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
72,296
AK1,638
AL5,339
AR3,412
AS44
AZ13,316
CA58,147
CO11,002
CT7,824
DC1,626
DE1,670
FL36,235
FM3
GA13,429
GU82
HI2,195
IA4,332
ID2,473
IL19,261
IN22,568
KS4,284
KY6,945
LA4,714
MA13,886
MD11,901
ME2,997
MH8
MI17,865
MN11,345
MO8,919
MP30
MS2,676
MT2,147
NC15,401
ND1,273
NE2,732
NH2,859
NJ17,232
NM3,702
NV4,071
NY32,763
OH18,072
OK5,940
OR7,954
PA22,457
PR2,104
QM2
RI1,911
SC6,055
SD1,133
TN8,691
TX34,122
UT4,023
VA13,944
VI49
VT1,661
WA13,811
WI10,395
WV2,220
WY805
XB5
XL1
XV2

ID: 1520738
Sex: F
Age: 34
State: LA

Vax Date: 07/31/2021
Onset Date: 07/31/2021
Rec V Date: 08/02/2021
Hospital:

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

Lab Data:

Allergies: Medications: penicillin, codeine, Demerol, Decorcel Forte Plus, Phenergan Food: mushrooms Products: wool, latex bandages

Symptom List:

Symptoms: Around 9pm on July 31, I began feeling feverish and having chills. My back also started hurting. I tried to go to bed and slept off and on all night. My upper left arm, which was where the shot was administered, was sore. The next day, August 1, I had a lessened fever with my skin still warm to the touch. I slept off and on throughout the day and drank vitamin flavored water and regular bottled water and ate small amounts of cinnamon applesauce and took Tylenol for the fever as the pharmacist at pharmacy had advised. I started feeling better that evening and attempted to eat some sliders around 7pm, only to feel nauseous and vomit three times after 9pm. My heartbeat was also irregular throughout the day. Today, August 2, I woke up with my skin still warm to the touch and irregular heartbeat. I took two naps at the time of this writing (7:47pm CDT). So far I have eaten cinnamon applesauce and Chicken-in-a-Biscuit crackers and drank vitamin flavored water and bottled water and have not vomited yet. I have also taken Tylenol and after the second nap, I woke up around 5:30pm CDT with a headache. I took some pharmacy brand Excedrin, which my body is used to for headaches, and ate some crackers and drank some water. I have also applied peppermint oil to my forehead, which is a standard treatment procedure I use for headaches. As of 7:49pm CDT, the time of this writing, my headache has subsided, along with any arm pain. I still feel slightly warm to the touch, though. The irregular heartbeats also seem to have slowed to normal pace/rate.

Other Meds: Herbal supplements: Theramedix BioSet Recovery Support; Xymogen Liver Protect; Arctic Oils OmegaPure 900 EC; Xymogen ActivNutrients without Iron; Xymogen MedCaps T3 Preventative: Mili 0.250 mg Painkillers: Equate Pain Reliever Acetaminophen

Current Illness: none

ID: 1520739
Sex: M
Age: 33
State: MA

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: none

Symptom List:

Symptoms: patient appeared to passout and possibly have a seizure . We called his name and his eyes rolled in his head. he awoke disoriented. He threw up a couple of times . ems was called and patient was monitored in store over an hour as he refused medical treatment. Patient was sweaty with low bp pale 108/78 patient later claimed to have ptsd with vaccinations since age 2

Other Meds: unknown

Current Illness: unknown

ID: 1520740
Sex: M
Age: 44
State: CA

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

Vax Type:
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Lab Data:

Allergies: NKA

Symptom List:

Symptoms: PATIENT IMMUNIZATION CONSENT FORM WAS REVIEWED AND CONFIRMED PATIENT IS NOT SICK AND CAN RECEIVED SECOND DOSE OF MODERNA COVID VACCINE. PATIENT DID NOT FEEL DIZZY OR FAINT ON FIRST DOSE OF MODERNA OR ANY PREVIOUS VACCINATION. AFTER GETTING THE VACCINE, PATIENT WAS TOLD TO SIT AND WAIT 15 MINUTES IN THE PHARMACY FOR ANY VACCINE ADVERSE REACTION. PATIENT STARTED TO FEEL DIZZY AND HIS WIFE GOT HIM AN ORANGE JUICE TO DRINK. PATIENT WAS ALSO SITTING IN THE BLOOD PRESSURE MACHINE AT THE TIME. SO AS THE PATIENT DRINKS THE ORANGE JUICE, HE PASSED OUT AND HIT THE BACK OF HIS HEAD ON THE FLOOR. WE IMMEDIATELY CALLED ED, AND PHARMACY EMPLOYEES WERE THERE TO ASSIST AND HELP OUT WITH THE SITUATION. PATIENT WAS THEN BROUGHT TO THE ER

Other Meds: N/A

Current Illness: N/A

ID: 1520741
Sex: F
Age: 60
State: MN

Vax Date: 04/20/2021
Onset Date: 04/22/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Aluminum, mercury, formaldehyde, polysorbate 80

Symptom List:

Symptoms: After first shot I was very tired and sore for four weeks. I had to nap often and take ibuprofen. I postponed second shot. I was very tired and sore for several weeks after second shot. I had aches in all my joints. I had to nap often. I had to cancel activities. I had to take ibuprofen. I needed help around the house. I was waiting for symptoms to resolve before filing a report. I am better but I still have intermittent body aches in my joints. I still have some residual fatigue. I am still hoping to make a full recovery. I don't know if that will happen.

Other Meds: Xyrem, Hizentra, potassium citrate, Vit D and E, low dose naltrexone, Tymlos, NAC, zinc, pqq, PREGNENOLONE. Tmg, B12, Algea-Cal, tyrosine, 5-HTP, Lithium, CoQ10,

Current Illness:

ID: 1520742
Sex: F
Age: 53
State: FL

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

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Lab Data:

Allergies: None

Symptom List:

Symptoms: 15 days after taking 2nd dose of Pfizer vaccine I noticed a scab on my lip and my face around my mouth got itchy. I?ve had cold sores before so familiar with the symptoms. But haven?t had one in years and had only occur when my immune system is weak from a fever. In the past. And I have not been sick.

Other Meds: OTC vitamins, psyllium, gut cleanser

Current Illness: None

ID: 1520743
Sex: M
Age: 12
State: UT

Vax Date: 07/22/2019
Onset Date: 07/22/2019
Rec V Date: 08/02/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: itching at vaccine site

Other Meds:

Current Illness:

ID: 1520744
Sex: M
Age: 39
State: VA

Vax Date: 04/08/2021
Onset Date: 07/01/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Fainted. Hit head on floor and went to ER. Likely a vasovagal syncope event observing blood in conjunction with fatigue and mild dehydration.

Other Meds: None

Current Illness: None

ID: 1520745
Sex: F
Age: 53
State: GA

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 08/02/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Fever, headache, body aches, chills and fatigue started about 7 hours after 2nd vaccination. Symptoms lasted about 24 hours. Dull headache and fatigue continued for a couple of more days.

Other Meds: Levothyroxine .112mg

Current Illness: None

ID: 1520746
Sex: F
Age: 11
State: VA

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient came with mother, after completing form online and making an appointment. I printed the completed form; had the mother go over it and sign it. Obtained copy of mother's ID and insurance card. Gave mother patient information sheet. Did counseling and administered vaccination to the daughter. When processing the claim, insurance rejected it for invalid DOB. I called insurance and was told the DOB for patient is 01/08/2009. This is not what the mother filled-out on the consent form.

Other Meds: None

Current Illness: None

ID: 1520747
Sex: M
Age: 25
State: WA

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
Hospital:

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Lab Data:

Allergies: n/a

Symptom List:

Symptoms: Patient fainted a few minutes after the shot was administered in the vaccine post waiting area

Other Meds: marijuana

Current Illness: n/a

ID: 1520748
Sex: F
Age: 49
State: SC

Vax Date: 04/01/2021
Onset Date: 07/12/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
Manufacturer:
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Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Covid 19 positive after vaccine

Other Meds:

Current Illness:

ID: 1520749
Sex: F
Age: 15
State:

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: no adverse event noted at this time. patient is in good health standing

Other Meds:

Current Illness:

ID: 1520751
Sex: F
Age: 29
State: CA

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
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Vax Name:
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Lab Data:

Allergies: none kown

Symptom List:

Symptoms: Vaccine Administered at 3:27 PM. After 15 minute obersation patient stated she was feeling tingling sensation on Left Arm. FNP assessed patient and per provider observe patient for additional questions. After (15) minute observation took vitals 3:59 PM Spo2: 89 % Pulse : 71 BP: 94/62 mmg. Per patient symptons were relieved after observation, Notified provider and was release home. Advised is symptoms persist she may contact Per PCP or our office. Or she may go to nearestest emergency room if symptons worsen or other symptoms develop. patient verbalized understanding and agreed

Other Meds: none kown

Current Illness: none kown

ID: 1520752
Sex: M
Age: 22
State: NM

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
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Lot:
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Vax Route:
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Lab Data:

Allergies: Allergic to Latex

Symptom List:

Symptoms: He was very anxious about getting the vaccine. As soon as the vaccine was administered he fainted. He regained consciousness within about 10 seconds. Was disoriented and very pale. He sat in the chair for about 20 minutes after and was given some cold water.

Other Meds: Unknown

Current Illness: None that he mentioned.

ID: 1520753
Sex: F
Age: 16
State: NV

Vax Date: 07/31/2021
Onset Date: 07/31/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: UNKNOWN

Symptom List:

Symptoms: NONE

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1520754
Sex: M
Age: 25
State: FL

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: None

Symptom List:

Symptoms: Patient passed out while shopping in the store 30 minutes after shot

Other Meds: None

Current Illness: None

ID: 1520755
Sex: M
Age: 66
State: NY

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: The next day I had severe diarrhea and extreme gas. It has improved slightly since then but has continued. I went to the Dr. and have had a stool culture done which was negative and a colonoscopy which was also negative.

Other Meds: Crestor 10mg Nexium 40mg Calcium 600 Multivitamin Aspirin 81 mg

Current Illness: None

ID: 1520756
Sex: M
Age: 13
State:

Vax Date: 07/30/2021
Onset Date: 07/31/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
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Lot:
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Lab Data:

Allergies: Amoxicillin,

Symptom List:

Symptoms: 13 yo m bib FOP at insistence of MOP for concerns of perceived facial swelling, most notably around superior eyebrow/lid of R eye, lesser on L eye and b/l cheeks, acute onset 3hrs pta noticed by MOP while eating dinner (pizza, which Pt has had previously); pt has hx of mild environmental allergies for which he takes zyrtec but Pt and FOP deny hx of severe/anaphylactic rxn or use of epipen/hospitalization; Pt states perceives mild swelling of this area only after MOP mentioned it, denies any frank pain or irritation sx's at this time; Pt denies any cp, sob, dyspnea, throat swelling/difficulty swallowing/talking, other rashes/lesions, sore throat, urinary color changes, fevers/ns/chills. FOP mentions that Pt received. FOP mentions that Pt received Pfizer vaccine for covid19 approx 24hrs pta and additionally has recently up-titrated anti-seizure Rx, and MOP was worried about rxn to these things (specifically describes SJS/TENS) ROS: General: No fatigue, fevers/chills, malaise Eyes: facial swelling; No eye pain, eye discharge, visual changes Ears: No ear pain, hearing changes Nose/throat: No nasal congestion, sore throat CV: No chest pain, palpitations, syncope, edema Pulm: No SOB, wheezes, cough, hemoptysis GI: No anorexia, abd pain, nausea, vomiting, diarrhea GU: No dysuria, hematuria, urgency, frequency Neuro: No HA, seizures, weakness, numbness/tingling, vertigo, lightheadedness, AMS Skin: No rash, lesions, itching Heme: No easy bruising/bleeding, petechiae All systems reviewed and negative except as stated above. Physical Exam: Vital signs reviewed, no acute intervention necessary General: NAD, WNWD, AOX3, cooperative Head: Normocephalic, atraumatic Eyes: mild edema of R superior lid w/o erythema/ttp/warmth; no other visible orbital edema of L or R orbits; no perceived edema of cheeks/rest of face; PERRL, EOMI, no conjunctival injection, no scleral icterus Ears: No edema/erythema of otic canal, no TM edema/erythema/dullness/bulging Nose: No nasal discharge Throat: No pharyngeal edema, erythema, tonsillar exudates, uvular deviation, asymmetric swelling, trismus, drooling, or voice changes Neck: No meningismus; normal ROM Lymph: No cervical lymphadenopathy Respiratory: Unlabored breathing, normal respiratory effort, LCTAB CV: Normal peripheral circulation, RRR, no m/r/g Abd: Soft, NTND Skin: No rashes, petechiae, or purpura Neuro: Grossly intact, moves all extremities equally, gait normal MSK: No TTP, deformity, ecchymosis, or focal edema Psych: Normal mood, normal affect, appropriate responses

Other Meds: UNK

Current Illness: brain tumor

ID: 1520757
Sex: M
Age: 60
State: FL

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 08/02/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: The shot seemed very high in my shoulder. I have had pain in my left shoulder since the shot. It started on the day of the shot and continues through today. It was more intense at the time of the shot, but it still is painful. It is difficult for me to sleep on my left side and it hurts when I lift my left are in certain ways.

Other Meds: Simvastin

Current Illness: None

ID: 1520758
Sex: F
Age: 31
State: CO

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

Symptom List:

Symptoms: Patient started feeling "pins and needles". She then had a seizure. Her blood pressure was low and she was extremely hot. The seizure was short. We had her lay on a mat and put ice packs on her and gave her water. She said she hadn't eaten today so we gave her orange juice to raise her blood glucose. Patient is not diabetic. Patient recovered quickly. She refused offer of ambulance. Her boyfriend arrived and said he was going to feed her then take her home.

Other Meds: Suboxone and sertraline

Current Illness: no known illnesses

ID: 1520759
Sex: F
Age: 49
State: TX

Vax Date: 07/26/2021
Onset Date: 07/30/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: Declomycin and zpac

Symptom List:

Symptoms: Immediate sore arm that I could hardly move. Was hot to the touch for days then the raised welted rash that is red and warm to the touch

Other Meds: None

Current Illness: None

ID: 1520760
Sex: F
Age: 50
State: NY

Vax Date: 07/29/2021
Onset Date: 07/31/2021
Rec V Date: 08/02/2021
Hospital:

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

Lab Data:

Allergies: Walnut, Enbril, Humira, beta blockers, ace inhibitors.

Symptom List:

Symptoms: White tongue with loss of taste, joint pain lasting 3 days, lethargy lasting 3 days

Other Meds: Hydroxychloroquine, Sulfasalazine, Verapamil, vitamin d, B12, Tiznadadine, ketorolac.

Current Illness: Psoriatic arthritis, psoriasis.

ID: 1520761
Sex: F
Age: 25
State: TN

Vax Date: 02/02/2021
Onset Date: 07/17/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Vax Site:

Lab Data:

Allergies: sulfa, zithromax

Symptom List:

Symptoms: first dose received 2/2/21. on 7/17/21 I experienced a blackout spot in the bottom left field of my vision. I was then diagnosed with central retinal vein occlusion after a second event on 7/27/21 that lasted approx. 48 hours.

Other Meds: nuvaring, pre/pro-biotic, xerac (underarms topical), acanya (facial topical), retinol cream (facial topical)

Current Illness: none

ID: 1520762
Sex: F
Age: 36
State: ME

Vax Date: 07/09/2021
Onset Date: 07/09/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Vax Route:
Vax Site:

Lab Data:

Allergies: biaxin, bacitracin, augmentin

Symptom List:

Symptoms: 45 minutes post vaxx- hit with the most intense wave of nausea, heart palpitations, sweats, chills, pain, numbness and tingling. First 48 hours- I've never felt worse in my body, never felts stranger in my body, and I honestly can't describe half of the sensations I experienced as I've got no reference points for them. 3 weeks later-was still spiking 101 fevers almost daily, most consistent symptom has remained numbness and tingling of my upper left quadrant, 2x the whole right side of my body went numb, far higher pulse rate than normal, diarrhea, nausea, lack of appetite, easily fatigued. 3.5 weeks-with treatment nerve symptoms are lessoning, and feeling better over all although still incredibly fatigued, and have brain fog/fullness sensation.

Other Meds: prenatal vitamins, vitamin d, liposomal vitamin c

Current Illness: none

ID: 1520763
Sex: F
Age: 52
State: CA

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: allergies to unknown substances, pt states thinks it's to shellfish but can't confirm

Symptom List:

Symptoms: Pt states history of two anaphylactic episodes requiring epi-pen use in the past, most recent January of 2021. Does not know what the allergen is. Pt received first dose Pfizer and stated top of head "itch" within 2 minutes followed by resolution of these symptoms several minutes later. Pt's vitals: 138/92, HR 82, lungs clear, unlabored breathing, no acute distress, no s/s shock, no notable oral swelling. Repeat vitals appx 5 minutes later 150/90 HR 96, states feeling anxious. EMS arrival at 2:37 pt not in distress states feeling well but anxious (states history of anxiety) EMS vitals 150's/90's and SpO2 97%. Pt clearing throat but states this is "normal" for her when nervous, daughter confirms this. Pt also states clears throat frequently because it's always "raw". EMS assessment no airway swelling/redness/compromise at this time. No visible hives/rash. Lungs clear bilateral on repeat auscultation. Pt educated safety of ride to hospital via EMS, states would like to take self to hospital with daughter instead of EMS, has epi-pen with her, declines EMS ride. Pt leaves after 30+ minute observation period, ambulating freely, speaking in clear/coherent sentences and able to swallow water freely, state going to the hospital down the street. States itching at top of head resolved.

Other Meds: ibuprofen

Current Illness:

ID: 1520764
Sex: F
Age: 74
State: AZ

Vax Date: 05/14/2021
Onset Date: 05/20/2021
Rec V Date: 08/02/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: The patient reported a rash developed on her abdomen, left breast and left shoulder the evening of 05/20/2021. By 06/09/2021, the rash covered more of her body including shins, calves, buttocks, right breast and shoulder. Her PCP prescribed triamcinolone cream and Zyrtec 10mg on 07/09/2021, but it has not been effective in treating the rash. He is now adding prednisone to the regimen in hopes of alleviating the itching associated with the rash. The patient reported the rash began as welts, then after being itched, developed into dry, scabby blisters.

Other Meds:

Current Illness:

ID: 1520765
Sex: F
Age: 58
State: SC

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 08/02/2021
Hospital:

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

Lab Data:

Allergies: Sulfur based medications

Symptom List:

Symptoms: Within 2 hours of taking the vaccine, I experienced tightness and weakness on my left side. My left eye and left side of my mouth tightening up as if I was having a stroke or some type of Paralysis like Bell's Palsy. Prior to the left side weakness/paralysis, it felt as if tiny balls or blood clots were going through my veins. I became very tired and as a result, I took a nap. I was awakened by the "pulling sensation" in my face. When I awakened, I couldn't speak correctly or open my left eye all the way.. My daughter researched and brought cold water to me. it helped. I am reporting this on the 3rd day after the event. I am currently suffering from wheezing, exhaustion, double vision and brain fog.

Other Meds: None

Current Illness: None

ID: 1520956
Sex: M
Age: 15
State: NY

Vax Date: 06/24/2021
Onset Date: 06/26/2021
Rec V Date: 08/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: 2 days later patient developed nausea and vomiting and then became lethargic. The following day the patient developed backstep while walking which progressed to freezing in place and more repetitive movements.

Other Meds:

Current Illness:

ID: 1520957
Sex: F
Age: 32
State: IA

Vax Date: 07/30/2021
Onset Date: 07/30/2021
Rec V Date: 08/02/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List:

Symptoms: Muscle twitching in bilateral lower legs starting 12 hours after vaccination. Periods of pins and needles occurring in conjunction with twitching. Has been going on for 3 days straight now.

Other Meds: Yaz birth control

Current Illness: No

ID: 1520958
Sex: F
Age: 52
State: MN

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 08/02/2021
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Allergies: Penicillin, dairy, Horses

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Symptoms: Itching/tingling neck, cheeks, mouth, tongue, lips. Took 50 mg Diphenhydramine, 600 mg ibuprofen. Swelling in neck and shoulder with large fluid-like bulges including down left side of ribs. Hives at injection site. Lasted about 4 days Fever over 102 degrees Fahrenheit for 42 hours. Lethargy, exhaustion, feeling of fogginess in thinking, dizziness lasting for first 3 days, then lessened but continued for about 15 days with periods of overall not feeling well for total of 4 months.

Other Meds: none

Current Illness: None

ID: 1520959
Sex: M
Age: 22
State: TN

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 08/02/2021
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Allergies: na

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Symptoms: Patient sat down and in under 5 minutes of receiving the vaccine the patient's eyes rolled back in head and he passed out. Patient was placed on the floor where he regained conscienciousness quickly. Said he had been in er previous week with low blood sugar possibly dehydrated. Checked his BP was close to normal ...and HR. His HR was 96. Patient was given a glucose tablet and sugar checked by ems once they arrived and it was normal. The ems evaluated his vitals stood him up and he began to look pale and light headed again. He was placed on gurney and taken to hospital. No further info on treatment available other than his grandfather a couple days later said he was doing ok and having someone check his heart.

Other Meds: unknown

Current Illness: pt had been dehydrated and low blood sugar previous week. He was possibly dehydrated and low blood sugar at time of vaccine as well per the patient.

ID: 1520960
Sex: F
Age: 47
State: WA

Vax Date: 05/21/2021
Onset Date: 07/14/2021
Rec V Date: 08/02/2021
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Allergies: none

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Symptoms: I had a mammogram done on 7/14 and the image shows three lumps in my left breast and under left arm, I was called back to get a ultrasound scan which showed potential malignancy, I had a biopsy done on 7/28 and the results confirmed existence of Diffuse Large B-Cell Lymphoma.

Other Meds: multi-vitamin

Current Illness: none

ID: 1520961
Sex: F
Age: 38
State: OH

Vax Date: 02/10/2021
Onset Date: 02/25/2021
Rec V Date: 08/02/2021
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Allergies: none

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Symptoms: Heart palpitations starting very suddenly and intensely starting at night and lasting through the next morning. Watch showed Afib so went to MD for an ECG. I have a history of PVCs and that is what this ended up being. I took metoprolol for 7-10 days and it went away. I have not had them since. Even with my history I do believe this "episode" was brought on by the vaccine. It started at a very specific moment and very intensely where I was more uncomfortable than I have been in the past and concerned it was something else.

Other Meds: Juice plus, Omega Complex, Vitamin C and D, Wellbutrin XL 300mg, Loestrin FE, xanax prn

Current Illness: none

ID: 1520962
Sex: M
Age: 68
State: AR

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
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Allergies: Biaxin, amoxicillin, IV Contrast, Demorol

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Symptoms: Feeling feverish, joint pain, sore muscles,

Other Meds: Omeprazole, Prozac, Losartin, Metaprolol, Minoxidil, Gabapentin, Flomax, statin, Mobic, Amitryptiline.

Current Illness: Sinus infection

ID: 1520963
Sex: F
Age: 15
State: CA

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 08/02/2021
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Allergies: None Known

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Symptoms: Vaccine Administered on 07/28/2021 at 1:39 PM. At 1:53 PM patient began experimenting nausea and vomitting . Patient was assesed by Dr. Vitals were taken: Pulse: 86 Spo2: 96% BP: 86/64 mmhg. Per Dr. ordered to provide patient with Zofran to alleviate Nausea vaccines, but patient deferred medication. Per Dr. provided hydration and observe patient for additional (15) minutes. After 15 minute observation Vitals taken 2:10 PM: Pulse: 81 Sp2: 97% BP: 90/64mmhg. Per patient symptons were relieved and per Dr. okay to release home. patient notified if symptoms worsen may go to emergency room.

Other Meds: None Known

Current Illness: None Known

ID: 1520964
Sex: F
Age: 36
State: CA

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 08/02/2021
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Symptoms: dizziness, headache immediately after vaccine, now with bilateral leg pain and heaviness

Other Meds: Tylenol

Current Illness:

ID: 1520965
Sex: M
Age: 49
State: MN

Vax Date: 05/20/2021
Onset Date: 05/22/2021
Rec V Date: 08/02/2021
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Allergies: None

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Symptoms: Fever, chills, muscle aches, and joint pain within 12 hours of receiving injection. I was already receiving treatment for SI joint pain prior to receiving the vaccination and this aggravated the joint. Approximately 48 hours after receiving injection, I experienced a sudden onset of Tinnitus. It has now been 10.5 weeks and the Tinnitus has not subsided or changed in intensity.

Other Meds: Buproprion XL tablet 300 mg once daily Loratadine tablet 10 mg once daily

Current Illness: None

ID: 1520966
Sex: M
Age: 16
State: CA

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
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Allergies: INJECTABLE IRON

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Symptoms: PATIENT BECAME PALE AND PASSED OUT FOR A BRIEF MOMENT AND PATIENT SPONTANEOUSLY SHOOK AWAKE WHILE SITTING IN CHAIR. UNCLE STOOD INFRONT OF HIM TO PREVENT FALLING, RN SUPERVISOR AND I CHECKED LOC PATIENT AAO AND GIVEN ORANGE JUICE AND REMAINED WITH PATIENT FOR 15 MINUTES. PATIENT INSTRUCTED TO LIE DOWN FOR ANOTHER 15 MINUTES AND VITALS CHECKED BEFORE DISCHARGE. PATIENT AMBULATION STABLE. LVN

Other Meds: N/A

Current Illness: N/A

ID: 1520967
Sex: F
Age: 32
State: MI

Vax Date: 07/28/2021
Onset Date: 07/30/2021
Rec V Date: 08/02/2021
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Allergies: N/a

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Symptoms: Starting feeling pain in left armpit of arm shot was given on 7/29 on 7/30 I woke up to a small red spot under the arm. On 7/31 spot got bigger and noticed another spot on the other side of same arm pit. On 8/01 red spots became larger, bumpy and more red, burning and tingling sensation. Spots are very painful. On 8/2 I went to emergency road where a doctor took a look and diagnosed me with Shingles, he stated it was due to the ingredients in the moderna shot causing shingles to surface as a reaction. I've never had this before. Never any skin issues like this. And it's very painful.. I now have noticed a red painful mark on the left side of my neck.

Other Meds: N/a

Current Illness: N/a

ID: 1520968
Sex: F
Age: 11
State:

Vax Date: 07/21/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
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Symptoms: Was informed today that patient is actually 11 years old. In the appointment scheduler and on form parent/guardian listed date of birth differently.

Other Meds:

Current Illness:

ID: 1520969
Sex: F
Age: 46
State: WA

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
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Symptoms: Patient experienced numbness of face and tongue; she said it felt like after the dentist. Onset was 15 minutes after administering the vaccine. Per patient was mostly gone after 1 hour of waiting and 50mg benadryl. at 6pm follow up phone call she said it was 90 percent better.

Other Meds:

Current Illness:

ID: 1520970
Sex: F
Age: 30
State: CA

Vax Date: 04/04/2021
Onset Date: 04/04/2021
Rec V Date: 08/02/2021
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Allergies: Sulpha drugs, bananas, walnuts, all raw foods, cats, dogs

Symptom List:

Symptoms: Rash, chest pains, tachycardia , high blood pressure, arm pain, cognitive difficulties.

Other Meds: Flexeril 10mg (3xday) Albuterol inhaler(6-8 puffs a.n.) Pantropazole 40mg Loratadine 10mg Gabapentin 600mg (3xdsy) Trazadone 50mg x2 Ipatropium Bromide (neb a.n) Albuterol (neb a.n) Advair 500/50 Zofran 4mg Tessalon pearls 100mg Montelukas

Current Illness:

ID: 1520971
Sex: F
Age: 37
State: FL

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
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Symptoms: patient felt fine but was itchy on neck. admistered benadryl and patient decided to leave after 20 more minutes of waiting

Other Meds:

Current Illness:

ID: 1520972
Sex: M
Age: 61
State: NV

Vax Date: 07/30/2021
Onset Date: 07/31/2021
Rec V Date: 08/02/2021
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Allergies: Pennicillen

Symptom List:

Symptoms: Chills, diarrhea, nausea, clammy skin

Other Meds:

Current Illness: None

ID: 1520973
Sex: F
Age: 51
State: FL

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
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Allergies: none i know

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Symptoms: as soon as i take the vaccine after 2 minutes my mouth salive test blood.

Other Meds:

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ID: 1520974
Sex: F
Age: 53
State: AZ

Vax Date: 02/18/2021
Onset Date: 07/08/2021
Rec V Date: 08/02/2021
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Allergies: None

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Symptoms: Developed tachycardia, heat intolerance, posterior cervical lymphadenopathy, a pruritic rash on the upper back, and a tender swollen thyroid.

Other Meds: Ibuprofen prn (1-2 per week), multivitamin (Women's One A Day) once per day

Current Illness: None

ID: 1520975
Sex: F
Age: 62
State: GA

Vax Date: 04/10/2021
Onset Date: 05/25/2021
Rec V Date: 08/02/2021
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Allergies: Dilantin

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Symptoms: Unexplained abdominal bruises on several occasions. I have previously had a history of abdominal pain; I don't know if the abdominal pain I now have is related in any way to the vaccine. First unexplained bruises appeared on about May 24th or 25th. Additional bruises since then, with the most recent one being on about July 22nd. I do not know if the bruising is a reaction to the vaccine. I am reporting in case my information is helpful to research. And of course, I would like to know if the bruises are related and if there is any action I should take.

Other Meds: Oxtellar, Cymbalta, Atorvastatin, Losartan, Amlodipine, Buproprion, Pantoprazole, Lidocaine patch, Tylenol 3, alprazolam. Multi-vitamin, B12, Calcium+D, Flaxseed oil, Biotin, Omega 3, Omega 6, Omega 9, collagen, lingonberry seed oil. vitam

Current Illness: None.

ID: 1520976
Sex: M
Age: 55
State: CA

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 08/02/2021
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Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA. Itchy left palm, slight swelling in left palm, finger joint pain in left palm. Symptoms last about an hour after presentation.

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Current Illness:

ID: 1521177
Sex: F
Age: 51
State: AL

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 08/02/2021
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Allergies: Demerol ((Symptom: [SOB] or [breathlessness] or [dyspnea]) or (breathlessness)); Dilaudid ((Symptom: [SOB] or [breathlessness] or [dyspnoea]) or (breathlessness)); codeine (Abdominal pain); morphine ((Symptom: [SOB] or [breathlessness] or [dyspnea]) or (breathlessness)); morphine (Acute chest pain (finding))

Symptom List:

Symptoms: PT STATES THAT SHE BEGAN TO EXPERIENCE SHORTNESS OF BREATH, MYALGIA, WEAKNESS AND THE INABILITY TO LIE FLAT THE EVENING OF THE VACCINE ADMINISTRATION. PT STATES THAT THE SYMPTOMS HAVE NOT IMPROVED SINCE THEY BEGAN, BUT THAT THEY HAVE BECOME MORE INTENSE.

Other Meds: Phazyme 250 mg capsule ("BEFORE MEALS" PO) Protonix 40 mg tablet,delayed release (QD PO) dicyclomine 20 mg tablet (QID PO) ibuprofen 800 mg tablet (BID or PRN PO) ropinirole 0.5 mg tablet (QHS PO)

Current Illness: NONE REPORTED

ID: 1521178
Sex: F
Age: 21
State: MI

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/02/2021
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Allergies: Sulfa based medications

Symptom List:

Symptoms: Nausea- top irritating Tiredness/ Fogginess

Other Meds: Cranberry Pills Levothyroxine Enpresse -28 day cycle oral contraceptive (birth control) Macrobid- for recurrent UTI prophylaxis, taken after intercourse

Current Illness: None

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm