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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1500954
Sex: M
Age: 39
State: DC

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient received Janssen Covid-19 vaccine 4/12/21 and requested Pfizer Covid-19 vaccine 7/24/21 after discussion with PCP. Patient worried about Delta varient.

Other Meds:

Current Illness:

ID: 1500955
Sex: F
Age: 73
State: CO

Vax Date: 07/09/2021
Onset Date: 07/14/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List:

Symptoms: Swelling, pain, blisters, pain, redness, itching around shot area. Spreading up and down and around arm. Itching through out body. Pain in legs

Other Meds: Losarton, Levothyroxine, Metoprolol, Eliquis, aspirin

Current Illness: none

ID: 1500956
Sex: F
Age: 37
State: HI

Vax Date: 04/30/2021
Onset Date: 07/21/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Positive COVID PCR on 7/23/21

Other Meds: Drysol

Current Illness: none

ID: 1500957
Sex: F
Age: 12
State: NV

Vax Date: 06/03/2021
Onset Date: 06/05/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Monthly menustration immediately afterwards...way early

Other Meds: None

Current Illness: None

ID: 1500958
Sex: M
Age: 33
State: NV

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List:

Symptoms: Full body rash- hives that got worse over night

Other Meds:

Current Illness:

ID: 1500959
Sex: M
Age: 52
State: DC

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient received Janssen Covid-19 vaccine 03/15/21. After discussion with PCP he decided to obtain the Pfizer Covid-19 7/24/21. He stated that he is worried about the Delta varient.

Other Meds:

Current Illness:

ID: 1500960
Sex: F
Age: 32
State: NJ

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

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: Patient stated she was nervous about getting vaccine due to fear of needles, but she got herself this far, so she wanted to proceed with the vaccine. Vaccine was administered, she seemed somewhat relieved that it was over. I asked her to stay sitting for at least 15 minutes to see if she had any reaction. I walked away from her, but about 2 minutes later I heard her calling me. I ran over to her and she was ready to faint. I held her onto the chair so that she wouldn't hurt herself by falling, I called a pharmacy tech over to help me, and we both eased her off the chair and onto the floor. She was breathing rapidly and had a strong pulse. We asked her if she wanted us to call anyone, she asked us to call her fianc?, pharmacy tech called him, he asked us to call 911, which pharmacy tech did. Police arrived within minutes and administered oxygen, EMS and fianc? also arrived later. EMS evaluated her and eventually allowed her to leave when they were satisfied that she was ok. I called her around 5 pm to check up on her, she said she was doing fine, simply a reaction due to her fear of needles.

Other Meds: None; using an IUD

Current Illness: None

ID: 1500961
Sex: F
Age: 47
State: FL

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

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

Lab Data:

Allergies: PENICILLIN

Symptom List:

Symptoms: Within 10 minutes of administering the vaccine, the patient reported numbness in the left arm. There was no pain or redness, but she reported that her arm felt numb. Advised the patient to take Tylenol or Ibuprofen and contact doctor if symptoms persist for more than 3 days. I called the patient 4 hours later and she reported that the numbness was gone and she was feeling better.

Other Meds:

Current Illness: SNIFFLES, LIGHT CONGESTION

ID: 1500962
Sex: M
Age: 16
State: FL

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient was given covid vaccine at approximately 8:15pm. About 5 minutes later, patient was sitting outside with mother when the mother started calling the patients name saying that he just had a seizure or it looked like he was convulsing. I ran out to check on the patient whom at the time was back to alertness and conscious. He was slowly breathing but fully alert and slightly leaning on the chair next to him while holding onto his mom. Technician was told to call 911 at that time as well . About 2-3 minutes later as I turned to grab the phone the patient started to shake again for about 5 to 10 seconds and went back to full alertness. At this point I was checking the patient breathing & pulse while following the instructions of the operator on the phone. After which the paramedics arrived and took over to work up the patient.

Other Meds: none

Current Illness: none

ID: 1500963
Sex: M
Age: 81
State: IA

Vax Date: 06/17/2021
Onset Date: 07/22/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Apparent vaccine administration error. According to vaccination registry, this patient received a complete 2 dose Pfizer series on 1/13/2021 and 2/03/2021, respectively. This was done at a different long term care facility by Department of Health did verify that records indicate vaccine doses were administered. Current facility and patient's wife indicated to us that no previous covid doses given and he was in need of the series. Error in the registry? Possible same name and date of birth but 2 different people? Wife a poor health historian? Regardless, another series was completed on 6/17/2021 and 07/16/2021. 4 doses. Patient experienced no known adverse effects.

Other Meds:

Current Illness:

ID: 1500964
Sex: M
Age: 81
State: IA

Vax Date: 07/16/2021
Onset Date: 07/22/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Apparent vaccine administration error. According to electronic vaccination registry, this patient received a complete 2 dose Pfizer series on 1/13/2021 and 2/03/2021, respectively. This was done at a different long term care facility by Department of Health did verify that records indicate vaccine doses were administered. Current facility and patient's wife indicated to us that no previous covid doses given and he was in need of the series. Error in the registry? Possible same name and date of birth but 2 different people? Wife a poor health historian? Regardless, another series was completed on 6/17/2021 and 07/16/2021. 4 DOSES. Patient experienced no known adverse effects.

Other Meds:

Current Illness:

ID: 1500965
Sex: M
Age: 19
State: IL

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

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

Lab Data:

Allergies: PEANUTS, GREENUTS, SESAME, SHELLFISH, BLUE CHEESE

Symptom List:

Symptoms: PATIENT CAME IN WITH HIS MOTHER, I ADDRESSED ALL CONCERNS AND QUESTIONS REGARDING JANSSEN VACCINE AND ALLERGIES PATIENT HAD. MOTHER STATED THAT THEY DISCUSSED WITH PCP ABOUT ALLERGIES AND VACCINE OPTIONS, MOTHER STATED SHE HAS HIS EPIPEN ON THEM INCASE OF EMERGENCY. VACCINE WAS GIVEN TO PATIENT, HE SAT DOWN AND WITHIN 10 MINUTES OR SO PATIENT LOSS CONSCIOUSNESS, BEGAN DROOLING, AND COULD NOT BE WOKEN UP AFTER REPEATED ATTEMPTS. EPIPEN 0.3MG (IM) WAS ADMINISTERED TO THIGH AND PATIENT REGAINED CONSCIOUSNESS. 911 WAS CALLED AND PARAMEDICS ARRIVED WITH 5-10 MINUTES. PATIENT VOMITED TWICE, AND WAS SWEATING PROFUSELY. ONCE AWOKEN, HE WAS AWARE OF HIS SURROUNDINGS, WHO I WAS AND HIS MOTHER, APOLOGIZED FOR THE INCIDENT. MOTHER AND SON THEN LEFT WITH PARAMEDICS TO HOSPITAL.

Other Meds: UNKNOWN

Current Illness: UNKNOWN, NONE THAT MOTHER OR SON EXPRESSED DURING CONSULTATION PRIOR TO VACCINE

ID: 1500966
Sex: M
Age: 38
State: MN

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Arm pain at injection site starting 5 hours post injection and continuing is intensity over the course of 12 hours. Pain decreased and was not present after 24 hours.

Other Meds:

Current Illness:

ID: 1500967
Sex: M
Age: 57
State: NC

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

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

Lab Data:

Allergies: none listed

Symptom List:

Symptoms: Patient was status-post recent stroke but came in to receive the second Moderna vaccine today. There are currently no contraindications from AHA or otherwise stating stroke patients should not receive the Moderna COVID vaccine. Immediately after the vaccine, the patient began sweating noticeably but no other symptoms were noted. After 15 minutes, the patient seemed OK and left the pharmacy.

Other Meds: toujeo, novolog, mitigare, ezetimibe, jardiance, clonidine , lisinopril, carvedilol, hydrochlorothiazide, blood sugar monitor

Current Illness: patient had experienced a recent stroke

ID: 1500968
Sex: F
Age: 35
State: DC

Vax Date: 05/02/2021
Onset Date: 07/01/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: DVT blood clot in right calf

Other Meds: None

Current Illness: None

ID: 1500969
Sex: M
Age: 18
State: FL

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

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

Lab Data:

Allergies: PENICILLIN, DAIRY, PEANUTS, TREE NUTS, SHELLFISH

Symptom List:

Symptoms: Within 10 minutes of vaccination, the patient reported feeling numb in the left arm. It was not painful, there was not swelling or redness. I advised patient to contact doctor if the numbness persisted for 3 days, I advised the patient to take Tylenol or ibuprofen. I called the patient back 4 hours later and the patient's mom reported that the numbness was gone, but the arm was now itchy. I advised the patient to seek out his PCP if the feeling was still there after 3 days.

Other Meds:

Current Illness:

ID: 1500970
Sex: F
Age: 13
State: NV

Vax Date: 06/03/2021
Onset Date: 06/05/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Early menstration immediately afterward

Other Meds: None

Current Illness: None

ID: 1500971
Sex: F
Age: 30
State: SC

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: Patient preceding to lobby after immunization and collapsed in the Immunizers Arms. Patient was immediately taken back to the immunization room and her preceding to faint again and convulsive. He was placed on the floor. We he came thru he was alert and responsive. His heart rate had dropped to 56. EMS arrived and accessed the patient. He was asked to stand and then he became light headed. EMS sat him down and he became very nauseated and begin to faint and seize again. Patient was immediately taken to the hospital for further evaluation.

Other Meds: NONE

Current Illness: NONE

ID: 1500972
Sex: F
Age: 16
State: OH

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: PATIENT WAS PALE, CLAMMY, FELT HOT, NAUSEA, VISUAL AND AUDITORY DISTURBANCES--- PATIENT GIVEN COLD COMPRESS TO NECK, BP CHECKED TWICE AND INCREASED ON 2ND READING, PATIENT LAID ON BACK/FEET UP--- OVER 10 MINUTE PERIOD, PATIENT FELT BETTER AND WAS ABLE TO LEAVE ON OWN.

Other Meds:

Current Illness:

ID: 1500973
Sex: F
Age: 12
State: PA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient reported having difficulty breathing about 5-10 minutes after COVID-a9 vaccine administration. She took her mask off to allow for easier breathing and was given water and 25 mg benadryl. She sat for about 30 minutes and began to feel better. Patient's dad stated that she often gets worked up when getting a vaccine and is anxious about the possible side effects she may experience. Patient and father left. We called them about 1 hour later and spoke with father who said she is feeling better and thinks it was all self-induced.

Other Meds:

Current Illness:

ID: 1500974
Sex: M
Age: 15
State: TX

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient experienced vasovagal symptoms, blacked out, excessive sweating, difficulty swallowing/drinking, difficulty keeping head up. Symptoms occurred within a few minutes of the vaccine injection. Patient stated similar symptoms when they drew blood previously. Patient started feeling better after a couple a minutes sitting down.

Other Meds: None

Current Illness: None

ID: 1500975
Sex: M
Age: 57
State: GA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 07/24/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient received his second dose of Moderna Covid-19 vaccine on 5/25/21 in the morning. That afternoon he had a headache and took a Goody's powder. He later vomited severely and vomited up blood. He went to the hospital and was hospitalized for 5 days. They did have to give him replacement blood in the hospital. No further information provided.

Other Meds: OTC Goody's powder

Current Illness: None

ID: 1500976
Sex: F
Age: 53
State: CO

Vax Date: 02/04/2021
Onset Date: 03/16/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin Sulfa Mollusks

Symptom List:

Symptoms: Rash within 24 hours of 2nd shot. Lasted 12 hours until I took liquid Benedryl. 5 weeks after 2nd Covid shot, sudden onset of hearing loss. Tinnitus. Went to primary care doctor. 1 week of oral steroids. Sent to ENT doctor. Audiology tests showed hearing loss right ear. Put on 1 week of oral viral medication No help. Had MRI. No pathology present. Hearing loss and tinnitus still present 4 months later.

Other Meds: Levothyroxin Ibuprofen Doxylamine succinate OTC

Current Illness: None

ID: 1500977
Sex: F
Age: 18
State: IL

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient fainted and fell down from the chair in the vaccination waiting area following first dose of Covid-19 vaccine . Syncope(fainting) , Fall from chair, : Paged "Code White", called store management over, Cleaned wound and blood with alcohol, have her drink water, have patient rest until she felt normal. Advised patient to take Tylenol or Advil for pain. Called to verify if patient was ok next day . Called Supervisor and spoke to pharmacy manager regarding the event . Reported the event into center System.

Other Meds: n/a

Current Illness: none

ID: 1500978
Sex: F
Age: 69
State: OH

Vax Date: 03/15/2021
Onset Date: 07/21/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: A MRI was done on my left breast on 7/21/21. The results showed an enlarged lymph node in the left axilla. An ultrasound was done to confirm it. Probably benign. I will go back for another ultrasound in 6 months.

Other Meds:

Current Illness:

ID: 1500979
Sex: F
Age: 76
State: MS

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: PATIENT AWOKE UNABLE TO MOVE. SHE CALLED AMBULANCE AND WAS TREATED AT HOSPITAL AND AT PRIMARY DOCTOR

Other Meds:

Current Illness:

ID: 1500980
Sex: M
Age: 40
State: NC

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

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

Lab Data:

Allergies: Codiene

Symptom List:

Symptoms: As soon as she injected me my lips, throat and face started tingling.

Other Meds: None

Current Illness: Sarcoidosis

ID: 1500981
Sex: F
Age: 46
State: AZ

Vax Date: 07/10/2021
Onset Date: 07/10/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: The patient presented to our pharmacy on 7/23/21 complaining of a red bump on her left arm near the vaccination site. The arm had a visible red spot on it. The patient said the spot appeared after getting the vaccine on 07/10/21 and has not improved since she got the vaccine. The patient stated the spot is warm to the touch and she reports pain radiating to her neck. The patient was counseled to follow up with her pcp and to take otc analgesics and antihistamines.

Other Meds:

Current Illness:

ID: 1500982
Sex: F
Age: 57
State: CT

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

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

Lab Data:

Allergies: none reported

Symptom List:

Symptoms: Beginning directly after immunization, patient asked if feeling hot (indicated chest up into neck, and that it felt like a hot flash) was typical. Given she was clearly getting worried, we took a BP, result 166/100 with pulse 112. Patient decided she wanted to sit and try to calm down, felt it could be anxiety, and asked for water. We gave water and some orange juice, which she thought might help. Within 10-15 minutes we retook BP, now 157/98 pulse 86. She noted feeling much improved, and after a couple minutes decided to leave, as she was feeling much better. Calling patient to check on her several hours later, she said it had just felt really odd, but that the feeling of hotness went away and she was feeling 100% improved

Other Meds: n/a

Current Illness: none reported

ID: 1500983
Sex: F
Age: 59
State: GA

Vax Date: 05/04/2021
Onset Date: 05/28/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Nausea Vomiting Extreme Muscle Fatigue Chills These symptoms began 24 hours after my second vaccination and lasted for 3.5 weeks. Today, they all recurred. I have had no treatment.

Other Meds: None

Current Illness: None

ID: 1500984
Sex: M
Age: 29
State: KS

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: pt passed out while sitting in waiting area after vaccination, hitting head on can display. Was unconscious for approx. 5-10 sec. Paramedics called and evaluated pt. Pt had not eaten today and had BG=65. BP normal x3. Pt was given water, OJ and a candy bar to elevate BG. Wife picked up pt per paramedics suggestion. Pt recovered and reports no injuries or other side effects

Other Meds: escitalopram, bupropion

Current Illness: none

ID: 1500985
Sex: F
Age: 30
State: AK

Vax Date: 02/16/2021
Onset Date: 07/24/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: Sore arm where vaccine was given 5 months ago. Visible spot of vaccination noted .

Other Meds: No

Current Illness: No

ID: 1500986
Sex: F
Age: 13
State: CA

Vax Date: 07/20/2021
Onset Date: 07/20/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List:

Symptoms: Moderna was given to 13 years old patient

Other Meds: n/a

Current Illness: n/a

ID: 1500987
Sex: M
Age: 60
State: CA

Vax Date: 10/10/2018
Onset Date: 10/13/2018
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: Up to the vaccination, I wasn't allergic to anything that I knew of

Symptom List:

Symptoms: 1) entire left side of body (from head to toes) went numb - this last about one year 2) Severe pain/inflammation in neck and shoulder - acute for almost a year, after a year and with various therapies it started to be less severe - but it's still present. In particular, when I walk up inclines it activates this injury. 3) Severe "nerve" headache in left back side of head. The worst stage lasted over a year It is still there -- it seems to increase and decrease with intensity, but it's always present. 4) Left side of my face was particularly numb -- acute for over a year -- slowly is getting better, but still comes and goes. 5) I could not lift my left arm for a year and a half. It was very weak and had no mobility of movement. In its acute stage it lasted over a year and a half. It is slowly improving, but is still quite compromised. The place where the needle went in is still sore as well. 6) severe fatigue -- this lasted for a year 7) fog brain/sluggish thinking -- the worst lasted for a year, but it still comes and goes 8) Cramps/spasms throughout my body -- they lasted for weeks at a time -- in calves, feet, thighs, and left hand mostly 9) other odd sensations in my torso -- a feeling of "flush" in my torso -- it would come and go. This lasted for about a month. 10) numb throat and hoarseness -- the numb throat went away after 2 months but the hoarseness lasted about 8 months 11) abdominal pain and mildly nauseous stomach until October 18th 12) twitches throughout my body (especially in arms and legs) that lasted about 4 months 13) Dizziness - lasted about 6 months 14) feelings of heaviness in body and head -- this lasted about 8 months 15) a feeling of pressure in my head -- this lasted for about 3 months

Other Meds: Temazepam PRN; fish oil; vitamin D; vitamin B complex

Current Illness: None

ID: 1500988
Sex: M
Age: 15
State: MA

Vax Date: 07/01/2021
Onset Date: 07/04/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient experienced chest tightness and pain 4 days post vaccination. Parents had the patient evaluated at local emergency department for endocarditis/pericarditis and they determined that he had an abnormal EKG finding but could not diagnose endocarditis without additional testing.

Other Meds: none

Current Illness: none

ID: 1500989
Sex: F
Age: 18
State: CA

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

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

Lab Data:

Allergies: None reported by client.

Symptom List:

Symptoms: At approximately 1132, following a 2nd dose Pfizer COVID (LOT# EW0183, exp: 08/31/2021) Co-Lead RN, noted client 18 y/o female sitting in observation area stating to her father " I am not feeling well". Co-Lead RN, Lead RN, and EMT responded. A few seconds later, client turned pale and lost consciousness while seated. Client assisted to a supine position on the floor by Lead RN , EMT and Co-Lead RN. Client regained consciousness within 10 seconds of being placed supine on the floor. Client's skins were pale, clammy and cool. At 1134 vital signs were taken in supine position: BP: 108/81, HR: 70, RR26, Spo2 98% RA. Client's father reports there is a family history of syncope with injections. Furthermore, the client's father states that the last time the client ate was last night. Client denies hydrating this morning prior to vaccination. Client's father denies allergies foods/medications/environment, medical history, or use of medications. At 1141, client was assisted to a seated positions on floor and monitored for about 1 minute before transferring client to wheelchair at 11:43. Vital signs were taken at 11:43 in seated position: BP 116/75, HR: 100, RR:16, Spo2: 99% RA, and skins were pink, warm and dry. At 1214 another set of vital signs were taken: BP 101/74, HR: 94, and RR 14. Pt states "I am feeling better" and symptoms have completely resolved at 1156. Client's father provided with ER precautions and advised to follow up with PCP. At 1215 client left observation site with her father and with a steady gait.

Other Meds: Non reported by client.

Current Illness: None reported by client.

ID: 1500990
Sex: F
Age: 16
State: NY

Vax Date: 04/27/2021
Onset Date: 04/30/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: NKDA/ none.

Symptom List:

Symptoms: Developed Postural Tachycardia Syndrome (POTS) with vomiting and diarrhea, 20 lb weight loss. She was evaluated by pedi GI, who made the diagnosis based on labs, EKG, vital signs, and clinical presentation. Symptoms started 3 days after the 2nd Pfizer COVID vaccination was administered. She was treated with supportive care (fluids, salt, compression stockings), omeprazole 20 mg BID, cyproheptadine 2 mg BID. She received a single dose of decadron (for croup on June 25,2021). Her symptoms have improved though they have not fully resolved. she continues on omeprazole and cyproheptadine.

Other Meds: Yaz, Claritin

Current Illness: none

ID: 1500991
Sex: F
Age: 70
State: UT

Vax Date: 07/07/2021
Onset Date: 07/11/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Rash with pruritis on both legs, behind knee and behind upper thigh. Onset was 4 days after injection. Nausea all day, onset was 1 week after injection. Depression, irritability, poor mood, onset was 1 week after injection.

Other Meds: None

Current Illness: None

ID: 1500992
Sex: M
Age: 51
State: NC

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: pt passed out within 5 seconds after receiving the first dose of moderna

Other Meds: none

Current Illness: none

ID: 1500993
Sex: M
Age: 50
State: FL

Vax Date: 04/19/2021
Onset Date: 04/26/2021
Rec V Date: 07/24/2021
Hospital: Y

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

Lab Data:

Allergies: unknown

Symptom List:

Symptoms: Starting 1 week after second dose; ear ringing, just getting better Starting from 3 weeks after second dose to now: swollen hands, feet, ankles, tingling pain along tibia bones, brain fog, joint pain whole body, nuscle weakness and twitching

Other Meds: None

Current Illness: none

ID: 1500994
Sex: M
Age: 20
State: IL

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Paralysis from the waist up including arms, hands and face for approximately 20 min. Difficult breathing, increased heart rate.

Other Meds:

Current Illness:

ID: 1500995
Sex: F
Age: 62
State: CO

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: My right eye started twitching, like a tic. It continued day and night. Gradually it tapered off and was gone 1 month later

Other Meds: Losartan

Current Illness: None

ID: 1500996
Sex: F
Age: 17
State: NC

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

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

Lab Data:

Allergies: none stated

Symptom List:

Symptoms: Patient got the vaccine and was fine and talking. Pt got up off the chair and walked to the door and she fainted. We got her lying on the floor and she was breathing and talking.. We sat her up once she felt better and gave her water. We monitored her for 30 plus minutes.

Other Meds: unknown

Current Illness: none stated

ID: 1500997
Sex: F
Age: 51
State: CA

Vax Date: 04/16/2021
Onset Date: 05/24/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Since 5/24 I have been having some episodes of low blood pressure and high pulse rate (e.g. 81/49 BP, 129 pulse). Experiencing at the same time palpitations, lightheadedness, fatigue, sleepiness. Frequency was average once a week but increased to nearly once per day in the last week. I do not think this is related necessary to the vaccine. But as the question on the survey was if I have had any issues since, I am reporting it.

Other Meds: Losartan

Current Illness:

ID: 1500998
Sex: F
Age: 48
State: CA

Vax Date: 07/13/2021
Onset Date: 07/13/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: E.Mycin, paprika, all hot peppers, mild black pepper, other food-related flushing reactions that I have not yet figured out the cause, cannot use NSAIDs due to gut issues (see below).

Symptom List:

Symptoms: Immediate severe burning pain from vaccine site up the right side of my neck to my head, and same down my arm almost to my hand. Throat also felt tight but no restriction of respiration. Shaking, cold/chills, dizzy after a few minutes, mostly subsided in 30min, but arm pain remained. Pain still present, red/purple rash appeared 24hr after vaccine as well as intense itching, ALL still remaining 11 days later. Called pharmacy, suggested Dr visit for blood work.

Other Meds: None

Current Illness: none

ID: 1500999
Sex: M
Age: 18
State:

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Attendee received first dose Pfizer vaccine at 13:10 in the left arm. Lot# FA3780. Attendee was directed to observation area. At 13:15 voiced complaints of nausea and feeling hot. Chest discomfort 1/10. Attendee's skin was warm and dry. Attendee assisted to the wheelchair and was taken to the cot to lie down. Icepack applied to face and neck. 13:21 - Attendee still with nausea and feeling hot. No chest discomfort, at this time. HR: 63 BP: 100/60 RR: 20 O2Sat%: 99 Temp: 97.4 13:35 - No voiced complaints- skin warm and dry. HR: 82 BP: 102/60 RR: 18 O2Sat%: 99 13:45 -Denied complaints - skin warm and dry. 13:50 - Care Practitioner educated on home discharge/adverse reaction instructions and attendee was discharged to home with his partner. Attendee did not have any reported escalation of symptoms and was able to walk out of clinic independently.

Other Meds:

Current Illness:

ID: 1501000
Sex: F
Age: 17
State: NJ

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient received a first dose Moderna Covid vaccine at a Pharmacy on January 13, 2021 accompanied by her parents. When the family returned to receive their Moderna vaccine second doses the facility refused to administer second dose Moderna vaccine to the patient as she was underage according to the Moderna guidelines. Parents were told that the pharmacy would be in touch to facilitate resolution and subsequently they were never contacted by anyone from the pharmacy according to the mother. The patient's pediatrician, was able to facilitate the patient receiving her second dose Moderna vaccine through a vaccination clinic at the hospital. The patient was given her second dose of Moderna vaccine as an off label use and according to CDC guidelines on July 23 at 5:30pm and was monitored for 15 minutes without incident. The mother filed a complaint with the pharmacy customer service about this situation of her daughter being delayed receiving her second dose Moderna shot.

Other Meds:

Current Illness:

ID: 1501001
Sex: M
Age: 16
State: NM

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: The patient received 1st dose, about 2 minutes after felt dizzy then fainted. The patient was accompanied by mother and grandmother. He passed out for several seconds then came back and said he felt hot, fingers on right hand felt tingling. Looked like he might have passed out again but for only 1 second. My mom requested EMTs be called, EMTs called and patient taken by ambulance to hopital. Mother did call 2 hours later saying the patient was released and doing fine.

Other Meds: epiduo

Current Illness:

ID: 1501002
Sex: F
Age: 49
State: TX

Vax Date: 07/22/2021
Onset Date: 07/23/2021
Rec V Date: 07/24/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List:

Symptoms: Hot arm to touch; pain at injection site; sore to lift/move arm; exhaustion

Other Meds: Lisinopril and Ziac

Current Illness: NA

ID: 1501003
Sex: M
Age: 51
State: FL

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: pt passed out approximately 2 minutes after receiving pfizer covid vaccine. he slid down his chair onto the floor. we immediately called 911. Pt woke up and started talking. Pt stayed on the floor until the paramedica arrived a few minutes later. The pt's blood pressure was low. He told them he didnt eat anything all day. They started an iv and pt was going to the hospital to evaluate him further. He said he has had this happen before when he had to draw blood.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm