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: 1388809
Sex: F
Age: 38
State: CA

Vax Date: 05/26/2021
Onset Date: 05/30/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Allergic to cat hair. Side effect sensitive to all medications

Symptom List:

Symptoms: I immediately did not feel well. Aftwr a week of extreme symptoms I felt ok enough to get out of bed. Not long after getting up I experienced shooting pain and throbbing. Within a minute my yoe was swollen and by the next day the entire toe was bruised so badly it was purple and blue. I now cannot walk and my whole leg hurts. Saw a teledoc and he said see a doctor immediately. Three days later I'm still waiting to receive emergency medical and I'm afraid I'm gonna die just so you can open up this economy. If I die my fam is instructed to be very loud and to go to press

Other Meds: Multi vitamins Cbd oil

Current Illness: None

ID: 1388810
Sex: F
Age: 57
State: MD

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: About 5 hours after injection patient experienced racing heart rate chills and extreme fatigue she reported resolution not until 48 hours post vaccination.

Other Meds:

Current Illness:

ID: 1388811
Sex: M
Age: 44
State: VT

Vax Date: 05/23/2021
Onset Date: 05/24/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: left shoulder pain at injection site starting the day after moderna vaccine. No ROM changes. Pain radiates to the scalupla, neck and into the forearm. Treatment plan will be referral to PT and pain management.

Other Meds:

Current Illness: No

ID: 1388812
Sex: F
Age: 50
State: IN

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Persistent fatigue since receiving the vaccination

Other Meds: Xarelto Vitamin B12, B6

Current Illness: None

ID: 1388813
Sex: F
Age: 67
State: OH

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient reports no side effects other than a sore arm following her first dose of Moderna on 3/10/21. Received 2nd dose of Moderna on 4/9/21. Reports noticing itching, hives, shortness of breath and bumps on her head the next morning (approximately 9am). Symptoms continued and lip swelling developed. Patient reports she sought care at Urgent Care on 4/12/21 for same. Was given steroid shot and Benadryl. Reports symptoms had greatly improved by the following morning (4/13/21), but itching has continued off and on since receiving 2nd dose of vaccine. Continues to tak e Benadryl as needed. Reports extreme fatigue as well. Advised to follow with PCP.

Other Meds: Vit B12, MagOx, Potassium, diazepam, trazadone, sleeping med

Current Illness: None

ID: 1388814
Sex: F
Age: 22
State: KS

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

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

Lab Data:

Allergies: Compazine, sulfa, influenza vaccines (developed muscle tetany)

Symptom List:

Symptoms: Within 30 minutes of the injection she developed forceful, involuntary muscle contractions to her abdomen and B. hands. Had less severe muscle contractions to jaw. She has had similar reactions to compazine and to influenza vaccines.

Other Meds: Claritin 10mg, Flonase nasal spray, Depo-Provera IM injection

Current Illness: Amplified pain syndrome

ID: 1388815
Sex: M
Age: 20
State: MD

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient reported 3 to 4 hours after administration of vaccination starting with 101 degree fever and chills achy body and fatigue symptoms that lasted a full 24 hours.

Other Meds:

Current Illness:

ID: 1388816
Sex: F
Age: 57
State: AR

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List:

Symptoms: I got real lightheaded, cold, clammy and had a fever of 100.9. The school nurse checked my blood pressure which was elevated. She also checked my blood sugar because she thought that it may had been dropping and gave me orange juice to drink. The nurse followed my home and next day I had high fevers and body racking chills that lasted for exactly 36 hours. I woke up on Wednesday feeling fine. I took Tylenol for the fevers and had no appetite. I mainly slept for those 36 hours.

Other Meds: None

Current Illness: None

ID: 1388817
Sex: M
Age: 55
State: VA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Severe, Systemic: Seizure-Mild, Systemic: Weakness-Mild, Additional Details: patient was sweating profusely, felt dizzy. We called 911 and they said patient's BP dropped and may not have had a real seizure. patient said he had experience the 'excessive sweating' side effect before when he had allergic reaction (but did not tell the pharmacy staff at check in when we were asking if he had any allergic reaction to something)

Other Meds:

Current Illness:

ID: 1388818
Sex: F
Age: 32
State: CA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: I currently have an iud and haven?t had a period in over 3 years and 7/8 hours after receiving the vaccine I received my period heavily for 6 days.

Other Meds:

Current Illness:

ID: 1388819
Sex: F
Age: 44
State: GA

Vax Date: 02/25/2021
Onset Date: 05/17/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: The two toes on my right foot have the sensation of burning and itching. There is no rash, but the sensation comes and goes. Essentially Covid Toes.

Other Meds: none

Current Illness: none

ID: 1388820
Sex: F
Age: 16
State: VA

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: PATIENT GOT LIGHT HEADED AND NAUSEOUS IMMEDIATELY AFTER GETTING VACCINE

Other Meds: NONE

Current Illness: NONE

ID: 1388821
Sex: M
Age: 21
State: NC

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
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 vaccine. He was sitting in the observation area and after about 10 minutes, he fell over and onto the floor. He said he hasn't ever passed out from vaccine before. We gave him some water and after a few minutes, he got up and sat back in the chair for another 20 minutes. He said he was fine and didn't feel the need for any medical treatment or ambulance.

Other Meds:

Current Illness:

ID: 1388822
Sex: M
Age: 63
State: AZ

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: I do have some allergies.

Symptom List:

Symptoms: I had rashes spread through out my body.

Other Meds: Yes I take dietary supplements.

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

ID: 1388823
Sex: F
Age: 65
State: NJ

Vax Date: 02/24/2021
Onset Date: 04/06/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Nickel

Symptom List:

Symptoms: 04/06/2021 Hives - right leg - 06/08/2021 Hives - left leg - Symptoms, itching, spreading of hives from buttocks to knee back and side of leg (not front) Treatment both times: Dr. visit for inspection, xyzel, benedryl spray, liquid benedryl at night, cool compresses, anti itch cream, steroids prescribed second time, accupuncture visit for second time. Have recovered each time, but unsure if it will be a chronic condition needing further and more extensive treatment.

Other Meds: Metropolol, Fluoxetine, Flonase

Current Illness: None

ID: 1388824
Sex: F
Age: 20
State:

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Chest pressure s\p vaccination- advised to follow up with PCP or urgent care as needed

Other Meds:

Current Illness:

ID: 1388825
Sex: F
Age: 15
State: OH

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Nausea-Mild, Systemic: Visual Changes/Disturbances-Mild, Additional Details: Around 5 minutes after vaccine pt reported dizziness, nausea and double vision. Within 10 mins, pt said double vision went away but she was still dizzy. EMS was called and pt was taken for follow up at hospital.

Other Meds:

Current Illness:

ID: 1388826
Sex: F
Age: 21
State: MD

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient took a Pfizer vaccine in 2/2021 , 4 months ago and scheduled for a Moderna vaccine which was given on 6/10/21

Other Meds: N/A

Current Illness: none

ID: 1388827
Sex: F
Age: 38
State: MD

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient started experiencing dizziness fogginess in her brain and "out of it" for a full 24 hours starting about 6 hours.

Other Meds:

Current Illness:

ID: 1388828
Sex: F
Age: 53
State: MI

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

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: Patient was in garden shoveling hole, lost balance, fell down brick steps and landed on patio and was able to catch herself on chair. She did not hit head, is feeling fine now. She reported having balance issues, but this felt different than the other incidents. No other side effects from vaccine.

Other Meds: multivitamin, calcium chew, Effexor, lamictal, clonazepam, reglan, verapamil, lyrica, Neurontin, Seroquel, trazodone, lithium, singulair, primidone, ritalin

Current Illness: no

ID: 1388829
Sex: M
Age: 12
State: WI

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

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: J AND J VACCINE ADMINISTERED TO 12 YEAR OLD. CHILD'S FATHER REQUESTED IN HOME VACCINATION DUE TO CHILDS SEVERE AUTISM AND PHOBIA OF INJECTIONS. AFTER CONFIRMING NKDA AND NO PAST ALLERGIES TO VACCINES, AND RECIEVING PARENTAL CONSENT, NURSE ACCIDENTILY ADMINISTERED J&J VACCINE.

Other Meds: Unknown

Current Illness: UNKNOWN

ID: 1388830
Sex: F
Age: 49
State: TX

Vax Date: 01/18/2021
Onset Date: 05/24/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Posterior pain in left scapula that radiates up spine, into left anterior and posterior shoulder down to left deltoid at injection site. Intermittent numbness and tingling from anterior left deltoid down to left hand. Intermittent muscle spasms that feels like skin crawling and moderate to sever pain from left deltoid at injection site down to left hand.

Other Meds: Metformin, levothyroxine, Crestor, klonopin, Cinnamon, MVI, Red rice yeast, Novolin 70/30, Omega 3-6-9,

Current Illness: N/A

ID: 1388831
Sex: M
Age: 32
State: IN

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient was mistakenly given a 2nd dose of Moderna when his first dose was Pfizer.

Other Meds:

Current Illness:

ID: 1388832
Sex: F
Age: 58
State: TX

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: severe headache tempreature of 101 photosensitivity didn't want any lights on. fatigue

Other Meds: crestor

Current Illness: none

ID: 1388833
Sex: M
Age: 100
State: PA

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: nka

Symptom List:

Symptoms: medication Error- Patient received first dose on 5/6/21 of Pfizer Covid-19 vaccine. On 6/2/21 he was given the Janssen Covid vaccine, instead of the second dose Pfizer. No Adverse event occurred.

Other Meds:

Current Illness:

ID: 1388834
Sex: M
Age: 17
State: CA

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: Patient received Moderna vaccine for his first dose of Covid vaccine instead of Pfizer.

Other Meds: cetirizine 10mg , Flonase allergy relief 50mcg

Current Illness: no

ID: 1388835
Sex: F
Age: 65
State: CA

Vax Date: 03/09/2021
Onset Date: 06/08/2021
Rec V Date: 06/10/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Inflamed heart.

Other Meds: Calcium tablets with vitamin D daily

Current Illness: None

ID: 1388836
Sex: F
Age: 16
State: AL

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1388837
Sex: F
Age: 48
State: WI

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Chills, sweating, ran a fever, body aches, and headache. Experienced fatigue. Treated at home with Tylenol, fluids, and sleep

Other Meds: Does not want to add

Current Illness: none

ID: 1388838
Sex: F
Age: 20
State: WV

Vax Date: 04/14/2021
Onset Date: 05/19/2021
Rec V Date: 06/10/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin, Sulfa

Symptom List:

Symptoms: Patient presented 0n 5/25/21 with chest pain, shortness of breath, nausea and headache. Work-up showed pericardial effusion with pericarditis. Drain placed. Patient responded to ibuprofen and colchicine therapy. Patient unsure of dates of vaccination. Stated April-May 2021.

Other Meds: Ibuprofen

Current Illness: None

ID: 1388839
Sex: M
Age: 49
State: MD

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient reported symptoms of chills brain fog and armpit swelling for full 24 hours started about 4 hours after vaccine administration.

Other Meds:

Current Illness:

ID: 1388841
Sex: F
Age: 23
State: PA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Headache/Migraine for 6 weeks treated at 2 weeks with 60 mg Torodol- headache went away for 2 days treated at 6 weeks with 30 mg Torodol, then a course of steroids, headache completely resolved

Other Meds: Singulair Lexapro Fish Oil Womens Multivitamin Magnesium Claritin

Current Illness: N/A

ID: 1388842
Sex: F
Age: 64
State: NY

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

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

Lab Data:

Allergies: Sulfa (throat closing), Tramadol (throat closing). Vaseline.

Symptom List:

Symptoms: She got her vaccine, at home as Public Health came and gave it to her, she was fine for 15 minutes, and she came upstairs and she started having a hard time swallowing and breathing. She had experienced that before and stayed calm, and probably about an hour it passed. She then she started feeling really weird and in a day she started having uncontrolled shaking, and put on a sweatshirt, coat and she continued to shake, and got under the covers and could not stop shaking with the chills. She was then sick to her stomach and could hardly stand up, she has two broken feet and was not able to stand that lasted for about a week. Every part of her was hurting and she was afraid to get up for fear of falling. After a week the reaction started to subside and in the meantime she developed hives on the back of her legs and on her stomach. The one on her stomach was so bad that it was the size of a grapefruit, and looked like she had been severely burnt, which is now basically just going away and has lasted for over a month. It was next to the wound that has not closed from her previous surgery. The blister was full of liquid which she left alone for it to heal on it's own. She had a telehealth conference with her endocrinologist who told her that she was not to get any vaccines of any kind. Public Health did call her the day before the 2nd shot and she explained to the supervisor what had happened and she also informed her that they would not give it to her and not to get the 2nd vaccine or any other vaccines. This supervisor was part of the team that was trying to get her to heal with the wound vac from her previous surgery. She does not carry an Epi-Pen for any other allergic reactions.

Other Meds: Lantus Solostar insulin, Losartan/HCTZ, Amlodipine, Onglyza, Metformin, one a day multivitamin with iron.

Current Illness: None.

ID: 1388843
Sex: F
Age: 58
State: AR

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: I went to clinic this morning and gave patient her Covid Vaccine. I thought I was giving her the 2nd vaccine. I called the manager of the facility when I left and she said patient had already received both vaccines. She faxed the copy of her card to me and it showed that she had received her first vaccine on 2/3/2021 her second on 5/13/2021. I reviewed her prescription records this morning but I did not go back to February because I thought she was receiving her 2nd shots along with the other residents. I made a new card and left it with the aid at the home that showed 5/13 as the first dose and 6/10 as the second dose(actually her 3rd ). ** I should have insisted on having the previous card and I should have check the vaccine registry. This will be done from now on.

Other Meds: Aspirin, Glipizide, Atorvastatin,levothyroxine, metformin,pioglitazone,omeprazole,gabapentin and phenytoin

Current Illness:

ID: 1388844
Sex: F
Age: 38
State: OR

Vax Date: 01/15/2021
Onset Date: 01/18/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Sciatica flare up that lead to inability to walk/work. Symptoms began aprox 3 days after the injection and it was at first like the normal signs of a flare, but then it became so severe I was out of work and saw my PCP who ordered an MRI and prescribed medication

Other Meds: None

Current Illness: None

ID: 1388845
Sex: F
Age: 45
State: OH

Vax Date: 06/01/2021
Onset Date: 06/05/2021
Rec V Date: 06/10/2021
Hospital:

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

Lab Data:

Allergies: Demerol

Symptom List:

Symptoms: Developed Covid Rash on legs

Other Meds: Atorvastatin 20mg, Citalopram 10mg, Glimepiride 4mg, Losartan 50mg

Current Illness: possible elevated RA Factor

ID: 1388846
Sex: M
Age: 16
State: MI

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
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Symptoms: Moderna vaccine was given to this 16 year-old patient

Other Meds:

Current Illness:

ID: 1388847
Sex: M
Age: 28
State: NC

Vax Date: 04/09/2021
Onset Date: 05/21/2021
Rec V Date: 06/10/2021
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Allergies: None

Symptom List:

Symptoms: Intense Chest Pain / Difficulty Breathing / Pericarditis Diagnosed in ER

Other Meds: None

Current Illness: None

ID: 1388848
Sex: F
Age: 0
State: ME

Vax Date: 06/10/2021
Onset Date: 06/01/2021
Rec V Date: 06/10/2021
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Allergies: Ibuprofen, Sulfa

Symptom List:

Symptoms: Pt was seen on 06/09/21 for her 1st Pfizer vaccine. I went to the med room to draw up this vaccine. I documented on the form in the med room, with the patients sticker. I drew up the vaccine, I accidently drew up the dilute with the 1mL syringe instead of the 3 mL syringe. 1.8mL. I added this to the vaccine and drew up 0.3mL . I then went to get the patient, asked the questions on the form and gave the injection. The Patient then waited the 15mins. It was discovered on 6/10/21 that the wrong syringe was used to draw up the dilute. I spoke with my provider and he stated that he feels the patient got enough of the vaccine to be effective. The patient is returning to the office on June 30th for her 2nd Pfizer vaccine. There were no adverse events with this patient.

Other Meds: Vitamin B12, Albuterol INH, Sertraline, Calcium with Vit D, Fluticasone

Current Illness:

ID: 1388849
Sex: M
Age: 29
State: IL

Vax Date: 06/03/2021
Onset Date: 06/04/2021
Rec V Date: 06/10/2021
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Allergies: None.

Symptom List:

Symptoms: Starting the day after the vaccine, 06/04/2021, I had severe body aches, severe headache, pain on my arm where the shot was given, and severely swollen eyes but no vision problems. The body aches, headache, and arm pain lasted until 06/06/2021. The swollen eyes are still swollen today, 06/10/21, 7 days after the vaccine. On 06/09/2021 my lymph nodes in my right arm pit and on my left pectoral muscle swelled up, became red, and had an aching pain without touch and a moderate pain when touched. As of today, 06/10/2021, my lymph nodes are still swollen but with very minor pain with touch.

Other Meds: None.

Current Illness: None.

ID: 1388850
Sex: M
Age: 81
State: MI

Vax Date: 03/25/2021
Onset Date: 04/25/2021
Rec V Date: 06/10/2021
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Allergies: None

Symptom List:

Symptoms: Shortness of breath, fatigue, mussels weakness.

Other Meds: Sim a statin 20 mg one a day. Lisinopril 20mg one a day. Zertac one a day .

Current Illness: None

ID: 1388851
Sex: F
Age: 13
State: MN

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/10/2021
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Symptoms: Patient in clinic with mom and brothers to get the second dose of the Pfizer COVID 19 vaccine. Patient received the vaccine in right arm and a small amount of blood came out of the injection site. Patient looked at the blood and got pale. She loss consciousness for 10 seconds in the chair with her mom on her left side. We attempted to put patient on the floor to elevate her feet but she resumed consciousness right away. An ice pack was placed on the back of patient's neck. Patient did shake a bit and didn't know what happened. Patient then loss consciousness again and myself as well as another nurse helped her to the floor. Her feet were then elevated and patient regained consciousness again. Vitals were done, see vital flow sheet. No other signs of symptoms of an allergic reaction. Patient as well as parent was given signs and symptoms of allergic reaction and directed to go to ER or call 911. Patient was able to sit up after 5 minutes, then eventually stand and was able to leave clinic after 15 minutes in stable condition with parent. RN/BSN on 6/10/2021 at 1:18 PM

Other Meds:

Current Illness:

ID: 1388852
Sex: M
Age: 33
State: OR

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/10/2021
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Allergies: CHOCOLATE, POLLEN

Symptom List:

Symptoms: REPORTED: ARM SORENESS, BRUISING, LETHARGY FOR 1 WEEK, RADIAL TENDONITIS INJURY REAGGRAVATED, EFFECTS BEGAN WITHIN A FEW HOURS AND LASTED 1 WEEK

Other Meds: CANNABIS INHALED, POSSIBLE OPIATE USE

Current Illness: NONE REPORTED

ID: 1388853
Sex: F
Age: 36
State: WA

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 06/10/2021
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Allergies: NA

Symptom List:

Symptoms: Upper lip tingling immediate after the injection Left and right calf pain Left calf muscle pain persistent Muscle pain throughout the body Dizziness and lightheaded Pain at the injection site

Other Meds: Birth control pill.vit d.multi vitamins. Omega 6.

Current Illness:

ID: 1388854
Sex: F
Age: 20
State: KY

Vax Date: 04/21/2021
Onset Date: 06/08/2021
Rec V Date: 06/10/2021
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Symptoms: TESTED POSITIVE WHEN FULLY VACCINATED

Other Meds:

Current Illness:

ID: 1388855
Sex: F
Age: 43
State: AZ

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 06/10/2021
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Allergies: codeine, coumadin, levaquin

Symptom List:

Symptoms: Per patient at injection site of right arm constant aching pain that does not go away, no relief by any rest or ibuprofen, patient states decreased right arm ROM, unable to extend posteriorly. started since given vaccine 3/5/2021

Other Meds:

Current Illness: none

ID: 1388856
Sex: M
Age: 61
State: PA

Vax Date: 06/06/2021
Onset Date: 06/06/2021
Rec V Date: 06/10/2021
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Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1388857
Sex: F
Age: 24
State: TX

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 06/10/2021
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Allergies: Shellfish

Symptom List:

Symptoms: C/o Dizziness. Patient noted to be leaning toward floor to pick up water from floor. Patient V/S assessed. She is very alert, oriented x4/ V'S 117/67 P62 T98 R18 PO2 99% on room air. Patient's parents were contacted as per request by patient. Once patient's parents arrived at site, nurse escorted patient out of facility. Ambulating with no difficulty. No fatigue noted.

Other Meds: No OTC, Prozac, Aldactone

Current Illness: None

ID: 1388858
Sex: F
Age: 63
State: OR

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 06/10/2021
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Symptoms: Patient was triaged and stated she needed her 2nd "Moderna vaccine. the Service line was doing a clinic and based on triage form repsonses she was given the Moderna vaccine. Chart historical data was not reviewed prior to administering the vaccine. Patient did not have a physical proof copy of vaccination history. "I don't have it" . No adverse reaction noted

Other Meds:

Current Illness:

ID: 1388859
Sex: M
Age: 27
State: MO

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 06/10/2021
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Symptoms: Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Shakiness-Mild

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm