VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1628305
Sex: M
Age: 43
State: WY

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 08/24/2021
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: n/a

Symptom List: Dysphagia, Epiglottitis

Symptoms: Developed Stevens-Johnson syndrome Develops a rash covering the majority of my body, skin became hot and painful to the touch, began to peel, pain in joints, severe chills despite wearing thermal pants, and sweat pants, two pair of wool socks, thermal top, tshirt, sweat shirt, and three blankets. Headache, dizziness, chest pain, and muscle cramps. Was given steroid shots and a prescription for prednisone.

Other Meds: Protonix, Concerta, Lamictal, Rizatriptan

Current Illness: n/a

ID: 1628306
Sex: F
Age: 61
State: MI

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

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

Lab Data: X-rays of hip, lumbar spine 8/5/21 X-ray of right heel8/20/21 Lab tests 8/6/21

Allergies: Penicillin Doxycycline Walnuts Sensitive to tomatoes, seafood, Alcohol, garlic, onion, lactose, gluten, pineapple,

Symptom List: Anxiety, Dyspnoea

Symptoms: Three days after receiving the first injection I had pain starting in my feet and coming up the backs of my legs. Every day the pain was slightly different. The pain was predominantly behind my knees and in my lower back. I would consider the pain moderate at the time. Although the Pain began to subside after a few weeks it came back on strong in force after the second vaccine. It tends to be mainly in my right heel, behind my knees, my lower back and my hips. I have had x-rays taken, have tried anti-inflammatory medication?s and have started physical therapy. It has been over five months since my first vaccine and the pain is still very strong. It?s not completely debilitating but I?m afraid to get any further vaccines because I?m afraid it?s going to get worse. That might be very debilitating to me. It seems to have affected my sciatic nerve pretty strongly. I never had problems with that in the past. In my mind and soul I know this is a result of the vaccine.

Other Meds: 81 mg aspirin 500 mcg Vitamin B12 40 mg Pantaprozole 180 mg Diltiazem Pepcid as needed I also receive immunotherapy every 2 to 3 weeks for allergies

Current Illness:

ID: 1628307
Sex: M
Age: 40
State: FL

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/24/2021
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: Vital Signs: B/P 143/94, HR 78, O2 98%, P 70.

Allergies: no

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

Symptoms: Pt. presented to walk to get the COVID-19 vaccine. Stated he was nervous. After shot, pt. sat down in the observation area. Pt. stated he was going to pass out. Nurse advised to sit on floor. Pt. vitals were taken and pt. put his feet up. After a while he stated he was ok and left with his wife.

Other Meds: no

Current Illness: no

ID: 1628308
Sex: F
Age: 62
State: ME

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/24/2021
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: Patient received first dose of Moderna on 8/23/21 at 12:30pm. She was observed for 30 minutes due to a medication allergic reaction in the past for throat swelling while taking penicillin. Pt did not show any signs or symptoms at the end of the 30 minute observation and left the pharmacy. The patient called the next morning stating that on her drive home she started to experience numbness in her face from under her eyes to her neck. She called her primary care physician. The patient states the nurse she spoke to checked with her physician and which point they asked if she had any issues breathing and she should go to the emergency department if so. Pt states she did not have any issues breathing so she decided to take Benadryl. The following day on 8/24 in the morning she contacted the pharmacy to let me know what happened. She reported the event to VEARS through the online process the pharmacy showed her to report to in the event of an adverse issue. While speaking with the patient she stated the numbness in her face has been slowly going down since yesterday.

Other Meds: unknown

Current Illness: not listed

ID: 1628309
Sex: F
Age: 32
State: ME

Vax Date: 08/01/2021
Onset Date: 08/20/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: New numbness to the tip of the tongue on the left side only, starting 8/23/21

Other Meds: Sertraline, omeprazole, metoprolol, multivitamin

Current Illness: None

ID: 1628310
Sex: M
Age: 25
State: TX

Vax Date: 08/21/2021
Onset Date: 08/22/2021
Rec V Date: 08/24/2021
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: X ray came back good, blood test came back with elevated monocytes, Troponin test came back normal

Allergies: N/A

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

Symptoms: Began feeling pressure and then shar, searing intermittent pain in the middle left of the chest.

Other Meds: N/A

Current Illness: Unknown viral respiratory infection

ID: 1628311
Sex: M
Age: 37
State: IL

Vax Date: 03/10/2021
Onset Date: 03/24/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: NA

Allergies: Seasonal allergies; mold, mildew, dust mites, pollen

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Adverse event was a daily nosebleed that occurred once a day, typically within about an hour or so after waking up. Patient had not experienced any nosebleeds in at least 15 years prior to vaccination. Nosebleed was anterior in nature from a single nostril and usually lasted between 3-5 minutes before subsiding. Nosebleeds began approximately two weeks following first dose, started to subside approximately 10 days after nosebleeds began, but then started back up following second dose on 4/7/21 and did not completely subside until approximately 10 days thereafter.

Other Meds: Over the counter medications: Advil, Zyrtec, Multi Vitamins

Current Illness: None

ID: 1628312
Sex: F
Age: 46
State: CO

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

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

Lab Data: Blood test 8/4/2021

Allergies: Naproxen, diclofenac, latex

Symptom List: Pharyngeal swelling

Symptoms: A lot of pain on left elbow then numbness seconds after shot on lwft forearm and top of hand, then 3am next day numbness on left leg. This triggered my Dystonia. Treatment IV and valium. Outcome got released from hospital with left arm and left leg still numb and 21 days latter my left arm and left leg still numb, maybe only 25% better.

Other Meds: None

Current Illness: Neurological

ID: 1628313
Sex: M
Age: 53
State: TX

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

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

Lab Data: BP 122/88 SP 98% 85P

Allergies: N/A

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient complained about having a fast heart rate. He asked if someone could check it as he had concerns. Patient was checked..

Other Meds: N/A

Current Illness: N/A

ID: 1628314
Sex: F
Age: 32
State: CA

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

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

Lab Data: No tests taken, just took care of my lady business.

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Immediately after I got the shot, my period started in full force, 8 days early, instantly. I mean it was 10 mins after the shot and the cramps started so Ihurried home so I could clean myself up. It only lasted 2-3 days, and then I still had my regular period occur on time and like normal.

Other Meds: Topiramate 25 mg

Current Illness: None

ID: 1628315
Sex: F
Age: 46
State: WA

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

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

Lab Data: CBC, TSH, vitamin B12, CMP

Allergies: Latex

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

Symptoms: Paresthesia left lateral foot

Other Meds: Vitamin C, Excedrin, vitamin D3, vitamin B12, hydroxyzine, lactobacillus, lisinopril, hydrocodone chlorothiazide

Current Illness:

ID: 1628316
Sex: F
Age: 37
State: SC

Vax Date: 05/28/2021
Onset Date: 06/10/2021
Rec V Date: 08/24/2021
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: Ibuprofen/sulfer/sulfa

Symptom List: Rash, Urticaria

Symptoms: Shot administration: 5/28 Episode of Bells Palsy: 6/10 No previous episodes before shot and none since shot

Other Meds: None

Current Illness: None

ID: 1628317
Sex: M
Age: 32
State: NY

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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 per patient

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

Symptoms: Due to reconstitution error patient was given less than half of required dosage. Patient was notified and returned to clinic to receive the appropriate dose the same day.

Other Meds: None per patient

Current Illness: None per patient

ID: 1628318
Sex: F
Age: 36
State: WA

Vax Date: 05/01/2021
Onset Date: 05/04/2021
Rec V Date: 08/24/2021
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: June 26, 2021; EKG - Sinus Tachicardia CRP - 10.7 SED Rate - 22 Platelet count - 468 Alergist e-consult regarding adverse effect to vaccine: inconclusive July 07, 2021: SED rate - 16 Platelet count - 474 CRP - 17.1 July 27, 2021 Platelet count - 501 CRP - 14.0 SED rate - 13

Allergies: None that I'm aware of

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

Symptoms: got first shot of pfizer vaccine on 5/1 at 5pm, felt fine that evening other than tired. Later that night my arm started to hurt. The next day had fatigue, dizziness. The third day my arm was better but eyes felt sensitive to light, burning sensation on both eyes but worse on right eye, then right eyelid got swollen, hurt with blinking. No eye redness. Every time I woke up there was crusting in my eye. Got visine drops that burnt when I applied them, washed eye twice a day with massage. Still had swollen eye for 10 days before it resolved. Also on the 3rd day after I got the vaccine, when my eye symptoms started, I noticed that when I lay down at night it felt like someone was pressing down on her chest and had racing a heart beat. Took tylenol PM to help sleep. Had to skip work those days, was not taking adderall those days or caffeine. Slowly chest symptoms resolved (took at least 2-3 weeks) and feeling fine now. I usually get spring allergies and this year was worse than other years, but this sort of reaction has never happened to me. On June 26 I visited the emergency room because I developed a rash in my arm (this might be unrelated but I'm still not sure what caused it). It felt like it was burning and a pins and needles sensation. I had EKG and full blood test done and it was determined that my inflammation levels were high. I have had 2 other blood tests showing persistent elevated levels of C-reactive protein, platelets and sedimentation. My primary doctor issue a referral to se a rheumatologist and currently waiting for an appointment.

Other Meds: Adderall, ibuprofen, multi-vitamins, ginger/turmeric supplement

Current Illness: None

ID: 1628319
Sex: F
Age: 56
State: RI

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: Testing done thru my PCP March 2021

Allergies: Sensitivity to CT contrast dye with hives throughout body.

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

Symptoms: Post first dose, generalized itching which lasted over a week despite taking Benadryl and Claritin simultaneously. Further prescribed Prednisolone which did NOT work at relieving my symptoms. Upon receiving second vaccine dose, I experienced itching intensify and within two weeks, developed bilateral exanthem under arms, wrapping around lower breasts. This continued for weeks while updating the CDC query which came weekly at first. Allergy consult further did not reveal any further sources of exanthem other than vaccine related. I also went for a derm consult at which time red blotches developed on both legs, pettichiae-like. Derm diagnosis was SDIFE- Symmetrical Drug Related Intertriginous Flexural Exanthema. I continue to itch all over my body and some days it is very intense. the exanthem is now appearing and extending on my right thigh! I am filing out this report after speaking with. Thank you

Other Meds: Benadryl oral tablets as well as Claritin over the counter tablets for generalized pruritus.

Current Illness: None

ID: 1628320
Sex: M
Age: 57
State: KY

Vax Date: 03/23/2021
Onset Date:
Rec V Date: 08/24/2021
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:

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

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1628321
Sex: M
Age: 72
State: TX

Vax Date: 03/09/2021
Onset Date: 03/16/2021
Rec V Date: 08/24/2021
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:

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

Symptoms: first Pfizer vaccination on 9 March , second on 30 March. One week after he received his first dose of vaccine he began to ?'get this?bad ammonia-type smell'' which seemed to permeate his whole house, clothing, and sheets. separate sensation, of a metallic taste on his tongue. He states both these symptoms worsened after dose 2; at their worst, the ammonia smell was occurring reliably whenever he spent 20-30 minutes in an area and the metallic taste was near constant. His symptoms began to spontaneously improve by the latter part of July, currently experiences the ammonia smell about 3-4x a day (still after remaining stationary for prolonged periods of time) and the metallic taste 1-2x a day. never had issues with reduced sense of smell or taste. He has never tested positive for COVID, nor has he had symptoms concerning for COVID infection. Symptoms: UNSPEC DISTURBNCES,SMELL&TASTE

Other Meds: Coumadin 6 mg QD Alfuzonin 10 mg QD Finasteide 5 mg QD Metoprolol 12.5 mg QD Lipitor 40 mg QD

Current Illness: none

ID: 1628322
Sex: F
Age: 50
State: FL

Vax Date: 02/08/2021
Onset Date: 02/01/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: MRI

Allergies: Multiple food allergies cause itching and rash on chest and back Almonds cause severe vomiting and facial swelling Adverse reaction to Phenergan and Benadryl....... increased heart rate 120's

Symptom List: Ear pain, Hypoaesthesia

Symptoms: My left pupil became larger than my right pupil. Noticed sometime in February after the vaccine. The beginning of May my left pupil was permanently larger than my right pupil with increased blurry vision. I went to 2 Ophthalmologists and a neurologist and a Neurologist Opthalmologist in June and July when there was no resolve on its own. Had an MRI and dx of Adies Pupil. recommended by Neurologist to defer any future COVID vaccine due to the nature of the neurological event that has caused decrease in vision and blurry vision and increase in light sensitivity.

Other Meds: Vistaril PRN sleep Butalbital PRN migraines Buspiradone PRN anxiety Adderall PRN ADHD

Current Illness: NONE

ID: 1628323
Sex: M
Age: 28
State: TX

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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: AFTER 10 OF OBSERVATION, THE PATIENT COMPLAINED OF ANXIETY FROM THE VACCINE. PATIENT STATED HE HADN'T EATEN, AND USUALLY DOESN'T EAT UNTIL 12:00. VITALS WERE GOOD WHEN CHECKED B/P 120/68, PULSE 60, AND HE WAS CLEARED.

Other Meds:

Current Illness:

ID: 1628324
Sex: M
Age: 34
State: PA

Vax Date: 08/10/2021
Onset Date: 08/11/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: Pending

Allergies: N/A

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

Symptoms: A day after I could feel all the way up to 2 weeks (current) I could feel my heart. Heart had pain every now and then but mostly I can just feel it in my chest and I never could before the shot. A numb, type of feeling. It hurts sometimes when I turn a different way.

Other Meds: N/A

Current Illness: N/A

ID: 1628325
Sex: M
Age: 46
State: MS

Vax Date: 08/19/2021
Onset Date: 08/19/2021
Rec V Date: 08/24/2021
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: no

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

Symptoms: Undiluted dose of Pfizer Vaccination given no adverse reactions noted , no additional treatment needed.

Other Meds: unknown

Current Illness: no

ID: 1628326
Sex: F
Age: 27
State: TX

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Unevaluable event

Symptoms: Severe body aches 12 hours after vaccine. 102 fever 24 hours after. Rash on stomach, neck, chest, back and legs 24 hours later. Severe body aches continued after 24 hours. Severe headache 6 hours later and continued 24 hours later. Taking Tylenol OTC

Other Meds: Adderall

Current Illness: None

ID: 1628327
Sex: F
Age: 32
State: IL

Vax Date: 08/15/2021
Onset Date: 08/18/2021
Rec V Date: 08/24/2021
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: EKG, ER Visit, Blood Work Performed, all results came back normal.

Allergies: None

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

Symptoms: Heart palpitations and heart arrhythmia beginning 3 days after vaccination and lasting over 24 hours straight.

Other Meds: Multivitamin, Vitamin D

Current Illness: None

ID: 1628328
Sex: F
Age: 27
State: CA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: I could not get checked afterwards because no health insurance and no job

Allergies: Z-pak Sulfa

Symptom List: Injection site pain, Pain

Symptoms: Heart rate rose to dangerously high for two hours. Pharmacists monitoring me and continual taking of blood pressure. Was sick for a long time after vaccination day

Other Meds:

Current Illness: Depression

ID: 1628329
Sex: F
Age: 47
State: TX

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: ct scan blood work both showed no clots or signs of stroke on July 27

Allergies: asprin

Symptom List: Injection site pain, Menorrhagia

Symptoms: dizziness within seconds of getting injection: nausea, dizziness, body aches, headache and fatigue onset about 3 hours after the injection next day woke to joint pain and eye sensitivity nausea stopped bu dizzy and body aches continued with no fever. 24 hours after injection same symptoms going on plus low-grade fever and extreme fatigue I could hardly get out of bed and continued with other symptoms nausea and dizziness came and went headaches never go away not even with migraine meds, Tylenol, or ibuprophen. Headaches and eye issues have continued for weeks I did go to the ER my dr was afraid I was having a stroke or a clot I had neither but was given 50 mg Bendryl iv and another medication that starts can not remember which took the headache away for awhile and I was able to sleep, but when I awoke it was back with a vengeance. I have been dealing with it and issues with blurriness and sensitivity to light everyday since the injection and seems like it will never go away sometimes I hide under my covers and relieves the pain and discomfort, but I have a 4 yr old and can not do that. I feel this injection has ruined my life.

Other Meds: buspirone 7.5 mg Lisinipril 20 mg famotidine 20 mg topiramate 25mg euthyrox 150mcg zyrtec Omega 3 Vitamin d

Current Illness: none

ID: 1628330
Sex: M
Age: 12
State: AZ

Vax Date: 08/22/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: n/a

Allergies: none

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

Symptoms: 2 days after taking the vaccine, he felt chest pain. He can't lie down as he will feel the pain, but sitting in the chair is ok.

Other Meds: none

Current Illness: none

ID: 1628331
Sex: F
Age: 40
State: IL

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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: NKA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient fainted approximately 1 minute after receiving vaccination. Patient reported a history of fainting in response to "needles" prior to vaccination. Patient reported feeling warm just after vaccination and moved to lie on the floor under her own power until she was assisted by reporter and partner who accompanied her. She lost consciousness for <30 seconds. Patient continued to breath and pulse was present. Patient was observed after regaining consciousness for 30 minutes. Patient reported resolution of symptoms and felt "normal" at departure from pharmacy.

Other Meds:

Current Illness:

ID: 1628332
Sex: F
Age: 62
State: NY

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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 according to patient

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Due to reconstitution error patient was given less than half of required dosage. Awaiting further guidance from regarding third dose for an immunocompromised patient.

Other Meds: Unknown

Current Illness: Multiple Sclerosis

ID: 1628333
Sex: F
Age: 51
State: SC

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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: Unknown

Allergies: self-reported: aspirin, atenolol, demerol, dilaudid, laritrex, toradol, mobic, morphine, oxycodone, pennicillin, phenergan, primaquine, quine, contrast dye

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

Symptoms: At 1112, the first dose of Pfizer vaccine was administered. Patient stated that they could taste the vaccine immediately after it was administered. Within 10 minutes, they reported a headache, dizziness, lightheadedness and throat tightness. The sense of swelling in their throat worsened and she became tachycardic. At 1135, Epi was administered. This helped initially, and then the throat tightness worsened and she started having difficulty breathing. EMS was called and took her for transport to the hospital at 1200.

Other Meds:

Current Illness: none

ID: 1628334
Sex: M
Age: 40
State: TX

Vax Date: 03/24/2021
Onset Date: 04/01/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: None. I had read some about myocarditis issues but wasn't sure that's what it was and wasn't sure how to describe what I was feeling to a doctor. If it happens with a subsequent booster, I will definitely seek medical care. I wanted to record my experience to give you better data on population-level incidence of myocarditis.

Allergies: none

Symptom List: Nausea

Symptoms: A few days after receiving my second dose of the Moderna vaccine, I started experiencing chest pain. I'm not exactly sure how to describe it, mostly like a pressure or odd feeling in my chest. It happened when I was exercising or not, seemingly with equal frequency. The events got less frequent over time with the last time I experienced it being about a month after the initial onset.

Other Meds: Azathioprine Remicade Montelukast

Current Illness: none

ID: 1628335
Sex: F
Age: 45
State: TX

Vax Date: 08/13/2021
Onset Date: 08/18/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: Went to see Dr. Tuesday August 24th, 2021. Diagnosis was shingles.

Allergies: none

Symptom List: Injection site pain

Symptoms: Night of shot- extreme arm pain for 3 nights couldn't raise arm above shoulder. Starting Wed. August 18th, 2021 rash on left forearm and left side rib cage rash began to develop. Thurs. August 19, 2021 right should injection site became irritated and sore again. The rashes and irritation progressed and peaked Sunday August 22, 2021 with blistering painful rashes at sites mentioned. Injection site red and swollen several inches around the injection.

Other Meds: Hydroxychloroquine, spironolactone, pristiq, multivitamin, allegra D

Current Illness: no

ID: 1628336
Sex: F
Age: 48
State: TN

Vax Date: 07/03/2021
Onset Date: 07/07/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: 7/20/21 - TSH, CBC, RF, ANA, ESR all within normal limits

Allergies: Neosporin - rash

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

Symptoms: Vertigo attack, tinnitus, headache, fatigue, joint swelling of hands, joint pain body wide,

Other Meds: Wellbutrin, Adderall, Multivitamin, Vit C, Vit D, Vit B-complex, probiotic

Current Illness: none

ID: 1628337
Sex: F
Age: 45
State: TX

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/24/2021
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: NKDA

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

Symptoms: Felt feverish/chills, body aches, cough, fatigue, generalized headache, nausea, vomiting, sore throat, decreased appetite, arm is sore.

Other Meds: Buproprion, Escitalopram, multivitamin, Vitamin c

Current Illness:

Date Died: 07/21/2021

ID: 1628338
Sex: F
Age: 66
State: WA

Vax Date: 04/08/2021
Onset Date: 07/13/2021
Rec V Date: 08/24/2021
Hospital: Y

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

Lab Data: 7/13/2021 COVID-19 positive PCR

Allergies: Unk

Symptom List: Tremor

Symptoms: 7/13/2021: headache, sore throat, cough, shortness of breath,. admitted to the hospital 7/21/2021 dies

Other Meds: steroids, except O2

Current Illness: Unk

ID: 1628339
Sex: F
Age: 54
State: CA

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: none( histamine eye drops )

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: EYE SUB CONJUCTEVAL HEMORRHAGE

Other Meds: mestinone

Current Illness: myasthenia Gravis

ID: 1628340
Sex: F
Age: 63
State: NE

Vax Date: 04/14/2021
Onset Date: 04/19/2021
Rec V Date: 08/24/2021
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: Blood test showed high risk of blood clotting happening. CAT scan with and without dye on chest and abdomen.

Allergies: none

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

Symptoms: High Fever (103) for 4 days, lower lobe pneumonia, headache pain, real fatigue, lack of appetite, dehydration.

Other Meds: none

Current Illness: none

ID: 1628341
Sex: F
Age: 50
State: MO

Vax Date: 02/03/2021
Onset Date: 03/01/2021
Rec V Date: 08/24/2021
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: N/A

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

Symptoms: Left shoulder pain and loss of motion. Migrated to right shoulder. PCP diagnosed as Adhesive Capsulitis. Started physical therapy. No progress so referred to Orthopedic surgeon. On 6/30/21 had manipulation under anesthesia on both arms. Ongoing physical therapy as of 8/24/2021.

Other Meds: Metformin Trulicity Levothyroxine Lipitor Lisinopril Citalopram

Current Illness: N/A

ID: 1628342
Sex: M
Age: 57
State: CO

Vax Date: 08/07/2021
Onset Date: 08/09/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: 8/17 - brain CT scan - normal

Allergies: Sulfa

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: "brain fog", difficulty thinking/concentrating, memory issues, confusion, dull headache, tinnitus, dizzy, vertigo, fatigue, elevated blood pressure, light sensitivity, nausea, feeling like going to faint, sweats/chills, sudden sweats when eating, felt feverish and flushed but temp never went above 98.6,

Other Meds: Vyvanse, Strattera, Ezetimibe, Atomoxetine, Vit D2 (prescription)

Current Illness: No illnesses, but was stung several times by a wasp about an hour prior to vaccination - no anaphylaxis type reaction but felt some nausea, headache, etc...

ID: 1628343
Sex: F
Age: 76
State: AR

Vax Date: 03/26/2021
Onset Date: 04/11/2021
Rec V Date: 08/24/2021
Hospital: Y

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

Lab Data: /14/21: CT Scan of abd. spelenomegaly, esophogeal and gastric varicies, cirrhotic changes of the liver and partially occluded thrombus in the main portal vein and superior mesenteric vein. Mild pancreatitis could not be excluded. Low platelet count

Allergies: darvocet, darvon, morphine, propoxphene

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

Symptoms: started not feeling well 2-3 days prior to admission to local Medical Center. CC abdominal pain and weakness. Progressive epigastric and upper abdominal pain. Afebrile. No diarrhea or vomiting

Other Meds: alprazalam, amolodipine, atenolol, celebrex, donidine, HCT, lantus, lasix, meclizine, montelukast, TNG(prn), omeprazole, ondasetron and synthroid

Current Illness:

ID: 1628344
Sex: M
Age: 54
State: UT

Vax Date: 03/08/2021
Onset Date: 03/15/2021
Rec V Date: 08/24/2021
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: I do not have the lab results. Was treated with Prednisone for the swelling

Allergies: none

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

Symptoms: Face, tongue and testicles swelled up and had to go to the emergency. A bad rash developed and lasted for about a week and for the week following my swelling at night my legs would experience uncontrollable tremors that would last for about 1 min at a time and happen several times during the night

Other Meds: HydroxyElite

Current Illness: none

ID: 1628345
Sex: F
Age: 60
State: MA

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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: Pain in extremity

Symptoms: Pt entered the clinic at approx.12:15 inquiring about the initial dose of the Pfizer per her primary care providers instruction. Pt reported a Hx of "her throat closing" s/p flu vaccination administration. No epi-pen administered at the time for that reaction. Pt was educated about the COVID-19 vaccine and received the first dose at 12:29 PM. Pt was instructed to wait in observation for 30 minutes. Shortly after COVID-19 vaccine administration pt stated that she "feels like her throat was getting scratchy", then proceeded to state "my throat is swelling"; "who even knows what is in these vaccines?". This RN did not observe any signs of angioedema upon examination. Pt was brought to ED for further evaluation per Nurse Manager. During transportation to the ED, Pt asked both RNs present "does this mean that I do not need a second dose of the vaccine? Who would authorize this?" Pt appeared stable during hand-off to ED triage RN.

Other Meds:

Current Illness:

ID: 1628346
Sex: M
Age: 59
State: GA

Vax Date: 08/18/2021
Onset Date: 08/21/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: NONE

Allergies:

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

Symptoms: SWELLING AND PAIN LOCATED IN LEFT EAR. THE INNER EAR IS MADE FROM TITANIUM PAIN IS A SLOW THOBBING WAVE LIKE PAIN THAT RADIATES TO THE CENTER OF MY HEAD THE TENITIS IN THAT EAR HAS INCREASED 10X MORE THAN USEAL. I TAKE TYLONOL AND ADVIL TO RELIEVE THE PAIN.

Other Meds: DILTIAZEM 240MG ONE A DAY LISYNIPRILL 12 ONE A DAY ADVIL 200MG 800 MG A DAY

Current Illness: NONE

ID: 1628347
Sex: F
Age: 66
State: VT

Vax Date: 04/12/2021
Onset Date: 04/18/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: None

Allergies: None known

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

Symptoms: On the night of day 6, I suddenly had incredible pain in my arm at the site of the vaccination, moving up into my shoulder and neck on the same side. It subsided quickly, but then returned as I was sleeping. I could not lie on my opposite side either. It passed by the next morning. Pain returned again on day 13, but this time the pain was agonizing, lasted two days, and seemed to be causing my right shoulder to spasm regularly. Ice, Advil or Tylenol weren't helpful. On day 28 the pain returned, my subscapular muscle spasm made my shoulder move, my heart rate went up, my blood pressure went WAY down, then became normal. My D.O. said as it wasn't SIRVA, or another type of injury, it was likely connected to the vaccine and that it might be helpful for researchers if I reported it here. Incidental to this very challenging experience, in the weeks following my vaccination I also developed a strange water retention through out my body and experienced some fatigue, particularly after exertion, and sleep disruptions, and changes in bowel movement that were like symptoms I'd experienced the previous year, post a presumed case of Covid 19. These issues continued even after the shoulder/neck muscular issue resolved. Sometime in the early part of July I suddenly stopped having the water retention, bowel issues, energy issues, or sleep disruptions too. I now feel well again. Note: I am presumed to have had Covid last year, in the early to mid part of March 2020. This was before tests were available, and before we understood that the symptoms I (and my husband) had were indicators of Covid 19. I went on to experience symptoms that later we learned were "long haul" symptoms for approximately 6 months after my illness in March, clearing in December of that year. I even had "covid toes" and developed Beau's lines in my toenails! I think it may be possible that I had a strong reaction to the vaccine because I already had some antibodies from the previous year. I am filing this as I hope having this information is helpful to someone. I waited until now to file so that I could be sure I had no other reactions to record.

Other Meds: Multivitamin

Current Illness: None

ID: 1628348
Sex: F
Age: 69
State: CO

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

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

Lab Data: 4/14/21-CHF BNP312 pg/mL, 4/15/21- CBC no auto diff-all standard range, 4/15/21-c-reactive protein- 15.4mg/L, 4/21/21- Lipidstrol Panel triglycerides- a38 mg/dL cholestrol 166mg.dL HDL 51 mg/dL LDL 91 mg/dL non HDL 115 mg/dL, 4/21/21-basic metabolic panel-all standard range, 4/22/21-US lower estremity venous Bil- No evidence DVT, 5/12/21- CBC w/ Man Dif if auto fails-normal, 5/12/21-comprehensive metabolic panel- all standard range, 5/12/21-TSH ultrasensitivr 0.767 mlU/L , 5/12/21- Hemoglobin A1c- 5.8%, 5/12/21- CBCw/ Maual Diff if auto fails- all standard range, 5/13/21- Lab use only GI PCR panel- all standard, 5/19/21-echo adult complete TTE-stable, 5/20/21- poct urinalysis automated- all standard range, 5/20/21- cbc w/ manual diff if auto fails- all standard range, 5/20/21- LIPASE - 105 U/L, 5/20/21- comprehensive metabolic panel- all standard range, 5/24/21 Viral direct detection- covid 19 SARS-coV-2RNA-NOT detected

Allergies: only milk (not all dairy). narcotics

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

Symptoms: diarhea up to 24 times per day, some nausea, headache, aches thruout body, severe gut & stomach wrenching, spine /vertebrae like being ripped out & crushed, lower back severe pain, kidneys severe pain like being ripped out, loss of taste, loss of appetite, can't focus, weak, fatigued.

Other Meds: tylenol, aspirin, estradiol, metoporol, simvastatin, orphenadrine, betanide, potassium, ashwagandra, b complex, calcium, gingko bilboa, milk thistle, melatonin, omega 3, multi-vitamin/mineral. (supplements & diuretics do NOT give me dia

Current Illness: No other illnesses or symptoms. lifelong pain due to re-injuries

ID: 1628349
Sex: F
Age: 58
State: ME

Vax Date: 06/19/2021
Onset Date: 06/25/2021
Rec V Date: 08/24/2021
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: No

Symptom List: Vomiting

Symptoms: Pain in right shoulder blade shoulder neck and electric feeling sensation down my right arm from shoulder down to fingers

Other Meds: Flonase

Current Illness:

ID: 1628350
Sex: F
Age: 33
State: NJ

Vax Date: 08/02/2021
Onset Date: 08/18/2021
Rec V Date: 08/24/2021
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: MRI of brain, EEG, cardiac echo, CT of head, EKG

Allergies: Sesame products

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fainting and seizure at about 3:30 on August 18. Fainted from sitting on stool, fell to ground and hit head face-on. Seizure movements and unresponsive to coworkers for 4-5 minutes. Paramedics arrived afteri awoke slightly and took me to emergency room where I stayed from Wednesday afternoon until Friday afternoon for tests and observation.

Other Meds:

Current Illness: Fatigue, loss of appetite, negative PCR tests for COVID-19

ID: 1628351
Sex: F
Age: 48
State: MN

Vax Date: 12/30/2020
Onset Date: 08/01/2021
Rec V Date: 08/24/2021
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: Chest X-ray 08/20/2021, covid test 08/20/2021

Allergies: Penicillin, tree nuts, scents, bleach, peanuts, black pepper

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

Symptoms: Fever, body aches, cough, diarrhea, loss of smell, congestion, shortness of breath, watery eyes, and runny nose. Prednisone 20mg 1 twice a day 9 tablets, cefuroxime 500mg 1 twice a day 10 tablets, azithromycin 500mg 1 tablet daily 3 tablets, Tylenol 500mg 2 tablets every 6 hours.

Other Meds: Xyzal, Breo inhaler

Current Illness: Asthma and arthritis

ID: 1628352
Sex: F
Age: 63
State: PA

Vax Date: 02/11/2021
Onset Date: 05/01/2021
Rec V Date: 08/24/2021
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: I had a CT scan, blood work and a nerve sensitivity test.

Allergies: I do not have any allergies.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: In the middle of May, I woke up one night having foot pain. When I woke up in the morning to stand up the pain was gone. I talked with a few co-workers and they were experiencing the same thing. On 06/06/2021, I woke up with a stinging sensation in my left foot around my toes. From that day on, there has been numbness in my foot, up to my ankle. The feeling would not go away. I started to have numbness in my left hand. The feeling would come and go. It felt almost like a stinging pain. I notice the pain generally occurred between 03:00AM ET - 05:00AM ET. Within a week, the pain moved to my right foot also. I made an appointment with my doctor to have some testing done. I am still having these feelings as of today. The numbness has moved to my knee from my foot and my elbow/shoulder from my hand. Most of this is occurring on the left side of my body. I'm still having testing done and the doctors are not able to figure out what is going on. Tomorrow I am having an MRI because they feel that it may be something with the connection from my brain.

Other Meds: levothyroxine

Current Illness: I did not have any illness at the time of my vaccination.

ID: 1628353
Sex: F
Age: 12
State: OR

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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: No adverse effects reported at this time. Patient received Pfizer COVID-19 vaccine with insufficient diluent, leading to multiple doses administered. Patient informed of error and advised to monitor for side effects per CDC guidance, and contact clinic if questions or concerns.

Other Meds:

Current Illness:

ID: 1628354
Sex: M
Age: 57
State: KS

Vax Date: 08/05/2021
Onset Date: 08/10/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: Aug. 10 saw Dr. with knee pain. Went to Dr. on Aug. 20th with BP spike, blood work done, normal. Went to ER on Aug. 21, EKG performed, and cat scan on brain performed, all normal. Follow up scheduled for Aug. 27 with Dr.

Allergies:

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

Symptoms: Severe pain in right knee on Aug. 10th. Blood pressure spiked found on Aug. 20th 165/110, my normal has always been 110/70. Went to Dr. after feeling bad all week. Aug. 11th began feeling off balance, and severe ringing in both ears with tightness in my head. Ears felt plugged. Heart racing, This is continuing through today Aug. 24 2021.

Other Meds: Fish oil, low dose aspirin

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am