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: 1666355
Sex: M
Age: 67
State: MI

Vax Date: 03/18/2021
Onset Date: 08/26/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data:

Allergies: Captopril Swelling, Angioedema, Throat swelling Penicillins Hives Adhesive Tape Rash Norco [Hydrocodone]

Symptom List: Dysphagia, Epiglottitis

Symptoms: Hospitalized; COVID-19 positive (8.26.21) - after being fully vaccinated Admission Date: 8/26/2021 Discharge Date: 8/30/2021 Active Hospital Problems Diagnosis Date Noted POA ? Pneumonia due to COVID-19 virus 08/26/2021 Yes ? ESRD (end stage renal disease) on dialysis (HCC) 07/31/2019 Yes HOSPITAL COURSE: 68 year old man with hx of CAD, pacemaker in place, NIDDM2, HTN, ESRD on HD on compassionate dialysis program. He was dialyzed on 8/23/21 and felt well. Developed cough, sputum, shortness of breath over the past 3 days. He developed a fever. Denied any weight gain or pedal edema or chest pain. His appetite has been down. He presented to the ER on 8/26/21. In the ER, he had a fever 38, 76 bpm, 95% on RA, CXR showed bilateral infiltrates, COVID PCR was positive. He will be admitted for further treatment of COVID pneumonia. CRP 64.6. D-dimer 1130. He is previously vaccinated, Pfizer COVID-19 vaccine: 3/18/2021, 2/23/2021. He was started on Decadron 6 mg po daily and received 5 doses, he needs 5 more days. Should stay in isolation until he finish Decadron 6 mg daily. He was evaluated by the dr. and was found to needs 2 l/m at all times. Airway Oxygen will deliver portable tank to room for DC home. ESRD on hemodialysis, he had 2 hemodialysis while in hospital. Should continue compassionate hemodialysis as before. He had mild thrombocytopenia with Plt. Count of 110 at discharge. PCP to follow.

Other Meds: acetaminophen (TYLENOL) 500 MG tablet aspirin EC 81 MG enteric coated tablet atorvastatin (LIPITOR) 40 MG tablet benzonatate (TESSALON) 100 MG capsule carvedilol (COREG) 25 MG tablet dexamethasone (DECADRON) 6 MG tablet diphenhydrAMINE-Zinc

Current Illness: Cough -- > found to be COVID-19 positive 8.26.21 Multiple hospital admissions: ESRD; dialysis; hyperkalemia; SOB; leg / facial swelling; uremia

ID: 1666356
Sex: F
Age: 56
State: WI

Vax Date: 05/27/2021
Onset Date: 06/27/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: none

Allergies: amoxicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: 1 month after injection she noted stiffness in hands every am lasting for <30 minutes, continuing and reported on 9/2/2021 since that time. Resolves on own with stretching. Never had prior and has not changed since.

Other Meds: Lipitor, prozac, baby aspirin

Current Illness: none

ID: 1666357
Sex: F
Age: 37
State: TX

Vax Date: 08/21/2021
Onset Date: 08/21/2021
Rec V Date: 09/02/2021
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: head CT - normal and meds. Thurdays was fine and the friday headache came back.

Allergies: shellfish; hazelnut; iodine; contrast dye

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

Symptoms: Sat night night headache started, flu like and sunday and fatigue. Monday - all gone except headache. Tuesday - telehealth - doctor said that was normal. Wed - continued to have headache. Thursday it got extreme painful. Right side to the right eye. Went ER. PCP on tuesday - sought medical 4 times and still had headaches.

Other Meds: Thyroid; Benadryl

Current Illness: no

ID: 1666358
Sex: M
Age: 76
State: OH

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

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

Lab Data: covid + 9/1/2021

Allergies: codeine, penicillin, sulfa

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: breakthrough covid + weakness, decreased appetite, cough, plan hospital admission. additional acute medical issues fa;;, L flank hematoma

Other Meds: allopurinol, anastrozole, coreg, citalopram, desloratadine, diltiazem, festerodine, furosemide, hctz, synthroid, potassium, tadalafil, tamsulosin, warfarin

Current Illness: none

ID: 1666359
Sex: F
Age: 29
State: WI

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: Guinea Pigs

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

Symptoms: I got Shingles with rash and scarring right after the COVID vaccine.

Other Meds: ibuprofen

Current Illness: NONE. I received the first vaccine dose on 1/21/2021, the second dose on 2/18/2021

ID: 1666360
Sex: F
Age: 30
State: MT

Vax Date: 01/27/2021
Onset Date: 08/30/2021
Rec V Date: 09/02/2021
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: Covid infection despite vaccination

Other Meds:

Current Illness:

ID: 1666361
Sex: F
Age: 50
State: KY

Vax Date: 01/20/2021
Onset Date: 08/23/2021
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:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: COVID-19 positive due to possible contact with family member or at work.

Other Meds:

Current Illness:

ID: 1666362
Sex: F
Age: 27
State: KY

Vax Date: 05/13/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Did not have any side effects but did become COVID positive on August 30, 2021

Other Meds:

Current Illness:

ID: 1666363
Sex: F
Age: 71
State: GA

Vax Date: 01/13/2021
Onset Date: 08/09/2021
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:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Hospitalization for two days due to shortness of breath and difficulty breathing

Other Meds:

Current Illness:

ID: 1666364
Sex: F
Age: 30
State: NJ

Vax Date: 08/16/2021
Onset Date: 08/17/2021
Rec V Date: 09/02/2021
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: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Chills, low-grade fever, muscle/body aches, headache experienced on 8/17/21. Recovered from these symptoms. Muscle/body aches experienced on 8/18/21. Recovered from these symptoms. Metallic taste in mouth present since 8/17/21 up until now, still currently experiencing it.

Other Meds: Vitamin D

Current Illness: none

ID: 1666365
Sex: M
Age: 73
State: GA

Vax Date: 02/18/2021
Onset Date: 08/09/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Pt std onset began 8/6/2021 with extreme fatigue and SOB. All other symps gradually developed. Pt was admitted into the hospital 8/9-8/11. Pt has also been fully vaccinated. Pt has a med hx of Heart disease and 2 hip replacements. Symptoms: fever, chills, muscle or body aches, new loss of taste or smell, runny nose/congestion, sore throat, cough, shortness of breath, chest pain, fatigue, headache, diarrhea.

Other Meds:

Current Illness:

ID: 1666366
Sex: F
Age: 67
State: OH

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies: Latex, Percocet.

Symptom List: Rash, Urticaria

Symptoms: Legs felt as if they were 200lbs, was unable to walk, burning eyes, faint feeling, severe headache.

Other Meds: Iron pill, Vitamin D 3, Aspirin.

Current Illness:

ID: 1666367
Sex: F
Age: 34
State: KY

Vax Date: 01/26/2021
Onset Date: 08/20/2021
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:

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

Symptoms: Works at hospital. Contact positive

Other Meds:

Current Illness:

ID: 1666368
Sex: F
Age: 39
State: KY

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: na

Allergies: NA

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

Symptoms: 3 hours after received vaccine face, right arm and leg swelling. Swelling still present three days later

Other Meds: NA

Current Illness: NA

ID: 1666369
Sex: F
Age: 39
State: CA

Vax Date: 08/24/2021
Onset Date: 08/25/2021
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:

Allergies: Gluten intolerance

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

Symptoms: Injection given 8/24/2021. Sore at injection site 8/25-8/27/2021. Sore arm lessened but injection site remained very tender. 9/1/2021, injection site became red, swollen, itchy and warm to the touch.

Other Meds: Lo Loestrin FE Multi vitamin

Current Illness: None.

ID: 1666370
Sex: F
Age: 41
State: MI

Vax Date: 03/16/2021
Onset Date: 08/27/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: vision changes, fatigue, weight loss, nausea

Other Meds:

Current Illness:

ID: 1666371
Sex: F
Age: 63
State: PA

Vax Date: 08/28/2021
Onset Date: 08/29/2021
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: N/A

Allergies: N/A

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

Symptoms: Severe weakness. Unable to rise from a chair or walk by myself. Fatigue. Slight nausea.

Other Meds: Lotensin 10 mg daily Vitamin D 5000IU daily Welbutrin XL 150mg daiy Asprin 80mg daily Adderall XR 10mg daily on work days only Dorzolomide Timerol eye drops twice daily, left eye Zioptin eye drops, both eyes once daily. Humalog insulin wit

Current Illness: N/A

ID: 1666372
Sex: M
Age: 17
State:

Vax Date: 09/02/2021
Onset Date: 09/02/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Adverse effects began within 5 minutes post-vaccination. Pt experienced sensations of nausea and dizziness; pt became pale. Mother was with pt. Had pt lay on floor and elevated legs. Pt was fanned and a cold pack was used to keep pt cool. Cold water was offered to pt if needed. Pt recovered about 20 minutes later.

Other Meds:

Current Illness:

ID: 1666373
Sex: F
Age: 91
State: KY

Vax Date: 02/26/2021
Onset Date: 08/22/2021
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:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Covid positive due to contact with positive family member

Other Meds:

Current Illness:

ID: 1666374
Sex: F
Age: 49
State: FL

Vax Date: 04/01/2021
Onset Date: 04/04/2021
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: 8/13/2021 Labs

Allergies: Penicillin

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

Symptoms: I was on the last day or two of a normal menstrual cycle, with very light bleeding and getting darker when I received my 2nd vaccination. I had the "normal" adverse reaction of very sore injection site, lightheaded (fuzzy brain), fatigue, muscle aches, and random shooting joint pain. These symptoms come on about 24 hours after the injection and got better after 48 hours or so. However, my menstrual bleeding ramped back up at about 72 hours after the injections and became an extremely heavy flow, one ultra tampon and an overnight maxi-pad every hour to two hours for almost 10 days. On day 9, I had to leave work as I was unable to contain the flow without leakage. I went to the pharmacy and purchased black cohosh and soy lecithin. I also bought soy milk and bean curd to eat as I read that these items might help get my system back in balance. It worked as by day 11 or 12 the bleeding had stopped. However, I was then experiencing EXTREME fatigue. Very light exertion, lifting, walking upstairs would cause my muscles to sting and my limbs to feel as though they weighed about 100 pounds, my heart would pound and I couldn't catch my breath in my burning lungs. I also experienced lightheadedness when going from a seated or bent over to a standing position. I made an appointment with my primary care physician after dealing with this for several months, thinking it would just get better. She changed my blood pressure medicine (at my request) and did some labs. A week later she advised me that I was critically iron anemic. She believes that it must have been from the long period of time that I was bleeding so heavily after the 2nd vaccine. I am now on Iron pills and have "beefed" up my diet, and am feeling better, however, I still have some lightheadedness and fatigue.

Other Meds: Losartan 20 mg 2x pd, Omeprazole 20 mg 2x pd

Current Illness:

ID: 1666375
Sex: M
Age: 67
State:

Vax Date: 04/20/2021
Onset Date: 06/01/2021
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:

Allergies:

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

Symptoms: Actually two doses were taken (Code #208). In the case of Item #4, issues like unusual cramping (possible parasite but no test taken) on June 1, 2021 at 5 a.m. resulting in hospital viist and check with doctor. There was also an issue with sensation of "freezing" in legs. The stomach cramp issue has continued from time to time. After the second Pfizer dose, received on June 23, Lot EY0579, I noticed some exacerbation of issues like athletes foot infection so I made an emergency visit on August 24 and was referred to my doctor's clinic. On August 25 at 1:00 a.m. I noticed unusual itching in my left hand (enough to keep me awake). Last night I had overall body itching (everywhere) during the night that kept me awake

Other Meds:

Current Illness:

ID: 1666376
Sex: F
Age: 67
State: FL

Vax Date: 08/27/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data: N/A

Allergies: N/A

Symptom List: Unevaluable event

Symptoms: Pt. states that after receiving the 2nd dose of Phizer 08/27/2021, started experiencing symptoms 09/01/2021 of weakness, headache, dizziness, neck pain, and hot flashes. No noted Primary visit. Still continuing to experience symptoms.

Other Meds: Prolia Shot 07/20/2021, Gummy Vitamins Hair & Nails

Current Illness: N/A

ID: 1666377
Sex: F
Age: 24
State: KY

Vax Date: 01/22/2021
Onset Date: 08/30/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: tested positive for COVID 19 08/31/2021

Other Meds:

Current Illness:

Date Died: 09/01/2021

ID: 1666378
Sex: M
Age: 63
State: KY

Vax Date: 04/07/2021
Onset Date: 08/21/2021
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: N/A

Allergies: Unknown

Symptom List: Injection site pain, Pain

Symptoms: Patient admitted to Hospital with acute hypoxic respiratory failure secondary to viral pneumonia from COVID-19 and exacerbation of COPD. Worsening of symptoms prompted Average Volume-Assured Pressure Support. Ventilation did not seem an option d/t HX of severe inflammatory interstitial lung disease.

Other Meds: Albuterol 2.5/3 mL QID Allopurinol 150 mg QD Amiodarone 200 mg QHS ASA 325 QD Vitamin D 1000U QD Famotidine 20 mg ii BID Ferrous Sulfate 325 QAM Advair 500/50 BID Gemfibrozil 600 mg QHS Guaifenesin 600 mg BID Norco 10/325 Q6H PRN Hydroxychl

Current Illness:

ID: 1666379
Sex: M
Age: 73
State: KY

Vax Date: 02/26/2021
Onset Date: 08/23/2021
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: Covid positive. Contact unknown

Other Meds:

Current Illness:

ID: 1666380
Sex: F
Age: 42
State: GA

Vax Date: 08/21/2021
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: SYR
Vax Site: LA

Lab Data: None

Allergies: None

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

Symptoms: Red spot at injection site, hot, itching, sore, raised area at injection site, occurring 11 days after first shot of Moderna, red spot about 3in long by 2 in wide

Other Meds: Birth control pills, zinc, D, calcium, B

Current Illness: None

ID: 1666381
Sex: F
Age: 24
State: WA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
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: X-ray of lungs - to see if it was Bronchitis - that have done a couple of those and didn't find anything. Sinus doctor- my sinuses have gotten worse - tried to order an MRI but it didn't get approved by insurance. Antibiotics didn't really help - it worked for a couple of days and then stopped working - Sephtinaire - possibly was the antibiotic

Allergies: amoxicillin; sulfa; intolerant to eggs

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I had a consistent migraine for 14 days following the second dose. Which I could not break with medication. It broke for one night after the 14 days and then it came back the very next day and lasted about three days (it broke each of those three nights of these days but then would come back again in the morning)- even with medication. And then finally after about three doctor appts ( neurologist ) and a cocktail of meds it went away. I also had really bad fatigue that lasted for months. I had some extra first vaccine but it was mild and this fatigue after the second vaccine hit me like a freight train. Auto Injector once a month: Engility - Added After the shot after the 14 day migraine. Changed from Rizatriptan to Sumatriptan. They also gave me a bunch of different kinds of cocktails to abort the migraine - Butaloprol (?) (Acetaminophen Caffeine cocktail to take once during the migraine and it didn't knock it out. Tried ibuprofen with one of the Triptans and that didn't work. Other cocktail: Triptan; Ibuprofen; Prochlorperazine and a Benadryl, too, and that is what finally got rid of the migraine. I also had problems with breathing - was worse - and I started coughing up phlegm really badly. The fatigue has slowly been getting better. That is still getting worked on - I did have some pre-existing fatigue beforehand and it's not quite back to that. I would say that I am about at 7 of trying to get back to my normal "10" if "10" was where I was before. It had gone down to a 4 or 5 before. The phlegm issue comes and goes and with that the breathing is affected. I have sinus issues that have gotten worse - they started getting worse within the first week after the vaccine and got their worse about 2 weeks after.

Other Meds: I was on Zoloft 200 prior to vaccine and Risperdal .5 at the time and I've been on Clonidine - .2 mg twice a day prior to vaccine too. I have been on Vyvanse 10 mg once a day - I think I was taking Gabapentin at the time of vaccine - if i

Current Illness: no

ID: 1666382
Sex: F
Age: 34
State: IN

Vax Date: 08/25/2021
Onset Date: 08/29/2021
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: Sulfa Medications, Red food dyes, shell fish

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 4 days after the shot I started cramping very very badly. I do not get cramps regularly. I woke up out of a deep sleep and had my period so bad. My period is on time every month and is not normally this heavy. My period arrived 3 days early while sleeping. I use soft discs to control my period. I am bleeding so much the disc is over filling and I have to change the cup 3 to 4 times per day. This has never happened. I am still on day 5 and still bleeding heavily and the blood is so dark it looks purple.

Other Meds:

Current Illness:

ID: 1666383
Sex: M
Age: 71
State: MI

Vax Date: 04/08/2021
Onset Date: 08/27/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data:

Allergies: fentaNYL - itching

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

Symptoms: Hospitalized; COVID-19 positive (after fully vaccinated) Admission Date: 8/27/2021 Discharge Date: 8/31/2021 Active Hospital Problems Diagnosis Date Noted POA ? Acute idiopathic gout of shoulder 08/31/2021 Yes ? Adrenal insufficiency (HCC) 08/30/2021 Yes ? Hereditary hemochromatosis (HCC) 08/29/2021 Yes ? Hyponatremia 08/27/2021 Yes ? Cardiomyopathy, nonischemic (HCC) 08/28/2014 Yes DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Patient is a 72 y.o. male with a past medical history of suspected pulmonary fibrosis, nonischemic cardiomyopathy, ventricular fibrillation, ICD placement, mural thrombus on chronic warfarin, hypertension, seasonal allergies, chronic obstructive pulmonary disease/asthma who presents with hyponatremia. In June of this year he was admitted with acute hypoxic respiratory failure and hyponatremia, he was seen by Pulmonology during that admission and he was found to have likely pulmonary fibrosis so was started on triple inhaler p.r.n. and discharged with a prednisone taper and follow-up with Metro pulmonology. He also had an echocardiogram during that admission which revealed EF 27%, which as been his baseline. He was doing well until he developed bilateral arm pain following work on April 2 to three weeks ago, he had gone to physical therapy and his PCP however his symptoms worsened after continue to workup the boat. Last night, he had nausea, vomiting, and diarrhea that was followed by chest pain so presented to the emergency department. HOSPITAL COURSE: Hypoosmolar hyponatremia due to diarrhea, adrenal insufficiency Na 116 -- > 117-- > 120 -- >122-- >122-- >127-- >128-- >127 -- >125 -- >124 -- >127 Due to adrenal insufficiency, CHF Urine sodium 33, urine osmolality 265, serum osmolality 258 TSH normal Seen by nephrology, continue current treatment Recheck next week by PCP, no need to follow with nephro unless hyponatremia worsening Adrenal insufficiency Cortisol level 0.9 on admission Cosyntropin stimulation test: 2.5-- > 11.7-- > 14.5 Endocrinology consult: suspect pituitary dysfunction related to hemochromatosis, steroid use or other pituitary etiology ACTH 19, inappropriately normal, will need MRI of pituitary gland, this could be done outpatiently, and will need follow up with Dr. He was given stress dose steroid with hydrocortisone 25 mg IV every 6 hours, and switched to hydrocortisone 15 mg AM and 5 mg PM. Discussed sick day rules. Double hydrocortisone dose for 2-3 days during acute illness. Recommend to obtain medical alert for adrenal insufficiency. TSH, FT4 normal. DHEA sulfate 17.6, In the emergency department, he was noted to have stable vitals. BMP revealed sodium 116, normal renal function, BNP 3980, negative troponins, no leukocytosis, hemoglobin 10.1 which has been his baseline for several months. EKG revealed paced rhythm, no significant ST changes, PVC. Chest x-ray revealed small right pleural effusion and mild bilateral airspace disease. Incidentally found to be COVID positive in the emergency department. He was given an aspirin and 500 mL normal saline bolus. He was admitted to Internal Medicine for further evaluation and management. Initial COVID-19 infection 10/21 Positive COVID-19 PCR on admission CTA 8/28: No central, lobar or proximal segmental pulmonary embolus. Distal segmental and subsegmental vessels are not well evaluated due to respiratory motion. Worsening mediastinal adenopathy. Grossly stable mild peripheral fibrosis throughout both lungs. Mediastinal adenopathy most likely due to COVID-19, will need recheck CT in 2 months Developed symptoms of diarrhea, nausea and vomiting on 8/26, date of positive test 8/27 On room air since admission, so I do not think this is true reinfection of COVID-19 Nausea, vomiting, diarrhea -resolved Probable due to COVID-19, adrenal insufficiency

Other Meds: acetaminophen (TYLENOL) 500 MG tablet albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler calcium-vitamin D (CALCIUM 600+D) 600-200 MG-UNIT TABS per tablet carvedilol (COREG) 12.5 MG tablet colchicine-probe

Current Illness: COVID-19 positive 8.27.21 Shortness of breath Shoulder tendinitis

ID: 1666384
Sex: M
Age: 79
State: CA

Vax Date: 08/20/2021
Onset Date: 08/23/2021
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: RA

Lab Data: Results as of 9/2/2021 09:32; 8/23/2021 14:35; NA: 138; K: 4.2 CL: 103; CO2: 29; BUN: 15; CREAT: 1.08; ANION GAP4 SERPL: 6; GLUC: 177 (H); TROPONIN I: <0.02; BNP: 213 (H); GFR-AFRAM: >60; GFR NONAFR AMER: >60; COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE; 8/23/2021 14:54; 8/23/2021 15:28; 8/23/2021 17:30; LACTATE: 1.1; 8/23/2021 23:25; 8/24/2021 00:55; 8/24/2021 03:48; NA: 137; K: 4.0; CL: 103; CO2: 28; BUN: 18; CREAT: 0.95; ANION GAP4 SERPL: 6; MG: 1.9 GLUC: 124; TROPONIN I: <0.02; LDH: 194; ALT: 18; AST: 18; ALKP: 70; TBILI: 0.5; COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE; CRP, SER QL: 11.3 (H); FERRITIN: 307; 8/30/2021 04:17; NA: 139; K: 4.2; CL: 105; CO2: 26; BUN: 18; CREAT: 1.04; ANION GAP4 SERPL: 8; GLUC: 152; TROPONIN I: <0.02; BNP: 129 (H) ALT: 85 (H); AST: 68 (H); ALKP: 87; TBILI: 0.4; GFR-AFRAM: >60; GFR NONAFR AMER: >60; COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE; CRP, SER QL: 5.3 (H); 8/30/2021 04:33; 8/30/2021 15:40; 8/31/2021 06:58; NA: 141; K: 4.2; CL: 105; CO2: 28; BUN: 24; CREAT: 0.94; ANION GAP4 SERPL: 8; GLUC: 164 (H); ALT: 70 (H); AST: 43 (H); ALKP: 93; TBILI: 0.5; COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE; CRP, SER QL: 2.8 (H) S AUREUS METHICILL RESIST ISLT; Final Report ; No Methicillin resistant Staph aureus isolated; XRAY CHEST; ** HISTORY **: Male, age 79 years: COUGH Possible COVID patient ** TECHNIQUE **: 1 view of the chest acquired. COMPARISON: Radiograph 8/23/2021 ** FINDINGS ** LUNGS: Lungs are hazy with airspace disease in left midlung. No pneumothorax. MEDIASTINUM/OTHER: The heart is enlarged.

Allergies: Allergies; Allergen; Reactions; Ciprofloxacin GI Symptoms; Severe heartburn. Feeling of impending doom. Fentanyl; Blood pressure/anxiety; Tolerated during conscious sedation for colonoscopy; Flomax [Tamsulosin] GI Symptoms; Severe heartburn. Succinylcholine Chloride; Anaphylaxis

Symptom List: Nausea

Symptoms: 79 y/o man with Diabetes Mellitus type II (not on meds), Afib(on Warfarin), MDD, chronic kidney disease stage 3 (baseline creat 1-1.3), Coronary artery disease (per MPS 6/2019, previously medical management), who is fully COVID-19 vaccinated (including 3rd shot 8/20/21), presents to ED with decreased O2 sat of 87% when ambulating at home in setting of 2 week history of dry cough (sxs starting 8/15) and positive COVID-19 test on 8/23/21, found to have COVID-19 pneumonia. Patient with mild desat at rest but very tachypneic with ambulation so was admitted for further monitoring and treatment. Started on Remdesivir and Decadron. Patient had stable respiratory status with improvement in SOB. Was able to ambulate without any desaturation or shortness of breath. COVID-19 Pneumonia- Symptom onset on 8/15. COVID positive on 8/23. Now on RA at rest and with exertion. Inflammatory markers improved. Will continue Decadron 6mg PO qday for another 7 days; Remdesivir 200mg IV x1 (8/30-), followed by 100mg IV daily. Stop after today's dose; Daily LFTs stable; Pepcid for GI prophylaxis; Patient on Warfarin; continue isolation in hospital per Regional/Local ID guidance. Mild transaminitis: no abdominal symptoms. Improving Afib: rate controlled; Cont Metoprolol 25mg BID; Warfarin per protocol. INR has been supratherapeutic. Hold Warfarin 8/31. INR check 9/1/21; Diabetes Mellitus type II: A1c 6.7 3/16/21. Not on meds. Was placed on correctional scale insulin during hospitalization. Overall controlled even with Decadron. Coronary artery disease: per MPS. No chest pain. Patient previously on ASA, Atorvastatin, unclear why no longer on this. F/u with PCP; Chronic kidney disease stage 3: stable monitor; Reason for Hospital Admission (Admitting Diagnosis): COVID-19 Pneumonia; Previous COVID Vaccine History; 8/20/2021 Given 0.3 mL Lt deltoid IM PFR EW0191 PFIZER COVID-19 VACCINE (PF) Delete History; 3/1/2021 Given 0.3 mL Lt deltoid IM PFR EN6201 PFIZER COVID-19 VACCINE (PF) Delete History; 2/8/2021 Given 0.3 mL Lt deltoid IM PFR EN6201 PFIZER COVID-19 VACCINE (PF) Delete History.

Other Meds: Amoxicillin 500 mg Oral Cap; Sig: Take 1 capsule by mouth 4 times a day for 7 days; Baclofen (LIORESAL) 10 mg Oral Tab; Sig: TAKE 0.5 TO 1 TABLET ORALLY 3 TIMES A DAY; Patient not taking: No sig reported; Cetirizine (ZyrTEC) 10 mg Oral Tab;

Current Illness: None

ID: 1666385
Sex: F
Age: 55
State: PA

Vax Date: 08/30/2021
Onset Date: 09/02/2021
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: Mri brain normal

Allergies: Avelox

Symptom List: Injection site pain

Symptoms: Vertigo and off balance of sudden onset with numbness in left foot

Other Meds: Claritin and Motrin prn

Current Illness: None

ID: 1666386
Sex: M
Age: 55
State: NV

Vax Date: 08/20/2021
Onset Date: 08/20/2021
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: Penicillin

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

Symptoms: continue dizziness after eat and very disoriented to the point that I can not driver, I feel depress and sad, before the second doses I was feeling perfectly happy, I have no reason to feel that.

Other Meds: Tylenol

Current Illness: none

ID: 1666387
Sex: M
Age: 19
State: WA

Vax Date: 08/29/2021
Onset Date: 08/30/2021
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: ecg, labs , echo

Allergies: none

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

Symptoms: acute pericarditis

Other Meds: none

Current Illness: none

ID: 1666388
Sex: F
Age: 36
State: AL

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: about 3-4 hours after getting the second dose of Moderna, she started having swelling of her hands and the swelling extended down to her feet. She also said she had some shortness of breath. She did not report the reaction until about 24 hours later. I told her to go to urgent care/emergency room. she said she had doctors appointment the next morning at 9am. I encouraged her to go anyway or at least call her doctor. She did call and md said ok to come in the next morning . MD confirmed allergic reaction and she called me about 1 hour after appt to tell me. she did say she was better and I told her to watch closely and go back to md if not better.

Other Meds:

Current Illness:

ID: 1666389
Sex: F
Age: 29
State: MA

Vax Date: 04/07/2021
Onset Date: 08/06/2021
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: Went to the Emergency Room 3 times for miscarriage from 8/6-8/9/21

Allergies: no

Symptom List: Erythema, Pruritus

Symptoms: Symptoms: - High fever for 4 days - chills for 3 days - nausea for 1 day - fatigue for 2 days - locked jaw from intense chills for 2 days - shortness of breath for 7 days - Body aches for a couple days Adverse event: Miscarriage on 8/6/21

Other Meds: prenatals

Current Illness: no

ID: 1666390
Sex: F
Age: 23
State: KY

Vax Date: 04/09/2021
Onset Date: 08/23/2021
Rec V Date: 09/02/2021
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: Covid positive due to contact with church member

Other Meds:

Current Illness:

ID: 1666391
Sex: M
Age: 23
State: FL

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: patient has an appointment next week

Allergies: no allergies

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

Symptoms: about 24 hours after vaccination with covid-19 (Pfizer) vaccine, patient had a 5 minute seizure. Patient fell while having seizure and hit his head.

Other Meds: none

Current Illness: none

ID: 1666392
Sex: F
Age: 18
State: IL

Vax Date: 09/02/2021
Onset Date: 09/02/2021
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: None

Allergies: No known allergies

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 18 yof, presented for her first dose of Pfzer on 09/02/21. Approximately 5 minutes after receiving the vaccine she stated, ?I feel dizzy?. Ice pack, water, juice, and gram crackers given to pt. 0901 Vitals: Temp: 97.0, BP 99/60, HR 62, Resp 16. Pt was diaphoretic; therefore, we lowered her to the floor and propped her feet up. She was fanned while laying down. 0908 she started to feel better. She ate some graham crackers and drank a little bit of juice. She did not eat breakfast today. She also reported that this happens every time she gets a shot. 0915 Temp 98.0, BP 118/70, HR 66, Resp 16. Pt was assisted to a nearby couch to finish out her observation period. 0940 Temp 98.1, BP 122/76, HR 74, and Resp 18. 0943 Pt feeling much better. She was instructed to rest, eat, and drink plenty of fluids. 0943 Pt left

Other Meds: No known medications

Current Illness: IBS and she is currently being worked up for suspected Crohn's disease

ID: 1666393
Sex: F
Age: 80
State: GA

Vax Date: 02/26/2021
Onset Date: 08/07/2021
Rec V Date: 09/02/2021
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:

Allergies:

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

Symptoms: Fully vaccinated and hospitalized. The patient's daughter reported that she experienced a: Fever, Abdominal Pains, Cough and a runny nose. Symptoms started on 8/6. The patient's daughter stated that she lives with her and her fiance who both tested positive. Reported current smoker and Diabetes as pre-existing medical conditions.

Other Meds:

Current Illness:

ID: 1666394
Sex: F
Age: 30
State: FL

Vax Date: 08/09/2021
Onset Date: 08/11/2021
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: Complete bloodwork which showed elevated levels on multiple test. elevated. CT scans, ultrasound of my leg to check for blood clots.

Allergies: None

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

Symptoms: Ever since getting the vaccine I have had high blood pressure. I normally have lower end blood pressure. Also my heart rate has been steadily in the 120s-150s. I ended up at the ER Bc I was having chest pains. My was elevated and they did scans to check for blood clots. Scans were clear. Also my left leg now has horrible pains and feels heavy all the time. Can?t catch a good breathe. Also I have been having ketones in my urine despite having very well controlled blood sugar numbers. A lot of my bloodwork came back elevated. My MPV and others were all elevated. This vaccine did something to my body and I haven?t been the same since.

Other Meds: Novolog, Buprenorphine, Trazadone

Current Illness: Type 1 diabetes

ID: 1666395
Sex: F
Age: 37
State: CA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
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: CBC-normal

Allergies: Vicodin

Symptom List: Pain in extremity

Symptoms: Almost immediately after the vaccine I started feeling numbness and tingling in my bilateral hand and face. I had to lay down and was dry heaving and immediately I had to go to the restroom 3 different times in a row with severe diarrhea. That night my face was numb and loss of appetite. No appetite the next morning but went to work. Started not feeling well so I left work and around 2pm I lost my voice and couldn't talk, began vomiting and loss all energy. I was so out of it I could not talk for about 24hrs. I was vomiting for about 8hrs straight with diarrhea close to every 30 minutes. I had a bad headache feeling like my head was going to explode and severe body pain. I was extremely nauseated. The next day my stomach felt as if it was burning, and I couldn't keep any food down. I have had diarrhea, been fatigued and extremely nauseated with acid burning from my stomach to my throat, can't sleep and gastritis since the day of the vaccine. On 8/18 I went to the ER because the symptoms were just so bad. I was administered Zofran and was sent home. On 8/31 I went back to the ER at and was given IV fluids and various meds to try to calm my stomach to bring down the acid. I have been referred to a GI specialist. I have a disability appointment scheduled. 9/10 appointment scheduled for an Endoscopy and have since been prescribed: Famotidine, Zofran, Pepcid, Ativan and Phenergan if the Zofran doesn't work. And I continue to have the diarrhea, nausea, upset stomachs and I still can't sleep without the Ativan. One provider feels I am allergic to the poly ethanol in the vaccine.

Other Meds: Vitamin C; Zinc

Current Illness: No

ID: 1666396
Sex: M
Age: 45
State: MN

Vax Date: 12/30/2020
Onset Date: 08/26/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Symptomatic COVID infection, COVID pneumonia, hospitalized for IV antibiotics and breathing treatments.

Other Meds:

Current Illness:

ID: 1666397
Sex: F
Age: 42
State: FL

Vax Date: 12/21/2020
Onset Date: 05/04/2021
Rec V Date: 09/02/2021
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: Covid test-positive, CXR.

Allergies: Doxycycline, gluten.

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

Symptoms: Pt came to ER after recent hospital admission for Covid Pneumonia . C/O SOB, shaking, chills, fevers, productive cough.

Other Meds:

Current Illness:

ID: 1666398
Sex: M
Age: 70
State: OH

Vax Date: 04/08/2021
Onset Date: 04/21/2021
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:

Allergies: None

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

Symptoms: Ringing in right ear

Other Meds: Olmesartan. Amlodipine hctz 20/5/12.5 Terazosin Hal. 10mg

Current Illness: None

ID: 1666399
Sex: M
Age: 13
State: NY

Vax Date: 08/06/2021
Onset Date: 08/08/2021
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: CBC and urinalysis were initially normal. Those tests as well as a sedimentation rate were performed again today (9/2/21) and were normal.

Allergies: Environmental, tobramycin, pecans

Symptom List: Vomiting

Symptoms: Two days following his initial vaccination he developed a red, vasculitic, tender rash on his lower legs. The rash seemed to only involve his lower legs for about 10 days, after which the rash progressed and involved his entire body. he also developed a headache and vague abdominal pain at that time. He was diagnosed at the hospital with Henoch Schonlein Purpura and placed on a Medrol steroid dosepack.

Other Meds: Methylphenidate, Albuterol Inhaler

Current Illness: none

ID: 1666400
Sex: F
Age: 77
State: NC

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: EKG, chest x-ray, BMP, CBC with differential, EGFR (MDRD) Magnesium level, PT/INR, Troponin-I and 3 hr. repeat.

Allergies: Pain meds, sulfa, cortisone, pneumonia vaccine, flu vaccines, lactose intolerant

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Within 3 minutes felt severe heat in chest, neck face, got clammy, sweaty the chest and neck felt like I was being gripped/squeezed. Was given water. BP went up 163/101. Nurse gave me benedryl. Was offered steroid but due to previous allergic reaction it was decided it would make matters worse. EMS called approx. 10:30. Sent to Wake Med ER. I was breathy when talking; had metallic taste immediately after jab that lasted into day 3; chest and throat felt like it was being squeezed. I was monitored for several hours and all blood tests were normal. BP came down to 143/93. Released around 5:15 pm. Took baby aspirin. Day 2: lungs felt like they were being squeezed, had eye pain, slept most of day, no appetite, no energy, any walking or moving was painful; body aches; back of lungs sore and chest very tender to touch or movement, headache. Day 3: same as day 2. Took Ibuprofen for pain, Day 4: slight headache with sore throat; back pain still tired although sleeping well. Tire easily when walking.

Other Meds: 81 mg aspirin daily

Current Illness: None

ID: 1666401
Sex: F
Age: 40
State: NC

Vax Date: 09/02/2021
Onset Date: 09/02/2021
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:

Allergies:

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

Symptoms: Patient asked for a Pfizer C-19 vaccine, but was administered a Janssen C-19 vaccine by mistake,

Other Meds:

Current Illness:

ID: 1666402
Sex: F
Age: 37
State: OR

Vax Date: 01/24/2021
Onset Date: 03/01/2021
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: I had an ER visit, CT Scan, EKG, Ultrasound, and then scope and biopsy.

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I got a fever and felt ill. My arm hurt. Shortly after I started having fatigue and then was diagnosed with EOE. My heart hurts, it didn't before.

Other Meds:

Current Illness:

ID: 1666403
Sex: F
Age: 31
State: MA

Vax Date: 05/01/2021
Onset Date: 08/22/2021
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: Negative for covid. Chest X-ray looked normal.

Allergies: None

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

Symptoms: I had a heart attack like occurrence and for a week after had strong chest pain. I am writing this today as I am highly concerned, I have heard of other people facing the same issue. I am a young woman In outstanding health. I feel the vaccine is causing heart and chest issues much more frequent than we are being told. I have had people near me die of heart attacked recently and think it?s a result of the vaccine

Other Meds: None.

Current Illness: None

Date Died: 08/18/2021

ID: 1666404
Sex: M
Age: 76
State:

Vax Date: 01/02/2021
Onset Date: 08/06/2021
Rec V Date: 09/02/2021
Hospital: Y

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: POSITIVE COVID TEST, SOB, O2 SAT 88%, ON O2 @ 3L/M.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am