VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1505661
Sex: F
Age: 32
State: MD

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 07/27/2021
Hospital: Y

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

Lab Data:

Allergies: n/a

Symptom List: Dysphagia, Epiglottitis

Symptoms: Okay well, so within 24 hours was the typical, just sore arm and fever within the first 24 hours. My fever got up to like 101 degrees and I just took Tylenol to mitigate that. Then the next thing that happened was that I gave birth to my baby that didn't have a heartbeat anymore, that was on July 22, 2021. Her original due date was October 4, 2021. I did have a history of fibroid removal surgery and had ultrasounds every two weeks up until that point, and they were negative for genetic issues, preeclampsia and diabetes. So I was scheduled for a C-section for the week around September 20th. But yea I had to deliver July 22, 2021, I noticed a lack of movement and they did an ultrasound and noticed no heartbeat. I did not have any other symptoms, I just noticed that there was no movement.

Other Meds: Prenatal Vitamins.

Current Illness: n/a

ID: 1505662
Sex: F
Age: 64
State: GA

Vax Date: 01/08/2021
Onset Date: 02/20/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: PENICILLIN - RASH

Symptom List: Anxiety, Dyspnoea

Symptoms: Heaviness in both legs, muscle twitching in both legs, aching all over and neuropathy in both legs and right fingers

Other Meds: Prozac 20 mg, Duexis PRN,

Current Illness: Colitis December 2020

ID: 1505663
Sex: F
Age: 33
State: WA

Vax Date: 07/17/2021
Onset Date: 07/25/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: I am feeling COVID-like symptoms a week after I received the second vaccine. Body aches, chills, sore throat, cough, runny nose, loss of taste/smell.

Other Meds: None

Current Illness: None

ID: 1505664
Sex: F
Age: 59
State: NY

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

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1505665
Sex: F
Age: 50
State: FL

Vax Date: 07/13/2021
Onset Date: 07/20/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Pin hole size itchy clear fluid filled blisters on hands, palms, fingers, wrists, arms, legs, bottom of feet. Raised red spots and extremely itchy. Red raised itchy rash clusters on left arm site of vaccination.

Other Meds: Trazodone 100mg, Sertraline 100mg, Propranolol 120mg

Current Illness: N/A

ID: 1505666
Sex: M
Age: 53
State: NY

Vax Date: 06/28/2021
Onset Date: 06/28/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1505667
Sex: M
Age: 71
State: NC

Vax Date: 03/05/2021
Onset Date: 07/19/2021
Rec V Date: 07/27/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Hospitalization for COVID-10 Reported per vaccine Authorization

Other Meds:

Current Illness:

ID: 1505668
Sex: M
Age: 16
State: IN

Vax Date: 07/25/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Nausea, vomiting, headache, arm soreness

Other Meds:

Current Illness:

ID: 1505669
Sex: M
Age: 35
State: FL

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1505670
Sex: M
Age: 57
State: CA

Vax Date: 06/05/2021
Onset Date: 06/19/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: No known drug allergies. Allergic to spinach.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Ever since my vaccination, I seem to be more sensitive to hot weather. Temperatures and humidity that didn't bother me last summer are now making me feel dizzy, nauseated and light headed.

Other Meds: Actos, Farxiga, Metformin, Starlix, Ozempic, Lisinopril, Amlodipine Besylate.

Current Illness: None

ID: 1505671
Sex: M
Age: 42
State: KY

Vax Date: 04/28/2021
Onset Date: 07/24/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Breakthrough case after full vaccination. Asymptomatic.

Other Meds:

Current Illness:

ID: 1505672
Sex: F
Age: 46
State: OK

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

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

Lab Data:

Allergies: NONE

Symptom List: Rash, Urticaria

Symptoms: POSITVE COVID-19 LAB

Other Meds: ACYCLOVIR

Current Illness: NONE

ID: 1505673
Sex: M
Age: 44
State: GA

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: 10 minutes after administration patient experienced a mild seizure-like reaction

Other Meds: None

Current Illness: None

ID: 1505674
Sex: F
Age: 28
State: NY

Vax Date: 07/21/2021
Onset Date: 07/21/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: Reported a cough, body aches, chills and a slight fever of 100.8. Symptoms resolved

Other Meds:

Current Illness:

ID: 1505675
Sex: F
Age: 36
State: NY

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

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

Lab Data:

Allergies:

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1505676
Sex: M
Age: 20
State: NY

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1505677
Sex: F
Age: 31
State: FL

Vax Date: 07/25/2021
Onset Date: 07/25/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Patient got shot, immediately said she didn't feel good, put her head in her hands and passed out with her head on the table. She was unconscious for about 10 seconds then came to. She was drenched in sweat and now chilled. We called EMS to check her out and she was fine. Also stated she had not eaten all day and was very nervous about the shot. She went grocery shopping once done with EMS.

Other Meds: none

Current Illness: none

ID: 1505678
Sex: M
Age: 69
State: GA

Vax Date: 05/03/2021
Onset Date: 07/06/2021
Rec V Date: 07/27/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pts wife stated pt experienced feverish 99. 9, diarrhea, shortness of breathe, cough, and running nose/congestion on 07/05/21. Pts isolation expires on 07/15/21 symptoms resolved. On 07/05/21,Pt was admitted to hospital for shortness of breathe, choking and abnormal color of urine (Red) . At that time, Physicians performed exams and administrated a Covid test and found a positive result for Covid-19 at the hospital. Pts wife continues to share the call to 911 was for abnormal urine , shortness of breathe and choking. Pts wife stated they were not aware of the pt having covid and that there were no close contacts. Wife has been vaccinated. . Pt was transported to another Hospital on 07/06/21 and released on 07/16/21. Pt has not traveled outside/country/state within 14 days of illness.

Other Meds:

Current Illness:

ID: 1505679
Sex: M
Age: 19
State: PR

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 19 year old male reports feeling dizzy, excessive sweating, nauseous and looks pale. Patient is placed on stretcher with legs elevated. Vital signs BP 85/60, SAT 97% P59, R24. Dxt 120 mg. Patient was evaluated by health personnel and Doctor. He was observed for 30 minutes. After 15 minutes patient was feeling better. He was observed for any changes. Patient was evaluated by medical emergency personnel. BP 120/80, 2:15 pm. Patient reports feeling better.

Other Meds: N/A

Current Illness: NKDA

ID: 1505680
Sex: F
Age: 48
State: WA

Vax Date: 01/15/2021
Onset Date: 01/17/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: Dilaudid

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: I got up in the middle of the night to go to bathroom and I was incredibly dizzy. Room was spinning and I fell down. I was nauseous and had a hard time getting back into bedroom. I needed to call someone - two people to come over and help me get back to bed. I didn't go to ER because of the amounts of COVID cases there. But I had never felt that sick before. I had a high fever, could hardly open up my eyes and threw up for two days. I couldn't work and I was super sleepy. The nausea subsided probably about Tuesday. I was really tired, and I slept until about Thursday before I could get up and move around and I had Vertigo really bad throughout those days coming and going - it was bad. I had never had vertigo before. I did that maneuver that can help with Vertigo and that didn't help at all. I was still dizzy when I got my second vaccine a month later. I had that on February 12, 2021, Lot# 006M20A. The dizziness lasted for about two months altogether, I didn't really have too much dizziness after the second vaccine. It would come and go. With both vaccines, within 10 minutes after the injection, I felt a little spacey. A month ago, I had swollen lymph nodes under my right arm. (I was vaccinated both times on my left arm.) Those are gone now. I have had a little bit of dizziness no nausea, vertigo or swollen lymph nodes though. It was about a day or so ago.

Other Meds: Tylenol

Current Illness: No

ID: 1505681
Sex: F
Age: 39
State: OK

Vax Date: 06/04/2021
Onset Date: 06/08/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: Miscarriage; No heartbeat observed at 10 week checkup on 6/8/21

Other Meds: Prenatal supplements

Current Illness: None

ID: 1505682
Sex: F
Age: 74
State: OH

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: pcn- caused a rash asa-just not allowed to have it

Symptom List: Unevaluable event

Symptoms: at one day after second injection, her arm got very red and sore, appeared to have welts developing from the inside out. she has been to her doctor and dermatology, she has had more areas develop all over her arms, back, chest, neck, legs

Other Meds: imuran, pantoprazole, folic acid, b-12, trilogy, flonase, albuterol, vit d2, sumatriptin, anxiety medicine, monolukast, eye drops, tylenol with caffeine, biotin, oxygen at night

Current Illness:

ID: 1505683
Sex: F
Age: 40
State: MN

Vax Date: 12/21/2020
Onset Date: 06/20/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: I have a weird tightening on the right side of my face. My right eye lid is droopy all the time and the right corner of my lip always pulls up, its kind of the opposite of bells palsy and the mornings are much more prominent. I have had occasional chest pain and R arm tingling when this first started. My vision is fine but my eye is very irritated and watery.

Other Meds: Wellbutrin Claritin

Current Illness: none

ID: 1505684
Sex: F
Age: 12
State: NY

Vax Date: 06/28/2021
Onset Date: 06/28/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Agency recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1505685
Sex: M
Age: 35
State: KY

Vax Date: 04/06/2021
Onset Date: 07/24/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Breakthrough case after full vaccination. Asymptomatic.

Other Meds:

Current Illness:

ID: 1505686
Sex: F
Age: 75
State: IL

Vax Date: 07/19/2021
Onset Date: 07/20/2021
Rec V Date: 07/27/2021
Hospital: Y

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

Lab Data:

Allergies: penicillin, contrast dye, morphine, shellfish

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Patient started to have a reaction the day after the vaccine was administered. She started to notice she was feeling "funny". Then on Thursday she noticed her tongue was swollen. Over the next day she had swelling in eyes, face, tongue, and she was unable to breathe. Patient went to the hospital where she was admitted and given benadryl+steroids.

Other Meds: Bupropion Atorvastatin Cetirizine Famotidine Mirtazapine Glipizide Eliquis Lyrica

Current Illness: open heart surgery and partial lung removal in march 2021

ID: 1505687
Sex: F
Age: 51
State: PA

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: adhesive

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient started to feel dizzy and light-headed about 10 minutes after vaccine. Gave patient some water and cool compress and monitored patient for about 30 minutes. Patient also started to having tight/numbing feeling in her left hand. Then developed a headache with a tight feeling in her face. Patient started to feel better but was still experiencing effects. Directed patient to seek medical care at urgent care or emergency room.

Other Meds: Synthroid 88 mcg

Current Illness: None

ID: 1505688
Sex: M
Age: 13
State: NY

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

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1505689
Sex: M
Age: 46
State: NY

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: Dust

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Doctor notes: Progress Notes, MD at 6/28/2021 3:30 PM Chief complaint: Neurologic problem.HPI:6/28/21Consult at request of Dr. 47 y/o man. JJ vaccine 4/6/21. Flew to Syracuse to get vaccine (friend is a pilot). Next AM had fever, flu-like symptoms which lasted 4.5 days. 1-2 days after vaccine developed vertigo. Vertigo occurred while lying down in bed and on getting up from bed. While walking lurched to either side. Couldn't stand on one foot. Turning over in bed with lifting head also caused it. Episodes subsided 1 min after stopped moving. Did not have vertigo while upright. Did not have double vision. No change in chronic tinnitus on L. No change in hearing. No change in speech, swallowing. No confusion. No facial numbness. No limb weakness or numbness. No new HA. Was taking Advil PM for fever, etc. Had covid test and Ab test a few weeks before vaccine. Vertigo lasted 4 - 5 days. On 4/18, after it ended, went on a date, had 2 drinks over course of 7 hours. 2 days later, on 4/20/21 again felt ill with temperature and vertigo, which persisted for another 5 days. Saw his acupuncturist Dr. and vertigo resolved after acupuncture treatment. Continued to have fatigue for several more weeks. Saw Dr. 5/13/21, dx BPPV. Sees functional medicine doctor. Lost 35 lb with diet. Started on B12 Data:3/12/21: covid ab neg5/13/21: covid ab neg PMH/PSH: Strabismus surgery 2002; psoriasis Social History: No substance abuse. Employment - business consultant; musicianFamily History: No neurologic illnessMedications: Vit d 500 daily; b12 1000 daily; topicals Allergies: Dust; shrimp; cocoa PE:General: NAD. MS: Oriented to person, place and time. Recent and remote memory intact. Attention and concentration normal. Normal fund of knowledge. Language - no evidence of aphasia or dysarthria. CN: VA grossly normal. VFF. PERRL. EOMI, no nystagmus. PP intact b/l V1-V3. Face symmetric. Hearing grossly intact. Palate elevates symmetrically. Shoulder shrug 5/5 b/l. Tongue midline.Motor: 5/5 x 4. Tone normal. No tremor or other abnormal movements. No drift. Sensory: PP intact x 4. Coord: FTN normal.DTR: Arms 1; KJs 1; AJs 2. Plantars: flexorGait: Narrow base. Normal heel, toe. Tandem slightly difficult. No Romberg. Impression:Positional vertigo and imbalance in setting of flu-like illness after Johnson and Johnson flu vaccine received 4/6/21. Symptoms currently resolved. MRI Brain/IAC and MRV head ordered to r/o CVA, venous sinus thrombosis. Covid PCR and Ab sent today. I will message with test results. FU PRN I personally spent a total of 60 minutes face-to-face and non-face-to-face time reviewing the patient's chart and documenting in the record. This total time was performed before, during, and after the visit on the same service date. 6/28/2021 3:30 PM1 sst tube, 1 viral swab sent to nyp lab

Other Meds: Omega-3 Capsules, Vitamin D, B12, Folate

Current Illness: None

ID: 1505690
Sex: F
Age: 47
State: TX

Vax Date: 07/24/2021
Onset Date: 07/25/2021
Rec V Date: 07/27/2021
Hospital:

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Lab Data:

Allergies: Penicillin and sulfa drugs.

Symptom List: Nausea

Symptoms: Fever of 101.2, fatigue, injection site pain, bone pain in shoulder and clavicle, diarrhea, sore neck, sore throat, runny nose, sneezing, headache, dry cough.

Other Meds: None

Current Illness: None

ID: 1505691
Sex: M
Age: 20
State: CA

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
Hospital:

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Allergies: none

Symptom List: Injection site pain

Symptoms: Patient sitting in chair and lost full consciousness. Patient fell over out of chair, hitting head on floor. Patient face mask removed, patient noted breathing but remained unconscious for a about 30 seconds. Upon regaining consciousness patient is alert and oriented x4, and diaphoretic. Denies any pain or discomfort at this time. Denies any other signs and symptoms. Denies Hx of anaphylactic reaction to medications, food, or vaccines. Patient denies adverse reactions to vaccinations in past. Vitals: 11:07: BP 123/55. Pulse 55, SpO2: 97%. Pain: 0; Rapid response called by staff. Rapid response team arrived and updated on patient's status. Patient transported to ER with rapid team per physicians recommendation at 11:10.

Other Meds: none

Current Illness: none

ID: 1505692
Sex: F
Age: 52
State: NY

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 07/27/2021
Hospital:

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Lab Data:

Allergies:

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1505693
Sex: F
Age: 92
State: GA

Vax Date: 02/13/2021
Onset Date: 07/24/2021
Rec V Date: 07/27/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Patient hospitalized due to COVID-19. Patient is fully vaccinated.

Other Meds:

Current Illness:

ID: 1505694
Sex: F
Age: 57
State: CA

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 07/27/2021
Hospital:

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Lab Data:

Allergies: antibiotics, amoxcicyllin

Symptom List: Tremor

Symptoms: Palpitations, anxiety, BP 160/82, Pulse 80, no chest pain, trouble breathing noted, patient asked to remove mask. Patient transferred to gurney, Gave her sips pf water. Vitals checked after 15 minutes Bp 142/82, Pulse 68. Patient states she feels better. Patient observed for another 30 mins. Patient left with daughter and stated she will take her blood pressure medication when she reaches home. Advised to consult with PCP regarding adverse reaction and to clarify before taking second dose of Pfizer. Suggested to go to ER is symptoms persist again. Not any palpitations or any adverse reactions while left for home.

Other Meds: beta blockers, nadolol

Current Illness:

ID: 1505695
Sex: M
Age: 91
State: NY

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

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Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1505696
Sex: M
Age: 51
State: MI

Vax Date: 02/10/2021
Onset Date: 03/10/2021
Rec V Date: 07/27/2021
Hospital:

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Lab Data:

Allergies: None

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Decreased Platelet Count

Other Meds: Multi Vitamin, Fish Oil

Current Illness: None

ID: 1505697
Sex: M
Age: 25
State: OH

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: No known allergies

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Site of injection became red, swollen & patient reported itchiness within 5 minutes of administration of vaccine

Other Meds:

Current Illness:

ID: 1505698
Sex: M
Age: 21
State: NY

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 07/27/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1505699
Sex: F
Age: 18
State: IN

Vax Date: 07/23/2021
Onset Date: 07/24/2021
Rec V Date: 07/27/2021
Hospital:

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Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: fatigue, shortness of breath, tightness in chest, low grade fever

Other Meds: Vyvanse 20 mg, Latuda 20 mg, Lexapro 10 mg, Naproxen 500 mg

Current Illness:

ID: 1505700
Sex: F
Age: 13
State: ID

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
Hospital:

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Lab Data:

Allergies: Augmentin, Omnicef, Strawberries, Latax

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Anaphylaxis

Other Meds:

Current Illness:

ID: 1505701
Sex: M
Age: 60
State: KY

Vax Date: 04/06/2021
Onset Date: 07/24/2021
Rec V Date: 07/27/2021
Hospital:

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Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Breakthrough case after full vaccination. Asymptomatic.

Other Meds:

Current Illness:

ID: 1505702
Sex: F
Age: 15
State: NJ

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

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Lab Data:

Allergies: No

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: She started with a fever 102, chills, headache, body pain. As of today she still exp sinus pressure, ear pain both sides (side going down gland to neck), headache and body pain. She was taken to the doctor informed to give Tylenol and Ibuprofen.

Other Meds: No

Current Illness: No

ID: 1505703
Sex: F
Age: 62
State: MI

Vax Date: 07/12/2021
Onset Date: 07/17/2021
Rec V Date: 07/27/2021
Hospital:

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Lab Data:

Allergies: Sulfa; Iodine; Latex; Tetracycline; Erythromycin

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Had only a very sore arm until on Saturday 7/17/21 woke up with severe pain, cramping, tightness, fizzing sensation in the calves of both legs. This sensation then spread to the backs of my thighs and buttocks on Sunday. 7/18. This burning, fizzing, tight pain has since spread to soles of my feet and I often have hip joint pain too. I have experienced this pain intermittently throughout the day and am awoken every night at 2or 3am with this pain in the calves, backs of my thighs, buttocks and joint pain in my hips.

Other Meds: Mercaptopurine 25 mg daily; Turmeric 2000mg daily; Hyaluronuc acid 1800 mg daily Flint stones vitamin with iron one daily; N-Acetyl Glucosamine 500 mg -2 daily; Co Q10 - 400 mg daily; Vitamin D3 2000 IU daily; Magnesium Glycinate 200mg dai

Current Illness: N/A

ID: 1505704
Sex: M
Age: 26
State: NY

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 07/27/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1505705
Sex: M
Age: 64
State: NM

Vax Date: 05/26/2021
Onset Date: 07/16/2021
Rec V Date: 07/27/2021
Hospital:

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Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: I received my comprehensive physical exam around the time of my second Moderna shot on May 26, 2021. I received my first Moderna shot on April 30, 2021. My blood was drawn the day before my second shot, on May 25, and I had a TSH reading of 8.06, higher than it had ever been before (my TSH was tested 5 times since September 2016). My blood was drawn again 6 weeks later, on July 16, and the TSH reading was 15.03! T3 and T4 levels were normal: T3 uptake 32, free T4 index 2.1, T4 total 6.5. I seem to feel decreased energy and possibly a change in mood associated with hypothyroidism.

Other Meds:

Current Illness:

ID: 1505706
Sex: F
Age: 33
State: NY

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

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Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 15 minutes after administration of Pfizer vaccine her Initial complaint was light headedness and nausea, shortly followed by shortness of breath and anxiety. Taken to ED

Other Meds:

Current Illness:

ID: 1505707
Sex: F
Age: 32
State: WI

Vax Date: 01/23/2021
Onset Date: 04/09/2021
Rec V Date: 07/27/2021
Hospital:

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Lab Data:

Allergies: NKA

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: I received the vaccine while pregnant. My son was born 4/9/21 at 10:45 pm. At 7 pounds 7.8 ounces. He got circumcised and had bleeding issues. Then over the course of the next few months he was having issues where he bruised really easily. Took him to his pediatrician and she the referred him to a hematologist who confirmed he has a mild platelet disorder-unsure of which one as he is too young to do further testing. My family has no history of bleeding disorders that I?m aware of.

Other Meds: Prenatal vitamins Protonix Unisom

Current Illness: None

ID: 1505708
Sex: F
Age: 55
State: CA

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 07/27/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient c/o itchiness in throat, given 25mg Benadryl, Vitals 176/82, Pulse 82, O2 98%, Patient transferred to gurney, no any symptoms of stroke, BP checked again after 10 minutes BP 150/90, Pulse 70, After 5 minutes patient c/o numbness on left side of face, no drooping noted, 911 called for suspected stroke, Patient notified husband by phone herself, Patient taken by ambulance to Hospital for further evaluation

Other Meds: lisinopril 20mg

Current Illness:

ID: 1505709
Sex: F
Age: 70
State: NE

Vax Date: 03/26/2021
Onset Date: 04/08/2021
Rec V Date: 07/27/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Zoloft; Cefzil; summer allergies

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: On April 8, 2021, a violent case of diarrhea, followed for the next 110 days by others (including today), almost daily, of very soft bowel movements, large amounts, sometimes entirely liquid coming on very suddenly. A colonoscopy June 18, 2021, with biopsies identified the culprit as lymphocytic colitis. Treatment so far is a careful diet, smaller meals, a Pepto Bismol capsule once daily in the morning with breakfast. Follow up appointment with Consultants in Gastroenterology on August 6, 2021, to determine if there is any other help to reduce inflammation.

Other Meds: Amlodipine 5 mg Once daily; Paroxetine HCI 10.0 mg Once daily; Estradiol tab 1 mg Once daily; Metronidazole Gel USP 1.00% Twice daily; Latanaprost-both eyes 0.01% Once daily; Levobunolol-left eye 0.01% Once daily; Methylcellulose-fiber 2000

Current Illness: High blood pressure - controlled; Irritable bowel syndrome

ID: 1505710
Sex: F
Age: 28
State: NJ

Vax Date: 04/26/2021
Onset Date: 07/02/2021
Rec V Date: 07/27/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: None

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Positive pregnancy test, followed by constipation, nausea, bloating, lower back pain (continuing until now)

Other Meds: Claritin, Align Probiotic, Ritual Prenatal Vitamin, Naturemade 600mg Calcium softgel

Current Illness: None

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am