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: 1341169
Sex: M
Age: 81
State: GA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Reporting incorrect second dose given. Moderna administered instead of Pfizer. No adverse reaction present

Other Meds:

Current Illness:

ID: 1341170
Sex: M
Age: 17
State: TX

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient fainted 3 minutes after receiving the first covid vaccine.

Other Meds: None

Current Illness: None

ID: 1341171
Sex: M
Age: 66
State: SC

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

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

Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: Developed shingles; case is ongoing.

Other Meds: None

Current Illness: None

ID: 1341172
Sex: F
Age: 42
State: OR

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Extremely stiff and painful neck and shoulders. Head ache and very rapid resting heart rate. It's 105 and normally 61

Other Meds: Buproprian and Trazadone

Current Illness: None

ID: 1341173
Sex: F
Age: 72
State: PA

Vax Date: 02/26/2021
Onset Date: 02/28/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: lopressor,amplicillin, doxycycline, ct dye, zantac, prilosec, latex, high dose flu vaccine

Symptom List:

Symptoms: pounding irregular heart beats lasting long periods of time and stronger. muscle and joint pain at intervals. lasting several weeks, not every day

Other Meds: losartan/hctz, bupropion, clonazepam, caltrate, vit.D, advil, tylenol, capzasin hp cream

Current Illness: none

ID: 1341174
Sex: M
Age: 58
State: MI

Vax Date: 04/22/2021
Onset Date: 05/02/2021
Rec V Date: 05/22/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Sun, 5-2-21, Petechiae appears on my lower feet, ankles, and lower legs/shins. Random bruises appearing without contact/bump. Mon, 5-3-21, Petechiae now appearing on my hands, forearms. Petechiae spots beginning to appear on my face. Nose and mouth bleeding. Went to hospital ER on 5-3-21. Rec'd IGIV (2 days), and Decadron (Steroid) 40mg daily (5 days). Discharged from Hospital after 5 days on 5-7-21, with platelet count at 58 (58,000). - Follow-up blood draw post-discharge on 5-13-21 showed platelet level back down to 1 (1,000). Directed to hospital by hematologist office, re-admitted on 5-13-21. Rec'd IGIV (3 days) and IV Solumedrol (Steroid), and Oral Steroid (2 days). Discharged again from Hospital after 2nd 5-day hospital stay.

Other Meds: 1. Tamsulosin (Flomax) - BPH 2. Occasional Osteo Bi-Flex Regular Strength - Joint Soreness

Current Illness: None

ID: 1341175
Sex: M
Age: 64
State: MI

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: not known

Symptom List:

Symptoms: Vaccine was administered to the patient in his left deltoid. When the needle was removed, blood started running down his arm and a large "knot" started to form at the injection site. Bandage was applied. Pharmacist told patient that we most likely hit a vein and that caused the bleeding. Told him that he would most likely end up with a nasty bruise and arm tenderness. and that he could take Tylenol or ibuprofen if needed. Also advised that a cold compress would likely help. Pharmacist called patient on 5/22 (the next morning). Patient said that he was "doing fine" and his arm "didn't bother him a bit."

Other Meds:

Current Illness: none

ID: 1341176
Sex: F
Age: 21
State: NY

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient was light-headed, dizzy, and pale minutes after receiving the vaccine. They also reported difficulty seeing (their field of vision was all bright light.)

Other Meds:

Current Illness:

ID: 1341177
Sex: F
Age: 40
State: MN

Vax Date: 05/11/2021
Onset Date: 05/19/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: I experienced my first abnormal menstural cycle where it was regular at first in terms of timing and amount of bleeding until the last day when I woke up at 2 a.m. with a lot of blood that continued into the next day so that every time I stood up blood came out and I was light headed. I went to ER because a lot of heavy bleeding soaking through pads and blood clots. I have NEVER experienced that much blood and NEVER have had large blood clots with my periods and my periods are always regular. It was scary and it was first period after getting shot. My breast also were itchy until menstural cycle and bleeding finished.

Other Meds: gabepentin, lyrica, lamotragine, wellbutrin

Current Illness: ptsd, radial nerve arm compression

ID: 1341178
Sex: F
Age: 85
State: WA

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

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

Lab Data:

Allergies: -Had a previous allergy to Moderna vaccine dose #1 - throat got hard, difficult to swallow, got the jitters, and tingling of tongue. -Guaifenesin - patient had a red blotchy rash after taking Mucuinex chest congestion

Symptom List:

Symptoms: Patient previously had a Moderna (dose #1) vaccine on 1/15/21. Patient had difficulty swallowing, tingling on tongue, and got the jitters about 10-15 mins post dose. She was recommended by her PCP to try the Johnson and Johnson vaccine because of this allergy. We had discussion with an ID specialist and pharmacy manager to go ahead and give the vaccine after weight the risks/benefits. A pharmacist was there to monitor the patient and about 15 minutes post dose, patient had difficulty swallowing and noted that this was a very similar onset to when she received the Moderna vaccine. A code blue was called, patient was sent up on stretcher to the ER. Patient received steroids (methylprednisolone) , famotidine, and Benadryl while in the ER. Currently being monitored in the ER.

Other Meds:

Current Illness:

ID: 1341179
Sex: F
Age: 40
State: CA

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

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

Lab Data:

Allergies: Seasonal allergies.

Symptom List:

Symptoms: Client reported loss of taste starting 2 hours after 1st dose and resolved without intervention the evening of the next day.

Other Meds: None.

Current Illness: Denies.

ID: 1341180
Sex: M
Age: 53
State: NJ

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Muscle pain in left forearm and hand Headache Agitation Light nausea

Other Meds:

Current Illness:

ID: 1341181
Sex: F
Age: 51
State: NJ

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List:

Symptoms: At 3:55pm patient complained of tingling in her right arm and hand with her finger tips feeling cold. At 4 pm she complained that her right arm felt weak and heavy , she was able to push with her right arm. She denies SOB or difficulty breathing. she declined to have an ambulance called and stated she would not go the the hospital. she stated she wanted to go outside and get fresh air, she stated the she felt better and was escorted outside by this writer and a police officer. She called her husband who came to pick her up. She got into his truck on her own and denied feeling any weakness in her arm.

Other Meds: Vitamin D3 1000 IU daily, Vitamin C 500 mg daily , B12 daily , patient states she takes medication for high blood pressure but does not know the name of it.

Current Illness: scleroderma , high blood pressure,

ID: 1341182
Sex: F
Age: 49
State: ME

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, codeine, feline dander

Symptom List:

Symptoms: Within 5 minutes of injection I experienced: Tingling in lips and mouth, then to numb; Flushing (bright red in face and chest); rapid heart beat, shaking, disorientation for roughly 10 minutes. I was given 50mg of Benadryl and stabilized. I remained slightly flushed and had tingling in my mouth and lips for the remainder of the evening. Another 50mg of Benadryl before bed. Tues am woke up feeling fine, took 25mg of Benadryl. By 1pm was experiencing: Tingling and numbness in lips; Flushing; Light wheezing Hot and painful skin and chills. Extreme lethargy I took another 50mg of Benadryl and my symptoms abated slightly. No difficulty breathing at any point. Another 50mg of Benadryl at ~11p. Tuesday am, another 50mg of Benadryl at ~8:30a, and still exhibiting the same symptoms w/ exception of wheezing. Note: I take Benadryl on a regular basis due to my cat allergy and it does not make me sleepy. These symptoms lasted for approximately a week. For the last three weeks I have had extreme lethargy - if I try to stay up and keep working, I become nauseous. My left leg is going numb on the left side along the leg periodically. Very infrequently I get a bit of numbness and tingling in my mouth. No more wheezing.

Other Meds: Multi-vitamin, biotin, iron (Slow FE), clonazepam, lamictal, sertraline, Benadryl

Current Illness: None

ID: 1341184
Sex: F
Age: 78
State: CA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: WOKE UP NEXT DAY WITH ACHING IN MY LEFT HIP AREA, CONTINUED TO GET WORSE THAT DAY AND NEXT DAY TO THE POINT I WAS HAVING TROUBLE MOVING AND BREATHING BECAUSE OF THE PAIN. EARLY MORNING THURSDAY HAD MY HUSBAND TAKE ME TO ER AS THE PAIN HAD MOVED UP MY BACK ON THE LEFT SIDE. ER TOOK X-RAY AND SAW NOTHING, GAVE ME PAIN MEDICATION, PRESCRIBED PREDNISONE AND THE PAIN STARTED TO SUBSIDE. TOOK PREDNISONE FOR A WEEK AND THE PAIN DISAPPEARED.

Other Meds: SYNHROID, 1 A DAY VITAMIN, VITAMIN D, VITAMIN B,

Current Illness: N/A

ID: 1341185
Sex: M
Age: 14
State: CA

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

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

Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: Situation: 14yo male came in for first dose Pfizer vaccine. Within 5 mins after receiving vaccine, patient had a seizure for approximately 1 minute. During seizure, patient was incontinent of urine. RN was able to get to patient's side before he fell. Background: Patient did not alert vaccinator or RNs that he had a history of seizure. Mom informed staff after the event that he had a febrile seizure when he was a young child. She did not disclose what age he was at the time of the previous seizure. Assessment: RN observed patient in an active seizure for 1 minute in which his body contracted out and his eyes rolled back. She was at his side to prevent him from falling. He was placed on a gurney and moved to room 6 for closer observation for 30 mins. Pfizer vaccine administered on 5/22/21 at 12:52PM 1255 vitals ? 121/64(83), 97.3F 1257 vitals ? 122/75(90) 1311 vitals ? 116/76, HR 68, 100% O2 1318 vitals ? 112/75, HR 68, 100% O2 1325 vitals ? 111/61, HR 68, 99% O2 Recommendation: MD on call, was called and notified of the event. Her recommendation was for the patient to go to the ED for evaluation and labs. RN called the ED to notify them of the patients intended arrival. The mom agreed to take the patient to ED for further evaluation. The patient was taken out via wheelchair.

Other Meds: unknown

Current Illness: no

ID: 1341186
Sex: M
Age: 66
State: CA

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Severe muscle aches and pain beginning in the large leg muscles and migrating to hips, shoulders, arms, neck and back

Other Meds: None

Current Illness: None

ID: 1341187
Sex: M
Age: 28
State: VA

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

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

Lab Data:

Allergies: Penicillin-he had rash

Symptom List:

Symptoms: Patient received the vaccine in the left arm and was fine. Patient sat and talk to family members and about 10 minutes he felt light headed and wanted to lie down. His breathing was normal, no allergic or anaphylaxis reactions or symptoms, 3 times patient declined the need of 911 call. Patient declined any medical service, as does not need it. Patient rested on the chair with his leg up and then patient wanted to rest on the floor with his leg elevated for a few minutes. Pharmacist called the manager to be present, again we offered water, drink or any foods patient would like. He said that he was fine and that he just needed to sit and rest for a few minutes. After about 10 minutes, he was fine, stood up and walked away without further light head symptom.

Other Meds: Patient said that he only uses an inhaler for mild asthma.

Current Illness: Patient stated he is healthy in general and hasn't been sick.

ID: 1341188
Sex: F
Age: 41
State: PA

Vax Date: 04/30/2021
Onset Date:
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: Latex, Gluten, Dairy, Bactrim

Symptom List:

Symptoms: Fatigued the night of 4/30/21. Woke up at 2:00am and had trouble breathing. Checked oxygen and it was 90. Had a fever of 102 and full body aches. 5/1/21-Chills and fever of 99 continue the following day. Oxygen went down to 87. elevated to 90-93. Heart rate was up and blood pressure was low. Light headed, nauseous. Pale and weak. This lasted about 4 days. 5/3/21- Sweating started and felt like knives poking through skin. 5/4/21- Rash developed under entire left arm. 5/6/21- Oxygen finally reach 97 and increased to normal. Nausea finally subsided. Doctor said I likely had anaphylaxis and a immunologic driven reaction.

Other Meds:

Current Illness:

ID: 1341189
Sex: M
Age: 13
State: WA

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: Allergy to tree nuts

Symptom List:

Symptoms: Patient developed SVT (supraventricular tachycardia) approximately 29 hours after receiving the COVID vaccine. Patient has no prior history of SVT or any other cardiac related events. Patient was engaged in a basketball game when the SVT occurred. Patient has been involved in multiple competitive sports since the age of four without any prior incident related to exercise. He felt like he could not breathe, his heart was racing, he became dizzy, began to lose his vision and I took him to the local fire station for evaluation.

Other Meds: None

Current Illness: None

ID: 1341190
Sex: F
Age: 22
State: IN

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: Augmentin

Symptom List:

Symptoms: Red, swollen bump at site of vaccine.

Other Meds: Humalog, losartan 100mg, Prozac 20mg, Wellbutrin 150mg, nexplanon, camila .35mg

Current Illness:

ID: 1341191
Sex: F
Age: 83
State: CA

Vax Date: 01/22/2021
Onset Date: 02/16/2021
Rec V Date: 05/22/2021
Hospital: Y

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: Patient had a TIA event at home about 3.5 weeks after 1st Moderna shot, eventually diagnosed at hospital. Stayed overnight 2 nights at hospital. She was approved to get 2nd Moderna shot. She did so on 2/26/2021. About a month later, she suffered vasovagal episode at home. Not clear if these events are related but doctor suggested we report it.

Other Meds: Losartan 100mg, HCTZ 25mg, Amlodipine 10mg, Multivitamins, Zinc, Fish Oil.

Current Illness: None

ID: 1341192
Sex: M
Age: 16
State: VA

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

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

Lab Data:

Allergies: nka

Symptom List:

Symptoms: pt began to have headache, chills, light headedness, and sweating approx 12 minutes after administration of vaccine. complained of throat feeling slightly constricted with feeling of gag reflex approximately 20 minutes after administration of vaccine. pt did not show signs or feel like lips or tongue were swelling but 50 mg liquid benedryl was given orally as a precaution. pt remained stable in described condition until was taken home by parent 50 minutes after initial vaccination time. pt contacted 2 hours later and reported no change in condition (neither better or worse)

Other Meds: none

Current Illness: none indicated

ID: 1341193
Sex: F
Age: 13
State: OK

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

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

Lab Data:

Allergies: no known

Symptom List:

Symptoms: Patient received her 1st dose of the Pfizer Covid vaccine around 11:20am, and started feeling bad within about 5-7 minutes of administration. Her grandmother came to the counter to alert me that she wasn't feeling well, patient was lightheaded and just "felt bad". She did say she was nauseous, but was very agitated and had trouble verbalizing what was wrong. She was very hot and clammy, her mother reported that she looked very pale. I went to get a cuff to take her blood pressure, but by the time I got it on her arm, she was slumping significantly in the chair, so we decided to move her back to the clinic room to lay her down and elevate her feet. Her mother and I each took an arm to move her. I thought she may have briefly lost consciousness, her legs were not holding any of her weight, but her head was down, so I couldn't tell if she was alert. We moved her a few more feet into the room and her mother moved to set her down in a chair, she was talking and alert. At this time, her bladder evacuated and she vomited, her mom moved her the rest of the way to the chair. I immediately went back to the room with them and dialed 911 at 11:34am. She was more alert at this time, did not report any difficulty breathing or any swelling or itching of the mouth or throat. She was very anxious/agitated, but she did say that she felt a little better after vomiting. EMS arrived at 11:52, I believe she vomited again before they got here, she did take a few sips of water. EMS left at 12:06pm, the patient and her mother left at 12:07, she was walking on her own, with support from mom.

Other Meds: no known

Current Illness: no known

ID: 1341194
Sex: M
Age: 35
State: MD

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Felt light-headed /nauseous/raised hand/EMT/paramedic/nurse responded /pt. placed on stretchers. Decreased Blood pressure, Increase Heart rate within 10 minutes, Increase Blood Pressure, taking water, responsive, wife called. Blood sugar 76 per finger stick. Wife picking patient up. 4:20 BP=84/57 HR=100 Now 4:27 BP=114/81 HR=98 Vital signs at 4:40 BP=128/87 HR=97 Recorded by Paramedic

Other Meds:

Current Illness:

ID: 1341195
Sex: F
Age: 30
State: ME

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List:

Symptoms: Red at injection site, warm to touch, swollen

Other Meds: Unknown

Current Illness: Unknown

ID: 1341196
Sex: M
Age: 42
State: NC

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/22/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: None on the first shot. Severe headaches, high fever, tiredness, cough, chills, sweats for2-3 days. Developed cough and shortness of breath which has persisted. Now I get winded easily while walking or talking. This has become concerning as a long time runner. I went to urgent care and they said seems like bronchitis contracted prior possibly, though I socially distance, always wear a mask and only go out if it is needed. I avoid crowds and indoors. Cough persists and winded easily

Other Meds: None

Current Illness: None

ID: 1341197
Sex: F
Age: 13
State: NC

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

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

Lab Data:

Allergies: PENUTS

Symptom List:

Symptoms: PATIENT FAINTED WHILE SITTING DOWN, MOM CAUGHT HER AND HELPED HER STAY IN THE SEAT. PATIENT LOOKED PAIL AND WAS FEELING NAUSEATED. MEDIC ARRIVED AND TOOK VITALS AND OBSEEREVED. PATIENT WENT HOME WITH MOTHER

Other Meds: NA

Current Illness: NA

ID: 1341198
Sex: M
Age: 29
State: CA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: The patient received the COVID-19/Janssen vaccine at 12:33pm. Approximately, 5 minutes after receiving it, the stated that he was feeling dizzy and had ringing in his ears. I had him lie down with his knees elevated. He stated that he felt better in the supine position. I attempted to take his blood pressure, but was unable to get a reading after two tries. After a few minutes, he stated that he no longer had any ringing in his ears, but felt some numbness in his arms. His fingers were cold and I had a difficult time finding his pulse. While he was resting, he stated that he had anxiety to needles and "white coat" syndrome. He felt that he was okay to sit up, so he did without any adverse reactions. He drank some water and stated that feeling was returning to his arm. I asked if he had eaten anything this morning and was told, just a cup of coffee. We speculated that low blood sugar could have possibly compounded the situation. At approximately 12:55pm, he felt well enough to leave. I had him contact his mother who was in the store to accompany him out at around 1:00pm.

Other Meds:

Current Illness:

ID: 1341199
Sex: F
Age: 42
State: NY

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/22/2021
Hospital:

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Lab Data:

Allergies: none that I know of

Symptom List:

Symptoms: Shortly after receiving the first dose, I felt numbness in both my temples. I have never experienced this sensation before. This was a constant feeling throughout the entire day, with occasional 'waves' where the numbness felt more intense. The next day, I still felt it but it wasn't as noticeable. By night time, the numbness had descended behind the ears. The third day (today) I can still feel it every now and then but it is not nearly as strong as on the first day (barely there). I have not consulted a doctor about it because I was not feeling sick otherwise, but I have decided to report it because, with the exception of a single forum, I have not been able to find anything about a similar side effect online to reassure myself that it is normal.

Other Meds: none

Current Illness: I had a miscarriage following IVF treatment earlier this year about a month ago.

ID: 1341200
Sex: F
Age: 64
State: IN

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/22/2021
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Allergies: None

Symptom List:

Symptoms: Severe joint pain; headache; fever (102); chills; fatigue.

Other Meds: Menest 1.25mg

Current Illness: None

ID: 1341201
Sex: M
Age: 72
State: NY

Vax Date: 03/19/2021
Onset Date: 05/18/2021
Rec V Date: 05/22/2021
Hospital: Y

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Lab Data:

Allergies: terbinafine

Symptom List:

Symptoms: Pt is a fully vaccinated individual as of 3/19/2021 when he had his 2nd Pfizer covid 19 vaccine. He presented to the Emergency room on 5/18/2021 with concerns for covid 19 pneumonia. He is a 72-year-old male undergoing chemotherapy for follicular lymphoma through cardiology center who stated he had a PET scan done at other facility earlier today and stated the oncologist did not like the results and sent him to the emergency room. They were concerned about Covid pneumonia and sent him to be evaluated and admitted as well as treated. Patient stated he has been having trouble over the past several weeks where he has been weaker and more tired, just the week prior he had a syncopal episode. He has since felt more tired than usual and he has had a chronic nonproductive cough. He was admitted to the hospital after testing positive on nasopharyngeal PCR for covid 19 with PET scan findings of ground glass opacities and b/l pneumonia. He was treated with remdesivir and decadron and sent home on 5/19 to recover. He did not require oxygen during his hospital stay or on discharge.

Other Meds: Eliquis, vit D, Hydrocodone, Victoza, levothyroxine, Celexa, Metformin, Protonix, Predmisone, Toujeo, Depakote, ferrous sulfate, coreg

Current Illness: None

ID: 1341202
Sex: F
Age: 51
State: VA

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/22/2021
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Allergies: None

Symptom List:

Symptoms: Flu like symptoms, light headed, clogged ears, swollen neck and face, sore eyes, sore throat (first day) , feeling spacey

Other Meds: None

Current Illness: None

ID: 1341203
Sex: F
Age: 32
State: IN

Vax Date: 05/18/2021
Onset Date: 05/20/2021
Rec V Date: 05/22/2021
Hospital:

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Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: Skin infection and severe acne lesions. Beginning one to two days post first vaccination. One lesion is so severe and and inflamed it is requiring oral antibiotic treatment.

Other Meds: Spironolactone Pre-Natal vitamin

Current Illness:

ID: 1341204
Sex: F
Age: 29
State: CA

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/22/2021
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Symptoms: . Received her second dose Pfizer vaccine (LOT#: EW0185 EXP: 8/2021) at 1424 on 5/19/21. Patient alerted , EMT at 1438. Patient stated that she felt chest pain and felt dizzy. Patient stated that her chest pain was a 6/10 on the pain scale. Patient was asked to stay another 30 minutes for observation. Patient agreed. EMT took patients vital signs at 1440. BP:180/100, pulse: 97, O2: 96%. Patient was given water. EMT retook patients vital signs and reassessed patient at 1450. BP: 120/70, pulse: 85, O2: 98%. Patient stated chest pain went down to a 4/10 with no dizziness. EMT retook and reassessed patient at 1510. Patient stated that she no longer had any chest pain. Patient stated that she had a weird feeling in her head. Patient stated that she was not dizzy and did not have a headache. Patient stated that she had eaten breakfast at 1000. Patient completed observation time. PHN educated patient on worsening signs and symptoms on side effects of the vaccine and when to contact EMS or go to emergency room/urgent care. Patient verbalized understanding of education. Patient left vaccination site unassisted and with a steady gait at 1515.

Other Meds:

Current Illness:

ID: 1341205
Sex: F
Age: 53
State: WA

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/22/2021
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Allergies: Bactrim - anaphylaxis Penicllins - anaphylaxis Allegra Compazine Flonase Montelukast Prednisone Prilosec Vicodin Prochlorperazine

Symptom List:

Symptoms: Patient has history of a history of idiopathic anaphylaxis and has allergies to many medications. Patient had premedicated herself with Symbicort, Montelukast, diphenhydramine 50 prior to coming in. But 5 minutes after receiving the Covid vaccination she developed throat itching itching all over her skin/lungs, and chest tightness with intermittent coughing. Code Blue was called, and patient was taken to the ER. Patient received epinephrine, famotidine, benadryl and methylprednisone. Patient was monitored in the ER and eventually discharged home.

Other Meds:

Current Illness:

ID: 1341206
Sex: F
Age: 47
State: VA

Vax Date: 04/16/2021
Onset Date: 05/17/2021
Rec V Date: 05/22/2021
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Allergies: None

Symptom List:

Symptoms: Received the 2nd vaccine in left arm. Had typical not Initial feeling of fatigue, sore back and swollen lymph nodes in clavicle and underarm. On May 14th noticed the lymph node behind my right ear was very tender, by morning of 5/17 noticed some swollen knots on top of head and small rash on right side of forehead and right eyelid. Was given Doxycycline for infected cyst (knots on head). By 5/19 rash had became more inflamed and lymph node in front of the ear was swollen. Started Valtrex at home in case it was shingles. Went to the doctor on 5/20 - prescribed additional Valtrex and prednisone. Swelling has gone down,rash and blisters on eyelids are smaller. Still recovering.

Other Meds: N/A

Current Illness: None

ID: 1341207
Sex: F
Age: 27
State: PA

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/22/2021
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Allergies: No known drug allergies

Symptom List:

Symptoms: Patient started to have itching immediatley at the injection site (arm) which we applied an icepack to area. Then after about 5 minutes patient said she felt itchy head to toe. We gave patient 25mg of Diphenhydramine and her itching subsided

Other Meds: Micogestin 1.5/30mcg

Current Illness: None

ID: 1341208
Sex: M
Age: 80
State: MO

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/22/2021
Hospital: Y

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Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Lactic acidosis, elevated troponin, fever, one day after

Other Meds: amlodipine, atorvastatin, glucophage

Current Illness: None

ID: 1341209
Sex: M
Age: 44
State: OR

Vax Date: 04/11/2021
Onset Date: 04/14/2021
Rec V Date: 05/22/2021
Hospital:

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Allergies: None

Symptom List:

Symptoms: Uveitis in right eye flared 3 days after 1st vaccine, it resolved after few weeks of treatment. It flared again 3 days after 2nd dose of pfizer vaccine. It continues to flare 10 days after the 2nd dose and is being treated.

Other Meds: None

Current Illness: none

ID: 1341210
Sex: F
Age: 58
State: TN

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 05/22/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Off balance for 3 days

Other Meds: None

Current Illness: None

ID: 1341211
Sex: M
Age: 50
State: PA

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

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Allergies: NONE KNOWN

Symptom List:

Symptoms: TWO TO THREE DAYS AFTER SHOT 5/2-5/3 PT HAD STIFF/ CRICK IN NECK FELT LIKE IT NEEDED TO VBE CRACKED BUT COULDNT CRACK IT.. ONE WEEK AFTER INJECTION 5/8 PT DEVELOPED BELLS PALSEY ON LEFT SIDE OF FACE PT STILL HAS BELLS PALSELY PT WAS SEEN BY HIS PHYSICIAN AND WAS ADVISED TO REPORT ADVERSE EVENT(S) TO PHARMACY TO REPORT TO VAERS

Other Meds: NONE KNOWN

Current Illness:

ID: 1341212
Sex: F
Age: 44
State: CA

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/22/2021
Hospital:

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Symptom List:

Symptoms: Vomiting and violent chills started Last night. Dry heaving this morning. Headache snd fever and continued nausea

Other Meds:

Current Illness:

ID: 1341213
Sex: F
Age: 41
State: CA

Vax Date: 05/16/2021
Onset Date: 05/19/2021
Rec V Date: 05/22/2021
Hospital:

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Lab Data:

Allergies: Cephalosporins like Cephalexin/Keflex

Symptom List:

Symptoms: hives

Other Meds:

Current Illness:

ID: 1341214
Sex: F
Age: 23
State:

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/22/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: Pain, redness, and swelling at injection site; overall muscle aches, headache, and fatigue

Other Meds:

Current Illness:

ID: 1341215
Sex: M
Age: 46
State: UT

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/22/2021
Hospital:

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Lab Data:

Allergies: Tramadol

Symptom List:

Symptoms: Vaccine administered at 12:30 pm. By 6:30 pm, a fever and chills started. I woke up at 11:00 pm and had a 104.7 fever with vomiting, nausea, join pains, weakness, fatigue, and headache, along sinus tachycardia. Went to the ER to be evaluated, it was determined that this was an adverse reaction. I was released from care around 2:30 am.

Other Meds: Clonazepam, HCT, Amlodipine, Pantropazole, Oxycodone

Current Illness: None.

ID: 1341216
Sex: F
Age: 70
State: NY

Vax Date: 02/22/2021
Onset Date: 05/05/2021
Rec V Date: 05/22/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: Codeine, Cat Dancer, Iodinated Contrast Media, Aspirin, Chlorine, Corn, Dairy Aid, Tartrazine, Latex, Lanolin, Lidocaine, Peanuts, Penicillin, Prevnar, Pulmicort, Tomato, yellow dye, purple dye

Symptom List:

Symptoms: Patient received Moderna Covid Vaccine on 01/25/2021 and second Moderna COVID vaccine on 02/22/2021 and was diagnosed with a left lower extremity deep vein thrombosis on 04/22/2021, patient was then subsequently admitted to the hospital on 05/05/2021 with acute on chronic respiratory failure and bilateral pneumonia requiring IV antibiotics and increased supplemental oxygen.

Other Meds: Alprazolam, Benzonatate, Cetirizine, Enoxaparin, gabapentin, HCTZ, Hydrocodone-acetaminophen, Duo-nebs, Omeprazole, Prednisone, Compazine, Qvar, montelukast

Current Illness: Left lower extremity DVT diagnosed April 22nd

ID: 1341217
Sex: M
Age: 23
State: WI

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 05/22/2021
Hospital:

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Allergies: None known.

Symptom List:

Symptoms: Since vaccine has experienced numbness in same side arm. Starting with middle finger, now effects all fingers in right hand. General numbness throughout all day. When performing physical activity with right arm, numbness travels further down past hand. Started prescription of naproxen. Have a EMG scheduled to rule out potential Carpel tunnel/ nerve damage.

Other Meds: Albuterol as needed for asthma.

Current Illness: Concussion approx. 1 month before.

Date Died: 05/05/2021

ID: 1341218
Sex: M
Age: 90
State: CA

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 05/22/2021
Hospital:

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Allergies: None

Symptom List:

Symptoms: Within hours of receiving the second Moderna vaccine, the patient began experiencing excruciating pain in his lower back and sciatica. Consensus among the health professionals he saw is that the second vaccine triggered an inflammatory response. The pain did not respond to medication physical therapies.

Other Meds: Escitalopram, Simvastin, Eliquis, Lisinoprel, Vit d3,

Current Illness: None

ID: 1341219
Sex: F
Age: 43
State: OR

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/22/2021
Hospital:

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Lab Data:

Allergies: Coedine

Symptom List:

Symptoms: 8 hours after receiving shot, I had migraine, sensor out to light, body aches and chills and could not sleep due to uncomfortableness. These symptoms continued for another 32 hours. By Friday morning I no longer had the chills. By Saturday, I no longer had major body aches and my right arm at injection site is swollen, puffy and hot. Still have a slight headache

Other Meds: Advil

Current Illness: None

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm