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
71,565
AK1,624
AL5,282
AR3,377
AS44
AZ13,261
CA57,706
CO10,937
CT7,771
DC1,620
DE1,653
FL35,910
FM3
GA13,288
GU82
HI2,178
IA4,299
ID2,453
IL19,159
IN22,489
KS4,256
KY6,832
LA4,685
MA13,812
MD11,822
ME2,975
MH8
MI17,704
MN11,232
MO8,820
MP30
MS2,656
MT2,124
NC15,277
ND1,221
NE2,705
NH2,849
NJ17,106
NM3,681
NV4,046
NY32,552
OH17,948
OK5,902
OR7,882
PA22,333
PR2,086
QM2
RI1,895
SC5,999
SD1,126
TN8,608
TX33,867
UT4,002
VA13,855
VI49
VT1,658
WA13,714
WI10,295
WV2,211
WY800
XB5
XL1
XV2

ID: 1220379
Sex: F
Age: 18
State: NJ

Vax Date: 04/16/2021
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:

Symptom List:

Symptoms: Patient vomitted once after five minutes of being vaccinated. She said she felt dizzy and nauseous. She felt better 20 minutes later.

Other Meds:

Current Illness:

ID: 1220380
Sex: F
Age: 51
State: NH

Vax Date: 04/16/2021
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: Trazadone and zyprexa

Symptom List:

Symptoms: Dizziness and itching at 1558. Given po 50 mg Benadryl. Stating chest tightness 1415. Given albuterol neb, refusing epi. EMS called.

Other Meds: None

Current Illness: None

ID: 1220381
Sex: F
Age: 53
State: NJ

Vax Date: 03/18/2021
Onset Date: 03/26/2021
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: Pads of toes and fingers had mosquito-like faint marks that were extremely painful to the touch. Hurt to type, grab or hold things. Went away after about a week and then returned less severe in fingers only.

Other Meds: None

Current Illness:

ID: 1220382
Sex: F
Age: 67
State: VA

Vax Date: 04/01/2021
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: Nortriptyline - Shortness of breath Zanaflex - Nausea/vomiting

Symptom List:

Symptoms: Acute bilateral lower extremity DVT found on venous duplex after reporting new bilateral leg swelling 7-8 days after receiving Janssen COVID-19 vaccine. No prior history of DVT. Brain MRA pending at time of report w/ concurrent history of new/moderate/persistent headache.

Other Meds: Ativan, Lexapro, Lopressor, Advair, Prilosec, Singulair, Lipitor, Plavix, aspirin, CoQ-10, Voltaren Gel, vitamin D3, lisinopril, albuterol

Current Illness: None

ID: 1220383
Sex: F
Age: 70
State: FL

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Mangos, claridon-d

Symptom List:

Symptoms: Severe (migrane type) headache = lasted for over 12 hours - had Tramadol HCL 50mg on hand for back problem, so I took 1 pill in the AM and a second in the PM. Headache gone on the morning of April 4th. No further reaction since then.

Other Meds: Onglyza Hydrochlorothiaside Hydroxyzine HCL Metformin Famitidine/Pepcid Rosuvastatin Losartan Tizanidine HCL women's 55+ multivitamin D3 Stool softener E B12

Current Illness: none

ID: 1220384
Sex: F
Age: 44
State: MD

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:

Symptom List:

Symptoms: After patient received this vaccine dose, it was discovered that the vial had been stored outside of the recommended temperature range calling into question its efficacy After conferring with immunization experts it was determined that this dose needs to be repeated. Patient was contacted by the person completing this form and made aware of this information. The patient has agreed to repeat this vaccine dose and has scheduled to return on 24 April 2021.

Other Meds:

Current Illness:

ID: 1220385
Sex: F
Age: 30
State: MA

Vax Date: 04/16/2021
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: Cefoxitin (reaction unknown)

Symptom List:

Symptoms: Currently pregnant, estimated date of delivery is 10/14/21 At the time of injection, some blood spilled out. The nurse said this does not happen frequently but I wanted to report this as an adverse event in case this is significant in any way.

Other Meds: Prenatal vitamins daily, Zyrtec as needed, Levothyroxine 88mg daily

Current Illness: N/A

ID: 1220386
Sex: M
Age: 63
State: MD

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:

Symptom List:

Symptoms: After patient received this vaccine dose, it was discovered that the vial had been stored outside of the recommended temperature range calling into question its efficacy After conferring with immunization experts it was determined that this dose needs to be repeated. Patient was contacted by the person completing this form and made aware of this information. The patient has agreed to repeat this vaccine dose and has scheduled to return on 21 April 2021.

Other Meds:

Current Illness:

ID: 1220387
Sex: F
Age: 62
State: ID

Vax Date: 04/08/2021
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: Soy, sulfa

Symptom List:

Symptoms: Extreme tiredness

Other Meds: HRT, extensive supplementation

Current Illness:

ID: 1220388
Sex: M
Age: 40
State: CO

Vax Date: 04/07/2021
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: N/A

Symptom List:

Symptoms: Rash on both arms, started the next day, still there a week later. no treatment Sore throat, next day still happening. Nausea started next day. went away two days after Fatigue. day after and went away after that.

Other Meds: N/A

Current Illness: N/A

ID: 1220389
Sex: F
Age: 40
State: CA

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: influenza vaccination, compazine, "one other medicine"

Symptom List:

Symptoms: Within 15 minutes after vaccination "flushed with noted erythema of face/ant chest with complaints of itchiness of face/chest, with tachypnea, wheezing and reported sensation of throat swelling w/ shortness of breath."

Other Meds:

Current Illness:

ID: 1220390
Sex: M
Age: 34
State: MO

Vax Date: 04/02/2021
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: Anterior uveitis brought on likely from vaccination dose 2

Other Meds: Enbrel Etanercept 50mg weekly injection

Current Illness:

ID: 1220391
Sex: F
Age: 31
State: FL

Vax Date: 04/10/2021
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: Amoxicillin

Symptom List:

Symptoms: A few minutes after the vaccine felt heart racing, and lightheaded, they checked my pulse it was fast. I got better but not completely. when EMS arrived my pulse was still high 100 and something I don't remember the exact number, and my blood pressure was 142 over I think 80. I left once my pulse was back to normal. I did not want to go to the hospital, I didn't feel it was necessary and I went home. I don't believe it was anxiety related because I was not anxious at all, the symptoms started a few minutes after and where sudden and unexpected.

Other Meds:

Current Illness:

ID: 1220392
Sex: M
Age:
State: MO

Vax Date:
Onset Date:
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: About 2 minutes after receiving the vaccine, the patient had a complete syncopal event, causing him to hit his head/face on the ground. He regained consciousness immediately afterwards. His blood pressure was low and he had a HR in the 30s, which improved slowly over time. We asked that he go to the hospital for further evaluation, but he refused to go.

Other Meds:

Current Illness:

ID: 1220393
Sex: F
Age: 59
State: FL

Vax Date: 04/11/2021
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: none

Symptom List:

Symptoms: Headache started 2 to 3 days after vaccination, Patient had fever for 2 days. Patient's arm feeling sore and heavy at the injection site. Patient is feeling better 5 days after vaccination. Patient consulted the doctor regarding her symptoms.

Other Meds:

Current Illness:

ID: 1220394
Sex: F
Age: 33
State: IL

Vax Date: 04/05/2021
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: large red, rectangular rash at injection site, slightly raise, warm to the touch, slightly itchy, 3 inches in diameter, another less homogeneous rash splotches half an inch distal to the primary rash, the more spotty blotch began to fill out becoming maybe 2 inches in diameter throughout in the next 2 days while the primary rash became less red. Currently three days since noticing the rash, overall surface area of the rash has grown .

Other Meds:

Current Illness:

ID: 1220395
Sex: F
Age: 61
State:

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: Caller states she received her second dose of Moderna on April 13, 2021 and to days later it became itch and red. She states that since then both s/sx have increased and the area is warmer compared to her other arm. Advised caller to call her PCP or urgent care to have the area assessed to r/o possibility of infection

Other Meds:

Current Illness:

ID: 1220396
Sex: F
Age: 58
State:

Vax Date: 04/08/2021
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: Penicillan

Symptom List:

Symptoms: Painful swollen red rash on left arm near vaccine location - rash is about 6 inches long by 3 inches wide; have also been feeling unsual fatigue for the past two days, headaches, and diarreah.

Other Meds: Vitamin D - 1000 iu daily

Current Illness: None

ID: 1220397
Sex: F
Age: 25
State:

Vax Date: 04/14/2021
Onset Date:
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: Caller received her second dose of the vaccine on Wednesday and on Thursday morning the area was sore and red. today she woke up and its more panfu;, the reddness has spread and its warm to touch.

Other Meds:

Current Illness:

ID: 1220398
Sex: F
Age: 21
State:

Vax Date: 04/14/2021
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: Caller states she received her second dose of Modenra on 4/14/2021 and on 4/15/2021 the area became red, sore and swollen. Caller does not believe it is warm to touch at this time. Caller states it seems to be gettig "redder", advised caller to have PCP or urgent care asses the site to r/o infection

Other Meds:

Current Illness:

ID: 1220399
Sex: M
Age: 56
State: PR

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: ASAL Iodine, Penicillin

Symptom List:

Symptoms: Insomnia, acute pain in the right arm, pain in the whole body on the second day.

Other Meds: AVALIDE; WELLBUTRIN; KLONOPIN; PLAVIX; QUESTRAN; ZEGERID; PEPCID; Vitamin D; C; Melatonin; Acetaminophen

Current Illness: Throat Infection, 3 days ZYTHROMAX

ID: 1220400
Sex: F
Age: 46
State: MO

Vax Date: 04/05/2021
Onset Date: 04/06/2021
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: arm pain for a few days after shot. Two weeks later, pain on right side of back

Other Meds: none

Current Illness: none

ID: 1220401
Sex: M
Age: 57
State: CA

Vax Date: 03/06/2021
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: None

Symptom List:

Symptoms: I am being denied my second shot because employee at Health center is saying she can't validate my first shot. I need my second shot ASAP. She will not validate the shot because she said I wasn't invited to the clinic.

Other Meds: Suboxone Flonase

Current Illness: None

ID: 1220402
Sex: M
Age: 44
State: CA

Vax Date: 04/16/2021
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: None

Symptom List:

Symptoms: Client got Pfizer COVID vaccine at 1405, started feeling light headed, dizzy, and sweaty with a rapid pulse at around 1410. Client was unresponsive and out of it like he passed out for a few seconds and came out of it and was coherent and responsive again. Client was safe, with three EMTs and lead nurse alongside him. Vital signs taken at 1414, BP 138/88, O2 99%, and P 80. Client started feeling better, no longer sweaty or dizzy at around 1415. Client informed healthcare staff that he had not eaten or had any water since 0800. Vital signs taken again 1425, BP 140/90, O2 100%, and P 72. Client was stabilized and ambulated out of the facility and driven home by his mother at 1430.

Other Meds: Suboxone

Current Illness: None

ID: 1220403
Sex: F
Age: 54
State: IN

Vax Date: 04/14/2021
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: None

Symptom List:

Symptoms: Body aches ,fatigue, headache, feeling nauseated, generally feeling ill

Other Meds: Gabapentin, levothyroxine, wellbutrin, celebrex, nabeutome, Aleve, claritin

Current Illness: None

ID: 1220404
Sex: F
Age: 51
State: HI

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: amoxicillin; Imitrex; betadine

Symptom List:

Symptoms: I was starting to feel a little off in thirty minutes and about 9 PM that night I had body aches. My body and joints hurt and really really tired. Those lasted until Sunday at 09:00. It just abruptly stopped. I woke up with rash all over my face and itchy and swollen eyes on Saturday and I went to the eye doctor on Saturday. I was given eye drops and and an anti-histamine; That is helping. I am still a little bit itchy on my face but it's better.

Other Meds: Potassium Cler 10 meq tablet; Atorvastatin - 20 mg; Omega 3 - 1 gm (4 capsules a day); Nystop powder; .5 mg once a week - Ozempic; Dexalac - 60 mg once a day; Tamoxifen - 5 mg once a day; Losartan Potassium - 100 mg once a day; Magnesium O

Current Illness: no

ID: 1220405
Sex: F
Age: 31
State: CO

Vax Date: 04/08/2021
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: NKDA

Symptom List:

Symptoms: Patient reports headache and chills that started the evening after the vaccine was administered (4/8/21). Headache, fatigue, chills, sore throat, body aches persisted. Patient did not take any medication until 4/12 (Excedrin for migraines), which reportedly made it worse. Patient was advised to go to ER on 4/14/21 in the morning, where a CT scan and blood tests were done with no remarkable findings. Patient was discharged that evening with instructions to hydrate, rest, and take ibuprofen and Tylenol.

Other Meds: Zyrtec

Current Illness: N/A

ID: 1220406
Sex: M
Age: 19
State: CA

Vax Date: 04/16/2021
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: n/a

Symptom List:

Symptoms: Patient had a dizzy spell, fainted twice for about 15 seconds each. appeared to have seizure like activity. Called 911 for furthur assistance. Patient was pale and cyanotic, became alert by the time paramedics got to the site.

Other Meds: n/a

Current Illness: history of dizzy spells and fainting

ID: 1220408
Sex: F
Age: 24
State: NV

Vax Date: 04/10/2021
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: no know allergies

Symptom List:

Symptoms: Syncope the evening of 4/12, witnessed by family. Woke up sweaty, chills and disoriented. Within 30 minutes overall felt much better. Residual symptoms the following day - chest tightness, anxious, fatigue.

Other Meds: biotene, thyroid support with iodine/selenium/l-tyrosine, claritin

Current Illness: no know illness

ID: 1220409
Sex: M
Age: 42
State: FL

Vax Date: 04/14/2021
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: Sulfa Antibiotics

Symptom List:

Symptoms: Extremely high blood sugar, required four times usual insulin

Other Meds: Humalog Kwikpen, Levemir, Atorvastatin, Pantoprazole, Levothyroxine, Adderall, Aspirin, Multivitamin, Metformin

Current Illness: None

ID: 1220410
Sex: F
Age: 36
State: WY

Vax Date: 04/14/2021
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: Allergy to amoxicillin - primary reaction is anaphylaxis

Symptom List:

Symptoms: On 4/15/21, I experienced extreme fatigue, insomnia, body aches, headache, nausea, chills, and extreme skin sensitivity. On 4/16/21, the flu-like symptoms had passed, but I discovered what looked like a red rash at the injection site. The area is swollen, occasionally itchy, and hot to touch. Throughout the day, it has grown larger. I also feel unusually hot, though I am not running a fever.

Other Meds: Escitalopram - 5 mg once a day, levothyroxine - 0.075 mcg once a day, montelukast - 10 mg once a day, Vyvanse - 50 mg once a day, spironolactone - 50 mg twice a day, vitamin D3 - 50,000 IU once a week, melatonin - 10 mg when needed

Current Illness: None

ID: 1220411
Sex: M
Age: 43
State: TN

Vax Date: 01/14/2021
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: N/A

Symptom List:

Symptoms: Individual fully vaccinated with COVID19 Pfizer vaccines on 12/26/20 and 1/14/21 and tested positive for SARS-CoV-2 on 4/16/21.

Other Meds: N/A

Current Illness: N/A

ID: 1220412
Sex: F
Age: 69
State: IL

Vax Date: 04/16/2021
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: reported having had previous reactions to other vaccines

Symptom List:

Symptoms: At 1500, after receiving 1st dose Moderna, pt reported feeling tongue tingling and feeling a little dizzy and sweaty. Pt placed on cont. Pulse ox monitoring sats 94-97%. We suggested administering Benadryl which she declined. After further discussion and reassurance that it will not interact with Moderna vaccine, she agreed to take Benadryl IM. Vital Signs: 1503- 175/106 HR 89 O2 96% 1509- 175-98 HR 74 O2 95% 1513- 168/90 HR 86 O2 94% (Benadryl IM given) 1525-156/93 HR 70 O2 95% ( At this time, pt reported feeling better) We offered to take her to car via wheelchair, but she declined. She walked out of clinic with husband to drive her home.

Other Meds: did not report

Current Illness:

ID: 1220413
Sex: F
Age: 20
State:

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:

Symptom List:

Symptoms: Dizziness, nausea, lightheaded, diaphoretic; BP 146/95, HR 89 RR 16 SpO2 100%.

Other Meds:

Current Illness:

ID: 1220414
Sex: M
Age: 79
State: MI

Vax Date: 03/25/2021
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: nka

Symptom List:

Symptoms: Patient had normal discomfort after the shot. helped family moving heavy items that day and next day and was sore afterward. no issues until two days ago when he has started having burning in the area with use of his arm. it is not happening constantly, just seldom with use of his left arm.

Other Meds:

Current Illness:

ID: 1220415
Sex: M
Age: 34
State: LA

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

Vax Type:
Manufacturer:
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Allergies: Unaware of any.

Symptom List:

Symptoms: Within an hour of receiving the vaccine, I began to feel "odd" (i.e heart racing, spine tingling, strange sensations in my hands, and dizziness). At the hour mark, while trying to "walk it off" inside my backyard, things escalated quickly. As I came back inside, I suddenly collapsed and and lost consciousness. Luckily my best friend was with me and she described my behavior as a full on seizure (which I am not predisposed to). According to her, I was flopping around, spitting wildly and drooling all over my face, my eyes wide and glazed staring into nothing, lips turning blue. She immediately called 911 and within 5-10 minutes, two EMT's arrived and began to speak to me and take my vitals. For a good 15 minutes I couldn't sit up and had to lay on the ground, still extremely out of it - unable to think, merely in extreme discomfort similar to the most intense flu I've ever experienced. After a half hour or so, I sat up and was able to thank them for helping me and answer some of their questions. Over another 15 or so minutes they said all my vitals were perfect and they were not worried about me - sure I'd make a full recovery, which I hope I did. I am feeling MUCH better today. The reason I felt it so important to submit this report is because I had never heard of anyone experiencing side-effects that severe. Of course I had heard it could wipe you out, give you chills, aches, and exhaustion - but I had never heard that it could lead to a seizure so scary that my best friend thought I might be dying. I truly don't know what might have happened without her. People should know to have someone at home with them after the second dose. I am not over-exaggerating about my symptoms whatsoever. My body still hurts all over and I feel as if I went through some type of gauntlet yesterday. I absolutely do NOT want to discourage anyone from getting the vaccine, but I wish I had some notion that something so severe could happen to me.

Other Meds: Suboxone, Bupropion, Sertraline, Gabapentin

Current Illness: None.

ID: 1220416
Sex: M
Age: 76
State:

Vax Date: 04/03/2021
Onset Date: 04/04/2021
Rec V Date: 04/16/2021
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Symptoms: patient reported numbness in right side of face and tooth pain on the day after his covid-19 immunization. His prescriber evaluated him today and said he has a sinus infection with mild bells palsey. Unsure if related to immunization.

Other Meds:

Current Illness:

ID: 1220417
Sex: F
Age: 64
State: WY

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 04/16/2021
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Allergies: Demerol

Symptom List:

Symptoms: Very loud tinnitus

Other Meds: Pioglitazone, allerest, sertraline, montelukast

Current Illness: None

ID: 1220418
Sex: F
Age: 49
State:

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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Allergies: penicillin, azithromycin, donato

Symptom List:

Symptoms: Pain at injection site, tingling on left side of face, slight feeling of left lip swelling (but didn't swell). On 4.16.21 sore left arm, entire body fatigued.

Other Meds: None

Current Illness: none

ID: 1220419
Sex: F
Age: 64
State: OH

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 04/16/2021
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Allergies: Sensitive to novocaine and lidocaine. Gives me severe headache

Symptom List:

Symptoms: On set March 6th, 2021: brain fog, fatigue, mild body aches. Took celebrex, 100 mg twice a day. Had to stop exercise routine. Side effects decreased after three and a half weeks. Side effects reappeared after odd gastrointestinal issue with chills. Side effects currently present.

Other Meds: Quetiapine, zanaflex, zoloft,restasis, ,synthroid, celebrex, zyrtec, vit. D, calcium, vitamins, probiotic, lysine, CoQ10, turmeric, iodine, vitalzyme, aloe vera juice

Current Illness: Fibromyalgia

ID: 1220420
Sex: F
Age: 45
State: CA

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
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Allergies: None

Symptom List:

Symptoms: Nausea, headache, Weakness, Aches and Pains, minor throat irritation, & minor nasal congestion

Other Meds: Voltaren, Omerpazole, Birth Control Pill

Current Illness: None

ID: 1220421
Sex: F
Age: 41
State: WI

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 04/16/2021
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Allergies: Yes- Penicillin

Symptom List:

Symptoms: Per Client received Pfizer COVID 19 vaccine second dose on 3/28/2021, at 1:00pm in left arm. Client C/O symptoms starting on 3/28/2021 around 9:00pm, fever and chills. ON 3/30/2021 started having difficulty with breathing, chest pain, racing pulse an increased blood pressure through 3/31/2021, so the Client went into the ER on 3/31/2021. In ER Client had a CT of chest performed and is currently wearing a internal heart monitor for other medical concerns present prior to vaccine. Per Client some of symptoms have subsided and Client will plan to follow up with PCP. PHN suggested that Client continue to monitor symptoms, follow up with PCP and go back to ER if needed and call 911 for medical emergency.

Other Meds: Yes- Triosent, supplements and herbal

Current Illness: None

ID: 1220422
Sex: F
Age: 71
State: CT

Vax Date: 02/24/2021
Onset Date: 03/10/2021
Rec V Date: 04/16/2021
Hospital: Y

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Symptoms: 71- year old woman with past medical significant for hypertension on 10 mg of Lisinopril daily for many years. She had her first dose of Pfizer vaccine two weeks prior to admission (3/11/21). After her vaccination, patient felt unwell and dizzy in the mornings. She felt persistent fatigue and had a decreased appetite. The week prior to admission she noticed a decrease in her urine output. She denied NSAID use. Her primary care physician ordered blood week and her Cr was found to be 16.54 and BUN of 163, phosphate of 17.5. Her last known Cr prior to her admission was 18 months prior and was 1.17. She was asked to present to the emergency room. Renal ultrasound showed no hydronephrosis or stones. Urinalysis showed 1+ protein, spec grav of 1.023 with a urine protein/creatinine ratio of 0.09. Urine sediment was unremarkable. Her temperature was 95.6 and her BP was as low as 75/46 and she was put on a low dose of levo. CRP was 202.3. COVID was negative. CK wnl. ANA + to 1:160 (dsDNA, Smith, RNP, SS-A, SS-B all negative). Blood smear was negative. Cultures were all negative. Echo showed an EF of 68% with trivial pericardial effusion. Patient was oliguric, and then initiated on hemodialysis. Renal biopsy was performed. The biopsy consists of one fragment which is stained with H&E, PAS, Trichrome, Jones Silver, and HPS stains. Review of all stains reveals 12 glomeruli, one of which is globally sclerotic. The architecture of the kidney is well-preserved. There is interstitial fibrosis with proportional atrophy involving 10% of the biopsy tissue. There is a focal interstitial infiltrate consisting of lymphocytes involving <5% of the interstitium. The tubules show diffuse acute tubular injury. Calcium oxalate crystals are present in seven tubular profiles. The glomeruli show expansion of Bowman's capsule. The mesangium shows normal cellularity. The vessels show no abnormalities. IMMUNOFLUORESCENCE MICROSCOPY: Frozen sections are stained for IgA, IgG, IgM, C3, C1q, kappa, lambda, and fibrinogen. All immunofluorescence stains are negative. ELECTRON MICROSCOPY: Specimens are prepared for electron microscopy and semi-thin sections stained with toluidine blue are reviewed prior to thin sectioning for ultrastructural examination. Electron microscopy demonstrates patent capillary loops. The glomerular architecture demonstrates segmental corrugation of basement membranes with increase in lamina rara interna. No subepithelial deposits and no intramembranous deposits are identified. The tubules show dilated mitochondria and injury. There is segmental effacement of foot processes. There are no subendothelial deposits. Mesangial electron dense deposits are not identified. Patient received three dialysis treatments and Creatinine began to improved down to 1.46 within 8 days.

Other Meds: Lisinopril, tumeric, aspirin, co-enzyme q, chondroitin, pyridoxine, omega 3

Current Illness:

ID: 1220423
Sex: F
Age: 42
State: CT

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/16/2021
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Allergies: N/A

Symptom List:

Symptoms: On 03/01/2021, I received dose 1 of the Moderna vaccine. I was scheduled to received my dose 2 of Moderna on 03/30/2021. On 03/30/2021, I was given a COVID-19 vaccination card indicating that I would be receiving the 2nd dose of Moderna. I received my shot at approx. 4:40pm on 03/30/2021. On April 1, 2021, I received a voicemail message from the pharmacy asking me to return her call regarding the vaccine I received. When I returned the call, the manager informed me that the person who administered the vaccine accidentally administered Pfizer vaccine to me (she picked up the wrong vaccine). This meant that I received my 1st dose as Moderna, and 2nd dose as Pfizer. I do not know whether I am experiencing any adverse side-effects. I experienced commonly reported side effects such as fatigue, headache, and slow cognition for approx. 1 week following second vaccine. Currently I am experiencing gastrointestinal discomfort lasting several days.

Other Meds: Synthroid, Sertraline, multivitamin, herbal allergy remedy

Current Illness: None

ID: 1220424
Sex: M
Age: 18
State: TX

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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Allergies: n/a

Symptom List:

Symptoms: Syncope, lightheadedness. Observation had him walk and he fainted while walking. Ate Crepes for breakfast, lunch he had chips and a small cup of water.

Other Meds: Vyvanse

Current Illness: n/a

ID: 1220425
Sex: F
Age: 54
State: NY

Vax Date: 03/28/2021
Onset Date: 03/30/2021
Rec V Date: 04/16/2021
Hospital:

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Allergies: none

Symptom List:

Symptoms: Tinnitus began a few days after I received the vaccination. It has not gone away.

Other Meds: Furosemide 20 mg. Once a day. Been taking for a few years without incident.

Current Illness: none

ID: 1220426
Sex: M
Age: 69
State: MD

Vax Date: 03/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/16/2021
Hospital: Y

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Lab Data:

Allergies: Bactrim...scallops

Symptom List:

Symptoms: Felt fatigue when I went out first few weeks after vaccination...3rd week fatigue was extreme and overwhelming... recommended I be tested that evening for cova d...at facility...determined my blood pressure extremely low... when could not elevate blood pressure sent me to hospital...emergency room doctor said he believed my exact symptoms were traced to the moderna cova d vaccine

Other Meds: Glipizide...atenolol...amlodipine...humalog...lantus...lisiniprol...lovastatin

Current Illness: Urinary tract infection...kidney issues

ID: 1220427
Sex: M
Age: 22
State: UT

Vax Date: 04/05/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
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Allergies: None

Symptom List:

Symptoms: Short dizzy spells, sometimes pretty strong. The first one (and the strongest) was on April 14, nine days after vaccination. It lasted between 30 and 60 seconds. Today, eleven days after vaccination, I'm experiencing them more often but not as strong.

Other Meds: None

Current Illness: None

ID: 1220428
Sex: F
Age: 71
State: WI

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/16/2021
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Allergies: Hydrochlorathiazide, Relafen, Requip, Doxycycline, Tacrolimus, Ace Inhibitors.

Symptom List:

Symptoms: Shingles, COVID Toes

Other Meds: diphenhydrAMINE (BENADRYL) 25 MG tablet Take 1 tablet by mouth every 6 hours as needed for Itching. amLODIPine (NORVASC) 5 MG tablet Take 1 tablet by mouth daily. glipiZIDE (GLUCOTROL ER) 10 MG 24 hr tablet Take 1 tablet by mouth daily. blo

Current Illness:

ID: 1220429
Sex: F
Age: 18
State: IN

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

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Lab Data:

Allergies: n/a

Symptom List:

Symptoms: pale, faint, fingers tingled, scared

Other Meds: n/a

Current Illness: n/a

Total 2021 VAERS Injuries: 595,365

Page last modified: 03 October 2021 5:28pm