VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer

Incidents per State

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

ID: 1385520
Sex: M
Age: 18
State: IN

Vax Date: 06/03/2021
Onset Date: 06/04/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Severe dry cough, temperate max = 99.4, hoarseness, headache, insomnia

Other Meds: Levothyroxine 100mcg/day, Focalin XR 30mg qd, MVI, Claritin 10mg qd, Singulair 10mg qd

Current Illness: None

ID: 1385521
Sex: F
Age: 34
State: KS

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: Codeine Pollen Yellow squash

Symptom List:

Symptoms: I started having heart palpations on site after I received the vaccine, I had an EKG on site. The results from the EKG were normal and I was advised that I would be ok to go. I later that night noticed my left arm, shoulder, and side were swelling. I propped my left arm up due to the swelling and pain. I went back to sleep and the swelling finally went away after 6 hours. Whenever I woke up, I was fine, and the swelling went away. I also had itchy eyeballs for weeks on and off, joint pain, and fatigue.

Other Meds: Progesterone ( 1xday - .35mg ) Flonase ( as needed )

Current Illness: NA

ID: 1385522
Sex: F
Age: 74
State: FL

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: Dental novocaine

Symptom List:

Symptoms: Severe vertigo; blurred vision: dizzy - movement restricted: nausea without vomiting: digestive upset: exhaustion; sweating; chills; malaise

Other Meds: Doxycycline 50mg; Estradiol; pregnenolone; Armour Thyroid; Betamethasone .05% lotion; Clobetasol cream; lysine; Restasis; Thera Tears; Vit D3 2,000; Epsom Salts; Echinacea Propolis throat spray; JointAstin; HydroEye; Nature?s Craft Liver Su

Current Illness: None

ID: 1385523
Sex: F
Age: 21
State: GA

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

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

Lab Data:

Allergies: yeast

Symptom List:

Symptoms: PATIENT PASSOUT AFTER VACCINE WAS ADMINISTER. SHE COMPLAINED OF SOB BEFORE PASSING OUT. EPIPEN WAS ADMINISTERED AT 12;35 AND EMT ARRIVED AT 12:44. PATIENT RECOVERED AND REFUSE GOING TO THE HOSPITAL.

Other Meds: none

Current Illness: N/A

ID: 1385524
Sex: F
Age: 37
State: NC

Vax Date: 03/26/2021
Onset Date: 03/28/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: 2 days following my second COVID shot, I started getting severe chest pains. I attributed it to a pulled muscle and just waited it out rather than seeing a doctor, but did wonder at the time if it could have been heart related. The pains were very severe, tightness/fullness in chest, some heart fluttering. Pain/fullness worsened by laying down or leaning forward. After 3 days, the pain began to subside, and was fully recovered within a week. In retrospect, I wish I had gone to a doctor for imaging.

Other Meds: Zoloft, multivitamin

Current Illness:

ID: 1385525
Sex: F
Age: 76
State: TX

Vax Date: 01/18/2021
Onset Date: 05/31/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: None.

Symptom List:

Symptoms: I took the Pfizer vaccine in January and had a anaphylaxis reaction which I reported earlier. This is not about that but a week ago I began experiencing sharp pain in my thumbs when I tried to open a jar, pull up my pants, rub my hands together, flush the commode, etc. I have never had this kind of pain before. I looked on the internet to see what might help and noticed that the pain could possibly be a reaction to the Covid vaccine. Therefore, I am reporting it to you.

Other Meds: No Prescription drugs. I take a multi vitamin, D3 and a probiotic. I have taken all three of the same brand for several years.

Current Illness: None.

ID: 1385526
Sex: F
Age: 36
State: LA

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: Latex, mushrooms, Keflex, augmentin, bananas, walnuts

Symptom List:

Symptoms: Severe headache , Fever , Chills , Muscle aches , Left arm hurt at injection site warm to the touch as well

Other Meds: none

Current Illness: none

ID: 1385527
Sex: F
Age: 64
State: TX

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

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

Lab Data:

Allergies: Keflex

Symptom List:

Symptoms: Our office did not administer the vaccine She has underarm pain on the arm the vaccine was administered

Other Meds: rosuvastatin carvedilol Vit D3 ASA 81mg

Current Illness:

ID: 1385528
Sex: F
Age: 50
State:

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

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

Lab Data:

Allergies: hx hives with pfizer vaccine from store (lot unknown)

Symptom List:

Symptoms: began feeling itchy again, transferred to ER

Other Meds:

Current Illness:

ID: 1385529
Sex: M
Age: 71
State: PA

Vax Date: 03/26/2021
Onset Date: 04/01/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: PENICILLIN

Symptom List:

Symptoms: SHORT BRIEF PERIODS OF CONFUSION & DISORIENTATION

Other Meds: TWICE A DAY (BID or Q12hr.) MEDICATIONS: ZONISAMIDE 100 MG BID (SEIZURES) CARVEDILOL (COREG) 3.125 MG BID (HEART) APIXABAN (ELIQUIS) 5 MG BID (A FIB) SOTALOL 120 MG BID (HEART) GABAPENTIN (NEURONTIN) 100 MG (SEIZURE & NERVE PAIN) BID = T

Current Illness: NO ACUTE ILLNESS

ID: 1385530
Sex: M
Age: 64
State: NY

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 06/09/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Arrived to ED complaining of increased work of breathing, black stool and chest pain. Vaccination prior day incidental to medical findings not suspected to be caused by vaccine. 64 years male with PMH of multiple upper GI bleed secondary, atrial fibrillation, CAD, HTN, HLD, COPD on 2L, morbid obesity, OSA on CPAP who presented to the ED with black stools. Has had multiple endoscopic clips and coils placed in the past. VSS; H/H 7.5/21 on admission. His troponin was elevated and peaked at 1.68. Cath in July 2019 showed 80% proximal LAD, difficult to image secondary to an obese patient, occluded nondominant RCA, moderate disease in a large OM (40% stenosis), large anterior apical wall motion. motion abnormality, EF of 45%. GI and cardiology were consulted in the ED. He was admitted for acute blood loss anemia secondary to GI bleed, likely AVM. While inpatient, he remained afebrile and hemodynamically stable. He required 6u RBC transfusion total during his admission (transfused for <8.0 given ischemic heart disease). GI performed upper endoscopy x2 and removed large amounts of blood clots and placed 4 additional hemoclips to stop the bleeding. Cardiology was also consulted due to elevated troponin in the setting of ischemia heart disease, and inability to have stent placement/antiplatelet therapy due to GI bleeds - recommended conservative treatment, likely type II demand ischemia. He received IV octreotide 50mcg/hr for 4 days, as well as IV PPI 40mg BID.

Other Meds: spironolactone, nitroglycerin SL, metoprolol XL, lisinopril, furosemide, Advair inhaler, ferrous gluconate, docusate, daily vitamin, cholecalciferol, vitamin C, acetaminophen

Current Illness: GI Bleed, chest pain

ID: 1385531
Sex: F
Age: 65
State: TX

Vax Date: 01/07/2021
Onset Date: 03/01/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List:

Symptoms: Shingles rash two months later accompanied by outbreak of mouth blisters which may or may not have also been shingles

Other Meds: fluoxetine vitamin D

Current Illness: none

ID: 1385532
Sex: M
Age: 56
State: MA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Shot was 2.00 on Monday 06/07/2021 Flue like Symptoms 12 hours after shot Body Rash 20 on Wednesday 8:00

Other Meds:

Current Illness:

ID: 1385533
Sex: F
Age: 39
State: MN

Vax Date: 04/29/2021
Onset Date: 05/07/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: onset nephrotic syndrome within 10 days of the covid vaccine, kidney biopsy 6/3/2021 with minimal change disease (also underlying thin basement membrane disease) No prior hx of proteinuria, one episode of gross hematuria as college student with negative urologic workup, no history of proteinuria, no hx edema Being tx'd now with prednisone

Other Meds: none

Current Illness: none

ID: 1385534
Sex: M
Age: 80
State: OK

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient had 1st dose on 05/19/21. After 2nd dose of vaccine was administered, it was discovered that patient was 7 days early for the vaccine. Company of Moderna was contacted and informed us to report the incident; patient should have received vaccine on 6/16/21. at time of administration and 15 minutes post he is not reporting any adverse reactions to vaccine. Moderna representative took information. patient and his primary care provider, Dr., made aware of the situation. Patient advised to contact us if he has any problems or go to the ER.

Other Meds:

Current Illness:

ID: 1385535
Sex: M
Age: 40
State: MI

Vax Date: 01/22/2021
Onset Date: 02/14/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Pericarditis/ pericardial effusion- chest pain that radiated to arm. difficulty breathing in. went to ER and had CT scans to verify this diagnosis. Was treated with Ibuprofen and colchicine

Other Meds: None

Current Illness: None

ID: 1385536
Sex: F
Age: 59
State: MO

Vax Date: 01/19/2021
Onset Date: 01/26/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: Yes, I am allergic to Amoxicillin.

Symptom List:

Symptoms: I had pain in my right arm and was diagnosis with frozen shoulder. I have a reduced range of motion. When I went to the doctor on 04/07/2021 I got a steroid shot in my shoulder. I had to have 4 weeks of physical therapy.

Other Meds: Yes.

Current Illness: No.

ID: 1385537
Sex: F
Age: 43
State: MA

Vax Date: 03/17/2021
Onset Date: 03/22/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to hazelnuts.

Symptom List:

Symptoms: I had moderate to serve Vertigo, feeling off balance like I was going to fall.

Other Meds: I was taking multivitamins.

Current Illness: None.

ID: 1385538
Sex: F
Age: 27
State: WV

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient was administered a pfizer covid vaccine at the wrong concentration. The initial vial was mixed with 0.8ml of diluent instead of 1.8ml of diluent.

Other Meds:

Current Illness:

ID: 1385539
Sex: F
Age: 31
State: GA

Vax Date: 03/04/2021
Onset Date: 03/18/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Pfizer shots 02/03/2021, 03/04/2021 03/18/2021 tiny bumps started appearing on my lips. I had more every day through 03/26/21 until both lips were covered in bumps. The bumps were like tiny sores, very itchy and slight weeping. During the same period of time, the roof of my mouth hurt and itched really bad as if I?d had a terrible burn, but I couldn?t recall burning it. Period started 3/25/21. 3/26/21 I was prescribed 4 doses of antivirals and the bumps went away within a few days. 4/18/21 rough spots appeared on my lips. 4/19/21 tiny bumps appeared just like the ones a month prior. Was prescribed antivirals 3 doses per day (21 doses total), 4/19-4/26/21. The bumps went away. Period started 4/24/21. After last dose of antivirals on 4/26/21 tiny bumps appeared and lasted four days until 4/30/21. 5/23/21 I had numerous bumps on my shoulders, arms, and face. It looked like acne pimples or bug bites. 5/24/21-5/25/21 the bumps multiple and became inflamed and looked more like hives or a rash. Again, the roof of my mouth hurt and itched really bad as if I?d had a terrible burn, but I couldn?t recall burning it. Period started 5/24/21. 5/28/21 I went to urgent care because the bumps were still multiplying and very inflamed. I was diagnosed with poison ivy. Received a steroid shot and pills to take twice daily for 15 days to reduce itching. Inflammation started to improve soon after the shot. Spread of bumps slowed, but I continued seeing new spots every day or every few days. I continued to feel incredibly itchy constantly until 6/3/21. 6/3/21 I started having one hour or longer without itching. 6/7/21 stomach rash appeared and a 3 inch red line of little bumps on my face.

Other Meds:

Current Illness:

ID: 1385540
Sex: F
Age: 18
State: MN

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Client was waiting in line for Covid shot, client fainted. She caught herself on a tale with her father's assistance. Event was not witnessed by any staff at POD site but client moved to cot after reporting what happened. Patient denied hitting head and it was confirmed b father. BP 102/81, P 85, oxygen 99%. Vaccination given without further incident.

Other Meds: Unknown

Current Illness: Unknown

ID: 1385541
Sex: F
Age: 57
State: FL

Vax Date: 01/30/2021
Onset Date: 03/03/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to penicillin.

Symptom List:

Symptoms: The day after I got my vaccine and I passed out and I stayed the night in observation and I was running a fever.

Other Meds: I take a high blood pressure medication and multi-vitamins.

Current Illness: No other illnesses.

ID: 1385542
Sex: F
Age: 39
State:

Vax Date: 02/16/2021
Onset Date: 06/05/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Miscarriage @ 8 weeks gestation

Other Meds:

Current Illness:

ID: 1385543
Sex: M
Age: 63
State: MI

Vax Date: 03/19/2021
Onset Date: 03/24/2021
Rec V Date: 06/09/2021
Hospital: Y

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

Lab Data:

Allergies: CODIENE

Symptom List:

Symptoms: 5 DAYS AFTER SHOT 1 BECAME FEVERISH (102.4), EVERYTHING TASTED SALTY, TIED, DIFFICULTY BREATHING, PHYSICALLY WEAK

Other Meds: LISINOPRIL, GLIPIZIDE, BUSPIRONE, FINASTERIDE, FLOMAX , D3, ZINC

Current Illness: NONE

ID: 1385544
Sex: F
Age: 39
State: WA

Vax Date: 06/08/2021
Onset Date: 06/09/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: IV contrast dye

Symptom List:

Symptoms: 24 hours after injection, stomach pain, diarrhea, dizziness, head pressure and mild chest pain / discomfort. Still occurring at 11am same day.

Other Meds: N/A

Current Illness: n/a

ID: 1385545
Sex: F
Age: 50
State: AZ

Vax Date: 05/04/2021
Onset Date: 05/10/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: hypertension, heart palpitations, shortness of breath lasting 2&1/2 weeks

Other Meds:

Current Illness:

ID: 1385546
Sex: F
Age: 23
State: PA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1385547
Sex: M
Age: 42
State: FL

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Develop shingles? Herpes zoster on the Left arm that goes towards the back.

Other Meds: none

Current Illness: Fatty liver

ID: 1385548
Sex: F
Age: 63
State: NC

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

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

Lab Data:

Allergies: Armor thyroid, onion, garlic Sensitive to medications especially those causing drowsiness

Symptom List:

Symptoms: Headache worsening after about 6 hours and pain at injection site. Headache continued during the night, with restlessness, muscle soreness preventing sleep. Headache continued after getting up around 7 am, with nausea. Started drinking water, vomited around 10 am. Ate 2 pretzels, drank ginger ale. Fever of 99 degrees, chills. Took tylenol. Vomited around 2 pm. Tool Emetrol. Headache worse. Vomited at 4pm. and again at 6 and 8. Went to ER at 9. Vomited 2 more times while waiting. Given meds for vomiting, pain and IV fluids around 11:30 pm.

Other Meds: NP-Thyroid Vitamin D3 B-Complex

Current Illness: Mild headache from weather changes, allergies, mild cold

ID: 1385549
Sex: F
Age: 21
State: PA

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Fainting / Unresponsive-Mild

Other Meds:

Current Illness:

ID: 1385550
Sex: M
Age: 4
State: CA

Vax Date: 06/01/2021
Onset Date: 06/03/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: 24 hours after, a small red papule and surrounding redness developed at injection site. 48 hours after, vesicular papules on an erythematous base developed on left thigh. 72 hours later, redness and vesicles spread to left groin and down left leg.

Other Meds:

Current Illness:

ID: 1385551
Sex: F
Age: 18
State: NY

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

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

Lab Data:

Allergies:

Symptom List:

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

Other Meds:

Current Illness:

ID: 1385552
Sex: F
Age: 36
State:

Vax Date: 05/02/2021
Onset Date: 05/04/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: Strong headaches happening for 4 days in a row Knee-joint aches

Other Meds: No

Current Illness: No

ID: 1385553
Sex: F
Age: 47
State: NY

Vax Date: 02/12/2021
Onset Date: 02/19/2021
Rec V Date: 06/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: After the shot I had pain for a few days. About a few weeks later I had pain in my upper arm and went to the doctor. The doctor advised to get a X-ray and MRI for my pain. The test showed inflammation in my arm. I still had a bad pain and they decided to a IV injection. I also did therapy for my arm. I am still doing therapy and I still have pain in my arm. When I move my whole joint in my arm hurts. I am not able to work because the pain is so bad.

Other Meds: Tylenol

Current Illness:

ID: 1385554
Sex: M
Age: 17
State: CA

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

Vax Type:
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Allergies: Medication- NKA. Food: fish, nuts, soy, wheat

Symptom List:

Symptoms: after injection. patient stood up and fainted. the patient hit his head on the floor. staff elevated legs on chair. patient regained consciousness. LOCx4., responsive, warm to touch, Denies headache, SOB, lightness and dizziness. EMT arrived at 0906: vital within normal limits. 0910 Fire EMT arrived. patient's mother refuse to go hospital. Vitals: @0906 1st, 130/62, 96% O2, 77 HR and Glucose: 105. 2nd vitals @ 01917: 130/64, 99% O2, HR 93. NP; NP reassessed and released patient after 30 minutes inn observation.

Other Meds: N/A

Current Illness: no

ID: 1385564
Sex: M
Age: 36
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 06/09/2021
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Symptoms: Myalgia fatigue Muscle ache and soreness all over. Fatigue experienced.

Other Meds:

Current Illness:

ID: 1385594
Sex: M
Age: 66
State:

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 06/09/2021
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Symptoms: Myalgia

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Current Illness:

ID: 1385816
Sex: F
Age: 54
State: NC

Vax Date: 01/28/2021
Onset Date: 05/27/2021
Rec V Date: 06/09/2021
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Allergies: Morphine- severe itching

Symptom List:

Symptoms: Shingles

Other Meds: Diltiazem, Atorvastatin, HCTZ, Tylenol

Current Illness:

ID: 1385817
Sex: F
Age: 26
State: WV

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/09/2021
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Symptoms: Patient was administered a covid 19 vaccine at the wrong concentration. The vial was mixed with 0.8ml of diluent instead of 1.8ml of diluent.

Other Meds:

Current Illness:

ID: 1385818
Sex: M
Age: 25
State:

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 06/09/2021
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Symptoms: Diarrhea: 4-6 times a day. Today is the third day, I'm still suffering from it.

Other Meds:

Current Illness:

ID: 1385819
Sex: F
Age: 46
State: TX

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 06/09/2021
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Symptoms: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)

Other Meds:

Current Illness:

ID: 1385820
Sex: M
Age: 64
State: AR

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 06/09/2021
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Allergies: Rosiglitazone

Symptom List:

Symptoms: **No adverse reactions noted** Patient received Moderna 2nd vaccination 2 days early, patients return appointment was scheduled in error after 1st vaccination, I realized the error when charting vaccination.

Other Meds:

Current Illness: no illnesses reported from patient

ID: 1385821
Sex: F
Age: 59
State: CA

Vax Date: 01/28/2021
Onset Date: 02/02/2021
Rec V Date: 06/09/2021
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Symptoms: Chief Complaint Patient presents with ABDOMINAL PAIN Pt reports right sided abd pain almost to right flank area since last night with urinary frequency and soft stools x 2 days HPI Per patient during my interview: Patient presents emergency department as noted above. Patient with right-sided flank and abdominal pain since last night. Patient notes lately evening and kept her up most of the night. Notes she had difficulty sleeping or finding a position of comfort due to discomfort. Had to lay on her left side. Reports pain persistent mainly when taking a deep breath. Also somewhat tender in the right upper quadrant. No nausea or vomiting. No fevers or chills. No lower abdominal pain. Denies any urina HPI Per patient during my interview: Patient presents emergency department as noted above. Patient withm right-sided flank and abdominal pain since last night. Patient notes lately evening and kept her up most of the night. Notes she had difficulty sleeping or finding a position of comfort due to discomfort. Had to lay on her left side. Reports pain persistent mainly when taking a deep breath. Also somewhat tender in the right upper quadrant. No nausea or vomiting. No fevers or chills. No lower abdominal pain. Denies any urinary complaints. No vaginal complaints. No recent cough or URI symptoms. She works from home and denies any Covid contacts. No prior history of gallstones or kidney stones. She states she is uncomfortable however denies having taking any medicine at home. Has had normal bowel movements and did so this morning. Did not relieve her pain. Felt like she had trapped gas. Denies alcohol. She is otherwise in her baseline health. Physical exam: Constitutional: BP 126/46 | Pulse 75 | Temp 98.6 ?F (37 ?C) | Resp 18 | Ht 1.6 m (5' 3") | Wt 91.6 kg (201 lb 15.1 oz) | SpO2 96% | BMI 35.77 kg/m? No acute distress. Does not appear ill. Speaking clear and coherent sentences. Pleasant and articulate. No cause was found. No treatment was provided. The pain slowly went away on its own over several days.

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Current Illness:

ID: 1385822
Sex: F
Age: 76
State: FL

Vax Date: 02/16/2021
Onset Date: 06/01/2021
Rec V Date: 06/09/2021
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Allergies: Clindamycin Possible penicillin allergy Lactose Intolerance

Symptom List:

Symptoms: There was no real treatment. The outcome faded shortly after covering a large area of my arm about 3/4. It wasn't hard to the touch or itched but I didn't use anything on it after seeing my dermatologist/physician. He was the one to suggest to get the second dose on the opposite arm. This one lasted about 18 days instead of 2 weeks.

Other Meds: Synthroid, 0.15mcg, 1xday Metformin, 500mg, 2xday Losartan-HCTZ,50/12.5mg, 1xday Potassium 20mg, 1xday Crestor, 20mg, 1xday metoprolol tartrate,12.5mg, 2xday Baby aspirin 18mg, 1xday Vitamin D3, 400IU, 1xday Multivitamin, (No dose)1xday Vit

Current Illness: None.

ID: 1385823
Sex: F
Age: 34
State: WI

Vax Date: 05/14/2021
Onset Date: 05/19/2021
Rec V Date: 06/09/2021
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Allergies: n/a

Symptom List:

Symptoms: Moderna COVID-19 Vaccine EUA. I had my first dose in May. Five days later I had a majorly swollen lymph node in my armpit on the injection arm. It took about 9 days for the swelling to go down.

Other Meds: Nuva Ring, Vitamin B, Vitamin C, Calcium, B-12, Vitamin D, OTC allergy meds, OTC hearburn meds, and Ashwaganda

Current Illness: None

ID: 1385824
Sex: M
Age: 19
State: IA

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 06/09/2021
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Symptoms: The patient was given the vaccination and told to wait 15 minutes in the recovery area to observe for signs of adverse reactions. The patient had syncope about 2 minutes after sitting and fell from a seated position on his chair to the ground. He had a brief seizure (unresponsive, tense muscles, open eyes) for about 2-5 seconds. He then became responsive and was able to respond to prompts and questions. He was given water. an ice pack (for injured spot on forehead), and told to wait for 30 minutes for further observation. He arranged to have a friend pick him up to take him home from the pharmacy and was told that he could not drive himself home after this adverse reaction. The patient stated that he otherwise felt normal afterwards (aside from some ache from the forehead after falling).

Other Meds:

Current Illness:

ID: 1385825
Sex: F
Age: 48
State: MT

Vax Date: 01/27/2021
Onset Date: 05/04/2021
Rec V Date: 06/09/2021
Hospital: Y

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Allergies: Augmentin Sulfa

Symptom List:

Symptoms: On 5-4-21 experienced SOB and left sided chest pain. Went to ER and diagnosed with massive bilateral pulmonary embolism. Emergency Thombectomy immediately.

Other Meds: Cozaar HCTZ Prozac Levothyroxin

Current Illness:

ID: 1385826
Sex: F
Age: 57
State: MA

Vax Date: 04/07/2021
Onset Date: 04/11/2021
Rec V Date: 06/09/2021
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Allergies: lisinopril codeine

Symptom List:

Symptoms: significant blood in urine. This also occurred within a few days of first Pfizer shot ( batch EP7534). Lasted 3-4 days each time.

Other Meds: levothyroxine Diltiazem Flonase loratodine CBD

Current Illness: none

ID: 1385827
Sex: U
Age: 29
State: MD

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 06/09/2021
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Allergies: Codeine

Symptom List:

Symptoms: headaches, lipoids swollen, breast swollen

Other Meds: No

Current Illness: No

ID: 1385828
Sex: F
Age: 50
State: OR

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 06/09/2021
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Lab Data:

Allergies: PCN, sulfa, Terbutaline, Iodine, Norafloxin, Macrobid, ASA, shellfish, strawberries, passionfruit, walnuts, pecans, beef, lactose intolerant, gluten intolerant, venom stings/bites, wool,

Symptom List:

Symptoms: Sore arm, head ache, back and shoulder ache (within 20 minutes), dizziness, extreme nausea and stomachache, wheezing, chest tightening, skin turning red, hives, itchiness, geographic tongue (1 hour 10 minutes after injection), mouth sores internal and external, swollen tongue, water weight around 5 pounds (48 hours after injection). Continued dizziness, headache, neck pain, swollen tongue, mouth sores, and continued itchiness as of today's date (06/09/21).

Other Meds: Advair, Zyrtec, Singulair, multi vitamin

Current Illness: none

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm