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: 1270672
Sex: F
Age: 55
State: PA

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

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

Lab Data:

Allergies: Codeine, Lisinopril, Penicillin, Celecoxib,Atorvastatin

Symptom List:

Symptoms: Very sore arm the next day that went away a couple days later only to come back a week after very painful and swollen. The ringing in the ears started right after I walked out of the hospital and has only gotten louder since.

Other Meds: Taltz, Gabapentin, Metoprolol, Pravastatin, Metformin, Ginger Root, Garlic Extract, Multi-Vitamin,

Current Illness: None

ID: 1270673
Sex: M
Age: 22
State: VT

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

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

Lab Data:

Allergies: None listed

Symptom List:

Symptoms: pt tipped his head back and then fell & caught himself ( maybe fainted for 2 seconds) extremely white, clammy, sweaty, light headed. sat with him and he drank water ,for 15 minutes friend brought him home.

Other Meds: Unknown

Current Illness: Unknown

ID: 1270674
Sex: M
Age: 80
State:

Vax Date: 03/10/2021
Onset Date: 03/17/2021
Rec V Date: 04/29/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient hospitalized within 60 days of receiving a COVID vaccine

Other Meds:

Current Illness:

ID: 1270675
Sex: M
Age: 34
State: CA

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: DURING ADMINISTRATION, RN NOTED 70 % OF THE VACINE LEAKED OUT BY THE LEUER TAPER. PT WAS GIVEN 0.3 ML OF PFIZER IN THE RIGHT DELTOID.

Other Meds:

Current Illness:

ID: 1270676
Sex: F
Age: 68
State: PA

Vax Date: 03/17/2021
Onset Date: 04/08/2021
Rec V Date: 04/29/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Suffered a stroke on April 7th 2021

Other Meds: none

Current Illness: none

ID: 1270677
Sex: M
Age: 12
State: NM

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: None reported by the parent via the school immunization consent form

Symptom List:

Symptoms: After receiving all three vaccines (HPV, MCV4 and Tdap) patient fainted. Patient was awaken by RN that administered the vaccine by using an alcohol swab and when the patient was stable he was taken to the nurses office by RN. Vital signs were taken B/P: 116/74 and HR: 101. Patient was given to juices and the RN stated the patient did complain about ringing in the ears otherwise was feeling better. Patient was picked up by his grandmother and she explained to the RN that he is afraid of needles.

Other Meds: None reported by the parent via the school immunization consent form

Current Illness: None reported by the parent via the school immunization consent form

ID: 1270679
Sex: M
Age: 45
State: NJ

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Fever, Chills, aches, nausea, diarrhea, fatigue, dizziness

Other Meds: Depakote Clonezapam Lexapro

Current Illness: n/a

ID: 1270680
Sex: F
Age: 39
State: IN

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

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

Lab Data:

Allergies: coconut, avocado

Symptom List:

Symptoms: Patient c/o tingling in mouth and tongue, and in hand 25 minutes post vaccination. Patient states this happened last time and resolved with Benadryl. No c/o SOB, lightheadedness, itchiness/rash. Does not appear to be in respiratory distress. Gave 25mg liquid Benadryl at 11:15am. Pt stayed 20 minutes, no change in symptoms. Advised to ER for possible reaction but patient declined and said she would be with someone and they would call 911 if any worse.

Other Meds: unknown

Current Illness: unknown

ID: 1270681
Sex: F
Age: 43
State: CT

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Have had severe localized reactions to flu vaccines in the past, no adverse reactions from 1st COVID vaccine.

Symptom List:

Symptoms: Fatigue, fever of 100-102, nausea, dizziness, headache, body aches, foggy thoughts. Fatigue started about 12 hours post injection. All symptoms are still present 48 hours post injection.

Other Meds: Rx Vitamin D 1x weekly (Saturday?s)

Current Illness: None

ID: 1270682
Sex: F
Age: 31
State: NJ

Vax Date: 01/30/2021
Onset Date: 04/11/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Late period

Other Meds: Collagen

Current Illness:

ID: 1270683
Sex: U
Age: 34
State: OR

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

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

Lab Data:

Allergies: Shellfish

Symptom List:

Symptoms: Onset of dizziness, shortness of breath, nausea, headache. Symptoms lasted App 30 minutes without resolution. Pt transported via ambulance to hospital.

Other Meds: Zyrtec, Albuterol

Current Illness: None known

ID: 1270684
Sex: F
Age: 62
State: CA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: increased tinnitus in left ear

Other Meds: Prozac

Current Illness: none

ID: 1270685
Sex: F
Age: 23
State: IN

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Augmentin

Symptom List:

Symptoms: Fever (100.5 persisting ~12 hours) Chills/sweats Aches Fatigue

Other Meds: Birth Control

Current Illness:

ID: 1270686
Sex: F
Age: 39
State: MD

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

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

Lab Data:

Allergies: None listed in chart, however, pt states this has happened after receiving flu vaccine

Symptom List:

Symptoms: Pt received vaccine about 1045 am, and complained of chest pain, throat closing and dizziness at 1055 am. Pt taken to urgent care. Pt d/c to home at 1113 in stable condition.

Other Meds: None

Current Illness: None

ID: 1270687
Sex: F
Age: 49
State: MN

Vax Date: 01/07/2021
Onset Date: 04/25/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Positive covid after fully vaccinated

Other Meds:

Current Illness:

ID: 1270688
Sex: M
Age: 20
State: MS

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List:

Symptoms: Reason for visit: Pfizer vaccine reaction HPI 20 year old 1st dose of Pfizer vaccine 6:15 PM mon 4/5/21 observed for 15" and mild pain at injection site Tuesday 4/6/21 noticed that his lips were feeling "sensitive" But didn't notice any swelling-sometimes gets similar feeling when he is fatigued Wednesday 4/7/21 noticed swelling of his lips. Called parents. Lips were swollen and he noticed some drainage of clear fluid-if he took a tissue and pressed against his lips would be a small amount of fluid. No blister. Took 200mg of ibuprofen once. Right now lips are dry. Today still feels like lips are swollen top and bottom and feels dry and "hard" Admits to cracks at angle of lips No swelling tongue or throat. No rash, flushing, rash, dizziness, lightheadedness, presyncope, syncope, n/v/d, difficulty swallowing or breathing, itching, diaphoresis No hx cold sores. No prior history of allergy No known allergies. No allergy or reaction to vaccines, food, medications, stings/insects No seasonal allergies, asthma, ecezma ACTIVE PROBLEMS: There are no active problems to display for this patient. REVIEW OF SYSTEMS: Per HPI No fevers, chills, loss taste or smell, myalgia/arthralgia, chest pain, dyspnea, cough, conjunctivitis PERSONAL HISTORY: No cig/vaping/marijuana No ETOH Not kissing anyone, not sharing drinks, not sexually active CURRENT MEDS: ibuprofen Allergies: Allergies Allergen Reactions ? Pfizer Covid-19 Vaccine (Eua) [Covid-19 Vacc,Mrna(Pfizer)(Pf)] Lip Swelling Patient reported vitals/weight: There were no vitals filed for this visit. Weight lbs. Exam: + dry skin upper and lower lips, + lesions with yellow crusting, largest left upper lip and along lower border ASSESSMENT AND PLAN: o Swelling of both lips (primary encounter diagnosis) Suspect delayed allergic reaction to the 1st dose Pfizer vaccine Lip swelling Still with mild swelling, dry peeling skin, and yellow crusting Start zyrtec 10mg daily Start mupirocin three times a day Report any new or worsening symptoms Student knows to call Acute Care. Gave Dr.'s cell phone number if he cannot get thru to AC Follow up with me Monday Forward visit note to EH Refer to Allergy clinic for recommendations regarding 2nd dose Pfizer vaccine I have reminded them of our office number should they need a more urgent appointment. Return in about 3 days (around 4/12/2021) for in person visit for follow up allergic reaction. No orders of the defined types were placed in this encounter. Requested Prescriptions Signed Prescriptions Disp Refills ? mupirocin (BACTROBAN) 2 % cream 15 g 0 Sig: Apply topically 3 (three) times daily for 7 days. I spent 25 minutes with the patient, of which 15 minutes were spent reviewing data, counseling and coordination of care. Specifically we discussed my impression of the etiology of the patient's symptoms, interpretation of test results, management plan, and acute symptoms for which to seek immediate medical attention.

Other Meds: none known

Current Illness: none known

ID: 1270689
Sex: F
Age: 66
State: NY

Vax Date: 03/21/2021
Onset Date: 03/22/2021
Rec V Date: 04/29/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Entered hospital on 3/22/21 At around 8am in the emergency room. Had ultrasound of left leg and was placed in ICU for a massive blood clot in the left leg. Had surgery at around 4pm on 3/22/21 and placed back in ICU until the next surgery on 3/23/21 to remove the blood clot. Was released on 3/25/21.

Other Meds: Propanolol, Hydrochlorothiazide

Current Illness:

Date Died: 04/27/2021

ID: 1270690
Sex: F
Age: 82
State: TN

Vax Date: 04/08/2021
Onset Date: 04/15/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

Symptom List:

Symptoms: Patient developed shortness of breath 3 days post injection. Death due to COVID-19 pneumonia 4/27/21

Other Meds: Abilify, Indapamide, Citalopram, Buspirone, Simvastatin, Vitamin B12, Wellbutrin, Albuterol, Losartan, Metoprolol, Advair, Vitamin D, Levothyroxine, Toviaz, Nexium, Aspirin

Current Illness: none

ID: 1270691
Sex: F
Age: 15
State: MI

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: On intake form stated that date of birth was 6/22/2004, father stated patient 16 years of age or older but had no ID to verify that. When trying to resolve billing issues later in the day, insurance has date of birth of 6/22/2005. Father informed that since ID was not provided to confirm patient age the second dose will not be completed

Other Meds:

Current Illness:

ID: 1270692
Sex: F
Age: 48
State:

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: After first dose 21 days prior, pt reported some tingling in mouth. After this second dose pt developed tongue/throat tingling, itching, clearing throat, anxiety, and diaphoresis. Pt given Benadryl and Epipen and was sent to ED.

Other Meds:

Current Illness:

ID: 1270693
Sex: F
Age: 72
State: LA

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Meds

Symptom List:

Symptoms: Seconds min after shot flushed red, & felt dizzy. My arm, neck shoulder, under arm & breast swole up with enlarged lymph nodes & glands. Had chills, low fever. After it did not clear up in 2 weeks- calmed doc- referred to allergy specialist. Still have swelling. Not as bad. Has not completely gone down.

Other Meds: Heart meds

Current Illness: No

ID: 1270694
Sex: F
Age: 27
State: VA

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Percocet

Symptom List:

Symptoms: Dizziness, blurred vision, hot/cold, nausea, Vertigo; Dizziness, blurred vision - lasted 45 minutes. 4/29/21 - typical side effects today except for pain behind eyes with headache.

Other Meds: None

Current Illness:

ID: 1270695
Sex: F
Age: 25
State: WI

Vax Date: 04/01/2021
Onset Date: 04/21/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List:

Symptoms: Tested PCR Covid positive more than 2 weeks after receiving 2nd Covid 19 vaccine. #1 dose 03/11/2021. Symptomatic with fatigue, nausea, loss of taste.

Other Meds: unknown

Current Illness: unknown

ID: 1270696
Sex: F
Age: 84
State:

Vax Date: 03/11/2021
Onset Date: 03/18/2021
Rec V Date: 04/29/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Developed a platelet count of 07 days after vaccination.

Other Meds: Biotin, hydrochlorothiazide, Centrum Silver, losartan, amlodipine, co-Q10, Colace, vitamin D, PreserVision, Crestor, Zyrtec, Advair Diskus, fenofibrate, Lovaza, ranitidine and ASA

Current Illness: Lung cancer

ID: 1270698
Sex: F
Age: 52
State: PA

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: amox, latex

Symptom List:

Symptoms: Woke up at 1 am with a temp of 101.7, pounding headache, tiredness, achy and nauseous. Took 2 Tylenol and went back to bed. Woke up at 6 fever was gone, but still had pounding headache, achiness, and fatigue. Called into work to call out sick.

Other Meds: HCTZ, effexer, calcium, multi vit

Current Illness:

ID: 1270699
Sex: F
Age: 59
State: IL

Vax Date: 04/08/2021
Onset Date: 04/23/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: superficial blood clot in right leg

Other Meds: none

Current Illness: none

ID: 1270700
Sex: F
Age: 56
State: MI

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Contrast dye

Symptom List:

Symptoms: Fever 102.5 sore arm but not as bad as first dose.

Other Meds: Tylenol, Omeprazole

Current Illness: None

ID: 1270701
Sex: F
Age: 37
State: NC

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: ragweed, cats

Symptom List:

Symptoms: Fever, chills, rigors, muscle aches, headache, insomnia, sore arm beginning 12 hours after dose and resolving 24 hours after beginning. Sweating for 4-6 hours after this. Fatigue and headache following.

Other Meds: Junel, Lexapro

Current Illness:

ID: 1270702
Sex: F
Age: 36
State: CA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List:

Symptoms: one of our County Ambulance staff inadvertently used the same syringe to vaccinate eight people, he did change the needles in between each patient.

Other Meds: Unknown

Current Illness: Unknown

ID: 1270703
Sex: F
Age: 56
State: WV

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/29/2021
Hospital: Y

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

Lab Data:

Allergies: unknown

Symptom List:

Symptoms: Patient presented for her COVID vaccine. She completed paperwork for vaccine and it was determined that she was eligible to receive the COVID vaccine. She received her Pfizer vaccine at 8:28 am. About 3 minutes after receiving the vaccine, the nurses noticed that she was looking pale. The patient told them that she was not feeling well. She became diaphoretic and this NP was alerted. At 8:35 the patient lost all color, diaphoresis increased and she had a syncopal episode. We removed her from the chair and lowered her cautiously to the floor. This NP was able to arose by sternal rub. Wheezes were noted upon auscultation on right side. At 8:38 am Epi 0.3 mg was administered to left thigh - injector held to leg for 10 second count. 8:45 am 20 G place into right hand by nurse. 8:46 am EMS on scene

Other Meds: unknown

Current Illness: none

ID: 1270704
Sex: F
Age: 47
State: PA

Vax Date: 04/21/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: cashews- non life-threatening

Symptom List:

Symptoms: Symptoms started at 7:00am. I had already been awake for two hours, drank a cup of coffee and had been standing and sitting during this time feeling fine; then I felt my head getting very light and had to go sit down. Even sitting down did not really help the light-headedness go away, I proceeded to laydown, close my eyes and breath deep. The feeling lessened after 10 or more minutes but I am still feeling wobbly and my mind is not fully clear and alert. I have eaten a full meal and proceed to drink water but my head feels foggy and like I could pass out if I move too quickly or stand for too long.

Other Meds: 125mcg vitamin D3, 2 tsp. Metamucil

Current Illness: none

ID: 1270705
Sex: F
Age: 57
State: UT

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Body and muscle pain, joint pain, nausea, headache, taste change, fatigue, body weakness

Other Meds: Lyrica, Duloxetine, Bupropion, Omeprazole, Buspirone, Metformin, HCTZ, Atorvastatin, Iron, Metoprolol, Vitamin D3

Current Illness:

ID: 1270706
Sex: F
Age: 29
State: TX

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: HALOPERIDOL

Symptom List:

Symptoms: PT was given a second dose of a one time dose vaccine, Janssen COVID vaccine. No signs/or symptoms of difficulty or none reported at this time.

Other Meds: NONE

Current Illness: NONE

ID: 1270707
Sex: M
Age: 30
State: CO

Vax Date: 04/27/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Sore arm on day of shot and second day of shot third day swollen lymph node under arm pit near chest

Other Meds:

Current Illness:

ID: 1270708
Sex: F
Age: 53
State: RI

Vax Date: 04/26/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: menstral flooding (clots, more than 2 super max tampons in 3 hours)

Other Meds: Levathyroxine, multivitamin, potassium

Current Illness: None

ID: 1270709
Sex: M
Age: 39
State: WA

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

Vax Type:
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Symptom List:

Symptoms: pt was vaccinated early

Other Meds:

Current Illness:

ID: 1270710
Sex: F
Age: 47
State: IN

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
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Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Chills, body aches, fever (up to 102.9), and extreme tiredness for about 24 hours

Other Meds: Lamictal, Prozac, toprol, singulaire

Current Illness:

ID: 1270711
Sex: M
Age: 74
State: TX

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
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Symptoms: THERE IS ACTUALLY NO KNOWN ADVERSE EVENT YET, BUT THE PATIENT RECEIVED THE 1ST DOS OF MODERNA VACCINE AT OUR STORE. WIFE CALLED TODAY AND SAID THAT THEY RECEIVED THE FIRST DOSE OF PFIZER ON 04/20/2021. THE PATIENT APPARENTLY DIDN'T REMEMBER THAT HE HAD PREVIOUSLY RECIEVED A DOSE OF THE PFIZER VACCINE. ADVISED PATIENT TO CALL DOCTOR AND ADVISE SO HE CAN DETERMINED WHETHER HE SHOULD STILL RECEIVE 2ND DOSE OF PFIZER WHEN SCHEDULED.

Other Meds:

Current Illness:

ID: 1270712
Sex: M
Age: 59
State: TN

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/29/2021
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Allergies: NONE

Symptom List:

Symptoms: MUSCLE PAIN THAT STARTED THE DAY AFTER THE SECOND DOSE OF PFIZER COVID VACCINE AND IS PERSISTING AND WORSENING WITH TIME. WE ARE OVER THREE WEEKS OUT AND HIS MUSCLE PAIN SEEMS TO BE SPENDING. THE PAIN STARTED IN THE LEFT SHOULDER AND IS NOW IN BOTH SHOULDERS AND ARMS.

Other Meds: BENAZEPRIL AND ATORVASTAIN

Current Illness: NONE

ID: 1270713
Sex: F
Age: 40
State: RI

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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Lab Data:

Allergies: Pennasilin

Symptom List:

Symptoms: Ear and face swelling. Headache nausea body aches chills. I tool benadryl and ibprophin

Other Meds: Levothyroxine,amlodipine

Current Illness: I had covid about 3 weeks prior

ID: 1270714
Sex: F
Age: 67
State: IN

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 04/29/2021
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Allergies: None

Symptom List:

Symptoms: 18 hours after getting vaccine in my left arm, I had body aches, headache and chills which lasted off & on for 3 days. 48 hours after getting vaccine in my left arm I developed a faint pink, itchy rash that ran from my shoulder down to my elbow. At the same time, I developed swollen lymph nodes in my left armpit. As of 04/28/2021, the lymph nodes are no longer swollen but the rash is still pink and itchy.

Other Meds: Tamoxifen 20 mg. 1 x daily Pilocarpine 5 mg. 4 x daily Citalopram HBR 10 mg. 1 x daily

Current Illness: None

ID: 1270715
Sex: M
Age: 91
State:

Vax Date: 03/04/2021
Onset Date: 03/23/2021
Rec V Date: 04/29/2021
Hospital: Y

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Symptoms: Patient hospitalized within 60 days of receiving a COVID vaccine

Other Meds:

Current Illness:

ID: 1270716
Sex: M
Age: 37
State: MD

Vax Date: 03/30/2021
Onset Date: 04/09/2021
Rec V Date: 04/29/2021
Hospital:

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Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Herpes zoster (shingles) in T4-5 dermatome on right side, starting 10 days after second vaccination. Patient prescribed a 7 day course of acyclovir with resolution of symptoms within 2 weeks.

Other Meds: none

Current Illness: none

ID: 1270717
Sex: F
Age: 44
State: MI

Vax Date: 04/08/2021
Onset Date: 04/10/2021
Rec V Date: 04/29/2021
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Allergies: none

Symptom List:

Symptoms: Menstrual cycle disruption - Received shot 4/8, started spotting 4/10. Started period 4/12. Lasted until 4/16. Then started spotting again on 4/24, spotting continues to today 4/29, where started period-heaviness bleeding again this morning.

Other Meds: none

Current Illness: none

ID: 1270718
Sex: F
Age: 39
State: KS

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
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Lab Data:

Allergies: NEOMYCIN

Symptom List:

Symptoms: EXTREME FATIGUE, MUSCLE SORENESS ENTIRE BODY, EXTREME JOINT PAIN ENTIRE BODY - ALL THIS BEGAIN AROUND 4:00AM ON 04/28 AND CONTINUED UNTIL AROUND 3AM 04/29. AT THAT TIME PATIENT NOTICED A FULL BODY RASH WHICH WAS VISIBLE AS WELL AS VERY ITCHY. ALL OTHER SIDE EFFECTS HAD SUBSIDED AND AT REPORT TIME 11:00AM ON 04/29/2021 RASH SEEMS TO BE THE ONLY SIDE EFFECT REMAINING.

Other Meds: NONE

Current Illness: NONE

ID: 1270719
Sex: F
Age: 40
State: SC

Vax Date: 04/21/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
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Allergies: None

Symptom List:

Symptoms: I woke up 7 days after vaccine with a red, raised, rash on my left arm appx 4" x 2"

Other Meds: Prozac

Current Illness: None

ID: 1270720
Sex: F
Age: 40
State: CA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/29/2021
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Symptom List:

Symptoms: Swelling at injection site, erythematous rash. Received Benadryl 25 mg PO.

Other Meds:

Current Illness:

ID: 1270721
Sex: F
Age: 41
State: CA

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
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Symptom List:

Symptoms: Palpitations, nausea, vomitedx1, body aches, dizziness, chills

Other Meds:

Current Illness:

ID: 1270722
Sex: F
Age: 35
State: MN

Vax Date: 04/07/2021
Onset Date: 04/14/2021
Rec V Date: 04/29/2021
Hospital:

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Lab Data:

Allergies: penicillin

Symptom List:

Symptoms: Red, itchy, swollen arm at injection site for 4-5 days Did not do anything other than some regular lotion to help with itching and the swollenness went away on its own

Other Meds: oral birth control

Current Illness: none

ID: 1270723
Sex: M
Age: 61
State: PA

Vax Date: 12/18/2020
Onset Date: 01/02/2021
Rec V Date: 04/29/2021
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Lab Data:

Allergies: Tramadol Esomeprazole Magnesium

Symptom List:

Symptoms: HEADACHE

Other Meds: amLODIPine (NORVASC) 5 mg tablet azelastine (ASTELIN) 137 mcg (0.1 %) nasal spray cetirizine (ZyrTEC) 10 mg tablet clonazePAM (KlonoPIN) 0.5 mg tablet colestipoL (COLESTID) 1 gram tablet DULoxetine (CYMBALTA) 60 mg capsule escitalopram (LEX

Current Illness: none

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm