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: 1655646
Sex: M
Age: 37
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
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: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655647
Sex: M
Age: 57
State: KY

Vax Date: 05/04/2021
Onset Date: 08/29/2021
Rec V Date: 08/30/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Moderna Covid Vaccine administered 04/06/2021 AND 05/04/2021 patient admitted to floor bed covid positive 8/29/2021

Other Meds:

Current Illness:

ID: 1655648
Sex: F
Age: 39
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
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: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655649
Sex: F
Age: 53
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
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: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655650
Sex: F
Age: 67
State: LA

Vax Date: 08/16/2021
Onset Date: 08/18/2021
Rec V Date: 08/30/2021
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: Nexxium and Thimersol

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

Symptoms: I have been suffering from shortness of breath with a feeling like my heart is skipping a beat, which is progressing to a tightness in my upper chest & some coughing, particularly at night. I contacted my primary care Dr.; however, he told me it wasn't a side effect of the vaccine and that those should only last about 3 days anyway, and mine has not, so I wasn't seen, but I didn't not have these symptoms prior to the vaccine.

Other Meds: None that day.

Current Illness: Limited Scleroderma and Osteoarthritis

ID: 1655651
Sex: M
Age: 18
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
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: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655652
Sex: F
Age: 48
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655653
Sex: F
Age: 14
State: MA

Vax Date: 08/28/2021
Onset Date: 08/28/2021
Rec V Date: 08/30/2021
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: A patient was given a more heavily concentrated dose of the Pfizer COVID-19 vaccine when the vial was improperly diluted with 0.8mL instead of 1.8mL. No acute reaction occurred. The error was identified prior to additional patients being affected. Clinic staff are currently attempting to contact the patient and parent regarding this error.

Other Meds:

Current Illness:

ID: 1655654
Sex: M
Age: 32
State: VA

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data: Duplex Lower EXT venous bilateral sonogram (Doppler)

Allergies: Amoxicillin Cinnamon in dental items

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Within a few minutes after vaccination pt passed out for about 2 minutes having seizure like symptoms. Early morning around 4 am he passed out again and woke up with neck pains. Begin experiencing leg pains in left leg which turned into redness in left legs. Was diagnosed with 3 blot clots in left leg.

Other Meds: None

Current Illness: None

ID: 1655655
Sex: M
Age: 75
State:

Vax Date: 04/21/2021
Onset Date: 08/27/2021
Rec V Date: 08/30/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Moderna Covid Vaccinations 03/24/2021 AND 04/21/2021. Patient admitted to floor bed covid positive 8/27/21

Other Meds:

Current Illness:

ID: 1655656
Sex: F
Age: 36
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
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: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655657
Sex: F
Age: 43
State: WV

Vax Date: 01/12/2021
Onset Date: 02/20/2021
Rec V Date: 08/30/2021
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: mushrooms

Symptom List: Rash, Urticaria

Symptoms: Having issues with joint pain. On 2/20/21 noticed swelling on R hand joint between index finger and 2nd finger. Worsening over a few days. Physician sent in prednisone on 2/23/21. Continue to have issues with R hand joint and now L hip and knees. Getting xray on hand and testing ANA and other possible inflammatory or rheumatology labs.

Other Meds: Lexapro 20mg daily Levothyroxine 225mg daily

Current Illness: none

ID: 1655658
Sex: F
Age: 42
State: TN

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

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

Lab Data:

Allergies: N/A

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

Symptoms: Strong metallic taste in mouth, day of injection, lasted about 12 hours Severe unbearable pain in hips and lower back, day of injection, lasting 24 hours and then subsiding to uncomfortable pain the following day. Cough, sneezing, sore throat, headache, chills, feeling of being unwell starting on day two after receiving the injection, still feeling this way 24 hours later.

Other Meds: Cosentyx 300mg injections, monthly Benadryl, OTC, 50mg, daily

Current Illness: N/A

ID: 1655659
Sex: M
Age: 25
State: FL

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 08/30/2021
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: Allergic to Penicillin.

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

Symptoms: After first injection, developed significant pain in L arm. After 7/8 days of first injection, developed small rash near injection site. After second injection about a month after first, developed significant pain in L arm and shoulder. Developed fever and fatigue. Developed muscle twitching in R forearm/elbow area as well. All symptoms besides twitching have resolved.

Other Meds: None

Current Illness: None.

ID: 1655660
Sex: M
Age: 37
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
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: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655661
Sex: F
Age: 36
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655662
Sex: F
Age: 46
State: NY

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data: 5/16 elevated IL 10 (3.1 pg/mL), IL2 receptor CD25 soluble 930.6 pg/mL normal IL1 beta, IL12, IL13, IL2, IL4, IL5, IL6, IL8, INF gamma, IL 17 tryptase 10.6 ug/L 8/19 laryngoscopy shows bilateral vocal cord paresis with incomplete adduction. Mild periarytenoid edema and moderate post-cricoid edema noted. 08/20 WBC 12.68, Hgb 10.8, Hct 31.7, Plt 227. absolute neutrophil 10.27 K/uL, absolute lymphocyte 1.67 K/ uL, absolute monocyte 0.62 K/ uL, absolute eosinophil 0.00 K/uL, absolute basolphil 80.9 K/uL normal tryptase (12.7 ug/L), C1q immune complex (1.3 ug Eq/mL), C3d Immune Complexes (9.9 ug Eq/ml) elevated IL 10 (6.3 pg/mL), IL2 receptor CD25 soluble (1056.0 pg/mL) normal IL1 beta, IL12, IL13, IL2, IL4, IL5, IL6, IL8, INF gamma, IL 17 COVID-19 Spike domain Ab >250 U/mL

Allergies: Mushrooms, shellfish, eggplant, pumpkin. Betadine, Biaxin, Sulfa drugs

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

Symptoms: pruritus of ears and hoarseness/loss of voice 30 minutes after vaccine administration. Given 25mg of Benadryl and 40mg of prednisone. Continues to have loss of voice despite treatment with antihistamine and oral prednisone.

Other Meds: carvedilol, clonidine, esomeprazole, ferrous sulfate, nifedipine ER, Procrit, Repaglinide, sevelamer, tacrolimus, prednisone, Velphoro,

Current Illness:

ID: 1655663
Sex: F
Age: 44
State: SC

Vax Date: 08/13/2021
Onset Date: 08/19/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data: none

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: big, hot red angry painful and itchy oval blotch. lasted a week and spread for a week. started small and got big. i also received the shot in the BACK of my arm where there is fat, instead of right below my shoulder on the side of my arm where most shots are usually given .

Other Meds: vit d vit c multi fish oil iron magnesium ashwaganda

Current Illness: none

ID: 1655664
Sex: M
Age: 18
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
Hospital:

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: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655665
Sex: F
Age: 43
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655666
Sex: F
Age: 37
State:

Vax Date: 08/19/2021
Onset Date: 08/23/2021
Rec V Date: 08/30/2021
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: styes and blepharitis on both eyes over a period of 7 days

Other Meds:

Current Illness:

ID: 1655667
Sex: F
Age: 69
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655668
Sex: F
Age: 78
State:

Vax Date: 03/05/2021
Onset Date: 08/29/2021
Rec V Date: 08/30/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Patient received Pfizer Covid vaccine 02/12/2021 AND 03/05/2021 admitted to floor bed Covid positive 08/29/2021

Other Meds:

Current Illness:

ID: 1655669
Sex: F
Age: 89
State: MN

Vax Date: 03/30/2021
Onset Date: 08/29/2021
Rec V Date: 08/30/2021
Hospital: Y

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

Lab Data: Symptomatic COVID positive 8/25/21

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Breakthrough COVID infection, admitted and tested symptomatic positive for COVID 8/25/21

Other Meds:

Current Illness:

ID: 1655670
Sex: M
Age: 69
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
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: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655671
Sex: F
Age: 59
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655672
Sex: M
Age: 63
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655673
Sex: M
Age: 46
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655674
Sex: F
Age: 44
State:

Vax Date: 06/19/2021
Onset Date: 08/28/2021
Rec V Date: 08/30/2021
Hospital: Y

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

Symptoms: Patient received Pfizer covid vaccine 05/29/2021 AND 06/19/2021 admitted to floor bed covid positive 08/28/2021

Other Meds:

Current Illness:

ID: 1655675
Sex: F
Age: 36
State: FL

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data:

Allergies: MORPHINE, MACROBID

Symptom List: Nausea

Symptoms: SWELLING AND BURNING OF ALL MEMBRANES ON MY BODY. VACCINE ALSO STARTED MENSTRAUTION AFTER NOT MENSTRUATING FOR 27 MONTHS.

Other Meds: NONE

Current Illness: NONE

ID: 1655676
Sex: M
Age: 45
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
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: vaccine expired in fridge

Other Meds:

Current Illness:

Date Died: 08/14/2021

ID: 1655677
Sex: M
Age: 53
State: KY

Vax Date: 07/23/2021
Onset Date: 07/29/2021
Rec V Date: 08/30/2021
Hospital: Y

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

Lab Data: 8/7/2021 Radiology: personally reviewed unless stated otherwise. Chest XR: post intubation and OETT 5 cm above carina, stable pneumomediastinum and pneumopericardium present

Allergies: NKDA

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

Symptoms: patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021 History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell. Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23. On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and "passed out" 4 times since symptoms developed. While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5. On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula. Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia. MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure. Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension. Assessment and Plan: The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID. ARDS COVID-19 PNA (POA) Pneumomediastinum, worsening -XR chest with B/L peripheral and bibasilar opacities -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN: - Evaluate to repeat CT chest with patient clinical decline. - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula. - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts. - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN: -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7. -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation. - Prior to intubation, patient had EMV 15, appropriate and no focal deficits. - Likely metabolic in nature, patient with BUN >100, sepsis, COVID - No past history of seizures. PLAN: - TSH, B12, ammonia - EEG Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN: -STOP coreg , HOLD home amlodipine -OP follow up with cardiology for further workup given COVID positive status Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN: - CMP today and as needed. Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance Obesity (POA) - BMI 35.8, complicates all aspects of care. Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending: Discharge Date: 08/14/21 Discharge Attending Physician: 8/9/2021 Assessment and Plan The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID. Acute Respiratory Failure Requiring Mechanical Ventilation Moderate ARDS COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable HAP -XR chest with B/L peripheral and bibasilar opacities -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8 PLAN: - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula. - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts. - DC nimbex today, PF ratio increased to 164 after paralytic -Continue dexamethasone 6 mg daily (stop date 8/11) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN: - Nephrology following, appreciate recs - Continue CRRT with goal net even - Dose meds for CRRT -Strict I&O, Daily weights Shock, multifactorial - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF - Cortisol 9.7 on 8/7 PLAN: - Levophed for MAP >65 - Treatment of infections - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS. Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN: -OP follow up with cardiology for further workup given COVID positive status Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN: - CMP improving, weekly checks. DM type 2 (POA) - Diet controlled at home. PLAN: - Start insulin gtt today, monitoring per protocol. Hypertension - Hold Home meds until clinically appropriate. Obesity (POA)- BMI 35.8, complicates all aspects of care discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell. Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23. On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab. On 8/6 the patient had worsening shortne

Other Meds: acetaminophen, allopurinol, amlodipine, calcitriol, ergocalciferol, sodium bicarbonate, Tamsulosin

Current Illness: exposed to covid 7/20, received first vaccine 7/23

ID: 1655678
Sex: F
Age: 58
State: AR

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 08/30/2021
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:

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

Symptoms: Pt came in for second Monderna vaccine but wanted clearance first. 7/15/21 received first vaccine, within 6 hours pat. developed a rash from shoulder to shoulder and back of neck and upper back. Also developed extreme fatigue- Pt states 3 yrs ago stung by red hornet and had same rash, stung 1 year later by another red hornet reaction was much worse. She could not walk for 6 weeks due swelling in legs, she developed blisters form head to waist,

Other Meds:

Current Illness:

ID: 1655679
Sex: F
Age: 73
State: CA

Vax Date: 03/16/2021
Onset Date: 04/19/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data: I had a diagnosis mammogram that showed no symptoms of cancer.

Allergies: Some foods, cats, and inhalants like solvents, smoke,mold

Symptom List: Tremor

Symptoms: Pain in left breast, and underarm so intense I cannot sleep on my left side. First reported to primary care doctor April 26, 2021. It is getting worse and it's been 6 months.

Other Meds: Breo, thyroxine, Lisinopril

Current Illness: None

ID: 1655680
Sex: F
Age: 47
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655681
Sex: F
Age: 48
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655682
Sex: F
Age: 60
State: FL

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 08/30/2021
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: None.

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

Symptoms: 3:00 AM the next morning had hot temperature, temp was 99.2-100.7, fever, fatigue for 24 hours straight.

Other Meds:

Current Illness:

ID: 1655683
Sex: F
Age: 33
State: CT

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data: I was prescribed Clomid in May (May 18- May 22) to induce a period but that still didn't work. I am still undergoing fertility treatments with RMA of CT to induce a period. My most recent appointment was today, August 30, 2021 at which they suggested I report my adverse side effect.

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I have not gotten my period since I have received the vaccine in February.

Other Meds: None

Current Illness: None

ID: 1655684
Sex: M
Age: 12
State: NM

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/30/2021
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: INADVERTENT ADMINISTRATION TO CHILD UNDER AGE 18 OF MODERNA VACCINE, NO KNOWN ADVERSE EFFECTS

Other Meds:

Current Illness:

ID: 1655685
Sex: M
Age: 44
State: NC

Vax Date: 07/31/2021
Onset Date: 08/04/2021
Rec V Date: 08/30/2021
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: Ekg - normal.

Allergies: None

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

Symptoms: After 4 days, heart palpitations, racing heart, lightheaded, chest discomfort. After 3 weeks, saw doctor. Diagnosed with very high blood pressure and likely heart inflammation.

Other Meds: None.

Current Illness: None.

ID: 1655686
Sex: F
Age: 86
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
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: Pain in extremity

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655687
Sex: F
Age: 30
State: AL

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

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

Lab Data:

Allergies: NKDA

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

Symptoms: PATIENT REPORTED A PAINFUL RASH THAT DEVELOPED ON HER LEFT HIP ONLY. IT IS THE SIZE OF A DECK OF PLAYING CARDS.. SHE STAED IT BLISTERED SOME AT FIRST THEN IS RED, SWOLLEN, AND ITCHY WITH HEAT IN IT.

Other Meds: ADIPEX, WEGOVY

Current Illness: NO

ID: 1655688
Sex: F
Age: 39
State: MO

Vax Date: 03/19/2021
Onset Date: 04/01/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data: multiple blood panels 3 biopsies of multiple patches of skin, one more on sept 4th x-rays, ultra sounds and MRI's

Allergies: Penicillin & Amoxicillin, Keflex, Bactrim, Ciprofloxacin, Vicodin, Hydrocodone, Doxycycline, Gabapentin

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

Symptoms: small rash and joint pain at first, rash started on legs, joint/tendon pain started in elbow and has move and progress to other areas, wrists, biceps hips. Finally in June the rash become so bad i was covered in hives that medication would not control, my freckles and moles swelled to look like ticks, the amount of rashes and hives were so sever I ended up covered in bruises, I am on LOTS of med to hardly keep it under control at this point, 3 biopsy's have been done and point to drug eruption. The people who gave me the shot did NOT check my allergies. I DO NOT WANT TO BE on medicine the rest of my life b/c of this vaccine.

Other Meds: Desvenlafaxine ER daily, Bupropion HCL XL daily, Adderall x2 daily, Maxalt as needed

Current Illness:

ID: 1655689
Sex: F
Age: 78
State:

Vax Date: 03/04/2021
Onset Date: 08/29/2021
Rec V Date: 08/30/2021
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:

Allergies:

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

Symptoms: Patient vaccinated Pfizer covid vaccine 02/11/2021 AND 03/04/2021 admitted to floor covid positive 08/29/2021

Other Meds:

Current Illness:

ID: 1655690
Sex: F
Age: 47
State:

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1655691
Sex: F
Age: 44
State: PA

Vax Date: 08/09/2021
Onset Date: 08/17/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data: N/A

Allergies: Sulfa drugs; anti-nausea medications

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I received the shot on the 9th of August, had 2-3 days of the initial arm site swelling and pain. Then It went away and I was fine. Then the morning of the 17th of August I woke up in pain in my arm and a pins and needles sensation in my arm. I looked at it and it looked like hives, it was hot to touch and was a big, hard, red area. That lasted the 17th/18th/19th and on the 20th when I woke up and was supposed to go to the Dr., it was pretty much gone. Oh, and you know else, my menstrual cycle is very regular, and it should've come right after my shot, and it didn't come then when it did come it was only two days which is very weird for me since I am never irregular like that. So, on the 20th of August I had went to the Dr., but he said it was "normal" as a reaction after the vaccine and he recommended getting the shot in the other arm for the vaccine. So, for my next vaccine, I have a Dr. appointment 3 days after my vaccine just in case. At home I had treated with Benadryl.

Other Meds: Garlic capsules; Multivitamin; Klonopin; Synthroid; Trazodone; Amitriptyline; Xyzal allergy medication

Current Illness: N/A

ID: 1655692
Sex: F
Age: 35
State: MN

Vax Date: 05/05/2021
Onset Date: 08/27/2021
Rec V Date: 08/30/2021
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: Patient tested at our outpatient testing site. Please contact her primary care provider

Allergies: Patient tested at our outpatient testing site. Please contact her primary care provider

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

Symptoms: Patient vaccinated as indicated above and tested positive for COVID-19 on 8/27/21.

Other Meds: Patient tested at our outpatient testing site. Please contact her primary care provider

Current Illness: Patient tested at our outpatient testing site. Please contact her primary care provider

ID: 1655693
Sex: F
Age: 60
State: CA

Vax Date: 06/22/2021
Onset Date: 06/23/2021
Rec V Date: 08/30/2021
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:

Allergies: NONE

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient stated that she had a seizure the day after getting her 2nd dose, patient stated that her eyes were swollen shut, and she also stated that she had vertigo. Patient stated that she started throwing up, and wasn't able to eat. Also stated that she was shaky and couldn't walk, and couldn't form a thought in her head. Patient is still having AEs.

Other Meds: Gabapentin, Keppra

Current Illness: NONE

ID: 1655694
Sex: M
Age: 50
State: SC

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: No adverse effect from dose 1. Dose 2 adverse affects: - Monday - By 11PM - Fever - 101.2, Headache - Wed - Severe abdominal pain. Put on antibiotics and pain meds

Other Meds: Nortriptyline Atorvistatin Coq-10 One-A-Day - Men's Daily Vitamin

Current Illness: N/A

ID: 1655695
Sex: F
Age: 33
State: KY

Vax Date: 08/21/2021
Onset Date: 08/22/2021
Rec V Date: 08/30/2021
Hospital:

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

Lab Data:

Allergies: None known

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

Symptoms: developed head to toe rash, swelling to ears and eyes, itching, feels lightheaded

Other Meds: Syeda OCP

Current Illness: none known

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am