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
63,479
AK1,562
AL4,914
AR3,110
AS44
AZ12,730
CA54,886
CO10,464
CT7,347
DC1,568
DE1,561
FL33,514
FM3
GA12,508
GU74
HI2,078
IA4,130
ID2,361
IL18,091
IN22,023
KS4,061
KY6,276
LA4,395
MA13,121
MD11,272
ME2,858
MH8
MI16,697
MN10,689
MO8,360
MP30
MS2,487
MT2,035
NC14,437
ND1,184
NE2,562
NH2,717
NJ16,033
NM3,532
NV3,784
NY30,921
OH17,029
OK5,673
OR7,479
PA21,111
PR1,959
QM2
RI1,833
SC5,601
SD1,087
TN8,048
TX31,896
UT3,791
VA13,180
VI48
VT1,592
WA13,026
WI9,856
WV2,120
WY754
XB5
XL1
XV2

ID: 1481585
Sex: M
Age: 44
State: FL

Vax Date: 06/03/2021
Onset Date: 06/18/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: NO

Symptom List:

Symptoms: Weakness or tingling sensations, especially in the legs or arms

Other Meds: CREATINE, PROTEINE POUNDER

Current Illness: NOTHING

ID: 1481586
Sex: F
Age: 10
State: MS

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

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Misinformation was given to the pre-screening nurse--given 2010 as year of birth by patient's mother. Vaccine given--later discovered that pt is 10 years old instead of reported 12.

Other Meds: unknown

Current Illness: none known

ID: 1481587
Sex: M
Age: 78
State: AZ

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: I have had crippling tinnitus in both ears 24/7 since the covid shots. Sometimes so loud I cannot hear anything or anyone else.

Other Meds: None

Current Illness: None

ID: 1481588
Sex: F
Age: 33
State: FL

Vax Date: 07/08/2021
Onset Date: 07/09/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: NSAIDs Bactrim walnuts macadamia nuts

Symptom List:

Symptoms: Low-grade fever, Aches, Chills began approximately 24 hours after vaccination. Onset was fairly quick, within hours. No treatment. Slept overnight and felt improved the next morning.

Other Meds: spironolactone elderberry women's multivitamin maca root

Current Illness: N/A

ID: 1481589
Sex: F
Age: 28
State: NY

Vax Date: 04/08/2021
Onset Date: 06/28/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: In the past few weeks, starting at the end of June, when I bend over, viscous fluid pours out of my nose. It's persistent post-nasal drip that lacks the consistency of familiar snot. It isn't minuscule enough to ignore. It's like I am climbing out of a chlorinated pool. It only happens when I bend down to pick something up and whatever comes out keeps coming until it decides it is done.

Other Meds:

Current Illness:

ID: 1481590
Sex: F
Age: 40
State: CA

Vax Date: 06/01/2021
Onset Date:
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: They treated me very well and I had no symptoms after the vaccine.

Other Meds: None

Current Illness: No

ID: 1481591
Sex: F
Age: 27
State: CO

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: Abilify, Augmentin, minocycline, Percocet, prochlorperazine, Septra, hormonal birth control, beer

Symptom List:

Symptoms: On 7/8/21 around 8 P.M., the mental fog I experienced from the first Moderna COVID-19 shot returned. The symptoms once again included an inability to think, focus, or remember stuff with a spaced out feeling in my head and a decreased ability to hear. I was completely unable to function normally. On 7/9/21 around 3:00 P.M., the symptoms listed above continued and I was still unable to function normally in my daily activities and work. At 7/10/21 at 2:57 P.M., the mental fog appeared to be receding, but I was still not back at normal function. On 7/11/21 at 5:25 P.M., the remainder of the mental fog manifested as being a little slow mentally as I attempted to return to normal activities and work. On 7/12/21, as of 2:37 P.M., the mental fog was completely gone. No treatment was given for this side effect or the same one one I experienced with the first Moderna shot on 6/10/21 because I did not think that anything could be done.

Other Meds: Escitalopram, fish oil, fludrocortisone, gabapentin, lamotrigine, melatonin, quetiapine, tazarotene, Vitex

Current Illness: Sunburnt starting on 6/10/21, lasted about 2 weeks

ID: 1481592
Sex: F
Age: 39
State: WI

Vax Date: 12/23/2020
Onset Date: 04/17/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: 4/17/2021 - New onset of significant pelvic/ abdominal pain, initially thought to be severe, early, out of the ordinary menstrual cramps. Because I had an IUD, checked to ensure my IUD was in proper position on 4/26. It was. A few weeks later, had abnormal bleeding (starting 5/28) not associated with normal menstrual cycle and significant pain starting 6/4. Transvaginal ultrasound showed cystic fallopian tube vs hematosalpinx. Workup has not shown a known cause. It was not an ectopic pregnancy. There have been no signs/ symptoms/ exam findings lab work consistent with PID (which would be the main cause with an IUD). Underwent antibiotic treatment and IUD removal with continued milder intermittent pain. Will be having a repeat US coming up to determine if it has resolved.

Other Meds: None - Regularly, copper IUD in place, occasional Vitamin D and Vitamin C

Current Illness: None

ID: 1481593
Sex: F
Age: 50
State: CA

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Started experiencing itchiness/rash same day of first shot. Now have horribly painful hives/bruises all over body. Urgent care, doctor and emergency room haven?t been able to help just say I?m ?allergic? to something.

Other Meds: Triamcinolone

Current Illness: None

ID: 1481594
Sex: F
Age: 15
State: WI

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

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

Lab Data:

Allergies: none reported

Symptom List:

Symptoms: Patient was faint a few minutes after receiving the vaccine. She was lowered to the ground and regained consciousness almost immediately. airway was stable--no other adverse events. Patient was able to sit up and drink water. When she was comfortable, she was moved to a chair to recover. She continued to drink water as needed and was monitored by staff. No medication/other interventions were needed. When patient was comfortable and feeling better she was able to leave with her father without incident.

Other Meds: not known

Current Illness: none reproted

ID: 1481595
Sex: M
Age: 17
State: AK

Vax Date: 06/03/2021
Onset Date: 06/17/2021
Rec V Date: 07/17/2021
Hospital: Y

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

Lab Data:

Allergies: penicillin

Symptom List:

Symptoms: Immediately after administration, he started taking deep breaths and holding his chest with chest pain. He then lay down on the exam table and symptoms improved in a few minutes. 14 days later, on 6/17/2021, he developed severe muscle pain and was hospitalized two days later on 6/19/2021 for rhabdomyolysis. Discharged 6/22/2021 from Medical Center. He is an active athlete, plays alot of basketball and lifts weights. This was his first episode of rhabdomyolysis.

Other Meds: none

Current Illness: none

ID: 1481596
Sex: M
Age: 29
State: TN

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Nausea, vomiting, dizziness, light headed

Other Meds:

Current Illness:

ID: 1481597
Sex: F
Age: 17
State: SC

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

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: PT WAS SEATED IN CHAIR WAITING FOR 15 MINS AFTER THE VACCINE AND HER MOM CAME TO GET ME JUST A FEW MINS AFTER SHE SAT DOWN AND SAID SHE PASSED OUT FOR A FEW SECONDS AND WOKE BACK UP. I PUT HER BACK IN THE IMZ ROOM, ASSESED HER AND ASKED FOR 911. SHE STATED SHE WAS FEELING BETTER AND DIDNT WANT 911 CALLED. I GAVE HER SOME WATER AND A COLD RAG AND FAN AND CALLED MANAGEMENT. SHE SAT IN THE ROOM FOR AN ADDITIONAL 30 MINS AND SAID SHE FELT FINE BEFORE SHE LEFT. I WILL FOLLOW UP WITH PT TOMORROW TO MAKE SURE SHE IS STILL DOING WELL.

Other Meds: VYVANSE, AVIANE

Current Illness: NONE LISTED

ID: 1481598
Sex: F
Age: 41
State: MO

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: First I had no period when it was due. Now I have been bleeding heavily for two weeks with no sign of easing up.

Other Meds: Levothyroxine

Current Illness:

ID: 1481599
Sex: F
Age: 38
State: TN

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

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

Lab Data:

Allergies: Tetracycline

Symptom List:

Symptoms: None stated.

Other Meds:

Current Illness: non

ID: 1481600
Sex: M
Age: 24
State: AZ

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Pt had a syncopal event a few minutes after receiving his COVID-19 Moderna vaccine. He was seated in a chair for a 15 minute observation period. He fell off the chair onto his side. He regained consciousness within about 10 seconds of falling off the chair. He was placed in a supine position with legs elevated. He was given water. He denied any pain associated with fall. Denied any symptoms of itching, swelling, cardiac, or GI complaints. He was alert and oriented x4 with color and temperature within normal limits. After 10 minutes lying down, he was assisted into a chair for further observation. He denied any further symptoms and was discharged after an additional 15 minute observation. He was advised to seek emergent care if he experienced any worsening symptoms.

Other Meds:

Current Illness: None

ID: 1481601
Sex: F
Age: 24
State: UT

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

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

Lab Data:

Allergies: Latex

Symptom List:

Symptoms: Left arm extremely sore (interfered with sleep, feels like a significant shoulder/arm injury). Extreme headache. General muscle soreness and joint aches and pains. Significant nausea. Pain going down left leg. Fever/chills. Curled up on couch sobbing from pain.

Other Meds: None

Current Illness: None

ID: 1481602
Sex: F
Age: 15
State: SC

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

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: Less than 5 minutes after receiving the vaccine the patient began vomiting and sweating. After vomiting, sitting down with a cold compress on the forehead and a few sips of water the patient felt perfectly fine. Patient's mother stated that this has happened with previous vaccinations and even doctors appointments. She believes it was more nerves than an actual reaction to the vaccine.

Other Meds:

Current Illness: no

ID: 1481603
Sex: F
Age: 52
State: CT

Vax Date: 07/01/2021
Onset Date: 07/02/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: The 2nd dose of the vaccine was very painful when first injected them a metallic taste in my mouth followed by numbness and tingling on the left side of my face and dizziness. Fave numbness subsided and metallic taste subsided after a few hours . However Continuous throbbing and pain after continue after 17 days post injection . Pain is on left deltoid and numbness and tingling , down the left arm day as he night . Shoulder pain and a feeling of numbness on hand . Weakness, numbness and tingling persists on the left arm to the point of having to stop doing activities . Pain in injection site keeps me awake at night .

Other Meds: None

Current Illness: None

ID: 1481604
Sex: M
Age: 16
State:

Vax Date: 07/15/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Swelling on injection site 1 day after vaccine. Major pain when moving arm, almost unable to move in some directions due to pain.

Other Meds:

Current Illness:

ID: 1481605
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Irregular period where it started on the second day of taking the vaccine even though I finished on July, 5th with a 9 days cycle, which is usually 21 or 24 or 28 days.

Other Meds:

Current Illness:

ID: 1481606
Sex: F
Age: 66
State: CT

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

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

Lab Data:

Allergies: Iodine in shellfish, lactose, laytex, synthroid, naproxen, flu vaccine, shrgrix vaccine, Pfizer Covid vaccine

Symptom List:

Symptoms: Painful injection site right away And within 20 min very painful left side-shoulder blade, shoulder, then pain went into neck, then jaw, then ear- felt blocked up and numb, then to eye- vision off, light headed. Pharmacist observed for 30 minutes and suggested I go to urgent care. I thought I was ok but on way home, jaw and cheek area went numb and sharp pain at left base of skull to top of head with chest and underarm muscles sharp pains. Went to urgent care. BP, temp & oxygen ok. While observing me for 45 min, also had left leg cramps, and profuse sweating Gave me 2 prednisone tabs 20 mg. Watched for another 45 minutes. Went home. 7 hours after injection still had these symptoms. Next morning 7/16/21, cheeks flushed, moderate jaw pain, cheek numbness and ear/ hearing not right. As day went on, numbness became intermittent but jaw pain remained.

Other Meds: Fish oil, vitamin C, calcium, Allegra, multi- vitamin, restasis, levothyroxine

Current Illness: Pulled hamstring and right neck muscles. Took Meloxicam

ID: 1481607
Sex: F
Age: 28
State: IL

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

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

Lab Data:

Allergies: Unknown

Symptom List:

Symptoms: Within 15 minutes, around my cheek started swelling, confirmed by the nurse. Then around my face started swelling then my lips. About an hour later, my tongue started swelling, but I was already admitted to the ER and was given an IV Benadryl and steroids. I was discharged at 4:30 PM. Around 10 PM started noticing purple-ish rashes on my right arm and left leg.

Other Meds: Took 2 tablets of Xyzal one hour prior to vaccination.

Current Illness: Food poisoning and IBS two weeks prior.

ID: 1481608
Sex: F
Age: 50
State: CT

Vax Date: 04/10/2021
Onset Date: 05/25/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Vision problems since shortly after second dose. My eyes no longer focus easily

Other Meds: Zoloft Wellbutrin

Current Illness: None

ID: 1481609
Sex: F
Age: 39
State: NE

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

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: PATIENT SAID SHE FELT LIGHT HEADED THEN PASSED OUT ALMOST 2 TO 3 MINUTES AFTER RECEIVING THE VACCINE.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1481610
Sex: F
Age: 28
State: PR

Vax Date: 07/09/2021
Onset Date: 07/11/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: Norflex, Aspirin, Atrovent, Azithromysin.

Symptom List:

Symptoms: Fever, Headache, dizziness, dry mouth, respiratory problems, loss of appetite, throat swelling, pain in the arm, cold sweat. Hot red face and chest.

Other Meds: NONE

Current Illness: NONE

ID: 1481611
Sex: F
Age: 25
State: AZ

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: pt slightly collapsed, paramedics called low heart rate and blood pressure

Other Meds: unknown

Current Illness: unknown

ID: 1481612
Sex: F
Age: 48
State: TX

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

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

Lab Data:

Allergies: NA

Symptom List:

Symptoms: The patient had no reaction to the first dose. She started to feel achy all over and have discomfort in her arm the evening after the vaccine. She noticed the glands in her neck were swollen and her throat was hurting. She said she felt anxious so she used her inhaler even though she was not short of breath. When I saw her the next day she was still achy but had not taken any pain relievers. She had naproxen and was planning to take it. She was still not short of breath.

Other Meds: Wixela, Montelukast, Naproxen, Baclofen

Current Illness:

ID: 1481613
Sex: M
Age: 12
State: KY

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

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

Lab Data:

Allergies: PCN

Symptom List:

Symptoms: Moderna COVID vaccine was administered to a 12 y/o child

Other Meds: None

Current Illness: None

ID: 1481614
Sex: F
Age: 41
State: MD

Vax Date: 07/08/2021
Onset Date: 07/11/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Severe and almost debilitating fatigue. Almost wrecked falling asleep while driving to and from work, falling asleep while sitting at the computer, slept for over 14 hours for 3 straight nights, difficulty waking up-sleeping through alarm. So severe that I considered going to the ER.

Other Meds: Cellcept Tumeric Vitamin D MVI Allegra Pepcid Garlic

Current Illness: None

ID: 1481615
Sex: F
Age: 15
State:

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

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

Lab Data:

Allergies: amoxicillin

Symptom List:

Symptoms: Patient received dose 1 of the Pfizer COVID vaccine (lot EW0191) at 1400. At 1425, patient and her mother approached RN reporting visible tremors in her left thumb, the same side that she received the vaccine. The Paramedic approached to assess and take vital signs. PHN brought over juice and goldfish. Vital signs: blood pressure 126/88, pulse 88, respirations 16, O2 96%. Patient reported she ate a meal before arrival at the vaccine site but only drank approximately 8oz of water at breakfast in the morning. Patient denied swelling, pain, numbness. PHN noted no swelling in the face. Patient maintained full range of motion of left arm and hand. PHN encouraged patient to follow up with provider and when to call 911. PHN offered Benadryl but patient declined. Patient reported an allergy to amoxicillin, medical condition includes PCOS, and medications include vitamin D and birth control pill. PHN encouraged patient to stay for 30 minutes from onset of symptoms. Patient drank juice and ate goldfish. At 1440, vital signs: respirations 16, blood pressure 132/84, pulse 84. Patient reported a decrease in symptoms. At 1445, patient left walking with steady gait, against medical advice.

Other Meds: vitamin D, birth control pill

Current Illness:

ID: 1481616
Sex: M
Age: 19
State: HI

Vax Date: 06/25/2021
Onset Date: 07/16/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Positive PCR test on 7/16/21

Other Meds: None

Current Illness: Allergic rhinitis

ID: 1481617
Sex: F
Age: 27
State: AZ

Vax Date: 06/10/2021
Onset Date: 06/30/2021
Rec V Date: 07/17/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Started having left sided chest pain on 6/27 which progressively worsened over the next few days, called OB on 6/30 who instructed me to go to emergency department to be evaluated. Throughout the day the chest pain became progressively worse especially on inspiration also accompanied with difficulty to take a full breath. After testing done in emergency room I was admitted and diagnosed with pericarditis and said to be having an acute inflammatory response post covid vaccination. At time of adverse event I was 26 weeks pregnant with an uncomplicated pregnancy, estimated delivery date is 9/29

Other Meds: Prenatal vitamin, vitamin D

Current Illness: None

ID: 1481618
Sex: F
Age: 40
State: GA

Vax Date: 07/09/2021
Onset Date: 07/10/2021
Rec V Date: 07/17/2021
Hospital:

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

Lab Data:

Allergies: Food sensitivities: Coconut, soy, chicken, pineapple

Symptom List:

Symptoms: Day after vaccine I started experiencing extreme headaches.

Other Meds: None

Current Illness:

ID: 1481619
Sex: M
Age: 65
State: UT

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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Allergies: None

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Symptoms: Patient was given Pfizer for first dose and Moderna for second dose

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Current Illness:

ID: 1481620
Sex: M
Age: 29
State: TX

Vax Date: 06/03/2021
Onset Date: 06/04/2021
Rec V Date: 07/17/2021
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Allergies: none

Symptom List:

Symptoms: heart area felt sore or inflamed for 2-3 days shortly after both injections. issue appears to have resolved itself without known side effects.

Other Meds: none

Current Illness: none

ID: 1481621
Sex: F
Age: 46
State: HI

Vax Date: 06/25/2021
Onset Date: 07/16/2021
Rec V Date: 07/17/2021
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Allergies: none

Symptom List:

Symptoms: Positive PCR on 7/16/21

Other Meds: none

Current Illness: Allergic rhinitis

ID: 1481622
Sex: F
Age: 22
State: AL

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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Allergies: nka

Symptom List:

Symptoms: Patient administered First Dose Covid Vaccine. 10 minutes into observation period, patient states she is having shortness of breath, increased heart rate, tongue numbness, and lip and mouth numbness. RPH Administered 25mg of liquid bendaryl to patient and called 911 for EMS/Paramedics. Patient was taken on stretcher to ER with father. Patient was alert and able to respond/talk to staff/paramedics at time of departure

Other Meds: n/a

Current Illness: N/A

ID: 1481623
Sex: M
Age: 54
State: AR

Vax Date: 07/16/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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Allergies: No known allergies

Symptom List:

Symptoms: approximately 24 hours post vaccine fainted. pt's partner describes he was walking toward her and then suddenly fell to the ground "passed out cold" She tried to talk to him and at first he did not make sense but after few minutes was able to converse. Call to pharmacy was made about 3 hours after event and pt has recovered, main complaints were weakness and sore (bruised himself when falling).

Other Meds: No known

Current Illness: no

ID: 1481624
Sex: M
Age: 33
State: HI

Vax Date: 04/01/2021
Onset Date: 07/14/2021
Rec V Date: 07/17/2021
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Symptoms: Onset of URI symptoms with fever, after traveling. Return flight 7/13/21. Symptom onset 7/14/21

Other Meds:

Current Illness:

ID: 1481625
Sex: F
Age: 44
State: NJ

Vax Date: 06/10/2021
Onset Date: 06/11/2021
Rec V Date: 07/17/2021
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Allergies: n/a

Symptom List:

Symptoms: Fever, headache, severe chills, whole-body fatigue--24 hours painful, red area at site of injection, measuring approx. 6"x8", hot, tender and swollen--2 weeks

Other Meds: Lexapro

Current Illness: n/a

ID: 1481626
Sex: F
Age: 20
State: IL

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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Symptoms: Following vaccination patient was dizzy and seeing stars. Moved patient to floor and checked blood pressure 118/68 heart rate 70. Patient did not faint and felt better. Observed patient and patient left with family member feeling fine and did not want further intervention.

Other Meds:

Current Illness:

ID: 1481627
Sex: F
Age: 41
State: CA

Vax Date: 06/18/2021
Onset Date: 07/12/2021
Rec V Date: 07/17/2021
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Allergies: Shrimp

Symptom List:

Symptoms: July 12 - Painful abdominal cramps and profuse sweating all over my body. 10 mins after cramps and sweating started, I started my period. Sweating lasted about an hour, while the cramps lasted a couple of hours. There was very little blood, but a lot of ?water? in my maxi pad. My periods are usually three days long, with only one heavy day. I am on my sixth day and have had a heavy flow each day. There still is very little blood but a lot of ?water.?

Other Meds: Levothyroxine 100mcg daily

Current Illness: None

ID: 1481628
Sex: F
Age: 35
State: CA

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 07/17/2021
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Allergies: None

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Symptoms: Periods out of sync, major bleeding, extreme fatigue, brain fog, hormonal changes

Other Meds: None

Current Illness: None

ID: 1481629
Sex: M
Age: 21
State: CA

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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Allergies: NKA

Symptom List:

Symptoms: Patient experienced dizziness, fainting, sweatiness, and blurry vision 10 minutes after receiving the vaccine. Pharmacist asked patient to sit down and remove facial covering. Pharmacist took blood pressure, first reading was 104/56. Pharmacist offered patient water to drink and continued to monitor patient's symptoms for 40 minutes. Pharmacist took another blood pressure reading and the results were 129/73. Patient stated he no longer feel dizzy or feel fainting. Patient's father took patient home. Pharmacist called patient 2 hours after he left pharmacy. Patient stated he has severe headache. Pharmacist advised patient to take one Tylenol and eat some snack.

Other Meds: None

Current Illness: None

ID: 1481630
Sex: M
Age: 58
State: MA

Vax Date: 06/05/2021
Onset Date: 06/23/2021
Rec V Date: 07/17/2021
Hospital: Y

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Allergies: Penicillin- rash

Symptom List:

Symptoms: Presented with generalized malaise, fever, chills on June 23. Had headache and cough on and off after receving vaccine. On July 8 admitted to hospital with rash concerning for erythema migrans. Positive Lyme IgM. Started doxycycline. Discharged 7/10. Came back on 7/11 with bilateral facial nerve palsy. noted to have severe back pain of unclear cause as well. Started on Ceftriaxone. Discharged again on 7/13. On 7/14 presented to oupatient ID clinic with increasing back pain and numbness on trunk and upper thighs. Sent back to hospital. CT head, MRI thoracic and lumbar spine normal. LP done normal cell count, mildly elevated protein on CSF. Increasing muscle weakness of extremities (proximal muscles of lower extremities first). Impression: Guillain Barre. Started on IVIG

Other Meds: Tylenol

Current Illness: none

ID: 1481631
Sex: F
Age: 38
State: OR

Vax Date: 07/09/2021
Onset Date: 07/15/2021
Rec V Date: 07/17/2021
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Allergies: None known.

Symptom List:

Symptoms: Hives appeared suddenly on left leg around ankle. They have continued to appear on the left leg, both upper and lower leg for around 3 days. Most recently the right leg has hives appearing.

Other Meds: Chai Hu Hui Zhi Tang (Chinese medicine with Bupleurum and Cinnamon Combination)

Current Illness: None.

ID: 1481632
Sex: F
Age: 29
State: PR

Vax Date: 04/08/2021
Onset Date: 05/29/2021
Rec V Date: 07/17/2021
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Allergies: Wheat and aspirin

Symptom List:

Symptoms: Irregular period, bleeding without period for eight days. Pain in the abdominal area.

Other Meds:

Current Illness:

ID: 1481633
Sex: M
Age: 23
State: OR

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/17/2021
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Allergies: Unknown

Symptom List:

Symptoms: Pt received first dose of Pfizer COVID-19 vaccine after already having completed vaccine series with Moderna COVID-19 vaccines on May 7, 2021 and 6/04/2021. Pt waited in observation area for fifteen minutes with no immediate adverse reactions observed or reported by patient while patient was in clinic. Dr. notified of incident by phone call.

Other Meds: Unknown

Current Illness: Unknown

ID: 1481634
Sex: F
Age: 68
State: OR

Vax Date: 07/14/2021
Onset Date: 07/15/2021
Rec V Date: 07/17/2021
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Allergies: Sulfa, tramadol

Symptom List:

Symptoms: On the second day, I got a headache, along with the previous illnesses, and 3rd day I got diaherea

Other Meds: Estratest, effexor, zolpidem, ritalin, tizanadine, multi vits

Current Illness: none

Total 2021 VAERS Injuries: 559,999

Page last modified: 03 October 2021 5:28pm