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: 1629301
Sex: F
Age: 0
State: CA

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: LA

Lab Data: N/A

Allergies: NKDA

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient fell out of observation chair and become diaphoretic, weak, dizzy, and nauseated post vaccination. Assisted to chair and assessed blood pressure of being hypotensive at 74/40 and bradycardic at 54. Gave Zofran ODT and Benadryl PO w/ resolve to condition after monitoring for approx 30 min. Discharged to self under supervision of family member.

Other Meds: NKDA

Current Illness: Hypotension

ID: 1629302
Sex: M
Age: 51
State: CA

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

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

Lab Data:

Allergies: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: Soreness at injection site persisting 32 hours+ Awakened with chills/shaking approx. 20 hours after vaccination. Low grade fever (99.1) and fatigue day following vaccination.

Other Meds:

Current Illness: NA

ID: 1629303
Sex: F
Age: 55
State: WA

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

Lab Data: None

Allergies: Eggs, tomatoes, pollen, dust mites, pines, detergents

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

Symptoms: Red itchy hives over entire body.

Other Meds: Ibuprofen, morphine-ER, omeprazol, claritin-D

Current Illness: None

ID: 1629304
Sex: M
Age: 30
State: GA

Vax Date: 08/18/2021
Onset Date: 08/20/2021
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: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: STATED SYMPTOMS STARTE ON THE FRIDAY THE 20TH AT 11PM, HAD SWOLLEN THROAT, CHEST PAIN, LIGHT HEADED, FATIGUE, DIZINESS.

Other Meds: none

Current Illness: none

ID: 1629305
Sex: F
Age: 34
State: CA

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

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

Lab Data:

Allergies: Levaquin cortisone reacted to whooping cough and flu shot nut allergy latex

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

Symptoms: Left arm and leg numb and tingled, tunnel vision, disoriented, swelling of throat dizzy, headache, fatigue, sweats, body aches, muscle aches Took benadryl, ibuprofen and Tylenol

Other Meds:

Current Illness:

ID: 1629306
Sex: M
Age: 29
State: OH

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

Allergies:

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

Symptoms: Patient was walking around the store after the vaccine and had felt lightheaded and passed out. He fell into a display. The pharmacy staff called 911 immediately and tended to him. He was sitting up and talking just stated that he felt lightheaded. He remained seated until the EMS arrived and took over from there.

Other Meds:

Current Illness:

ID: 1629307
Sex: F
Age: 49
State: SC

Vax Date: 07/26/2021
Onset Date: 07/27/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Pt stated Headaches everyday since vaccine- not normal

Other Meds:

Current Illness:

ID: 1629308
Sex: F
Age: 52
State: FL

Vax Date: 08/12/2021
Onset Date: 08/13/2021
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: Pharyngeal swelling

Symptoms: Patient reported getting a rash around the neck area the day after receiving the vaccine. She self treated with a cold compress and cool water. She contacted her prescriber when the rash began to spread to her face, ears and arms. The prescriber gave a script for Prednisone. Prescriber is also doing blood work to check liver function due to Dress Syndrome.

Other Meds:

Current Illness:

ID: 1629309
Sex: F
Age: 12
State: CA

Vax Date: 08/06/2021
Onset Date: 08/14/2021
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: 08/23/21 18:45 White Blood Cell Count 7.1 (Ref. Range 5.0 - 11.0) Red Blood Cell Count 5.33 (Ref. Range 4.10 - 5.10) Hemoglobin 15.4 (Ref. Range 12.0 - 16.0) Hematocrit 44.7 (Ref. Range 36.0 - 46.0) Mean Corpuscular Volume 84 (Ref. Range 78 - 98) Mean Corpuscular Hemoglobin 28.9 (Ref. Range 25.0 - 35.0) Mean Corpuscular Hemoglobin Conc 34.5 (Ref. Range 31.0 - 37.0) Red Cell Distribution Width 11.4 (Ref. Range 11.0 - 14.5) Platelet Count 305 (Ref. Range 150 - 450) Mean Platelet Volume 11.0 (Ref. Range 8.9 - 13.1) NRBC (%) (Auto) 0.0 (Ref. Range 0.0 - 0.0) NRBC # (Auto) 0.00 (Ref. Range 0.00 - 0.01) Neutrophils (%) (Auto) 73 (Ref. Range 30 - 70) Lymphocytes (%) (Auto) 21 (Ref. Range 20 - 40) Monocytes (%) (Auto) 6 (Ref. Range 0 - 10) Eosinophils (%) (Auto) 0 (Ref. Range 0 - 4) Basophils (%) (Auto) 0 (Ref. Range 0 - 1) Immature Granulocyte (%) (Auto) 0.3 (Ref. Range 0.0 - 0.7) Neutrophils # (Auto) 5.2 (Ref. Range 1.5 - 7.0) Lymphocytes # (Auto) 1.5 (Ref. Range 1.1 - 4.5) Monocytes # (Auto) 0.4 (Ref. Range 0.0 - 0.9) Eosinophils # (Auto) 0.00 (Ref. Range 0.00 - 0.20) Basophils # (Auto) 0.01 (Ref. Range 0.00 - 0.04) Immature Granulocyte # (Auto) 0.02 (Ref. Range 0.00 - 0.05) Erythrocyte Sedimentation Rate 39 (Ref. Range 0 - 20) Sodium, Serum 132 (Ref. Range 133 - 143) Potassium Level 4.4 (Ref. Range 3.6 - 5.0) Chloride Level 102 (Ref. Range 98 - 107) Carbon Dioxide Level 29 (Ref. Range 22 - 30) Blood Urea Nitrogen 8 (Ref. Range 7 - 17) Random Glucose * 106 (Ref. Range 60 - 115) Creatinine 0.4 (Ref. Range 0.6 - 0.9) Calcium Level 8.6 (Ref. Range 8.4 - 10.2) Anion Gap Calculation 1 (Ref. Range 5 - 15) Albumin 3.1 (Ref. Range 3.8 - 5.4) Phosphorus Level 5.3 (Ref. Range 2.5 - 4.5) Magnesium Level 2.1 (Ref. Range 1.6 - 2.3) C-Reactive Protein <5.0 (Ref. Range 0.0 - 10.0) Urine Beta Human Chorionic Gonadotropin Negative (Ref. Range Negative - ) 08/23/21 18:54 Urine Color Colorless (Ref. Range Yellow - ) Urine Clarity Clear (Ref. Range Clear - ) Urine Specific Gravity 1.009 (Ref. Range 1.005 - 1.030) Urine pH 7.0 (Ref. Range 5.0 - 8.5) Urine Protein 100 (Ref. Range - <=30) Urine Glucose (UA) Negative (Ref. Range Negative - ) Urine Ketones Negative (Ref. Range Negative - ) Urine Bilirubin Negative (Ref. Range Negative - ) Urine Nitrite Negative (Ref. Range Negative - ) Urine Urobilinogen <2.0 (Ref. Range - <=2.0) Urine Leukocyte Esterase Negative (Ref. Range Negative - ) Urine Hemoglobin Free 2+ (Ref. Range Negative - ) Urine RBC <4 (Ref. Range - <=4) Urine WBC <4 (Ref. Range - <=6) Urine Squamous Epithelial Cells <4 (Ref. Range - <=6) Urine Random Total Protein 173 (Ref. Range - <=12) Urine Creatinine 36.9 08/23/21 19:07 (UA) Yellow (Ref. Range Yellow - ) Clarity- (UA) Clear (Ref. Range Clear - ) Glucose-(UA) Negative (Ref. Range Normal - ) Bilirubin-(UA) Negative (Ref. Range Negative - ) Ketones-(UA) Negative (Ref. Range Negative - ) Specific Gravity-(UA) 1.020 (Ref. Range 1.001 - 1.035) Bl

Allergies: penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient woke up on 8/14 with bilateral lower extremity swelling and periorbital edema, 7 days after her COVID-19 vaccine (dose #1). Had 3+ protein via urine dipstick on 8/14 and 4+ protein via urine dipstick on 8/16. Symptoms continued despite starting on prednisone 20 mg. Presented to Hospital ED on 8/23. Nephrology consulted on admission and recommended albumin infusion followed by lasix x2. Patient tolerated her 2 albumin infusions and lasix well. US LE were obtained to assess for DVT and were negative. Patient remained hemodynamically stable on room air throughout admission. At time of discharge, patient on room air and sent home with plan for follow up with nephrology in 3 weeks with 60 mg of prednisone per day. Pt informed by nephrology that she should get her second covid vaccine approx 1 week after originally scheduled date.

Other Meds:

Current Illness:

ID: 1629310
Sex: F
Age: 40
State: VT

Vax Date: 03/11/2021
Onset Date: 05/06/2021
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: See above*

Allergies: N/A until after Pfizer Covid shot

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I had the first Pfizer shot in my left arm on 3/11/21. Shortly after, I had a patch on my lower forearm that was itchy and would not heal. I had surgery on my right arm at the end of March and had my second shot on 4/2/2021 in my right arm. Around May 6, 2021, I began to have weeping around the surgical scar on my right arm from a partial elbow replacement surgery in March. It was yellow fluid. Initially I was treated for a bacterial infection and put on steroids. The weeping spread and I had a rash on my lower right arm. There was concern I might be allergic to the metal implant. It then spread fully to my left arm with the initial patch never healing. I was taken off of Lamictal to ensure that was not the cause. I went to dermatology and was put on oral and topical antibiotics and steroids. The rash continued to spread and I went for patch testing June 21-25, 2021 and was found to be allergic to linalool, bacitracin, neomycin and tobramycin (none of which I had previously been allergic to.) I was not found to be allergic to anything in the implant, as the doctors contacted Johnson and Johnson to ensure none of the above allergens were in in the implant that was used and after reviewing their notes, none of the known allergens were used deeply during my surgery. I continued to have weeping, itchy patches on my body which the dermatologist treated with topical and oral steroids. To try to control the skin outbreaks, I have been prescribed Dupixent, of which I took my first does on 8/16/2021 along with topical steroids. As of 8/24/2021 the outbreaks are continuing.

Other Meds: Seroquel (0.5 tab Am, 1.0 tab PM) Lamictal (100 mg)

Current Illness: N/A

ID: 1629311
Sex: F
Age: 12
State: NJ

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

Allergies: none

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

Symptoms: Client arrived with father for first dose Pfizer vaccine. While sitting in medical monitoring the patient began to exhibit what appeared to be a vasovagal response. Vital signs BP 90/65, HR 60, RR 16. Patient appeared weak, nauseous, and diaphoretic with an immediate onset. Patient stated she did not eat and was given a snack of chips and water by charge nurse. Cool compress applied to cooling areas on patient's body. Charge nurse ambulated patient and patient began to converse with nurse stating, " I feel better now." Patient appears in no apparent distress and answers appropriately. Charge nurse instructed patient and caregiver patient's father to seek medical attention immediately if new symptoms arise or previous symptoms reoccur. Approximately 1 hr 15min later caregiver patients father returned to vaccine site and stated his daughter is feeling much better. Caregiver indicated daughter is eating and resting at present. Charge nurse instructed caregiver to provide fluids throughout the day and to monitor for any symptoms. Caregiver instructed to seek medical attention immediately if symptoms reoccur.

Other Meds: none

Current Illness: none

ID: 1629312
Sex: M
Age: 32
State: NY

Vax Date: 08/19/2021
Onset Date: 08/23/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data:

Allergies: Bee Stings

Symptom List: Rash, Urticaria

Symptoms: Eyes hurt afterwards, felt like stroke

Other Meds: Viagra

Current Illness: None

ID: 1629313
Sex: F
Age: 60
State: NJ

Vax Date: 08/17/2021
Onset Date: 08/17/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Rash, swelling and pain at injection site. It was very sensitive to the touch and the area was hot. The rash was 2 inches by 3 inches.

Other Meds: Vitamin D3

Current Illness: none

ID: 1629314
Sex: F
Age: 24
State: CA

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: SYR
Vax Site: LA

Lab Data: N/A

Allergies: has history of dizziness with vaccinations

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

Symptoms: Patient in for her 2nd Pfizer covid vaccine dose, has history of dizziness with vaccinations, assisted to immunization room, given vaccine in supine position. 2 mins after vaccination, patient reported feeling dizzy. 3:50pm BP 105/69 HR 63 O2Sat 99%, remains alert and responsive. Advised to conitnue deep breathing and try to relax. 3:55 PM patient states she feels a little better BP 108/73 HR 65 Sat 100%. Advised patient to remain in supine position. 4PM, patient denies dizziness, BP 103/67 HR 59 Sat 98%. BP rechecked at 4:3pm 107/71, assisted in a sitting position (legs still up in the exma table/bed) 4:05pm BP 100/75 HR 71, Sat 100%. Denies diziness. 4:10PM sitting with leg dangling BP 104/72 HR 79 Sat 99%. Patient states she feels better, assisted into standing position 4:15PM BP 106/71 HR 66 Sat 99%, no dizziness, Patient to be discharged, assisted by NP to patient;s vehicle. Advised to contact primary MD if any other symptoms arise.

Other Meds: unknown

Current Illness:

ID: 1629315
Sex: F
Age: 34
State: OR

Vax Date: 04/26/2021
Onset Date: 05/02/2021
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: i am unsure what information is relevant. there was many notes back and forth between me and provider. was recommended to an ultrsound and bloodwork. also saw an endocrinologist related to PCOS menstrual changes.

Allergies: latex, adhesives, bandaides

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

Symptoms: after the first shot I had unusual menstrual bleeding , cramping pain. I was experiencing pcos symptoms prior, but had never had such prolonged bleeding. fast forward to Jul 20, 2021 I had begun to period just 8 weeks after my dose 2. I ended up bleeding for 35 days straight. heavy flow with clotting. I have been on birthcontrol progesterone for one week to attempt to regulate/stop bleeding. It has begun to taper to a light spotting. as of now im still experiencing bleeding. When I contacted the on-call doctor they advised me to report just in case it is related to the vaccine. both prolonged episodes of heavy bleeding occurred after the vaccines, and I have no history of bleeding like this ever.

Other Meds:

Current Illness: missing period, progesterone given begining of april.

ID: 1629316
Sex: M
Age: 74
State: OH

Vax Date: 04/30/2021
Onset Date: 05/06/2021
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: IM
Vax Site: LA

Lab Data: EMG - 08-04-21 Spinal tap- 08-17-21

Allergies: None

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

Symptoms: Guillian-Barre syndrome

Other Meds: Ocuvite Vitamin D Vitamin C

Current Illness: None

ID: 1629317
Sex: F
Age: 82
State: GA

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

Allergies: nkda

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

Symptoms: patient's husband reports it was mental distortion the night after taking the vaccine with some memory loss the following day. husband also reported fever, hypertension ,and extreme fatigue the night of the vaccine. The paramedics had to be called

Other Meds: eliquis, klorcon, levothyroxine, losartan, metoprolol, diltiazem

Current Illness: unknown

ID: 1629318
Sex: F
Age: 59
State: NJ

Vax Date: 08/23/2021
Onset Date: 08/24/2021
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: None

Allergies: Omega 3

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Room spinning out of control, dizziness, lightheadness, naseau, vomiting, vertigo, unsteady on feet

Other Meds: Oxygen use only at night 2 liters Ursodiol Tab 250 mg - 1 tablet, 2x/day Dexilant 60 mg - 1x/day Ezetimibe Tab 10 mg - 1x/day CBD Oil 1500 mg - 1ml 2x/day Stool Softener Docusatesodium 100mg - 1 tablet, 2x/day Albuterol, as needed Cyanocoba

Current Illness: Cancer in abdomen, origin unknown, treating as colon cancer Scarring in lung from cancer surgery

ID: 1629319
Sex: F
Age: 62
State: CA

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Excessive vomiting, chills, fever. Achey and painful, face, sinuses, jaw.

Other Meds: none

Current Illness: none

ID: 1629320
Sex: M
Age: 0
State: FL

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

Allergies: novocain, lisinopril

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

Symptoms: patient fainted after the vaccine administration, within 5 min, patient experienced temporary black out of vision, tingling in the hands and feet, patient came to quickly, was checked out by emergency personal, blood pressure 128/68

Other Meds: amlodipine

Current Illness: n/a

ID: 1629321
Sex: F
Age: 46
State: MN

Vax Date: 01/27/2021
Onset Date: 08/20/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Tested positive

Other Meds:

Current Illness:

ID: 1629322
Sex: M
Age: 15
State: MI

Vax Date: 08/18/2021
Onset Date: 08/21/2021
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: Unevaluable event

Symptoms: Patient complained of cough and coughed up some blood. Referred to primary doctor and to get tested for possible infection.

Other Meds:

Current Illness:

ID: 1629323
Sex: F
Age: 30
State: AZ

Vax Date: 08/06/2021
Onset Date: 08/07/2021
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: NA

Allergies: musucle relaxers

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

Symptoms: Started having respiratory issues ( Shortness of Breath, unable to take deep breaths) and increased generalized muscle fatigue, I believe that the side effects triggered my Myasthenia Gravis and made my respiratory muscles weaker. It lasted for about a week and a half before I started to feel better but I was afraid at one point the shortness of breath was causing a Myasthenic Crisis

Other Meds: Cellcept, Pyrdostigmine, Tylenol, Lexapro

Current Illness: Myasthenia Gravis, Acute Respiratory failure ( 6/30 - 7/3)

ID: 1629324
Sex: F
Age: 27
State:

Vax Date: 08/21/2021
Onset Date: 08/21/2021
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: Chest X-ray, EKG 12 lead, bloodwork

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Acute chest pain, multiple short episodes of stabbing pains in my left side(near heart), tightness in the chest and area. Increased anxiety/anxiety attack.

Other Meds:

Current Illness:

Date Died: 03/26/2021

ID: 1629325
Sex: F
Age: 89
State: TN

Vax Date: 03/18/2021
Onset Date: 03/21/2021
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:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Died!

Other Meds:

Current Illness: Scoliosis

ID: 1629511
Sex: M
Age: 53
State: MD

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

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

Lab Data:

Allergies: None

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

Symptoms: Red rash and hives developing on torso, thighs, neck and arms. Accompanied by minor itching.

Other Meds: None

Current Illness: None

ID: 1629512
Sex: F
Age: 37
State: NH

Vax Date: 08/22/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillan, bactrum, doxicycline, z-pack, levaquin, and ciprofloxacin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I received my second dose of Moderna Covid-19 Vaccine at approximately 11am. By 10pm that night, I had a fever of 100.9 and the chills, body aches, headache, along with an elevated heart rate of 125bpm. I woke up at 12am and my chills were making my whole body shake. I had trouble sleeping and by 3am I woke again and went to get water. I felt winded just going to the kitchen to get water and suddenly felt nauseous. My heart rate still felt high because I could feel my heart pounding. I made it to my bathroom and ended up dry heaving since I didn't have much of an appetite the day before. I broke out into a sweat and started shaking again and had trouble standing so my husband helped me back to bed. I took one tylenol to help with the pain from my headache and body aches. I woke in the morning and still found I had a fever of 100.9 and my heart rate was still about 125bpm. I was very fatigued and had trouble walking due to being unbalanced. The headache came back once the tylenol wore off. I did not fell completely well until this morning about 36 hours after my shot.

Other Meds:

Current Illness:

ID: 1629513
Sex: F
Age: 17
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: PATIENT STARTING FELLING DIZZY, THEN FAINTED. WHEN SHE CAME AROUND , SHE STARTED FEELING NAUSEOUS AND LATER VOMITTED.

Other Meds:

Current Illness:

ID: 1629514
Sex: M
Age: 52
State: PA

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

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

Lab Data: N/A

Allergies: None

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

Symptoms: I had severe numbness and tingling of my hands and feet as well as in my arms legs and torso. I became uncomfortably cold and had to sit in the 90*F sun with a heavy sweatshirt to warm myself. I then experienced an excruciating headache that lasted over 2 hours and was only relieved by an nsaid and sleep.

Other Meds: None

Current Illness: None

ID: 1629515
Sex: F
Age: 68
State:

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient experienced swelling, pain, itching, and redness on the entire upper arm. Swelling decreased over the next 2-3 days. redness still evident 3 days later.

Other Meds:

Current Illness:

ID: 1629516
Sex: F
Age: 51
State: FL

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: Her EKG was normal and Blood pressure was normal (125/78). EMT suggested she could go to the hospital to just observe but she decline.

Allergies: demerol

Symptom List: Injection site pain

Symptoms: Patient started having trouble breathing and felt like she was going to vomit. This happened about 3 minutes after the injection was given in the left arm. We took her blood pressure and it was 135/95, pulse was 74 and patient was fully coherent. We called 911 and EMT arrived in 5 minutes.

Other Meds: No prescriptions

Current Illness: none

ID: 1629517
Sex: F
Age: 35
State: ID

Vax Date: 08/13/2021
Onset Date: 08/13/2021
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: None.

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

Symptoms: Swollen lymph node on collarbone lasting longer than a week with 6/10 pain. Low grade fever lasting one day.

Other Meds: None.

Current Illness: None.

ID: 1629518
Sex: F
Age: 25
State: CA

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: none

Allergies: anaphylactic reaction after "eating mangoes, sometimes egg, and avocado."

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

Symptoms: Pfizer vaccine administered at 3:00 pm. At 3:25, patient reported "tingling" in throat. Pt denied all other symptoms. No dyspnea, hives/rash, GI symptoms noted. Patient administered cetirizine (10mg) and diphenhydramine (25 mg) at 3:36 pm.

Other Meds: unknown

Current Illness: not known

ID: 1629519
Sex: F
Age: 34
State: CA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Tremor

Symptoms: Client sitting in chair in observation area after receiving vaccine. Observation period for 15 minutes. Client appeared to be hyperventilating and stated she had "extreme needle phobia" to RN. Client skin moist and pale. Vitals taken at 1504: BP 142/104, HR 111 bpm, SpO2 100 %. RN gave client water to drink and removed mask to support breathing. Clt c/o feeling "lightheaded." RN offered to lie down on cot, client refused, remained sitting. Vitals taken at 1511: BP 137/103, HR 107 bpm, SpO2 100%. Client reported at 1511 felt like "anxiety was improving" and "my breathing is better." Skin is dry and appropriate color for Ethinicity, no rash observed. Client denied lightheadedness, chest pain ,nausea, denied dizziness. Vitals taken at 1532: BP 132/92, HR 100 bpm, SpO2 100%. Client appeared more relaxed, no hyperventilation noted. Client reported lightheadedness is gone, stated "I am ready to go home." RN educated s/s of emergency and to f/u with PMD. Client walked off with steady gait unassisted at 1537. Client with friend.

Other Meds: Aderall

Current Illness: none

ID: 1629520
Sex: F
Age: 22
State: AR

Vax Date: 07/05/2021
Onset Date: 08/20/2021
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: NA

Symptom List: Erythema, Pruritus

Symptoms: Server migraine, lost of appetite, nausea, vomiting, and muscle pain and aches

Other Meds: Birth control

Current Illness: NA

ID: 1629521
Sex: M
Age: 30
State: GA

Vax Date: 08/12/2021
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:

Allergies:

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

Symptoms: After 3 days of Vaccine I had 3-4 days of chills, body aches and low grade fever. Now about a week and a half later Im having continuous heart palpitations, heart racing, chest discomfort.

Other Meds:

Current Illness:

ID: 1629522
Sex: F
Age: 29
State: CA

Vax Date: 08/20/2021
Onset Date: 08/22/2021
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: N/A

Allergies: None

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

Symptoms: Patient got first dose of Moderna Covid-19 vaccine on 8/20/21. She already got Johnsen & Johnsen on 6/21/21 at a different place

Other Meds: N/A

Current Illness: None

ID: 1629523
Sex: F
Age: 30
State: CA

Vax Date: 07/30/2021
Onset Date: 07/31/2021
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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Severe flare ups in joints are 24 hours of second dose causing me to not be able to work

Other Meds: Sulfasalazine

Current Illness: None

ID: 1629524
Sex: F
Age: 25
State: FL

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: NKDA

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

Symptoms: PATIENT FELT VRY FAINT , DIZZY AND LIGHTHEADED

Other Meds:

Current Illness:

ID: 1629525
Sex: F
Age: 24
State: NJ

Vax Date: 08/23/2021
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: N/A

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

Symptoms: Breastmilk decrease

Other Meds: N/A

Current Illness: N/A

ID: 1629526
Sex: M
Age: 59
State: CO

Vax Date: 05/04/2021
Onset Date: 05/04/2021
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:

Allergies: Zoloft

Symptom List: Pain in extremity

Symptoms: None stated.

Other Meds: All Documented, See hospital chart

Current Illness: Epilepsy

ID: 1629527
Sex: F
Age: 36
State: DC

Vax Date: 05/22/2021
Onset Date: 06/29/2021
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: I had numerous blood labs by Cardiologist and Endrocronoglish that resulted in the following diagnosis: hyperthyroid, Graves Disease, and Hashimoto as well as a heart murmur in August 9 & 24 2021. Allergic Contact Dermatitis June 17, 2021

Allergies: none

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

Symptoms: abnormal EKG within a month of 2nd dose Allergic reaction to skin on chest same month of the shot hyperthyroid, Graves Disease, and Hashimoto as well as a heart murmur in August 2021

Other Meds: Vitafusion Prenatal

Current Illness: none

ID: 1629528
Sex: F
Age: 35
State: TX

Vax Date: 08/16/2021
Onset Date: 08/16/2021
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: saw virtual Dr. via app following the rules mandated: they confirmed 'Allergic Reaction'. I was unable to be hospitalized- the two rural hospital heres were full.

Allergies: Levaquin and petroleum based plastic products

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

Symptoms: immediate drop in heart rate: 123 to 71 BPM within minute of receiving. Experienced kidney difficulty/failure (severe back pain and inability to urinate after shot at 3 PM Mon until 7:30 pm the following day, Tues and low grade fever persisted. Tuesday Night/Wed AM following vaccination I awoke from fevered delirious sleep to what can only be described as labor contractions. This pain was So Bad it Really was worse than when I gave birth to my son naturally!: menstruation started 11 days sooner than it should (and I have Never been a day early or late). Approx. 3x heavier than any period experienced: similar to 'afterbirth' with deeply coagulated chunks so large each time i urinated, they clogged the bath facilities, and shower drain.

Other Meds: clonazepam .025 for panic disorder

Current Illness: N/A

ID: 1629529
Sex: M
Age: 59
State: MO

Vax Date: 04/09/2021
Onset Date: 04/10/2021
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: IM
Vax Site: LA

Lab Data: Eye loss, stayed in hospital for 12 days and now has to have surgery to see if he will be able to see again out of his left eye. Stay home from work on medicine through a pic line for 23 days with a nurse coming to see him weekly.

Allergies: None

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

Symptoms: Pt had a fever over 102 degrees, he had shaking and chills, a cough, headache, vomiting's, nausea, Red and bruised looking toes, feet swollen and eye sight loss in the left eye

Other Meds: Losartan, Aspirin, Amlodipine, Clopidogrel, Metoprolol, Atorvastatin , Hydralazine

Current Illness: None

ID: 1629530
Sex: F
Age: 21
State:

Vax Date: 08/19/2021
Onset Date: 08/19/2021
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: None

Symptom List: Vomiting

Symptoms: Initially I got a red bump around the injection site shortly after receiving the shot. It went away after 2 days, but 4 days after i got the shot I broke out in hives. They have spread and now cover my whole body. Legs, arms, hands, back, feet are covered in bumps. I have to take Benadryl every 4 hours or else they itch like crazy. Cortisone creams help with the inflammation but it's been 3 days with the hives and they're just getting worse instead of better. I had a virtual appointment and my doctor told me to just keep taking benadryl but I am going through a ridiculous amount of allergy creams/pills/ointments and there is no end in sight. Relief for a mere 4 hours before the itching starts again. If I wasn't mandated by my employer to get the second dose of this stupid vaccine I wouldn't as I'm concerned I will have a worse reaction! I expected initial discomfort but not endless hives!!!

Other Meds: Birth control (nuva ring) , Diflucan, multivitamin

Current Illness: None

ID: 1629531
Sex: M
Age: 16
State: AL

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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: dose of pfizer covid-19 vaccine was drawn up at full strength/concentration and given to patient

Other Meds:

Current Illness:

ID: 1629532
Sex: F
Age: 12
State: IL

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

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

Lab Data: Any tests or laboratory results would be at the Hospital in the area

Allergies: NO KNOWN ALLERGIES

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

Symptoms: This was the second covid dose for the patient. There were no complications with the first dose. Approximately 10-15 minutes after receiving the vaccination the child reported feeling tightness in her chest from her arm to her chest and felt like her heart was racing. The child did appear nervous getting the vaccine. She was given a bottle of water and we continued to monitor the child. She still wasn't feeling good. We took her blood pressure which was normal. Mom wanted the paramedics called so she could be checked out. The paramedics came and checked her vitals which appeared within normal range, however, she was transported to the hospital for further observation.

Other Meds: NO CURRENT MEDICATIONS TAKEN.

Current Illness: ASTHMA

ID: 1629533
Sex: M
Age: 39
State: PA

Vax Date: 08/20/2021
Onset Date: 08/21/2021
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: None

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 20 hours after the second injection I got a fever of 102.3 that actually subsided to 100.6 by the time I went to bed 36 hours after second injection I woke up with a severe headache (I get migraines once a month) worse than any headache I ever had before. It was so painful I thought I'd have to go-to the hospital. That lasted pretty much all day until 8 pm when the headache just disappeared. Now the initial couple hours were the worst, I vomited 1 hour into the onset of the headache. 72 hours after symptom onset I was having cold chills all morning which stopped maybe after a few hours but after that I'm having pain shooting down the backside of my right arm and into the back of my armpit area, almost like a numb feeling but a little pain

Other Meds: Suboxone sublingual tablets 16 mg/day Immitrex for migraines when needed usually once a month

Current Illness: End of a cold

ID: 1629534
Sex: M
Age: 20
State: MA

Vax Date: 04/09/2021
Onset Date: 04/15/2021
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: Cardiac MRI 7/18/2021: 1. The left ventricular size is normal. The left ventricular ejection fraction is 59 % by Simpson's method. Global left ventricular function is normal. There are no regional wall motion abnormalities of the left ventricular wall. The left ventricular mass is normal. 2. There is no resting first pass myocardial perfusion defect. There is a small amount of focal mid-myocardial late gadolinium enhancement at the basal inferoseptum. This finding may represent myocarditis. Normal global native T1 time, measured at 1200 ms (normal 1200 +- 80 ms). The extracellular volume fraction is normal, measured at 25%. There is no evidence of focal myocardial edema by T2 weighted imaging. 3. The right ventricular size is normal. Global right ventricular function is normal. There are no regional wall motion abnormalities of the right ventricular wall. 4. Left atrial size is normal. Right atrial size is normal. Ziopatch 7/12/2021: Patient had a min HR of 27 bpm, max HR of 186 bpm, and avg HR of 81 bpm. Predominant underlying rhythm was Sinus Rhythm. First Degree AV Block was present. 1 episode(s) of AV Block (2nd?) occurred, lasting a total of 5 secs. Second Degree AV Block-Mobitz I (Wenckebach) was present. Isolated SVEs were rare (<1.0%), SVE Couplets were rare (<1.0%), and no SVE Triplets were present. Isolated VEs were rare (<1.0%), and no VE Couplets or VE Triplets were present.

Allergies: cinnamon

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

Symptoms: The timeline of patients COVID vaccinations are: 3/18/21 & 4/9/21. He experienced shortness of breath and palpitations about a week after the second vaccine. The symptoms slowly improved since then, although never completely went away. He was seen by a PCP at this time with normal ECG. He also had antibody titers that was notable for SARS Cov2 spoke IgG quant 882.5 and nucleocapsid IgG negative, confirming no prior history of COVID infection. He did have COVID exposures during the pandemic with a roonmate at college but he tested negative multiple times and was isolated. After a few months with persistent symptoms he was referred to myself in cardiology. I performed lab tests with negative hs-TnT and hs-CRP. A cardiac MRI revealed evidence of a focal area of LGE consistent with myocarditis. I also performed a Ziopatch which demonstrated no evidence of arrhythmia, did show type 1 AV block and one episode of Wenkebach.

Other Meds:

Current Illness:

ID: 1629535
Sex: F
Age: 42
State: TX

Vax Date: 05/06/2021
Onset Date: 05/08/2021
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: 5/27/21- I had a full thyroid panel that came back in all normal ranges.

Allergies: None

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

Symptoms: I had severe diarrhea within the first 12 hours and then did not have a bowel movement for 10 days. I gained 10 lbs in less than 30 days. Since the injection, my hair has fallen out in large amounts at a time, I was tired all of the time, always cold, blurred vision, and have struggled to have normal bowel movements.

Other Meds: Potassium CoQ10 100 mg Methyl CpG Vitamin D3 5000 IU Omega 3 B12 Aspirin 81 mg Synthroid .025 mg Lisinopril 10mg x 1

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am