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: 1281672
Sex: F
Age: 57
State: IL

Vax Date: 03/01/2021
Onset Date: 04/16/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: After TWO years of being in menopause, I had HEAVY bleeding out of nowhere.

Other Meds:

Current Illness:

Date Died: 01/08/2021

ID: 1281673
Sex: F
Age: 81
State: FL

Vax Date: 12/28/2020
Onset Date: 01/01/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: stroke leading to death

Other Meds: unknown

Current Illness: none

ID: 1281674
Sex: F
Age: 58
State: TN

Vax Date: 03/26/2021
Onset Date: 04/26/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Large Volume Pulmonary Embolus

Other Meds: Cytomel; Synthroid, Lipitor, Pepcid

Current Illness:

ID: 1281675
Sex: M
Age: 29
State: IN

Vax Date: 03/31/2021
Onset Date: 04/27/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Began having chest pains on the morning of 4/27. I was taken to the ER at 7pm. An EKG was ran and came back normal. Blood tests showed my Trop level was high. I was taken to another hospital via ambulance. My trop levels were taken 2 more times that night, both coming high at 3.49 and 4.19. They took two more EKGs that night. On the morning of 4/28, they conducted an echocardiogram that came back normal. On 4/29, they performed an angiogram at 1:45pm that came back with no blockages. I was discharged on 4/29 at 6pm with the diagnosis of myocarditis.

Other Meds:

Current Illness:

ID: 1281676
Sex: F
Age: 60
State: FL

Vax Date: 04/23/2021
Onset Date: 05/01/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: One week after 2nd dose of COVID vaccine, extremely dizzy and nauseous.

Other Meds: Synthroid .05 mcg

Current Illness: none

ID: 1281677
Sex: F
Age: 42
State: PA

Vax Date: 12/22/2020
Onset Date: 12/30/2020
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: PenicillinsOther (document details in comments) Sulfa (Sulfonamide Antibiotics)Other (document details in comments)

Symptom List:

Symptoms: Cough Fatigue Muscle or body aches Headache New loss of taste or smell Sore throat Congestion or running nose

Other Meds: amitriptyline (ELAVIL) 25 mg tablet levonorgestrel (MIRENA) 20 mcg/24 hr (5 years) IUD

Current Illness: None

ID: 1281678
Sex: F
Age: 53
State: CT

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

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

Lab Data:

Allergies: Lisinopril - Produced coughing side effect - haven't taken it in about 5 years.

Symptom List:

Symptoms: Severe pain about 2 hours after the injection in the area of my left shoulder/rotator cuff. Could not lift my arm up at all. Felt like someone ripped my rotator cuff. The pain was very intense, neither ibuprofen or Tylenol worked and I iced my shoulder. The severe pain lasted about a day and I'm still experiencing a sore/dull ache in my left shoulder. I also continue to have joint and muscle aches all over to this day which I did not have before the injection. About 4 days after the injection, I also developed a rash on the left arm of the injection site which cleared up about 3 days. I did not go see my primary care physician, because they would have told me to ice it and take over the counter pain meds. Also, the handwriting of the lot number is difficult to read: it's either 018B21N, or 018B21A for my second dose. My first dose is: 018B21A

Other Meds: Citalopram HBR 20mg, Hydrochlorothiazide 25 mg, Metoprolol Succ Er 50 mg, Rosuvastatin Calcium 20 mg, Losartan Potassium 100 mg, Womans One a day 50+ multivitamins

Current Illness: Perfectly healthy

ID: 1281679
Sex: M
Age: 32
State: OH

Vax Date: 03/29/2021
Onset Date: 04/09/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Approx 2 weeks after, Severe dizziness, mental fog, massive panic attacks, heart palpitations, nausea. High epinephrine levels seen in clinical testing. Brain MRI, Heart workup, Bloodwork all within normal levels, except epinephrine levels.

Other Meds: Lipator for high cholesterol

Current Illness: none

ID: 1281680
Sex: F
Age: 38
State: MD

Vax Date: 12/30/2020
Onset Date: 04/17/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Currently having hives that feel like bruises. might be totally unrelated to the vaccine. I took prednisone and they went away but then came back whenever i stopped.

Other Meds:

Current Illness:

ID: 1281681
Sex: F
Age: 39
State: MD

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: About 10 hours after injection began experiencing flu like symptoms: chills, feverish (did not take temp), body aches, in addition to arm pain. Extreme hot/cold feelings, chills aches and continued overnight. Took ibuprofen for relief. Following day, chills and fever were gone, but had extreme tiredness and aches. 48 hours after injection, felt better over all, but developed pain and swelling in armpit (assuming its lymph nodes) 72 hours post shot, armpit still a bit swollen-- tender and sore and painful when touched. Like a bruise.

Other Meds: Women's Daily Vitamin

Current Illness: none

ID: 1281682
Sex: F
Age: 28
State: CA

Vax Date: 03/01/2021
Onset Date: 04/02/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

Symptom List:

Symptoms: Pregnancy loss. First pregnancy, 5-6 weeks gestation

Other Meds: Prenatal vitamin

Current Illness:

ID: 1281683
Sex: F
Age: 39
State: MO

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: The excursion expiration date of 7 days thawed in refrigerator was followed because of the Pfizer email approving the 7 days. Policy was to follow the expiration of 5 days.

Other Meds:

Current Illness:

ID: 1281684
Sex: M
Age: 15
State: MN

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient falsified DOB when registering for vaccination, stating the minor was 05/28/2004. Guardian consented to the vaccination. Department of Health verified with statistical records that the patients actual DOB is 05/28/2005 which made the vaccine a contraindication. No known adverse reactions noted.

Other Meds:

Current Illness:

ID: 1281685
Sex: F
Age: 72
State: OK

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

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

Lab Data:

Allergies: doxycycline, voltaren, gentamycin

Symptom List:

Symptoms: n/a

Other Meds: tramadol, fexofenadine, methylPREDNIsolone, levothyroxine, albuterol, thiamine, hydroxyzine, cephalexin, folic acid, atenolol

Current Illness: n/a

ID: 1281686
Sex: F
Age: 22
State: NE

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: <15 min from immunization, individual experienced LOC <60 sec, hypotension, convulsions, and loss of bladder. Comfort care and oral fluids given, and donor recovered within 20 minutes. No EMS care necessary.

Other Meds: None

Current Illness:

ID: 1281687
Sex: F
Age: 15
State: MN

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient falsified DOB when registering for vaccination, stating the minor was 01/24/2005. Guardian, consented to the vaccination. Department of Health verified with statistical records that the patients actual DOB is 01/24/2006 which made the vaccine a contraindication. No known adverse reactions noted.

Other Meds:

Current Illness:

ID: 1281688
Sex: F
Age: 65
State: TX

Vax Date: 04/08/2021
Onset Date: 04/19/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: pulmonary embolism

Other Meds: ReliOn Insulin Syringe 1ML/31G Miscellaneous USE AS DIRECTED. Insulin Syringe 31G X 5/16 Miscellaneous as directed. Reglan 10 MG Tablet as directed Orally 4 times a day as needed. Diphenhydramine Cit-Aspirin 38.3-500

Current Illness:

ID: 1281689
Sex: F
Age: 63
State: IL

Vax Date: 03/28/2021
Onset Date: 04/18/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: 1st dose: hives that started 2 days post the injection and lasted 1.5 weeks 2nd dose: hives that started 5 days post the injection and hives are continuing to rise and blister.

Other Meds: None

Current Illness: None

Date Died: 04/30/2021

ID: 1281690
Sex: M
Age: 67
State:

Vax Date: 02/24/2021
Onset Date: 04/29/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Death Non-STEMI (non-ST elevated myocardial infarction) (CMS/HCC) Chronic renal failure

Other Meds:

Current Illness:

ID: 1281691
Sex: M
Age: 15
State: MN

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient falsified DOB when registering for vaccination, stating the minor was 01/09/2005. Guardian, consented to the vaccination. Department of Health verified with statistical records that the patients actual DOB is 01/09/2006 which made the vaccine a contraindication. No known adverse reactions noted.

Other Meds:

Current Illness:

ID: 1281692
Sex: M
Age: 75
State: UT

Vax Date: 03/13/2021
Onset Date: 03/16/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: cipro antibiotic

Symptom List:

Symptoms: lots of fatigue, neck and shoulder stiffness then sore ankle joints and more pain in knees than uasual. now over the last month and a half scince the shot i am having severe knee joint flare ups that are becoming more frequent. i have tried ice packs , heat. and i have an infrared sauna that usually helps and taking extra advils with no results. the only thing i have done different is had the shots. this something you are seeing in people my age. iam nomally very active and this is becoming very frustrating. do you have any suggestions

Other Meds: advil, vitamin c, mag cal supplement, b-complex, ashwaganda, krill oil,

Current Illness: none

ID: 1281693
Sex: F
Age: 49
State: MA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: A few hours after the injection, I had a feeling in the lips - similar to when novocaine wears off from the dentist (not the pins & needles, more like the cold numbness tingling). 24 hours after the injection, became very tired, and vertigo (have had in the past) also set in. The fatigue & vertigo were helped after a few doses of meclizine.

Other Meds: tri-legest fe

Current Illness:

ID: 1281694
Sex: F
Age: 26
State: IN

Vax Date: 05/01/2021
Onset Date: 05/02/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: Mango

Symptom List:

Symptoms: 12hours after my 2nd shot, I was woken up by pain. I had a fever of 101F. My whole body aches. I feel chill. I took 2 tablets of Tylenol at 8am the second day then another two tablets at 8pm.

Other Meds:

Current Illness:

ID: 1281695
Sex: M
Age: 36
State:

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pfizer vaccine vial was incorrectly diluted with 1.6ml of sterile 0.9%sodium chloride instead of 1.8ml. Pt was injected with 0.3ml of diluted vaccine. Vaccine administrator was informed of vaccine dilution error as soon as error was realized (after vaccine was administered). Patient was stable after administration and left clinic after observation. Clinic manager and supervising MD were notified on same day. I was advised to report event to VAERS per manager. Patient was not contacted per manager recommendation on 4/30.

Other Meds:

Current Illness:

ID: 1281696
Sex: F
Age: 70
State: MI

Vax Date: 03/06/2021
Onset Date: 04/01/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies: Anexsia - headache

Symptom List:

Symptoms: Submassive PE 5-6 weeks after the 2nd dose of COVID Moderna vaccine, no other pre-disposing factors other than hx of DVT after a surgery.

Other Meds: Aleve, Hair/Skin/Nails supplement, Vitamin D

Current Illness: none

ID: 1281697
Sex: M
Age: 34
State: NY

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: -vomiting; fevers; chills, fatigue starting 9 hours after vaccine administration -hives on arms; chest and bilateral legs 24 hours after vaccine administration -night sweats for 3 days

Other Meds: none

Current Illness: none

ID: 1281698
Sex: F
Age: 34
State: NY

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: squash, peas, eggs

Symptom List:

Symptoms: Approximately 11-12 hours after vaccination (2-3 AM), i woke up with many usual symptoms (headache, nausea, swollen lymph nodes, stiff neck, etc.) and one symptom that I have not heard about : muscle cramps & twitching. I also had this symptom after the first vaccination. Both times the onset of muscle cramps & twitching started approx 12 hours post injection and lasted for a total of 24 hours thereafter.

Other Meds: cymbalta (20mg), sprintec, mesalamine 1gm

Current Illness: none

ID: 1281699
Sex: M
Age: 13
State: MN

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient falsified DOB when registering for vaccination, stating the minor was 10/16/2004. Guardian, consented to the vaccination. Department of Health verified with statistical records that the patients actual DOB is 10/16/2007 which made the vaccine a contraindication. No known adverse reactions noted.

Other Meds:

Current Illness:

ID: 1281700
Sex: F
Age: 36
State: NJ

Vax Date: 05/02/2021
Onset Date: 05/02/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Shot injected into left shoulder. Immediate shock/pain radiated down arm into fingers. Not able to move arm past elbow. Cannot straighten left arm. Cannot lift left arm straight out or above head.

Other Meds: None

Current Illness: None

ID: 1281701
Sex: F
Age: 17
State: MN

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient falsified DOB when registering for vaccination, stating the minor was 05/26/2002 Guardian, consented to the vaccination. Department of Health verified with statistical records that the patients actual DOB, which made the vaccine a contraindication. No known adverse reactions noted.

Other Meds:

Current Illness:

ID: 1281702
Sex: F
Age: 17
State: PA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List:

Symptoms: PATIENT HAD NO ADVERSE REACTION VACCINE WAS ADMINISTER TO PATIENT UNDER AGE OF 18 PATIENT WAS 17 YEARS OF AGE

Other Meds: NA

Current Illness: NA

ID: 1281703
Sex: F
Age: 34
State: TX

Vax Date: 04/22/2021
Onset Date: 05/01/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: uritcarial rash

Other Meds: oral birth control (heather)

Current Illness: none

ID: 1281704
Sex: F
Age: 52
State: NC

Vax Date: 04/24/2021
Onset Date: 05/01/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: None aware of

Symptom List:

Symptoms: Red, rash-like circle developed on arm one week post-injection. There is also some swelling and soreness.

Other Meds: None

Current Illness: None

ID: 1281705
Sex: M
Age: 52
State: PA

Vax Date: 04/02/2021
Onset Date: 04/16/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies: unknown

Symptom List:

Symptoms: Per call with hospital infection control nurse, client reported lower extremity weakness at hospital 4/16/21 and was advised to follow up with family physician. Client admitted to hospital 4/18/21 with severe lower extremity weakness. Weakness progressed to upper extremities. Diagnosis of guillain-barre was made. No mechanical ventilation required. Client to be discharged to rehabilitation center.

Other Meds: unknown

Current Illness: unknown

ID: 1281706
Sex: M
Age: 35
State: CO

Vax Date: 04/29/2021
Onset Date: 05/02/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Patient received his 2nd dose of the COVID vaccine (pfizer) on 4/29/21. The next day he developed a fever of 103 F which lasted about 36 hours. He felt achy and generalize malaise and felt sweaty in the evening on 5/1. Presented to ED on 5/2 with chest pain and shortness of breath. Patient given nitro x3, asa, and heparin gtt and transferred for ongoing management of NSTEMI. Family history of CAD; grandfather and all 6 of his brothers died from heart attack

Other Meds: Men's multivitamin, denies other supplements. High blood pressure (never on meds)

Current Illness:

ID: 1281707
Sex: M
Age: 75
State: FL

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Stiff/painful neck x 1.5 mos immediately followed by outbreak of Shingles on ant chest wall

Other Meds: Lisinopril 20mg Verapamil 120mg

Current Illness: none

ID: 1281708
Sex: F
Age: 23
State: MN

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Vaccinator administered only 0.1 cc after realizing her mistake she gave 2nd vaccination of 0.2 cc.

Other Meds:

Current Illness:

ID: 1281710
Sex: F
Age: 36
State: FL

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 05/03/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Allergies: Penicillin

Symptom List:

Symptoms: Numbness in left side of the body after few hours of getting the vaccine. This only lasted for a few hours. After few hours and to this day, only the left side of the face feels kind of numb at times. Not every day. Haven't received any medical treatment for this.

Other Meds: None

Current Illness: None

ID: 1281711
Sex: M
Age: 59
State: MN

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 05/03/2021
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Symptoms: Nurse gave pt 2 doses of Janssen vaccine in the smae arm using a 1" needle, then a 1.5" needle. Nurse was removed immediately & counseled. No known adverse reactions noted.

Other Meds:

Current Illness:

ID: 1281712
Sex: F
Age: 32
State: IL

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 05/03/2021
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Allergies: Ceclor, Demerol, Penicillin

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Symptoms: The evening after, my inner labia began to burn. The next day, I developed blistering which slowly turned black. I then went to the doctor with excruciating pain and proceeded to faint from the pain in Walgreen's while waiting for the lidocaine topical to treat the affected area. I saw an OBGYN that afternoon who also had her partner look at the affected area. Both agreed they had never seen anything like this and set me up to have my blood drawn and see a dermatologist within the hour. The dermatologist concluded it looked like shingles (which was negative) and sent me home with an anti-viral prescription. Once home, the pain and area got worse and turned black and white. I went to the dermatologist for a follow-up once all the tests were negative and she informed it was worse and has been checking on me since. I received a cortisone shot and was put on Doxycycline, in addition to the pain medication. The necrotic black tissue fell off, exposing an open ulceration on the inner labia that is extremely painful. Every doctor agreed the vaccine was the cause but nobody knows what is wrong. The pain remains 10 days later to the point of inability to function.

Other Meds: Calcium, Spironolactone, Minoxidil, Fish Oil, Nutrafol, CBD Oil, Vitamin D

Current Illness: None

Date Died: 05/01/2021

ID: 1281713
Sex: F
Age: 68
State:

Vax Date: 02/27/2021
Onset Date: 04/29/2021
Rec V Date: 05/03/2021
Hospital: Y

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Symptoms: This 73 year old black female received the Covid shot on 2/27/21 and went to the ED on 4/29/21 and was admitted on 4/29/21 with respiratory distress, cardiac arrest and other symptoms and died on 5/1/21 . Please refer to the other details submitted within this report and contact the person who submitted this report via email for additional follow up details and investigation.

Other Meds:

Current Illness:

ID: 1281714
Sex: F
Age: 80
State: OR

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 05/03/2021
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Allergies: Black Truffle, benadryl, marcaine, lidocaine, tetracaine,tetracycline, SSRI's

Symptom List:

Symptoms: 3-4 hr onset fatigue. for 3 days confined to bed from fatigue. Has slowly remitted. - Now - 8 weeks after second shot still daily fatigue, pedal edema with activity. Nap required daily. Occasional episodes of sleep disruption. 2-4 days severe arthritis flare with rheumatoid joints swelling as well as mild swelling in OA joints: fingers, wrists, elbows, neck, back, hips, knees and ankles. deformity of dips, not previously present. Now, 8 weeks later, swelling resolved but arthritis still worse than prior to 2nd immunization. Severe bruising in R upper arm. 8 weeks later still have brown discoloration over6 inch area - INR increased to 5.4 3-4 hour mild headache lasted 2 days reoccurred 2 or 3 times over the week

Other Meds: warfarin,prednisone,CoQ10,resveratrol,Pro-omega,Ca/Mg,flonase,Optique,candasartin, APAP, methadone, yunnan bai yao patches, Traumeel S,

Current Illness: clotting disorder, osteoarthritis, connective tissue disease, slight residual fatigue from first covid vaccine

ID: 1281715
Sex: M
Age: 17
State: WI

Vax Date: 04/23/2021
Onset Date:
Rec V Date: 05/03/2021
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Allergies: No allergies

Symptom List:

Symptoms: Patient was given the vaccine without the vaccine being put into RECIN first. Writer/administering staff thought that COVID vaccines were not put in RECIN first but instead just given the card with the information. When I attempted to add the vaccine into RECIN the next day when I found out I was suppose to put it in; it would not go in. I contacted my manager immediately.

Other Meds: methylphenidate HCL and multivitamin with Iron-Mineral

Current Illness: None

ID: 1281716
Sex: M
Age: 34
State: MN

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 05/03/2021
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Symptoms: While nurse was injecting vaccine into pt arm, the needle separated from the syringe causing the vaccine to spray all over arm. Estimating less than 50% of vaccine was injected into pt.1st Pt was administered another does of 0.5 ml immediately with pt consent.

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Current Illness:

ID: 1281717
Sex: F
Age: 38
State: MA

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 05/03/2021
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Allergies: None

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Symptoms: Elevated heart rate: sleeping 1a-9a average heart rate was 96 bpm (compared to normal average of 66 bpm). Heart rate remained elevated (resting, 90-120 bpm) until early afternoon 4/18

Other Meds: None

Current Illness: None

ID: 1281719
Sex: F
Age: 64
State: NY

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/03/2021
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Allergies: Lidocaine, penicillin, ampicillin, doxycycline, Para-phenylenediamine (PPD), garlic, green/red/yellow/orange peppers, all onions except red.

Symptom List:

Symptoms: Fever of 101, body aches, severe ongoing headache, chills, rash, itching

Other Meds: nothing

Current Illness: None

ID: 1281721
Sex: F
Age: 52
State: MN

Vax Date: 01/31/2021
Onset Date: 01/31/2021
Rec V Date: 05/03/2021
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Symptoms: Due to faulty syringe vaccine squirted out of syringe during injection. Pt received at least 0.3 ml. No additional vaccine given.

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Current Illness:

ID: 1281722
Sex: F
Age: 35
State: MO

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 05/03/2021
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Symptoms: The excursion expiration date of 7 days thawed in refrigerator was followed because of the Pfizer email approving the 7 days. Pharmacy policy was to follow the expiration of 5 days.

Other Meds:

Current Illness:

ID: 1281723
Sex: F
Age: 57
State: IA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 05/03/2021
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Allergies: Chantix

Symptom List:

Symptoms: Later that night back off knee started to hurt needed day pain has spread to include a larger area. Noticed blisters on Friday. Saw Dr. Monday

Other Meds: Dextroamphetamine 10 MG (6/day)- Attenolol 10mg (3/day) - Venlafaxine HLR ER 150 MG (2/day) - Sertraline HCL 50 mg (5/day) - Buspirone 15 MG (4/day) - Rexulti 2 mg (1/day) - Zolpidem Tartrate 10 mg (1/day) - Lamotrogine Tablets 100 mg (2/d

Current Illness: None

ID: 1281724
Sex: M
Age: 26
State: TX

Vax Date: 03/21/2021
Onset Date: 04/30/2021
Rec V Date: 05/03/2021
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Allergies: None

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Symptoms: Tested Positive for COVID-19. No severe symptoms. Mild symptoms. Feels like really bad allergies. Lots of sneezing.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm