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: 1431326
Sex: M
Age: 9
State: PR

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: It has come to my knowledge that the nurse vaccinated a child under 12 years old. No adverse effects have been reported.

Other Meds:

Current Illness:

ID: 1431327
Sex: M
Age: 22
State: MI

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Attempt to contact patient who has a wrong number listed to advise that 2nd dose was given 6 days to early. Unable to contact at this time., he has not contacted the LHD to advise of any adverse reactions.

Other Meds: none

Current Illness: None mentioned

ID: 1431329
Sex: F
Age: 17
State: SC

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient called 2 hours after having immunization stating she was having some swelling specifically around the eye-no issues with breathing or mouth/throat area.

Other Meds:

Current Illness:

ID: 1431330
Sex: M
Age: 45
State: TX

Vax Date: 03/31/2021
Onset Date: 04/25/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Hearing loss, tinnitus, distortion of sounds in left ear

Other Meds: None

Current Illness: None

Date Died: 06/26/2021

ID: 1431331
Sex: M
Age: 79
State: TN

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient received second COVID vaccine on 2/3/2021. Was admitted to Medical Center on 6/15/21 for generalized weakness and tested positive for COVID 19 on 6/15/2021. Patient was also positive for COVID 19 in November 2020. Patient expired on 6/26/2021 while hospitalized.

Other Meds:

Current Illness:

ID: 1431332
Sex: F
Age: 35
State: NY

Vax Date: 04/25/2021
Onset Date: 06/05/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: Celexa Gabipentin

Symptom List:

Symptoms: Swollen lymph nodes under left arm immediately after shot Inflammation of the coastal joint of 3rd and 4th rib

Other Meds: Bupropion 150mg Zyrtec 10mg Singular 10mg CBD 25mg Vitamin D

Current Illness: PTSD

ID: 1431333
Sex: F
Age: 60
State: OH

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: Codeine, Penicillin, sulfa, corticosteroids

Symptom List:

Symptoms: Patient states that arm has been sore to use since receiving the vaccine; NO redness, rash, warmth to touch or lump or swelling; she states it is sore upon waking in the morning and the stiffness lesses slightly as the day progresses but is sore all day sometimes she has issues gripping & moving arm front to back but not as much soreness raising arm upwards; she was advised by her prescriber to have pharmacy report

Other Meds:

Current Illness:

ID: 1431334
Sex: F
Age: 12
State: TX

Vax Date: 06/24/2021
Onset Date: 06/26/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient reported shortness of breath and tightness in chest that started around 4pm on June 26, 2021 during volleyball game that led to patient not being able to continue activity. On June 28, 2021 at 11am to 1pm, pt reported the same shortness of breath that led to patient not being able to continue strength and conditioning activity. Patient has been advised to contact primary care doctor for further guidance and evaluation.

Other Meds:

Current Illness:

ID: 1431335
Sex: M
Age: 11
State: PR

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: It has come to my knowledge that the nurse vaccinated a child under 12 years old. No adverse effects have been reported.

Other Meds:

Current Illness:

ID: 1431336
Sex: M
Age: 50
State: KS

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

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: Initially I had a more severe pain than i had with the first dose. Swelling and Soreness at the injection site was worse than the first dose. Later at night when trying to go to sleep I felt a SUDDEN Onset of CHILLS. I then had Muscular Pain thruout various parts of my body. I had Headache. I felt cold thruout the first night after I got the vaccine. I felt tired and unable to do day to day tasks the following day.

Other Meds: NONE

Current Illness: NONE

ID: 1431337
Sex: F
Age: 46
State: CA

Vax Date: 05/03/2021
Onset Date: 05/04/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: Codein

Symptom List:

Symptoms: As of today my left forearm is still hurting since vaccine dose 1. It?s very difficult to pull / push / turn / lift

Other Meds: Armour 120mg

Current Illness:

ID: 1431338
Sex: F
Age: 45
State: MD

Vax Date: 05/22/2021
Onset Date: 05/25/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: About 3 days after vaccine I started having severe headaches. After 9 days of the headaches I went to see my doctor. I no longer have the severe headaches now I'm having a lingering low level headaches and fatigue.

Other Meds: No

Current Illness: No

ID: 1431339
Sex: F
Age: 29
State: MI

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

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

Lab Data:

Allergies: None reported.

Symptom List:

Symptoms: Patient was sitting in the pharmacy waiting area after receiving her COVID vaccination. One of my technicians noticed the patient looked barely conscious. We called Fire Department and EMS arrived within 10-15 minutes. While we were waiting I and 2 others stayed with the patient. We took her vitals. BP and pulse were 116/76, heart rate 76. Patient was clammy and sweaty and was semi-conscious. We were able to communicate with her. EMS arrived and ran more tests. Patient's vitals were fine except she had orthostatic hypotension. She also reported a history of syncope (this was not noted in her questionnaire). Patient did not want to go with EMS. Her fiance's mother came and picked her up.

Other Meds: Unknown

Current Illness: None reported. After receiving the vaccine, patient reported that she has had a history of sycope.

ID: 1431340
Sex: M
Age: 10
State: PR

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: It has come to my knowledge that the nurse vaccinated a child under 12 years old. No adverse effects have been reported.

Other Meds:

Current Illness:

ID: 1431341
Sex: F
Age: 10
State: PR

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: It has come to my knowledge that the nurse vaccinated a child under 12 years old. No adverse effects have been reported.

Other Meds:

Current Illness:

ID: 1431342
Sex: F
Age: 36
State: TX

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient reports tingling in knees and restlessness that started on day of vaccination and has continued since. Patient has been asked to continue following up/reporting with status of the adverse event to healthcare provider.

Other Meds:

Current Illness:

ID: 1431343
Sex: M
Age: 65
State: IL

Vax Date: 04/01/2021
Onset Date: 05/30/2021
Rec V Date: 06/28/2021
Hospital: Y

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

Lab Data:

Allergies: No known Allergies

Symptom List:

Symptoms: Pt received 1 dose of Moderna COVID-19 vaccine on 4/1/2021. He was initially seen at outside hospital ED for weakness, cough, and pain all over. He had initially also tested positive for COVID-19 via PCR test on 5/30/2021. Treated for both COVID pneumonia and superimposed bacteria pneumonia. Reported to live locally in a nursing home. Pt was placed on a ventilator with IJ catheter on 6/8/2021. Due to condition decline in condition, he was transferred to the Meriter ICU on 6/11/2021. He has since been extubated, but currently remains in the ICU.

Other Meds: insulin glargine, insulin lispro, lisinopril, pantoprazole, quetiapine Fumarate, rivaroxaban

Current Illness:

ID: 1431344
Sex: M
Age: 0
State: OH

Vax Date: 06/25/2021
Onset Date: 06/26/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Pt found with blue lips and forehead, which resolved spontaneously when mother repositioned. Was evaluated in ED and diagnosed with BRUE.

Other Meds: vitamin D.

Current Illness: none

ID: 1431345
Sex: F
Age: 49
State: TX

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

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

Lab Data:

Allergies: macadamine nuts, seasonal allergies

Symptom List:

Symptoms: Skin feels very itchy since I was injected with the shot.

Other Meds: None

Current Illness: None

ID: 1431346
Sex: M
Age: 8
State: PR

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: It has come to my knowledge that the nurse vaccinated a child under 12 years old. No adverse effects have been reported.

Other Meds:

Current Illness:

ID: 1431347
Sex: M
Age: 69
State: SC

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Pt had diffuse myalgias beginning the day after the vaccination. CK level, BMP, CBC unremarkable, no other acute illness appears to be present to explain this. He does have longstanding psoriasis with likely psoriatic arthritis which could easily be a confounding factor.

Other Meds: Lipitor, Trulicity, gabapentin, Insulin NPH 70/30, Zestoretic, metformin, metoprolol, Prilosec, Kenalog ointment

Current Illness: None

ID: 1431348
Sex: M
Age: 31
State: TX

Vax Date: 04/26/2021
Onset Date: 05/09/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies

Symptom List:

Symptoms: Almost a week after I received the second dose of the Moderna Covid vaccine, I started experiencing some chest tightness/pressure, and extreme fatigue, which continued for another 6 weeks after May 3rd, during which I felt extreme fatigue, chest tightness, shortness of breath and heart palpitations (mostly at night, when lying down). I visited Urgent Care on May 3rd and had to go to the ER again on May 9th, for the same reason.

Other Meds: Tylenol, Fexofenadone 180mg

Current Illness: None.

ID: 1431349
Sex: M
Age: 7
State: PR

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: It has come to my knowledge that the nurse vaccinated a child under 12 years old. No adverse effects have been reported.

Other Meds:

Current Illness:

ID: 1431350
Sex: F
Age: 45
State: CA

Vax Date: 03/20/2021
Onset Date: 05/24/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: So I have excruciating pain in my left shoulder blade, shoulder, arm, fingers and hand. It keep me up at night because of the pain. It is a constant and sever pain. I am seeing a chiropractor and acupuncture on my own, it's not covered.

Other Meds: None

Current Illness: No

Date Died: 03/21/2021

ID: 1431351
Sex: M
Age: 67
State: WA

Vax Date: 02/09/2021
Onset Date: 03/05/2021
Rec V Date: 06/28/2021
Hospital: Y

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

Lab Data:

Allergies: UNK

Symptom List:

Symptoms: 3/7/2021: dysregulated taste, dyspnea, Myalgia, pneumonia, hospitalized, treated but died

Other Meds: UNK

Current Illness: UNK

ID: 1431352
Sex: M
Age: 68
State: ME

Vax Date: 03/01/2021
Onset Date: 03/04/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: Bee stings

Symptom List:

Symptoms: Pounding heart, heart palpitations chest pain pain in neck muscles (like a cramp), numbness tingling along both sides of jaw, shortness of breath.

Other Meds:

Current Illness: diabetic mild hypertension , hi triglycerides ,anxiety

ID: 1431353
Sex: M
Age: 49
State: MD

Vax Date: 04/24/2021
Onset Date: 04/30/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: Augmentin, Levaquin, Aspertame

Symptom List:

Symptoms: About a week after shot 1 I started to feel very fatigued and run down. I was able to function but got tired easily. On May15, I received shot 2 and my fatigue got worse. I started to get tremors and shakes in my hands and arms. Legs felt weak, its difficult to hold my arms up at times. I felt hyper, yet weak. Unable to stay asleep. On June 6 I took a hot shower and barely made it out before collapsing. I went to the emergency room .

Other Meds: Gaviscon antacids

Current Illness:

ID: 1431354
Sex: F
Age: 13
State: IL

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Shortly after vaccination client felt intense pain in the right side of her neck radiating down her arm. Client was at the vaccination site in the observation lot at this time, and the Nurse called the ambulance to come assess the client. The client was transported to the ER with the consent of the mother.

Other Meds: None

Current Illness: None

ID: 1431355
Sex: F
Age: 42
State: TX

Vax Date: 04/15/2021
Onset Date: 04/19/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Employee stated that she developed hives 4 to 5 days after receiving the second dose of the Pfizer COVID-19 vaccine. Stated the hives started off mild, but are now severe and all over (face, stomach, back, legs, arms, neck). Employee stated when the hives first started she would take Benadryl and the hives would go away for a couple of days then return. Now the Benadryl is not helping. Employee stated that she went to the ER Friday (6-25-2021) because the hives were so bad and she was having trouble swallowing. Stated the ER discharged her home with some steroids and Benadryl, but the medication does not appear to be helping. The employee stated that she had the flu shot 5 years ago and had the same reaction with the hives and is no longer able to receive the flu vaccine. Advised employee to follow the advise of the ER, and if symptoms do not improve or get worse to return back to the doctor. Also advised employee that she may need to see an allergist or immunologist.

Other Meds:

Current Illness:

ID: 1431356
Sex: F
Age: 29
State: MI

Vax Date: 02/04/2021
Onset Date: 02/18/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient contacted the clinic 14 days after receiving her 1st dose of the Moderna vaccine stating the 2nd toe and base of the toe on her right foot was experiencing a sharp pain. She had to walk on the side of her foot. There was no known injury. She experienced increased pain when pressure was applied. Xrays showed no injury. About 1 month after symptoms began, the patient began experiencing pain up her leg to the thigh.

Other Meds:

Current Illness:

ID: 1431357
Sex: M
Age: 65
State: TN

Vax Date: 05/04/2021
Onset Date: 05/15/2021
Rec V Date: 06/28/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfur drugs - latex

Symptom List:

Symptoms: Only slight injection site pain for first shot. With the 2nd shot, I had pain at injection site that radiated into my shoulder 8-15 hours after initial injection. Noticed swollen lymph glands in armpit of vaccinated arm after 24 hrs. All these particular symptoms disappeared after 36-48 hrs. Along with these symptoms I began to have very loud tinnitus which I have suffered from for years but nothing to this volume. Approximately 11 days after the 2nd dose I came home from working a short day and after a meal began to feel like my blood pressure was up because my head felt pressured and I could tell my heart was racing. Checked my blood pressure and it was at rest 140/105 w/ 96 bpm. I am not on any bp meds because I have never been prone to high blood pressure. Bp prior to this occurrence has always been in the 117-120/76-80 range with a bpm of around 64-70. Chest pain radiate from front to back to front and stayed that way until I went to emergency room 3 days later believing I may have had a heart attack. I was administered an EKG, had blood serum tests and a CT scan - all of which were normal and or showing no signs of a heart attack. I was kept overnight for observation with blood being drawn middle of the night and vitals being monitored. The morning of the next day I was administered a stress test which I apparently passed no problem.

Other Meds: Armour Thyroid - Vitamin D - B12 - Curcumin

Current Illness: 03/30/2021 - Went to CVS Urgent Clinic for COVID-19 test (negative) and was diagnosed by PA as having sinusitis. Was given a 7 day run of amoxicillin and 14 days of antihistamine.

ID: 1431358
Sex: F
Age: 11
State: PR

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: It has come to my knowledge that the nurse vaccinated a child under 12 years old. No adverse effects have been reported.

Other Meds:

Current Illness:

ID: 1431359
Sex: F
Age: 42
State: MI

Vax Date: 01/08/2021
Onset Date: 03/04/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: pulmonary embolism. Felt sluggish and strange for a week and then had MRI on 3/4 and it was on MRI.

Other Meds: Imitrex but I don't think I took it around the time of the vaccination as I only take as needed. Women's multi vitamin.

Current Illness: none

ID: 1431360
Sex: M
Age: 37
State: LA

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient given Pfizer as their second dose when should have received Moderna. Patients first dose was Moderna 26 days prior on 6/1/2021.

Other Meds: None

Current Illness: None

ID: 1431361
Sex: F
Age: 45
State:

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

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Vaccine error occurred in office where MA was unaware of multidose vial and patient received 3 doses (1.5 mL) of Janssen vaccine. Patient was observed for 25-30 minutes without any adverse affects. Will be monitored closely with phone call next day and in office evaluation in 2 days. No rash, swelling, or signs of allergic reaction.

Other Meds: None

Current Illness: H/o vitamin D deficiency, breast abscess

ID: 1431362
Sex: M
Age: 39
State: CA

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 06/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Day 1: Within 1 hour of shot, feelings of delirium and low-grade fever (99 F), posterior neck pain and stiffness. 4 hours after shot, arm pain (significantly less than with first dose). Chills. Joint pain (fingers, knees, hips). Mild headache. After 8 hours, chills and fever subsided, but hot; sweaty. General fatigue. At 12 hours, worsening but intermittent finger, hand and knee tenderness. Clamminess, sweats, intolerance to both heat and cold. Eye sensitivity. Day 2: Severe body aches. Mild asthma exacerbation (effectively alleviated with albuterol sulfate inhalation). Severe fatigue. Description was, "like having just gotten out of a pool, but whole body instead of just swimsuit being wet." Light sensitivity/aversion with dull headache. Difficulty concentrating. Elbow joint paint. Fever. Day 3: Significantly reduced headache, fever and body "heaviness." Pain in legs and elbows improved or eliminated. Gastric and esophageal inflammation. Diarrhea; stomach bloating; nausea; gas; gastritis. Mild. Esophageal and splenic discomfort (upper-left quadrant tenderness). "Brain fog" persists. Better than previous day. Forgetfulness. Insomnia. Day 4: Significantly reduced symptoms. Pain virtually gone. Gastric symptoms persist, but reduced. Somnolence. Day 5 - 7: Complete improvement, however notable axial (underarm) lymph swelling and tenderness. Day 7 - 14: Resolution of all symptoms, mild lymph swelling persists. Day 17: Lymph swelling resolved.

Other Meds: Albuterol, Pulmicort, Nexium, N-acetylcysteine supplement, Nasacort

Current Illness:

ID: 1431363
Sex: F
Age: 40
State: AZ

Vax Date: 06/11/2021
Onset Date: 06/15/2021
Rec V Date: 06/28/2021
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Allergies: Latex

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Symptoms: High blood pressure, lots of shaking, sugars dropping drastically, tingling and numbness in arms and legs, headaches, exhaustion. Went to hospital 2 times but they didn't give anything and told me to see my doctor. I'm scheduled to see my doctor on July 1.

Other Meds: Humalog Lantus Duloxitine

Current Illness: Diabetic

ID: 1431364
Sex: F
Age: 72
State: GA

Vax Date: 02/15/2021
Onset Date: 02/24/2021
Rec V Date: 06/28/2021
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Allergies: Sulfer, HCTZ

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Symptoms: SED rate and C Reactive Protiine as well as other bloodwork started being abnormal about ten days after shot two. It did not go down until I was hospitalized May 7 and diagnosed with atypical pneumonia. Felt bad whole time and ran temps.

Other Meds: Edarbi, Clonidine, Diltize, Omeprazol, Vitamin D, Preservision, Zoliphin

Current Illness: Mixed Connective Tissue Disease

ID: 1431365
Sex: F
Age: 54
State: CA

Vax Date: 06/15/2021
Onset Date: 06/16/2021
Rec V Date: 06/28/2021
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Allergies: Tree nuts; tree pollens; grasses

Symptom List:

Symptoms: Over the next 24 hours from 06/16/21 - 06/17/21, starting at 1:45 am - high fever of 102; severe body aches; headache; chills; lethargy; weakness; loss of appetite; nausea; diarrhea.

Other Meds: Cetirizine HCL 10 mg

Current Illness:

ID: 1431366
Sex: M
Age: 71
State: FL

Vax Date: 02/09/2021
Onset Date: 02/23/2021
Rec V Date: 06/28/2021
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Allergies: None

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Symptoms: Rapid heart rate Happened 1 st time for 2 hours two weeks after 1 st vaccine and 2nd time a week later for 3 hours

Other Meds: lisinopril . Amlodipine, Probiotic ,Vitamin C

Current Illness: None

ID: 1431367
Sex: M
Age: 82
State: OH

Vax Date: 06/25/2021
Onset Date: 06/27/2021
Rec V Date: 06/28/2021
Hospital: Y

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Allergies: sulfa drugs statin medications macrobid ciprofloxacin

Symptom List:

Symptoms: Patient experienced normal immune related response after dose two (Friday afternoon)- chills beginning about 12 hours after vaccination (Saturday morning) and ending by Saturday at 4 pm. On Sunday morning, patient reported feeling as though something was in his eye. He went to the mirror and saw that his eyelid and mouth were drooping on one side of his face. He lives in an assisted living facility and immediately sought medical attention by the staff and was taken to the nearest emergency department to verify that this reaction was not a stroke. Emergency room physician determined that it was not a stroke and the patient was diagnosed with Bell's Palsy, potentially related to his recent vaccination. Patient was prescribed steroids and an eye lubricant drop. On Monday, the patient is still experiencing the facial drooping.

Other Meds: Losartan Eliquis Meloxicam Propranolol Loratidine (patient reported)

Current Illness: atrial fibrillation hypertension arthritis tremors (patient reported)

ID: 1431368
Sex: F
Age: 88
State: MI

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

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Allergies: Avapro, Benicar, lidocaine, Macrobid, quinidine-quinine analogues, sulfas, cozaar

Symptom List:

Symptoms: Fully vaccinated patient admitted to hospital with detected COVID PCR test. Patient with positive COVID swab in ED on 05/31/21. Came to ED with leg swelling, weakness. Discharged home on 1 L/NC of O2 due to lower O2 sats 92-94%. Patient seen again in ED on 06/06/21 this time for increasing shortness of breath, increasing oxygen demand, and icnreased work breathing. O2 needs since last ED visit increased to 2-3 L. Admitted to hospital for COVID infection and CHF exacerbation. Treated with aggressive diuretics, remdesivir, and dexamethasone. Blood cultures tested positive and was started on IV ATB's. Patient discharged back to AFC with Hospice services.

Other Meds: Xanax, Norvasc, vitamin C, Tenormin, calcium supplement, D3 supplement, celexa, B12 supplement, digoxin, multivitamin, Neurontin, Lasix, levothyroxine, melatonin, K-dur, Pravachol, Flomax, coenzyme 10, coumadin, sinc

Current Illness: increasing weakness and failure to thrive

ID: 1431369
Sex: F
Age: 45
State: CT

Vax Date: 06/28/2021
Onset Date: 06/28/2021
Rec V Date: 06/28/2021
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Allergies: None

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Symptoms: Administered expired MMR II vaccine with expiration date of 2020NOV01

Other Meds:

Current Illness:

ID: 1431370
Sex: M
Age: 20
State: MA

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/28/2021
Hospital: Y

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Allergies: None known

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Symptoms: Chest pain developed later on the same day as his 2nd Moderna COVID-19 vaccine dose. He presented to the emergency department on 6/27/21. Other symptoms, including body aches, headaches, and fatigue resolved prior to presentation. The chest pain resolved completely by 6/28/21, the day after presentation. He was given ibuprofen for pain management. He was monitored on telemetry without significant events as of the time of this report. He was being treated for a presumed diagnosis of myocarditis secondary to the Moderna COVID-19 vaccine.

Other Meds:

Current Illness: None known

ID: 1431371
Sex: F
Age: 33
State: TX

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/28/2021
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Allergies: Macrobid, cephaloxime

Symptom List:

Symptoms: Constant dizziness, migraines & elevated blood pressure (not typical) every day since injection.

Other Meds: Daily- Adderall xr, multivitamin, probiotic gummy, gabapentin, omeprazole, calcium citrate/d3 chew, amitriptyline, zyrtec As needed-klonopin, promethazine, zofran, tizanidine, lidocaine patch, tiger balm, volteran gel, biofreeze, tylenol,

Current Illness: Uti (treated with keflex 3 weeks prior)

Date Died: 05/12/2021

ID: 1431372
Sex: F
Age: 49
State: OH

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 06/28/2021
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Symptoms: 13 hours after the patient had had her 2nd covid-19 shot, she was found dead. She had indicated that she had no side effects after her shot.

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Current Illness:

ID: 1431373
Sex: M
Age: 9
State: PR

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 06/28/2021
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Symptoms: It has come to my knowledge that the nurse vaccinated a child under 12 years old. No adverse effects have been reported.

Other Meds:

Current Illness:

ID: 1431374
Sex: F
Age: 66
State: NY

Vax Date: 03/20/2021
Onset Date: 03/01/2021
Rec V Date: 06/28/2021
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Allergies: Levaquin - Antibiotic Augmentin - Antibioic Adhesive Tape like bandaids and tape - I break out into a rash.

Symptom List:

Symptoms: Shortly after getting the 2nd vaccine, I started getting Fecal Incontinence. I would get no cramps, no indication that I needed to use the bathroom, NOTHING. The feces just flowed right out of my body like a waterfall or kitchen faucet and ran down my legs and all over me. I had a mess that I could not control.

Other Meds:

Current Illness: No

ID: 1431375
Sex: F
Age: 71
State: VA

Vax Date: 04/27/2021
Onset Date: 05/01/2021
Rec V Date: 06/28/2021
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Allergies: Sulfa drugs, topical Thiomersal (contact lens solution). No reactions to flu shot, etc.

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Symptoms: Pain along side for 2 days (shooting pain along ribs). Broke out with blisters 2 days after the pain started. Spot approximately as big as an egg on left back. Small strip 1'' x 1/4'' under left breast.

Other Meds: Metformin, Pravastatin, Tolterodine Tartrate, CoQ10, Glucosamine HCL/Chondroitin, Multivitamin, D3, PreserVision, Lysine

Current Illness: None

ID: 1431376
Sex: M
Age: 14
State: MO

Vax Date: 06/09/2021
Onset Date: 06/19/2021
Rec V Date: 06/28/2021
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Allergies: None

Symptom List:

Symptoms: Hives started 6/19/2021

Other Meds: Lexapro

Current Illness: None

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm