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: 1450228
Sex: F
Age: 60
State: MD

Vax Date: 03/17/2021
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: No allergies to meds, foods or other.

Symptom List:

Symptoms: I experienced muscular pain, my shoulder joints would not work so I could not lift.

Other Meds: No prescriptions or over the counter meds.

Current Illness: No other illnesses.

ID: 1450229
Sex: F
Age: 63
State: CA

Vax Date: 01/18/2021
Onset Date: 02/09/2021
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:

Symptoms: Bilateral detached spontaneous retinas requiring laser, complete vitrectomy and gas bubble.

Other Meds: HRT

Current Illness: none

ID: 1450230
Sex: M
Age: 0
State: LA

Vax Date: 06/18/2021
Onset Date: 06/24/2021
Rec V Date: 07/06/2021
Hospital: Y

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Tested positive for coronavirus and strep pneumonia. Turned into Bacterial Meningitis which led to multiple organ failure and spontaneous bacterial paratonalious. (Other complications unknown at this time due to still being in a medical coma.)

Other Meds: Gerber Smooth Probiotics MiraLAX

Current Illness: Ear Infections Low Grade Fever

Date Died: 06/29/2021

ID: 1450231
Sex: F
Age: 50
State: CA

Vax Date: 06/22/2021
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: Unknown

Symptom List:

Symptoms: Pt. went to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177. The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch. It was too painful to fully extend her arm. There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing. She went to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type). One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down. She was very tired and her arm did not lessen in pain as the days passed. On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting. At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television. As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle. He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place. He removed and called EMS immediately, not detecting any obvious signs of life. Her daughter came into the room and immediately started CPR. Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m. Paramedics departed and the Police arrived staying until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility. The Family is seeking an autopsy and the coroner is claiming one is not necessary. The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted. Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her in the emergency and days in the hospital on oxygen. She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis. Her last episode of atrial fibrillation which landed in the hospital was 12/29/16. She has been on anticoagulants for many years. Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy. She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death.

Other Meds: Eliquis

Current Illness: Unknown

ID: 1450232
Sex: F
Age: 68
State: MA

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: sulfa, erythromycin, statins,

Symptom List:

Symptoms: New symptom of sharp pain in sternum area worse on any movement (side to side in bed, lifting, reaching.) Lingered, finally went to Medical urgent care on April 11, seen by Dr., given medrol pack, and muscle relaxant-, EKG-normal. After 1 week, pain no better. Pain continued to linger, present every day, sharp, especially on movement. Seen by my new primary (Dr.) on 6/17 because pain had not abated, sometimes severe-took naproxen as needed. Dr. diagnosed me with costochondritis, drew blood work, checked for inflammation, clotting time, etc., ekg and chest xray done- all results were normal. Suggested I take NSAIDs. To date pain continues limiting my activities

Other Meds: Protonix, losartan, fluoxetine, wellbutrin sr, zyrtec, singulair, azelastine nasal spray, nasonex nasal spray, trazadone, centrum mvi, metamucil, citracal+D3,

Current Illness: none

ID: 1450233
Sex: F
Age: 56
State:

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 07/06/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Patient experienced fever and chills after her 2nd Moderna vaccine.

Other Meds:

Current Illness:

ID: 1450234
Sex: M
Age: 45
State: VA

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

Vax Type:
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Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: The patient stated that one hour after receiving his second dose, everything started to turn yellow, he got dizzy and lightheaded, and his hearing was "off"/impaired. He closed his eyes for about 20-30 seconds, and when he opened his eyes again, he felt better. He has not had any issues since that episode.

Other Meds:

Current Illness:

ID: 1450235
Sex: F
Age: 48
State: WI

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: Aspirin, Latex Gloves

Symptom List:

Symptoms: Patient was staying in store for mandatory 15 min wait period. patient fell in the back of the store complaining of severe dizziness. fall was not seen by store personel. I (pharmacist was called) 911 was immediately called as injuries were unknown from both fall and the nature of the reaction to the vaccination. patient complained of some tingling of the lips but refused epinephrine shot. as dizziness subsided, patient experienced severe nausea and some shivering. EMS arrived shortly after. patient refused transport, yet did allow monitoring in the Ambulance. Results unknown.

Other Meds: Omeprazole, Trazodone, bupropion, Duloxetine, Topiramate, Atorvastatin, Gabapentin,

Current Illness: none known

ID: 1450236
Sex: M
Age: 38
State: NV

Vax Date: 04/03/2021
Onset Date: 04/21/2021
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:

Symptoms: 18 days after 2nd vaccination I started feeling intermittent paresthesias in my feet. These slowly progressed to my lower legs. After about a week I noticed numbness/paresthesias in my fingers and forearms. About a week later it progressed to my face and is now also in my oral cavity (teeth, tongue, and posterior oropharynx). The paresthesias have been accompanied with intermittent mild vertigo, headaches, mild shortness of breath, and palpitations.

Other Meds: Vitamin d3, zinc, super b complex, c

Current Illness: None

ID: 1450237
Sex: M
Age: 46
State: WI

Vax Date: 07/02/2021
Onset Date: 07/04/2021
Rec V Date: 07/06/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient received his first dose of the Pfizer Covid-19 vaccine on 7/2/21. Later that day the tip of his tongue had no taste. About 72 hours later, patient experienced numbness/tingling down the side of his face. He went into the emergency room and had workup/CT scan. Patient was diagnosed with Bell's Palsy.

Other Meds: Montelukast

Current Illness:

ID: 1450238
Sex: M
Age: 63
State: OR

Vax Date: 01/15/2021
Onset Date: 01/21/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: ACE

Symptom List:

Symptoms: Missing Heart Beat. Often 1/4 beats were missed and at times 1/2 the beats were missing. Heart Rate slowed to 38 beats per min per my home BP monitor. These events were sudden, lasting hours and repeated daily.

Other Meds: omeprazole, D3, Magnesium

Current Illness: None

ID: 1450239
Sex: F
Age: 33
State: IN

Vax Date: 06/30/2021
Onset Date: 07/01/2021
Rec V Date: 07/06/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: Day after: Sore arm Following day: fever, chills Following day: headache, cold/flu-like symptoms Following day: Underarm pain and swelling, cold/flu-like symptoms (stuffy nose, fatigue, mucus from nose-green/yellow) Today is Tuesday, almost a week since vaccine: cough, a lot of mucus from nose, temp is 99.1, underarm pain is diminishing.

Other Meds: None

Current Illness: Sore throat.

ID: 1450240
Sex: M
Age: 60
State:

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

Vax Type:
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Lab Data:

Allergies: Wheat , Shellfish

Symptom List:

Symptoms: Dizzyness, feeling faint , lasted for 15 to 20 minutes. Feel more sensitive to dizzyness if roll on ground or spin ever since.

Other Meds: None

Current Illness: None

ID: 1450242
Sex: F
Age: 51
State: CT

Vax Date: 12/28/2020
Onset Date: 03/08/2021
Rec V Date: 07/06/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Vax Route:
Vax Site:

Lab Data:

Allergies: None.

Symptom List:

Symptoms: Since last VAERS report- -03/08/2021 I was recently diagnosed with severe hip, knee, groin pain, and back pain. I ended up needing to get a referral to see a rheumatologist because my orthopedics doctor couldn't figure out what was wrong. My rheumatologist put me on prednisone taper and leflunomide and it seems that I'm getting some relief with those two medications and I have to follow-up with my rheumatologist soon. I never had any inflammatory issues before so this is a whole new diagnosis for me.

Other Meds: Synthroid, Sertraline.

Current Illness: None.

ID: 1450243
Sex: M
Age: 71
State: CA

Vax Date: 03/01/2021
Onset Date: 05/31/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: scallops

Symptom List:

Symptoms: Facial muscle weakness developed in left jaw within 4-5 weeks. Within two weeks of that complete paralysis of left eye, blocking vision and making employment nearly impossible. Went to Dr. where blood work indicated his immune system was working overtime. When eye started drooping, within one week went to ER. No major cause. Best educated diagnosis ... Bell's Palsy, perhaps instigated by the exposure to virus in vaccine.

Other Meds: Calcium Citrate, Pure Defense, Turmeric, Phenocane

Current Illness: none

ID: 1450244
Sex: U
Age: 15
State: CA

Vax Date: 05/25/2021
Onset Date: 05/26/2021
Rec V Date: 07/06/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: On 5/26/21, the day after receiving COVID-Pfizer vaccine #1, Patient has been urinating blood , experienced loss of appetite, weight loss, headaches and fatigue. He is currently a patient at A medical center. His doctors' have completed blood work , urine samples , a CT scan , ultra sound and cystoscopy.

Other Meds:

Current Illness:

ID: 1450245
Sex: M
Age: 14
State: CA

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

Vax Type:
Manufacturer:
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Lot:
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Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Chills-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: initial bp: 99/60 hr 65 and 10 minutes later 112/73 and hr70

Other Meds:

Current Illness:

ID: 1450246
Sex: F
Age: 38
State: MN

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient tested positive for COVID-19 on 7/5/21

Other Meds:

Current Illness:

ID: 1450247
Sex: F
Age: 24
State: MD

Vax Date: 04/13/2021
Onset Date: 04/19/2021
Rec V Date: 07/06/2021
Hospital:

Vax Type:
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Lot:
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Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Symptoms started to appear six days after my first shot. On the morning of 4/19, I woke up with sharp and stabbing chest pain which radiated to my back. I was unable to take full breaths. This chest pain continued for two weeks. In addition to the chest pain and inability to take a full breath, I also felt chest discomfort, like my chest was full of something. Wooziness (feeling like I?m going to faint), weakness, and heart palpitations also accompanied my symptoms. Sometimes, my heart palpitations s are so bad that it shocks my body. These symptoms are still here, 2 months after getting my first shot.

Other Meds: Phosphate 250 neutral Iron

Current Illness: Iron deficiency anemia Diarrhea

ID: 1450248
Sex: F
Age: 18
State:

Vax Date: 07/05/2021
Onset Date: 07/05/2021
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:

Symptoms: Client became dizzy, pale, and had 5 second loss of consciousness about 2 minutes after vaccine administration. Client stated feeling warm and lightheaded. Cool towels placed on client's forehead and neck. Reported feeling much better about 20 minutes after onset. Vital signs returned to baseline about 5 minutes after onset.

Other Meds: None

Current Illness: No

ID: 1450249
Sex: F
Age: 50
State: MN

Vax Date: 06/10/2021
Onset Date: 06/17/2021
Rec V Date: 07/06/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Vax Route:
Vax Site:

Lab Data:

Allergies: chlorhexidine gluconate Rash Environmental clindamycin Rash Environmental duloxetine GI intolerance Environmental gabapentin Other (see comments) Environmental lansoprazole Rash Environmental nabumetone Rash Environmental naproxen sodium GI intolerance Environmental oxymetazoline Palpitations Environmental pseudoephedrine HCl

Symptom List:

Symptoms: Rapid heartbeat at erratic times, along with sweating, chest pain, headaches, tinnitus

Other Meds: Restasis Magnesium Aloe sucralfate 1 gram tablet multivitamin Tylenol

Current Illness:

ID: 1450250
Sex: F
Age: 42
State: OK

Vax Date: 06/29/2021
Onset Date: 07/02/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: Codine

Symptom List:

Symptoms: I woke up in my sleep feeling my chest vibrating like a cell phone . Every day since I have chest pains. I am nauseous off and on.

Other Meds: Albuterol

Current Illness: None

ID: 1450251
Sex: F
Age: 53
State: MI

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: Codeine, robatussin

Symptom List:

Symptoms: I am tired all the time. Vaccine has caused my psorcsis the flare up in a way it has never flared up in my life.

Other Meds: Yes, daily medication

Current Illness: No

Date Died: 06/24/2021

ID: 1450252
Sex: F
Age: 30
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: my wife died of a hart attack 4 days after her shot she was only 30 years old,. with no previous symtoms. please explain to me how this could happen.

Other Meds:

Current Illness:

ID: 1450253
Sex: M
Age: 95
State: KY

Vax Date: 01/20/2021
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: Pcn [Penicillins]

Symptom List:

Symptoms: TEST POSITIVE FOR COVID 07/01/2021

Other Meds:

Current Illness:

ID: 1450254
Sex: F
Age: 52
State: VA

Vax Date: 05/15/2021
Onset Date: 06/10/2021
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:

Symptoms: Afib Episode

Other Meds: None

Current Illness: None

ID: 1450255
Sex: F
Age: 37
State: GA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies

Symptom List:

Symptoms: With in 5 minutes of receiving the vaccine, I started to feel light headed, dizziness, and faint. Then I felt a heat that traveled from the top of my head to me throughout my body. It caused my eyes, nose, ears, and throat to itch and burning. My eyes were itching and burning and I had an uncontrollable cough that I couldn?t control and had the feeling of my throat getting tight. I made it to get help from employee health nurse, I was given Benadryl po. And my vitals were checked. My blood pressure and heart rate was extremely elevated. The Benadryl didn?t help the coughing , so I was sent to the emergency room and given over Benadryl and steroids. The iv Benadryl was not effective so they gave my the iv steroid which helped some. I had to take steroids for two weeks to keep form coughing. I also had to got to the emergency and doctors office due to recurring elevated blood pressure, headaches, dizziness, fatigue. I was put on blood pressure medication for 3 months.

Other Meds: None

Current Illness: None

Date Died: 04/06/2021

ID: 1450256
Sex: M
Age: 76
State: FL

Vax Date: 02/28/2021
Onset Date: 03/08/2021
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:

Symptoms: Wife stated that Husband passed after receiving dose of Pfizer vaccine, he developed a Guillain-Barre Syndrome after receiving vaccine. Wife stated that he lost ability to walk, ability to speak was severely impacted, had difficulty eating and drinking bc his throat muscles were effected from the syndrome. Then, he couldn't sit up in bed. Then, after was diagnosed that's when his kidneys started to fail and then his heart stopped. DOD: 04/06/2021

Other Meds: Lipitor, Diabetes medication, plavis

Current Illness:

ID: 1450257
Sex: F
Age: 14
State: PR

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

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Vaccine was administered to a person under 18 years of age.

Other Meds:

Current Illness:

ID: 1450258
Sex: F
Age: 18
State: NC

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Passed out (twice) within 5 minutes of receiving shot. 1st time she was standing and fell to the ground. 2nd time she passed out while still laying on ground.

Other Meds: None

Current Illness: None

ID: 1450259
Sex: F
Age: 58
State: MI

Vax Date: 03/26/2021
Onset Date: 03/28/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List:

Symptoms: Two days after the first Covid Shot I bit my tongue in my sleep and ended up unconscious on the floor and rushed to hospital. Nothing determined but Syncope. I followed up with a neurologist who ordered an EEG. In between i received my second Covid Shot and 6 days later i bit my tongue in my sleep. I did not pass out this time as i stayed in bed. The EEG results showed sharp waves in the left temporal section of the brain. The neurologist ordered an MRI which came back normal. Currently, the neurologist has diagnosed me with having seizures. I am a very healthy person, no history of seizures, not family history, no medical issues, i do not take prescription drugs and rarely get any type of vaccinations until now. The neurologist thinks it is coincidental, and with my stellar health record i do not....I have not had another nocturnal tongue biting since. I felt the need to report this situation.

Other Meds: Standard Process whole plant based food supplements such as Calci food

Current Illness: None

ID: 1450260
Sex: F
Age: 65
State: NY

Vax Date: 02/22/2021
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: PCN, SULFA

Symptom List:

Symptoms: DVT LEFT LEG AND PULMONAEY EMBOLISM SHORTNESS OF BREATH ABOUT 6 WEEKS AFTER 2ND DOSE

Other Meds: OPTAVIA DIET SUPPLEMENT, CALCIUM, VIT D

Current Illness: NONE

ID: 1450261
Sex: M
Age: 52
State: SC

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 07/06/2021
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Allergies: None

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Symptoms: Bowel movements, stutterring, stimmering

Other Meds: Advil

Current Illness: Autistic

ID: 1450262
Sex: F
Age: 39
State: GA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 07/06/2021
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Allergies: No

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Symptoms: Lips started itchy at the time of vaccination. Later that day I started having shortness of breathe and racing heart rate. Went to the ER continued to have racing heart rate for 2 weeks. I had cold sweats, fatigue, shortness of breathe. Still having racing heart rate. Had to be put on medication to slow heart rate down.

Other Meds: Yes

Current Illness: No

ID: 1450263
Sex: M
Age: 42
State: FL

Vax Date: 06/04/2021
Onset Date: 06/29/2021
Rec V Date: 07/06/2021
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Allergies: No

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Symptoms: Pain on upper left part of back. Stiffness on left arm.

Other Meds: No

Current Illness: No

ID: 1450264
Sex: M
Age: 21
State: WA

Vax Date: 06/28/2021
Onset Date: 07/02/2021
Rec V Date: 07/06/2021
Hospital: Y

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Allergies: none

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Symptoms: received Moderna COVID-19 vaccine on 6/28 and since 6/29 has had worsening chest pain with shortness of breath, but it was most notable yesterday. He went to urgent care , and had an EKG, with the results being abnormal. He reports it feels better when laying down and is exertional. He had chills, abdominal pain and myalgias, headache.. impression is myocarditis likely related to the vaccine.

Other Meds: none

Current Illness: none

ID: 1450265
Sex: M
Age: 40
State: SC

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 07/06/2021
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Allergies: N/A

Symptom List:

Symptoms: Arm pain in shot area and reduced range of motion

Other Meds: Omprezol, turvata, and one a day men?s

Current Illness: N/A

ID: 1450266
Sex: F
Age: 30
State: NY

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 07/06/2021
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Symptoms: Patient has pain from the injection site to the elbow.

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Current Illness:

ID: 1450267
Sex: F
Age: 38
State: MD

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 07/06/2021
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Allergies: shellfish, contrast dye (MRI, etc.)

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Symptoms: initial shot 3/9-diarrhea began the day after vaccination and is still occurring today. Rashes began appearing on both breasts as well as arm pits and arms. The rashes are gone but the diarrhea is occurring daily. Arm pain in both injection sites is still occurring but not daily or constantly, only on occasions.

Other Meds: none

Current Illness: none

ID: 1450268
Sex: M
Age: 52
State: SC

Vax Date: 05/08/2021
Onset Date: 05/09/2021
Rec V Date: 07/06/2021
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Allergies: none

Symptom List:

Symptoms: Red spots on chest, trouble breathing, fever , stuttering, stammering, bowel movements once every hour

Other Meds: Advil

Current Illness: Autism

ID: 1450269
Sex: M
Age: 37
State: FL

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/06/2021
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Allergies: cats, pollen, amoxicillin

Symptom List:

Symptoms: Arms, neck, and back of head turned red and itchy, shortly followed by mild shortness of breath

Other Meds: none

Current Illness: I had a cold (tested negative for covid) 2 weeks prior

ID: 1450270
Sex: F
Age: 27
State: MI

Vax Date: 03/04/2021
Onset Date: 03/15/2021
Rec V Date: 07/06/2021
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Allergies: N/a

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Symptoms: Had generalized teeth sensitivity to cold about 10 days after 1st vaccine. Ended up getting an Rx for a steroid dose, which took care of it. 3 days after 2nd dose, generalized inflammation, redness, and sensitivity developed all around my gums/teeth. Took another round of steroids, still not 100% recovered.

Other Meds: Levothyroxine, birthcontrol

Current Illness: N/a

ID: 1450271
Sex: M
Age: 66
State:

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

Symptom List:

Symptoms: None stated.

Other Meds: Nonr

Current Illness: None

ID: 1450272
Sex: F
Age: 21
State:

Vax Date: 06/08/2021
Onset Date: 06/09/2021
Rec V Date: 07/06/2021
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Allergies: N/A

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Symptoms: The week following my vaccination I experienced menstrual spotting, cramps, and nausea.

Other Meds: Birth Control

Current Illness: None

ID: 1450273
Sex: F
Age: 38
State: MO

Vax Date: 06/30/2021
Onset Date: 07/01/2021
Rec V Date: 07/06/2021
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Allergies: dicloxacillin

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Symptoms: I received the vaccine in my left arm around 11:00 am on June 30, 2021. Tingling/Numbness started in my right arm at approximately 2:00 am July 1, 2021. The tingling/numbness remained in the right arm and traveled into my right leg at approximatey 3:00 pm. Around 12:00 am the tingling and numbness were still in my right arm and leg, and now traveling up my left leg. By 8:00 am the tingling and numbness had subsided.

Other Meds: Remicade, Hydroxychloroquine, Restasis

Current Illness:

ID: 1450274
Sex: F
Age: 63
State: NY

Vax Date: 04/05/2021
Onset Date: 05/06/2021
Rec V Date: 07/06/2021
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Allergies: None

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Symptoms: Experienced sever burning and rash on the left side of my chest that extended to the left part of my upper back near the shoulder blades. Upon seeking medical care, I was informed that I had shingles.

Other Meds: Vitamin D, multivitamen, Calcium supplement

Current Illness: None

ID: 1450275
Sex: F
Age: 43
State: CA

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 07/06/2021
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Allergies: Gluten

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Symptoms: High fever, intense headache first 4 days Major hormone disruption: heavy menstrual bleeding 10 days prior to expected period ; impact on energy, mood; swollen breasts/nipples. Bleeding stopped, other symtpoms weakening but not entirely gone. Not due next period yet (assuming it will arrive my normal 29 days from the vaccine-induced bleeding). Context: Not pre-menopausal Regular, light/average bleeding, never early Generally well, fit and healthy

Other Meds:

Current Illness:

ID: 1450276
Sex: F
Age: 72
State: MD

Vax Date: 07/05/2021
Onset Date: 07/05/2021
Rec V Date: 07/06/2021
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Allergies: n/a

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Symptoms: Patient had already taken 2 doses of the pfizer in March 2021. She said that her physician told her to get the Janssen vaccine

Other Meds: n/a

Current Illness: n/a

ID: 1450277
Sex: M
Age: 16
State: KY

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 07/06/2021
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Allergies: N/A

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Symptoms: My son began experiencing chest discomfort a few hours after he had received his 2nd dose. The discomfort only increased with his anxiety and having difficulty breathing. He also experienced his heart racing. I took him to the facility the following afternoon - approximately 31 hours after the 2nd dose and the facility completed blood work, x-ray and EKG; I was to follow-up with a cardiologist and that was also completed with Dr. and another EKG was performed, followed by an ultrasound of his heart. I have not received the result of the ultrasound as it was just performed on 06/30/2021.

Other Meds: N/A

Current Illness: N/A

ID: 1450278
Sex: M
Age: 62
State: FL

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 07/06/2021
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Allergies: Penicillin

Symptom List:

Symptoms: Nausea, vomiting, pasted out twice at the pharmacy, Dizziness, Muscle Weakness, Shortness of breath, chest pain and tightness.

Other Meds: Carvedol, Entresto, Rosuvastatin, 325 aspirin, vitamin C, D, one day multi vitamin, chondrotin, Glucosamine, l- Lysine

Current Illness: Heart failure

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm