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: 1314996
Sex: F
Age: 64
State: MO

Vax Date: 04/16/2021
Onset Date: 04/27/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: Penicillins, sulfa drugs

Symptom List:

Symptoms: Patient reported increased shortness of breath and headache since 1st COVID vaccine. Stated "I felt like I was drowning last night and I took a Lasix." Symptoms improved with Lasix. Also reported increased cough and sputum production. She refused admission but did receive dexamethasone 10 mg IV, ketorolac 20mg IV and Norflurane spray in ED.

Other Meds:

Current Illness:

ID: 1314997
Sex: M
Age: 27
State: WA

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: On data entry into IIS, it was noted that patient had a first dose of the Pfizer vaccine on 4/27/21 at another facility. I called the patient to confirm if he got the Pfizer vaccine and he said yes. When patient came to get the vaccine, he did not mention getting another kind of COVID-19 vaccine previously and that he mentioned that he wants to do the Janssen vaccine. I told the patient that I will follow-up with him on what to do next after checking with DOH on next steps. To prevent future errors, the vaccinator will ask if the patient has gotten any other COVID-19 vaccine in the past and will double check data in IIS before administration.

Other Meds: unknown

Current Illness: none

ID: 1314998
Sex: M
Age: 21
State: NJ

Vax Date: 05/05/2021
Onset Date: 05/07/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: Prevacid/Zantac/Prilosec - anaphylaxis Vancomycin - anaphylactoid reaction (red man syndrome)

Symptom List:

Symptoms: pruritic rash x 4 extremities

Other Meds: augmentin, claritin

Current Illness: taking augmentin for sinus/ear infection

ID: 1314999
Sex: F
Age: 47
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient seen at a vaccination clinic and given first dose Pfizer EN6204 in LA on 3/12/2021. Subsequently returned for second dose and was given the Moderna vaccine to complete her series.

Other Meds:

Current Illness:

ID: 1315000
Sex: F
Age: 41
State: VA

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

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

Lab Data:

Allergies: nkda

Symptom List:

Symptoms: Within 5 to 10 minutes of giving her the vaccine, patient complained of extreme nausea and she was also sweating more than normal. She was able to communicate the entire time and I had an associate monitor her and be with her the entire time. She had a few sips of water and felt better. After about 20 minutes she felt better. The associate was with her for 30 minutes and she felt better and continued to shop on and stopped by before she left the premises.

Other Meds:

Current Illness:

ID: 1315001
Sex: F
Age: 15
State: PA

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient began to get pale, lightheaded and dizzy about 3 minutes after injection - pharmacist applied two ice packs to patients neck area and patient felt better with color returning and dizziness going away about 10 minutes later. Pharmacist followed up with mother at home via phone and confirmed that patient was fine about two hours after vaccination.

Other Meds: none

Current Illness: none

ID: 1315002
Sex: M
Age: 39
State: NH

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Received a second dose of moderna on 5/13/2021 after receiving a first dose moderna on 4/22/2021. Second dose of moderna was given at day twenty-one rather than on day twenty-eight, ultimately, seven days early. The administrator informed management, who discussed the incident.

Other Meds: None

Current Illness: N/A

ID: 1315003
Sex: F
Age: 27
State: WA

Vax Date: 05/03/2021
Onset Date: 05/07/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: - Severe allergic reaction - Swelling of the face and entire body - Rash on the entire body - Hives

Other Meds: None

Current Illness: None

ID: 1315004
Sex: F
Age: 30
State: WA

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Swollen axillary lymph node on left side

Other Meds: Adult multivitamin, creatine

Current Illness: N/A

ID: 1315005
Sex: M
Age: 43
State: AZ

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Severe Flu Like Symptoms

Other Meds:

Current Illness:

ID: 1315006
Sex: F
Age: 16
State: CA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient received first dose Moderna when not eligible due to age (16 at date of vaccination).

Other Meds:

Current Illness:

ID: 1315007
Sex: F
Age: 16
State: MD

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

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

Lab Data:

Allergies: Cipro, shellfish

Symptom List:

Symptoms: Hives on thighs -contacted PCP who stated to give patient Benadryl for Hives and complete this form

Other Meds: Adderal XR 10 mg

Current Illness: N/A

ID: 1315008
Sex: M
Age: 45
State:

Vax Date: 05/07/2021
Onset Date: 05/11/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Tiny small vessel acute infarct within the left dorsal midbrain

Other Meds:

Current Illness:

ID: 1315009
Sex: M
Age: 34
State: CA

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient received expired vaccine. Expiration date: 03/2021 Did not have a reaction or complaint

Other Meds:

Current Illness:

ID: 1315010
Sex: M
Age: 62
State: CA

Vax Date: 04/28/2021
Onset Date: 04/30/2021
Rec V Date: 05/13/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Acute encephalitis with seizure-like symptoms

Other Meds: Atorvastatin, Lantus

Current Illness: none

ID: 1315011
Sex: F
Age: 1
State: OR

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Lower extremity swelling and purple discoloration with warmth (per mom). Happened about 24 hrs after injections. Legs seemed painful and patient was very fussy. Symptoms started at 6am and I saw baby at 10:30am. Legs were only very mildly swollen with no real erythema or discoloration.

Other Meds: none

Current Illness: none

ID: 1315012
Sex: F
Age: 43
State: TX

Vax Date: 04/08/2021
Onset Date: 04/11/2021
Rec V Date: 05/13/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies:

Symptom List:

Symptoms: 3 days after the vaccination I started my menstrual cycle even though I had already had one 10 days before. My menstrual cycles are very regular and this was not normal to start it so soon after the previous one. The cycle that started 3 days after my vaccination was lighter than my normal cycles and only lasted 5 days (as opposed to 7-8). 6 days later, I started spotting again. It only lasted 2 days that time and was very light spotting.

Other Meds: Zoloft 150mg Metroprolol 100mg 2Xday

Current Illness:

ID: 1315013
Sex: F
Age: 47
State: MI

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: vomitting ,fever, chills, severe joint pain in most joint, chills, days of fatigue,

Other Meds:

Current Illness:

ID: 1315015
Sex: F
Age: 40
State: AZ

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: wheat; barley; rye; - included in fillers and pills; NSAIDS - ibuprofen; naproxen; Celebrex; trees and grass and flowers

Symptom List:

Symptoms: I noticed right away after the vaccine, I noticed nerve pain through my body. I noticed a headache. I had some weird stomach pain (kind of sharp, nerve pain) that was on my right side. It felt sudden and it startled me. It ended up going away - that happened four or five times the first day. The next day, I woke up with migraine headache - told doctor experienced nausea, vomiting, sweating. That migraine lasted three or four days. I was taking Imitrex (I take it as needed - 2 a day) and that was not helping. It was a horrible headache. I saw the PCP and the rheumatologist and they did a nerve block which helped. The nerve block was about a month ago. And that worked for about a month but now I'm having migraines again. I am still having a lot of the nerve pain. The doctor said that I have pre-anti-fossid lipid - syndrome (APS) - and was concerned about clots.

Other Meds: Cymbalta - 20 mg; Trazadone - 50 mg; Placinol - 400 mg/day; Methotrexate subacute injections - I stopped taking them for two weeks post shot - I did have this injection the day before the injection (21st); amlodipine - 2.5 mg; Singulair;

Current Illness: had a UTI that I had antibiotics for that month

ID: 1315016
Sex: F
Age: 52
State: PR

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

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Patient was in the observation area and report feeling dizziness and blurry vision. Patient was sweeting. At this point we take the vitals of the patient sugar was 100, O2% 83% at 4:40pm, 120/90 blood pressure. The paramedic put the oxygen 2units and repeated the vital. The was transfer to the hospital.

Other Meds: Metformine 500mg Metropolol 100mg Abilyfy 30mg efexor 150mg

Current Illness: no

ID: 1315017
Sex: F
Age: 56
State: FL

Vax Date: 01/15/2021
Onset Date: 03/01/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Deafening ringing my ears bilateral

Other Meds: N/A

Current Illness: N/A

ID: 1315018
Sex: M
Age: 20
State: UT

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient told us he already received first dose of Moderna covid vaccine at another location. He was overdue for his 2nd dose. We administered the shot. The next day he reported to us that he actually received the Pfizer covid vaccine (his error). He reported typical symptoms from the covid vaccine (tiredness, achy muscles) .

Other Meds: unknown

Current Illness: not known

ID: 1315019
Sex: F
Age: 50
State: AZ

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Fever Chills and Sore Arm. Does not want revaccinate at this time

Other Meds:

Current Illness:

ID: 1315020
Sex: F
Age: 41
State: WA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: fever 102.1

Other Meds: levothyroxine, tylenol

Current Illness: thyroid cancer - total thyroidectomy April 22. Hospitalization due to hypercalcemia April 26 - 28

ID: 1315021
Sex: F
Age: 31
State: WA

Vax Date: 04/11/2021
Onset Date: 04/28/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: On 4/28/21 (+/- 1 day, I think) I started having a scabies like rash that has since continue spreading on my body. I went to a dermatologist today (5/13/21) but they were unable to confirm the presence of scabies.

Other Meds: None

Current Illness: None

ID: 1315022
Sex: F
Age: 55
State: CA

Vax Date: 05/08/2021
Onset Date: 05/09/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Ecchymosis rash on extremities and trunk.

Other Meds:

Current Illness:

ID: 1315023
Sex: F
Age: 52
State: CA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pt c/o flush and sweaty approx 30 min post-vaccination. Symptoms resolved with rest. Denies chest pain, palpitations, SOB. Discharged home in stable condition. SpO2 98% RA Respirations unlabored. BP 116/68 HR 66

Other Meds:

Current Illness:

ID: 1315024
Sex: F
Age: 51
State: CA

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: continuing heart palpitations and flutters

Other Meds: Lamotrigine, Quetiapine, Wellbutrin XL

Current Illness: None

ID: 1315025
Sex: F
Age: 33
State: AZ

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Headache, high fever, body aches

Other Meds:

Current Illness:

ID: 1315026
Sex: U
Age: 22
State: AZ

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: No ADA

Other Meds:

Current Illness:

ID: 1315027
Sex: F
Age: 39
State: CA

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Starting the following evening after the vaccine at approximately 9:00pm on Wednesday, my stomach started hurting - from then all the way through the following morning around 4:00am I experienced diarrhea, vomiting (7-8 times), fever and severe chills. As of this morning (Thursday), I no longer have a fever, chills, diarrhea or vomiting, but have intermittent stomach/intestinal pain and exhaustion/fatigue.

Other Meds: None

Current Illness: None - am breastfeeding

ID: 1315028
Sex: F
Age: 43
State: OH

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: After getting my second vaccine, I instantly became tired and sore. I woke up in the middle of the night sick. I started with vomiting and diarrhea. My left arm was swelled and hurt. My body was achy and I could hardly walk. Swelling ended up going into my arm pit and left chest. That afternoon I had some trouble breathing along with chest pains. The pains lasted all day and then my throat became sore. I slept most of that evening. The next morning I woke up and my chest pain became a little worse, along w/a severe sore throat. My arms, legs, feet, and hands were very achy. I ended up going to the emergency room because I didn?t feel right. Returned home after they said that was normal symptoms after the shot. Within two hours, my face started swelling, throat hurt worse and I couldn?t swallow, and my lips were swelling. I also had a rash in various places that itched pretty bad. I ended up being covered in hives that were raised up like knots everywhere. I returned to the ER and finally they said I was having an allergic reaction to the vaccine. I was hooked up to IV meds, then returned home. The next day (Sunday) my legs were swelling and it was very hard to walk. The rash became worse and was popping up all over. Didn?t feel like moving because my hand and feet hurt so bad. On Monday my leg was swelled double the size, hot and red. I was told they were worried about a blood clot, so I had blood work done. All of my levels were elevated, d-dimer was 2500. I was sent to Chillicothe Er to have testing done. They suspected blood clots in my lungs, however that came back ok. I was put on more meds and watched for awhile. After a CT scan and getting new meds, I left, but had to return to have a Doppler completed on my leg. It came back negative for blood clot, however the swelling still comes and goes. I ended up taking two kinds of steroids and a couple other meds to help the reaction. To this day, I am still tired easy, have some shortness of breath, my legs, feet and hands still swell and they ache pretty bad.

Other Meds: None

Current Illness: None

ID: 1315029
Sex: F
Age: 28
State: CA

Vax Date: 05/06/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Around 10:00pm, I started developing very intense chills and a fever. I went to sleep and awoke 2 hours later with the loudest ringing in my left ear (tinnitus) and a fever of 104. The ringing in my ear was the most disturbing part. I knew it was being caused by a ton of inflammation near my ear, so for 7 hours I sat up and drank water (and tried not to panic about the sound). The ringing went away hours later, but my fever was still high at 7:00am. I got up to go to the bathroom and fainted. My twin sister -- who also got the vaccine with me (same batch) -- had fainted the night before. But her symptoms were not as intense as mine. My fever continued on and off for 48 hours.

Other Meds: None

Current Illness: None

ID: 1315030
Sex: F
Age: 43
State: CA

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: I got back pain, tiredness, thirst, and arm?s pain at the following day. Also, I got chills about 30 minutes 24 hours later. I got the same side effects with both doses, and they last in 24 hours.

Other Meds: Nine

Current Illness: None

ID: 1315031
Sex: M
Age: 68
State: PA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Wife reports joint swelling in multiple areas of the body after vaccination.

Other Meds:

Current Illness:

ID: 1315032
Sex: F
Age: 48
State: WI

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Client scheduled and receive Pfizer vaccine after previously getting Moderna Dose 1. Client reported to clinic that they had not received any COVID vaccine previously and system did not have capability to check this. on 5/13/2021 client received the second dose of Pfizer erroneously as well reporting that was their second dose.

Other Meds:

Current Illness:

ID: 1315033
Sex: M
Age: 78
State: KS

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

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

Lab Data:

Allergies: Nka

Symptom List:

Symptoms: Pt recieved a 3rd (accidental) administation dose of Shingrix: staff believed it to be th e2nd injection as the actual 1st injection was administered at the Dr Office, thus, the information on that injection was not in the pharmacy's patient record; patient stated that he has never had any reaction to previouly administered vaccinations.

Other Meds: Unknown

Current Illness: Unknown

ID: 1315034
Sex: M
Age: 46
State:

Vax Date: 05/10/2021
Onset Date: 05/11/2021
Rec V Date: 05/13/2021
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Symptoms: Fever to 101 F deg, headache, and full body muscle pain, for a day.

Other Meds:

Current Illness:

ID: 1315143
Sex: F
Age: 39
State: NY

Vax Date: 05/08/2021
Onset Date: 05/10/2021
Rec V Date: 05/13/2021
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Allergies: None

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Symptoms: Tingling in fingers, sore arm, chills, fever, tired Short of breath, still short of breath today

Other Meds: None

Current Illness: None

ID: 1315144
Sex: F
Age: 33
State: IN

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
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Allergies: No

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Symptoms: I have an erythema on my arm, it hurts a lot and is very hot.

Other Meds: Planing pills "Bellaface" (DIENOGEST, ETINIL ESTRADIOL)

Current Illness: No

ID: 1315145
Sex: M
Age: 85
State: PA

Vax Date: 05/11/2021
Onset Date: 05/13/2021
Rec V Date: 05/13/2021
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Allergies: unknown

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Symptoms: Per discussion with wife, patient experienced worsening shortness of breath after each Moderna vaccine. The patient has history of inhalers used for COPD, but the patient's wife stated that he has had difficulty moving from room to room without becoming short of breath, which did not happen before the vaccines.

Other Meds: furosemide, potassium, isosorbide, hydrocortisone, simvastatin, levothyroxine, carvedilol, clopidogrel, valsartan, Breo Ellipta

Current Illness: patient received antibiotic levofloxacin and prednisone on 4/15, 2 days after receiving first does of Moderna COVID-19 vaccine

ID: 1315146
Sex: F
Age: 16
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 05/13/2021
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Symptoms: Patient came to a vaccination clinic and received her first dose Moderna vaccine- she was ineligible for this vaccine due to her age (16 at time of vaccination).

Other Meds:

Current Illness:

ID: 1315147
Sex: F
Age: 37
State: CA

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/13/2021
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Allergies: None

Symptom List:

Symptoms: Itchy in the shot area after a minute of getting it. After about 30mn, a red spot appeared on the vaccine shot. I was about half of an inch in diameter. Flesh was a little bit rigid to the touch after an hour. A little of inflammation of the same area after 7 hours accompanied of pain. The pain is not strong but its is alike as the pain when I have a black bruise and it only happens when I move my arm. After 24hr of the shot, the itchy and ache continue even though I am taking Tylenol of 500 every 6hr. My head ache too.

Other Meds: Venlafaxine Bupropion

Current Illness: Seasonal allergy

ID: 1315148
Sex: F
Age: 18
State: CA

Vax Date: 05/08/2021
Onset Date: 05/08/2021
Rec V Date: 05/13/2021
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Allergies: NKA

Symptom List:

Symptoms: Pt received vaccine soon after began to c/o syncope episodes. Pt able to walk to cot and lay down. No sob noted. Pt cold and clammy. 911 called paramedics out to assess pt refused to go to hospital. after 30 minutes pt began to feel better. 1st set V/S 530 pm p-88, 02 sat 97, BP 104/80 waited 1.5 hrs for husband to pick pt up. Pt stable no c/o no distress able to ambulate on own home with husband.

Other Meds: none

Current Illness: none

ID: 1315149
Sex: U
Age: 24
State: AZ

Vax Date: 05/12/2021
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Rec V Date: 05/13/2021
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Symptoms: No AVE

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Current Illness:

ID: 1315150
Sex: U
Age:
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Rec V Date: 05/13/2021
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Symptoms: None stated.

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Current Illness:

ID: 1315151
Sex: F
Age: 20
State: CA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/13/2021
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Symptoms: By 8 pm, I was feeling a headache and my hands were aching. By 9 pm all my joints were aching. At 11:30 pm, I had the chills and a fever. At 3:00 am I had an extreme headache. At 7:30 am, the headache became less intense. I still had body aches and I felt tired throughout the rest of the day.

Other Meds:

Current Illness:

ID: 1315152
Sex: M
Age: 16
State: CA

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 05/13/2021
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Symptoms: Patient received his 1st dose COVID Moderna vaccination at 16 years old - an age ineligible for this vaccine type.

Other Meds:

Current Illness:

ID: 1315153
Sex: F
Age: 32
State: FL

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 05/13/2021
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Allergies: Amoxicillin. Penicillin. Rosefin

Symptom List:

Symptoms: Fatigue ,irritability,confusion, muscle spasms, tachycardia, dizziness, upon drifting off to sleep body will jolt gasp for air and heart racing, next day right leg was throbbing with moderate joint pain in ankle and knee, brain fog

Other Meds: GNC women?s multivitamin B12 Biotin

Current Illness: NA

ID: 1315154
Sex: M
Age: 16
State: IL

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

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Allergies: Penicillin

Symptom List:

Symptoms: Patient is a 16-year-old male patient admitted with seizure like activity. One day prior to admission patient received his second COVID vaccine, Pfizer brand. On the day of admission Patient woke at 0200 with pain in the left side of the chest, mid-axillary per patient's description it was cramp-like pain and he was able to go back to sleep. At 0500 he got up to use the restroom and went into the kitchen. He told his mom he didn't feel well and fell forward making a gurgling sound, arms rigid, was unresponsive, and this lasted 1.5minutes according to mom. Mom called EMS and when he awoke he stated he was nauseous. After EMS arrived it was 2-3 minutes and he did not feel well again, he stood up and head fell back, eyes open, he was shaking, and making a gurgling noise again, this episode lasted 30 seconds. Upon awaking he was disorientated for a few minutes then back to baseline, he was nauseous again and very tired. He came to the ED where EKG (pending), CBC (normal), PT/PTT/INR (slight elevation), CMP (normal), TSH (normal), Ethanol (None), Troponin (normal), Head CT (normal), and chest xray (normal) were done. He received a NS bolus was given. He was admitted to the pediatric hospitalist for further evaluation and management. This is where he had a 24hour Video EEG with normal EEG he was discharged home.

Other Meds: Sertraline and Methylphenidate

Current Illness: ACL tear

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm