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: 1403481
Sex: M
Age: 20
State:

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: NVD, Headache

Other Meds:

Current Illness:

ID: 1403482
Sex: M
Age: 58
State: MO

Vax Date: 04/01/2021
Onset Date: 04/04/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to amoxicillin and clarithromycin.

Symptom List:

Symptoms: Four days after I received the vaccine, I woke up and my vision was blurry. My right eye lost focus and it was foggy. I couldn't focus clearly at all. My family recommended that I go to the ER. I decided to see my optometrist because they know my eyes very well. They checked the pressure of my optic nerve. They didn't see anything there that would need to be treated by an ophthalmologist. There was nothing wrong with my eye pressure. They gave me some eyedrops and told me to take it easy for a couple of days. I would have issues on and off and it would normally clear up after I used Visine. As of today, everything is good. I am going for a follow up with my optometrist in a week or two.

Other Meds: I was taking atorvastatin.

Current Illness: I did not have any other illnesses.

ID: 1403483
Sex: F
Age: 38
State: MN

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

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

Lab Data:

Allergies: No allergies indicated on vaccine screening form

Symptom List:

Symptoms: Client came in for second dose Moderna COVID-19 vaccine at 4 week interval. Pfizer COVID-19 vaccine was inadvertantly administered for second dose instead of Moderna. Error was caught within 5 minutes while client was waiting after injection. No adverse events were noted in 20 minutes following. Pfizer COVID-19 vaccine EUA was given and read by client. Informed from CDC guidance to not repeat second dose of either product at this time.

Other Meds: Unknown

Current Illness: No

ID: 1403484
Sex: M
Age:
State:

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: NVD, Headache

Other Meds:

Current Illness:

ID: 1403485
Sex: U
Age: 18
State:

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: NVD, HEADACHE

Other Meds:

Current Illness:

ID: 1403486
Sex: F
Age: 80
State: PA

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: Penicillin (rash), Neomycin sulfate (rash), Ampicillin (rash), Nickle (rash), metal (rash). Stress test caused her not being able to walk. Barium and sulfate (rash on stomach felt to be related to the contrast dye), steroids (faints and 3 days later gets redness and a hot feeling ), Benzotate (faint and feel bad for 2-3 hours), Xanax Activus manufacturer but can take Greenstone brand. Cipro, Biaxin, Flagyl, Sumycin syrup, Prilosec, Nexium, Codeine, Sulfa, Dexilant, Carafate (these all cause stomach upset). Food allergies: Grouper.

Symptom List:

Symptoms: She got her 2nd vaccine, they kept her 30 minutes as she had problems with the 1st one, her BP was okay and that she could drive home and was told to drink a lot of water. She went home and after every bottle of water she had 3-4 episodes of diarrhea and kept drinking water all day and after 3-4 she did not have any more diarrhea. She had some pain in her arm. She started having visions of chicken scratches/white lines across her eyebrows from the left to the right across her whole forehead. She always has this vision discrepancy all day long inside the house and outside when she goes and gets the mail. She first went to the eye doctor as she was having floaters, white lines visually appearing but have not had them for a long time, and these did not go away and they were not the usual floaters like she had before. They got her in the office immediately and that doctor said that he did not have an answer for her and he didn't find anything wrong with her eyes. She told him that she was worried about what happened after the vaccine. She went to her PCP and she ended up in the hospital as she has a problem with her left rotator cuff and needs surgery on that but is waiting for her leg to heal from total knee surgery. When she lays down at night she has chest pains, and didn't know what it was and was told that there is a nerve that runs down from the shoulder and crosses over to the heart and gives the feeling of chest pains. She had tests done and they did not give her any answers to what the pains were. She then went to her PCP again and told her about the vision issues and she didn't have an answer to her issues either. Her daughter suggested that perhaps her BP was an issue and she brought that to her attention and she told her to document it and to FU this week with her nurse to see that everything was working okay. She states that her BP has never been the same, she has never had a BP problem before. She takes it every morning between 9-10 AM. 131/86, 139/80, at 5:00 132/74, 148/88, 133/84, 139/92, yesterday was 137/83, today 132/84. She has been placed on BP medicine, Cardizem 30 mg.

Other Meds: Xanax 1 mg 4 times a day as needed, Vitamin D 250,000 mg a day, Pepcid as needed, Vitamin B-12 2500 mcg.

Current Illness: None.

ID: 1403487
Sex: M
Age: 20
State:

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: NVD, Headache

Other Meds:

Current Illness:

ID: 1403488
Sex: F
Age: 55
State: SC

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: No known

Symptom List:

Symptoms: At the moment of injection, I was in the middle of saying that the shot wasn't that bad to the pharmacist when I started to get very lightheaded. When he pulled the needle out of my arm quite a bit of blood ran down my arm even though I wasn't on any blood thinners. Fortunately, the pharmacists got me through it and I started to feel better in a few minutes. I ended up bruising very badly at the site of the shot. It took several weeks to go away completely. Three months later in June 2021, I have been experiencing prolonged unexplained pain in my left leg. Ultrasound showed no blood clots.

Other Meds: Venlafaxine 150MG Metoprolol 100MG Levothyroxine 0.05MG Amitryptyline 25 MG Rousvastatin 5MG

Current Illness: None

ID: 1403489
Sex: M
Age: 58
State: KS

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Fever, Shortness of breath, chills

Other Meds:

Current Illness:

ID: 1403490
Sex: F
Age: 68
State: PA

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: Eggs, macrodontia

Symptom List:

Symptoms: My hands turned a purplish blue

Other Meds: Vitamin C, Calcium, vitamin D, probiotic, cranberry extract Xanax, Zoloft

Current Illness: None

ID: 1403491
Sex: F
Age: 34
State: VA

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: Once I received the vaccine, I immediately felt a cough in my throat. About half an hour later my nose was runny. That night at 11pm I had the chills, a couple hours later I had a fever, nautious ness, vomiting, belly cramps, joints and muscle pain especially in my back and legs, terrible headache. This lasted till around 3pm the following day. I started with a headache BEFORE the vaccine as well. Day 2 after the vaccine I was feeling much better.

Other Meds: None

Current Illness: Headache

ID: 1403492
Sex: U
Age: 19
State:

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: NVD, HEADACHE

Other Meds:

Current Illness:

ID: 1403493
Sex: M
Age: 19
State:

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: NVD, Headache

Other Meds:

Current Illness:

ID: 1403494
Sex: M
Age: 19
State: IL

Vax Date: 04/02/2021
Onset Date: 04/13/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List:

Symptoms: Patient presented to ER and was diagnosed with hydrocele. Reports still experiencing symptoms.

Other Meds: unknown

Current Illness: none known

ID: 1403495
Sex: M
Age: 19
State:

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: NVD, Headache

Other Meds:

Current Illness:

ID: 1403496
Sex: F
Age: 46
State: TX

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: I was in very bad pain. I have fever, a really bad headache, my body and my joints ached as well. All my lymph nodes was swollen on the left side of my body. The site where I got my injection was sore for days. I had to be off work for 3 days due to this.

Other Meds: I take Advair, Emgality, Flonase, Mucus D, Omega 3,6,9, Pristiq, Aciphex, Ubrelvy, Ursodiol, Verapamil and Zyrtec. I was also taken at the time, Vyvanse, Zoloft.

Current Illness: No

ID: 1403497
Sex: F
Age: 47
State:

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: After first vaccine, developed fever, fatigue, and sweating lasting 4 days. She also had a loss of taste and smell for one day.

Other Meds:

Current Illness:

ID: 1403498
Sex: F
Age: 69
State: NC

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: Codeine, penicillin , latex, and sulfa drugs, and all stinging insects

Symptom List:

Symptoms: This one has been much longer. I woke up with fever, sever headache, joint aches and pain. I had 103 temperature for 5 days, fever, chills, shortness of breath and difficulty breathing . The week after that I had a rash on lower body went all the way down my leg. I saw my dermatologist in march. He gave me triamcinolone . DR. ordered a bunch of test on me . I had a lymes disease test , Cortisol test, hemoglobin, full cbc blood panel , bone density, TSH, progesterone, estrogen

Other Meds: Vit C, VIt B12, Vit D multi vitamin, HPA axis, DHEA 5

Current Illness:

ID: 1403499
Sex: U
Age: 19
State:

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: NVD, HEADACHE

Other Meds:

Current Illness:

ID: 1403500
Sex: M
Age: 19
State:

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: NVD, Headache

Other Meds:

Current Illness:

ID: 1403501
Sex: F
Age: 74
State: CA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 06/16/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: I had severe chills through the night. Felt lke i had the flu the next morning. I couldn't eat but tried and threw up over myself and passed out. My temp went up to 103 that day and i took tylenol. For the next week i barely ate. I woke up on a Friday morning and my heart was beating funny. I checked my blood pressure and it showed I had an irregular heart beat. I went to the hospital they gave me an IV that brought my heart arrythmia back to normal.The cardilogist told me to come back in a week to get a heart murmur on to watch my heart beat.

Other Meds: Edarbyclor Atorvastatin Levothyroxine Multivitamins

Current Illness: Intestinal Upset

ID: 1403502
Sex: F
Age: 89
State:

Vax Date: 02/06/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pt received both vaccines of Pfizer. Pt was admitted to the hospital on 6/15 for SOB/dyspnea. SOB contributed to CHF exacerbation. COVID was incidental. No COVID treatments so far during admission.

Other Meds:

Current Illness:

ID: 1403503
Sex: M
Age: 19
State:

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: NVD, Headache

Other Meds:

Current Illness:

ID: 1403504
Sex: M
Age: 77
State: GA

Vax Date: 01/16/2021
Onset Date: 01/28/2021
Rec V Date: 06/16/2021
Hospital: Y

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

Lab Data:

Allergies: Lisinopril

Symptom List:

Symptoms: I had the vaccine on 01/16/2021 and my heart stopped. I had a long period of Atrial fibrillation, my heart will stop for 8 seconds and then it will start again. I had like 3 or 4 fainting episodes. Since then, I have had a heart pacer implanted. They put a Halter monitor to check my heart behavior. I was already under treatment for the fibrillation but this was an exaggeration of this problem. My cardiologist told me to come in because I had the monitor and they saw that my heart was stopping so I went in since it was an emergency. They kept me in the hospital for 3 days because they wanted to keep me in observation before they put the pace maker in.

Other Meds: Aspirin, Eliqius, Atorvastatin, Metroprolol,

Current Illness: None

ID: 1403505
Sex: F
Age: 73
State: CA

Vax Date: 03/04/2021
Onset Date: 04/23/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: Dioxycillin, latex, soy, gluten

Symptom List:

Symptoms: Sudden Hearing Loss with vertigo/dizziness

Other Meds: Prilosec, multi-vitamin

Current Illness: None.

ID: 1403506
Sex: M
Age: 39
State: CA

Vax Date: 05/11/2021
Onset Date: 05/27/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: histamine intolerance salicylate intolerance

Symptom List:

Symptoms: Soreness in left arm near injection site similar to what occurred immediately after the getting the injection. This faded over the course of a couple of days. Abnormal fatigue and feverishness similar to the flu for a few hours only.

Other Meds: Vitamin D3 (12 mcg/day) Vitamin K2 (100 mcg/day) Copper (2 mg/day)

Current Illness:

ID: 1403507
Sex: M
Age: 70
State:

Vax Date: 03/08/2021
Onset Date: 03/21/2021
Rec V Date: 06/16/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Right Coronary Artery blockage, stent was installed on 3.22 at 6 PM

Other Meds: None

Current Illness: None

ID: 1403508
Sex: M
Age: 15
State: OR

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: pt fainted shortly after vaccination (within 5 minutes). Pt regained consciousness within few seconds. Pt lied down with feet higher on a chair. Pt was monitored for 30 minutes and recovered fully.

Other Meds:

Current Illness:

ID: 1403509
Sex: M
Age: 12
State: VA

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient had Covid vaccine yesterday morning. Developed fever and vomiting at 9pm last night. Brought to the ER poorly responsive. Found to have a large intracranial bleed with an apparent ruptured AVM. Sent to larger hospital for pediatric neurointerventional radiology and pediatric neurosurgical care.

Other Meds:

Current Illness:

ID: 1403510
Sex: M
Age: 43
State: NE

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: Allergic to Sulfa drugs ( Bactrum ), and common seasonal allergies.

Symptom List:

Symptoms: Felt lethargic (aprox. 1 hour after shot) went home fell asleep for about 2 hours and woke up severe pain in chest and tightening of chest and airway and could only get about half at most of a full breath of air every breath. Could only get sufficient O2 it seemed when lying on back and laying down on my side. Was every bit of all my energy to just take a shower and nearly blacked out with heart racing as I tried to breath in the shower but steam in air was too much to breathe. Lasted for 4 days that way. I still feel like I am constantly winded and I as of today have only regained about half the lung capacity I had prior to incident, and that is just over 1 month mark. I also now have been getting these bad facial breakouts particularly on and around my nose and forehead /;eyes area. I never ever had any acne issues to speak of prior, even as a teen and during puberty. Never had any acne ever and now its bad breakouts some appear to may even leave ling term scarring in certain spots. My day to day diet and normal habits have not been added to or altered in any way either. My heart feels like it beats twice as fast and twice as hard now and I am always short of breath now too. I do not have a family doctor to go and see and I was afraid to call for an e.m.t. or go to the e.r. at the early onset of it all. I truly hought I was a gonner a couple of times though throughout the first 4 days.

Other Meds: None

Current Illness: None

ID: 1403511
Sex: F
Age: 52
State: TX

Vax Date: 04/06/2021
Onset Date: 04/17/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: describes symptoms beginning 11 days later as swelling to bilateral medial elbows, without pruritis or erythema. The swelling on the right arm was associated with digital paresthesias of the 4th and 5th digits. About two days had macular erythema and pruritis on medial arms, trunk, back, legs, starting small and coalesced to grew, accompanied by intense pruritis and sought care in the ED x 2. With complaint of arm swelling, had negative DX, determined not to be a venous thrombotic disorder. On 22 Apr patient presented again to clinic and diagnosed with acute generalized urticaria. Reported rash lasted less than 24 hrs. No airway involvement. Arm swelling lasted about 1 wk. Did report low grade fever and slight site soreness the day of vaccine that lasted less than 24 hrs. Symptoms: URTICARIA, UNSPECIFIED(L509), EDEMA, UNSPECIFIED(R609).

Other Meds: Zyrtec, Synthroid

Current Illness:

ID: 1403512
Sex: M
Age: 39
State: VA

Vax Date: 03/26/2021
Onset Date: 03/29/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Severe and erratic heartbeats, heavy slow breathing accompanied with severe fatigue, severe headaches, and severe chills with no energy to move around for a week. After these symptoms eased, no appetite (went from eating five times a day and gym workouts 5 days a week to maybe eating twice a day and unable to walk up 20 stairs without shortness of breathe and heavy erratic heartbeats) still accompanied with little energy, erratic heartbeats, shortness of breath, and lingering headaches well into week three. Admitted myself to the ER on due to lingering affects and a new symptom of swelling/throbbing on the left side of my head; previous mentioned symptoms still there but milder than before. Diagnosis at ER was high blood pressure 150 over 92; never had blood pressure problems prior 1st COVID vaccine dose. Follow-up visit with primary care provider, checked my vitals and high blood pressure remained; primary care provider diagnosed high blood pressure, prescribed Amlodipine 5MG tablets.

Other Meds: Daily multi-vitamin, pre-workout with caffeine, protein powder post weight training workout.

Current Illness: None

ID: 1403513
Sex: F
Age: 66
State: CA

Vax Date: 04/04/2021
Onset Date: 04/04/2021
Rec V Date: 06/16/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List:

Symptoms: Cardiac Arrhythmia and high blood pressure, now under the care of Cardiologist

Other Meds: unknown

Current Illness: unknown

ID: 1403514
Sex: F
Age: 63
State: PA

Vax Date: 03/05/2021
Onset Date: 04/02/2021
Rec V Date: 06/16/2021
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Lab Data:

Allergies: Heparin

Symptom List:

Symptoms: I had already been scheduled for a mammogram three days before my mammogram. I had to do my annual breast check up and noticed a big mass I never felt before. That same day it was confirmed that it was a mass but the doctors didn't know what it was. Then I was scheduled five days later to have a biopsy with an oncologist Dr. from Hospital. Everything started moving fast in my body once they detected what I have. I have o negative blood. When I have anything foreign in my body in causes my body to overreact.

Other Meds: Metformin Vitamin C Vitamin D Vitamin B Magnesium Elderberry

Current Illness:

ID: 1403515
Sex: M
Age: 77
State: MI

Vax Date: 04/06/2021
Onset Date: 05/20/2021
Rec V Date: 06/16/2021
Hospital: Y

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Allergies: Singulair, sulfa antibiotics

Symptom List:

Symptoms: 77 yo male presented to the ED given unresponsiveness at SNF via EMS, found to be hypoglycemic- intubated/sedated on admission - he was recently admitted, and had prolonged hospital stay (4/30 - 5/10) after orthopedic intervention / ORIF 4/30 Rt hip Fracture- s/p. - Acute hypoxic and hypercarbic respiratory failure, on mechanical ventilation - Bibasilar infiltrates, Lt > Rt, will small bilateral pleural effusions, HCAP - COVID PNA - Small bilateral pleural effusions - Encephalopathy - A-Fib - HFrEF, EF 45%, Mild MR - Acute on CKD - UTI

Other Meds: Lexapro, ferrous sulfate, Proscar, Folate, Neurontin, insulin lispro, levothyroxine, midodrine, vitamins, solifenacin, tamsulosin, temazepam, Eliquis

Current Illness:

ID: 1403516
Sex: M
Age: 38
State: MO

Vax Date: 04/13/2021
Onset Date: 05/01/2021
Rec V Date: 06/16/2021
Hospital: Y

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Allergies: None

Symptom List:

Symptoms: On May 1 began to feel ill and was diagnosed on May 10 with endocarditis.

Other Meds: Simvastatin 10mg, Metoprolol 15mg

Current Illness: None

ID: 1403517
Sex: F
Age: 35
State: MD

Vax Date: 05/13/2021
Onset Date: 06/16/2021
Rec V Date: 06/16/2021
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Allergies: none

Symptom List:

Symptoms: 3 days after I received a first doze of Pfizer vaccine on May 13, I found out that I was pregnant, about 5 weeks. I consulted with my OBGYN and also called CDC phone number to consult regarding getting the 2nd doze, and both encouraged me to get the 2nd doze. My bloodwork showed low levels of progestrerone, so I was prescribed it to support the pregnancy. My 2nd doze was on June 3, and on the next day after the vaccination I've experienced strong vatigue, headache, and overall low-grade fever achy sensations. On the 4th day after getting vaccinated with my 2nd doze, I got a terrible migrain that lasted for 48 hours; I was unable to keep any food or fluids in, and actually lost 7.5 lbs over the period of 2 days. A couple of days after that, I had a similar migraine that lasted by 24 hours, and I lost another 3 lbs. Today, June 16, I came in for my 1st 10-week sonogram, only to find out that I had a Blighted Ovum Miscarriage. This is make it my 3rd pregnancy and my 3rd miscarrige. My OBGYN has ordered some blood tests, and we're trying to get as much information about the possible cause on our end. In the meantime, I felt obligated to share my story in case the vaccine had any hand in this... I get the flu shot every year, and I am pro vaccination. I've been tested negative for COVID-19; prior to getting teh vcaccine I also checked for anti-bodies, and the result was negative as well.

Other Meds: 3 days after I received a first doze of Pfizer vaccine on May 13, I found out that I was pregnant, about 5 weeks. I consulted with my OBGYN and also called CDC phone number to consult regarding getting the 2nd doze, and both encouraged me t

Current Illness: none

ID: 1403518
Sex: M
Age: 22
State: TX

Vax Date: 06/16/2021
Onset Date: 06/16/2021
Rec V Date: 06/16/2021
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Allergies: none

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Symptoms: Event: On 6/16/2021 it was identified post vaccination that one of Medical Assistants inadvertently administered an expired vaccine. The patient did not have any adverse reactions to the vaccine while at my lab. The vaccine was last punctured on 6/7/2021 at 4:26 p.m. and was kept refrigerated in accordance with the vaccine requirements. Action Taken to mitigate future events: 1. Conducted a Safety Stand-down/retraining with all Lab staff. 2. Punctured vile will immediately be labeled with date and time. 3. Expired vaccines and diluent will be removed immediately to avoid inadvertent administratio

Other Meds: Unknown

Current Illness: unknown

ID: 1403519
Sex: M
Age: 34
State: TX

Vax Date: 06/05/2021
Onset Date: 06/08/2021
Rec V Date: 06/16/2021
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Allergies: No allergies noted

Symptom List:

Symptoms: Pt developed rash throughout whole body, with fever and chills. Eventually pt seeked medical attention at ER where pt got prescribed Benadryl and Azithromycin. Wife states pt was diagnosed with pneumonia from vaccine. Two days later pt got prescriptions for prednisone and glipizide

Other Meds: Paroxetine 20mg, Seroquel 100mg, Benztropine 1mg, Metformin 1000mg, Glipizide ER 10mg, Lamotrigine 100mg, Lisinopril 10mg, Levothyroxine 100mg, Aspirin

Current Illness: Obesity, diabetes, asthma, mental issues

ID: 1403520
Sex: M
Age: 29
State: CA

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
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Allergies: None stated

Symptom List:

Symptoms: Patient filled out immunization consent form incorrectly, failing to mark yes for "have you ever fainted or felt dizzy after receiving an immunization." After receiving the vaccination, patient was sitting for the 15 minute observation and another patient noticed he tried getting up and walking and immediately fell down. He tried standing back up and the 2nd patient had to grab and hold the fainting patient until I was able to come help. Patient fainted for less than 10 seconds, as I cautiously helped lay him down on the floor. I checked for vitals, and elevated patient's legs, and gave him ice to help. Patient remained in laying position for 15 minutes, regained strength and sat up for another 15 minutes, in which time, he was given water to drink and a protein bar to eat. I also took patient's blood pressure, which was within normal limits (approx. 117/82, HR 86). Patient and his mother both left the pharmacy without further incident.

Other Meds: None stated

Current Illness: None stated

Date Died: 05/05/2021

ID: 1403521
Sex: F
Age: 90
State: WA

Vax Date: 03/26/2021
Onset Date: 04/19/2021
Rec V Date: 06/16/2021
Hospital: Y

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Lab Data:

Allergies: UNK

Symptom List:

Symptoms: weak, loss of appetite, pneumonia, ARDS

Other Meds: UNK

Current Illness: none reported

ID: 1403522
Sex: F
Age: 53
State: CA

Vax Date: 03/31/2021
Onset Date: 04/17/2021
Rec V Date: 06/16/2021
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Lab Data:

Allergies: Penicillan

Symptom List:

Symptoms: Muscle weakness to right side of face. Could not close right eye, lift right eyebrow. Smile drooped. Was prescribed Prednisone, Valacyclovir for 7 days and carboxymethylcellulose drops when needed

Other Meds: Daily multi-vitamin

Current Illness: None

ID: 1403523
Sex: M
Age: 28
State: FL

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/16/2021
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Allergies: none

Symptom List:

Symptoms: Patient reported sudden vision impairment, started palpating and had profuse sweating with shortness of breath; patient was administered one dose of Epipen; 911 initiated per protocol. By the time ambulance arrived, patient was already feeling better; for safety and evaluation , they took him to emergency.

Other Meds: none

Current Illness: none

ID: 1403524
Sex: F
Age: 20
State: NJ

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/16/2021
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Allergies: Cherry - hives, latex-rash

Symptom List:

Symptoms: Janssen vaccine is viable for 6 hours after the vial is punctured. This vaccine was given past that time. The vial was punctured on Tuesday June 8th and administered to the patient on Friday June 11th.

Other Meds: Albuterol, Bupropion HCL, epinephrine, levocetirizine dihydrochloride, montelukast sodium, omeprazole, ondansetron HCL, venlafaxine HCL

Current Illness: N/A

ID: 1403525
Sex: F
Age: 58
State: FL

Vax Date: 06/11/2021
Onset Date: 06/12/2021
Rec V Date: 06/16/2021
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Lab Data:

Allergies: Amoxicillin Iodine

Symptom List:

Symptoms: hives, itchy, and burning started 6/12 generalized rash over the entire body including mouth now . Pt was seen in the ER twice 6/13/21 and 6/14/21

Other Meds: Vitamin D Losartan-HCTZ 100-12.5mg Poly-Iron 150mg Sertraline 50mg Synthroid 125mcg

Current Illness: none

ID: 1403526
Sex: M
Age: 22
State: MA

Vax Date: 04/18/2021
Onset Date: 05/09/2021
Rec V Date: 06/16/2021
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Lab Data:

Allergies: Most Antibiotics

Symptom List:

Symptoms: Extreme Dizziness and Vertigo onset exactly a month after second dose. No seasonal allergies. Antibiotics have not worked.

Other Meds: None

Current Illness: None

ID: 1403527
Sex: F
Age: 58
State: MN

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 06/16/2021
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Lab Data:

Allergies: levothyroxine

Symptom List:

Symptoms: new onset atrial fibrillation

Other Meds: please refer to patients completed VAERS document for accuracy

Current Illness: unknown/not applicable

ID: 1403528
Sex: F
Age: 75
State: FL

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 06/16/2021
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Allergies: Amoxicillin

Symptom List:

Symptoms: As soon as I got the shot it went straight to my joint. It was a aching burning pain for over a monht. I had swollen lymph nodes under armpits.

Other Meds: Levolevothyroxine, Monmprazole, Vasgime, Ambien, Xanax, Miralax, Mutlivitamin, D3, Advair, pregalbin, fiourcet

Current Illness: None

ID: 1403529
Sex: M
Age: 69
State: TX

Vax Date: 03/29/2021
Onset Date: 04/05/2021
Rec V Date: 06/16/2021
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Symptoms: I have had two adverse reactions. The first was one week after the second vaccination. The second was yesterday (06/16/21). In both cases I encountered severe swelling in my lips. In the first case, my lower lip swelled. In the second case, the swelling began in the lower left lip, then moved to the upper lip, and finally moved to the lower right lip. In both cases the swelling subsided by 90% within a day and fully within two days.

Other Meds:

Current Illness:

ID: 1403530
Sex: F
Age: 51
State:

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 06/16/2021
Hospital:

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Allergies: None

Symptom List:

Symptoms: Evening of vaccination pt reports experiencing right arm soreness, fever (tmax 102F), HA, N/V (x2 episodes), body aches, and fatigue. She reports she has not vomited since but has been persistently nauseous with intermittent HA and body aches; fever resolved as of 06/15/2021.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm