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: 1666661
Sex: F
Age: 53
State: WA

Vax Date: 05/22/2021
Onset Date: 07/17/2021
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: LA

Lab Data:

Allergies: cleaning products

Symptom List: Dysphagia, Epiglottitis

Symptoms: About 8 weeks after my second Moderna dose I started to have some eyelid issues. My eyelids started to feel heavy and by the end of the day my eyes were stinging. About 2 1/2 weeks after symptoms started I had an appointment with an Optometrist (8/4/21) who diagnosed dry eye syndrome and gave me artificial tears to lubricate my eyes. Three days later (8/7/21) my eyelids dropped onto my eyes and I was unable to open my eyes except for a small slit. I went to the emergency room following day (8/8/21) but they didn't know what was going on. On 7/2/21 I'd had Dysport injections in my forehead, and around my eyes and they thought maybe this was causing my eyelids to drop. The gave me some ointment to put in my eyes and referred me to another eye clinic. I called my Optometrist and told him what had happened and he referred me to an Ophthalmology doctor (8/11/21) who diagnosed a condition called Benign Essential Blephorospasm. When I try to open my eyes my eyelids spasm and won't open. Treatment involves Botox injections in the eyelids to stop the spasms and I have had three treatments on the following dates: 8/11/21, 8/17/21, 8/24/21. I can open my eyes a little now and see down but when I try to open my eyes all the way the eyelids spasm and I'm unable to open my eyes all the way. I have been referred to a neurologist and my appointment is scheduled for 10/7/21.

Other Meds: multi vitamin, fish oil, vitamin D

Current Illness: none

ID: 1666662
Sex: U
Age: 94
State: TN

Vax Date: 02/22/2021
Onset Date: 08/13/2021
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: ABGs showed PO2 of 60 Chest XRay showed bilateral pna

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Presented to the ED with c/o headache, chest pain, shortness of breath, cough, fever, chills and diarrhea. Patient was diagnosed with COVID 19 days ago. patient was admitted to the hospital. patient was given remdisvir and convalescent plasma. Patient was discharged home on 08/21/2021

Other Meds:

Current Illness:

ID: 1666663
Sex: M
Age: 70
State: GA

Vax Date: 03/08/2021
Onset Date: 08/17/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Pt had lung biopsy scheduled for 8/17 at hospital due to breathing issues for several months and order of Pulmonary Dr from chest xray in April. Only symptoms cough and fatigue other than the breathing difficulty which has been ongoing. Pt has Crohn's disease and hypertension and has been diagnosed with interstitial Lung Disease.

Other Meds:

Current Illness:

Date Died: 08/30/2021

ID: 1666664
Sex: M
Age: 63
State: KY

Vax Date: 03/20/2021
Onset Date: 08/12/2021
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: tested positive for COVID on 8/12/21 & 8/19/21

Allergies: NKDA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21 Hospitalization Admit Date/Time: 8/19/2021 9:06 AM Discharge Date: 8/30/2021 Referring provider name and address: No referring provider defined for this encounter. Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation. On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED. Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021. The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care. Our service was consulted to evaluate the patient for ICU admission. On exam, he is calm, conversant and ATO x 3. ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53. He is hemodynamically stable. The remainder of his labs are relatively normal. We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required. His wife was called with the above discussion as well and the patient conversed with her at length before intubation. AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU Chronic Microcytic Anemia d/t Thalassemia - monitored Hb At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805

Other Meds: cholecalciferol, glucosamine-chondroitin, loratadine, metoprolol tartrate, multivitamin, warfarin, meloxicam

Current Illness:

ID: 1666665
Sex: F
Age: 37
State: MI

Vax Date: 07/12/2021
Onset Date: 07/14/2021
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: angiogram, MRI, ECG and EKG

Allergies: None

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

Symptoms: While taking a shower Wednesday morning, employee started to feel like she was going to faint. she sat down, hoping it would go away. After so much time of it not going away, she started to crawl out of the shower, but passed out x3, right in a row, for about a second each time.she crawled to bed when she could, but could not relax because her heart rate was very elevated. This happened after receiving the first dose of COVID on Monday night, about 6pm.

Other Meds: None

Current Illness: Moya Moya disease

ID: 1666666
Sex: F
Age: 99
State:

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

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: 9/1/2021: COVID-19 nasal swab: positive

Allergies:

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

Symptoms: COVID PNA with worsening cough, SOA, diarrhea

Other Meds:

Current Illness:

ID: 1666667
Sex: M
Age: 41
State: FL

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

Lab Data: Went to primary dr for blood and urine analysis and everything came back fine she had no idea why that was happening. I then made an appointment for cscan from my andrologist and that also came back fine after two weeks it stopped so scary. Also my girlfriend did not get her period for two months we both had real sore arms for a week and both have never felt the same way since.

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Blood in urine and semen. Went to primary dr for blood and urine analysis and everything came back fine she had no idea why that was happening. I then made an appointment for cscan from my andrologist and that also came back fine after two weeks it stopped so scary. Also my girlfriend did not get her period for two months we both had real sore arms for a week and both have never felt the same way since.

Other Meds: Bitkarvy; Hydromorphone

Current Illness: None

ID: 1666668
Sex: F
Age: 35
State: OR

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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: gluten, dairy

Symptom List: Pharyngeal swelling

Symptoms: Vomiting, severe abdominal pain, body aches, severe body chills. Began approx. 10 hours following vaccination and continued until for 48 hours.

Other Meds: Amitriptyline, prevacid, sprintec birth control, magnesium, potassium, multivitamin, iron, vitamins B, C and D daily

Current Illness:

ID: 1666669
Sex: F
Age: 26
State: OH

Vax Date: 08/28/2021
Onset Date: 09/01/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data: 9/2/21 CT head: no acute intracranial abnormality CT soft tissue neck with contrast: cervical adenopathy Sodium: 133; chloride: 96 COVID-19 rapid: negative Blood cultures: pending

Allergies: NKA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient began experiencing nausea, emesis, and headache after second dose of Moderna COVID-19 vaccination on 8/28/21. Patient also reports neck stiffness, fever, and malaise. In ED, patient is febrile to 103.2F with pulse 104 and BP 100/55. The patient is being evaluated for suspected meningitis. Patient will receive lumbar puncture to further evaluate. Patient has received fluid bolus, acetaminophen, ceftriaxone, and vancomycin. The patient will be admitted to the hospital.

Other Meds: None

Current Illness:

ID: 1666670
Sex: F
Age: 31
State: WA

Vax Date: 08/20/2021
Onset Date: 08/31/2021
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: N/A

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: My menstrual cycle is very regular- exactly to the day and time of day. My period came a week early unexpectedly with no warning. I have had no cramps like I usually get on the first two days. The bleeding is heavier than normal and bright red.

Other Meds: None

Current Illness: None

ID: 1666671
Sex: F
Age: 44
State: NJ

Vax Date: 05/14/2021
Onset Date: 05/18/2021
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: 5-18-2021 Blood test (D-Dimer, Troponin I, CBC, and TSH), EKG (vent. rate 94BPM, atrial rate 94, P-R interval 188ms, QRS duration 92ms, Q-T interval 378ms, QTC calculation (bazett) 472ms, P axis 55 degrees, R axis 43 degrees, T axis 15 degrees), and Chest x-ray. 8-7-2021 EKG and Echo = negative

Allergies:

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

Symptoms: My heartrate went up to 168 bpm resting and it lasted for about 20 minutes staying within the range of 145-168 (Since I work for a hospital/medical facility they were monitoring me the whole time). The EMS picked me up after 30 from the beginning of the event. I got to the hospital emergency room within 10 minutes. By the time I reach the hospital my heartrate was documented at around 98. They did all type of test and everything except for the EKG came back abnormal. I had a few episodes of palpitation within 1 weeks of the vaccine including a few hours after the 1st dose. I monitor my heartrate at the time and it was at about 125 resting but it went back down to the 90s within a few minutes so I didn't think anything of it. The same happened a few times within the first week of the vaccine except on the 4th day it went up to 168 and didn't go back down within a few minutes. I was discharged from the hospital the same day and told to follow up with a cardiologist which I did and was told everything was ok with my heart.

Other Meds: Synthroid 75mcg and Nuva-ring

Current Illness:

ID: 1666672
Sex: M
Age: 31
State: NC

Vax Date: 04/30/2021
Onset Date: 04/30/2021
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: None.

Allergies: None.

Symptom List: Rash, Urticaria

Symptoms: He got the vaccine, initially it seemed pretty expected. About bedtime he started to feel a little different, like maybe his lymph nodes were responding a little bit in his jaw line. Feeling like sensitivity or soreness, and that was kind of expected. Then he went to bed and he started to feel like maybe a sore throat that was minor. He went to bed and woke up the next day he started to notice that his cognitive ability was falling apart. He is normally really sharp and quick, and later that day he was having trying to figure out how to put together a sentence. He was able to think what he wanted to say, but not able to turn it into speech. About 7:00 PM the next day at it's peak and not able to communicate anymore. He told his fiance that he was having a lot of problems, and not able to talk very well and just rested. Was scared and nervous, wanting to know if it was going to be permanent and not able to speak anymore. He was able to communicate a little bit, but would take a full minute to be able to figure out how to get a single word out and to respond when he was being asked a question. He then started using head jestures instead of talking. He went to bed and then the following day his speech had come back a little bit and felt better about that. He could communicate better, but not up to normal and went on for about 4-5 days after the shot, and slowing getting back to an area to being somewhat normal again. Now he is able to speak pretty quickly, but it was a scary situation, and it was brain related which was the worse part of it. He went to the place where he got the vaccine, and asked them what h e needed to do, and told them that he had a very weird reaction that he had not heard of before and did not know what to do and gave him our #. He now feels that he is fully recovered. He did not get the 2nd vaccine.

Other Meds: None.

Current Illness: None.

ID: 1666673
Sex: F
Age: 16
State: TN

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:
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: Patient given Moderna per request; but when billed later patient was 16 (under-approved age).

Other Meds:

Current Illness:

ID: 1666674
Sex: F
Age: 71
State: TN

Vax Date: 03/11/2021
Onset Date: 08/27/2021
Rec V Date: 09/02/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: admitted to hospital with COVID after being vaccinated. Mostly DI related symptoms. Discharged home after 6 day stay

Other Meds:

Current Illness:

ID: 1666675
Sex: F
Age: 26
State: RI

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

Lab Data: None indicated

Allergies: cat dander, NKDA

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

Symptoms: No adverse reaction. Patient previously received Janssen vaccine on 3/30/2021 and requesting Pfizer. Discussed pros/cons, recommendations, and potential outcomes. Patient expressed understanding and had first dose of Pfizer on 9/2/21. Well tolerated.

Other Meds: Allegra-D, dextroamphetamine 20mg, testosterone 60mg SQ weekly

Current Illness: none

ID: 1666676
Sex: F
Age: 60
State: NM

Vax Date: 08/19/2021
Onset Date: 08/19/2021
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:

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

Symptoms: The patient was supposed to get the Moderna vaccine but was given the Pfizer vaccine instead. No adverse event occurred with patient.

Other Meds:

Current Illness:

ID: 1666677
Sex: M
Age: 20
State: VA

Vax Date: 08/30/2021
Onset Date: 08/31/2021
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:

Allergies: N/A

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

Symptoms: My legs feel like they have very bad sunburn. I also have a sensitive to touch area on my leg.

Other Meds: N/A

Current Illness: N/A

ID: 1666678
Sex: M
Age: 43
State: MD

Vax Date: 04/17/2021
Onset Date: 04/17/2021
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: unknown

Allergies: unknown

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Following injection of COVID19 Moderna LOT 043B21A in the left arm, the patient stated tingling of arm and pain in the injection site. The Client stated that the tingling sensation radiated to opposite arms as well.

Other Meds: unknown

Current Illness: unknown

ID: 1666679
Sex: F
Age: 40
State: TX

Vax Date: 07/29/2021
Onset Date: 08/20/2021
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: Sulfa

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Around 3AM on August 20, 2021, I woke up with blood in my underwear and on my bed. I went to the restroom and passed a large blood clot about the size of my hand. My doctor said that my pregnancy is ok, but I had a sub chorionic hemorrhage. My estimated date of delivery is March 25th 2022.

Other Meds: Citalopram; Progesterone; Estrace; Prenatal vitamin

Current Illness:

ID: 1666680
Sex: F
Age: 45
State: KS

Vax Date: 02/05/2021
Onset Date: 03/01/2021
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:

Allergies: Amoxicillin, Cefdinir, Celecoxib, cephalexin, EES, Farxiga, Clindamycin, Sulfa, Dapagliflozin, Bactrim

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

Symptoms: Irregular periods, heavy periods

Other Meds: Multivitamin, Metformin HCl 500 mg, Tizanidine 4 mg, Vitamin A

Current Illness: nothing at the time of vaccination

ID: 1666681
Sex: F
Age: 60
State: GA

Vax Date: 07/20/2021
Onset Date: 07/21/2021
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: X-ray due

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

Symptoms: Flare up of auto immune disease to extreme levels of fibromyalgia pain and chrons GI problems, severe headache, vertigo, brain foggyness, severe chills

Other Meds: Doluxitine Pregabilin Clonazepam Tramadol Vitamins Probiotics

Current Illness: No

ID: 1666682
Sex: M
Age: 35
State: KY

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: unknown

Symptom List: Unevaluable event

Symptoms: unknown

Other Meds: unknown

Current Illness: unknown

ID: 1666683
Sex: F
Age: 45
State: CA

Vax Date: 04/08/2021
Onset Date: 08/29/2021
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: LA

Lab Data: Results for patient as of 9/2/2021 12:32 4/3/2019 17:31 CRP, SER QL: 0.4 4/11/2019 08:44 12/5/2019 17:43 12/5/2019 17:45 12/7/2019 11:43 CRP, SER QL: 0.9 (H) 11/3/2020 17:05 11/3/2020 17:09 11/5/2020 19:55 11/10/2020 17:48 11/21/2020 11:27 1/26/2021 16:58 1/26/2021 17:00 6/30/2021 12:10 8/28/2021 21:22 8/28/2021 22:41 8/28/2021 22:50 CRP, SER QL: 1.6 (H) 8/28/2021 22:52 8/29/2021 03:06 8/30/2021 06:10 CRP, SER QL: 0.6 8/31/2021 06:10

Allergies: Allergies Allergen Reactions ? Hydrocodone Nausea/Vomiting

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

Symptoms: 45 woman with depression, presented to ED on 8/29/21 with symptoms of congestion, loss of sense of taste and smell starting on 8/25.she later developed mild shortness of breath, worse with exertion and had adry cough but no fevers. Had J&J vaccine 4/2021. Patient tested COVID positive and came to ED, while in ED, desat to 91 while doing squats in her room and later 88% when walking and was admitted and started on decadron and remdesivir. She received a few days of decadron and remdesivir, her CRP normalized, her DDimer remained normal. She was only hypoxic with activity and the hypoxia resolved in about 2 days but she continued to have some symptoms of DOE and chest congestion or pressure. She was monitored another day and was tried on an albuterol inhaler which significantly helped her chest symptoms. On the day of discharge, her O2 sat was 97 on RA and she feels overall improved. She is not continued on steroids since her hypoxia has fully resolved. She is instructed to monitor her O2 sats at home and isolate. She is ordered for a prn albuterol inhaler for home.

Other Meds: None

Current Illness: None

ID: 1666684
Sex: F
Age: 63
State: NE

Vax Date: 06/03/2021
Onset Date: 07/28/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data:

Allergies: Lipitor, morphine, nubain, taxotere, zocor

Symptom List: Injection site pain, Pain

Symptoms: Moderna COVID19 Vaccine EUA Admitted for ileus.

Other Meds:

Current Illness:

ID: 1666685
Sex: M
Age: 80
State:

Vax Date: 08/28/2021
Onset Date: 08/28/2021
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: Patient received an expired vaccine. It expired on 8/26/21 and received the vaccine on 8/28/21. Patient did not have any adverse events from this injection.

Other Meds:

Current Illness:

ID: 1666686
Sex: F
Age: 38
State: IN

Vax Date: 03/04/2021
Onset Date: 03/09/2021
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:

Allergies: None

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

Symptoms: Bad psoriasis flare within 5 days of vaccine. Have not had even 1 little psoriasis spot in over 5 years, psoriasis was well controlled or in remission

Other Meds:

Current Illness: None

ID: 1666687
Sex: M
Age: 25
State: MD

Vax Date: 04/17/2021
Onset Date: 04/17/2021
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: unknown

Allergies: unknown

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Following injection of COVID19 Moderna vaccine in LA via IM Lot 043B21A, the patient states tingling in fingers.

Other Meds: unknown

Current Illness: unknown

ID: 1666688
Sex: M
Age: 75
State: WI

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

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

Lab Data:

Allergies: No known allergies

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient tested positive for COVID-19 after being fully vaccinated

Other Meds: Multivitamin Daily Omeprazole 20mg daily

Current Illness: None Documented

ID: 1666689
Sex: F
Age: 40
State: KY

Vax Date: 08/31/2021
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:

Allergies: None

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

Symptoms: Terrible unbelievable headache, chills, heart rate is extremely elevated, nose congestion, muscle soreness, chest hurts

Other Meds: Zyrtec, vitamin D3, turmeric, potassium, zinc

Current Illness: None

ID: 1666690
Sex: F
Age: 54
State: OK

Vax Date: 03/04/2021
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: Pennacilluan, codiene, iodine, msg, shell fish, sulfur drugs

Symptom List: Nausea

Symptoms: Adverse reaction..swollen eyes face, neck and throat. Benign tumor in parotid gland that had to be surgically removed. Then diagnosed with Triple Negative Invasive Ductal Carcinoma. No history of breast cancer in family and no genetic mutation for cancer. All of these issues came about one right after the other after that 1 vaccine.

Other Meds: None

Current Illness: Covid pneumonia, Bronchitis

ID: 1666691
Sex: M
Age: 28
State: AZ

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

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

Lab Data:

Allergies: No

Symptom List: Injection site pain

Symptoms: Patient came in for his first dose of his covid vaccination. Almost immediately after administration, patient became pale and began to sweat profusely. He began to complain of difficulty breathing, feeling faint and dizzy, and tingling in his arms. EMS was called at this time. EMS monitored the patient at the pharmacy for approximately 30 minutes. During this time they had difficulty obtaining a blood pressure reading for the patient but were successful after several attempts. The patient had a blood pressure of 108/60 mmHg while sitting with a pulse of 68. When the patient stood, his blood pressure dropped to 84/50 mmHg. His symptoms did not improve while being monitored and EMS recommended transport to hospital for further evaluation, to which patient agreed.

Other Meds: None that we were made aware of.

Current Illness: No

ID: 1666692
Sex: F
Age: 63
State: TN

Vax Date: 04/19/2021
Onset Date: 08/27/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: ADMITTED AFTER RECEIVING FULL SERIES OF VACCINE. ADMITTED FOR 2 DAYS THEN DC'D HOME ON 02

Other Meds:

Current Illness:

ID: 1666693
Sex: F
Age: 45
State: FL

Vax Date: 06/24/2021
Onset Date: 07/08/2021
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: Brain MMR, neurological tests, blood tests, thyroid scan

Allergies: No.

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

Symptoms: July 8th, extreme tiredness, July 9th, dizziness, affected speech, confusion, difficulty thinking, July 10th, in bed, unable to open my eyes, tingling in the mouth and tongue, and then for 2 weeks symptoms getting worse, I was unable to be out of bed, extremely tired, face, numbness in the faced, confusion, difficult understanding speech and talking

Other Meds: Levothyroxine 75, Daflon 1000, PAUSAFREN

Current Illness: None apart from Hashimoto and hypothyroidism

ID: 1666694
Sex: M
Age: 56
State: TX

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

Lab Data: None

Allergies: none

Symptom List: Tremor

Symptoms: Fever, Headache, sore throat, chills, sweats. Basically the same issues I had when I had Covid in Jan 2021 except it lasted only 24 hours instead of 10 days.

Other Meds: Lipitor, Nexium, baby aspirin

Current Illness: none

ID: 1666695
Sex: M
Age: 44
State: TX

Vax Date: 08/21/2021
Onset Date: 08/26/2021
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: Penicillin, Codeine.

Symptom List: Erythema, Pruritus

Symptoms: Itchy rash on chest and stomach, spreads to arms turning a purplish color.

Other Meds: None.

Current Illness:

ID: 1666696
Sex: M
Age: 74
State: IN

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

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

Symptoms: Severe pain at injection site and fever, both lasting approximately 6 hours. Treated with aspirin which reduced the symptoms.

Other Meds: amlodepine, atorvastatin, dutasteride

Current Illness: None

ID: 1666697
Sex: F
Age: 47
State: MD

Vax Date: 02/02/2021
Onset Date: 02/07/2021
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 Mild seasonal allergies

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

Symptoms: Since the second does of Pfeizer, the number of my menstrual cycles have increased and the pattern of menstruation has significantly changed. On three occasions, I have gotten two periods per month with distance of 10 to 15 days. My normal menstrual cycle is 28 days all my life. Also the pattern of my periods were: 1 day of stain, followed by two to three days of moderate bleeding and another 2-3 days of stain. Since the second dose of vaccine, my period starts abruptly with heavy bleeding and stays that way for the whole period. Currently, 7 months post vaccine, I am going through 10 days of moderate to heavy bleeding that is not stopping.

Other Meds: Multi-Vit Calcium, Magnesium

Current Illness: none

ID: 1666698
Sex: F
Age: 23
State: MD

Vax Date: 04/24/2021
Onset Date: 04/24/2021
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: unknown

Allergies: unknown

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Short after injection of Moderna COVID19 vaccination (009C21A) in RA via IM, the patient states she feels dizzy. light-headed and felt like she is going to pass out. The patient looks pale and diaphoretic.

Other Meds: unknown

Current Illness: unknwon

ID: 1666699
Sex: M
Age: 42
State: TX

Vax Date: 08/27/2021
Onset Date: 08/29/2021
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: macrolides, doxycycline, peanut, pecan

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

Symptoms: Left axillary adenopathy - improved in 3 days Left facial weakness consistent with Bell's palsy - mild to moderate; started on prednisone and Valtrex

Other Meds: Dovato

Current Illness:

ID: 1666700
Sex: M
Age: 50
State:

Vax Date: 04/29/2021
Onset Date: 04/30/2021
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: na

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

Symptoms: Patient came to pharmacy and got a dose of Janssen covid vaccine in the middle of Moderna series at a different facility

Other Meds: na

Current Illness: na

ID: 1666701
Sex: F
Age: 30
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: I had a ultrasound done on 09/01/21 and it showed I had subchronic hematoma.

Allergies: None

Symptom List: Pain in extremity

Symptoms: I received the second dose of the shot on 08/21/21 at that time I was 5 weeks pregnant. On 08/30/21 I started experiencing cramping and a little spotting. I went to the doctor on 09/01/21 when I got to the doctor I had blood everywhere coming from me. I formed 3 blood clots and prior to receiving the 2nd shot I went to the doctor and nothing was wrong and everything as fine. Now I have cramping and on blood thinners and 2 more blood clots to pass and I believe it?s from the 2nd shot. I never experienced anything like this.

Other Meds: Prenatal vitamins, and labetalol-high blood pressure medicine .

Current Illness: High blood pressure

ID: 1666702
Sex: F
Age: 38
State: WV

Vax Date: 08/15/2021
Onset Date: 08/29/2021
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: Elevated troponin of 63, repeat 1120. Question of possible mild anterior ST-elevation on initial EKG, repeat showed no ST elevation. Chest x-ray normal.

Allergies: Codeine

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

Symptoms: Patient received Pfizer COVID vaccine on 07/23/2021 and 2nd dose on 08/15/2021 at Pharmacy . Patient presented to Hospital ER early on 08/29/2021 at 1:52 a.m. with complaints of chest pain for an hour and half, left chest radiating down the left arm, was talking on the phone when chest pain started. Was evaluated in the ER, initial troponin 63, repeat 1120. Transfer to Hospital and underwent cardiac catheterization, had angioplasty to the diagonal artery with no stent placement. Patient was started on Plavix, aspirin, Lipitor 80 mg, metoprolol succinate and discharged home. Ultimately diagnosed with NSTEMI.

Other Meds: Vitamin D, folic acid, vitamin B6, levothyroxine, potassium chloride

Current Illness: None

ID: 1666703
Sex: M
Age: 67
State: TN

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient received vaccination on 08/25. on 08/26 patient developed SOB with witnessed cardiac event. CPR start immediately, found to be in v fib. single shock administered and 1 round of epi. ROSC. ekg showed St changes with RBBB. NSTEMI, pt transferred to ICU and placed on vent. Ultimately patient transferred to outside hospital for placement of AICD.

Other Meds:

Current Illness:

ID: 1666704
Sex: M
Age: 16
State: NC

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Vitals signs obtained BP 124/68, temp: 97.7, pulse 67, oxygen saturation 98 on room air. No complaints of pain, or shortness of breath, evaluated by a Physician Assistant and remained in observation for 45 minutes

Allergies: no known food or drug allergies

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

Symptoms: The client and his mother entered the mobile vaccination tent, via automobile, to receive an initial dose of Pfizer vaccine. The client pulled up his sleeve to receive vaccine dose in left deltoid by the vaccinator. A second vaccinator approached the vehicle with the intent to vaccinate the other party in the vehicle, however, the client pulled up his right sleeve and received another dose of the Pfizer vaccine. The vaccination team became aware when the other party in the vehicle (mother), inquired about the client receiving two doses in one day.

Other Meds: none

Current Illness: Cardiac issue identified by PCP in June 2021. Client had an echocardiogram in August 2021. Client is unable to verbalize a cardiac condition and states he is being followed by a Cardiologist

ID: 1666705
Sex: M
Age: 43
State: TN

Vax Date: 08/28/2021
Onset Date: 08/28/2021
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:

Allergies: Unknown

Symptom List: Vomiting

Symptoms: Patient became faint. He was pale, diaphoretic and complained of tunnel vision. He never passed out.

Other Meds: Unknown

Current Illness: None

ID: 1666706
Sex: F
Age: 46
State: FL

Vax Date: 08/13/2021
Onset Date: 08/20/2021
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:

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I had hives arrive on my hand/fingers and also bottom of my heels and toes. They itched and were irritated for about 5 days and then slowly went away. I had made no other changes to any detergents, soap, shampoo etc anywhere around this time.

Other Meds: Synthroid 75 mcg

Current Illness: none

ID: 1666707
Sex: F
Age: 21
State: NC

Vax Date: 07/09/2021
Onset Date: 08/02/2021
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: Amoxicillin PCN

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

Symptoms: Red and swollen arm; hot to touch; developed rash on shoulders extending to back; patch of red, raised rash on left cheek and jawline and chin. Treated with Benadryl and Prednisone taper. Complete recovery.

Other Meds:

Current Illness:

ID: 1666708
Sex: F
Age: 5
State: CO

Vax Date: 12/17/2013
Onset Date: 12/17/2013
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: none

Allergies: sensitive to gluten and dairy

Symptom List: Injection site swelling, Limb discomfort

Symptoms: screaming, head banging, poop smearing, regression with verbal skills, regression with fine motor skills, anxiety, fear, fever, sleep issues, decreased pain sensitivity, obsessive tendencies, oppositional tylenol for initial treatment still same issues after years of ABA, OT, SLP, and meds

Other Meds:

Current Illness:

ID: 1666709
Sex: F
Age: 17
State: NC

Vax Date: 04/26/2021
Onset Date: 04/26/2021
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:

Allergies: None known

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

Symptoms: Vaccine given before patient was 18 years old. No adverse events reported.

Other Meds: None known

Current Illness: None known

ID: 1666710
Sex: M
Age: 82
State: NJ

Vax Date: 02/05/2021
Onset Date: 03/04/2021
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: extreme fatigue, breathing problems, swollen abdominal area

Other Meds: thyroid meds, blood pressure meds

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am