Date: 03/29/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Keflex

Symptom List: Dysphagia, Epiglottitis

Symptoms: Today woke up with itchy red bump at injection site and my arm is now swelling. I took Advil and put antihistamine ointment on the site. I contacted my doctor and told him I wanted topical steroid.

Other Meds: birth control, Xyzol for allergies, hydrochlorothiazide for blood pressure.

Current Illness:

ID: 1176866
Sex: M
Age: 17
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient under age 18 was vaccinated with Moderna, which is a vaccine error. Troubleshooting: Scribe and vaccinator did not validate age; screeners at the beginning of the process did not ask or turn her away on a Moderna-only day. An ID requirement has been put in place to prevent this situation from occurring in the future. Follow up to be done by Physician or delegee will include specific description of next steps for obtaining dose 2.

Other Meds:

Current Illness:

ID: 1176867
Sex: M
Age: 65
State: MD

Vax Date: 03/28/2021
Onset Date: 03/29/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Fever, chills, muscle contractions in lower back and stomach for two days. Loss of appetite, lower back pain. My urine was deep orange in color and bowel movements were very loose (not formed). Extreme fatigue for almost 8 full days before I felt any sense of feeling normal.

Other Meds: Maxalt ? MLT; 10mg - As needed on the onset of a Migraine Pantoprazole SOD DR 40mg; 2/day ? Barrett?s Esophagus, Acid Reflux and Heartburn Atorvastatin (Lipitor) 40mg; 1/day ? Cholesterol Telmisartan 80mg; 1/day - Blood Pressure Carveddilol

Current Illness: None

ID: 1176868
Sex: F
Age: 31
State: IL

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

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

Lab Data:

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: At 6:20am the following day almost 24 hours later, I woke up and started my day after a few minutes I felt numb and lost conscience for a few seconds. Then I was disoriented and my husband took me back to bed where I slept for a few hours. And battled a fever for the rest of the day. Fever ranged between 100-101 for most of the day.

Other Meds: N/A

Current Illness: N/A

ID: 1176869
Sex: F
Age: 26
State:

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

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

Lab Data:

Allergies: None

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

Symptoms: I started to feel weird around 7pm, like the feeling of being "off" right before you get sick. By 9pm, I had the chills and a fever. For the next hour, I experienced nausea, headache, and worsening fever. I was shaking, had body aches and intense chills. I went to sleep at 10:30pm with a fever of 101.4 and had a fever until 8am the next morning. I experienced a terrible headache throughout the next day and felt extremely exhausted.

Other Meds: None

Current Illness: None

ID: 1176870
Sex: F
Age:
State: TX

Vax Date:
Onset Date: 01/25/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: After the 1st injection, she had the worst period of her life, extreme bleeding and painful. After the 2nd injection she was still bleeding and her period stopped. She began to have horrible diarrhea.

Other Meds:

Current Illness:

ID: 1176871
Sex: F
Age: 28
State: TX

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Sulfa; Topamax; Cefzil

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Started having seizures. One after the other. 3 within 20 minutes. Became completely unresponsive for 1 1/2 hours. Was taken to the ER to be monitored.

Other Meds: Clobazam; Lamotrigine; Memantine; Synthroid; Seroquel

Current Illness:

ID: 1176872
Sex: F
Age: 64
State: AL

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Levequine, corn, shrimp

Symptom List: Pharyngeal swelling

Symptoms: April 2 vaccine - injection shot location pain Day 2 - flu like symptoms Severe body aches, fever, terrible sinus pressure, fluid in ears. Slept all day Took Advil, aspirin, Benadryl, corcidin. Day 3- reduced by 1/3 still weak and tired Day 4- reduced still. Mostly sinus pressure, vertigo, aches, fatigue Day 5 woke up with some sinus, tired, vertigo Day 6 woke up with some sinus still tired, vertigo but was relatively better. About 12 noon heart started racing felt very lightheaded and dizzy. Felt like I was going to pass out. After about an hour or so it started to subside and I felt very drained and tired. still feeling unwell. Loss of apetite

Other Meds: Levothyroxine .075- Amlodepine, Lisinopril, 81 mg Asprin, Ezitimbe

Current Illness:

ID: 1176873
Sex: F
Age: 51
State: MD

Vax Date: 03/29/2021
Onset Date: 04/05/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient received second dose of Pfizer's vaccine on 3/29/2021 and the rash started on 4/5/2021. Pox like bumps under breast to rump that are itching and liquid filled. Currently not draining and no fevers noted. Denies pain. Currently using OTC calamine lotion and Benadryl lotion for the itching but is looking for more treatment from PMC.

Other Meds:

Current Illness:

ID: 1176874
Sex: F
Age: 80
State:

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

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Dizziness, nausea, vomiting, dry heaves, 100.3 fever, weakness

Other Meds:

Current Illness:

ID: 1176875
Sex: F
Age: 25
State: MD

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Doxycycline and penicillin (and all drugs of the same families)

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

Symptoms: I have had very very mild tinnitus for a few years now, where it is only noticeable in dead silence. I sleep with a sound machine and that fixes the problem completely. But after getting the vaccine, I have ringing in my left ear that is 10x louder than it ever has been before. My ears feel clogged. It is taking over my life. I can't focus. I can't sleep.

Other Meds: Wellbutrin, Vyvanse, Seasonique (birth control), Vitamin D

Current Illness: UTI (possibly)

ID: 1176876
Sex: F
Age: 46
State: IN

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Post injection, Immediate wave of dizziness while I waited for 15 minutes. It subsided and I drove home. Within two hours I was feeling extremely drowsy and achy. The drowsiness felt like I had been given a heavy sedative. I felt this for 48 hours post shot. I have continued to feel extreme fatigue and headache since the shot. Headache worsened today April 7th. I have also been having nausea.

Other Meds: Effexor, buspirone, vitamin d, testosterone supplement, estrogen patch, progesterone, probiotic.

Current Illness: None

ID: 1176877
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Starting April 6 around 6 pm, ran fever of 99 to 100. My normal temp runs around 97 to 97.5. Fever, then chills, then fever again and mild body aches. By 10 pm I had no chills, but the fever remained. I also had a very intense headache. I woke up around 3 am on April 7 and no longer had fever or chills, but the headache remained and then the mild body aches started. By 2 pm April 7 I still have mild body aches. I have swollen lymph nodes under my left arm. I have mild fatigue.

Other Meds:

Current Illness:

ID: 1176878
Sex: F
Age: 22
State: AZ

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/07/2021
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: 102 fever, extreme chill, sore and stiff neck, body aches, joint pain, very bad headache, restless legs, hot flashes later, nausea, weak, fatigue, and the next morning I still had a fever, fatigue, weakness, and joint pains.

Other Meds:

Current Illness: None

ID: 1176879
Sex: M
Age:
State: AZ

Vax Date:
Onset Date: 03/26/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: JUST A BIG KNOT IN ARM AT INJECTION SITE; DIARRHOEA; EXTREME LETHARGY; EXTREME FATIGUE; NAUSEA; FEVER/LOW GRADE FEVER; EXTREME ABDOMINAL PAIN 12HRS AFTER INJECTION; UPPER GASTROINTESTINAL GAS; BLOATING; CHILLS AND SHAKING VERY STRONGLY; VOMITING; This spontaneous report received from a patient concerned a 49 year old male. The patient's weight was 260 (unit not reported) and height was 73 inches. The patient's concurrent conditions included non alcohol user, non smoker, type 2 diabetes, hypertension, and pain, and other pre-existing medical conditions included patient had no history of allergy to vaccine, drug, or food. patient had no drug abuse. the patient had no family history of any disease. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 1805020 expiry: 25-MAY-2021) dose was not reported, administered on left arm on 26-MAR-2021 10:01 for prophylactic vaccination. Concomitant medications included atorvastatin for cholesterol, dapagliflozin propanediol monohydrate for diabetes mellitus, metformin for diabetes mellitus, amlodipine for hypertension, atenolol for hypertension, irbesartan for hypertension, and capsaicin/menthol for pain. On 26-MAR-2021, the subject experienced extreme abdominal pain 12hrs after injection. On 26-MAR-2021, the subject experienced upper gastrointestinal gas. On 26-MAR-2021, the subject experienced bloating. On 26-MAR-2021, the subject experienced vomiting. On 26-MAR-2021, the subject experienced chills and shaking very strongly. On 26-MAR-2021, the subject experienced nausea. On 26-MAR-2021, the subject experienced fever/low grade fever. Laboratory data included: Body temperature (NR: not provided) 100 (unit not specified). On 27-MAR-2021, the subject experienced extreme lethargy. On 27-MAR-2021, the subject experienced extreme fatigue. On 28-MAR-2021, the subject experienced diarrhoea. On 29-MAR-2021, the subject experienced just a big knot in arm at injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from extreme abdominal pain 12hrs after injection, upper gastrointestinal gas, bloating, extreme fatigue, and nausea on 30-MAR-2021, vomiting, chills and shaking very strongly, and fever/low grade fever on 26-MAR-2021, and diarrhoea on 28-MAR-2021, and the outcome of extreme lethargy and just a big knot in arm at injection site was not reported. This report was non-serious.

Other Meds: METFORMIN; FARXIGA; ATENOLOL; AMLODIPINE; IRBESARTAN; ATORVASTATIN; ALLEVESS

Current Illness: Abstains from alcohol; Hypertension; Non-smoker; Pain; Type II diabetes mellitus

ID: 1176880
Sex: M
Age: 38
State: MN

Vax Date: 01/12/2021
Onset Date: 04/05/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt completed Covid 19 vaccine series on 01/12/2021 and tested positive for Covid 19 on 04/05/2021.

Other Meds:

Current Illness:

ID: 1176881
Sex: F
Age: 80
State: NH

Vax Date: 03/26/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital: Y

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

Lab Data:

Allergies: Morphine

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

Symptoms: Walking Pneumonia

Other Meds:

Current Illness:

ID: 1176882
Sex: F
Age: 39
State: OH

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

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

Lab Data:

Allergies: None provided

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient was given a 1.0ml dose of Moderna CVID19 vaccine. Double the single dose recommendation. At this time no adverse side effects. Reporting due to dose administration error.

Other Meds: None provided

Current Illness: None provided

ID: 1176883
Sex: F
Age: 37
State:

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 04/07/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: persistent fever despite Tylenol, started a few hours after vaccination, "blood shot" eyes, admitted to hospital

Other Meds:

Current Illness:

ID: 1176884
Sex: F
Age: 69
State: GA

Vax Date: 02/01/2021
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Codeine

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

Symptoms: Blood clot left arm.

Other Meds: Simvastatine, lantus, lamotrigine

Current Illness: No

ID: 1176885
Sex: M
Age: 17
State: CA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/07/2021
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: Father and Son came in together about 45 min earlier than their appointment. They were in a rush when checking in for the appointment. They came to the check-in table and we went over the consent form and made sure we saw that the patients date of birth was in the year of 2003. However, after the vaccination was given at the point of data entry we realized that the patient is not actually 18 years old till a month later. We called and were sent directly to voicemail and we left a message to call us back. And no call back has been received.

Other Meds:

Current Illness:

ID: 1176886
Sex: F
Age: 35
State: NV

Vax Date: 04/03/2021
Onset Date: 04/06/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: None that I know of.

Symptom List: Unevaluable event

Symptoms: Rash all over stomach. Started centralized in the right abdominal side and progressed over time across my stomach, to my left side. The rash is less prominent on my upper right back side back area, however it is progressing in that direction. I took a Zyrtec to see if it would help, and the rash still seems the same.

Other Meds: Advil, Tylenol, Zyrtec

Current Illness: No illness at time of vaccination. I had surgery one month prior though.

ID: 1176887
Sex: F
Age: 59
State: VA

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Codeine-Severe nausea and vomiting; Local anesthesia w/ 1% Lidocaine-Makes BP go way too low.

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

Symptoms: 3/18/2021 - Mild Nausea, Injection Site bruised, hematoma at site and very painful all around injection site for 2 weeks. 3/18/19/20/2021 - 3 days of extreme fatigue kept me from usual activities. Resumed activities on 4th day. Received no Dr. treatment.

Other Meds: Metoprolol, Folic Acid, Fluoxetine, Stopped Methotrexate 2 Days before vaccination. No cortisone Injections in hips before vaccine. Last cortisone injections in hips was Dec 2019. Allegra, Excedrin Migraine, D3 &Pepcid AC Complete.

Current Illness: None

ID: 1176888
Sex: M
Age: 61
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Injection site pain, Pain

Symptoms: After patient received the covid -19 vaccine, he reported: anxious, and does not feel good. We observed him for 15mins, after 15mins, patient reported he wants to pass out, developed cough and then he developed wheezing, his breathing is heavily, I gave him a dose of Epipen and called 911.

Other Meds: Xanax taken before the vaccine.

Current Illness: NA

ID: 1176889
Sex: M
Age: 50
State: IL

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient was very dizzy and fell on the floor. He hit his head on the floor and starting bleeding from his hear. 911 came and took him to the hospital

Other Meds: none

Current Illness: none

ID: 1176890
Sex: F
Age: 30
State: HI

Vax Date: 03/12/2021
Onset Date: 03/21/2021
Rec V Date: 04/07/2021
Hospital: Y

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

Lab Data:

Allergies: Amoxicillian

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

Symptoms: Miscarriage of baby at 20 weeks and 3 days of gestation. Preterm labor. Due date was August 6, 2021. Baby was surgically removed on March 22, 2021.

Other Meds: Lithium, Latuda, Concerta

Current Illness:

ID: 1176891
Sex: F
Age: 58
State: TN

Vax Date: 03/30/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: none reported

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Client reported no adverse symptoms but noted that she had been given the wrong shot on 3/30/21 and wanted another Moderna on 4/7/2021. She was not revaccinated

Other Meds: none reported

Current Illness: None reported

ID: 1176892
Sex: F
Age: 24
State: IN

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

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Headache, fever, chills, aches and soreness, slight nausea. Started approximately 5 hours after the shot and lasted until about 24 hours after the shot.

Other Meds: Birth control pills

Current Illness: None

ID: 1176893
Sex: M
Age: 18
State: MI

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Fainting about 2-3 minutes after shot was administered. Could have been anxiety. He has never fainted from just a shot but has when he has had blood drawn.

Other Meds: None

Current Illness: None

ID: 1176894
Sex: F
Age: 26
State: MD

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

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Brain fog, difficulty concentrating beginning 9 hours after vaccine administration.

Other Meds: Nexplanon, LoLoestrin Fe

Current Illness: None

ID: 1176895
Sex: M
Age: 22
State: AK

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Penicilin

Symptom List: Injection site pain

Symptoms: Fainted while standing in line to check-out minutes after getting the vaccine; Blood pressure was low so transported by med unit; Laceration on the bottom of chin and chipped two front top teeth; IV was started on scene to administer fluids.

Other Meds: N/A

Current Illness: N/A

Date Died: 04/06/2021

ID: 1176896
Sex: M
Age: 64
State: MT

Vax Date: 02/04/2021
Onset Date: 03/04/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Patient died of an apparent Cardiac Arrest.

Other Meds: Losartan Potassium 50mg PO q day Claritin 10mg po q day Calcium 600mg PO q day CO Q 10 ASA 81mg q day

Current Illness:

ID: 1176897
Sex: M
Age: 37
State: PA

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies: Doxycyclin

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

Symptoms: Starting 1.5 days after injection, patient experienced mild fever for 4 days peaking at 100.8F on 3rd day after injection. Very dry mouth and rectum (with difficulty going to the bathroom). Sore throat starting on 3rd day after injection to 5th day after injection. Mild shortness of breath on fifth day after injection, General fatigue and dizziness throughout for 5 days.

Other Meds: None

Current Illness: none

ID: 1176898
Sex: M
Age: 50
State: TX

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Arm pain from injection site. Feels like he is sick and is exhausted.

Other Meds:

Current Illness:

ID: 1176899
Sex: F
Age: 66
State: WI

Vax Date: 03/02/2021
Onset Date: 04/04/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: tested positive for COVID-19 on 04/06/2021 at Clinic. Pt symptom onset was 04/04/2021 (sx include; cough, sore throat, runny nose, fatigue, shortness of breath, fever, chills, and headaches).

Other Meds:

Current Illness:

ID: 1176900
Sex: F
Age: 25
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies:

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

Symptoms: a few minutes after patient received vaccine she told us she did not feel well. a few seconds later she passed out for a few seconds before she came back to. her bp was low upon monitoring

Other Meds:

Current Illness:

ID: 1176901
Sex: F
Age: 48
State: MN

Vax Date: 02/13/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies: Codeine

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

Symptoms: Patient received her first dose of pfizer COVID vaccine on 01/23/2021, her second dose was 02/13/2021. She became symptomatic with new loss of taste and smell, headache, nasal congestion, runny nose and fatigue on 04/03/2021. She reported to our facility on 04/07/2021 for COVID testing due to her symptoms. Now rapid COVID and a PCR were obtained, the rapid returned positive. Her PCR is pending lab, they will run the sample upon receipt and instructions were given to send the specimen on ice to the health dept.

Other Meds: Unknown

Current Illness: Unknown

ID: 1176902
Sex: F
Age: 39
State: CA

Vax Date: 02/25/2021
Onset Date: 02/28/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies: Gluten Penicillin Versed Vicodin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I contracted Covid-19 a week after receiving the first dose of the vaccine. I had all symptoms of the disease after the vaccine except for a fever and then I got tested and was positive. I got the second dose of the vaccine 23 days after testing positive with Covid-19. I started having Heart Palpitations three days after the second shot. Six days after the shot I started to have a high heart rate. It was 111-132 resting intermittently throughout the day. It is still doing that after 10 weeks and I am scheduled to be put on a heart monitor this week. I sometimes had shortness of breath when I was having Palpitations. I have a normal heart rate of 52-58 . My doctor is unsure whether it is a symptom of Covid-19 or from the vaccine. After twelve weeks the symptoms have been consistent since they started.

Other Meds: Zinc Vitamin D Multivitamin Calcium Detox Tincture Fish Oil

Current Illness: Covid-19 positive 23 days before second dose shot.

ID: 1176903
Sex: F
Age: 73
State: MS

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies: None

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

Symptoms: After the second dose I barely had side effects. The following day I felt my arm was sore at the injection site and it lasted for about 2 days. I also noticed that my left knee that I was having physical therapy since after the 1st dose due to nerve pain in the knee and upper calf area had stopped working. It had improved a lot and after the 2nd dose the improvement stalled. I also felt mild fatigue for quite a while and noticed that I developed a sensitivity to wine. I always drink 2 glasses of wine at night and now, after the 2nd dose I can barely drink one and I feel comatose. I feel extremely sleepy fast and just can't function.

Other Meds: Primrose, probiotic (multi biotin), magnesium

Current Illness: None

ID: 1176904
Sex: F
Age: 53
State: DC

Vax Date: 03/18/2021
Onset Date: 03/31/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies: None

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

Symptoms: I had my first Moderna shot on March 18 with no immediate reactions except for a sore left arm. But two weeks later I developed a rash around my navel which rapidly spread across my torso, chest and breasts, and back as well as itching (and some bumps) on the back of knees and itching/redness on my forearms. My doctor first suggested over the counter Zyrtec and Benadryl, which I took for 3 days with no result. On day 6 of the rash he prescribed Prednisone. I started it immediately. Today is day 7. I think the rash is calmer but I still need to take the medication to see if it has effect.

Other Meds: None

Current Illness: None

ID: 1176905
Sex: F
Age: 65
State: TX

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies: none

Symptom List: Pain in extremity

Symptoms: About 3 days after shot: severe inflammatory skin reaction began. Eventually covered about 1/3rd of my body. Still active, to now a lesser degree

Other Meds: none

Current Illness: none

ID: 1176906
Sex: F
Age: 25
State: CA

Vax Date: 03/23/2021
Onset Date: 03/26/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies: None

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

Symptoms: Diarrhea, chest/lung pain, lightheaded, cough, sore throat, fever/chills, headache, fatigue. Just rested and drank as much water as possible. Worst symptoms occurred through 3/26-3/38 and then it felt like I had a cold till 4/2. I took over the counter cold medicine on 4/1 and 4/2 to help with sore throat, runny nose and stuffed nose.

Other Meds: None

Current Illness: None

ID: 1176907
Sex: F
Age: 17
State: TX

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

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Lab Data:

Allergies:

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

Symptoms: Patient under age 18 was vaccinated with Moderna, which is a vaccine error. Troubleshooting: Scribe and vaccinator did not validate age; screeners at the beginning of the process did not ask or turn her away on a Moderna-only day. An ID requirement has been put in place to prevent this situation from occurring in the future. Follow up to be done by DCHHS Physician or delegee will include specific description of next steps for obtaining dose 2.

Other Meds:

Current Illness:

ID: 1176908
Sex: F
Age: 28
State: CA

Vax Date: 02/18/2021
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies: N/A

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

Symptoms: INTENSE PAIN AND FLU-LIKE SYMPTOMS AFTER 12 HOURS, BUT ALSO EXPERIENCED UTI AND YEAST INFECTION LESS THAN TWO WEEKS AFTER SECOND DOSE, CLEARED WITH MEDICATION PRESCRIPTIONS.

Other Meds: N/A

Current Illness: N/A

ID: 1176909
Sex: F
Age: 59
State: GA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies: Aspirin and Sulfa drugs

Symptom List: Vomiting

Symptoms: 10-15 minutes after the vaccine was administered that patient c/o "feeling dizzy and eyes were swirling" Some mild shortness of breath and patient was sweating. Rapid response was called and responded. Pt was taking to Urgent care In facility for further evaluation.

Other Meds:

Current Illness: None Known

ID: 1176910
Sex: F
Age: 42
State: TX

Vax Date: 03/06/2021
Onset Date: 03/19/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: On 03/19/2021 She felt dizzy and went to sit down. She ended up passing out and fainting. Now her platelets have dropped 120 points.

Other Meds:

Current Illness:

ID: 1176911
Sex: F
Age: 46
State:

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies: Keflex

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

Symptoms: Woke up nauseous, hot flashes. Threw up a little, felt very strange and uncomfortable, racing heart, the rest of the night. Tingling in arms and heavy chest. Next evening had night sweats and hot flashes. Ended up having my heart checked to make sure I wasn't having a heart attack (I wasn't). Determined later chest pain and tingling arms could be anxiety-related. Following up with my doctor.

Other Meds: Birth control, Zyxol for allergies, hydrochlorothiazide for blood pressure

Current Illness:

ID: 1176912
Sex: M
Age: 67
State: FL

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/07/2021
Hospital:

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Lab Data:

Allergies: Penicillin, Codeine

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 1:38pm c/o lt. hand and lower lt. arm numbness post vaccination. 136/90, HR 84, T 97.4, O2sat 98%. States had surgery on hand due to bones being crushed in an accident and arm goes numb from time to time. 2:04pm released from observation, stated hand feeling somewhat better.

Other Meds: Epileptic Medications

Current Illness: None

ID: 1176913
Sex: F
Age: 32
State: NY

Vax Date: 03/31/2021
Onset Date: 04/06/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies: Penicillin (hives)

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

Symptoms: Day following: fatigue, body ache, headache Day 6-7: Severe swelling and redness at injection site, injection site very itchy

Other Meds: Fish oil, Vitamin D (2,000), B-Complex

Current Illness: N/A

ID: 1176914
Sex: M
Age: 81
State:

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 04/07/2021
Hospital:

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

Allergies:

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

Symptoms: Weakness, fatigue

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am