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: 1355025
Sex: M
Age: 17
State: TX

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient under age 18 was vaccinated with Moderna, which is a vaccine error, on 3/16/2021. Second vaccine provided 4/03/2021 - Pfizer EP EP6955. Troubleshooting: Scribe and vaccinator did not validate age; screeners at the beginning of the process did not ask or turn away on a Moderna-only day. For the second error (Pfizer #2) scribe, screener, and vaccinator did not look at the vaccine card or the computer- there is only one record for this person. Unreported as error, found in data mining. Age restriction/confirmation rules were put into effect after the date of this vaccine to prevent underage vaccines.

Other Meds:

Current Illness:

ID: 1355026
Sex: M
Age: 53
State: CA

Vax Date: 03/17/2021
Onset Date: 03/24/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Anxiety, Dyspnoea

Symptoms: I've been experiencing ear ringing from ear clogging to buzzing, hissing sounds. First it is started in my left ear after few days of the first doze then the right ear. It started real bad after the second injection. Presently, the clogging ear state has diminished but the buzzing, hissing and cricket alike sounds yet present. This pulsatile emerging sounds of perhaps tinnitus, disrupts my personal life and to concentrate me at work.

Other Meds: Zyrtec, 10 mg

Current Illness: None

ID: 1355027
Sex: M
Age: 32
State: WA

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

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

Lab Data:

Allergies: None

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

Symptoms: Patient was waiting in a chair after the vaccine and bent over to pick up a phone off of the ground. He got lightheaded and passed out as he was bending over. The patient hit his head and briefly passed out. We got him to the ground slowly and provided him with an ice pack and bottle of water. He was breathing quickly and shallowly for about 30 seconds but returned to normal shortly after.

Other Meds: None

Current Illness: None

ID: 1355028
Sex: M
Age: 11
State: VA

Vax Date: 05/24/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Redness around the area of the incision site on the right arm.

Other Meds:

Current Illness:

ID: 1355029
Sex: F
Age: 65
State: GA

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

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

Lab Data:

Allergies: Biaxin, adenosine

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

Symptoms: Large lump appeared in right breast suddenly, itching on right back, mess right side of breast area, itchy pimple rash right back atea

Other Meds: Motrin, allergy tablet, breo

Current Illness: None

ID: 1355030
Sex: M
Age: 45
State: TX

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

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

Symptoms: patients caregiver has described pain at injection site -7 days past injection. pain at injection site started morning after injection. patient informed me that they will seek medical evaluation. no other details given.

Other Meds: none listed

Current Illness: none stated on form

ID: 1355031
Sex: F
Age: 63
State: MO

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: PGE, metals, chemicals, steroids, most narcotics, most antibiotics, majority of western medications, cleaning product ingredients, fertilizers

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: As the lady jabbed me and started putting the vaccine in my arm, it started burning. It hurt so bad that I wanted to scream. I felt lightheaded and needed to sit for awhile after the shot. The next night I started getting pain in my right arm and I couldn't move it. My nerve endings in my arm, shoulder, and clavicle felt like they were on fire. The lymph nodes under my right arm and neck were swollen. I had three swollen lymph nodes in my neck, but one went down, and I still have two swollen nodes in my neck. My quality of life has suffered because the pain in my arm is so bad.

Other Meds: Vitamin C, D3, and E, Joint Supplement, Red Yeast, Magnesium, Calcium, CBD Oil

Current Illness: No

Date Died: 05/16/2021

ID: 1355032
Sex: M
Age: 68
State: MN

Vax Date: 03/31/2021
Onset Date: 04/21/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Patient was hospitalized and died within 60 days of receiving a COVID vaccine

Other Meds:

Current Illness:

ID: 1355033
Sex: F
Age: 35
State: NY

Vax Date: 04/14/2021
Onset Date: 04/16/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 24-48 hours of intense joint pain- exacerbated the pain felt in joints affected by psoriatic arthritis, nausea, feeling of being overheated but no temperature.

Other Meds: Enbrel

Current Illness:

ID: 1355034
Sex: F
Age: 38
State: AR

Vax Date: 05/25/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Swollen, red injection site. Fever of 102F with vomiting and fatigue.

Other Meds:

Current Illness:

ID: 1355035
Sex: F
Age: 63
State: GA

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: itching over the trunk, arms and legs.

Other Meds:

Current Illness:

ID: 1355036
Sex: M
Age: 82
State: IN

Vax Date: 03/01/2021
Onset Date: 04/01/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Rash, Urticaria

Symptoms: had covid injections in March of Moderna doses at Health Center, stated had second shot 4 days prior to operation that ?went sour,? had hernia repair that was supposed to be ?in and out,? BP 65 systolic after procedure and received 5 units of blood, he is not sure of the cause of hemorrhaging, client did not provide dates of Moderna dosing but stated all in March and that hernia surgery was also in March 4 days after the 2nd Moderna dose.

Other Meds: Current med list: CoQ10, acidophilus, nitroglycerin 0.4 mg, carvedilol 3.125 mg, Ranexa 500 mg, Brimonidine 0.2% eye drops, ezetimibe 10 mg, fenofibrate 160 mg, omeprazole 20 mg, latanoprost 0.005%, dorzolamide 2% eye drops, pravastatin 20

Current Illness: awaiting hernia surgery at time of injection, HTN

ID: 1355037
Sex: F
Age: 42
State: WI

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

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

Lab Data:

Allergies: Capsaicin Topical, General Anesthesia, Vicodin, Penicillin, Sulfa, Artichokes, Cats, Dogs, Grasses, Latex, Macadamia Nuts, Seasonal, Stevia, Trees

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

Symptoms: 50 minutes after receiving second dose of Moderna, became lightheaded and dizzy. Hot feeling in face and neck, chills elsewhere. Headache and itching in lips and face. Large hive upper lip.

Other Meds: Albuterol Inhaler, Flonase, Loratadine.

Current Illness: None.

ID: 1355038
Sex: F
Age: 63
State: MN

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Nerve pain and numbness of lips within 30 minutes of first shot. Second day complete flare up of fibromyalgia. It started to get better at day 16 so I went ahead and got 2nd shot. By next day full flare again that continues to today, 5/27/2021. Exhaustion, extreme muscle pain, weakness, nausea, nerve pain, blurred vision.

Other Meds: Advair, Femhrt, Vitamin B12, Vitamin D3, multivitamin, Qnasl

Current Illness:

Date Died: 05/25/2021

ID: 1355039
Sex: M
Age: 20
State: OR

Vax Date: 05/22/2021
Onset Date: 05/23/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Cardiac Arrest

Other Meds:

Current Illness:

ID: 1355040
Sex: F
Age: 47
State: NJ

Vax Date: 04/27/2021
Onset Date: 05/01/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Biaxin, minocycline

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

Symptoms: I realize this isn?t an SAE, however: My menstrual period began a full 8 days early and was also different /heavier than normal. I am consistently 28 days on my cycle to this took me by surprise. After some googling of similar items in the weeks after, it seems there may be other studies that are exploring whether this is a causal event. As such I?ve decided to report it. It?s just very odd to me because I am extremely like clockwork., so it took me by surprise. I mentioned it to my pharmacist today while getting my second shot and he suggested I report it said that perhaps you can keep track in case others are. I know there are external CDC studies that are apparently going on to try to investigate this abnormality. Thank you for your time.

Other Meds: Synthroid

Current Illness: N/a

ID: 1355041
Sex: F
Age: 27
State: MD

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Patient states that she had received the vaccine on May 25, 2021 at approximately 12pm. Soon after around 3pm, she developed chills headaches, sore arm , body aches, and cough. As of date, 5/27/2021, symptoms have mostly reseolved except for sore arm and localized redness and swelling to injection site.

Other Meds: None

Current Illness: none

ID: 1355042
Sex: M
Age: 59
State: IN

Vax Date: 04/10/2021
Onset Date: 04/27/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: The patient presented to the emergency department with 2 weeks of worsening bilateral lower extremity pain, erectile dysfunction and urinary retention. 24 hours prior to presentation he had been experiencing new neck pain/headache. He had no chronic history of these symptoms apart from arthritic pain in both knees and hips.

Other Meds: Amlodipine 10 mg, atorvastatin 10 mg, hydrochlorothiazide 50 mg, metoprolol 25 mg BID, torsemide 20 mg daily, ibuprofen PRN

Current Illness: None

ID: 1355043
Sex: F
Age: 69
State: MD

Vax Date: 03/04/2021
Onset Date: 03/17/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Two weeks following the first COVID vaccination I awoke with Sudden Onset Hearing Loss in my right ear. No prior hearing loss, no other symptoms. No other changes in health prior to the hearing loss.. Hearing loss confirmed by audiologist on 3/23/21.

Other Meds: levothyroxine, citalopram (40mg), estradiol (1mg), Meloxicam (7.5mg) Women's one a day vitamin, krill oil, B-complex, B12, vitamin C, vitamin D3

Current Illness: none

ID: 1355044
Sex: F
Age: 53
State: MA

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None reported

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

Symptoms: Patient reported experiencing a "weird taste" in her mouth upon injection of the vaccine. A few minutes later she experienced sudden nausea (? vomiting) and diaphoresis lasting <4 minutes. Patient was evaluated by EMTs at the vaccination clinic - VSS, Sa02 98% and above. Pt recovered quickly and did not require transport.

Other Meds: None reported

Current Illness: None reported

ID: 1355045
Sex: F
Age: 54
State: SC

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/27/2021
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: Had shot 2 around 1:30pm on 5/20 - shortly after midnight around 12:30am 5/21 I woke up with severe stomach cramps which led to diarrhea and throwing up for about 20 minutes then began itching all over my body and broke out in hives everywhere and started having trouble breathing - I immediately took several Benadryl and waited to see if it would help. I ended up falling back asleep and didn?t have to seek medical help. Fast forward to Tuesday, 5/25 I woke up around 11:30 with severe stomach cramps and had diarrhea again. I didn?t throw up this time. Within 10-15 after the diarrhea finished I broke out in severe hives all over my body and the itching was way worse than the first episode. I was having difficulty breathing so had someone drive me to the Emergency Room. I was immediately taken back to a room and administered an epi-pen and given Benadryl and dexamethasone in iv then given iv fluids. Around 4am they decided they needed to keep me for observation because my blood pressure was so low. At that time it was 85/49. They decided to release me around 1:00 and at that time my boss was 94/57?.however when I went to unhook from the machine it had fallen to 89/54. They still release me and told me to follow up with my doctor on 5/27.

Other Meds: ADDERALL, SAXENDA, LEVOTHYROXINE

Current Illness: NONE

ID: 1355046
Sex: F
Age: 16
State: IN

Vax Date: 05/25/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Bananas

Symptom List: Unevaluable event

Symptoms: Generalized rash

Other Meds: Amoxicilian Prednisone Ibuprofen Tylenol Nasacort

Current Illness: Ear infection

ID: 1355047
Sex: M
Age: 58
State: NJ

Vax Date: 04/12/2021
Onset Date: 05/10/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: May 10 started to experience numbness and tingling in both hands and feet. May 20 got in to see a neurologist symptoms worsened became difficult to walk. May 20 admitted into hospital.

Other Meds: Aspirin Atorvastatin Jardiance Lantus Metformin Sertraline Toprol Valsartan Victoza

Current Illness: None

ID: 1355048
Sex: M
Age: 34
State: MI

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Patient was in waiting room immediately following vaccine and got up to briskly walk to restroom, at which time patient reports feeling very hot (~2 minutes after vaccine administration) and went to bathroom to get cold water. Patient came back to waiting area and sat down and then vomited in the chair. Pharmacist walked over to patient to ask how they were feeling and offered water. Patient reported that they remember feeling very hot and getting up to splash water on face. Patient stated "oh wow, I must have gotten sick" indicating they had no recollection of that. The patient reported feeling fine following the episode and stayed in the waiting room for 30 minutes. Patient was advised to go to urgent care to be checked for further evaluation.

Other Meds: n/a

Current Illness: None

ID: 1355050
Sex: M
Age: 63
State: NV

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Initial reaction to second dose was typical inflammation response - fever, chills, extreme fatigue and aches for 36 hours. Initial reaction also included severe joint pain. The joint pain has persisted to current date. The pain is most intense in joints that had previous pain from arthritis, surgery, burst disk or injury (in order, fingers, neck, neck, knee and hip.) In each case the pain after the vaccination is several degrees more intense than I experienced in the year previous to the vaccination.

Other Meds: Farxiga, Basaglar, Ozempic Atavorstatin, Brilinta Tamsulosin Vitamin C

Current Illness: None

ID: 1355051
Sex: M
Age: 66
State: NY

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient was onsite at a Vaccine Clinic, open to the public and received a Pfizer shot for his 2nd dose, when the first shot given was Moderna. Patient had no adverse reactions and did not report any injury or illness. This is being reported for the deviation from process with the mixed series as outlined on the Covid 19 Vaccine Error and Deviations flyer dated from 5/18/2021 as this is still considered an administration error.

Other Meds:

Current Illness:

Date Died: 02/15/2021

ID: 1355052
Sex: F
Age: 77
State: CA

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: She received her vaccine. The next few days, she was extremely tired and slept a lot. A couple days after the vaccine, she complained that her stomach hurt slightly. Days went by and the pain slowly got worse. She didn't feel like eating. Then on 2/8/21 in the middle of the night, she woke up in excruciating pstomach pain and her husband called ambulance. They rushed her to ER. The determined that her colon had ruptured near her stomach and they took her in for emergency colonoscopy. The surgery was a success, but a couple days after, she was weak and said she didn't want to fight any longer. They put her on hospice measures and she died 2/15/21. We feel that she was doing fine before the vaccine, and then all of a sudden this occurred. Seems to be too much of a coincidence. Finally taking the time to report it, in case there are others having colon and or stomach issues.

Other Meds: She had been receiving medicine for cancer, but was well on the road to recovery, and doctors were optimistic.

Current Illness: Cancer

ID: 1355053
Sex: M
Age: 35
State: CO

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: none reported

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA: patient presents to urgent care three days after receiving vaccine hypoxic (room air saturation 86% (96% after administered albuterol during visit) with headache, chills, nausea, fever, cough, sweats, fatigue, malaise, and mild wheezing and shortness of breath. Diagnosed with bronchitis, prescribed albuterol and antimicrobials, and discharged to home. On follow-up visits with primary care provider bronchitis resolved.

Other Meds: fluoxetine, omeprazole

Current Illness: none reported

ID: 1355054
Sex: M
Age: 12
State: CA

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: no known

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

Symptoms: sees black, was dizzy, blurriness, clammy skin, diaphoretic. Apple juice, Grahm crackers, icepack, fan air-- felt better, having whole conversation, no complaints 18: 50 --84,16, 82/42, 18: 58-- 86/58, 99, 16, 98% monitored for 30 minutes, walked out of clinic with parent in stable condition give juice, icepack-- better no meds, no previous fainting episode

Other Meds: none

Current Illness: non known

ID: 1355055
Sex: F
Age: 45
State: FL

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

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

Lab Data:

Allergies: Dilated, Reglan

Symptom List: Nausea

Symptoms: Headache, vision loss, stiff neck. Caused Aseptic Chemical Meningitis

Other Meds: Protonix, Xanax, losarton, Lyrica, Rybelsus

Current Illness: None

ID: 1355056
Sex: M
Age: 26
State: MO

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Injection site pain

Symptoms: Rph administered expired vaccine because she misunderstood the time of expiration after the update indicating that it is good for 30 days. She thought it is good for punctured one as well. Pharmacy manager wasn't sure either. We have to find out from DM since the pharmacy manager wasn't sure.

Other Meds: NONE

Current Illness: NONE

ID: 1355057
Sex: M
Age: 71
State: CA

Vax Date: 04/24/2021
Onset Date: 05/15/2021
Rec V Date: 05/27/2021
Hospital:

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Allergies: None

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

Symptoms: Loud ringing in ears, lose of some hearing in left ear.

Other Meds: None

Current Illness: None

ID: 1355058
Sex: F
Age: 60
State: NY

Vax Date: 04/02/2021
Onset Date: 05/15/2021
Rec V Date: 05/27/2021
Hospital:

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Allergies: none

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

Symptoms: Debilitating fatigue and muscle soreness for 2 days from 1'st shot; Debilitating fatigue and muscle soreness for 3 days from 2nd shot; also developed numbness in 3 toes on right foot after 2nd shot

Other Meds: Crestor, Citalopram 10mg/day (1/2 pill), vitamin D, Valtrex 500 mg twice/day

Current Illness: herpes, asthma

ID: 1355059
Sex: M
Age: 32
State: MA

Vax Date: 04/14/2021
Onset Date: 05/02/2021
Rec V Date: 05/27/2021
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Allergies: All Seafood, Environmental and Cat Allergies

Symptom List: Tremor

Symptoms: In the morning of May 2nd I was driving and I felt my heart rate increasing lasted about 30 minutes to an hour. I ended up going to the ER and I was diagnosed with sinus tachycardia, I stayed overnight. After that event I developed a cognitive fog and a sensation of numbness on the left side of my head like someone is pulling the skin on my face ever so slightly. I also developed a sense of imbalance like I am in a boat for an extended period of time. These feelings remained constant and I noticed that they were getting better by May 19th. At 6 am on May 19th I walk up to the feeling of my heart pounding and my heart rate increasing, I measured my pulse on my watch and it was around 150 bpm average. This event lasted about 5 minutes and went away. On May 19th around 10 pm I was in the shower and my heart rate increase again and I felt a tickling sensation on the left side of my chest when I was breathing in. I ended up going to the ER gain and stayed overnight. May 26th I felt the sensations of fogginess and just feeling off cognitively. May 27th I woke up rested without fogginess and after a morning walk with my dog I felt my heart increasing. This episode lasted about 10-20 minutes and my heart rate was ranging between 120-150 bpm. My stools from April 20th till May 26th have been lighter in color yellowish and soft, when I consumed vegetables I could see specs of them in my stools like they were not fully processed. May 27th was the first day where my stool color was brown but still soft.

Other Meds: Omeprazole 40mg per day, 20mg in the morning and 20mg at night / Loratadine 10mg per day / Folic Acid 800mcg per day / Vitamin D 2000IU per day / Vitamin B12 500mcg per day

Current Illness: No

ID: 1355060
Sex: F
Age: 53
State: WA

Vax Date: 05/25/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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Allergies: Too many to include.

Symptom List: Erythema, Pruritus

Symptoms: I woke up today May 27 with COVID arm. Raised but not itchy. Keeping tabs on it. Sent a message to my primary making them aware. I will enter the info in VSAFE when I receive today's text link.

Other Meds: To many to list.

Current Illness: Too many to write.

ID: 1355061
Sex: F
Age: 70
State: PA

Vax Date: 03/16/2021
Onset Date: 04/02/2021
Rec V Date: 05/27/2021
Hospital:

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Lab Data:

Allergies: Penicillin

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

Symptoms: Pain down left arm, severe pain, to hand and hand was numb, up all night could not sleep. Went to ER because she thought it might be her heart, it wasn't. Diarrhea was uncontrollable, messed herself a few times, never had time to run to restroom. Had to take a leave from work. Has been out of work a month because of the diarrhea. Had a colonoscopy, endoscopy, has to go back for another endoscopy, was in the hospital. Had blood in stool. Never experienced diarrhea or pain like that before. Afraid to go back to work or leave her house because the diarrhea continues and starts without warning.

Other Meds: Trelegy Inhaler for COPD, Metoprolol

Current Illness: None

ID: 1355062
Sex: M
Age: 27
State: FL

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
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Allergies: NKDA

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

Symptoms: Patient stood up and walked over to register and said he didn't feel so well. I came around the pharmacy and he was fainting as I got to him. Technician called paramedics, store manager was called and when I asked him his name and if he knew where he was he said yes. We sat him up per his request. When he was well enough we sat him on a chair, I took his blood pressure and we got him water. He was on the phone with his dad who is a physician and dad said it sounded like a syncope and asked we give him gator aid. Paramedics arrived and they took his vitals and ran some tests.

Other Meds: None

Current Illness: None

ID: 1355063
Sex: F
Age: 37
State: MA

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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Lab Data:

Allergies: Unknown

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient developed nausea post vaccination, was evalatued and refused treatment

Other Meds: Unknown

Current Illness: Unknown

ID: 1355064
Sex: F
Age: 59
State: WI

Vax Date: 03/20/2021
Onset Date: 04/09/2021
Rec V Date: 05/27/2021
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Allergies: I have seasonal allergies and adhesive.

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

Symptoms: The only thing I had initially was a sore arm. I'm not sure that it is 100% yet. On April 9th, I started having headaches. I had an MRI and it came back negative for any complications. I am still experiencing headaches. It seems like one continuous headache. It's better in the afternoon, but worse in the early morning and going into the early evening.

Other Meds: I was taking Lisinopril, Omeprazole, the generic of Prilosec, Vitamin D3, Promethazine and Albuterol.

Current Illness: I had Anal fissure surgery the day before I received my vaccine.

ID: 1355065
Sex: M
Age: 31
State:

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
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Allergies:

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

Symptoms: pt got dizziness, fainted, shaking after 5 minutes of vaccine administration. His heart rate dropped to 60 and his blood pressure 105//70. pt was conscious and breathing on his own and felt normal after 30 minutes and went home with his family members.

Other Meds:

Current Illness:

ID: 1355066
Sex: F
Age: 7
State: CO

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 05/27/2021
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Allergies: none

Symptom List: Pain in extremity

Symptoms: On 03/26/2021 medical assistant saw patient for an iz update. Medical Assistant gave patient a varicella vaccine. Medical Assistant explained that at the time of the visit the full record was not uploaded and she accidentally did not see the record on the chart. I MA supervisor talked to Medical Assistant about this incident. I retrained her on the process to follow when she has to give a vaccine. I explained that she has to double check our immunization history on chart and database, if she can not find any record in database or immunization history she had to double check the chart to see if there is an immunization record. Medical Assistant gave verbal understanding of information given and she called the patient to inform parents of the mistake and to schedule another appointment for missing vaccines.

Other Meds: none

Current Illness: none

ID: 1355067
Sex: F
Age: 30
State: DE

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/27/2021
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Allergies: NONE

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

Symptoms: patient received dose of pfzier covid vaccine and within 5 minutes started shaking from head to toe. Ambulance was called. Vitals were checked by EMT and patient sign off to go home with spouse

Other Meds: NONE

Current Illness: NONE

ID: 1355068
Sex: F
Age: 15
State: NY

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/27/2021
Hospital:

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Allergies:

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

Symptoms: Patient recieved a dose of Pfizer prior to it being authorized for the age group that the patient is in. 15 at the time of vaccination of first dose. Second dose was held until 15 year old age category was allowe dto get the vaccine. Same dose and product were administered on 5/13/2021 when 12-15 year olds were allowed to get the vaccine.

Other Meds:

Current Illness:

ID: 1355069
Sex: F
Age: 38
State: CA

Vax Date: 05/03/2021
Onset Date: 05/08/2021
Rec V Date: 05/27/2021
Hospital:

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Allergies: Allergic to penicillin/sulfa drug family

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

Symptoms: Beginning 5 days after my first dose, I began to experience panic attacks that do not appear to be triggered by anything. The only change in my routine was the vaccine, and between dose 1 and 2 I had a total of 7 panic attacks; since dose 2 I have had 3 panic attacks, for a total of 10 panic attacks. All attacks last for approximately 1 minute and occur at varying times of the day and night.

Other Meds: Buspirone

Current Illness:

ID: 1355070
Sex: F
Age: 17
State: MN

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/27/2021
Hospital:

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Allergies:

Symptom List: Vomiting

Symptoms: gave first dose at age 17 guidance was to proceed and complete second dose as she was in age 16-17 range

Other Meds:

Current Illness:

ID: 1355071
Sex: M
Age: 12
State:

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
Hospital:

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Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: headache and soreness at injection site. No interventions/ treatment

Other Meds:

Current Illness:

ID: 1355072
Sex: F
Age: 17
State: CA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
Hospital:

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Allergies: Allergies to food

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

Symptoms: at 7:00pm got hives all over body (arms, stomach, face, neck inside mouth, took Benadryl hives on body went down, the hives inside mouth went away by morning next day.

Other Meds: None

Current Illness: None

ID: 1355073
Sex: F
Age: 55
State: MO

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/27/2021
Hospital:

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Lab Data:

Allergies: NONE

Symptom List: Injection site swelling, Limb discomfort

Symptoms: NO ADVERSE EVENTS

Other Meds: NONE

Current Illness: NONE

ID: 1355074
Sex: F
Age: 50
State: NJ

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
Hospital:

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Lab Data:

Allergies:

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

Symptoms: Dizziness

Other Meds:

Current Illness:

ID: 1355075
Sex: F
Age: 13
State: CO

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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Allergies: no allergies

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

Symptoms: pt was dizzy - after 15 minutes of watching her she complained of a headache she could answer questions but not with any enthusiasm. she was groggy - I got a blood pressure cuff and took three readings and they continued to increase the last reading was 148/120 I suggested to mom we need medical care and offered to call an ambulance - mom said she would take her to the er across the street

Other Meds: loratadine 10 mg monteleukast 10 mg proair

Current Illness: none listed

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am