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: 1632507
Sex: F
Age: 39
State: TX

Vax Date: 12/21/2020
Onset Date: 12/24/2020
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: MRI -Cervical 7-23-2021 Electromyogram (EMG) Test 6-14-2021 Nerve Conduction Study (NCS) 6-14-2021

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: I started having migraine issues (no prior history) intense pain in the head, sensitive to light, blurred vision, and not able to concentrate (December). I have numbness, pins and needle sensations from the elbow to the fingers, extreme temperature differences between fingers, loss of strength in arms, extreme sharp pain in both elbows (Bi-lateral ulnar nerve entrapment symptoms).

Other Meds: none

Current Illness: non

ID: 1632508
Sex: F
Age: 41
State: CO

Vax Date: 01/30/2021
Onset Date: 06/16/2021
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: I went to the emergency room that night, and to the OB 3 days post the incident. In the emergency room they did bloodwork and ultrasound and in the OB office repeated bloodwork to confirm it has occured.

Allergies: none

Symptom List: Anxiety, Dyspnoea

Symptoms: I had a miscarriage.

Other Meds: prenatal vitamins and folic acid

Current Illness: none

ID: 1632509
Sex: F
Age: 43
State: DE

Vax Date: 08/11/2021
Onset Date: 08/12/2021
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: Blood work.

Allergies: Acrylic; most adhesives; latex; Augmentin; penicillin

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

Symptoms: First day I was scared to go to sleep, I took Tylenol and Motrin off and on, because my first dose I didn't feel well. I fell asleep at 5 am, I was very weak, dizzy, fatigued and that last about 24 hours. My arm pain started radiating and moving towards my entire arm and into my left breast became swollen and my lymph nodes were swollen, then I started having severe diarrhea. Then my blood pressure 165/103 went up and had a horrible headache. I went to hospital afraid I was going to have another stroke. They did blood work and pushed fluids, waited for my BP to come down and discharged. I still feel very sluggish and I'm still get sharp cramping and I feel nauseated. I'm taking medication for GERD.

Other Meds: Benadryl; Motrin; Tylenol; propranolol; aspirin; HCTZ; nephadaphine; Magox; multivitamin

Current Illness:

ID: 1632510
Sex: F
Age: 27
State: TX

Vax Date: 02/13/2013
Onset Date: 02/14/2013
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: Ultrasound revealed my uterus had stopped building up lining causing infertility.

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Immediately stopped having a minstrel cycle

Other Meds: None

Current Illness: None

ID: 1632511
Sex: M
Age: 64
State: TN

Vax Date: 08/09/2021
Onset Date: 08/10/2021
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: EKG 08/23/2021

Allergies: N/A

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

Symptoms: Pt. states that after receiving the 2nd dose of Moderna 08/09/2021, started experiencing symptoms 08/10/2021 of lose stool, weakness, chest pain, fatigue, chills, and A-fib (2 Valve replacement 07/19/2021). Primary visit 08/17/2021. Cardiologist appt. 08/26/2021 A-Fibrillation repair. Symptoms have subsided, exemption to A-Fibrillation.

Other Meds: Fluid pill, Alpurol, Elaquix, Lasitapril, Matrolapal, Trazadone, Prazalam, Potassium Chloride

Current Illness: N/A

ID: 1632512
Sex: M
Age: 76
State: KY

Vax Date: 03/09/2021
Onset Date: 08/24/2021
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: Respiratory Panel PCR w/COVID-19(SARS-CoV-2) CXRAY

Allergies: Irbesartan (anaphylaxis) Molindone (Anaphylaxis) Hydralazine (arrhythmia) PCN (rash) Atorvastatin (myalgia)

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

Symptoms: Patient diagnosed with Covid-19

Other Meds: Bumex, Clonidine, Plavix, Imdur, Nebivolol, Renvela, Insulin Degludec

Current Illness: HD, DM, BMI of 30.89 kg/m2

ID: 1632513
Sex: F
Age: 68
State: IL

Vax Date: 06/15/2021
Onset Date: 06/01/2021
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: HEARING TEST PERFORMED BY AUDIOLOGIST ON 8/5/2021, MRI SCHEDULED FOR 8/27/2021

Allergies: NKA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: DIMINISHED HEARING IN BOTH EARS, DIZZINESS AND RINGING/BUZZING IN EARS AFTER 1 ST DOSE ADMINISTERED ON 6/15/2021. LOSS OF HEARING IN RIGHT EAR, TINNITIS AND VERTIGO AFTER 2ND DOSE ADMINISTERED ON 7/6/2021. PRIMARY CARE PHYSICIAN REFERRED TO ENT FOR TESTING. ON 8/5/2021 HEARING TEST PERFORMED BY AUDIOLOGIST SHOWED VERY LITTLE HEARING IN RIGHT EAR. ENT PRESCRIBED TREATMENT OF ORAL PREDNISONE FOR24 DAYS AND REFERRED FOR MRI. MRI SCHEDULED FOR 8/27/2021 AND FOLLOW UP WITH AUDIOLOGIST & ENT ON 8/31/2021.

Other Meds: ATORVASTATIN 40 MG DAILY, LISINOPRIL 10 MG DAILY, EYE PROMISE RESTORE DAILY, FLORASTOR 500 MG PROBIOTIC DAILY, PROLIA 60 MG/ML SOLUTION SUBCUTANEOUSLY SEMI-ANNUALY (ADMINSTERED OM 6/18/21)

Current Illness: NONE

ID: 1632514
Sex: F
Age: 46
State: MI

Vax Date: 08/17/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

Symptom List: Pharyngeal swelling

Symptoms: Tired the next day. Lots of little muscle spasms in my left arm and left eye.

Other Meds: Zofran, Prozac, Losartin HTC, taxotere, perjeta, kanjinti, benadryl.

Current Illness: Metastatic breast cancer

ID: 1632515
Sex: F
Age: 17
State: IN

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:

Allergies: Codine, Polymixin B, Sulfa, Silicone, Aspratame

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Extreme fatigue, dizziness, blurred vision, very low blood pressure, hot and cold flashes, disoriented

Other Meds: Guanfacine, Zoloft, Klonopin

Current Illness: N/A

ID: 1632516
Sex: M
Age: 76
State: OH

Vax Date: 01/27/2021
Onset Date: 02/06/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Did echocardiogram March 4, heart cath March 25 approx, cardioversion April 21 and muga scan Aug 16

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Shortness of breath, Dr. diagnosed Atrial Fibulation

Other Meds: Lansoprazole 30mg 1 per day, Pravastatin 40mg 1 per day, Doxasosin 0.4 mg 1 per day, Centrum Dilver 1 per day, Carvedilol 12.5 mg 1 per day, Benezepril 10mg 1 per day, Aspirin 81mg 1 per day

Current Illness: none

ID: 1632517
Sex: F
Age: 28
State: AK

Vax Date: 08/22/2021
Onset Date: 08/23/2021
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: chemistry, cbc, covid test, x-ray, urinalysis

Allergies: pseudophedrine

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

Symptoms: Patient developed fevers, chills, muscle twitches, vomiting, and dizziness one day after receiving the vaccine. 2 ED visits since the reaction

Other Meds:

Current Illness:

ID: 1632518
Sex: F
Age: 49
State: CA

Vax Date: 08/19/2021
Onset Date: 08/19/2021
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: N/A

Allergies: NKA

Symptom List: Rash, Urticaria

Symptoms: Severe sore on the injection site, Fever of 101.5, severe muscle aches, and severe headaches

Other Meds: Multi-vitamins, Vit D3, Vit B12, Vitamin C

Current Illness: None

ID: 1632519
Sex: F
Age: 35
State: SC

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

Lab Data:

Allergies:

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

Symptoms: Tachycardia had to go to emergency department

Other Meds:

Current Illness:

ID: 1632520
Sex: F
Age: 56
State: SC

Vax Date: 08/20/2021
Onset Date: 08/20/2021
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: MSG, latex

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

Symptoms: Very sore arm 3 days 101.3 temp 2 days Body aches/chills 2 days Headache 1 day

Other Meds: Sulfasalazine, welbutrin, hydrochlorothyazide Fiber, probiotic, folic acid, calcium, vitamin D3

Current Illness:

ID: 1632521
Sex: F
Age: 63
State: CA

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

Allergies: Environmental and Flu vaccine.

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

Symptoms: 17 minutes after injection patient notice a tingling in the left side of her face and the sensation that it was swollen ( it did not appear swollen) She also had a very strong metallic taste in her mouth. She administered her own Benadryl at 8:40. Patient began coughing and vomiting and became dizzy about 5 minutes later. At this time it was decided to administer Epi Pen 0.3mg and 911 was called. 8:50am pulse was 105 Blood pressure was 172/99 and O2 was 99 at 8:54 am O2 was 97 this is about the time the EMT's arrived and took over care.

Other Meds: Diazepam, Diclofenac Sodium, Diclofenac Misoprostol, Epinephrine, Hydrochlorothiazide, Meclizine, Zofran, Tramadol

Current Illness:

ID: 1632522
Sex: F
Age: 40
State: NJ

Vax Date: 04/12/2021
Onset Date: 04/16/2021
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: n/a OBGYN appointment on 8/30/21 Wellness exam on 9/7/21

Allergies: Codine Sorbitol-potassium sorbate, berries, honey, grapes, agave syrup, brown rice syrup, tapioca syrup, plums, asparagus, cough syrup

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

Symptoms: Within 12 hours, 103 fever, vomiting, migranes. Lasted 3 days. Within 4 days, joint pain (fingers, hands, wrists, ankles, hips, knees. This lasted a week. It now flares up every 7-10 days. I can't lift groceries, can't do push ups, can't do yoga. My wrists and fingers especially swell. By next menstrual cycle (9 days later) and continuing menstual cycles since 4/21/21, extremely heavy periods with a lot of pain in lower abdomen near ovaries. Periods so heavy that I am unable to leave the house for the first 2 days. This has never been the case since my first period in 1994.

Other Meds: Nasonex Women's One-A-Day Magnesium Probiotic

Current Illness: None

ID: 1632523
Sex: F
Age: 31
State:

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

Allergies:

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

Symptoms: Patient complained that two days after the shot that she started experiencing muscle spasms in the opposite arm and her legs. The spasms have continued now for 3 days

Other Meds:

Current Illness:

ID: 1632524
Sex: F
Age: 39
State: MA

Vax Date: 08/20/2021
Onset Date: 08/21/2021
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: cbc

Allergies: nkda

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pfzizer vaccine 8/20. ONset of back pain. onset of dizziness, migraine Saturday. Pounding migraine. photophobia and body aches. She has "never felt this sick before" pfizer ew0185

Other Meds: citalopram

Current Illness: no

ID: 1632525
Sex: F
Age: 57
State: CA

Vax Date: 08/16/2021
Onset Date: 08/17/2021
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: no

Allergies: no

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: upset stomach, bad dreams, fever, chills, vomiting, diaherra, pain throughout the body, night sweats

Other Meds: lisinopril-hctz,

Current Illness: no

ID: 1632526
Sex: M
Age: 34
State: MA

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

Allergies: n/a

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

Symptoms: A the time of injection my heart rate dropped to 49 BPM and for 30 minutes yoyoed between 50 BPM and 120BPM.My heart rate stabilized after time and I was encouraged to leave the vaccine site and contact ambulance if the problem persisted. Upon returning home i found myself extremely fatigued and slept earlier than usual as i did not feel myself. On 08/24/2021 I woke with pain in my left ankle, similar to an ankle sprain with minor swelling. I have been checking my temperature to check for fever and i am running from 98.1-99.00. I usually record a temperature at around 96.5. I regularly record my heart rate on my apple watch and have noticed that my resting heart rate has been higher since vaccination. aprox 10-20 BPM increase from my usual resting rate. I have also dropped to 54 BPM on occasion which is not normal for me,. I also notice that my heart rate has entered the exercise range even when i have been inactive however this seems to stopped on day three of vaccination. I have noticed a fluttering feeling in my chest which i am attributing to my heart. This has been less noticeable since vaccination. Additionally i have some soreness and redness at the injection site. I live in a humid area but also notice that i may be sweating more than usual.

Other Meds: n/a

Current Illness: n/a

ID: 1632527
Sex: F
Age: 25
State: MD

Vax Date: 06/22/2021
Onset Date: 07/24/2021
Rec V Date: 08/25/2021
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: Negative pregnancy test done on July 30th and August 15th.

Allergies: None

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

Symptoms: I WAS SUPPOSED TO SEE MY PERIOD ON THE 17TH OF JULY OR LATEST 23RD of July but still haven't received it. My period is usually regular so this is very odd for me. Did a pregnancy test twice and they were all negative. Today's date is 8/25/2021 and i still haven't had my period. Its scary and i request this adverse effect be looked into because i have friends going to their 4th month without a period.

Other Meds: None taken

Current Illness: None

ID: 1632528
Sex: F
Age: 78
State: MI

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

Symptom List: Unevaluable event

Symptoms: Pt has been having shortness of breath with dry cough for 4 days. She lives with daughter and son who both have been diagnosed with COVID.

Other Meds: Actos 30mg PO atorvastatin 40mg PO at bedtime Catrate 600 + D qday Celebrex 200mg oral qday lisinopril 20mg at bedtime metformin 1000mg PO qPM oxybutynin 5mg PRN PO bid Synthroid 100mcg PO qday Vitamin B12 1000mcg qday Vitamin D3 1000 intl

Current Illness:

ID: 1632529
Sex: M
Age: 36
State: KY

Vax Date: 08/24/2021
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:

Allergies:

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

Symptoms: Body aches, pain at injection site, nausea

Other Meds:

Current Illness:

ID: 1632530
Sex: F
Age: 52
State: MN

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

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient was exposed to a positive co-worker at place of employment and started with symptoms 3 days later.

Other Meds:

Current Illness:

ID: 1632531
Sex: F
Age: 41
State: NC

Vax Date: 02/12/2021
Onset Date: 02/14/2021
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: ACE inhibitors

Symptom List: Injection site pain, Menorrhagia

Symptoms: Blisters and aphthous ulcers inner lower lip area.

Other Meds: buproprion, celecoxib, duloxetine, fluticasone nasal, hydrochlorothiazide, prazosin, armour thyroid, tizanidine

Current Illness: none known

ID: 1632532
Sex: M
Age: 81
State: VA

Vax Date: 02/01/2021
Onset Date: 06/01/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data:

Allergies: REACTION TO CODIENE

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

Symptoms: MY PSA HAD INCREASED PRIOR TO MY VACCINATIONS AND INCREASED AGAIN AFTER MY TWO MODERNA VACCINATIONS. MY UROLOLGIST MENTIONED THAT THEY WERE SEEING APSA INCREASE ON SOME PATIENTS AFTER COVID VACCINATION. I AM BEING TREAT FOR ENLARGED PROSTATE AND UNDER EVALUATION FOR THE INCREADED PSA VALUES.

Other Meds: FINESTERIDE 5MG PREVASTATIN 20MG LISINOPRIL 10MG ASPIRIN 81MG CENTRUM SILVER

Current Illness: NONE

ID: 1632533
Sex: F
Age: 36
State: FL

Vax Date: 07/28/2021
Onset Date: 08/04/2021
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: Blood work normal, x-ray normal, Covid test negative.

Allergies: Penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I started having shortness of breath, sitting or walking. I went to see my doctor because I thought I had Covid. They did the test and it was negative. It continued for the next week. I went to urgent care and told them about my symptoms. They prescribed me a Zpack and an inhaler. I just used the inhaler because I did not feel sick. I started to get chest pain a few days later. I started to get real bad chest pain so I went to emergency room. They only prescribed an inhaler. They did blood work and an x-ray, which came back normal. I still have shortness of breath.

Other Meds: Prenatals

Current Illness: None

ID: 1632534
Sex: M
Age: 38
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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data: none

Allergies: NKDA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: The vaccine that was administered was expired. RN, failed to waste/discard of the unused vaccines from Monday 08/23/21.

Other Meds: none

Current Illness: unknown

ID: 1632535
Sex: F
Age: 74
State: NJ

Vax Date: 02/05/2021
Onset Date: 07/01/2021
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:

Allergies: Ketoconazole, fluconazole, NSAIDs, naproxen, oxycodone, penicillin, hair dye

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

Symptoms: Moderna COVID-19 Vaccine EUA: Vaccine recipient further reported to have a history of sarcoidosis (2010), valve replacement (2014), and dual pacemaker/defibrillator (July 2021). She has had sarcoidosis since 2010 and never had any symptoms. She reported in July 2021, she had a bout of ventricular tachycardia and subsequently had a pacemaker/defibrillator implanted. A scan revealed myocarditis. She was subsequently diagnosed with inflammation of the heart secondary to sarcoidosis. She had concerns that the Moderna vaccine may have exacerbated her heart condition.

Other Meds: warfarin, famotidine, zolpidem

Current Illness: COVID-19 Positive 12/2020.

ID: 1632536
Sex: F
Age: 28
State: MA

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

Allergies:

Symptom List: Nausea

Symptoms: Undiluted Pfizer vaccine, cc's was administered in error

Other Meds:

Current Illness:

Date Died: 08/04/2021

ID: 1632537
Sex: M
Age: 82
State: GA

Vax Date: 03/06/2021
Onset Date: 07/30/2021
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:

Symptom List: Injection site pain

Symptoms: Patient tested positive for COVID-19. Patient was fully vaccinated. He started feeling "different" about the middle of July. He was more fatigued, disoriented, and unstable. The following week, he developed cold symptoms which everyone assumed was just the common cold. Pt. daughter was sick the previous week with a common cold (took her 3yo to the doctor to confirm, but wasn't tested for Covid). After 7/26, his condition started to deteriorate more with fever and vomiting. By the evening of 07/30, he was having great difficulty breathing and so he was taken to the hospital. He was admitted for very low blood oxygen levels as well as Covid pneumonia. He has several underlying health conditions to include heart disease and obesity. Patient died due to COVID.

Other Meds:

Current Illness:

ID: 1632538
Sex: F
Age: 58
State: SC

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

Lab Data:

Allergies:

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

Symptoms: Patient has chronic ezcema on her hands. The morning after administration of the vaccine, she woke up with a permanent dark rust colored stain ("iodine-like") on her palm of her right hand and partly on the fingers of her right hand. It is not washing off with soup or water. There is no abnormal irritation or pain at the site.

Other Meds:

Current Illness: ECZEMA

ID: 1632539
Sex: F
Age: 45
State: MD

Vax Date: 05/27/2021
Onset Date: 05/28/2021
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: N/A

Allergies: pollen

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

Symptoms: Allergic reaction - hives over entire body - started on arms spread to legs, stomach, and neck Took Benadryl for 3 days after and symptoms cleared after 3rd day..

Other Meds: none

Current Illness: none

ID: 1632540
Sex: F
Age: 71
State: KY

Vax Date: 03/05/2021
Onset Date: 08/11/2021
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: COVID-19 - Swab, Nasopharynx CXRAY

Allergies: Codeine, Latex

Symptom List: Tremor

Symptoms: Patient is admitted to the hospital with Covid-19

Other Meds: Albuterol HFA Casirivimab / Imdevimab

Current Illness: Metastatic colon cancer in female Malignant tumor of splenic flexure Hypercholesterolemia

ID: 1632541
Sex: F
Age: 73
State: MD

Vax Date: 08/17/2021
Onset Date: 08/20/2021
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: UNKNOWN

Allergies: UNKNOWN

Symptom List: Erythema, Pruritus

Symptoms: PATIENT EXPERIENCED - CHILLS, SLEEPINESS, LOSS OF APPETITE AND HOTNESS OF STOMACH 3 DAYS AFTER THE ADMINISTRATION OF VACCINE. EXCEPT FOR THE HOTNESS OF STOMACH AND LOSS OF APPETITE, OTHER SYMTOMPS GOT RESOLVED IN 24 HOURS.

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1632542
Sex: F
Age: 29
State: NY

Vax Date: 08/19/2021
Onset Date: 08/22/2021
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: Visited urgent care (8/23) 4 days after receiving the vaccine- where I was tested for covid and strep a- both came back negative

Allergies: Nkda

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

Symptoms: Approximately 20 weeks pregnant at the time of vaccine administration, EDD 1/6/2021. On 8/21- About 3 days after receiving the vaccine I experienced sore throat, nasal congestion the following day with body aches and a low grade fever

Other Meds: Prenatal vitamins Ferrous sulfate 325mg

Current Illness: None

ID: 1632543
Sex: M
Age: 59
State: TX

Vax Date: 02/17/2021
Onset Date: 07/26/2021
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: CT scan, did not find anything usual detected. MRI did not find anything unusual detected. An ultrasound of my heart/cardiac ultrasound. The previous week I had a cardiac procedure, checking to see if I had leakage in between the chambers of my heart. Everything was fine.

Allergies: Sulfa

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

Symptoms: On 07/26/2021, visual migraine halo, aphasia. I could not understand what people were saying and I couldn't speak back. I called 911 and took a ride in the ambulance to the ER. In the 2 hours I was in the ER, they did test and gave me 2 children's aspirin in 24 hours. I went to my GP, after a week 1/2, 08/05/2021, the doctor did not think I had a TIA. (The symptoms were pretty much like a stroke). He was confident that I had a complex migraine. On the 08/162021, I visited my cardiologist, he confirmed it was a complex migraine. I have no history of migraines.

Other Meds: Crestor; Xarelto; lisinopril; Norvasc; metoprolol succinate; testosterone cypionate; vitamin D; K-1; K-2; iodine; Macu guard; magnesium glycinate; Allegra; coQ10; fish oil

Current Illness: No

ID: 1632544
Sex: F
Age: 49
State: MI

Vax Date: 04/06/2021
Onset Date: 04/07/2021
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: I had blood drawn a few weeks later and all my inflammatory markers were elevated.

Allergies: Gluten and Dairy

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I was super sick that night with 102 fever that lasted for three days. I called my doctor who said if I was not better in 5 days she would send me to the hospital. My whole body got inflamed and my feet blew up like balloons where I could not walk. I was weak, tired, nauseous and felt like I was dying for almost five days.

Other Meds: NP thryoid Testostorone cream Progrestone pills

Current Illness: I had torn my Achilles heel 1 month earlier, but was almost healed.

ID: 1632545
Sex: M
Age: 31
State: AL

Vax Date: 08/14/2021
Onset Date: 08/15/2021
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: Yes x-ray came back normal echocardiogram came back normal lab work came back with the elevated blood cell count

Allergies: Mushrooms

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

Symptoms: Shortness of breath, tight chest, chest pain, low-grade fever, swelling in the hands arms feet legs and face, body aches all over, felt like muscles were tightening in the entire body.

Other Meds: None

Current Illness: None

ID: 1632546
Sex: F
Age: 42
State: OR

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

Allergies:

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

Symptoms: Patient was questioned about receiving a previous dose of covid-19 vaccination and she stated she did not and that it was an error on the state reporting form. We administered the pfizer covid-19 vaccine. When the technician called the other pharmacy to have the state registry entry corrected they stated she did get the shot and they had signatures on file. When re-questioned, the patient stated she had gaps in her memory due to a recent panic attack and may have gotten it but did not have any memory of it.

Other Meds:

Current Illness:

ID: 1632547
Sex: F
Age: 46
State:

Vax Date: 08/21/2021
Onset Date: 08/23/2021
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: Potassium 3.3

Allergies: Codeine, Garlic, Novocain, Onion, Sulfites, Sulfur, Honey bee venom, Nickel

Symptom List: Pain in extremity

Symptoms: 46-year-old female presents to the emergency department for evaluation of a suspected allergic reaction. The patient states that she received the COVID-19 vaccine on Saturday. She states that later that evening she started having intermittent episodes of muscle twitching. States that she 1st noticed it in her face with some associated facial numbness. Reports that she was also having episodes in her arms, legs and feet. The patient reports that she treated her symptoms with Benadryl and Motrin with no improvement. Reports that she had difficulty sleeping last night and continued symptoms today so came to the emergency department for further evaluation. The patient states that she has multiple allergies and was initially hesitant to get the COVID-19 vaccine because of fever that she would have a reaction to it. The patient states that along with the intermittent episodes of twitching she has also had chest pain that she describes as intermittent nonradiating and nonexertional 6/10 pain. She denies fevers, chills, nausea, vomiting, diarrhea, sick contacts, recent travel, shortness of breath and diaphoresis.

Other Meds:

Current Illness:

ID: 1632548
Sex: M
Age: 17
State: TX

Vax Date: 08/24/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data: NONE

Allergies: NKDA

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

Symptoms: The vaccine that was administered was expired. I, RN, failed to waste/discard of the unused vaccines from Monday 08/23/21.

Other Meds: none

Current Illness: none

ID: 1632550
Sex: M
Age: 47
State: WI

Vax Date: 02/03/2021
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:

Allergies: No known allergies

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

Symptoms: Patient contracted COVID-29 after being fully vaccinated

Other Meds: Vitamin D3 2,000 IU daily Paxil 30mg daily

Current Illness: None documented

ID: 1632551
Sex: M
Age: 62
State: CA

Vax Date: 04/09/2021
Onset Date: 06/17/2021
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: (6/18/2021) EKG (no issues), ECG (no issues), Blood panel x2, Chest X-ray, MRI. (all clear)

Allergies: NKA

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

Symptoms: (06/17/2021) Pressure and pain in chest area, was worse lying down. Progressively got worse as the night progressed. By 4AM on 6/18/2021 went to ER. Was determined was Pericarditis. Ibuprofen 600mg three pills for one day. Felt better and no reoccurring issues after that.

Other Meds: Crestor; Airborne one-a-day gummies; D3; Topamax

Current Illness: None

ID: 1632552
Sex: F
Age: 47
State: MA

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

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Undiluted Pfizer vaccine, 0.3cc's, was administered in error

Other Meds:

Current Illness:

ID: 1632554
Sex: F
Age: 27
State: CA

Vax Date: 07/28/2021
Onset Date: 08/06/2021
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: 8/10/2021 autoimmune panel. No autoimmune abnormalities detected.

Allergies: Sulfa drugs; amoxicillin.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: On 8/6/2021 at about 7:00 PM, I noticed I had hives and itching. The hives were on my legs and bikini line, but the itching was all over my body. I also began having esophageal swelling and acid reflux that night. The hives and itching lasted about 4-5 days. After the hives finally went away, I then had itchy, red blotches all over my body; the esophageal swelling and acid reflux continued at this time. At around the time the blotches appeared, I began experiencing severe achiness in my wrists, knees, ankles, and feet. The joints aches lasted about 3 days, but after they went away, the blotches, itchiness, esophageal swelling, and acid reflux still persisted. About a week and a half after their onset, the blotches finally went away. However, I would still get itchy areas, and when I scratched them, they became red and inflamed. This still takes place once or twice a day, but it's now localized to just my back. On 8/10/2021, I went to see a PA, at a HCF. She had me do an autoimmune panel, and no autoimmune disorders were detected. She held off on prescribing steroids, as I was still nursing my son. Instead, she recommended that I continue taking OTC Zyrtec for relief. On 8/16/2021, I saw another dr. That dr. gave me a solu medrol injection, which really helped. She also gave me a GI cocktail, and I noticed a marked improvement in my acid reflux the following day. She also prescribed me sucralfate for acid reflux and recommended that I consult with an allergist before getting a second dose of Moderna. 8/24/2021 was the first day I had real relief from acid reflux and didn't have to take sucralfate. At this time, my symptoms have improved markedly, though I still have some itchiness on my back and some acid reflux.

Other Meds: Prenatal vitamins; birth control pill (name not recollected).

Current Illness: None.

ID: 1632555
Sex: M
Age: 49
State:

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

Lab Data:

Allergies:

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

Symptoms: Tingling all over the body.

Other Meds: Unknown

Current Illness:

ID: 1632556
Sex: M
Age: 70
State: CA

Vax Date: 08/04/2016
Onset Date: 05/01/2017
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:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Extreme pain for a period of 30 days, could not sleep for more than 5 to 7 minutes for the first ten days due to sharp pain in my back every 5-7 minutes

Other Meds: Hydrochlorothiazide (25 mg) Lisinopril (40mg) Amlodipine Besylate (10mg) Labetalol (600 mg) 2x per day Atorvastation (40mg) Prazosin (2mg) dietary supplements, or herbal remedies Vitimin C Vitimin D3 Aspirin Fish Oil Zinc drops

Current Illness: None

ID: 1632557
Sex: M
Age: 71
State: CA

Vax Date: 03/31/2021
Onset Date: 04/30/2021
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: Yes, showing his uric acid is high.

Allergies: None.

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

Symptoms: No reaction or pain after vaccine, but he is a 72 yo old gentleman with history of gout for about 12 years, but had resolved after eating foods like cherry's, gradefruit juice and would go away after about a week without medication. He got the vaccine and about a month later the gout came back and was eating the foods that he ate before and it did not go away. He went to the doctor and she prescribed medicine for him, and he took it and it went from the left leg and then it went into her right leg and it has not resolved completely and continues to have flares about every 2 weeks without drinking and eating a lot of foods that help with gout flares. It seems to have affected his immune system and will not resolve the gout issues. He is just concerned about why the symptoms will not go away using the remedies he has had used in the past.

Other Meds: None.

Current Illness: None.

ID: 1632558
Sex: F
Age: 48
State: PA

Vax Date: 07/29/2021
Onset Date: 07/29/2021
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: none

Allergies: erythromycin

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

Symptoms: Within first 5 minutes of receiving the injection I had a hot flash which continued for approx. 1.5- 2 hours. Also within 20-25 minutes of the injection I started having a rapid heart rate and extreme heart burn for an hour and forty-five minutes if not longer, until it subsided.

Other Meds: none

Current Illness: n/a

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am