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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






Manufacturers

Total Manufacturer

Incidents per State

State Total
72,296
AK1,638
AL5,339
AR3,412
AS44
AZ13,316
CA58,147
CO11,002
CT7,824
DC1,626
DE1,670
FL36,235
FM3
GA13,429
GU82
HI2,195
IA4,332
ID2,473
IL19,261
IN22,568
KS4,284
KY6,945
LA4,714
MA13,886
MD11,901
ME2,997
MH8
MI17,865
MN11,345
MO8,919
MP30
MS2,676
MT2,147
NC15,401
ND1,273
NE2,732
NH2,859
NJ17,232
NM3,702
NV4,071
NY32,763
OH18,072
OK5,940
OR7,954
PA22,457
PR2,104
QM2
RI1,911
SC6,055
SD1,133
TN8,691
TX34,122
UT4,023
VA13,944
VI49
VT1,661
WA13,811
WI10,395
WV2,220
WY805
XB5
XL1
XV2

ID: 1378284
Sex: F
Age: 61
State: FL

Vax Date: 06/04/2021
Onset Date: 06/06/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pt got Moderna COVIDvaccine on 6/4/21 in the evening and said she had some headache on 6/5/21 we told her to take Tylenol and let us know if it helped or got worse. She called back today 6/7/21 stating that the Tylenol worked for the headache. However, her husband mentioned to her that over the previous 24 hours, she had episodes of confusion where she didn't understand what he was saying. We gave her VAERS phone number so she could report it and counselled her to go to the ER to get proper care and to reach out to us about the outcome of the visit

Other Meds:

Current Illness:

ID: 1378285
Sex: F
Age: 17
State: TN

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: PFIZER VACCINE WAS PLACED IN FREEZER 05062021 AND DUE TO BE MOVED TO REFRIGERATOR 05192021. VACCINE WAS LEFT IN FREEZER UNTIL 05212021 THEN MOVED TO REFRIGERATOR. IMMUNIZATION PROGRAM WAS NOTIFIED OF ISSUE ON 05252021 AND SENT EMAIL STATING VACCINE AS SAFE TO USE . 05272021 TIP EMAILED VACCINE WAS NOT SAFE TO USE AND TO DESTROY THE VACCINE. THEN TIP EMAILED 05282021 THAT PFIZER PHARMACIST HAD DEEMED VACCINE STABLE AND IT WAS SAFE TO USE SO DOSES GIVEN 05252021 WERE GOOD.

Other Meds: UNKNOWN

Current Illness: NO

ID: 1378286
Sex: F
Age: 40
State: NJ

Vax Date: 04/02/2021
Onset Date: 04/22/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: grapefruit

Symptom List:

Symptoms: I have a strange full arm rash/stripped skin discoloration on my right arm. It appeared two weeks after the shot and is still present. It does not itch and is not irritating. It looks like a series of stretch marks almost. It is slightly fading from an angry red to a lighter brown. My body had a very bad reaction on the next day after the second shot. I anticipated that reaction, but not this skin discoloration / rash. I do not think it is going to go completely away. It is very strange.

Other Meds: n/a

Current Illness: no

ID: 1378287
Sex: F
Age: 23
State: MA

Vax Date: 01/06/2021
Onset Date: 06/07/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: No Allergies to medications, food, or other products.

Symptom List:

Symptoms: I just had flu like symptoms. I woke up in the middle of the night with stomach ache with a fever and chills with slight muscle aches. These symptoms would last for 20-22hrs.

Other Meds: Yes I was taking medications such as birth control , multi vitamins.

Current Illness: I had a lip infection 1 month prior.

ID: 1378288
Sex: F
Age: 70
State: MD

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: Aspirin

Symptom List:

Symptoms: Patient with persistent and chronic fatigue. She can no longer perform activities that she once did. She takes an hour nap in the morning and 2 hour nap in the afternoon. She has no energy. She no longer goes for walks.

Other Meds: Levothyroxine Norvasc Cozaar Atorvastatin One-A-Day Vitamin

Current Illness: None

ID: 1378289
Sex: M
Age: 45
State: NY

Vax Date: 04/27/2021
Onset Date: 05/03/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient presented at facility for second dose of Pfizer. Patient received his first dose of Pfizer on 4/27/2021 at location in another area. Patient developed a diffuse itchy rash over arms and legs one week after initial vaccine. Patient reports never had similar rash in the past. Continues to have severe itching and irritation now for past four weeks later. Dr recommended patient wait until rash has completely resolved. Patient can return for second Pfizer dose and will be monitored for one hour after. Patient was referred to PCP for referral to allergist. Patient understood and is in agreement.

Other Meds:

Current Illness:

ID: 1378290
Sex: F
Age: 29
State:

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: The first day of the vaccine later that night I had body ache and chills (moderna ). The next day I leg pain. after 4 weeks I still had leg pain with numbness and tingling started. I was told to take otc medication for the leg pain and they gave me gabapentin the numbness and tingling. Ive been feeling like this since 04/25/2021 and today is June 07/2021. This vaccine is has done something to my body that the doctors cant find .

Other Meds: none

Current Illness: none

ID: 1378292
Sex: M
Age: 34
State: CT

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: Patient received first dose of Moderna Covid 19 Vaccine at approximately 10:20AM and shortly began complaining of trouble breathing. Assessed patient. Patient denied experiencing any lightheadedness or any itching. Gave patient 2 capsules of diphenhydramine 25mg (50mg total) at approximately 10:30AM. At 10:33AM patient breathing continued to become more labored. Administered 0.3mg of epinephrine into anterior right thigh. At 10:37AM, EMT arrived on scene and continued to monitor and evaluate patient. Patient was transported to hospital.

Other Meds: NONE

Current Illness: NONE

ID: 1378293
Sex: F
Age: 20
State: PA

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: patient was seated when received vaccine. she was led to main waiting area to wait for observation. about 5 to 10 min after the shot patient was seated and began to pass out. she came to after a few min and put into lying down position with feet up. appearance was and clammy skin. 911 was called. her blood pressure was normal. heart rate normal. 911 call- based on my answers to their questions they decided to come to the pharmacy. patient stated that she did not have much to eat and that she has passed out from a nose piercing in the past. her color came back by the time she left. ems checked her out. she signed a form stating that she did not want taken to hospital.

Other Meds:

Current Illness:

ID: 1378294
Sex: M
Age: 72
State: OH

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: Sulfa Erythromycin

Symptom List:

Symptoms: Significant very difficult to control bleeding with a very minor procedure. 3 hours of pressure required to control his bleeding. Pt has received a testosterone pellet insert every 4 months since 2014. This involves a very small incision in the upper lateral buttocks. He has never had any complications or bleeding from prior insertions. He occasionally takes a Motrin and had taken one the night before; however nothing that could explain this uncontrollable bleeding other than the fact that he had a Moderna vaccine series completed 1-2 months prior.

Other Meds: Atorvastatin 10mg 1/2 Cap at bedtime. Started by his PCP 2018 Lotemax eye soln for corneal transplants Flomax 0.4mg 1 Cap Urinary retention - prescription 90 day Melatonin 1mg | 1-5 tabs | under the tongue at night Pure

Current Illness: None

ID: 1378295
Sex: M
Age: 12
State: TN

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: PFIZER VACCINE WAS PLACED IN FREEZER 05062021 AND DUE TO BE MOVED TO REFRIGERATOR 05192021. VACCINE WAS LEFT IN FREEZER UNTIL 05212021 THEN MOVED TO REFRIGERATOR. IMMUNIZATION PROGRAM WAS NOTIFIED OF ISSUE ON 05252021 AND SENT EMAIL STATING VACCINE AS SAFE TO USE . 05272021 EMAILED VACCINE WAS NOT SAFE TO USE AND TO DESTROY THE VACCINE. THEN EMAILED 05282021 THAT PFIZER PHARMACIST HAD DEEMED VACCINE STABLE AND IT WAS SAFE TO USE SO DOSES GIVEN 05252021 WERE GOOD.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1378296
Sex: F
Age: 44
State: NC

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient Reported feeling flush and having chest tightness

Other Meds:

Current Illness:

ID: 1378297
Sex: F
Age: 47
State: VA

Vax Date: 05/31/2021
Onset Date: 06/01/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: COMPAZINE

Symptom List:

Symptoms: FEVER OVER 102 DEGREES FOR APPROXIMATELY 72 HOURS. NAUSEA AND VOMITTING FOR OVER 72 HOURS. UNABLE TO KEEP DOWN ANY LIQUIDS OR TYLENOL. VOMITTING EVERY 15 MINUTES OVER A 5 HOUR PERIOD BETWEEN HOURS 48 AND 53. FINALLY ABLE TO GET ACCESS TO ONDANSETRON TO ALLEVIATE VOMITTING AND KEEP FROM GOING TO URGENT CARE FOR DEHYDRATION.

Other Meds: NONE

Current Illness: NONE

ID: 1378298
Sex: M
Age: 15
State: IL

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Severe pain in the left shoulder immediately after the injection. Decrease in range of motion.

Other Meds: None

Current Illness: None

ID: 1378299
Sex: F
Age: 36
State: CA

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: Aspirin, Keplex

Symptom List:

Symptoms: 2-3 minutes after I received the vaccine, I experience feeling of my heart racing immediately and I informed the staff working the nurse practitioner and the EMT monitored me and they told me at heart rate was 130. My palpitations continued in an interval of every few minutes on and off. After more than 45minutes waiting for my symptoms to go away, the palpitations continued with feeling of blood rushed throughout my body and my head, slight sob. It progressed and I experienced Feeling my jaw tightening. The EMT transported me to emergency at Hospital in. During transportation he gave me 50 mg of Benadryl IV. At the ER they tested me for Covid , negative result. I was discharged around 2 PM, ER doctor diagnosed me with adverse reaction to COVID 19 vaccine. I experienced another episode of palpitations 4/17/2021 and currently under the care of cardiologist Dr. medical foundation.

Other Meds: None

Current Illness: None

ID: 1378300
Sex: M
Age: 46
State: TX

Vax Date: 05/10/2021
Onset Date: 05/13/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Doctors appointment on May 18th to address right arm swollen lymph node identified on May 13th. On May 19th I experience the lost of my sense of taste and after my doctor's visit, Steroids and NAC were prescribed. It is now June 7th and I have yet to regain my sense of taste.

Other Meds: Sulfasalazine 500 mg, Floracil50, Testro-X, Bilberry 80mg, Elderberry 125mg, Fish Oil 1200mg , Protandim NRF2 790mg,

Current Illness:

ID: 1378301
Sex: F
Age: 75
State: MA

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: AMOXICILLIN, BACITRACIN, HYDROCHORTHIAZIDE, IODINATED CONTRAST MEDIA, SULFANAMIDE

Symptom List:

Symptoms: THE NEXT DAY 5/18/21 AT 900 AM WHEN PT WOKE UP NOTED TO HAVE ANGIOEDEMA ON THE FACE, BOTH CHEEKS ARE SWOLLEN. Pt took Zyrtec per advise of provider, for 2 days, edema resolved but came back. after 4 days, then she took Zyrtec again for another 2 days.

Other Meds: NONE

Current Illness: SEASONAL ALLERGIES

ID: 1378302
Sex: F
Age: 35
State: OR

Vax Date: 06/04/2021
Onset Date: 06/05/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: Allergies to benadryl

Symptom List:

Symptoms: Localized redness and soreness at injection site

Other Meds:

Current Illness:

ID: 1378303
Sex: F
Age: 61
State: OH

Vax Date: 04/07/2021
Onset Date: 04/15/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: Vicadine

Symptom List:

Symptoms: Severe hair loss, severe rashes. Extreme scaling on scalp. Unbearable itching. Scalp flaking. Over 30% hair loss. Still losing.

Other Meds: Lisinopril

Current Illness:

ID: 1378304
Sex: M
Age: 0
State: NY

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: Seasonal

Symptom List:

Symptoms: Itchiness occurred 20 mins post vaccination

Other Meds:

Current Illness:

ID: 1378305
Sex: M
Age: 51
State: VA

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pt. received 2nd dose of Moderna vaccine 2 weeks after receiving the first dose on 5/20/2021, the recommended time frame is 28 days between doses. The dose was given during a clinic provided by the Department of Emergency Services and was administered by the nurse. This nurse has tried to contact client with no success, messages have been left on his voicemail.

Other Meds:

Current Illness:

ID: 1378306
Sex: F
Age: 23
State: MA

Vax Date: 02/05/2021
Onset Date: 02/19/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: No Allergies to medications, food, or other products.

Symptom List:

Symptoms: About 9 days after receiving the second dose I noticed a red spot around the deltoid area where I received my vaccination.

Other Meds: I was taking a multi-vitamin and birth control.

Current Illness: No Other illnesses at the time of vaccination and up to one month prior.

ID: 1378307
Sex: M
Age: 14
State: MD

Vax Date: 06/03/2021
Onset Date: 06/05/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: Seasonal and environmental

Symptom List:

Symptoms: Hives

Other Meds: Zyrtec, Xyzal, Albuterol, Flovent

Current Illness: None

ID: 1378308
Sex: M
Age: 14
State: CT

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: amoxicillin

Symptom List:

Symptoms: patient passed out for about 10-15 secs 5-10min after administration of the vaccine

Other Meds: none reported

Current Illness: NK illness

ID: 1378309
Sex: F
Age: 1
State: NM

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: Patient with an erythematous rash on right cheek and scalp minutes after administration of vaccines. No signs of anaphylaxis. Follow up with mother the following day by phone - rash had resolved.

Other Meds: No

Current Illness: None

ID: 1378310
Sex: F
Age: 15
State: AZ

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient felt nauseous after vaccine and her mother tried to take her to the restroom. When she stood up she got lightheaded. Her mother caught her. She did not hit anything. The paramedics were called. She remained reclined on the floor until they arrived. She said she felt fine. They monitored her for a short while. She required no further treatment. On follow-up several hours later she states she feels fine.

Other Meds:

Current Illness:

ID: 1378311
Sex: F
Age: 15
State: PA

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: PT started to feel "dizzy and complain of body burning". PT slumped over with no LOC. Reaction tam notified. PT remained slumped over for 10 minutes, then said she was starting to feel better. Talking normal, drinking water with no complaints. Sitting up on phone. PT stayed extra 30 minutes per reaction team order. Vitals as follows: 1426 Lying BP 137/89 HR 84 RR 16 SPO2 98% 1501 Lying BP 142/83 HR 60 RR 18 SPO2 96% 1520 Sitting BP 130/68 HR 84 RR 18 SPO2 98

Other Meds: Trazidone 25mg, Citalopram 40mg, Apria

Current Illness:

ID: 1378312
Sex: M
Age: 28
State: MN

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: Cephalosporins

Symptom List:

Symptoms: Patient presented for his second dose and noted lingering arm pain and difficulty raising left arm to shoulder height.

Other Meds: No prescriptions, OTC unknown

Current Illness: Unknown

ID: 1378313
Sex: F
Age: 33
State: MA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Immediate reaction, redness on arm, hot to the touch, hard area at site of vaccination; began 5/25/21 5/26 and 5/27 had to take time off work due to fatigue, hot flashes, arm soreness, neck soreness, chills. Symptoms continued and I was seen at Urgent Care on 5/29 where they prescribed an antibiotic and steroid due to cellulitis at the site. 5/30 I began having headaches which have continued non-stop. Hot flashes, chills, and neck soreness have gone away. Fatigue, cellulitis at the site, and arm soreness have continued. I've had symptoms for 13 days. I saw my nurse practitioner due to headaches on 6/2 and was told to use heat and tylenol for headaches.

Other Meds: Blisovi Cymbalta Vitamin D

Current Illness: N/A

ID: 1378314
Sex: F
Age: 48
State: GA

Vax Date: 05/09/2021
Onset Date: 05/18/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: I had a reaction at injection site nine days later. Injection site was red, swollen and very firm to the touch. It was about the size of a quarter and was very hot and sore.

Other Meds: Prozac Adderall

Current Illness: None

ID: 1378315
Sex: M
Age: 22
State: NY

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Syncope. Felt very light headed, then said he was 'dreaming' but lost consciousness for a few seconds. Gave water, and orange juice when pt said he hadn't eaten. We moved him to the floor, where he laid down for a few minutes. He continued to sip water and OJ, and within a few minutes regained color and strength. Gradually felt better and back to baseline in about 15-20 minutes

Other Meds:

Current Illness:

ID: 1378316
Sex: F
Age: 20
State:

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient reported progressively worsening dizziness and lightheadedness few minutes after receiving the 2nd dose of covid vaccine. EMS was called to evaluate the patient. Patient started feeling better about 15 minutes after and was able to leave the facility on her own.

Other Meds:

Current Illness:

ID: 1378317
Sex: F
Age: 38
State: MD

Vax Date: 05/27/2021
Onset Date: 06/04/2021
Rec V Date: 06/07/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Chest pain, elevated troponin, suspected myocarditis

Other Meds: None disclosed

Current Illness:

ID: 1378318
Sex: M
Age: 42
State: WA

Vax Date: 03/26/2021
Onset Date: 03/28/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Vertigo and tinnitus

Other Meds: Multi vitamin

Current Illness: None

ID: 1378319
Sex: F
Age: 53
State: CA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: penacilian , kelefx, sulfar, Ropinorole, Medical adhesive, iodine contrast, mold allergy, cats, pollen and Levaquin

Symptom List:

Symptoms: 12 hrs in to Johnson feel lesser allergy effects of breathing and feverish without fever five days of headaches and hot flashes that start 12 hours in that got worse over the next couple of weeks and ultimately required treatment of homoral replacement, estrongine and progesterone's. Still seeking treatment with appts. scheduled.

Other Meds: Vitamin D, Zetec, Pepcid, Benadryl, Quenicipan .5, Plaquenil 200ml, Singular 10,

Current Illness: no

ID: 1378320
Sex: M
Age: 58
State: WA

Vax Date: 03/23/2021
Onset Date: 04/03/2021
Rec V Date: 06/07/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Diffuse palpable purpuric rash, followed by acute kidney injury with gross hematuria and proteinuria

Other Meds: allopurinol 100 mg daily, amlodipine 5 mg daily, ASA 325 mg daily, lisinopril 80 mg daily, metoprolol XL 100 mg daily

Current Illness: None

ID: 1378321
Sex: F
Age: 53
State: PA

Vax Date: 03/26/2021
Onset Date: 04/25/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: ibuprofen bactrim sick on codeine hay fever/seasonal allergies

Symptom List:

Symptoms: Developed significant left axillary swelling and soreness - lasted about 2.5 to 3weeks - 1st shot was worse than the 2nd

Other Meds: Cetrizine for allergies Zinc Vit C fiber gel

Current Illness: None

ID: 1378322
Sex: M
Age: 41
State:

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 06/07/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: He received a second dose of Moderna covid vaccine on 5/27 and progressed to develop some lethargy and decreased oral intake over the following days. When he arrived in the ED on 5/31 his temperature was 30.0?C rectally and bradycardic (HR51), BP 115/81, mentally altered. No evidence of infection or worsening of existing chronic conditions. he was admitted to ICU for hypothermia.

Other Meds:

Current Illness:

ID: 1378323
Sex: F
Age: 48
State: GA

Vax Date: 06/06/2021
Onset Date: 06/07/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: I received second Moderna dose on 6/06/2021 at 1:00 pm. At 2:00 am I woke up with fever, chills and full body aches. I feel like I have the flu with no energy.

Other Meds: Prozac Adderall

Current Illness: None

ID: 1378324
Sex: M
Age: 42
State: CA

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: "I feel short of breath, palpitations and I feel dizzy." RN put Client supine in gravity chair. RN provided juice and a protein bar. After 3 minutes, Client stated, "I feel better now, they symptoms are gone."

Other Meds: None

Current Illness: None

ID: 1378325
Sex: F
Age: 78
State: TX

Vax Date: 04/14/2021
Onset Date: 04/21/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Started with heartburn which I never had. Took Prilosec. Covid tested negative on May 3 at the local urgent care clinic. On May 4 at 9 am went to the emergency room of hospital. Blood test and ultrasound done. I was low on sodium, but my organs around my stomach were fine. On May 7 at 2 am, woke up with 103 degree temerature, felt chilled and shaking/spasms violently which I had never experienced before. EMS came at about 3 am, and shaking subsided after drinking hot water. Had follow up visit with my primary care doctor on May 11 at 1 pm Still experience heartburn and am taking Sucralfate and Nexium.

Other Meds: one a day vitamins, acidophilus, Benefiber

Current Illness: none

ID: 1378326
Sex: F
Age: 28
State: NH

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient started to experience pain in her shoulder that increased in severity over a few hours to the point she could no longer lift her arm.

Other Meds:

Current Illness:

ID: 1378327
Sex: F
Age: 52
State: WA

Vax Date: 06/01/2021
Onset Date: 06/05/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List:

Symptoms: pt fainted after vaccine while in waiting area, no further issues, she was fine within a few minutes

Other Meds: unknown

Current Illness: unknown

ID: 1378328
Sex: F
Age: 55
State: CA

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: Next day I got rash, redness, and swollen lyph nodes on left arm, hot to touch and itchy on injection site. I also had aches and pains which little by little started to get worse and turned into spasms in my right side of my back, shoulder blade and elbows swollen and hurting. The my right started to hurt and continued elbow pain. To find out there is now inflamation in my blodd.

Other Meds: Yes. Metformin, Glipiside, Claratin, Omeprazole, Potassium, Chlorthalidone

Current Illness: None

ID: 1378329
Sex: M
Age: 34
State: MD

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: R axillary / ant/ lateral chest wall swelling with TTP. no erythema, warmth, bruising, swelling. direct injection site appears normal. no arm swelling

Other Meds: wellbutrin, atarax

Current Illness: none

ID: 1378330
Sex: F
Age: 84
State: GA

Vax Date: 06/04/2021
Onset Date: 06/06/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient called today and said her arm really hurts and kept her up at night. It is also swollen , red and hot to touch.

Other Meds:

Current Illness:

ID: 1378331
Sex: M
Age: 20
State: NY

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Syncope, fell from standing. I do not have many details as I am reporting second hand. Paramedics were called and provided support. Pt did report that he had not eaten since the previous day.

Other Meds:

Current Illness:

ID: 1378332
Sex: M
Age: 63
State: AZ

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: NO

Symptom List:

Symptoms: RIGHT ARM WHICH IS WHERE THE INJECTION WAS RECEIVED IS SORE WHICH STARTED ON 05/20/21 STILL TO THIS DAY 06/07/21. PATIENT HAS FULL RANGE OF MOTION. CAN LIFT ARM A LITTLE MORE THAN HALF WAY TO THE SKY WHEN THE PAIN IS FELT IN THE MUSCLE. AT POINT OF INJECTION THERE IS STILL A SCAB.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1378333
Sex: F
Age: 33
State: NC

Vax Date: 05/16/2021
Onset Date: 05/16/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: PATIENT REPORTS "NERVE-LIKE PAIN" RUNNING FROM LEFT SHOULDER DOWN TO HAND SINCE DAY OF VACCINATION. APPROX 3 WEEKS

Other Meds:

Current Illness:

ID: 1378334
Sex: F
Age: 78
State: ID

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/07/2021
Hospital:

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

Lab Data:

Allergies: none listed

Symptom List:

Symptoms: Moderna vaccine was administered 2/18/2021 lot # 031M20A. Client dx with covid on 2/21/2021 and given monoclonal antibodies on 3/2/2021

Other Meds: n/a

Current Illness: na

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm