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: 1470498
Sex: M
Age:
State: HI

Vax Date:
Onset Date: 07/13/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient received 6/8/2021 Given 0.5 mL Lt deltoid IM MOD 034C21A Moderna COVID-19 Vaccine (EUA) History 5/4/2021 Given 0.5 mL L Deltoid IM MOD 002C21A Moderna COVID-19 Vaccine (EUA) completed full vaccination for COVID with moderna and tested positive for COVID-19 on 7/13/21 with mild COVID symptoms. His other family members also tested positive for COVID

Other Meds:

Current Illness:

Date Died: 05/10/2021

ID: 1470499
Sex: F
Age: 64
State: MI

Vax Date: 03/17/2021
Onset Date: 03/20/2021
Rec V Date: 07/14/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot. She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP. After multiple visits, the patient was sent to Hospital. She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19). She returned to hospital on April 25 in distress and diagnosed with COVID. The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021.

Other Meds: flexeril, topamax, maxide, centrum silver, gingko biloba, Norco

Current Illness: UTI

ID: 1470500
Sex: F
Age: 63
State: RI

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Patient states that on the first vaccine she experienced a bad headache which is a common side effect. She states it was the second dose that caused her to have issues with dizziness within an hour after having the second dose. She states the dizziness isn't positional and has been on and off she since had the second dose back in April. She also still has reoccurring headaches and isn't sure if these are contributed to it but the most concern is the dizziness as she states she has a few times where she has had to pull over while driving because of it.

Other Meds:

Current Illness:

ID: 1470501
Sex: F
Age: 50
State: MO

Vax Date: 03/31/2021
Onset Date: 04/14/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: The patient complains of finger tips and feet numb and has also felt "off balance." The patient stated her symptoms have been ongoing for about 3 months

Other Meds: n/a

Current Illness: n/a

ID: 1470502
Sex: F
Age: 51
State: WI

Vax Date: 03/29/2021
Onset Date: 07/13/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: SARS-CoV-2 RdRp Resp Ql NAA+probe~COVID-19 rapid diagnostic test (nucleic acid amplification test NAAT) performed on 7/13/2021. Test came back positive. Case investigation interview with patient has not been conducted as of time of this note.

Other Meds:

Current Illness:

ID: 1470503
Sex: M
Age: 57
State: MA

Vax Date: 07/13/2021
Onset Date: 07/13/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: Penicillin ampicillin keflex SSRIs

Symptom List:

Symptoms: Fever arm pain. Fatigue. Stomachache chills

Other Meds:

Current Illness:

ID: 1470504
Sex: F
Age: 13
State:

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: No reaction. Wrong vaccine given

Other Meds: essential oils

Current Illness: no

ID: 1470505
Sex: M
Age: 51
State: MI

Vax Date: 04/26/2021
Onset Date: 05/09/2021
Rec V Date: 07/14/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient suffered a Heart Attack 13 days after receiving his second covid vaccine. The heart attack was unknown and presented as the flu at the time. 9 days later he had a second event that finally drove him to the hospital. A bout 3 days after entering the hospital he suffered a dual hemispherical stroke. NOTE: this report is being filed by me as POA as requested by his family.

Other Meds: Daily vitamin, Motrin

Current Illness: Lower back pain

ID: 1470506
Sex: F
Age: 69
State: MO

Vax Date: 07/10/2021
Onset Date: 07/11/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List:

Symptoms: Patient states she developed a mild case of "Covid tongue." Patches appearing on the tongue.

Other Meds: Unknown

Current Illness: Unknown

ID: 1470507
Sex: F
Age: 40
State: PA

Vax Date: 02/05/2021
Onset Date: 02/19/2021
Rec V Date: 07/14/2021
Hospital: Y

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

Lab Data:

Allergies: Allergies to nuts

Symptom List:

Symptoms: Afib r/t graves

Other Meds: Zoloft 150 mg

Current Illness: Was hospitalized for atrial fibrillation r/t Graves disease. My TSH was less then 0.007. Also starting around May 1 2021 i started to exhibit Asthma symptoms which i have never had. Now I have to take a daily inhaler and rescue inhaler

ID: 1470508
Sex: F
Age: 39
State: CA

Vax Date: 04/14/2021
Onset Date: 04/24/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: I was unable to stand or walk. When trying to walk I was tripping over my feet and falling. I had to be held up. I could not walk or stand on my own and I was extremely dizzy when upright.

Other Meds: Lamictal, Onfi, Zonisimide, Zoloft, Ambien CR, Red Yeast Rice, CQ10, Multi Vitamin

Current Illness: None

ID: 1470509
Sex: F
Age: 42
State: ME

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

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: On the fifth it?s self I was tired felt sick to my stomach was weak on the seventh I woke up and couldn?t see lost my near site vision called my doctor and got my eyes examined and found out I lost my near sight I need glasses now lost my near side and some of my far vision on the 11th went to go see my dr. was having trouble breathing and had a sore throat I have respiratory issues throat issues losing my hair I have recently had an upper G.I. colonoscopy have been having lots and lots of health issues ever since my second Covid shot

Other Meds:

Current Illness: N/a

ID: 1470510
Sex: F
Age: 43
State: OH

Vax Date: 07/13/2021
Onset Date: 07/14/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Pediatric dose given instead of Adult dose

Other Meds: None

Current Illness: None

ID: 1470511
Sex: M
Age: 76
State: NC

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List:

Symptoms: patient previously received both doses of Moderna and tolerated well. patients doctor ran spike protein test to verify immunity, even though patient is immunocompromised (therefore he was originally told the efficacy could be decreased). Patient states he was not immune and needed another dose of vaccine. patient and doctor were explained what the EUA allowed for us to do. Dr wrote script for patient to receive a dose of j&j vaccine.

Other Meds: unknown

Current Illness: unknown

ID: 1470512
Sex: M
Age: 66
State: NJ

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient previously received Moderna vaccine on 6/23/2021. Patiwnt mistakenly given Pfizer vaccine 21 days later. No immediate adverse reactions noted by patient who was informed of administration error.

Other Meds:

Current Illness:

ID: 1470513
Sex: F
Age: 22
State: NJ

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List:

Symptoms: Patient informed that she went to store with her sister 3-4 hrs after she recieved her first COVID vaccine. She said she felt lightheaded and nauseous and attempted to sit down. She reported that she felt "off" and that it was like she was "under water and her ears were clogged" shortly before she had the episode. Her sister who was with her reported that she fell to the floor with her hands/arms postured toward her chest, and could be audibly heard "frothing from her mouth" as per sister's report s he still had her mask on. Sister informed that she stopped breathing during this time for an unknown period of time, and was sweating a lot with body "tightness." After the episode, Patient reported that she felt ok other than a very bad headache. 911 was called during the episode for transport to the hospital.

Other Meds: none known

Current Illness: none known

ID: 1470514
Sex: M
Age: 35
State: SC

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Persistent arm pain, weakness, feels like an injury. Left shoulder and wrist. Rested for 2.5 weeks and the pain subsided some but still remains (1 month so far). Difficulty sleeping on left side.

Other Meds: None

Current Illness: None

ID: 1470515
Sex: F
Age: 40
State: OH

Vax Date: 07/13/2021
Onset Date: 07/13/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: HAS RASH TO RT ARMPIT, NECK, CHEST AND LT WRIST. DENIES ANY DIFFICULTY BREATHING OR SWALLOWING. ADVISED TO USE COOL PACK AND BENADRYL FOR COMFORT AND CALL PCP TO SEE IF CORTISONE SHOT OR OTHER TX NEEDED. GO TO ER IF SX WORSEN/JAW

Other Meds:

Current Illness:

ID: 1470516
Sex: F
Age: 67
State: HI

Vax Date: 04/19/2021
Onset Date: 06/29/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: Montelukast

Symptom List:

Symptoms: Pt tested positive for covid infection on 7/13/21

Other Meds: Lisinopril, atorvastatin

Current Illness: None

ID: 1470517
Sex: F
Age: 41
State: WI

Vax Date: 04/02/2021
Onset Date: 07/13/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: SARS-CoV-2 RdRp Resp Ql NAA+probe~COVID-19 rapid diagnostic test (nucleic acid amplification test NAAT) performed on 7/13/2021 at a pharmacy. Case investigation interview with patient has not be conducted as of the time of this note.

Other Meds:

Current Illness:

ID: 1470518
Sex: F
Age: 60
State: FL

Vax Date: 04/07/2021
Onset Date: 07/02/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: penicillan

Symptom List:

Symptoms: Left jaw swelled at throat, under ear and jaw bone area. Advil, Tylenol, ice, moist heat, Arnica cream, triple antibiotic ointment over area Swelling reduced to normal and pain-free by 07/14/2021

Other Meds: Lisinopril, HRT (estradial, progesterone, testosterone), Flonase Supplements: Fish oil. Omega 3 oil, vitamin C, Biotin, B12, milk thistle, astragalus, alpha lipoic acid, beta glucan, glucosomine, turmeric, bergamot, CoQ10, SamE, zinc, vitam

Current Illness: none

ID: 1470519
Sex: M
Age: 31
State: CA

Vax Date: 04/03/2021
Onset Date: 07/03/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: Due to adverse event, we have listed terbinafine as a possible allergy

Symptom List:

Symptoms: It was a fully body rash the developed over the course of 24 hours. The night before I noticed a bit of itching an a bump that seemed like a bug bite. The following morning I had many such bumps in clusters on my neck and arm (and a few more bumps on my legs). At the time I thought I had bed bugs. By about 6 PM, I had more bumps and many of them had spread and turned into welts. There were bumps and rashes on all limbs, my neck and redness on my chest and back, The itchiness was severe. While not extremely painful, it was extremely uncomfortable and seemed like it would be hard to sleep or do anything. Around 9 PM I took Allegra to try and alleviate symptoms. I also used hydrocortison cream and calamine lotion all over my body to reduce symptoms of itching. By around 11 PM, I the rash was spreading into my face in the form of some bumps and redness. I visited the ER after consultation with a nurse over the phone, who said that anaphylactic shock could be a possibility and that it would be best to go in. At the ER, I was treated with 50 mg diphenhydrAMINE , 20 mg famotidine , 10 mg dexAMETHasone. I was given a prescription for dexAMETHasone and instructed to take a refill in 3 days if I still had symptoms. I was discharged a couple hours later. I did not need to refill the dexAMETHasone as the sympoms subsided and was almost unnoticeable by day 3 (and completely gone by day 4).

Other Meds: None at time of vaccination. Was taking terbinafine at time of adverse event (for 29 days).

Current Illness: None

ID: 1470520
Sex: M
Age: 27
State: KY

Vax Date: 04/07/2021
Onset Date: 07/03/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: became symptomatic 07/03, at home test positive, rapid antigen invalid and PCR inconclusive.

Other Meds: no

Current Illness: no

ID: 1470521
Sex: F
Age: 91
State: LA

Vax Date: 06/09/2021
Onset Date: 06/10/2021
Rec V Date: 07/14/2021
Hospital: Y

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

Lab Data:

Allergies: unknown

Symptom List:

Symptoms: The day after vaccination EMS was called to the patients home EMS States: Pt had right sided gaze noted possibly for the past 2 days. upon EMS arrival pt had tonic clonic seizure activity x3, family denies history of seizures. 12 lead EKG showed afib RVR. Pt was stoke activated and transported to the hospital.

Other Meds: unknown

Current Illness: Dementia & Diabetes

ID: 1470522
Sex: M
Age: 60
State: CA

Vax Date: 05/01/2021
Onset Date: 06/01/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Sulfa

Symptom List:

Symptoms: This may just be coincidental, but developed polymyalgia rheumatica within one month after the second dose. Diagnosed with PMR on June 12, 2021. ESR 40 mm/hr, CRP 87.3 mg/L. Severe pain in hips and shoulders in the morning. Very difficult to get out of bed. Some stiffness in hands. Some stiffness in legs. Pain fades in late morning. Had been doing very high level of work/exercise during 3 months previous. Also got Shingles vaccine in January 2021. Currently on Prednisone 25mg/day. Pain reduced from level 7-8 to 2-3.

Other Meds: Claratin, Flonase

Current Illness: None

ID: 1470523
Sex: F
Age: 49
State: NH

Vax Date: 12/29/2020
Onset Date: 05/17/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: I have always had HYPOGLYCEMIA, went for my lab work in preparation for my yearly physical and found out i am unexplained diabetic. None of the medications so far, that they have tried has improved my blood sugar or HBA1C.

Other Meds: Cymbalta Xanax

Current Illness: none

ID: 1470524
Sex: F
Age: 31
State: MI

Vax Date: 12/01/2020
Onset Date: 02/01/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Menstral cycle has been every 4th Wednesday my whole life and after the covid vaccine it has fluctuated tremendously.

Other Meds: Birth control

Current Illness:

ID: 1470525
Sex: M
Age: 26
State: VA

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: None at time of encounter.

Symptom List:

Symptoms: Pt is a 26 yo M w/ a PMH of COVID 19 infection (resolved), seasonal allergies, and head trauma (2019). He arrived at Facility on 6/15/21. On 7/8/21, pt had his tooth extracted (#30) at 0930 without complication. At 1200 same day, he received the first dose of the COVID-19 Moderna vaccine. At 1323, the pt was found lying on couch in dorm c/o pain in dental area, dizziness, and lightheadedness (BP 150/77, HR 91, RR 18, O2sat 99%). Heart sounds normal, breath sounds absent on auscultation. Pt was confused and in distress. (unable to respond verbally). His eyes were red and tearing. Tongue and lips appeared red and were mildly swollen. RN was unable to visualize throat in dorm. Epipen was administered at 1340 which resulted in an immediate decrease in symptoms. Pt was calmer and in less distress. Normal uvula with some narrowing of airway noted. He was then taken to clinic and was calm but shaking with an open airway and mild swelling noted; VS wnl. He left via EMS in stable condition to ED at 1400 for evaluation. Pt returned from ED same day in no acute distress but still c/o dental pain (5/10). He was last evaluated by provider on 7/9/21 and is asymptomatic. Denies swelling, SOB, or fatigue. No bleeding or swelling at dental extraction site noted. Pt evaluated by dental on 7/12/21. No swelling, erythema, exposed bone, or signs of infection noted. Area appears to be following normal post-operative course. Pt remains asymptomatic. ED summary- Medical Center (7/8/21): Pt sent to ED for allergic reaction/near-fainting (vagal reaction); Assessment: ?Most likely the syncopal episode was due to vasovagal syncope. Cannot rule out allergic reaction to the COVID 19 vaccination?. Drug screen negative. Discharged on 7/8/21.

Other Meds: CETIRIZINE 10MG, SIG: 1HS. IBUPROFEN 600MG, SIG: 1TID PRN

Current Illness: Dental extraction same day: 07/08/21. Seasonal allergic rhinitis, epigastric pain, headache, change in bowel habits.

ID: 1470526
Sex: M
Age: 18
State: WI

Vax Date: 06/29/2021
Onset Date: 07/04/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Five days post vaccination the patient was participating in a cross country meet. While running, the patient lost consciousness and needed to be rushed via ambulance to the emergency department. Patient stated he had no abnormal feelings leading up the the syncopal event. Patient's mother stated he was unconscious for 20 minutes, but she was unable to confirm. Also, stated patient vomited multiple times en route to the hospital. Treatment was performed in the emergency department, so I am unaware of exact therapies.

Other Meds: N/A

Current Illness:

ID: 1470527
Sex: M
Age: 60
State: WA

Vax Date: 01/08/2021
Onset Date: 06/14/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: sulfa, latex

Symptom List:

Symptoms: Chronic lethargic, headaches, stiff muscles, lightheadiness

Other Meds: Synthroid, lisinopril, topiramate, amiodipine, wellbutrin

Current Illness:

ID: 1470528
Sex: F
Age: 63
State: CA

Vax Date: 05/13/2021
Onset Date: 05/30/2021
Rec V Date: 07/14/2021
Hospital: Y

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

Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: Guillan-Barre Syndrome - with slow neurologic recovery. Residual deficits include significant generalized weakness, dysphagia and dysphonia, trach dependent and PEG tube dependent. Also with urinary retention and poor rectal tone requiring intermittent disimpaction. Continue supportive care including PT/OT, indwelling Foley catheter and daily disimpaction/stool softeners as needed. Fortunately, patient has had some evidence of minor improvement (evidence of flexion extension of the right arm and flexion of the right wrist). Transferring from our facility Hospital today 7/14/21. Accepting physician.

Other Meds: None

Current Illness: None

ID: 1470529
Sex: F
Age: 15
State: IL

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Syncope episode/shaking/seizure low blood pressure transported via ambulance to ER

Other Meds: None

Current Illness: None

ID: 1470530
Sex: M
Age: 51
State: PA

Vax Date: 06/17/2021
Onset Date: 06/25/2021
Rec V Date: 07/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Eosinophilia, low grade leukocytosis, monocytosis, without neutrophilic predominance patient received vaccine on 6/17. These were normal when checked 6/3 monocytes and wbc normal when check 6/16 (eso not checked 6/16) Next time these labs were check was on 6/25 - WBC and eso - elevated eosinophils & monocytes remained elevated until 7/13 WBC still elevated more substantial now - maybe be increased for other reasons now Inpatient from 6/27- to present Patient admitted for other reasons -

Other Meds:

Current Illness:

ID: 1470531
Sex: M
Age: 75
State: CO

Vax Date: 02/01/2021
Onset Date: 03/01/2021
Rec V Date: 07/14/2021
Hospital: Y

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Allergies: sulfa, penicillin

Symptom List:

Symptoms: GBS/Arachnoiditis, flaccid weakness lower ext, pain and neurogenic bowel bladder.

Other Meds: Finasteride, tamsulosin, MVI, Vit C Vit D3, ASA 81 mg

Current Illness: none

ID: 1470532
Sex: F
Age: 59
State: NC

Vax Date: 01/28/2021
Onset Date: 02/01/2021
Rec V Date: 07/14/2021
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Allergies: shrimp, animals (some), outdoor allergies (pollen, weed, grass) Levaquin, oxi codone, morphine

Symptom List:

Symptoms: Vaccine on Thursday, Fever and aches on Friday and Saturday. Sunday got out of bed for a bit and tried to walk around. Weak. On Monday I couldn't step up on my car sideboard. No muscle. Got to work, no muscle on stairs. Figured just fatigue from vaccine, not sure. Next day called dr. crying because I was depressed, felt lousy, muscle loss. Went in and had full blood work done. Came back hyperthyroidism so began meds immediately. Allergic reaction to 1st med so after 6 weeks it was changed to a lighter med. Ended up a couple of weeks ago turning into Graves Disease and TEDS (Thyroid eye disease). It's like the thyroid just woke up and started attacking everything after the vaccine. If I could go back I would. I miss feeling healthy and being able to eat what I want. On a strict iodine free diet right now. I'm tired of blood work. My eyes feel like there is pressure behind them and light sensitive. Heart palpations keep me awake at night. Somethimes I'm afraid I'm not going to wake up.

Other Meds: Vitamin D, B12

Current Illness: arthritis lower back osteopina diviticulosis

ID: 1470534
Sex: M
Age: 57
State: NJ

Vax Date: 04/02/2021
Onset Date: 05/22/2021
Rec V Date: 07/14/2021
Hospital: Y

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Allergies: none

Symptom List:

Symptoms: suffered a stroke

Other Meds: tirosint, diltiazem, aspirin , mirtazapine, vit d, vit c

Current Illness:

ID: 1470535
Sex: F
Age: 53
State: UT

Vax Date: 05/26/2021
Onset Date: 06/19/2021
Rec V Date: 07/14/2021
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Allergies: N/A

Symptom List:

Symptoms: Pt. states after receiving the Janssen vaccine, 06/19/2021 started experiencing vertigo, chest pain, and Migraine. ER visit 06/23/2021 continuing to experience the symptoms continuing for 10 days. Blood Test ran showing low white blood cell count. Resuming normal activity but continuing to experience short time of vertigo but no longer symptoms.

Other Meds: N/A

Current Illness: N/A

ID: 1470536
Sex: M
Age: 17
State: SD

Vax Date: 07/13/2021
Onset Date: 07/13/2021
Rec V Date: 07/14/2021
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Allergies: NA

Symptom List:

Symptoms: Patient, aged 17, was inappropriately given Moderna COVID19 vaccine, not recommended under the age of 18. Pharmacy attempted to contact patient immediately upon realization, roughly 3 hours after vaccination. Pharmacy finally reached patient's mother the next morning, and she was informed of the error. Patient's mother will monitor patient, and in accordance with CDC recommendation, the pharmacy will plan to administer the second dose of Moderna to the patient at the appropriate time. Patient's mother agrees with this plan. At the time of contact, patient had only developed mild soreness at the injection site.

Other Meds: NA

Current Illness: NA

ID: 1470537
Sex: M
Age: 64
State: NV

Vax Date: 04/13/2021
Onset Date: 04/17/2021
Rec V Date: 07/14/2021
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Allergies: Penicillin

Symptom List:

Symptoms: 4-13,14,15,16 : Fever and sweats while sleeping. Palpitations / rapid heart rate prior to sleep. Upset stomach.

Other Meds: Levothyroxine (200mcg), Novolin insulin 70/30 - 80 units / day

Current Illness: hypothyroidism, possible MEN (undiagnosed), diabetes II.

ID: 1470538
Sex: F
Age: 16
State: NM

Vax Date: 04/08/2021
Onset Date: 07/13/2021
Rec V Date: 07/14/2021
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Allergies: HAY DUST, PINEAPPLES, BANANAS, MELOXICAM, TREE NUTS, KIWI FRUIT, SPINACH, MELONS

Symptom List:

Symptoms: vomited x1 yesterday and has been having nausea all day today. Patient c/o headache, congestion, loss of smell, and fatigue.

Other Meds: Medroxyprogesterone, Multivitamins

Current Illness: URI 4 days prior, Covid 19 test negative.

ID: 1470539
Sex: F
Age: 37
State: CT

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/14/2021
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Allergies: None

Symptom List:

Symptoms: Metallic taste and tingling in throat about 14 mins after shot. This happened with the first shot too. With the 1st shot my throat was itchy/achy for a few days but nothing serious occured with the 1st dose so I said nothing about the sensation with the 2nd dose. About 5 minutes after leaving (20 mins after receiving 2nd dose) the sensation in my throat worsened and my throat tightened. My throat was itchy. Arriving home I took my inhaler (Albuterol) since the tightening feeling somewhat reminded me of the onset of an asthma attack. But finding no relief I took Benadryl and layed down. Since July 2nd my throat has on and off bothered me. Nothing severe or painful just bothersome. It's not constant. Its On and off sometimes I'll experience tightness scratchiness or a odd tingling taste and sometimes I'm fine.

Other Meds: Multi vit

Current Illness: None

ID: 1470540
Sex: M
Age: 15
State:

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/14/2021
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Symptoms: 15 y/o M with hx of autism presents to the ED with chest pain. Pt received 2nd dose of COVID vaccine on Monday. Pt had body aches onset Monday and L sided chest pain onset last night. Per mom, swelling on L side of chest. Pt given Tylenol. Pt denies SOB, cough, diarrhea, emesis. Pt has 38.2C fever onset this morning. No PMH. No sick contacts. NKA. Vaccines UTD. No medications taken on a daily basis. EKG Findings Time 07/14/21 08:36:00, Rate 101, Normal sinus rhythm, T wave inversion in Inferior leads. Case d/w cardiology. Normal troponin level. Unlikely myocarditis induced by COVID vaccine. Recommends mom to follow up with Pediatrician. If pain persists next week can follow up with Cardiology or have Pediatrician do 2nd troponin test done outpatient.

Other Meds:

Current Illness:

ID: 1470541
Sex: F
Age: 32
State: KS

Vax Date: 12/29/2020
Onset Date: 07/09/2021
Rec V Date: 07/14/2021
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Allergies: NONE.

Symptom List:

Symptoms: SARS-COV-19 Infection. Congestion, runny nose, fever, headache, shortness of breath. Fully vaccinated as of 26 January with second booster of Moderna, Lot No. not recorded in patient record.

Other Meds: NONE.

Current Illness: NONE.

ID: 1470542
Sex: F
Age: 29
State: MA

Vax Date: 04/01/2021
Onset Date: 05/10/2021
Rec V Date: 07/14/2021
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Allergies: No

Symptom List:

Symptoms: Severe hives all over my body They appear daily throughout the entire day They are large itchy lumps that come and go with allergy meds allergist suggested for me

Other Meds: No

Current Illness: None

ID: 1470543
Sex: F
Age: 55
State: WA

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 07/14/2021
Hospital: Y

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Allergies: Nuts, red dye

Symptom List:

Symptoms: Difficulty breathing started 3 minutes after injection. At minute 13 I was transferred to the Emergency Room at Hospital, followed by admission to the Intensive Care Unit.

Other Meds: Estradiol, Atorvastatin, Sertraline.

Current Illness: None

ID: 1470544
Sex: M
Age: 76
State:

Vax Date: 01/01/2021
Onset Date: 02/01/2021
Rec V Date: 07/14/2021
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Allergies: none

Symptom List:

Symptoms: Adverse event #1: approximately 12 hrs after receiving the first dose while at home he became paralyzed and fell to the floor. This soon wore off and he was able to get up so medical assistance was not requested. This never happened before. Adverse event #2: approximately 6 weeks after the 2nd dose he noticed onset of swollen lips and large hives over the body. He was started on steroids/montelukast/cetirizine. 2 weeks after stopping the steroids/monteluklast he again broke out in intermittent hives. Pt has never had hives before. He continues to take ceterizine for this issue. He did not see an immunologist for this problem.

Other Meds: biotin , Orally Fish Oil , Orally fluticasone 50 mCg/inh nasal spray See Instructions, USE 1 SPRAY NASALLY DAILY AS DIRECTED gabapentin 300 mg oral capsule 300 mg = 1 Capsule, Orally, BID hydroCHLOROthiazide 12.5 mg oral capsule See Instruc

Current Illness: none

ID: 1470545
Sex: F
Age: 30
State: OK

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 07/14/2021
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Symptoms: Immediately after injection patient began complaining of dizziness. VS WNL. After 15 minutes of sitting, patient got up to walk out and reported difficulty walking. Monitored patient another 15 minutes and symptoms resolved.

Other Meds:

Current Illness:

ID: 1470546
Sex: F
Age: 27
State: TN

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/14/2021
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Allergies: Lactose

Symptom List:

Symptoms: After second vaccination became very nausea, arm is swollen. Arm currently still swollen, bruised, itchy and painful.

Other Meds: Zoloft 50mg, Xulane (Birth control patch), Vitamin D2.

Current Illness: None.

ID: 1470547
Sex: F
Age: 83
State: FL

Vax Date: 04/12/2021
Onset Date: 06/29/2021
Rec V Date: 07/14/2021
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Allergies: Penicillin Myacins Mushrooms Zinc Oxide

Symptom List:

Symptoms: Turned hair colors. Hair was originally white and hair has turned black in the back of her head and new hair growing in the front. Aches in hip, shoulders, elbows and knees. Lasted about 2 weeks.

Other Meds: Nifedipine 60mg once daily Levothyroxine 50mg once daily Simvastatin 5mg once daily Hydrocodone 500mg as needed Stool Softener Multi Vitamins Calcium

Current Illness: Thyroid Issues High Blood Pressure Arthritis

ID: 1470548
Sex: F
Age: 52
State: TX

Vax Date: 07/10/2021
Onset Date: 07/11/2021
Rec V Date: 07/14/2021
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Symptoms: Patient reported significant nausea/vomiting starting day after vaccine dose to post vaccine hotline. Patient directed to see additional care via PCP/urgent care. Unknown if patient sought additional care. Per notes patient has prior history of nausea/vomiting episodes.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm