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: 1528633
Sex: M
Age: 71
State: FL

Vax Date: 01/19/2021
Onset Date: 08/01/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Similar left arm pain in left are as which I experienced after first injection. Very uncomfortable for 4 days.

Other Meds: Allopurinol Crestor Carvedilol Lisinopril

Current Illness: None

ID: 1528634
Sex: F
Age: 71
State: MN

Vax Date: 02/25/2021
Onset Date: 07/23/2021
Rec V Date: 08/05/2021
Hospital: Y

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

Lab Data:

Allergies: Diphenhydramine, Pseudoeph-dm-gg-acetaminophen

Symptom List:

Symptoms: hospitalized at her local hospital 7/26/2021, transferred to hospital on 8/1/2021, currently hospitalized

Other Meds:

Current Illness:

ID: 1528635
Sex: M
Age: 35
State: GA

Vax Date: 07/26/2021
Onset Date: 08/01/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Shingles appeared on my left abdominal area(got shot in my left arm) roughly a week after vaccination.

Other Meds: N/A

Current Illness: N/A

ID: 1528636
Sex: F
Age: 28
State: AR

Vax Date: 07/02/2021
Onset Date: 07/03/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: abilify,prozac, antibiotic

Symptom List:

Symptoms: Pfizer COIVD 19 EUA- Pt was vaccinated @ 0957 7/2/21 at 1 am next morning pt woke up with widespread itching and rash all over body, feet swelled, fever 103. Pt called the pharmacy was told to call which was closed Saturday. Pt took Tylenol, ibuprofen & benadryl. Monday she was feeling better so she did not call . Fever broke on 7/6/21 and rash went away on 7/8/21

Other Meds: klonipin

Current Illness: none

ID: 1528637
Sex: F
Age: 52
State:

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient presented to doctor's office and reported: "Started with left upper arm pain, erythema, and swelling. The next day she had a fever. Two days later, the erythema resolved but the shoulder began to throb with a sharp stabbing pains when she would move her arm. Now having significant neck muscle tenderness. The pain is now making her nauseous because it is down to her fingers. She has not been able to use that arm due to the pain. She has been icing it on and off, which does help to reduce the swelling. Denies any current fever. Reports pain 5/10." She called clinic again on 6/10/2021, note states: "She states she was told to call back if symptoms did not go away, and she is still experiencing 6-10/10 throbbing/aching/sharp pains from shoulder to wrist on left side. States the swelling and redness have gone down and the Flexeril/Tylenol/Ibuprofen help some, but the pain is still excruciating. Ultrasound on 6/17/21 should no evidence of blood clot. She declines appointment." She was treated for left shoulder impingement syndrome on 7/22/2021 .

Other Meds:

Current Illness:

ID: 1528638
Sex: F
Age: 64
State: IL

Vax Date: 04/14/2021
Onset Date: 04/21/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: The lot number for the first dose of vaccine taken on 03/17/2021 is: 044A21A. And the lot number for the second dose of vaccine taken on 04/14/2021 is: 036B21A. About a week after the second dose, my skin on clavicle started changing and getting harder and there are two sections the size of a little finger, also it is on my back and neck and right arm and below the panty line. the hard skin feels like a callus. It is mainly on my torso.

Other Meds: Yes

Current Illness: None

ID: 1528639
Sex: F
Age: 69
State:

Vax Date: 03/11/2021
Onset Date: 04/23/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Following second dose on 4/8, developed low grade fevers and fatigue around 4/23/21. Labs showed elevated LFTs, anemia and thrombocytopenia. Bone marrow biopsy on 6/30/21 showed acute myelomonocytic leukemia.

Other Meds: blood pressure and high cholesterol medication

Current Illness:

ID: 1528640
Sex: F
Age: 35
State: MN

Vax Date: 08/04/2021
Onset Date: 08/05/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Patient stated she had a formaldehyde allergy and cherries

Symptom List:

Symptoms: Patient stated she had a formaldehyde allergy, after thorough review of ingredients and discussing risk with pharmacist patient decided to get the vaccine. She was observed for 30 minutes after vaccination. At 15 to 20 minutes after vaccine patient started to experience hives, 50 mg of oral benadryl was given. The patient was offered IM Benadryl and an Epipen, she declined both.

Other Meds:

Current Illness:

ID: 1528641
Sex: F
Age: 21
State: IN

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: My temp was up to 102.9 blood pressure spiked to 140/110 pulse was 160 and respiration?s were in the 40s. I had body aches like no other diarrhea and a headache that was excruciating.

Other Meds:

Current Illness:

ID: 1528642
Sex: F
Age: 46
State: OK

Vax Date: 07/30/2021
Onset Date: 08/01/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Pt. states that after receiving the 1st dose Phizer 07/30/2021 (Noted 07/30/2021 MMR 1st dose received), started experiencing symptoms 08/01/2021 of pain throughout the right leg and shortness of breath. 08/02/2021 Primary visit and was determined to have a blood clot located in the PVT calf. Prescribed a blood thinner. (Previous history of DVT 13yrs). Recommendation to continue prescription with follow up to ER if continue or shortness of breath.

Other Meds: Adivan

Current Illness: N/A

ID: 1528643
Sex: M
Age: 72
State: NY

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: 17 hrs. after shot - racing pulse; diarrhea; tingling pain in feet, ankles, shins, knees. 24 hrs after shot - same as above plus long spiking pains that came ands went in various parts of body, feeling of being on 4 cups of coffee - like a powerful reaction was going on in my body; one more episode of diarrhea and then it stopped. 4 days after shot - did not feel well late afternoon; 11 pm presented with insomnia, worst nausea ever had (no vomiting), extremely painful feet, fatigue, muscle weakness, slight chiils, long pains in my colon that would come and go. Most symptoms gradually got better over the next two months. Racing heartbeat gradually slowed down over two weeks. Nausea, intestinal distress, lack of appetite, sick feeling have not resolved. I have not felt good since taking the first Moderna shot. Upon advice of my doctor I did not get a second Moderna shot. Now because of the COVID Delta variant, I need a second shot of Pfizer or J&J. Can you offer any advice as to which one I should get? slight headache, general systemic sick feeling, no appetite

Other Meds: Pepsid 20 mg @ bedtime, Mirtazapine 1 mg (tapering off)

Current Illness: None

ID: 1528645
Sex: M
Age: 52
State: IA

Vax Date: 03/02/2021
Onset Date: 07/09/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, sulfa

Symptom List:

Symptoms: probable trigeminal neuralgia. severe pain in left side of face, mainly in lower and upper jaw. intensity comes and goes since the first episode. in first 9 days, beginning July 9, had several episodes of severe pain daily, lasting from 5 min to 2+ hrs. For next 12 days, had no severe pain episodes, but had constant dull pain in same area. Had two more severe pain instances in same area over a 24 hr. period on July 30-31, and since then have had constant but bearable pain in same area.

Other Meds: n/a

Current Illness: n/a

ID: 1528646
Sex: F
Age: 34
State: NE

Vax Date: 04/09/2021
Onset Date: 05/16/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: She was given Moderna vaccine on 4/9/21. She was given Pfizer vaccine on 5/16. Patient unknowingly re-scheduled second vaccine appointment at a different location than 1st vaccine.

Other Meds:

Current Illness:

ID: 1528647
Sex: F
Age: 16
State: AR

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Patient was inadvertently administered incorrect COVID vaccine. Due to age patient should have received Pfizer COVID vaccine, Janssem vaccine was administered. Attempted to call patient several times 8/2/21 no answer or on voice mail. Called pt. today grandmother answered pt. was home, informed grandmother of incident and she stated patient was doing well and no S&S of adverse reactions.,

Other Meds: none

Current Illness: none

ID: 1528648
Sex: F
Age: 75
State: MN

Vax Date: 04/08/2021
Onset Date: 04/30/2021
Rec V Date: 08/05/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient hospitalized for peripheral vascular disease on 4/30/2021. Patient hospitalized for wound dehiscence, hypotension on 5/7/2021. These visits are within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1528649
Sex: F
Age: 41
State: MD

Vax Date: 04/20/2021
Onset Date: 05/01/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Irregular sense of smell- most food smells like rotten meat, artificial scents smell sickly sweet (overripe pineapple smell) Abnormal menstruation- menses cycle reduced to 21-22 days. Prior to vaccine, menses were a predictable 27 days.

Other Meds: none

Current Illness: none

ID: 1528650
Sex: F
Age: 71
State: OH

Vax Date: 07/30/2021
Onset Date: 08/01/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Wheat Dairy

Symptom List:

Symptoms: Sore arm, pain on right side of hip and rear end, tingling sensation, started breaking out in Shingles on the right side from top of rear end to the bottom of rear end

Other Meds: Vitamin C Vitamin D Magnesium B-12

Current Illness: None

ID: 1528651
Sex: M
Age: 40
State: IN

Vax Date: 08/04/2021
Onset Date:
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Patient received Pfzier Vaccination on 4/10/2021 at the health center. Patient came to clinic on 08/04/2021 for his 1st Covid vaccination and had chosen the Moderna vaccine. Patient stated that this will be the 1st Covid shot he had gotten. Looked into database and noticed that patient has received the Pfizer in April 2021. Patient was contacted to inform him that he doesn't need to get another Moderna vaccination.

Other Meds: N/A

Current Illness: N/A

ID: 1528652
Sex: F
Age: 66
State: KY

Vax Date: 03/24/2021
Onset Date: 08/02/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: PATIENT IS HAVING CONGESTION, HEADACHE AND COUGH.

Other Meds:

Current Illness:

ID: 1528654
Sex: M
Age: 33
State: WI

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient sneezed/coughed and then passed out in chair about 5 minutes after vaccine administration. He slumped over in his chair, I ran over to him and held him up. I shook his shoulders and shouted his name. Patient was shaking, he had his eyes open but was not coherent. After about 20 seconds patient came to and was able to tell me his name, birthday, where he was at, etc. He was very sweaty, dizzy, lightheaded, and shaky. We had called 911 and gotten patient water and a chocolate bar. He improved rather quickly. All checked out well with the paramedics. Patient felt much improved and left about 40 minutes after his shot was administered.

Other Meds:

Current Illness:

ID: 1528655
Sex: M
Age: 74
State: MI

Vax Date: 03/10/2021
Onset Date: 07/29/2021
Rec V Date: 08/05/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient was vaccinated with Moderna on 2/10/21 and 3/10/21. Patient was admitted to the hospital, COVID positive, on 7/29/21 for respiratory failure with hypoxemia secondary to COVID 19 pneumonia. Hospitalized for 5 days.

Other Meds:

Current Illness:

ID: 1528656
Sex: M
Age: 56
State: VA

Vax Date: 04/28/2021
Onset Date: 06/01/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: So I had diarreha for about 3 days.

Other Meds: Yes

Current Illness: No

ID: 1528657
Sex: F
Age: 57
State: TX

Vax Date: 07/18/2021
Onset Date: 07/18/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Shellfish, Vicodan, erythomycin

Symptom List:

Symptoms: Symptoms: Brief, acute, localized, rolling pain in descending colon beginning upper section just below ribcage on left side of abdomen. Successive days, 7 in total, pain proceeded along descending colon, continuing as brief and localized to a small section at a time, ending in sigmoid colon on day 7. Treatment: None. As pain was intense but brief, I just waited it out. Time Course: 7 days Outcome: As far as I can tell, I am now symptom free with no other adverse effects.

Other Meds: Lipitor 20MG; Prinzide 20/2.5MG

Current Illness: None

ID: 1528658
Sex: F
Age: 49
State: MO

Vax Date: 07/30/2021
Onset Date: 07/30/2021
Rec V Date: 08/05/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Pt. reports that symptoms started 2 hours after vaccination (weakness, SOB, headache, leg pain). She stated she had left-sided pain including the left side of her chest that developed last p.m. with shortness of breath. She had the leftsided chest pain that felt like a stabbing and a sharp knife running from the lateral left side through her chest. Shortness of breath. Hospitalized with PE.

Other Meds:

Current Illness:

ID: 1528659
Sex: F
Age: 74
State: MA

Vax Date: 02/13/2021
Onset Date: 02/15/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Numbness/pain in feet, traveling up legs. Followed by numbness in hands and arms, mostly left side. Numbness in face.

Other Meds: amlodipine, lorazemam, vitamins B12, C, D

Current Illness:

ID: 1528660
Sex: F
Age: 22
State: AR

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Pfizer BioNTech COIVD 19 vaccine EUA- Pt. was given pfizer vaccine that was not properly diluted. Should have been diluted with 1.8 cc diluent was actually diluted with 0.8 by mistake. Pt notified of incident and to watch for reactions, No reactions at time of vaccination or within 15 minutes afterward.

Other Meds: none

Current Illness: none

ID: 1528662
Sex: F
Age: 42
State: MD

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Fever 102.8 degrees- sustained over 72 hours Chills- 48 hours Body Ache- 48 hours Pain and swelling at injection site

Other Meds: none

Current Illness: none

ID: 1528663
Sex: F
Age: 63
State: FL

Vax Date: 07/30/2021
Onset Date: 08/04/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: codeine, sulfa, vibramycin

Symptom List:

Symptoms: started out as what looked like someone punched her and then sort of red

Other Meds: progesterone, atorvastatin 40mg

Current Illness: none

ID: 1528664
Sex: M
Age: 43
State: IL

Vax Date: 07/27/2021
Onset Date: 07/28/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List:

Symptoms: A day after my 2nd vaccine I experienced muscle cramping/pain in neck/shoulder blade area, forearms, calves and hamstring, muscle spams throughout body, palpitations, brain fog, unbalanced, and hypnic jerks. It has been nine days since my 2nd dose and symptoms seem to be worsening.

Other Meds: Amlodipine .5 MG

Current Illness: None

ID: 1528665
Sex: M
Age: 12
State: SC

Vax Date: 07/22/2021
Onset Date: 07/26/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: headache, fatigue, dizziness, nausea. Not explainable by other cause. Tested for COVID and negative. Clinically well appearing with normal VS and exam so elected expectant care, supportive care, monitoring.

Other Meds: None

Current Illness: None

ID: 1528666
Sex: F
Age: 48
State: FL

Vax Date: 07/23/2021
Onset Date: 07/26/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: nkda

Symptom List:

Symptoms: normal for first 3 days except pain at injection site. Then, gradually feeling drained and numbness and tingling in thighs. Feels as if walking through water. Feeling sluggish and heavy.

Other Meds: multivitamins

Current Illness: GBS, HTN

ID: 1528667
Sex: F
Age: 56
State: TX

Vax Date: 05/15/2021
Onset Date: 05/16/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Allergic to Norco and flax seed

Symptom List:

Symptoms: First day after vaccine left arm numb and tingling, severe headache, fluish, fatigue, on 05/17/2021 yearly OB/GYN appointment. Pap smear results were candida but no symptoms of infection. Started amoxicillin 05/24/2021 UTI and Strep B Also in conjunction my primary care diagnosis was acute vaccine allergic reaction. Steroid shot to try and slow vaccine effects Bell?s palsy for two weeks left side of face, conditions worsening. Extreme chest pain leading to pneumonia and then bronchitis. Every 4-5 days intestinal cramping and feels like my bowels are falling out Dizzy spells, fainting, random nausea and occasional vomiting, small rashes that come and go, extreme shortness of breath from the beginning

Other Meds: Multi vitamin, progesterone, nature thyroid

Current Illness: None

ID: 1528668
Sex: F
Age: 41
State: NC

Vax Date: 01/03/2021
Onset Date: 01/06/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Reglan

Symptom List:

Symptoms: I actually started to notice an adverse event with the 1st dose (Lot EL0140 IMLA). On 1/6/2021 I notice a knot swelling in my right arm pit. The inflammation traveled like a rope like formation to my elbow. It was red, inflamed and painful to the touch. I contacted my PCP and thought I had a blood clot. I was sent for an ultrasound to check for a DVT on 1/6/2021 and it was negative for a blood clot. I started taking aspirin and a week later, started on an antibiotic Doxycycline. It has improved but not completed resolved. I went ahead and proceeded to get my 2nd dose (EL3246 IM RA). I had no symptoms or adverse event with my 2nd dose.

Other Meds: Fiasp Insulin; Metoprolol; Flonase; Crestor; Gabapentin; Cymbalta; Tirosint; Aspirin; Motrin

Current Illness: None

ID: 1528670
Sex: M
Age: 66
State: FL

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: As a military veteran, I have had a low level form of tinitus since serving during Vietnam era. Since receiving Moderna second injection, following 1-2 weeks, my tinitus has significantly increased from a level 2 to a level 7-8 and has remained at that level to date ( approx 5 months). I have completed a TON of research on line, and have discovered that there are many websites operated by audiology physicians that are reporting possibly thousands of patients are discovering a link between exasperated tinitus or NEW tinitus findings. Ironically however; the CDC or media is not reporting ANY SUCH adverse reaction, as I am suspecting out of fear that vaccine levels will plummet. Im not sure many people are taking the time to report this, but I am, and I am telling everyone I know of this side affect that occurred to me. I got vaccinated not for myself, but for a 95 y/o that lives in my household. She is frail yet healthy. I REGRET getting the vaccine, and would have elected to remain A SHUT IN, rather than listen to a train in my head for the rest of my life. This SUCKS !

Other Meds: hydrochlorothazide 25 mg for BP

Current Illness: none

ID: 1528671
Sex: M
Age: 77
State: TN

Vax Date: 04/03/2021
Onset Date: 04/15/2021
Rec V Date: 08/05/2021
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Allergies: None

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Symptoms: Increase in heart beat without physical activity followed by chest paid, not continually but on and off.

Other Meds: Vitamin D, Multi vitamin centrum 55 plus, Turmeric capsule

Current Illness: None

ID: 1528672
Sex: F
Age: 50
State: NM

Vax Date: 01/28/2021
Onset Date: 07/29/2021
Rec V Date: 08/05/2021
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Allergies: No allergies

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Symptoms: head congestion, headache, chest cold, lost of taste and smell and had diarrhea x one day

Other Meds: Lisinopril, Metformin, Ferrous Gluconate, Glyburide

Current Illness: None

ID: 1528673
Sex: M
Age: 38
State: ID

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 08/05/2021
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Allergies: Erythromycin

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Symptoms: Severe headaches, feeling of overall unwell, extreme swelling of lymph nodes in axilla and groin, fever, pain and swelling at the injection site. Ongoing pain at the injection site MONTHS later with intermittent swelling of lymph nodes on the side the injection happened.

Other Meds: NA

Current Illness:

ID: 1528674
Sex: F
Age: 28
State: AR

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/05/2021
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Allergies: none

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Symptoms: Pfizer BioNTech COIVD 19 vaccine EUA- Pt. was given pfizer vaccine that was not properly diluted. Should have been diluted with 1.8 cc diluent was actually diluted with 0.8 by mistake. Pt notified of incident and to watch for reactions, No reactions at time of vaccination or within 15 minutes afterward.

Other Meds: none

Current Illness: none

ID: 1528676
Sex: M
Age: 49
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 08/05/2021
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Allergies: None reported

Symptom List:

Symptoms: Moderna, dose 2 administered fewer than 24 days after the first dose. Moderna dose 1, administered on .3/27/2021

Other Meds: None reported

Current Illness: None reported

ID: 1528677
Sex: F
Age: 0
State: VA

Vax Date: 05/17/2021
Onset Date: 05/21/2021
Rec V Date: 08/05/2021
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Allergies: NONE

Symptom List:

Symptoms: BLOODY STOOL

Other Meds: NONE

Current Illness: NONE

ID: 1528678
Sex: F
Age: 49
State: KY

Vax Date: 02/25/2021
Onset Date: 08/03/2021
Rec V Date: 08/05/2021
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Symptoms: Tested positive and symptomatic for COVID, fully vaccinated as of 2/25/21

Other Meds:

Current Illness:

ID: 1528679
Sex: F
Age: 31
State: IN

Vax Date: 06/17/2021
Onset Date: 07/17/2021
Rec V Date: 08/05/2021
Hospital: Y

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Allergies: Flu vaccine, latex

Symptom List:

Symptoms: Symptoms began roughly one month after administration. Symptoms began with numbness and tingling in the feet, moving to the calves, upper legs, arms, hands, and face. Weakness developed in the extremities shortly thereafter. Patient consulted with primary care provider (?PCP?) on July 21, 2021. PCP ordered various laboratory blood tests and recommended patient see a rheumatologist. On July 27, 2021, patient contacted PCP for a neurology referral. Upon receiving referral, Patient contacted Neurology for a consult. Patient described symptoms to via a web portal. On July 28, 2021, ,clinic advised patient to go to the emergency room. Patient visited emergency room at Hospital and Health center on July 28, 2021. Patient was admitted to the hospital with a diagnosis of Guillain-Barr? syndrome on the same day after a clinical examination, MRI of the entire spine, and a lumbar puncture showing elevated protein levels. Patient lost almost all strength in legs and developed saddle paresthesia shortly thereafter. Patient was treated with Immunoglobulin therapy over the course of five days. Patient was discharged from the hospital on August 4, 2021.

Other Meds: Sertraline; Synthroid

Current Illness: N/A

ID: 1528681
Sex: F
Age: 16
State: AR

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/05/2021
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Allergies: none

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Symptoms: Pfizer BioNTech COIVD 19 vaccine EUA- Pt. was given pfizer vaccine that was not properly diluted. Should have been diluted with 1.8 cc diluent was actually diluted with 0.8 by mistake. Pt notified of incident and to watch for reactions, No reactions at time of vaccination or within 15 minutes afterward.

Other Meds: none

Current Illness: none

ID: 1528682
Sex: F
Age: 22
State: KS

Vax Date: 08/04/2021
Onset Date: 08/05/2021
Rec V Date: 08/05/2021
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Allergies: Benzodiazepine, Penicillin, Sulfacet

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Symptoms: Patient reports Fever, Chills, Body aches, and a little chest pain that started 8/5/21 at 3am

Other Meds:

Current Illness: None

ID: 1528683
Sex: M
Age: 16
State: GA

Vax Date: 07/12/2021
Onset Date: 07/14/2021
Rec V Date: 08/05/2021
Hospital: Y

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Allergies: NKA

Symptom List:

Symptoms: chest pain starting 2 days after second dose

Other Meds: ibuprofen, minocycline

Current Illness: none

ID: 1528684
Sex: F
Age: 75
State: MI

Vax Date: 04/08/2021
Onset Date: 05/22/2021
Rec V Date: 08/05/2021
Hospital: Y

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Symptoms: Received J&J on 4/8/21. Admitted 5/22/21 - 5/25/21 for hypokalemia and COVID pneumonia.

Other Meds:

Current Illness:

ID: 1528685
Sex: F
Age: 45
State: MN

Vax Date: 01/14/2021
Onset Date: 08/04/2021
Rec V Date: 08/05/2021
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Symptoms: PATIENT IS FULLY VACCINATED AND TESTED POSITIVE TO COVID ON 8/4/21

Other Meds:

Current Illness:

ID: 1528687
Sex: M
Age: 83
State: MN

Vax Date: 02/16/2021
Onset Date: 08/04/2021
Rec V Date: 08/05/2021
Hospital: Y

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Allergies: N/A

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Symptoms: In the patient's medical chart, the immunization information is incomplete. All I am able to report on is that the patient received the first Pfizer vaccine on 1/26/2021 and the second dose on 2/16/2021. This information was pulled from the an Immunization Registry. Lot numbers are not available. On 8/4/2021, the patient presented the ED with worsening symptoms following a previous ED visit the day before (8/3/2021) where he was diagnosed with community pneumonia and advised to monitor symptoms. During the ED visit on 8/4/2021, the patient was diagnosed with a NSTEMI, fever of unknown origin, SOB, and confusion. The patient was admitted for observation. Patient was tested for COVID upon admission to the hospital and the test returned positive. At the time of this note, the patient's condition is stable.

Other Meds: N/A

Current Illness: N/A

ID: 1528688
Sex: M
Age: 19
State: GA

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 08/05/2021
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Symptoms: Moderna Covid-19 Vaccine EUA Vaccine found to be out of date after dose was administered on 8/4/21

Other Meds:

Current Illness:

ID: 1528689
Sex: F
Age: 84
State: OH

Vax Date: 07/29/2021
Onset Date: 07/30/2021
Rec V Date: 08/05/2021
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Allergies: Vidacan, Lasitapril, Amirodien, Wool

Symptom List:

Symptoms: Pt. states that after receiving the 1st dose of Moderna 07/29/2021, started experiencing symptoms 07/30/2021 of a rash forming throughout the body. Still continuing to form under the breast and back of the shoulders. No Primary visit noted.

Other Meds: Norvasc, Lipitor, Tamacor, Warfarin, Tylenol, Osteobiflex, Mult-Vitamin, Cod-Liver Oil

Current Illness: N/A

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm