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: 1632404
Sex: M
Age: 65
State: PA

Vax Date: 01/28/2021
Onset Date: 08/20/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: 08/20/21 2134 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/20/21 0937 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/20/21 2134 COVID-19 PCR Collected: 08/20/21 0937 | Final result | Specimen: Swab from Nares

Allergies: NKA

Symptom List: Dysphagia, Epiglottitis

Symptoms: COUGH

Other Meds: atorvastatin (LIPITOR) 20 mg tablet hydrocortisone (CORTEF) 5 mg tablet

Current Illness:

ID: 1632405
Sex: M
Age: 78
State: NC

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 08/25/2021
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: none

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient came to pharmacy asking for Moderna COVID vaccine. Asked patient if they had ever received any COVID vaccine before to which he replied no he had not. Administered Moderna COVID vaccine on 8/25/2021 and added to database. Also logged in database was a completed series of Pfizer COVID vaccine in 2/2021 which was unknown to us when vaccine was administered. Per our policy we should not mix manufacturers unless absolutely necessary and must report to VAERS if we do.

Other Meds: unknown

Current Illness: unknown

ID: 1632406
Sex: F
Age: 46
State: NC

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
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: N/A

Allergies: CORN HUSKS

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

Symptoms: FEVER, CHILLS, MUSCLE ACHES, NAUSEA, ARM PAIN AT INJECTION SITE, SWEATING

Other Meds: SYNTHROID MULTIVITAMIN VITAMIN C ZINC IRON MELATONIN BIOTIN BENADRYL CALCIUM

Current Illness: NONE

ID: 1632407
Sex: F
Age: 52
State: MN

Vax Date: 08/22/2021
Onset Date: 08/22/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: NONE

Allergies: SULFA.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: BODY ACHES. LOOSE STOOL. CHILLS AND EXTREME HOT. SKIN SENSITIVITY. HEADACHE. JOINT PAIN. EYES HURT. DIZZINESS. INTESTINES FELT INFLAMED. SOMETIMES SYPMTOMS NOT ALL AT THE SAME TIME.

Other Meds: MESALEMINE. LEVOTHYROXINE. D3. C. B COMPLEX.

Current Illness: NONE

ID: 1632408
Sex: F
Age: 32
State: PA

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Fever, nausea, chest pain

Other Meds: Venlafaxine hcl

Current Illness:

ID: 1632409
Sex: M
Age: 59
State: IL

Vax Date: 03/26/2021
Onset Date: 08/12/2021
Rec V Date: 08/25/2021
Hospital: Y

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: indigestion and throwing up, once they put an EKG on him they noticed he was having heart attack and was hospitalized for 3 days, he had a stint put in his right coronary artery and now takes medication,

Other Meds:

Current Illness:

ID: 1632410
Sex: M
Age: 71
State: PA

Vax Date: 01/29/2021
Onset Date: 08/14/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: 08/17/21 2135 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/17/21 1349 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/17/21 2135 COVID-19 PCR Collected: 08/17/21 1349 | Final result | Specimen: Swab from Nares

Allergies: NKA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: FEVER, COUGH, Fatigue, Muscle or body aches, Congestion or runny nose, and Diarrhea

Other Meds: atorvastatin (LIPITOR) 10 mg tablet desoximetasone (TOPICORT) 0.25 % cream doxazosin (CARDURA) 4 mg tablet multiple vitamins (HEXAVITAMIN) tablet tablet ustekinumab (STELARA) injection

Current Illness:

ID: 1632411
Sex: F
Age: 43
State: NV

Vax Date: 06/01/2021
Onset Date: 07/01/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: not for a moment, but i am going to see a doctor soon

Allergies: penicillin, sea food

Symptom List: Pharyngeal swelling

Symptoms: Right after my first dose, i was sweating, by the next day, I got cold sores in my whole mouth in and out ( my tongue, my throat, and my lips were full of cold sores...my second dose, only my left arm hurts for about two- three days, by the middle of the week, I get rushes all over my body, I called my allergic doctor, because I thought it was for the allergy shots; but it's weird, I've been receiving the same shots and same amount before and no allergy reactions. Now, I decided not to get the allergic shots and I am still getting the rushes on my body and not only that, my arms swallow every night and I have to move my fingers slow, because I feel the pain.

Other Meds: none

Current Illness: none

ID: 1632412
Sex: M
Age: 29
State: NY

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: D Dimer blood test 6/7/21 CT Scan 6/16/21 Neurologist visit 7/20/21 MRI 7/27/21

Allergies: Sulfa, omnipaque

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Fever (101.6), muscle aches, chills, fatigue, blurriness/cloudiness; headache that has been consistent everyday since

Other Meds: Vitamin D

Current Illness: None

ID: 1632413
Sex: F
Age: 74
State: CA

Vax Date: 12/29/2020
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data: covid PCR+ 8/24. Fever, n/v/d, HA, sore throat. Not requiring oxygen currently.

Allergies: hydrocodone

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Hospitalized for COVID-19 disease

Other Meds: temazepam, protonix, losartan, metformin, atenolol, lipitor

Current Illness: NA

ID: 1632414
Sex: M
Age: 50
State: LA

Vax Date: 08/18/2021
Onset Date: 08/18/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Starting just after 11:00pm on the 18th of August 2021 I started to slightly shake like the chills. I was not cold or have a fever at this time. While this continued for around an hour or so it gradually became worse until around 1:00am on the 19th of August I started having full body convulsions shaking violently. The left side of my face and body felt like I had no control over it . My face felt like it was drooping and my leg was dragging all on my left side. Eventually around 3:00am the convulsions stopped. While the convulsions finally stopped my fever shot up to 101.9 at this time. I took two Tylenol for the fever and around 4:00 am it finally broke but I was freezing after my temperature went back down to 98.0. The next day I went to my doctor, Dr. I have been extremely weak since these events which have made it difficult to perform my job.

Other Meds: Benazepril/Amlodipine Atorvastatin Meloxicam

Current Illness: N/A

ID: 1632415
Sex: F
Age: 34
State: LA

Vax Date: 08/24/2021
Onset Date: 08/25/2021
Rec V Date: 08/25/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Severe body aches, headache, nausea, chills, sweating, passed out.

Other Meds:

Current Illness: None

ID: 1632416
Sex: F
Age: 37
State: PA

Vax Date: 03/31/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: 8/24 two rapid tests

Allergies: Sulfa

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

Symptoms: Tickle in throat and mild congestion.

Other Meds: No

Current Illness: No

ID: 1632417
Sex: F
Age: 71
State: TX

Vax Date: 02/22/2021
Onset Date: 08/15/2021
Rec V Date: 08/25/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Redness and tenderness at injection site for 24 hours

Other Meds: Losartan

Current Illness: none

ID: 1632418
Sex: M
Age: 66
State: PA

Vax Date: 01/29/2021
Onset Date: 08/17/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Updated Procedure 08/17/21 2136 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/17/21 1615 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/17/21 2136 COVID-19 PCR Collected: 08/17/21 1615 | Final result | Specimen: Swab from Nasopharynx

Allergies: ChlorhexidineHives / Urticaria Neomycin-bacitracnzn-polymyxnbHives / Urticaria, Rash

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

Symptoms: COUGH Internal Medicine COVID-19 virus infection Dx Medication Infusion Reason for Visit Progress Notes (Registered Nurse) ? ? Internal Medicine ? ? Encounter Date: 8/20/2021 ? ? Signed Patient is here for MAB Infusion O2 sats > or = 90% Signs of potential reaction reviewed with patient. Tolerated IV start and MAB infusion without complication. Pt has access to pulse oximeter and thermometer for home monitoring Discharge instructions reviewed. Patient denies any questions Pt's PCP is Dr Instructions COVID 19 Monoclonal Antibody (MAB) Infusion Patient Reference Guide MAB Infusion Treatment Team: Primary Care Physician: The physician that referred you for the infusion and who will conduct the follow-up appointments related to your infusion. COVID-19 MAB Navigator: The person who will schedule you for your infusion, ensure you schedule follow-up appointments as needed and that you have all the necessary tools to track your health. COVID-19 MAB Navigator Contact Information MAB Infusion Follow-up Plan: No COVID-19 vaccine for 90 days from your infusion date. Date: 11/20/2020 Day of Infusion: o You will be discharged home after your infusion. o You will begin recording your temperature and oxygen levels (pulse ox). Please log your temperatures and oxygen levels in your portal or on a piece of paper. The MAB Navigators will review these with you when they call. o Day 2-3 after Infusion: o You will receive a follow-up call from the COVID-19 MAB Navigator to review how you are feeling, your temperatures, oxygen levels and remind you to schedule your 7-day follow-up video visit with your Primary Care Physician. Day 10-11 after Infusion: o You will receive your final call from the Navigator. If you are doing well, you will graduate from the MAB Infusion Program. You will resume your routine appointments with your Primary Care Physician. When to call your Primary Care Physician: If you do not have a Primary Care Physician please go to the nearest Urgent Care: o Please call your Primary Care Physician if you have pre-existing health conditions that you feel need medical attention and are unrelated to your COVID-19 diagnosis and symptoms. o If you are experiencing non-life threatening COVID-19 symptoms and have additional questions. o Unrelieved temperature greater than 100.4 after taking Tylenol. When to call the COVID-19 MAB Navigator: o Please call the COVID-19 MAB Navigator if you have general questions regarding the infusion you received today, questions concerning follow up appointments, or home monitoring procedures & equipment. o You should receive a follow-up phone call from the Navigator within 2-3 days of receiving your infusion. o If you do not receive a follow-up phone call, please call the Navigator When to call 911 or Proceed to the closest Emergency Department: If you are experiencing life threatening COVID-19 symptoms including but not limited to: o high fever o trouble breathing o sustained oxygen level less than 90% after trying a different finger, deep breathing and coughing o persistent pain or pressure in the chest o new confusion o inability to wake or stay awake o blueish lips or face To help you breath easier: Try to spend as little time as possible on your back. When you lay on your back this causes fluid to pool in those parts of your lungs making it harder to breathe. Laying in different positions will allow all parts of your lung to expand properly. Eat meals sitting up in a chair when possible. Consider eating small frequent meals rather than three large meals. Try laying in a prone position, which is laying face down on your belly. Laying on your sides or sitting up in a chair is also helpful for breathing. If a position is too uncomfortable move to another position. Outpatient After Visit Summary (Printed 8/20/2021)

Other Meds: alfuzosin (UROXATRAL) 10 mg 24 hr tablet aspirin 81 mg tablet atorvastatin (LIPITOR) 20 mg tablet blood sugar diagnostic (ONETOUCH VERIO) strip BRILINTA 60 mg tablet coenzyme Q10 (CO Q10) 100 mg capsule insulin glargine 100 unit/mL (3

Current Illness:

ID: 1632419
Sex: F
Age: 57
State: NC

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/25/2021
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: Saphris

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

Symptoms: Face numb, headache, fever, chills, rash on chest, body aches

Other Meds: Bisoprolol, synthroid, Viibryd, gabapentin, Xanax, seroquel, crestor, celebrex

Current Illness: None

ID: 1632420
Sex: F
Age: 61
State:

Vax Date: 08/16/2021
Onset Date: 08/18/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: SARS COVID TEST - NEGATIVE

Allergies: Morphine, Latex, Sulfa.

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

Symptoms: Loss of taste.

Other Meds: None.

Current Illness:

ID: 1632421
Sex: M
Age: 59
State: FL

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: none reported

Allergies: none reported

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Series of events happened between 11am-11:15am: Pt said he was feeling warm and was sweating. I asked tech for bottle of cold water/thermometer and gave water to pt and took a temp from forehead. It read 94.4F twice. I asked if he had problems swallowing and he said he could swallow. He took one or two sips and then he started talking and suddenly stopped. He begin to mildly shake just enough to spill his water on his lap and the floor and as I went to grab it, he dropped the open bottle. He seemed as if he was having a mild seizure sitting upright with eye partially closed. I called for tech help with someone calling 911 and someone giving me napkins to catch the water. The patient came to within a minute or so and started talking to me that he's feeling better. Store management showed up. I asked the tech to go get me the blood pressure monitor. I asked patient his name, if he had diabetes, high blood pressure or on any medications. He said no and he was on his way to work. He didnt realize anything just happened. That's when EMT took over the scene.

Other Meds: none reported

Current Illness: none reported

ID: 1632422
Sex: F
Age: 37
State: FL

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data:

Allergies: Prednisone

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Bells Palsy

Other Meds:

Current Illness:

ID: 1632423
Sex: F
Age: 74
State: CO

Vax Date: 05/03/2021
Onset Date: 05/23/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: dental and medical evaluation

Allergies: penicillin, adhesive tape, food items

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

Symptoms: received vaccine at external site 5/3/21 Had onset of Right facial weakness, diagnosis of Bell's Palsy on 5/23/21

Other Meds: methimazole, multivtamin, metoprolol

Current Illness:

ID: 1632424
Sex: M
Age: 33
State:

Vax Date: 08/16/2021
Onset Date: 08/20/2021
Rec V Date: 08/25/2021
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:

Allergies:

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

Symptoms: Patient reported chest pressure and discomfort as well as shortness of breath. Pt. had elevated troponin and CXRP. Mild fever, migraine . Hx of connective tissue disorder. Sever swelling in lymph nodes. EKG showed diffuse ST-depression. Held for observation, and prescribed prednisone 40 mg and colchicine. On day of discharge was asymptomatic and able to ambulate.

Other Meds:

Current Illness:

ID: 1632425
Sex: M
Age: 41
State: KY

Vax Date: 03/12/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
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: Covid19

Other Meds:

Current Illness:

ID: 1632426
Sex: F
Age: 69
State: IL

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 08/25/2021
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 at pharmacy

Allergies: Morphine

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

Symptoms: After administering vaccine, patient started to bleed, enough for blood to start dripping down arm. Pressure applied, followed by bandaid. Vaccination site swelled within the first minute after administration. Patient reported severe headache and nausea. Cold pack applied to site, cold water provided to patient to sip. After 15 minutes, nausea diminished, headache and site swelling remained. Patient reported feeling "better besides headache". Patient obtained some generic excedrin 250mg/250mg/65mg and took 2 before leaving pharmacy.

Other Meds: Excedrin

Current Illness: None known

ID: 1632427
Sex: F
Age: 54
State: WA

Vax Date: 02/15/2021
Onset Date: 03/01/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: March 8, 2021: hemoglobin 10.7, hematocrit 35.3, MCV 78, MCH 23.7, MCHC 30.3, BUN/Creatinine ratio 24, chloride 107, HDL 37, Vitamin D3 25-hydroxy 117.0.

Allergies: Whole wheat, gluten, soy, mushrooms, dust, all tree pollens, all grasses, hay fever, cat dander, dog dander

Symptom List: Injection site pain, Pain

Symptoms: Diagnosed with iron deficiency anemia. Started taking ferrous sulfate 220mg liquid daily. Had normal upper endoscopy on August 3, 2021, normal colonoscopy on August 24, 2021 and scheduled for capsule endoscopy. Have had intermittent low O2 SATs between 87-92 with a baseline of 97. Occasional mild SOB and some mild orthostatic hypotension.

Other Meds: Omeprazole, vitamin D3, calcium, estrogen, progesterone, montelukast, NP thyroid, Flonase, azelastine nasal spray

Current Illness: None

ID: 1632428
Sex: M
Age: 18
State: WI

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
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: He has extreme aching and soreness in both hands. Still has the symptoms, 2 days after vaccination. Unable to improve symptoms with tylenol and ibuprofen.

Other Meds: none

Current Illness: none

ID: 1632429
Sex: M
Age: 78
State: VA

Vax Date: 08/20/2021
Onset Date: 08/21/2021
Rec V Date: 08/25/2021
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: NKDA

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

Symptoms: Client called office on 8/23/21 c/o "skin itching all over with tiny red bumps" appearing the following day after vaccination. Denies any other sx, however, client did state that he had trouble swallowing at one point the following day after sx began, but states he had not had any further instances of dysphagia. Advised client to notify his PCP and follow up in PCP office if warranted. Followed up with client on 8/25/21 via phone call and client states "red bumps are almost gone" and itching has resolved. Denies c/o any additional sx . client states he did not contact PCP as advised on 8/23/21 and declines need to do so at this time as well.

Other Meds: none listed

Current Illness:

ID: 1632430
Sex: F
Age: 55
State: FL

Vax Date: 08/12/2021
Onset Date: 08/14/2021
Rec V Date: 08/25/2021
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 test required

Allergies: Tetnus, Quinalones, Chamomille,

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: After a day or so started with coughing, then wheezing, with cough increasing, hoarse voice, weak tired, muscle aches Started to need to use inhaler this increased for several days over weekend, went to work on Monday, they sent me home, made me get Covid tested, This was negative. Still unable to return to work on Tuesday, some better on Wednesday with inhalers and had visit with MD to let her know what had been going on. She agreed with treatment of Symbicort Inhaler and Proair, Continue with Vitamins. Started to feel better about a week after vaccine. Still on 08/25/21 have some residual cough and using inhaler.

Other Meds: Vit B-12, Vit D3, Levothyroxine, Topamax, Carbamazepine, Metoprolol ER, Minivelle Patch, Progesterone Cap, Omeprazole, Symbicort, Proair, Azithromycin PRN, and Entyvio infusions every 8 weeks

Current Illness: Ulcerative Colitis,

ID: 1632431
Sex: M
Age: 32
State:

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever on same day of second dose of the Moderna COVID-19 vaccine (5/7/2021). For a week (5/7/2021 - 5/14/2021) I had an accelerated heart rate, high blood pressure and rashes along the left arm and leg. These symptoms I have never experienced since I do not have any medical conditions and have never had an allergic reaction to any food, drink or medication.

Other Meds: None

Current Illness: None

ID: 1632432
Sex: M
Age: 75
State: OH

Vax Date: 02/17/2021
Onset Date: 08/02/2021
Rec V Date: 08/25/2021
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: COVID-positive

Allergies: Shelled shrimp

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

Symptoms: On 8/2 after being fully vaccinated I tested positive to COVID. I experienced SOB but no other symptoms were associated. 8/4 I had the infusion.

Other Meds: Lisinopril; Statin

Current Illness: No

ID: 1632433
Sex: F
Age: 78
State: FL

Vax Date: 02/17/2021
Onset Date: 08/04/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: No

Allergies: Macrobid antibiotic

Symptom List: Nausea

Symptoms: On August 04, 2021, I had severe itching and rash on the left upper side of my back. I had a virtual visit with the doctor on Monday, 08/09/2021 and it was diagnosed as shingles. She prescribed antiviral for 7 days, I don't remember the name. By the end of the 7 days it was getting better. Within a week after completing the medication, it completely resolved. I don't feel like there is any relationship with me getting shingles and the Moderna vaccine.

Other Meds: Metoprolol; raloxifene; lisinopril; pravastatin; omeprazole; calcitonin nasal spray; low dose aspirin; vitamin D; multivitamin; calcium magnesium; vitamin C

Current Illness: No

ID: 1632434
Sex: M
Age: 77
State: CO

Vax Date: 01/21/2021
Onset Date: 08/07/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data:

Allergies: Latex, penicillin, sulfa

Symptom List: Injection site pain

Symptoms: Patient hospitalized for covid-19 pneumonia in August after completing the Moderna vaccine series in February

Other Meds: allopurinol, Vitamin C, Symbicort 160-4.5, colchicine, apixaban, escitalopram, ferrous sulfate, finasteride, furosemide, lisinopril, metformin, omeprazole, simvastatin, Spiriva respimat, Ocuvite

Current Illness: None

ID: 1632435
Sex: M
Age: 44
State: AZ

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Covid 19 Vaccine is the only variable associated with my current state of health.

Allergies: none

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

Symptoms: Shot was administered at my pharmacy, not at the Dr. office. Next day reactions that continue today are as follows: Headache, body ache, joint pain, nausea, diarrhea, dizziness, fatigue, shortness of breath, congestion, shortness of breath.

Other Meds: Multi-Vitamin

Current Illness: none for over 3 years

ID: 1632436
Sex: F
Age: 56
State: FL

Vax Date: 08/22/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
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: NKA

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

Symptoms: GI Bleed

Other Meds:

Current Illness:

ID: 1632437
Sex: M
Age: 79
State: PA

Vax Date: 01/30/2021
Onset Date: 08/14/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data: 08/16/21 2224 Respiratory virus detection panel Collected: 08/16/21 2032 | 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 Metapneumovirus Not Detected ED to Hosp-Admission Discharged 8/16/2021 Surg Nursing Imaging Results Procedure Component Value Ref Range Date/Time X-ray chest 1 view, Portable Resulted: 08/16/21 2152 Order Status: Completed Updated: 08/16/21 2152 Narrative: PROCEDURE INFORMATION: Exam: XR Chest Exam date and time: 8/16/2021 8:48 PM Age: 79 years old Clinical indication: Shortness of breath; Additional info: Suspected sepsis. Suspected sepsis TECHNIQUE: Imaging protocol: XR of the chest. Views: 1 view. COMPARISON: DX RAD CHEST PORTABLE 9/22/2017 11:23 AM FINDINGS: Lungs: Left mid and lower lung pleural calcification is again demonstrated. Patchy left mid and lower lung opacification may be related to chronic scarring and/or atelectasis. Superimposed infection is possible. Pleural spaces: See "Lungs" finding. Heart/Mediastinum: Unremarkable. No cardiomegaly. Diaphragm: There is mild elevation of the left hemidiaphragm. Bones/joints: Unremarkable. IMPRESSION: Left mid and lower lung pleural calcification and probable scarring and/or atelectasis. Superimposed infection is possible.

Allergies: NKA

Symptom List: Tremor

Symptoms: fever, cough, not feeling well, vomiting ED to Hosp-Admission Discharged 8/16/2021 - 8/21/2021 (5 days) Hospital MD Last attending Treatment team Shortness of breath Principal problem Care Coordination Progress Note LPN (Licensed Nurse) referral received for Covid today. Called ato screen patient. Reached patient in hospital room, but patient states he is HOH over phone and requests I call wife. She was educated on the program and its benefits. He is appropriate and agreeable to the program. Kit to be delivered to their home by delivery service. She was advised to go ahead and open up the kit when when it arrives to their home unpack the tablet and charger, charge the tablet, and then turn on the tablet which will walk her through an instructional video to explain how to obtain his first set of vitals. Patient was also given our contact information. One of the RNs, with the program will call her after receiving the first set of vitals to further explain the program. patient verbalized understanding. Patient reports having the following equipment Scale, Blood pressure cuff and monitor and thermometer. Kit direct shipped to patient's home. Program referral re entered in EMR. Original did not populate into computer program. After several attempts referral still did not populate into computer. Profile entered manually.kit assigned

Other Meds: amLODIPine (NORVASC) 10 mg tablet aspirin 81 mg tablet atorvastatin (LIPITOR) 80 mg tablet cefuroxime (CEFTIN) 500 mg tablet dexAMETHasone (DECADRON) 2 mg tablet folic acid/multivit-min/lutein (CENTRUM SILVER ORAL) hydrALAZINE (APRESO

Current Illness:

ID: 1632439
Sex: M
Age: 17
State: WA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/25/2021
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: Erythema, Pruritus

Symptoms: Patient called me at the pharmacy on 08/24/2021 after receiving the Pfizer vaccine the day before. He reported "rash on face and itchiness on face and neck" the day after receiving the first dose of Pfizer. I asked him to see a doctor regarding his reaction and unsure if he has yet.

Other Meds:

Current Illness:

ID: 1632440
Sex: M
Age: 79
State: UT

Vax Date: 02/25/2021
Onset Date: 03/25/2021
Rec V Date: 08/25/2021
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: MRI--August 17, 2021; Blood tests--August 23, 2021.

Allergies: None

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

Symptoms: Initial blurry vision (March 25, 2021) that then became doubled (July, 2021) and diagnosed with a 4th Cranial Nerve Palsy (August 16, 2021).

Other Meds: OTC-- Vit. D3 Vit. E B-complex Cranberry extract CoQ-10 Krill Omega 3 Zinc Magnesium Citrate Rx-- Fluconazole 200 mg, every 3rd day Fluoxetine 20 mg, take periodically.

Current Illness: None

ID: 1632441
Sex: F
Age: 35
State: FL

Vax Date: 07/23/2021
Onset Date: 07/24/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Went to my specialist for annual exam and ran blood work and everything came back fine.

Allergies: Gluten

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

Symptoms: Right Arm Pain, Right swollen lymph nodes , right shoulder and neck swelling and pain for first week. From day of vaccination (7/23) to Currently (8/25) my entire body is still extremely swollen from head to toe and my hormones are out of wack and my menstrual cramps have been excruciating. Before shot, all of my hormonal symptoms were under control. I do not know how to get rid of the swelling and pain and fear that I have permanently made my condition (endometriosis) worse.

Other Meds: Birth Control - Microgestin Vitamin B, C, D zinc

Current Illness:

ID: 1632442
Sex: M
Age: 46
State: VA

Vax Date: 01/01/2021
Onset Date: 03/01/2021
Rec V Date: 08/25/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Infrequent (4-5x per week) 'heavy' heart beat. Lasts 15-30 seconds. Creates a sense of anxiety/panic. Uncorrelated with actual emotions/anxiety level, environmental conditions, diet, or exercise.

Other Meds: Fish oil, joint support (MSM/Glucosamine/Chondroitin), Red Yeast Rice, men's multivitamin, probiotic, CLA

Current Illness: none

ID: 1632443
Sex: F
Age: 36
State: TX

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
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: KETAMINE, LORTAB, LATEX

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

Symptoms: Right arm began to itch at vaccination site. Patient later notified staff that she was allergic to latex

Other Meds: AMOXICILLIN

Current Illness: EAR INFECTION

ID: 1632444
Sex: M
Age: 16
State: TX

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 08/25/2021
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: MRIs, CTs, Infectious disease blood test, and still testing

Allergies: n/a

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

Symptoms: Dropy Ear and speech issues, still occuring

Other Meds: Multi Vitamin and Vit C

Current Illness: n/a

ID: 1632445
Sex: F
Age: 30
State: TN

Vax Date: 08/13/2021
Onset Date: 08/17/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: 8/20/21 - No tests at clinic. Given antihistamines and hydrocortisone cream. 8/21/21 - Went to urgent care. Had EKG showing sinus tachycardia. Confirmed fever. 8/24/21 - Went to clinic again for chest pain and shortness of breath. Had another EKG and chest X-ray. Still waiting on x-ray results to be called in by the MD.

Allergies: No known allergies

Symptom List: Pain in extremity

Symptoms: Severe shortness of breath, chest pain, dizziness, tachycardia, heart pounding, tremors, hives with whelps, itchiness, fever, night sweats, fear of doom, shoulder pain, nausea, headaches, all over body aches and tenderness. Medications included Benadryl, hydrocortisone cream, famotidine, Vistaril, Allegra, Tylenol. Most of these symptoms have been going on for 7 days.

Other Meds: Multivitamin, CoQ10, Vitamin D3

Current Illness: None

ID: 1632446
Sex: F
Age: 48
State: PA

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: No

Allergies: Constract dye

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

Symptoms: Was tired, joint pain, fever, chills, couldn't eat.

Other Meds: Aleve

Current Illness: No

ID: 1632447
Sex: M
Age: 61
State: LA

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
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: Bactrim

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

Symptoms: Chills, weakness, muscle/joint aches

Other Meds: None

Current Illness: None

ID: 1632448
Sex: F
Age: 53
State: MD

Vax Date: 04/30/2021
Onset Date: 07/01/2021
Rec V Date: 08/25/2021
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: Celiac anything gluten; Latex; Erythromycin; Tetracycline

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

Symptoms: My rash on my back has flared up again, welched up and it is worsening. The rash I have produces this huge welch, and it is white in the middle. They are painful and very itchy. I have pictures of my rash when it flares up and it does not seem to be going away. I also get muscular pain when walking up the stairs. I feel my muscles are on fire, and I get spasms on the right leg and thigh. My rash has been worsening and does not seem to be going away.

Other Meds: Multi Vitamin; probiotic; Adderall; Pantoprazole; valium

Current Illness:

ID: 1632449
Sex: F
Age: 17
State: AZ

Vax Date: 08/18/2021
Onset Date: 08/19/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data:

Allergies: No known allergies to foods or medications

Symptom List: Vomiting

Symptoms: She reports headache, fatigue, nausea, diarrhea and intermittent facial flushing. She had photo sensitivity yesterday (8/18/2021) . She now has numbness that radiates from her back up her neck whenever she sits down.

Other Meds: Patient takes Ibuprofen as needed Patient takes birth control pills as directed

Current Illness: Foot pain Tonsillitis

ID: 1632450
Sex: M
Age: 67
State: PA

Vax Date: 02/02/2021
Onset Date: 08/12/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: 08/16/21 0229 Respiratory virus detection panel Collected: 08/16/21 0108 | 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 Metapneumovirus Not Detected Imaging Results Procedure Component Value Ref Range Date/Time X-ray chest 1 view - Portable [3297896452] Resulted: 08/16/21 0644 Order Status: Completed Updated: 08/16/21 0644 Narrative: XR CHEST 1 VW PORT IMPRESSION: AP upright portable chest x-ray shows no acute pulmonary process. END OF IMPRESSION: INDICATION: Cough, fever, shortness of breath. TECHNIQUE: Portable AP view of the chest was obtained. COMPARISON: January 7, 2019. FINDINGS: The cardiac silhouette is normal in size and contour. Both lungs are fully expanded. There is no focal infiltrate or consolidation. No visible pleural effusion.

Allergies: NKA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: ED Discharged 8/15/2021 - 8/16/2021 (5 hours) Hospital ED MD Last attending ? Treatment team COVID-19 virus infection +1 more Clinical impression Fever ? Flank Pain ? Cough Chief complaint ED Provider Notes DO (Resident) ? ? Emergency Medicine Cosigned by: MD at 8/16/2021 2:14 PM Expand AllCollapse All ED RESIDENT NOTE Patient: MRN: Attending: Dr. Chief Complaint Chief Complaint Patient presents with ? Fever ? Flank Pain ? Cough History of Present Illness Patient is a 67 y.o. male with a history of COPD, hepatitis C, hypertension, presenting to the ED with multiple complaints. Patient reports productive cough, congestion, some shortness of breath, body aches, fatigue, headache. He reports right flank pain. He reports that his symptoms have been going on for about a week and a half. He states the pain in his right flank is worse with movement. Patient recently had an outpatient ultrasound of his liver after having elevated LFTs on labs. Patient has had both his Covid vaccines. Denies recent sick contacts. Denies known Covid exposure. Denies dysuria, urinary symptoms, hematuria. Denies abdominal pain, nausea, vomiting, diarrhea. Medical Decision Making Patient is a 67-year-old male presenting the emergency department with multiple complaints, see HPI. Patient's vital signs are stable upon arrival, nearly febrile. He appears in no acute distress, however does appear uncomfortable secondary to his symptoms. Heart is regular rate and rhythm. Lungs are clear to auscultation bilaterally, no wheezes or rales. Nonpitting peripheral edema. Tenderness to palpation over right lower back. No CVA tenderness or midline lumbar spine tenderness. Differential includes Covid, pneumonia, musculoskeletal back pain, kidney stone, lower suspicion for aortic pathology. Will obtain labs, EKG, chest x-ray, CT abdomen pelvis. Will give Toradol and lidocaine for his symptoms. ED Course as of Aug 16 0801 Mon Aug 16, 2021 0159 Laboratory evaluation shows no leukocytosis, H/H stable, electrolytes within normal limits, normal kidney function, AST 128, ALT 142, which are improved from previous lab work. Urinalysis does not show signs of infection or stone. 0240 COVID-19 SARS-CoV-2 Overall Result(!!): Detected 0320 No acute findings. No focal infiltrates or consolidations. X-ray chest 1 view - Portable 0320 Patient maintained oxygen saturations of 94 to 95% on room air while ambulating. 0344 CT scan of the abdomen and pelvis with contrast shows no specific cause of the patient's right flank pain. There is minimal calcification in the dependent portion of the bladder. The gallbladder is normal in size and contour. No acute obstruction. There are small lymph nodes in the retroperitoneum and central abdomen. This is nonspecific and correlation should be made with patient's history. Calcifications are present. Normal bony structures. CT abdomen pelvis without contrast 0455 Patient reports some improvement in his symptoms with given medications. Patient able to ambulate without difficulty and maintaining his oxygen saturations. Patient stable for discharge. He will be discharged home with a pulse oximeter. He was given return precautions regarding his Covid status. He was also given Covid isolation precautions. Prompt follow-up with his PCP. Discussed appropriate outpatient medications. Given strict ED return precautions. He voiced understanding was agreeable to plan. ED Course User Index

Other Meds: clobetasoL (TEMOVATE) 0.05 % cream furosemide (LASIX) 20 mg tablet lisinopriL (ZESTRIL) 10 mg tablet meclizine (ANTIVERT) 25 mg tablet

Current Illness:

ID: 1632451
Sex: F
Age: 52
State: NV

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 08/25/2021
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: NONE

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

Symptoms: NAUSEA, VERTIGO, VOMITING, EXTREME FATIGUE, LOW FEVER, ACHING, EXTREMELY PAINFUL ARM AT INJECTION SITE, DIMINISHING OVER TIME BUT LOST 7 DAYS OF WORK/NORMAL LIFE.

Other Meds: ESTRADIOL-NORETH 1-0.5 MG TAB

Current Illness: NONE

ID: 1632452
Sex: F
Age: 73
State: MA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 08/25/2021
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: EKG, Echocardiogram

Allergies: Penicillin, some eye makeup, some skin creams, wool, sheep, pineapple

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I stayed the required 15 min. Then while driving home I felt a very sharp pain travel up my left arm, and I felt a little lightheaded. I immediately turned on the AC which made me feel better. I continued driving home , another 15 minutes. I rested for a little while and felt like myself again. I told my self that I had just had a delayed reaction to the shot, and thought all was well. I had no other side effects, not even a sore arm. Two months later June 15, I had an EKG in my doctors office, because it was required before my cataract surgery. It was abnormal, and the doctor told me I may have suffered a heart attack. My previous EKG (2 years earlier) also before cataract surgery, was normal. The doctor also told me there was nothing active going on now. She Showed my results to a cardiologist who sent me for an echocardiogram.

Other Meds: Extra strength Tylenol, vitamin D, Cranberry

Current Illness: None

ID: 1632453
Sex: M
Age: 39
State: NV

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: NA

Allergies: Shrimp - Anaphylaxis

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

Symptoms: Expired dose administered in error. Expired 8/8/2021. Notified manufacturer Sanofi Pasteur, spoke with Medical Staff dept. Per Sanofi does not endorse using vaccine past the expiration, states there have not been studies done on efficacy after expiration date printed on vial, expired doses are considered invalid, and per CDC recommendation dose should be repeated as soon as possible. Doctor notified, dose repeated with valid vaccine / current expiration date.

Other Meds: None

Current Illness: Knee pain Dog bite wound

ID: 1632454
Sex: M
Age: 63
State: CA

Vax Date: 07/14/2021
Onset Date: 08/13/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: n/a

Allergies: NKA

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

Symptoms: Per mom, the affected individual received a second dose of the covid vaccine on 8/13/2021 . On 8/21/2021, mom said the individual was unable to get up, walk, or do his normal activities of daily living. He fell three times within one night, at 8pm, 9pm, and 2am. He had to be bathe and taken care of by the family. Per mom, they called the ambulance and paramedics advised them not to take him to the hospital due to having signs and symptoms of a minor stroke only. Therefore, the individual was not taken to the hospital and instead, taken to city where his wife and sons reside.

Other Meds: Aspirin 81mg, vitamin C 500mg, folic acid 400mcg, mulivitamin, nitroglycerin 0.4mg, potassium chloride 10mEq, vitamin D3 50mcg (2,000 unit)

Current Illness: CAD, dental caries, hearing loss, refractive error, vitamin D deficiency, hypokalemia, folic acid deficiency

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am