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: 1549074
Sex: F
Age: 35
State: VA

Vax Date: 02/01/2021
Onset Date: 03/01/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: dyshidrotic eczema- symptoms began in march. Hands were red and itchy. Skin became dry to the point of bleeding. I first thought it was due to environmental, went back to work in the school at the start of March. Symptoms continued after getting out of school for the summer(mid-June). Went to the doctor late July. Doctor said I had dyshidrotic eczema. Never had skin issues until March 2021.

Other Meds: Effexor

Current Illness:

ID: 1549075
Sex: F
Age: 47
State:

Vax Date: 04/15/2021
Onset Date: 08/01/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: I63.9 - Acute ischemic stroke (CMS/HCC)

Other Meds:

Current Illness:

ID: 1549076
Sex: F
Age: 35
State: MN

Vax Date: 05/06/2021
Onset Date: 08/11/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Admitted to L&D, delivered baby 8/11/2021. Asymptomatic for COVID SxS

Other Meds:

Current Illness:

ID: 1549077
Sex: M
Age: 1
State: MA

Vax Date: 08/09/2021
Onset Date: 08/11/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: Lactose intolerence

Symptom List:

Symptoms: Pt's mother reports that pt was brought to Hospital ED at 3AM and 12PM 8/11/21 - Pt w/ reaction R arm one day after vaccine administration - R arm red/purple swollen, firm, hot to touch, pt scratching at arm and crying out/pulling away when arm touched - Pt w/ fever and poor appetite - Pt brought to ED, given allergy medication, motrin, and abox Pt now with smaller area of redness and swelling, reduced warmth, mild congestion and nasal drainage Mother continuing to monitor pt, declined f/u appt, will cb tomorrow if continues or gets worse.

Other Meds: None.

Current Illness: Diaper rash ED visit to Hospital 7/19/21 for diarrhea, cough, rhinitis

ID: 1549078
Sex: F
Age: 21
State: FL

Vax Date: 08/03/2021
Onset Date: 08/04/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: Peanuts

Symptom List:

Symptoms: Pain and weakness in right leg. Weakness worsens with use up to the point where leg feels like jelly. Treatment with ice packs. Symptoms persist/ have not been resolved

Other Meds: N/A

Current Illness: N/A

ID: 1549079
Sex: F
Age: 59
State: OR

Vax Date: 07/24/2021
Onset Date: 08/05/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Vancomycin, Cleocin, Gentamycin, Cipro, Prednisone, Swordfish

Symptom List:

Symptoms: Pulsatile Tinnitus on and off from day 4-11 Severe Pulsatile Tinnitus day 12 to present

Other Meds: Colace, Aleve, Trazodone, Propranolol, Zyrtec, Centrum Multivitamin, Calcium

Current Illness: 3-day episode of diarrhea

ID: 1549081
Sex: F
Age: 13
State: GA

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: Pt got second covid vaccine two days prior to the 21th day of first dose.

Other Meds: none

Current Illness: none

ID: 1549082
Sex: F
Age: 56
State: MD

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: This patient who received a 3rd dose of Moderna on 8/4 . However, was fully vaccinated with Pfizer. This individual did list ?No? to the question of if this was their first vaccine dose when they registered on-site.

Other Meds:

Current Illness:

ID: 1549083
Sex: F
Age: 14
State:

Vax Date: 06/05/2021
Onset Date: 06/07/2021
Rec V Date: 08/12/2021
Hospital:

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

Allergies:

Symptom List:

Symptoms: Prior to her second dose of the COVID vaccine, although my daughter had neurological issues that caused her to use orthotics to assist in walking, she was able to stand, walk and navigate stairs relatively easily. Within 48 hours of her second dose of the Pfizer COVID vaccine, she reported pain and weakness in her legs and became no longer able to walk even with the assistance of the orthotics that previously had been helpful. It has been weeks and she still has not regained the ability to walk/stand in spite of physical therapy that she has received. It is possible that her undiagnosed neurological condition is Guillian Barr Syndrome, though her neurologist has not made a definitive diagnosis of this, her symptoms are consistent with that disease and it is possible that the vaccine's adverse effect is a result of that undiagnosed disorder.

Other Meds: Medicines for ADHD and Anxiety, insulin for type 1 diabetes

Current Illness:

ID: 1549085
Sex: F
Age: 55
State: AR

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Intensive pain & tingling in vaccinated arm. 8 hours later, can not move left arm without severe pain. Swelling & heat at injection site. Pain kept me awake most of the night.

Other Meds: None

Current Illness: None

ID: 1549086
Sex: M
Age: 77
State: FL

Vax Date: 03/02/2021
Onset Date: 06/10/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: ON JUNE 10 , 2021 I DID HAVE A STROKE AND WAS TO THE HOSPITAL WITH THE AMBULANCE , I AM NOT SURE THAT IT WAS RELATED TO THE VACCINE WITH MODERNA .I WAS A HEALTHY PERSON EXCEPT HIGH BLOOD PRESSURE .

Other Meds: AMLODIPINE ,OLMESARTAN + PYCNOGENOL

Current Illness: NONE

ID: 1549087
Sex: M
Age: 37
State: WI

Vax Date: 01/10/2021
Onset Date: 08/04/2021
Rec V Date: 08/12/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: CLIENT CONTRACTED COVID DESPITE FULLY VACCINATED AS OF 1/24/21. LAB POSITIVE PCR.

Other Meds:

Current Illness:

ID: 1549088
Sex: M
Age: 43
State: CA

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

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Tinnitus in both ears and mid-range hearing loss in left ear.

Other Meds: None

Current Illness: None

ID: 1549089
Sex: F
Age: 67
State: OH

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

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

Lab Data:

Allergies: clonidine; codeine; demerol; erythromycin; heparin; lidocaine; morphine; novocain; robinul; statins; valium; zetia

Symptom List:

Symptoms: Pt experienced seizure-like activity with clonic tonic movements of all extremities directly following the administration. Pt did not lose consciousness and was not incontinent during the event. Pt complained of felling fatigue - challenge to keep her eyes open. EMS arrived in 4 minutes and took patient to ER

Other Meds: amlodipine 2.5mg; aspirin 81 mg; enalapril 10 mg; Xopenex; rosuvastatin 5 mg; vitamin D

Current Illness:

ID: 1549091
Sex: F
Age: 40
State: TX

Vax Date: 04/10/2021
Onset Date: 06/19/2021
Rec V Date: 08/12/2021
Hospital:

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

Allergies: No

Symptom List:

Symptoms: 2 months after my second vaccine shot - 17 days late period, which is unusual, maybe miscarriage, and after delay whole month heavier flows with big clots.

Other Meds: No

Current Illness: No

ID: 1549092
Sex: F
Age: 0
State: NC

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

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: Patient was given Pentacel and another HIB instead of a dose of hepatitis B vaccine.

Other Meds: NONE

Current Illness: NONE

ID: 1549093
Sex: F
Age: 56
State: IL

Vax Date: 06/15/2021
Onset Date: 06/29/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: Allergic to walnuts, pollen, and possibly penecillin

Symptom List:

Symptoms: Circular rash at injection site, hot to the touch, swelling The morning after receiving the second dose, I experienced all general side effects: swelling of lymph node in armpit of injected arm, fatigue, muscle/joint pain, chills, nausea vomiting, and vertigo severe enough to cause me to fall resulting in a bruise on right side lasting 2 weeks.

Other Meds: None

Current Illness: None that I know of

ID: 1549094
Sex: M
Age: 70
State: VA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Fever, body aches, chills, fatigue, chest tightness

Other Meds: Nexium, Welbrutin, Alpurinol, Metformen

Current Illness: none

ID: 1549095
Sex: F
Age: 50
State: MD

Vax Date: 07/31/2021
Onset Date: 07/31/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: I was looking through the vaccinated list and there was an individual who received a 3rd dose of Moderna on 7/31. This individual did list ?No? to the question of if this was their first vaccine dose when they registered on-site.

Other Meds:

Current Illness:

ID: 1549096
Sex: F
Age: 81
State: CA

Vax Date: 05/11/2021
Onset Date: 08/08/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies: Codeine - stomach pain

Symptom List:

Symptoms: 81 Y female with PMHx of DM2, allergies, and asthma who presents with weakness, confusion, SOB and cough. Pt admitted for acute hypoxemic respiratory failure 2/2 COVID pneumonia # Sepsis and acute hypoxemic respiratory failure both 2/2 COVID Pneumonia - Symptom onset on 8/2/21. COVID positive on 8/4/21. Low grad fever to 99.6 on 8/8/21. No clinical signs of bacterial pna. Will hold off on further abx. Patient received 2 doses of Pfizer vaccine in April and May 2021. - Nasal Cannula at 3-4 Lpm. Goal SpO2 >92%. Consider ICU evaluation if requiring >40LPM and 60% FiO2 for SpO2 >/= 90% - Self-proning as tolerated for O2 req >3L - Decadron 6mg IV or PO qday for up to 10 days (8/8 - ) or until no longer hypoxic. - Remdesivir 200mg IV x1, followed by 100mg IV daily until clinical improvement or 5 days (8/9 - ) - Daily LFTs. Hold Remdesivir if ALT >10xULN or CrCl<30 - pepcid for GI prophylaxis while on steroids - trend inflammatory markers - Lovenox 40mg SQ daily and hold for Plt <25k, Fibrinogen <100, active bleeding - continue isolation in hospital per Regional/Local ID guidance. # Normocytic Anemia: Hgb 10.8 on admission, 9.3 today (hgb was 12 back in 2016, no data since). Pt reports dark brown stool, not black or bloody. No blood in urine. Unclear cause of anemia at this time. - Iron labs - B12, folate - If hgb down trends will need to consider holding Lovenox. Pt will be discharged in a day or 2 pending improvement in O2 requirements. So far pt has been in hospital 4 days and not yet discharged.

Other Meds: Docusate Sodium 100mg, Hydrocodone-Acetaminophen 5-325mg, Multivitamin

Current Illness: unknown

ID: 1549097
Sex: F
Age: 70
State: FL

Vax Date: 02/12/2021
Onset Date: 03/22/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: Penicillam

Symptom List:

Symptoms: I have NEVER had any ear problems in my entire life, including no was problem and I woke up with Sudden Hearin Loss, only 35% ability to hear in right ear.

Other Meds: Sotolol, Pantazole, Diltiazin, Xifaxin, Elliquis

Current Illness: None

ID: 1549098
Sex: F
Age: 53
State: MS

Vax Date: 01/05/2021
Onset Date: 08/09/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: 8.9.2021 Routine Covid19 no signs or symptoms of Covid.

Other Meds: Unknown

Current Illness: None

ID: 1549099
Sex: F
Age: 55
State: NC

Vax Date: 07/26/2021
Onset Date: 08/05/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List:

Symptoms: ON 8-5-2021 it was discovered that the patient received 1 entire undiluted vial of Pfizer COVID-19 vaccine.

Other Meds: Unknown

Current Illness: Unknown

ID: 1549100
Sex: F
Age: 62
State: MD

Vax Date: 05/04/2021
Onset Date: 05/31/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies: Codiene, Morphine, Lidocaine, Sulpha Antibiotics

Symptom List:

Symptoms: Within 7 days started with generally feeling unwell, swollen gland, escalated blood pressure, and joint pain. By day 12, I started have "flutters" of my heart and feeling like my heart was jumping in my chest several times a day. This made me highly anxious and feeling even more unwell. I noticed shortness of breath and weakness. I normally walk 2 miles each morning and was unable to walk without feeling dizzy. On May 31st was a work and pressure in chest, dizziness, chest pain escalated and I was having difficulty thinking straight, and slurring my speech talking to my husband, so I went to the emergency room. Diagnosed with TIA in ER.

Other Meds: 81mg aspirin Vitamin B Complex Vitamin D Lisinopril 5mg

Current Illness: None

ID: 1549101
Sex: F
Age: 48
State: VA

Vax Date: 04/25/2021
Onset Date: 05/03/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Began feeling heart palpitations, noted skipped pulse, sometimes experienced mild dizziness, and developed a dry cough within 2ish weeks of my second shot. Intense bouts would last for approximately 3 days and gradually get better, then repeat again. As time has gone on, the intensity and duration has lessened, but is still occurring.

Other Meds: Valcyclovir Zyrtec Multi-vitamin Fish oil Vitamin D Probiotic

Current Illness: None

ID: 1549102
Sex: F
Age: 15
State: CA

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

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: EMT reports that patient received the 1st dose of Pfizer 08/11/2021, Pt. fainted immediately after resulting transport for observation. Cognitive test preformed and showed normal cognitive ability. Pt. currently has recovered and discharged.

Other Meds: N/A

Current Illness: N/A

ID: 1549103
Sex: F
Age: 42
State: MA

Vax Date: 04/06/2021
Onset Date: 04/25/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: codeine, tetracycline

Symptom List:

Symptoms: Increased joint pain, swelling, unable to complete ADLs without assistance.

Other Meds: sulfasalazine, Advair, vitamin D

Current Illness: HLAB27+ , inflammatory arthritis, asthma, insomnia

ID: 1549104
Sex: F
Age: 64
State: AZ

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

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

Lab Data:

Allergies: Sulfa allergy

Symptom List:

Symptoms: Positive COVID-19 on 8/11/21 in fully vaccinated individual. Developed symptoms of fever, malaise, and congestion on day of test, approximately 5 days after exposure to an unvaccinated individual in her household who had tested positive for the virus.

Other Meds:

Current Illness:

ID: 1549105
Sex: F
Age: 41
State: MT

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

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: My Doc and I are not sure if it's realated to me getting COVID or the Vaccine but I got thyroditis at the beginning of April and it lasted 3 months. Thought I would let you all know. My doctor just had me keep up with the NSAIDs (Aleve) like I did with the pericarditis I had after COVID. As of Mid July the thyroid pain has gone away.

Other Meds: thyroxine, Yaz, multi vit

Current Illness: Got the moderna covid vac 1st dose Jan 7th and 2nd Feb 4th. I had Covid in October of 2020 and had pericarditis mid Nov to about mid Dec.

ID: 1549106
Sex: F
Age: 58
State: VA

Vax Date: 04/16/2021
Onset Date: 04/26/2021
Rec V Date: 08/12/2021
Hospital:

Vax Type:
Manufacturer:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: After 3 days after the second dose my mom developed dermatographism (we went to her primary dr and a dermatologist) and about 10 days later on April 26th she developed symptoms as: shortness of breath, palpitations, chest pain. I neglected her symptoms thinking it was anxiety (she was going back to visit my sister in a couple of days). Her symptoms persisted and got even worse (she also started spitting blood) and went to see some doctors there and they gave her medication and suggested it is a reaction to the vaccine (I have the doctors' findings and prescriptions of medication). I do have to mention my mom is a resident and she got the vaccine. I am writing because she does not speak English. She is coming back on August 19th, and I will take her to other doctors for further investigation, but I wanted to get this information to you soon.

Other Meds:

Current Illness:

ID: 1549107
Sex: F
Age: 67
State: NH

Vax Date: 06/06/2021
Onset Date: 07/01/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: Thimerosol, beta blockers contra-indicated

Symptom List:

Symptoms: A fib , new onset Lightheaded ness/vestibular symptoms

Other Meds: Acyclovir, calcium, cell protect, fish-oil Coenzyme Q10, prednisone, mestinon, probiotic, Bactrim, multivitamin

Current Illness:

ID: 1549108
Sex: F
Age: 43
State: FL

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient was given J&J on 8-10-21 and when Shots was pulled up to enter information it was discovered that she had already recived (2) doses of Moderna in Jan & Feb of this year. I asked her if the profile I showed her on shots was correct and she admitted that yes she had received the Moderna already. I called her on 8-11-21 to ask how she was feeling and she stated she was not having any side effects. She again apologized for not being forthcoming the previous day and admitted she was wrong for doing this.

Other Meds:

Current Illness:

ID: 1549109
Sex: F
Age: 81
State: WI

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: The client came to the clinic and requested her "first" Pfizer vaccine and stated she did not have a vaccine card. Her electronic record was looked up, but none was found. Her last name was entered incorrectly at check-in. The client added an "e" in the spelling of her last name. This was corroborated by 2 people at check-in. Upon entry into Immunization Registry, it was found that she was already fully vaccinated with Pfizer.

Other Meds:

Current Illness:

ID: 1549110
Sex: F
Age: 50
State: OR

Vax Date: 12/24/2020
Onset Date: 07/18/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: ASA NSAIDS SULFA

Symptom List:

Symptoms: productive cough, nasal congestion, SOB, headache, body aches, fever, stridor. MEDS: Albuterol MDI, Flonase, Tylenol. Symptoms resolved after 3 weeks

Other Meds: Trazadone Zofran

Current Illness: None

Date Died: 02/21/2021

ID: 1549111
Sex: F
Age: 84
State: MD

Vax Date: 01/22/2021
Onset Date: 02/19/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: shellfish

Symptom List:

Symptoms: Death, massive heart attack

Other Meds: Parkinsons meds, Urinary incontinence, Thryoid

Current Illness:

ID: 1549112
Sex: M
Age: 36
State: AR

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

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Symptoms: Patient received their vaccine around 10 am on 8/11/21, and they reported they went to lunch and felt fine, then a few hours later they got back to work and their heart rate was elevated and they felt dizzy. Upon a follow-up call, they reported their heart rate was still 120-130bpm despite resting and relaxing and taking Benadryl.

Other Meds:

Current Illness:

ID: 1549113
Sex: F
Age: 31
State: MO

Vax Date: 07/22/2021
Onset Date: 08/02/2021
Rec V Date: 08/12/2021
Hospital:

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Lab Data:

Allergies: None

Symptom List:

Symptoms: Red patch/rash? raised skin in rectangular shape, approx 2? by 3?, injection site. Itchy and hot to touch. Went away after 1 week.

Other Meds: Prenatal Vitamin

Current Illness: None

Date Died: 06/02/2021

ID: 1549114
Sex: F
Age: 75
State: FL

Vax Date: 02/09/2021
Onset Date: 02/14/2021
Rec V Date: 08/12/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: Penicillin Aspirin Tylenol

Symptom List:

Symptoms: After the shot, sick, tired, aches and pains for two - three days. Day 3 - 5 Dizziness, blurred vision. Day 5 went to the hospital, ER found sign of stroke. Day 7 saw a neurologist, was told that a stroke occurred, but was not sure if it was new or old. Day 12, massive Ischemic Stroke followed by multiple hemorrhages. The Clot left a 10mm hole in the left side of the brain.

Other Meds:

Current Illness: NA

ID: 1549115
Sex: M
Age: 27
State: TX

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

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Lab Data:

Allergies: n/a

Symptom List:

Symptoms: Patient reported he has history of fainting after getting a ceftriaxone injection years ago. We talked through the possible scenarios and proceed with the vaccine with his partner next to him for support. Patient sat down after vaccine for 5 minutes and his partner came up to notify me that patient was not feeling well. I went to check on him and saw that he was still alert, conscious and able to have a conversation. However, he appeared pale, uncomfortable and sweating. I went to get him some paper towel and went I came back he said he felt nauseous and wanted to head toward the restroom. I urged him to stay seated and I went to get him a plastic bag. By the time I came back, he already started vomiting tan fluid on the floor. Patient vomit for lest than one minute and felt better. He stayed for observation for another 20 minutes and felt well and left.

Other Meds: n/a

Current Illness: n/a

ID: 1549116
Sex: F
Age: 52
State: TN

Vax Date: 08/09/2021
Onset Date: 08/10/2021
Rec V Date: 08/12/2021
Hospital:

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Lab Data:

Allergies: NKA

Symptom List:

Symptoms: PATIENT'S ARM AT THIS TIME IS VERY SWOLLEN AND HOT TO TOUCH. PATIENT STATES ALSO VERY PAINFUL.

Other Meds: None that I am aware

Current Illness: none

ID: 1549117
Sex: F
Age: 42
State: OH

Vax Date: 08/03/2021
Onset Date: 08/12/2021
Rec V Date: 08/12/2021
Hospital:

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Lab Data:

Allergies: none reported on the administration form she filled out, cyclobenzaprine in her patient file

Symptom List:

Symptoms: Pt developed redness, swelling, and itchiness at the injection site 9 days post vaccination. Pt was advised to do ibuprofen/acetaminophen, cold compress, and Benadryl if needed. Also to go to urgent care/call doctor if symptoms spread. Today was day 1 of symptoms.

Other Meds: None reported/in patient file

Current Illness: None reported

ID: 1549118
Sex: F
Age: 43
State: CA

Vax Date: 03/25/2021
Onset Date: 03/29/2021
Rec V Date: 08/12/2021
Hospital:

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Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: My menstrual cycle started a few days after and wasn't supposed to start for a few weeks. It lasted almost 3 weeks instead of the usual 5 days and in the months since has nearly ceased completely being very light and and weeks late

Other Meds: none

Current Illness: none

ID: 1549119
Sex: F
Age: 53
State: GU

Vax Date: 01/13/2021
Onset Date: 02/11/2021
Rec V Date: 08/12/2021
Hospital:

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Lab Data:

Allergies: None

Symptom List:

Symptoms: Had severe chest pain that cause difficulty breathing for a few minutes on 2/11/2021 at 9pm. Went to Clinic in the morning since still experiencing chest pain, but milder than the night before. Was prescribed Macrobid for abnormal urinalysis result and was instructed to stay away from meat, oil, caffeine, dairy and eggs. Went to Hospital on 2/14/2021 after experiencing recurrence of chest pain at around 8:30am. No treatment was given. Instructed to return if with another episode.

Other Meds: Metformin 500mg PO BID Amlodipine 5mg PO once daily Glucosamine 1500mg PO once daily Collagen 1200mg PO once daily Vitamin C 1000mg PO once daily

Current Illness: None

ID: 1549120
Sex: M
Age: 36
State: NY

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

Vax Type:
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Lab Data:

Allergies: No known allergies

Symptom List:

Symptoms: Patient became sweaty and felt dizzy. Got patient water and they remained seated. While seated patient "passed out" for a few seconds. He never had swelling of face or tongue and did not have trouble breathing. Pharmacist and store manager remained with patient until EMS took over. EMS put patient on stretcher and took him to hospital. Local police officers also responded after 911 call was made.

Other Meds: Patient stated he had 6-7 drinks last night. Came in today on empty stomach. Sated has no long-term health care problems. Asked him if he ever had an adverse event following a vaccine and stated he did not. Pt has no allergies.

Current Illness: Pt stated in good health

ID: 1549121
Sex: M
Age: 68
State: CA

Vax Date: 03/10/2021
Onset Date: 04/13/2021
Rec V Date: 08/12/2021
Hospital:

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Lab Data:

Allergies: Sulfa drugs

Symptom List:

Symptoms: While camping I experienced extremely bad heart burn. After trying all available means to control pain, called paramedics to make sure it wasn't a heart attack. It wasn't a heart attack, but paramedics found 30-40% PVCs and advised going to ER to get checked out. I have had PVCs for decades, but not at medically significant levels. ER confirmed no heart attack, but recommended followup on PVCs. Followup with specialists found no mechanical reason for high PVC rate, and I am schedule for heart ablation procedure to hopefully correct problem. I do not know when the increase in PVCs occurred. PVCs were lower before inoculation and higher after, but there is a several month period over which the increase may have occurred and the vaccination just happened to be in that period. PVCs are not impacting my life and I would not even know I had them without the tests, but they are a long term health issue that need to be addressed.

Other Meds: Omepresol 20mg/day for GERD Hydrocholorothiazide 12/mg/day for blood pressure Alfuzosin 10 mg/day for BPH

Current Illness: None

ID: 1549122
Sex: F
Age: 63
State: WI

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

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Symptom List:

Symptoms: This client came to the clinic, denied having a vaccine card and stated she presented for her first Pfizer vaccine. She was looked up in the and the staff missed looking at the record correctly and that she was already fully immunized with 2 doses of Moderna. This error was caught while the client was still at the facility in observation. When asked if her record was correct in her already receiving 2 doses of Moderna, she said yes. She stated that she takes immunosuppressive medication and her immunologist told her to get another vaccine any way she could so she was protected against Covid.

Other Meds:

Current Illness:

ID: 1549123
Sex: F
Age: 44
State: OR

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: Sulfa penicillin

Symptom List:

Symptoms: Wheezing, shortness or breathe, tired, fever, runny nose, muscle cramps, uterine cramps, achy joints, chills, migraine

Other Meds: None

Current Illness: None

ID: 1549124
Sex: M
Age: 38
State: TN

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

Vax Type:
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Lab Data:

Allergies: lidocaine

Symptom List:

Symptoms: Pt presented to facility to get a Janssen COVID vaccine. Pt reports history of vasovagal reactions to flu vaccines in the past. Patient began feeling hot and became diaphoretic within 5 minutes of receiving the vaccine. Nurse noted pallor, tachypnea, and hypotension. Patient c/o tingling extremities, headache, and fatigue. Patient remained alert and oriented. He began to improve without further intervention within 10 minutes of injection, and fully recovered "feeling better" within 30 minutes of injection. Patient reported fatigue, but otherwise feeling well two hours later by phone on follow-up.

Other Meds: hyoscyamine prn - taken about 2x/week on average ; zyrtec prn;

Current Illness: none

ID: 1549125
Sex: M
Age: 60
State: WA

Vax Date: 05/04/2021
Onset Date: 07/07/2021
Rec V Date: 08/12/2021
Hospital:

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Lab Data:

Allergies: topical ketoconazole

Symptom List:

Symptoms: loose bowels, cough (mostly dry, occasionally clear mucous), congestion (clear mucous), fatigue, low back ache, (*no* fever), (*no* nausea)

Other Meds: Pravistatin 40mg, allergic (generic zirtec), vitamin D 2000 iu, beta carotene

Current Illness: n/a

ID: 1549126
Sex: F
Age: 13
State: ME

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

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Lab Data:

Allergies:

Symptom List:

Symptoms: Patient underage for this vaccine according to EUA. No adverse outcomes/reactions noted. No extra monitoring required. Moderna (manufacturer) was contacted. We were given the advice that the patient may receive a 2nd dose of Moderna vaccine after 28 days if the provider chooses, although such use is still technically off-label and we need to acknowledge that fact.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm