VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
PLEASE CHECK BACK SOON
Download the files above while you wait.






Manufacturers

Total Manufacturer

Incidents per State

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

ID: 1545683
Sex: M
Age: 82
State: NC

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: No adverse event was reported. When processing the vaccination, patient stated multiple times that they were receiving the 2nd dose of the vaccine. After processing through insurance and after administration I logged the dose in the vaccine database and they received their second dose in February of 2021.

Other Meds:

Current Illness:

ID: 1545684
Sex: M
Age: 59
State: OH

Vax Date: 07/10/2021
Onset Date: 07/01/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Opioid analgesics (rash)

Symptom List:

Symptoms: Patient reported that after his first dose of the Pfizer vaccine on 6/16, he had a pruritic, erythematous rash of the L arm. After his 2nd dose, he then developed a whole-body, pruritic, erythematous, papular rash. He was given a prednisone burst + taper w/improvement, but after the taper, his symptoms recurred. Now admitted to the facility for an un-related reason and rash was noted. Seen by Dermatology who felt his symptoms were most likely c/w vaccine-induced eczematous exanthem. His symptoms improved dramatically w/40mg of prednisone. Plan for prolonged taper of prednisone.

Other Meds: Hydrochlorothiazide, lisinopril, olanzapine, trazodone

Current Illness: None

ID: 1545685
Sex: M
Age: 52
State: CA

Vax Date: 08/08/2021
Onset Date: 08/09/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: NO SYMPTOMS , WE DISCOVERED PATIENT HAD J&J AT pharmacy IN MARCH

Other Meds: N/A

Current Illness: UNKNOWN

ID: 1545687
Sex: M
Age: 25
State: SD

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: He had received a Moderna COVID vaccination this morning and about 5 minutes later he began to feel lightheaded and dizzy, clammy, and had hot flashes. Denies nausea or vomiting. Denies chest discomfort or palpitations. Denies shortness of breath. Patient presently states that he is feeling much better.

Other Meds: Allegra

Current Illness: n/a

ID: 1545688
Sex: F
Age: 16
State: NY

Vax Date: 08/06/2021
Onset Date: 08/07/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: fever followed by mouth, tongue, lip blisters and sores

Other Meds: oral contraceptive pills

Current Illness: none

ID: 1545689
Sex: M
Age: 74
State: IL

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Tinnitus started at the very beginning of April 2021

Other Meds: Multiple medications

Current Illness: No new illnesses, continued with chronic illnesses

ID: 1545690
Sex: M
Age: 76
State: OH

Vax Date: 02/20/2021
Onset Date: 04/01/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: shellfish

Symptom List:

Symptoms: The patient developed Polymyalgia Rheumatica as diagnosed via severe proximal muscle pain/weakness and elevated ESR/CRP that was very responsive to steroids. symptoms recurred with steroid withdrawal and we have committed to long term slow steroid wean. this occurred within 8 weeks of vaccination. unclear if this was related to vaccine or not, but this is the 3rd case of PMR that I have seen in proximation to covid vaccine and will report the other 2 separately.

Other Meds: multiple medications

Current Illness: multiple medical problems

ID: 1545691
Sex: F
Age: 42
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Left supraclavicular swelling

Other Meds:

Current Illness:

ID: 1545692
Sex: M
Age: 39
State: WA

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: bee venom

Symptom List:

Symptoms: No adverse event happened. patient tolerated the injection well. The injection was five days early.

Other Meds: Epinephrine 0.3 mg injector auto

Current Illness: none

ID: 1545693
Sex: M
Age: 35
State: CA

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

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

Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: Case got vaccinated 8/3 , became symptomatic 8/4 reports feeling like a truck hit him, Fever, muscle aches, full body cramping, runny nose, sore throat, headaches, shortness of breath, difficulty breathing which worsened until he went to Hospital 8/10 and tested positive for Covid-19. He was released from hospital same day. He attributes his reaction to the vaccine, but I explained he was likely exposed to Covid-19 before his vaccination date.

Other Meds: Multi Vitamin

Current Illness: None reported

ID: 1545694
Sex: F
Age: 73
State: IN

Vax Date: 01/28/2021
Onset Date: 02/18/2021
Rec V Date: 08/11/2021
Hospital: Y

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

Lab Data:

Allergies: Demerol, Codeine, Wellbutrin, Ativan, Statins

Symptom List:

Symptoms: I started feeling bad on July 20, 2021. Ended up in ER July 27, 2021 and again July 31. Could not move air through my lungs. Was taken by ambulance on the 31st to the Hospital. Symptoms similar to Covid.

Other Meds: Fluoxetine HCL10 MG, Omeprazole DR 20 mg, Alendronate Sodium, Aspirin 81 mg, Amlodipine 5 mg, Carvedilol 6.25mg, Clonazepam .5 mg, Glucosamine 2000mg, C 1000mg, D3 1000mg, Calcium 600mg, naproxen Sodium 220, Loratadine, Sud ephedrine PE

Current Illness: None

ID: 1545695
Sex: F
Age: 35
State:

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: No adverse event. Shot was administered past the recommended 6 week window after first shot. Patient received first shot on 4/20/21 at different location.

Other Meds:

Current Illness:

ID: 1545696
Sex: F
Age: 40
State: CA

Vax Date: 07/31/2021
Onset Date: 08/06/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: rash on legs has spread up to chin, developed cold sore, full body rash

Other Meds:

Current Illness:

ID: 1545697
Sex: F
Age: 50
State: CO

Vax Date: 01/29/2021
Onset Date: 02/12/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Penicillin; morphine

Symptom List:

Symptoms: On 02/12/2021 I woke up feeling dizzy, I couldn't stand on my own, when I moved, I was nauseous, and I had a headache. I went and saw the doctor after 2 days, because I couldn't get out of bed. Doctor diagnosed me as having vertigo. Doctor prescribed me Meclizine one tablet by mouth 3 times a day as needed. I still have the vertigo, it's not as bad, but I still have it. My balance has been impacted and I get bouts of dizziness. I have to lay down and rest and take my medication. I think the vertigo is going to be permanent because it should have gone away by now.

Other Meds: Levothyroxine; duloxetine hcl

Current Illness: No

ID: 1545698
Sex: F
Age: 67
State: MI

Vax Date: 03/17/2021
Onset Date: 04/15/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: mold, trees, weeds

Symptom List:

Symptoms: Eye pain, bilaterally. "Hard to get eyes open". Has trouble focusing vision first think in the morning for 10 minutes. Also has bilateral hand pain and headaches. Never had these issues before. Also, neck pain/lymph node swelling.

Other Meds: naproxen, Tylenol, atorvastatin, pataday eye drops, miralax, Vitamin B 12

Current Illness: none

ID: 1545699
Sex: M
Age: 79
State: KY

Vax Date: 02/06/2021
Onset Date: 08/07/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: positive for COVID 08/09/2021, had mild symptoms. no known epi link. He got the infusion and feeling better already.

Other Meds:

Current Illness:

ID: 1545700
Sex: F
Age: 29
State: CA

Vax Date: 07/20/2021
Onset Date: 07/23/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: N/a

Symptom List:

Symptoms: My menstrual period was due to begin on July 23rd and was late by 9 days. I was very concerned as I am always regular and have made no changes to my routine or diet - it is closely regulated and consistent.

Other Meds: N/a

Current Illness: None

ID: 1545701
Sex: F
Age: 72
State: FL

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient stated that she is having problems out of her right ear. She has loss hearing in her right ear. Hearing improved after a VAC that was inserted in her ear but lost hearing again. Was diagnosed auto immune inner ear disease.

Other Meds: Livorozine 75micrograms Metoprolol- 25mg Pantoprazole 20mg Crestor generic 10mg

Current Illness:

ID: 1545702
Sex: M
Age: 29
State: PA

Vax Date: 01/26/2021
Onset Date: 05/26/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: On the date of the injection: tenderness at injection site and that went away after 24 hours. I also had some general aches and pains for about 12 hours. After that I felt perfectly fine. Until May 26, I developed some flu-like symptoms: headache, dry cough, low grade fever, body aches and pains and that lasted for about four days. I got a COVID test -negative result. I took some ibuprofen for the headache - 800 mg twice about 8 hours apart and after that I didn't feel the need for any further medication. I had a brief doctor's visit - televisit.

Other Meds: daily men's multi-vitamin: Centrum

Current Illness: no

ID: 1545703
Sex: F
Age: 16
State: CA

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: Seizure

Other Meds: Keppra 500mg BID

Current Illness: Epilepsy

ID: 1545704
Sex: F
Age: 32
State: TX

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: allergic to morphine, latex, penicillin

Symptom List:

Symptoms: the patient felt dizzy and light headed ...vitals taken 3 times and was released by the nurse. 1. 4:59 temp98, bp 140/92 hr 78 oxy 97 2. 5:05 temp 98, bp 142/90, hr 72 oxy 99 3. 5:15 temp 97.8 bp 130/80, 0xy 98 hr 74 patient recovered and was released by the nurse

Other Meds: none

Current Illness: none

ID: 1545705
Sex: M
Age: 23
State: CA

Vax Date: 08/09/2021
Onset Date: 08/09/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Patient received the vaccine went to sit for the 15 min observation period and fainted about 5 mins after the vaccine was administered

Other Meds: unknown

Current Illness: none stated

ID: 1545707
Sex: M
Age: 60
State: TX

Vax Date: 02/06/2021
Onset Date: 02/16/2016
Rec V Date: 08/11/2021
Hospital: Y

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

Lab Data:

Allergies: Relafin Oranges Walnuts & pecans

Symptom List:

Symptoms: Right knee pain, swelling & fluid removal Rheumatoid arthritis to upper extremities Generalized musculoskeletal pain UTI related to steroid use -prescribed for inflammation & pain

Other Meds: Benicar 20 mg Declination 30 mg Motrin 400 as needed

Current Illness: None

ID: 1545708
Sex: F
Age: 80
State: MA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: sulfur

Symptom List:

Symptoms: Since my Pfizer vaccine first dose, I have shortness of breath, at times I feel shivering, cold and hot. I also experience SOB, very difficult to walk, extreme headache and have high blood pressure. Also feeling dizzy and feeling very ill, there were times I could not eat for many weeks. I also hear noises in my ears which persist. I barely started walking a bit longer but still very difficult for me. My appetite has gotten better. The sound in my ears and my walking is still present, this comes and goes, and it would clear up for a few days then come back. I do not know what to do. I did not take my second vaccine due to my symptoms. I also feel very pressure to make the right decision in my health because no one has been able to help me in regards to my symptoms. I need someone to contact me and give me guidance. I do not have my lot# to provide.

Other Meds: Coumadin 5mg, Atacand 8 mg, Aldactone 25 mg, Vitamin D3, Vitamins for skin, hair and nails

Current Illness: none

ID: 1545709
Sex: F
Age: 73
State: MO

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: MORPHINE, SULFA, OMEPRAZOLE, BACITRACIN-POLYMYXIN B

Symptom List:

Symptoms: VIAL FROM PREVIOUS DAY WAS USED TO DILUTE THAWED VIAL ON 8/11/2021. PATIENT WAS ADMINISTERED 0.3 ML. PATIENT IMMEDIATELY NOTIFIED WHILE STILL IN PHARMACY OBSERVATION. COUNSELED ON EXPECTED SIDE EFFECTS. PATIENT WAS ANXIOUS WITH A BP OF 191/75, 193/80. PATIENT WAS ESCORTED TO HER PRIMARY CARE OFFICE FOR NURSE TO TAKE BLOOD PRESSURE. BP READING WAS 145/85 AND SATISFACTORY WITH NURSE. FOLLOWED UP WITH PATIENT WHO MENTIONED DIARRHEA DUE TO NERVES. PATIENT WAS DIGANOSED WITH COVID ON 2/16/2021 AND STATED AWARE OF POSSIBLE SYMPTOMS.

Other Meds: GABAPENTIN, PANTOPRAZOLE, ATENALOL

Current Illness:

ID: 1545710
Sex: M
Age: 42
State: VA

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient fainted a couple of minutes post injection. He was "out" for less than a minute. EMS was called to monitor vitals and released. Patient indicated after the fact that he is afraid of needles

Other Meds:

Current Illness:

ID: 1545711
Sex: F
Age: 49
State: NY

Vax Date: 05/31/2021
Onset Date: 06/20/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: 11 day headache/neck pain. Arm itched and was sore for 7 days. Menses delayed. Heat flushes. Shingles - right wrist.

Other Meds: escitalopram, levocetirizine, iron, niacin, magnesium, multivitamin, Vit C

Current Illness: None

ID: 1545712
Sex: F
Age: 20
State: SC

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: immediately after imz - upper arm became swolen

Other Meds:

Current Illness:

ID: 1545713
Sex: F
Age: 28
State: NJ

Vax Date: 08/09/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: I am 4 weeks pregnant. I estimate the delivery to be April 2022. I experienced breakthrough bleeding today that was not implantation bleeding, and is not the correct time for a period. This occurred about a day and a half after the Covid Vaccine 1st shot.

Other Meds: N/A

Current Illness: N/A

ID: 1545714
Sex: F
Age: 77
State: OH

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: statins, cephalexin

Symptom List:

Symptoms: Patient developed Polymyalgia Rheumatica within 7 days of vaccination. she did not get the second shot due to this outcome. she required steroids and a prolonged taper with good results over a very slow steroid taper. her pain was severe, esr/crp were very high, and she had proximal weakness.

Other Meds: multiple medications.

Current Illness: had a ?UTI a few weeks prior to vaccination

ID: 1545715
Sex: M
Age: 55
State: CA

Vax Date: 04/01/2021
Onset Date: 04/29/2021
Rec V Date: 08/11/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Cerebral venous sinus thrombosis

Other Meds: benazepril 5 mg

Current Illness:

ID: 1545716
Sex: M
Age: 22
State: NJ

Vax Date: 03/19/2021
Onset Date: 08/09/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List:

Symptoms: Client was vaccinated with Pfizer Covid vaccine on 3/19 and 4/9/2021. He tested positive for Covid with symptoms on 8/11/2021. Symptoms: difficult breathing x 1 day, fever x 2 days, loss of smell and taste. VAERS report submitted because this is a case of Covid in a previously fully vaccinated person.

Other Meds: none known

Current Illness: none known

ID: 1545717
Sex: F
Age: 55
State: IN

Vax Date: 03/01/2021
Onset Date: 03/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Itchy tongue. Post menopausal bleeding. I have itchy tongue since vaccine for 5 months diagnosed today with thrush. Have autoimmune disease and started 3 days after injection

Other Meds:

Current Illness: Autoimmune disease

ID: 1545718
Sex: F
Age: 33
State: PA

Vax Date: 01/16/2021
Onset Date: 01/20/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Ancef, oxycodone, keflex, adhesive, versed

Symptom List:

Symptoms: Spontaneous CSF leak starting 4 days after second vaccine. Horrible positional headache every day for 5.5 months following the second vaccine. Treated with a lumbar blood patch.

Other Meds: None

Current Illness: None

ID: 1545719
Sex: M
Age: 15
State: NJ

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: DIZZINESS, SWEATING, DIFFICULTY GREATHING, LOSS OF CONSCIOUSNESS, LOW BLOOD PRESSURE

Other Meds: none

Current Illness: none

ID: 1545720
Sex: M
Age: 36
State: NV

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: PT WAS SHAKING AND FAINTED (NOT SEEN BY PHARMACIST) PT WAS PALE AND FELT SWEATY. ASKED PT TO SIT DOWN AND GIVEN WATER. PT FELT FINE AFTER 15 MINUTES AND LEFT WITH WIFE. STATING HE WAS ANXIOUS ABOUT VACCINE. PT DENIED SEEKING MEDICAL PERSONNEL.

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1545721
Sex: M
Age: 22
State: AR

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Patient indicated he has no known allergies.

Symptom List:

Symptoms: Syncope resulting in possible head injury starting approximately 5 minutes post-administration

Other Meds: Unknown. No current prescriptions at our pharmacy.

Current Illness: None disclosed

ID: 1545722
Sex: F
Age: 44
State: TX

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: latex, wheat, sesame, tomato

Symptom List:

Symptoms: mild fever (99.5F), severe joint and muscle aches, severe fatigue, severe arm pain.

Other Meds: Synthroid 88 mcg qd Vitamin D3 2000 IU qd

Current Illness:

ID: 1545723
Sex: M
Age: 38
State: CO

Vax Date: 04/07/2021
Onset Date: 04/28/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Extreme allergy to banana Minor allergy to avocado

Symptom List:

Symptoms: Morning of July 9, 2021 ~3:00AM experienced pain on right side along ribs. Pain increased while breathing in. Sought medical treatment at urgent care facility 7/9/21 ~10:00 AM. Imaging done on site revealed multiple subsegmental pulmonary emboli without acute cor pulmonale.

Other Meds: Montelukast 10mg Omeprazole 20mg

Current Illness: None

ID: 1545724
Sex: M
Age: 39
State: WA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: Foggy Brain - Decreased cognitive ability, forgetfulness, lack of ability to focus. Fatigue - low energy. Slight constant head pressure that turned into occasional painful headache. Feel exhausted after normal workouts where usually I feel energized and revitalized.

Other Meds: Vitamin D

Current Illness: None

ID: 1545725
Sex: F
Age: 51
State: MO

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient reports having >50 itchy pustule eruptions on the skin all over her body. (states that it looks like chicken pox) Patient was advised to contact her Dr. for examination.

Other Meds:

Current Illness:

ID: 1545726
Sex: M
Age: 55
State: VA

Vax Date: 02/04/2021
Onset Date: 02/01/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Gluten sensitive

Symptom List:

Symptoms: Patient has history of low level tinnitus since childhood. Within a few days of receiving the second Pfizer COVID19 vaccination patient reported experiencing a significant increase in the level of "ringing" in both ears. There were no other proximate causes to this change, reported as going from a level 1 to variating between a level 3 - 4 on a scale of 5. Over the counter medications to alleviate potential allergy and ear wax issues had no positive effect, nor did prescribed medications taken about two months later. Five months later an ear examination at the clinic showed no ear wax build up or eustachian tube issues, but did reveal high frequency hearing loss. Uncertain whether the hearing loss is causing the elevated tinnitus, or the elevated tinnitus is in frequency range of hearing loss and simply masking these low level sounds.

Other Meds: Multivitamins, vitamin C

Current Illness: N/A

ID: 1545727
Sex: F
Age: 48
State: GA

Vax Date: 02/15/2021
Onset Date: 02/28/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Aspirin, Gluten, Dairy

Symptom List:

Symptoms: Chronic diarrhea started February 28th and lasted until June 13th. No treatment or dietary change altered the symptoms. It stopped abruptly and has not recurred.

Other Meds: Wellbutrin, Remeron, Zyrtec

Current Illness: None

ID: 1545728
Sex: F
Age: 46
State: MI

Vax Date: 03/25/2021
Onset Date: 03/30/2021
Rec V Date: 08/11/2021
Hospital: Y

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

Lab Data:

Allergies: sulfa

Symptom List:

Symptoms: onset of right calf muscle pain 3/29/21. Pain resolved after 3 days. On 4/5/21, had vever, SOB and back pain and headache.. COVID test 4/6/21 negative. Saw PCP 4/8/21 and 2nd COVID 19 test done and negative. CXR done and dx with pneumonia. Given Antibiotics and steroids. Sxs improved. All sxs returned 4/13/21 and different abx given with albuterol inhaler. Mild improvement but still with dyspnea then on 5/14/21, had back pain returned and went to PCP who sent her to ED and blood clots found. She was in Hospital and was told clots likely due to her estrogen-containing BCP and long drives.

Other Meds: estrogen-containing birth control pills for fibroids

Current Illness: none

ID: 1545729
Sex: M
Age: 30
State: NY

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Local pain for 2 days, Headache for 3 hours, Body aches for 24 hours, Fatigue for 2 days. Symptoms were mitigated using Advil (Iboprufen 200 mg).

Other Meds:

Current Illness:

ID: 1545730
Sex: M
Age: 54
State: TX

Vax Date: 07/05/2021
Onset Date: 07/05/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Tingling, muscle cramps/twitching in different areas of the body that is still persistent

Other Meds: Vitamin d

Current Illness: None

ID: 1545731
Sex: F
Age: 45
State: LA

Vax Date: 08/10/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Injection site swollen with redness, itching & site pain. Swollen area feels hard underneath & painful to touch. Redness in a circle on arm with injection site in the middle. Redness area feels warm to the touch, like feverish. Noticed day after vaccine injection. Was 2nd dose of Moderna vaccine. This did not happen after 1st dose.

Other Meds: Citalopram, Women's One A Day Multivitamin, Extra Strength Probiotic taken night before vaccination. Advil dual action taken day of vaccination.

Current Illness: None

ID: 1545732
Sex: M
Age: 22
State: PA

Vax Date: 08/09/2021
Onset Date: 08/09/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Pen-Vee-K, reported history of anaphylactic reaction

Symptom List:

Symptoms: First dose administered 1357, 08/09/21 Second dose administered 1733, 08/09/21 Med error

Other Meds: Meloxicam 7.5 mg tab Metoprolol 100mg tab

Current Illness: none

ID: 1545733
Sex: M
Age: 76
State: SC

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List:

Symptoms: No adverse events reported as of yet. Patient misled our staff and received a 3rd Moderna vaccination. He only revealed this after the dose was already given. He stated that he would not need his "second" appointment as this was actually his 3rd shot. He was concerned about the Delta variant and wanted a "booster". He received his first 2 vaccines.

Other Meds: n/a

Current Illness: n/a

ID: 1545734
Sex: F
Age: 73
State: CA

Vax Date: 01/16/2021
Onset Date: 02/13/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: None that i know of.

Symptom List:

Symptoms: After the first shot, I was not felling well, but not ill, as i could not tell what was wrong with me. I lost my appetite, but i still could eat. A week after the second shot, I totally lost my appetite and could not eat anything, or sleep. I lost 10 ponds in a month, 6 pounds following the second dose. My doctor ordered ultra sound of abdominal area, and results were normal. My white Blood count was slightly high mostly high in Lymphocytes. The WBC came back normal the following week. My doctor prescribed Mitrazopine (15 mg) to correct for lose of appetite and to sleep. I felt back to normal about a week later.

Other Meds: Benazeperil, HCL, Triamteren HCTZ, Rosuvastatin, D3, Co Q10, Vitamin C, Metamucil. Receive injection of NUCALA once a month.

Current Illness: No illness prior to vaccination other than anxiety and fear of getting covid. I was sick for 10 days, and I feel fine now.

Total 2021 VAERS Injuries: 679,999

Page last modified: 03 October 2021 5:28pm