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: 1208608
Sex: M
Age: 63
State: NC

Vax Date: 04/08/2021
Onset Date: 04/12/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient's wife called PCP's office to report possible vaccine reaction. Approximately 4 days after vaccine, patient had significantly worse neuropathy in bilateral extremities as well as sleeplessness. These are chronic conditions for the patient but per wife they were notably worse following vaccination.

Other Meds: Vitamin C, Vitamin D3, klonopin, vitamin B12, doxazosin, gabapentin, melatonin, mirtazapine, omeprazole, suvorexant

Current Illness:

ID: 1208609
Sex: F
Age: 40
State: VA

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List:

Symptoms: Patient started with swollen injection site 2 and 1/4 inch in diameter. Hurt to touch and hot to touch. Headache, bodyache, severe fatigue, and nausea. On April 13th blood pressure started to rise and was 160/106. Patient decided to go to the Emergency Department and was seen by Dr. She was prescribed ibuprofen, Zofran, acetaminophen. Dr concluded that all symptoms were from the Janssen vaccine.

Other Meds: fluoxetine 20mg

Current Illness:

ID: 1208610
Sex: F
Age: 67
State: IL

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient received Pfizer as second dose instead of Moderna.

Other Meds:

Current Illness:

ID: 1208611
Sex: F
Age: 40
State: GA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Severe stomach pain, diarrhea for 48 hours, vomiting, nausea, severe headache. Also very sore arm.

Other Meds: Tylenol

Current Illness: Neurological condition

ID: 1208612
Sex: F
Age: 72
State: MA

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

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Headache; muscle aches; soreness at vaccination sight; ringing in ears; nausea; dizziness

Other Meds: estradiol; centrum Silver; Vitamin C 500mg

Current Illness: none

ID: 1208613
Sex: F
Age: 32
State: FL

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pt had an red rash in her arm, bruising, fatigue, diarrhea, abdominal pain.

Other Meds:

Current Illness:

ID: 1208614
Sex: F
Age: 51
State: MA

Vax Date: 03/10/2021
Onset Date: 03/20/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: Long list of symptoms that have happened 10 days after vaccine inlcluding abdominal pain, pins and needles of skin, leg numbness and hard time navigating stairs, and tremors in hands.

Other Meds: Citalopram 20mg

Current Illness: N/A

ID: 1208615
Sex: M
Age: 22
State: CA

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

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

Lab Data:

Allergies: bees, doxycycline

Symptom List:

Symptoms: 1330 recevied pfizer covid vaccine, lot # EW0153 right deltoid 1345 walked to tent, due to lightheadedness, anxiety, feels itchy at throat, VSS 1352 scratchy throat, rash at throat, ENT clear , HR RR,lungs clear A&P 1355 worsening symptoms , clearing throatt, sob, wheals on neck, epinephrine 1:1000 0.5ml IM given , 02 10 L via mask, 1402 throat symptoms resolved, no sob, pulse ox 100 , VSS ENT : clear, cardio rr without murmur,lungs clear A&P diphenhydramine 50mg IM left deltoid, IV hep lick Right antecubital 1413transported via ambulance sse progress note scanned into chart

Other Meds: testosterone cypionate intramuscular oil

Current Illness:

ID: 1208616
Sex: F
Age: 27
State: WI

Vax Date: 04/07/2021
Onset Date: 04/12/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: headache, cramping by her hip, pain in her legs

Other Meds: none

Current Illness: none

ID: 1208617
Sex: F
Age: 19
State: FL

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient was very nervous upon receiving vaccine and told immunizing tech that she had previously fainted upon donating blood. Immediately after receiving the shot, she said she felt like fainting. Her mother walked her to the observation chair for monitoring. She fainted and her mother along with two grocery associates went to hold her from falling off the chair. Two paramedics who happened to be a few feet away came to assist and took her vitals. Other medics arrived and took her to the hospital.

Other Meds: Enskyce (birth control pill)

Current Illness: previous history of syncope upon donating blood

ID: 1208619
Sex: M
Age:
State: NY

Vax Date: 03/01/2021
Onset Date: 04/14/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Shellfish, sulfa medications

Symptom List:

Symptoms: Tinnitus

Other Meds:

Current Illness: None

ID: 1208620
Sex: M
Age: 23
State:

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: syncope for 2-3 seconds, hit head on ground. symptoms improved after laying down.

Other Meds:

Current Illness:

ID: 1208621
Sex: F
Age: 53
State: CA

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Body aches, fever 100 deg or more, 30 hours post vaccine. Then ok for several days, normal activity. One week post 4/13/21 more symptoms: body aches, joint and muscle pain, fatigue, ear ringing, headache, fever, chills.

Other Meds:

Current Illness:

ID: 1208622
Sex: F
Age: 29
State: NC

Vax Date: 03/26/2021
Onset Date: 03/29/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Ibuprophen

Symptom List:

Symptoms: Injection site nodule - approximately the size of a ping pong ball, no symptoms (no pain, itching, swelling or tenderness), persisting three weeks post injection.

Other Meds: Effexor, Lamictal, Sronyx.

Current Illness: n/a

ID: 1208623
Sex: F
Age: 18
State: IA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: There was a miscommunication between the pharmacist and the nurse and the shot did not get reconstituted so patient was injected with 0.3mL of the concentrated stock solution which probably ended up being about 4-5 doses worth. She complained of a sore arm the next day and said it was moderate pain (4/10). This was the only adverse event that was reported by the patient we followed up with her on 4/14/21 and she said she had fully recovered.

Other Meds: NA

Current Illness: N/A

ID: 1208624
Sex: F
Age: 30
State: GA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: right sided facial numbness

Other Meds: none

Current Illness: vertigo

ID: 1208625
Sex: F
Age: 66
State: MN

Vax Date: 03/18/2021
Onset Date: 03/21/2021
Rec V Date: 04/14/2021
Hospital: Y

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

Lab Data:

Allergies: amoxcillin contrast dye

Symptom List:

Symptoms: developed severe abdominal pain; multiple CT scans of abdomen, treated with abx no better, originally had diarrhea then constipation original felt to have diverticulitis labs normal sigmoidoscopy - swollen sigmoid hospitalized, symptoms resolved

Other Meds: hctz fluoxetine buproprion montelukast Breo inhaler

Current Illness: none

ID: 1208626
Sex: F
Age: 49
State: AZ

Vax Date: 03/27/2021
Onset Date: 04/04/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: 7 days following the shot I had extreme fatigue, shortness of breath, GI issues, chest pain, sharp headache and extreme leg pain. Symptoms started about 6am and got increasing worse through the day. At night when I was in bed at about 6pm my legs and chest hurt so bad I couldn't take it, so that by 11pm I went to the ER. Because of where we live in and it was a hot day, I suggested that I was dehydrated and never thought about the shot or that it might be side effects. I was treated with IV fluids and paid meds, I have given chest Xrays and it was determined I had inflammation in my chest. Once my PVCs were under control (I had been in bi-Gemini) I was released with Zofran and Tramadol. I have felt extremely tired since. And I am unsure if I should contact a health care provider.

Other Meds: carvadol, levothyroxine, losartin, spironolactone, acetazolamide,

Current Illness: none

ID: 1208627
Sex: M
Age: 60
State: TX

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: This was the second shot. I didn't expect to get sick since I had been sick after the first one. Symptoms were for the first night uncontrollable shaking, vomiting & light fever (100). This is the second day and I feel tired although I slept about 20:00 hours yesterday and 12 today. Expect to recover tomorrow!

Other Meds: None

Current Illness: None

Date Died: 04/13/2021

ID: 1208628
Sex: M
Age: 67
State: VA

Vax Date: 04/09/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Codeine, Lipitor

Symptom List:

Symptoms: It was reported by the Sheriff's Dept. that patient was found expired on 4/13/21 - sitter reported that patient went to take a nap and the sitter went to check on him and found him unresponsive and called 911; patient was DOA on arrival

Other Meds: Coreg, Furosemide, Aspirin, Fish Oil, Nitroglycerin, Nystatin topical, Lasix, Lactulose, Potassium Chloride, Omeprazole, Loratadine, Flomax, Gabapentin, Narcan, Tramadol, Zolpidem, Combivent, Imdur

Current Illness: Essential hypertension, Cardiomyopathy, Chronic viral Hepatitis C, Cirrhosis of the liver, Hypokalemia, Anxiety disorder, CHF, Gout, Ischemic heart disease, COPD, Smoker, Diabetic neuropathy, Lipid disorder, Diabetes Mellitus, Cataracts, Chronic insomnia, Radiculopathy lumbar region, GERD, Benign prostatic hyperplasia with lower urinary tract symptoms, Chronic kidney disease stage 3, Seasonal allergies, BMI 39.0-39.9

ID: 1208629
Sex: F
Age: 27
State: CA

Vax Date: 03/01/2021
Onset Date: 03/12/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: I had sparkles in my vision 5 min. after getting my shot. They went away quickly, so I wasn't concerned. I had a little bit of hotness up my neck and a little itchy, but both also were quick to go away. I went home and went to bed without issue. I woke up at 4am crying and in a lot of pain all over my body. I had a crushing headache, my back, arms and legs ached down to the bone. I had a fever of 100.7, and had to call in sick from work. I took 3 ibuprofen and it didn't help stop the pain or fever. I cried myself back to sleep after wreathing in pain for 3 hours. Woke up again crying again and the pain and fever continued on. I drank 2 beers to see if that would help relax my muscles and back around 3pm and by 4pm I finally felt somewhat better, but still couldn't get up out of bed. I had to call my brother over to help me and considered asking him to take me to the hospital several times because the pain was so intense. The spot where I got my shot wasn't inflamed, or if it was I didn't notice. It did seem a little stiff. I managed to fall back asleep and by the time I woke up again the next day around 5am, I felt completely fine. Fever disappeared and the body pain was gone. It was like nothing had ever happened.

Other Meds: None

Current Illness: None

ID: 1208630
Sex: M
Age: 37
State: AZ

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: Patient reports that within 2 hours of receiving Janssen vaccine, started with migraine-symptoms and dizziness; he had to stay out from work the next next day due to fatigue/dizziness/headaches/myalgias. Started with shortness of breath and asthma exacerbation symptoms on 4/1/21; saw PCP, on 4/2/21 for shortness of breath and asthma/allergy-like symptoms. He also reports that since the time of his vaccine his BP has been running slightly high around 140/85 and headaches have continued off and on. He was started on Budenoside inhaler by PCP and prednisone (patient does not recall dose). Came to see me at on-site clinic on 4/13/21 for continued headaches and concerns to blood pressure elevation persistence

Other Meds: Albuterol PRN

Current Illness: None known

ID: 1208631
Sex: F
Age: 21
State: NV

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: After about 7 hours of receiving the vaccine I started to shiver. My body felt extremely cold even though I was in 75 degree temperature indoors. I started getting goosebumps. That lasted for about 9 hours throughout the night. I also experienced nausea for about 30 minutes at 8:45 pm. I felt like I was going to pass out within that time period too. My head was also hurting throughout the night. My body was aching through the night as well. The only reason I am not sure if I had a fever is because I did not have a thermometer. My arm was sore for 3 days and I was also sweating throughout the first night.

Other Meds:

Current Illness: No

ID: 1208632
Sex: F
Age: 33
State: GA

Vax Date: 01/04/2021
Onset Date: 01/15/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Received first Moderna vaccine on 1/4/2021 Continued taking daily consumption of OCP No illness, infection or ABX use during this time LMP 1/15/2021 Positive HPT on 2/14/2021 Experienced episodes of early vaginal bleeding in pregnancy on x2 separate occurrences, primary care and OBGYN notified ABD pain and cramping present Monitored with hcg levels every 2 days and pelvic ultrasounds Confirmed right ectopic pregnancy 3/4/2021 Diagnosed with a non-viable pregnancy Treatment to end ectopic pregnancy with methotrexate required (other option was surgical management and I declined) Pain/trauma and emotional distress occurred Still being followed with weekly blood draws related to ectopic and methotrexate use

Other Meds: Prenatal vitamin Vitamin D Vitamin C Biotin Iron supplement Progesterone only birth control pills Synthroid

Current Illness: None

ID: 1208633
Sex: F
Age: 37
State: CO

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

Symptom List:

Symptoms: Fever, chills, body aches, tiredness for 24 hours starting from 8pm 4/5/21 to 8 pm 4/6/21

Other Meds: Ibuprofen, women?s daily probiotic garden of life, women?s daily multivitamin garden of life vitamin code, and nutrafol hair vitamin

Current Illness: None

ID: 1208634
Sex: F
Age: 62
State: TX

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: several antibiotics, asprin

Symptom List:

Symptoms: High Fever (over 101), vertigo, severe shaking, nausea, muscle and joint pain, migraine, fatigue

Other Meds: Lunesta, estrogen, restasis

Current Illness: none

ID: 1208635
Sex: F
Age: 61
State: CT

Vax Date: 03/01/2021
Onset Date: 03/19/2021
Rec V Date: 04/14/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Stroke- hearing loss in right ear, extreme headache left temple lobe, nausea, dizziness, diarrhea, inability to move legs. Hospitalized for 5 days Continued weakness left side of the body

Other Meds: Blood thinner, heart medication, statin, aspirin

Current Illness:

ID: 1208636
Sex: M
Age: 49
State: IN

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

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Headache

Other Meds: N/A

Current Illness:

ID: 1208637
Sex: F
Age: 42
State: TX

Vax Date: 04/01/2021
Onset Date: 04/09/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Allergic to Ceclor, Codeine, Vicodin, Morphine and some sulfa

Symptom List:

Symptoms: The 1st dose (on 3/3/21) caused nausea, gerd, fever of 100.4 for and body aches for 2 days, with mild headache. The 2nd dose, (on 4/8/210 I took Tylenol prior to vaccine and every 5-6 hours for over 48 hours but still ran 103 fever for two days after the injection. The reaction began with nausea, vomiting and 102 fever about 12 hours after injection and quickly rose to 103 for the next 48 hours. I had severe headache, dizziness and body aches for 3-4 days after the vaccine.

Other Meds: Levothyroxine, Oxybutiynin, Gabapentin, Omeprazole, TylenolDiclofenac

Current Illness: none

ID: 1208638
Sex: F
Age: 49
State:

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: tree nuts, amoxicillian, avolox

Symptom List:

Symptoms: Facial selling. Started in chin area where I had facial filler and then spread over face and neck overnight. Woke up with hives on torso, back, butt and inner thighs.

Other Meds:

Current Illness: none

ID: 1208639
Sex: F
Age: 68
State: NJ

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin, fish, nuts, metrotrexosate, all fruits, okra

Symptom List:

Symptoms: Later the day after the vaccine I developed severe chills and a really bad sore throat. I developed hives in my throat and mouth which cause hoarsness and was hurting really bad. On that Monday I visited my PCP who prescribed an antibiotic which did help and took antihistimines also. I developed a fever an was really tired and after about 3 day the symptoms subsided. My arm was really sore for about 2 days also.

Other Meds: Genivua, Farciegia, Clortmomeride, Trocevia, Decolicant, Crestor, prilia, Vit D.

Current Illness: no

ID: 1208640
Sex: F
Age: 41
State: MA

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

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: Burning hot sensation on tight side of chest/breast

Other Meds: None

Current Illness: None

ID: 1208641
Sex: M
Age: 75
State: MO

Vax Date: 02/26/2021
Onset Date: 03/05/2021
Rec V Date: 04/14/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: 1 week after receiving the second dose of the Pfizer vaccine, started to feel short of breath with chest pain, a week later showed up to the hospital with extensive bilateral PEs and new onset A. fib. Physician can not determine the etiology behind the PEs, but cannot find any malignancy. Referred patient to pulmonology and hematology for further work-up. Physician feels that this could be an adverse reaction to the Pfizer vaccine Heparin drip for pulmonary emboli 4/8

Other Meds: glimeperide 2 mg, metformin 500 BID, metoprolol tart 50 BID, ASA 81 QD, plavix 75 mg QD, lisinopril 10 mg QD, simvastatin 40 mg QD, nitro SL prn

Current Illness:

ID: 1208642
Sex: F
Age: 61
State: MS

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 04/14/2021
Hospital: Y

Vax Type:
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Allergies: Zucchini

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Symptoms: Diagnosed as Guillan-Barre?Syndrome

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Current Illness: Rheumatoid arthritis

ID: 1208643
Sex: M
Age: 40
State: TX

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
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Allergies: Bee Stings

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Symptoms: Fatigue beginning the following morning (6AM) Fever 99.9 at 6AM treated with Ibuprofen Fever 102.2 at 7PM treated with Ibuprofen Fever 102.8 at 8:30 PM Fever throughout the night accompanied with excessive sweating Consistent Body and Joint aches

Other Meds: Omeprazole

Current Illness: none

ID: 1208644
Sex: F
Age: 35
State: CA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/14/2021
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Allergies: None

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Symptoms: Minor blurred vision on the next morning and lasted about 6 hours then vision came back at late evening

Other Meds: None

Current Illness: None

ID: 1208645
Sex: F
Age: 28
State: CA

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/14/2021
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Symptoms: The day after the first shot, I felt the normal symptoms very sore arm, headache, lightheaded, and achy. The lightheaded feeling continued off and on for at least nine days or more and so did my very mild headaches. On April 9th I noticed that I had a red splotch at the injection site and that my arm, shoulder and neck were still sore. I called the pharmacy and they advised me to start benydryl which I took for two days and the blotch went away. The areas mentioned are still slightly sore but overall I am feeling better.

Other Meds: Flovent HFA 44 MCG, Omeprazole, Multi Vitamin, cetirizine hydrochloride tablets 10 mg

Current Illness:

ID: 1208646
Sex: F
Age: 47
State: FL

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/14/2021
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Allergies: PCN SULFA IODINE VANCOMYCIN

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Symptoms: 4/10/2021 started with bloody nose & dry cough. Still with symptoms today.

Other Meds: Cymbalta Metformin Trulicity Lantus Humalog Amlodipine

Current Illness:

ID: 1208647
Sex: F
Age: 56
State: CA

Vax Date: 03/01/2021
Onset Date: 03/18/2021
Rec V Date: 04/14/2021
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Allergies: None

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Symptoms: I had rash all over body including face. Legs arms Dr gave me a shot of benadryl, and an anti inflammatory shot one in each arm.

Other Meds: Ibrupfren, metropolol 25 mg

Current Illness: None

ID: 1208648
Sex: F
Age: 50
State: IN

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
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Allergies: Eggs, soy, corn, multiple other food allergies

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Symptoms: Fever, nausea, severe myalgia in body areas other than the vaccination site (e.g. upper back, neck)

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Current Illness:

ID: 1208650
Sex: F
Age: 39
State: NC

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/14/2021
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Allergies: Sulfa Drugs

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Symptoms: Headache, nausea, body aches, chills and fever ranging from 99 to 101 for a period of 24 hours. Ibuprofen helped with symptoms and alleviate some of the body aches.

Other Meds: None

Current Illness: None

ID: 1208651
Sex: F
Age: 50
State: CA

Vax Date: 04/07/2021
Onset Date: 04/10/2021
Rec V Date: 04/14/2021
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Allergies: NSAIDs, salmon, nuts

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Symptoms: I developed a low-grade fever nine hours after getting my shot on Wednesday morning. The next day, Thursday, I woke up with achy joints. Acetaminophen helped with the pain and the fever and so I felt better and was up and about by 3 pm that day. I was perfectly fine on Friday, but by Saturday late morning, I had a mild, migraine-like headache, like the feeling of having an elevated blood pressure. By late afternoon the headache started intensifying. I had a severe headache and great pressure in my head from Saturday night through Sunday night, and the acetaminophen wasn't helping much. By Monday morning, the pain had lessened, and I managed to get out of bed. It's been a week since I got vaccinated, and although I no longer have a headache, I am feeling woozy every now and then, like there is still pressure in my head.

Other Meds: Omeprazole for GERD and Lisinopril for Hypertension

Current Illness: n/a

ID: 1208652
Sex: M
Age: 17
State: PA

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/14/2021
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Symptoms: Patient was given the Moderna vaccine at age 17 years old on 4/14/21 before noticing that the appt scheduler allowed the appointment to be made and the voucher completely screened. Not only did the registration not flag the error, but the health department gave authorization to give the vaccine when we logged the vaccine in the patient's profile. The patient's insurance also allowed the vaccine to process through. I referenced the CDC guidance in this scenario and it said that if the Moderna vaccine is given to a 16 or 17 year old, that they can get the second dose as "off label" use

Other Meds:

Current Illness:

ID: 1208653
Sex: F
Age: 51
State: DC

Vax Date: 04/07/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
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Allergies: penicillin, sulfa drugs, lactose intolerant

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Symptoms: Doesn't seem serious, but one week after the shot I have developed a large, itchy red spot at the site of the injection

Other Meds: buporprion, loloestrin

Current Illness: none

ID: 1208654
Sex: F
Age: 87
State: WI

Vax Date: 03/12/2021
Onset Date: 03/15/2021
Rec V Date: 04/14/2021
Hospital: Y

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Allergies: Amoxicillin causes rash and hives Hydrocodone acetaminophen causes a rash Lisinopril causes GI upset Penicillin causes rash

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Symptoms: Patient presented 3 days after her second DuoNeb vaccine with weakness dizziness chest pain or shortness of breath and was initially diagnosed with a pneumonia by chest x-ray obtained with antibiotics without improvement. Subsequently she was hospitalized and CT of the chest showed left lower lobe segmental pulmonary embolism. The patient never had history of venous thromboembolism in the past. She had weakly positive anticardiolipin antibody of IgG type of unknown significance. She was treated initially with antibiotics but after diagnosis of the blood clot she was started on anticoagulation with apixaban with improvement

Other Meds: doxycycline hyclate 100 mg oral capsule, 100 mg= 1 cap(s), Oral, BID lisinopril 20 mg oral tablet, 20 mg= 1 tab(s), Oral, DAILY nitrofurantoin macrocrystals-monohydrate Cap (Macrobid equiv), 100 mg= 1 cap(s), Oral, BID

Current Illness: Hypertension Hyperlipidemia

ID: 1208655
Sex: F
Age: 40
State: GA

Vax Date: 04/10/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
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Allergies: Percocet, latex

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Symptoms: The night of the vaccine (4/10/2021), and the following two days (4/11/2021, and 4/13/2021) I experienced extreme fatigue & low-grade fever (99.6F). On 4/14/2021, the injection site became red, hot, and slightly hard to the touch.

Other Meds: Generic Wellbutrin 300mg XL/daily, Lamotrigine 400mg/daily, Trazodone 50mg/as needed.

Current Illness: None

ID: 1208656
Sex: F
Age: 44
State: TX

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
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Allergies: NONE KNOWN

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Symptoms: The patient received the vaccine at approximately 1:30 pm, when we returned from lunch at 2:00 pm I checked on her at which point she began to feel itchy. I administered 50mg of diphenhydramine and advised patient to obtain a driver for transportation to her house. We continued to monitor the patient while she waited and she said that her throat was tightening so we administered 0.3 mg Epi-Pen at 2:30 pm. EMS personnel arrived approximately 5 minutes later and took over care of the patient.

Other Meds: NONE KNOWN

Current Illness: NONE KNOWN

ID: 1208657
Sex: F
Age: 58
State: NE

Vax Date: 03/31/2021
Onset Date: 04/06/2021
Rec V Date: 04/14/2021
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Allergies: amoxicillin

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Symptoms: The Tuesday after the vaccine I have been unable to get my blood pressure under control. I have been dizzy, light headed and my worst blood pressure reading was 151/109. I debated to go to the emergency room because I was so weak but I waited it out. I am going to a cardiologist on Monday April 19th to try and get my blood pressure under control

Other Meds: Diovan HCT 80-12.5, 1 Daily, Pantoprazole 40mg 1 daily Atorvastatin 20mg 1 daily Osteo Biflex COQ-10

Current Illness:

ID: 1208658
Sex: F
Age: 32
State: FL

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/14/2021
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Allergies: None

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Symptoms: Within minutes of receiving the vaccine I had pain and soreness at the injection site. The pain continued for approximately 30hrs. I had a headache, dizziness, and heightened emotional state for approximately 30hrs. I developed a twitch underneath my eyebrow but above the eyelid on the right side of my face, which was constant for 24hrs. following the vaccine, but is still twitching at various moments throughout the days.

Other Meds:

Current Illness: None

ID: 1208659
Sex: M
Age: 46
State: IN

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/14/2021
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Allergies: none

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Symptoms: Chills, Headache, teeth hurt and exhausted for 50 hours. It was worse then when I had Covid.

Other Meds: none

Current Illness: None

Total 2021 VAERS Injuries: 559,999

Page last modified: 03 October 2021 5:28pm