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
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1553719
Sex: M
Age: 71
State:

Vax Date: 04/11/2021
Onset Date: 08/08/2021
Rec V Date: 08/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: 72-year-old male with past medical history of basal cell carcinoma, colon cancer, hyperlipidemia, hypertension, insomnia presents to the emergency department with shortness of breath. Diagnosed with COVID-19 on August 8, 2021. Has tolerated outpatient therapy until now. Prompting emergency department visit. Shortness of breath has improved in the emergency department. Complaining of cough productive with clear sputum. Admits to subjective fevers and chills. Denies nausea vomiting or diarrhea. 8/11/2021 tested positive

Other Meds:

Current Illness:

ID: 1553720
Sex: F
Age: 72
State:

Vax Date: 03/09/2021
Onset Date: 08/04/2021
Rec V Date: 08/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: This is a 72-year-old female with past medical history of hyperlipidemia, coronary artery disease status post CABG x4, anxiety, depression, multiple sclerosis, immunocompromised. She came to the hospital with a chief complaint of progressive worsening cough and shortness of breath over the last 10 days. Initially tested positive about 4 days after starting to have symptoms. Was prescribed azithromycin as an outpatient by her primary care physician. Her son initially tested positive for COVID-19 after which the patient started having symptoms as well due to exposure. The patient was having significant worsening of the shortness of breath over the weekend and had a very severe heada 8/11/2021 tested positive This is a 72-year-old female with past medical history of hyperlipidemia, coronary artery disease status post CABG x4, anxiety, depression, multiple sclerosis, immunocompromised. She came to the hospital with a chief complaint of progressive worsening cough and shortness of breath over the last 10 days. Initially tested positive about 4 days after starting to have symptoms. Was prescribed azithromycin as an outpatient by her primary care physician. Her son initially tested positive for COVID-19 after which the patient started having symptoms as well due to exposure. The patient was having significant worsening of the shortness of breath over the weekend and had a very severe headache so she decided come to the hospital for further evaluation and treatment. Patient was also having some cough, chest pain associated with cough, back pain, fevers, chills, nausea, vomiting, loss of taste. Denies any abdominal pain, burning or painful urination or diarrhea.

Other Meds: Metoprolol Succinate ER

Current Illness:

ID: 1553721
Sex: F
Age: 68
State: FL

Vax Date: 02/04/2021
Onset Date: 02/17/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin Clindamycin/lincomycin Sulfamethoxazole-trimethoprim (Bactrim DS)

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

Symptoms: In mammogram taken 13 days after the 2nd dose, the images and ultrasound indicated swollen lymph nodes under my arm on the left side. Quite alarming as I had been diagnosed with breast cancer the year before. I had a followup ultrasound on April 27, 2021 and the lymph nodes had returned to normal.

Other Meds: Rosuvastatin Calcium 10 MG once/day Tamoxifen 20 MG once/day started Omega 3&6 1000mg Fish oil once/day Vitamin D3 5000 once/day Red Yeast Rice 1200 mg once/day PreserVision AREDS2 twice/day Niacin 500mg once/day CoQ

Current Illness: None

ID: 1553722
Sex: M
Age: 46
State: IN

Vax Date: 03/14/2021
Onset Date: 03/27/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: Common seasonal allergies, very susceptible to seasonal allergies, cooking cloves, dog and cat dander, tree molds, other common airborne pollen and molds.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Approximately 2-3 months after the shots, the shots were in my left arm my upper lip began to swell on a regular basis. My upper left lip on the lip line and above the lip approximately 3 centimeters. The first time was a feeling of numbness with swelling similar to a cold sore or fever blister. The appearance of the swelling was similar to a bee sting area swelling. This happened and continue to happen 4-6 times a month now. I have never/not experienced this at any point in my life, this began after the vaccination shots. Today 08/13/2021 was one of the worst swelling reactions I have experienced since the first occurrence. I reported the events during the first month, 4/2021, via the vaccination text communication they sent out. I reported the events, ongoing events, to my Doctors at Our Health also known as The lip swelling happens randomly, but seems to trigger under stress, lack of sleep, but also it is just random. The adverse events happen at least once a week, some are mild others are more severe and very noticeable outwardly appearing like a bee sting on the left side of my upper lip.

Other Meds: Lipitor

Current Illness: I was tested and found to be positive for Covid-19, with Covid SARs related pneumonia approximately 90 days prior to my first vaccination.

ID: 1553723
Sex: F
Age: 78
State:

Vax Date: 03/02/2021
Onset Date: 08/07/2021
Rec V Date: 08/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: This is a 78-year-old female with past medical history of hypertension, hyperlipidemia, type 2 diabetes mellitus insulin dependent, diabetic nephropathy, chronic kidney disease stage 3, myocardial infarction status post 3 stents, permanent atrial fibrillation on chronic anticoagulation with Eliquis, history of multiple episodes of epistaxis, COPD/emphysema, history of CVA with residual deficit in the vision, hypothyroidism, peripheral neuropathy, history of skin cancer status post excision, chronic sinusitis. She came to the hospital with a chief complaint of an episode of syncope this morning. Patient was here in the emergency room last night for epistaxis. Patient underwent nasal 8/7/2021 tested positive This is a 78-year-old female with past medical history of hypertension, hyperlipidemia, type 2 diabetes mellitus insulin dependent, diabetic nephropathy, chronic kidney disease stage 3, myocardial infarction status post 3 stents, permanent atrial fibrillation on chronic anticoagulation with Eliquis, history of multiple episodes of epistaxis, COPD/emphysema, history of CVA with residual deficit in the vision, hypothyroidism, peripheral neuropathy, history of skin cancer status post excision, chronic sinusitis. She came to the hospital with a chief complaint of an episode of syncope this morning. Patient was here in the emergency room last night for epistaxis. Patient underwent nasal packing in the emergency room. She has previous similar episodes of epistaxis. Eliquis was advised to be held. Patient was supposed to see her cardiologist Dr. for decision regarding resuming Eliquis. This morning the patient woke up but she could not really sleep all night due to discomfort in the nasal cavity from the packing. She felt that the packing was too tight. She had some difficulty breathing due to tight packing in the nasal cavity. The patient denied any fevers but did have some chills. Denies any cough. Currently the epistaxis is resolved. Nasal packing is removed. The patient denies any chest pain, shortness of breath, palpitations, abdominal pain, burning or painful urination, diarrhea. She did have some nausea but denies any episodes of vomiting. After the patient got up from the bed this morning she went to the bathroom but she collapsed on the floor, she hit her head, then she suddenly found herself in the bathroom but does not remember how she went there, the episode was unwitnessed. She came to the hospital and had low blood pressure. Nasal packing was removed.

Other Meds: codeine, benadryl

Current Illness:

ID: 1553726
Sex: F
Age: 53
State: KS

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

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Imitrex, atenolol, flunisolide

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

Symptoms: Hives on legs, arms, hands, and face

Other Meds: Omeprazole, cetirizine, fish oil, probiotic, chlorthalidone, amlodipine, zinc, vitamin c, vitamin d

Current Illness: None

ID: 1553727
Sex: F
Age: 52
State: MD

Vax Date: 02/10/2021
Onset Date: 08/04/2021
Rec V Date: 08/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Tramadol - numbness in legs

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient reported to medical center on 8/4/2021 after complaints of shortness of breath for 3 days and increased cough for 2 days. Patient is fully vaccinated against COVID-19 and had a negative COVID-19 test as of 8/2/2021. The morning of 8/4/2021, the patient was extremely short of breath which was not improved with albuterol, and presented to the ER for treatment. The patient had an oxygen saturation of 84% on room air upon arrival.

Other Meds: Albuterol, bupropion, cetirizine, citalopram, duloextine, AirDuo RespiClick, folic acid, gabapentin, hydrochlorothiazide, oxycodone-APAP, pantoprazole, pravastatin, valacyclovir

Current Illness:

Date Died: 06/15/2021

ID: 1553728
Sex: M
Age: 51
State: UT

Vax Date: 04/15/2021
Onset Date: 06/15/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Allergic to peas

Symptom List: Pharyngeal swelling

Symptoms: There were no signs or symptoms. Patient received his last Covid19 vaccine on 5/13/21. He passed away on 06/15/2021. The diagnosis on the autopsy report shows that he died from Dilated Cardiomyopathy. There was no evidence of trauma and a clean toxicity report. He has no previous diagnosed health problems.

Other Meds: Tylenol and Ibuprofen

Current Illness: No

ID: 1553729
Sex: F
Age: 73
State: MN

Vax Date: 03/10/2021
Onset Date: 05/02/2021
Rec V Date: 08/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Started with shortness of breath, increased heart rate, lightheadedness morning of May 2, called doctor Monday may, 36, went to Urgent Care.

Other Meds: Olmesartan Medoxomil 5 mg,, Triamterene-Hctz37,5-25 Mg,., Amlodipine besylate 10 mg,, , Vitamin D3 1000 unit, Colace 100 mg, Rhthmol 150 mg 1 every 8 hrs., Simvistatin Zocor 10 mg

Current Illness: None

ID: 1553730
Sex: F
Age: 49
State: IN

Vax Date: 01/08/2021
Onset Date: 03/01/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: aspirin - urticaria ketorolac tromethamine - pruritis

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient states her cycles have been irregular, heavy, and painful since March post COVID vaccine. Patient states she is having bleeding every 4-5 days with at least 10 bleeding days per month and saturating through overnight pads every 2-3 hours. Cycles prior were normal every 28-32 days with mild cramping.

Other Meds: 1) DICLOFENAC NA 1% TOP GEL APPLY 4 GRAMS TOPICALLY 4 ACTIVE TIMES A DAY AS NEEDED FOR PAIN AND INFLAMMATION. MAX 32 GRAMS DAILY. 2) FLUTICASONE PROP 50MCG 120D NASAL INHL USE 2 SPRAYS ACTIVE IN BOTH NOSTRILS

Current Illness: n/a

ID: 1553731
Sex: F
Age: 64
State:

Vax Date: 08/07/2021
Onset Date: 08/07/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None.

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

Symptoms: Dizziness.

Other Meds: Tylenol, Levothyroxyine, Amlodipine.

Current Illness:

ID: 1553732
Sex: F
Age: 54
State: FL

Vax Date: 04/30/2021
Onset Date: 06/04/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: On June 3 I started feeling dizzy and nauseated at work. I woke up on the morning of June 4 2021 experiencing extreme dizziness and nausea that lasted for 3-4 days. On June 24th I woke up experiencing the same symptoms and couldn't go to work as of today- 8/13/2021 I wake up with slight dizziness (although manageable) every morning and have to be very conscious of my head movements so as not to make myself more dizzy or nauseated

Other Meds: Rizatriptan 10mg adderrall 30 mg

Current Illness:

ID: 1553733
Sex: F
Age: 17
State: IA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: 1 hour after receiving Bexsero became nauseated, sweaty, and achy all over. Left deltoid wnl, other than tender to touch where immunization administered.

Other Meds: pepcid

Current Illness: none

ID: 1553735
Sex: F
Age: 34
State: OK

Vax Date: 08/06/2021
Onset Date: 08/08/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NKDA

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

Symptoms: Headaches, nausea, slight chest pain, and backaches. Patient states that has affected her ability to work. Symptoms started two days after receiving her second dose of the Pfizer.

Other Meds: hydroxyzine HCl 25 mg tablets, Cetirizine HCl 10 mg tablets, Flonase Allergy Nasal Sray 50 mcg/act suspension

Current Illness: None

ID: 1553736
Sex: M
Age: 44
State: OH

Vax Date: 08/09/2021
Onset Date: 08/09/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Hands tingling. Left side has a unique tightness

Other Meds: Atorvastatin, Xaralto, Baby Asprin, Cealis, Finastaride

Current Illness:

ID: 1553737
Sex: M
Age: 70
State: ID

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: ICU hospitalization for Covid 19 severe infection.

Other Meds:

Current Illness:

ID: 1553738
Sex: F
Age: 32
State: MN

Vax Date: 04/09/2021
Onset Date: 08/09/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: none

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

Symptoms: began feeling ill on 8/9/21 with cold like symptoms, sore throat, body aches, fatigue

Other Meds: Alprazolam, Sertraline,

Current Illness: none

ID: 1553739
Sex: M
Age: 65
State:

Vax Date: 03/30/2021
Onset Date: 07/26/2021
Rec V Date: 08/13/2021
Hospital: Y

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 65-year-old male with past medical history of hypertension, hyperlipidemia, GERD, BPH, peripheral vascular disease, anxiety, diabetes mellitus on insulin, and end-stage renal disease on hemodialysis Tuesday/Thursday/Saturday presented to the emergency department complaints of worsening right testicular pain. Patient reports that he was usual state of health until yesterday evening when he started having persistent nausea and vomiting and also had 1 episode of diarrhea. Patient reports that he went to his primary care physician this morning and started having testicular pain therefore, requested that he come to the emergency department for further evaluation. 7/26/2021tested positive 8/7/2021 discharged Upon arrival to the emergency department, patient was found to have sepsis secondary to prostatitis and epididymo-orchitis. Patient also noted to be incidentally positive for COVID-19. CT abdomen consistent with severe prostatomegaly. Reactive lymphadenopathy. Ultrasound of the scrotum consistent with epididymo-orchitis. Chest x-ray was otherwise negative for any acute findings. Patient was noted to have elevated troponin however, EKG independently reviewed and negative for any acute findings. Also noted to have hypertensive urgency, leukocytosis, anemia, hyponatremia, hypochloremia, metabolic alkalosis, uremia, hyperglycemia, hyperproteinemia, elevated BNP, and elevated lipase.

Other Meds:

Current Illness:

ID: 1553740
Sex: F
Age: 61
State: MI

Vax Date: 07/30/2021
Onset Date: 08/05/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: My blood pressure was dangerously elevated, (<200/120), and could not be reduced by the usual oral medications. It has been over a week and the condition persists.

Other Meds:

Current Illness:

ID: 1553741
Sex: M
Age: 65
State: AR

Vax Date: 08/01/2021
Onset Date: 08/03/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Penicilin, Cefouroxime, Amooxicillin, Ampicillin, Sulfamethoxazole and Trimethoprim

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

Symptoms: Starting on 08/03/2021 (day three) rash down both arms and on chest. Heart palpitations with some chest pain lasting about three days.

Other Meds: None

Current Illness: None

ID: 1553742
Sex: F
Age: 69
State: TX

Vax Date: 05/01/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: developed cough few days ago and came for covid testing

Other Meds:

Current Illness:

ID: 1553743
Sex: M
Age: 90
State:

Vax Date: 03/23/2021
Onset Date: 07/25/2021
Rec V Date: 08/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: antihistamines

Symptom List: Unevaluable event

Symptoms: Upon arrival to the emergency department, patient was found to have acute hypoxemic respiratory failure. Chest x-ray was concerning for mild left basilar infiltrate. He was also noted to have leukocytosis, anemia, hypernatremia, hyperchloremia, uremia, and elevated troponin. Renal function seems to be at baseline. 07/25/2021tested positive 7/28/2021 discharged 91-year-old male with past medical history of prostate cancer 30 years ago status post surgical removal, coronary artery disease, and stage 3 chronic kidney disease who is also a DNR presented to the emergency department with worsening weakness and confusion. Patient is unable to provide any history himself. Patient's daughter was contacted directly. Per her reports, patient was his usual state of health until approximately few months ago when his wife died. Patient has not been himself since then. He was admitted approximately 1 month ago due to changes in mental status. He was discharged and went to rehab facility. Patient went home approximately 1.5 weeks ago and at that time, per the daughter's report, he was doing very well. Patient was able to take care of himself for the most part. Mental status was also intact. After about 1-2 days, patient started having weakness, poor oral intake, and lack of interest in food. Patient also had poor appetite. During this time frame, patient had multiple episodes of chills along with cough and shortness of breath. He also had nausea and vomiting along with diarrhea 5 days ago. Patient only lives with his daughter. Patient was accident for COVID-19 in April 2021. Over the last 5-6 days, patient has had barely anything to eat and has been very weak. This morning, he was unable to bear his own weight therefore, his daughter brought him to the emergency department for further evaluation. Upon arrival to the emergency department, patient was found to have acute hypoxemic respiratory failure. Chest x-ray was concerning for mild left basilar infiltrate. He was also noted to have leukocytosis, anemia, hypernatremia, hyperchloremia, uremia, and elevated troponin. Renal function seems to be at baseline. Elevated troponin also seems to be lower than baseline. EKG independently reviewed and negative for any ST elevations or depressions. No new T-wave inversions noted. Urinalysis negative. Patient was discharged approximately 1 month ago after being presented with similar symptoms. At that time, patient has metabolic encephalopathy was deemed of unclear etiology. MRI brain was negative for any acute findings. Carotid ultrasound was also negative. Hemoglobin A1c was 5.3. TSH was unremarkable. Lipid panel was also negative. Patient was evaluated by Neurology and his mental status changes were deemed most likely secondary to toxic metabolic encephalopathy. There was no clear source of infection identified. Chest x-ray and UA were negative. Also negative for COVID-19. CT abdomen was also negative. During the hospitalization, patient did have an episode of aspiration pneumonia and was treated appropriately. Modified barium swallow was recommended however, daughter refused at that time.

Other Meds:

Current Illness:

ID: 1553744
Sex: M
Age: 78
State: MI

Vax Date: 03/24/2021
Onset Date: 08/12/2021
Rec V Date: 08/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: PT TO ED WITH C.O CHEST PAIN X 4 DAYS, Reports cough. Pt on 3L NC, satting at 94%.

Other Meds:

Current Illness:

ID: 1553745
Sex: F
Age: 61
State: KY

Vax Date: 04/19/2021
Onset Date: 08/10/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Tested positive for Covid 19 on 8/10/21

Other Meds:

Current Illness:

ID: 1553746
Sex: F
Age: 44
State: CO

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 08/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: no

Symptom List: Injection site pain, Menorrhagia

Symptoms: LOST VISION IN RIGH EYE 10 DAYS HOSPILIZED STERIOD TREATMENTS PLEXPHERIS (5 DAYS) ON STERIODS FOR ANOTHER 2 WEEKS AFTER I CAME HOME STILL BLIND IN RIGHT EYE

Other Meds: medication Protonics 40mg Cimetidine 800mg Singular pills

Current Illness: no

ID: 1553747
Sex: M
Age: 17
State: KS

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Hep A adult dose given instead of pediatric to 17 year old patient.

Other Meds:

Current Illness:

ID: 1553748
Sex: F
Age: 72
State: KY

Vax Date: 04/20/2021
Onset Date: 08/06/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Tested positive for Covid 19. Runny nose, cough, headache

Other Meds:

Current Illness:

ID: 1553749
Sex: M
Age: 57
State: AZ

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Very bad headache and fever, 101.0 degrees.

Other Meds: Amlodipine Besylate 5mg/day for high blood pressure, Atorvastatin 40mg/day for Cholesterol

Current Illness: none

ID: 1553750
Sex: F
Age: 33
State: KY

Vax Date: 02/26/2021
Onset Date: 03/26/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: got COVID twice

Other Meds:

Current Illness:

ID: 1553751
Sex: F
Age: 64
State: KY

Vax Date: 02/13/2021
Onset Date: 03/06/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: n/a

Symptom List: Nausea

Symptoms: N/A

Other Meds: n/a

Current Illness: n/a

ID: 1553752
Sex: M
Age: 74
State: IA

Vax Date: 02/11/2021
Onset Date: 06/22/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Bells Palsy, right side of face

Other Meds: Losartan, Hydrochlorothiazide, AndroGel

Current Illness: None

ID: 1553753
Sex: F
Age: 22
State: MN

Vax Date: 08/09/2021
Onset Date: 08/10/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Reglan

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

Symptoms: My left eye became numb for two days

Other Meds: Zoloft

Current Illness: No

ID: 1553754
Sex: M
Age: 45
State: MA

Vax Date: 04/30/2021
Onset Date: 07/08/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Sore shoulder/back, followed by numbness, paresthesia, and mild pain in left arm, from shoulder to fingertips. Symptoms are intermittent and seem to relate to position & posture but not in any consistent way. Soreness in shoulder sometimes returns, but main symptom now is the intermittent paresthesia. Consulted with primary care MD by video, he prescribed cyclonenzaprine orally at bedtime to relax muscles, referred physical therapist but haven?t seen them yet.

Other Meds: Fluticasone/Salmeterol inhaler, Claritin, vit. D, B12, folic acid

Current Illness:

ID: 1553755
Sex: F
Age: 63
State: LA

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Tremor

Symptoms: headaches every day for 2 weeks starting the day of the shot....palpitations every day starting 4 days after the shot. No treatment...saw dr who did blood work and ekg (he just told me blood work good...no comment on ekg which is abnormal)

Other Meds: Losartan

Current Illness: none

ID: 1553756
Sex: M
Age: 23
State: AL

Vax Date: 08/05/2021
Onset Date: 08/07/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: peanuts

Symptom List: Erythema, Pruritus

Symptoms: Headache and severe rash in both armpits.

Other Meds: none

Current Illness: none

ID: 1553757
Sex: M
Age: 24
State: KS

Vax Date: 06/02/2021
Onset Date: 08/04/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: NKA

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

Symptoms: SARS COV-19 Infection. Congestion, Loss of Taste, Loss of Smell, Headache, Fatigue.

Other Meds: NONE

Current Illness: NONE

Date Died: 04/06/2021

ID: 1553758
Sex: M
Age: 67
State: SC

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Patient was sick with flu like symptoms, fever and congestion, until April 5, 2021. He had a massive heart attack on 04/06/2021 died instanly.

Other Meds:

Current Illness: He was fine. Until he received the first moderna vaccine.

ID: 1553759
Sex: M
Age: 40
State: LA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 8 days after injection, arm was hard and red and inflammed. On day 10, arm is inflammed to near elbow

Other Meds: no

Current Illness: no

ID: 1553760
Sex: F
Age: 50
State: NY

Vax Date: 05/14/2021
Onset Date: 05/21/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: I received the J&J vaccine May 14th.. May 20 I started with severe ear pain. (thought I was getting a ear infection) was leaving May 21st for another state. On Saturday May 21st, I was driving and I said to my husband, "I can't feel half my face" I went to take a drink and it went down the front of me. I couldn't shut my eye, my face was drooping, can see out of my eye but everything is blurry, I had sharp pains behind my ear and a ear ache and my speech was slurred. I waited to call my doctor back home on Monday morning. I was scared had no idea what was happening to me. Monday was also my birthday. She ordered me to go to the ER as she thought maybe I had a stroke. So I spent my birthday in the ER. They did a CT scan, x-rays, bloodwork and EKG. They ruled out a stoke. The dr. said I had Bells Palsy, "it is a known side effect to the covid vaccine" and should go away within 2 days to two weeks. He prescribed Acyclovir and Prednisone and Symptoms seemed to get worse. The sever pain behind my ear was horrible. The dr. told me I could up my Gabapentin to 4-6 pills a day for the pain. We cut a vacation short by a couple of days because I wanted to see my doctors back home for the pain. It wasn't normal! I seen my doctors and they sent me for more bloodwork thinking maybe it was Lyme's disease. Did that and that was negative. Then ordered a MRI to see if anything was wrong. It came back that I had Bells palsy, I also have a enlarged lymph node and inflamed nerve. She then recommended my to a Neurologist. The Neuro doctor ordered another MRI for a couple of week ahead as well as a CT scan of the chest, told me to see a eye doctor, and more bloodwork. I have seen a eye doctor and she says it's normal for me to have blurred vision with Bells palsy and my vision should eventually come back. My regular doctor also added a CT scan of the abdomen area to rule out cancer or anything else. Both the CT scans came back normal for my age, no cancer cells. The MRI came back the same as first one. On July 19th I had a Spinal Tap. I'm still awaiting all the results. As of today, I still have slurred speech, blurred vision, I get tired fast, have no energy, my pain behind the ear comes and goes. When my pain is real bad my speech worsens, still have a droopy face but not as bad as it was. I get dizzy to the point I feel like I'm drunk. I spend half of the day in bed because I can't move, I have had what the neurologist says is "blackout pain" Where the pain is so sever your body just shuts down and I can't move. I've had to have my daughter or husband help me up because I have no strength to move. This is all so scary for me, stressful. I am emotionally, mentally, physically drained! I am not working.

Other Meds: Gabapentin Methotrexate Meloxicam Propranolol Folic acid Levothyroxine Chlorthalidone Enbrel

Current Illness:

ID: 1553761
Sex: M
Age: 92
State: CT

Vax Date: 01/14/2021
Onset Date: 08/12/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin, tomatoes

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

Symptoms: resident had mental status change, low oxygen, back pain. Sent to hospital for evaluation. Identified as positive covid.

Other Meds: Allopurinol, Aspirin, Atonastatin, Eliquis, Escitalopram, Furosemide, Kapspargo, Losarten, Travoprost, Folic Acid, Lasix, Lexapro, Losartan, Metoprotol,

Current Illness: unknown

ID: 1553762
Sex: F
Age: 66
State: MA

Vax Date: 04/12/2021
Onset Date: 04/26/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Mold, Metformin, Morphine, Penicillin

Symptom List: Pain in extremity

Symptoms: States she had chest pain, heavy chest, SOB, joint pain, and vertigo. She did not report this to us (her PCP) she reported this to her Intergrative medicine Doctor after the fact, a few months later, and he told her to have us report this to VAERS.

Other Meds: Vit D3, Proiotic, Nitroglycerin PRN

Current Illness: None

ID: 1553763
Sex: F
Age: 63
State: OK

Vax Date: 02/03/2021
Onset Date: 02/12/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: I am allergic to mango, chocolate, walnuts, iodine which causes anaphylaxis shock. Latex, Sulpha, Flanadine, Levetieractane, Levaferoxeine, Gapapentin, Cephaxine, Lacosamide, Paroxetine, Metoprolol, Hydroxycholoriquine,

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

Symptoms: After the vaccination I experienced severe fatigue the day of and the next day after the vaccination. Nausea and dizziness was also experienced. I also had body aches.

Other Meds: At the time of the vaccination I was taken Glucasomine, Magnesium, CO Q 10. Vitamin D, B2, Advair 100/60, also I get allergy shots.

Current Illness: No other illnesses.

ID: 1553764
Sex: F
Age: 47
State: MS

Vax Date: 07/29/2021
Onset Date: 08/01/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none known

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

Symptoms: Severe itching, redness, swelling. Swelling went away. Itching has been continuous even on today.

Other Meds: wegovy

Current Illness: none

ID: 1553765
Sex: F
Age: 70
State:

Vax Date: 03/29/2021
Onset Date: 07/20/2021
Rec V Date: 08/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient is a 71-year-old female, who presents to the Hospital with a several-day history of increasing cough, increasing weakness, shortness of breath. The patient is on hemodialysis, for which she undergoes hemodialysis 3 times per week. The patient has had diabetes mellitus, for which she is on insulin with the last hemoglobin A1c of 6.6. The patient denies chest discomfort, palpitations, or syncope. 7/20/2021tested positive 8/9/2021 discharged This is a 71-year-old woman who was admitted yesterday with complaints worsening cough shortness of breath and fatigue. The patient is on hemodialysis for end-stage renal disease. She is quite drowsy but easily arouses. She had maximum temperature of a 100.3? F since admission, she is currently afebrile. On presentation she was saturating at 81% on room air. She is currently on 8 L of oxygen via OxyMask. She had an elevated BNP of greater than 70,000. Chest x-ray done on admission revealed mild cardiomegaly She received the COVID-19 vaccine at dialysis per her nephrologist.

Other Meds:

Current Illness:

ID: 1553766
Sex: M
Age: 36
State: IN

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Consistent and extreme heartburn since receiving the vaccine on 08/11.

Other Meds: Klonopin 1mg daily

Current Illness:

ID: 1553767
Sex: F
Age: 97
State:

Vax Date: 02/11/2021
Onset Date: 04/14/2021
Rec V Date: 08/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Codeine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 97 Y/O male comes in with C/O Falls. States has chronic dizziness but fell when she lost her balance. Also C/O cough. Denies fever chills. Chronic leg swelling and takes Bumex. CT abd pelvis reported neg for acute pathology. CXR showed LLL consolidation. UA with > 182 WBC. Nitrite Neg She Lives in an ALF and uses walker to walk. PMHX HTN 2) Chronic Leg edema 3) HLD 4) GERD 5) achalasia 6) Hypothyroidism 4/14/2021 tested positive 4/16/2021: patient discharged.

Other Meds:

Current Illness:

ID: 1553768
Sex: F
Age: 32
State: KS

Vax Date: 03/25/2021
Onset Date: 08/07/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKA

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

Symptoms: SARS COV-19 Infection. Cough, Congestion, Runny Nose, Fever, Loss of Taste and smell, Headache, Shortness of Breath, Sore Throat, Fatigue, Chills, Muscle Aches

Other Meds: N/A

Current Illness: N/A

ID: 1553769
Sex: F
Age: 38
State: KY

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: NA

Other Meds: NA

Current Illness: NA

ID: 1553770
Sex: M
Age: 68
State:

Vax Date: 03/14/2021
Onset Date: 07/26/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin.

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

Symptoms: Both wrist were in pain, right wrist was more swollen. Was prescribed Diclofenac Potassium by healthcare professional Pain in neck. Symptoms are currently getting worse.

Other Meds: None.

Current Illness:

ID: 1553771
Sex: F
Age: 82
State:

Vax Date: 05/28/2021
Onset Date: 07/28/2021
Rec V Date: 08/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Ciprofloxacin

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

Symptoms: 82-year-old female with PMH of hypertension, CKD stage 4, anemia in chronic disease, recently diagnosed with diabetes sent in from infusion center for low Hb level , in ED CBC showed Hb 9.3 , and BMP back with K level 6.5 , Creat 1.96 , pt seen in ED and states she feels weak will admit for hyperkalemia and AKI 7/28/2021 tested positive 7/28/2021: patient discharged.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm