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: 1232606
Sex: F
Age: 62
State: MA

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: pine nuts, tree nuts, penicillin

Symptom List:

Symptoms: chills, fever, headache, swollen lymph nodes

Other Meds: synthroid, Xanax, Symvastin, vitamin D, C

Current Illness: none

ID: 1232607
Sex: M
Age: 46
State: MO

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: NKMA

Symptom List:

Symptoms: Developed left arm pain and swelling after 1st vaccine in left shoulder. Persisted longer than previous reactions. Found to have blood clot in left brachial vein on 4/15/21 on ultrasound after evaluation by me

Other Meds: atorvastatin, flonase nasal spray

Current Illness: Chronic right shoulder pain

ID: 1232608
Sex: F
Age: 23
State: CA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List:

Symptoms: Patient waved down observation nurse 5 minutes after receiving her 2nd dose of Moderna. Patient felt nauseous and observation nurse brought over trash receptacle and patient vomited. Charge nurse was called over and vitals taken at 1:50 pm B/P 168/87 HR 104 Temp 96.9 Resp 18 O2 97%. Patient's skin was wet and clammy Both patient and mother informed nurses that this reaction was common for patient when receiving "shots". Patient also informed nurses she did not experience any reactions to 1st dose of Moderna. B/P was taken at 2PM 132/103 and then again at 2:05pm with patient standing 132/86 HR 86. Patient said she felt "much better" and left with mother without requiring further treatment.

Other Meds: Unknown

Current Illness: Unknown

ID: 1232609
Sex: M
Age: 38
State: WI

Vax Date: 04/05/2021
Onset Date: 04/13/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

Symptom List:

Symptoms: Confusion, very tired, joint aches, at first. On Tuesday April 13, my husband woke up in pain to his left leg. The left leg had a painful softball sized hard lump on inside of knee and a little bigger than a golf ball hard lump on his calf. Had no treatment until April 18th

Other Meds: None

Current Illness: None

ID: 1232610
Sex: M
Age: 31
State: NV

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

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: PT COMPLAINS OF SIGNIFICANT WEAKNESS, FAITUGE, AND SEVERE CONSTIPATION STARTING HOURS AFTER VACCINATION.

Other Meds:

Current Illness:

ID: 1232611
Sex: M
Age: 25
State: CO

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient passed out shortly after receiving his second dose of moderna vaccine.

Other Meds:

Current Illness:

ID: 1232612
Sex: M
Age: 18
State: WA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient presented for 1st dose of Pfizer vaccine today. Patient reported dizziness, difficulty hearing. Patient was assisted to the supine position, onsite EMS was called. Vital signs were taken (below) and were stable. EMS discharged the patient to the care of his mother. Patient continued to be observed following the event, left of own volition.

Other Meds:

Current Illness:

ID: 1232613
Sex: F
Age: 71
State: PA

Vax Date: 03/23/2021
Onset Date: 03/30/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Augmentin family, Aleve, amoxicillin

Symptom List:

Symptoms: noises in lungs

Other Meds: centrum silver, calcium, metoprolol, hctz, Crestor, vitamin d3

Current Illness:

ID: 1232614
Sex: F
Age: 30
State: CA

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Enbrel, Humira, Orencia, Rituximab

Symptom List:

Symptoms: Moderna COVID-19 Vaccine EUA intense dizziness and vertigo beginning day after vaccine administration, noticed when woke up around 11:30am. Intensity continued through the following day and began to subside ~55 hours after vaccine. Mild dizziness remained on day 3, and an OTC antihistimine was recommended to assist. No remaining dizziness on day 4

Other Meds: Taken day of vaccine: Esomeprazole, Multivitamin, Dicyclomine, Calcium Magnesium Zinc + D3, Glucosamine Chondroitin, B Vitamin Complex, Probiotic, Folic Acid, Biotin Silicon Collagen, Flaxseed Omega-3 Held day of vaccine: Meloxicam, Sulfas

Current Illness:

ID: 1232615
Sex: F
Age: 76
State: ND

Vax Date: 03/17/2021
Onset Date: 03/29/2021
Rec V Date: 04/20/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient presented to ED and was subsequently admitted within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1232616
Sex: F
Age: 45
State: TX

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Bactrim, Cipo, Penicillin

Symptom List:

Symptoms: diarrhea, nausea, body aches, sore throat

Other Meds: Wellbutrin SR, Clonazepam, atorvastatin, levothyroxine, liothyronine, metoprolol, patoprazole, ambien

Current Illness: no known

ID: 1232617
Sex: F
Age: 64
State: MN

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 04/20/2021
Hospital: Y

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

Lab Data:

Allergies: statins,sulfa,

Symptom List:

Symptoms: about 10 hours later increased sob and chest tightness and then hypoxia and hospitalization x 4 days and IV steroids Patient is a 64 y.o. female with PMH notable for von Willebrand disease, asthma, OSA on CPAP, DMT2, HLD, lumbar stenosis, chronic opioid use, GERD, PUD, and anxiety who presents with SOB, weakness, fever. Patient with history asthma, controlled on symbicort and PRN albuterol, now with progressive worsening SOB since the day prior to admission, patient received 2nd dose of Moderna COVID-19 vaccine on 03/10/21. Also, with chest tightness, body aches, headache and chills. Was up last night with fever 101F, took ibuprofen. She had worsening wheezing and SOB while bring dog to dog groomer and had groomer call ambulance. EMS called, received albuterol nebs in route with some improvement in symptoms. Chest tightness has improved. SOB improved now at rest but still winded when up to bathroom. Vitals on arrival notable for BP 144/55, HR 125 (sinus tach on EKG), temp 102.1F, RR 22, 92% on RA. Labs notable for WBC 8.6, CR 0.54. Normal LFTs. Lactate 3.3. D-dimer 0.9. pBNP 56, troponin <0.012. COVID-19 PCR panel negative. CXR with Chronic linear atelectasis or scarring at the lung bases, unchanged. CT PE study negative for PE, possibly some mild pulm congestion, increased interstitial markings. Patient given 2L NS in ED as well as ceftriaxone 2g and doxycycline 100mg. Patient will be admitted to inpatient for further evaluation and management of sepsis. Met sepsis criteria given fever, tachycardia, elevated lactate. Infectious source most likely pneumonia (though only slight increase interstitial markings on CT). Could be atypical or viral pneumonia. However, timing of symptoms could also fit with reaction to COVID-19 vaccine and asthma exacerbation. COVID-19 negative and influenza negative. Was treated with abx for CAP and prednisone + albuterol for asthma exacerbation. Lactate normalized with IVFs, fevers and tachycardia resolved. Patient able to wean to RA, dyspnea and wheezing slowly improved. Abx narrowed to cefzil, doxycycline. 1/2 admission blood cultures positive for streptococcuss. Patient was febrile and septic on admission. Subsequent blood culture without growth to date. Abx returned to IV ceftriaxone given strep + BCx.. Low blood cultures x2 were negative at 48 hours. Dr. was consulted over the phone and he recommended 5 days of oral amoxicillin on discharge. Chronic medical conditions were stable while hospitalized. No medication changes were made.

Other Meds: asa, Symbicort, Nexium, Zetia, Norco,Lyrica, nortriptyline, metformin

Current Illness: underlying asthma but marked severe episode that started 10 hours after vaccine and required hospitalization and CT showed mosiac lung pattern and required iv steroids and 4 day hospital stay Here are her CT results from 3/11/21 The aorta and its major branches are normal in course and caliber. The heart size is within normal limits without pericardial effusion. The thyroid is normal.There is no supraclavicular, mediastinal, hilar, or axillary lymphadenopathy. There is no focal consolidation, pleural effusion or pneumothorax. Diffuse prominence of the interstitial markings with a mosaic attenuation. Bilateral atelectasis. Diffusely decreased hepatic attenuation. Remainder of the partially visualized abdomen is unremarkable. There are no osteolytic or osteoblastic lesions. Degenerative change of the spine. IMPRESSION: 1. No pulmonary embolism. 2. Pulmonary congestion. 3. Hepatic steatosis

ID: 1232618
Sex: F
Age: 39
State: CA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: 2:15pm- The patient experienced the following reaction(s) during the immediate of observation: pt reported feeling "hot" and "dizzy". 2:20pm- Patient was treated/managed as follows: Pt brought to treatment area, VS taken: BP-124/82, HR - 81, 02-99%, RR -18. Pt asked to lay down and given Gatorade. Pt states she hasn't eaten today and had a stressful morning. 2:25pm- Pt states she feels and symptoms have resolved. Patient given educational material regarding vaccine and advised to continue to self-monitor per the CDC guidance.

Other Meds: none

Current Illness: none

ID: 1232619
Sex: F
Age: 61
State: WA

Vax Date: 03/28/2021
Onset Date: 04/03/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: Six days after my 2nd vaccine I had an anaphylaxis reaction. Out of the blue while I was driving my face started to burn like acid was rubbed on it. It got really hot and turned very bright red. Then my lips began to feel like they had been sunburned badly. Then my forearms both started burning and also turned bright red. I was very anxious. Had two bouts of diarrhea. All this occurred within about a 20 minute time-frame. I chewed up 4 children's Benadryl (50mg) and the redness, burning and anxiousness subsided mostly. My heart rat was still over 100 bpm even after 6 hours. (Usually my HR is 68-70 bpm). I slept for 12 hours and the next day seemed fine. This has occurred two more times since that first time. The 2nd reaction being 5 days after that first one and the 3rd reaction being 5 days after that. Same reaction, same treatment and same outcome.

Other Meds: Vitamin A, Vitamin B complex, Vitamin D + K.

Current Illness: None

ID: 1232620
Sex: F
Age: 27
State: WA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: It was reported that approximately 10 minutes after receiving the second dose of the vaccine, guest stated that she felt nauseous and as if the room was spinning. She sat down and this seemed to improve the symptoms. EMS was called. They did vital signs which were WNL. Guest then stated that she felt better but still slightly lightheaded. Guest was observed for an additional 15 minutes, for a total of 30. At that point she comfortable and was able to stand/walk with no balance concerns. Not on medications, no allergies.

Other Meds:

Current Illness:

ID: 1232622
Sex: F
Age: 97
State: FL

Vax Date: 04/08/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Asymptomatic Positive PCR on 4/19- reuslts received 4/20 Pt vaccinated 3/18 and 4/8

Other Meds: Aspirin colace diltiazem mirtazapine carafate

Current Illness: none

ID: 1232623
Sex: F
Age: 0
State: OK

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List:

Symptoms: Patient was short of breath, dizzy & had cold sweats initially. Became incoherent for brief period of time. Epinephrine was administered at 16:20 to patients right leg.

Other Meds: Unknown

Current Illness: None Known

ID: 1232624
Sex: M
Age: 15
State: KS

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Note at this time, patient was currently 15 years of age. Per parent who is present, Mother , states, I Mother take full responsibility for allowing vaccination of a at 15 y.o. Noted his birthday.

Other Meds: No medication

Current Illness: NA

ID: 1232625
Sex: M
Age: 49
State: IN

Vax Date: 01/05/2021
Onset Date: 04/09/2021
Rec V Date: 04/20/2021
Hospital: Y

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

Lab Data:

Allergies: Iodine

Symptom List:

Symptoms: We did not administer the vaccine. The pt was admitted to our hospital on 4/18 with ITP, platelets of 3k.

Other Meds: Nexium, Aldara

Current Illness: none

ID: 1232626
Sex: M
Age: 27
State: OH

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Patient experienced syncope shortly after receiving first dose of Pfizer COVID vaccine in the lobby during his 15 minute waiting period. Patient hit chin and did lacerate it; this was attended to by NP who was administering shots at the time. Patient mentioned that he "tasted like he threw up," was instructed to drink water. NP took vitals and patient showed no sign of concussion. In the mean time patient was trying to get ahold of a friend or family member to come pick him up. Still felt lightheaded 15 minutes after being attended to, at this time we called the squad. Before the squad could show up patients brother came to pick him up... was whisked away too quickly for us to stop him. Patient was adamant about us not calling squad because he does not have insurance.

Other Meds: Unknown

Current Illness: Unknown

ID: 1232627
Sex: F
Age: 95
State: MT

Vax Date: 01/19/2021
Onset Date: 04/16/2021
Rec V Date: 04/20/2021
Hospital: Y

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

Lab Data:

Allergies: levothyroxine (angioedema), lipitor, ceftin, NSAIDS, sulfa drugs

Symptom List:

Symptoms: Presented to ED with UTI symptoms with apparent septicemia. COVID-19 test upon hospital admission was (+). Patient had low O2 sats on RA at 88%. She also reported chills, fever and myalgias and cough. Denied SOB.

Other Meds: Loratadine, Norvasc, multi-vitamins

Current Illness:

ID: 1232628
Sex: F
Age: 48
State: KS

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Effexor, iodine

Symptom List:

Symptoms: Hypertension and chest pain.

Other Meds: unknown

Current Illness:

ID: 1232629
Sex: F
Age: 18
State: WA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List:

Symptoms: Pt and father moved into the waiting area with vehicle. According to dad, pt began seizing in the car one minute after the vaccine administration. Dad called out to waiting area Monitor. Monitor called for help. LT and SPC appeared on scene. 1257 Pt was visibly having tonic clonic seizure. SPC administered EpiPen in Right Leg. 911 was called. Pt stopped seizing and was awake and confused. She then became AOx4. Pt visibly distressed and hyperventilating. 1259 Pt had tonic clonic movements and seizure again. Seizure last less than 15 seconds. Pt then became AOx4 again, distressed, and became nauseous. HR 56 SpO2 98% 1300 Pt vomited while sitting up. Still distressed and hyperventilating. RR 30. Post vomiting HR 116, SpO2 97%. Pt moved to stretcher and moved to shade. 1306 Firefighters arrived. HR 114 BP 141/46 SpO2 97% RR 24 AOx4 1312 Ambulance arrived. 1320 Pt left for medical center.

Other Meds: PROzac 20 mg oral capsule, 20 mg= 1 cap(s), Oral, Daily, 4 ref

Current Illness: Anxiety

ID: 1232630
Sex: M
Age: 16
State: MO

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: unauthorized age group.

Other Meds:

Current Illness:

ID: 1232631
Sex: M
Age: 10
State: WI

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Client registered with false DOB, 11/16/2004, showing that they were 16 years old and eligible for Pfizer vaccine. Vaccine was given due to state data entry software system inability to cross check with DOB of the client in the state immunization registry before entering. No known adverse events. DOB updated in data entry software system to show client is in fact 10 years old, client removed from site's invitation list, and message left for parent.

Other Meds:

Current Illness:

ID: 1232632
Sex: F
Age: 69
State: ME

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: pet dander, penicillin, dissolvable sutures,, bactrim, pollen

Symptom List:

Symptoms: Moderna COVID-19 Vaccine EUA Fever (101.6), chills, slight headache, joint and muscle pain, swelling and pain at site of injection, fatigue, difficulty falling asleep Still have these reactions as of 4/20/01 5:45pm with temperature rising throughout day

Other Meds:

Current Illness: bronchitis, lyme disease

ID: 1232633
Sex: F
Age: 50
State: NC

Vax Date: 04/08/2021
Onset Date: 04/10/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pt called to report she had developed mouth sores & blisters on lips "a few days after" her vaccination. 4 days after she experienced explosive diarrhea x10 that day 4/12/2021. Pt contacted PCP but was referred back to Clinic without any instructions for resolving issues. RN instructed Pt to try OTC meds for diarrhea , BRATT diet discussed, maintain hydration, warm salt water rinses for mouth sores?avoid spicy food & hard , pointy food & to wipe gently after diarrhea. Pt verbalized understanding. Pt denies any fever, abdominal discomfort or breathing issues. RN discussed V-safe with Pt to report side effects. Pt given website to sign up. Pt verbalized understanding. Pt aware to call PCP if s/s worsen or Clinic for any questions or concerns.

Other Meds:

Current Illness:

ID: 1232634
Sex: M
Age: 43
State:

Vax Date: 04/15/2021
Onset Date: 04/19/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: No side effects with the exception of minor irritation at injection site, until 96 hours later, sever flu like symptoms, chills, nausea - which lasted around 1 day. Feeling much better at this point but the delayed response was unexpected. I'm fairly sure there wasn't another event that prompted the symptoms but anything's possible.

Other Meds: None

Current Illness: None

Date Died: 01/28/2021

ID: 1232635
Sex: F
Age: 82
State: WV

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patients husband was bringing his daughter to a vaccine event. Spouse spoke of concern over his wife having a Pfizer COVID-19 vaccine in January and withing 24 hours being found unresponsive. Patient details that she did not show symptoms of distress after this second vaccination. He went to check on her in the morning on 1/28/21 at different points in the morning but when checking on patient at around 11:00 AM she was found laying on her side unresponsive, not breathing. Emergency medical profesisonals arrived but resuscitation efforts were unsuccessful.

Other Meds:

Current Illness:

ID: 1232636
Sex: M
Age: 68
State: IL

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

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

Lab Data:

Allergies: nka

Symptom List:

Symptoms: Arm pain with redness and swelling at injection site, headache, severe shaking/chills, fever of 102.7 for 2 days, numbness on left side of face including tongue and gums with a slight facial droop lasting for 3 days, night time hallucinations lasting 6 days.

Other Meds: doxazosin 8 mg tab

Current Illness: none

ID: 1232637
Sex: M
Age: 19
State: NE

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: none reported

Symptom List:

Symptoms: Syncope after receiving the immunization. Recovered immediately with no lasting effects

Other Meds: none reported

Current Illness: none reported

ID: 1232638
Sex: F
Age: 43
State: OH

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/20/2021
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Allergies: Bactrim

Symptom List:

Symptoms: Rash, headache , fatigue, blurred vision, leg pain

Other Meds: Orllisa Levothyroxin Woman?s one multi vitamin

Current Illness: Covid long hauler.

ID: 1232639
Sex: F
Age: 68
State: CA

Vax Date: 04/09/2021
Onset Date: 04/16/2021
Rec V Date: 04/20/2021
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Allergies: unknown

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Symptoms: Received the wrong 2nd dose of covid 19 vaccine 2 weeks early. Should have received a second dose of Pfizer vaccine on 4/30/2021

Other Meds: unknown

Current Illness: unknown

ID: 1232640
Sex: F
Age: 41
State: AR

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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Allergies: agave nectar

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Symptoms: Within the first 5 minutes post vaccination, the patient began experiencing itching and tingling of the lips. I instructed patient to remove her mask and inquired about any changes to her tongue, throat, skin, vaccination site. Her lips were physically normal in size. After verbal consent, I administered 50mg of diphenhydramine to the patient and continued to observe her. The itching decreased over the next several minutes and was completely gone after approximately 10 minutes. I continued to observe the patient for another 20 minutes and instructed the patient on repeating diphenhydramine if symptoms return at home and to seek 911 care for any difficulty breathing or swelling of lips/tongue/throat.

Other Meds: none

Current Illness: none

ID: 1232641
Sex: M
Age: 47
State: CA

Vax Date: 03/24/2021
Onset Date: 04/08/2021
Rec V Date: 04/20/2021
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Allergies: None

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Symptoms: Persistent high-pitch (10-11kHz) ringing in both ears.

Other Meds: Vitamins B12 and D

Current Illness: None

ID: 1232642
Sex: F
Age: 25
State: VA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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Allergies: Peanuts, nuts, latex, prednisone, percocet

Symptom List:

Symptoms: Allergic reaction: cough, tight chest, tight throat, itch

Other Meds: Singular Albuterol as needed

Current Illness: None

ID: 1232643
Sex: F
Age: 20
State: CA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/20/2021
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Allergies: None per patient

Symptom List:

Symptoms: patient c/o shortness of breath and dizziness. Started at 2:05PM, Dr. was notified and evaluated patient Vitals: 100/72mm hg Pulse: 82 SPo2: 98% DX: Vasovagal syncope Monitored patient symptoms for 30 minutes patient was stable and was release home

Other Meds: On Depo-Provera 150 mg/ml

Current Illness: None per patient

ID: 1232644
Sex: M
Age: 28
State: MI

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/20/2021
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Allergies: none

Symptom List:

Symptoms: right arm axilla lymph node swelling, fatigue, headache and right arm pain

Other Meds: Cymbalta 20 mg po qd, NP thyroid 15mg po qd

Current Illness: none

ID: 1232645
Sex: F
Age: 38
State: MD

Vax Date: 04/01/2021
Onset Date: 04/10/2021
Rec V Date: 04/20/2021
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Allergies: Bactrim

Symptom List:

Symptoms: Fatigue, headache, and pain on injection site - 1 + 2 days after shot Red rash spot on the injection site - 10 days after shot

Other Meds:

Current Illness:

ID: 1232646
Sex: F
Age: 40
State: TX

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/20/2021
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Allergies: Seasonal pollen allergy. Anaphylactic reaction to allergy shots

Symptom List:

Symptoms: Fatigue, fever 102, aching joints, chills, rapid heart rate - 135 bpm per Polar heart rate monitor while at rest. Began around 6:00pm day of injection. Worsened until 10:00pm when I contacted the 24 hour nurse about my hear rate. Was advised to monitor it and rest. Slept until 8:00am next day and woke in pool of sweat with slight headache. Fever was gone and heart was back to normal. Drank lots of water and rested. By noon I felt 100% fine again.

Other Meds: Zyrtec

Current Illness: None

ID: 1232647
Sex: F
Age: 39
State: TX

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/20/2021
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Allergies: None

Symptom List:

Symptoms: Fever, Chills, Headache, Swelling in lymph nodes (armpit) - pain associated with swelling, Joint pain (primarily shoulder of injection arm), body aches, Fever up to 100.6 lasting 36 hours (treated with over the counter Tylenol)

Other Meds: Daily multivitamin (centrum women's)

Current Illness: None

ID: 1232648
Sex: F
Age: 77
State: MN

Vax Date: 03/19/2021
Onset Date: 03/23/2021
Rec V Date: 04/20/2021
Hospital: Y

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Symptoms: Patient presented to ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1232649
Sex: F
Age: 56
State: CA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/20/2021
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Allergies: NKDA

Symptom List:

Symptoms: Spoke to Pt who states worsening calf pain and recent redness of feet since Covid vaccine. Pt with h/o J&J vaccine in March. Pt scheduled for breast reconstruction surgery. Pt advised to go to ER for increased leg pain given h/o recent J&J vaccine.

Other Meds: NORVASC, OMPRAZOLE, PREPARATION H CR., TAMOXIFEN

Current Illness:

ID: 1232650
Sex: F
Age: 26
State: VA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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Allergies: None

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Symptoms: 1620- Patient began vomiting , sweating, and was warm to touch. Patient denied shortness of breath, tightness in the chest or throat, itching, dizziness, or changes in heart rate. Patient stated, " That she did not eat much today only rice". Pt was given a bottle of water, and crackers, and recieved a mint and was advised to sip the water and eat the crackers slowly. 16:24-Patient ate the crackers, and sipped the water and explained that she was feeling better and is cooling down and the nausea was improving. She was advised to wait additional 15 minutes for monitoring. 16:34-vitals-BP 106/55, HR-76, O2-97, Temp 99.8. Patient was released from observation at 16:35.

Other Meds:

Current Illness:

ID: 1232651
Sex: F
Age: 47
State: CA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/20/2021
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Allergies: none

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Symptoms: tongue swelling

Other Meds: omeprazole

Current Illness:

ID: 1232652
Sex: M
Age: 27
State: OH

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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Allergies: NKDA

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Symptoms: Patient experienced syncope resulting in a laceration to the chin in the 15 minutes following vaccination. Patient was tended to by the NP on duty, instructed to lie down and drink water while she tended to his cut. Patient mentioned it "tasted like he threw up" and still felt lightheaded after 15 minutes after the event. Patient was insistent that we should not call the squad as he does not have insurance. Patient in the meantime was trying to get ahold of a friend or family member to pick him up as we advised him that he could not leave in this state. We elected to call the squad as he had not recovered yet. Before the squad could come, the patients brother showed up and quickly whisked him away. Squad did show up but there was nothing to attend to so left without intervention.

Other Meds: UKN

Current Illness: UKN

ID: 1232653
Sex: F
Age: 25
State: CA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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Symptoms: Patient LOC decreased resulting in her hitting another vehicle with her vehicle. Pt Conscious and responsive 119/81, 68, 98% O2. VS Remained WNL at 09:54 and 10:05.

Other Meds:

Current Illness:

ID: 1232654
Sex: M
Age: 54
State: CA

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/20/2021
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Allergies: None

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Symptoms: I had previously had COVID during the first week of January 2021 and recovered. During that time, I had lost about 80% of my sense of smell which I still have not regained. But at time, I never has any loss of taste. However, immediately after receiving the vaccination I noticed an altered sense of taste. I would describe it as almost all of my sense of taste is gone but actually everything I eat has a rancid taste. Some foods cause the bad taste more than others. Some foods I used to love now bring out the worst after taste such as peanut butter. The more bland the food usually results in less "bad" taste. But overall I can't really taste the actual taste of any food. And to make it worse, before when I couldn?t smell, it was bearable, but now most of the same foods that taste bad also have the same rancid odor I smell also. So to summarize, I now can?t really taste or smell anything except for the rancid taste and odor the food has. It is amazingly challenging as people don?t understand when I describe it to them that almost all food smells and tastes bad since that isn?t just loss of taste. As of today, it has now been over 3 weeks since my vaccination and I don't see any improvement yet. I did recently (about 2 week ago) have full lab work done as part of an annual checkup and all results came back normal. So now I have reduced smell from COVID and loss of taste from the vaccine. I don?t see any other explanation than that the vaccine caused this new phenomenon. It could has something to do with the fact that I previously had COVID. I am hesitant to even go to the doctor since I am certain they will have no idea what to do.

Other Meds: Atorvistatin

Current Illness: None

ID: 1232655
Sex: F
Age: 53
State: SC

Vax Date: 04/12/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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Symptoms: patients PCP office called to inform us that patient was positive for a DVT today. She was calling to inform us of the adverse event following her vaccination 04/12/2021. Blood clots were the reason that was reported for this vaccine to be pulled from the market the very next day 04/13/2021. Called the office back and left message with them to report as well since they have lab work and other patient information

Other Meds:

Current Illness:

ID: 1232656
Sex: F
Age: 66
State: WA

Vax Date: 03/08/2021
Onset Date: 03/17/2021
Rec V Date: 04/20/2021
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Allergies: sulfa

Symptom List:

Symptoms: tinnitus

Other Meds: omeprazole flax seed oil

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm