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
79,774
AK1,685
AL5,660
AR3,642
AS44
AZ13,762
CA60,607
CO11,423
CT8,212
DC1,673
DE1,752
FL38,310
FM3
GA14,095
GU88
HI2,280
IA4,474
ID2,549
IL20,223
IN22,966
KS4,447
KY7,398
LA4,981
MA14,515
MD12,404
ME3,095
MH8
MI18,744
MN11,773
MO9,331
MP30
MS2,829
MT2,218
NC16,140
ND1,305
NE2,851
NH2,981
NJ18,199
NM3,825
NV4,302
NY34,234
OH18,888
OK6,128
OR8,309
PA23,571
PR2,203
QM2
RI1,962
SC6,398
SD1,165
TN9,169
TX35,814
UT4,203
VA14,534
VI50
VT1,723
WA14,409
WI10,778
WV2,299
WY847
XB5
XL1
XV2

ID: 1282775
Sex: F
Age: 46
State: VA

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: Dairy Gluten Bee/wasp venom Sulfa

Symptom List:

Symptoms: 4/29/21- date of shot, tongue tingling, throat swelling within 10min of shot 4/30/21- fatigue, sore arm 5/3/21- headache, sore throat, tongue tingling/swelling, throat swelling (moderate)

Other Meds: Adderall Lo Loestrin Fe Montelukast Fluticasone

Current Illness:

Date Died: 04/23/2021

ID: 1282776
Sex: M
Age: 79
State: MO

Vax Date: 03/03/2021
Onset Date: 03/17/2021
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: March 22 had a stroke, admitted, respiratory entire time, then rec'd death certificated Death Certificate

Other Meds:

Current Illness:

ID: 1282777
Sex: M
Age: 25
State: VA

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

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

Lab Data:

Allergies: Effexor, Morphine, robaxin, Bactrum

Symptom List:

Symptoms: 8 hours later burning feeling all over body, rash across the forehead, 2 weeks later swollen gland/infection on left side of ear and face

Other Meds: baclofin, gabapentin, benadryl, amantadine, B, C, magnesium

Current Illness:

ID: 1282778
Sex: F
Age: 30
State: AK

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 05/03/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Approximately 14 hours after the shot I woke up with extreme shivers (2:30am). I had shivers for 45 minutes until I climbed into a warm bath. The shivers stopped and I became extremely tired. I got out of the bath and had to climb back to bed because the room was spinning and I was nauseous. I did not have a fever at this time. I was able to go back to sleep. I woke up about 2 hours later sweating and with a fever of 100.7. I slept for another 3-4 hours and woke up symptom free. My morning went on normal. Ate breakfast and hung out. I was tired in the early afternoon and took a 4 hour nap which is not normal but expected since I didn't get a good night sleep with symptoms mentioned above in the middle of the night. I also missed my period that month. My period was supposed to start March 30th and it never came. Confirmed I am not pregnant. Period returned in April on normal schedule.

Other Meds: Birth Control, Daily Vitamin, Vitamin D

Current Illness: None

ID: 1282779
Sex: F
Age: 34
State: TN

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

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

Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: Patient received vaccine at department POD, located across the street from the department. Patient finished 15 minute monitoring and nurse approached car to advise that patient could leave. It was at that time that patient notified nurse, that the left side of her face was numb. Nurse initiated emergency response. Vital signs were obtained. Patient reported headache and began exhibiting erythema and edema on left side of face and upper left arm. Epinephrine and IM Benadryl were both given. patient was transported to local hospital via EMS.

Other Meds: Wellbutrin

Current Illness: Unknown

ID: 1282780
Sex: F
Age: 48
State: CO

Vax Date: 04/15/2021
Onset Date: 04/29/2021
Rec V Date: 05/03/2021
Hospital:

Vax Type:
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Lot:
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Vax Route:
Vax Site:

Lab Data:

Allergies: n/a

Symptom List:

Symptoms: I havent had a mentral cycle for over 6 months and after recving the vaccine i started menstraiting again.

Other Meds: Progesterone/estriol/estradiol

Current Illness: n/a

ID: 1282781
Sex: F
Age: 44
State: OR

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: Not on file yet reported that she has issues with itching and takes antihistamines 1-2x per day regularly. She had not taken any today.

Symptom List:

Symptoms: Patient-reported generalized itching after vaccination. There was no obvious skin lesion of note on the body. She reports that she often has issues with itching and takes antihistamines 1-2 times per day on a regular basis, but has not done so yet today. She requested 50mg of oral Benadryl. She was given 50mg of Benadryl, which she takes on a regular basis without sedation. After monitoring, she had returned to baseline and returned home.

Other Meds:

Current Illness: Not reported

ID: 1282782
Sex: M
Age: 20
State:

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

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Per office notes on 3/30/21 from APRN, CNP: About 5?10 minutes after receiving vaccination, patient developed itching to the posterior scalp area and to his lower back. Patient brought back for evaluation. Patient denied any sensations of swelling of the tongue or throat. Denied any wheezing or stridor. Only complaints were itching sensation. peripheral IV started and diphenhydramine 50 mg in addition to methylprednisolone 125 mg given intravenously. Patient had clearing of the hives and red patches after medication administration. Pruritus improved.

Other Meds:

Current Illness:

ID: 1282783
Sex: F
Age: 48
State: CT

Vax Date: 04/28/2021
Onset Date: 04/30/2021
Rec V Date: 05/03/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Adhesive Grass Trees

Symptom List:

Symptoms: Jaw, saliva gland, teeth, lymph nodes. After 1st I felt my saliva gland and teeth hurting. Top and bottom teeth. Also back of jaw sore and tender. I went to a dentist. Beside my jaw being a little tender I felt fine said it might be from the cavity. I have an appointment to go back 5/8/21 After the 2nd shot my jaw I can barely open, my saliva gland I feel water sometimes, my teeth only bottom hurt in the left and the back one that has no cavity hurts. My lymph nodes under my jaw are swollen and hurt very much. I went to the walk in clinic in 5/2/21 she gave my amoxicillin and naproxen. Which I feel like are only helping a little as at least I can swallow without pain. I hope to improve. Both dentist and doctor and person I told that gave me the shot said not related but I?ve never had anything like this before. And both times happened when I got the vaccine shot, I just hope I feel better as no one can really say why this is happening.

Other Meds: I take Claritin as I'm allergic to grass and my allergies and sinuses are bad this time of year. I was in so much pain after getting the vaccine shot I went to the walk in and she prescribed me amoxicillin and naproxen. I?m on day 2 and

Current Illness: So after the 1st shot last month my teeth and mouth, jaw , saliva gland was bothering me. After a couple days it went away and wasn't as bad. I did still have some pain before my jaw and I went to a dentist who said I have cavities and I have an appointment for 5/8/21. Everyone tells me not shot related but I feel it is as I was fine in between the shots.

ID: 1282784
Sex: F
Age: 63
State: CA

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

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: Onset of adverse reactions started about 12 after injection. Symptoms were muscle pain in left are from injection site through neck, chills, cold sweats, nausea, and extreme fatigue. At some time during the night, I woke to use the restroom and fainted on the floor. Symptoms lasted about 24 hours after onset.

Other Meds: Simvastatin, Women?s gummy vitamins

Current Illness: None

ID: 1282785
Sex: F
Age: 56
State: TX

Vax Date: 03/31/2021
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: Azithromycin (hives, itching)

Symptom List:

Symptoms: 2 days after vaccination, patient developed right arm (opposite injection site) swelling, erythema, bruising on her wrist and pain/loss of range of potion in her wrist joint. It gradually worsened over about 2 weeks, then began to improve. She remains with some tenderness and her R wrist and thumb and does not have full range of motion but other symptoms have mostly resolved.

Other Meds: None

Current Illness: None.

ID: 1282786
Sex: F
Age: 71
State: WI

Vax Date: 04/05/2021
Onset Date: 04/05/2021
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: The patient said she "had mental problems." She didn't know who she was or where she was for about a day and a half.

Other Meds: unknown

Current Illness: unknown

ID: 1282787
Sex: F
Age: 49
State: IL

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

Vax Type:
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Vax Site:

Lab Data:

Allergies: no known allergies

Symptom List:

Symptoms: NO visual adverse reaction per staff present. patient received 1st dose of Pfizer vaccine 4/24/2021 and 2nd dose of Pfizer vaccine 5/1/2021. per staff present patient denied any sided effects. called and spoke to patient today 5/3/2021 patient still denies any adverse reactions. stated " I feel perfectly fine"

Other Meds: Insulin, Enalapril, Glipizide, Metformin, Cyanocobalamin

Current Illness: unknown

Date Died:

ID: 1282788
Sex: F
Age: 57
State: CO

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

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Vaccine was administered on 04/29/20201 or 04/30/2021. On 05/02/2021 patient was found deceased in residence. Coroner's office will be performing autopsy.

Other Meds:

Current Illness:

ID: 1282789
Sex: M
Age: 40
State: CA

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: unknown

Symptom List:

Symptoms: The dose for the Moderna vaccine is 0.5 mL. The patient inadvertently received an extra 0.01 to 0.02 mL. The manufacturer instructed us to contact the patient to inform them that the excess dose could potentially lead to side effects that could be local or systemic. No serious adverse events were experienced by the patient.

Other Meds: unknown

Current Illness: UNKNOWN

ID: 1282790
Sex: F
Age: 43
State: PA

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

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

Lab Data:

Allergies: Milk Codeine Contrast dye

Symptom List:

Symptoms: Nausea, diarrhea, headache, rash on chest, shortness of breath, loss of color in face, dizziness, light-headed, extreme fatigue (could not drive home from site), elevated blood pressure

Other Meds: Synthroid 50mg Gianvi

Current Illness: None

ID: 1282791
Sex: F
Age: 87
State:

Vax Date: 02/05/2021
Onset Date: 03/12/2021
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: Patient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1282792
Sex: M
Age: 25
State:

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:

Symptom List:

Symptoms: Vomiting, dizziness. Gave water. Stable, released from vaccination site.

Other Meds:

Current Illness:

ID: 1282793
Sex: F
Age: 42
State: TX

Vax Date: 03/09/2021
Onset Date: 04/12/2021
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: On my right foot I got Herpes soster, intense pain in the muscles, burning and itching, balls with water, the treatment that the doctor gave me was the same to treat shingles.

Other Meds: Metformin, Levier.

Current Illness: Diabetes, cholesterol.

ID: 1282794
Sex: F
Age: 30
State: FL

Vax Date: 04/25/2021
Onset Date: 04/25/2021
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: I took my first Pfizer shot on 4/25/2021 and I started feeling "woozy" about 3 hours after the shot. I got a headache that night, but it went away. On Monday (the following day), I woke up with my ears popping and pressure in my head, still feeling woozy/dizzy. On Tuesday, my whole body was exhausted, and I took the day off from work. I was not drowsy, just physically exhausted. I went to urgent care and took a COVID test just in case. It was negative. The exhaustion was better on Wednesday and I returned to work (I work at a bank), still feeling woozy/dizzy. I first described this woozy/dizzy feeling kind of like changing eye glasses prescriptions or like being on a boat or right when you get off a spinning ride like the teacups , except pretty constant and does not go away. Thursday I noticed if I touched under my left eye, it hurt, and when I blinked it hurt (still dizzy). That got better on Friday. I continued feeling woozy/dizzy the whole weekend with some pressure in the head. I noticed on Sunday that if I pressed the bone right above and behind the left earlobe, it hurt, so I made an appointment with an ENT doctor. I went to work today, but immediately felt dizzy when looking at my computer screen and down to my papers so I went to urgent care again. I have taken Tylenol which helped with the headache the first day. I have been trying to take an Advil every 4 hours for the past day or so to see if I possibly have some inflammation somewhere. I have also started to take EmergenC and Benadryl.

Other Meds: None

Current Illness: None

ID: 1282795
Sex: F
Age: 34
State: IN

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

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

Lab Data:

Allergies: imitrex

Symptom List:

Symptoms: I had some tingling and then numbness in my face (right) and right arm and it lasted 2-3 hours. I had the same symptoms 4 weeks after the vaccine. I did not take the second dose of the pfizer vaccine on recommendation from the doctor since we do not know if these symptoms are related to the brain.

Other Meds: multivitamins and Vit D

Current Illness: none

ID: 1282796
Sex: F
Age: 33
State: MI

Vax Date: 04/12/2021
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: Very heavy menstrual flow during the first cycle after vaccine, noticed small clots. This is a first time ever for me. Also, longer menses than usual by a few days.

Other Meds: None

Current Illness: None

ID: 1282797
Sex: M
Age: 59
State: TX

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

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

Lab Data:

Allergies: codeine (shortness of breath), vancoymcin (itching/rash), iodanated contrast media (hives; gets premedication)

Symptom List:

Symptoms: Pt had progressive shortness of breath 4-5 days prior to vaccine administration that resulted in hospital admission and ICU transfer for hypoxic respiratory failure (possible secondary to pneumonia, acute HF exacerbation with fluid overload, etc.). Unclear if related to vaccine given patient's underlying comorbidities and progressive nature of the respiratory failure starting even prior to vaccine administration.

Other Meds: Atorvastatin, Bacitracin ointment, carbamazepine, divalproex sodium, enoxaparin, esomeprazole, fluticasone/salmeterol, gabapentin, insulin glargine, isosorbide mononitrate, lisinopril, metoprolol succinate, polyethylene glycol, tamsulosin,

Current Illness: Worsening shortness of breath over the last 4-5 days prior to vaccination, possible pneumonia versus HF exacerbation, hypercapnic respiratory failure and acidosis

ID: 1282798
Sex: F
Age: 19
State: OR

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: Not on file

Symptom List:

Symptoms: The patient was minimally responsive when I arrived at her car consistent with a severe vasovagal episode with syncope. The patient rapidly regained consciousness with a supine position with legs elevated. The patient was given oral hydration but had large volume emesis. The patient was given SL 8mg Zofran. Emesis continued. The patient was transferred to EMS. The patient was given IV fluids and IV Zofran via EMS. A severe vasovagal episode with true syncope and significant emesis. Improved with IV fluids and antiemetics via EMS. Patient discharged home with father as the driver.

Other Meds:

Current Illness: Unknown

ID: 1282799
Sex: F
Age: 81
State: IL

Vax Date: 03/23/2021
Onset Date: 04/02/2021
Rec V Date: 05/03/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient presented to ED on 4/5/2021 with 3 day history of dyspnea and productive cough. Patient was hypoxic at 76% on room air at doctor's office prior to presentation at ED. Patient had a known COVID-19 exposure (daughter) in past 1-2 weeks. Patient tested positive for COVID 19 on 4/5/21. Patient was treated with oxygen, antibiotics, steroids, remdesevir, and convalescent plasma. Patient underwent CTS chest to rule our PE--this study was negative for PE. Patient improved and was discharged to home with new oxygen therapy.

Other Meds:

Current Illness:

ID: 1282800
Sex: F
Age: 16
State: OR

Vax Date: 04/02/2021
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: NKDA

Symptom List:

Symptoms: Patient received 1st dose of Moderna at age 16 through a clinic provider office. No adverse outcome. No side effects. Patient missed her 2nd dose appointment and called the clinic main Vaccine Clinic to reschedule. Case discussed with clinic CMO and per CDC guidelines patient will be offered 2nd dose of Moderna to complete series. Will be considered as off label use. Patient will be counselled on events prior to 2nd dose administration.

Other Meds: None stated

Current Illness: None stated

ID: 1282802
Sex: F
Age: 66
State:

Vax Date: 03/12/2021
Onset Date: 03/26/2021
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: Patient was hospitalized within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1282803
Sex: F
Age: 23
State: GA

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 05/03/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: DUE TO THE DIFFENERENCE IN THE INTERVALS OF MODERNA AND PFIZER COVID VACCINES, WE HAD A FEW DAYS INWHICH SECOND DOSES OF BOTH VACCINES WERE BEING ADMINISTERED. THIS PATIENT WAS GIVEN THE CORRECT FORM, INSTEAD OF RECEIVING HER SECOND DOSE OF MODERNA, SHE RECEIVED A DOSE OF PFIZER VACCINE. PT DID NOT SUFFER FROM ANY ADVERESE EVENT. WE HAVE TAKEN STEPS TO AVOID THIS SITUATION IN THE FUTURE.

Other Meds: none known

Current Illness: DENIED

ID: 1282804
Sex: F
Age: 56
State: FL

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

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

Lab Data:

Allergies: Sulfa meds, Penicillin, Ibuprofen

Symptom List:

Symptoms: 1244: Patient was complaining of dizziness. Patient evaluated by on site NP and EMT. Patient was given water and vital signs were taken . BP 150/103, pulse: 84, o2: 99%, respirations:18. Patient stated that sipping on the water aided her symptoms. Symptoms lasted about 5 minutes. Patient stated she had a light breakfast, and that she has been eating minimal to now carbs daily to lose weight. 1250: Second set of vitals taken, BP: 151/94, pulse: 84, 02: 99%, respirations 16. Patient stated she was comfortable to be driven home by husband.

Other Meds: Losartan, Hydrochlorothiazide

Current Illness: None

ID: 1282805
Sex: F
Age: 60
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: Chocolate. Mild

Symptom List:

Symptoms: Day 2 muscle pain and fatigue, low grade fever, fatigue, at injection site: edema erythema pain, limited range of motion and strength Day 3 muscle soreness, fatigue I jerk tion site pain swelling and strength with poor range of motion. Day 4: fatigue arm pain swelling and strength with limited range of motion.

Other Meds: 25mg HZTZ QD. 1000mg Vitamin C QD 150mg Effexor XR QD. 2000iu Vitamin D. QD 50mg Trazadone QD .5mg lorazepam QD 125mcg aerobic BID

Current Illness: None

ID: 1282806
Sex: F
Age: 30
State: UT

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: sulfa drugs

Symptom List:

Symptoms: 12 weeks pregnant at time of shot. Due Nov 11 2021. Second pregnancy. First pregnancy had no abonormal instances. Vaginal bleeding started at about 5pm. Lower abdominal pains + constipation before bleeding. Went to ER that evening and got RhoGAM. 300 mcg. Intramuscular.

Other Meds: b12, unisom, pre natal vitamins, krill oil.

Current Illness: pregnancy sicknesses/morning sickness/growing a baby sickness

ID: 1282807
Sex: M
Age: 41
State: CA

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

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Allergies: knknown

Symptom List:

Symptoms: The dose for the Moderna vaccine is 0.5 mL. The patient inadvertently received an extra 0.01 to 0.02 mL. The manufacturer instructed us to contact the patient to inform them that the excess dose could potentially lead to side effects that could be local or systemic. No serious adverse events were experienced by the patient.

Other Meds: unknown

Current Illness: unknown

ID: 1282808
Sex: F
Age: 39
State: NY

Vax Date: 04/26/2021
Onset Date: 05/01/2021
Rec V Date: 05/03/2021
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Allergies: None

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Symptoms: Terrible HSV-1 outbreak all over my nose (worst cold sore outbreak I have ever had)

Other Meds: Omeprazole, diazepam

Current Illness: No

ID: 1282809
Sex: F
Age: 55
State:

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/03/2021
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Symptoms: Dizziness; lightheaded; shaky. Given apple juice and water. Stable and released from vaccination site.

Other Meds:

Current Illness:

ID: 1282810
Sex: F
Age: 39
State: WI

Vax Date: 04/15/2021
Onset Date: 04/24/2021
Rec V Date: 05/03/2021
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Allergies: Adhesives, chlorhexidine

Symptom List:

Symptoms: Bell's Palsy

Other Meds: BuSpar 30 mg b.i.d., lorazepam 0.5 mg p.r.n., acetaminophen a 1000 mg p.r.n., clindamycin 1% gel, sertraline 200 mg daily, omeprazole 20 mg b.i.d..

Current Illness: Viral pharyngitis with symptoms starting on 04/19/2021

ID: 1282812
Sex: M
Age: 46
State: CO

Vax Date: 04/18/2021
Onset Date: 05/02/2021
Rec V Date: 05/03/2021
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Allergies: Clindamycin (Vomiting), Epinephrine (palpitations), Erythromycin (Nausea), Metformin (Nausea/Vomiting/Diarrhea), Azithromycin (Nausea/Vomiting), Keflex (Nausea)

Symptom List:

Symptoms: Patient received his second Moderna COVID vaccine (4/18/21). Patient began to feel ill (5/1/21) and presented to the ED (5/2/21) where he had tested positive for COVID-19. He is currently hospitalized and receiving Remdesivir and steroids (Dexamethasone).

Other Meds: Xarelto, Lipator, Coreg, Cozaar, Aldactone, Bumex, Humulin R

Current Illness:

ID: 1282813
Sex: F
Age: 89
State:

Vax Date: 02/26/2021
Onset Date: 03/29/2021
Rec V Date: 05/03/2021
Hospital: Y

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Symptoms: Patient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1282814
Sex: F
Age: 61
State: CO

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/03/2021
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Symptoms: Patient received first dose on 4/19, second dose administered today 5/3 which is too soon

Other Meds:

Current Illness:

ID: 1282816
Sex: M
Age: 47
State: CA

Vax Date: 04/06/2021
Onset Date: 05/02/2021
Rec V Date: 05/03/2021
Hospital: Y

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Allergies: No known allergies

Symptom List:

Symptoms: Patient developed presumptive Guillain-Barr? syndrome after receiving the J&J vaccine outside of a hospital.

Other Meds: None reported

Current Illness: None reported

ID: 1282817
Sex: F
Age: 44
State: GA

Vax Date: 04/28/2021
Onset Date: 04/30/2021
Rec V Date: 05/03/2021
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Allergies: None that I know of

Symptom List:

Symptoms: Two days after the 2nd dose of the vaccine I started breaking out in hives on my right arm. Later that night it had spread to my right arm and parts of my legs. When I woke up Saturday it had spread further to the front and back of my thighs . By Saturday night both of my feet were swollen along with my hands. By Sunday morning it was all over my back my neck and face and my eyelids were swollen. It was then that I went to the ER at the Hospital. My vaccination was done in sporting event stadium.

Other Meds: None

Current Illness: None

ID: 1282818
Sex: F
Age: 39
State: MN

Vax Date: 01/19/2021
Onset Date: 04/20/2021
Rec V Date: 05/03/2021
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Symptoms: Employee tested positive for COVID-19 after completion of vaccination series

Other Meds:

Current Illness:

ID: 1282819
Sex: M
Age: 42
State: CA

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/03/2021
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Allergies: none

Symptom List:

Symptoms: Tinnitus starting on the left side after the second Moderna shot and continuing still. The ringing in my ear is distracting and quite loud at times. In addition to the persistent tinnitis, I experienced intense headaches to the point where I was seeing flashes of light as well as cold sweats, body chills.

Other Meds: none

Current Illness: none

ID: 1282820
Sex: F
Age: 17
State: CA

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/03/2021
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Allergies: None known

Symptom List:

Symptoms: Patient received 1st Moderna vaccine from facility according to mom and immunization card with patient. Patient is 17 yo. Moderna used for second dose; recommended by Pediatric Director after consultation. No adverse reaction.

Other Meds: None

Current Illness: NA

ID: 1282821
Sex: M
Age: 19
State:

Vax Date: 04/26/2021
Onset Date: 04/28/2021
Rec V Date: 05/03/2021
Hospital: Y

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Allergies: NKA

Symptom List:

Symptoms: Chest pain 2 days after COVID vaccine. Midsternal cramping, pressure-like associated with shortness of breath. Pain resolved, but then returned later in the evening when lying down to go to sleep. Symptoms - chills, fever, shortness of breath, chest pain COVID 19 vaccine related myopericarditis cannot be ruled out

Other Meds: Humalog (insulin pump) Hydrocortisone cream Lantus (only if insulin pump failure)

Current Illness: Hospitalized in March for DKA

ID: 1282822
Sex: M
Age: 48
State: MD

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 05/03/2021
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Symptoms: administrative error, dose 2 given 1 week to early, pt has not reported any adverse side effects

Other Meds:

Current Illness:

ID: 1282823
Sex: F
Age: 26
State:

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/03/2021
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Symptoms: After receiving 1st vaccine shot of Pfizer, patient developed mild generalized itching, feeling hot and red patches on left arm. Benadryl 25 mg was given orally. After several minutes, she was feeling fine. Er precautions given.

Other Meds:

Current Illness:

ID: 1282824
Sex: F
Age: 54
State: MA

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/03/2021
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Allergies: unknown

Symptom List:

Symptoms: While sitting in observation following vaccine administration pt told observation nurse that she felt "warm" and "faint". She stated she felt well enough to walk so she was brought to EMS guided by RN and care was transferred to EMTs. With EMTs she was placed in wheelchair and wheeled outside for fresh air. With EMTs she reportedly lost consciousness for ~30 seconds. When she regained consciousness vitals taken by EMTs were reportedly BP 150/80, HR 68, and O2 98%. She reported chief complaints at this time to be fatigue, nausea, and chest pain. She was then transferred to ED via ambulance with onsite EMS for further evaluation.

Other Meds: unknown

Current Illness: unknown

ID: 1282825
Sex: F
Age: 80
State: MN

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

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Symptoms: Patient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1282826
Sex: F
Age: 55
State: FL

Vax Date: 04/23/2021
Onset Date: 04/26/2021
Rec V Date: 05/03/2021
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Symptoms: ( H/O bilateral mastectomies with reconstruction and right breast radiation in 2014.) New onset right breast discoloration, discomfort, and swelling that started three days after second dose of COVID vaccine. Vaccine was given in right arm. There are no s/s of bacterial infection, no fever, chills, or drainage.

Other Meds:

Current Illness:

ID: 1282827
Sex: M
Age: 22
State: CO

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 05/03/2021
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Allergies: None reported

Symptom List:

Symptoms: Patient felt slight shortness of breath, sweats/chills, tingling in the right extremity, mental fog/fatigue, nausea within 10 minutes of being vaccinated with the first dose. Patient reported not having swelling or tingling in lips/tongue/throat. Patient reported not having much to eat or drink prior to coming in for his vaccine. Called 911 due to patient's complaints and concern about him having a possible allergic response.

Other Meds: None reported

Current Illness: None reported

Total 2021 VAERS Injuries: 631,330

Page last modified: 03 October 2021 5:28pm