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: 1259476
Sex: F
Age: 49
State: CA

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: DIZZINESS, WEAK, FINGERS/LIPS TINGLING. PARAMETIC CAME, SYMPTOMS IMPROVED, REFUSED TRANSPORT, DRIVEN HOME BY DAUTHER.

Other Meds:

Current Illness:

ID: 1259477
Sex: M
Age: 44
State:

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

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: syncope. Evaluated by EMS-Cleared.

Other Meds:

Current Illness:

ID: 1259479
Sex: F
Age: 73
State: CA

Vax Date: 03/24/2021
Onset Date: 04/12/2021
Rec V Date: 04/26/2021
Hospital: Y

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

Lab Data:

Allergies: NO KNOW ALLERGIES

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Single subsegmental pulmonary embolism without acute cor pulmonale? (present on admission) A: UnprovokedSubsegmental pulmonary emboli noted on prelim report CT chest with slight straightening of interventricular septum could reflect presence of right heart strain. Likely a larger embolism which dispersed. Currently not hypotensive. DVT negative P: Check 2D echo: if showing evidence of R heart strain will consult IR for systemic thrombolysis Therapeutic anticoagulation with Lovenox subcutaneous . Will transition to DOAC in AM tomorrow. She will need to be on for life Malignancy screening to be done as an outpatient. - morphine 4mg IV q4h as needed for pain RIGHT SIDED ABDOMINAL PAIN X 2 DAYS STARTED 4/12/21, WENT TO ER ON 4/14/21, DISCHARGED ON 4/16/21 IN STABLE CONDITION STARTED ON XARELTO 15MG DAILY FOR 21 DAYS THEN 20 MG DAILY

Other Meds: STARTED LISINOPRIL 10MG QD ON 3/23/21 AS NEEDED WHEN SYSTOLIC IS GREATER THAN 140, FISH OIL, RED YEAST RICE

Current Illness: NONE KNOWN

ID: 1259480
Sex: F
Age: 60
State:

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Acute bilateral pulmonary embolus

Other Meds:

Current Illness:

ID: 1259481
Sex: F
Age: 66
State: NE

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Patient c/o itching and redness on bilateral wrists. RN notes mild rash and administers benadryl 25 mg PO at 2:14pm. Patient also given water to drink. Patient states at 2:20pm that itchiness has decreased. No respiratory distress. No anaphylaxis symptoms or other complaints by patient. At 2:25pm, patient states that there is no itching. RN observes that rash is gone. Patient d/c home with daughter at 2:30pm. Stable and ambulating to exit.

Other Meds:

Current Illness:

ID: 1259482
Sex: F
Age: 76
State: LA

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

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

Lab Data:

Allergies: Iodine, Latex, PCN

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: 2nd Moderna COVID Vaccine given 23 days after 1st. No adverse reaction noted.

Other Meds:

Current Illness:

ID: 1259483
Sex: F
Age: 21
State: CA

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

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

Lab Data:

Allergies: nonw

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: complained of lightheadedness. Pt was clammy to touch. Pt had rx at 12:30 Pt was given water and placed in Trendelenburg position. Vitals: BP 108/68, O2 99%, HR 57 Vitals at 12:50 BP 100/60, O2 97%, HR 82 Pt recovered, vitals signs stable. Pt left and stated her friend will be driving pt home. Pt was discharged at 12:52.

Other Meds: Zoloft

Current Illness: low iron

ID: 1259484
Sex: F
Age: 64
State: IL

Vax Date: 04/15/2021
Onset Date: 04/26/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: sulfa, egometrine

Symptom List: Pharyngeal swelling

Symptoms: increased neutrophils , decreased lymphs 4/26/21 rash 1 inch from injection site approx 6 cm raised itchy, recurrent...had 2 days after vaccine, subsided until today returned at 11 days post vaccine

Other Meds: nexium, pulmicort, atrovent, singulair

Current Illness: mild asthma

ID: 1259485
Sex: F
Age: 31
State: VA

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Nipple vasospasms (in breastfeeding mother) accompanying the expected chills/fever following vaccination. Bad nipple pain occurred twice the day after vaccination, along with chills. Nipples remain sensitive 48 hours later, particularly to cold, but pain has diminished.

Other Meds:

Current Illness:

ID: 1259486
Sex: F
Age: 71
State: AZ

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient called health department and reported that day after her vaccine 4/16/21 in the morning she had a large lump on her arm that was swollen. She went to her doctor and he had her apply ice and hot, alternating. Her lump is now gone, about a week later.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1259487
Sex: F
Age: 44
State:

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

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

Lab Data:

Allergies:

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Dizziness. Evaluated by EMS-Cleared.

Other Meds:

Current Illness:

ID: 1259488
Sex: F
Age: 58
State:

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: MULTIPLE ALLERGIES ALLERGIC TO SULFITES, SULFATES, SULPHUR, SULFA,.....

Symptom List: Rash, Urticaria

Symptoms: SEIZURES (PARTIAL / FOCAL MOTOR) OFF & ON FOR ABOUT 35 MINUTES FLANK PAIN

Other Meds:

Current Illness:

ID: 1259489
Sex: F
Age: 57
State: CO

Vax Date: 04/21/2021
Onset Date: 04/23/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: sulfa and erythromycin

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: The reaction started with a stuffy nose, then runny nose, then went back and forth. That was followed by a red-spotted rash that began on legs and arms. The rash is extremely itchy and in certain areas the spots all ran together into giant red patches which burn and hurt like a severe sunburn. At the same time the spots were showing up, a small lump formed behind the left ear and was painful. The pain ran up higher on the head on the same side and down the neck on the same side. Over the counter pain meds, benadryl, pepcid, and clariton were tried with no results. An urgent care visit resulted in a steriod pack prescription.

Other Meds: multi vitamin, fish oil, vitamin C, Vitamin D

Current Illness: none

ID: 1259491
Sex: F
Age: 18
State: SD

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: After vaccination, patient became lightheaded as she left the room. Mother lowered patient to ground with feet resting on chair in hallway. Pulse was mildy tachy and patient had severe pallor at that point per Dr. Patient was taken to urgent care via wheelchair. Blood pressure 92/61 at 1646, pulse 76 BPM. Patient felt improvement lying on bed. Patient had been hiking that morning and admitted to not drinking enough water that day. Dr. suspected dehydration and vasovagal reaction.

Other Meds: unknown

Current Illness: dehydration

ID: 1259492
Sex: F
Age: 54
State: CT

Vax Date: 03/27/2021
Onset Date: 03/31/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: Allergic to Sulfa drugs, Multiple food allergies: Fruits, nuts, Yogurt

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: On 3/31, noticed a bruise (looked like a hematoma?) below my right knee - dark brown with purplish hue. Two days later, I had a bruise above my left knee, milder than the one on my right knee - brownish hue (did not turn purple/ yellow). A couple of days later, I noticed a bruise on my left forearm (even milder than the one above my left knee) and careful examination noticed a faint bruise at the back of my right upper arm. The bruises became faint and disappeared over time - I am scheduled for my second shot on 4/30/ 2021

Other Meds: Sumatriptan (50 mg) as needed; Atorvastatin 10 mg, daily; multivitamins (once or twice a week)

Current Illness: None

ID: 1259493
Sex: F
Age: 31
State: AZ

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Started feeling feverish and chills. Fever continued to reach 102.6 until about 6:00am the next day. Migraine followed, along with some slight nausea, keeping me bedridden until about 2:00pm

Other Meds: Blisove Fe 1/20, D-Mannose

Current Illness: None

ID: 1259494
Sex: M
Age: 49
State: MI

Vax Date: 04/16/2021
Onset Date: 04/21/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Ongoing- pain under right arm radiating towards chest area. With numbness and tingling. Sharp pain located outside edge of pectoralis major. Also random bumps appearing in different areas of body. Currently 6 bumps all same size shape and appearance. All occurred on different days and different times. Perfectly healthy prior to vaccination.

Other Meds: None

Current Illness: None

ID: 1259495
Sex: F
Age: 58
State: NY

Vax Date: 03/26/2021
Onset Date: 04/21/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient went to an emergency room for pain and fever and was diagnosed with pancreatitis, something she has never had an issue with before the vaccine.

Other Meds: Linzess, Pravastatin, Metformin ER, Lisinopril, Trazodone,

Current Illness:

ID: 1259496
Sex: F
Age: 53
State: TN

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: NO KNOW ALLERGIES

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: PATIENT RECEIVED COVID 19 VACCINE THAT WAS OUTSIDE TO THE EXPIRATION TIME. PATIENT DID NOT REPORT ADVERSE REACTION TO THE PHARMACIST WHEN SHE WAS INFORMED OVER THE PHONE. NO ADVERSE REACTION IS KNOWN TO HAVE OCCURRED.

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1259497
Sex: F
Age: 60
State: CA

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

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

Lab Data:

Allergies: None

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: 04/26/21 @ 1324 Patient c/o itching at injection site right arm. Upon assessment, there was no redness, swelling, Skin Temp WNL, no skin discoloration at the injection site. VS 97% O2, 87HR, BP: 190/98. 1330 - Benadryl was administered 50 mg tab by mouth. 1345- Patient states, "I feel better, I no longer have itching on my arm".

Other Meds: None

Current Illness: NKA

ID: 1259498
Sex: M
Age: 45
State:

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

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

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: "Client awaiting his wife who was was being observed for 30 mins 12:17 Dizziness and 12:18 syncope few secs rescue called regained consciousness diaphoretic, Bp 87/50, Hr 63 reg, Sats 95%, resp 15. Placed on stretcher, place on Ekg monitor sinus rhyth"

Other Meds:

Current Illness:

ID: 1259499
Sex: F
Age: 57
State: NY

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: 14 hrs after receiving the second dose I had what I would compare to as a vertigo reaction. The room spun while I was sitting down, no fast movement, no quick turn of my head, just severe room spins. I also had a severe headache within a few hours after that, but, I expected it. It has now been2 and a half full days and I am still experiencing the dizziness, not as severe, but, noticiceable.

Other Meds: None

Current Illness: Sero Negative Rheumatoid Arthritis

ID: 1259500
Sex: M
Age: 17
State: MA

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

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

Lab Data:

Allergies: None

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Patient 17years and 11 months old

Other Meds: None

Current Illness: None

ID: 1259501
Sex: F
Age: 37
State: TX

Vax Date: 04/14/2021
Onset Date: 04/16/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain, Pain

Symptoms: Patient came in this morning and asked about her left arm. She had a red rash like we would expect but she had the vaccine on 04/14/2021 and today is the 26th. She stated it was actually getting larger and her arm hurt.

Other Meds: N/A

Current Illness: N/A

ID: 1259502
Sex: M
Age: 17
State: CA

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: PT RECEIVED FIRST DOSE WHILE UNDER AGE REQUIREMENT. MOTHER SIGNED THE CONSENT FOR PT TO RECEIVE THE SECOND DOSE

Other Meds:

Current Illness:

ID: 1259503
Sex: M
Age: 45
State: FL

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: Allergic to aspirin, naproxen, ibuprofen, dipiron, antinflamatories, analgesics

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Fever; muscular pain; joint pain; fatigue; headache; pain in the eyes, shaking; sweetness;

Other Meds: Magnesium

Current Illness:

ID: 1259504
Sex: F
Age: 62
State: WY

Vax Date: 03/16/2021
Onset Date: 04/19/2021
Rec V Date: 04/26/2021
Hospital: Y

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

Lab Data:

Allergies: Ibuprofen contraindicated due to her poor kidney function

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 1 week post vaccine had 1 day with a sore throat and runny nose. Developed right calf pain 04/19/2021. Presented to ER on 04/25/2021 w/ a 2 day history of shortness of breath and some chest tightness worse with exertion, with worsening symptoms at time of ER visit. Admitted for observation with "Pulmonary embolism without acute cor pulmonale and Acute respiratory failure with hypoxia"

Other Meds: Amlodipine 5 mg oral tab 1 tab once a day; Over the counter supplements: Cinnamon; Beet powder capsule; cranberry tablets; Kidney formula from Long-jevity

Current Illness: None

ID: 1259505
Sex: F
Age: 40
State: UT

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Severe vomiting, diarrhea, fever

Other Meds:

Current Illness:

ID: 1259506
Sex: M
Age: 20
State: IN

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Shortness of breath, difficulty swallowing (current) Fever, joint pain, tiredness (former: ended on 4/25/21)

Other Meds: Ibuprofen

Current Illness:

ID: 1259507
Sex: M
Age: 25
State: AR

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Nurse at clinic incorrectly diluted a Pfizer vaccine vial with 0.8 ml of sodium chloride instead of 1.8 ml of sodium chloride and administered 0.3 ml to the patient. The patient experienced 104 degree fever with vomiting, dizziness and extreme muscle joint pain. We explained to him that we noticed the dose he was given had been diluted improperly and he had received a slightly higher than normal dose. I apologized for the incident and he said ?it?s ok?, and that now he knew why he was so sick. He was very pleasant and appreciative of us trying to contact him over the weekend. He was encouraged to contact us with any questions or if any new symptoms arise. We also offered to have one of our providers contact him to discuss further, but he declined.

Other Meds:

Current Illness:

ID: 1259508
Sex: F
Age: 20
State: UT

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Client received just NS instead of Pfizer COVID vaccine. Client was notified and recommended to return for a correct dose. Client returned on 04/24/2021 and received a correctly mixed dose of Pfizer vaccine. Lot number ER8735, intramuscular, in right deltoid.

Other Meds:

Current Illness:

ID: 1259509
Sex: M
Age: 37
State: WA

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

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

Lab Data:

Allergies:

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Needle came off syringe during administration, unsure if patient received full dose. Revaccinated in right arm

Other Meds:

Current Illness:

ID: 1259511
Sex: F
Age: 31
State: GA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: vaccine given below the deltoid muscle and per the patient's mother it was red and hot to the touch Friday evening thru the weekend. Mother sent pictures at 4 pm today (Monday, 4/26/21), slightly pink and mother reports that it is no longer hot. Patient has been active and has not complained of pain or discomfort since the vaccine was given on Friday per the mother. Clinic doctor prescribed Benadryl be given oral and will see the patient in the morning for a full examination. Mother was instructed to go to ER if things change or if she spikes a high fever. Mother voiced understanding.

Other Meds: unknown

Current Illness: none

ID: 1259512
Sex: U
Age: 77
State: CA

Vax Date: 04/19/2021
Onset Date: 04/23/2021
Rec V Date: 04/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: I already did.

Other Meds: 2nd shot - 4/23/21 11:20am 1st reaction: Hard to sleep; back pain, easy to confuse with severe aching muscle or kidney problems 2nd reaction 4/24/21 after midnight; did not notice rash across the left side of by body trunk from my sternum

Current Illness:

ID: 1259513
Sex: F
Age: 75
State: SD

Vax Date: 04/01/2021
Onset Date: 04/05/2021
Rec V Date: 04/26/2021
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Symptom List: Erythema, Pruritus

Symptoms: loss of hearing on left ear

Other Meds:

Current Illness:

ID: 1259514
Sex: F
Age: 39
State: MT

Vax Date: 04/23/2021
Onset Date: 04/25/2021
Rec V Date: 04/26/2021
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Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Headache, Fever, Chills , Swollen right eye

Other Meds:

Current Illness:

ID: 1259515
Sex: F
Age: 59
State: NE

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 04/26/2021
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Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Patient exhibits rash on inside of R arm after receiving 1st dose Pfizer vaccine in R deltoid. Patient also notes "dry throat". At 0953, RN administered 25mg oral liquid benadryl. 2nd dose 25mg benadryl liquid oral administered at 1015am. Patient rash diminished. Patient states "feeling great" and ready to go home after benadryl administration. Patient instructed to stay hydrated.

Other Meds:

Current Illness:

ID: 1259516
Sex: F
Age: 63
State: NC

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/26/2021
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Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Tiredness and lack of appetite - days 2 - 7 Cough (with mucus) - days 2 - 12 and ongoing

Other Meds: Omeprozole 20 mg Alendronate sodium 70 mg AReds Multi vitamin Fish Oil Calcium Vitamin D

Current Illness: none

ID: 1259517
Sex: F
Age: 16
State: TN

Vax Date: 04/16/2021
Onset Date: 04/26/2021
Rec V Date: 04/26/2021
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Allergies: NKDA

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Patient has not has an adverse event. When logging data into reporting agency, we were made aware that our nurse had given a 16 year old the Moderna vaccine which is for >18 years.

Other Meds: UNKNOWN

Current Illness:

ID: 1259518
Sex: F
Age: 43
State: MS

Vax Date: 04/25/2021
Onset Date: 04/26/2021
Rec V Date: 04/26/2021
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Allergies: none

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Pt received 1st Moderna immunization on left deltoid on Sunday 4/25/21 around 3:00 pm. Patient reported symptoms of arm pain at site of injection (left arm) starting around midnight 4/26/21. Symptoms became more noticeable next day around 5am 4/26/21. Patient reported arm pain/tenderness/soreness at injection site, as well as pain radiating down toward lower arm. Patient also reported signs of axillary pain and tenderness in the underarm area and near left breast.

Other Meds: n/a

Current Illness: none

ID: 1259519
Sex: F
Age: 48
State: OH

Vax Date: 03/29/2021
Onset Date: 04/05/2021
Rec V Date: 04/26/2021
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Symptom List: Pain in extremity

Symptoms: Exactly 1 week after receiving first dose of moderna, patient reported having a rash (4 to 5 inches in diameter) around injection site/upper arm. Rash was itchy and hot to touch and noticed bruising. Patient took tylenol and used an OTC anti-itch cream. Itchiness went away in 2 days and rash went away 1 week later.

Other Meds:

Current Illness:

ID: 1259520
Sex: M
Age: 36
State: TX

Vax Date: 03/30/2021
Onset Date: 04/07/2021
Rec V Date: 04/26/2021
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Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: tinnitus, ongoing

Other Meds:

Current Illness:

ID: 1259521
Sex: F
Age: 52
State: OR

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 04/26/2021
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Allergies: PCN

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Shortly after COVID vaccine #1 patient developed right sided tinnitus that progressed to bilateral. Later that evening she developed right facial tingling. The next day she developed right arm, leg and scalp tingling with mild. No change in mental status. 1 week later all symptoms resolved except bilateral tinnitus persists.

Other Meds: cholecalciferol, vitamin D3, 50 mcg (2,000 unit) capsule methocarbamoL (ROBAXIN) 500 mg tablet levothyroxine 125 mcg tablet VENTOLIN HFA 90 mcg/actuation inhaler gabapentin (NEURONTIN) 300 mg capsule zolpidem (AMBIEN) 5 mg tablet hydroCHLOR

Current Illness: Dyspnea, pleuritic chest pain and urinary urgency

ID: 1259522
Sex: F
Age: 52
State: IL

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 04/26/2021
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Allergies: NKA

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Numbness, pain, weakness, and purple spot on skin on all eft arm

Other Meds: none

Current Illness: HTN

ID: 1259523
Sex: F
Age: 30
State: CA

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 04/26/2021
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Allergies: na

Symptom List: Vomiting

Symptoms: Day 2 after the 1st dosage of the Covid 19 vaccine (Moderna) I noticed that I had a slight cough. I was not feeling ill. Other than the tiredness. The cough would come and go. It was in no sense persistent. Day 3 after the vaccine, my cough returned in morning, around 10:00AM. I was no longer feeling any of the described side effects but this cough was now noticeable. It went away in the afternoon, around 2:00pm. It returned at night, briefly before bed time at around 11:00pm. Day 4 the cough was all day. On and off. If I got excited and if I moved around too much it felt like an asthma cough. I would then feel uncomfortable in my breathing. It persisted all day. At night I could not lay down to sleep. I needed to be propped up. I needed to use my Alvesco inhaler. Day 5, In the morning the cough was not immediate, I used an air purifier the entire night and day. Used the Inhaler again. My breathing felt unconformable but it was not as bad as day 4. Day 6, the cough was gone. Only when going up stairs or moving around too much did it come back for a few mins then would go away. Inhaler used again at night. No air purifier. Am able to sleep laying down again. Day 7 I am feeling better now and no longer have discomfort breathing. No longer need inhaler.

Other Meds: Acetaminophen Extra Strength, Alvesco Ciclesonide Inhaler 80mcg/ acutation

Current Illness: na

ID: 1259524
Sex: F
Age: 39
State: WI

Vax Date: 04/08/2021
Onset Date: 04/13/2021
Rec V Date: 04/26/2021
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Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I have been breastfeeding a toddler since December 2018 and a baby since September 2020 with no issues. A few days after my 2nd dose I started having very painful clogged milk ducts in my right breast. A few days later it had progressed to mastitis and eventually was in both breasts. I had severe pain, fever, chills, etc. Started taking one antibiotic and after 4 days it still wasn't working so I went to the ER and got switched to a different antibiotic. I don't think the vaccine caused the mastitis but wanted to report it just in case.

Other Meds: Fluvoxamine ER 200 MG Prenatal vitamin Vitamin D B12 Iron

Current Illness: none

ID: 1259525
Sex: F
Age: 74
State: IN

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 04/26/2021
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Allergies: NONE

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Shot11 AM Sat .Sun morning bad headache upset stomach in bed all day Mon better kind of weak but much better

Other Meds: NONE

Current Illness: NONE

ID: 1259526
Sex: M
Age: 52
State: CO

Vax Date: 04/03/2021
Onset Date: 04/18/2021
Rec V Date: 04/26/2021
Hospital: Y

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Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient developed portal vein thrombosis and thrombocytopenia

Other Meds:

Current Illness:

ID: 1259528
Sex: F
Age: 64
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/26/2021
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Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Patient states 3 minutes after receiving the vaccine felt head to toe sensation of "blood rushed out of my body." Felt "nervy and tingling". States heart rate was 100 and was told she was pale. 2-3 days post vaccine developed severe left ear preauricular pain. Now continues to feel vertigo, lightheadedness, dizzy, on and off palpitations, fatigue, "nervy tingly" and some changes in short term memory.

Other Meds:

Current Illness:

ID: 1259529
Sex: M
Age: 29
State: MN

Vax Date: 03/30/2021
Onset Date: 04/13/2021
Rec V Date: 04/26/2021
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Allergies: Penicillin

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Chronic headache beginning ~2 weeks after the vaccination and continuing for roughly 2 full weeks after; pain level 2-3 out of 10. No treatment administered regularly, ibuprofen taken one time. Headaches have been reported through last week and seem to have subsided as of a few days ago. Onset of chronic tinnitus and individual "tinnitus events" roughly ~2 weeks after vaccination. 7 "tinnitus events" have been experienced where the patient reports rapid onset auditory muting in one or both ears with the onset of an audible frequency and will persist for roughly 5 seconds before quickly fading. The frequency has been both low frequency as well has high frequency during different events, and this has happened in each ear individually as well as both ears, random between events. The most recent tinnitus event happened yesterday, so the condition is ongoing. Chronic tinnitus has been reported as well, with a mild case of constant high-pitched tinnitus (roughly 8khz tone) that has continued from 2 weeks post vaccination to today.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am