VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer

Incidents per State

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

ID: 1198241
Sex: M
Age: 29
State: FL

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pfizer COVID-19 vaccine vial was mixed with 1.4 instead of 1.8 ml of diluent. Spoke to patient 04/11/2021. He reported mild soreness of injection site. Provided counseling.

Other Meds:

Current Illness:

ID: 1198242
Sex: F
Age: 39
State: SC

Vax Date: 03/17/2021
Onset Date: 04/02/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: I am having headaches every day and some have become Migraines. I have dizziness, light-headed feelings. Headaches do not go away with ibuprofen. Horrible burning pain. Started after my first dose, March 17 ,and I creased significantly more and worse with my second dose which was on April 7.

Other Meds: Ibuprofen, iron

Current Illness: None

ID: 1198243
Sex: M
Age: 58
State: TN

Vax Date: 03/30/2021
Onset Date: 04/05/2021
Rec V Date: 04/12/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Pt reports beginning to feel ill on 4/5/21 with flu-like symptoms (body aches, muscle pain, fatigue, and chest pain when deep breathing). Saw PCP on 4/6/21 and was sent to hospital for chest X-ray. Pt states that X-ray was normal but PCP treated for pneumonia with antibiotics based on symptoms.

Other Meds:

Current Illness:

ID: 1198244
Sex: F
Age: 53
State:

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 04/12/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Bursitis in left shoulder. Left shoulder continues to be painful when pulling or pushing. Minimal response to Naproxen 500 mg. I have tried to see my PMD for further evaluation, but she had to cancel my appointment and I have been unable to reschedule.

Other Meds:

Current Illness:

ID: 1198245
Sex: F
Age: 32
State: TX

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies: none

Symptom List:

Symptoms: severe body aches

Other Meds: none

Current Illness: none

ID: 1198246
Sex: F
Age: 55
State: UT

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: Codeine, Oxycodone, walnuts

Symptom List:

Symptoms: Upper eyelids slightly swollen and intensely burning beginning around 5pm 4/11. Morning of 4/12, burning continuing and eyelids are a little more swollen. Bruises appeared under eyes. I have not had a fever at all, but have had intense fatigue each morning and evening since the vaccine on 4/9. I tried hydrocortisone on my eyelids, but it didn't help. Tylenol and ibuprofen help relieve the burning sensation a little.

Other Meds: Spironolactone, Wellbutrin, Ambien, Multi-vitamin, Vitamin D, MSM, Krill Oil, Zyrtec, Vitamin B2, Magnesium, low dose Aspirin, and Claritin.

Current Illness: None--I've been very healthy

ID: 1198247
Sex: F
Age: 21
State: OH

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: Cymbalta

Symptom List:

Symptoms: Fever of 102.9. Nauseous. Pain, dizzy. Went to ER. Given tordal shot and nausea meds

Other Meds: B yaz Hydroxazine

Current Illness:

ID: 1198248
Sex: F
Age: 22
State: FL

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

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

Lab Data:

Allergies: Mild allergy to corn.

Symptom List:

Symptoms: Pain and soreness in muscle of the injection site for 3 days; no mark.

Other Meds: Clonidine 0.1 mg, Gabapentin 300 mg

Current Illness: None.

ID: 1198249
Sex: F
Age: 65
State: MA

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

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Caller stated that she received her second vaccine on 4/05/2021 and a few hours later she became lightheaded and dizzy. She fell down when at home and could not get up, she crawled to her bedroom and tried to get up and broke her right foot while trying to get up. She states that she had a reaction with the first one, but was not as severe as the second one. She state that she contacted her PCP.

Other Meds:

Current Illness:

ID: 1198250
Sex: M
Age: 49
State: VA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/12/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: General illness. Drowsiness. Headache. Full body muscle soreness, with greater soreness at the injection site. Symptoms lasted until the next morning.

Other Meds: None

Current Illness: None

ID: 1198251
Sex: M
Age: 63
State: CA

Vax Date: 01/21/2021
Onset Date: 01/24/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List:

Symptoms: 1/21 vaccination 1/22 pain at urination; possible dehydrated. Mild flu like symptoms. 1/23 subsided 1/24 By 4am I woke up in pain. The pain in urination came back very painful; blood in urine. I called immediately to clinic as it was painful. Drank a lot of fluids. The NP called back; 2 weeks of cipro. Might have been a particle; stone, low level. But was gone with hydration.

Other Meds: n/a

Current Illness: n/a

ID: 1198252
Sex: F
Age: 72
State: FL

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: sat 9;30 am when tried to get out of bed horrible pain in my bones. it hurt so bad i screamed with each step. sun .a.m. the bone pain was bad and I could not walk or move. without screaming mon pain less but sick to stomach and bones still hurt

Other Meds: aspirin 81mg; bisoprolol hctz10.625mg, losartan potossium 50mg, burpropion hcl 150mg(2X daily), alprazolam 0.25mg(2x daily as needed) vitamins as follows: D, E, cranberry, elderberry, CoQ-10, biotin, B12, K2, melatonin

Current Illness: no

ID: 1198253
Sex: M
Age: 18
State: CA

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

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: About 10 minutes after the vaccine, the patient was standing in front of the pharmacy with his mom and fainted. He landed on his buttocks and did not appear to hit his head. He immediately appeared conscious but disoriented. He had a steady pulse and no itching or rash or trouble breathing, but he seemed pale. EMT was called and upon evaluation determined that he did not need further treatment. The patient went home with his mother.

Other Meds:

Current Illness:

ID: 1198254
Sex: M
Age: 52
State: LA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Severe ringing in ears (tinnitus) since the day after 2nd dose. Causing headache and some dizziness

Other Meds: None

Current Illness: None

ID: 1198255
Sex: F
Age: 49
State: OH

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin,indomethacin,naproxen,phenothiazines,prednisone,vancomycin,zithromax,advil

Symptom List:

Symptoms: Patient recieved Second COVID vaccination around 2:45 pm and was waiting for her 15min . Suddenly became diaphoretic and c/o palpitations to chest. Sweaty and clammy. B/P was 140/101 pulse 82 O2 sat 100 % at 3:20 pm. Was given a cool compress and apple juice to drink. Agreed to be escorted to nearby ER via wheelchair accompanied by RN and a medical assistant.

Other Meds: cytotec,medroxyprogesterone,linzess,lysteda,ibuprofen,levothyroxine,lasix,trazadone,tramadol,atenolol, Nucynta ER, Bystolic

Current Illness: Diabetes mellitus,migraines tachycardia,artial fibrillation, cardiac defibrillator, pacemaker, asthma, fibroids, GERD , Cervical spondylosis, obesity

ID: 1198256
Sex: F
Age: 32
State: OH

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: 4/10/21 4:30pm severe migraine, numbness in fingers and toes, fever, nausea 4/11/21 severe migraine, nausea 4/12/21 severe migraine, nausea, vomiting

Other Meds: None

Current Illness: None

ID: 1198257
Sex: F
Age: 62
State: NY

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: Morphine

Symptom List:

Symptoms: Stabbing pain at injection site 20 minutes after injection. Stabbing, Aching and Throbbing pain intermittently since injection. I believe it was injected in the wrong area of the arm. Either the nerve, or tendon.

Other Meds: Elivil, Hydroxychloquine, Simvastatin, omeprozole, fish oil, iron, selenium, turmeric, biotin

Current Illness:

ID: 1198258
Sex: F
Age: 50
State: AR

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: Zanaflex, demerol

Symptom List:

Symptoms: Generalized maculopapular erythematous rash, quite pruritic. Present for 3.5 d at time of clinic visit. Given Kenalog/Celestone for pruritis

Other Meds: Aimovig, duloxetine, estradiol, eszopiclone, gabapentin, hydrocodone, metoprolol succinate, Prilosec OTC, trazodone

Current Illness: none

ID: 1198259
Sex: F
Age: 56
State: NC

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

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

Lab Data:

Allergies: Iodine if injected in my bloodstream

Symptom List:

Symptoms: Became Lightheaded within 5 min of injection, progressed to severe dizziness, black spots in my eyes, could hardly lift my arms, progressed further to nausea, was given zofran on tongue by EMS, progressed to severe vomiting. EMS took blood pressure it was 93/50 hear rate was very low. Called ambulance and advised I go to hospital immediately. Blood pressured jumped to 150 then dropped again. Once in ambulance they put IV in and gave Zofran through IV, I don't know if they put anything else in there. Blood pressure stabilized around 110 which is normal for me, I normally have low blood pressure and heart rate. Nausea and dizziness dissipated by the time I got to hospital. They put EKG on also while I was in ambulance and said I was having PVC's advised dr to do another EKG once I got to hospital. Felt better by about 5:00 PM. Overnight I had slight fever and body aches, took Advil and symptoms subsided. Slight soreness in arm and armpit, but not major. Have been feeling fine now other than being traumatized by the whole event.

Other Meds: Levothyroxine .75 mcg Lexapro 10mg Vit C 1,000 mg Vit D3 2,000 IU Fish Oil 1,200 Tumeric 500 mg Milkthistle 250mg Collagen 1,500 mg CO Q10 100 mg Zinc 50mg

Current Illness: None

ID: 1198260
Sex: M
Age: 36
State: NC

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Headache and migraines Mortan Joint pain matron Nausea Hot cold sweats

Other Meds:

Current Illness:

ID: 1198261
Sex: F
Age: 53
State: OH

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: 4-8-21 4:40PM INFORMED RN THAT PT GOT COVID DOSE #2 OF MODERNA INSTEAD OF GETTING PFIZER. COVID DOSE #1 WAS PFIZER. NO NEED TO REPEAT DOSE #2. 4-12-21 11AM TC TO INFORM PT - NO ANSWER.

Other Meds:

Current Illness:

ID: 1198262
Sex: F
Age: 50
State: GA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: I felt like I was having a heart attack I had a very sick stomach too. I had to go to the emergency room and get fentanyl and Benadryl in an IV.

Other Meds: Gabapentin

Current Illness: None

ID: 1198263
Sex: F
Age: 45
State: NC

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: patient reports feeling lightheaded and sleepy after vaccination. Patient reports on 3L of continues oxygen but left oxygen at home. Patient started on 3L of O2, patient felt immediate relief.

Other Meds:

Current Illness:

ID: 1198264
Sex: F
Age: 60
State: FL

Vax Date: 03/31/2021
Onset Date: 04/05/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Second day pain at IM injection site upon touching. Noted by 5th day large knot on site. (apprx.2") Here it is 5 more days & the IM site has grown approximately 2 inches & moved to left side of arm, I've been having fatigue, muscle & joint pain-(just n left side) that wasn't notable prior to s IM injection. I have lymph nodes swelling in my left groin area. The only thing I worry about is having my WBC chasing for the fever & I end up with more problems. Haven't seen my doctor. I was so fatigued Sunday that I could hardly prepare dinner. Do you have a time or approximate time when the side effects ease or cease?

Other Meds: Advair (250/50 Diskus), Acet/Codeine (#4, Tizanidine 2mg, Alprazolam0.5 mg, ASA 81mg, Furosemide 20mg,Gabapentin 24mg,

Current Illness:

ID: 1198265
Sex: F
Age: 34
State: PA

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Moderna COVID-19 Vaccine - High fever (102-103 degrees) for 24 hours, with mild fever for an additional 24 hours. Headache and pain at injection site

Other Meds: Prenatal vitamins

Current Illness: none

ID: 1198266
Sex: M
Age: 24
State: CA

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Pt reports body aches throughout

Other Meds: None

Current Illness: None

ID: 1198267
Sex: F
Age: 42
State: WI

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: On day 5 I started exp sore arm causing muscle pain. About 16 days I had swollen lymph nodes under both under my arms. I contacted my PCP on 4/5 and as of today 4/12 doing better.

Other Meds: Sertraline, Vit

Current Illness: No

ID: 1198268
Sex: M
Age: 82
State:

Vax Date: 01/11/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: patient reports completing 2 shot series of Pfizer covid vaccine, 1st shot given 1/11 per wife, 2nd shot complete 1/25 per wife, but maybe actually given in February? Both shots were taken, interval just unclear from family. Patient admitted to Medical center on 4/9 with cough, fevers and coughing. Reported that his daughter was diagnosed at end of march and him and his wife had symptoms 4 days prior to admit and was positive for covid.

Other Meds: BACLOFEN 10MG PO BID, FLOMAX 0.4MG QHF, SPIRIVA 1 PUFF INHALE DAILY, ZANAFLEX 2MG PO BID PRN, AMIODARONE 200MG PO DAILY, TOPROL XL 25MG PO DAILY, NITROSTAT PRN, CRESTOR 10MG QHS, ASA 325MG PO DAILY, CELEBREX 200MG DAILY, REMERON 15MG Q HS,

Current Illness: UNKNOWN

ID: 1198269
Sex: M
Age: 23
State: NY

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

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Patient experienced syncope about 1 minute after receiving the vaccine, falling from a seated position to the floor. Patient was evaluated by EMS on site and released from the clinic to care of his mother who came to drive him home. Follow-up with patient on 4/12/21, patient states he has not experienced any other negative reactions since the syncopal episode and is feeling fine.

Other Meds: None

Current Illness: None

ID: 1198270
Sex: M
Age: 62
State: MI

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Severe itching @ 10:00 following day, hives, arm pits, soles of feet palms of hands Treated with Benadryl. Symptoms gone by evening of second day following injection. No other symptoms since. Concerned about second dose??????

Other Meds: Trazodone 150 mg. Losartan 25 mg D3 125 mcg

Current Illness: None

ID: 1198271
Sex: M
Age: 35
State: NC

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

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

Lab Data:

Allergies: NKDA NKA

Symptom List:

Symptoms: Patient in the spouse of a employee. Employee contacted an RN requesting the RN reach out to her spouse regarding getting his second COVID vaccination. The RN contacted the patient and per patient was told he had missed his UNCA second dose appointment and was very concerned due to his desire to be fully vaccinated. The RN discussed the intricacies of the including the medication given at the clinic was MODERNA. Patient and spouse verbalized understanding. Patient was scheduled for a same day appointment. Patient arrived, filled out his paperwork, indicating he had previously received Pfizer. This was not observed by the Vaccination RN. Patient received the dose of MODERNA vaccination, and quickly after the vaccinating RN alerted the lead RN of the differences between the first vaccination the patient received and the second. Provider Putnam was also alerted. Patient was observed for 15 minutes after the vaccine was given, per protocol, and was notified that he received the Moderna vaccination as his second dose. Patient was instructed to contact the facility or his PCP with any issues observed from the vaccine. Patient educated on expected side effects of Second Dose vaccination.

Other Meds: Iron Supplement Singulair Flonase AirDuo Diginhaler Omprazole Ventolin Inhaler Flexeril Advil ProAir Inhaler

Current Illness: Mycrocyctic Anemia, GERD, Obesity, Asthma

ID: 1198272
Sex: F
Age: 84
State: TN

Vax Date: 02/11/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: PATIENT'S DAUGHTER CALLED TO HEALTH DEPARTMENT 4/12/21 TO REPORT THAT THIS PATIENT HAD "STROKE LIKE" SYMPTOMS THAT STARTED 4/10/21, WENT TO ER, HAD CT SCAN AND WORK UP AND WAS DIAGNOSED WITH BELL'S PALSY. SHE IS HAVING FOLLOW UP APPTOINTMENT WITH HER PCP 4/12/2021

Other Meds:

Current Illness:

ID: 1198274
Sex: F
Age: 51
State: GA

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: shellfish, penicillin

Symptom List:

Symptoms: Patient reported for second dose of Pfizer BioNTech vaccine. Patient complained of headache during observation approximately 25 minutes after vaccination. Vitals taken: 10:19am 157/86, HR60 Resp 20 O298, 10:24am 155/98, HR58, Resp 20 O296, 10:29am 159/92 HR59 Resp 20 O2 95, 10:34am 154/90, HR61 Resp 18 O298, 10:39am 163/91 HR 69 Resp 20 O2 97. 10:44 176/100, HR 57 Resp 20 O2 97, 10:49am 174/102 HR65 Resp 20 O2 96, 10:54 am 180/111 HR71 Resp 20 O2 96. Patient headache increased. EMS called and arrived at 10:54am. EMS transported patient.

Other Meds: Losartan 100mg, Levothyroxine 112mcg

Current Illness:

ID: 1198275
Sex: F
Age: 57
State: TX

Vax Date: 04/01/2021
Onset Date: 04/04/2021
Rec V Date: 04/12/2021
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Allergies: Kerflex, Flexirol, Penicillin Family

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Symptoms: First dose received 4March2021, mild discomfort in right breast. Second dose received 2April2021, extreme discomfort in right breast. Had lymnodes removed from right arm in 2005, no cancer. Multiple breast surgeries on right breast. Right arm had two knots near the lymnode area and very painful in my breast breast after the second vaccine. Still experiencing mild pain and soreness in right breast. Scheduled mammogram on 21April.

Other Meds: Lorstan, Zoloft, Protonix, Vitamins D, C, B12, MULTIPLE VITAMINS

Current Illness: Seasonal Allergies

ID: 1198276
Sex: F
Age: 19
State: TN

Vax Date: 03/22/2021
Onset Date: 03/24/2021
Rec V Date: 04/12/2021
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Symptoms: A few days after getting the vaccine, I was dizzy, light-headed, nauseated, short of breath, and had bad chest pains. It has been three weeks and my symptoms have not gotten any better.

Other Meds: Cryselle-birth control

Current Illness: I had strep and was taking amoxicillin. I finished the medication the day before my vaccine.

ID: 1198277
Sex: F
Age: 59
State: PA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/12/2021
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Allergies: celebrex and lipitor

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Symptoms: Arm became sore the evening of the injection, was sore on and off for several days (to the touch and laying on it) - within the last 3 days, pain increased and mobility decreased to the extent of yesterday not being able to lift arm. Does not believe there is a rash...thinks there may be slight swelling. At this point has not been seen by a physician. Advised she needs to see a physician.

Other Meds: lantus humalog insulin, atenolol, privastatin, vitamin b12, lisinopril, gabapentin, tramadol, vitamin d, tizanidine, toradol injections (3 months ago)

Current Illness: none

ID: 1198278
Sex: F
Age: 33
State: CA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
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Allergies: None

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Symptoms: Week 29 pregnancy , given COVID moderna vaccine Experienced chills, fever, severe muscle ache, diarrhea, nausea from 4/10/21 to 4/12/21

Other Meds: Iron supplement Stool softener

Current Illness: None

ID: 1198279
Sex: M
Age: 63
State: OR

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/12/2021
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Allergies: hay fever, grass-pine etc.

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Symptoms: within 20 minutes after shot the left side of my face felt light the dentist shot me with a light does of novocaine . the left eye feels tired, tongue and lips feel slightly numb, left side of face feels strange along with a headache

Other Meds: omeprazole 20mg, d3,b-complex, calcium, daily, glucosamine1500mg with msm 1500mg

Current Illness: none

ID: 1198280
Sex: F
Age: 17
State: MN

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/12/2021
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Allergies: unknown

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Symptoms: no adverse event. Patient was under 18 years of age when vaccine was given.

Other Meds: unknown

Current Illness: unknown

ID: 1198281
Sex: M
Age: 76
State: IA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/12/2021
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Allergies: none

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Symptoms: There was no adverse event. Patient had received a third vaccination. Patient received 2 doses of the Moderna Covid vaccine at our location on 3/10/21 and 4/7/21. Patient received 1 dose of Pfizer from store number 10329. We were contacted to complete a VAERS report for the 3rd dose given. After contacting the patient to confirm their dose with they let us know that they were not even aware a dose was given nor were they given any documentation/screened by . The then told the patient that the dose he received was not valid and the patient would have to get 2 more doses of a vaccine somewhere since they had covid a week prior to receiving the Pfizer vaccine. The patient was not screened correctly by , was not given proper documentation by and was misinformed by the village.

Other Meds: Unknown

Current Illness: none

ID: 1198282
Sex: M
Age: 39
State: FL

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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Allergies: NO ALLERGIES

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Symptoms: PATIENT RECIVED THE VACCINE AND PASSED OUT, PATINET WAS SITTING IN THE CHAIR AND WAS DIRECTED TO STAY IN PLACE UNTIL RECOVERING. PATIENT RECIEVED A BOTTLE OF WATER. PATIENT RECOVERED AND WAS ESCORTED HOME WITH HIS PERSONAL NURSE.

Other Meds:

Current Illness: N/A

ID: 1198283
Sex: F
Age: 58
State: PR

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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Allergies: Atropine causes me anaphylaxis shock

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Symptoms: Severe pain and numbness on my arm. Chest pain, I thought it was a heart attack.

Other Meds: Diltiazem 180 and Chlorthalidone 25

Current Illness: No

ID: 1198284
Sex: M
Age: 75
State: GA

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/12/2021
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Allergies: NA

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Symptoms: Patient received second dose of Moderna COVID-19 vaccine at 21 days rather than the recommended 28 days.

Other Meds: NA

Current Illness: NA

ID: 1198285
Sex: F
Age: 36
State: AZ

Vax Date: 04/01/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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Allergies: Latex

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Symptoms: I had sore arm for whole week after shot. It felt sore and achy. But got better as time passed. However, on April 11th arm felt itchy and my arm was red at injection area. I could see a small round visible bump or welt at injection site and about an inch and a half down there was a crescent moon flat like lump or welt. It felt warm and I could tell it was affecting my circulation. So I decided to rub it kinda hard. And massaged my whole arm. Afterward I could feel that must?ve helped. Because my arm started twitching from the shoulder my hand then my forearm. I finally fell asleep and the next morning the swelling was gone along with the redness. But it?s sore of course from my rubbing. Circulation is way better. So I hope that?s it. And no other problems occur.

Other Meds: One a day chewable multivitamin. Calcium tablet with vitamin d. And B12 vitamin.

Current Illness:

ID: 1198286
Sex: F
Age: 56
State: TX

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
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Allergies: Bactrim, morphine, vicodin

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Symptoms: chills, fever 99.1 day of, severe headache, pain at site and hot to touch, muscle fatigue in neck, back, arms and all over, night sweats, nausea, diarehea, no appetite day after, pain at injection site, lower back pain, fatigue 2 days after.

Other Meds: zoloft, levoxyl

Current Illness:

ID: 1198287
Sex: F
Age: 68
State: CA

Vax Date: 03/09/2021
Onset Date: 03/14/2021
Rec V Date: 04/12/2021
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Allergies: nausea from Codeine

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Symptoms: After the first dose on 2/16/2021, approximately 6-7 days later, I felt queasy and the smell and taste of food was distasteful. For two days, unable to eat anything but broth and oatmeal. After the second dose on 3/9/21, similarly, after 6-7 days same symptoms, however, to date, they have not subsided. Food and liquids (even water and fizzy water) tastes funny, flat. The smell of most food is nauseating, and in the last few days I have had some explosive diarrhea, now just loose stools. For the last 3 days have felt dizzy; not constantly, but if I move my head quickly or bend over. I did not have covid at the time of vaccination; I have had 8 covid tests in 2021 due to medical procedures and flying.

Other Meds: Buproprian,Celexa,, Duloxitine, Diazapam, Trazadone, Atovastin

Current Illness:

ID: 1198288
Sex: M
Age: 62
State: CA

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/12/2021
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Allergies: Sulfa drugs

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Symptoms: Warm feeling followed by fainting and slight convulsions. Nausea, gas, feeling faint, and usability to drive a vehicke for approximately 75 minutes. Slept for several hours, faint feelings subsided after 15 hours.

Other Meds: No

Current Illness: None

ID: 1198289
Sex: M
Age: 30
State: NC

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/12/2021
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Allergies: NKDA

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Symptoms: 30 yo M with h/o vasovagal events with lab draws was vaccinated with his first Pfizer Covid-19 vaccine (Lot# ER8729) in the left deltoid at 1202 4/12. Prior to vaccination, patient had had nothing to eat or drink. Pt became syncopal when moving from the vaccination chair to the observation area. When he fell, he hit his head. After the fall, pt remained on the floor and was placed in Trendelenburg position. BP - 105/63; P-40 to 51. Patient reports having a low heartrate. Patient 15 minutes patient attempted to sit up but was dizzy and laid back down. After 5 to 10 minutes, patient was able to sit up and eat some crackers and drink juice and water. After 15 minutes, pt was moved to recliner. Provider noted a bruise above his right eye. About 15 minutes later the pt vomited and started coughing. Provider called EMS and patient was transferred to ED. During ED visit, reaction assessed and thought to be vasovagal reaction.

Other Meds: unidentified antidepressants

Current Illness: None

ID: 1198290
Sex: M
Age: 38
State: FL

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
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Allergies: none

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Symptoms: I can smell the smoking smell like someone is smoking next to me and it come and goes but more often I smell it the entire day.

Other Meds: none

Current Illness: none

ID: 1198291
Sex: F
Age: 36
State: MA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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Allergies: gluten, lactose penicillin

Symptom List:

Symptoms: 4/10/21 - spotted after getting the vaccine (period) and shoulder muscle where the shot was given was very tender and hot to the touch. 4/10/21 - started period 1 week early, heavier than normal. (This is not something that happens to me.) Also felt sick which included mild sore throat, head ache, easily sweating or cold, and had fatigue. Symptoms are improved but lingering today, 4/12/21.

Other Meds: daily dietary supplements: 1300 mg magnesium 1000 mg calcium 1 multivitamin every other day (Eve NOW brand)

Current Illness: IBS, thirst, frequent urination (same as below)

Total 2021 VAERS Injuries: 559,999

Page last modified: 03 October 2021 5:28pm