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: 1628863
Sex: F
Age: 40
State: ID

Vax Date: 07/16/2021
Onset Date: 08/21/2021
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: No known allergies

Symptom List: Dysphagia, Epiglottitis

Symptoms: Bells Palsy

Other Meds: Unknown

Current Illness: None

ID: 1628864
Sex: F
Age: 41
State:

Vax Date: 01/22/2021
Onset Date: 08/21/2021
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:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: PATIENT RECEIVED COVID VACCINE DOSES ON 1/22/21 AND 2/11/21, AND TESTED POSITIVE TO COVID ON 8/23/21

Other Meds:

Current Illness:

ID: 1628865
Sex: F
Age: 17
State: WA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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:

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

Symptoms: No SEs reported after 15 min observation. Administered vaccine to under 18 years old.

Other Meds:

Current Illness:

ID: 1628866
Sex: F
Age: 66
State: AK

Vax Date: 08/05/2021
Onset Date: 08/06/2021
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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Starting the day after vaccination, the patient experienced fatigued and feverish. Patient remained in bed for a couple of days. Symptoms improved, but still ongoing.

Other Meds:

Current Illness:

ID: 1628867
Sex: F
Age: 25
State: ND

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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: N/A

Other Meds:

Current Illness:

ID: 1628868
Sex: F
Age: 38
State: CA

Vax Date: 08/17/2021
Onset Date: 08/17/2021
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: Blood test 8/21/21 and EKG 8/17/21

Allergies: Erythromycin

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

Symptoms: Palpitations and High Blood pressure less than 5 mins after the vaccine

Other Meds: Prenatal Vitamins and Vitamin C

Current Illness: none

ID: 1628869
Sex: M
Age: 50
State: NJ

Vax Date: 08/17/2021
Onset Date: 08/19/2021
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: Pyrexia, White blood cell count decreased

Symptoms: tongue is numb, loss of taste, right eye does not close fully and twitches, and pupil is dilated

Other Meds: n/a

Current Illness: n/a

ID: 1628870
Sex: F
Age: 38
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: LA

Lab Data: none

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: After 5 minutes post injection of dose 2 , patient became nauseous,gagging and then vomited. No treatment initiated at pharmacy. Patient left to her car where her driver was waiting for her with water and nausea medication. She anticipated this would happen and ran out in a hurry.

Other Meds: none

Current Illness: none

ID: 1628871
Sex: M
Age: 79
State: CA

Vax Date: 07/30/2021
Onset Date: 08/05/2021
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: penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Extreme itching , fever

Other Meds: Lorestan ,lodopine

Current Illness:

ID: 1628872
Sex: F
Age: 38
State: NJ

Vax Date: 08/13/2021
Onset Date: 08/17/2021
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: On saturday 8/21. I took a covid test and it was negative.

Allergies: Pennicilin. Any other drug am unaware of until I take it then 3days later I would start showing reactions.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Immediately after the shot I only feel a tingle to my middle finger. No othersympthoms. By midnight i feel a little numbness to my hand, no fever no other pain. Until about a hour later I feel the back of my head started to hurt I took tynelol and wentvto sleep woke up feel fine on saturday. With a little soar to the injection site which I use warm water and it was good as normal by end of day. Sunday no major pain just a few dizzy spell but noting that cause me an alarm.monday i woke up feel great no pain, tuesday i woke up woth a pain in the back of my head closer to my shoulder i took tynelol and by about 3:30pm i realise my entire body was hurting i had to take another tynelol. And since then I cant sleep or walk without any pain it hurt to lay down it hurt to sit and to dend is worse because i feel dizzy.

Other Meds: Tynelol as advise by pharmacies. After 3days of no help they advise me to take ibuprohen which i have been taken until saturday 8/21. When i was seen by a doc at the urgent care who advise me to reduce the frequency of how i am taking it si

Current Illness: No.

ID: 1628873
Sex: M
Age: 35
State: KY

Vax Date: 08/17/2021
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: SYR
Vax Site: LA

Lab Data: not given

Allergies: no drug allergies listed

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

Symptoms: had headache for a few days, then starting on 8/24 had rash all over body from head to toe

Other Meds: none that patient stated

Current Illness: not given

ID: 1628874
Sex: M
Age: 62
State: CA

Vax Date: 08/13/2021
Onset Date: 08/15/2021
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: na

Allergies: na

Symptom List: Rash, Urticaria

Symptoms: Started with diarrhea, then severe head-ache and low grade fever. Aching body, low energy and loss of weight (~8lbs). Still feeling very sick on day 10.

Other Meds: fish oil, glucosam-chondroit, vit D, probiotic Losartan, venlafaxine, triamterene, pravastatin

Current Illness: na

ID: 1628875
Sex: F
Age: 27
State: CA

Vax Date: 08/18/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Cashews Keflex

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

Symptoms: Migraine x 3 day at 0700 pm Burning shoulders Left leg nerve pain Sore arm Rash on bilateral arms and chest

Other Meds: None

Current Illness: Respiratory infection

Date Died: 04/01/2021

ID: 1628876
Sex: F
Age: 97
State: LA

Vax Date: 02/19/2021
Onset Date: 02/23/2021
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: EKG, chest Xray, bloodwork.

Allergies: Morphine

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

Symptoms: On the 4th day following the vaccine, patient suddenly became extremely weak, unable to do smallest of activities which were easy to perform before. Could not get up from toilet, chair, etc. Unable to get into vehicle without assistance. Unable to walk without walker and assistance. Prior to day 4 after vaccine, completely able to live independently, preparing meals, doing minor housework, get into and out of chair, on and off of toilet, etc. Patient was moved to daughter's home, and homecare was set up. After visit to cardiologist and various tests, she was diagnosed with afib and congestive heart failure; was taken off of all blood pressure meds as now blood pressure was suddenly low. Condition continued to deteriorate, and placed on hospice care. Died five weeks later.

Other Meds: Ibersartin, Hydrochlorothiazide, Simvastatin, Metoprolol Suc, Pantoprazole, Potassium Chloride, Bayer Aspirin, Vitamin D3

Current Illness: None.

ID: 1628877
Sex: F
Age: 52
State: CA

Vax Date: 05/18/2021
Onset Date: 06/10/2021
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: All the infections disease tests came back negative though Hep B was low and did get that vaccine. The inflammatory markers indicated PMR. Rubella came back positive.

Allergies: Allergic to cut grass, saw dust.

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

Symptoms: Started getting muscle pain in hip flexor(s) then shoulders June 10 and then grew bilaterally. July 16 stated feeling it in my shoulders. By evening of July 29 was in excruciating bilateral pain in shoulders, neck, hips, knees and even in hands. Went on predinsone on Aug 13 diagnosed with PMR on August 18 from RA doctor.

Other Meds: Levothyroxine 113 mcg. Hair and Nails vitamin. Vitamin D 50 Mcg. Daily Vitamin for women, Amberen, Tumeric, Collagen, Super B Complex with Vit C and Folic Acid

Current Illness: None beyond thyroid condition.

ID: 1628878
Sex: M
Age: 19
State: NH

Vax Date: 08/20/2021
Onset Date: 08/23/2021
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:

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

Symptoms: Scratchy throughout, heightens allergies leading to severe asthma ataccks that have lasted 2 days keeping me out of work. I used my inhalers and stay inside and I don't have attacks. It's still hard to breathe in air-conditioning. If I go out side I have an asthma attack. I also work in a metal shop Wich makes it so I can't go to work cause I would be in a load of polutents

Other Meds: Albuterol

Current Illness:

ID: 1628879
Sex: F
Age: 51
State: CO

Vax Date: 08/19/2021
Onset Date: 08/20/2021
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: elevated d-dimer on Hospital ER visit 8-22-21. Evaluated in Hospital ER - ultrasound demonstrated right upper extremity DVT and axillary lymphadenopathy.

Allergies: Biaxin, cephalosporins, clarithyromycin, codeine, hydrocodone, iodinated contrast media, latex, levofloxacin, metronidazole, nalbuphine, oxycodone, povidone-iodione, propoyphene, rizatriptan, sumatriptan, statins, sulfa

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

Symptoms: Right upper extremity DVT.

Other Meds: Esgic 50/325/40, gabapentin, levothyroxine, mesalamine, sertraline, sucralfate, lansoprazole

Current Illness:

ID: 1628880
Sex: M
Age: 35
State: TN

Vax Date: 07/31/2021
Onset Date: 08/01/2021
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:

Allergies: n/a

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient stated that he had permanently lost sense of smell after the second dose. Stated he started the day after and has not returned. Denied that he has or had covid. Advised patient to seek medical care from primary care doctor, but stated he does not have primary care doctor and was not going to seek any additional care.

Other Meds: buprenorphine, pregabalin, clonazepam

Current Illness: dermatologic disorders

ID: 1628881
Sex: M
Age: 35
State: WV

Vax Date: 04/17/2021
Onset Date: 04/23/2021
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: I noticed a very small bald spot forming in my mustache. After a few more days another spot in my facial hair started forming on my neck, soon followed by 2 more bald spots on my neck and just in the past three weeks two more on my chin. The spots have steadily grown in size as time has progressed, with a week where the spots appeared to be slowing progression. I have tried applying hydrocortisone cream with no noticeable change. All areas affected are growing in size. I have started taking Vitamin D, a daily multi-vitamin and a probiotic. No positive changes have occurred as of yet.

Other Meds: Buprenorphine

Current Illness:

ID: 1629053
Sex: F
Age: 44
State: OR

Vax Date: 03/30/2021
Onset Date: 03/30/2021
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: No worrisome abnormalities on CBC, pending audiometry results regarding tinnitus

Allergies: NKDA

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

Symptoms: Patient had delayed onset of menses and irregular menstruation x 2 months. Also 2 months of moderate to severe dysesthesia/hyperesthesia of skin. High pitched tinnitus, continuous and ongoing at date of report.

Other Meds: Vitamin D 5,000 IU Daily Fish oil Magnesium 150 mg Daily Calcium 500 mg Daily

Current Illness: None

ID: 1629054
Sex: F
Age: 50
State: CA

Vax Date: 08/17/2021
Onset Date: 08/18/2021
Rec V Date: 08/24/2021
Hospital: Y

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: ct with and without contrast, mri, chest xray, mult bloodwork, meds administered. ivs and anti blood coagulants

Allergies: pennclln, codine, verced, markaine

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

Symptoms: bad taste directly after shot, next day left side of face went numb. rushed to er for stoke protocol. was admitted into hospital. Had follow up with rheumatologist and new vascular and neuro doctors scheduled. symptoms come and go with one sided face numbness headache and extreme tiredness

Other Meds: Hydrocodone 3x day 10 mg did jot take 12 hrs before

Current Illness: rheumatoid arthritus, anklozing spondilitis

ID: 1629055
Sex: M
Age: 47
State: VA

Vax Date: 04/27/2021
Onset Date: 04/28/2021
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: none

Allergies: none

Symptom List: Unevaluable event

Symptoms: Fever and muscle soreness lasting approx 5 days, stomach cramps and nausea lasting approx 3 weeks , dizziness lasting approx 10 days, cough and shortness of breathe lasting approx 3 weeks.

Other Meds: pantoprazole, losarten

Current Illness: none

ID: 1629056
Sex: F
Age: 34
State: NC

Vax Date: 01/06/2021
Onset Date: 02/18/2021
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: No s

Allergies: Nine

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

Symptoms: Menses irregularity. Menses came early and was heaviest of my life. Would be constituted as menorrhagia. Could not sleep through the night without accident. Using new sanitary device once and hour for multiple hours a day. Included large clots, silver dollar in size. Menses lasted for three weeks. And every month thereafter has lasted just as long.

Other Meds: None

Current Illness: None

ID: 1629057
Sex: M
Age: 65
State: NV

Vax Date: 03/17/2021
Onset Date: 08/16/2021
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: none

Symptom List: Injection site pain, Pain

Symptoms: I had both Pfizer vaccinations the 2nd on 4-7-2021 and got the varriant infection for covid and lost my sense of smell and taste

Other Meds: metformin , lysinipril

Current Illness: none

ID: 1629058
Sex: F
Age: 72
State: TX

Vax Date: 02/21/2021
Onset Date: 03/01/2021
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: I had a few urinalysis done and a culture. They all always revealed that I had a UTI.

Allergies: Grass; pollen; airborne things; mold.

Symptom List: Injection site pain, Menorrhagia

Symptoms: In March I got a UTI and I have had 2 more since then. I went to my PCP with this problem and he performed a urinalysis. He gave me a 2 day antibiotic. It did not help me at all. I called for a refill for 2 more days of the antibiotic. It helped a little more. About 10 days later, the UTI came back. My doctor's office was closed that day. I spoke with a different doctor at the practice and he gave me a 5-7 day antibiotic that fully helped. About 6-8 weeks, I got another UTI. This time I went to my GYN. I saw the NPA, and she requested a urinalysis and they did a culture also. This verified that I did have a UTI. I was given more antibiotics for 5-7 days and that cleared it up. Even though it seemed cleared up, I still had a feeling that it wasn't completely gone. In late June, I had another UTI come on. I was visiting my daughter out of town. I called my GYN office to see if they could call in a prescription for me. They told me to buy AZO medication to assist me until I could get in for an appointment with them. I went to an appointment the day after I got back from my trip. I had a urinalysis done that day and by that time it cleared up. About two weeks ago, another UTI came on.

Other Meds: Levothyroxine; pantoprazole; EEMT-HS (estrogen); Celebrex; krill oil capsules; multivitamin (Centrum); magnesium; rizatriptan; propranolol; calcium.

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

ID: 1629059
Sex: M
Age: 17
State: NY

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

Lab Data: none

Allergies: cat, dog, mouse urine, oak trees

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

Symptoms: had two seizures after second covid vaccine (a minute each, about 15 minutes between seizures) stares, jerking, choking noise, got stiff occurred 25 minutes after vaccine different from usual seizures in that when came to didn't know who he was, his name had fever to 101.1 (rectal) given tylenol no rashes +headache after seizure poor appetite that day but drank well was back to normal next day

Other Meds: Flonase, Triamcinolone Ointment, Eucrisa, Ketotifen Fumarate, Symbicort, Albuterol Sulfate, Topiramate, lamoTRIgine

Current Illness: none

ID: 1629060
Sex: M
Age: 12
State: CA

Vax Date: 08/22/2021
Onset Date: 08/23/2021
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: vaccine given 8/22/21, chest pain/pressure started 8/23 night, chest pressure continued into 8/24. no other sx and pt stable. parent monitoring at home.

Other Meds:

Current Illness:

ID: 1629061
Sex: F
Age: 53
State: MI

Vax Date: 05/21/2021
Onset Date: 06/01/2021
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: General Practitioner Dr Visit - 6/15/21 - prescribed steroids Ear, Nose, Throat Dr Visit - 6/22/21 - prescribed stronger dose of steroids; hearing test shows hearing loss Follow up hearing test - 7/21/21 - hearing test shows slight improvement but hearing loss remains MRI - 7/27/21 - prescribed to make sure rare tumor was not affecting hearing. No tumor found.

Allergies: Pennicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Hearing loss in my left ear. Tinnitus in my left ear. Treated with 2 rounds of steroids, but hearing never fully returned.

Other Meds: None

Current Illness: None

ID: 1629062
Sex: F
Age: 50
State: TN

Vax Date: 08/23/2021
Onset Date: 08/23/2021
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: None

Allergies: Bees, IV Contrast, Depakote, Copaxone, Cephalosporins

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

Symptoms: Due to my MS I have numbness, and a ?pins and needles? feeling in my lower legs, bilaterally, below the knee. About 30 minutes following the 3rd shot I began to have a feeling of numbness (new) in both legs extending up to my mid-thighs - not completely numb, I can still feel everything, the feeling is just diminished. More on the left than the right. It has made walking more challenging than usual. If not improved in the am then I was going to go to the doctor.

Other Meds: Diamox, Propranolol, Topiramate, Wellbutrin, Abilify, Adderall, Lyrica, gabapentin, Tysabri

Current Illness: Multiple Sclerosis

ID: 1629063
Sex: F
Age: 36
State: AL

Vax Date: 08/14/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data: X-ray and ct of neck and chest at ER on 08/18/2021 were clear. COVID 19 test on 08/20/2021 was negative.

Allergies: None

Symptom List: Nausea

Symptoms: I had my 2nd vaccine dose on 8/14/2021. I had a nose bleed on 8/16/2021 and 8/17/2021. While at work on 8/18/2021 I noticed I was having difficulty breathing. I was reading to my students and couldn?t get another word out because it felt like my airway was closing in. I went straight to the ER for evaluation of my airway, but on the way there my nose started gushing blood. Huge clots were coming out. I was looked at but the doctor was only focusing on the nosebleed. My blood pressure was extremely elevated as well. I got not treatment at ER and was referred to my Primary care doctor. She say me on 08/19/2021 where she gave me a breathing treatment and prescribed an anti inflammatory, anti histamine, steroids, and an inhaler and referred me to Allergy/Asthma as well as ENT. That day I also noticed a small red spot on my neck. On 08/20/2021 the spot had spread just a little bit but I just thought it was a small rash that would go away. I called to schedule an appointment with ENT on 08/21/2021 and they said I needed a negative Covid test so I went to urgent care to be tested for COVID. It came back negative. On 08/ 22/2021 I returned to the ER because the rash had now spread down my neck to my shoulder and chest and had blisters forming. I was diagnosed with shingles and given a prescription for Valtrex.

Other Meds: Emergenc +

Current Illness: None

ID: 1629064
Sex: M
Age: 11
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: R/O nausea post vaccination. Assessed by EMS and released for stable condition.

Other Meds:

Current Illness:

ID: 1629065
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: No tests or labs have been taken between covid19 vaccine injection on 8/23/21 @1pm and 8/24/21@6:23pm. I carry an epi pen and continue to monitor.

Allergies: Omnicef, ceftin, augmentin, trazadone, pantoprazole Peanuts, shellfish, corn, all corn containing products, wheat (gluten), mustard, watermelon, eggs

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

Symptoms: 1:12pm Fast heartbeat, clamy hands, chills, sinus drainage, 1:26pm coughing, chest tightness, raspy voice, tingling/itchy nose, flush cheeks, chills 2:30pm slight fever, extremely tired 6:00pm sweating, loss of appetite, coughing, drainage, and tightness continued through night 9:00pm severe back ache (all over), injection site, bruised, tender, and throbbing 8/24/21 @6:30am after a restless evening woke up with a cough, extended hoarse voice, extreme thirst, and complete body aches. As of 6:20pm (8/24/21) complete body muscle/ joints ache, tired, sinus drainage continues, chest is tight with light wheezing periodically, voice remains raspy, and dry coughing continies, small hives appear on face and back,

Other Meds: Zyloft, zyrtec, Singulair, gabapentin, omeprazole, calcium, vitamin d, magnesium

Current Illness: erosions of spine, easy bruising,

ID: 1629066
Sex: M
Age: 49
State: PA

Vax Date: 02/13/2021
Onset Date: 08/16/2021
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: None

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

Symptoms: Shingles

Other Meds: None

Current Illness:

ID: 1629067
Sex: F
Age: 73
State: WA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
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: CT Scan, Abnormal 1.9 CM Lung Node. PET Scan, Abnormal 1.9CM Lung Node.

Allergies: Pollens (tree & grass); sulfa; amoxicillin; Keflex; antibiotics; codeine; morphine.

Symptom List: Tremor

Symptoms: I experienced flu like symptoms after receiving the vaccine. On 05/07/2021 during a routine CT Scan, the doctor discovered swollen Lung Node that measured 1.9 centimeters which was unable to reached via biopsy. Then, on the 05/20/2021, I had a PET Scan and they mentioned that it could have been from the injection of the vaccine. I had three CT Scans within 3 months and it was finally gone on 08/02/2021. I still have a nighttime cough.

Other Meds: Alexa; HCTC; verapamil; potassium; lovastatin; Ceftin; magnesium oxide; aspirin; Ventolin; vitamin D supplement.

Current Illness: No

ID: 1629068
Sex: F
Age: 47
State: WA

Vax Date: 07/08/2021
Onset Date: 08/15/2021
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: n/a

Symptom List: Erythema, Pruritus

Symptoms: "shingles" type rash on left leg, inner thigh. Have never had any type of rash issue like this before. Painful and tender on Sunday 8/15, swollen by the next day, then became red with bumps, which were at times mostly painful and sometimes itchy. The bumps are now sores that are red and dark. It is only on the one side of my body. Left leg. Inner thigh. I have self treated with ibuprofen, anti inflammatory and anti itch OTC creams.

Other Meds: n/a

Current Illness: n/a

ID: 1629069
Sex: M
Age: 44
State: NY

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

Allergies: None

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

Symptoms: Consistent Itchiness throughout the body. Some temporary hives which lasted about a half hour or so.

Other Meds: None

Current Illness: None

ID: 1629070
Sex: F
Age: 56
State: PA

Vax Date: 04/30/2021
Onset Date: 05/15/2021
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: TSH & Testosterone labs ordered/pending

Allergies: NKA

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

Symptoms: Hair loss (Alopecia areata & overall thinning)

Other Meds: Trazodone, multi-vitamin, IBU

Current Illness: None

ID: 1629071
Sex: F
Age: 1
State: WA

Vax Date: 08/10/2021
Onset Date: 08/21/2021
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: AMOXICILLIN, AUGMENTIN

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: swelling, redness, hard spot

Other Meds: N/A

Current Illness:

ID: 1629072
Sex: F
Age: 41
State: FL

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

Lab Data: None

Allergies: None

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

Symptoms: Spotting 7 days in advance of start of menstrual cycle. Light cramping too. I called my OBGYN to report it and they recommended that I report it. Advil to treat cramping. No other symptoms other than soreness at site of injection.

Other Meds: Advil, multivitamin, fish oil, vitamin D

Current Illness: None

ID: 1629073
Sex: M
Age: 53
State: IN

Vax Date: 03/11/2021
Onset Date: 03/22/2021
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: Not applicable. Did have hearing test on seeing doc, very slight hearing loss in left ear, nothing abnormal. Ringing continues today.

Allergies: None

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

Symptoms: Ringing in ears on and off after first shot. About a week after the second shot, ringing is continuous. Diagnosis is tinnitus

Other Meds: Claritin

Current Illness: None

ID: 1629074
Sex: M
Age: 48
State: CA

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:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Fever 101-102 Headache Aches and pains Brain fog Insomnia Sore arm

Other Meds: Pepcid

Current Illness: None

Date Died: 08/17/2021

ID: 1629075
Sex: M
Age: 78
State: NY

Vax Date: 02/25/2021
Onset Date: 08/10/2021
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: 8/10: COVID-19 positive (PCR) 8/11: urine culture: negative 8/11: Blood culture: negative 8/17: COVID-19 positive (PCR) 8/17: CXR: likely mild linear atelectasis in the lung bases

Allergies: NKDA

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

Symptoms: PMH of diet controlled DM, hepatitis C induced cirrhosis, CAD with stent replacement, HTN, osteoarthritis, colonic polyps, history of several liver lesions with an elevated AFP consistent with multifocal HCC (refused biopsy) sent in from PCP office for evaluation of hypotension. Patient has been c/o generalized weakness with decreased appetite for 1 week. Patient also endorses urinary symptoms mainly frequency. Denies any CP, SOB, LH, dizziness, N/V/D, HA, abdominal pain, fever, chills or any other complaints. In the ED blood work showed AKI. UA was positive for UTI and incidentally he was found to be covid +. Patient denies any SOB and is not hypoxic. CXR is unremarkable. In the ED patient was given IVF and was started on ceftriaxone x 5 days for UTI. CXR without evidence of pneumonia. On 8/16 Breathing comfortably. However, SPO2 was as low as 80s with activity on 8/13, started on Decadron. On 8/17: 8/17 RRT was called this morning for hypotension with BP 70/40s. Per RN patient received 500cc over night which did not respond, remains hypotensive. Patient reports he "doesn't feel well". At bedside, patient is lethargic but responsive to commands, satting 97% on room air. Patient transferred to the MICU and Pt emergently intubated at beginning of ACLS and during intubation was noted to have large amount of coffee ground emesis in esophagus and airway concerning for possible UGIB and aspiration. Despite resuscitative efforts for over 30 minutes, no sustained ROSC was able to be obtained.

Other Meds: rosuvastatin, prednisolone acetate eye drops, metoprolol succinate XL, latanoprost, amlodipine, ranolazine, cholecalciferol

Current Illness: January 14, 2021 - melena

ID: 1629076
Sex: F
Age: 52
State: FL

Vax Date: 08/21/2021
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:

Allergies: No

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

Symptoms: Day after shot: aches, very tired, low grade fever (not verified) weak, hot then cold ended 8-23-21. Area of injection is swollen light red and warm still on 8-24-21.

Other Meds: Metformin

Current Illness: None

ID: 1629077
Sex: F
Age: 62
State: NC

Vax Date: 08/11/2021
Onset Date: 08/11/2021
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: Penicillin

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

Symptoms: Received the shot and within one to two minute I was extreme dizzy to the point I had to Touch the side of the shelving because I thought for sure I was gonna pass out on the floor. I felt like I needed more oxygen is the reason I got up out of that chair the pharmacist had advised me to sit in. This extreme dizziness lasted for a few minutes and then I regain composure and left the store. No I did not tell anybody because they were very very busy and what could they do about dizziness nothing. I got into my car I drink my drink I went to the pool I swim for about an hour and a half of course I felt better during

Other Meds: Bi- estrogen 0.625 mg. Atenolol 25 mg . Vitamin D and K2 omega 370 mg Saul Palmetto vitamin C echinacea DHA turmeric L lysine.

Current Illness: Checking for my exhaustion from the doctor.

ID: 1629078
Sex: F
Age: 48
State: PA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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:

Symptom List: Vomiting

Symptoms: Immediately after I received the shot I had soreness in my arm and shoulder. The pain kept getting worse and also caused pain in my left shoulder and left side of my neck. It has never gotten better. I was diagnosed with bursitis in my shoulder after 6 months of pain. I am being treated by my chiropractor and family doctor for the bursitis caused from the first dose of the Moderna covid shot

Other Meds: Multivitamin

Current Illness:

ID: 1629079
Sex: M
Age: 41
State: OH

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: none

Allergies: n/a

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: patient stated got a sensation in his right jaw soon after the immunization and they it went across to the left jaw and then disappeared after a 1/2 hour.

Other Meds: n/a

Current Illness: n/a

ID: 1629080
Sex: F
Age: 70
State: IL

Vax Date: 02/18/2021
Onset Date: 06/01/2021
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: CT scan, stress test, EKG, heart monitor.

Allergies:

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

Symptoms: Fatigue, lower pulse in right leg.

Other Meds:

Current Illness:

ID: 1629081
Sex: F
Age: 51
State: OH

Vax Date: 08/21/2021
Onset Date: 08/23/2021
Rec V Date: 08/24/2021
Hospital: Y

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

Lab Data: 8/23/21 COVID-19 - negative Lactic acid - 3.5 Creatinine - 0.95; BUN - 25; sodium - 125; glucose - 286; calcium - 6.4; CO2 - 12; Anion gap - 32 CT chest PE - no evidence of PE; bilateral ground glass opacities Hemoglobin - 10.9

Allergies: ceftriaxone, sumatriptan, bee venom, peanut butter, adhesive tape, erythromycin, lisinopril, ketorloac

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient presented to ED with altered mental status, unable to provide much history beyond feeling unwell for the past few days. She was found to have metabolic anion gap acidosis, with no osmolar gap. Patient was found to have pneumonia and pancolitis. She was treated with vancomycin and meropenem in ED and transitioned to levofloxacin and metronidazole as an inpatient. She was started on norepinephrine due to low blood pressure. She is COVID-19 negative and legionella negative. Blood cultures are pending. Patient currently in ICU.

Other Meds: amlodipine, aspirin, atorvastatin, duloxetine, hydrochlorothiazide, hydroxyzine, Creon, Dulera, multivitamin, pantoprazole, topiramate

Current Illness:

ID: 1629082
Sex: F
Age: 57
State: IL

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

Lab Data: unsure

Allergies: penicillins

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

Symptoms: Patient states that she had redness and pain in her left arm, the day following the vaccination. Patient states that she has gone to urgent care/ER and was diagnosed with cellulitis. Not sure of the course of time, however as of today Aug 24th, the patient states that she is seeking additional medical help as the antibiotic she took, has not resolved the cellulitis. Her symptoms were soreness, redness, heat, at the site and fever.

Other Meds: metoprolol tart 25mg keppra 500mg alprazolam 0.5mg clopidogrel albuterol hfa hydroxyzine 10mg

Current Illness: n/a

ID: 1629083
Sex: F
Age: 15
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Reporting feeling nauseous, dizzy and temporary loss of hearing after vaccination. Assessed by EMS released due to stable condition.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am