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
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1321152
Sex: M
Age: 43
State: PA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Penicillin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt states they were "fine" prior to vaccine administration. Pt was given vaccination and then began to experience immediate partial hearing loss, dizziness and lethargy. Reaction went to assess pt and brought pt water. Pt transported to MO1 on wheelchair. MO1 received 2 sets of VS and both sets were appropriate for pt age and current state. Last vitals taken @ 1655: P: 76, R, 20, BP: 143/84, SpO2: 100%.

Other Meds: Atorvastatin 1x per day 10 Mg PO

Current Illness: None reported

ID: 1321153
Sex: F
Age: 49
State: NC

Vax Date: 04/16/2021
Onset Date: 05/11/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Four weeks after send dose of Pfizer experience Stroke-like symptoms such as numbness on left face, arm and leg; confusing head; sharpness of skin sense declined. Hospital ED, did multiple tests including MRI.

Other Meds: None

Current Illness: None

ID: 1321154
Sex: F
Age: 14
State: IA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Patient was sitting in our recovery area when mom came and said she was having an "itchy" throat. She said she felt like it was congestion, then said it just felt funny. We had her sit for 5 more minutes, no change. Gave her 2-25 mg benadryl with mom's approval and waited 10 more minutes. Patient said she was feeling better, mom not concerned anymore. Left after about 30 minutes recovery total

Other Meds: Unknown

Current Illness: Unknown

ID: 1321155
Sex: M
Age: 71
State:

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

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Customer complained of right arm tingling (not the arm receiving the vaccine) on 5/15/21. Customer complained of a pain in chest for about one second, took a breath and pain was resolved on 5/14/21. Blood pressure was normal (125/70 pulse 68).

Other Meds:

Current Illness:

ID: 1321156
Sex: F
Age: 13
State: MA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Patient became unconscious after about 10 minutes after vaccine was given for about 10 seconds. Once consciousness was regained, patient appeared confused and pale. Patient's eyes rolled back and arms and legs were flailing about during unconscious episode

Other Meds: Unknown

Current Illness:

ID: 1321157
Sex: F
Age: 47
State: IA

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: Shingles - presented first as nerve pain in right arm and then after 23 days a skin reaction of sores/blisters appeared. Prescribed an anti-viral (acyclovir) and nerve pain reliever gabapentin

Other Meds: None

Current Illness: None

ID: 1321158
Sex: F
Age: 20
State: FL

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Morphine, Shellfish

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 20 yo WF c/o dizziness and nausea 20 minutes after receiving her 2nd dose of Pfizer vaccine. Patient stated she attempted to stand and got light headed. Staff member notified EMS and NP of the incident. Patient was evaluated by on-site EMS and NP. VS, BS initiated. Both were WNL. Patient has no PMH. Patient stated she started her Period and bleeds heavy on the first day which could have trigger her dizziness. After about 15 minutes patient was reevaluated by NP and EMS. Patient stated she was feeling and agreed to call family member to drive her home.

Other Meds: none

Current Illness: none

ID: 1321159
Sex: M
Age: 38
State:

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: -chest tightness -short of breath -seen by EMS, transported to ER

Other Meds:

Current Illness:

ID: 1321160
Sex: F
Age: 14
State: IL

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 14 year old female fainted. alert and oriented X 0 not verbally responsive

Other Meds: unknown

Current Illness: per mother no illnesses

Date Died: 05/09/2021

ID: 1321161
Sex: M
Age: 57
State: PR

Vax Date: 05/06/2021
Onset Date: 05/09/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient was vaccinated on May 6,2021. On Friday May 14 ,2021 a relative of the patient report that the patient died on May 9,2021..She report that the patient doesn't take the prescriptions needed for a vascular condition he have and was suppose to received medicines by mail on tuesday before vaccination

Other Meds:

Current Illness:

ID: 1321162
Sex: F
Age: 47
State: WA

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

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

Lab Data:

Allergies: none

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: ?Pfizer-BioNTech COVID-19 Vaccine EUA? swollen joints in both hands and feet fuzzy head feeling unable to sleep 36 hrs after injection

Other Meds: sleep aid 1/2 pill at 10pm

Current Illness:

ID: 1321163
Sex: F
Age: 18
State:

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

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: swelling of throat, difficulty swallowing. patient went to emergency room after leaving and reported diagnosis of anaphylaxis

Other Meds:

Current Illness:

ID: 1321164
Sex: F
Age: 48
State: OH

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: dizziness, nausea, and vomiting almost immediately after injection

Other Meds: none

Current Illness: none

ID: 1321165
Sex: F
Age: 22
State: LA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: nkda

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: Patient had a skin reaction which had a red and blueish pattern on legs. She was experiencing itching and I gave her 50 mg of bendadryl. I check her vital sign and she was breathing normally. No sign swelling of throat or tongue or having trouble breathing. I observe her for 1 hr before her dad came and pick her up to bring her to urgent care. Patient was alert throughout the process.

Other Meds: Patient said she vapes.

Current Illness: no

ID: 1321166
Sex: F
Age: 61
State: WI

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: sulfa; adhesive

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: local swelling, redness, itching, warmth

Other Meds: multiple Rx meds

Current Illness:

ID: 1321167
Sex: F
Age: 31
State: TN

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: I received my second Moderna shot on 4/9/2021. I was sick for about 36 hours and it went away. No big deal. On 4/12 I got my period. I haven?t had a period in 3 years because of my birth control. I had really bad cramping and lots of clots. It lasted about 5 days and was gone. On 4/30 I got another period. Same lots of clotting and bad cramps. That went away after about 5-6 days. I went to the dr on 4/13 and told her about it which she ignored and said it could be anything. She will run labs but won?t check estrogen levels since I?m on birth control. I go for labs on Monday 4/17. Well on 4/15, which is the day I am writing this I am again on my period. This isn?t normal. As well as the pains that I am constantly feeling in what feels like my tubes or something. I also know I am not the only person this has happened to. The shots have just became available for teens and I have a 14, 12 and 6 year. All girls. And I am all for the shot however this makes me question if it won?t affect my daughters and how it will affect them if it?s doing this to me. I am hesitant to give it to them and I wasn?t before.

Other Meds: Birth control, Zoloft and allergy medicine

Current Illness: No

ID: 1321168
Sex: F
Age: 21
State: LA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: The patient stated that she had not received a vaccine in several years but that the last time she did, she blacked out for maybe 30 seconds and felt dizzy. She states she thinks it was because she did not eat that day and stood up too quickly because she felt ok after. I notified (pharmacist) to be on stand by in case any incidence occurred and we had smelling salts and epipen on hand. I had the patient sit in the vaccine chair afterwards and about 3 minutes later, she started screaming to the top of her lungs that she felt like she was going to die. She screamed that she couldn't breathe and that her chest and head were "killing her". She kept screaming to remove the vaccine out of her arm (the liquid). Her eyes were starting to roll, but I knew she was breathing because she was screaming to not let her die. Her mother was with her and was very nervous and wanted emergency services, so We called 911. I took the girls hands and asked her to look me in the eyes and follow my deep breaths, because I began to think it was more of a panic attack. She followed by breaths and regained some composure but was sweating profusely, so I began fanning her. After a while of talking her through taking deep breaths and assuring her she was breathing and we had emergency services on the way, she began to calm down. EMS showed up about 15-20 minutes later and she declined to go with them. I stayed with the patient the entire time. She did not faint. I believe she just had a panic attack from working herself up about the vaccine. She was a little scared since she had fainted with the last vaccine.

Other Meds:

Current Illness:

ID: 1321169
Sex: M
Age: 60
State: AZ

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

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

Lab Data:

Allergies: non-itchy full upper body skin rash when ingesting Penicillin and Sulfas

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 1. Sore upper left arm for a few days 2. Mild numbness in left arm from elbow down to fingers similar to tendonitis (experienced from day 1 to current day 10) 3. Significant upper body itchy rash on abdomen, back, arms, hands, chest, neck and face starting 8 days after injection and continuing.

Other Meds: Lovastatin 20 mg Glucosamine Sulfate 1,500 mg Chlorophyll Vitamin D3 Multi-Vitamin

Current Illness: None

ID: 1321170
Sex: M
Age: 42
State: NJ

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pt stood up with the help of his cane after receiving his 2nd dose of moderna covid19. He started walking towards me as i held the door. He went stiff and started tipping over. I ran in and tried to keep him from falling. I guided him to the wall and down to the floor. His friend who also received the shot, came in to assist me since pt. is pretty big and was dead weight. His friend said this happens several times a day. We sat him up and waited. He then started having a seizure that lasted 3-5 seconds. Then he stated he was seeing black spots and felt weird. I called EMS and the police and EMT's took him out on a stretcher.

Other Meds: lisinopril 40mg daily, gemfibrozil 600mg twice daily, glipizide 5mg twice daily, rizatriptan 10mg, topiramate 200mg twice daily, lamotigrine 200mg twice daily, tamsulosin 0.4mg daily, levetiracetam 750 twice daily, hydroxyzine pamoate 50mg

Current Illness: seizures blood pressure problems depression prostate migraines

ID: 1321171
Sex: M
Age: 0
State: CO

Vax Date: 05/14/1971
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: penicillin, bell peppers, alfalfa, "hay fever" allergies to many to list

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: severe fatigue and body pain. chill, cold sweats. no fever.

Other Meds: none

Current Illness: none

ID: 1321172
Sex: F
Age: 41
State: GA

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: I was sick the next morning when I woke up. I have been sick ever since and seem to be declining. I am unable to work. I have been to the ER and urgent care several times. I have no one to take care of me and am about to lose my house. I am scared for my life. High BP hyper and hypo and heart rate High lymphocytes High monocytes (wbc was 1c high but has lowered while these have risen) Bm isssues-frequent, diarrhea, orange, mucus Body aches and pain Feel uncoordinated/unbalanced Weakness Shallow rapid breathing Headaches Drowsy Trouble texting and typing Memory Exhaustion Constant hunger Dark circles under eyes Sweating Cold sores Frequent urination Dry, sore, tired eyes Rashes Sore swollen feet at night Itching lower body Heartburn Swollen, red, hot aching joints Rashes, flushing, hives Delirium Aip elimination diet has decreased autoimmune symptoms, but muscle weakness, fatigue, mental and cognitive issues are getting worse.

Other Meds: Yuvavem 2xweek Estradiol patch .1 2xweek Seroquel 25mg sleep/anxiety 1xday Clonazepam .5mg as needed for anxiety/ptsd Ropinerol .5pm severe RLS Horizant 600mg pm RLS Eliquis 5mg 2xday Factor 5 Lieden Flexeril as needed. Cervical pain. Ome

Current Illness: None

ID: 1321173
Sex: F
Age: 23
State: TN

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Unevaluable event

Symptoms: Swollen tongue

Other Meds:

Current Illness: Cronh?s Disease

ID: 1321174
Sex: F
Age: 49
State: TX

Vax Date: 04/21/2021
Onset Date: 05/05/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Propylene glycol

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Brain fog, short term memory issues, aphasia

Other Meds: Methylfolate, PQQ

Current Illness: None

ID: 1321175
Sex: F
Age: 55
State: OK

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Sulfa Drugs, Amoxicillin, Methylprednisolone, Dilaudid, Diflucan. Foods, Aloe Vera, Milk Chocolate, Watermelon, Cauliflower, Red Dye. Other: Ragweed, Lavender, Pine, Vicks Vapor Rub.

Symptom List: Injection site pain, Pain

Symptoms: 5 hours after injection: Headache, Neck Stiffness, Low Back Pain, & Very tired. An hour later my symptoms increased: Fever of 101.6 which lasted for 3 hours. Chills, Shivering, Exhaustion. Nausea. After my fever broke, my Legs started Kicking involuntarily,. They kicked Constantly for 2 hours. (It was scary and out of the ordinary.) So much so that my knees hurt. If I forced my lag to stop kicking, my ankles and feet start jittering. If I get up to walk around my feet swell up. I was Still nauseous. I was unable to eat Lunch or Dinner. At bed time I was able to eat a bowl of cereal, and my legs finally stopped kicking. Nausea subsided. Next morning felt achy and had a runny nose. 34 hours after vaccination. felt tired, had chills and nausea again. I had to take a nap. The following day I felt like I was back to normal.

Other Meds: N/A

Current Illness: N/A

ID: 1321176
Sex: F
Age: 22
State: CA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: received the 2nd COVID vaccine (Moderna Lot # 021C21A and expiration date 05/26/2021) at 1655. Client reported to EMT Noor at 1703 that she ?wasn?t feeling good.? PHN responded at 1703. Client stated that she was feeling ?anxious about shot? she also said that she felt nauseas and that her vision went ?spotty.? Vital signs were taken at 1705 (Oxygen 95%, Heartrate 85, Blood pressure 118/60, respiration 14). Client was diaphoretic and pale, alert and oriented x3, no shortness of breath. At 1710 client stated that was feeling better, skin was pink and dry. Client stated that she ate in the car on the way over to receive her vaccine. She has no medical history, she is taking oral birth control and topical acne medicine. She is allergic to Amoxicillin, Vital signs taken at 1720 (blood pressure 106/74, Oxygen 99%, Heart rate 88). Client stated, ?I don?t want to stay 30 minutes, I?m feeling fine now.? Client advised to seek medical care if symptoms re appear and worsen, and to follow up with her primary care provider. Client left at 1722 unassisted with a steady gait.

Other Meds: Oral birth control and topical acne treatment

Current Illness: None

ID: 1321177
Sex: F
Age: 52
State: FL

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

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

Lab Data:

Allergies: nka

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Patient called at 5:10pm on 5/16/21 stated she has shortness of breath. I asked for details of what she felt and when it started and she stated about 30 -40 minutes after receiving the vaccine feeling very tired. I discussed that fatigue/tiredness were normal with the vaccine but shortness of breath was not ands asked if she has shortness of breath or fatigue and she stated "well both" I advised her fatigue is normal and SOB is not, and if she is experiencing shortness of breath to consider it an emergency and seek emergency care (911) and I would also report her adverse event.

Other Meds: heart and diabetes

Current Illness:

ID: 1321178
Sex: F
Age: 49
State: TX

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: morphine

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient had constant shivering , skin felt clammy, increase in heart rate and blood pressure after 15 minutes of receiving the 1st dose Moderna vaccine. EMS was called and evaluated the patient and informed patient she had anxiety. No reaction to the vaccine and recommend to go home and rest or if symptoms worsen to go the ER. Patient left the site and went home.

Other Meds: migraine medication .

Current Illness:

ID: 1321179
Sex: F
Age: 49
State: CA

Vax Date: 05/08/2021
Onset Date: 05/10/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: No e

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Blood pressure spike for several days afterward, could not be controlled.

Other Meds: Lisinopril, zoloft

Current Illness: None

ID: 1321180
Sex: F
Age: 59
State:

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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

Lab Data:

Allergies: sulfa, iodine

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Patient vaccinated at 10:18am by mobile vaccinator. At 10:48am patient reported symptoms of headache rated 4/10, chest heaviness that lasted a ?few? moments, and lightheadedness. Patient?s 30 minute wait increased to 45 minutes by mobile team. Patient given Gatorade and instructed to recline seat, patient declined any breathing issues. Patient?s new wait time now 11:03am from 10:48am. When checking on patient at 11:05am, patient informed her headache has increased and moved to sinuses and reported chest heaviness had returned. Patient?s spouse reported that patient used her inhaler before the RN came to car. MBC paged at 11:08am to come for further evaluation. Patient?s vital signs taken at 11:15am were a pulse of 84, blood pressure of 138/82, and pulse oximetry of 97%. Patient was alert and oriented to person, place, time, and event. And able to hold a conversation. MBC called EMS at 11:17am, and continued to monitor patient for any status changes. No hives, itchiness, tongue swelling, or respiratory obstruction were noted. EMS arrived at 11:29am and performed an evaluation. Vital signs were a pulse of 89, blood pressure of 145/89, and pulse oximetry of 96% at room air. At 11:35am, patient reported muscle pain in her chest that radiated up to her shoulders, and no acute distress or respiratory issues. Patient declined EMS transport and left the site at 11:44am. Provided education to patient and told to follow up with primary care doctor, and if symptoms worsen to head to the nearest ER or Call EMS. Patient and spouse verbalized understanding of the education. Patient left in the passenger side of the car, spouse was driving the vehicle.

Other Meds:

Current Illness:

ID: 1321181
Sex: F
Age: 49
State: MS

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/15/2021
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Allergies: Codine, nsaids

Symptom List: Nausea

Symptoms: Loss of muscle control, paralized on right side of body. In bed for three day and still need to have support to walk.

Other Meds: Gavapantin 800mg 3xdaily Tizanidine 4mg 3xdaily Alprazolam 1mg 3xdaily Lasix 80mg 1xdaily Potasium 200mg 1xdaily Protonix 45mg 1xdaily keppra 2000mg 1xdaily Baby Aspirn Oxycodone 10mg 2xdaily Atorvastatin 10mg 1xdaily

Current Illness:

ID: 1321182
Sex: M
Age: 66
State: TN

Vax Date: 03/26/2021
Onset Date: 05/10/2021
Rec V Date: 05/15/2021
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Allergies: none erported

Symptom List: Injection site pain

Symptoms: This patient went to his vascular doctor on 5-10-21 and a clot was discovered on the groin area of the left leg. The MD said it did not warrant going to the ER. He has 2 stents in the right leg, (1 in thigh and 1 in calf). Patient reported it being uncomfortable but not "painful". Md placed him on Eliquis 10 mg, BID for 7 days then reducing the dose to 5 mg BID thereafter for about 5 months/

Other Meds: unknown

Current Illness: none reported (2 vascular stents in right leg)

ID: 1321183
Sex: F
Age: 19
State: AZ

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/15/2021
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Lab Data:

Allergies: SUNFLOWER SEEDS

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: -FIRST HOUR, ARM GREW EXTREMELY SORE - LATER THAT NIGHT, HEADACHE, BODY SORENESS AND BACK AND FORTH CHILLS OR SWEATSING (SOAKED SHEETS SLEEPING). RELIEF ON 5/14 EXCEPT FOR RED RASH AROUND INJECTION SITE.

Other Meds: NONE

Current Illness: NONE

ID: 1321184
Sex: F
Age: 42
State: CA

Vax Date: 05/07/2021
Onset Date: 05/10/2021
Rec V Date: 05/15/2021
Hospital:

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Allergies:

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Extremely heavy period for several hours. I went through 14 super heavy pads. This has never happened before and I was terrified.

Other Meds:

Current Illness:

ID: 1321185
Sex: F
Age: 15
State: CA

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/15/2021
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Allergies: none

Symptom List: Tremor

Symptoms: syncope with bilateral tonic/clonic movements. per parents, patient has history of vasovagal syncope following exposure to needles or lancets (vaccines, finger prick). approx 2 minutes following injection, patient lost consciousness, followed by several clonic movements bilaterally of upper and lower extremities. patient was transfered from chair to floor, legs were elevated. She regained consciousness quickly, was given water. When she felt better, she once again sat in a chair. After another 5 minutes (approx), she had another episode of loss of consciousness with increased tone of UE and LE bilaterally and also several clonic movements. She was again transferred to the floor, regained consciousness. She was more shaky and diaphoretic following the second episode but was otherwise aware and oriented. She was observed for another 30 minutes at the pharmacy and then left.

Other Meds: none known

Current Illness: none

ID: 1321186
Sex: F
Age: 18
State: CA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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Lab Data:

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: syncope

Other Meds: none

Current Illness: none

ID: 1321187
Sex: M
Age: 52
State: FL

Vax Date: 05/01/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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Allergies: None

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Blood blisters in hand

Other Meds: None

Current Illness: None

ID: 1321188
Sex: M
Age: 72
State: MD

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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Allergies: N/A

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: INJECT 0.3 ML PFIZER VACCINE INSTEAD OF MODERNA FOR 2ND DOSE.

Other Meds: N/A

Current Illness: N/A

ID: 1321189
Sex: F
Age: 19
State: NH

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient said she had ringing in ear, and was nauseous immediately after immunization. Patient appeared pale, sweaty, and shaky. I told the patient to put her head between her knees. She regained color within minutes. She felt better but we called 911 just to be safe. The patient and the EMT decided the she would be driven home bu her mother to rest.

Other Meds: na

Current Illness:

ID: 1321190
Sex: F
Age: 38
State: TX

Vax Date: 05/01/2021
Onset Date: 05/02/2021
Rec V Date: 05/15/2021
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Lab Data:

Allergies: Sulfa

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Increasing foot pain on the second day of the injection, tiredness and weakness. The foot pain continued then my spine and my feet got numbed. My hands, my lower lip and several parts of my body got numbed. The pain in the spine does not subside, I had a bitter or metallic taste in the mouth and moderate diarrhea.

Other Meds: None

Current Illness: Urinary infection on 4/22/21. They prescribed me Ciprofloxacin 500 mg tablet.

ID: 1321191
Sex: F
Age: 13
State:

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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Allergies:

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Nurse administered Pfizer vaccine into patients left deltoid. Dose leaked out from syringe tip no Dose noted as administered. Clinical supervisor informed of incident, pharmacy coordinator informed of incident. Vaccine re-administration advised. Patient father requested different nurse. Pfizer Re- administered into Right Deltoid to initiate their series of Pfizer vaccination. Vaccination complete no signs and symptoms of distress. Patient and parent in monitoring with no further questions or concerns. Incident reports filled out.

Other Meds:

Current Illness:

ID: 1321192
Sex: M
Age: 43
State: LA

Vax Date: 05/08/2021
Onset Date: 05/08/2021
Rec V Date: 05/15/2021
Hospital:

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Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: NONE

Other Meds:

Current Illness:

ID: 1321193
Sex: F
Age: 57
State: MD

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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Allergies: N/A

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: PHARMACIST INTERN GAVE 0.3ML PFIZER INSTEAD OF MODERNA.

Other Meds: N/A

Current Illness: N/A

ID: 1321194
Sex: F
Age: 14
State: CA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
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Allergies: None

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: 9:45am a 14 year old patient reported not feeling well, vital signs taken BP: 76/50, HR 60, then dropped to 50s, 02 sat at 98% room air. Then patient became unresponsive with that 2 minutes, still with pulse of 52, Benadryl 50mg IM given to right arm, within 2 minutes patient became responsive and with color came back to her face. Ambulance came within 6 minutes, patient became responsive and vital signs stable. Report given to the ambulance. Patient and mom and sister went in the ambulance in stable condition.

Other Meds: None

Current Illness: None

ID: 1321195
Sex: F
Age: 53
State: NJ

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/15/2021
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Allergies: insect bites, latex, penicillin

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: 24 hours after the injection my breasts started swelling and I developed fever up to 102F. Also very fatigued.

Other Meds: n/a

Current Illness: n/a

ID: 1321196
Sex: M
Age: 32
State:

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 05/15/2021
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Allergies: None

Symptom List: Vomiting

Symptoms: Chills, headache, fatigue, fever at 12 hours after injection. Headache and fever persisted for 24 hours after onset.

Other Meds: Vitamin D

Current Illness: None.

ID: 1321197
Sex: F
Age: 15
State: CA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient fainted within 5 minutes after injection. Patient experienced a syncope event passed out. Patient regain conscious within a minute. Patient may have injure her head upon falling.

Other Meds: none

Current Illness: none

ID: 1321198
Sex: M
Age: 40
State: CT

Vax Date: 04/21/2021
Onset Date: 04/30/2021
Rec V Date: 05/15/2021
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Allergies: N/a

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Persistent shoulder pain. Not painful to touch but rather more like. Deep tissue or nerve injury. Range of motion limited above location of injury. Ex: opening a standard window is rather painful due to the positioning and strain on muscles in this particular area.

Other Meds: I was still taking a naproxen 500mg tablet 2x/day for unrelated condition when I was administered first dose. I did not begin to experience my adverse effect until I completed that prescription.

Current Illness: Chronic Epidymitis event. Have experienced this regularly since 3/2020.

ID: 1321199
Sex: M
Age: 18
State: CA

Vax Date: 04/23/2021
Onset Date: 04/28/2021
Rec V Date: 05/15/2021
Hospital:

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Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient called to say she was having a reaction to the COVID vaccine that she received Thursday. She reported that her arm where she received the injection was red, swollen, and itching very bad. It started the same day as the injection. She already takes 3 Benadryl a day and says she cannot apply ice to the area because "ice makes her hurt." I advised her to increase the amount of Benadryl she was taking and that she could use a topical steroid to the area. I also advised that it should go away on its own but to follow up with her doctor if she has any further issues.

Other Meds:

Current Illness:

ID: 1321200
Sex: F
Age: 56
State: MD

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/15/2021
Hospital:

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Lab Data:

Allergies: Shellfish

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: ?Covid arm? - red, itchy rash at injection site

Other Meds: Atorvastatin Levothyroxine Pantoprazole Famotidine Magnesium 500 mg, Vitamin B-12, Vitamin D3

Current Illness: None

ID: 1321201
Sex: F
Age: 32
State: VA

Vax Date: 03/17/2021
Onset Date: 04/07/2021
Rec V Date: 05/15/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: None

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Miscarriage: I was due at the end of the year. Miscarried after 2nd shot.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am