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: 1376808
Sex: F
Age: 54
State: GA

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: About 45 minutes after l received my vaccine, my eyes started to water and nose was runny ( most of the entire day! No allergies before this! About 4 hours after vaccine l had a drink of water had was chocking on a sip( couldn?t breathe ( spitting and sweating) couldn?t catch my breath! Very scary. Shortly a few minutes later ( tried to suck on a piece of melted chocolate and could pass throat. Another chocking event occurred. I find by gagging and spitting to get relief and breathe. Heavy feeling in my chest lasted until evening ! Still very sore arm today

Other Meds: Verapamil , Xanax, adderal, Crestor, vitamin D,C, hydrochloride ( water pill)

Current Illness: High WBC 13.5 just about 3 weeks prior was on steroids WBC went to 10 much lower. That?s all l can think of ( didn?t feel ill)

ID: 1376809
Sex: M
Age: 35
State: NV

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Headache-Severe, Systemic: Shakiness-Severe, Additional Details: pt has fear of needles, has fainted in the past with injections. patient went in and out of conciousness for about 15 seconds and then woke up, 911 was called and paramedics checked all vitals. he said he felt better and did not want to go to hospital wife drove him home.

Other Meds:

Current Illness:

ID: 1376811
Sex: F
Age: 15
State: CA

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Tinnitus-Medium, Additional Details: After getting the Pfizer vaccine, patient started to feel fainted. Patient stated that she has lightheaded and ringing in her ear. Patient was helped to lie down on the ground with both feet elevated. After 20 minutes, patient was feeling better. Blood pressure at this moment was 101/69, and pulse was 74. Patient was able to stand up and walk around.

Other Meds:

Current Illness:

ID: 1376812
Sex: F
Age: 31
State:

Vax Date: 04/12/2021
Onset Date: 04/17/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Irregular menstrual cycle - incredibly light for two months (April and May) and now late/missed entirely in third month (June).

Other Meds:

Current Illness:

ID: 1376813
Sex: M
Age: 26
State: OR

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: no medications listed on vaccine form

Symptom List:

Symptoms: Patient recieved Covid vaccination from our intern and 10 seconds later reported feeling dizzy and unwell. Pt sat down immediately in consult room but then fainted and fell out of the chair and landed face first on the floor and experienced seizing motions. Patient was out for 30 seconds to a 1 minute. The patient came to and reported feeling better, wanted to sit up and wanted water. A water bottle was provided for the patient. 911/paramedics were called and 3-5 minutes later the patient fainted with seizing motions again but was supported and did not fall out of chair again. shortly after the second fall, paramedics arrived and took over. patient ate 4.5 hours prior to vaccination and also reported never fainting before after or while getting a vaccine.

Other Meds: Unknown - patient does not fill RX here at Pharmacy

Current Illness: unknown

ID: 1376814
Sex: F
Age: 45
State: MN

Vax Date: 05/22/2021
Onset Date: 05/24/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: Latex sensitivity, seasonal allergies

Symptom List:

Symptoms: Constant heartburn-like chest pain for two weeks now. Treated with Omeprazole 10 days, didn?t help. Switched to Famotidine, seems to be improving. Whole body skin sensitivity started same time as heartburn pain, itchiness and symptoms like dermatographia. Itchiness has improved with Zyrtec.

Other Meds: Ibuprofen

Current Illness: None

ID: 1376816
Sex: F
Age: 68
State: NC

Vax Date: 05/14/2021
Onset Date: 05/17/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: lisinopril

Symptom List:

Symptoms: Pt reported a rash and itching that started Monday after receiving her vaccine on Friday (3 days later). fine erythematous itchy rash on hands, neck, forehead

Other Meds: Omega 3, losartan-HCTZ, aspirin, vitamin D, calcium, amlodipine

Current Illness:

ID: 1376817
Sex: F
Age: 49
State: CO

Vax Date: 04/29/2021
Onset Date: 05/01/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: First dose was not much of an issue, I had the expected soreness in my arm where the shot was administered. I would get an occasional twinge of pain ( as if I had the shot again). However, since I have had the second dose on 4/29/21 _ I am experiencing horrible pain in my deltoid, upper bicep and tricep. To the point that I cannot sleep due to the constant stabbing pain. I have rested the arm, iced it, heated it. I have seen the chiropractor, had massage therapy, and cannot find relief. The pain is AWFUL and stabbing and sharp. Yesterday I went to the orthpedic specialist and they say that it seems to be all muscular and likely inflammatory reaction from the vaccine. this is 6 weeks of a reaction.

Other Meds: calcium, magnesium supplements

Current Illness: none

ID: 1376819
Sex: M
Age: 56
State: TX

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild, Systemic: Weakness-Mild, Additional Details: Patient fainted after 15-20 minutes of getting vaccination. He said he felt overheated and exhausted before passing out. Gave him ice pack and water and had him lie down for several minutes. His bloodpressure was low then rose after a few minutes. Patient declined to be checked out by EMTs and stated was fine to go home and lay down. Figured he was probably anxious about getting the shot

Other Meds:

Current Illness:

ID: 1376820
Sex: F
Age: 38
State: FL

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

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

Lab Data:

Allergies: As Per Pt. None

Symptom List:

Symptoms: Pt. after Vaccination pt. report feeling faint and weak. Appear pale. Pt. slump down in chair. Placed supine on floor feet elevated. Pt regain consciousness. EMS arrived .Pt refuse transport stated starting to feeling better. Pt Stay seated on floor until 1300. Drank water and was able to get walk. Pt. left ambulatory accompanied by spouse and aunt.

Other Meds: As Per Pt. None

Current Illness: As Per Pt. None

ID: 1376821
Sex: F
Age: 56
State: IL

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: possibly erythromycin latex most artificially scented products

Symptom List:

Symptoms: 1. Swollen lymph nodes--axillary, left upper chest, arm. Also left side of face--cheek, jaw, throat (tonsil). This began within half and hour of vaccination and lasted about 3-4 days. Also happened similarly on second dose (4-16-21, same location). 2. Left upper arm pain. Still ongoing at this time (June 6, 21). Mild to moderate. Occasionally up into neck to behind ear. Difficult to lift left arm from straight out (away from body) further up. Was not affected by second dose.

Other Meds: Coreg Hydrochlorothiazide Omeprazole Metformin Lisinopril Zyrtec Pepcid AC

Current Illness: none

ID: 1376822
Sex: F
Age: 35
State: IN

Vax Date: 06/02/2021
Onset Date: 06/03/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List:

Symptoms: Exhaustion, fatigue, low grade fever, diffuse red blotchy rash over stomach, chest, back, shoulders, armpits. Took naproxen, Tylenol and Benadryl. Rash is still ongoing. Other symptoms have resolved.

Other Meds: Zyrtec, Singulair, Flonase

Current Illness: None

ID: 1376823
Sex: M
Age: 27
State: NH

Vax Date: 06/01/2021
Onset Date: 06/03/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Rash Generalized-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Lymph Node Swelling-Medium.

Other Meds:

Current Illness:

ID: 1376824
Sex: M
Age: 37
State: IN

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Chest pain; pain and soreness in kidneys. Both chest pain and kidney pain lasted for about 36 hours

Other Meds: Losartan, Allegra

Current Illness:

ID: 1376825
Sex: M
Age: 13
State: MD

Vax Date: 06/03/2021
Onset Date: 06/06/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Chest pain, fevers, elevated BNP

Other Meds: None

Current Illness: None

ID: 1376826
Sex: M
Age: 29
State: FL

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Fainting / Unresponsive-Medium, Systemic: Seizure-Mild, Additional Details: patient fell down and apper to have seizure , we called emc ,emc take care of the pt, and he was ok,pt refuse to go to er.

Other Meds:

Current Illness:

ID: 1376827
Sex: F
Age: 46
State: TX

Vax Date: 05/24/2021
Onset Date: 06/02/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Developed swollen legs tight and discolored.. had a massage to relieve pressure on Friday.. started noticing Thirsday and at present have very bad vision changes that isn't normal. I also have on and off cheat pains this morning with numbness in my left arm and tingling fingers. Pain move from my right under breast area to left side before subsiding. But vision problem persists with swollen face and headache.

Other Meds:

Current Illness:

ID: 1376828
Sex: M
Age: 14
State: NY

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Nausea-Severe, Systemic: Seizure-Severe, Systemic: Vomiting-Severe, Systemic: Weakness-Medium, Additional Details: Patient fainted, seized for less than a minute and then vomited. 911 was called. Patient was examined and felt normal after medics left the store.

Other Meds:

Current Illness:

ID: 1376829
Sex: F
Age: 15
State: IL

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

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

Lab Data:

Allergies: coconut oil

Symptom List:

Symptoms: Patient felt shooting pain up her arm, felt light headed, and then had a seizure. 911 was called, she was taken out in the parking lot by EMT. Spoke to the parent and she has not had any prior history of adverse reaction to other vaccinations. According to the EMT, immunizer may have hit the never. Patient is doing fine as of few hours later, upon follow up with the parent.

Other Meds:

Current Illness:

ID: 1376830
Sex: M
Age: 44
State: SC

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: Mold, Nuts, Pollens

Symptom List:

Symptoms: The day after getting the vaccine he began to feel like he had the flu. He progressed each day to become weak and dyspneic. He became hypoxic with a pulse ox of 80%.

Other Meds: Toprol 50mg daily Allegra D daily

Current Illness: None

ID: 1376831
Sex: F
Age: 54
State:

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Attendee received second dose Pfizer vaccine at 15:55 in the left arm. Lot# EW0186. Attendee was directed to observation area. At 16:00 voiced complaints of dizziness, and a rash was generalized on the chest and neck. No tachypnea or dyspnea. Attendee was given 50 mg of Benadryl and an ice pack. HR: 80's BP: 184/88 O2Sat%: 97 16:05 - Attendee stated feeling better. 16:35 - Care Practitioner educated on home discharge/adverse reaction instructions and attendee was discharged to home with her family as her symptoms were completely resolved. HR: 75 BP: 150/70 O2Sat%: 96

Other Meds:

Current Illness:

ID: 1376832
Sex: F
Age: 37
State: FL

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

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

Lab Data:

Allergies: Both

Symptom List:

Symptoms: Racing heart beat up to 125 bpm. Felt numbness on left arm Itching around mouth (lips) Dizzy

Other Meds: Nothing

Current Illness: No

ID: 1376833
Sex: M
Age: 13
State: VA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Site: Pain at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Weakness-Medium, Additional Details: patient was given 2nd dose of phizer covid 19 vaccine. patient was fine intially and became lifeless and pale after 5 minutes. Patient was disoriented , pale, and complained of blackened vision and huge sound in his ears. paramedics were contacted and patient was arousable. after 15 min patient was ok and documented color restored to complexion. paramedic deducted anxiety due to needles and patient was taken home by parents

Other Meds:

Current Illness:

ID: 1376834
Sex: M
Age: 14
State: FL

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadedness-Mild, Systemic: Fainting / Unresponsive-Severe, Systemic: Shakiness-Mild, Additional Details: Patient received the shot in the left arm. After he passed out his left wrist bent and twisted.

Other Meds:

Current Illness:

ID: 1376835
Sex: M
Age: 31
State: OR

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

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

Lab Data:

Allergies: latex

Symptom List:

Symptoms: About two minutes after receiving the vaccine, the patient was talking to me then suddenly stopped talking and slumped over. He was able to speak to us after about 30 seconds and drink water.

Other Meds: none

Current Illness: none

ID: 1376836
Sex: F
Age: 34
State: MA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: Pollen, dust mites etc

Symptom List:

Symptoms: After the first week of the second dose started developing stiffness and swollenness in ankles and left-hand finger joint pain. The pain and discomfort were manageable and lasted for about 2 weeks after the first dose. Then I got the second dose. After getting second dose, had fever, muscle and joint pain on second day after second dose. Then the fever and muscle pain went away but joint pain has been progressively getting worse. On day 12 after the second dose the joint pain reached a point of interfering with daily normal activities. Most of the joints have discomfort but the ankles and wrists have the most pain. The symptoms include joint pain, stiffness, discomfort, feel of swolleness, and heaviness.

Other Meds: st John's wort fish oil vitamin D turmeric

Current Illness: n/a

ID: 1376837
Sex: M
Age: 45
State: WA

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

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

Lab Data:

Allergies: Patient indicated ; No allergies.

Symptom List:

Symptoms: Patient came to the pharmacy for the Janssen COVID vaccine. He was feeling fine, and was injected with vaccine in the left deltoid at 1:05pm. He remained alert throughout the time information and instructions were provided. Later, he mentioned fear of needles and looked pale. I gave him a Gatorade drink and glucose tablets. At about 1:10pm he fainted while seated in our pharmacy waiting area. He was accompanied by his significant other. He had mild convulsions that lasted less than 5 seconds. Our request to call 911 was denied. Store management responded to our call immediately. Observation and care was provided. Moist cloths were given to patient. He recovered in about 15-20 minutes. He walked out with his significant other. He was very thankful and said he felt normal.

Other Meds: Unknown. No prescriptions in pharmacy profile.

Current Illness: None.

ID: 1376838
Sex: F
Age: 14
State: OH

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: patient passed out for abt 5sec and cameback, Her face was flushed and immediatly after turned white. She drank some water and after that she was feeliong okay. Mother reported she has fained before from the HPV vaccine. SHe didnt not want to call the ambulace. Sat for another 15 under observaction and then she was okay to go home

Other Meds:

Current Illness:

ID: 1376839
Sex: F
Age: 55
State: NJ

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 06/06/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Outcome: Fever of Unknown Origin, Elevated WBC and Elevated Liver Enzymes ( Transaminases) Days Sick: Twice in March, 3/31, 4/20, 4/27, 4/29, 5/8, 5/20, 5/24. On 5/8 fever 103 other days over 102. F/U with Doctors,

Other Meds: Flecainide 100 mg every 12 hours, Rosuvastatin 20 mg at bed, Vit. C, 500 mg, D3,125 mcg, Zinc 50 mg, One -a-day Vit 50+, Black Elderberry Gummies

Current Illness: Recurrent elevated high fevers on for almost 2 months, 8 times, Er3 times admitted to hospital on 5/24/21 Chills, body aches fevers over 102 each time

ID: 1376840
Sex: F
Age: 55
State: GA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Rash on right arm, left arm and left leg.

Other Meds:

Current Illness:

ID: 1376841
Sex: F
Age: 42
State: WA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Extended shoulder pain amd limited range of motion, not in exact injection site but in surrounding tissues in shoulder and upper arm

Other Meds:

Current Illness:

ID: 1376842
Sex: F
Age: 26
State: MD

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: Dairy

Symptom List:

Symptoms: After receiving the vaccine I passed out. Waited the 15 minutes then got into my vehicle. At that time my entire body felt as though it was on fire and I broke out in hives. Had trouble breathing. Went home, took Benadryl and waited it out. Breathing went away a few minutes later but hives stayed for 3 days. My arm was swollen and tender the next day and stayed swollen for 4 days.

Other Meds: Loestrin Fe Buproprion HCL XL

Current Illness: None

ID: 1376843
Sex: F
Age: 28
State: NY

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: patient reports severe fatigue , tachycardia and inablility to exercise for two weeks after vaccination

Other Meds: none

Current Illness: none

ID: 1376844
Sex: F
Age: 39
State: CO

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

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Symptoms: Roughly 16 hours after receiving the second dose of the Pfizer COVID-19 vaccination I began experiencing abdominal cramping that I would normally associate with menstrual like cramping. The reason I found this to be abnormal is that I underwent an ablation procedure more than seven years ago and have rarely if ever experienced abdominal cramping since that time. Approximately two weeks after the injection I experienced what I could consider an abnormal menstrual cycle with bleeding that lasted four to five days. I found this to be strange considering I've not experienced any such menstrual cycle since undergoing the ablation more than seven years ago. Since the ablation procedure I could count the number of times, on one hand, when I've experienced any type of bleeding and those instances have produced such an insignificant amount of blood that I could not justify even wearing a tampon. In those handful of situations I spotted for 2-4 hours maximum. Fast forward two more weeks and here I am having a menstrual cycle and bleeding enough to wear a tampon.

Other Meds: 50 MG Metoprolol per day

Current Illness: None

ID: 1376845
Sex: F
Age: 41
State: VA

Vax Date: 06/03/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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Allergies: Allergic to certain to skin of certain fruits

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Symptoms: 6/5/2021- Dizziness, loss of consciousness, nausea, vomiting, diarrhea, shaky arm

Other Meds: Zoloft, birth control, clonopin

Current Illness: No

ID: 1376846
Sex: F
Age: 15
State: WA

Vax Date: 06/06/2021
Onset Date: 06/06/2021
Rec V Date: 06/06/2021
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Allergies: n/a

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Symptoms: Gave Moderna vaccine to 15 year old. Moderna is approved for 18 and older only.

Other Meds: n/a

Current Illness: n/a

ID: 1376848
Sex: M
Age: 13
State: TN

Vax Date: 06/05/2021
Onset Date: 06/06/2021
Rec V Date: 06/06/2021
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Allergies: Allergic to peanuts, tree nuts (except almonds), lentils, green peas

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Symptoms: Red bumpy rash on left leg and right leg. More rash on the left leg than the right. Does not itch.

Other Meds: Flovent inhaler

Current Illness:

ID: 1376849
Sex: F
Age: 19
State: CA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/06/2021
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Symptoms: patient's grand mother came to the pharmacy on 06/04/2021 evening to inform us that her grand daughter went through a significant side effect from her 2nd dose of Moderna Covid-19 vaccine, which she received on 05/25/2021. She informed us that patient went through partial paralysis of her facial nerves and had to go to the ER, where she was told that she has suffered Bell's Palsy. She was provided treatment for the same and is still recovering from the adverse event

Other Meds:

Current Illness:

ID: 1376850
Sex: M
Age: 14
State: IN

Vax Date: 06/05/2021
Onset Date: 06/06/2021
Rec V Date: 06/06/2021
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Allergies: Amoxicillan

Symptom List:

Symptoms: Low grade fever: 98.9, joint pain, body aches, fatigue, nausea, vomiting, headache beginning overnight after receiving the vaccine.

Other Meds: None

Current Illness: None

ID: 1376851
Sex: F
Age: 67
State: AZ

Vax Date: 06/06/2021
Onset Date: 06/06/2021
Rec V Date: 06/06/2021
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Allergies: Compazine

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Symptoms: The vaccine caused my prescription for insomnia to become completely useless for an entire month.

Other Meds: Meloxicam Temazapam, Mirtazipine Multi-vitamin

Current Illness: None

ID: 1376852
Sex: M
Age: 34
State: OH

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 06/06/2021
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Allergies: Benzoin

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Symptoms: Persistent Right deltoid pain that has existed since the administration of the vaccine. Radiates to lateral elbow, top of forearm moving to ulnar area of wrist intermittently, sometimes without agitating factors (exercise, movement, etc)

Other Meds: Nexium, Pepcid, Zinc, Vitamin C, Vitamin D

Current Illness: None

ID: 1376853
Sex: M
Age: 30
State: WA

Vax Date: 06/06/2021
Onset Date: 06/06/2021
Rec V Date: 06/06/2021
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Allergies: NO

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Symptoms: J&J leaked out of the needle - definitely did not administer the full dosage in the right arm - so i readministered another shot in the opposite arm (left); pt was fine with it

Other Meds: N/A

Current Illness: NO

ID: 1376854
Sex: M
Age: 35
State: NY

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 06/06/2021
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Allergies: n/a

Symptom List:

Symptoms: L sided facial numbness, persisted 3-4h after dose #1, then 30 days after dose #2

Other Meds: Propranolol, bentyl, multivitamin, omega3, melatonin, ibuprofen

Current Illness: anal fissure

ID: 1376855
Sex: F
Age: 65
State: CA

Vax Date: 02/01/2021
Onset Date: 02/18/2021
Rec V Date: 06/06/2021
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Symptoms: Hot flashes. After the 2nd Pfizer shot, I get hot flashes. It is the same as when I went through menopause, but it started up again right after the 2nd dose. My face gets very red and flushed and my body gets hot, then it goes away. It especially happens when I feel stress or at night. It happens at once a day or several times a day. Within an hour of getting the 2nd Pfizer shot, my skin was very red and itchy. The hot flashes occur regularly since February after the shot.

Other Meds:

Current Illness:

ID: 1376856
Sex: M
Age: 17
State:

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 06/06/2021
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Symptoms: PATIENT was given Modern vaccine and is 17 yrs old. No reactions.

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ID: 1376857
Sex: M
Age: 54
State: OR

Vax Date: 06/03/2021
Onset Date: 06/06/2021
Rec V Date: 06/06/2021
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Symptoms: Patient filled out consent form indicating that he was looking for a second dose of Moderna Covid vaccine. On processing forms at a later time it was found that his initial vaccination had been with Pfizer Covid-19 vaccine

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Current Illness:

ID: 1376858
Sex: F
Age: 49
State: CA

Vax Date: 04/03/2021
Onset Date: 04/08/2021
Rec V Date: 06/06/2021
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Symptoms: Continuous headache in the middle frontal part. Jaw and tooth pain, aching feeling in my teeth. Occasional episodes of shortness of breath.

Other Meds:

Current Illness:

ID: 1376859
Sex: F
Age: 50
State: CA

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 06/06/2021
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Allergies: Red Food dyes, alcohol, wool, walnuts, erythromycin, nickle

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Symptoms: 5" itchy welt

Other Meds: Mementine, coq10, magnesium, multivitamin with fish oil, lo loestrin birth control pill, l-lysine, zyrtec

Current Illness: None

ID: 1376860
Sex: F
Age: 40
State: UT

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 06/06/2021
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Allergies: None

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Symptoms: The day after I received the second dose of the COVID-19 vaccine, I developed tingling in my right arm that progressed to intense pain in my arm whenever I used it or just at various time. MRI's showed that I have a Cavernoma in my spine that had not be identified before due to never having any symptoms. The symptoms indicate that the Cavernoma had been activated and had started to bleed, causing the neurological symptoms. The symptoms have continued and neurosurgery will be occurring to remove the Cavernoma.

Other Meds: Birth control pills.

Current Illness: None

ID: 1376861
Sex: F
Age: 72
State: MN

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 06/06/2021
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Allergies: Aspirin, bees, clindamycin, diclofenac, Imuunoglobulin(IgG), Levaquin, Cipro, Avelox, propofol, Valcyclovir

Symptom List:

Symptoms: Elevating fever, extreme fatigue, body aches- 9th day bleeding while urinating: 10th day- BLOOD CLOT while urinating 2nd vaccine - milder fever, less fatigue, fewer body aches. 5th day, blood in urine. End of side effects.

Other Meds: Klonepin, Gabepentin, Plaquenil, Estradiol, Flinstone vitamin, vit D, Calcium, Tylenol

Current Illness: Autoimmunity

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm