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: 1628762
Sex: M
Age: 53
State: MI

Vax Date: 08/06/2021
Onset Date: 08/07/2021
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: PCN, Flu shots

Symptom List: Dysphagia, Epiglottitis

Symptoms: Weakness of legs the next day, then rash, and swelling of the neck, and face.

Other Meds: isosorbide, magnesium, glipizide, ropinirole, duloxetine, metformin, lisinopril, atorvastatin, liothyronine, levothyroxine.

Current Illness: none

ID: 1628763
Sex: M
Age: 43
State: PA

Vax Date: 06/01/2021
Onset Date: 06/18/2021
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: Covid rapid test which was negative

Allergies: Bananas

Symptom List: Anxiety, Dyspnoea

Symptoms: On 6/18/2021, started to feel brain fog, nausea, lethargy, and fatigue. On 6/19/2021, started to progress to cold sweats, muscle soreness in his legs. Went to Urgent Care, thought it was viral once Covid Rapid test came back negative, prescribed Azithromycin. On 6/20, the above symptoms continued. In the evening of 6/20, started with joint pain, bone pain. Progressed from legs to upper back, to the neck. Pain has worsened. Tylenol, Ibuprofen, heat, ice, and massage not helping, symptoms remain to the point can not walk without excruciating pain. Not able to sleep because the pain is constant.

Other Meds: N/A

Current Illness: N/A

ID: 1628764
Sex: M
Age: 43
State: FL

Vax Date: 08/19/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Chocolate

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

Symptoms: Brain fog, feeling of tightness in throat that comes and goes. Slight dizzyness

Other Meds: Nexium, Move free

Current Illness:

ID: 1628765
Sex: M
Age: 51
State: CA

Vax Date: 07/29/2021
Onset Date: 07/29/2021
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: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient received 3rd dose of moderna COVID vaccine no adverse reactions at time or thereafter from Patient. This submission is to inform of 3rd dose.

Other Meds: NA

Current Illness: NA

ID: 1628766
Sex: F
Age: 34
State: IL

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:
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: Fever (100.8), severe chills (convulsions), headache, diarrhea Currently 31 weeks pregnant.

Other Meds: Procardia, prometrium, prenatal vitamins

Current Illness: None

ID: 1628767
Sex: F
Age: 39
State: AK

Vax Date: 04/01/2021
Onset Date: 05/01/2021
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: Pelvic ultrasound on June 8th

Allergies: Bee stings Levaquin

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

Symptoms: I have always had very regular me trial cycles, every 26 days. After receiving the vaccine, I did not have a cycle in May. I had one in early June, beginning on the 7th. Then I had no cycle at all until August 23rd. I have no signs or symptoms of early menopause and no family history of menopause. I was diagnosed with cysts on both ovaries in June, again, with no family history or personal history of this issue. I feel there may be a possible link to the vaccination I received.

Other Meds: None

Current Illness: None

ID: 1628768
Sex: F
Age: 57
State: PA

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: none

Allergies: Latex, Corn, carbemazapine, iron

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: About 10 minutes after patient recieved the vaccine , she said her face and arm and legs felt itchy . She asked for benadryl. She took one tablet of benadryl. She waited another 20 minutes after taking the benadryl and said she felt fine then.

Other Meds: levothyroxine, topiramate, vitamin D2 50,000 units, citalopram. Patient smokes cigarettes and drinks coffee also

Current Illness: none

ID: 1628769
Sex: M
Age: 52
State: MN

Vax Date: 03/26/2021
Onset Date: 08/20/2021
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: CBC with diff, BMP,

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Hyperkalemia, AKI, weakness of lower extremities

Other Meds:

Current Illness:

ID: 1628770
Sex: F
Age: 53
State: MO

Vax Date: 08/22/2021
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 taken at this point.

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I was fine until I woke up at 2am the next morning with a sever headache, body aches, injection site swollen and extremely sore. I was very nauseous. I slept most of the day the next day and was not functional. On Day 2 now and I have started to feel better but I have ringing in my ears, a slight headache and some body aches. I can function at least, but still tired. FYI - I did have covid in late october of 2020.

Other Meds: Nitrofurantion(preventative antibiotic for UTI) Divigel and Progesterone

Current Illness:

ID: 1628771
Sex: M
Age: 26
State: FL

Vax Date: 08/21/2021
Onset Date:
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:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient did not have an adverse event. This was an administration error. The patient showed up to the pharmacy 14 days after his first dose to receive his second dose. Due to extremely long lines for patients waiting for the vaccine, the person entering the information did not notice that he was requesting it early. When I ,the pharmacist reviewed the information, I noticed he was too early for his second dose. I went to tell the immunizing intern to ask the patient to come back at a later date. The intern then informed me that they were working fast to clear the line and had already given the patient the immunization before I could review the information

Other Meds:

Current Illness:

ID: 1628772
Sex: F
Age: 36
State: WA

Vax Date: 08/03/2021
Onset Date: 08/03/2021
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: None completed - patient advised to see a provider.

Allergies: unknown

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

Symptoms: A interpreter is used for this intake. Client reports she is scheduled for second Pfizer vaccine tomorrow. She reports nausea and vomiting for several days after her first vaccine. She reports fatigue and has experienced heart palpitations since her first vaccine twenty days ago. A MD call was made by the house supervisor and client was advised to have her fatigue and heart evaluated by a provider before moving forward with a second vaccine. Two providers were provided to the patient. Patient plans to travel back to her home by the end of the month and wishes to move forward with the second vaccine. She was advised to see a provider first, but she wishes to have the second vaccine tomorrow and take the risk of having worsening symptoms. Patient will return tomorrow with her uncle who is her driver and is staying at his home. Patient advised to eat a full meal and drink plenty of fluids before her appointment. She was also advised that she will need to stay in observation for 30 minutes.

Other Meds: unknown

Current Illness: unknown- patient reported she had a physical prior to travel and was told she did not have a heart condition.

ID: 1628773
Sex: M
Age: 35
State: CA

Vax Date: 08/13/2021
Onset Date: 08/14/2021
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: ER visit 8/14 - troponins negative, abs lymphocytes low (0.8 when lower reference range was 1.0), chest x-ray negative. EKG with sinus tachycardia. ER visit 8/16 - troponins negative, abs lymphocytes remain low (0.8), WBCs now also low (3.2 when the lower reference range is 4.0). These CBC changes were never present prior to the COVID-19 vaccine. CTA was normal. Pericarditis was ruled out. EKG with sinus tachycardia. Orthostasis test revealed highly orthostatic. PCP visit 8/17 - EKG with sinus tachycardia and other changes Cardiologist visit 8/18 - EKG with sinus rhythm, however borderline PR interval

Allergies: Penicillin

Symptom List: Rash, Urticaria

Symptoms: 12 hours after receiving the Pfizer-BioNTech COVID-19 Vaccine EUA, the patient experienced heart pounding and palpitations. Went back to sleep and in the morning (~11am) his heart rate was 120-135 bpm at rest. On rising it elevated to 153. The advice nurse advised us to go to the ER 8/14. Blood work in the ER was negative for troponins and chest x-ray negative (myocarditis appeared to be ruled out), but tachycardia persisted after receiving 2 L IVF and he was discharged as such. Symptoms worsened over the next 3 days and a virtual MD visit advised us to return to the ER on 8/16. His heart rate would elevate 30-40 bpm on rising and would be mildly tachycardic while at rest. Despite 3 L IVF in the ER, he was very orthostatic. He was discharged home still with tachycardia which is only relieved by laying flat. He is currently wearing a heart monitor provided by a cardiologist following the ER visit and is being worked up for postural orthostatic tachycardia syndrome secondary to the first vaccine. It has been 11 days and the symptoms have not improved. Heart rate elevates to 145-151 on standing. Dizziness and head pressure when sitting. This vaccine has completely altered his health, which was perfect prior to receiving this initial dose.

Other Meds: None, n/a

Current Illness: None, n/a

ID: 1628774
Sex: M
Age: 43
State: PA

Vax Date: 01/20/2021
Onset Date: 08/22/2021
Rec V Date: 08/24/2021
Hospital: Y

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

Lab Data: Updated Procedure 08/22/21 1813 Respiratory virus detection panel Collected: 08/22/21 1716 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Procedure Component Value Ref Range Date/Time X-ray chest 1 view [3299044137] Resulted: 08/22/21 1748 Order Status: Completed Updated: 08/22/21 1748 Narrative: XR CHEST 1 VW IMPRESSION: Nonspecific slight interstitial prominence in the right infrahilar region. This is stable to slightly increased from prior and could be due to developing infiltrate or subsegmental atelectasis. END OF IMPRESSION: INDICATION: Shortness of Breath. 44 years TECHNIQUE: AP chest COMPARISON: 5/19/2021 FINDINGS: The heart is normal in size. There are subtle interstitial opacity in the right lower lung zone that is stable to slightly increased from prior. There is no pleural effusion. There is no pneumothorax.

Allergies:

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

Symptoms: ED to Hosp-Admission Discharged 8/22/2021 - 8/24/2021 (2 days) Hospital Last attending ? Treatment team 2019-nCoV acute respiratory disease Principal problem shortness of breath. Chief complaint: shortness of breath. Patient is an 44 y.o. male with hx of morbid obesity, hypertension NSTEMI in 2019 with subsequent clean cardiac cath, OSA not presently treated who presents with progressive shortness of breath for the past few days. Loss of taste and smell. Subjective fevers with chills. URI symptoms. Pt had been fully vaccinated for COVID earlier this year. Actually had additional vaccine on 8/18. Pt states he was exposed to COVID recently.

Other Meds: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler ALPRAZolam (XANAX) 2 mg tablet aspirin 81 mg tablet atorvastatin (LIPITOR) 40 mg tablet blood sugar diagnostic (ACCU-CHEK AVIVA PLUS TEST STRP) strip blood-glucose meter (ACCU

Current Illness:

ID: 1628775
Sex: F
Age: 25
State: OH

Vax Date: 02/19/2021
Onset Date: 02/01/2021
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: SYR
Vax Site: LA

Lab Data: Covid test negative

Allergies: Environmental allergy; peanut allergy; peaches

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

Symptoms: I got a headache a couple of days afterwards. Some of the first adverse events where I got extremely tired, and I had to go back to work and I felt really tired. I ended up calling off the next day. I was very cold. I was under a lot of blankets. I developed a low-grade fever. They wanted me to keep an eye on it just in case. The next day and the rest of the week my arm was really sore. The second vaccine was so bad. I had an even stronger headache. It took awhile for the swelling for my arm to go away. I had a bruise at the injection site and it kept getting darker and would spread. I took some medicine for the pain and headache. I could not even function. I was so tired and in so much pain. Most of the pain was in my arm. I was having a GI issue, I had diarrhea for a day or two afterwards. I had a telehealth visit with a nurse practitioner and they instructed me to go to urgent care if I did not feel better. Then I started having more GI issues, so I ended up going to urgent care. They told me to take Imodium to stop the diarrhea and take a lot of electrolytes. I had to take a Covid test at that time. Then I was off for like a week from work. I ended up going back to work and then I left like an hour after because I was having a bad GI issue, I was constipated. I was in pain and miserable. I went home and not only having diarrhea, but I had a stomach bug, I was throwing up. I could not keep anything in. Sometimes I still have diarrhea or constipation.

Other Meds: Birth control; headache medicine; blood pressure medication; Singulair; probiotics

Current Illness: None

ID: 1628776
Sex: M
Age: 23
State: MO

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: mild tightness around sternum, pain/discomfort. NP addressed patient and cleared him with no future eval neccessary unless pt feels discomfort later. Pt stated he feels fine

Other Meds:

Current Illness:

ID: 1628777
Sex: M
Age: 20
State: IL

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: none

Allergies: none

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

Symptoms: Patient had a vasovagal response in father's truck. He was diaphoretic and had low blood pressure 93/46. Father informed me that son had not eaten all day. Ambulance was called to have him checked out. He was fine. Blood pressure went up to normal and he refused to go to the hospital.

Other Meds: unknown

Current Illness: unknown

ID: 1628778
Sex: F
Age: 35
State: NM

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

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

Symptoms: Patient received 3rd dose of Moderna vaccine 8/23/21 at 10:16AM. Her mother called 8/24/21, stating that she had an adverse reaction to the vaccine and wanted to report it. Patient was in the background of the call and gave permission for her mother to speak on her behalf. She states that on 8/24/21 at approximately 3am she experienced sever fever/chills/sweating. This woke her up and she got out of bed to turn on the air-conditioner and passed-out (fainted) in the hallway. She was passed-out for 15 minutes and then got up and went back to bed. At the time of the phone call on 8/24/21 at 3pm, she was experiencing only a mild headache and mild chills. Patient states that she is taking Mavenclad for Multiple Sclerosis.

Other Meds: Mavenclad

Current Illness: n/a

ID: 1628779
Sex: F
Age: 38
State: CA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
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:

Allergies: N/A

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Swollen lymph nodes in neck

Other Meds: Wellbutrin

Current Illness: N/A

ID: 1628780
Sex: M
Age: 45
State: GA

Vax Date: 08/23/2021
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: None

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: - Fever - Aches - Fatigue - Muscle Cramping - Soreness at injection site

Other Meds: Testosterone therapy

Current Illness: None

ID: 1628781
Sex: M
Age: 34
State: DE

Vax Date: 05/20/2021
Onset Date: 05/20/2021
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: Blood work, CT scan, x-ray

Allergies:

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

Symptoms: I had a lot of chest pain at first. I change in my vision. I had dizziness. I had pressure above my eyes. I was really fatigue. I feel like I am on a boat rocking all the time. I had a migraine. There was time that I could not walk. I went the ER. They did a blood work, CT scan, and chest x-ray. They could not find anything wrong with me. I feel light headed all the time. I feel confusion.

Other Meds:

Current Illness:

ID: 1628782
Sex: F
Age: 67
State: IN

Vax Date: 08/21/2021
Onset Date: 08/22/2021
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: N/A

Allergies:

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

Symptoms: Swelling, redness, and increased pain to injection site. Then started to have increased itching to bilateral arms and face Seen at medical facility and prescribed medrol dose pack.

Other Meds:

Current Illness:

ID: 1628783
Sex: M
Age: 66
State: WA

Vax Date: 02/18/2021
Onset Date: 05/28/2021
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: Holter Monitor, EKG, Chest X-Ray

Allergies:

Symptom List: Unevaluable event

Symptoms: I have a history of intermittent Atrial Fibrillation. I had an Ablation procedure in March of 2020. On 05/28/2021 I felt like I was having PACs more frequently and my heart rate dropped markedly. I went to the ER on 06/06/2021. I was diagnosed with Sinus Arrythmia which I have never had before. I also had Bradycardia and it is still happening after two months. I wore a monitor for two weeks and I had PACs and PVCs as well as the Bradycardia. I have had an issue with PACs for 3 months after a Flu Vaccine in the past. I had not had any problems immediately after the vaccine.

Other Meds: Sotalol; phenobarbital; tamsulosin

Current Illness:

ID: 1628784
Sex: M
Age: 25
State: PA

Vax Date: 08/10/2021
Onset Date: 08/11/2021
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: Pulse ox monitor

Allergies: None

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

Symptoms: Adverse Effects- Muscle pain, Arm Pain, LICHEN PLANUS upper thigh area and other areas, stomach pain, tinnitus, headache, insomina, fever, cough, cold sweats, chills, runny nose, sneezing, sore throat, sleep apnea, bradypnea, strained eyes, itching, confusion, loss of appetite, flank pain, neck pain, neck spasms, upper leg spasms

Other Meds: None

Current Illness: None

ID: 1628785
Sex: M
Age: 59
State: AZ

Vax Date: 08/06/2021
Onset Date: 08/06/2021
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:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: PATIENT REPORTED TODAY 8/24/21 THAT HE HAS EXPERIENCED LOSS OF APPETITE AND REGULAR NAUSEA SINCE VACCINATION ON 8/6/21. PATIENT HAS FELT GENERALLY ILL SINCE VACCINATION AND HAS PREVENTED HIM FROM COMPLETING DAILY WORK/ACTIVITIES.

Other Meds:

Current Illness:

ID: 1628786
Sex: F
Age: 46
State: AL

Vax Date: 06/14/2021
Onset Date: 07/01/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: EkG and blood work on August 21, 2021 no chest xray. More test to follow after appointment on September 2nd.

Allergies: Toradol

Symptom List: Injection site pain, Menorrhagia

Symptoms: Symptoms of myocarditis which started July 1 2021 a couple weeks after receiving 2nd shot of vaccine. Currently been to the emergency room twice and have another follow-up with Dr. on Sept 2. Was placed on buspirone due to fact doctors thought it was anxiety or panic attacks.

Other Meds: Norvasc, simvastatin, amtripryline, lyrica

Current Illness: Fibromyalgia, lumbar degenerative disc disease, blood pressure, cholesterol

ID: 1628787
Sex: F
Age: 85
State: CA

Vax Date: 02/05/2021
Onset Date: 07/20/2021
Rec V Date: 08/24/2021
Hospital: Y

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

Lab Data: 7/20/21, COVID-19 (NAA), DETECTED and 8/15/21, COVID-19 (NAA), POSITIVE

Allergies:

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

Symptoms: Per documentation, this person received the Moderna vaccine 2/5/2021 and 3/13/21. This person has been admitted twice with COVID-19. 7/20/21 - 7/25/21 and 8/15/21 and 8/19/21

Other Meds:

Current Illness:

ID: 1628788
Sex: F
Age: 16
State: WA

Vax Date: 05/10/2021
Onset Date: 05/10/2021
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: None

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The parent falsified the date of birth of the patient. On the vaccine consent form she stated the date of birth was 0/1/13/2003 making her 18 y.o. at the time of vaccination. I was told her real birthday is 01/13/2005

Other Meds: None

Current Illness: None

Date Died: 08/10/2021

ID: 1628789
Sex: M
Age: 67
State: TX

Vax Date: 02/12/2021
Onset Date: 08/09/2021
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: RA

Lab Data:

Allergies: No known allergies

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA Patient received Pfizer-BioNTech COVID Vaccines on 1/20/2021 and 2/12/2021. Presented to ED on 8/9/21 from acute rehab with complaints of unresponsiveness at Rehab. PMH of CVA (2019). 2 weeks prior to admission patient with admitted to hospital and diagnosed with pontine stroke. Patient was scheduled for TEE and underwent routine COVID test and tested positive. Pt caregivers reported patient showed no respiratory symptoms prior to this admission. During this stay patient was treated with empiric antibiotics, Decadron for 10 days and Lovenox for treatment of a DVT and discharged to acute rehab. Upon arrival to ED pt was hypotensive, intubated and found to have a large retroperitoneal hematoma. Pt was also started on Cefepime, Vancomycin, and Doxycycline. Patient diagnosed with acute hemorrhagic shock and, acute blood loss anemia. Patient continued to decline and family decided to withdraw care and initiate comfort care. Patient expired on 8/10/2021.

Other Meds: apixaban 5mg BID; Polycitra 1,100-334 mg/5mL TID; escitalopram 10mg daily; gabapentin 100mg TID

Current Illness:

ID: 1628790
Sex: M
Age: 68
State: PA

Vax Date: 01/21/2021
Onset Date: 08/14/2021
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: 08/19/21 0244 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/18/21 1552 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/19/21 0244 COVID-19 PCR Collected: 08/18/21 1552 | Final result | Specimen: Swab from Nasopharynx Imaging Results Procedure Component Value Ref Range Date/Time CT angiogram chest pulmonary embolism with and without contrast [3299362384] Resulted: 08/24/21 1442 Order Status: Completed Updated: 08/24/21 1442 Narrative: CTA CHEST PULMONARY EMBOLISM W WO CONTRAST IMPRESSION: 1. There are patchy, bilateral peripheral infiltrates with underlying centrilobular emphysema. Areas of basilar subsegmental atelectasis/infiltrate and scarring are also present. 2. Commonly-reported imaging features of COVID-19 pneumonia are present. Other processes that can cause a similar imaging pattern include but are not limited to: Atypical infections (such as influenza virus, adenovirus, or organizing pneumonias) or noninfectious etiologies (such as drug-induced lung toxicity or connective-tissue disease.) 3. There are no findings for pulmonary thromboemboli, aortic dissection, or aneurysmal dilation. 4. Additional findings and lesser details are as described below. END OF IMPRESSION: INDICATION: COVID-19 positive, shortness of breath, chest pain, dyspnea, hypoxia, positive for COVID-19, high D-dimer. Assess for pulmonary artery embolism. TECHNIQUE: Enhanced helical CTA scan of the chest was performed from the lung apices to below the diaphragm, including the pulmonary artery. 2 mm axial reconstruction with MPR coronal, oblique, and sagittal images were created. 3D post processing imaging were obtained and stored. CONTRAST: 100 mL of IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUSLY. Quality of contrast opacification was adequate. COMPARISON: None. CT CHEST PULMONARY ANGIOGRAPHIC FINDINGS: There are no findings for aortic dissection or aneurysmal dilation. Post-operative sequelae of median sternotomy and open heart surgery are present. Coronary arterial calcifications are present. No pulmonary thromboemboli are identified. Paratracheal, paracarinal, and prominent right hilar lymph nodes are present and likely of reactive etiology. A right hilar lymph node measures 30 x 19 mm. There are patchy, bilateral peripheral infiltrates with underlying centrilobular emphysema. Areas of basilar subsegmental atelectasis and scarring are also present. Protocol included aspects of the superior abdominal viscera demonstrate decreased hepatic density likely representing steatosis. Calcified hepatic and splenic granulomata are present. There is fatty infiltration of the pancreas. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient.

Allergies: NKA

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

Symptoms: headache ? Sore Throat ? Fatigue ? Shortness of Breath ? Cough RN 8/24/21 8:42 AM Note Wife reporting that patient tested + for covid; having hard time with o2_ 88-89%. Patient is having DOE while walking. Pt reporting that his P/O was low this morning when he woke up despite being on cpap at night. (88%) Pt with + wheezing that can be heard across the room while on the phone. Denies any chest pain. + mild sob while up and moving and is winded very quickly while ambulating. Advised ER, verbalized understanding and will take over for treatment. Verbalized understanding to call back if condition worsens. Reason for Disposition ? Wheezing can be heard across the room Answer Assessment - Initial Assessment Questions 1. RESPIRATORY STATUS: "Describe your breathing?" (e.g., wheezing, shortness of breath, unable to speak, severe coughing) Wheezing, sob, doe, sever coughing 2. ONSET: "When did this breathing problem begin?" 2 days ago 3. PATTERN "Does the difficult breathing come and go, or has it been constant since it started?" constant 4. SEVERITY: "How bad is your breathing?" (e.g., mild, moderate, severe) - MILD: No SOB at rest, mild SOB with walking, speaks normally in sentences, can lay down, no retractions, pulse < 100. - MODERATE: SOB at rest, SOB with minimal exertion and prefers to sit, cannot lie down flat, speaks in phrases, mild retractions, audible wheezing, pulse 100-120. - SEVERE: Very SOB at rest, speaks in single words, struggling to breathe, sitting hunched forward, retractions, pulse > 120 modertae 5. RECURRENT SYMPTOM: "Have you had difficulty breathing before?" If so, ask: "When was the last time?" and "What happened that time?" "not like this" 6. CARDIAC HISTORY: "Do you have any history of heart disease?" (e.g., heart attack, angina, bypass surgery, angioplasty) Open heart 7. LUNG HISTORY: "Do you have any history of lung disease?" (e.g., pulmonary embolus, asthma, emphysema) copd 8. CAUSE: "What do you think is causing the breathing problem?" covid 9. OTHER SYMPTOMS: "Do you have any other symptoms? (e.g., dizziness, runny nose, cough, chest pain, fever) cough Protocols used: BREATHING DIFFICULTY ED Discharged 8/24/2021 (6 hours) Hospital ER MD Last attending ? Treatment team Pneumonia due to COVID-19 virus Clinical impression Shortness of Breath Chief complaint

Other Meds: acetaminophen (TYLENOL) 500 mg tablet albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler amoxicillin (AMOXIL) 500 mg capsule ASPIRIN ORAL atorvastatin (LIPITOR) 40 mg tablet clopidogreL (PLAVIX) 75 mg tablet fluticasone (FLONASE) 5

Current Illness:

ID: 1628791
Sex: M
Age: 21
State: IA

Vax Date: 03/09/2021
Onset Date: 03/14/2021
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

Allergies: None

Symptom List: Nausea

Symptoms: A couple days after the shot my taste and smell was altered and since then I have not been able to taste and what I can taste only tastes like nickels

Other Meds: None

Current Illness: None

ID: 1628792
Sex: F
Age: 58
State: CO

Vax Date: 08/11/2021
Onset Date: 08/12/2021
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: None

Allergies: None

Symptom List: Injection site pain

Symptoms: I had COVID infection in April 2021. After the vaccine, 1st dose, around 1am (11 hours later), I started throwing up, diarrhea, chills, body aches and my arm was sore. My left arm was red and inflamed. The next day, I still had flu-like symptom and my arm was red, sore, warm, painful to the touch and itchy. Over the next several days, it started to get worse. It started to spread and move down to my elbow and bicep. It was red, raised, warm to the touch with a burning sensation. I continued to ice it. I saw my doctor on 8/14/2021 who advised that he would prescribed antibiotics if not cleared in a week. My left arm continued to get worse and I continue to ice it and not bother it or irritate it even further. It finally start to resolve around 8/21/2021. The soreness and redness was starting to improve and it no longer itched or burned.

Other Meds: None

Current Illness: None

ID: 1628793
Sex: F
Age: 13
State:

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: n/a

Allergies:

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

Symptoms: headache within 5 minutes, dryness of throat/claimed itch of tongue 5-10 minutes post vaccination, to which patient was given a chair to sit, a glass of water and 25mg of liquid diphenhydramine and observed for appx additional 15-20 minutes. Patient then claimed to be feeling better and she and her mother left pharmacy.

Other Meds:

Current Illness:

ID: 1628794
Sex: F
Age: 41
State: UT

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: latex, levothyroxine, iron, relpax, cherries, blueberries

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

Symptoms: severe itching in throat and mouth diphenhydramine 50mg patient declined calling 911, mother picked patient up to take home for observation

Other Meds: oxycodone/apap 5/325mg, verapamil er 240mg, gabapentin 800mg, np thyroid 120mg, vitamin d 50,000 units,

Current Illness:

ID: 1628795
Sex: M
Age: 29
State: TX

Vax Date: 04/12/2021
Onset Date: 04/14/2021
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: Hearing test and two appointments with ENT about this issue on April 29th and June 16th 2021

Allergies: None

Symptom List: Tremor

Symptoms: Loud ringing constantly in both ears. Diagnosed with Tinnitus by ENT. No prior history of tinnitus or hearing issues, no loud noise exposure that could have caused it. The symptoms started along with the typical vaccine side effects (fever, chills) but the ear ringing never stopped and is constant. I am a young healthy adult male with no medical issues, active in sports and have a healthy diet.

Other Meds: None

Current Illness: None

ID: 1628796
Sex: M
Age: 44
State: WA

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: 12:45pm 153/84 12:59pm 152/93 1:20pm 136/97 HR 75

Allergies: aspirin

Symptom List: Erythema, Pruritus

Symptoms: Patient complained of palpitation and hypertension ~20minutes post 2nd Pfizer COVID vaccine.

Other Meds: gabapentin and buspirone for anxiety

Current Illness: Heightened anxiety after the first shot of Pfizer COVID vaccine

ID: 1628797
Sex: F
Age: 55
State: MN

Vax Date: 02/16/2021
Onset Date: 08/15/2021
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: COVID 19 PCR test on 8/18/2021

Allergies:

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

Symptoms: Patient received 2 doses of the Pfizer COVID19 vaccine, dose 1 on 1/26/21 and dose 2 on 2/16/21. Patient traveled domestically by plane to another state and then by cruise ship and by plane again to return to home state (8/7/21 - 8/12/21) . Patient then became symptomatic on 8/15/21 with shortness of breath, cough, diarrhea, nausea, anorexia, dizziness, chills, fever, headache, congestion, fatigue, and low O2 levels ~85% - 89%. Patient still symptomatic as of 8/24/21 and instructed to follow up with a provider ASAP for low oxygen levels below 90%.

Other Meds:

Current Illness:

ID: 1628798
Sex: M
Age: 18
State: WA

Vax Date: 07/26/2021
Onset Date: 07/26/2021
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:

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

Symptoms: when reconciling doses in noticed that patient had received a dose of Janssen vaccine from a pharmacy 5/8/2021. Unable to reach patient to verify as phone number is disconnected

Other Meds:

Current Illness:

ID: 1628799
Sex: F
Age: 17
State: WI

Vax Date: 05/07/2021
Onset Date: 08/19/2021
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:

Allergies: No known allergies

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient contracted COVID-19 after being fully vaccinated

Other Meds: amitriptyline 50mg HS Benadryl 100mg HS as needed for insomnia Norethindrone 0.35mg Daily

Current Illness: None Documented

ID: 1628800
Sex: F
Age: 39
State: AZ

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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa

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

Symptoms: Blurry Vision 5 minutes after shot administered. Warming sensation spread throughout my chest. It felt like a chain reaction within the muscle layer of my chest. It traveled outward and into my left arm and up towards my neck. Face became a little itchy. The sensation last for about 1 to 2 minutes then it subsided. After and an additional 5 minutes the warming sensation began again from the same locations. A traveling warming sensation began to spread in my chest. At that point the decision was made to call 911 for further evaluation. The paramedics assessed that my blood pressure was elevated, abut that oxygen vitals were good. It was determined I would not need further intervention and to go home and rest and take some Benadryl as a precaution. On the way home, I got the warming sensation again this time on my abdomen. And it passed after a few minutes.

Other Meds: Synthroid 112mcg?s 1 daily Paxil 10mg 1 daily

Current Illness: None

ID: 1628801
Sex: F
Age: 17
State: FL

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient was seated for two minutes after the injection and fainted for several seconds. EMTs were called at the request of the mother. She had low blood pressure when they arrived but quickly recovered after laying with her feet elevated. The patient remained seated at the pharmacy for an additional 45 minutes before leaving under her own power.

Other Meds:

Current Illness:

ID: 1628803
Sex: M
Age: 50
State: KY

Vax Date: 03/10/2021
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:

Allergies:

Symptom List: Pain in extremity

Symptoms: Positive COVID unknown contact mild symptoms

Other Meds:

Current Illness:

ID: 1628804
Sex: F
Age: 77
State: LA

Vax Date: 02/23/2021
Onset Date: 03/09/2021
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: Saw family physician to no avail. Did nothing about it. Seemed like a joke to him. Never experienced anything like this before the vaccine.

Allergies: Metformin

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

Symptoms: Episodes of feeling really bad, chest having extreme tension, heart flutters, tiredness, complete disorientation within these episodes. Slight disorientation event around 8/12/2021. No major events since. Feeling Better.

Other Meds: Metoprolol, rosuvastatin, losartan, januvia, glimepiride, dexilant, curalin, krill oil, immuniti, breathe, estroven

Current Illness: UTI

ID: 1628805
Sex: M
Age: 42
State: NV

Vax Date: 08/17/2021
Onset Date: 08/22/2021
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

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

Symptoms: Dizziness followed by Vertigo

Other Meds: none

Current Illness: none

ID: 1628806
Sex: F
Age: 60
State: MT

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Patient presented to the Health Department for a J&J Janssen vaccine. An on-site nurse administer the vaccine and brought the patient to the waiting area for a 30 minute observation to monitor for side effects. After 25 minutes of sitting, the patient stated she was having substernal chest pain which had begun five minutes prior to notifying the paramedic. Patient denied any other symptoms. The patient stated her only medical history was rheumatoid arthritis and an allergy to penicillin. Patient stated she has never had chest pain before. Vital signs were stable. Patient was advised that this could be a serious problem and she should be transported to the ER by ambulance. Patient declined transport. Patient stated she would be taken to the ER by her husband.

Other Meds: Fish oil, Calcium

Current Illness: None

ID: 1628807
Sex: F
Age: 29
State: OR

Vax Date: 05/20/2021
Onset Date: 05/27/2021
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: They don?t listen

Allergies: None

Symptom List: Vomiting

Symptoms: I have had a gnarly rash for 3 months, it started about a week after the shot. I?ve had multiple antibiotics and multiple steroid creams prescribed and it hasn?t gotten any better. I?ve never had anything like this before

Other Meds: Lamactal Strattera Wellbutrin Tumeric Ashwaganda

Current Illness: None

ID: 1628808
Sex: F
Age: 48
State: PR

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

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

Lab Data: Sedimentation rate, PCP IGG ABS, vitamin D, lipid panel, CMP, RA test qualitative, ultra PSA third generation, complete blood count, everything came back normal

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: After the first dose I was very tired and I could not get out of bed the next morning. I did not have a fever but I was sweating a lot. I had joint pain but that lasted only for a day. Then, I got the second vaccine in the morning and at night I was very tired and I felt there was something weird in my body. I felt the same way as I did with the first dose. The only difference is that I still have joint pain and fatigue. I am very tired. I have low energy. I am a very active person but this is keeping me from doing my daily activities since it takes a lot of energy off me. On 08/11/2021 I went to the doctor and they did some tests, Sedimentation rate, PCP IGG ABS, vitamin D, lipid panel, CMP, RA test qualitative, ultra PSA third generation, complete blood count, and everything came back normal. When the doctor examined my joints it really hurt.

Other Meds: Vitamin C; D3; omega 3; multivitamin

Current Illness: None

ID: 1628809
Sex: F
Age: 47
State: KY

Vax Date: 08/17/2021
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: RA

Lab Data:

Allergies: butrans pain patch

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

Symptoms: patient felt like she was going to pass out and realized it was her blood pressure. pt recorded bp of 76/63 with hr of 140bpm the symptoms quickly resolved after a few minutes and hr decreased to 80bpm after she remained lying down flat. Pt continued to have POTS through out the day and was managed by lying down

Other Meds: metimazole 5 mg, zonegran 200mg, notriptyline 25mg, lexapro 10mg, ,vitamin d3, ivag, norco 10, zanaflex 4mg, imitrex 50mg, midodrine 5mg,

Current Illness: na

ID: 1628810
Sex: F
Age: 51
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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: NA

Allergies: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt c/o of anxiety 3 minutes after vaccination, encouraged to take full deep breaths, "gets anxiety everytime with vaccinations, just like recent flu shot, also going through alot" V/S 138/82, 71, 18, O2 stat-99% on RA. Obs pt til 5pm, stated "she feels much better" Educated pt to seek urgent care/ER if anything else arises post clearance.

Other Meds: NA

Current Illness: NA

ID: 1628811
Sex: F
Age: 32
State: CA

Vax Date: 06/16/2021
Onset Date: 06/23/2021
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: RA

Lab Data: yes x-ray, ultrasound

Allergies: no

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

Symptoms: few days after taking the vaccine his foot started swelling, fingers started turning black and also from his ankle down it was turning black, went to ER had a lot of blood clots

Other Meds: no

Current Illness: no

ID: 1628812
Sex: M
Age: 15
State: IL

Vax Date: 08/02/2021
Onset Date: 08/05/2021
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: No medical test or lab results

Allergies: Mold, dogs, cats, evergreen trees, ragweed, blueberries, and tomatoes

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

Symptoms: Severe rash lasting for days on face neck and both arms

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am