VAERS 2021 Database www.vaers.hhs.gov

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

Total Manufacturer

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1410948
Sex: F
Age: 27
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: used wrong diluent to dilute medication

Other Meds:

Current Illness:

ID: 1410949
Sex: F
Age: 49
State: IN

Vax Date: 06/16/2021
Onset Date: 06/17/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Large knot/lump in armpit of my left arm. Where my lymph node is located. Severe fever, chills and Migraine

Other Meds:

Current Illness:

ID: 1410950
Sex: M
Age: 37
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Vaccines that expired on 6/16 at 10:30pm were left out overnight and administered the following day on 6/17. The floating pharmacist assumed that the technicians had drawn up the vaccines and the immunizing technicians assumed that the floating pharmacist drew them up- neither of them looked at the USE BY label on the vial containing the vaccines.

Other Meds:

Current Illness:

ID: 1410951
Sex: F
Age: 48
State: MI

Vax Date: 01/01/2021
Onset Date: 01/21/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Immediate heart racing, dizziness, stomach upset and mild wheezing after first dose. Diarrhea and dizziness for hours. Had Epi pen just in case I needed it, but didn?t use it. Did not get second dose.

Other Meds: NP Thyroid 30 mcg

Current Illness: None

ID: 1410952
Sex: M
Age: 41
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: used wrong diluent to dilute medication

Other Meds:

Current Illness:

ID: 1410953
Sex: F
Age: 41
State: NV

Vax Date: 05/20/2021
Onset Date: 05/27/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: Headache

Other Meds:

Current Illness:

ID: 1410954
Sex: F
Age: 39
State: FL

Vax Date: 04/28/2021
Onset Date: 04/30/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I started having Arrhythmia and asI never had any kind of this episode in my life and this started being more and more I am doing all the check to see what s going on. I found everything very strange that it started in conjunction with the COVID vaccin.

Other Meds: vitamin Group B Vitamin E Vitamin D Vitamin C Collagene

Current Illness:

ID: 1410955
Sex: M
Age: 71
State: IL

Vax Date: 02/19/2021
Onset Date: 06/18/2021
Rec V Date: 06/18/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin

Symptom List: Pharyngeal swelling

Symptoms: Pt diagnosed with COVID infection and hospitalized for new oxygen requirement along with community acquired pneumonia on 6/18/21

Other Meds: Albuterol, Atorvastatin, Trelegy, HCTZ, lisinopril, lyrica, metoprolol, omeprazole

Current Illness:

ID: 1410956
Sex: M
Age: 16
State: TX

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: UNKNOWN

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: The patient is 16 years old and received the Janssen vaccine.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1410957
Sex: F
Age: 66
State: CA

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: Vicodin - makes me nauseous and throw up

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I woke up the next morning after vaccine, with severe pain in my right shoulder. I had previously had had an injury and inflammation in that shoulder and I had been going to physical therapy and it was pretty much taken care of. But it was in pain when I woke up that morning and a few hours later all my joints started hurting. I had severe flu-like symptoms; I felt feverish but had no fever. All of this lasted for five days. Towards the end of the five days it was getting better. I was in bed for three of those days. Pain in my right shoulder where it had all started first, it stayed after the rest of the symptoms left; this didn't go away. I saw my doctor and got a cortisone shot. I did that about a month ago. The cortisone shot took the pain away for about three weeks. Right shoulder pain and inflammation came back really strong now. Also, on the following day of the shot, I had a Baseball size lump on injection site - that lasted for about five or six days.

Other Meds: Carvedilol; Diltiazem; Levothyroxine; Vit D; Omega 3 - to lower cholesterol -supplement that's OTC; Aspirin - 81 mg

Current Illness: no

ID: 1410958
Sex: M
Age: 15
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: used wrong diluent to dilute medication

Other Meds:

Current Illness:

ID: 1410959
Sex: M
Age: 28
State: PA

Vax Date: 06/15/2021
Onset Date: 06/16/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: None known.

Symptom List: Rash, Urticaria

Symptoms: "Covid Arm" -- received vaccine in morning, developed standard arm pain by late afternoon/early evening, which then progressed sometime overnight/early the next morning into a large, swollen, circular rash approx. 3 inches in diameter. Rash was painful at first, has diminished over the last 48 hours to a dull itch and painful only when touched/pressed directly. Rash is warm to the touch. Swelling is still present but has declined. Appears to be gradually improving as of this report. Did not experience reaction from first dose, as far as I can recall (only experienced normal arm pain).

Other Meds: None.

Current Illness: None.

ID: 1410960
Sex: M
Age: 39
State: MD

Vax Date: 04/30/2021
Onset Date: 05/09/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Patient presented to ED on 5/12/21 with Bell's palsy. Reported symptoms started 5/9/21. Initial symptoms was loss of taste.

Other Meds: None

Current Illness: None

ID: 1410961
Sex: M
Age: 20
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: used wrong diluent to dilute medication

Other Meds:

Current Illness:

ID: 1410962
Sex: M
Age: 45
State: NJ

Vax Date: 03/21/2021
Onset Date: 03/30/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: I had a mild COVID-19 infection in January, 2021. My symptoms were mild congestion and slight body ache. I did not lose any sense of smell or taste, nor were those senses altered in any way during my infection. I waited 3 months for my COVID-19 vaccine. About 10 days after I received my first shot of the Pfizer COVID vaccine I started to experience weird tastes and smells with certain foods such as eggs, corn chips and popcorn, and strawberries. I did not lose my sense of smell or taste, but they have been altered. When I eat these foods I have a bad taste and smell. The sensation seems to have dissipated a bit but is still with me 3 months after the first dose.

Other Meds:

Current Illness:

ID: 1410963
Sex: M
Age: 39
State: CA

Vax Date: 05/21/2021
Onset Date: 06/11/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Right shoulder tightness, pinching sensation when lifting arm above head and rotating backwards and limited range of motion. Unresponsive to application of cold and heat, elevation of affected limb, topical over the counter medications, and acetaminophen and ibuprofen.

Other Meds: Multivitamin

Current Illness: None

ID: 1410964
Sex: F
Age: 63
State: NY

Vax Date: 04/27/2021
Onset Date: 05/08/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: codeine-

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: on 5-8-2021- felt pain in chest and shoulder, on 5-10 went to clinic walk in for pain, on 5/11/2021- beginnings of shingles rash appeared - I currently have post herpetic neuralgia in my left shoulder, arm, wrist, hand and fingers

Other Meds: Levothyroxine, multivitamin, b-complex, d3 -4000

Current Illness: none

ID: 1410965
Sex: F
Age: 48
State:

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Increased heart rate and 'shaking' feeling inside was first symptom, then tingling/numbness/burning/pins and needles in hands and feet, pain in lower back/spine and feeling of heaviness in legs, difficulty walking, weakness in arms and legs, squeezing feeling around ribs, chest pressure/pain, increased heart rate when not at rest, fluctuating heart rate, pressure in neck and head, pins and needles feeling around body. This all has progressed over a 5 week period.

Other Meds: Vitamin D, multi-vitamin

Current Illness: No

ID: 1410966
Sex: F
Age: 70
State: OR

Vax Date: 01/19/2021
Onset Date: 01/24/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: Bactrim

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I had a large lump under right arm pit, also had red on left arm, doctor said she felt it may have been a pre-existing cyst that may have been in reaction to the vaccine.

Other Meds: Sirolimus Zyrtec Vitamin D, C Citalopram Multi-Vitamin Symbicort Resveratrol Iron Pro-air Metamucil Melatonin

Current Illness: None

ID: 1410967
Sex: F
Age: 67
State: CA

Vax Date: 03/18/2021
Onset Date: 03/30/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: Narcotics, Vicodin, Percocet, Tylenol, Penicillin, Levaquin

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: My face began to feel like it was burning, my cheeks and up to my eyes, including my eye lids were red and began to swell. It continued to burn for about 4 days. It looked like I had a sunburn but I have not been on the sun. At that point I went to Urgent care, they prescribed prednisone for 2 weeks. I went to a dermatologist and she also put me on prednisone for only for 1 week. Then I saw my internist and at this point I had some burning in my chest and it felt like bacon popping it was completely different. It never met my face. When I saw my internist she ordered a lot of lab panels and an ultrasound and it looked like lupus maybe. I went to the dermatologist she did 3 tests on my chest they came back negative for cancer. We do not know what it is and they took me out of all the other medications They got me on a vegan diet and no change at all. My face was feeling the same but my chest cleared up. Last time I had a flare up was two weeks ago.

Other Meds: Vitamin D 5000 mg once a week, small dose Aspirin every day, Valtrex 500 mg daily, Cintride 112 microg daily, Estradiol 1 mg every day, Singulaire 10 mg, Folic Acid 1 mg every day, Crestor 20 mg, Prozac 40 mg, Asthma inhaler200 microg, Breo

Current Illness: None

ID: 1410968
Sex: F
Age: 35
State: MT

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: Plavix

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: Fever & chills for 2 days Nauseous & lack of appetite for 9-10 days Vomiting & dehydrated Treatment: Anti nausea medication

Other Meds:

Current Illness:

ID: 1410969
Sex: M
Age: 26
State: TX

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

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

Lab Data:

Allergies: unknown

Symptom List: Unevaluable event

Symptoms: Patient felt dizzy approximately 25 minutes after administration of vaccine. He fell in the store and cut his elbow. He returned to the pharmacy to report. He was advised to sit for another 30-40 minutes so that pharmacist could continue to monitor him. After about 1 hour he felt fine and left.

Other Meds: unknown

Current Illness: unknown

ID: 1410970
Sex: F
Age: 93
State: MO

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: UNKNOWN

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: PATIENT RECIEVED 1ST DOSE MODERNA COVID-19 VACCINATION ON 03/23/2021 AT PHARMACY. PATIENT THEN RECIEVED ANOTHER VACCINATION, PFIZER COVID-19 ON 06/18/2021.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1410971
Sex: M
Age: 85
State: MD

Vax Date: 03/19/2021
Onset Date: 04/03/2021
Rec V Date: 06/18/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Pt was admitted to hospital from the ED for a fever on 4/3/21 after receiving the second dose of vaccine on 3/19/2021. Per guidelines, all hospitalizations are reported

Other Meds:

Current Illness:

ID: 1410972
Sex: F
Age: 35
State: NY

Vax Date: 01/05/2021
Onset Date: 01/19/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Injection site pain, Menorrhagia

Symptoms: I had hives. Vasculitis

Other Meds: Advil

Current Illness: No

ID: 1410973
Sex: F
Age: 15
State: KS

Vax Date: 06/16/2021
Onset Date: 06/16/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: pt is under age 18, she received the johnson and johnson vaccine in error. pt did c/o fever and body aches later that pm that was relieved with Tylenol. we have talked to mom since and she is feeling better, fever has resolved. no sob, no chest pain, no other symptoms. symptoms pt displayed is common with all covid vaccines.

Other Meds: none

Current Illness: nasal congestion

Date Died: 04/10/2021

ID: 1410974
Sex: M
Age: 86
State: WA

Vax Date: 02/05/2021
Onset Date: 03/29/2021
Rec V Date: 06/18/2021
Hospital: Y

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

Lab Data:

Allergies: unk

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: presented to the ED with generalized weakness progressing to fever, cough, dyspnea, myalgia, pneumonia. admitted to Hospital

Other Meds: unk

Current Illness: unk

ID: 1410975
Sex: F
Age: 61
State: OR

Vax Date: 05/20/2021
Onset Date: 06/08/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: penicillin hay fever - grass and tree pollen

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: atrial fibrillation. I do not know if this was related to the vaccine or not.

Other Meds: Citalopram Omeprazole Thyroid herbal rhubarb supplement Vitamin D 1000 IU

Current Illness: none

ID: 1410976
Sex: M
Age: 25
State:

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Patient became dizzy/loss coordination and collapsed after completing 15 minute observation period. He was able to stand back up and walk to a chair with assistance from family members. At the immediate time of him sitting down after fall, he was unresponsive when asked his name. Approximately 5 minutes after initiation of episode he began to communicate and regain responsiveness but stated he continued to feel dizzy, sweaty, and had some difficulty breathing. At this time EMS arrived on the scene and took over the care of the patient.

Other Meds:

Current Illness:

ID: 1410977
Sex: F
Age: 28
State: NM

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: None.

Symptom List: Nausea

Symptoms: 3 hours after 2nd vaccine I felt Lower Urinary Tract Symptoms and Hematuria. The symptoms are frequency urinating, burning and pain peeing and blood in urine.

Other Meds: None.

Current Illness: None.

ID: 1410978
Sex: F
Age: 50
State: AZ

Vax Date: 05/16/2021
Onset Date: 06/06/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: The entire body was swollen. Heart inflammation. Heart ache. Difficulty breating. Dizziness and vertigo. The doctor proceeded to take blood work that confirmed heart inflammation doctor recommended meclizine 12.5 mg every day for vertigo and dizziness

Other Meds: none

Current Illness: none

ID: 1410979
Sex: F
Age: 46
State: VA

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Patient was administered 0.1 ml of pfizer covid vaccine transdermal in the right forearm instead of the PPD applisol. Patient has previously been vaccinated with 2 doses of the pfizer vaccine.

Other Meds:

Current Illness:

ID: 1410980
Sex: F
Age: 67
State: LA

Vax Date: 06/16/2021
Onset Date: 06/17/2021
Rec V Date: 06/18/2021
Hospital: Y

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

Lab Data:

Allergies: GRASS POLLEN-JUNE (KENTUCKY BLUE) GRASS, STD; GRASS POLLEN-MEA

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: pt. presented to the ED at clinic on 17 June. She reported SOB and slurred speech since last night at 2100. as well as abd, flank and back pain. COVID vaccine noted in provider note and temporarily related. Stroke ruled out but possible CVA-TIA. Severe HTN also noted. Still admitted

Other Meds: amilodipine, atorvastatin, ASA, insulin, carvedilol, Clopidogrel, furosemide, gabapentin, Imdur, Keppra, losartan, pantoprazole, KCL

Current Illness: CVA TIA, CP, SOB, abd pain, arrythmia, severe elevated HTN

ID: 1410981
Sex: M
Age: 28
State: WA

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

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

Lab Data:

Allergies: none documented

Symptom List: Tremor

Symptoms: fever, chills, syncope, unconscious. starting 5-10mins after vaccine received. s/s experienced for about 30min following vaccination emergency services contacted

Other Meds: none documented

Current Illness: none documented

ID: 1410982
Sex: F
Age: 15
State: GA

Vax Date: 06/07/2021
Onset Date: 06/11/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: RECONSTITUDED WITH BACTERIOSTATIC SODIUM CHLORIDE 0.9% CUSTOMER DID NOT EXPERIENCE ADVERSE EVENTS

Other Meds:

Current Illness:

ID: 1410983
Sex: F
Age: 15
State: CO

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: nkda

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: nausea, numbness in arms, bilateral upper abdominal pain and lowered bp

Other Meds: wellbutrin, ameprazole, gunafacine

Current Illness:

ID: 1410984
Sex: F
Age: 62
State: VA

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

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

Lab Data:

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: No adverse event. Administered outside of six hour stability window

Other Meds:

Current Illness:

ID: 1410985
Sex: M
Age: 58
State:

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

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Woke up feeling okay, then body felt achy with flu-like symptoms, then dizziness set in and a headache developed. Mid-afternoon chills developed and a fever of 101.

Other Meds:

Current Illness:

Date Died:

ID: 1410986
Sex: M
Age: 81
State: MD

Vax Date: 04/01/2021
Onset Date: 04/16/2021
Rec V Date: 06/18/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Pt was admitted to hospital from hospice care with UTI on 4/16/21 after receiving 2nd dose of vaccine on 4/1/21. Patient passed on 4/21/21. Per guidelines, all hospitalizations are reported.

Other Meds:

Current Illness:

ID: 1410987
Sex: F
Age: 15
State: CA

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: PATIENT SHOWED UP FOR THE APPOINTMENT FOR HER 2ND DOSE. WHILE GOING THROUGH THE , EVEN THOUGH PATIENT (PARENT) MARKED NO ALLERGIES, I ALWAYS STILL RECONFIRM WITH PATIENT THAT THERE IS NO ALLERGY. PATIENT WITH HER PARENT (MOM AND DAD) PRESENT INDICATED THAT SHE HAD LOST LIP COLOR (PALE), VOMITING, DIZZINESS, SHORTNESS OF BREATH. PATIENT WENT TO THE ER AND HER BLOOD PRESSURE WAS LOW AND HAD IV GIVEN TO HER. SHE WAS RELEASED THE SAME DAY. PATIENT DID NOT CALL THE PHARMACY AFTER THE REACTION. PATIENT IS ALSO NOT SURE IF THE ER HAD REPORTED IT. FOR THIS REASON WE ARE REPORTING THIS EVENT.

Other Meds:

Current Illness:

ID: 1410988
Sex: F
Age: 50
State: OH

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Pain in extremity

Symptoms: Pain and mobility in left arm (1st shot) still going on

Other Meds: Doxepin Dupixant Metropolol vitamin D

Current Illness: NA

ID: 1410989
Sex: M
Age: 23
State: TN

Vax Date: 05/03/2021
Onset Date: 06/16/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: mom states patient had chest and dr is treating from myocarditis

Other Meds: zoloft

Current Illness:

ID: 1410990
Sex: F
Age: 18
State: VA

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Patient was administered 0.1 ml of pfizer covid vaccine transdermal in the right forearm instead of the PPD applisol. Patient has previously been vaccinated with 2 doses of the pfizer vaccine.

Other Meds:

Current Illness:

ID: 1410991
Sex: F
Age: 74
State: OH

Vax Date: 03/15/2021
Onset Date: 03/17/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Codeine and most pain medications, Lisinopril

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Pain in right arm, soreness, difficulty reaching

Other Meds: Levothyroxine, Digoxin, Warfarin, Furosemide, Atorvastatin, Spironolactone, Metoprolol, Diltiazem, Citalopram, Famotidine, Vitamin C, Advair Discus, Calcium w/Vit D

Current Illness: no

ID: 1410992
Sex: F
Age: 14
State: VA

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: No adverse event. Vaccine administered outside of stability window.

Other Meds:

Current Illness:

ID: 1410993
Sex: M
Age: 69
State: MI

Vax Date: 03/17/2021
Onset Date: 04/28/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: Niaspan-strong vit b humalog

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I had abdominal pain, across to the liver as well, bloated. That lasted for three weeks. I still have that sometimes.

Other Meds: I was taking Imdur, Levetheroxin, insulin, lantus, novolog, losartan, xanex, avodart, tarisamide, matropalol, grenexa, plavix, aspirin, lerica, protonics, allopurinol, lypator, vit d, iron, pro-air, carafate.

Current Illness: No

ID: 1410994
Sex: F
Age: 16
State:

Vax Date: 06/14/2021
Onset Date: 06/15/2021
Rec V Date: 06/18/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Admitted to hospital 2 days after second Pfizer covid vaccine. Presented with abdominal/chest pain, found to have a small subsegmental pulmonary embolus on CT scan. No history of prior PE or clots.

Other Meds:

Current Illness:

ID: 1410995
Sex: M
Age: 45
State: TX

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: No, I only have seasonal allergies.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I broke out with Shingles on the right side of my face and woke up with soreness along with being unable to turn my head from left to right because my neck was very stiff (soar), had high fever of 102 (bumps appeared and the pain worsen). I went to the Doctor and he diagnosed me with Shingles. I was given a medication called Valtrex and also prescribe Gabapentin for nerve pain which I had to take for five weeks.

Other Meds: I take a multi-vitamin daily but not at the time of the vaccination (afterwards).

Current Illness: No

ID: 1410996
Sex: M
Age: 32
State: CA

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies: Seafood

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Patient c/o tingling lips and throat irritation after receiving 2nd dose. Patient was taken to exam room for assessment and vital signs were taken. Patient was then evaluated by provider FNP and Benadryl 25mg IM was ordered and administered. Vitals taken again and patient was observed another 30 minutes and then released.

Other Meds: Epinephrine Auto-Injector, Testosterone Cypionate, Zyrtec

Current Illness:

ID: 1410997
Sex: M
Age: 60
State: IA

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 06/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: NO ADVERSE EVENT. Patient received Covid Moderna vaccine 40 days after Monoclonal antibody infusion.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am