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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1662815
Sex: M
Age: 28
State: IL

Vax Date: 07/24/2021
Onset Date: 09/01/2021
Rec V Date: 09/01/2021
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: Penicillin

Symptom List: Dysphagia, Epiglottitis

Symptoms: The adverse event is that I received my first dose of the vaccine on July 24th and received a CDC COVID-19 Vaccination Record Card that stated moderna as my 1st dose of the covid vaccine but when I called the pharmacy to verify the information, because the follow up date was incorrect on the vaccine card, the pharmacy told me I had received the Pfizer vaccine as my first does not Moderna as stated on my vaccine card. When I received my follow up vaccine I showed the original card to the pharmacist and she kept it, refusing to return it to me. Then she had wrote the 1st dose for the pfizer vaccine and gave me a new card. I told her I took photos of the original card either way but she refused to return the card to me.

Other Meds: Claritin-D

Current Illness: none

ID: 1662816
Sex: M
Age: 83
State: OH

Vax Date: 02/09/2021
Onset Date: 07/31/2021
Rec V Date: 09/01/2021
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: iodinated contrast dye

Symptom List: Anxiety, Dyspnoea

Symptoms: 8/9/2021:came to ED with SOB, cough and weakness for 10 days 8/10/2021: pos for COVID - discharged 8/13/2021: admitted with worsening symptoms 8/19/21: discharged to home with home health care and dexamethasone and told to return if worsens

Other Meds: allopurinol, insulin, finasteride, MVM, folic acid, furosemide, losartan, lubiprostone, metformin, mirabegron, NTG, omega 3 FA, omeprazole, senna, tamsulosin, Maxide, trospium

Current Illness: none

ID: 1662817
Sex: F
Age: 43
State: NY

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 09/01/2021
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: Instantaneous burning sensation in eyes. I have since developed an allergy to the chemical wipes I have Been using for the last 16 years at work.

Other Meds:

Current Illness:

ID: 1662818
Sex: F
Age: 30
State: OH

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: Patient has been treated with 2 prednisone courses, helped/lessened, but then symptoms return

Allergies: Orange food color-rash and hives

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Since the vaccine, bilateral lymph node swelling in the neck and right ear pain (7 months)

Other Meds: Birth control pill and Loratadine 10 mg

Current Illness: None This was patient's second Moderna vaccine

ID: 1662819
Sex: F
Age: 58
State: GA

Vax Date: 01/29/2021
Onset Date: 02/10/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: ER- Feb 14, CT of Brain Physical Therapy VNG 6/23 Brain MRI 6/24 Vestibular Therapy 6/29 Neurologist prescribed Prednisone

Allergies: Penicillin Ceclor Lortab Medrol Pack

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

Symptoms: Dizziness, brain fog, stiff neck, migraine head aches, Constant Pressure

Other Meds: Synthroid 100mc Estradiol patch .01 Progesterone 200 Testosterone Cream

Current Illness:

ID: 1662820
Sex: F
Age: 58
State: OH

Vax Date: 08/30/2021
Onset Date: 09/01/2021
Rec V Date: 09/01/2021
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: Patient said she developed a stye from the covid vaccine. Patient purchased some OTC medication.

Other Meds:

Current Illness:

ID: 1662821
Sex: M
Age: 80
State: MI

Vax Date: 05/19/2021
Onset Date: 07/28/2021
Rec V Date: 09/01/2021
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: COVID positive test on 07/28/21

Allergies: Penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fully vaccinated patient admitted through ED for CVA (c/o dizziness). No s/s of COVID during his admission stay.

Other Meds: Aspirin, lipitor, plavix, lofibra, luvox, hydrodiuril, lantus, losartan, lyrica, januvia, flomax

Current Illness:

ID: 1662822
Sex: F
Age: 3
State: NV

Vax Date: 08/23/2021
Onset Date: 08/28/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: Mom reports going to children's ER, but did nothing and told to call HD regarding vaccines.

Allergies: mother deinis

Symptom List: Pharyngeal swelling

Symptoms: Had a high temperature, rash (bumps and redness) on trunk and arms and moving to face. Clt mom reports that she is drinking and not eating and is lethargic. Mom reports child now has a head ache. Swelling around her eyes and eyes are hurting. mom reports child is constipated, and reports giving her prune juice and did give milk but ER told her not to give that anymore.

Other Meds: Motrin prn

Current Illness: mother denies

ID: 1662824
Sex: F
Age: 26
State: UT

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/01/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: THE PATIENT RECEIVED THE MODERNA SHOT AND WAS TOLD TO WAIT FOR 15 MINUTES FOR OBSERVATION. HER HUSBAND WAS WITH HER AND HELPED KEEP AN EYE ON HER. APPROXIMATELY 10 MINUTES AFTER RECEIVING THE SHOT SHE STARTED TO FEEL LIGHT HEADED, VISION BEGAN TO FADE, HER FACE WAS WHITE, SHE WAS COLD TO THE TOUCH, AND SHE WAS SWEATING PROFUSELY. THE PATIENT LAID DOWN AND AFTER ABOUT 10 MORE MINUTES SEEMED TO BE FEELING BETTER AND COLOR WAS RETURNING TO HER FACE. THE PARAMEDICS ARRIVED AND CHECKED HER. SHE LEFT WITH HER HUSBAND.

Other Meds:

Current Illness:

ID: 1662825
Sex: M
Age: 57
State: UT

Vax Date: 07/26/2021
Onset Date: 07/27/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: 8-24-21. CBC with Auto Diff (GMC, IHC). Comprehensive metabolic panel, C-Reactive Protein, Vitamin B12. All tests were normal 8-24-21. Basic Neurological exam by doctor. Normal 8-25-21. MRI Brain WO +W Contrast. No contributing findings 9-1-21. Ear exams and hearing tests. All Normal

Allergies: Possibly Cipro

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Had dizziness the next morning, and reduced sensory in left foot, and feeling of weakness. Dizziness settled a bit but about 1.5 weeks later it came back with dizzy spells daily occurring throughout the day with head pressure, foggy feeling and a disconnected feeling also a feeling of weakness more in left leg but general feeling of weakness, as well as Nausea that comes and goes, also roaming headaches usually mild not severe. Symptoms have continued on and off each day with some days more symptoms and some days less symptoms.

Other Meds: None

Current Illness: None

ID: 1662826
Sex: M
Age: 42
State: OH

Vax Date: 08/01/2021
Onset Date: 08/30/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: ER evaluation

Allergies: NKDA

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

Symptoms: patient experiencing SIRVA

Other Meds: none

Current Illness: nothing reported

ID: 1662827
Sex: F
Age: 70
State: KY

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 09/01/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: macrobid

Symptom List: Rash, Urticaria

Symptoms: pt had full vaccine series now + with COVID and hospitsalized

Other Meds: unknown

Current Illness: unknwon

ID: 1662828
Sex: F
Age: 20
State: CA

Vax Date: 06/04/2021
Onset Date: 06/06/2021
Rec V Date: 09/01/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: She got her vaccine, just had a lot of redness around the area. It got a little swollen which was there for about a week. Then it went away. Then the beginning of August she noticed that it was almost like a bruise, and after that it kind of started forming a dent in her arm where she had swelling that had spread. On the side/back of her arm kind of. She went to the doctor for it, and the first doctor told her that it was probably due to the vaccine and something about the tissue that when it was swollen and when it subsided her arm indented. The 2nd doctor she talked to told her it typically happens with vaccines with steroids, but COVID does not, and she did not tell her anything else. She told her that she could get filler in her by going to a plastic surgeon. It is not painful, but there are times when she feels like somebody is pinching her which is random. It definitely has gotten worse since the vaccine as times goes forward. The area looks more and more dented and depending on how she holds her arm it looks bad, huge dent in her arm.

Other Meds: Paroxetine, Ibuprofen, Ciprofloxicin, Nitrofurantoin.

Current Illness: Kidney infection.

ID: 1662829
Sex: F
Age: 39
State: FL

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 09/01/2021
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: Penicillin

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

Symptoms: About 10 minutes after receiving the shot, tasted a metallic taste and then had the feeling of dry mouth. This lasted throughout the day so I did my best to stay hydrated. By the evening, my hearing was muffled and just felt off. The next day, those symptoms went away and new ones began. Each day for a week, felt heart palpitations and also a feeling of needing to take deeper breaths, but not short of breath. I also felt tired and experienced headaches for 3-4 days. I do get regular headaches, but these were more intense. After the week from when I received the shot, those daily symptoms seem to have subsided.

Other Meds: In the morning, took Mesalamine and CBD

Current Illness:

ID: 1662830
Sex: F
Age: 40
State: PR

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/01/2021
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: Fish

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

Symptoms: 40 year old female, after the administration of the vaccine, reports to the EMT feeling of heavy tongue. Approximately 29 minutes after the administration. 12:47pm an evaluation is done to the patient and we take vitals BP 90/50, respirations 20, pulse 71, SPO2 99%. At 12:45pm we consult with Doctor R and she orders "GATORADE" to increase volume and leg elevation and to keep her in observation for 30 minutes. Vitals are reevaluated at 1:17 BP 11/90, P64, R20, SPO2 98%, temp 36.4C. Patient reports feeling better and does not feel tongue heavy, she is discharge from the observation area and patient leaves the center.

Other Meds: Unknown

Current Illness: None

ID: 1662831
Sex: M
Age: 12
State: NJ

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/01/2021
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: NKDA

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

Symptoms: Patient was given the whole vial of the vaccine without the diluent.

Other Meds: NONE

Current Illness: NONE

Date Died: 09/01/2021

ID: 1662832
Sex: M
Age: 72
State: CO

Vax Date: 03/22/2021
Onset Date: 08/26/2021
Rec V Date: 09/01/2021
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: pollen

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

Symptoms: Fever of unknown origin and encephalopathy. Rapid neurological and respiratory decline of unknown origin.

Other Meds: lipitor

Current Illness: none

ID: 1662833
Sex: F
Age: 88
State: TX

Vax Date: 02/23/2021
Onset Date: 08/27/2021
Rec V Date: 09/01/2021
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: Hospitalized with COVID-19 infection

Other Meds:

Current Illness:

ID: 1662834
Sex: F
Age: 60
State: AK

Vax Date: 01/23/2021
Onset Date: 02/13/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data:

Allergies: Sulfer

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Extreme pain in right and left temples. Pain in arms, legs, stomach, eyes, ears, muscles. These side effects lasted for weeks. Issues with concentration and memory. Stomach pain. I?m still having muscle pain.

Other Meds: Tylenol, vitamin C, Benadryl

Current Illness: None

ID: 1662835
Sex: F
Age: 62
State: CA

Vax Date: 05/19/2021
Onset Date: 08/25/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data:

Allergies: Vicodin; Prednisone; Tetracycline; Cipro; Bactrim

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

Symptoms: Around the 08/18/2021 I thought I was having allergies, I started feeling like my chest and throat were congested. I started having a mild to moderate headache. I started feeling weak and tired. After that I lost my taste and smell and the abdominal pain came on. I went to a mobile clinic and tested positive for COVID 19 on 08/25/2021. On 08/27/2021 I went and had another test done with a positive result. My symptoms have gotten better.

Other Meds: Symbicort; Albuterol; Flonase; Cetirizine; Guaifenesin; Vitamin D; Celebrex; Baclofen

Current Illness:

ID: 1662836
Sex: M
Age: 59
State: MI

Vax Date: 05/06/2021
Onset Date: 08/01/2021
Rec V Date: 09/01/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: COVID positive test on 08/01/2021

Allergies: None

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

Symptoms: Fully vaccinated patient admitted to hospital for COVID. Patient with positive COVID exposure reported at work on 07/25/21. Fully vaccinated with Jansenn vaccine in May. Patient admitted through ED for shortness of breath and hypoxia at 88%. Admitted for shortness of breath, dizziness, headache, cough, pleuritc chest pain. Recieved Remdesivir, Decadron, Actemra, IV lasix, ATB's. Sent home on portable O2 and 3L/nasal cannula.

Other Meds: Lasix, prevacid, K-dur, trazadone

Current Illness:

ID: 1662837
Sex: F
Age: 41
State: FL

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 09/01/2021
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: patient had bright burning rash, urticarial rash and focal neuropathy

Other Meds:

Current Illness:

ID: 1662838
Sex: F
Age: 26
State: NC

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 09/01/2021
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: penicillin and all dirivitives

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

Symptoms: breast milk reduction

Other Meds: birth control

Current Illness:

ID: 1662839
Sex: M
Age: 15
State: OR

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Vaccine was reconstituted incorrectly. 0.8ml instead of 1.8ml of diluent was used. 3 patients received the higher concentrated doses. patients were notified. No adverse reactions have been reported.

Other Meds:

Current Illness:

ID: 1662840
Sex: F
Age: 81
State: FL

Vax Date: 01/05/2021
Onset Date: 06/25/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: Covid test, cxr.

Allergies: NKA

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pt came to ER c/o difficulty breathing onset 1 day prior. Tested positive for Covid day prior.

Other Meds:

Current Illness:

ID: 1662841
Sex: M
Age: 62
State: MO

Vax Date: 04/19/2021
Onset Date: 08/31/2021
Rec V Date: 09/01/2021
Hospital: Y

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

Lab Data: Contains critical data CORONAVIRUS (COVID 19) PCR - Asymptomatic, No Close Contact Exposure, or Screening Only Order: 277816126 Status: Final result Specimen Information: NASOPHARYNGEAL SWAB 0 Result Notes Ref Range & Units 8/31/21 0526 CORONAVIRUS SARS COV 2 PCR (RESP) POSITIVE Panic

Allergies:

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

Symptoms: History of Present Illness: Patient is a 63-year-old male presenting as a level 2 trauma activation. He is transfer from a local hospital. He was driving his motorcycle approximately 25 to 30 miles an hour when he rear-ended his brother-in-law, striking the steering column and being thrown onto his left side. He sustained a left elbow laceration which underwent primary repair with facility. He is complaining of severe groin pain as well as chest wall discomfort. Prior to the injury he was independently ambulatory without assistive devices and denies any history of previous groin or pelvic surgeries. He is right-hand dominant. He is complaining of some mild pain in his right elbow as well. He was unable to ambulate after the accident.. He denies any numbness or tingling in his legs. He denies any personal or family history of DVT, PE, problems with anesthesia. He is retired. Lives in Perryville, MO. Assessment and Plan: Patient is a 63-year-old male with APC 2 pelvic ring injury and extraperitoneal bladder rupture, as well as left arm road rash and right elbow pain/limited motion Discussed with patient his brother natural history and treatment options for unstable left pelvic ring injury with evidence of anterior disruption more than 2.5 cm and some suggestion of left SI instability as well as well as associated bladder rupture. Multidisciplinary conversation held with Dr of urology and Dr of trauma in formulation of treatment plan.. We discussed treatment options including nonoperative management, external fixation, as well as open reduction internal fixation. Discussed my plan would be to start with an exam under anesthesia. Given his age, obese status, would not recommend an external fixator. If there is evidence of complete disruption of the sacroiliac ligaments, he will require associated posterior fixation as well. After exam under anesthesia is complete, we will plan to proceed with combined open reduction internal fixation of the anterior pubic diastases as well as displaced superior pubic ramus fracture with combined repair of extraperitoneal bladder injury to be performed by urology. Additional posterior fixation would be dictated by instability based off preoperative exam. We discussed risks of surgery including bleeding, infection, nonunion,, damage to local structures including lumbosacral nerve roots, sexual dysfunction including erectile dysfunction dyspareunia which are noted to be significantly increased with this pattern of injury regardless of treatment option, chronic pain, DVT, PE, intraoperative cardiopulmonary event, recurrent bladder rupture.. After discussion of risks and benefits, patient agrees to proceed with surgical intervention. We discussed that right lower extremity weightbearing status will be dictated by exam under anesthesia instability after fixation 1. Weight bearing status: Bedrest until the OR. Weightbearing as tolerated bilateral upper extremities for now. Continue to monitor right upper extremity pain and motion with consideration of CT to evaluate for occult fracture if persistent limitation of motion 2. Anticoagulation Recommendations: Started on Lovenox within 24 hours of mission. Plan to hold a.m. dose with planned open pelvic surgery tomorrow 3. Antibiotic Recommendations: We will plan for perioperative Ancef less than 24 hours. May consider additional duration given traumatic bladder disruption if indwelling Foley are required. 4. N.p.o. past midnight. Plan for exam under anesthesia, open reduction internal fixation of anterior pelvic ring as well as possible posterior fixation tomorrow in conjunction with open bladder repair INCIDENTAL FINDING OF COVID POSITIVE ON 8/31/2021 PATIENT STILL HOSPITALIZED AT THE TIME OF REPORT

Other Meds:

Current Illness:

ID: 1662842
Sex: F
Age: 56
State: PA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 09/01/2021
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: Preservatives, like polysorbate 880

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I am allergic to preservatives which trigger migraines. This vaccine gave me the second worse migraine i have ever had - severe pain and vomiting, nausea. Should have gone to emergency room , but too afraid of the high volume of covid at the time

Other Meds: non

Current Illness: none

ID: 1662843
Sex: M
Age: 62
State: KY

Vax Date: 04/29/2021
Onset Date: 08/14/2021
Rec V Date: 09/01/2021
Hospital: Y

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

Lab Data: 8/14/21: XR Chest 1 View Result Date: 8/14/2021 Narrative: Exam/Procedure: XR CHEST 1 VIEW ordered by ordering provider, CLINICAL INDICATION: hypoxia TECHNIQUE: Frontal view of the chest. COMPARISON: None. FINDINGS: Diffuse bilateral airspace disease. The cardiac silhouette, mediastinum and pulmonary vascularity are unremarkable. No evidence of pneumothorax or pleural effusion. The osseous structures are unremarkable

Allergies: NKDA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient received COVID vaccine 4/29/21, tested positive for COVID 8/14/21 8/14/21: patient is a 62 y.o. male with no significant past medical history presents with mild shortness of breath, myalgias, cough, somnolence and poor appetite. He was found to be significantly hypoxic while in the waiting room in the emergency department when his pulse ox was found to be 74%. He was put on supplemental oxygen of 6 liters/minute by nasal cannula and his pulse ox improved to about 92%. Currently he is on 60% FiO2 with high-flow nasal cannula an oxygen flow of 30 liters/minute. Patient is a 62 y.o. obese male with no significant past medical history presenting with shortness of breath, cough, myalgias for 6 days and severe hypoxemia. Principal problem: Hypoxia Viral pneumonia with severe hypoxemia: 62-year-old male presenting with 6 day history of shortness of breath, myalgias, cough and severe hypoxemia likely due to viral pneumonia caused by COVID 19 infection. COVID-19 pneumonia chest x-ray shows diffuse bilateral infiltrates most likely due to COVID-19 pneumonia Intravenous dexamethasone 6 mg daily started in the emergency department COVID-19 PCR test is pending The patient is a candidate for intravenous remdesivir because of severe new onset hypoxemia Check CBC, CMP, CRP, LDH, ferritin, D-dimer with morning labs Discharge Summary 9/1/21: Hospitalization Admit Date/Time: 8/14/2021 10:57 AM Admitting Attending: Discharge Date: 8/28/21 Discharge Attending Physician: medical doctor PCP name and Address: Referring provider name and address: No referring provider defined for this encounter. Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 62 y.o. male with a history of diabetes that presented with a 6 day history of myalgias, cough and poor po intake with new reports of shortness of breath. Patient Received the Johnson and Johnson vaccine in April of 2021. Upon arrival to ED was found to have an SpO2 of 74% on room air, and was placed on 6 liters nasal cannula. His O2 requirements continued to increase requiring high flow nasal cannula. As a result he was started on Dexamethasone and remdesivir. He continued to have increasing O2 requirements and was transferred to the ICU for closer monitoring. He did not require intubation. Ultimately he completed a five day course of remdesivir as well as a ten day course of dexamethasone. He was able to tolerate wean of his supplemental O2 and tolerated 2 liters NC on the day of his discharge. His room air SPO2 was 88% with improvement to 93% on 2 liters NC. He will be provided with home O2 at the time of his discharge. His hospitalization was complicated by a PE (CT scan 8/28/21) for which anticoagulation was started. He was started on Apixaban 10mg po BID with plan to continue for ten days (last dose will be the evening dose on 9/4/21) prior to beginning Apixaban 5 mg BID for at least 3 months. Additionally his hospitalization was complicated by Enterobacter Cloacae. (blood cultures on 8/27/21). He was started on Cefepime with plan to continue for seven days total. His repeat blood cultures have remained negative. Given his he is medically appropriate for discharge otherwise we will transition to oral antibiotic therapy today and continue Bactrim for two more days to complete the total antibiotic course. The patient's blood sugars were poorly controlled on admission (HgbA1C was 14). Insulin adjustments were made. His blood pressure was also poorly controlled on admission but with medication adjustments improved. The patient declined insulin plus Metformin ER recommendations at discharge. Given this he will be discharged on Metformin ER plus trulicity (PA was obtained by pharmacy). Diabetes educators were consulted for assistance with diabetic teaching. It is strongly recommended that the patient follow up with primary care for ongoing management. Lastly, the patient was noted to have incidental findings of thyroid and pancreatic masses on CT imaging. Given his COVID positive status and other acute medical conditions MRI was not obtained as an outpatient. It is strongly recommended that he follow up with his PCP for ongoing workup in addition to all age appropriate cancer screenings. The patient was evaluated by PT/OT and deemed appropriate for home with assistance. He was evaluated by internal medicine on am rounds and deemed appropriate for discharge home. He will be provided a referral for a PCP at discharge (order placed in system). The patient is aware of his upcoming discharge and is agreeable with the discharge plan of care.

Other Meds: None

Current Illness:

ID: 1662844
Sex: F
Age: 17
State: NC

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/01/2021
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: none

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

Symptoms: The patient was administered the Janssen COVID-19 vaccine at age 17, when it has only been "approved" for adult patients 18 years and older. The patient and her mom have been made aware of the error, and will monitor her for adverse effects.

Other Meds: n/a

Current Illness: n/a

ID: 1662845
Sex: M
Age: 27
State: MA

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Nausea

Symptoms: SOB, chest pain, chest tightness

Other Meds: none reported

Current Illness: no illnesses prior to vaccination

ID: 1662846
Sex: M
Age: 21
State: MT

Vax Date: 08/30/2021
Onset Date: 08/31/2021
Rec V Date: 09/01/2021
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: Chest pain and SOB 1d after shot in pt w/ h/o CP and SOB.

Other Meds:

Current Illness:

ID: 1662847
Sex: M
Age: 14
State: OR

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Vaccine was reconstituted incorrectly. 0.8ml instead of 1.8ml of diluent was used. 3 patients received the higher concentrated doses. patients were notified. No adverse reactions have been reported.

Other Meds:

Current Illness:

ID: 1662848
Sex: M
Age: 59
State: CT

Vax Date: 01/27/2021
Onset Date: 05/01/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: UNK

Allergies: None

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

Symptoms: CALLED INSISTENT THAT WE REPORT HIS NEUROPATHY AND ISSUES DUE TO THE VACCINE. Has a history of shingles 2x in the past; has had 1 shingles vaccination. He claims he has had an Herpes virus in his back for 2 years. In May he developed a severe case of shingles that has caused such severe neuropathy, he can't work. Claims it is a result of the COVID vaccination he got in Jan/Feb 2021. Claims he knows this is an issue with others and asking for it to be reported.

Other Meds: Cymbalta and Levothryoxine

Current Illness: None

ID: 1662849
Sex: F
Age: 91
State: MO

Vax Date: 03/18/2021
Onset Date: 08/23/2021
Rec V Date: 09/01/2021
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:

Allergies: unknown

Symptom List: Tremor

Symptoms: hospitalized 8/23 throu 8/27 for unknown reason. case not interviewed.

Other Meds: unknown

Current Illness: unknown

ID: 1662850
Sex: M
Age: 17
State: OR

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/01/2021
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 reconstituted incorrectly. 0.8mL instead of 1.8mL of diluent used. 3 patients received the higher concentrated doses. Patients notified. No adverse reactions reported.

Other Meds:

Current Illness:

ID: 1662851
Sex: F
Age: 46
State: NY

Vax Date: 07/26/2021
Onset Date: 08/30/2021
Rec V Date: 09/01/2021
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: Severe a headache that does not go away even with 3 Advil's . Headache started 1 week post vaccination and is constant.

Other Meds:

Current Illness:

ID: 1662852
Sex: F
Age: 36
State: FL

Vax Date: 04/10/2021
Onset Date: 06/25/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: Covid test-positive,

Allergies: NKA

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

Symptoms: Pt came to ER with URI and nasal drainage onset 2 days prior.

Other Meds:

Current Illness:

ID: 1662853
Sex: F
Age: 87
State: GA

Vax Date: 01/22/2021
Onset Date: 08/07/2021
Rec V Date: 09/01/2021
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:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: COVID pneumonia related hospitalization

Other Meds:

Current Illness:

ID: 1662854
Sex: M
Age: 61
State: MI

Vax Date: 04/01/2021
Onset Date: 08/05/2021
Rec V Date: 09/01/2021
Hospital: Y

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

Lab Data: COVID positive PCR on 07/29/2021

Allergies: None

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

Symptoms: Fully vaccinated patient admitted for COVID PNA after trip. CTA positive for PE, dx with "subcutaneous emphysema and peneumomediastinum COVID19 infection." Required high flow oxygen, antibiotics, decadron. D/C home on 3L/NC and antibiotics for pseudomonal pneumonia and Eliquis for PE.

Other Meds: Eliquis, lexapro, prilosec, crestor

Current Illness:

ID: 1662855
Sex: F
Age: 16
State: KY

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/01/2021
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: None

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

Symptoms: About a minute after receiving the vaccination, the patient stated she felt lightheaded and appeared to pass out while still seated. Her eyes remained open, but her head dropped backward for a few seconds while she was seated (with support from her mother, who was expecting this reaction and was ready to support her head). Her body also seemed to convulse for just a couple of seconds as she was maintaining eye contact with her mom. That part was over within seconds and she was able to respond to questions, but her lips stayed pale for about 20 more seconds before normal color returned. She was able to get up and walk from the consultation room to the pharmacy waiting area where she stayed seated for about 15 more minutes with no further issues other than feeling overheated. Orange juice and crackers were retrieved from the store to help her get back to feeling normal. Her mother says this entire reaction is exactly like what happened to her after receiving the second Gardasil shot in 2020.

Other Meds:

Current Illness:

ID: 1662856
Sex: M
Age: 81
State: WI

Vax Date: 02/24/2021
Onset Date: 08/03/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: COVID-19 test blood work

Allergies: bees

Symptom List: Pain in extremity

Symptoms: In August, I started feeling lethargic. I had lose of energy. I was confused at time. My wife noticed it. I went to the doctor. They did a COVID-19 test, which came out positive. They did blood work.

Other Meds:

Current Illness:

Date Died: 08/30/2021

ID: 1662858
Sex: M
Age: 72
State: KY

Vax Date: 08/19/2021
Onset Date: 08/30/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data:

Allergies: NO KNOWN ALLERGIES

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

Symptoms: PATIENT BELIEVED TO HAVE HAD A STROKE PER DAUGHTER AND PASSED AWAY

Other Meds: UNKNOWN

Current Illness: CHEMO TREATMENT

ID: 1662859
Sex: M
Age: 12
State: TX

Vax Date: 08/31/2021
Onset Date: 09/01/2021
Rec V Date: 09/01/2021
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: none

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

Symptoms: 9:30 am 9/1/21 started getting headache and dizzy. school nurse sent him home at noon, and i picked him up from school and took him home to go to bed. Symptoms were headache, dizzy, walking wobbly, some chills, head feels heavy, visual aura in periphery vision, flashing lights like a laser light show. Green dot in the center that is spiraling out and spiraling back in. He went to bed at 12:30pm. I checked on him at 2pm and woke him up accidentally. He felt hot so i took his temp and he and now has a 101.3 fever.

Other Meds: flonase, vitamins

Current Illness: had some diarrhea September 30th (the day before), but it was gone in 2 hours. we told the pharmacist that administered the shot this and they said that's okay, he can still get his second pfizer shot. He also complained once about ear pain. He had no congestion, no fever, nothing else.

ID: 1662860
Sex: F
Age: 47
State: TX

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 09/01/2021
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: Opiates

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

Symptoms: Severe blinding headache, aches, diarrhea, nausea, stomach cramps, severe congestion and sinus pressure

Other Meds: Euthyrox (levothyroxine sodium)75mcg, Zyrtec 10mg, melatonin 6mg, multi-vitamin, CBD oil

Current Illness: Hashimoto's thyroiditis Non-Hodgkin's lymphoma, erratic blood pressure, colon cancer, cervical cancer due to HPV,

ID: 1662861
Sex: M
Age: 38
State: VA

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/01/2021
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: Unknown

Symptom List: Vomiting

Symptoms: Patient was given their 2nd dose Moderna vaccine after the ?use by date.? On 8/30/21 The manufacturer was contacted and advised that the dose was not valid and would need to be repeated. The Medical Information representative advised not to repeat the dose until the interval between doses was determined and that they will call back with that information. F/U Call today ? no answer yet. Will continue to follow up. Unable to contact patient. Left several messages. will continue to call patient.

Other Meds: Unknown

Current Illness: Unknown

ID: 1662862
Sex: F
Age: 15
State: FL

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/01/2021
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: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: After patient was given the injection, she passed out within 3 seconds and started jerking (about 7-8 times) after being limp for 5-6 seconds. She then came to within 30-45 seconds. She had no color in her face (looked flush). After drinking water, her color came back in her face. The patient and the patient's mother refused to get emergency medical treatment, The patient was observed for 20 minutes to make sure she was okay before leaving the pharmacy,

Other Meds: unknown

Current Illness: none

ID: 1662863
Sex: F
Age: 78
State: CA

Vax Date: 08/14/2021
Onset Date: 08/18/2021
Rec V Date: 09/01/2021
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: Sulfa; Sotalol; Lidocaine

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

Symptoms: Initial reaction was a sore arm. Then it would start itching and it would not go away. It was on and off. I went to the doctor 08/18/2021. Then my arm started to get swollen, hard, and red. They did not do any medical tests they just gave me an antibiotic. I started Keflex on the 18th, 500 mg 3 times a day. She only gave it to me for 7 days. It's still itching and warm so I am trying to get a refill.

Other Meds: Sirolimus 2 mg every morning; Tacrolimus 2 mg morning and night; Plavix 75 mg once a day; Folic acid 1 mg once a day; Allopurinol100 mg once a day; baby aspirin once a day; vitamin D3 25 mg twice a day; vitamin E 180 mg once a day; Vitamin

Current Illness: Bladder Infection

ID: 1662864
Sex: M
Age: 73
State: MT

Vax Date: 02/18/2021
Onset Date: 08/03/2021
Rec V Date: 09/01/2021
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: SARS-CoV-2 RNA Resp Ql NAA+probe (SARS CoV-2 PCR (COVID-19)) Positive (LOCAL) Ordered Test: SARS-CoV-2 RNA Resp Ql NAA+probe (SARS CoV-2 PCR (In House)) Ordered Test Codes: 94500-6 (LN LOINC)/7459134031 (L LOCAL) Status: Final Accession Number: 2021212002203001 Specimen Source: Nasopharynx Specimen Site: Specimen Collection Date/Time: 2021-07-31 22:36:00.0

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Case completed the Pfizer Covid vaccine series on 2/18/21, then was admitted to hospital for treatment of Covid Pneumonia on 8/3/2021.

Other Meds: ? amLODIPine (NORVASC) 5 mg tablet TAKE ONE TABLET BY MOUTH EVERY DAY 90 tablet ? aspirin 81 mg EC tablet Take 81 mg by mouth Daily. ? atorvaSTATin (LIPITOR) 80 MG tablet TAKE ONE TABLET BY MOUTH EVERY DAY 90 tablet ? Blood Glucose Mon

Current Illness: ASHD/CAD Unspec 3/8/2006 anterior MI ? Back pain neck pain w/ lumbar radiculopathy ? Benign hypertension 3/8/2006 ? BPH ? Colon Polyps, adenomatous 5/15/2007 ? Depression 11/29/2007 ? Diabetes (HCC) ? Diabetes Uncompl Type II 5/15/2007 ? Diverticulitis 06/18/2018 muliple found in the sigmoid colon ? Fatigue ? Hypercholesterolemia 1/27/2011 ? Hypogonadism 3/16/2010 ? Myopathy elevated CPK ? Nephrolithiasis ? Obstructive sleep apnea hypopnea, severe ? Pain Back Unspec ? Sessile colonic polyp 06/18/2018 sigmoid, distal transverse, mid ascending colon and cecum (4-7mm size)

ID: 1662866
Sex: M
Age: 50
State: MI

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: N/A

Allergies: N/A

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

Symptoms: Soreness at injection site, extreme fatigue, light headed, cold sweats, muscle soreness pain, sore back/kidneys(?), headache, testicular tenderness

Other Meds: sertraline hydrochloride, Aleve

Current Illness: N/A

ID: 1662867
Sex: F
Age: 73
State: AR

Vax Date: 08/25/2021
Onset Date: 08/30/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: None

Allergies: Pen,reframpin,flu shot

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

Symptoms: I had no problem with the first two shots but the COVID booster my reaction started Sunday 8/26/21 with a very red mark and touch to area was very sore the next two days the rash started to spread to the elbow this morning it spread to the elbow.and today9/1/2021 it speed again and a new patch started and it was painful very harm and started to itch just like poison ivy.I saw the dr at a walk in clinic and she is treating. With a antibiotic to be picked up today and taking wal-Zyrtec and already taking prednisone 5 milligram going to try to see. If my dr will let me increase to 10 for 3days

Other Meds: Propranolol,potassium,montelukast,losartain,hydrochlorothazde,estradiol,biotin,fish oil,halo hair growth,prednisone,vita fusion daily bites,nature?s bounty gummies hair skin&nails

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am