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: 1478069
Sex: F
Age: 59
State: FL

Vax Date: 06/02/2021
Onset Date: 06/08/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List:

Symptoms: 6/10/21 went to ER cause headache, dizziness, hoarse,fatigue. They took EKG, Chest Xray, blood 3 times cause first 2 clotted. Swabbed for Strep. all came back negative . ER doctor suggested rest, drink plenty of fluids and Ibuprofen also suggested flowwup with a primary care doctor. 6/18/21 saw ENT who send a tune up my nose to my throat where my vocals were the size of grapes. ENT prescribe Fluticasone spray 2 times a day. Still can't speak. Family Care doctor prescribe 7/2/21 Methprednisolone 21 pills

Other Meds: None

Current Illness: None

ID: 1478070
Sex: M
Age:
State: TX

Vax Date:
Onset Date: 07/14/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: developed Fever, chills, Cough, and Body ache. Got tested for Covid-19 with Rapid Antigen and came back POSITIVE.

Other Meds: Metoprolol

Current Illness: none

ID: 1478071
Sex: F
Age: 58
State: GA

Vax Date: 05/12/2021
Onset Date: 05/22/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: I developed a lot of pain in my elbow to the point that is is difficult to move my arm. and the pain has gone down my arm to my wrist and the bottom side of my arm down to my fingers are numb. I get a throbbing pain that comes and goes in my hand.

Other Meds: None

Current Illness: None

ID: 1478072
Sex: F
Age: 41
State: NC

Vax Date: 07/08/2021
Onset Date: 07/14/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: nkda

Symptom List:

Symptoms: Pain, redness, swelling and hot to touch at inj site. Pt reports has taken tylenol for treatment. This begin 71321.

Other Meds: unknown

Current Illness: unknown

ID: 1478073
Sex: F
Age: 39
State: OK

Vax Date: 06/23/2021
Onset Date: 06/27/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: 4 days after 2nd shot, started experiencing tingling/ numbness on left leg up body and face. Went to urgent care. Said it would pass. Now three weeks after experiencing more tingling, extreme fatigue and weakness. Face and down left side.

Other Meds: Thyroid medication

Current Illness: No

ID: 1478074
Sex: M
Age: 57
State: NJ

Vax Date: 05/21/2021
Onset Date: 06/21/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient reported having left arm swelling for about 2 weeks. Both injections were done on his left deltoid. Underwent screening, patient had a positive left upper extremity DVT and was given an apixaban prescription to take 10 mg by mouth twice daily for 7 days followed by 5 mg twice daily. Doctor reached out to the patient after discharge from the emergency department, patient did not pick up the call on 07/12/21 or the second follow up call on 07/13/2021. They are waiting for the patient contact them back regarding his symptoms.

Other Meds: Bictegravir-Emtricitabine-Tenofovir (Biktarvy)

Current Illness:

ID: 1478075
Sex: F
Age: 29
State: OH

Vax Date: 04/01/2021
Onset Date: 05/27/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Heavier menstruation immediately following 2nd dose and has continued for next 2 cycles

Other Meds: Menstruation since receiving the vaccines have been very heavy. For the past 10 yrs I have been a light to medium bleeder with my period lasting only 4 days. I would have light bleeding day 1 then transition to medium on day 2 and back to l

Current Illness: None

ID: 1478076
Sex: M
Age: 55
State: IL

Vax Date: 06/22/2021
Onset Date: 07/02/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Tingling and numbness in arm injection was given, lasts about 30 seconds and is intermittent. Patient compares it to a TENS device on low setting.

Other Meds: LOSARTAN/HCTZ, SPIRONOLACTONE, LEVOTHYROXINE, METOPROLOL TARTRATE

Current Illness: NONE KNOWN AT TIME

ID: 1478077
Sex: F
Age: 71
State: NC

Vax Date: 02/20/2021
Onset Date: 03/20/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List:

Symptoms: Started noticing lump which has since shrunk but is still there one is under collarbone and the other is under armpit, has been looked at by doctors ruled out being pacemaker put in October 28, 2020

Other Meds: Bupropheine atorvastatin low dose aspirin . Spironolactone metopopro Vitamins fish oil, b12 D3

Current Illness: no

ID: 1478078
Sex: F
Age: 34
State: IL

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Chills, sore throat, tender skin, joint and muscle ache, dizziness/vertigo, headache, blurred vision, fever, drainage/earache

Other Meds: None

Current Illness: None

ID: 1478079
Sex: F
Age: 51
State: MO

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Topamax

Symptom List:

Symptoms: At 6pm the day of the injection I began post menopausal bleeding. (I have have not had a period for 4-5 years). I have contacted primary care provider to see if I need to follow up with him. Have not yet heard back from his office. I have also contacted GYN, and they have scheduled me for an appointment on 7/21/21.

Other Meds: Propranolol bid for migraines Botox injections every 12 weeks for migraines Fish oil, vitamin d3, vitamin c, Allegra, magnesium.

Current Illness: None

ID: 1478080
Sex: F
Age: 29
State: MD

Vax Date: 05/12/2021
Onset Date: 05/15/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Ragweed, dustmites, birch, dog danger

Symptom List:

Symptoms: Felt like allergies with a sore throat and stuffy nose on Saturday afternoon. After dinner time I felt that my left neck lymph node swelling started and my tongue also gelt swollen. I had pain in both of my underarms that had started on the left underarm and had lasted around 4 days.

Other Meds: Syeda

Current Illness: None

ID: 1478081
Sex: M
Age: 54
State: ME

Vax Date: 04/28/2021
Onset Date: 05/05/2021
Rec V Date: 07/16/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: congestive heart failure, left bundle branch blockage, left ventricle wont dialate, EF of 20%. water pills 160mg a day, beta blocker, 1/2 a day. muscle twitch while sleeping or rest.

Other Meds: Aleve, vit B complex

Current Illness:

ID: 1478082
Sex: F
Age: 46
State: LA

Vax Date: 04/29/2021
Onset Date: 06/10/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Reactivation of Shingles (varicella-zoster virus). I decided to report this information just in case you are tracking potential correlations between COVID-19 and delayed impact on immune system for things like Shingles reactivation. My first episode with Shingles was in 2006.

Other Meds: Bupropion; Vitamin D

Current Illness: None

ID: 1478083
Sex: M
Age: 65
State: FL

Vax Date: 03/11/2021
Onset Date: 03/21/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: 1. Pain in right achillies tendon , lower near heel, 3-4 days could not walk, xrays at clinic inflammation, pain gradually resided in a week. 2. 4-5 days later right side neck muscle pain developed, MRI performed with no indications of injury or cause, pain still exist.

Other Meds: Flow max

Current Illness:

ID: 1478084
Sex: M
Age: 61
State: FL

Vax Date: 03/22/2021
Onset Date: 07/09/2021
Rec V Date: 07/16/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: pt was hospitalized Final Diagnosis: Acute renal failure Adm Diagnosis: Acute renal failure & Disease caused by severe acute respiratory syndrome coronavirus 2 (disorder)

Other Meds:

Current Illness:

ID: 1478085
Sex: F
Age: 76
State: CT

Vax Date: 07/10/2021
Onset Date: 07/11/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Strawberries, seasonal

Symptom List:

Symptoms: Arm swelling and pain, Diaria, fever chills, extreme fatigue

Other Meds: Lipitor D3, Krill Oil, CQ 10, baby aspirin Biotin

Current Illness: Seasonal allergies

ID: 1478086
Sex: M
Age: 66
State:

Vax Date: 04/07/2021
Onset Date: 04/12/2021
Rec V Date: 07/16/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient experienced not being able to breathe after his 1st COVID vaccine.

Other Meds:

Current Illness:

ID: 1478087
Sex: F
Age: 55
State: NJ

Vax Date: 03/05/2021
Onset Date: 03/09/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List:

Symptoms: 3 days after the 1st vaccine- inflammation in joints, pain in old injury locations, muscle, tendon pain. Muscle spasms. Extreme for 2 weeks. Barely being able to walk in the mornings, Unable to do my normal daily runs. The following 6-7 weeks the pain continued ( not as extreme but not good) Endurance, strength, remained low. Fatigue I'm over 3 months since the vaccine(s)- Injection spot still feels like a torn muscle, endurance and strength still not back to normal, heaviness in breathing, fatigue. pain in chest during intense training days, achy tingling arms.

Other Meds: Synthroid, Diclofenac

Current Illness: n/a

ID: 1478088
Sex: M
Age: 30
State: TX

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: A couple days after the second dose I experienced increased heart rate that would not stop and increased blood pressure. Even while laying and relaxed my BPM was averaging 100-120 (normal rate 60). It was a couple weeks of this when i finally decided to seek medical help. When i did the doctor thought this might be a longer reaction to vaccine, my body still "fighting". She set me up with a monitoring device that i used for the next 1-2 weeks. So this was about a month of elevated heart rate. Towards the end of the month i would experience periods of rest (60bpm) until finally it stayed there.

Other Meds: None

Current Illness: None

ID: 1478089
Sex: F
Age: 55
State: MI

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: sulfa drugs, nitrofurantoin

Symptom List:

Symptoms: 2 hours after vaccination head to toe rash occurred. next day SOB and cough started. lasred about i week.

Other Meds: Albuterol. zytrtec, premarin prenatal vit.

Current Illness: none

ID: 1478090
Sex: F
Age: 73
State: GA

Vax Date: 03/04/2021
Onset Date: 03/31/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Pt. reports an allergy to Wellbutrin that causes pruritis. Pt. states Monistat cream that causes pruritus.

Symptom List:

Symptoms: 74 year old white female pt. received second dose of Moderna-COVID-19 vaccine on 3/4/21. Pt. called to report severe leg rash that started at the end of March 2021 that has been ongoing since and has spread to other parts of her body. Currently rash is located on chest, arms, legs, groin, and breasts. Patient states she was diagnosed with Hashimoto's disease 8 or 9 years ago. She's been taking Levothyroxine 75 mcg daily for nine years, Caltrate 600 + B3 for "many years", vitamin D3, Vitamin C 1000 mg for 20 years, and Omega 3-6-9 for about a year. She also reports she began taking Atorvastatin 40 mg daily on 4/9/21. Pt. reports an allergy to Wellbutrin that causes pruritis. Pt. states Monistat cream also causes pruritus. Pt. denies any illness at time of vaccination and prior to. Patient encouraged to seek medical treatment for symptoms by this RN.

Other Meds: Patient states she's been taking Levothyroxine 75 mcg daily for nine years, Caltrate 600 + B3 for "many years", vitamin D3, Vitamin C 1000 mg for 20 years, and Omega 3-6-9 for about a year. She also reports she began taking Atorvastatin 4

Current Illness: Patient denies.

ID: 1478091
Sex: F
Age: 57
State: AL

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Shellfish, iodine, sulfur, codeine

Symptom List:

Symptoms: Patient felt light-headed after 5 minutes of vaccination, experienced dizziness, syncope, and was required to lay down. After 15 minutes she experienced shaking that continued until 5:50 PM. Patient was alert the entire time, no problems breathing, some problems speaking. We called 911 after 10 minutes; however, patient refused EMT transport, and had family members pick her up at 5:50 PM.

Other Meds: Linzess Trulance Amlodipine Armour thyroid Diphenhydramine

Current Illness:

ID: 1478092
Sex: M
Age: 17
State: NJ

Vax Date: 07/07/2021
Onset Date:
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Denied

Symptom List:

Symptoms: Minor age is 17 years and 6 months. Age not recommended for type of vaccine

Other Meds: Unknown

Current Illness: None

ID: 1478093
Sex: F
Age: 90
State: MA

Vax Date: 07/14/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Alendronate and Penicillin

Symptom List:

Symptoms: Golf sized red area on injection site accompanied by mild pain. Pt. iced site, took Tylenol and antihistamine. Symptoms have greatly improved, not yet resolved. Pt. also fatigued.

Other Meds: Unknown

Current Illness: Unknown

ID: 1478095
Sex: F
Age: 63
State: GA

Vax Date: 04/14/2021
Onset Date: 04/22/2021
Rec V Date: 07/16/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: It started with numbness around the left side of my mouth and chin and progressed to the left side of my face and left forearm and left calf. On July 3rd the numbness moved up my left arm and to my shoulder and left side of my head. I went to the ER was admitted to the hospital. Numerous tests were given which couldn't find any problem. I was given prednisone and sent home. My last day at the hospital, I experience and burning sensation in my left elbow and foot. Once home, the burning progressed to both arms from my elbows to fingertips and both legs from my knees to my toes. July 15 the burning progressed to my center chest and left side of my brain. I went to the ER, was evaluated and sent home.

Other Meds: multi-vitamin

Current Illness: swollen tongue due to overbrushing of tongue and use of antiseptic mouthwash

ID: 1478096
Sex: M
Age: 14
State: CA

Vax Date: 07/13/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Suspect axillary lymphadenopathy

Other Meds:

Current Illness:

ID: 1478097
Sex: M
Age: 50
State: MI

Vax Date: 07/08/2021
Onset Date: 07/10/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Ongoing neuropathy that began after my flu shot in 2017 became significantly worse about 36 hours after the COVID vaccine. This neuropathy had no physical cause when it began in 2017 other than it began about 36 hours after my flu shot. Over the course of 3 years while taking Lyrica the pain decreased substantially. It is now approaching it highest levels from 3 years ago 8 days after the COVID vaccine.

Other Meds: Lyrica and Rosuvastatin

Current Illness: None

ID: 1478098
Sex: M
Age: 60
State: MN

Vax Date: 03/25/2021
Onset Date: 07/14/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Positive for COVID-19 by PCR test on 7/15/2021. Patient had mild low grade fever and was exposed to household members who were also positive for COVID-19

Other Meds:

Current Illness:

ID: 1478099
Sex: M
Age: 55
State: CO

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Lomotil, Bactrim

Symptom List:

Symptoms: Moderna COVID-19 Vaccine EUA: patient in clinic for follow-up of left shoulder/arm pain starting right after immunization. Patient evaluated that day in the emergency department (ED), administered analgesics, and pain improved. Noted to be hyponatremic and blood glucose increased and was administered intravenous fluids. Patient discharged rom ED stable. On follow-up symptoms have resolved.

Other Meds: losartan-hydrochlorothiazide, omeprazole, potassium chloride, trazodone, vitamin D3

Current Illness: none

ID: 1478100
Sex: M
Age: 17
State: WI

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient was 17 years old. Vaccine currently licensed for 18 years of age and older

Other Meds:

Current Illness:

ID: 1478101
Sex: F
Age: 58
State: NJ

Vax Date: 05/13/2021
Onset Date: 07/07/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: None reported by client

Other Meds: None

Current Illness: None

ID: 1478102
Sex: F
Age: 33
State: MI

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: from doctor notes: On Friday morning, she received her second dose of the Moderna vaccine. Starting Saturday, she began to have swelling in the region of the right deltoid. On Sunday night, she went to an urgent care where they drew a border around it. They started her on Keflex and Pepcid. Today, she noticed the erythema was worsening and growing past the border. The pain is worst at the deltoid, sharp, comes and goes, without aggravating or alleviating factors, radiates down her arm. No relief with Benadryl, Pepcid. Has had intermittent nausea but no vomiting. Denies fevers, chest pain, dyspnea. No family or personal history of DVT/PE. started on bactrim, continued keflex diagnosed with cellulitis

Other Meds: none

Current Illness: none

ID: 1478103
Sex: M
Age: 18
State: NY

Vax Date: 07/02/2021
Onset Date: 07/04/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Chest tightness, shortness of breath, tight jaw, tingling left foot, racing heart rate/arrhythmia, irritability, inability to sleep more than 1 hour a night, excessive thirst? still waiting on treatment

Other Meds: N/A

Current Illness: N/A

ID: 1478104
Sex: F
Age: 17
State: IL

Vax Date: 07/09/2021
Onset Date: 07/09/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient was not 18 at the time of the vaccine. No adverse effects reported from patient or parent and parent chooses to continue with 2nd dose in series as off-label use.

Other Meds:

Current Illness:

ID: 1478105
Sex: F
Age: 27
State: CA

Vax Date: 07/10/2021
Onset Date: 07/11/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: N/a

Symptom List:

Symptoms: Dizziness, lightheaded and brain fog started 7/11 around afternoon time and has lasted till today 7/16, been feeling very fatigued as well.

Other Meds: N/a

Current Illness: N/a

ID: 1478106
Sex: F
Age: 44
State: OR

Vax Date: 01/30/2021
Onset Date: 04/24/2021
Rec V Date: 07/16/2021
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Allergies: None

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Symptoms: I had a palm sized very itchy, dry, uncomfortable area show up on my left quad that spread to be approximately 5 inches in diameter. I also had a similar, smaller patch on my abdomen about the size of a quarter. The abdomen patch went away. The patch on my quad continued and flared up again in June. I used betamethasone steroid cream to clear it up. I also had an unrelated issue of small itchy, burning red bumps on my hands and feet that appeared in June when this same patch flared up. I used ice packs to cool these and took anti-histamine even though I had no evidence of any allergic reaction or exposure to anything new in my environment.

Other Meds: None

Current Illness: Eczema on face and hands

ID: 1478107
Sex: M
Age: 83
State: AR

Vax Date: 02/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/16/2021
Hospital: Y

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Symptoms: Presented to hospital for increased SoB and weakness. Diagnosed with COVID-19 on 7/8. Discharged home on 2L O2 and dexamethasone. On 7/12 presented again with hypoxia, elevated WBC/ D-dimer. O2 titrated to 5 L NC and transferred to our facility on 7/12. Oxygen requirement continued to increase and patient admitted to ICU on 7/14. Currently receiving dexamethasone and received tocilizumab 7/13. Received remdesivir initially but was discontinued on transition to HFNC> Currently on HFNC w/NRB 50 L at 90%

Other Meds: Medications at time of admission: Apixaban, clopidogrel, finasteride, folic acid, losartan, montelukast, pantoprazole, pravastatin, tamsulosin

Current Illness:

ID: 1478108
Sex: M
Age: 27
State: FL

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 07/16/2021
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Allergies: None

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Symptoms: Began with weakness in extremities around 7:00PM. By 9:00 PM lost feeling in legs. This lasted for about 12 hours to one day.

Other Meds: None

Current Illness: None

ID: 1478109
Sex: F
Age: 47
State: CA

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 07/16/2021
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Allergies: sulfur and penicillin

Symptom List:

Symptoms: Minor reaction to the first vaccine included cold sweats, body aches, fatigue, and sore arm, which lasted approximately 3 days. Following the vaccine, I had a very light menstrual cycle which lasted only 2 days. Reactions after the second vaccine were similar but longer lasting and more intense. These reactions included a fever >100.0 for 5 days, body aches, extreme fatigue, and sore arm. After the second vaccine, I also experienced weakness in my legs, tingling or numbness in my legs that would come and go, and an inability to stand for more than a few minutes - which progressively got better, but lasted for about two weeks. In regards to my menstrual cycle, I skipped a cycle, had a light cycle, and had abdominal swelling until the end of the next full cycle. Since the second vaccine I have had two menstrual cycles, both of which were light, but each one becoming more typical of pre-vaccine menstrual cycles.

Other Meds: none

Current Illness: none

ID: 1478110
Sex: F
Age: 47
State: VA

Vax Date: 05/18/2021
Onset Date: 06/01/2021
Rec V Date: 07/16/2021
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Allergies: None

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Symptoms: My period was 2 weeks late, which is not typical. Then, my POTS symptoms became much worse, making it feel like my beta blocker wasn't working. Symptoms include feeling dizzy, fatigued, headaches, shakiness, more adrenaline surges, rapid heartrate.

Other Meds: Atenolol, Zoloft

Current Illness:

ID: 1478111
Sex: F
Age: 27
State: FL

Vax Date: 07/09/2021
Onset Date: 07/14/2021
Rec V Date: 07/16/2021
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Allergies: AMOXICILLIN, PENICILLINS, SULFAS, WHEAT

Symptom List:

Symptoms: ROBUST REACTION AT VACCINATION SITE, HARD KNOT 5 CM IN DIAMETER SURROUNDING ERYTHEMA, LOCALIZED REDNESS AND PAIN, FLU LIKE SYMPTOMS

Other Meds: TRI SPRINTEC

Current Illness: GI ISSUES 6/18/2021

ID: 1478112
Sex: M
Age: 33
State: NJ

Vax Date: 05/27/2021
Onset Date: 07/07/2021
Rec V Date: 07/16/2021
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Allergies: NKDA

Symptom List:

Symptoms: Vaccinated twice using 2 different type of vaccine (Janssen and Moderna)

Other Meds: None

Current Illness: None

ID: 1478113
Sex: F
Age: 36
State: VA

Vax Date: 05/21/2021
Onset Date: 06/27/2021
Rec V Date: 07/16/2021
Hospital: Y

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Allergies: None

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Symptoms: Experienced premature rupture of membranes (broken water) in twin pregnancy at 27 weeks pregnant, admitted to the hospital for monitoring and prevention of both labor and infection. At 28 weeks and 2 days pregnant (July 6, 2021), needed an urgent Caesarean section to deliver both babies, who were subsequently admitted and still remain in the NICU. Birth weights were 2lbs 5oz and 2lbs 8oz.

Other Meds: Zoloft (25mg), prenatal vitamin with DHA, baby aspirin

Current Illness: None

ID: 1478114
Sex: F
Age: 68
State: TX

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 07/16/2021
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Allergies: none

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Symptoms: Patient received the Moderna approximately 2 weeks before the 90 day period from her last Remdesivir that was given on 4/24/2021. Patient was called on Monday, 7/12/21 and she stated that she was doing fine and felt well. Patient stated that she had a low grade fever and body aches the day after the vaccine, but Tylenol controlled her symptoms.

Other Meds: unknown

Current Illness: none

ID: 1478115
Sex: F
Age: 50
State: CA

Vax Date: 06/18/2021
Onset Date: 07/03/2021
Rec V Date: 07/16/2021
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Symptoms: Acute and sudden blurred vision Posterior vitreous detachment diagnosed and the blurred vision a secondary thing Sore eyes and unable to focus flashes of light, floaters and headaches

Other Meds: Vit d,b,c,zinc,magnesium and calcium

Current Illness: No

ID: 1478116
Sex: F
Age: 4
State: OH

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/16/2021
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Allergies: Egg, milk, peanut

Symptom List:

Symptoms: Fever, malaise and poor appetite within 2 hrs of administration, with persistent moderate symptoms x 48-72hrs

Other Meds: None

Current Illness: None

ID: 1478117
Sex: F
Age: 51
State:

Vax Date: 03/05/2021
Onset Date: 07/07/2021
Rec V Date: 07/16/2021
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Symptoms: BREAKTHROUGH INFECTION. LOSS OF TASTE AND SEMILL

Other Meds:

Current Illness:

ID: 1478118
Sex: M
Age: 38
State: UT

Vax Date: 07/09/2021
Onset Date: 07/14/2021
Rec V Date: 07/16/2021
Hospital: Y

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Allergies: Gluten, lactose, seasonal allergies

Symptom List:

Symptoms: Appendicitis, Surgically removed, currently recovering

Other Meds: Airborne

Current Illness:

ID: 1478119
Sex: F
Age: 48
State: NJ

Vax Date: 07/08/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
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Lab Data:

Allergies: N/A

Symptom List:

Symptoms: tingling in fingers and toes 30 mins after receiving injection. red patch and soreness at injection site one week later.

Other Meds: N/A

Current Illness: N/A

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm