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: 1217611
Sex: F
Age: 45
State: TN

Vax Date: 04/07/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Ibuprofen and aspirin

Symptom List:

Symptoms: Covid arm rash and bruise near injection site

Other Meds:

Current Illness: Shingles

ID: 1217612
Sex: F
Age: 27
State: MA

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Injection site pain, hard red bump at injection site, dry mouth, fatigue

Other Meds: Depo-provera birth control shot Ibuprofen for headaches

Current Illness:

ID: 1217613
Sex: F
Age: 35
State: CA

Vax Date: 03/09/2021
Onset Date: 03/19/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Site: Pain at Injection Site-Mild, Systemic: see below -Medium, Additional Details: Patient states that 10 days after vacccination, started to get swollen legs and pain which went away a week later. She was concerned due to blood clot warning and I advised her to seek additional medical assistance which she said she would seek. She did state in addition, she experienced swollen lymph nodes and breast tenderness which occured right after vaccination and lasted 2 weeks.

Other Meds:

Current Illness:

ID: 1217614
Sex: F
Age:
State: TX

Vax Date:
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: DIARRHEA; VOMITING; GASTRO-INTESTINAL SYMPTOMS; FATIGUE; HEADACHE; NAUSEA; MUSCLE ACHES; BODY PAIN; PAIN AT INJECTION SITE; BODY TEMPERATURE INCREASED; FEVER; NIGHT SWEATS; CHILLS; This spontaneous report received from a patient concerned a 56 year old female. The patient's weight was 176 pounds, and height was 63 inches. The patient's past medical history included covid-19 infection, low thyroid, and kidney disease, and concurrent conditions included bactrim allergy. The patient experienced drug allergy when treated with morphine, and hydrocodone bitartrate/paracetamol. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 10-APR-2021, the subject experienced body pain. On 10-APR-2021, the subject experienced night sweats. On 10-APR-2021, the subject experienced chills. On 10-APR-2021, the subject experienced muscle aches. On 10-APR-2021, the subject experienced pain at injection site. On 10-APR-2021, the subject experienced body temperature increased. On 10-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 99.1 F. On 11-APR-2021, the subject experienced diarrhea. On 11-APR-2021, the subject experienced vomiting. On 11-APR-2021, the subject experienced gastro-intestinal symptoms. On 11-APR-2021, the subject experienced headache. On 11-APR-2021, the subject experienced nausea. On 11-APR-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from diarrhea, night sweats, chills, nausea, and fever on APR-2021, and vomiting on 11-APR-2021, was recovering from headache, muscle aches, fatigue, pain at injection site, and body pain, and the outcome of body temperature increased and gastro-intestinal symptoms was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1217615
Sex: F
Age: 20
State: TX

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Major dizziness, tightness of the chest, diarrhea, difficulty breathing, rapid heart beat, the symptoms began to show after the vaccination in 4 hours. At first, it was only pain in the arm where the injection occurred. Now, there is also swelling of the arm when the injection occurred.

Other Meds:

Current Illness:

ID: 1217616
Sex: F
Age: 38
State: VA

Vax Date: 04/14/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Topical minor allergy to latex, informed vaccine staff at both appointments

Symptom List:

Symptoms: Itchy pink hives on torso, chest, both underarms, back and buttocks, hips

Other Meds: None

Current Illness: Only normal seasonal allergies (high pollen count)

ID: 1217618
Sex: F
Age: 34
State: AR

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Sore arm, Fever, chills, migraine, body aches, felt like I was dying. If improvements to the vaccine are not made, I will not be getting a booster shot. I'm pretty sure I'm not the only person that feels that way. That vaccine is ridiculous, nothing has ever made me feel that bad in my entire life. I am also concerned that I may be pregnant right now although it has not been confirmed by a test.

Other Meds: Vitamin C prenatal vitamins

Current Illness: None

ID: 1217619
Sex: M
Age: 78
State: CA

Vax Date: 03/10/2021
Onset Date: 03/17/2021
Rec V Date: 04/16/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Blood Disorder (diagnosed by MD)-Severe, Systemic: blood clut in the lungs and legs-Severe, Additional Details: Per patient he went to the hospital on 3/17/21 and 3/23/21 and was diagnosed with a blood clut in his lungs as well as his legs. He was treated with Pradaxa but still continues to have difficulty walking and has overal body aches.

Other Meds:

Current Illness:

ID: 1217620
Sex: M
Age: 50
State: GA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: BACKGROUND NOTE: I had Covid mid-January ands ome of the lingering effects have been to my smell (still very diminished) and taste (greatly improved but still not 100 percent). . Following Sat. 4/10 first vaccination, I had some of the normal side effects starting overnight Saturday night (fatigue chills nausea) which continued through Sunday and Monday and have generally improved since then though still not 100%.. However I am having more smell and taste issues including an after taste issue which I have not had before. The smell taste and after taste are not ones I have seen cited as a typical side effect so that is the main reason for my question regarding whether this is normal and should quickly subside or if it is not normal so it is documented and if it affects timing or if I have the second dose. Hope that makes sense.

Other Meds: Valsartan, Zyrtec

Current Illness:

ID: 1217621
Sex: F
Age: 32
State: KS

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Soreness in arm for first 2 days. Low back pain and abdominal cramping for 1 day on day vaccine received. Fatigue for 1 day on day after receiving vaccine.

Other Meds: Loratadine, Fish oil, Vitamin D

Current Illness:

ID: 1217622
Sex: M
Age:
State: ME

Vax Date:
Onset Date: 04/11/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: OFF LABEL USE; VACCINE USED IN INAPPROPRIATE AGE GROUP; This spontaneous report received from a health care professional concerned a 17 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included hydrocephalus and has a shunt, and cerebral palsy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: UNKNOWN) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 11-APR-2021, the subject experienced off label use. On 11-APR-2021, the subject experienced vaccine used in inappropriate age group. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine used in inappropriate age group and off label use was not reported. This report was non-serious.

Other Meds:

Current Illness: Cerebral palsy; Hydrocephalus

ID: 1217623
Sex: F
Age: 58
State: MA

Vax Date: 04/03/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Skin rash on legs and feet spreading to arms. Very itchy ....extremely itchy. Raised red bumps. Also had red hot sore patch at injection site in both shots. O1st shot delayed by two weeks . Second shot the next day hot red raised. This other rash is much worse completely covering legs incredibly itchy...incredibly!

Other Meds: None

Current Illness: None

ID: 1217624
Sex: M
Age: 52
State: IN

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Headache, fever, lethargy

Other Meds: Kombiglize, Ritalyn, Hydrochlorothiazide, lisonpril, Omeprazole

Current Illness: none

ID: 1217625
Sex: M
Age: 27
State: CA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Fainting / Unresponsive-Severe, Systemic: Shakiness-Mild, Additional Details: As soon as the vaccine was given, pt immediately passed out. Patient then began mildly shaking, this is when I administered the epipen.

Other Meds:

Current Illness:

ID: 1217626
Sex: F
Age: 44
State: FL

Vax Date: 04/10/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Head ache on right side. Neck pain. Nausea

Other Meds: None

Current Illness: None

ID: 1217627
Sex: F
Age: 52
State: SC

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Arm heaviness/ache, shivering with chills, then fever and terrible headache, body aches

Other Meds: Cymbalta, Nuvigil

Current Illness:

ID: 1217628
Sex: F
Age: 36
State: VA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: I was already on menses prior to injection with my regular heavy flow and no cramping. Around 2 hours post injection my flow was increased **substantially** and I continue to have some pretty intense cramping, which is not my normal. I will be contacting my regular family physician when they open to follow up.

Other Meds: Losartan 100mg 1x daily Vitamin D 1000IU 1x daily

Current Illness: N/A

ID: 1217629
Sex: F
Age:
State: PA

Vax Date:
Onset Date: 04/09/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: CHILLS; FEVER; FATIGUE; BODY ACHES; This spontaneous report received from a patient concerned a female of unspecified age. The patient's height, and weight were not reported. The patient's concurrent conditions included iodine allergy, shellfish allergy, alcoholic, and non-smoker, and other pre-existing medical conditions included the patient had no history of drug abuse or illicit drug use. The patient experienced drug allergy when treated with ciprofloxacin, and metronidazole. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 09:00 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021, the subject experienced body aches. On 09-APR-2021, the subject experienced fever. On 09-APR-2021, the subject experienced fatigue. On 12-APR-2021, the subject experienced chills. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, fever, and fatigue on APR-2021, and had not recovered from chills. This report was non-serious.

Other Meds:

Current Illness: Alcoholic (Consumes occasionally.); Iodine allergy; Non-smoker; Shellfish allergy

ID: 1217630
Sex: F
Age: 61
State: NC

Vax Date: 04/13/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Site: Swelling at Injection Site-Medium, Additional Details: swelling in right arm in the arm pit (lymph node inflamation)

Other Meds:

Current Illness:

ID: 1217631
Sex: F
Age: 62
State: NJ

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, bee stings

Symptom List:

Symptoms: Extreme pain in injection site, shoulders two days after.

Other Meds: None

Current Illness: None

ID: 1217632
Sex: F
Age: 58
State: FL

Vax Date: 04/10/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Omnicef

Symptom List:

Symptoms: Loss of smell and taste

Other Meds: Calcium, vitamin D, multivitamin

Current Illness: None

ID: 1217633
Sex: M
Age: 45
State: CT

Vax Date: 03/25/2021
Onset Date: 03/30/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: Severe skin rash in abdominal area, lower back and upper legs. Was prescribed Triamcinolone 0.1% cream for affected areas.

Other Meds: Multivitamin and omega3 supplement

Current Illness: None

ID: 1217634
Sex: F
Age: 57
State: WI

Vax Date: 03/31/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Woke up around 2:00 am on 4/14 with leg pain on left side of lower left leg above the ankle in the calf area. Felt like pain was moving up leg. Pain was strong enough to wake me up and was something I never experienced before. Leg is still tender in that spot but there is no bruising or discoloration.

Other Meds: none

Current Illness: none

ID: 1217635
Sex: F
Age: 32
State: IN

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Singular

Symptom List:

Symptoms: Tingling from fingertips to lower neck for a few hours after vaccine followed by pain from elbow to neck. Pain still occurring day after. Injection was given unusually high (above the crease of shoulder) and I am thinking that may be the reasoning for the unusual pain and tingling.

Other Meds: None

Current Illness: None

ID: 1217636
Sex: F
Age: 88
State: CT

Vax Date: 04/07/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: hives, erupted less than week after administration of second Pfizer vaccine dose, no other potential triggers identified

Other Meds:

Current Illness:

ID: 1217637
Sex: F
Age: 68
State: MI

Vax Date: 04/02/2021
Onset Date: 04/11/2021
Rec V Date: 04/16/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Admitted to hospital for TIA, NSTEMI, hypertensive emergency 4/11

Other Meds:

Current Illness:

ID: 1217638
Sex: F
Age: 23
State: CA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Hyperventilation-Mild, Additional Details: patient remained conscious. paramedics arrived and followed up with patient.

Other Meds:

Current Illness:

ID: 1217639
Sex: U
Age:
State:

Vax Date:
Onset Date: 04/08/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: ACHES; DIDN'T SLEEP; TIRED; CHILLS; FEVER; BAD HEADACHE; EYES FELT HEAVY; HOT AND BURNING MOUTH; HOT AND BURNING IN THROAT; BURNING OF EYES; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. The patient's concurrent conditions included mild arthritis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 08-APR-2021, the subject experienced eyes felt heavy. On 08-APR-2021, the subject experienced hot and burning mouth. On 08-APR-2021, the subject experienced hot and burning in throat. On 08-APR-2021, the subject experienced burning of eyes. On 08-APR-2021, the subject experienced chills. On 08-APR-2021, the subject experienced fever. On 08-APR-2021, the subject experienced bad headache. Laboratory data included: Body temperature (NR: not provided) 98.6 unit not reported, 101.6 F. Treatment medications included: ibuprofen. On 09-APR-2021, the subject experienced aches. On 09-APR-2021, the subject experienced didn't sleep. On 09-APR-2021, the subject experienced tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from eyes felt heavy, hot and burning mouth, hot and burning in throat, burning of eyes, didn't sleep, chills, and fever on 10-APR-2021, had not recovered from bad headache, and tired, and the outcome of aches was not reported. This report was non-serious.

Other Meds:

Current Illness: Arthritis

ID: 1217640
Sex: M
Age: 35
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Elevated heart rate of ~115 bpm for 7 continuous hours. Fever of 102.7. Severe chills. Aches.

Other Meds: Timilol

Current Illness: None

ID: 1217641
Sex: M
Age: 51
State: IN

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: The day after my vaccination I felt like I had mild to moderate flu symptoms, achy, stuffy with headache. The day after that the flu like symptoms abated, but then were replaced with muscular and joint soreness, especially in the lower legs. It felt like my calf muscles were going to charlie horse at any moment. Also, I experienced random muscle twitches throughout my body, but mostly in the calf region. This muscular twitching has continued for two weeks now, though it has abated to some degree in terms of frequency and intensity. The muscle twitching is the reason that I'm writing this report. I expected that I might have flu like symptoms, but not twitching muscles all day and night.

Other Meds: None

Current Illness: None

ID: 1217642
Sex: F
Age: 30
State: OH

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Flagyl Cyclobenzaprine Cehpalexin

Symptom List:

Symptoms: About 4 hours of non stop diarrhea, headache, fatigue, weakness, severe dehydration and chills. Followed my fatigue, weakness, and headache the entire next day.

Other Meds: Levothyroxine Vitamin d Probiotic

Current Illness: None

ID: 1217644
Sex: F
Age: 23
State: CA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Hyperventilation-Mild, Additional Details: patient remained conscious. paramedics arrived and followed up with patient.

Other Meds:

Current Illness:

ID: 1217645
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: BRAIN FOG; DIZZY; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 01-APR-2021 for prophylactic vaccination. The batch number was not reported. As per procedure no follow-up will be requested for this case. No concomitant medications were reported. On APR-2021, the subject experienced brain fog. On APR-2021, the subject experienced dizzy. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from brain fog, and dizzy. This report was non-serious.

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Current Illness:

ID: 1217646
Sex: F
Age: 30
State: NC

Vax Date: 04/06/2021
Onset Date: 04/11/2021
Rec V Date: 04/16/2021
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Symptoms: Shot was given on April 6th. Mild arm pain and lymph node in armpit was sore the day after. No other side effects till April 11th when injection site turned red and hot. April 14 back pain started in the middle of the day. Later that day fever spiked up to 101.4. Major body aches, skin sore to the touch, sore throat, sore ears, swollen throat. April 15th, slept most of the day, side effects not so bad. Fever never went past 99.5. April 16, swollen throat and sore ears, temp still at 99.

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Current Illness:

ID: 1217647
Sex: M
Age: 42
State: MI

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 04/16/2021
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Symptoms: AFTER RECEIVING THE VACCINE HE COMPLAINED OF BEING DIZZY ON SITE EMS RESPONDED AND VITALS ARE BELOW. AFTER BEING MONITORED, HE FELT BETTER AND WAS RELEASED TO HOME

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Current Illness:

ID: 1217648
Sex: F
Age: 60
State: FL

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
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Allergies: Penicillin

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Symptoms: Weakness, stomach pain , fever , diarrhea lasting for 3 days

Other Meds: Montelukast , vitamin C , calcium + D , Omega 3 , Tylenol

Current Illness: None

ID: 1217649
Sex: M
Age: 59
State: CT

Vax Date: 11/30/2019
Onset Date: 12/13/2019
Rec V Date: 04/16/2021
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Allergies: None

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Symptoms: SSHL sudden sensorineural hearing loss in right ear. ENT prescribed 2 weeks of prednisone, followed by a mini myringotomy incision with a solution of buffered dexamethasone. Audiograms showed severe unilateral SSHL. Hearing never returned, no improvement. Tinnitus also present.

Other Meds: None

Current Illness: None

ID: 1217650
Sex: M
Age: 35
State: WV

Vax Date: 03/23/2021
Onset Date: 03/30/2021
Rec V Date: 04/16/2021
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Allergies: None

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Symptoms: Horrible pains for several days, went to doctor and was diagnosed w shingles. Two weeks later now, still in horrible pain. Worst experience of my life, would rather have had covid again.

Other Meds: None

Current Illness: None

ID: 1217651
Sex: M
Age: 21
State: CA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient received his moderna shot on april 15 at around 3:50pm, and was seated for observation for 15 minutes. Patient felt dizzy and fainted and fell to the ground and hit his head. I ran to him and he gained concious within few seconds and stood up. I helped him to lay back on the floor and raised his leg on a chair. At 4:02 Temprature was 97.2 & blood pressure 120/71. Patient was responding & mention he fainted also few days ago when he had blood drawn for some blood work. Ambulance took over

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Current Illness:

ID: 1217652
Sex: F
Age: 65
State: NY

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
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Allergies: None

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Symptoms: Evening of Day 1, shaking chills, fever (100), headache. Went to bed at 9:00, woke at 3am with severe "swelling" I felt like my brain was too big for my skull, my entire face felt swollen. Joint aches, muscle aches, nausea. Nausea has been intermittent thru day 5. Headache continues but not as severe. I still wake up with it every day (this is now day 5). Diarrhea began on Day 3 (watery, every 1/2 hour for 4 hours). fever subsided and returned on Day 3 (100). no fever since but muscle aches, headache and joint aches continue.

Other Meds: 5-hydroxytryptophan, Thyroid Glandular, Magnesium

Current Illness:

ID: 1217653
Sex: M
Age: 44
State:

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 04/16/2021
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Symptoms: Patient reported to medical clinic 24 hours after COVID 19 injection (03/19/2021) with symptoms of visual hallucinations, myalgia, rigors, headache, nausea, vomiting and dehydration. At the time of arrival to the medical clinic, he had refractory nausea and vomiting after receiving Zofran earlier in the day at another clinical site. Medical treatment consisted of IV Fluid bolus with maintenance fluids, IV Phenergan for the nausea and vomiting, and IV Ketorolac for headache pain. His symptoms resolved and he started to feel better so a clinical decision was made to discharge him home in the care of a close friend. He declined any other treatment modalities or medications at the time of the discharge. The patient returned on 03/28/2021 with a right arm DVT proven on U/S. He was then started on anticoagulation therapy after specialist phone consult and will be closely followed.

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Current Illness:

ID: 1217654
Sex: M
Age: 21
State: CA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Additional Details: Redo: Pt was waiting for 15 mins observation, he felt dizzy and fainted and fell to the ground and hit his head. Called ambulance, temp. was 97.2 bp 120/71. pt gained concious right away and stood up. I assisted pt to lay back to the ground and raised his leg to a chair. ambulance came, checked blood sugar was 80. took him to hospital.

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Current Illness:

ID: 1217656
Sex: U
Age:
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Rec V Date: 04/16/2021
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Symptoms: EXTREMELY SORE ARM; SEVERE FATIGUED; HORRIBLE HEADACHE; LOW GRADE FEVER; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure no follow up will be requested. No concomitant medications were reported. On an unspecified date, the subject experienced extremely sore arm, severe fatigued, horrible headache, and low grade fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from extremely sore arm, severe fatigued, horrible headache, and low grade fever. This report was non-serious.

Other Meds:

Current Illness:

ID: 1217657
Sex: F
Age: 38
State: TN

Vax Date: 04/10/2021
Onset Date: 04/19/2021
Rec V Date: 04/16/2021
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Allergies: Vancomycin

Symptom List:

Symptoms: Rash/hives on palms of hands, bumps on you get, rashes on body, swollen lips, yeast infection

Other Meds: Levothyroxine

Current Illness:

ID: 1217658
Sex: M
Age: 59
State: GA

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
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Allergies: NA

Symptom List:

Symptoms: Lymph node swelling in left underarm started the following day and continued to increase for about 24 hours to the size of a baseball. Swelling has stabilized. Waiting for swelling to decrease. Will seek medical attention next week if swelling does not decline.

Other Meds: Singulair, atorvistatin, aspirin (80mg), budesonide sinus wash, vitamin D, fish oil capsule

Current Illness: NA

ID: 1217659
Sex: F
Age: 43
State: IN

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
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Allergies: N/A

Symptom List:

Symptoms: Body aches, nausea, slight chills - lasted 12 hours. Then totally fine and normal. Treatment - tried to sleep, but didn't sleep well.

Other Meds: Pantoprazole 20mg, once a day.

Current Illness: None

ID: 1217660
Sex: M
Age: 42
State: TN

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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Symptoms: Error: Wrong Dose of Vaccine - Too Low

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Current Illness:

ID: 1217661
Sex: F
Age: 33
State: NJ

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
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Allergies: Latex

Symptom List:

Symptoms: Chills, low-grade fever, headache, body aches - lasted for about 24 hours. Treated with Tylenol, rest.

Other Meds: Pre-natal vitamins

Current Illness: None

ID: 1217662
Sex: M
Age: 59
State: PA

Vax Date: 04/10/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital: Y

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Symptoms: Patient presented 5 days after vaccine administration with a lacunar stroke. He had numbness in his right face and right hand which he woke up with on day 5.

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Current Illness:

ID: 1217663
Sex: M
Age:
State: MO

Vax Date:
Onset Date: 03/21/2021
Rec V Date: 04/16/2021
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Symptoms: BODY ACHE; This spontaneous report received from a consumer concerned a 59 year old male. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown, expiry: unknown) dose was not reported, administered on 21-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 21-MAR-2021, the subject experienced body ache. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body ache on 21-MAR-2021. This report was non-serious.

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Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm