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: 1663802
Sex: M
Age: 53
State: NY

Vax Date: 04/19/2021
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: My primary physician saw me, asked questions, checked my ears. He referred me to an ENT doctor. This doctor checked me further, did an audiology test, and referred me to an expert in cochlear implants and hearing problems of the brain. I saw a second ENT doctor who prescribed Ambien for sleep, but it was not effective in helping my insomnia. The cochlear implant doctor canceled my appointment at the last minute because she said there was nothing they could do for me or people like me with tinnitus.

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: On April 24, 2021, when I woke at about noon, I immediately experience very loud, disturbing tinnitus, with no apparent reason for it, such as having gone to a loud musical event, etc. I was immediately extremely uncomfortable with a borderline panic attack. From that point on, I have had tinnitus, chronic insomnia, and early I had very bad anxiety. I have NEVER had such a response in my entire life.

Other Meds: Valtrex 500 mg/day; finasteride 1mg/day

Current Illness:

ID: 1663803
Sex: F
Age: 30
State: NY

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

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

Lab Data: Doctors said all test appear to be normal with the exception of the D-dimer. Symptoms still persist.

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Headache, tightness of chest, trouble breathing, numbness in right arm and leg, dizziness, and elevated blood pressure. Went to the ER and was given an EKG, chest X-Ray and CT scan. Blood work was drawn and came back with a high D-Dimer. No clots were found so I was sent to my PCP. More blood was drawn and D-diner was still elevated. Sent to hematologist for more test. Leg Doppler and echocardiogram was also administered. Waiting on MRI for my head. Starting on 8/31/2021, headache followed by numbness to the left side of my face surfaced. Chest is still tight and I often feel like I am having heart palpitations.

Other Meds:

Current Illness:

ID: 1663804
Sex: F
Age: 45
State: OR

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: BP 137/70

Allergies: Kelfex, Contrast Die

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

Symptoms: Patient presented reported increased salivation and a swollen tongue. Pt was taken to consult room. Skin exam revealed 1 hive on left abdomen. Pt took 50 mg PO diphenhyradmine. EMS notified. While waiting with patient in room, tongue had additional swelling and 0.3 mg EpiPen was administered in the L Vastus Lateralis. EMS arrived within a minute after EpiPen administration. EMS evaluated and recommended transport. Pt refused and reported improvement of symptoms. EMS contacted ER physician and provided patient with instructions. Patient observed until 8:05 with no return of symptoms. Ride home was offered and refused. Pt left the store with a bottle of Benadryl with the agreement to contact EMS with any return of symptoms.

Other Meds:

Current Illness: None

ID: 1663805
Sex: M
Age: 45
State: TX

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: No

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: At 2:27 pm patient c/o feeling dizzy. Vital - BP: 132/78. HR: 106. Nurse practitioner assessed and clear patient. Patient left in stable condition.

Other Meds: No

Current Illness: No

ID: 1663806
Sex: M
Age: 31
State: OR

Vax Date: 08/16/2021
Onset Date: 08/21/2021
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: n/a

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

Symptoms: About 5 days after recieving my first dose of the Pfizer vaccine. I got out of the shower and noticed a small rash forming on my left inner leg. Since then it has spread about the back on my leg and lower buttocks and down my leg slightly.

Other Meds: n/a

Current Illness: n/a

ID: 1663807
Sex: F
Age: 56
State: MO

Vax Date: 09/01/2021
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: Shaking, fever, headache and nausea

Other Meds: Collagen

Current Illness:

ID: 1663808
Sex: M
Age: 57
State: MO

Vax Date: 07/01/2021
Onset Date: 08/01/2021
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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Sudden stabbing pain in back. Deep under shoulder blade

Other Meds:

Current Illness:

ID: 1663809
Sex: F
Age: 30
State:

Vax Date: 07/21/2021
Onset Date: 07/21/2021
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: Allergic to food dyes and energy drinks, some laundry detergents

Symptom List: Pharyngeal swelling

Symptoms: I broke out in hives that lasted for three weeks they started on my chest and spread all over my torso up my neck and to my face. This happened within the first 3 hours after receiving the shot.

Other Meds: Daily Multi Vitamin

Current Illness: None

ID: 1663924
Sex: F
Age: 31
State: CA

Vax Date: 06/01/2021
Onset Date: 08/22/2021
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: Blood tests on 8/23/21 and 8/25/21 to measure HCG, confirmed miscarriage.

Allergies: Amoxicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Got vaccinated in June (#1 6/5/21 and #2 6/26/21) Conceived in mid-July, miscarried in August when I was 8 weeks pregnant.

Other Meds: Pre-Natal Vitamins

Current Illness: None

ID: 1663925
Sex: F
Age: 26
State: WA

Vax Date: 02/04/2021
Onset Date: 08/23/2021
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:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: CG tested positive for COVID 8/24

Other Meds:

Current Illness:

ID: 1663927
Sex: F
Age: 53
State: CA

Vax Date: 08/20/2021
Onset Date: 08/22/2021
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: none

Allergies: NKMA

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

Symptoms: ongoing headaches and dizziness

Other Meds: D3, Vitamin C, Zinc

Current Illness: none

ID: 1663928
Sex: F
Age: 31
State: NY

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

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

Lab Data:

Allergies: Hazelnut, grass, dust,

Symptom List: Rash, Urticaria

Symptoms: Shot in upper left arms, very soar that night, 2 days after noticed red/pink blotch 2 inches wide near injection site with additional inflammation surrounding.

Other Meds: Zyrtec, vyvanse, lexapro, adderrall

Current Illness: Symptomatic Covid 19; 3- weeks prior tested positive July 31st (vaccinated with Pfizer 2nd vaccine date April 14, 2021.

ID: 1663929
Sex: F
Age: 42
State: OH

Vax Date: 12/23/2020
Onset Date: 04/01/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: April 2021 CBC, then iron profile after low hemoglobin. Monthly CBC, iron profiles since April.

Allergies: Trimethoprim

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

Symptoms: Received covid #1 end of Dec 2020. Received Covid #2 January 2021. Heavy periods started Feb 2021. Found out I have iron deficiency anemia in April. Heavy periods continued. Now I am having to get iron infusions and a hysterectomy.

Other Meds: Nexium, Metformin, HCTZ, ambien prn, elderberry, calcium, multi vitamin, baby asa

Current Illness: None

ID: 1663931
Sex: F
Age: 36
State: CA

Vax Date: 04/14/2021
Onset Date: 04/17/2021
Rec V Date: 09/02/2021
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: Two Emergency Room visits Cardiologist visits -Stress test, halter monitor Neurologist visits, MRIs, multiple blood tests (Abnormal DNA (DS) Antibody) Rheumatologist visits, Blood tests, X-rays

Allergies: None

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

Symptoms: 4/18/21 through Present - headaches, heart palpitations, shortness of breath, joint pain, muscle spasms, numbness/tingling throughout head/body, shooting pains on breasts and arm, blurry vision.

Other Meds: None

Current Illness: None

ID: 1663932
Sex: F
Age: 35
State: FL

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

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

Lab Data: None

Allergies: None

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

Symptoms: About 3 hours atter 1st shot. I became very hot and my whole body feels flushes. I have a tingle all over my uper body. My face neck chest and sholders feel as if the shin is crawling. It has been happening now for about 35 min. I took Tylenol after like they said. I also feel like my heart is skipping or having a change in the rhythm and beat. Its going. Boom boom with normal spacing then my heart beat is going fast and out of rhythm. I almost feel as though im having some sort of panic attack. Im remaining calm and still. And i just wanted to report this feeling because i dont know if it has anything to do with receiving the vaccination. However my husband feels fine.. I feel like im trying to catch my breath.. I do have copd and high blood pressure. Ill continue to evaluate my feelings and all.

Other Meds: Methadone 110 mg daily

Current Illness: None

ID: 1663933
Sex: F
Age: 32
State: AL

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

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

Lab Data: Ekg, chest x-ray, and blood work 09/01/21

Allergies: Zoloft, Prednisone, Lamictal, and seasonal

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

Symptoms: Chest pains, shortness of breath, and sore arm. ER visit at 9:00 pm

Other Meds: Micardis, Metformin, and Januvia

Current Illness: Bells Palsy

ID: 1663935
Sex: M
Age: 42
State: CA

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

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

Lab Data: NONE

Allergies: NONE

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

Symptoms: PATIENT RECEIVED PFIZER AS A SECOND DOSE BUT SHOULD HAVE RECEIVED MODERNA. PATIENT DID NOT REPORT ANY SIDE EFFECTS DURING OBSERVATION PERIOD POST VACCINATION.

Other Meds: NONE KNOWN

Current Illness: NONE

ID: 1663936
Sex: F
Age: 41
State: SC

Vax Date: 08/30/2021
Onset Date: 08/31/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies: Penicillin and sulfur

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I had a horrible asthma flare up which made me tight in my chest and was painful in my chest. It was terrible. Each time I get this vaccine it makes me horribly sick. I cannot take ever getting another Moderna vaccine. These vaccines have been hell on earth.

Other Meds: Paxil, Wellbutrin,levothyroxin, lisinopril ,trazadone, breo,ventolim

Current Illness: Sinus infection

ID: 1663938
Sex: M
Age: 55
State: KY

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: none

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Multiple Fevers on Saturday and the Following Monday and Tuesday

Other Meds: Metoprolol Er succinate 50 mg , Lisinopril 20 mg , rosuvastatin 40 mg Warfarin 5 mg nighttime sleep aide 25mg

Current Illness: none

ID: 1663939
Sex: F
Age: 60
State: AZ

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: Sent to an Urgent Care for heart evaluation resulting in no issues, then sent to have Brain and Neck MRI's, which came back as showing I had two mild strokes and arthritis in my neck.

Allergies: Penicillin

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

Symptoms: Headache, rise in Blood Pressure, Rash and Itching all over body, Backstabbing pain, tightness, and pain in the chest. Was placed on Benadryl two every four hours, Tylenol, and additional blood pressure meds

Other Meds: Hydrochlorothiazide 25 mg, Losartan 50 mg tab, Citalopram 20 mg, Atorvastatin 10 mg Over the counter: Fish oil 1200 mg, Evening Primrose 1000 MG, Turmeric, 500 mg, Calcium & Vitamin D3, and Zinc

Current Illness: None

ID: 1663940
Sex: F
Age: 23
State: CA

Vax Date: 08/21/2021
Onset Date: 08/29/2021
Rec V Date: 09/02/2021
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: EKG, and blood work on the night of August 29th, 2021. Then, I had an echocardiogram on September 1st, 2021.

Allergies: Nothing.

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

Symptoms: Twenty-four hours after the first dose of the Pfizer vaccine, I began to experience some chest pain and pressure. I have never had heart issues before, so this was alarming. I went to the ER to get it checked out. It was there they told me I had some heart inflammation. Since that visit, I have also had these alarming symptoms, abnormal vaginal bleeding, irregular heart rating, lightheaded feeling and extreme fatigue. I had COVID before and it was nothing compared to this shot. I am five days post vaccine and I am still suffering.

Other Meds: Trileptal is the only medicine taken.

Current Illness: Nothing.

ID: 1663941
Sex: F
Age: 42
State: CA

Vax Date: 05/06/2021
Onset Date: 06/01/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: Several blood tests for lupus followup showed no flare indication. Vit D, iron, vitamin B12, zinc tests were also normal

Allergies: Penicillin

Symptom List: Unevaluable event

Symptoms: Three weeks after the second dose, chest pain and low grade fever occurred. I had a similar episode before following a quadrivalent flu shot. A month after the second dose, extreme hair loss started and within two months it progressed to Alopecia Universalis. I saw rheumatologist and dermatologist. Steroid injections and oral treatments did not stop complete hair loss on head, eyebrows, and arms..

Other Meds: hydroxychloroquine 200 mg, vitamin D 2000 IU, levoxyl 80mcg

Current Illness: Systemic Lupus, Hypothyroid

ID: 1663942
Sex: F
Age: 35
State: CA

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/02/2021
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: prednisone, seafood

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

Symptoms: After 1 dost dose of Pfizer was given to the left arm of the patient, Pt was instructed to have a seat for 15 minutes. Pt started to shop after and came back to the pharmacy and reported symptoms of flush face, rash, dizziness, upset stomach and throat tightness of throat and slight SOB. Monitored the patient for symptoms after 5 minutes, the patient said she felt slightly better. After another 5 minutes the pt said her throat felt tight again and dizzy again as well. I administered the Epi-pen 0.3 mg in the upper left thigh at 7:35 pm and called EMS from hospital. After checking again in 5 minutes the patient states she felt better and most symptoms resolved including tightness of throat and SOB. I did not administer another dose. The EMS arrived checked vitals and reported her BP was normal and cleared the patient to check with MD office for followup. I agreed with the EMS and obtained pt contact info for followup and advised likewise.

Other Meds: unknown

Current Illness: No

ID: 1663943
Sex: F
Age: 69
State: CA

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/02/2021
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: Codeine

Symptom List: Injection site pain, Pain

Symptoms: 7 hrs following injection I started having a sore throat, 7.5 hrs temp of 99.9, 8 hrs injection site swelling and pain, headaches, muscle/joint pain, 12 hrs post injection temp off 100.9

Other Meds: Methotrexate, folic acid, omega 3, atorvastatin, metoprolol, synthroid,

Current Illness: Rheumatoid arthritis, osteoarthritis

ID: 1663945
Sex: M
Age: 34
State: UT

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/02/2021
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: After about 12 hours (around 11PM), I started feeling sick. By midnight I felt flu-like symptoms like lethargy, body aches, and a headache. I also had a dull pain at the injection site. I still had sense of smell and taste and a normal appetite. I slept on and off through the night, and felt worse in the morning. I took 1000 mg's of generic acetaminophen around 11AM and felt much better after about 45 minutes. My symptoms started coming back after about 5 hours, so I took another 1000 mg's of generic acetaminophen at 4PM and felt relief after 45 minutes. I fell asleep for a couple hours around 5PM and when I woke up at 7PM I felt noticeably better. I took 500 mg's of generic acetaminophen before bed at 10PM and slept through the night. When I woke up the next day (today), my body aches and headache had mostly receded but I still felt tender pain at the injection site. It's now 11PM and I'd say I feel 80% better. I just took 500 mg's of generic acetaminophen about 45 minutes ago and I feel almost 100% normal. I expect to feel 100% normal in the morning without taking any additional acetaminophen based on my current rate of recovery.

Other Meds:

Current Illness:

ID: 1663946
Sex: F
Age: 78
State: CA

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: PCR negative for COVID on Sept 1st.

Allergies: Piqray

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

Symptoms: Loss of taste within 5 hours. Other adverse events listed in common list including fatigue, low grade fever, arm pain, muscle pain, bone pain

Other Meds: Abraxane Tecentriq Aspirin

Current Illness: Metastatic Breast Cancer Bels Palsy Brachial Plexopathy

ID: 1663947
Sex: M
Age: 38
State:

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 09/02/2021
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: Within a minute of second shot, immediately felt flush and faint and alerted staff i may pass out. That feeling never went away and increased intensity. Had extreme mental fog and felt like did not exist or was in a dream. Felt like i could faint at any given moment. After a week seeked care from urgent care at which time was sent to ER by staff. Blood pressure was 166/133 and i felt like i was going to faint and could feel buzzing/vibrating pressure throughout body. Got on a blood pressure medication and since it has been great. I continued to feel same way for the past 4-5 months and still do mildly now. About 6 weeks after vaccine my legs started giving out occasionally. Then it started happening more frequently. Soon it was every step could barely stand up. Legs were very weak. Ended up in ER in mid June after experiencing a bout of paralysis for an hour or so. After which both legs were so weak and my fainting feeling and extreme brain fog kicked in severely for days. Have had MRIs on head, spine, ct scan on head, chest xrays, ekg, nerve conduction tests, extensive blood work all or which showed im heathy and could not explain the issues. Did physical therapy to strengthen leg (primarily left) and walk with a cane. Took almost 2 months of work. Getting much better now 5 months in. Still leg weakness and still the faint/brain fog feeling however it is much less severe and livable. Feel like now finally on path back to normalcy. About 80% now.

Other Meds: No prescriptions. Multi vitamin.

Current Illness: None. Was feeling great.

ID: 1663948
Sex: F
Age: 51
State:

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies: banana, latex, macrobid, walnut

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: swelling at injection site, redness around injection site extending down arm, pain at injection site, itching, fever, chills, abdominal pain, diarrhea, headaches

Other Meds: ascorbic acid, cyanocobalamin, Vitron-C, levothyroxine, multivitamin with minerals

Current Illness:

ID: 1663949
Sex: F
Age: 38
State: GA

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/02/2021
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: Reglan Phenargan Morphine

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

Symptoms: I had a headache and got a metallic taste in my mouth around 5-10 minutes after my injection. I still have the metallic taste 11 hours later.

Other Meds: Synthroid Vitamin C Zinc Vitamin D3

Current Illness: None

ID: 1663950
Sex: F
Age: 55
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: Please see continuation page. Additional information for Item 19: 01/16/2021. ECG Impression - BORDERLINE ECG - Sinus rhythm, Low voltage, precordial leads, Borderline T abnormalities, diffuse leads, NEW REPOLARIZATION ABNORMALITY SINCE THE PREVIOUS RECORD. 01/16/2021. Metabolic Panel - Normal. 01/16/2021. Troponin I - Normal. 01/26/2021. Echo - Transthoracic Echo +Doppler - Some mild findings which may link to the aging. 02/18/2021. Ferritin - 302 ng/mL (Normal range: 13 to 150 ng/mL)

Allergies: None

Symptom List: Nausea

Symptoms: All the listed symptoms last about 7 days after the vaccination: - None stop palpitation, - None stop chest tightness, - Occasional chest pain, - Heart rate is about 10 beats per minute faster than my normal rate, and - There is a painful spot on my back. 1-2 inches lateral to the mid-line on the left side of T5 spine. On a pain scale is about 2-3/10. I am an acupuncturist and seeing bodily pain on daily bases. This confined painful spot is definitely weird.

Other Meds: None

Current Illness: None

ID: 1663952
Sex: M
Age: 18
State: MN

Vax Date: 08/31/2021
Onset Date: 09/01/2021
Rec V Date: 09/02/2021
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: Mild Headache, general muscle soreness and aches, general feeling of malaise. Sore shoulder where injection occurred.

Other Meds:

Current Illness:

ID: 1663953
Sex: M
Age: 27
State: NV

Vax Date: 04/03/2021
Onset Date: 04/21/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Got lethargic & chronic fatigue a couple weeks after my second dose & been dealing with ever since (Mid April), Been taking vitamins like B12, zinc, vitamin c's to help alleviate the symptoms & fatigue here for a few weeks now as of filling this out & its been helping a bit.

Other Meds: None

Current Illness: None

ID: 1663954
Sex: F
Age: 15
State: NV

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

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

Lab Data: Her BP is normal. 174/82mmhg

Allergies: none

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

Symptoms: Pt received 2nd dose of Covid-19 vaccine. Within 5 minutes she fainted but revived quickly. This happened a couple of times more. She was shaking for a short time. Whenever she comes through, she always say she is ok, to me and to her mom. She says she maybe dehydrated and wanted to drink. I advised her not to take anything by mouth until she is stable. I started asking her mom if she is taking any medication for seizure and Mom says no. Pt says she purposely shakes to wake up. Her shaking is not involuntary. No difficulty breathing. She was pale. A cold bottle of water was placed behind around her neck, head. I asked if she wanted to lie down on the floor and we will raise her leg from the floor, she says she'll do that if she feels worse. I told her to at least have her leg raised on one of our chairs which she did. Her mom and I observed her. Within 12 minutes, she got her color back. She says she's feeling better. When the 15minutes is up, we went to the BP monitor machine and Her BP is normal. 174/82mmhg. They said they'll wait a little longer, which I answered they are more than welcome to. Less than 5 minutes, they were gone.

Other Meds: none

Current Illness: none

ID: 1663956
Sex: F
Age: 26
State: MN

Vax Date: 01/19/2021
Onset Date: 02/13/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: No tests were ordered while I was at urgent care or following my visit and diagnosis.

Allergies: None. Just seasonal allergies.

Symptom List: Tremor

Symptoms: Diagnosed with Bell's Palsy following the second dose of the Pfizer vaccine. On 2/13 I noticed my tongue on the left side felt like it was numb. I don't usually drink any hot drinks, but work gave out hot chocolate on 2/12 so I originally thought I burnt my tongue even though I didn't recall. Then on 2/14 I felt very fatigued, still had the left sided tongue numbness, and my left ear felt as though it was muffled. Then on 2/15 I again felt very fatigued, had left sided tongue and cheek numbness, muffled ear, and then noticed that my smile was sideways/ facial drooping and when I would rub my lips together it was side ways/uneven. I originally thought maybe I was having a stroke based on my left sided symptoms, but I am an RN and had heard of Bell's Palsy so I went to urgent care on 2/15 right when I noticed my facial drooping. After being diagnosed with Bell's Palsy on 2/15 and started on 20mg oral Prednisone, I had symptoms for a little over 3 weeks that progressively got better over time. My symptoms continued to be left sided tongue and cheek numbness, left sided smile and lip drooping/ some drooling especially when drinking with straws, muffled left ear, and it was difficult to blink my left eye for about 12 days after being diagnosed. My eye never stayed open when sleeping, but I really had to think about blinking and the eye was teary. No symptoms on my right side

Other Meds: None.

Current Illness: None

ID: 1663957
Sex: M
Age: 24
State: UT

Vax Date: 08/17/2012
Onset Date: 03/01/2013
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: Thyroid hardening, blood tests revealed something was off

Allergies: Lactose intolerance

Symptom List: Erythema, Pruritus

Symptoms: Patchy hairloss, eventual complete baldness and loss of eyebrows and eyelashes. Contracted an auto-immune disease

Other Meds:

Current Illness:

ID: 1663960
Sex: F
Age: 0
State:

Vax Date: 06/12/2021
Onset Date: 08/12/2021
Rec V Date: 09/02/2021
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: n/a

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

Symptoms: I went to bed feeling perfectly fine, and woke up 2 hours late with blood 9 blood blisters in my mouth. I went to ER, they sent me home with an appointment with an NP. the following day I wake up with petichae and bruises all over my body and was voiding blood. I had bloodwork drawn and my plateless came back less than 1. I have no history of blood disorders or auto immune diseases in my family and was perfectly healthy up until now. The doctors have not identified a cause for this episode of ITP, nor do we know if this is a chronic issue. I received 2 plateless transfusions, a couple doses of IVIG, and am now on steroids and getting weekly bloodwork. As a nurse, I am 98% sure this is a vaccine reaction. I nearly died.

Other Meds: Quetiapine Sertraline Wellbutrin

Current Illness: no other health concerns at time of vaccine

ID: 1663961
Sex: M
Age: 62
State: CA

Vax Date: 08/19/2021
Onset Date: 08/20/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: N/A

Allergies: Pollens, latex, Zinc

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

Symptoms: Intense crazy itching of slight pain swollen round welts all over the body.

Other Meds: Ibuprofen, and Aller-Fex

Current Illness: None

ID: 1664484
Sex: F
Age: 16
State: PA

Vax Date: 08/31/2021
Onset Date: 09/01/2021
Rec V Date: 09/02/2021
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: face feels funny. headache. leg pain.

Other Meds:

Current Illness:

ID: 1664485
Sex: M
Age: 46
State: NV

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/02/2021
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: Many different types of foods

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

Symptoms: High blood pressure. Was 131/83 taken mid july 2021 by home nurse Is now 158/98 taken on sept 1st 2021 by home nurse

Other Meds: Celebrex

Current Illness: COPD

ID: 1664486
Sex: F
Age: 37
State: NY

Vax Date: 07/29/2021
Onset Date: 07/30/2021
Rec V Date: 09/02/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Serious headache, fatigue 24 hours after vaccine. 4 weeks after the first dose, I experienced a massive bleeding period. My blood pressure dropped to 40/60. I was chilling on the bed under 28C room temperature.

Other Meds:

Current Illness:

ID: 1664487
Sex: M
Age: 41
State: CA

Vax Date: 06/28/2021
Onset Date: 07/26/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data: 8/13/2021- Ultra Sound of right leg confirmation of DVT 8/13/2021 CT scan of chest showed bilateral PE 08/13/2021 showed hemoglobin at a 5.1

Allergies: None

Symptom List: Pain in extremity

Symptoms: DVT, low hemoglobin 5.1 and Bilateral PE

Other Meds: None

Current Illness: Rolled ankle

ID: 1664488
Sex: M
Age: 36
State: CA

Vax Date: 04/28/2021
Onset Date: 05/05/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: My doctor and nurse practitioner said this is only Dequervains Tenosynovitis. I have an appointment 9/28/21 with a rheumatologist, and I swear, if I find out I've developed an autoimmune disease such as rheumatoid arthritis because of the vaccine, I will be devastated.

Allergies: Sulfa antibiotics

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

Symptoms: The pain started in the injection site and lingered for about 3 days. The Friday after my vaccination, the pain moved from my left shoulder muscle down to my elbow. It was almost a dull throbbing pain on 4/30/21. This lasted through the weekend the next week until finally, the pain moved down to my left wrist. It hurts every time make a fist, bump it slightly, or jam it just doing normal things. It has been hurting for nearly 5 months now and I never had any wrist problems prior to the vaccine. I used to be able to do high intensity training and weight lifting. No issues. The pain is excruciating when I wake up. I have to wear a brace while I go to bed. The ibuprofen is making my stomach hurt. I have resorted to Diclofenac Sodium for temporary but insufficient relief.

Other Meds: Finasteride (propecia), Vitamin D, MCT Oil, Lysine, Melatonin

Current Illness:

ID: 1664919
Sex: F
Age: 23
State: MN

Vax Date: 08/30/2021
Onset Date: 08/31/2021
Rec V Date: 09/02/2021
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: Amoxicillin

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

Symptoms: Raised skin, red skin, sensitive to touch, in a lot of pain, difficult to move: all near the injection site. Also have chills, headache, sore throat, and feeling very weak and tired.

Other Meds: Birth control

Current Illness:

ID: 1664920
Sex: M
Age: 46
State: CO

Vax Date: 08/31/2021
Onset Date: 09/02/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: Emergency room visit - ekg

Allergies: N/a

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

Symptoms: Vertigo

Other Meds: N/a

Current Illness: N/a

ID: 1664921
Sex: F
Age: 46
State: RI

Vax Date: 04/14/2021
Onset Date: 07/01/2021
Rec V Date: 09/02/2021
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 - if the situation persists, I will ask my GP when I see her for a regularly scheduled appointment on Sept. 27, 2021

Allergies: none known

Symptom List: Vomiting

Symptoms: After my second shot (5/13/21), I had one menstrual period shortly thereafter (I don't recall the exact dates), and have not have one since. Ordinarily my periods are fairly regular, with the exception of once after receiving multiple vaccinations (hepatitis A & B, tdap, rabies) in spring of 2019, after which I had a period that lasted more than 2 weeks.

Other Meds: vitamin D (sporadically)

Current Illness: none known

ID: 1664976
Sex: F
Age:
State: PR

Vax Date:
Onset Date:
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: Test Name: COVID-19 antibody test; Result Unstructured Data: antibodies not created; Comments: vaccine did not create antibodies

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: SUSPECTED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a consumer concerned an 80 year old female of unknown race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included the patient was bed bound. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, expiry: UNKNOWN) dose was not reported,1 total administered on 29-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the patient was diagnosed with suspected immunological vaccine failure (antibodies not created, vaccine did not worked). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected immunological vaccine failure and bed bound was not reported This report was serious (Other Medically Important Condition). This report was associated with a product quality complaint: 90000191670.; Sender's Comments: V0. 20210900338-COVID-19 VACCINE AD26.COV2.S- Suspected immunological vaccine failure. This event is considered not related. The event has an unknown/unclear temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the events than the drug. Specifically: SPECIAL SITUATIONS

Other Meds:

Current Illness: Bedridden

ID: 1664977
Sex: U
Age:
State: PR

Vax Date:
Onset Date:
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: short of breath; fatigue; sugar level abnormal; This is a spontaneous report from a contactable consumer or other non hcp. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19-19 mRNA VACCINE, Formulation: Solution for injection, (Batch/Lot number was not reported)), via an unspecified route of administration on an unspecified date as dose unknown, single for COVID-19 immunisation. The patient's medical history and concomitant medications were not reported. The patient experienced short of breath, fatigue, sugar level abnormal and my sugar has been out of control. The outcome of the events were unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1664978
Sex: F
Age:
State: PR

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: fever; head pulses; muscle aches; This is a spontaneous report from a non-contactable consumer, the patient. A 34-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ER8734) via an unspecified route of administration in the left arm on 21Apr2021 at 16:30 (at the age of 34-year-old) as a single dose for COVID-19 immunisation. Medical history included hypothyroidism. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included levothyroxine sodium (SYNTHROID) for an unknown indication on an unknown date. The patient previously took Aspirin and experienced allergy to the medication. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0158) via an unspecified route of administration in the left arm on 31Mar2021 at 10:30 (at the age of 34-year-old) as a single dose for COVID-19 immunisation. On 22Apr2021 at 06:00, about 12 hours after the injection (next morning), the patient experienced fever, head pulses and muscle aches. Therapeutic measures were taken as a result of adverse events and included treatment with acetaminophen. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event fever was resolved on 22Apr2021 while that of head pulses and muscle aches was resolving at the time of this report. No follow-up attempts are possible. No further information is expected.

Other Meds: SYNTHROID

Current Illness:

ID: 1665039
Sex: F
Age: 82
State: FL

Vax Date: 03/10/2021
Onset Date:
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: swelling in right arm/swollen arm; occassional aches in that arm where the patient got the vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (swelling in right arm/swollen arm) and VACCINATION SITE PAIN (occassional aches in that arm where the patient got the vaccine) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Penicillin allergy (allergic to PCN) and Drug allergy (statins allergy.). On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PERIPHERAL SWELLING (swelling in right arm/swollen arm) and VACCINATION SITE PAIN (occassional aches in that arm where the patient got the vaccine). At the time of the report, PERIPHERAL SWELLING (swelling in right arm/swollen arm) and VACCINATION SITE PAIN (occassional aches in that arm where the patient got the vaccine) had not resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. No concomitant medications were reported. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 15-Aug-2021: Non-Significant follow up: swollen arm and aches were similar events mentioned in initial document.

Other Meds:

Current Illness: Drug allergy (statins allergy.); Penicillin allergy (allergic to PCN)

ID: 1665040
Sex: F
Age:
State:

Vax Date: 08/20/2021
Onset Date: 08/01/2021
Rec V Date: 09/02/2021
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:

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

Symptoms: Painful lumpy knot at injection site; Muscle aches; Chills; Painful lumpy knot at injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE MASS (Painful lumpy knot at injection site), MYALGIA (Muscle aches), CHILLS (Chills) and VACCINATION SITE PAIN (Painful lumpy knot at injection site) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 20-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In August 2021, the patient experienced VACCINATION SITE MASS (Painful lumpy knot at injection site), MYALGIA (Muscle aches), CHILLS (Chills) and VACCINATION SITE PAIN (Painful lumpy knot at injection site). At the time of the report, VACCINATION SITE MASS (Painful lumpy knot at injection site), MYALGIA (Muscle aches), CHILLS (Chills) and VACCINATION SITE PAIN (Painful lumpy knot at injection site) had not resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No concomitant medication was reported. Treatment medication was not provided by the reporter.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am