VAERS 2021 Database www.vaers.hhs.gov

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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

Date Died: 05/07/2021

ID: 1307897
Sex: F
Age: 69
State: NV

Vax Date: 05/04/2021
Onset Date: 05/07/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
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Vax Route:
Vax Site:

Lab Data:

Allergies: Unknown

Symptom List:

Symptoms: The decedent experience nausea, headache, and chest pain approximately 72 hours after receieving her second shot. She was found deceased later that day.

Other Meds: Ibuprofen , Potassium Chloride

Current Illness:

ID: 1307898
Sex: M
Age: 54
State: NY

Vax Date: 05/09/2021
Onset Date: 05/10/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: nka

Symptom List:

Symptoms: 1st shot: No side effects after 1st vaccine shot other than slight bruise-like pain at site of injection (upper left . 2nd shot: 27 hours after, fatigue, general malaise, and light headache noticed. 29 hours after, minor swelling of left armpit with associated minor discomfort. After sleep, all symptoms gone save swelling which has increased. Noticeable overall swelling in the area visibly, inferior of armpit. At time of report (17:30 11 May 2021), swelling persists but pain reduced.

Other Meds: Edarbi (azilsartan medoxomil) 40mg

Current Illness: none aside from treated hypertension

ID: 1307899
Sex: M
Age: 60
State: IL

Vax Date: 04/20/2021
Onset Date: 04/24/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: 4 days after shot woke with headache and difficulty breathing. Deep breaths would hurt a bit and sometimes cause a cough. Temp was 99.7 to 99.9 for 2 days. Lethargic for about 4 to 5 days after start of symptoms.

Other Meds: Occasional multi vitamin

Current Illness:

ID: 1307900
Sex: F
Age: 87
State:

Vax Date: 02/23/2021
Onset Date: 03/24/2021
Rec V Date: 05/11/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: AKI (acute kidney injury)

Other Meds:

Current Illness:

ID: 1307901
Sex: F
Age: 42
State: PR

Vax Date: 04/01/2021
Onset Date: 05/03/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
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Vax Route:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Hearing loss

Other Meds: None

Current Illness: None

ID: 1307902
Sex: F
Age: 53
State: NJ

Vax Date: 05/09/2021
Onset Date: 05/09/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Pain on arm within minutes, redness on shot place within 1/2 hour, then a hard rash within hours, next day rash was even bigger (close to her palm of hand).

Other Meds: 1 Airplus 6/200 mcg-dosis, 1 pack of regular Advil, 1 Vitamin E 180 mg (400 IU), 1 Cetirizine 10mg.

Current Illness: None

ID: 1307903
Sex: F
Age: 32
State: OH

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: I woke up the next morning around 9 am feeling very dizzy. Upon trying to get out of bed I fell over because my vision was sideways. I layed back down for a few hours. Upon rising again, my vision was again sideways and the dizzying effects lasted intensely for the remainder of that day. The following day I was able to go to work but by mid-afternoon had to lay down again and was unable to do yoga for the following 5 days. For a total of 2 weeks, I felt nauseous and dizzy. Now, once a week I feel dizzy still but positional therapy has helped me get back to my work and exercise lifestyle.

Other Meds: Concerta, Prozac, Welbutrin, Albuterol, Ritalin

Current Illness: none

ID: 1307904
Sex: M
Age: 63
State: AZ

Vax Date: 04/22/2021
Onset Date: 05/01/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
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Vax Name:
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Lab Data:

Allergies: UNKNOWN

Symptom List:

Symptoms: Patient reported 5/10/21 that one week after vaccine, around May 1st, he developed a pain in his left shoulder. He reported no pain immediately after vaccine given. The pain starts at his shoulder to his elbow, and to his fingers. He states it feels like nerve pain. He says the pain does not go away. I referred him to follow-up with his doctor. He understood.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1307905
Sex: M
Age: 71
State: TX

Vax Date: 01/01/2021
Onset Date: 02/01/2021
Rec V Date: 05/11/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: My name is patient, 71 year old. On 5/5/21 my Cardiologist told me to go to the ER to get a Chest CT. I was diagnosed with PE (Pulmonary Embolism). I was put in ICU under blood thinner Heparin drip treatment. On 5/09/21, I was discharged to go home to continue treatment with blood thinner Eliquis. I have always been an active healthy person with no major issues other than one Stent put in my Left Descending Artery by doctor in June of 2013. I've been playing Tennis (mostly singles) on weekends till last November and I've been playing Ping Pong on weekdays till end of April. Never expected to getting this PE. Could this blood clots be the result of Pfizer Covid Vaccine ?

Other Meds: Metoptolol, Pravastin, CoQ10, babay asprin, vitamin D,E,B12

Current Illness: None

ID: 1307906
Sex: F
Age: 69
State:

Vax Date: 02/27/2021
Onset Date: 04/19/2021
Rec V Date: 05/11/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: N17.9 - Acute kidney failure, unspecified

Other Meds:

Current Illness:

ID: 1307907
Sex: F
Age: 73
State:

Vax Date: 01/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/11/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Myocarditis

Other Meds: Nil

Current Illness: None

ID: 1307908
Sex: F
Age: 39
State: CA

Vax Date: 05/06/2021
Onset Date: 05/08/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: PENICILLIN

Symptom List:

Symptoms: SX: LEFT ARM REDNESS AND SWELLING APROX 10X10CM, LYMPHADENOPHATHY 2 DAYS FOLLOWING MODERNA VACCINE. TREATMENT: WATCHFULL WAITING.

Other Meds:

Current Illness:

ID: 1307909
Sex: F
Age: 34
State: OR

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: I am tracking my menstrual cycle very closely because I am trying to get pregnant. I got my period quite a bit earlier than expected. I got the vaccine on April 9th and got my period on April 12th. According to my period tracker (OVIA) that I've been using since December, I was supposed to get my period on April 23rd. The period also lasted 5.5 days, when I usually average 3-4 days.

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1307911
Sex: M
Age: 32
State:

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Patient received the 2nd dose of the Moderna Vaccine on the 21st day on 5/10/21 as opposed to the 28th day, Pt received the first dose on 4/19/21

Other Meds:

Current Illness:

ID: 1307912
Sex: F
Age: 40
State: IN

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

Vax Type:
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Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Sweating, paleness, cold extremities, increased HR, reported temporary numbness in arms and legs

Other Meds: unknown

Current Illness: none listed

ID: 1307913
Sex: F
Age: 43
State: CA

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Body aches, chills lasted until 3/20/2021. Took over the counter iboprufen for the pain.

Other Meds: Nortriptyline 40mg

Current Illness: None

ID: 1307914
Sex: F
Age: 26
State: SD

Vax Date: 04/23/2021
Onset Date: 04/29/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: No

Symptom List:

Symptoms: Miscarriage less than a week after the second vaccine with Moderna. Estimated due date 01/07/2022, started with extreme dizziness and ended with Contraction like cramps and bleeding. History of very healthy full term pregnancies.

Other Meds: Prenatal

Current Illness: No

ID: 1307915
Sex: F
Age: 54
State: MI

Vax Date: 03/31/2021
Onset Date: 04/02/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Penicillin Bactrim

Symptom List:

Symptoms: 12 plus hours vertigo Severe shaking 2 hours Tinnitus Ear fullness

Other Meds: Metoprolol Chlorthalidone Allegra D

Current Illness: None

ID: 1307916
Sex: M
Age: 77
State:

Vax Date: 02/26/2021
Onset Date: 04/20/2021
Rec V Date: 05/11/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: N17.9 - Acute kidney injury (CMS/HCC)

Other Meds:

Current Illness:

ID: 1307917
Sex: F
Age: 69
State:

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

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Patient received first dose of Moderna COVID-19 vaccine on 4/21/21 and was scheduled to receive second dose on 5/19/21; patient instead received second dose of the Moderna COVID-19 vaccine on 5/22/21 (8 days early).

Other Meds:

Current Illness:

ID: 1307918
Sex: F
Age: 50
State: CA

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

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: Patient had potential allergic reaction to second dose of Moderna vaccine. She stated no issues to first dose and answered no to all patient screening questions. Approximately 10 minutes after administering the dose, the patient complained of a painful tongue, which she was instructed to stay for further monitoring. After 15 minutes, the patient stated that she felt like her tongue was swollen and stating her tongue felt dry. Patient also noted at this time that she has had a reaction similar to this previously with other vaccines (Metallic taste) and to Zanaflex (Swollen tongue). Before vaccine given, noted patient did not mention previous issues or adverse reactions to vaccines or medications, tolerated 1st dose of Moderna. Was given oral liquid Benadryl 25mg. Checked back with patient 15 minutes after giving Benadryl, which the patient felt it was better and not progressing. No issues breathing during event. Advised to follow up with provider if continues, continue Benadryl as needed and monitor severe allergic reactions.

Other Meds: No

Current Illness: No

ID: 1307919
Sex: F
Age: 44
State: PA

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 05/11/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Headache Day 2 through Day 14. Flu like symptoms Day 3&4. Dizziness/pressure in head upper neck and ears and ringing in ears Days 6 through present. Was in ER on 5/4 and treated with vertigo. Seen by ENT on Friday, 5/7, he started me on steroids. Pressure in eyes and dizziness still present today(Day 4 of prednisone).

Other Meds: None

Current Illness: None

ID: 1307921
Sex: F
Age: 46
State: MO

Vax Date: 04/16/2021
Onset Date: 04/23/2021
Rec V Date: 05/11/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Bruising on the back of both legs and both arms. Some discomfort in right arm.

Other Meds: Albuterol, Breo

Current Illness: None

ID: 1307922
Sex: F
Age: 39
State: MN

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 05/11/2021
Hospital:

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

Lab Data:

Allergies: eggs, dairy

Symptom List:

Symptoms: Headache, body aches, jaw ache, sore throat, skin sensitivity, fatigue and stomach pains.

Other Meds: birth control

Current Illness: none

ID: 1307923
Sex: M
Age: 44
State: TX

Vax Date: 04/06/2021
Onset Date: 04/09/2021
Rec V Date: 05/11/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Vision and gait disturbances began 4/9/21, progressively worsened and he began nausea/vomiting 4/11/21, requiring ER visit on 4/12/21 then hospitalization for 5 days. Comprehensive labs done. Follow-up advised with Dr. (has not occurred). Per Dr. (Neurology), do not get second dose of Covid-19 vaccine as there is a chance the vaccine contributed to development of these symptoms. Doctor said it could possibly be Guillain-Barre Syndrome. As of 5/11/21, significant vision impairment still exists and patient is unable to work. Patient is uninsured.

Other Meds: None

Current Illness: none

ID: 1307924
Sex: M
Age: 16
State: WI

Vax Date: 04/29/2021
Onset Date: 05/10/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: HPI: Patient is a 16-year-old male who was upgraded to our emergency department after blood work showed a significant thrombocytopenia. Please see walk-in clinic provider NP for presenting history and physical exam. Patient reports to me development of sore throat as well as blood from the throat last Thursday. Patient also began to notice development of bruising to his legs without any injury approximately a week ago. Denies any pain. Denies any blood in the urine or stool. No other medical complaints at this time. Chief Complaint Patient presents with ? Sore Throat was seen a few weeks ago for ear infection, also had sore throat at that time that never went away. School nurse wanted him swabbed for strep and covid PCR ? Bleeding/Bruising has large bruising to right leg for about a week, no injury. also states bruise to upper left thigh and right shoulder and scattered small bruises. School nurse wants his platelets checked. Denies pain. States mild bleeding in gums and states notices blood in back of throat ROS: See HPI above. All other 12 review systems negative otherwise specified in HPI above. ROS PMH: Past Medical History Past Medical History: Diagnosis Date ? Asthma ? GI symptoms 10/2018 with pharyngitis ? Headache ? Strep throat ? Tonsillar and adenoid hypertrophy nasal scope Past Surgical History Past Surgical History: Procedure Laterality Date ? COLONOSCOPY 12/07/2018 with biopsies ? ESOPHAGOGASTRODUODENOSCOPY 12/07/2018 with biopsies ? TONSILLECTOMY & ADENOIDECTOMY 2011 Family History Family History Problem Relation Age of Onset ? Hypertension Father ? Diabetes Mellitus Father Social History Tobacco Use ? Smoking status: Never Smoker ? Smokeless tobacco: Never Used ? Tobacco comment: no second hand smoke exposure Substance Use Topics ? Alcohol use: No Allergies: No Known Allergies Meds: No current facility-administered medications on file prior to encounter. Current Outpatient Medications on File Prior to Encounter Medication Sig Dispense Refill ? albuterol HFA 108 (90 Base) MCG/ACT inhaler Inhale 2 puffs every 4 hours as needed. 1 inhaler 1 ? Aspirin-Acetaminophen-Caffeine (EXCEDRIN PO) ? acetaminophen (TYLENOL) 325 MG tablet Take 975 mg by mouth every 6 hours as needed for Pain. ? naproxen (NAPROSYN) 220 MG tablet Take 440 mg by mouth twice daily - with breakfast and supper. Physical Exam: Blood pressure (!) 148/93, pulse 107, temperature 98.6 ?F (37 ?C), resp. rate 20, height 6' 5" (1.956 m), weight (!) 348 lb 8 oz (158.1 kg), SpO2 96 %. O2 flow: Physical Exam Constitutional: He is well-developed, well-nourished, and in no distress. No distress. HENT: Head: Normocephalic. Right Ear: External ear normal. Nose: Nose normal. Mouth/Throat: Oropharynx is clear and moist. No oropharyngeal exudate. Mild erythema in the posterior pharynx with some bleeding. No posterior pharynx edema. Eyes: Conjunctivae are normal. Right eye exhibits no discharge. Left eye exhibits no discharge. No scleral icterus. Cardiovascular: Exam reveals no gallop and no friction rub. No murmur heard. Pulmonary/Chest: Effort normal. No stridor. No respiratory distress. He has no wheezes. He has no rales. Abdominal: Soft. Left upper quadrant tenderness. Musculoskeletal: General: No tenderness, deformity or edema. Cervical back: Normal range of motion. Neurological: He is alert. Gait normal. GCS score is 15. Skin: Skin is warm. He is not diaphoretic. Multiple baseball to softball size bruises to the bilateral lower extremities worse on the right than left. Mild petechiae. Psychiatric: Mood, memory, affect and judgment normal. Diagnostics: Results for orders placed or performed during the hospital encounter of 05/10/21 CBC WITH DIFFERENTIAL Result Value Ref Range White Blood Cells 7.72 4.0 - 13.0 K/uL Red Blood Cells 3.48 (L) 4.15 - 5.30 M/uL Hemoglobin 10.8 (L) 11.8 - 15.4 g/dL Hematocrit 30.5 (L) 35.5 - 46.5 % MCV 87.7 77 - 94 fL MCH 31.0 25.0 - 32.3 pg MCHC 35.4 31.9 - 35.9 g/dL RDW 16.2 (H) 11.5 - 14.8 % Platelet Count 9 (LL) 160 - 424 K/uL MPV 11.4 (H) 6.8 - 10.5 fL Neutrophil % Pending % Lymphocyte % Pending % Monocyte % Pending % Eosinophil % Pending % Basophil % Pending % Absolute Neutrophils Pending 1.6 - 7.5 K/uL Absolute Lymphocytes Pending 1.2 - 4.9 K/uL Absolute Monocytes Pending 0.1 - 0.9 K/uL Absolute Eosinophils Pending 0.0 - 0.6 K/uL Absolute Basophils Pending 0.0 - 0.2 K/uL COMPREHENSIVE METABOLIC PANEL Result Value Ref Range Sodium 138 133 - 144 mEq/L Potassium 4.4 3.5 - 5.0 mEq/L Chloride 101 95 - 107 mEq/L Carbon Dioxide 22 22 - 32 mEq/L Anion Gap 15 6 - 15 mEq/L BUN 14 8 - 24 mg/dL Creatinine 0.81 0.69 - 1.20 mg/dL Glomerular Filt Rate NOT CALCULATED due to age less than 18 years. mL/min Glucose 110 (H) 70 - 100 mg/dL Albumin 4.9 3.5 - 5.2 g/dL Calcium 10.0 8.6 - 10.4 mg/dL AST 23 11 - 41 IU/L ALT 28 (H) 0 - 19 IU/L Alkaline Phosphatase 142 90 - 366 IU/L Bilirubin, Total 0.4 <1.5 mg/dL Total Protein 7.7 5.9 - 7.8 g/dL Globulin 2.8 1.8 - 3.7 g/dL A:G Ratio 1.8 1.2 - 2.7 PROTHROMBIN TIME Result Value Ref Range Prothrombin Time 18.4 (H) 12.0 - 14.6 sec INR 1.5 (H) 0.9 - 1.1 PTT, PARTIAL THROMBOPLASTIN Result Value Ref Range PTT 32 23 - 36 sec CRITICAL VALUE HEME Result Value Ref Range Critical Value ED Course: Patient was upgraded to the emergency department after he was noted to have significant thrombocytopenia. Patient is pleasant he has no active complaints other than some throat irritation bleeding in the throat and bruising that was nontraumatic to the legs. My physical examination reveals multiple rather large bruises to the bilateral lower extremities up to softball size worse on the right than left. Patient had some mild left upper quadrant discomfort. Very minimal bleeding in the posterior pharynx. I personally reviewed the labs and CBC revealed an anemia at 10.830.5 hemoglobin hematocrit respectively. Most notably a 9000 thrombocytopenia. CMP essentially unremarkable. INR 1.5 PTT normal. I added on Lyme disease and tick-borne illness as well as a Monospot type and screen. Patient did receive his 1st visor vaccine for COVID-19 on April 29, 2021. IV was established in the emergency department in consultation made to Pediatric Oncology. I spoke with pediatric oncology in regards to patient's history and present illness. He does agree that the patient should in fact be transferred under the pediatric care but recommended under the general hospitalist service. He did not advise to proceed with any active treatment in our emergency department such as gamma globulin, platelets or steroids. Awaited call back from pediatric hospitalist and spoke with Dr. She has agreed to accept the patient in transfer. Patient and family are comfortable disposition plan no further questions at this time. Impression: 1. ITP Disposition: Transfer ED on 5/10/2021 Revision History Detailed Report Note shared with patient Note filed date Mon May 10, 2021 12:24 PM

Other Meds: This is your record. Keep this with you and show to your community pharmacist(s) and physician(s) at each visit. Allergies: No Known Allergies Medications Valid as of: May 11, 2021 - 4:41 PM Generic Name Brand Name Tablet Size Instruct

Current Illness: 4/16/21 ED visit N/V/D diagnosed with viral gastroenteritis COVID-19 antigen negative 4/25/21 ED visit fever, sore throat, earache, dizziness, shortness of breath. Rapid strep negative, COVID-19 antigen and Influenza negative diagnosised with otitis media 4/28/21 Ed Visit Sore Throat diangosed with viral syndrome

ID: 1307925
Sex: F
Age: 57
State: NC

Vax Date: 04/28/2021
Onset Date: 04/30/2021
Rec V Date: 05/11/2021
Hospital:

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

Lab Data:

Allergies: Antibiotic

Symptom List:

Symptoms: My left arm that I received the injecton in started to hurt the feeling with like a numbing pain it felt like it was swelling even when it didn't, matter waht I did to find comfort it didn't help; I ran a fever that felt like my body was on fire especially the left arm where I received the shot; and I also experienced hives in my left arm that rar acroos to my other arms, hands, legs and back. I also began to experience headaches that lasted through out the day.

Other Meds: Metoprol Tar 25mg, Nortriptylin 25mg, Isosorb Mono Er 30mg

Current Illness: Allergies

ID: 1307926
Sex: F
Age: 32
State: NJ

Vax Date: 04/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/11/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Shingles

Other Meds: None

Current Illness: None

ID: 1307927
Sex: F
Age: 17
State: TN

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 05/11/2021
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Symptoms: Patient WAS INAVERTENTLY GIVEN FIRST DOSE MODERNA VACCINE ON 04/08/2021 AT DRIVE THROUGH COVID-19 VACCINE VISIT AT HEALTH DEPT. ( SHE IS ONLY 17 YEARS OLD). STATED SHE HAD SCHEDULED HER APPOINTMENT ON LINE. PHONE CALL WAS MADE TO PATIEN T AND HER PARENT ON 04/29/2021 , ADVISING OF INCIDENT AND RECOMMENDATIONS FROM DR, TO RECEIVE SECOND DOSE OF MODERNA AS SCHEDULED (WILL BE CONSIDERED AS OFF LABEL)

Other Meds:

Current Illness:

ID: 1307928
Sex: F
Age: 64
State: NY

Vax Date: 03/01/2021
Onset Date: 05/08/2021
Rec V Date: 05/11/2021
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Allergies: nkda

Symptom List:

Symptoms: cough congestion after known covid eposure >2 weeks after second pfizer dose

Other Meds: enalapril-HCTz, pantoprazole, Meloxicam, primidone, dulera, proair

Current Illness: hypertension, asthma

ID: 1307929
Sex: F
Age: 63
State: CA

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/11/2021
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Allergies: sulfa drugs

Symptom List:

Symptoms: severe muscle/bone pain (even after taking fiorinal w/codiene), tinnitus, sore eyes ( for a week), teeth hurt (for a week), eruptions on skin (red blood dots, when fully erupted watery like a blister, with a white solid core if squeezed, came in 2s on leg, back, chest, not all over body/just 6 eruption sites), yellow patches of skin on both forearms (like a healing bruise yellow, but no bruise at sites), regular sore arm - not a big deal, sick/unwell feeling for a week.

Other Meds: fibrates, green tea, turmeric, probiotic, aged garlic, mature multivitam, vit Cw/rosehips, CBD oil 15mg

Current Illness: none

ID: 1307930
Sex: F
Age: 45
State: OR

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 05/11/2021
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Symptoms: Dose 1 - Fatigue and headaches that lasted around 3 days. Dose 2 - I had brain fog, dizziness and fatigue. Over the weekend, I was still more tired than usual. By Monday, I was wiped out. I had severe brain fog and had to leave work because I couldn't focus on my patients. I also experienced a sore throat and swollen lymph nodes. I was in bed all day Monday and Tuesday due to severe fatigue. It gradually increased, but didn't completely resolved until about 3 weeks later.

Other Meds:

Current Illness:

ID: 1307931
Sex: M
Age: 55
State: TX

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/11/2021
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Allergies: Tomato

Symptom List:

Symptoms: Patient reported palpitation and rash on the opposite arm after receiving the shot. Blood pressure was 164/89 and he was alert and able to communicate. He took 50 mg of Benadryl and 911 was called. Patent then reported shortness of breath but he was able to talk. 911 operator advised against epipen shot and recommended to wait for paramedics. Patient was asked by paramedics if he wants to be taken to hospital and he said yes and was taken to hospital

Other Meds: Unknown

Current Illness: Unknown

ID: 1307933
Sex: F
Age: 24
State: FL

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/11/2021
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Symptoms: 15:54, dizziness. BP 104/65, HR 66, SATS 99%, Resp 16. Drank water, laid down. 16:00, symptoms resolved. 16:09, left ambulating for home. Second vaccine.

Other Meds:

Current Illness:

ID: 1307934
Sex: F
Age: 50
State: PA

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 05/11/2021
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Lab Data:

Allergies: gold, seasonal allergies, balsam of Peru

Symptom List:

Symptoms: second dose of Moderna given at 4:00 pm. The next day around 12:30 pm I started to feel fatigue and feverish. I went to bed and continued to feel tired, lethargic, headache and fever. My temperature went to 102 and I took Tylenol. By 8 pm I was feeling better and able to eat a small dinner, but still tired. Sunday I did not have a fever and felt a bit tired but nothing sever and able to function all day and be out. Monday morning I had an outbreak of Cold Sores- the worst ever, I have 4 blisters one on each corner of my lips. I took Valtrex and have had a head ache for 2 days, which is not unusual if I take a Valtrex. I will note that I also gave myself my Duplexent injection on Sunday- cold sore can be a side effect- although I have not had one in 2 years.

Other Meds: Duplxent, Wellbutrin, Flonase

Current Illness: none

ID: 1307935
Sex: F
Age: 42
State: TX

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/11/2021
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Allergies: None

Symptom List:

Symptoms: Lethargy Chills and fever beginning 17 hours after vaccination lasting approximately 12 hours accompanies by mild headache and mild body aches

Other Meds:

Current Illness: None

ID: 1307936
Sex: F
Age: 17
State: MI

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/11/2021
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Symptom List:

Symptoms: Hives covering arms, chest, back, and neck

Other Meds:

Current Illness:

ID: 1307937
Sex: F
Age: 44
State: HI

Vax Date: 03/18/2021
Onset Date: 05/10/2021
Rec V Date: 05/11/2021
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Symptom List:

Symptoms: 1ST DOSE ON 3/18/2021 2ND DOSE ON 4/8/2021 TESTED POSITIVE FOR sars CoV2 ON 5/10/2021

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Current Illness:

ID: 1307938
Sex: M
Age: 54
State: FL

Vax Date: 05/08/2021
Onset Date: 05/08/2021
Rec V Date: 05/11/2021
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Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Patient recieved the second dose of moderna vaccination 21 days after first dose instead of 28 days. Patient did not experience any adverse reaction from the vaccination.

Other Meds: unknown

Current Illness: Unknown

ID: 1307939
Sex: M
Age: 15
State: GA

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 05/11/2021
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Lab Data:

Allergies: unknown

Symptom List:

Symptoms: vaccine not approved for patient's age at time of administration

Other Meds: unknown

Current Illness: unknown

ID: 1307940
Sex: F
Age: 27
State: OR

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 05/11/2021
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Allergies: sulpha

Symptom List:

Symptoms: So the first night, I had a fever, achy, near the injection site was warm and it hurt; stiffness there at the site and headache- a lot of flu-like symptoms - it was about 36 hours that they lasted. Thursday evening, 8th, I got hives - all over my body and that started on my left arm and then it didn't go in my mouth but otherwise all over. I went to my doctor - the ER at my doctor's site - on Saturday, 10th. He prescribed me some medicine - don't remember what plus I took Benadryl . I had to take a week and a half off of work because the medication was so strong. My hives lasted another week. It stopped growing after that week and then it started healing.

Other Meds: no

Current Illness: no

ID: 1307941
Sex: M
Age: 17
State: WI

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/11/2021
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Symptoms: no known adverse reactions occurred to our knowledge

Other Meds:

Current Illness:

ID: 1307942
Sex: F
Age: 61
State: NC

Vax Date: 05/03/2021
Onset Date: 05/08/2021
Rec V Date: 05/11/2021
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Lab Data:

Allergies: Bactrim, Percocet, Prednisone, Proair, Statins,

Symptom List:

Symptoms: 5 days after the first shot, she has experienced itchiness at the site, which developed into redness, which has become a red splot about silver dollar sized "kind of like tatooed on arm." Currently treating with ice and peppermint oil; counseled her to use an antihistamine orally like benadryl but patient stated, it "makes her hyper." Advised to use topical steroid then. Read to her CDC statement on "COVID arm".

Other Meds: Ezetimibe 10mg, metformin 750mg ER, propylthiouracil 50mg

Current Illness: none

ID: 1307943
Sex: F
Age: 0
State: CO

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/11/2021
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Lab Data:

Allergies: gluten

Symptom List:

Symptoms: Throat tightness, numbness throughout body, patient used their personal albuterol inhaler, called 911 pt left with paramedics

Other Meds: none known

Current Illness: no known

ID: 1307944
Sex: F
Age: 64
State: CA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/11/2021
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Lab Data:

Allergies: None

Symptom List:

Symptoms: 24 hours of muscle aches, chills, fatigue

Other Meds: Levothyroxin; Carvedilol

Current Illness: None

ID: 1307945
Sex: F
Age: 39
State: RI

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/11/2021
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Rash all over my body and itchy throat

Other Meds: None

Current Illness: None

ID: 1307946
Sex: M
Age: 54
State: CA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 05/11/2021
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Allergies: Avocado& Banana

Symptom List:

Symptoms: Pt developed a rash 36 hrs post vaccine administration. R/o impetigo, poison oak.

Other Meds: Triamcinolone Acetonide (KENALOG) 0.1 % Top Crea Fluocinonide (LIDEX / FLUEX) 0.05 % Top Crea Lisinopril (PRINIVIL/ZESTRIL) 10 mg Oral Tab

Current Illness:

ID: 1307947
Sex: M
Age: 39
State: CA

Vax Date: 04/29/2021
Onset Date: 05/02/2021
Rec V Date: 05/11/2021
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Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Left facial tingle, left arm tingle, paresthesias

Other Meds: N/A

Current Illness: N/A

ID: 1307948
Sex: M
Age: 15
State: GA

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 05/11/2021
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Lab Data:

Allergies: unknown

Symptom List:

Symptoms: parent lied about patient's age and patient received vaccine not authorized for patient's age

Other Meds: unknown

Current Illness: unknown

ID: 1307949
Sex: M
Age: 23
State: KS

Vax Date: 04/22/2021
Onset Date: 04/26/2021
Rec V Date: 05/11/2021
Hospital: Y

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Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient presented to ER 4/26/21 with sharp chest pain associated with SOB that started the night of 4/25/21. EKG suggestive of pericarditis. Troponin I peaked at 11 and trended down to 6, TTE showed normal EF, no structural abnormalities and no pericardial effusion. patient was observed overnight, did well, discharged 2nd day on Ibuprofen 600 TID PO for 2 weeks. chest pain persisted for two more days and now completely resolved off the NSAID.

Other Meds: None

Current Illness: No past medical hx

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm