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
72,296
AK1,638
AL5,339
AR3,412
AS44
AZ13,316
CA58,147
CO11,002
CT7,824
DC1,626
DE1,670
FL36,235
FM3
GA13,429
GU82
HI2,195
IA4,332
ID2,473
IL19,261
IN22,568
KS4,284
KY6,945
LA4,714
MA13,886
MD11,901
ME2,997
MH8
MI17,865
MN11,345
MO8,919
MP30
MS2,676
MT2,147
NC15,401
ND1,273
NE2,732
NH2,859
NJ17,232
NM3,702
NV4,071
NY32,763
OH18,072
OK5,940
OR7,954
PA22,457
PR2,104
QM2
RI1,911
SC6,055
SD1,133
TN8,691
TX34,122
UT4,023
VA13,944
VI49
VT1,661
WA13,811
WI10,395
WV2,220
WY805
XB5
XL1
XV2

ID: 1234139
Sex: M
Age: 21
State:

Vax Date: 04/17/2021
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: none

Symptom List:

Symptoms: Patient received the COVID vaccine (Pfizer dose 1, lot #EW0171, expiration date 8/2021) in his left deltoid at 1437. The client was observed to fall out of his chair in the observation area, fall to the ground, and hit his head. The client made no attempt to protect his head or break his fall. RN, PHN, RN, and RN responded at 1438. PHN called EMS at that time as well. The client was observed to jerk his arms twice. The client was unconscious for approximately 90 seconds, and was turned on his side at this time. When the client regained consciousness, he was alert and oriented, complained of no pain in his head or any dizziness or lightheadedness. No difficulty breathing. Pupils were equal and reactive to light. At 1439, the vital signs obtained were: blood pressure 130/90, heart rate 57, O2 98, respiratory rate 26. The client denied any history of seizures, epilepsy, or any other medical history. The client stated he has no allergies and that he takes no medications. Upon examination, there were no cuts observable on the client's head. The client denied any feelings of dizziness before his loss of consciousness but stated he did not eat any breakfast or lunch that day. At 1443, the repeat vitals were as follows: 128/94 blood pressure, heart rate 60, respiratory rate 22, temperature 98. A manual pulse was 88 and thready. At 1447, EMR responded to the scene and assumed care of the client. Client transported to hospital.

Other Meds: none

Current Illness: none

ID: 1234140
Sex: F
Age: 45
State: VA

Vax Date: 04/15/2021
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: No known allergies

Symptom List:

Symptoms: Got shot noon Thursday no adverse effects besides moderately tired until 3pm Friday. Then fatigue set in, headache, fever of 101, and lymph nodes in left arm very tender and swollen to size of goofball. Night sweats on Friday night and struggling to sleep because of tenderness under arm. Saturday morning adding left lymph node in collarbone area swollen. Both were swollen the size of eggs, warm to the touch and very tender. But no more fever. However still fatigued. The injection site still warm, slightly swollen, and patches of red on left arm. For 5 days my left arm ached, tingling and began to feel numb. Used ibuprofen, Tylenol, cool and warm compresses, and slept a lot. Woke Monday to now adding right collarbone lymph node starting to swell. Called Dr on Monday and went in at 4:30pm. Just continued same home treatment understanding it may take weeks to get back to normal.

Other Meds: Zyrtec, Metoprolol, Levothyroxine, Vitamin D, and CHLORTHALIDONE

Current Illness: None

ID: 1234141
Sex: F
Age: 18
State: MD

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

Vax Type:
Manufacturer:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Dizziness No treatment required

Other Meds: Migraine medication

Current Illness:

ID: 1234142
Sex: M
Age: 51
State: CO

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

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Pt reports symptoms appearing approximately 1 day after receiving vaccination. Rash covering approximately 90% of body. Skin felt like "sandpaper".

Other Meds: Aspirin 81mg, Lamotrigine 150mg BID

Current Illness:

ID: 1234143
Sex: F
Age: 73
State: KY

Vax Date: 04/07/2021
Onset Date: 04/12/2021
Rec V Date: 04/20/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Penacylin

Symptom List:

Symptoms: Pain in right and left leg. Pain started at hip and run down to toes. Pain was not shooting pain but was a constant pain. On a pain scale of 1-10, pt reports pain was around 20. Pain woke patient up from sleep and was strong enough that patient muscles locked up. Patient began trembling from the pain. Pain lasted about about 24 hours. Pain was so strong that patient could not think. Pain caused patient to become weak and lethargic.

Other Meds: Metformin 1,000mg , Gabapentin 800mg, Celexa 20mg, Lasinopril 20/25mg. Tylenol 1,000mg. No dietary.

Current Illness: No.

ID: 1234144
Sex: M
Age: 68
State: WA

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: On 04/12/2021, I received my second COVID-19 vaccine. I had a few bumps on the top of my head which I thought were mosquito bites from working outside at dusk. Two days after I received second vaccine shot, I got a cluster of bumps and a headache. I contacted my primary care physician at medical facility on the following Tuesday. The Doctor said it looks like Shingles and started me on medication.

Other Meds: Lidocaine 5% Topical Cream, Atenolol, metformin, Simvastatin, Warfarin, Potassium Chloride, Furosemide, Hydrocodone-Acetaminophen

Current Illness: None

ID: 1234145
Sex: M
Age: 52
State: IA

Vax Date: 02/09/2021
Onset Date: 03/01/2021
Rec V Date: 04/20/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: 52-year-old male with no significant past medical history presenting with acute hypoxic respiratory failure and pancreatitis. Admitted to hospital on March 1, 2021 at Medical Center, for presentation of abdominal pain, elevated lipase and pancreatitis. Was airlifted to Medical ICU unit at a Larger Hospital on March 6, 2021. Was in the hospital until March 17, 2021 and was sent to Rehabilitation until discharge on March 26, 2021.

Other Meds: None

Current Illness: None

ID: 1234146
Sex: F
Age: 59
State:

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

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

Lab Data:

Allergies: Penicillins

Symptom List:

Symptoms: Presented to ED with abdominal pain (hx of stage IV pancreatic cancer) and admitted for pain control and palliative care. Occurred the day after second dose of Moderna.

Other Meds:

Current Illness:

ID: 1234147
Sex: F
Age: 57
State: OH

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Patient states she had her first Moderna COVID-19 vaccine on 18 March, 2021. She started to have experience back spasms and involuntary muscle movement in her legs the following day. Caller is due to have her second vaccine on Saturday 17 April 2021 but her PMD wants her see a Neurologist before doing so. Symptoms have subsided, but her legs are weak, has difficulty standing for long periods of time.

Other Meds: Amlodipine

Current Illness:

ID: 1234148
Sex: F
Age: 54
State: NY

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/20/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Lab Data:

Allergies: Aspirin Iodine

Symptom List:

Symptoms: Tongue swelled. I was able to take Benedryl every 4 hours for the next 24 hours. Headache, tired, and sore arm.

Other Meds: Levothyroxine - 50 MCG Estradiol Ajovy Eletriptan - 40 mg as needed Vitamin D3 - 1,000 MCG Vitamin C - 1,000 MCG

Current Illness: n/a

ID: 1234149
Sex: F
Age: 39
State: WA

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

Vax Type:
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Lot:
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Lab Data:

Allergies: wheat; corn; soy; seasonal allergies

Symptom List:

Symptoms: Headache started on the 10th. I was exhausted. Monday, I started having abdominal pain and the pain throughout my left side of my body. I still had a slight headache. The abdominal pain comes and goes - I still get it to this day. I called my Dr and he referred me to go to ER on Tuesday, 13th. No treatment, they told me to follow up with dr if I had pain continue. I just went today to a follow up with my doctor. She increased my medication for pain so I can get to work as I've been out for the last 5 days since I have not been able to. She told me to do the Naproxen twice a day now and also gave me Gabapentin and Tramadol.

Other Meds: no

Current Illness: no

ID: 1234150
Sex: M
Age: 66
State: OH

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

Vax Type:
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Lab Data:

Allergies: Benzene, Formaldehyde, IV contrast Dye, Perfume Ht52, Glycerin, Glycerol Dioleate, Glyeryl Behenate, Glycil Dimetharcylate Crossppolymer, Adhesive, Dlomax, Flonase, Nsaids, Valium

Symptom List:

Symptoms: Female who presents to the office today stating last Thursday on 2/25/2021 she received her first Covid vaccine which was Pfizer. She reports premedicating herself before the vaccination with 1 Pepcid and 2 Benadryl. However unfortunately within 13 minutes of receiving the vaccine she started to experience a and irritation of the tongue/throat with tingling sensation followed by throat hoarseness, a cough and a red face. She was experiencing a little bit of chest tightness in addition to a little bit of shortness of breath and therefore used her albuterol inhaler. Shortly thereafter her red face improved. EMS was called to the scene however by the time they arrived she was improving and was sent home. She took a Benadryl at home later in the evening and the following day on Friday she started Pepcid daily since that time. She states since the vaccine she has felt poorly describing exhaustion and feeling achy all over with continued raw throat. She has not warranted use of her albuterol inhaler since last Thursday and ran out of Benadryl Thursday evening only utilizing Pepcid daily and continues on her other medications. She reports a history of allergies to petroleum products including polyethylene glycol which is suspected to be the cause of her allergic reaction

Other Meds: Albuterol, 81 Aspirin, Atorvastatin. Zyrtec, Cranberry Extract, Bentyl, Vitamin D, Vitamin D2, Lexapro, Nexium, Tricor, Advair Diskus, Duoneb, Celturelle, Linzess, Magnesium, Robaxin, Singulair, Multivitamin, Procardia XL, Lovaza, Phenergan

Current Illness:

ID: 1234151
Sex: F
Age: 68
State: NC

Vax Date: 03/16/2021
Onset Date: 03/18/2021
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: Admit information: Delightful 68-year-old white female with past medical history that significant for chronic pain disorder, degenerative disc disease, DJD, history of joint replacement, with history of tobacco use. Patient was admitted 4/15/2021 due to the fact that she has had ongoing arthralgias and myalgias after undergoing the Moderna vaccination approximately 1 month ago..

Other Meds:

Current Illness:

Date Died: 03/28/2021

ID: 1234152
Sex: M
Age: 47
State: MA

Vax Date: 03/12/2021
Onset Date: 03/18/2021
Rec V Date: 04/20/2021
Hospital: Y

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: Pt. had (what we think) a small seizure on Thursday, March 18th and then again on Saturday, March 20th. On Sunday, March 21st, 911 had to be called as his seizure did not end. He had a grand male. He was seizing for several hours. At the time this was all occurring he has been on anti seizure meds for a few years Divalproex 1000 mg am and 1000 mgs pm daily). He passed 1 week later, March 28 at approx 6:45pm at the Clinic. I am unable to get any information on his medical report for that week. Statement from his Nurologists is on second page. Additional information for Item 18: Statement: 47 year old gentleman who passed away on March 28 from aspiration pneumonia secondary to status epilepticus and on a history of multiple sclerosis / additional leukoencephalopathy of unknown etiology (both treated with rituximab), prior seizures (on valproic acid) and pulmonary embolism (on apixaban). The key reason for reaching out is in light of the announcement about the side effects of the Johnson & Johnson vaccine specifically cerebral venous sinus thrombosis. While he had a known history of seizures, he had no clear trigger for these seizures; including that his valproic acid level was therapeutic (83.0 mcg/mL) at time of presentation. He had, however, received the Johnson & Johnson vaccine on March 12 before having what in hindsight appeared to be repeated seizures between March 18-21; he had a more significant one on March 21 that hospitalized him. This time frame appears consistent with the reported cases of central venous sinus thrombosis associated with the Johnson & Johnson vaccine. Equally, he was taking apixaban at that point in time and his PLT (173) / INR (1.1) / PTT (36.6) at time of presentation were all normal and stable. He did have an elevated ProBNP (552.0) at presentation; nasopharyngeal swab was negative for COVID / Influenza A/B / RSV and non-contrast head CT did not show any clear new abnormalities. His only D-dimer was obtained on March 23 and was 226. He did not have a CT angiogram or venogram. Overall the link between the vaccine and pt. seizures is not definite. At the same time, the similarity with the reported cases has led to me wanting to report it in case of the possible link. If you require further information then please don't hesitate to email me Pt. med list at the time of this incident Modifinil - 100 mg/1per day/AM Sertraline - 100 mg/1per day/AM Vitamin D3 - 50 mg/1per day/AM Divalproex - 500 mg/2per day/AM Eliquis - 5 mg/1per day/AM Furoseminde - 20 mg/1per day/AM Metroprolol - 100 mg/1per day/AM Lisinopril - 10 mg/1per day/AM Divalproex - 500 mg/2per day/PM Eliquis - 5 mg/1per day/PM Metroprolol - 100 mg/1per day/PM Melatonin - 5 mg/1per day/PM Quetiapine - 50 mg/3per day/PM

Other Meds: SEE PAGE 2

Current Illness: MS

ID: 1234153
Sex: F
Age: 47
State: CA

Vax Date: 04/15/2021
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:

Symptom List:

Symptoms: Patient vaccinated around 9:57 AM. In observation and felt it was "hard to swallow". RN walked patient to the bed and took vital signs. DOC of the day called to assess the patient. Patient reporting difficulty swallowing. Speaking in full sentences. Denies itchiness, vomiting, or hives. Patient given water which visibly looked difficult to swallow. 50 mg IM Benadryl given to patient. Will continue to monitor. After giving Benadryl, patient reported improvement in symptoms. About 10 minutes later, patient stated symptoms were coming back and were worse with posterior tongue swelling and throat constriction. 0.3 mg EPI pen administered to patient. EMS transport recommended to patient when EPI was given. Patient denied transport at that time. Patient instructed and educated on the risks of denying EMS transport. After ten minutes post EPI pen, patient and provider both agreed it necessary to call 911 because patient reported no significant improvement after EPI pen. 911 called at 1041 and arrived on scene at 1055. Patient taken to hospital. Patient awake and alert speaking in full sentences at the time of transport.

Other Meds:

Current Illness:

ID: 1234154
Sex: F
Age: 30
State: WA

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: No know allergies

Symptom List:

Symptoms: Patient should have received the second dose as Pfizer, not Moderna. Nurse vaccinator inadvertently gave incorrect 2nd dose vaccine. Follow up with patient today (4/20/21) reports no adverse events other than the expected reaction after 2nd dose.

Other Meds:

Current Illness: None

ID: 1234155
Sex: F
Age: 51
State: VA

Vax Date: 04/01/2021
Onset Date: 04/05/2021
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: The day after the vaccine I had chills and body aches and then a day or two following that I started having daily hot flashes and night sweats. The hot flashes and night sweats that have continued since. I had a hysterectomy 2 years ago with one ovary remaining. The last we checked I still had estrogen producing hormones and wasn't in perimenopause or menopause yet.

Other Meds: Synthroid 88 mcg 5 days/weeks Hydrochlorathiazide daily Oracea daily Vitamin D every other day Baby aspirin daily

Current Illness: None

ID: 1234156
Sex: F
Age: 62
State: FL

Vax Date: 04/06/2021
Onset Date: 04/08/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Codeine, penicillin

Symptom List:

Symptoms: Cellulitis or ?Moderna arm?, 10 days clindamycin

Other Meds: Calcium citrate

Current Illness: None

ID: 1234157
Sex: M
Age: 59
State: CA

Vax Date: 04/06/2021
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: None

Symptom List:

Symptoms: Left arm is still sore after 2 weeks of vaccination. The soreness is still the same for the past 10 days, and has not improved. I am not able to lift more than 10 pounds using my left arm with some pain in the forearm or shoulder.

Other Meds: None

Current Illness: None

ID: 1234158
Sex: F
Age: 65
State: PA

Vax Date: 03/09/2021
Onset Date: 03/16/2021
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 called today to report an adverse event. She states she developed an arm rash a week after her first Moderna vaccine. it was red and bumpy and about 6 inches in length. It lasted a few days and then went away. She had no adverse to her 2nd Moderna vaccine administered on 04/06/2021

Other Meds:

Current Illness:

ID: 1234159
Sex: F
Age: 46
State: CA

Vax Date: 03/30/2021
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: none

Symptom List:

Symptoms: Patient arrived at Vaccine POD for 2nd dose of Pfizer and reported that after her 1st dose she had facial numbness on the right side of her face for 1 hour - about 4 hours after vaccine. Patient did not seek medical follow up. Symptom self resolved.

Other Meds: none

Current Illness: none

ID: 1234160
Sex: M
Age: 45
State: FL

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

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

Lab Data:

Allergies: Allergic reaction to chicken and eggs

Symptom List:

Symptoms: I had chicken for dinner at about 5:30 in the evening and within fifteen minutes, I start to itch all over and then I broke out into hives on my hands, neck, shoulders, back and sides. I thought at first that I was just having an allergic reaction to the vaccine so I took two benedryl and the hives went down the following day. I had chicken two days later and the same thing happened. I only realized that this was a chicken allergy on April 16th 2021. Each time the allergic reaction was more intense and lasted longer. I am now apprehensive about taking the second dose of the same vaccine as I am not sure whether or not this will intensify the adverse reaction and amplify the food allergy.

Other Meds: None

Current Illness: None

ID: 1234161
Sex: F
Age: 63
State: CA

Vax Date: 04/17/2021
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: None

Symptom List:

Symptoms: On Sunday evening, day after receiving vaccine, started having urinary frequency, urgency, urine pink and cloudy. Urination mildly painful. I have never had a UTI in my life, but had one now. I drink at least 8 liters of water per day, so definitely not dehydrated.

Other Meds: Allergy/Asthma medication: Trilogy, Flonase, Azalastine

Current Illness: None

ID: 1234162
Sex: F
Age: 56
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Dilauded Ciproflaxin Levaquin Steroids Advil

Symptom List:

Symptoms: The evening that I got the shot I had a low-grade fever and severe headaches. The next day I had a really painful mass in my groin on the left side. The headaches are still present at base of my Occipital Lobe. There is a lump there that is the size of a marble. I went to the ER four days after the shot, and they gave me antibiotic. after locating a mass in my groin. The doctor thinks it might be a lymph node 1X3 centimeter lump. I have an Ultrasound scheduled for this week. Both Lumps are still present. Tylenol normally works on the headaches. I have been to the ER, PCP and a gynecologist.

Other Meds: Migraine shots

Current Illness:

ID: 1234163
Sex: F
Age: 51
State: NC

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List:

Symptoms: Started feeling short of breath and dizzy on 3/27/21 (the day following vaccination). Symptoms continued into Monday 3/29/21. Was seen by urgent care on 3/29/21 due to shortness of breath, dizziness, and cough (congestion in lungs). EKG (normal), O2 Sats (normal), and COVID testing (normal) all done at my appt.

Other Meds: Claritin, Vitamins (A, C, & D), Elderberry

Current Illness: None

ID: 1234164
Sex: F
Age: 74
State: OR

Vax Date: 04/03/2021
Onset Date: 04/05/2021
Rec V Date: 04/20/2021
Hospital:

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

Lab Data:

Allergies: Salfa

Symptom List:

Symptoms: I took over the counter Tylenol and used a heat had. There is no treatment for Torticollis.

Other Meds: Simvastatin,Felodipine ER,Quinapril,Propranolol,Furosemide,Calcium,Asprin 81,Preser vision

Current Illness: No

ID: 1234165
Sex: F
Age: 48
State: NJ

Vax Date: 03/28/2021
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: N/A

Symptom List:

Symptoms: Lymph Node swelling,

Other Meds: Lantus, Humalog, multivitamin

Current Illness: Type 1 diabetes

ID: 1234166
Sex: F
Age: 38
State: OH

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: Amoxicillin morphine

Symptom List:

Symptoms: Chest pains, shortness of breath, vomiting, passing out twice with in the first few hours of the vaccine.

Other Meds: Gabapentin, Ativan, Prozac, Elavil, sumatriptan

Current Illness:

ID: 1234167
Sex: F
Age: 34
State: VA

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

Symptom List:

Symptoms: Attempted top vaccinate with vanishpoint needle in left arm. Vaccine leaked out around needle. Unable to determine amount given to patient. Gave another dose, per CDC guidance, in right arm.

Other Meds: denies

Current Illness: denies

ID: 1234168
Sex: M
Age: 30
State: NY

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/20/2021
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Allergies: none

Symptom List:

Symptoms: after about 5 to 6 minutes, pt was seated in waiting area and became rigid seizurelike. Pharmacist immediate went to aid to make sure did not fall to floor from chair. Seizure lasted about 10-15 seconds. Patient was diaphoretic and was pale. He regained consciousness within 15 seconds. Was able to answer questions and alert. Waited about 5 minutes he ask for water & I gave about 4 ounces of water. kept him seated in waiting area for another 5 minutes then moved to a sofa in adjacent room . he was evaluated for about 30-45 minutes. was hungry had not eaten all day. remembered he had a similar reaction when blood was taken. I offered to call ambulance various times he stated no. After about 45 minutes he stated he was feeling fine and wished to go. Patient seemed in good shape. Told him to please make the reaction known to health care practitioner administering second shot. He will return in 28 days to receive second shot in 28 days.

Other Meds: none

Current Illness: none

ID: 1234169
Sex: F
Age: 25
State: MA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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Symptoms: Patient described feeling flushed, Nausea, dizzy, and anxious after receiving shot

Other Meds:

Current Illness:

ID: 1234170
Sex: F
Age: 46
State: CA

Vax Date: 04/09/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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Symptoms: We got a call from Doctor from ER to inform us that this patient came to the ER today & got swollen arm @ the injection site (left arm). They did the ultra sound & found there's a clot in brachial vein on the opposite arm (right arm). Doctor said they'll give pt Eliquist today.

Other Meds:

Current Illness:

ID: 1234171
Sex: M
Age: 60
State: IL

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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Lab Data:

Allergies: Not aware of any

Symptom List:

Symptoms: Patient was given the Pfizer instead of the Moderna (2nd dose).

Other Meds: Not aware of any

Current Illness: Not aware of any

ID: 1234172
Sex: F
Age: 73
State: OR

Vax Date: 02/03/2021
Onset Date: 02/21/2021
Rec V Date: 04/20/2021
Hospital: Y

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Lab Data:

Allergies: benadryl, septra, lidocaine

Symptom List:

Symptoms: On 2/21 the patient presented to the ED with a c/o chest pain. She was ultimately discovered to have a submassive pulmonary embolism. She was admitted 2/21-2/24. There was no known instigating factor for her PE, it is currently determined to be unprovoked. Malignancy evaluation has been negative. She was treated with heparin drip and is now on apixaban daily for an unknown period of time, potentially lifetime. Hematology consultation is pending.

Other Meds: valacyclovir 500mg daily, pantoprazole 40mg twice daily, omega-3 1000mg daily, magnesium 250mg twice daily, loratadine 10mg daily as needed, escitalopram 10mg daily, vitamin D3 2000 IU daily, atorvastatin 40mg daily.

Current Illness: Fissure of the tongue and vulvovaginitis noted on 2/19/21 and treated with fluconazole 150mg once

ID: 1234173
Sex: F
Age: 50
State: CA

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/20/2021
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Lab Data:

Allergies: Ativan (rash)

Symptom List:

Symptoms: Patient reported numbness and tingling on left side of her throat ad tongue about 20 minutes after her shot. Vital signs stable. Patient then reported feeling dizzy, lightheaded, and weak. No hives, itching, or swelling at site. Patient requested to go to the emergency department and she was transferred there.

Other Meds: None reported

Current Illness: None reported

ID: 1234174
Sex: F
Age: 52
State: NH

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

Allergies: Mango; Poison Ivy

Symptom List:

Symptoms: Towards the end of 30 minute waiting period following the vaccine, I noticed red hives(red swollen bumps) that were slightly itchy on my left wrist. Later in the evening, my lips and tongue felt odd and a bit numb. Lips and roof of mouth continued to feel strange the next day and my throat was a little scratchy. When I awoke in morning, there was also a patch of hives (identical to those that were on my wrist) on my chest - about a 3" diameter. All symptoms dissipated about 24 hours after initial onset.

Other Meds: Junel birth control pills- daily; Pantoprazole- as needed; Propranolol- 2x/day Alprazolam- as needed

Current Illness: N/A

ID: 1234175
Sex: M
Age: 61
State: GA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/20/2021
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Lab Data:

Allergies: No Known Medication Allergies

Symptom List:

Symptoms: Subconjuctival hemorrhage left eye. Treatment- recommended to scheduled appointment with his primary care provider for further evaluation

Other Meds: Hydrochlorothiazide mg tablet, Lidocaine 5% patch, naltrexone 50mg tablet, Ketoconazole 2% cream, Flexeril 5mg tablet, PRN OTC Tylenol and Ibuprofen

Current Illness: MDD ETOH Tobacco use

ID: 1234176
Sex: F
Age: 37
State: NH

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 04/20/2021
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Lab Data:

Allergies: Amoxicillin

Symptom List:

Symptoms: Rash and Hives

Other Meds: Generic Wellbutrin

Current Illness: none

ID: 1234177
Sex: F
Age: 16
State: NC

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 04/20/2021
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Symptom List:

Symptoms: No adverse Event - Medication Error - Moderna Given to 16 year old

Other Meds:

Current Illness:

ID: 1234178
Sex: F
Age: 11
State: AL

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/20/2021
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Lab Data:

Allergies: UNKNOWN

Symptom List:

Symptoms: Knot at injection site and joint pain

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1234179
Sex: F
Age: 17
State: PA

Vax Date: 04/11/2021
Onset Date: 04/14/2021
Rec V Date: 04/20/2021
Hospital:

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Lab Data:

Allergies: Cephalosporins Penicillin's

Symptom List:

Symptoms: Unable to fill in lot number as facility kept vaccine card. Day 4 developed a small amount red raised hives on thighs used antihistamine and cortisone. Continued by day 7 hives completely covered thighs, legs, trunk, arms, and face as large red raised and itchy.

Other Meds: Lamictal Pristiq

Current Illness: none

ID: 1234180
Sex: F
Age: 23
State: CA

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

Symptom List:

Symptoms: Patient complained about left arm and leg numbness. Patient states she cant feel pressure on left leg when she gets up.

Other Meds:

Current Illness:

ID: 1234181
Sex: M
Age: 34
State: NY

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 04/20/2021
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Allergies: None

Symptom List:

Symptoms: Headache, chills, fever from 9:00am - 2:00pm day after vaccine. Extreme migraine from 2:00pm - 4:00pm. Symptoms stopped very rapidly and did not come back.

Other Meds: None

Current Illness: None

ID: 1234182
Sex: F
Age: 23
State: CA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: Patient fainted a few minutes after receiving the covid-19 shot.

Other Meds: None

Current Illness: None

ID: 1234183
Sex: M
Age: 21
State: MI

Vax Date: 04/01/2021
Onset Date: 04/20/2021
Rec V Date: 04/20/2021
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Lab Data:

Allergies: Allergic to zithromax, cyproheptadine, shellfish, nuts, peas, beans, poultry

Symptom List:

Symptoms: Fainted immediately after the shot. This is not the first time he has fainted after a shot, though.

Other Meds: Flaxseed oil 1000 mg, Vitamin A 2400 mcg, Vitamin C 500 mg, Vitamin D3 1000 IU

Current Illness: None

ID: 1234184
Sex: F
Age: 30
State: IL

Vax Date: 04/05/2021
Onset Date: 04/19/2021
Rec V Date: 04/20/2021
Hospital: Y

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Symptoms: Patient tested Covid + on 4/17/21. Admitted to Hospital on 4/19/21 with acute pancreatitis.

Other Meds:

Current Illness:

ID: 1234185
Sex: M
Age: 22
State: VA

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/20/2021
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Lab Data:

Allergies: No

Symptom List:

Symptoms: Pt started complaining of feeling nauseous and light headed within a hour of his vaccination. He was able to eat a small meal; however, he started using the bathroom around 12:30pm and the diarrhea and nausea increased as the night progressed He denies vomiting, but by today he is very fatigued and possibly dehydrated.

Other Meds:

Current Illness:

ID: 1234186
Sex: F
Age: 52
State: PA

Vax Date: 03/29/2021
Onset Date: 04/01/2021
Rec V Date: 04/20/2021
Hospital:

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Lab Data:

Allergies: Penicillin and sulfa

Symptom List:

Symptoms: Gradually over the last several weeks I have developed all over body swelling, lymphedema triggered, nodules under my arm, pressure on my chest, difficulty catching my breathe, out of breathe walking or even doing nothing, tired, elevated heart rate

Other Meds: Vitamin D, Osteo Bioflex, Vitamin C, melatonin, Allegra Flexeril, amiridex, omeprazole, gabapentin, Xanax,

Current Illness: Fibromyalgia Rhumatoid arthritis

ID: 1234187
Sex: M
Age: 61
State: PA

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

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Lab Data:

Allergies: SEROQUEL, MORPHINE

Symptom List:

Symptoms: PALPITATIONS, SWEATING AND MILD LIGHTHEADEDNESS POST VACCINE ADMIN REPORTED BY PATIENT, BROUGHT TO OBS VIA WC. PLACED IN TRENDELENBERG ON STRETCHER IN OBS, PATIENT STATES S/S RESOLVED SOON AFTER. VSS. ESCORTED TO EXIT WITH NO ISSUES AT 1415.1408 BP 128/80 HR 72 RR 16 SATS 96% RA.

Other Meds: LISINOPRIL, CELEXA, KLONOPIN, ASA, MVI

Current Illness: NONE

ID: 1234188
Sex: M
Age: 70
State: OR

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/20/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: Varenicline (Chantix)

Symptom List:

Symptoms: SOB, fever, and productive cough

Other Meds: unknown

Current Illness: unknown

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm