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: 1450123
Sex: F
Age: 56
State: CA

Vax Date: 05/02/2021
Onset Date: 06/14/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Dysphagia, Epiglottitis

Symptoms: Blurry vision beginning 6/27/21. Ended up at retinal specialist, diagnosed 6/30/21 with APMPPE -- a rare condition where virus from liver inflames the lens of the eye, resulting in inability to focus or see.

Other Meds: n/a

Current Illness: n/a

ID: 1450125
Sex: F
Age: 22
State: MA

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

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient had a syncope and recovered in few seconds, emergency response team was called to make no other adverse reaction

Other Meds:

Current Illness:

ID: 1450126
Sex: F
Age: 85
State:

Vax Date: 03/01/2021
Onset Date: 03/24/2021
Rec V Date: 07/06/2021
Hospital: Y

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: I21.4 - Non-ST elevation (NSTEMI) myocardial infarction

Other Meds:

Current Illness:

ID: 1450127
Sex: F
Age: 64
State: CO

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 07/06/2021
Hospital: Y

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

Lab Data:

Allergies: Several medications (do not recall)

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Shortly after shot, 104 degree fever, nausea, fatigue, extreme aches, did not immediately seek treatment (live in rural area). All of those things have persisted, 102 fever every night, 100 fever. Kidneys shut down since April 1st. Blood pressure and breathing difficulties (especially bad because living at elevation)

Other Meds: Pain Medications (oxycotin, time-released zamtpon), 2 Different Muscle Relaxers (zanadin), Promethazine, Blood Pressure Medication, thyroid medication, antidepressant (stopped taking since April),

Current Illness: N/A

ID: 1450128
Sex: F
Age: 44
State: MA

Vax Date: 04/22/2021
Onset Date: 05/01/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: No.

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

Symptoms: About 7 days after being vaccination, I ended with a rash that look like individual bumps. Started from my neck and covered all over my body. The rash got itchy, red and irritated still there currently.

Other Meds: No.

Current Illness: No.

ID: 1450129
Sex: M
Age: 85
State: AZ

Vax Date: 05/04/2021
Onset Date: 05/10/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: no

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

Symptoms: Extreme diarrhea and food doesn"t taste right, have accidents in the middle of the night

Other Meds: no

Current Illness: asthma

ID: 1450130
Sex: F
Age: 71
State:

Vax Date: 03/03/2021
Onset Date: 06/26/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: J18.9 - Pneumonia, unspecified organism

Other Meds:

Current Illness:

ID: 1450131
Sex: F
Age: 15
State: MI

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

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

Lab Data:

Allergies: unknown

Symptom List: Pharyngeal swelling

Symptoms: Patient slumped over almost immediately after receiving her first covid vaccination. She was unresponsive but breathing and hearbeat for 30-45 seconds. At that point she became responsive and asked for water. We gave her bottled water and some candy. She sat for about 20 minutes and appeared alright. Her mother was present and said that the patient has had this type of reaction before. She also said that the patient hadn't eaten or drank much previously during the day. It was in the high ninties outside. The mother said that she would make sure that the patient ate something when she got home and she would be home with her all day.

Other Meds: unknown

Current Illness: unknown

ID: 1450132
Sex: M
Age: 61
State: CT

Vax Date: 03/25/2021
Onset Date: 04/01/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I had cardiac arrhythmia. I was in the ER for one day.

Other Meds: Multivitamin Redeftice

Current Illness: None

ID: 1450133
Sex: F
Age: 55
State: NY

Vax Date: 03/30/2021
Onset Date: 05/07/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: Medication: sulfa; food: citrus fruits

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I started to have pain around my left elbow when using my hand or even just walking around May 7. When it did not get better after three weeks, I went to see my orthopedist, Dr. on May 28, 2021. He examined me and took x-rays (normal) and diagnosed it as radial tunnel syndrome/ulnar nerve lesion. I was instructed to perform an exercise at home, and to ice it and use topical diclofenac gel. After 4 weeks, it had improved a bit, but not fully, and I was then instructed to get hand therapy, which I am scheduled to begin on July 12, 2021. I do not know if this is related at all to the vaccine, but it occured in the same arm in which I received both doses and I reported it as a new medical problem when surveyed.

Other Meds: Prevalite, Flovent HFA, Montelukast, Flonase, Vitamin D3, Mg

Current Illness: None

ID: 1450135
Sex: U
Age: 53
State: TX

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 07/06/2021
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: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1450136
Sex: M
Age: 48
State:

Vax Date: 04/17/2021
Onset Date: 06/27/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: J18.9 - Pneumonia

Other Meds:

Current Illness:

ID: 1450137
Sex: F
Age: 57
State: ME

Vax Date: 07/02/2021
Onset Date: 07/03/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: patient describes a 3 inch lump that is not red or hot, but very sore under her left arm.

Other Meds:

Current Illness:

ID: 1450138
Sex: M
Age: 62
State: NC

Vax Date: 03/30/2021
Onset Date: 04/19/2021
Rec V Date: 07/06/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

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

Symptoms: Congestive Heart Failure Fluid builup in lungs Enlarged Heart Palpitations in beating of Heart

Other Meds: None

Current Illness: None

ID: 1450139
Sex: U
Age: 24
State: TX

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 07/06/2021
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: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1450140
Sex: F
Age: 66
State: PA

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Vaccination administered, and patient was observed after 30 minutes. At 1434, pt feeling that her "heart is racing"; vs done; bp 165/82 with HR of 101; sats 99%; pt states the bp is a little high for her but not unusual given the situation. Pt states she feels ok to go home

Other Meds:

Current Illness:

ID: 1450141
Sex: U
Age: 13
State: TX

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1450142
Sex: M
Age: 71
State: TN

Vax Date: 02/13/2021
Onset Date: 03/01/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient treated in our office 5/5/2021 for persistant tremors in bilateral hands since vaccinations recieved 2/13/21 and 3/13/21. Patient referred to neurology for evaluation

Other Meds: Verapamil, Atorvastatin, Dexilant, Benazepril, Amlodipine, Aspirin

Current Illness: None

ID: 1450143
Sex: M
Age: 72
State: TX

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: Gentamycin, Sulfa

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: The day after receiving the shot, I became very ill with fever, chills, nausea and somewhat disoriented. It lasted about 3 days. Took tylenol and unable to go about daily routine. Had to let it run its course. Contacted doctor by phone. After the third day, I had severe sweating for at least 12 hours. It took a while for me to get my strength back again, real weak and tired.

Other Meds: Benicar, Bystolic, Zetia, Actos, Cymbalta, Amitza, Allegra, Nortriptylene, Norco, Furosemide, Omeprazole, Crestor, Probiotic, Ondansetron, Dymista , stool softner, men's vitamin

Current Illness: None

ID: 1450145
Sex: F
Age: 69
State: NC

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: I am allergic garlic.

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

Symptoms: I had a very sore arm

Other Meds: I take vitamins.

Current Illness: No other illnesses.

ID: 1450146
Sex: M
Age: 18
State: TX

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 07/06/2021
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, Lymph node pain, Lymphadenopathy

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1450147
Sex: M
Age: 29
State: NY

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: None Stated

Symptom List: Unevaluable event

Symptoms: Patient stated he never received a covid 19 vaccination or any other vaccination per heath questionnaire, no other form of verification is used to determine if patient is telling the truth. This writer found out due to immunization supervisor that this patient had received the Moderna vaccination prior. This writer was asked to fill out Vaers form.

Other Meds: TRIUMEQ 600 MG-50 MG-300 MG TABLET

Current Illness: None Stated

ID: 1450148
Sex: M
Age: 26
State: UT

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 07/06/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: This was the Johnson and Johnson shot I received. Normal symptoms of tiredness, soreness occurred immediately. Within 3 days I developed chronic stomach pain and GI problems. Bloody stool has been going on now for 3 months. I weigh 145 lbs and have lost 40 lbs. currently at 105 lbs. Doctors haven't been able to diagnose my situation even after several blood tests, colonoscopies and biopsy's. I was a perfectly healthy 26 year old with no family issues of GI problems or other complications. I now can barely stand for a few minutes at a time. Doctors think I have either Chrons, or Ulcerative Colitis, but the biopsy's are inconclusive.

Other Meds: None

Current Illness: No

ID: 1450149
Sex: F
Age: 33
State: CA

Vax Date: 07/01/2021
Onset Date: 07/02/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Injection site pain, Pain

Symptoms: Migraine all over pain in head. Nausea. Weakness. Sore Body.

Other Meds: Levothyroxine

Current Illness:

ID: 1450150
Sex: F
Age: 75
State: FL

Vax Date: 06/22/2021
Onset Date: 06/23/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: Cephalosporins. anaphylaxis episode- ceftin penicillin sulfites flowers seasonal allergies clindamycin CARRY EPI PEN

Symptom List: Injection site pain, Menorrhagia

Symptoms: rash began on arm at site, on legs, fingers, lower legs anklesRt side of face. Itching, pustules, went to walk in physician. Had cortisone injection, 5 day regimen of prednisone ,mistaken rash for cellulitis in one area - left leg. week went by, rash and uncontrollable itching did not abate. Tired, achy, went back to same physician. showed her report on vaccine rash mistaken as cellulitis. I researched the side effects and although rare, Rash can present as cellulitis mistakenly. Received rx for Triamcinolone cream . Today I called an allergist specialist who refused to see me with this reaction., I need to know what caused this severe reaction and have taken pictures of the rash. What specialist can help me with this reaction? I need guidance please

Other Meds: Losartan 50mg Levothyroxine.125mg

Current Illness: Healthy, active no illnesses , do not get flu, viruses

ID: 1450151
Sex: F
Age: 54
State: NY

Vax Date: 02/19/2021
Onset Date: 02/26/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: Mobic, Bacitracin

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

Symptoms: I experienced ringing in my ears started one week after my vaccine. At time it created a whole lot of pressure to the point it is painful, loud ring. Past couple of weeks have started to subside but the ringing is still present. I believe I had a sinus infection before I went to get the second dose, but I had attributed to a migraine headache. I still have the sinus infection, it is continuing and I will be seeking treating with another ENT. I've had hearing tests and a sleep test performed.

Other Meds:

Current Illness:

ID: 1450152
Sex: M
Age: 48
State: MI

Vax Date: 02/22/2021
Onset Date: 03/01/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Severe tiredness after 2nd shot for 3 days, but became less run down feeling over time. 3 weeks after second shot, noticed extreme fatigue during cardiovascular activity. Reported to Primary Healthcare Provider during routine physical on 06/11/21. Bloodwork (taken 6/15/21) showed symptoms of myodysplastic syndrome. Referred to hematologist for treatment. Awaiting further testing including bone tap and appointment. Patient had none of these symptoms prior to second COViD vaccination and assumed symptoms would disappear over time. He is still symptomatic as of this date.

Other Meds: None

Current Illness: None

ID: 1450153
Sex: F
Age: 15
State: OR

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

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient developed fatigue 3 hrs post injection. The following day, developed fever to 103F, nausea and vomiting, dizziness and pleuritic chest pain, difficulty breathing. fever last for 2 days. Went to ED for evaluation on day 3 (7/1). Symptoms ultimately resolved, but then developed facial hives and facial swelling on day 5 post vaccine.

Other Meds: None

Current Illness: None

ID: 1450154
Sex: M
Age: 46
State: VA

Vax Date: 06/30/2021
Onset Date: 07/04/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: n/a

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

Symptoms: On 7/4 patient developed a painful rash on his face, vaccine was given on 6/30/21. He has no history of rashes like this occurring.

Other Meds: n/a

Current Illness: n/a

ID: 1450155
Sex: M
Age: 12
State: WA

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Uncontrolled coughing fit and shortness of breath

Other Meds:

Current Illness:

ID: 1450156
Sex: U
Age: 14
State: TX

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1450157
Sex: M
Age: 15
State: DC

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

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

Lab Data:

Allergies: Remote history of hives after eating a Korean meal, was not disclosed prior to receiving vaccine

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

Symptoms: About 25 minutes after vaccine was administered, the patient developed erythematous patches bilateral deltoid muscles, bilateral forearms, upper back, and bilateral shins/ankles. He denied itching. He did not experience any additional symptoms. His vital signs were stable and he was breathing comfortably and speaking in full sentences. He received 25 mg capsule of Benadryl with some improvement seen in rash on arms and shins. He was discharged to home after being monitored in the health center for about 90 minutes after vaccination. Vital signs remained normal. He was accompanied by his mother who was going to be able to watch him closely and with a prescription for Benadryl to take prn every 6 hours. Mom was instructed to call 911 for any worsening including difficulty breathing.

Other Meds: none

Current Illness: Denies

ID: 1450158
Sex: F
Age: 75
State: PA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Within minutes, felt like she was going to fall. Patient's eyes were droopy but able to respond to questions. BP 93/98, HR 93, RR 20. No SOB. VS rechecked and BP 169/78, RR 18, HR 92. No lightheadedness. Able to stand and patient was relaxing. BP 175/93, HR 60 bpm and RR 16. Released home with daughter. Received shot #2.

Other Meds:

Current Illness:

ID: 1450159
Sex: M
Age: 74
State: OK

Vax Date: 02/03/2021
Onset Date: 07/01/2021
Rec V Date: 07/06/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Hospitalized 7/1/2021 - still inpatient. Pneumonia and hypoxemia

Other Meds:

Current Illness: NONE

ID: 1450160
Sex: F
Age: 53
State: OK

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

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Patient arrived at the pharmacy with daughter and another patient to receive their first doses of the Pfizer vaccine. While answering the pre-vaccine questionnaire the patient's daughter asked a question regarding first dose side effects the patient made a vague comment about have no side effects herself. I then asked the patient directly if this was their 1st dose of the vaccine and they stated that it was. After giving the vaccine I then went to report the vaccination to OSIIS and saw that the patient had already completed a sequence of the Moderna vaccine back in JAN/FEB. I then asked the patient if they had received the Moderna vaccine already to which she admitted that she had. Patient told me she had seen in the news that it was recommended to get the other two dose series then you already had to help protect against the delta variant. As I was unsure of the recommendations in this scenario I contacted the Health Department Covid Hotline, who recommended to report the incident to VAERS. As of this writing the patient has had no side effects, but I did recommend that the patient inform her PCP that she had received 3 doses of the vaccine now.

Other Meds:

Current Illness:

ID: 1450161
Sex: U
Age: 12
State: TX

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 07/06/2021
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Allergies:

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

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1450162
Sex: F
Age: 62
State: WA

Vax Date: 03/25/2021
Onset Date: 07/05/2021
Rec V Date: 07/06/2021
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Allergies: vaccine

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

Symptoms: Burning , itching sensation starting with ears, then throat, this time corner of eyes started itching at that point took medication to counter reaction

Other Meds: milk thistle, heal n sooth, losartan/ hct 100-25, niacan

Current Illness: N/A

ID: 1450163
Sex: F
Age: 51
State: SC

Vax Date: 05/27/2021
Onset Date: 05/27/2021
Rec V Date: 07/06/2021
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Allergies: Nothing.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: So the 2nd dose my eye sight started getting worse, best way I can describe is that I don't see very well. I can see but it's off. They hurt, they were achy and irritated like I wanted to rip my eyeballs out. That was the major thing I noticed when I was eating my dinner. This was a precursor that happened after the first dose but it got worse. And then my emotional state was really bad and that happened after the first one too. I was very irritable and could cry at the drop of a hat, short fused. and that is very unlike me to be like that. Fatigue got worse, it was off from the first dose but it got worse. Muscle, joint, body ache and pain. Heaviness in my chest. Constant dry cough, always clearing my throat which is still there and hasn't gone away. Flu like symptoms. Chills like when you're sick, and I would get really hot but I didn't have a fever. Then chills, my body temperature was really off. I was driving to work and got a severe dizzy spell and threw up all over myself and got in shower and threw up for a half hour. The consistency and smell reminded me of slimy oatmeal, it was coming out of my ears, eyes and pores. I could smell it all over while in the shower and was for 30 minutes and this scared me along with the other symptoms so I had my father take me to the ER. Also I have fogginess, confusion and loss of focus and concentration.

Other Meds: A multivitamin gummy Equate, CVS probiotic.

Current Illness: No I wasn't sick or anything except from the first dose of the vaccine. And I had to wait at least 6 weeks until I didn't feel bad so I could take the 2nd dose.

ID: 1450164
Sex: F
Age: 55
State: VA

Vax Date: 06/10/2021
Onset Date: 06/18/2021
Rec V Date: 07/06/2021
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Allergies: Sulfa, pseudoephedrine, aspirin, wheat, rosemary, lavender.

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

Symptoms: A small oval itch and swollen, My arm was achy. This decreases over the next week. By June 17, it was just a small amber swatch across my arm. It was about ? in x 1 ?. On June 18, it started getting swollen red and itchy again. ON June 19, it got really huge. It was like 8 inches wide, 4 in wide. It swelled about ? in. It was like a plateau on my arm. On June 20, the swelling went down and looked like a tick bite like a bullseye. By the 22, I noticed my lymph nodes were swollen under my armpit and near my breast. I contacted my doctor and saw her on June 25th at 9:30AM. The patch was not as big at the appointment, but it was still visible. She told me to put hydrocortisone on it which I did not do. It has gotten less red. My lymph nodes were still present and began getting less tender until present day. The secondary reaction still shows a faint outline of where it was. The injection area is also a little dark. At no point did I feel fevered, chills, body aches or anything. It was very localized to my arms and lymph nodes.

Other Meds: Generic allergy medication (Pharmacy non drowsy formula)

Current Illness: No

ID: 1450165
Sex: F
Age: 38
State: TX

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 07/06/2021
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Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1450166
Sex: F
Age: 38
State: PA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 07/06/2021
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Allergies: Latex; Adhesives; Surgical Glue; Darvocet; Vicodin; Clindamycin; Zithromax Meloxicam; Topamax.

Symptom List: Pain in extremity

Symptoms: Within first 6 hours of the shot I had Muscle pain like I was running marathon. My joints felt like they were on fire. Nothing was working for me- not marajuana or Tylenol. It lasted for 5 weeks and mid-April it just stopped. I went to the chiropractor during the 5-week time frame. I seen a rheumatologist and he said he thinks it's a fibromyalgia flare-up. Muscular and joint pain was just terrible. It was almost like the fatigue of working out on days on end and finally getting a break. I seen chiropractor on 04/02/2021 and they suggested trying turmeric ginger and he did an exam but found nothing and found no restrictions.

Other Meds: Zofran 8mg As Needed (PRN) Ativan 1mg PRN 2x/day Doxepin 150mg bed time Abilify 2mg bed time Crestor 10mg daily in the morning Imitrex 100mg PRN, 2nd one hour after if needed Depo-Provera shot once every 3 months Synthroid 75mcg daily in t

Current Illness: None.

ID: 1450167
Sex: M
Age: 66
State:

Vax Date: 05/21/2021
Onset Date: 05/24/2021
Rec V Date: 07/06/2021
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Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: Right leg and foot feel dead harder to walk. Many issues of loss of balance.

Other Meds: C+ZINK COD LIVER

Current Illness: diabetes, psorisis psoriatic arthritis; heart ;

ID: 1450168
Sex: F
Age: 24
State: PR

Vax Date: 07/06/2021
Onset Date: 07/06/2021
Rec V Date: 07/06/2021
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Allergies: Midol

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

Symptoms: 24-year-old female patient oriented in time and space. She refers to feeling dizzy to EMT. Within 4 minutes of your first dose of Pfizer. At 12:32 p.m. the EMT obtains his vital signs are: B / P. 80/50 mmHg, P. 85, R. 18, Sat. 99% and Temp. 35.5 Celsius. The case is consulted with Doctor. His recommendation was to observe for 30 minutes and elevate his legs. Upon reevaluation of the patient after 30 minutes, her vital signs were B/P. 100/70 mmHg, R. 18, Sat 99% and Temp. 35.5 Celsius.

Other Meds:

Current Illness:

ID: 1450169
Sex: U
Age: 39
State: TX

Vax Date: 06/20/2021
Onset Date: 06/20/2021
Rec V Date: 07/06/2021
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Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1450170
Sex: F
Age: 42
State: NY

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 07/06/2021
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Allergies: penicillin, cats

Symptom List: Vomiting

Symptoms: Next day :pt felt achey, felt bad 08:00 p.m. had extreme pain and flashes in back of eye, felt concerned but let it go, following saturday 04/10/2021 taking shower , noticed that part of vision in eye that cannot see. calls eye dr, and has retinal detachment, immediate surgery, had complications, 2 weeks later had detachment in left eye. severe anxiety in patient .

Other Meds: no

Current Illness: no

ID: 1450171
Sex: F
Age: 43
State: PA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 07/06/2021
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Allergies: Imitrex

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: At 6:15, right on the nose, I felt like I got hit all at once. I had a fever (103.1). I had cold and hot chills. I had body aches. I felt like my body was made out of china. I felt like I would just shatter if I moved. My neuroglia got worse. I have been trying really hard to find something to help with the pain of that. I have been in excruciating pain. I had a facial pain and I had trouble chewing. I have lots of brain fog. I have been getting very confused. I had a virtual appointment with my PCP. I also had that infusion and I feel like that made it worse also. That was after my 2nd dose of my covid vaccine. I saw my neurologist after seeing my PCP. My pain is just increasing. I was always in pain before, but this has been a drastic increase. I am having to have quality of life conversations with my PCP and my pain therapist. I just don't have the strength to even do normal daily activities. I have more triggers than I used to have with the pain. I would have nights where I couldn't wait to fall asleep. My PCP kept telling me to go to the ER, but I never did. Even a shower just wipes me out for the rest of the day. I don't like the "high" feeling you get from pain killers, so I did not want to go to the ER. I feel like every single nerve is exposed everywhere. Everything hurts.

Other Meds: Valium - 5mg/1xday morning Valium - 10mg/1xday night Soma - 500mg/ 1xday night Lyrica - 75mg/ 1xday night Lyrica - 25mg/ 1xday morning Conserta - 18mg and 54mg/1xday morning Vyepti infusion Oxycodone - 15mg/as needed (caused me to get sick

Current Illness:

ID: 1450172
Sex: F
Age: 69
State: NC

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 07/06/2021
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Allergies: Garlic.

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

Symptoms: Soon as the needle went in I felt a fire sensation, I was sick that next day and I had sore arm. I went to donate platelets the lady put the needle in my left arm my hand start tingling and burning, I felt awful, she said she must hit a nerve and backed out and my left arm has been tingling and burning ever since.

Other Meds: Vitamins.

Current Illness: No other illnesses.

ID: 1450173
Sex: F
Age: 57
State: WA

Vax Date: 03/31/2021
Onset Date: 05/18/2021
Rec V Date: 07/06/2021
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Allergies: codeine; sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: For background - I have ITP -and have to get my blood drawn usually weekly and platelets were down the middle of March - saw an oncologist - take me off blood thinners and increase the Prolacta. Sometimes platelets go up and down for no reason. I went in to get a steroid injection in knee for knee pain on May 18th. I had one three months earlier in my other knee with no problems at all. Before I got the injection, my blood pressure was really high - they told me to watch it. Which is very abnormal for me - usually it's low and very stable. First time in the history of my life that my blood pressure was ever like that. When they gave me the steroid injection - I got a pounding headache the next couple of days. It was the worst pain I'd ever had. It was a headache I have never had before. That Sunday, I went in to the Urgent Care because I couldn't take the pain anymore. The doctor sent me home to wait for bloodwork results. Got results on Monday, 24th. My platelet count was through the roof - 700,000 PLUS. I would have had blood clots if I wouldn't have been on Blood thinners. I would have had a blood clot on the brain. They have never been that high. This was with no medication change - just had had the vaccine and the injection. I called my oncologist on the 24th after that and they had me go to go to ER. They took me off Prolacta and put me on blood thinners. They were having me get my bloodwork at least twice a week and it took about three weeks for platelets to go back down. Now they are low. The headache has stopped. Have spoken just on the phone with my primary care doctor. I feel like this had to do with the combination of the vaccine and the steroid injection.

Other Meds: Prolacta - 75 mg daily; Pradaxa - 150 mg 2 times a day; Metoprolol - 25mg twice a day Iron - 325 mg daily; Emergen C - daily

Current Illness: no

ID: 1450174
Sex: U
Age: 13
State: TX

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 07/06/2021
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Allergies:

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

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1450175
Sex: F
Age: 15
State: TX

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 07/06/2021
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Allergies:

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

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am