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: 1251324
Sex: M
Age: 27
State: VA

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: fever and body aches starting @ 1 am the next day, including pain in spine and minor headache, felt like shingles lite (without the itching) Then, 11:50 pm next day: itchy bumps began appearing over body, hands and feet itched profusely for 24 hours until benadryl administered, symptoms diminished consecutively each day,

Other Meds: Vyvanse 40 mg, zyrtec, vitamin D supplement, fish oil supplement, vitamin C supplement

Current Illness:

ID: 1251325
Sex: M
Age: 25
State:

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Incorrect diluent volume was mixed (the vial contents were diluted with a diluent volume of 0.8 mL instead of 1.8 mL), but a 0.3 mL dose was administered. We have already talked to Pfizer-BioNtech. They told us that if the dose given in error is the first dose, a second dose should be administered at the recommended interval of 21 days. If the dose given in error is the second dose, the series is complete, and no additional doses are needed. We have already informed the patients of the potential for local and systemic adverse events.

Other Meds:

Current Illness:

ID: 1251326
Sex: M
Age: 20
State: RI

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Right Testicular Pain / difficulty urinating

Other Meds: One a day Men's Multivitamins, Vitamin D 2000 IU.

Current Illness: None

ID: 1251327
Sex: F
Age: 34
State:

Vax Date: 04/17/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: A week later after my left arm bruised up I now have a mild rash at the injection site about 3? in diameter. It?s not bothering me actively but I wanted it documented. After the first shot that I had a week ago I also had an upset stomach. I believe that the red itchy arm is already improving and will resolve in a few days.

Other Meds: N/A

Current Illness: No

ID: 1251328
Sex: F
Age:
State: IN

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Sore injection site, fatigue, body aches, sore joints, fever

Other Meds: Sertraline, Wellbutrin, Zyrtec D, Nasacort

Current Illness: N/A

ID: 1251329
Sex: F
Age: 55
State: TX

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: Salvage vaccine was given greater than 6 hours after reconstituted. The patient was contacted and will follow up with her doctor. Patient experienced sore arm and shoulder. She also experienced swelling of her hands

Other Meds:

Current Illness: Unknown

ID: 1251330
Sex: F
Age: 56
State: VT

Vax Date: 04/08/2021
Onset Date: 04/13/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: sulfa drugs

Symptom List:

Symptoms: rash: forearms and front of abdomen; both sides,-not vesicular at this time 11 days duration-unresponsive to over the counter topical hydrocortisone and oral diphenhydramine

Other Meds: baby aspirin, melatonin, curcumin, vitamin C, fish oil, magnesium, probiotic

Current Illness: none

ID: 1251331
Sex: F
Age: 32
State: OK

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: About ten hours after vaccine I started feeling lightheaded, chills, fever, body aches and weakness. All through the the night I had flu like symptoms - chills, fever, aches. 24 hours after vaccine I am still feeling weak, fever, body aches.

Other Meds: Multi vitamin, Walzyr

Current Illness: None

ID: 1251332
Sex: F
Age: 32
State: IL

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Diziness without weakness . Steady gait Alert x4

Other Meds: IUD , no meds

Current Illness: none

ID: 1251333
Sex: F
Age: 36
State: TX

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: cedar pollen, ragweed pollen, sulfa related medicine

Symptom List:

Symptoms: Sore arm for 48h; constant tired for a week after vaccination; After a week, the injection area started turning to red rash; After 13 days, the color gets darker red with a bit itchy. After 10 days of vaccination, I had severe abdominal pain when my period came.

Other Meds: omeprazole

Current Illness: sore arm for two days; tired for a week; started from the second week of vaccination, I have red skin around my injection area. After 13 days, the red color turns to darker red ( a bit purple), the skin is a bit itchy.

ID: 1251334
Sex: F
Age: 18
State:

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Incorrect diluent volume was mixed (the vial contents were diluted with a diluent volume of 0.8 mL instead of 1.8 mL), but a 0.3 mL dose was administered. We have already talked to Pfizer-BioNtech. They told us that if the dose given in error is the first dose, a second dose should be administered at the recommended interval of 21 days. If the dose given in error is the second dose, the series is complete, and no additional doses are needed. We have already informed the patients of the potential for local and systemic adverse events.

Other Meds:

Current Illness:

ID: 1251335
Sex: M
Age: 43
State: IN

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Woke up next morning with 101 degree fever, aches, chills, headache, fatigue, weakness. Started around 3am day after dosage, recovery began around 3pm day after dosage. I still have a headache 46 hours after dosage, but no more fever.

Other Meds: Verapamil 180 MG Omeprazole 20 MG Multivitamin

Current Illness: None

ID: 1251336
Sex: F
Age: 59
State: CO

Vax Date: 03/27/2021
Onset Date: 04/03/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Swollen arm around the site of injection (left arm) that occurred a week later. Arm was patchy red spots based on pictures and patient reported hardness and warm in this area. The reaction lasted 1-2 days

Other Meds:

Current Illness:

ID: 1251337
Sex: M
Age: 42
State: NJ

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Both eyes are swollen and itchy

Other Meds: None

Current Illness: None

ID: 1251338
Sex: M
Age: 74
State: TN

Vax Date: 03/01/2021
Onset Date: 03/29/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin

Symptom List:

Symptoms: Shingles

Other Meds: Atorvastatin 40mg, Eliquis 5mg 2X daily, Metformin 500mg 2X daily, Tamsulosin 4mg, Finasteride 5mg,Omeprazole 20mg, Aspirin 81mg, Metoprolol ER 25mg, men's Vitamin, Tylenol

Current Illness: None

ID: 1251339
Sex: M
Age: 17
State:

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1251340
Sex: F
Age: 36
State:

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: apples, avocado, penicillin, naproxen, injectafer

Symptom List:

Symptoms: chest pain shortness of breath within 15 minutes , s/p 3 doses of epi, admitted for drug reaction

Other Meds: maxalt, Carafate, imitrex, zanaflex, desyrel, Cymbalta, plaquenil, topamax

Current Illness:

ID: 1251341
Sex: M
Age: 47
State: AZ

Vax Date: 04/16/2021
Onset Date: 04/19/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: 1. Injection site of second doese started to have pronounced discoloration after day 2 that looks like a bruise. The site had a little bleeding as the male nurse adminiter the dose. Redness faded but circular yellowish discoloration about 2 inches in diameter is still visible on left arm after 7th day. 2. Eyes started itching the first shot and left eye had itchy corner like dry skin or something. Itchiness faded then came back again after second shot. Same reaction, itchy eyes the next day and the left eye corner started itching and drying up. Applied 1% cortizone to relieve itchiness and dryness on 3rd day. Seem to have releived the itchiness and dryness but still monitoring it. Will report this reaction with my provider when I see them next week,

Other Meds: Rosuvastatin

Current Illness: None

ID: 1251342
Sex: F
Age: 23
State:

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Incorrect diluent volume was mixed (the vial contents were diluted with a diluent volume of 0.8 mL instead of 1.8 mL), but a 0.3 mL dose was administered. We have already talked to Pfizer-BioNtech. They told us that if the dose given in error is the first dose, a second dose should be administered at the recommended interval of 21 days. If the dose given in error is the second dose, the series is complete, and no additional doses are needed. We have already informed the patients of the potential for local and systemic adverse events.

Other Meds:

Current Illness:

ID: 1251343
Sex: F
Age: 45
State: IN

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Headache, fatigue, body aches

Other Meds: Dapson, ibuprofen

Current Illness:

ID: 1251344
Sex: F
Age: 69
State: IN

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Pt states that she woke up this am with pain and numbness in her left shoulder and arm. She denies a fever and dizziness. There is some pain reported at the injection site, but the most pain is in the shoulder blade and up into her neck. Numbness is reported mostly in the fingers. Pt does not know if this is worsening of previous shoulder injury exacerbated by injection or vaccine side effect. I recommended pt to see an MD and she has an immediate care visit scheduled at 5pm 4/24/21. I will follow up with her on 4/25/21 regarding results of visit.

Other Meds:

Current Illness:

ID: 1251345
Sex: F
Age: 28
State: CO

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Slight rash, about the size of a quarter, an inch below the injection site.

Other Meds: None

Current Illness: None

ID: 1251346
Sex: F
Age: 39
State: MS

Vax Date: 04/01/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: Kiwi

Symptom List:

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA I woke up with a sizable lump on my right collarbone. Last night my lump could be ?cupped? with my hand and I felt pressure in the right side of my chest. The pressure is so uncomfortable at times though that I can feel it in my chest and the back of my head.

Other Meds: None

Current Illness: None

ID: 1251347
Sex: F
Age: 30
State: IN

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Chills Fever Muscle and joint aches

Other Meds: Gianvi Citalopram

Current Illness:

ID: 1251348
Sex: F
Age: 35
State: MD

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: tramadol, macrobid

Symptom List:

Symptoms: Patient developed hives, itchy mouth and throat developed about 10 minutes after receiving her second vaccine. benadryl 50mg IM was given at 11:42AM

Other Meds: levothyroxine

Current Illness: hashimotos, asthma, epilepsy, migraine

ID: 1251349
Sex: M
Age: 43
State: IN

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: O

Symptom List:

Symptoms: Headache, fatigue, chills, general aches and pains

Other Meds: Sertraline 50mg

Current Illness: No

ID: 1251350
Sex: F
Age: 42
State: PA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs, ceclor, erythromycin, levaquin

Symptom List:

Symptoms: Fever up to 99.9, chills, nausea, lethargy, difficulty sleeping, swollen lymph node in left armpit

Other Meds: None

Current Illness: None

ID: 1251351
Sex: F
Age: 64
State: DE

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

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

Lab Data:

Allergies: latex

Symptom List:

Symptoms: Patient stated on same day as immunization (4/20/2021) she experienced high fever (102.9 F), vomiting, diarrhea, excruciating headache, and a swollen injection site. During the next day or two (4/21/2021 or 4/22/2021), she experienced shooting pain across her collarbone to her jawbone. On 4/23/2021, she experienced blisters in her mouth on the roof of her mouth and under tongue. She visited the emergency room on 4/24/2021 and received a prescription for lidocaine viscous 2% for mouth sores.

Other Meds: Unknown

Current Illness: unknown

ID: 1251352
Sex: F
Age: 65
State: GA

Vax Date: 04/01/2021
Onset Date: 04/17/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: Shellfish, nuts, chocolate, bees, dust mite,pollen

Symptom List:

Symptoms: Twelve hours after vaccine I felt like I was freezing and hot at the same time. I had muscle cramps and complete body fatigue and felt like I had the flu. I couldn't get up and do my usual thing, I'm really afraid to take the next shot if it's going to be worse than the first one.

Other Meds: Amlodipine 5mg, NP Thyroid 90 mg,

Current Illness: None

ID: 1251353
Sex: F
Age: 52
State: WI

Vax Date: 01/26/2021
Onset Date: 01/31/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Left ear hearing loss and tinnitus bilaterally. Still present and has ben present for 4 months. Broke out into immediate flushing, heart rate went up to 132, and severe nausea following vaccine. Had to stay at clinic for 90 minutes to recover.

Other Meds:

Current Illness:

ID: 1251354
Sex: F
Age: 32
State: MA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Severe arm pain, migraine, nausea

Other Meds: No e

Current Illness: None

ID: 1251355
Sex: M
Age: 65
State: PA

Vax Date: 04/07/2021
Onset Date: 04/10/2021
Rec V Date: 04/24/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Started with SOB and palpitations. Foudn to have new congestive heart failure and arrhythmia.

Other Meds:

Current Illness:

ID: 1251356
Sex: F
Age: 60
State: GA

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

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: 6 hours after the injection, i developed lymph node swelling on my collar bone approx. 3 in x 3in area, headache, watery ices and sneezing that lasted 48hours. As of today, April 24th the swollen lymph node is still present

Other Meds: losartan tab 50mg, hydrochlorothiazide 125mg, l-thyroxine 137mcg

Current Illness: no

ID: 1251357
Sex: M
Age: 62
State: OH

Vax Date: 03/31/2021
Onset Date: 04/07/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Significant increase in ringing in ears, fatigue, mild headache

Other Meds: atorvastatin, fish oil, omeprozole

Current Illness:

ID: 1251358
Sex: F
Age: 49
State: ID

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Burning/discomfort in throat 10 minutes after vaccine administration. Elevated blood pressure and heart rate.

Other Meds: Levothyroxine taking this morning

Current Illness:

ID: 1251359
Sex: M
Age: 34
State:

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Incorrect diluent volume was mixed (the vial contents were diluted with a diluent volume of 0.8 mL instead of 1.8 mL), but a 0.3 mL dose was administered. We have already talked to Pfizer-BioNtech. They told us that if the dose given in error is the first dose, a second dose should be administered at the recommended interval of 21 days. If the dose given in error is the second dose, the series is complete, and no additional doses are needed. We have already informed the patients of the potential for local and systemic adverse events.

Other Meds:

Current Illness:

ID: 1251360
Sex: F
Age: 33
State: FL

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List:

Symptoms: Patient experienced chills, fever and body aches after moderna vaccination

Other Meds: n/a

Current Illness: n/a

ID: 1251361
Sex: M
Age: 38
State: DE

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

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Large red swollen rash near injection site. Started small about eight hours after injection and continue to grow for four days following.

Other Meds: Fluoxetine Testosterone Claritin Synthroid

Current Illness:

ID: 1251362
Sex: F
Age: 16
State: AZ

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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Allergies: peanuts

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Symptoms: Pt received first Moderna dose in on 3/25/21 at age 16 years old. Physician spoke to Moderna regarding if patient should receive second dose due to age; was advised that patient should receive second dose. .

Other Meds: none

Current Illness: none

ID: 1251363
Sex: F
Age: 22
State: TX

Vax Date: 04/14/2021
Onset Date: 04/21/2021
Rec V Date: 04/24/2021
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Allergies: NKDA

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Symptoms: CHEST PAIN:

Other Meds: SERTRALINE

Current Illness: NONE

ID: 1251364
Sex: M
Age: 59
State: CA

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/24/2021
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Allergies: No known allergies

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Symptoms: swollen tongue, no treatment beside tylenol. After 3 days, still feel tongue is swollen or slightly sore. Feels like tongue is sprained. Symptoms are not severe but are worrisome. Some discomfort in muscles near stomach. Started happening on 2 day. Not happening on day 3.

Other Meds: Vitamin World Ultra Man 50Plus Daily multi Vitamin World Probiotic10 Tylenol Acetaminophen Extra Strength 500mg each

Current Illness: none

ID: 1251365
Sex: F
Age: 34
State: IN

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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Allergies: Egg, gluten, dairy

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Symptoms: Dizzy/vertigo, nausea, body aches, felt feverish, lowgrade temp of 99, extreme fatigue

Other Meds: Fluoxetine, levenorgestral, azelastine nasal spray,, Women's multivitamin, clacium+vitamin D, zyrtec, Claritin, pepcid,

Current Illness:

ID: 1251366
Sex: M
Age: 50
State: AZ

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/24/2021
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Allergies: Augmentin.

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Symptoms: Vomiting and severe chest pain. 9 out of 10.

Other Meds: None.

Current Illness: None.

ID: 1251367
Sex: M
Age: 74
State: MD

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 04/24/2021
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Allergies: Penicillin

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Symptoms: Red itchy skin that started on arms. It advanced to raised bumps on arms and torso and upper thighs. It began on 3/19/2021 and he still has residual redness and itchiness, although it has receded a bit, as of 4/15/2021

Other Meds: Metformin, Simvastatin, Amlodipine, HCTZ,Losartan

Current Illness: none

ID: 1251368
Sex: F
Age: 64
State: WI

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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Allergies: Selfish

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Symptoms: 13 hrs after injection woke with chills, body aches and fever of 100.9. Felt like severe flu. Also fatigue so bad could not get out of bed for 1 day. Fever lasted for 12 hrs. Body aches and headache lasted 2 days. Felt slightly better on 04/23/21. Today is 04/24/21 still have fatigue, weakness and sweating. feeling better but not back to normal.

Other Meds: Atorvastatin 10mg Amlodipine 2.5 mg Biotin 10,000 mcg K2 100mcg B12 500mcg D3 10mcg Fiber Con 2 tablets a day Osteo Bi-Flex 1 tablet a day Vitamin C 250 mg

Current Illness: none

ID: 1251369
Sex: F
Age: 62
State: MD

Vax Date: 04/20/2021
Onset Date: 04/22/2021
Rec V Date: 04/24/2021
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Allergies: NKDA

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Symptoms: 2 days after receiving vaccine patient developed hives on trunk, face, arms and legs and swelling of lips. Right arm felt heavy 1 day after receiving vaccine.

Other Meds: Synthroid

Current Illness: Unknown

ID: 1251370
Sex: F
Age: 49
State: PA

Vax Date: 04/16/2021
Onset Date: 04/19/2021
Rec V Date: 04/24/2021
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Allergies: Sulfa

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Symptoms: Dizziness/lightheadedness

Other Meds: Multivitamin Iron

Current Illness: No

ID: 1251371
Sex: F
Age: 51
State: FL

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/24/2021
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Allergies: NKA

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Symptoms: Fever and chills were horrible but also experienced hallucinations. This lasted from 8pm day of 2nd shot through 6am following morning.

Other Meds: Lipitor 20 mg/day

Current Illness: Na

ID: 1251372
Sex: F
Age: 68
State: MD

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
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Symptoms: Pt had presented for #2 Moderna to observation area @1120 am via motorized scooter accompanied by her daughter. @1130am pt was eating roasted salted almonds and taking home medications having conversations with daughter and staff. @1140 pt began to c/o left leg heaviness and "feeling different". Slight SOB. Pt was able to stand but w/labored effort worsened SOB and w/increased left leg heaviness and numbness-pt had slight slurred speech and c/o "feeling woosy". Pt took 2 Albuterol inhaler puffs 1144 911 called. Advised to take 2 Atrovent inhaler puffs also. @1145 AED obtained, BP 158/81 P 96 pulse ox 100%. 1158 EMS arrived and took over care, pt agreed for transport to nearest emergency facility, pt to be transported to GA AUC, daughter took personal belongings. Pt was AAOx3 entire vaccine and observation area visit time and at time of d/c.

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ID: 1251373
Sex: M
Age: 0
State: MA

Vax Date: 08/28/1961
Onset Date: 04/19/2021
Rec V Date: 04/24/2021
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Allergies: Had food allergies about 25 yrs ago. About 25 years ago, I was test to be allergic to 12 foods including: Chicken, Beef,milk,wheat gluten, grapes, bannas, chocolate, oranges, etc... However, the reason for the allergies as because I had a major vitamin deficiency for which I was prescribe a vitamins as the cure. I eventually grew out of all the allergic reactions to all the foods except whole milk.

Symptom List:

Symptoms: On 4/19/21 at about 9:00PM, I begin developing a migraine headache. The headache worsen with time and became severe by 11:00PM. After taking Inositol for sleep, I still had the headache the next morning, but it was less severe. The headache had subsided by the end of the 2nd day. On 4/23/21 about 5:00PM, I notice that my upper lip was beginning to swell. Within an 1 hour my upper lip was fully swollen. Just a coincidence, I had just visit my doctor the same day earlier at around 8:15AM for a swollen knee area for which the doctor had prescribed 220mg Aleve for the swollen knee area and blood work. The following day, my lip was still severely swollen, but the swelling began going down around 10AM.

Other Meds: Lisinopril 20mg, Atorvastatin 20mg, Turmeric 553mg, multivatim, Turmeric 553mg - 1 per day Ultimate Man 50+ Multivatimin - 1 per day Vitamin C 1000mg - 1 per day Calcium Mag Zinc 2:1 Calc to Mag - 1 per day Mega B-150 B-Complex - 1 per day

Current Illness: Right knee area was swollen

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm