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: 1641685
Sex: M
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: 8/26/2021 8/27/2021

Allergies: Unknown

Symptom List: Dysphagia, Epiglottitis

Symptoms: Chest pain results in hospital stay diagnosed with heart inflammation

Other Meds: None

Current Illness: None

ID: 1641686
Sex: F
Age: 47
State: OH

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: 04/06/2021 -bloodwork-potassium dropped and a few over things were off, but doesn't remember all. CT of abdomen-normal 04/12/2021 ENT did a hearing test and it was normal

Allergies: Penicillin; Cefzil; Codeine; Peroxide; Darvocet; Phenobarbital; Depakote; Ammonia; most detergents; latex; most nuts; Gluten; adhesives; silicon; MRI contrast dye; Calmoseptine; Propranolol.

Symptom List: Anxiety, Dyspnoea

Symptoms: On 04/02/2021 that night it began with headache, chills, fatigue, on 04/03/2021 body aches, nausea and upset stomach, stuffy nose, sore throat.-those symptoms latest till about the 5th. Headache and fatigue lasted for a couple weeks. I went to the ER on 04/06/2021-only stayed for 6 hours. On 04/09/2021 I woke up and could not hear out of my left ear, that latest for 6/8 hours. I went to an ENT on 04/12 and hearing was normal.

Other Meds: Lyrica; Singular; Zythormisosin; Otezla; Natazia; Prilosec; Cardizem; Meloxicam; Iron; Tylenol

Current Illness: no

ID: 1641687
Sex: F
Age: 44
State: MN

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: She received a COVID vaccine at the conclusion of her appointment. As she was walking out she felt lightheaded and sat on the ground. The staff who witnessed the episode say she might have loss consciousness. There was no direct impact or true fall. Vital signs at the time showed no tachycardia, normal blood pressure and good saturations. Point of care glucose was 117, although this was checked shortly after she was given some orange juice. She was evaluated by the rapid response team here and remained hemodynamically stable

Other Meds:

Current Illness:

ID: 1641688
Sex: F
Age: 16
State: IN

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 08/27/2021
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: Fever, Body Aches, Headaches, Lack of Appetite, Lethargy. Managed with Ibuprofen.

Other Meds:

Current Illness:

ID: 1641689
Sex: F
Age: 17
State: TX

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/27/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Patient began seizing , fell over from chair and hit her head on the floor; right forehead. Patient seized for 1 minute and a half. Upon patient coming to she was then placed in chair and vitals were taken: BP 130/80, respiration 21, Pulse 77, O2 98%. Ice pack was placed on her forehead to keep her cool. EMS was called, patient was evaluated and transported.

Other Meds:

Current Illness:

ID: 1641690
Sex: F
Age: 33
State: GA

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Experiencing fluttering heartbeat on and off all day.

Other Meds: labetaol 100mg twice a day, sertraline 75mg per day, clonazepam as needed.

Current Illness:

ID: 1641691
Sex: F
Age: 38
State: NY

Vax Date: 04/14/2021
Onset Date: 04/30/2021
Rec V Date: 08/27/2021
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: CBC/CMP, CT angio chest, CTV abdomen/pelvis, TTE, vascular ultrasound

Allergies: None known

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pt had symptoms of leg pain starting 03/30/21. Had a negative ultrasound at that time. Pt received vaccine 04/14/21. Then developed severe leg pain/swelling and cough a few days later. Was then subsequently diagnosed with a saddle PE and extensive lower extremity DVT requiring thrombectomy/thrombolysis on 4/30/21. She continues on full dose anticoagulation at this time.

Other Meds: Zyrtec, Tylenol PRN

Current Illness: None known

ID: 1641692
Sex: F
Age: 48
State: TX

Vax Date: 04/29/2021
Onset Date: 05/01/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies: Blue contrast dye, anti depressants nutts, bees, wasp, jalepenos

Symptom List: Pharyngeal swelling

Symptoms: Two days after the shot I felt very light headed. Then a fever rapidly started. I felt like I had the flu but did not have the flu. I was very dizzy for days.

Other Meds: Levothyroxine 125mcg Rousuvastatin 20mg

Current Illness: no

ID: 1641693
Sex: F
Age: 15
State: CA

Vax Date: 08/07/2021
Onset Date: 08/08/2021
Rec V Date: 08/27/2021
Hospital: Y

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

Lab Data: ALT615, AST 443 (8/12/2021)

Allergies: NKDA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Hives, nausea, rash 1 day after vaccine. Mild transaminitis and rechecked 8/12/21 and increasing LFTs as below. hepatitis. Seen at ED and LFTs increasing so transferred to Hospital and admitted. LFTs improved and patient able to be discharged home. COVID antibodies IgG were checked given recent COVID + infection on July 1, 2021 and IgG was positive.

Other Meds: No

Current Illness: COVID positive on July 1, 2021. No symptoms reported at time of vaccination.

ID: 1641694
Sex: F
Age: 36
State: SC

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: Vitals check and physician assessment

Allergies: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient received second Covid vaccine at 4:20pm. @ 4:31pm, patient reported numbness and tingling in her right had from the wrist to the finger tips. Patient had no other complaints (No SOB,Dizziness, blurred vision, headache.) I had see patient @ 4:30pm to assess. Patient's blood pressure was checked at 127/91 and heart rate of 99. Per Dr. to patient, this is likely a nerve that was irritated during the vaccination process. Patient was given three 200mg Ibuprofen. I offered for patient to wait longer with us to ensure nothing else occurred. Patient said she was ok and felt fine to leave. I did tell patient that if this worsened over the weekend to contact her physician for further advise. Patient voiced understanding and agreed to plan. Will send this note to sign off on.

Other Meds: None

Current Illness: none known

ID: 1641695
Sex: F
Age: 40
State: NY

Vax Date: 08/23/2021
Onset Date: 08/27/2021
Rec V Date: 08/27/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Left arm muscle spasms and weakness, ongoing

Other Meds:

Current Illness:

ID: 1641696
Sex: F
Age: 37
State: KY

Vax Date: 04/02/2021
Onset Date: 08/27/2021
Rec V Date: 08/27/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Diagnosed with COVID-19

Other Meds:

Current Illness:

ID: 1641697
Sex: F
Age: 36
State:

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 08/27/2021
Hospital: Y

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

Lab Data: Axonal sensory neuropathy. Initial evaluations have been normal including testing for diabetes, common vitamin deficiency and Sjogren's and more common inflammatory neuropathies ( additional testing pending)

Allergies:

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

Symptoms: Patient the with a mild axonal sensory neuropathy confirmed by electrophysiological evaluation with an onset at the time of her 1st injection with worsening leading to hospitalization at a local hospital after the 2nd dose were symptoms were exaggerated symptoms have since improved but continue. Her symptomatology is worsened by onset of chronic fatigue, widespread pain and sleep disturbance.

Other Meds:

Current Illness:

ID: 1641698
Sex: F
Age: 5
State: CT

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/27/2021
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: no

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

Symptoms: Rash above lip w/ dark, flat spots. Swollen upper lip.

Other Meds: children's multivitamin

Current Illness: no

ID: 1641699
Sex: M
Age: 66
State: VA

Vax Date: 07/31/2021
Onset Date: 08/04/2021
Rec V Date: 08/27/2021
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: Neuropathy in arms and hands. Numbness. tingling. Some loss of dexterity.

Other Meds: Rinvoq

Current Illness: High BP Rheumatoid arthritis

ID: 1641700
Sex: F
Age: 48
State: TX

Vax Date: 04/29/2021
Onset Date: 05/20/2021
Rec V Date: 08/27/2021
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: blue contrast dye, antidepressandts nutts, bees, wasp, jalepenos

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

Symptoms: After I received the shot I felt terrible, like I had the flu. Only lasted two days.

Other Meds: Levothyroxin 125mcg Rousuvastin 20mg

Current Illness: no

ID: 1641701
Sex: F
Age: 43
State: CA

Vax Date: 03/04/2021
Onset Date: 04/19/2021
Rec V Date: 08/27/2021
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: none

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

Symptoms: Severe headache, chills, and nausea the first night. A month after the second vaccine, on April 19, 2021, I had a heart attack. I was in good health; no family history of heart disease, no high blood pressure, no high cholesterol, not overweight, healthy eater, regular exercise. The healthcare workers are unable to explain what caused the rupture of plaque in my LAD artery that was 99% blocked. I now have a stent in my heart. Since most risk factors were ruled out for me I am being told it was probably due to stress, but it seems like an extreme response to stress. Many people believe it had something to do with the vaccine, but the healthcare workers say it's too soon to say because we don't know enough about the v

Other Meds: post-natal vitamins

Current Illness: none

ID: 1641702
Sex: F
Age: 68
State: WI

Vax Date: 05/27/2021
Onset Date: 07/08/2021
Rec V Date: 08/27/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient presented to the ED and was subsequently hospitalized for atrial fibrillation with RVR, bacteremia due to e-coli within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1641703
Sex: M
Age: 70
State:

Vax Date: 08/21/2021
Onset Date: 08/24/2021
Rec V Date: 08/27/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient with metastatic lung adenocarcinoma, received 3rd dose of COVID vaccine, was on holter monitor with PSVCs and PVCs, requested to come to emergency center, with nonsustained VTs, cardiology consulted for possible ischemia, prior history of ibrutinib, CARTOX. Patient discharged in stable condition

Other Meds:

Current Illness:

ID: 1641704
Sex: M
Age: 40
State: IA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Patient started experiencing chest pain, fever and chills 3 hours after receiving his third dose of Moderna. Chest pain, fever and chills continued into Tuesday. Early Wednesday morning, the chest pain had not lessened, so the patient went to the emergency room. Emergency room visit showed no sign of a heart attack or other critical medical condition and patient was sent home. Doctor believed all symptoms to be related to his third shot. He received his first shot 2/5/21 and second shot 3/5/21. Symptoms of fever, chills and chest pain lasted for 8 days after his third shot. He had no reports of side effects after his first and second shot.

Other Meds: unknown - pt does not fill any medications at our pharmacy

Current Illness: none reported

ID: 1641705
Sex: F
Age: 44
State: CA

Vax Date: 05/21/2021
Onset Date: 08/03/2021
Rec V Date: 08/27/2021
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: Covid-19 Positive 07/19/2021, PCR Test 07/30/2021 Negative, Antibody Test one month after shows the maximum amount of antibodies.

Allergies: None

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

Symptoms: I tested positive for Covid-19. I had a very sore throat for three days straight. It was there all the time. It was unusual and I thought I was getting. I then started to feel like a normal cold with sneezing coughing and aches and pains. About three days later I developed a low grade fever and a headache. After that I got really congested and I lost my sense of taste and smell. I was also very fatigued the whole time. The most unusual symptom was that I felt like I was going to sneeze and my nose hurt for periods of time. I also lost my voice for a short period of time. In total I had symptoms for three weeks and I still had a little lingering fatigue.

Other Meds: Migraine PRN

Current Illness: None

ID: 1641706
Sex: F
Age: 69
State: NJ

Vax Date: 08/19/2021
Onset Date: 08/20/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to amoxicillin

Symptom List: Unevaluable event

Symptoms: I experienced fatigue, tiredness, pain in my arm, arm swelling and body aches, muscle weakness, light headedness, congestion and lost of balance. I also experienced ear pain, memory fog and fever.

Other Meds: I am taking hydroxychloroquine and levothyroxine.

Current Illness:

ID: 1641707
Sex: M
Age: 22
State: PR

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 08/27/2021
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: N/A

Allergies: Bexacarbotanate, Oxycodone, Gabapentin, Gelatin, Papilloma Vaccine

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

Symptoms: 22 year old male patient reports feeling chest tightness, itchy throat and dizziness. Paramedic protocol is activated. Verbal medical orders via phone with Doctor R. DECADRON 4ml intramuscular. Medication is administered according to the medical orders in the right arm by nurse. Patient is referred to Hospital.

Other Meds:

Current Illness:

ID: 1641708
Sex: M
Age: 69
State: NC

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Initial fever for 3 days. Subsequent persistent nausea before and after eating. Extreme fatigue. Complete loss of taste sensing only salt or sugar.

Other Meds: None

Current Illness: None

ID: 1641709
Sex: F
Age: 49
State: CA

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: 7/10/21 TPO Ab: positive 7/30/21 ANA titer, IF: >1:2590 7/30/21 IgE, QN: 306 (normal 0-130 U/mL)

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Within 48 hours of vaccination, patient developed nasal congestion, ear fullness, and left sensorineural hearing loss. This progressed over the next several weeks to persistent, transient urticaria, small-fiber neuropathy, and autonomic dysfunction.

Other Meds: None

Current Illness: None; had colonoscopy on 1/26/2021

ID: 1641710
Sex: M
Age: 21
State: AR

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/27/2021
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:

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

Symptoms: Patient received the wrong medication for his second dose of the Covid Vaccine. He should have had Moderna

Other Meds:

Current Illness:

ID: 1641711
Sex: M
Age: 18
State: VT

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/27/2021
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: Troponin 24 on 8/27/2021 ECHO normal on 8/27/2021

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Myocarditis with chest pain, fever, chills

Other Meds:

Current Illness:

ID: 1641712
Sex: F
Age: 65
State:

Vax Date: 08/21/2021
Onset Date: 08/24/2021
Rec V Date: 08/27/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient with history of no small cell lung cancer with metastatic disease (T8 lesion). Patient received Moderna COVID vaccine from different facility, two days later complained of bilateral leg numbness, admitted to hospital for T8 laminectomy. Remains admit at current time of VAERS report.

Other Meds:

Current Illness:

ID: 1641713
Sex: F
Age: 73
State: OH

Vax Date: 03/19/2021
Onset Date: 03/01/2021
Rec V Date: 08/27/2021
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: Codin

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

Symptoms: Pain left arm ,can't rise arm very sore.

Other Meds: Simvastatin

Current Illness: None

Date Died: 08/18/2021

ID: 1641714
Sex: F
Age: 77
State: TX

Vax Date: 03/05/2021
Onset Date: 08/13/2021
Rec V Date: 08/27/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Nausea

Symptoms: Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 2/5/2021 and 3/5/2021. Presented to ED on 8/13/21 via EMS from home due to shortness of breath. Patient was 93% on RA en route to ED and stable upon arrival. After arriving to ED, patient has SpO2 88% and was placed on supplemental O2. It was noticed patient may have had short run of ventricular tachycardia and patient went unresponsive with a pulse but agonal respirations. Patient was intubated in the ED on 8/13/21 and eventually extubated on 8/15/21. Patient received Rocephin, Decadron, remdesivir. During this time patient was in AKI. On 8/16/21, pt found to have HR in 20-30s and on 8/17 was severely bradycardic. Remdesivir was stopped. Pt was transitioned to comfort care and hospice Patient expired on 8/18/21.

Other Meds: Ascorbic acid 500mg daily, aspirin 325mg daily, atorvastatin 80mg nightly, Calcium Carbonate- vitamin D3 600mg-400unit BID, digoxin 0.125 1 tab M/W/F, donepezil 10mg BID, ferrous sulfate 325mg daily, furosemide 20mg bid prn, insulin aspart

Current Illness:

ID: 1641715
Sex: F
Age: 17
State: TX

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/27/2021
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: Patient complained about being lightheaded. Patient was pale. Ice pack was used to keep patient cool. Vitals were taken: BP was low 86/43, O2 99%, heartrate 51, respiration 14. Patient advised to take deep breaths and stay calm. After 10 minutes patient felt better and vitals were taken again BP 126/84, heartrate 67. Patient advised to see PCP and lookout for symptoms of reaction. Call 911 if symptoms persist.

Other Meds:

Current Illness:

ID: 1641716
Sex: F
Age: 24
State: VA

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: Blood pressure check: 119/91 and 117/85, blood glucose was checked by EMT. Unknown results but it seemed to have been within normal.

Allergies: None

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

Symptoms: Patient appeared nervous and did not want to get the vaccine but she needed to get it for work. She came in and received the first dose of the pfizer covid19 vaccine from a technician under the authorization of a pharmacist. She went and sat down in the waiting area after the shot. Approximately 5 minutes later she passed out for a few seconds and her head did hit the floor. Pharmacist came immediately to check on her while technician called EMT services. Patient appeared conscious but felt dizzy and her head hurt. She was encouraged to continue laying down and to not get up. She was clear headed and even reached over to her phone to call and text her family members. Patient has no history of adverse reaction to other vaccines. She did state she had not eaten that day but did drink water. Blood pressure was 119/91 and then 117/85 later. EMT services arrived and took over the situation. Patient's mom came to pick patient up. They refused to leave with EMT. They were counseled to see the doctor or go to the emergency room. Pharmacist followed up with the patient later that day. She said she still did not go to see the doctor but she was fine and felt a lot better. She still has a mild headache and was again counseled by pharmacist to see the doctor.

Other Meds: Birth control

Current Illness: None

ID: 1641717
Sex: F
Age: 61
State: PA

Vax Date: 07/28/2021
Onset Date: 08/13/2021
Rec V Date: 08/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Dizzy spells started day 3. Developed mild sore throat and had little sores inside mouth on day 5. Day 13 extreme dizziness where it was difficult to stand or walk. Black spots in peripheral vision. Could not catch breath, chest tightness and vision went in and out of focus. Went to Urgent Care facility, all vitals were normal, said that?s all they could do and suggested it was anxiety. Gave a prescription for dizziness. Went 6 more days not being able to breathe properly, symptoms were not improving at al/worsening l and went to emergency room. Hospital ran vitals tests and could find nothing wrong other than elevated heart beat, Prescribed Ativan . An out of state doctor suggested trying benadryl, took 2 and all symptoms cleared within 4 hours.

Other Meds: Adderall

Current Illness: None

ID: 1641718
Sex: M
Age: 66
State: NJ

Vax Date: 01/21/2021
Onset Date: 02/08/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: Mammogram, Testicular Ultrasound, Thyroid Ultrasound, Blood work

Allergies: None

Symptom List: Tremor

Symptoms: Gynecomastia, Head Ache, general continued fatigue, neck pain

Other Meds: Colchicine Allopurinol

Current Illness: None

ID: 1641719
Sex: F
Age: 47
State: OH

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: no

Allergies: I am allergic to Silicon, Latex, adhesives, Penicillin, Cefzil, Codeine, Morphene, Peroxide, Darvaset, Phenobarbital, Decoct, ammonia, most detergents. MRI Contrast. Calmoseptine, Propranolol.

Symptom List: Erythema, Pruritus

Symptoms: On 04/25/2021 I began to have hip pain, sharp jabbing pain, itching. On 04/26/2021 itching with rash and bumps, fatigue, and body aches, joints hurt. All symptoms went away by May 5th, besides the joint and hip pain, it is still ongoing as of today.

Other Meds: I was taking Lyrica, Singular, Zythromax, Otezla, Matazia, Prilosec, Cardizam, Meloxicam, iron, Allegra.

Current Illness: no

ID: 1641720
Sex: M
Age: 76
State: MN

Vax Date: 05/20/2021
Onset Date: 06/29/2021
Rec V Date: 08/27/2021
Hospital: Y

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Patient presented to the ED after intentional acetaminophen overdose within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1641721
Sex: F
Age: 91
State: OK

Vax Date: 08/23/2021
Onset Date: 08/25/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: MRI brain - negative CBC -normal BMP - normal ESR - 39 TSH 1.22

Allergies: none

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

Symptoms: The patient developed vertical binocular diplopia two days after booster dose of Moderna vaccine.

Other Meds: none

Current Illness: none

ID: 1641722
Sex: F
Age: 21
State:

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/27/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pt said "everything was spinning". No chest pain, No SOB, No nausea. Dizziness resolved after a few minutes.

Other Meds:

Current Illness:

ID: 1641723
Sex: F
Age: 70
State: MD

Vax Date: 03/04/2021
Onset Date: 03/08/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: Nothing specific yet related to the adverse event. My visit with Dr. and the preceding blood tests were a scheduled general health visit.

Allergies: None

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

Symptoms: Nocturnal leg pain (no particular area) within a week of the first dose. Generally cleared up during the day but continued for one month. After 2nd dose (April 1, 2021) had fever and body ache next day and only for one day. In May, began to have morning stiffness, and pain and weakness in hip joints and legs during the day especially after sitting or longer periods. Saw Dr. April 27th but didn't connect the symptoms to the vaccine. Have been healthy and active and was surprised by sudden onset of symptoms. Dr. had no explanation. Blood tests showed nothing unusual. Started taking Tylenol, which relieved symptoms somewhat and continued yoga, swimming, and walking, all of which helped. Still feel occasional pain and stiffness after inactivity, but weakness was greatly reduced. Subsequently, developed pain and reduced range of motion in the shoulders and pain in the upper arm muscles, especially the left arm and shoulder. Stretching and swimming improve the symptoms temporarily, but the pain returns, although not as severely as initially. Some weakness also remains.

Other Meds: 10mg Lisinopril

Current Illness: None

ID: 1641724
Sex: F
Age: 25
State: MN

Vax Date: 03/12/2021
Onset Date: 07/23/2021
Rec V Date: 08/27/2021
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: none

Allergies: none/seasonal allergies

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

Symptoms: I was diagnosed with shingles on May 24, 2021. I have since been diagnosed with Psorasis.

Other Meds: none

Current Illness: none

ID: 1641725
Sex: M
Age: 77
State: NY

Vax Date: 04/15/2021
Onset Date: 04/17/2021
Rec V Date: 08/27/2021
Hospital: Y

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

Lab Data: EJECTION FRACTION IS: 50-55%. Resting Images Normal left ventricular systolic function, normal right ventricle, no pericardial effusion. No regional wall motion abnormalities noted. Stress Findings 4/8/21 There is appropriate global augmentation in myocardial contractility with no regional wall motion abnormalities. Left ventricular hypertrophy with normal systolic function, EF 50-55%. - Trace to mild mitral regurgitation. - Normal left ventricular diastolic function. - Normal right ventricle. cxrIMPRESSION: IMPRESSION: Bilateral interstitial infiltrates. covid testing neg

Allergies: azithromycin, latex

Symptom List: Pain in extremity

Symptoms: 77-year-old female with prior non-Hodgkin's lymphoma (dx 2003 s/p chemotherapy, no recurrence), T2DM, HTN, and hypothyroidism who presented to the ER on 4/17/21 with progressive shortness of breath, diarrhea, and constitutional symptoms of fatigue, nausea, vomiting and diarrhea. Pt reports his symptoms started pretty much of the same day of his vaccine. Patient states that he had like 8 episodes of diarrhea the day of and the day.after second Covid vaccine on 4/15/21 found to have respiratory failure requiring BiPAP with severe sepsis admitted to the ICU. Imaging showed dense consolidation of left lung and respiratory symptomatology consistent with pneumonia. Started on IV Zosyn with significant improvement. He did have sepsis based fluid resuscitation and was mildly fluid overloaded, though improved with gentle diuresis, no further required. Ultimately found to have strep pneumoniae bacteremia. Transitioned to oral Augmentin to complete 14-day course and discharged on 4/20/21. He was readmitted on 8/26/21 with the sudden onset of sob again and found to be in acute pulmonary edema and admitted again. treated with iv Lasix and antibiotics. the cause for the pulm edema was unclear. his oxygen was weaned and he was sent home on prn Lasix. he has no history of chf and has a normal echocardiogram. he denies changes in medications or diet and follows a low sodium diet his bp is well controlled.

Other Meds: Lipitor, trulicity, synthroid, metformin, omeprazole, tadalafil, Flomax, metoprolol

Current Illness: none

ID: 1641726
Sex: F
Age: 26
State: WA

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: Pt made no mention of which hospital she would be going to. You will need to follow up with her for further information on tests and lab results completed in hospital setting.

Allergies: diphenhydramine HCL - moderate hives

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

Symptoms: Pt called clinic in the afternoon after having been vaccinated in the am under the provision of another nurse (not me). Chief pt complaint at time of afternoon call: Leg/upper thigh pain not addressed after pt had taken otc Tylenol. Pt reported swelling and significant discomfort in involved lower limb. Recommendation: Pt seek immediate attention in ER setting to rule out blood clot, given pt's dx of Heterozygous factor V Leiden mutation and possibility of a clot having formed. Pt verbalized understanding and intent to seek immediate medical care.

Other Meds: baclofen 10 mg, famotidine 10 mg, Flonase 50 mcg/actuation nasal spray, ibuprofen 600 mg, loratadine 10 mg, omeprazole 40 mg DR, ProAir HFA 90 mcg/actuation aerosol inhaler, propranolol 10 mg, sertraline 100 mg

Current Illness: Heterozygous factor V Leiden mutation - clotting disorder.

ID: 1641727
Sex: F
Age: 60
State: AZ

Vax Date: 05/07/2021
Onset Date: 05/12/2021
Rec V Date: 08/27/2021
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: CT brain (negative) 5/12/2021 XRay chest - mild cardiomegaly 5/12/2021 MRA Head w/o 5/12/2021: intact proximal anterior and posterior intracranial circulations without proximal high grade stenosis, major branch occlusions, saccular aneurysm, or evidence of arteriovenous malformation. MRA carotid w/o 5/12/2021: no hemodynamically significant stenosis or flow limiting dissection of the common carotid, internal carotid, or vertebral arteries of the neck. MRI brain w/wo (5/12/2021): mild appearing underlying chronic microangiopathic disease without acute or sizable chronic cortical infarct. No mass effect, hydrocephalus, intracranial hemorrhage, or convincing evidence of demyelinating disease. No abnormal intracranial enhancement. Echocardiogram with bubble study (5/13/21) EF 60%, grade 2 left ventricular diastolic dysfunction. Lumbar Puncture 5/14/2021: unsuccessful after two attempts. IR lumbar puncture 5/14/2021 : obtain 6ml bloodtinged CSF. - workup unremakable MRI c-spine w.o contrast 5/15/2021: normal signal intensity of spinal cord, mild cervical disc degneration greatest at C4-5 and C5-6, no central spinal canal stenosis, mild to moderate left neural foraminal narrowing at c7-t1.

Allergies: sulfa

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

Symptoms: Patient experienced Guillan Barre Syndrome/TIA on 5/12/2021 and was hospitalized at Deer Valley Medical Center (Honor Health) 5/12-5/15/2021

Other Meds: Primidone 50mg TID, Mirtazapine 45mg qhs, symbicort 160-4.5mcg/act aerosol prn, diclofenac sodium 75mg prn, omeprazole 20mg qd, certizine 10mg qd, levothyroxine 100mcg qd, losartan 50mgqd, ambien 10mg qgs

Current Illness: Essential tremor, HTN, Hyperlipidemia, asthma, depression, IBS, gerd

ID: 1641728
Sex: F
Age: 39
State:

Vax Date: 03/06/2021
Onset Date: 08/27/2021
Rec V Date: 08/27/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Patient continues to experience left arm pain since first Pfizer vaccine given 3/6/2021, pain is sharp when raises arm, no further information available

Other Meds:

Current Illness:

ID: 1641729
Sex: F
Age: 51
State: IA

Vax Date: 06/04/2021
Onset Date: 06/05/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: None

Allergies: none known

Symptom List: Vomiting

Symptoms: For about a full week after I received the vaccine I had what I would describe as night terrors. The most vivid & horrible dreams I have ever had in my life. To the point that I was screaming in my sleep & my husband would have to come wake me up to stop me from screaming. Several times I woke up crying from the screaming events. Luckily they went away after a week but I do not normally have dreams like that and most of the time never even remember what I dreamed about. I felt disturbed & paranoid to go to sleep every night knowing what might happen again. Due to this side effect, I have yet to go get the 2nd dose.

Other Meds: atorvastatin, levothyroxine, asprin

Current Illness: none known

ID: 1641730
Sex: M
Age: 49
State: WI

Vax Date: 05/02/2021
Onset Date: 05/04/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies: MSG, Apples

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Sudden onset severe tinnitus and pressure/plugged sensation in left ear, starting roughly 36 hours after injection. The pressure/plugged ear sensation went away after about a 3 days, but the tinnitus remains in that ear to this day. I thought this was possibly related to seasonal allergies, so I have not consulted medical advice yet, but I will mention during my yearly physical. As of now, the condition isn't quite debilitating as long as I try to keep my mind off it, but when the tinnitus is louder than the ambient noise (and is not getting any better), this becomes increasingly difficult.

Other Meds: Latanaprost, Cetirizine, Montellukast

Current Illness: none

ID: 1641731
Sex: F
Age: 56
State: FL

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: N/A

Allergies: NKS/NKDA

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

Symptoms: 9:20 am received vaccination, monitored for 15 minutes, until 9:35 am. Client returned at 9:56 am stating " left side of throat sore/feels like swelling." Client denied any issues swallowing or any other symptoms. 9:58 am took client to private area (bathroom), explained possible allergic reaction, need for epi pen and call 911 for assessment. I (nurse) administered epi-pen 0.3 mg (lot # G201104X expiration 2/2022) administration left thigh muscle; b/p taken 140/82 client stated "high for her." 10:00 am client stated "feel better, swelling gone away since epi pen administration. I (nurse) spoke with Program Director who called 911 @ 10:05 am; client continued to state swelling gone away, and feeling better "don't need to go to hospital. I (nurse educated client importance being assessed further, and that she will be given option for transport to ER. 10:10 am EMS arrived; client was walked outside by nurse and Program Manager to sit on bench. I (nurse) gave report to EMS, who then directed client to get on stretcher for assessment and possible transport to ER. EMS stated unsure which hospital transport to until call re: all hospitals on divert. Client was put into EMS vehicle. 10:24 am client returned to me (nurse) informing they did not take her to hospital, took blood pressure 166/93 "higher nervous." Educated client importance following up with PMD before getting second Pfizer vaccination.

Other Meds: none reported

Current Illness: none reported

ID: 1641732
Sex: F
Age: 52
State: GA

Vax Date: 06/13/2021
Onset Date: 06/27/2021
Rec V Date: 08/27/2021
Hospital: Y

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

Lab Data: EKGs (multiple), blood tests (multiple) July 8th and 9th, echocardiogram (August 23rd)

Allergies: Rhopressa (glaucoma medication), cantaloupe and honeydew melons

Symptom List: Injection site swelling, Limb discomfort

Symptoms: First began with sharp pain in my back on the right side. When the pain did not subside, but worsened and began to radiate to my chest, I made an appointment with my PCP. During the visit, I was told that my heart rate was very low (40) and that they were going to try to see they could get me in to see a cardiologist on that day - if not, I was advised to go to the ER (after an EKG test was run in office). When a cardiologist was not found to be available, I was told to go directly to the ER, and was given the EKG printout to take with me. I went to hospital on July 8, 2021 and after several hours and tests there, I was admitted into the cardiac unit. I was released the next day, with instructions to follow-up with my PCP and a cardiologist (still in pain). I followed all of the instructions given to me - and was told that I had "had low heart rate since 2014" but there were now some abnormalities that were showing up on the EKGs that were done. I have been going to the same practice for several years, and never has anyone ever indicated that my heart rate was low, mentioned bradycardia or anything of that nature. Although the physician that I saw on my doctors visit wasn't my regular PCP,, I had seen her in that practice before, and I also have access to My (medical records online) and there is nothing that points to any heart issue at all until two weeks [exactly] after my second shot. I am currently still being seen by a cardiologist, and just days ago had to have an echocardiogram done. This is all new for me and very daunting.

Other Meds: Glaucoma medication

Current Illness: None

ID: 1641733
Sex: M
Age: 85
State:

Vax Date: 04/02/2021
Onset Date: 05/01/2021
Rec V Date: 08/27/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient presented to the ED and was subsequently hospitalized for abdominal pain, vomiting r/t acute diverticulitis within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1641734
Sex: F
Age: 70
State: GA

Vax Date: 02/18/2021
Onset Date: 03/30/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: Venagram: Found two blockages

Allergies: N/A

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

Symptoms: Leg started swelling in late March, became severe in May. Saw regular doctor. He sent me to another doctor (cardiovascular surgeon). He did an ultrasound, then did a venogram. Found an 80% blockage and a 60% blockage in abdomen veins. Had stent put in (July), given Plavix and Eliquis. It seems to have improved since the stint and medication, will return in november. Still having some swelling, but minimal.

Other Meds: Lisinopril; Metoprolol; Orizapan; Tramadol; Vitamin D; COQ-10

Current Illness: N/A

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am