VAERS 2021 Database www.vaers.hhs.gov

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VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer

Incidents per State

State Total
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: 1361693
Sex: F
Age: 18
State: IN

Vax Date: 05/28/2021
Onset Date: 05/29/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies: Shrimp

Symptom List: Dysphagia, Epiglottitis

Symptoms: Nauseous, 101.5 temperature very aching all over

Other Meds: None

Current Illness: None

ID: 1361694
Sex: F
Age: 56
State: CA

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

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

Lab Data:

Allergies: Had food allergies as a child (tomatoes, eczema), dust mite allergy, phthalate allergy (from working in laboratory, rubber coagulants), Biaxin allergy, past mild asthma. Also allergic to ragweed.

Symptom List: Anxiety, Dyspnoea

Symptoms: Felt OK for about 12 hours, able to eat lunch/dinner do a bit of work. By 11 PM I had a fever of 102.8F, stabbing pains all over my body, and had to get in bed. Also chills, and my eyeballs hurt. The next day I spend nearly the entire day in bed, with fever ranging from 101.5 to 102.3 until late evening, slightly less stabbing pains, very weak, no appetite, could not stay out of bed for more than about an hour because I would become nauseous. I ate some toast and a handful of potato chips. Anything more complex than that seemed really not reasonable to attempt to eat. I have had influenza many times, and this vaccine reaction was physically more unpleasant than the when I got swine flu in 2009 (higher fever, too). I can count the number of times I have had a fever more than 102 on one hand. I am a bit better today. Perhaps you should consider adjusting the dose or schedule for middle aged people? My housekeeper had a 105F fever after her second shot. She is 45. I am not sure if she got Pfizer or Moderna. Might be Pfizer.

Other Meds: Sertraline 150 mg QD also zolpidem 10 mg the night before

Current Illness: No illnesses

ID: 1361695
Sex: M
Age: 14
State: RI

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 05/30/2021
Hospital:

Vax Type:
Manufacturer:
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Vax Site:

Lab Data:

Allergies:

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

Symptoms: Systemic: Fainting / Unresponsive-Severe, Additional Details: Patient has long history of fainting whenever getting vaccines. No history of seizures, per mom.

Other Meds:

Current Illness:

ID: 1361696
Sex: M
Age: 56
State: PA

Vax Date: 05/02/2021
Onset Date: 05/02/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: CHILLS,FEVER, TIREDNESS.

Other Meds: LOPRESSOR, AMLODIPINE,METFORMIN, ZYRTEC, HYDROCHLOROTHIAZIDE.

Current Illness:

ID: 1361697
Sex: F
Age: 54
State: CA

Vax Date: 04/13/2021
Onset Date: 05/04/2021
Rec V Date: 05/30/2021
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, Injection site warmth

Symptoms: Horrible body aches, extreme joint pain, especially in both knees. (This has been taking place for 3 straight weeks)...

Other Meds: Lexapro 10mg, Lisinopril 10mg, Hydrochlorothiazide 25mg (daily for each prescription)

Current Illness: None

ID: 1361698
Sex: M
Age: 57
State: CA

Vax Date: 05/28/2021
Onset Date: 05/29/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fast heartrate of 120

Other Meds: Duloxetine, Citrucel

Current Illness:

ID: 1361699
Sex: F
Age: 13
State: ND

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Nausea-Medium, Systemic: Shakiness-Medium, Additional Details: Patient sat down to wait for 15 minutes then all of a sudden started to shake & looked like she was dizzy. She said she only felt nausea. We called the ambulance & they checked on her. Her mother said she reacted this way about a year ago to her HPV shot. We called the patient a few hours later & she was feeling fine.

Other Meds:

Current Illness:

ID: 1361700
Sex: F
Age: 37
State: TX

Vax Date: 05/28/2021
Onset Date: 05/29/2021
Rec V Date: 05/30/2021
Hospital:

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

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Lymphadenopathy: axillary- swollen and tender to touch- bilateral. Ipsilateral more significant than contra lateral.

Other Meds: Ibuprofen 600 mg ATC

Current Illness: None

ID: 1361701
Sex: F
Age: 38
State: NJ

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 05/30/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies: Adversion of Codiene, Avocado, Gluten

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 1/23/21 - After 1st Vaccine patient experienced extreme sleepiness for two days. (Fells asleep sitting up and with limited noticed for a few hours a time) 2/13/21 - After 2nd Vaccine patient experienced similar symptoms for the 1st two days. On day 3 at 10am patient began experiencing stabbing pain in base of skull. Stabbing pain bony pain radiated down spinal column down to bra strap. Pain continued until about 4pm when, patient took Claritin and pain dissipated (Ibuprofen and Acetaminophen where taken and did not help). Patient continued to take Claritin with pain 3 out of 10 constantly. By 4/1/21, pain increased to a 6 out of 10. Patient began seeing Dr. for pain management. (call patient more info.)

Other Meds: Vitamins

Current Illness: N/a

ID: 1361702
Sex: F
Age: 76
State: PA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: My mom had the 2nd vaccine and was the sickest she's every been for one day. At the time she experienced Delirium. She had been diagnosed with Mild Cognitive Disorder prior to the vaccine. She seemed to recover from this episode but 2 months later she went from Mild Cognitive Disorder to Hallucinations, Delirium and a full blown Advanced Lewy Body Diagnosis. We are unable to explain how she has progressed to this degree and wondering if the vaccine could have accelerated her path. She is currently in a Facility and will have to be moved to 24 Care in a Memory Care Unit

Other Meds: Levothyroxine 88 MG, Linzess 290 MCG, Fludrocortisone 0.1 tablet 1/2 pill daily, Crestor, Flonase, Ipratoplum, Pantorazole SOd CR 40

Current Illness: Diagnosed with Lewy Body after Vaccine (Mild Cognitive Disorder prior to Vaccine)

ID: 1361703
Sex: M
Age: 35
State: NJ

Vax Date: 05/28/2021
Onset Date: 05/29/2021
Rec V Date: 05/30/2021
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: 24h after 2nd shot (when I woke up in the morning) chest/heart pain. Sharp pain similar to a side stitch. I slept and rested during the day. 48h after 2nd shot, chest/heart tickling but no pain anymore.

Other Meds:

Current Illness:

ID: 1361704
Sex: M
Age: 71
State: MD

Vax Date: 01/07/2021
Onset Date: 01/16/2021
Rec V Date: 05/30/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies: No

Symptom List: Rash, Urticaria

Symptoms: Headache fogginess dizziness fatigue

Other Meds: Methotrexate, placquinil, livalo, folic acid

Current Illness:

ID: 1361705
Sex: F
Age: 22
State: PA

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Extreme fatigue, severe nausea, chills, and severe headache. Dry mouth as well

Other Meds:

Current Illness:

ID: 1361706
Sex: F
Age: 40
State: TN

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies: None known to us.

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

Symptoms: Patient stated that she broke out in all over rash the next day following her COVID vaccine of Pfizer. I advised her to take Benadryl and use hydrocortisone cream. I also told her that if it got worse or did not get better to seek care from a doctor.

Other Meds: Do not know.

Current Illness: None.

ID: 1361707
Sex: F
Age: 12
State: NY

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

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

Lab Data:

Allergies: NKDA

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

Symptoms: After receiving vaccination, syncopal episode while sitting in the chair. Mom held child from falling to the ground and slowly placed her on the floor. LOC for less than 2 minutes. Alert and talking, ice pack to forehead and fluids offered. Placed in wheelchair and sent to med evaluation for further evaluation. Mom present at all times. VS taken 104/80 HR 72 Resp 16, diaphoretic with c/o's of lightheaded and foggy feeling. Lying on cot with Gatorade/water offered. Pt has never passed out with a vaccination in the past, had carrots for breakfast and little fluid intake. Very anxious with getting the shot. Discussion with mom & pt. importance of hydration eating when the next dose given, it will be in the med evaluation area lying down. Pt alert an ambulatory with 1/2 Gatorade and 1/2 eater prior to discharge with mom. Discussed s/s of reaction and call pediatrician with any further concerns. Verbalized understanding, discharged ambulatory with mom.

Other Meds: None

Current Illness: None

ID: 1361708
Sex: M
Age: 23
State: KS

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

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

Lab Data:

Allergies: none

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

Symptoms: vaccine was not diluted before injection.

Other Meds:

Current Illness:

ID: 1361709
Sex: F
Age: 16
State: CA

Vax Date: 05/08/2021
Onset Date: 05/17/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Rash on trunk of body started on 5/17 as small red spots that covered from chest to pubic area and back from neck to lower back. Spots were raised and began itching after a day or so then they got bigger and spread and in some cases peeled. It seems to be getting better as of today 5/30.

Other Meds: None

Current Illness: None

ID: 1361710
Sex: F
Age: 27
State: MI

Vax Date: 05/08/2021
Onset Date: 05/09/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I experienced a small itchy/red rash on the forearm of the arm I was vaccinated. My identical twin sister, who has the autoimmune disorder also experienced an allergic reaction but more severe. She experienced hives 5-6 days following her Maderna vaccine

Other Meds: Fish oil, spironactone 50mg 1x/day.

Current Illness:

ID: 1361711
Sex: F
Age: 36
State: NJ

Vax Date: 12/15/2020
Onset Date: 12/30/2020
Rec V Date: 05/30/2021
Hospital:

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

Allergies: NKA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Abnormal spotting between menstrual cycles. Occurred again in May 2021. No history of previous abnormal bleeding or spotting between periods.

Other Meds: Ambien, MVI, melatonin

Current Illness: N/A

ID: 1361712
Sex: M
Age: 25
State: CA

Vax Date: 04/24/2021
Onset Date: 04/26/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: heart palpitations began 2 days after receiving the vaccine

Other Meds:

Current Illness:

ID: 1361713
Sex: F
Age: 43
State: VA

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies: Cephalosporins, Seasonal Allergies

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

Symptoms: First felt light headed, then my tongue, throat, and neck felt sore within approximately one hour of injection. Then my eyes started itching and it was more difficult to breathe through my nose. Things looked funny/off and I felt off; heavy/like lead and fuzzy and spacey at the same time. My vision was blurry when I tried to look at objects up close - like my phone. I had to blink several times and hold the object further away to see it. By dinner time, around 5:30, I noticed raised bumps on the sides and back of my tongue. To my knowledge, they were not there prior to the injection, but I don?t usually inspect my tongue. I did so around dinner because of how sore, puffy, swollen, and big my tongue felt. It looked splotchy in shades of white and yellow. My throat also felt puffy and swollen. At 3:50 am I woke up and my left eye was puffy and difficult to see out of. I was cold, clammy, and sweating. I had a really bad headache and felt nauseous. I took 2 ibuprofen and went back to bed. Around 7:30 or 8:00 am I got up and moved around. My left eye was no longer puffy and I could open it, but my eyes, nose, and throat were itching so badly that I wanted to scratch at them. My tongue, throat, and respiratory system felt puffy and swollen. I noticed it took much more effort to breathe. I got some water and took a Benadryl. I layed down and put my feet up. I covered up because I was cold. I fell asleep. A few hours later I woke up and could breathe easier. The itching was less intense and my tongue, throat, and respiratory system felt less swollen and more normal.

Other Meds: Claritan

Current Illness: None

ID: 1361714
Sex: F
Age: 52
State: CO

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: On the day of vaccination approximately 7 hours after, I developed aches all over my body. The following morning (5-30-21) I got out of bed, sat down to use the bathroom when I experienced an excruciating sharp, sudden pain so powerful it actually threw me back against the toilet tank. I could not stand up, sit down, or move without the constant, excruciating back pain. As of this writing I am still experiencing it.

Other Meds: Lithium, Prozac, Diazepam, Tizanidine

Current Illness:

ID: 1361715
Sex: M
Age: 52
State: MN

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/30/2021
Hospital:

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: 24 hours later, patient and wife had plans and patient stated that he was not feeling well, generally. Wife then states that he did complain of leg pain since they had been driving in the car. 05/30/2021 Patient presented to ED and was found to have DVT and extensive PEs

Other Meds: none

Current Illness: none

ID: 1361716
Sex: M
Age: 63
State: TN

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

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

Lab Data:

Allergies: penicillin allergy

Symptom List: Injection site pain, Pain

Symptoms: Patient lost consciousness and was in and out for roughly 5 minutes. Clammy, sweaty, confused. EMS was called. vitals checked. patient cleared. pt went home from pharmacy with wife.

Other Meds: n/a

Current Illness: none

ID: 1361717
Sex: F
Age: 59
State: WV

Vax Date: 05/19/2021
Onset Date: 05/27/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Mild.

Other Meds:

Current Illness:

ID: 1361718
Sex: F
Age: 39
State: PA

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

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

Lab Data:

Allergies: PENICILLIN

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

Symptoms: TIREDNESS, SORE ARM.

Other Meds: REPHATA, ELIQUIS, CARVEDILOL, ATORVASTATIN, ENTRESTO, RETIN-A 0.1% CREAM, SPIRONOLACTONE

Current Illness:

ID: 1361719
Sex: M
Age: 34
State: CA

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies: none reported

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Client was in observation area, Ancillary, said ?client stood up and took a step and then fell to down, in one or two seconds, and his body was shaking for a second more?. Client was seated in a chair while answering questions. Client stated, ?everything went black?. Client was transferred to anti-gravity chair . RN assessed his mental orientation AAOX4 alert and oriented to place, time, location, and situation. Client denied any history of chronic illness or history of allergies. Client was found to be cool, pale and clammy . Vital Signs at 1316 110/86 HR 59 02 96%. Paramedics were called immediately. Client was transported to Hospital via ambulance.

Other Meds: none reported

Current Illness: None reported

ID: 1361720
Sex: F
Age: 31
State: CT

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Felt neck ache and back ache the morning after as well as headache and fatigue. That Monday had a pounding headache, nausea, vomiting, light headed, weak. Was prescribed Zofran. Nausea subsided but dizziness, pulsing headache, fatigue and light headed continued all week. That Friday I almost fainted and my head felt like there was liquid wooshing around and kept pulsating. Went to walk in and was sent to ER. Was prescribed Promethazine at ER. Here I am a week and two days after the second dose feeling constant dizziness and light headed.

Other Meds:

Current Illness: Miscarriage two weeks prior to second dose

ID: 1361722
Sex: F
Age: 12
State: NJ

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies: tree nut and sesame allergies

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

Symptoms: patient has experienced three episodes of bloody nose and one of prolonged bleeding gum (after tooth loss) in the week since receiving the vaccine (not previously experienced these issues before)

Other Meds:

Current Illness:

Date Died: 05/07/2021

ID: 1361723
Sex: F
Age: 90
State: NJ

Vax Date: 03/02/2021
Onset Date: 03/08/2021
Rec V Date: 05/30/2021
Hospital: Y

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

Lab Data:

Allergies: No

Symptom List: Nausea

Symptoms: Weaknesses. Dizziness. Headaches. Blurry vision both eyes. Sleepiness. Strokes. Hospitalization. Death

Other Meds: Gapepentan, Tylenol 3, triamadone,

Current Illness: Arthritis, neuropathy

ID: 1361724
Sex: M
Age: 31
State:

Vax Date: 05/15/2021
Onset Date: 05/22/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Patient developed left lower extremity weakness, numbness & gait disturbance concerning for Guillain-Barree syndrome 1 week after receiving second dose of Pfizer Covid 19 vaccine.

Other Meds:

Current Illness:

ID: 1361725
Sex: F
Age: 76
State: TX

Vax Date: 05/25/2021
Onset Date: 05/26/2021
Rec V Date: 05/30/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, tetracyclines, sulfa, flagyl

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

Symptoms: began with headache and chills during the night and the next day continued headache, chills, tired, loose stool decreased appetite. The second day after injection was better but not normal and the third, fourth, fifth, and sixth days were mainly headaches with minor chills. The most persistent event has been waking with headaches each morning. Goody's headache powder helped but then they returned. Sixth day just felt tired along with the headache. Normal appetite has not returned.

Other Meds: amitriptyline and Losartan

Current Illness: none

ID: 1361726
Sex: F
Age: 14
State: CT

Vax Date: 05/30/2021
Onset Date: 05/30/2021
Rec V Date: 05/30/2021
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Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)

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Current Illness:

ID: 1361727
Sex: F
Age: 74
State: NJ

Vax Date: 02/28/2021
Onset Date: 03/16/2021
Rec V Date: 05/30/2021
Hospital: Y

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Allergies: Sulfa drug allergy

Symptom List: Tremor

Symptoms: I suffered a stroke on March 16, 2021, with the only symptom being complete numbness on my left side. Emergency room in hospital, then overnight for observation. CT scan and MRI of brain, Ultrasound on Carotid arteries and heart. All tests were negative and no reason for the stroke was found. I now have a loop recorder implant to check for AFib

Other Meds: Spironolactone 50mn, Quinapril-HCTZ 10-12.5mg, Xhance nasal spray, Olopatadine nasal spray, Vitamin C and Vitamine D

Current Illness: No other illinesses, but I did have an adverse reaction that started 5 days after my first Phizer vaccine on Feb 7. Symptoms were extreme exhaustion, weakness, nausea, dirrhea, joint pain, and fever as high as 102*. This kept me in bed for a week Covid-19 testing at that time proved negative. On March 16th, I had stroke that caused complete numbness on my left side. Hospital testing , CT scan and MRI of brain, Ultrasound on carotid arteries and heart all came back negative.

Date Died: 05/27/2021

ID: 1361728
Sex: M
Age: 72
State: NV

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/30/2021
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Allergies: Unknown

Symptom List: Erythema, Pruritus

Symptoms: 05/222/2021, a few hours after receiving the vaccine, the decedent started to experience shortness of breath. On 05/25/2021, the decedent went to the Medical Center, where he was diagnosed with pneumonia.

Other Meds: Doxycycline Hyclate

Current Illness: Diagnosed with pneumonia on 05/25/2021. Death occurred 05/27/2021

ID: 1361729
Sex: F
Age: 14
State: AZ

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 05/30/2021
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Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Error: Wrong Route (SC, IM, etc.)

Other Meds:

Current Illness:

ID: 1361730
Sex: M
Age: 50
State: CA

Vax Date: 04/06/2021
Onset Date: 04/12/2021
Rec V Date: 05/30/2021
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Allergies: None.

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

Symptoms: 4/8/2021 - felt very winded, dizzy and out of breath during physical exertion. Temporary chill developed. Went away over night. 4/12/2021 - same symptoms during physical exertion. Chills and fever developed shortly after and stayed for 2 weeks ranging from 99.5 to 102. Fever, fatigue, dizziness, headache, sore muscles and joints, rapid heart beat, tingling and burning sensation in hands and feet and increased tinnitus lasted for 3 weeks. Ongoing - sore muscles, joints and tendons, tingling/burning sensation in hands and feet, cold hands and feet, muscle fatigue and tiredness since 4/12/2021 and ongoing today.

Other Meds: Benazepril 40 mg Hydrochlorothiazide 25 mg

Current Illness: None.

ID: 1361731
Sex: M
Age: 17
State: MI

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 05/30/2021
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Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: administered moderna to 17 year old patient

Other Meds: none

Current Illness: none

ID: 1361732
Sex: M
Age: 26
State: NJ

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 05/30/2021
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Allergies: NKA

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

Symptoms: FAINTING EMS WAS CALLED. PARAMEDICS INTERVIEWED THE PATIENT. PATIENT WAS RELEASED WITH NO ADVERSE REACTION.

Other Meds: NONE

Current Illness: NONE

ID: 1361733
Sex: F
Age: 69
State: MN

Vax Date: 01/23/2021
Onset Date: 01/27/2021
Rec V Date: 05/30/2021
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Allergies: Seasonal allergies, contact allergies to nickel and gold.

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

Symptoms: 4 days after in the evening my neck started hurting on the right side, so I started hurting. I massage it to see if that would help, and it did not. Psoriasis on right side flared up that had been dormant for 2 years. Cyst in groin area flared up that had been dormant for 8 years. Had sore on her right side of head, couldn't remember if she bumped or not. It would without touching and would keep her up at night. Went to urgent care 3-4 days after symptoms began. Showed the doctor he said it was just a scab Lymph nodes were swollen. They were swollen for 7 days. F/u with a dermatologist in early April for psoriasis and she said lymph nodes were fine and the lesion on her head was a immune response.

Other Meds: blood pressure medication- lisinopril 5mg- daily.

Current Illness: no

ID: 1361734
Sex: F
Age: 69
State: TN

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/30/2021
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Symptom List: Pain in extremity

Symptoms: Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Itch Generalized-Medium, Systemic: Allergic: Rash Generalized-Medium

Other Meds:

Current Illness:

ID: 1361735
Sex: M
Age: 20
State: MD

Vax Date: 05/29/2021
Onset Date: 05/30/2021
Rec V Date: 05/30/2021
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Allergies: NA

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

Symptoms: I felt extreme chills at night, and could not sleep even with a ton of clothing and layers on, and even after taking sleep medication. Also, nausea, and fatigue (but I think fatigue is due to lack of sleep)

Other Meds: Adderall XR

Current Illness: N/A

ID: 1361736
Sex: M
Age: 44
State: IA

Vax Date: 04/10/2021
Onset Date: 05/06/2021
Rec V Date: 05/30/2021
Hospital: Y

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Allergies: carvedilol, morphine

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

Symptoms: Shortness of breath and chest tightness. Hospitalized for fluid volume overload after a couple weeks of having symptoms. Responded well to iv Lasix and was discharged on PO lasix. Has not had any heart issues since transplant 2009

Other Meds: aspirin, imuran, wellbutrin, metroprol succinate, rosuvastatin, sertraline, tacrolimus

Current Illness:

ID: 1361737
Sex: F
Age: 50
State: WA

Vax Date: 05/06/2021
Onset Date: 05/12/2021
Rec V Date: 05/30/2021
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Allergies: na

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

Symptoms: Right inner ear whooshing coinciding with heartbeat began 6d post 1st Covid shot (had on April 15, 2021). Persistent and constant. Coupled with extremely high blood pressure; atypical for patient. Ear whooshing went away 2 weeks after 2nd Covid shot. Intermittently returning 3+ weeks after 2nd Covid shot. Three days post 2nd shot (May 9th), awoken at night with repeated intense 'adrenaline' rushes/panic attack like feelings, which prevented sleep. The events seemed to occur at the moment the patient was about to fall asleep, then would jolt patient up. These INTENSE events continued for 4.5 hours. Patient tried deep breathing exercises to no avail. Patient eventually rose from bed and did multiple 'full body shakes' to try and relax. Finally was able to sleep. Patient experienced 2nd menstrual cycle in one month. Atypical for this person, who had never had any anomalous or difficult cycles in her life. May 29. This night again experienced same adrenaline rush/panic symptoms overnight, again wholly preventing sleep. Patient took ibuprofen to relax muscles, to no effect. Patient again tried full body shakeout 2x. After 2nd time, was able to sleep after 4-5h of insomnia--complete inability to fall asleep.

Other Meds: na

Current Illness: na

ID: 1361738
Sex: F
Age: 66
State: WI

Vax Date: 02/24/2021
Onset Date: 03/05/2021
Rec V Date: 05/30/2021
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Allergies: Neomycin

Symptom List: Vomiting

Symptoms: Leg numbness and Tingling in both legs and feet starting 9 days after second vaccine. Lightheaded, sweats and leg tingling at night, nausea starting May 17. Continuing and now am in week 12.

Other Meds: Calcium; vitamin D

Current Illness: None

ID: 1361739
Sex: F
Age: 75
State: MN

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

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Allergies: NKDA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Development of unexplained Cerebral venous sinus thrombosis

Other Meds: acetaminophen (TYLENOL) 500 mg oral tablet amLODIPine (NORVASC) 10 mg oral tablet apixaban (ELIQUIS) 5 mg (74 tabs) oral tablet starter pack apixaban (ELIQUIS) 5 mg oral tablet atorvastatin (LIPITOR) 40 mg oral tablet cefdinir (OMNICEF) 300

Current Illness: None

ID: 1361740
Sex: F
Age: 50
State: FL

Vax Date: 05/09/2021
Onset Date: 05/25/2021
Rec V Date: 05/30/2021
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Allergies: Compazine, mostly all fruits.

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

Symptoms: Next day after shot, felt like I had the flu. Body aches, sleepy and headaches. Felt fine the day after. May 25th, felt very lightheaded,dizzy and slight headaches. As of May 30th, still not feeling 100%. Still feel slightly dizzy and lightheaded. Will be going to the doctor if it persists after today.

Other Meds: Not that day.

Current Illness: None

ID: 1361741
Sex: F
Age: 27
State: OK

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/30/2021
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Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 5/18/21 - 3PM: extreme nausea, dizziness, fatigue 5pm 100 degree fever 6pm - 11pm 102 degree fever, slight arm pain 12pm fever broke 5/19/21 - Entire day: severe arm pain at injection site, nausea, diarrhoea, fatigue, whole body aches 5/20/21 - 5/22/2021extreme fatigue, nausea, watery diarrhoea 5/23/2021 - went to urgent care because I was in a lot of pain, fatigue, nausea, could not eat food without passing watery stool, extreme lower stomach pain, body aches. They ran blood and urine tests which all came out ok. They said my immune response was high which indicated I was still reacting to the vaccine. They prescribed me nausea medication and told me to drink pepto. Sent off a stool sample. 5/30/21 - I still cannot eat without feeling nauseous, stool alternating between extremely hard to watery, the bruise at my injection site is getting worse and it still hurts if I touch it.

Other Meds: Metformin 1000mg, Lamotrigine 100mg, Gabapentin 200mg

Current Illness: None

ID: 1361742
Sex: M
Age: 40
State: CT

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 05/30/2021
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Allergies: multiple enviormental and some food allergies

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

Symptoms: This report is being filed after the papers on the event where found when clinic was closed. Shortly after 1st moderna dose while in observation patient noted that he felt a funny sensation in his throat that felt on several other occasions upon exposure to know environmental and food allergies. he noted that this symptom always responded to benadryl and never required epi pen. there were no signs of distress nor other signs or symptoms of allergy. He appeared somewhat anxious and 50 mg of Benadryl Po liquid was given, with observation this symptom completely resolved and no other signs or symptoms developed. He was discharged form the clinic and advised at this time not to receive the second dose of moderna norother mRNA vaccine and follow up with his PCP or allergist to assess for second dose or consideration for Janssen as second dose. He was advised to go to ER if allergic symptoms subsequently developed.

Other Meds: none know

Current Illness: none know

ID: 1361743
Sex: M
Age: 40
State: MA

Vax Date: 05/30/2021
Onset Date: 05/30/2021
Rec V Date: 05/30/2021
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Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Body Aches Generalized-Mild, Systemic: Chest Tightness / Heaviness / Pain-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Patient felt faint, had increased heart rate, and a pressure at back of neck. Stated he felt some minor tightness on and off at throat area. No difficulty breathing.-Mild, Systemic: Nausea-Mild

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am