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: 1591944
Sex: F
Age: 54
State: TX

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: Extreme muscle aches and tightening - neck, shoulders, chest. Can barely move neck

Other Meds: Lisinopril, Hydrochlorothiazide

Current Illness: None

ID: 1591945
Sex: F
Age: 35
State: ME

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: Sulpha drugs; penicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: I was light headed and body aches and fatigued. The body ache stopped the next day but I was still tired and little bit dizzy and a week later I had the worst feeling was really dizzy and tired and fatigued and pain in my body. I called my doctor and explained everything and they did the tests and thought I had vertigo and then they sent me to the ENT and they had me do the maneuver. It was not vertigo and then I got blood work done and everything was fine and then they felt like it might be related to the vaccine. I still have the dizziness and light headed. The doctors recommend to try the Flonase and allergy medication.

Other Meds: Vitamins; birth control

Current Illness: None

ID: 1591946
Sex: M
Age: 37
State: TX

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/20/2021
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: none

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

Symptoms: constant ringing in both ears. began shortly after shot and has not stopped or weakened since. have never had this issue before

Other Meds: none

Current Illness: none

ID: 1591947
Sex: M
Age: 34
State: ID

Vax Date: 03/21/2021
Onset Date: 08/17/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Tested positive for COVID on 8/20/2021. Symptoms: Headache, congestion, sinus pressure, cough.

Other Meds:

Current Illness:

ID: 1591948
Sex: M
Age: 54
State: TX

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient fainted about 4 minutes after receiving first Moderna vaccine. Patient admitted that he has had similiar reactions before from immunizations and blood draws. He does not think his reaction was due to the vaccine. He believes it was from fear of getting shots.

Other Meds:

Current Illness:

ID: 1591949
Sex: F
Age: 27
State: NJ

Vax Date: 04/16/2021
Onset Date: 04/19/2021
Rec V Date: 08/20/2021
Hospital: Y

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:

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

Symptoms: I received the 2nd Pfizer vaccine on a Friday morning at 10:30am. Severe flu like symptoms began 1am that night until 1am Sunday night. That Monday night at 6:00pm I had really bad pains in my chest when I would breathe. It hurt so bad I describe it as a lightning bolt hugging my heart. It kept me up all night and then Tuesday I went to the ER around 9am. After doing multiple test they found elevated Troponin levels in my blood. They assumed it was from the vaccine. I stayed the night and they took blood every few hours and the troponin levels kept rising. They wanted to keep me another night but my insurance kicked me out because I wasn?t sick enough. I went to a cardiologist and he referred me to the hospital and I got an MRI that confirmed the left side of my heart was inflamed and delayed. My pain lasted consistently for 3 months. I still have a pain every now and then.

Other Meds: Birth control, adderall xr 20mg

Current Illness:

ID: 1591950
Sex: M
Age: 41
State: CA

Vax Date: 01/13/2021
Onset Date: 02/01/2021
Rec V Date: 08/20/2021
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: Pyrexia, White blood cell count decreased

Symptoms: tendonitis appeared right away, within 1 month of first shot and has been there ever since. Chest pain started 2 months after the vaccine.

Other Meds: levothyroxine 88mcg

Current Illness: none

ID: 1591951
Sex: M
Age: 22
State: LA

Vax Date: 07/24/2021
Onset Date: 07/24/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: nka

Symptom List: Pharyngeal swelling

Symptoms: Pt received Moderna vaccine on BAFB on 05/04/2021, then proceeded to go off base to receive two doses of Pfizer on 07/24/2021 and 08/15/2021. Pt stated he did not have any adverse events from vaccines.

Other Meds: n/a

Current Illness: n/a

ID: 1591952
Sex: F
Age: 35
State: IL

Vax Date: 08/13/2021
Onset Date: 08/14/2021
Rec V Date: 08/20/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt came in to our office on 8/18/21 after dealing with involuntary muscle twitching all over since 8/16/21 that was worsening

Other Meds: None

Current Illness: None

ID: 1591953
Sex: M
Age: 61
State: FL

Vax Date: 03/07/2021
Onset Date: 08/04/2021
Rec V Date: 08/20/2021
Hospital: Y

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

Lab Data:

Allergies: No known drug allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 8/3/2021 Pt presents to ER. CT brain that shows no hemorrhage or CT evidence for acute large vessel infarction, marked ventriculomegaly out of proportion to the degree of sulcal atrophy. Findings are concerning for normal pressure hydrocephalus. He was seen by the stroke neurologist, who recommends activated stroke protocol admission order set, stroke/telemetry floor, neuro checks, bedside swallow eval, DVT prophylaxis, IV fluids, normal saline, head of the bed 30 degrees, euglycemia, avoid hyperthermia. Cleared for dc 8/2 however prior to SNF placement, tested positive for COVID-19. Of note, patient received J&J COVID-19 vaccine March 2021. 8/11/2021: Pt discharged to SAR

Other Meds: unknown

Current Illness: unknown

ID: 1591954
Sex: F
Age: 36
State: WI

Vax Date: 01/08/2021
Onset Date: 04/06/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: Sumitriptan

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

Symptoms: Started having frequent palpations requiring multiple visits and tests to be done. Unknown cause of palpations, but could be related to any number of things such as the oral birth control pills that were started that same month that the palpations started (April) or gneral stress. Due to it being a new medical problem since my Covid vaccination, though 3 months later, I felt as though I should report it in my VSafe text for tracking/research purposes, though I do not personally think it is related to the Covid vaccine. Determined ultimately that the PVCs are not be pathologic and only need to treat the symptoms if desired. No cardiac abnormalities on EKG or Echo. Of note, I was called after reporting these new symptoms on the VSafe text, but forgot to return the call promptly so decided to fill in online form.

Other Meds: Prenatal vitamin, vitamin D 2000iu

Current Illness: None

ID: 1591955
Sex: F
Age: 27
State: WI

Vax Date: 04/15/2021
Onset Date: 08/16/2021
Rec V Date: 08/20/2021
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: N/A

Symptom List: Rash, Urticaria

Symptoms: PATIENT CONTRACTED COVID DESPITE BEING FULLY VACCINATED AT TIME OF EXPOSURE/POSITIVE PCR TEST

Other Meds: N/A

Current Illness: N/A

ID: 1591956
Sex: F
Age: 53
State: FL

Vax Date: 05/19/2021
Onset Date: 07/24/2021
Rec V Date: 08/20/2021
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: lisinopril

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

Symptoms: 7/24/2021: Pt presents to ED complaining of migrating joint pain and back pain for the past 3 days. She notes that she did vomit 1 time earlier today, but is no longer nauseous. She has been compliant with her diabetes medications. Patient noticed some dysuria earlier today.. The onset was 3 days ago. Patient dc home same day. 7/25/2021: Pt presents to ED with similar symptoms as day prior. Patient tests positive for COVID-19 upon admission. Patient discharged home on 8/1 8/1/2021: Pt presents to ED with CC SOB. Per patient, recently tested positive for COVID-19 (7/24/2021) and reports having worsening SOB and hypoxia that was recorded at 66% O2 at room air with her home monitoring kit. Pt arrives to the ED in

Other Meds: unknown

Current Illness: unknown

ID: 1591957
Sex: F
Age: 48
State: NV

Vax Date: 02/04/2020
Onset Date: 02/05/2020
Rec V Date: 08/20/2021
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: None

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

Symptoms: Raised Red hive/lump size of a silver dollar that lasted for 6 days and includes flu/bronchitis type symptoms. After the 6 days the Bronchitis type symptoms still persist to the present day and are on going!!!

Other Meds: None

Current Illness: None

ID: 1591958
Sex: M
Age: 16
State: TX

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 08/20/2021
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: unknown

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

Symptoms: Male inadvertently administered Moderna Covid 19 Vaccine for a person under the age of 18.

Other Meds: Unknown

Current Illness: unknown

ID: 1591959
Sex: F
Age: 39
State: CT

Vax Date: 08/19/2021
Onset Date: 08/20/2021
Rec V Date: 08/20/2021
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: No

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

Symptoms: Moderate site pain yesterday and today with a lump Terrible chills and sweats the entire night of the shot Next day rash ALL over stomach and neck Next day feel like I?ve been hit by a bus and run over repeatedly. Sore, weak, tired

Other Meds: Vitamin C

Current Illness: Nothing

ID: 1591960
Sex: F
Age: 77
State: FL

Vax Date: 03/16/2021
Onset Date: 08/04/2021
Rec V Date: 08/20/2021
Hospital: Y

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

Lab Data:

Allergies: Shellfish, sulfadiazine, oxycodone

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

Symptoms: 8/4/2021 Patient came to the emergency room on account of shortness of breath and acute hypoxemic respiratory failure. Chest x-ray showed bilateral pulmonary infiltrates and was positive for Covid 19 pneumonitis on the day of admission. She is on a heated high flow 15 L oxygen nasal cannula. She denies any chest pain no shortness of breath or palpitation no nausea no vomiting no diarrhea but was febrile when she came in. Of note, patient received Pfizer COVID vaccine, last dose administered March 2021. 8/16/2021: Patient still admitted as of this report submission.

Other Meds: unknown

Current Illness: unknown

ID: 1591961
Sex: M
Age: 32
State: MA

Vax Date: 05/10/2021
Onset Date: 06/30/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: Paxil, Penicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: So this is what is going on, I went to the DR because I felt the shot go into my arm, go down my arm and into my right ring finger and stay there. After that shot, also, my Lyme disease from 2016 had been horrible. My limbs, my joints, everything felt like they were being pulled apart. It felt as though my Lyme disease was reoccurring all over again. I told the DR that and he said he has had an increase of people going in. I was bed ridden for a long time, I do not even remember. But my DR re-treated me for Lyme disease when I went in, he put me on Doxycycline daily. Each day, I do not know what to expect. Some days I am okay and other days I feel horrible for hours and hours. I take a doxycycline as night and it could feel fine, or it could feel like I am being ripped apart. Again, it was never ever this severe until after the second shot. And tomorrow is my last day on the doxycycline. Really it's like the lyme disease completely reactivated. Also, I had a rash immediately after the injection, it was double the size and thickness of a half dollar coin - it was also hot to touch. I also had five back to back, very vivid nightmares in the night and they were so bad that it distorted my reality. It was the most horrifying thing I have ever gone through. Though, the vivid dreams have continued although they are not back to back they happen here and there and they are just horrific.

Other Meds: Clonopin for severe anxiety

Current Illness: N/a

ID: 1591962
Sex: M
Age: 69
State: NJ

Vax Date: 04/06/2021
Onset Date: 05/04/2021
Rec V Date: 08/20/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Came to ER on 5.4.21 w/ abdominal pain. -- > L-sided abdominal pain, dull aching up to 4/10 pain scale non-radiating not associated with nausea, vomiting, diarrhea, constipation or fever. WBC was 1.6 with ANC 1.1, low and absolute lymphocyte count of 0.4, low Hb was 9.9 g/dl Plt count was 85 5.4.21 CT abd/pelvis w/IV and po contrast revealed splenomegaly 12.8 x 29.8 x 25.1 cm with retroperitoneal lymphadenopathy.

Other Meds: None

Current Illness: None

ID: 1591963
Sex: M
Age: 58
State: FL

Vax Date: 04/22/2021
Onset Date: 07/24/2021
Rec V Date: 08/20/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

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

Symptoms: 7/28/21: Pt presents to the ED with SOB x 4 days. Pt states he was recently tested positive for COVID-19 and complains of SOB, body aches, cough, and fever. He also complains of bilateral LE swelling. The onset was 4 days ago. Pt states he was recently admitted to Health Central 4 days ago for evaluation of his symptoms, but was discharged after 2 days. He mentioned he is fully vaccinated with Pfizer for COVID-19. Last COVID vaccine admin in April 2021. 7/28/2021: SARS CoV 2 PCR COVID-19 Positive 7/30/21: Pt discharged

Other Meds: unknown

Current Illness: unknown

ID: 1591964
Sex: M
Age: 38
State: CO

Vax Date: 12/23/2020
Onset Date: 12/25/2020
Rec V Date: 08/20/2021
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: None

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

Symptoms: Cardiac chest pain. Burning, crushing 7/10 for 8 hours. Gradual reduction in discomfort over 3-6 weeks. Sought medical evaluation 2 weeks after via telehealth recommendation ibuprofen and Tylenol. Pain decreased. 6 weeks after:Chest X-ray and full cardiac work with echocardiogram. Pain and discomfort down to a 1 or 2 out of 10 after two months. Continuing to be noticeable as of 8/20/2021

Other Meds: Zyrtec, seasonal allergy injections for pollen.

Current Illness: None

ID: 1591965
Sex: M
Age: 63
State: PA

Vax Date: 07/30/2021
Onset Date: 07/31/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: acetaminophen, cimetidine, griseofulvin

Symptom List: Unevaluable event

Symptoms: convulsions lasting for a half hour, starting at 6 AM the day after vaccination. Per patient, venous distention in entire body.

Other Meds: depo-testosterone, trazodone, cymbalta, ativan, flomax, sildenafil

Current Illness:

ID: 1591966
Sex: M
Age: 36
State: AR

Vax Date: 08/19/2021
Onset Date: 08/20/2021
Rec V Date: 08/20/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Over the course of the day after vaccination, arm pain worsened and patient found a "knot" above the injection site, near where the shoulder meets the neck. He said that pressing on the knot or moving his arm around made his arm go numb.

Other Meds:

Current Illness:

ID: 1591967
Sex: F
Age: 83
State: FL

Vax Date: 05/03/2021
Onset Date: 07/28/2021
Rec V Date: 08/20/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain, Pain

Symptoms: 7/29/2021: presented to HCF via EMS for Fever. Per patients' son she has been febrile over the last 24 hours as high as 102.5. She did receive the Johnson & Johnson Vaccine about 1 month ago. On arrival to ED pt's temperature is 103.4, blood pressure 219/88. Chest x ray showed cardiomegaly with CHF. Pt tests positive for COVID 7/29/21. Transferred to another HCF for care same day. 7/31/2021: Pt dc to home, then 8/11/2021: Per patient, since getting home from her recent discharge on 07/31/21 pt has been having persistent cough and congestion. Pt was treated for COVID-19. Her PCP has prescribed her medication to avoid visiting the ED, however pt has had worsening fatigue as she reportedly sleeps all day and has been nonproductive. 8/16/2021: Patient still hospitalized at the time of this report submission.

Other Meds: unknown

Current Illness: unknown

ID: 1591968
Sex: M
Age: 79
State: DC

Vax Date: 02/17/2021
Onset Date: 02/22/2021
Rec V Date: 08/20/2021
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: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Evening of 2/22 (5 days after 2nd Pfizer shot) I had onset of fast and erratic pulse (120+/min). I had a 10-yr history of paroxysmal atrial fibrillation and had a successful ablation about 4 yrs before this event. Being familiar with Afib symptoms, this even felt very different. I contacted my electrophysiologist, Dr. on 2/23 and on 2/24 Dr. after diagnosing an "atypical atrial flutter", performed a cardioversion at Hospital center restoring sinus rhythm (stable now for 7+ months). I did not initially connect the atrial flutter event to the 2nd Pfizer injection at the time (February 2021), but after reading much later about the very rare cardio problems in mostly younger males shortly after r

Other Meds: 25 mg Metoprolol 2x/day; Azopt 1 drop right eye 2x/day; Clon

Current Illness: None

ID: 1591969
Sex: F
Age: 56
State: CA

Vax Date: 04/26/2021
Onset Date: 04/30/2021
Rec V Date: 08/20/2021
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: Allergic to white-fleshed saltwater fish

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

Symptoms: Later during the day of the vaccination and the following 2nd through 4th day, I experienced common symptoms such as injection site pain, joint pain, fatigue and itchiness. On the 5th day, the palms of my hands became very itchy and turned red and splotchy although I refrained from scratching. My arms felt itchy as well. Late that night (4/30), I broke out in full body hives. By morning, when I woke up, I felt itchy, but the hives had resolved. I continued to feel occasional itchiness and joint pain for several more days. On 6/3/21, I completed blood tests for my 6-month check with my oncologist/hematologist. My AST level, typically/historically in the 20's, was elevated at 112. A 6/22/21 abdominal ultrasound showed signs of fatty liver infiltration. This was a new development, and I do not fit the typical physical/lifestyle profile of someone at risk for liver disease. A 2nd round of blood tests ordered by my primary care physician were completed on 8/13/21, and my AST had dropped to 36. I am now waiting for an appointment with a GI specialist as recommended by my primary care physician. My oncologist/hematologist and his nurse had both mentioned seeing an unusual number of patients with sudden elevation of liver enzymes which caused me to wonder if there is any connection with the vaccine?

Other Meds: Multivitamin, vitamin D

Current Illness: None

ID: 1591970
Sex: F
Age: 40
State: TX

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/20/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient received a Pfizer 2nd dose on 8/13/2021 after receiving a Moderna 1st dose on 7/16/2021. The mistake was due to miscommunication among the clinical team.

Other Meds: Vitamins and PRN Migraine pill (butalbital-acetaminophen-caffeine)

Current Illness: None

ID: 1591971
Sex: M
Age: 83
State: TN

Vax Date: 02/03/2021
Onset Date: 08/14/2021
Rec V Date: 08/20/2021
Hospital: Y

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

Lab Data:

Allergies: CIPRO MACROBID IODINE BACTRIM

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: COVID VACCINATIONS 1/6/21 MODERNA LOT # 032H20A GIVEN AT HEALTH DEPT SECOND DOSE NOTED ABOVE. PATIENT SEEN AT ER. TRANSFERRED TO MEDICAL CENTER FOR HIGHER LEVEL OF CAE. PATIENT NOTED TO HAVE FEVERS 101, PRODUCTIVE COUGH, SHORTNESS OF BREATH. REQUIRED 3L OF O2.PATIENT DID NOT USE HOME O2 PRIOR . NOW O2 UP TO 6 L. DX; PNA, ACUTE RENAL FAILURE, ATRIAL FEB, CAD, HYPERTENSION, HYPERLIIDEMIA, BPH.PATIENT TREATED ON STEP DOWN MEDICAL UNIT. DISCHARGED 8/18/21 TO HOME WITH HOME HEALTH NURSING AND THERAPY.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1591972
Sex: M
Age: 14
State: KY

Vax Date: 08/19/2021
Onset Date: 08/20/2021
Rec V Date: 08/20/2021
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: Benadryl

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

Symptoms: Fever vomiting sleepiness

Other Meds: Nutropin Levothyroxin

Current Illness:

ID: 1591973
Sex: F
Age: 77
State: FL

Vax Date: 02/03/2021
Onset Date: 07/29/2021
Rec V Date: 08/20/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Nausea

Symptoms: 7/29/2021: Pt found unresponsive by a relative at home and her blood sugar was around 30s. She was taken by EMS and D10W given during transfer to ED. Pt returned to her baseline of consciousness but was noted to have low O2 Sat% in her vitals signs with 87% at RA. Pt was feeling dyspneic and fatigued recently, when asked. Pt received Pfizer COVID vaccine, last dose Feb 2021. She was taking Pioglitazone for management of T2DM. Chest x ray was done because the low O2Sat% and showing Bilateral perihilar infiltrates which could represent multifocal pneumonia in the appropriate setting. 8/17/2021: Patient still admitted at time of this report submission

Other Meds: unknown

Current Illness: unknown

ID: 1591974
Sex: M
Age: 57
State: MI

Vax Date: 08/18/2021
Onset Date: 08/18/2021
Rec V Date: 08/20/2021
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 KNOWN

Symptom List: Injection site pain

Symptoms: Patient was screened ahead of vaccination and asked if he had received any previous doses of any covid vaccine. He said that he had not, and specifically wanted the Janssen single-injection. The vaccine was administered, then when it was logged in CIR (vaccine reporting system), it was discovered that he had already previously received both doses of Pfizer (12/21/20 and 01/11/21) and both doses of Moderna (05/28/21 and 06/25/21). No adverse effects have been observed, but he received several more doses than currently recommended.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1591975
Sex: F
Age: 60
State: IL

Vax Date: 08/16/2021
Onset Date: 08/17/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: Victoza

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

Symptoms: I have auto immune issues and began with a rash on my scalp ears upper back the morning after the skin in my mouth sloughed off and tongue was sore

Other Meds: Glipizide metformin lantus ibuprofen aspirin, d, zinc probiotic calcium

Current Illness: No

ID: 1591977
Sex: M
Age: 34
State:

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 08/20/2021
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: Patient reported feeling lightheaded, feeling hard of hearing, and having ringing in the ears. Patient was sweaty upon observation. Patient was given water and a snack and reported starting to feel better after about two minutes had elapsed. Patient remained in the pharmacy for about 30 minutes after he began to feel better to make sure he was ok. Patient left feeling ok, per patient.

Other Meds:

Current Illness:

ID: 1591978
Sex: F
Age: 16
State: TX

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 08/20/2021
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: Unknown

Symptom List: Tremor

Symptoms: 16 Year old female inadvertently administered both doses of moderna covid 19 vaccine to a person under the age of 18.

Other Meds: Unknown

Current Illness: Unknown

ID: 1591979
Sex: F
Age: 14
State: TX

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 08/20/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: Client inadvertently received the Moderna vaccine during an employee vaccine clinic. Client was not of eligible age for the Moderna vaccine and the age was not caught until post vaccination. Client monitored for 30 minutes post vaccination. No adverse signs and symptoms noted. Client was informed of the event and provided next step instructions.

Other Meds:

Current Illness:

ID: 1591980
Sex: F
Age: 51
State: MI

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 08/20/2021
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: Penicillin, Admelog, Amlodipine, Hydralazine, Hydrochlorthiazide

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

Symptoms: Tingling throat - Benadryl IM 50mg per protocol, patient reported tingling went away in 20 minutes after Benadryl injection

Other Meds: N/A

Current Illness:

ID: 1591981
Sex: M
Age: 69
State: FL

Vax Date: 01/27/2021
Onset Date: 07/27/2021
Rec V Date: 08/20/2021
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: NKA

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

Symptoms: presents in the facility with complaints worsening dyspnea. States patient has not been feeling good for the past 5 days with onset of dyspnea on exertion about 2 days ago. He reports that last night, he experiences chest tightness and orthopnea while lying in bed with chills and generalized weakness,

Other Meds: Benzonatate, dexamethasone, fluticasone nasal, budesonide form

Current Illness:

ID: 1591982
Sex: F
Age: 15
State: AL

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 08/20/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Arm and back pain when she was first given vaccine. Patient is underage 15 years old.

Other Meds: None

Current Illness: None

ID: 1591983
Sex: F
Age: 20
State: CA

Vax Date: 07/28/2021
Onset Date: 08/14/2021
Rec V Date: 08/20/2021
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: Latex, Dairy Products, Sulfa

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

Symptoms: Elevated heart rate and chest pain, shortness of breath and difficulty breathing. Ended up in the Emergency Room on 08/16/2021 and now have follow up appointments and blood work to be completed on 08/23/2021. No treatments or outcomes have been found. COVID test was taken to rule out symptom but it came back NEGATIVE.

Other Meds: None

Current Illness: NONE

ID: 1591984
Sex: M
Age: 20
State:

Vax Date: 08/17/2021
Onset Date: 08/20/2021
Rec V Date: 08/20/2021
Hospital: Y

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:

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

Symptoms: pt with syncopal episode, found to be in v fib. shocked with return of HR to 110s, transferred to local hospital for monitoring.

Other Meds:

Current Illness:

ID: 1591985
Sex: F
Age: 28
State:

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

Symptom List: Pain in extremity

Symptoms: Staff received 1st dose of Covid 19 vaccine. pt reports hx of allergy to shellfish. pt reports to observation RN that she is feeling nauseous, dizziness, and lethargic. VS taken at 1444 BP 120/64, RR 22, HR 85, SPO2 100%. pt reported that her "throat feels like tightening and closing" Called the on-call provider, MD, and 1 dose of epi pen was given at 1450 per providers order. immediately after, pt reports, "I feel a lot better; I felt a cool rush and I can breathe so much better." Called EMT 1452 per MD's advice for pt to be transported and observed in the ED. 1502 EMT arrived and pt BP 117/60 HR 93 RR 19 SPO2 100%. pt transported to ED. Per ED report, pt was monitored, evaluated, and D/C home the next day. Pt received Benadryl x1 in the ED.

Other Meds:

Current Illness:

ID: 1591986
Sex: M
Age: 69
State: CA

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

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

Symptoms: at this time, no adverse events

Other Meds: not known

Current Illness: Stage 4 bladder cancer.

ID: 1591987
Sex: M
Age: 54
State: NV

Vax Date: 01/26/2021
Onset Date: 02/12/2021
Rec V Date: 08/20/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: After the first pfizer shot I did not feel any concerning side effects. Just a sore arm. However two weeks after the first shot I experienced an entired day of "jitteryness" which was very unusal, but then it went away. After the second pfizer shot I had sore arm, fatigue, 99.0F temperature but that cleared up the following day. That night I had a strange sensation that the chest conjestion that I have had for the last few years mysteriously relaxing and going away never to return. I felt fantastic for two weeks but then the jittery feeling came back but this time it did not go away. Over the next few days I experienced what I mistook to be hyperthyroid symptoms of increasing "jitteryness", tremor, tachycardia, heat intolerance, digestive upset, rapid weight loss, tinnitus and severe insomnia. 20210304 online doctor service, Ordered blood tests that didn't show anything unusual. Prescribed Propranalol to reduce high pulse. Propranalol reduced tachycardia and jitteryness but I continued to have worsening insomnia. Mid March signed up with GP and had consulation. 20210323 Propranalol started having reduced effect on pulse, worsening insomnia and increasingly desperate I checked into ER hoping to be admitted to hospital to have observation, diagnosis and effective treatment. Blood tests showed low sodium and low chloride. ER Doctor diagnozed anxiety attack. Given a shot of Lorazepam, prescription for hydroxyzine HCL and sent home. Slept ok that night and felt ok the next day until the Lorazepam shot wore off. That night I took one tablet of hydroxyzine HCL before bed and woke up suddenly in an absolute panic feeling suffocated while having a nightmare. Never took hydroxyzine HCL again. I continued to rapidly worsen over the next few days with increasing distress and symptoms taking time off work. I could not sleep at all in bed anymore, instead dozing in living room recliner. 20210327 I accidentally fell asleep while wearing my new PulseOx ring. It woke me up vibrating and the data showed multiple SpO2% drops down to as low as 76%. Finally I had an answer. 20210328 Asked for and recieved CPAP prescription from PCP for obstructive sleep apnea. While waiting for the CPAP one night I experienced as many as 55 drops to as low as SPO2 75% in a single hour. 20210329 By the time I had my complete set of labs and tests at PCP done I was in rough shape but hung on since I had hope of treatment. 20210330 Started on CPAP with improving sleep and O2 levels over the following week. AHI on CPAP reduced from a high of 17.15 down to 5. Early in April I reviewed my tests with and he said I was in excellent health except for being deficient in vitamin D3 (18ng/ml). 202104-202108 Over the following months I have continued to experience symptoms of jitteryness, tachycardia, fatigue, tinnitus and sleep maintenance insomnia. Symptoms are improving slowly as the months go by. This ordeal has been severely upsetting, financially exhausting and very troubling due to lack of effective medical help in the early stages of my distress. My current perspective on what happened is that my immune system response to the vaccine somehow triggered a cascade of symptoms stemming from sudden sleep disturbance.

Other Meds: none

Current Illness: none

ID: 1591988
Sex: F
Age: 70
State: NV

Vax Date: 02/10/2021
Onset Date: 02/24/2021
Rec V Date: 08/20/2021
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: Cipro - anaphaxasis; Sulfa; Augmentin (not allergic to Penicillin) - rash; Flagel - seizures; Clindamycin - nausea and vomiting; Colchicine - nausea and vomiting; don't tolerate any pain medication that I am given - my stomach doesn't tolerate it.

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

Symptoms: Abdominal Pain; ER - I had an ileus and every test done in the sun: Endoscopy; Diagnosed with me - possible upper bowel obstruction and thickening of the small bowel - severe abdominal pain and constipation Endoscopy; colonoscopy; three CAT SCANs with - two different contrasts IV and oral and two with IV contrasts - biopsies of the small bowel; I went to the doctor yesterday - I have to leave work with severe abdominal pain and vomiting - have had every blood test, too. I am going to get a breath test for bacteria - drink something and then breathe into different tubes throughout the day; more stool specimens scheduled too. Irritated -stomach lining - when they did the endoscopy last month or the month before - that is when they saw it was irritated. Went to ER last week. Another time they said ileus was fine. Three or four ER visits all together so far. They just give me pain medication and send me home - they gave me Fentanyl - through nasal or IV - that's all I have been able to take. More blood work - scheduled as well. Treatment: bland diet - I've lost 20 minutes - 10 of it in a week because of I was throwing it what I ate. He ordered medication for me for when I get the abdominal pains - I haven't got it yet - it's for the spasms that are occurring when I get the pain. Still getting symptoms off and on - not linked to anything.

Other Meds: Multiple Vitamins; Vit D; Calcium; Magnesium and Zinc

Current Illness: no

ID: 1591989
Sex: M
Age: 61
State: CA

Vax Date: 05/03/2021
Onset Date: 08/14/2021
Rec V Date: 08/20/2021
Hospital: Y

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

Lab Data:

Allergies: nka

Symptom List: Vomiting

Symptoms: 61 Y male with h/o GERD, myotonic dystrophy (adult onset muscular dystrophy dx age early 40s, now with bilateral hand and leg weakness, difficulty with balance, fecal incontinence, last neuro note from 1/20/21), ?tachyarrhythmias followed by cardiology (last in 3/2020), right knee OA, who presents with increasing shortness of breath. Pt started having headache, sore throat, cough, myalgias on 8/2. He had a positive covid test on 8/11/21. He was vaccinated with pfizer on 4/12/21, 5/3/21. The last two days he has been feeling much worse. He has shortness of breath, wheezing, cough, chest congestion, fatigue, more sputum production. He has had chest discomfort across both sides of his chest. He had a VAV today and was referred to ED for evaluation. Per ED Dr "Pt placed on o2 by nursing as sats were at 90% on ra. I had him do squats in the room off o2. His oxygen levels initially dropped into the high 80's, but then became very dyspneic/tachypenic and felt like he was going to syncopize. His o2 levels rebounded quickly with rest and his increased respiratory rate, but pt did not feel comfortable going home." Regarding his myotonic dystrophy, he reports that his weakness has been steadily worsening monthly. He is still able to eat and swallow normal texture foods. Last night he was able to eat steak and mashed potatoes. No choking episodes. However, sometimes his jaw "catches" and he is unable to chew or speak temporarily. His hands and legs are weak. On ROS, he denies fever, abd pain, nausea, vomiting, dysuria, hematochezia, melena. He has a walker but does not use it. He still drives; his car is in our parking lot. He takes an occasional antiacid for GERD but it is mostly controlled by diet and lifestyle modification. " 1) COVID Pneumonia, Acute hypoxemic Respiratory failure - Symptom onset on 8/2/2021. Patient found to be COVID positive on 8/11/2021. Patient was on nasal Cannula at 2Lpm and now on RA. 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 (started 8/14/2021) or until no longer hypoxic. - Remdesivir 200mg IV x1, followed by 100mg IV daily until clinical improvement or 5 days (started 8/14/2021), last dose 8/18/21. - Daily LFTs. Hold Remdesivir if ALT >10xULN or CrCl<30 - Pecid for GI prophylaxis - 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. -Plan to increase activity levels in room and check 02 sats on RA tomorrow. Modified IMPROVE VTE SCORE (for discharge) Age more than 60 years. - 1 POINTS Total Points: 1 o Consider anticoagulation if IMPROVE VTE score greater or equal to 4 OR IMPROVE VTE score is 2 or more, and the D-dimer is greater than 2x ULN on discharge. o Anticoagulate with Rivaroxaban 10mg orally daily for 30 days total post-discharge or Enoxaparin 40mg SC q24 hours

Other Meds: Outpatient Home Medications Taking? Albuterol (PROAIR/PROVENTIL/VENTOLIN) 90 mcg/actuation Inhl HFAA Takes Occasionally Sig: Inhale 2 puffs by mouth one-half hour before sports or exercise to prevent cough or wheezing. May repeat every 4 ho

Current Illness: none

ID: 1591990
Sex: F
Age: 35
State: ID

Vax Date: 08/06/2021
Onset Date: 08/09/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: Lidocaine Amoxicillan Oysters Gluten Dairy Adhesive IV Contrast Morphine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Approximately 3 days after receiving my first dose of the Pfizer vaccine, I began experiencing extreme anxiety, panic, fatigue, and intrusive thoughts, including suicidal ideation. The episode lasted approximately 2 days. I consulted with my therapist 2 days after the episode ended and sent a message to my primary care provider.

Other Meds: Euthyrox Thorne 2/day Basic Multivitamin Cortisol Manager

Current Illness: N/A

ID: 1591991
Sex: F
Age: 38
State:

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 08/20/2021
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: Pt w/ hx of allergy to Erythromycin Base (arrhythmia).

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

Symptoms: "Pt w/ hx of allergy to Erythromycin Base (arrhythmia) and ""walking corpse"" syndrome in 2015. No additional PMH or medication hx available to this writer. 10mins post vaccination pt c/o palpitations and SOB. Pt abulated to triage area. Vitals:13:38 BP 150/83, HR 153, RR 16, O2Sat 99% -- > 13:43 111/67, 107, 99%. Pt A&Ox4, denies sxs N/V, headache. NP recommended rest and water and continued to monitor. 14:00 pt c/o chest discomfort and a cold sweat. NP recommended to call 911. 911 Called @14:02. EMS arrived 14:15 and report was given to EMS. EKG showed sinus tachycardia. Pt was taken to Kaiser via ambulance, VSS at the time of departure."

Other Meds: Unknown

Current Illness:

ID: 1591992
Sex: F
Age: 63
State: NY

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/20/2021
Hospital: Y

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: Sword Fish

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient said she became dizzy and lightheaded after the vaccine. The next day her heart rate stated to beat at a rapid speed. Patient was very disoriented. Patient was admitted to the hospital on 8/17/21. As of 8/20/21 while filling the report the patient is still in the hospital.

Other Meds: Lyrica

Current Illness:

ID: 1591993
Sex: M
Age: 16
State: KY

Vax Date: 08/19/2021
Onset Date: 08/20/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fever vomiting headache sleepiness

Other Meds: Focalin

Current Illness:

ID: 1591994
Sex: F
Age: 40
State: GA

Vax Date: 02/12/2021
Onset Date: 07/21/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: Latex Codeine Lactose intolerant

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

Symptoms: The adverse event was not vaccine-related. First dose 1/23/2021 Second dose 02/12/2021 Wednesday evening, July 21, 2021, I was very very tired. This continued through Thursday. Thursday evening, I was started to feel sick; run down, some congestion, a bit of what felt like a pressure headache, fatigued, just exhausted. Friday morning, I woke up feeling terrible. I had a slight fever, a pretty bad headache, and some congestion. I scheduled a PCR test for COVID that afternoon, which came back positive. I spent the rest of the day napping as I could and just generally feeling bad. Saturday, however, I was doing pretty badly. I woke about 9AM. My fever spiked to 102, I had chills, my skin got so hot it actually ached. My o2 dropped to the mid-80s very briefly and, thankfully, popped back up to the low 90s. I had *severe* congestion, a very bad headache (but not a migraine), significant body aches, and incredible fatigue. Some dry coughs, but not many. I took vitamins C, D, zinc, and fish oil, as well as acetaminophen as advised by the urgent care and drank a LOT of water, as I was able. Within about 24 hours, I was feeling a little better. My o2 had gone back to about 96 and stayed there and my fever lessened to about 100 degrees. Sunday was better, but the fever, congestion, body aches, headache, and fatigue remained. By Monday, July 26, my temperature was holding steady at 99, the headache had mostly subsided, the chills, skin aches, and body aches were gone. I was still incredibly congested and fatigued. I began using DayQuil and NyQuil to combat the remaining flu-like symptoms, and this helped significantly, in conjunction with the D, C, zinc, and fish oil. I got better daily.. but had a slight regression Wednesday, July 27, but felt better again by Thursday. The congestion cleared up by July 30th. As of this writing, I am still fatigued, but that is the only lingering symptom, aside from the rare dry cough, usually brought on by laughing. :)

Other Meds: Fluoxetine, 10mg 1x/day Ativan, 1mg as needed Over the counter allergy medication, as needed

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm