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
88,334
AK1,815
AL6,133
AR3,993
AS45
AZ14,539
CA64,759
CO12,159
CT8,719
DC1,747
DE1,868
FL41,499
FM3
GA16,132
GU92
HI2,477
IA4,739
ID2,763
IL21,496
IN23,655
KS4,844
KY8,414
LA5,328
MA15,281
MD13,105
ME3,277
MH8
MI20,143
MN12,873
MO10,275
MP30
MS3,073
MT2,392
NC17,450
ND1,440
NE3,023
NH3,124
NJ19,456
NM4,089
NV4,600
NY36,525
OH20,140
OK6,525
OR8,918
PA24,920
PR2,483
QM2
RI2,092
SC6,952
SD1,243
TN10,038
TX38,745
UT4,482
VA15,477
VI62
VT1,780
WA15,487
WI11,573
WV2,461
WY894
XB5
XL1
XV2

ID: 1497948
Sex: F
Age: 53
State: KY

Vax Date: 07/21/2021
Onset Date: 07/21/2021
Rec V Date: 07/23/2021
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Lab Data:

Allergies: Bictegravir-emtricitab-tenofov Buspirone Cephalexin Duloxetine Hcl Erythromycin Escitalopram Guaifenesin Guaifenesin & Derivatives Hydrocodone Hydrocodone-acetaminophen Metronidazole Morphine Morphine And Related Nitrofurantoin Nsaids Ondansetron Oxycodone Oxycodone-acetaminophen Pregabalin Sulfa Drugs Sulfacetamide Sulfur Tetracycline Venlafaxine

Symptom List:

Symptoms: onset of vertigo, stomach cramps, vomiting a few hours after receiving the vaccine

Other Meds: Vitamin E, Vitamin C, atovaquone, dolutegravir, TAF/FTC, gabapentin, Synthroid, meclizine, Robaxin, tramadol, valacyclovir, ambien, Mg-Ox, fentanyl patch, Wellbutrin, diazepam

Current Illness: HIV/AIDS

ID: 1497949
Sex: F
Age: 47
State: OH

Vax Date: 04/19/2021
Onset Date: 05/26/2021
Rec V Date: 07/23/2021
Hospital:

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Lab Data:

Allergies: Can't take Tramadol and I can't take NSAIDS (NSAIDS due to gastric bypass surgery)

Symptom List:

Symptoms: Woke up morning of 05/26 to room spinning. Been dealing with vertigo and dizziness every day since. Ear pressure/pain, nausea, diarrhea, vomiting, I've been through 2 courses of antibiotics, 2 courses of steroids, I've seen an after hours dr, my family doctor, an ears nose and throat specialist and I've started vestibular therapy. So far nothing has helped. I go back to ENT dr next month for follow up. He diagnosed me with Vestibular Migraine but admitted he wasn't certain of that diagnosis and that he was treating me as if it was that and then we would re-evaluate again next month at my appt. I've been working from home and been able to do my job but afraid to drive. The dizziness is constant to some degree but I get spells that are really bad and I have trouble focusing, reading, and nothing makes them better, I just have to wait for them to pass, usually it's no more than an hour, sometimes only 20-30 minutes. I'm not sure I really think it's related to the vaccine but I can't completely rule it out considering I'm

Other Meds: Estrogen patches, tylenol, multivitamin, vitamin c, calcium, vitamin B 12, Biotin and Vitamin D.

Current Illness: Dealing with back pain and being treated by family dr and chiropractor, but no illness.

ID: 1497950
Sex: F
Age: 32
State: OK

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 07/23/2021
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Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient received her vaccine and fainted. She did fall forward and bust her lip. After a few minutes of dizziness she was feeling better. Had her stay and drink some water with no other side effects.

Other Meds:

Current Illness:

ID: 1497951
Sex: F
Age: 57
State: TX

Vax Date: 04/13/2021
Onset Date: 06/28/2021
Rec V Date: 07/23/2021
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Lab Data:

Allergies: Sudafed, Penicillin

Symptom List:

Symptoms: So I, two months after the vaccine, I had a bad upper respiratory infection. I had a cough, a lot of drainage in my nose and a sore throat. I saw a NP on July 1, 2021 and had a Covid test which was negative. the NO determined that it was an upper respiratory infection and to stay hydrated. I was taking some Mucinex to help with the cough and congestion. The symptoms did get less severe after about a week but I continued to have drainage and a cough for at least three weeks. I still have a little bit of drainage today, on 7/23/2021, but not much coughing anymore.

Other Meds: Claritin as needed, Sudafed as needed, Nasacort as needed, Zyrtec as needed, Multivitamin, B12, D3, Fish Oil

Current Illness: N/A

ID: 1497952
Sex: F
Age: 54
State: NE

Vax Date: 01/20/2021
Onset Date: 03/01/2021
Rec V Date: 07/23/2021
Hospital:

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Lab Data:

Allergies: ambien trazodone

Symptom List:

Symptoms: pt reports experiencing heart palpitations in March. first noted at a wedding which she thought stress/anxiety. but reports they have been happening much more frequently since then and even when not stressed.

Other Meds: Lipitor vit d proviotic Ativan - uses for sleep fish oil multivitamin

Current Illness: saw derm in dec for itchy skin around the eye had URI 3/2 - suspected viral etiology

ID: 1497953
Sex: F
Age: 34
State: MD

Vax Date: 07/22/2021
Onset Date: 07/23/2021
Rec V Date: 07/23/2021
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Pt developed numbness in right side of face approximately two hours after recieving the vaccine. Pt woke up the next day with the same symptom. No weakness or drooping, no swelling in tongue, lips or throat. No itching or shortness of breath. No treatment indicated

Other Meds: Oral birth control, Zyrtec, singulair, Flonase, prenatal vitamins

Current Illness: none

ID: 1497954
Sex: F
Age: 55
State: TX

Vax Date: 05/16/2021
Onset Date: 07/18/2021
Rec V Date: 07/23/2021
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Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: /Pt c/o fever, cough congestion X 3 days Pt here with c/o a sore throat since Sunday, it has progressed to ear pain, mildly productive cough, fatigue, minimal malaise, + nasal congestion, + fever, + headache, no changes in taste / smell.

Other Meds: Taking ?sertraline 100 mg tablet 1 tab(s) orally once a day ?trazodone 50 mg tablet 1 tab(s) orally qhs, as needed for insomnia Discontinued ?Ambien 10 mg tablet 1 tab(s) orally once a day (at bedtime) ?atenolol 25 mg tablet 1 tab

Current Illness:

ID: 1497955
Sex: F
Age: 30
State: IN

Vax Date: 03/09/2021
Onset Date: 03/18/2021
Rec V Date: 07/23/2021
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Allergies: NKDA

Symptom List:

Symptoms: Pregnancy - I was about 5 weeks pregnant at the time of my second vaccine dose. I started bleeding one week later which resulted in miscarriage. Conceived again in April 2021, which miscarried in June 2021 at 11 weeks requiring D&C. One previous successful pregnancy conceived naturally with no complications.

Other Meds: Prenatal vitamin

Current Illness: n/a

ID: 1497957
Sex: F
Age: 71
State: MI

Vax Date: 10/18/2019
Onset Date: 11/05/2019
Rec V Date: 07/23/2021
Hospital:

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Lab Data:

Allergies: Sulfa Latex

Symptom List:

Symptoms: Numbness in hands and feet Swelling in legs & feet Weakness in hands & feet requiring strong mental concentration to make them work I communicated via message with my doctor, as I was on vacation Spent 2 weeks like that, then slow improving .. feet swelling remained for over a month

Other Meds: Levothyroxine

Current Illness: None

ID: 1497958
Sex: F
Age: 19
State: IN

Vax Date: 07/21/2021
Onset Date: 07/21/2021
Rec V Date: 07/23/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: Fever, chills, headache, body aches, nausea, and pain at injection site ( started at 8 pm lasted until 10 am)

Other Meds:

Current Illness:

ID: 1497959
Sex: F
Age: 26
State: PA

Vax Date: 07/14/2021
Onset Date: 07/17/2021
Rec V Date: 07/23/2021
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Lab Data:

Allergies: Amoxicillin

Symptom List:

Symptoms: Extreme stomach cramps, diarrhea multiple times a day for 6 days so far.

Other Meds: True Calm by NOW supplement Dramamine

Current Illness: Anxiety

ID: 1497960
Sex: F
Age: 41
State: TX

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

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Allergies: None

Symptom List:

Symptoms: Heat and swelling at injection site 12 hours post vaccine continuing until at least 23 hours post vaccine when reported Pain and weakness in right hand 13 hours post vaccine continuing until at least 23 hours post vaccine when reported Heart racing and trouble breathing 16 hours post vaccine intermittent symptoms coming and going continuing until at least 23 hours post vaccine when reported Nausea 17 hours post vaccine intermittent symptoms coming and going continuing until at least 23 hours post vaccine when reported Swollen and painful lymph node in right armpit 21 hours post vaccine continuing until at least 23 hours post vaccine when reported Pain in right breast 21 hours post vaccine continuing until at least 23 hours post vaccine when reported

Other Meds: None

Current Illness: Kidney Stone

ID: 1497961
Sex: M
Age: 16
State: AR

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

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Lab Data:

Allergies: no known allergies

Symptom List:

Symptoms: Doctor administered vaccine to a patient that didn't meet age requirement. Pt under the age of 18 years old. Pt has reported no adverse reactions. Doctor spoke with patients mother as well and she has reported no adverse side effects.

Other Meds: Unknown

Current Illness: none

ID: 1497962
Sex: F
Age: 89
State: AR

Vax Date: 04/03/2021
Onset Date: 07/22/2021
Rec V Date: 07/23/2021
Hospital: Y

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Lab Data:

Allergies: Sudafed

Symptom List:

Symptoms: Patient hospitalized with pneumonia.

Other Meds:

Current Illness: Fall july 2

ID: 1497963
Sex: F
Age: 72
State: TX

Vax Date: 01/26/2021
Onset Date: 02/03/2021
Rec V Date: 07/23/2021
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Allergies: None

Symptom List:

Symptoms: Felt out of sorts. Repeatedly asked ?what happened ?? Taken by ambulance to hospital shortly after 1pm. Memory returned about 4:30 pm while finishing CTA. All cognitive testing normal after 4:30pm

Other Meds: None

Current Illness: None

ID: 1497964
Sex: M
Age: 59
State: NJ

Vax Date: 06/04/2021
Onset Date: 06/05/2021
Rec V Date: 07/23/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: NONE

Symptom List:

Symptoms: 1ST EVENT SWELLING AND EXCRUIATING PAIN IN ALL JOINTS (EXCEPT SHOULDER JOINTS) COULD NOT MOVE FEET HOSPITALIZED IN HOSPITAL 6/13/2021 - 6/18/2021 2ND EVENT SWELLING AND MOST EXCRUIATING PAIN IN HIP JOINTS COULD NOT MOVE FEET HOSPITALIZED IN HOSPITAL 7/16/2021 - 7/18/2021

Other Meds: HIGH BLOOD PRESSURE,KIDNEY DISEASE MEDICATIONS

Current Illness: HIGH BLOOD PRESSURE, KIDNEY DISEASE

ID: 1497965
Sex: M
Age: 35
State: MN

Vax Date: 12/18/2020
Onset Date: 07/21/2021
Rec V Date: 07/23/2021
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Lab Data:

Allergies: Penicillin, Morphine, Codeine

Symptom List:

Symptoms: Patient fully vaccinated with Pfizer Covid-19 vaccine, seen in clinic and test results show positive for Covid on 7-21-2021

Other Meds:

Current Illness: Patient has tested positive for Covid-19 on 7-21-2021 and he is fully vaccinated. First Covid-19 Pfizer dose given on 12/18/2020 and second dose given on 1-26-2021.

ID: 1497966
Sex: M
Age: 8
State: VA

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 07/23/2021
Hospital:

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Allergies: None

Symptom List:

Symptoms: On 6/8/21 the 8 year old client presented for catch up vaccination. After reviewing the clients record, it was determined by this nurse that the client had missed his 5th dose of DTaP and his 4th dose of IPV, also his second dose of both MMR and Varicella. This nurse inadvertently administered the Kinrix vaccine to the 8 year old child and Kinrix is only licensed for use in children ages 4 to 6 years old. Due to the clients age, the child should have received 2 separate injections of Tdap and IPV. This error was caught by billing on 7/8/2021. The clients mother was notified of the vaccine error on 07/19/2021 , an incident report was completed and now this nurse is submitting a VAERS form for vaccine error.

Other Meds: None

Current Illness: None

ID: 1497967
Sex: F
Age: 34
State: NJ

Vax Date: 05/16/2021
Onset Date: 05/30/2021
Rec V Date: 07/23/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Allergic to Ibuprofen

Symptom List:

Symptoms: Bells Palsy

Other Meds: Allegra

Current Illness: None

ID: 1497968
Sex: F
Age: 49
State: FL

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/23/2021
Hospital:

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Lab Data:

Allergies: lodine doxycycline

Symptom List:

Symptoms: Felt disoriented 2.5 hrs after shot. 3 hours after shot felt complete body numbness. Could not feel hard pinches, slaps, etc. Felt completely drugged and unable to feel my body. Pressure in my head. Felt blood pumping in my head. Lasted about 48 hrs. Still do not have full feeling in my skin at three weeks later timeframe. Other symptoms more common were - pain at injection site, hard to lift arm because of pain night of 7/2. 4-5 days of nausea and loss of appetite. Sporadic joint pain in areas never had any joint paint before.

Other Meds: n/a

Current Illness:

ID: 1497969
Sex: F
Age: 64
State: MI

Vax Date: 03/17/2021
Onset Date: 06/01/2021
Rec V Date: 07/23/2021
Hospital:

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Lab Data:

Allergies: Cipro, Cellebrex, Monistat

Symptom List:

Symptoms: Dizziness, light headed, fatigue

Other Meds: Losartan - 50 mg 2/day, multi vitamin, D3, B complex, zinc

Current Illness: None

ID: 1497970
Sex: M
Age: 43
State: TX

Vax Date: 06/06/2021
Onset Date: 06/08/2021
Rec V Date: 07/23/2021
Hospital:

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Lab Data:

Allergies: None.

Symptom List:

Symptoms: After the first dose heart palpitations worsened, muscle pain, fatigue, chest pain (sharp pains), shortness of breath, pain and numbness in legs.

Other Meds: Naproxen, Metoprolol, Rosuvastatin, Levothyroxine.

Current Illness: None.

ID: 1497971
Sex: F
Age: 12
State: SD

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

Vax Type:
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Lab Data:

Allergies: PCN and Amoxicillin

Symptom List:

Symptoms: Patient given vaccination at the age of 12 instead of 18. Patient had no adverse reactions. Family was notified of results.

Other Meds: NA

Current Illness: NA

ID: 1497973
Sex: F
Age: 34
State: IN

Vax Date: 07/14/2021
Onset Date: 07/22/2021
Rec V Date: 07/23/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Time- 8 days after injection Symptoms- paint and heat at injection site

Other Meds: Duloxetine HCL DR 90 MG, cyclobenzapr 10MG, Gabapentin 300 MG, ibuprofen 200 MG

Current Illness:

ID: 1497974
Sex: F
Age: 23
State: IN

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/23/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: N/a

Symptom List:

Symptoms: I was freezing with chills but had a fever. Muscle aches and a bad headache. It happened all night until about 4am. I only felt those side effects through the night.

Other Meds: N/a

Current Illness: N/a

ID: 1497975
Sex: M
Age: 58
State: NC

Vax Date: 04/12/2021
Onset Date: 05/19/2021
Rec V Date: 07/23/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: I have never had eczema before. I started to get an eczema type rash on my inner elbows, back of the neck, and behind the ears. A teledoc dermatologist prescribed a topical cream that seemed to clear it up, however, it came back. I have it on all of my whole neck, lowers legs, arms, belly, upper thighs, and inside my ears. I also have little red dots on much of my body. I have no idea if this is related to the Covid Vaccine.

Other Meds: Escitalopram 40mg Bupropion xl 150

Current Illness:

ID: 1497976
Sex: M
Age: 66
State: KY

Vax Date: 03/12/2021
Onset Date: 07/20/2021
Rec V Date: 07/23/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: positive for covid-19

Other Meds:

Current Illness:

ID: 1497977
Sex: U
Age: 0
State: KY

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 07/23/2021
Hospital:

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Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Staff went to World Refugee Day to perform COVID19 vaccinations. All 3 vaccines were made available to clients due to boost and prime doses needed. Baskets for each vaccination were label and color coded. Staff ensured the syringes used for each vaccination were different. Upon returning from the event, the vaccinations were entered into a Mass Event in KYIR. Based on the amount given of each, doses wasted, and amount of vaccine taken to the event, the numbers did not match. Upon assessment into the discrepancy, a few situations were determined to be possible: 1) Two patients may have received J&J that were suppose to get Moderna or Pfizer. 2) Nurses miscounted the amount of doses wasted. 3) Nurses miscounted how many doses were obtained from the vials. Due to the small possibility of two patients receiving the wrong vaccination, this nurse notified the Regional Vaccine Coordinator. The Vaccine Coordinator consulted with the state. The state then spoke with the CDC regarding the possibility and they determined the following actions were necessary: 1) Complete VAERS report. 2) Notify all patients who received the Moderna & Pfizer vaccine regarding the possibility of having received the J&J vaccination. 3) Go ahead and administer the required boost doses on time. 3) Provide J&J Fact Sheet to each recipient of Moderna & Pfizer. Staff completing all of the above steps. An interpreter was used to relay the education and the Fact Sheet was given in the appropriate language. No adverse events have been reported by the recipients. Process changes have been implemented within the clinic. One nurse will be assigned to each vaccine when multiple types are offered. Vaccines will be labeled. Will have patients form lines for each vaccine requested. Nurses will remember the 5 rights to safe medication administration.

Other Meds: N/A

Current Illness: N/A

ID: 1497978
Sex: F
Age: 54
State: IN

Vax Date: 01/10/2021
Onset Date: 03/01/2021
Rec V Date: 07/23/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: NKA, NKDA environmental

Symptom List:

Symptoms: Last injection 1/10/2021 began with SOB in Feb, visited Cardiologist on 3/1/2021 - EKG changes 3/24/2021 Echo cardiogram with decreased EF 4/15/2021 CTA, cardiac, with decreased EF started heart failure Rx beginning of April (coreg & entresto) 4/27/2021 - Consult with cardiologist, 6/4/2021 - MRI @ coming up, June 29th, f/u echo with MD appt,

Other Meds: asa, turmeric, cardizem, femara, HTCZ, Ca, Mg, multi-vit, Vit C, Vit D, Zyrtec

Current Illness: SOB noted in February

ID: 1497979
Sex: M
Age: 47
State: FL

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

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Lab Data:

Allergies: None.

Symptom List:

Symptoms: The night of the vaccine I felt like I was coming down with a cold, had chills, felt cold and my body temperature was 100.4. A week later I still have adverse symptoms such as laryngitis, sore throat, runny nose, watery eyes and cough.

Other Meds: None.

Current Illness: None.

ID: 1497980
Sex: F
Age: 53
State: WV

Vax Date: 04/16/2021
Onset Date: 05/12/2021
Rec V Date: 07/23/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Lisinopril; Sulfa

Symptom List:

Symptoms: On May 13th participant went to the hospital because her muscles from the hip down was hurting extremely. Participant stated she could barely move, the next day it felt even worse than the day before. Body was in pain for days could barely walk. Went to medical center and they diagnosed her with polymyalgia rheumatica (PMR). They put her on steroid everyday until she got better.

Other Meds: Aspirin; B12; Calcium Supplement; One a Day; Synthroid mcg; Metformin; Metoprolol; Lasix; Singular; Hydrocodone; Losartan

Current Illness:

ID: 1497981
Sex: M
Age: 72
State: KY

Vax Date: 02/23/2021
Onset Date: 07/19/2021
Rec V Date: 07/23/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: positive for covid-19

Other Meds:

Current Illness:

ID: 1497982
Sex: F
Age: 78
State: CA

Vax Date: 01/01/2021
Onset Date: 01/01/2021
Rec V Date: 07/23/2021
Hospital:

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

Lab Data:

Allergies: Naproxen; Neomycin

Symptom List:

Symptoms: The arm swollen and redness went from my injection site to past my elbow and around to the back. I contacted my Dr about 5-7 days after it began, it was so long ago how am I supposed to remember the dates. The Dr gave me a 7 day supply of Cortisone. After that it began to go down, although I did have pain in the arm and around the arm as well, which was constant and is still there for that matter actually. The Dr just said it was an allergic reaction to the shot.

Other Meds: Vitamin D; Collagen; AREDS PRESERVISION; Biotin

Current Illness: N/a

ID: 1497984
Sex: F
Age: 20
State: WV

Vax Date: 03/19/2021
Onset Date: 03/26/2021
Rec V Date: 07/23/2021
Hospital: Y

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Allergies: The covid vaccine and my birth control shot depo counter reacted got them at about the same time

Symptom List:

Symptoms: The depo and covid shot counter reacted and I was in and out of hospitals and doctors offices and I was Admitted into hospital for three days from a infection from two shots

Other Meds: No

Current Illness: Was in and out of hospital and doctors office from being so sick from the depo shot and covid shot counter reacting

ID: 1497986
Sex: F
Age: 38
State: GA

Vax Date: 07/19/2021
Onset Date: 07/21/2021
Rec V Date: 07/23/2021
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Allergies: PENICILLIN TREE NUTS

Symptom List:

Symptoms: HEADACHE STARTED DAY AFTER VACCINATION (20JULY2021) , CONTINUED UP UNTIL TODAY (23JULY2021) NAUSEA 2 DAYS AFTER VACCINATION PAIN IN MUSCLE OF THE ARM OF SITE DAY OF AND DAY AFTER VACCINE. ICE APPLIED TO SITE, INDUCED MOTION, IBUPROFEN FOR HEADACHE AND ARM PAIN

Other Meds: MULITIVITAMIN VITAMIN D3 IRON IBUPROFIN

Current Illness: HEADACHE NAUSEA

ID: 1497987
Sex: F
Age: 78
State: CA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 07/23/2021
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Allergies: Penicillin; NAPROSYN; Naproxen

Symptom List:

Symptoms: Well my upper right arm swelled up about twice as big as it did with the first shot. It lasted well about a week or so, but I also went to the Dr immediately this time. The Dr prescribed Cortisone. I still have pain in the arm but it is bearable.

Other Meds: Multivitamin; Biotin; Collagen

Current Illness: n/a

ID: 1497988
Sex: F
Age: 42
State: IN

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 07/23/2021
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Allergies: Penicillin

Symptom List:

Symptoms: 1. Hives 2. Facial swelling 3. Wheezing 4. Legs warm to the touch All occurring approximately 2 hours post injection and are still present 23 hours later.

Other Meds: N/A

Current Illness: N/A

ID: 1497989
Sex: F
Age: 53
State: GA

Vax Date: 04/16/2021
Onset Date: 07/07/2021
Rec V Date: 07/23/2021
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Allergies: Macrobid

Symptom List:

Symptoms: The main symptoms was nausea and vomiting. I also exp swollen lymph node (left arm). I had a Xray for the swelling will have a repeat in 3 months to see if the lymph node has went down in size.

Other Meds: No

Current Illness: No

Date Died: 07/04/2021

ID: 1497990
Sex: M
Age: 29
State:

Vax Date: 03/24/2021
Onset Date: 07/04/2021
Rec V Date: 07/23/2021
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Symptoms: Death

Other Meds:

Current Illness:

ID: 1497991
Sex: M
Age: 78
State: MI

Vax Date: 03/02/2021
Onset Date: 07/19/2021
Rec V Date: 07/23/2021
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Allergies: no known allergies

Symptom List:

Symptoms: Pt presented to the ED on 07/19/21 with complaints of nausea, vomiting, sore throat, and generalized weakness. Pt was found to be COVID positive that same day. Pt has been fully vaccinated.

Other Meds: Eliquis, glucophage, miralax, konsyl, norvasc, aspirin, lipito, vitamin D3, synthroid, cozaar, lopressor, deltasone, aldactone, testosterone

Current Illness:

ID: 1497993
Sex: M
Age: 56
State: MD

Vax Date: 05/08/2021
Onset Date: 05/12/2021
Rec V Date: 07/23/2021
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Allergies: Almonds

Symptom List:

Symptoms: Tinnitus in both ears. no polarity , no relief, constant ringing in ears. First emerged ~1week after 2nd dose. Persists until today

Other Meds: Benadryl, Zyrtec

Current Illness: Stress, tightness in gut, stiff / painful neck, psoriasis

ID: 1497994
Sex: F
Age: 43
State: NJ

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 07/23/2021
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Allergies: Unknown

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Symptoms: Continued and persisent nausea and abdominal/stomach pain. Sometimes interfering with daily activities. -No pregnancies in this time period and no history of IBS or related illnesses, etc.

Other Meds: None

Current Illness: None

ID: 1497995
Sex: M
Age: 54
State: SC

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 07/23/2021
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Allergies: None.

Symptom List:

Symptoms: Flu-like symptoms that persisted more than two weeks. Body aches. Nausea. Lethargy. Sadness. Hopelessness.

Other Meds: Gabapentin

Current Illness: Small Fiber Neuropathy, diagnosed 5/26/21

ID: 1497996
Sex: F
Age: 21
State: IA

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 07/23/2021
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Symptoms: This dose was the patient's third dose.

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ID: 1497997
Sex: F
Age: 44
State: NC

Vax Date: 04/14/2021
Onset Date: 04/01/2021
Rec V Date: 07/23/2021
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Allergies: None

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Symptoms: I started having my period for every day for 1 month. It is very heavy and it does not stop.

Other Meds: Birth control pill, vitamin D, and multi vitamin

Current Illness: None

ID: 1497998
Sex: F
Age: 61
State: NY

Vax Date: 03/24/2021
Onset Date: 03/26/2021
Rec V Date: 07/23/2021
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Allergies: None

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Symptoms: Ongoing muscle aches in arm up through neck. Only on the second shot location.. Achiness continuing and persistent 4 months later. And not improving. It's minor but noticeable. Reported initial side effects back in March but this has not gone away. In the neck area it seems as though it may be lymph nodes as well.

Other Meds: Multivitamin, chondroitin glucosamine, magnesium, vitamin d, CoQ10 supplements

Current Illness: None

ID: 1497999
Sex: F
Age: 18
State: CA

Vax Date: 02/26/2021
Onset Date:
Rec V Date: 07/23/2021
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Allergies: NA

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Symptoms: Period cycle became extremely heavy after receiving vaccination. Ever since the vaccine I have been having my cycle for 2 full weeks at a time. There is about a week break of no bleeding and then another 2 week cycle.

Other Meds: Effexor, birth control (Natazia)

Current Illness: NA

ID: 1498001
Sex: M
Age: 17
State: NH

Vax Date: 07/15/2021
Onset Date: 07/17/2021
Rec V Date: 07/23/2021
Hospital: Y

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Allergies: Penicillin

Symptom List:

Symptoms: **Please note - we do not have access to the immunization registry and cannot provide lot numbers or exact dates** Admission Date/Time: 07/18/2021 18:23:00 Discharge Date/Time: 07/21/2021 12:53:15 Chief Complaint COVID vaccine myocarditis Patient Narrative ILLNESS SEVERITY: The patient is returning to baseline, requires assessment. PATIENT SUMMARY: Reason for Hospitalization: Chest pain Admission HPI: a 17 year old young man with a remote history of asthma (last used inhaler 5-6 years ago) who is presenting with 1 day chest pain in the setting of recent Pfizer Covid vaccination. He received his second Pfizer vaccine dose 3 days ago. The following day, he experienced low grade fever to 100.4 and mild headache. He felt fine yesterday, but this morning he woke up with dyspnea and feeling like he "couldn't get air in all the way". He denied feeling chest pressure but endorsed mid sternal chest pain without radiation. The pain was not exacerbated by exercise and was not positional. He presented to an urgent care facility this morning, where they did an EKG that showed ST segment elevations diffusely. He was then transferred to Hospital. he was overall well appearing with slight tachypnea but otherwise normal vital signs. He initially was not endorsing chest pain. They drew a troponin that was elevated to 1515 ng/L with an upper limit of normal 54 (likely 1.5 on our scale). BNP, electrolytes, CBC were all within normal limits. Initial EKG did not have any ST segment elevation. They did a chest XR which did not show any signs of pulmonary edema or cardiomegaly. He later developed chest pain so an EKG was repeated which showed recurrence of the ST elevations diffusely; most prominently in V1-2. Repeat troponin was 2000. He was given a single dose of aspirin 81mg and transferred for further care. In the ED, he was well appearing and no longer endorsing chest pain. He was monitored on continuous telemetry with no abnormalities. His troponin here was 0.27 ng/mL, CRP was elevated to 2.6, he had a mild transaminitis of 41/37 and mildly elevated LDH to 236. Covid antibodies were positive. CBC, ferritin, d-dimer, ESR were all within normal limits, rapid Covid/flu/RSV negative. Repeat EKG was similar to the second EKG with very minimal ST-segment elevations. He denies any URI symptoms, rashes, N/V/D, and joint pain. He's had good PO intake until today. He is an athlete (currently playing baseball) and has never experienced chest pain with exercise. Surgical hx: T&A Family history: Negative for any cardiac pathology or autoimmune disease Allergies: rash with penicillin Social: here with grandma who is legal guardian Hospital Course: admitted to the cardiology floor for continued monitoring of his troponin levels and EKG. The morning after his admission, his troponin was uptrending slightly to 0.37 and echocardiogram showed mildly depressed systolic function and longitudinal strain, so the decision was made to treat. Cardiac MRI performed prior to treatment showed good systolic function but mild LV late gadolinium enhancement and corresponding hypokinesis. He received one time IVIG 2g/kg and IV methylprednisolone 30mg BID for 2 doses. His chest pain came and went throughout his admission and was treated with ibuprofen and Tylenol as needed. He was transitioned over to PO steroids on 7/20 which he tolerated well. On day of discharge, his troponin levels were trending down. Pt was scheduled for outpatient follow up including ECHO at that time. By time of discharge, patient was well-appearing, vitals stable, demonstrating good PO intake. Chest pain was fully resolved. Prescriptions sent to preferred pharmacy. Follow up with cardiology in place. Discharge instructions and return precautions reviewed with patient and parent, who expressed good understanding and agreement with plan. Reasons for new, changed, and discontinued medications: Prednisone for myocarditis to complete 5 day steroid course (last dose morning of 7/24) Famotidine (GI protection while taking prednisone) Reasons for new, changed, and discontinued equipment: NA Relevant Diagnostic Images/Studies: Echocardiogram 7/19: ? Technically difficult examination due to suboptimal echocardiographic windows. Unable to evaluate the atrial septum, systemic and pulmonary veins, pulmonary arteries, and aortic arch. Coronary artery dilation is not excluded. ? Normal valvular function. ? Normal left ventricular size and low-normal systolic function. Reduced longitudinal strain. ? Qualitatively normal right ventricular systolic function. ? No pericardial effusion. Cardiac MRI 7/19: ? Normal left ventricular size and global systolic function. ? Basal inferoseptal, inferior, and inferolateral left ventricular late gadolinium enhancement with corresponding mild hypokinesis. ? Normal right ventricular size and global systolic function. No right ventricular late gadolinium enhancement or regional wall motion abnormalities. ? No significant valvular dysfunction. ? No coronary artery aneurysms. ? No pericardial effusion. Admission EKG 7/18: ST segment changes, non-specific. Discharge EKG: minimal ST segment changes, improved from admission. Tests Pending Adenovirus PCR QuaNT, Stool Adenovirus PCR QuaNT, Urine CMV Antibody IgG CMV Antibody IgM EBV Antibody IgG EBV Antibody IgM EBV Antibody to EA-D, IgG EBV Antibody to NA, IgG Enterovirus PCR QuaL, Stool HSV I/II Combined Antibody IgG Lyme Antibody, Total Mayo Misc Test Miscellaneous Lab Test Miscellaneous Test Arup Miscellaneous Test Arup Miscellaneous Test Arup Parvovirus B-19 IgG Parvovirus B-19 IgM Parvovirus DNA PCR QuaNT, Blood Respiratory Virus PCR Panel - sendout Viral Culture, Non Respiratory These tests will be followed by the Primary Service at Discharge after Discharge Vitals and Discharge Physical T: 37.1 ?C HR: 64 (Monitored) RR: 20 BP: 120/58 SpO2: 96% HT: 167 cm WT: 94.9 kg BMI: 34 Discharge Physical Exam Gen: Well-appearing, well-developed teenager sitting up in bed. Appropriately interactive./ HEENT: Normocephalic, atraumatic. Moist mucous membranes. EOMI, no conjunctivitis. Resp: Clear to auscultation bilaterally, no increased work of breathing. No wheezes CV: Normal rate, RR with no murmurs, rubs, or gallops. Capillary refill <2 sec. Distal pulses 2+. Abd: Soft, non-distended, non-tender. Normal bowel sounds Ext: Normal range of motion of all extremities, no peripheral edema Skin: Pink, warm, no bruising Neuro: Alert, responsive, developmentally appropriate, normal tone Diagnosis List 1. Chest pain, 07/18/2021 2. Shortness of breath, 07/18/2021 3. Myocarditis, 07/18/2021 Procedure History No Procedure History Social History Smoking Status No Smoking Status Documented Allergies penicillin Laboratory Results Returned 48 Hours Prior to Discharge Labs Last 48 Hours Event Name Event Result Date/Time WBC 7.88 K cells/uL 07/20/21 Hemoglobin 12.6 g/dL 07/20/21 Hematocrit 36.6 % Low 07/20/21 Platelet 298 K cells/uL 07/20/21 MPV 9.1 fL Low 07/20/21 RBC 4.17 M cells/uL Low 07/20/21 MCV 87.8 fL 07/20/21 MCH 30.2 pg 07/20/21 MCHC 34.4 g/dL 07/20/21 Red Cell Distribution Width CV 11.9 % 07/20/21 Nucleated Red Blood Cell % 0 /100 WBC 07/20/21 Nucleated Red Blood Cell Count 0 K cells/uL 07/20/21 Absolute Neutrophil Count 6.38 K cells/uL High 07/20/21 Absolute Lymphocyte Count 0.97 K cells/uL Low 07/20/21 Absolute Eosinophil Count 0.02 K cells/uL Low 07/20/21 Absolute Basophil Count 0.01 K cells/uL Low 07/20/21 Absolute Monocyte Count 0.45 K cells/uL 07/20/21 Absolute Immature Granulocyte Count 0.05 K cells/uL High 07/20/21 Neutrophil/Band 81 % High 07/20/21 Immature Granulocytes 0.6 % High 07/20/21 Lymphocyte 12.3 % Low 07/20/21 Monocyte 5.7 % Low 07/20/21 Eosinophil 0.3 % Low 07/20/21 Basophil 0.1 % Low 07/20/21 Sodium 137 mmol/L 07/19/21 Potassium 5.14 mmol/L High 07/19/21 Chloride 102 mmol/L 07/19/21 CO2 21 mmol/L Low 07/19/21 Anion Gap 14 mmol/L 07/19/21 Glucose Level 133 mg/dL 07/19/21 BUN 11 mg/dL 07/19/21 Creatinine 0.61 mg/dL 07/19/21 Calcium 9.3 mg/dL 07/19/21 Phosphorus 4.5 mg/dL 07/19/21 Magnes

Other Meds: None

Current Illness: None

ID: 1498003
Sex: M
Age: 13
State: MI

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/23/2021
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Symptoms: Dose of .5 given of pfizer vaccine instead of .3

Other Meds:

Current Illness:

ID: 1498004
Sex: F
Age: 65
State: VA

Vax Date: 03/21/2021
Onset Date: 04/12/2021
Rec V Date: 07/23/2021
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Allergies: N/A

Symptom List:

Symptoms: Pt. states that after receiving the 2nd dose of Phizer 03/21/2021, started experiencing symptoms 04/12/2021 of arthritis in heels with severe pain.

Other Meds: N/A

Current Illness: N/A

Total 2021 VAERS Injuries: 679,999

Page last modified: 03 October 2021 5:28pm