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: 1632812
Sex: M
Age: 66
State:

Vax Date: 03/10/2021
Onset Date: 08/17/2021
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:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: sore throat; fatigue, nausea/vomiting, cough

Other Meds:

Current Illness:

ID: 1632813
Sex: M
Age: 25
State: CA

Vax Date: 03/10/2021
Onset Date: 04/21/2021
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: Frequent instances of memory / cognitive function degraded. Difficulty remembering things on short-term and occasional long-term. Symptoms began within a month of taking the second dose of vaccine.

Other Meds: None

Current Illness: None

ID: 1632814
Sex: F
Age: 45
State: MS

Vax Date: 08/13/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Rapid Covid test

Allergies:

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

Symptoms: Tested positive for Covid.

Other Meds: Ozempic Glimepiride

Current Illness:

ID: 1632815
Sex: F
Age: 63
State: KY

Vax Date: 03/04/2021
Onset Date:
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:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1632816
Sex: F
Age: 78
State: CA

Vax Date: 08/09/2021
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: N/A

Allergies: NKDA

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

Symptoms: CLIENT DENIED RECEIVING A DOSE OF THE COVID VACCINE WITH A PUBLIC HEALTH AGENCY AND NURSE, HOWEVER WHEN PUBLIC HEALTH EMPLOYEE ENTERED CLIENTS VACCINE RECORD ON THE CARE PROGRAM, IT SHOWED THAT CLIENT RECEIVED THE MODERNA VACCINE (ONE TIME DOSE ONLY) AT STORE ON 05/29/21. CLIENT WAS CALLED ON 8/24/21 BY THE PUBLIC HEALTH AND CLIENT DENIED ANY ADVERSE REACTIONS OR PROBLEMS AT THE TIME PHIZER WAS ADMINISTERED TO TODAY. THEREFORE, THERE HAVE BEEN NO ADVERSE REACTIONS AT THIS TIME.

Other Meds:

Current Illness:

ID: 1632817
Sex: F
Age: 21
State: KY

Vax Date: 12/23/2020
Onset Date: 08/19/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: POSITIVE COVID

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1632818
Sex: F
Age: 56
State: MN

Vax Date: 01/25/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Received Moderna vaccines on 12/29/20, 1/25/21 Tested positive for COVID by PCR on 8/24/21 From Group Home Admitted to Hospital on 8/24/21 to ICU

Other Meds:

Current Illness:

ID: 1632819
Sex: F
Age: 29
State:

Vax Date: 04/20/2021
Onset Date: 08/19/2021
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:

Symptom List: Pharyngeal swelling

Symptoms: runny nose, headache, fatigue

Other Meds:

Current Illness:

ID: 1632820
Sex: M
Age: 53
State: WA

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: ASA Codeine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 8/17/2021: Our Medical Assistant mixed the 1.8mL Normal Saline Diluent with the Moderna Vaccine Vial. Thereafter, she had given 0.5mL IM Moderna with Diluent X 1 dose to the patient. Moderna contacted for recommendations. 8/18/2021: Patient contacted, doing well 8/19/2021: Called patient to follow up - mild headache and fatigue, which resolved. Denies any other symptoms DOH also contacted, advised patient to receive one additional dose of Moderna immediately on the opposite arm. 8/24/2021: Called patient - denies any symptoms. Patient notified of plan as discussed above and has an appt on 8/26/2021

Other Meds: Patient denies

Current Illness: Denies

ID: 1632821
Sex: F
Age: 40
State: OR

Vax Date: 02/01/2021
Onset Date: 04/01/2021
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: 4/16/21 Punch Biopsy: pityriasis rosea, possible drug induced given the dermal eosinophils 7/27/21: Urgent Care physical exam to diagnose Bell's Palsy

Allergies: Lovenox, penicillin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Experienced wide spread rash and sought medical care initially on 4/1/21, : Diagnosed via biopsy on 4/16/21 as pityriasis rosea, possibly drug induced Diagnosed with Bell's Palsy 7/26/21

Other Meds: Hydroxychloroquine, paroxetine

Current Illness: none

ID: 1632822
Sex: F
Age: 65
State: TN

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: SYR
Vax Site: LA

Lab Data:

Allergies: Latex, penicillin

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

Symptoms: Nightmares, headache, fever 102.1 F, severe joint pain (7 / 10), shaking chills

Other Meds:

Current Illness:

ID: 1632824
Sex: F
Age: 76
State: MO

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: none

Allergies: resin

Symptom List: Rash, Urticaria

Symptoms: About 2 hours after injection my stool began to be more liquid than usual and continued that way for about 36 hours

Other Meds: Judy Barnett Medicines Ketoconazole Cream Elidel 30g Triamcinolone Acetonide Cream Claratin(2X per day) Benazephil 20mg Folic Acid-400mcg Devrom Omeprazole 40 mg Letrozole 2.5mg (Femera)

Current Illness:

ID: 1632825
Sex: M
Age: 78
State: MO

Vax Date: 02/16/2021
Onset Date: 08/14/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data:

Allergies: nkma

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

Symptoms: Chief Complaint pt brought to ED via EMS for diarrhea, SOB, weakness, and lethargy. tested positiver for covid last thursday History of Present Illness Patient is a 79-year-old male with past medical history significant for diabetes type 2, hypertension, gout presenting to the emergency department today with profound shortness of breath and increased fatigue and weakness after recently being infected with COVID-19. Patient was diagnosed on Thursday with COVID-19. Patient had 2 days of symptoms prior to this. Patient had positive sick contact of his daughter who also had Covid. Patient notes that he was vaccinated against COVID-19. Patient was obtunded on scene for EMS and perked up after 700 mL of normal saline. Patient admits nausea associated with symptoms. Patient has had persistent diarrhea associated with the symptoms.

Other Meds: unknown

Current Illness: unknown

ID: 1632826
Sex: F
Age: 51
State: IL

Vax Date: 08/20/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
Hospital: Y

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: Erythromycin

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

Symptoms: At 7:10 AM on 8/24/21 Patient reported that her ICD was firing and that she would be going to the ED for evaluation. After arriving at the ED Patient's husband reported that the Patient would be having a cardiac catheterization completed due to chest pain . Around 11:10am on 08/24/21. Husband reported following the cardiac catheterization that there was no new blockage identified, with fluid build up surrounding heart, the treatment was to provide diuretics with plan for the patient to remain in the hospital for at least 24 hours. On 8/25/21 husband reported that the patient remained in the ICU for monitoring of output. Cardiac defibrillator did not deliver any further shock (defibrillation).

Other Meds:

Current Illness: Insulin Dependent Diabetic

ID: 1632827
Sex: F
Age: 16
State: IL

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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Approximately 25-30 minutes after vaccination, patient complained of itchiness to arm only.

Other Meds:

Current Illness:

ID: 1632828
Sex: F
Age: 28
State:

Vax Date: 08/18/2021
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:

Allergies: gluten

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

Symptoms: red line at nail bed of 4th finger (left). macular rash/erythema to left arm and left leg (only lasted 45 min, warm to touch, occurred 2 days in a row. not appreciated at time of visit), left shoulder/arm/neck/trap pain (also has a torn left labrum). HA 2 days post vaccine (resolved)

Other Meds: COCP (Ocella)

Current Illness: PT for torn labrum (left) and right ACL tear

ID: 1632829
Sex: F
Age: 54
State: OH

Vax Date: 04/15/2021
Onset Date: 04/29/2021
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: I had my FSH and LH tested on 4/09/21. FSH was 73.1 and LH was 58.2. I was having all traditional menopause symptoms at that time. I did see my gynecologist and she retested the same hormones on 8/3/21. By then many menopause symptoms had returned. Results were : FSH 63.5 and LH 32.5. Hot flashes returned 8/6/21.

Allergies: Allergic to sulfa drugs

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

Symptoms: First, the hot flashes disappeared. Then I could sleep through the night. Then my energy and mental focus returned and I even lost a couple of pounds of fat. Basically, the second shot reversed menopause. While this sounds glorious (and it was) I have hormone receptor positive breast cancer so getting my hormones back drives up my chances of more cancer considerably. My break from menopause lasted between three and four months, complete with monthly two-day periods. I reported this to my oncologist, who would only respond ?that hasn?t been reported?.

Other Meds: None

Current Illness: Menopause and cancer

ID: 1632830
Sex: M
Age: 24
State: OH

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: NA. Covid test was negative

Allergies: NA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Hyperventilation for 6 hours - feeling short of breath.

Other Meds: NA

Current Illness: NA

ID: 1632831
Sex: F
Age: 72
State: PA

Vax Date: 08/18/2021
Onset Date: 08/19/2021
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: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient developed a rash all over her arm and leg on one side.

Other Meds: n/a

Current Illness: none

ID: 1632832
Sex: F
Age: 28
State: CA

Vax Date: 08/22/2021
Onset Date: 08/22/2021
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: Just went to the urgent care and doctor suggested it's a reaction to the vaccine . And to wait it out be it getting worse.

Allergies: Morphin, Dilaudid penicillin, and soy.

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

Symptoms: Numbness, pins and needles it started in my arms , underarm back and now it's moved to my face, neck, both legs and inner thighs. And today it's Aug 25 and it?s getting worse .

Other Meds:

Current Illness:

ID: 1632833
Sex: F
Age: 17
State: KS

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

Allergies:

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

Symptoms: Headache, vomiting, severe arm pain for over 5 days, swelling of the arm at injection site for over 5 days.

Other Meds:

Current Illness:

ID: 1632834
Sex: F
Age: 60
State: WA

Vax Date: 05/01/2021
Onset Date: 05/15/2021
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: Printed at 8/23/21 9:04 AM Page 4 of 5 DIAGNOSES/PROBLEMS: (D89.89, G63) Immune-mediated neuropathy (primary encounter diagnosis) (G54.0) Brachial plexopathy without trauma (R73.03) Borderline diabetes mellitus: follow with Primary Care Physician Positive asialo-GM1 and GD1a antibodies supporting immune-mediated neuropathy in the form of Parsonage-Turner syndrome (idiopathic brachial plexitis). It is likely a variant of Guillian-Barre syndrome (AIDP, Acute Inflammatory Demyelinating Polyradiculoneuropathy), and may be triggered by Covid-19 vaccination. No improvement with initial prednisone treatment. We discussed the findings and treatment options especially IVIG benefit and possible side effects. We agree to pursue IVIG treatment. Will start with five days of loading dose at 0.4 g/kg (45 gm) per day x 5 days. Will follow up two weeks after completing loading to determine further treatment options. Please complete the following lab studies. Keep MRI and OT appointment. I will ask our nurse to work with you to facilitate scheduling infusion. Therapy Plan entered. Orders Placed This Encounter: IGA COMP. METABOLIC PANEL CBC/PLT ONLY (HEMOGRAM) Printed at 8/23/21 9:04 AM Page 4 of 5 DIAGNOSES/PROBLEMS: (D89.89, G63) Immune-mediated neuropathy (primary encounter diagnosis) (G54.0) Brachial plexopathy without trauma (R73.03) Borderline diabetes mellitus: follow with Primary Care Physician Positive asialo-GM1 and GD1a antibodies supporting immune-mediated neuropathy in the form of Parsonage-Turner syndrome (idiopathic brachial plexitis). It is likely a variant of Guillian-Barre syndrome (AIDP, Acute Inflammatory Demyelinating Polyradiculoneuropathy), and may be triggered by Covid-19 vaccination. No improvement with initial prednisone treatment. We discussed the findings and treatment options especially IVIG benefit and possible side effects. We agree to pursue IVIG treatment. Will start with five days of loading dose at 0.4 g/kg (45 gm) per day x 5 days. Will follow up two weeks after completing loading to determine further treatment options. Please complete the following lab studies. Keep MRI and OT appointment. I will ask our nurse to work with you to facilitate scheduling infusion. Therapy Plan entered. Orders Placed This Encounter: IGA COMP. METABOLIC PANEL ----------------------------------- MOTOR & SENSORY NEURO. EVAL - Details ---------------------------------------- CBC/PLT ONLY (HEMOGRAM) Component Your Value Standard Range Flag HEMOGLOBIN A1C 5.9 % 4.5 to 5.6 %4.5 - 5.6 % H NORMAL: 5.6% or less IMPAIRED GLUCOSE TOLERANCE: 5.7%-6.4% DIABETES DIAGNOSIS: 6.5 or greater (on 2 occasions) per KP Type 2 Diabetes Guideline. Targets differ for different people with diabetes. You should discuss with your provider what the most appropriate HbA1c target is for you. ESTIMATED AVERAGE GLUCOSE 123 mg/dL mg/dLmg/dL FOR PATIENTS: The estimated Average Glucose (eAG) number is calculated from the result of your A1c. Like the A1c, eAG shows what your average

Allergies: Penicillins Aspirin Reactions:Shortness of breath Added 1/31/2007 Nsaids (Non-Steroidal Anti-Inflammatory Drug) Reactions:Shortness of breath Added 4/11/2012 Amoxicillin Reactions:Rash Added 3/9/2018 Cat/Feline Products Reactions:Other Added 3/9/2018 Penicillins Aspirin Reactions:Shortness of breath Added 1/31/2007 Nsaids (Non-Steroidal Anti-Inflammatory Drug) Reactions:Shortness of breath Added 4/11/2012 Amoxicillin Reactions:Rash Added 3/9/2018 Cat/Feline Products Reactions:Other Added 3/9/2018

Symptom List: Unevaluable event

Symptoms: I received my second dose of the Moderna vaccine in my right deltoid in 1 May 2021. All my joints were very painful and sore for about two weeks. I took acetaminophen at least once a day during this period, I cannot take NSAIDs, After this, I notices my right pinkie tingled. My assumption was that this was the beginning of a repetitive stress injury and I wore a wrist braces. Over the next month, my ring and middle finger became numb as well and I could not control these three fingers at all,. I had minor pain in the location I received the injection if I touched or engaged the muscle. I made a video appointment on 24 June with the earliest available doctor. She is not my regular primary care doctor, so I made a second in person appointment with another doctor for 2 July. The first doctor also thought this was probably an RSI and recommended I keep the arm straight with a brace or towel wrapped around it, The second doctor had the advantage of seeing me in person. I did not present with any typical RSI symptom. She consulted with someone out of the exam room and returned to refer me to a neurologist. I met with a third doctor on 6 August where he and his staff did several tests ordered labs and MRIs for further work up and followed up with me on 23 August after the blood tests returned. I will still have an MRI in September. The diagnosis is: (D89.89, G63) Immune-mediated neuropathy (MA-HCC) (primary encounter diagnosis) (G54.0) Brachial plexopathy without trauma Positive asialo-GM1 and GD1a antibodies supporting immune-mediated neuropathy in the form of Parsonage-Turner syndrome (idiopathic brachial plexitis). It is likely a variant of Guillian-Barre syndrome (AIDP, Acute Inflammatory Demyelinating Polyradiculoneuropathy), and may be triggered by Covid-19 vaccination. I have not had a COVID test, but I have not been ill at all since early 2020. I work at home and my family and I rarely go inside public places beyond the doctor's office. l. I always wear a mask even after restrictions were lifted.

Other Meds: acetaminophen 325 mg tablet ALVESCO 80 mcg/actuation inhaler FLUoxetine 10 mg capsule FLUoxetine 20 mg capsule levonorgestreL 20 mcg/24 hours (6 yrs) 52 mg IUD levothyroxine 0.1 mg tablet lisinopriL 10 mg tablet VENTOLIN HFA 90 mcg/actuati

Current Illness: None

ID: 1632835
Sex: M
Age: 81
State: MN

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

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

Lab Data: 8/14/21 POSITIVE COVID ON RESPIRATORY TEST

Allergies: NONE

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

Symptoms: COVID DIAGNOSIS AND HOSPITALIZATION AFTER BEING FULLY IMMUNIZED

Other Meds: ADVAIR INHALER, ALBUTEROL NEB, ATORVASTATIN, CITALOPRAM, ELIQUIS, FINASTERIDE, DUONEB, MEMANTINE, PANTOPRAZOLE, SPIRIVA INHALER, TAMSULOSIN

Current Illness: NONE

ID: 1632836
Sex: F
Age: 48
State: KY

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Allergic to Prozac and Zoloft medications.

Symptom List: Injection site pain, Pain

Symptoms: Itching in various places on body. Just like when I have allergic reactions to meds. Itchiness moves around to different spots.

Other Meds: Wellbutrin XL morning of vaccination and morning following. Also, morning following, took Zinc, Vitamin C and Vitamin D3.

Current Illness: /A

ID: 1632837
Sex: F
Age: 51
State:

Vax Date: 01/13/2021
Onset Date: 08/20/2021
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:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Employee tested positive after being vaccinated

Other Meds:

Current Illness:

ID: 1632838
Sex: M
Age: 65
State: WA

Vax Date: 08/09/2021
Onset Date: 08/11/2021
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: none

Allergies: wheat and dairy sensitivity

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

Symptoms: 2 day fever of 101, headache, deep dry cough for three days, fatigue, ongoing left arm deltoid pain, sinus pain and infection

Other Meds: Vitamin d, magnesium, zinc, multi-vitamin, fish oil, vitamin b complex, vitamin k, turmeric

Current Illness: none

ID: 1632839
Sex: M
Age: 48
State: MN

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

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: Nausea, Pain in extremity, Pyrexia

Symptoms: Received Moderna vaccines on 2/25/21, 3/25/21; tested positive for COVID by PCR on 8/24/21 hospitalized for ileal perforation on 8/25/21; incidental finding of asymptomatic COVID infection.

Other Meds:

Current Illness:

ID: 1632840
Sex: F
Age: 57
State: AZ

Vax Date: 03/12/2021
Onset Date: 03/19/2021
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: extreme allergy skin rash since first vaccine until today

Other Meds: Ibuprofen

Current Illness: none

ID: 1632841
Sex: M
Age: 39
State: CA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
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: zomig, imitrix

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

Symptoms: Muscle knots on left side of back that will not go away with acupuncture and massage therapy (referral from Clinic). Constant back pain, more-so on my left side. general feeling of muscle fatigue and tiredness. a feeling of having "waxed canvas under my skin at the injection site" that is persistent to today (25AUG2021). Joint pain primarily on left side of body that I never had before (specifically in my shoulders and shoulder blade).

Other Meds: n/a

Current Illness: n/a

ID: 1632842
Sex: F
Age: 80
State: FL

Vax Date: 08/18/2021
Onset Date: 08/21/2021
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: RA

Lab Data: CT of the brain without contrast Carotid doppler This resident is currently in the hospital receiving treatment

Allergies: ace inhibitors, amlodipine, armour thyroid, aspirin, buspirone, donepezil, hydralazine, morphine, paxil, ritalin, synthroid

Symptom List: Nausea

Symptoms: This resident received the J&J vaccine on August 19, 2021. On Saturday, August 21, 2021 she began exhibiting signs of altered mental status. It was discovered that she had a urinary tract infection and was started on Macrobid. Her physician gave the order to transport her to the emergency room for further evaluation and treatment. It was discovered during her ER evaluation that she had suffered a subacute evolving lacunar infarct in the right corona radiata. The hospital notified this nurse for VAERS reporting.

Other Meds: clonidine, cyanocobalamin, eliquis, famotidine, losartan, memantine, phos-NaK, prednisolone, probiotic, simvastatin, allopurinol, escitalopram, ferrous sulfate, magnesium oxide, metoprolol succinate, spironolactone, sucralfate, vitamin D3,

Current Illness: atrial fibrillation, UTI, hyperlipidemia, dementia, hypertension, gastro-esophageal reflux disease, dysphagia, weakness, history of CVA in 2016

ID: 1632843
Sex: F
Age: 41
State: OH

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Covid Vaccine was punctured at approximately 9 am on 8/25/21 to be administered to a patient that presented to the pharmacy. The vial was then left at room temperature for approximately 5 hours. The patient reported above then presented to the pharmacy for a Covid vaccine. The vial that had been left at room temperature was then used to administer the Covid vaccine to the patient reported above. The vaccine may only be left at room temperature for max of 2 hours.

Other Meds:

Current Illness:

ID: 1632844
Sex: F
Age: 35
State: KY

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: None

Allergies: Nkda

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

Symptoms: Patient was given Pfizer for her second dose. Her first dose was Moderna. When asked if she was receiving her second dose of Pfizer she answered yes. Not discovered until after it was given that her first dose was Moderna. No adverse effect noted 30 minutes after shot was given

Other Meds: Unknown

Current Illness: Unknown

ID: 1632845
Sex: F
Age: 86
State: NH

Vax Date: 04/29/2021
Onset Date: 05/07/2021
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: Sulfa drugs, strawberries, Bacitracin

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

Symptoms: First sign was itching on Right Wrist and Palm. Then blisters appeared mostly on the Upper Right Arm. The blisters were diagnosed as Bullous Pemphigoid by Primary Care Doctor and confirmed by Dermatologist. They resolved themselves after a few weeks. This was the first such blistering event and we believe the Bullous Pemphigoid was triggered by the second shot of the COVID vaccine.

Other Meds: Clonidine, Doxazosin, Eplerenone, Amlodipine Besylate, Aliskiren, Atorvastatin, Lamotrigine, Levothyroxine, Letrozole, Omeprazole, Ferrous Gluconate, Aspirin, Vitamin B12, Vitamin D, Colace, MiraLax

Current Illness:

ID: 1632846
Sex: M
Age: 66
State: TX

Vax Date: 07/31/2021
Onset Date: 08/01/2021
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: Called my physician to discuss with him. He suggested testing for Covid19, test result (tested 11 days after vaccine) was negative.

Allergies: None

Symptom List: Tremor

Symptoms: Alarming tightness in chest for 3 days, difficulty breathing. Other symptoms, extreme fatigue, soreness at injection site for 5 days, headache for 10 days, body ache 7 days.

Other Meds: Multi Vitamin Low dose blood pressure med

Current Illness: None

ID: 1632847
Sex: M
Age: 68
State: MO

Vax Date: 03/16/2021
Onset Date: 08/12/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data: (08/12/2021 18:33 CDT XR Chest) IMPRESSION: 1. Bibasilar, right greater than left, airspace opacities with few scattered peripheral opacities. Differentials include multifocal infection such as COVID 19 pneumonia. Aspiration or bacterial infection is a possibility. 2. Small to moderate right pleural effusion with adjacent compressive atelectasis. [1] SINUS RHYTHM RIGHT AXIS DEVIATION RIGHT BUNDLE BRANCH BLOCK Compared to ECG 03/28/2021 08:10:54 Right-axis deviation now present First degree AV block no longer present Indeterminate axis no longer present [2]

Allergies: ACE inhibitors, Diovan, Topamax

Symptom List: Erythema, Pruritus

Symptoms: Chief Complaint Generalized weakness, cough, shortness of breath History of Present Illness Patient is a 69 years old male with medical history of Kappa light chain amyloidosis, renal biopsy-proven (currently on daratumumab + CyBorD), ESRD on HD-MWF, paroxysmal a-fib (previously on dofetilide now on amiodarone & Eliquis), HLD, HTN, CVA 2017, DM2, hx of CVA, OSA (on CPAP) presented to ER on 8/12/2021 with a history of worsening generalized weakness for 1 day, productive cough with greenish sputum for 4 days. Patient reports he started to have cough with yellowish-greenish sputum starting from 8/9/2021. He endorses associated mild shortness of breath and wheezing and chills but, denies associated chest pain, palpitation, fever, nausea, vomiting, incision bowel bladder habit. Since this morning, he has been feeling very tired to the point that he could not walk prompting his wife brought him to the ER. He endorses associated dizziness, lightheaded. Patient is fully vaccinated against Covid-19 (2/2021), no known history of exposure. Vitals at presentation is stable, heart rate at 80s, blood pressure at 100s/70s. Saturating at 90s in room air. Labs notable for WBC 9.4, hemoglobin stable at 11.5, platelet 91, CMP notable for creatinine 4.5. Covid rapid antigen positive, CRP 2.99. Chest x-ray notable for bibasilar airspace opacities consistent with Covid-19 pneumonia versus aspiration versus bacterial pneumonia. Moderate right pleural effusion with compressive atelectasis. EKG sinus rhythm, without acute ischemic changes. QTc 487. Patient has been admitted to Hemet oncology service for management of Covid pneumonia as well as for inpatient hemodialysis.

Other Meds: unknown

Current Illness: unknown

ID: 1632848
Sex: M
Age: 28
State: IL

Vax Date: 08/23/2021
Onset Date: 08/24/2021
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: Advised patient to take Tylenol for pain and monitor the swollen Lymph node , if does not feel improvement in few days of feels getting worse, contact pharmacy and doctor

Allergies: unknown

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

Symptoms: Patient came to pharmacy complaining he has swollen lymph node in left armpit started on 08/24/2021 evening, with minor pain

Other Meds: unknown

Current Illness: unkown

ID: 1632849
Sex: M
Age: 29
State: WI

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data: 2 surgeries and 1 week in the hospital. Dozens of scans and tests.

Allergies: None known

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

Symptoms: Abdominal pain, leading to small bowel obstruction requiring surgery to correct.

Other Meds: Multivitamin and occasional antihistamine (Zyrtec)

Current Illness: None.

ID: 1632850
Sex: F
Age: 55
State: NC

Vax Date: 08/11/2021
Onset Date: 08/13/2021
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 yet

Allergies: Just latex skin irrations

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Stomach is not feeling right feeling nauseous

Other Meds: Metformin 1000 mg 2 times a day Linisipril 20 mg paraxitine 20 mg before work

Current Illness: None

ID: 1632851
Sex: F
Age: 31
State: NJ

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

Allergies:

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

Symptoms: Immediately after shot was given I could feel my chest closing, and shortness of breath I also immediately felt nausea and light headed. I had waited for 40 mins prior to leaving to make sure I was okay to drive. I have since had shortness of breath and it has been almost 3 weeks now. I was 20 weeks pregnant at time of shot, due on 12/18/21. I am scheduled for my second dose on 8/28 but am now unsure if I will get it.

Other Meds:

Current Illness:

ID: 1632852
Sex: M
Age: 65
State: MD

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

Lab Data:

Allergies: NKDA

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

Symptoms: Expired Vaccine 24 August 2021

Other Meds: NKDA

Current Illness: Expired medication LOT number 025A21A of Moderna. Expired 24 August 2021

ID: 1632853
Sex: M
Age: 46
State: CA

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

Lab Data: None

Allergies: None

Symptom List: Pain in extremity

Symptoms: Body aches and chills

Other Meds: None

Current Illness: None

ID: 1632854
Sex: M
Age: 59
State: MA

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data: Bloodwork- elevated WBC- 03/03/2021, elevated liver enzymes. I am working on the medical records to find out what other tests were while in hospital.

Allergies: Benadryl

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

Symptoms: 02/28/2021 the day after I got the vaccine, I had arm swelling, it was hot, and I had redness around lunch time. Monday 03/01/202I went to work and told my supervisor I was not feeling well around 9:00AM, I felt nauseous, I just did not feel "right". 03/02/2021 I developed a fever around 103.0, I called my PCP and was told to treat it with Tylenol and Advil, my fever ranged from 100.00 to 104.0. I began having hallucinations on 03/02/2021 which I believe was related to the fever. My daughter told me to call my doctor and I thought I did but later realized I did not. 03/03/2021, fever began increasing to 103 to 107 even on Tylenol and Advil. I went to ER hospital, city, state. Around 03:00PM I began to developed cyanosis, my wife found me in a confused state, dark purple in color, not responding well to questioning. Wife took me to hospital and my fever was around 107.1; they began an IV of antibiotic (unsure name). Was admitted to hospital around midnight 03/04/2021, between then and 03/06/2021, they ran a number of tests checking for various diseases, my liver enzymes began elevating, fever still had not broken; it was ranging from 103.0 to 105.0. 03/07/2021 After the hospital had ran every test, they could my fever did finally break, I was kept 24 hours after fever broke, they still could not give me a diagnosis, they said they did not believe it was due to the vaccine but recommended I not get 2nd vaccine. 03/09/2021 I was seen by my regular doctor who expressed my liver enzymes were so high it appeared within the range of an alcoholic, but I am not a drinker and doctor knows I don't drink so we ruled alcoholism. Since then, it has affected my memory, I have very large gaps rom 02/27/2021 until now. I have periods of hours and days that are gone. My liver enzymes have begun going down, but they are still not back to my baseline. I have tinnitus, fatigue, respiratory fatigue and muscular. Daughter began speaking on his behalf. His words are not correct, it's like he has a speech impediment, his words do not come out right or letters are jumbled with occasional slurring. He also bites his tongue a lot.

Other Meds: None

Current Illness: None

ID: 1632855
Sex: F
Age: 66
State: SD

Vax Date: 07/26/2021
Onset Date: 07/31/2021
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: Penicillin, Levaquin

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

Symptoms: about 5 days after 2nd dose, 7-26-21 (first dose was 6-28-21, same lot number) she noticed every joint hurting. Hands were the worst. She felt fatigued and chilly. No noted fevers. She felt this way for about 3 weeks. On 8-22-21 she said she started feeling better with the joint pain, easier to get out of bed and to use her curling iron. Used Ibuprofen for the joint pain.

Other Meds: calcium, Vitamin d, Vitamin C, HLA joint support

Current Illness: none

ID: 1632856
Sex: F
Age: 44
State: MO

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

Lab Data: None

Allergies: All furry critters, all feathered critters, mold, roaches, presevatives used in health & beauty products, caine family medications, dust, weeds, trees, flowers, perfumes, soy

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

Symptoms: Swelling and redness of face, swelking of lips, tongue, and throat. Feeling of jitteriness. Headache & fatigue

Other Meds: Sinulair, xyzal, dulera, synthroid, lisinprol-hctz, amlodipine, nuvigil, multi vitimin, probiotic, vitamin D. Took Benadryl for reaction to vax.

Current Illness: None

ID: 1632857
Sex: M
Age: 73
State: MN

Vax Date: 03/29/2021
Onset Date: 08/21/2021
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: 8/21/21 SARS-CoV-2 RNA (COVAS PCR test) POSITIVE

Allergies: SULFA, ERYTHROMYCIN

Symptom List: Vomiting

Symptoms: COVID DIAGNOSIS/HOSPITALIZATION AFTER BEING FULLY IMMUNIZED

Other Meds: ATROVENT INHALER, JANTOVEN, MESALAMINE, METOPROLOL, MONTELUKAST, OMEPRAZOLE, QVAR INHALER, TYLENOL

Current Illness: NONE

ID: 1632858
Sex: F
Age: 70
State: IL

Vax Date: 08/19/2021
Onset Date: 08/24/2021
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: None

Allergies: sulfa, tegretol, dilantin, gluten, celebrex,

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 5 days After injection, Diffusely red and swollen rash developed on the upper left arm, followed by a maculopapular rash covering the whole body . Prior to this I experienced headaches for 4 days, no fever,

Other Meds: Actemra, Gabapentin, Budesonide, Eliquis, cardizem, zyrtec, Vitamin d, melatonin

Current Illness: Atrial fib

ID: 1632859
Sex: M
Age: 67
State:

Vax Date: 03/05/2021
Onset Date: 08/20/2021
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: Abdominal pain, diarrhea, nausea and vomiting

Other Meds:

Current Illness:

ID: 1632860
Sex: F
Age: 54
State: CO

Vax Date: 08/18/2021
Onset Date: 08/19/2021
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:

Allergies: Sulfer

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Went to the hospital on Sunday August 22nd with shortness of breath and abdominal pain. The test they ran are basic metabolic panel, CBC with audio differential, hepatic functional panel, lipase, POCT Troponin I, ECG (electrocardiogram ) 12 Lead, they gave me an IV and some oxygen, dicycomine. They sent me home with dicycomine and ondansetron still was feeling bad so went to see my doctor and they prescribed a few other prescriptions and now I'm starting to feel better

Other Meds: No

Current Illness: No

ID: 1632861
Sex: F
Age: 36
State: IL

Vax Date: 08/06/2021
Onset Date: 08/07/2021
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: Adhesives, Bactrim, Nafcillin, Doxycycline, Wellbutrin

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

Symptoms: Severe vomiting, severe diarrhea, fever, body aches, nausea, no appetite, abdominal pain, headaches, dizziness, chills, diaphoresis

Other Meds: Viibryd, Ferrous Gluconate, hydroxyzine

Current Illness: None

ID: 1632862
Sex: F
Age: 41
State: KY

Vax Date: 07/16/2021
Onset Date: 07/16/2021
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: Nothing came in MRI 07/17/2021

Allergies: None

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

Symptoms: Num right side of body , face moving one side kind of stroke

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am