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: 1666963
Sex: F
Age: 45
State: CA

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

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

Lab Data:

Allergies: NKA

Symptom List: Dysphagia, Epiglottitis

Symptoms: 9/1/2021- Pt c/o slight headache before vaccine, was recommended to wait if not feeling well patient consented to receive the vaccine. Patient was monitored for 15 minutes. After the 15 minutes were up patient stated she was feeling dizzy and with nausea. A/O to time, date, and location, vitals were taken at 2:15pm read BP-127/84, HR-84, RR-23, O2 Sat-98% she was provided a barf bag, she proceeded to vomit. she stated feeling a bit better after, she stated having history of migraines and Anemia. Pt stated feeling these symptoms before with migraine headaches. Provider was called to check on her as she was still not feeling well, stated she should just be monitored and if symptoms worsen to be sent to hospital. Provider requested RBS to be taken read- 149. Vitals taken again @ 2:30pm BP-119/78, HR-81, RR-24, O2 Sat-98%. Pt was monitored until she was feeling better, she laid down for a few minutes, ice pack was provided to her. . Pt was provided water and laid down again for few minutes with legs elevated. Pt stated she was feeling better and was ready to go home. Pt called daughter as she was advised to not drive herself. last vitals read BP-119/72, HR-72, RR-24, O2 sat 98%. Pt was walked out to her daughter's car with assistance to daughter alert and oriented at all times.

Other Meds: Birth Control pill

Current Illness: Pt stated Suffering from mild headache prior to vaccination, advised to reschedule to when she was feeling better but pt. consented to receive the vaccine anyway

ID: 1666964
Sex: M
Age: 64
State: FL

Vax Date: 08/03/2021
Onset Date: 08/03/2021
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: I?m still waiting for results from the low dose cat scan. No other testing has been done.

Allergies: Levofloxacin, Sulfa (Sulfinamide Antibiotics)

Symptom List: Anxiety, Dyspnoea

Symptoms: The first dose on Aug 3 left me with extreme nausea, moderate joint soreness and muscle weakness. I was extremely fatigued that afternoon. I started having chest congestion and sought medical treatment at a Pulmonologist clinic. I was given two injections. One was an antibiotic, I think it was Doxycycline but I?m not sure. I believe the other to be an antibiotic. I was also given a prescription for Doxycycline, 10mg Prednisone and Fluconazole 150mg. I was sent for a low dose cat scan and have yet to receive the results from that. I received the second Moderns vaccination on Aug 31, 2021. Again, the nausea started a few hours after receiving the shot. This time it?s much worse! I haven?t vomited, but my stomach is literally churning. The location of the shot unreasonably swelled up . I?ve been icing that. I don?t have any fever, but I feel terrible. I?m completely exhausted and my have aches and pains throughout my body. It?s flu like without the vomiting.

Other Meds: 25mg Metoprolol, 20mg Lasix, 20mg prednisone, Combivent 20-100mcg, 25mg Spironolactine, 75 mg/ml injector pen of Praluent.

Current Illness:

ID: 1666965
Sex: M
Age: 37
State: CA

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

Allergies: Penicillin

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

Symptoms: Sore throat, throat swelling, congestion, cough and injection site pain.

Other Meds:

Current Illness:

Date Died: 08/20/2021

ID: 1666966
Sex: F
Age: 74
State: KY

Vax Date: 02/09/2021
Onset Date: 08/20/2021
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:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient expired on 08/20/2021. 1st dose 02/09/2021 2nd dose 03/06/2021

Other Meds:

Current Illness:

ID: 1666967
Sex: F
Age: 44
State: GA

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

Lab Data: none

Allergies: NKA

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

Symptoms: On 8/31/2021 at about 12.05p.m. patient received her 1st dose of Pfizer covid-19 vaccine at our pharmacy. Immediately after getting the injection she started complaining of feeling hot, nauseated and dizzy. She sat down and requested for some cold water. She was given a bottle of water which she drank some and dabbed some on her forehead. she remained conscious all the while and refused to have an ambulance called for her. She stated that she has a history of feeling this way whenever a needle is used on her even when drawing blood. Her husband and son were with her and they both collaborated her statement. Both men had received their Pfizer vaccines from the same vial a few minutes before her. I checked patients BP and pulse and they were all normal(BP 119/78, P62).We monitored her for 30 minutes after which she walked out of the pharmacy on her own.

Other Meds: None

Current Illness: None

ID: 1666968
Sex: F
Age: 16
State: SD

Vax Date: 09/01/2021
Onset Date: 09/02/2021
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: None

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

Symptoms: Patient developed 101.3 fever, chills, body aches, and swelling/redness of the limb within 12-18 hours of vaccination. Patient took advil which helped alleviate fever and pain. Encouraged mother and patient to continue to alternate ibuprofen and acetaminophen every 4-6 hours as needed and to seek further care if sx worsen or do not resolve within a few days or if temperature does not decrease with otc meds.

Other Meds: nexplanon 68 mg subcutaneous implant

Current Illness: None

ID: 1666969
Sex: F
Age: 74
State: MN

Vax Date: 01/21/2021
Onset Date: 02/11/2021
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: Muscle aches with certain statins

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient reports she developed Herpes Zoster on left chest wall 11 days after second Covid Pfizer shot. She feels the vaccination caused the Shingles and requested a VAERS report be completed.

Other Meds: Gabapentin, Atorvastatin, Intrarosa, Vitamin B12, CoQ10, multivitamin, Calcium

Current Illness: none known

ID: 1666970
Sex: F
Age: 35
State: TX

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

Lab Data: unknown

Allergies: NKDA reported

Symptom List: Pharyngeal swelling

Symptoms: Patient called the pharmacy Thursday 9/2/21 at about 12:43p to say that she had a reaction to her vaccine. Pt stated that she got an itchy rash on her face and chest that started Saturday. On Monday she went to her doctor and her doctor referred her to an allergist to see if she should get the second dose. Pt said she used benadryl cream and benadryl oral at night and zyrtec during the day. She denied any other symptoms.

Other Meds: Fluticasone, Aciphex, Tri-sprintec

Current Illness: unknown

ID: 1666971
Sex: M
Age: 29
State: CA

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

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I was administered the injection in my left shoulder, and was directed to sit down on a bench. Within 30 seconds I started to feel strange, followed by a fuzzy sound and I started to get tunnel vision. I then began to have what were described to me as muscle spasms, with all of my muscles tensing, my mouth open and eyes open the entire time. I also trembled lightly. I came to with various people and the administering doctor around me, and I was sweaty and pale, and had to lay down for half an hour. Afterwards I felt slight pangs of motion sickness-like nausea, which subsided after a few hours, perhaps 3. The following day I felt very fuzzy, and a bit incoherent, with a very strong soreness in the injected arm and shoulder.

Other Meds: None

Current Illness: None

ID: 1666972
Sex: F
Age: 65
State: TN

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

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

Lab Data:

Allergies: Sulfa, niacin, codeine

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 2 oral cancers, one squamous cell and the other adenocarcinoma; Right hemi-maxillectomy; Clean margins, no cancer growth in bone, follow-up CT 9/8/2021 to check for recurrence.

Other Meds: Lipitor, Citrus bergamot, letrozole, Zyrtec, Flonase, Azelastine, Singulair, Advair, Vesicare, Aldactone, Xiidra, multivitamin with minerals, omega 3, magnesium (CALM), Prevagen

Current Illness:

ID: 1666973
Sex: M
Age: 67
State: WA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
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: Pennicillin

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

Symptoms: Fatigue and a bad case of psorisis

Other Meds: Metformin, Atorvistatin, Lisinipril/HCTZ

Current Illness:

ID: 1666974
Sex: F
Age: 38
State: FL

Vax Date: 09/01/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: - Vaginal bleeding started about 0600 on 09/02/2021; not menstrual bleeding. Consistency and color not typical of my monthly menstrual bleeding. Currently monitoring. - Also experiencing mild joint pain (elbow, wrist) in injection arm - started evening of vaccination date (9/1/21) and not yet resolved; experienced mild numbness and tingling in hand on injection arm early morning of 09/02/2021.

Other Meds: Pre-natal vitamins by VitaFusion.

Current Illness: None

Date Died: 09/01/2021

ID: 1667100
Sex: F
Age: 71
State: KY

Vax Date: 04/09/2021
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:

Allergies:

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

Symptoms: Patient expired on 09/01/2021

Other Meds:

Current Illness:

ID: 1667101
Sex: F
Age: 21
State: NY

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

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

Lab Data:

Allergies:

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

Symptoms: I am on hormonal birth control and do not get my period on it. I have been on the same medication for over 9 months with no period or spotting. Right after the vaccine, in a matter of a couple of days, I developed heavy, dark spotting and other symptoms like cramping that I regularly associate with my menstrual cycle. It seems to me that the vaccine interacted somehow with my hormonal processes to cause this menstrual abnormality.

Other Meds: Hormonal birth control Doxycycline hyclate

Current Illness:

ID: 1667102
Sex: F
Age: 25
State:

Vax Date: 12/23/2020
Onset Date:
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: PATIENT WAS GIVEN COVID -19 VACCINE ON Dose 1 date: 12/23/2020, Dose 2 date: 01/13/2021, AND TESTED POSITIVE TO COVID ON 8/30/21

Other Meds:

Current Illness:

ID: 1667104
Sex: M
Age: 30
State: FL

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:

Allergies: NKDA

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

Symptoms: Patient passed out 5-10 minutes after receiving vaccine. 911 was notified. His wife said he "got up to walk to the car because he overheated and fainted upon standing." He lost consciousness for a second time. The patient laid on a couch in the pharmacy until the ambulance arrived. His wife noted that he "has a history of heat related syncope and has been very stressed this week." Vaccine given - 5:45pm, Syncope - 5:50

Other Meds: Unknown

Current Illness: Unknown - stressful and emotional week noted

ID: 1667105
Sex: M
Age: 56
State: MA

Vax Date: 04/19/2021
Onset Date: 04/20/2021
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: I was myself a biomedical researcher. After some literature research, I concluded there was not much you could do with the symptoms. I did not see a doctor for the condition.

Allergies: No

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

Symptoms: Typical manifestations of plantar fasciitis, pain on the right foot for two months, reduced now, bearable.

Other Meds: Hydrochlorothiazide, Amlodipine Besylate, Lisinopril

Current Illness:

ID: 1667106
Sex: M
Age: 41
State: HI

Vax Date: 03/21/2021
Onset Date: 06/05/2021
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: not applicable

Allergies: ACE - cough

Symptom List: Ear pain, Hypoaesthesia

Symptoms: RT sided bells palsy x 3 mos

Other Meds: metoprolol; albuterol; risperdal; buspar;

Current Illness: see below

ID: 1667107
Sex: F
Age: 54
State: GA

Vax Date: 08/19/2021
Onset Date: 08/23/2021
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: The patient received a Shingrix vaccine on 8/19/2021. The patient came in today (9/2/21) complaining of limited range of motion and a tingling sensation radiating down the administration arm that started 3 days after the vaccine and has got progressively worse. The patient indicated that they had reached out to their provider and were awaiting a reply.

Other Meds:

Current Illness:

ID: 1667108
Sex: F
Age: 66
State: DE

Vax Date: 03/12/2021
Onset Date: 03/14/2021
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: none yet

Allergies: none

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

Symptoms: room spinning spills

Other Meds: none

Current Illness: none

ID: 1667109
Sex: F
Age: 69
State: CA

Vax Date: 02/25/2021
Onset Date: 06/26/2021
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: See above - June 29th

Allergies: No

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

Symptoms: Dizziness; my mouth was dry; I felt like I was having Arrhythmias I went to Hospital on June 29th - tested and I had PACs and PVCs as well; Little runs of atrial Tachycardia -Super Ventricle Tachycardia; D-Dimer was slightly elevated. CTA of the chest - CT with contrast of chest. IV fluids - liter of fluids - was dehydrated. They referred me to a cardiologist. I had to wear a heart monitor for two weeks and it showed the same thing as I was seeing in the ER - occasional PVCs and a lot of PACs and Super Ventricle Tachycardia. No treatment. I am feeling some Arrhythmias now in fact. But I don't have the dehydration anymore.

Other Meds: Trazadon; Lovastatin; Pantoprazole; Tylenol with Codeine; melatonin

Current Illness: Recovering from total knee replacement - two weeks post op

ID: 1667110
Sex: M
Age: 22
State: OH

Vax Date: 08/06/2021
Onset Date: 08/10/2021
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: no

Allergies: no

Symptom List: Unevaluable event

Symptoms: Heart racing . could not continue to work .

Other Meds: vitamin c

Current Illness: no

ID: 1667111
Sex: M
Age: 39
State: AL

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

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

Lab Data:

Allergies: no known

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

Symptoms: Patient came in to get his second covid vaccine. He was given the shot and it had only been 8 days since his first shot.

Other Meds:

Current Illness: no known

ID: 1667112
Sex: F
Age: 50
State: TX

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: BP: 189/102 HR: 96 R 18 BP: 179/102 HR: 93 R 18 BP: 190/97 HR: 92 R 18

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient claims to feel dizzy, hot and shaking after receiving shot. Ambulance crew took patient to truck to cool down and drink cold water. First set of vitals where taken and then 2nd and final. Patient claims she no longer felt dizzy, hot or shaking. Told patient if she does not feel better to seek medical attention.

Other Meds:

Current Illness:

ID: 1667113
Sex: M
Age: 43
State: NM

Vax Date: 03/24/2021
Onset Date: 03/25/2021
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: Woke up in the middle of the night with intense dizziness, nausea, followed by abdominal pain and diarrhea that lasted 4 hours.

Other Meds:

Current Illness:

ID: 1667114
Sex: F
Age: 30
State: TX

Vax Date: 08/18/2021
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: N/A

Allergies: Allergy to strawberries

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

Symptoms: Patient received the flu shot on 8/18 at an offsite clinic. Patient reported to pharmacy on 9/1 stating that she has still been experiencing vaccine-induced shoulder injury which consists of pain and limited range of motion.

Other Meds: None disclosed

Current Illness: Patient has asthma and received a steroid shot for unknown reason on July 25, 2021

ID: 1667115
Sex: F
Age: 47
State: MN

Vax Date: 03/25/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: EKG several Blood work several

Allergies: Rochephrin pennicillian

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: With in a couple day started have shortness of breathe. By June it was really bad so I talked to my dr. They ran several tests showing a high d dimer and inflammatory markers. Shortness of breath is getting worse.

Other Meds: Spironalactone lasix mirtazipine robaxin

Current Illness: None

ID: 1667116
Sex: M
Age: 20
State: CT

Vax Date: 05/13/2021
Onset Date: 08/26/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data: EKG significant for ST elevations, mild interventricular conduction delay, and PR depressions. Maximum lab values as follows: Troponin I 20/98, CK 1,258, CK-MB, 79.5, pro-BNP 655. Echo demonstrating reduced function with EF of 38%.

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient was admitted for myocarditis on 8/29/21 with diffuse ST changes on EKG and elevated inflammatory markers. It is unclear if this event was related to vaccination as it was several months removed from the second shot it the series. there was significant heart dysfunction on echo with EF of 38%. Heart function quickly recovered to normal EF of 63% 3 days later after having support with milrinone and enalapril. Patient also received IVIG. the quick improvement of function fits more with vaccine related myocarditis as opposed to viral myocarditis. Infectious workup negative to date. Possible viral trigger with symptoms of headache and body aches for 3 days before presentation. Unclear at this time whether vaccine related or from an unknown viral etiology.

Other Meds: none

Current Illness: unknown

ID: 1667117
Sex: M
Age: 74
State: PA

Vax Date: 03/23/2021
Onset Date: 04/05/2021
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: BLOOD WORK 5/4/2021 BLOODWORK 5/16/2021

Allergies: NONE

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

Symptoms: STARTED WITH PAIN IN THE WRISTS AND WITHIN A DAY BOTH HANDS SWELLED UP AND HAVE BEEN SWOLLEN EVER SINCE

Other Meds: LISINIPRIL, DUPIXENT, METFORMIN, ROSUVASTATIN,LORATADINE, GLIMEPERIDE

Current Illness: NONE

ID: 1667119
Sex: F
Age: 26
State: MI

Vax Date: 08/26/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data: None

Allergies:

Symptom List: Nausea

Symptoms: I received my shot on 8/26. Sunday the 1st my anxiety got triggered and caused me to have a night of insomnia (which is very abnormal for me). Monday the 2nd I felt okay during the morning, but then my anxiety got triggered again and since the following days have been the worst anxiety I've ever felt. I've had to skip work and go get on medication to try to help. I've been crying none stop, I wanna crawl out of my skin, my whole body feels electric at times, and I feel out of it. I've struggled with anxiety before but I've never, ever felt like this. At first I thought it was a culmination of a lot of things and I'm sure they're contributing, but then I looked into if the vaccine could have caused this and I found several other people experiencing the same things as me after their first dose, some after their second. Of course I'm not sure if it's the vaccine, but my experiences were lining up so much with the other people. When I went to see my family doctor I hadn't thought of this connection yet so I hadn't discussed it with him, but I plan to at my follow up. At the end of the article, past the ads, there's comments of all sorts of people with severe anxiety side effects.

Other Meds:

Current Illness:

ID: 1667120
Sex: M
Age: 52
State: IN

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

Lab Data: Had retina imaging perform on 30Aug2021.

Allergies: Cipro

Symptom List: Injection site pain

Symptoms: I received my first dose of Pfizer COVID shot 27Aug2021 at 5:40pm. On the morning of 28Aug2021 around 11:45am I started seeing dots and floaters in my left eye. On 30Aug2021 at 12:30pm went to eye doctor to get checked out. Stated that I had a vitreous detachment that is causing the dots and floaters. May or may not be due to vaccine but also had a friend that had the same symptoms after the vaccine so reporting this incident just in case. Eye doc stated he will see me again on 29Sep2021 to check again. He is estimating that the dots/floaters should dissipate in strength within 2-4 weeks.

Other Meds: Finasteride and Equate daily multivitamin

Current Illness: None

ID: 1667121
Sex: F
Age: 45
State: TX

Vax Date: 08/18/2021
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: Unknown

Allergies: None disclosed

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

Symptoms: Patient received the flu vaccine at an offsite clinic on 8/18. Patient stated that on 9/1 she still had residual pain in her arm that she believes is a vaccine-induced shoulder injury. She noticed the pain increasingly after attempting to lift her luggage on a trip in between these dates.

Other Meds: None disclosed

Current Illness: Patient received the Pfizer vaccine on 7/18/21

ID: 1667122
Sex: F
Age: 43
State: TX

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: RA

Lab Data:

Allergies:

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

Symptoms: Patient received COVID vaccine @ 17:15 patient stated she was dizzy as soon as she received the vaccine. EMS assessed patient and took her vitals. Vitals are stabled and patient felt better after a few mins. She then requested to leave.

Other Meds:

Current Illness:

ID: 1667123
Sex: M
Age: 71
State: FL

Vax Date: 07/27/2021
Onset Date: 08/11/2021
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: On August 31st 2021 I went to my heart doctor and found out I was in AFib. I had been out of AFib for over two years and now it comes back for no reason.

Allergies: None

Symptom List: Tremor

Symptoms: After I recieved the shot I had a sore arm that went back to normal after a few hours. Then in August I started sleeping a lot more than normal and all my energy was gone. I would work outside for about 30 minutes doing very light work but was soaked in sweat and had a hard time breathing. I also noticed I was out of breath eveytime I climbed my stairs.

Other Meds: Vitamin C, Zinc, Vitamin D, Fish Oil

Current Illness: None

ID: 1667124
Sex: M
Age: 79
State: SC

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

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

Lab Data: none

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: pt received a moderna 3rd shot booster instead of a pfizer booster shot. patient is complaining that his arm is a lot more sore than the pfizer shot - a constant pain that increases in intensity with movement

Other Meds: temazepam, carvedilol, sotalol, eliquis, lisinopril, amlodipine, pantoprazole, glimepiride

Current Illness: no

ID: 1667125
Sex: F
Age: 56
State: OH

Vax Date: 04/03/2021
Onset Date: 04/03/2021
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: MRI of brain on 8/30/2021 at EEG on 8/31/2021 at

Allergies: Sulfa, bactrim, E-mycin, cats, dogs, shell fish, wheat, dairy

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

Symptoms: Within 2 hrs of the 1st covid vaccine, neck glands were so swollen and painful POUNDING HEADACHE and dizziness. FOUR asthma attacks that night about 40 minutes a part. The headache started to dissipate when it was time to get the 2nd shot 4/24/21 same location as the first EN5318 . The POUNDING headache returned with a vengeance. That continued for approximately 2 weeks still dizzy. On 5/11/2021 Woke up with 102 fever pounding headache exhaustion and dizziness. This last 24 hours. STILL DIZZINESS continued. On 6/1/2021 EXTREME SHARP ROLLING pain that starts in my neck travels up the side of my head and ear caused me to scream-I take an asprin. On 6/4/2021 I blurt out the word cucumber no reason no through process( brain damage) then 6/4/21, 6/5/21 ,6/6/21 I call my grandson all weekend. THIS IS NOT HIS NAME. I finally can get in to see my doctor on 7/6/21 he is concerned and refers me to a Neuro. Dr FINALLY has an opening on 8/21/21 She orders a brain MRI and EEG. Working diagnosis ,".....her symptoms complex highly suggestive of POST VACCINE ASEPTIC MENINGITIS..."

Other Meds: Premarin, Acyclovir, Synthroid, 1-a-day vitamin, vitamin C, Vitamin B, Calcium, Yeast Plus, B12

Current Illness: NONE

ID: 1667126
Sex: M
Age: 46
State: CA

Vax Date: 08/17/2021
Onset Date: 08/20/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: None

Allergies: No

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

Symptoms: There were more than 50 red dots on the left shoulder, armpit, chest, and back, and the tickling and tingling phenomenon has been going on for 3 weeks.

Other Meds: No

Current Illness: No

ID: 1667127
Sex: F
Age: 21
State: MO

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 known

Allergies: No known drug allergies

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: The vaccine was given and she was waiting her 15 minutes after the injection. The pharmacist was checking on her occasionally. When the pharmacist handed her immunization Covid card to her, she acted like she was going to pass out. The pharmacist called for help. The technician stayed with patient until a doctor and 2 nurses came to aid with the situation. The doctor thought she was having a seizure and called the ambulance. The ambulance got here within 5 minutes and took the patient to the hospital.

Other Meds: aripiprazole, venlafaxine, pantoprazole, levothyroxine, ibuprofen, levetiracetam, topiramate, nicotine patch, propranolol, hydroxyzine

Current Illness: None known

ID: 1667129
Sex: F
Age: 12
State: CA

Vax Date: 08/26/2021
Onset Date: 08/26/2021
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: n/a

Allergies: no

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

Symptoms: 15 minutes after getting vaccinated patient stated that her tongue felt itchy. I ask if she felt anything else , she said it's itchy and she may felt a little swollen tongue. I ask patient to wait another 15 minutes and let me know if she needed emergency service. In about ten minutes she told one of our tech she would like emergency service. I call 911 and was referred to paramedic line. They told me to watch patient and have Epipen ready. When ems arrive she said her daughter also felt itchy tongue. I let EMS take care of patient. After close at 7 pm. I made a call to follow up and patient said she was ok

Other Meds: n/a

Current Illness: no

ID: 1667130
Sex: F
Age: 76
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: Patient c/o dizziness and HTN 15 minutes after receiving Covid vaccine booster. Patient states she felt dizzy when she stood up from exam table "too fast" . Patient's BP 148/86, HR 75. Patient declined to come to UC for observation but agreed to wait another 15 minutes to have BP rechecked. Recheck BP142/82. Patient unsteady on feet and still c/o dizziness, denies HA or CP. Patient agreed to come to UC for observation. Patient transported to UC in WC. Pt dc'd home after 1 hour of observation. Patient ambulatory with steady gait and dizziness resolved

Other Meds:

Current Illness:

ID: 1667131
Sex: F
Age: 37
State: TX

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: 8/30/2+ i revecived the second dose of the vaccines at 2:30pm. Jus like the first doae i thought i was gana have uh sore arm, fever, nasesua whwn i recieved the first dose of the vaccine two weeks prior. . After recieveing the shot waiting 15mins bfo returning bac to work, i felt dizzy at moments but thought it was normal.. after a few hours passes i started felling my face burning and itchy my neck started itchjng and hand.. lil by lil my face, neck and hand started gettn red like irritated. I came home round 8:00pm that night and notice red swollen patches forming on my face,neck and hand. Waking up at 8:00am on 8/31/21 my face with swellon and neck and hand were itching and burning badly.. rubbed uh cortizone cream on but it didnt help it at all.. haven to miss work on 8/31/21, 9/1/21 & 9/2/21 due to the rection tht accured. The itching and burning woudnt stop. I went to employee health on 9/1/21 at 12:30-1:00pm and was told to take benydryl and buy a cream other then corizone.. its 9/2/21 today and i still have the itching on my face, neck, and hand.. the redness and swelling have slightly went away but the itching still accures.. skin feel dry and cracky now.

Other Meds: None

Current Illness: None

ID: 1667132
Sex: M
Age: 78
State: SC

Vax Date: 01/21/2021
Onset Date: 02/18/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: Tests: 4 MRIs, complete blood work, neurological exams, full cardiological exams with stress tests, nerve conduction study (EMG) with findings femoral nerve atrophy with right quadriceps atrophy, with almost no strength in it.

Allergies: Not that I am aware of.

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

Symptoms: Approximately two weeks after receiving the COVID vaccine my legs became very weak. I was previously working and I noticed my legs were weaker and giving out on me. I went to my primary doctor on 2/28/21, but he did not detect any abnormality other than weak legs. The first week in March, I resigned from my job due to the fact that my legs were getting worse and became weaker each day and I was falling very frequently. With the onset of acute leg weakness with severe pain; I requested my doctor to order further exams. Due to the sudden evolution and thrombosis affecting; there is a strong possibility that the COVID vaccine given could well have affected and contributed to the partial paralysis suffered by this senior.

Other Meds: Aspirin 81mg; Carvedilol (Coreg) 3.125 mg; Plavix 75 mg; Zetia 10 mg; Metformin 850 mg Actos 15 mg; Altace 10 mg; Socor 40 mg; Januvia 100 mg; I have been taking most of these medications for several years, with no side effects.

Current Illness: None

ID: 1667133
Sex: F
Age: 26
State: MT

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: n/a

Allergies: SULFA DRUGS, SHELLFISH, TREE NUTS

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

Symptoms: After 15 min. of monitoring patient she thought she might have a hive on her forehead and her face felt a little itchy. No report of facial or tongue swelling or any difficulty breathing. Monitored another 15 min and symptoms did not change. Patient then took 2 diphenhydramine 25mg and sat in waiting area another 10 minutes. She said she was feeling better (face not as itchy) and no additional symptoms. I explained to her and her mom what signs and symptoms would be of concern (facial swelling, tongue swelling, any s/s of difficulty breathing, any airway issues, generalized hives, etc) that they should call 911. She said she has nut allergy and understood what s/s I was explaining. She stated that sometimes her tongue tingles with nut allergy- I told her that yes, it would be similar. I will follow up with the patient tomorrow.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1667134
Sex: F
Age:
State: NE

Vax Date: 05/30/1980
Onset Date: 08/18/2021
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 meperidine hydromeephone morphine oxycodone ketorolac preabalin metoclopramide hydroxychoroquine venafaxine

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

Symptoms: Rash chills chest pain headache fever body pain shortness of breath fast beating weakness armpits swollen

Other Meds: ENBREL 50mg prednisone 5mg duloxetine 60mg lisinopril 10mg levothyroxine 25mh

Current Illness: No

ID: 1667135
Sex: F
Age: 67
State: MD

Vax Date: 02/24/2021
Onset Date: 08/19/2021
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: UTI culture and sensitivity tests

Allergies: Statins

Symptom List: Vomiting

Symptoms: No fever but chills, extreme fatigue, dizziness, and that was main thing. When I stood up the dizziness was overwhelming. I have never had chills like that before - ever. After I was back from vacation - on the 19th - I went to Urgent Care - I had a UTI - positive for that - had prednisone and antibiotic and I had it because later found out I had the kidney stones. Prior to that, on vacation, I had sun poisoning (rash) and dehydration and couldn't urinate on vacation - they gave me fluids at some Urgent Care don't remember the name, and gave cream for my skin and prior to vacation, I had shingles before I left. I had mild shingles at this time - because I knew to start the medicine. Was told I had a UTI and Pneumonia - they said I had a slight Pneumonia - I wasn't short of breath. Later on, I discovered I had a kidney stone - about a week and a half after - I went to my doctor and he told me to get a sonogram which I did. It has passed now. I'm just sore now. I had another sonogram but haven't had the results yet. Dr.

Other Meds: Vitamins - Multi Vitamin; Calcium; Biotin; B12; Amlodipine; Losartan HCL; Valacyclovir

Current Illness: No

ID: 1667136
Sex: F
Age: 59
State: OR

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

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

Lab Data: Blood work, CT scan of the abdomen, Ultrasound of the abdomen, Echocardiogram, CT scan of the heart, Heart monitor

Allergies: Erythromycin; Pepcid

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Morning fatigue, Gastrointestinal problems, Nausea, Bloating, Cramping.

Other Meds:

Current Illness:

ID: 1667137
Sex: M
Age: 57
State: PA

Vax Date: 06/03/2021
Onset Date: 06/05/2021
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: NO

Allergies: YES

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

Symptoms: PATIENT STATES HE HAS A SORE ARM BUT IT HAS GOTTEN BETTER OVER THE PAST WEEK. HE IS NOT SURE IF ITS FROM THE VACCINE BUT IT HAPPENED AFTER THE SHOT. HE HAS NOT SEEN THE DR AND IS NOT INTERESTED TO SO. I SUGGESTED TO PATIENT TO APPLY COMPRESS OR TAKING MOTRIN AND HE SAID THAT ITS GETTING BETTER. HE DID REPORT IT TO VAERS.

Other Meds: NO

Current Illness: NO

ID: 1667138
Sex: F
Age: 43
State: KY

Vax Date: 08/30/2021
Onset Date: 09/01/2021
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:

Allergies: Wellbutrin, Cymbalta, Mobic, Lexapro, PCN,

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt presented to clinic with hives/itching on entire body, torso, and extremities, was treated with Dexamethasone IM and improvement was seen after a few hours. She states rash began the evening before. She was unable to take PO Benadryl due to working.

Other Meds: St Johns Wort, Ibuprofen 600mg as needed, Vit D 2000IU daily

Current Illness: none

ID: 1667140
Sex: M
Age: 25
State: TX

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: RA

Lab Data: BP: 131/98 HR: 83 RR: 16 @18:16 BP 109/80 HR:82

Allergies:

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

Symptoms: Patient stated that he had tightness in the throat, felt light headed and hot.

Other Meds:

Current Illness:

ID: 1667141
Sex: F
Age: 66
State: TX

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Blood pressure measured initially 169/94 with heart rate of 65. 2nd measurement 10 minutes post dose was 183/83 with heart rate of 66 (advised patient to seek emergency care), third measurement was 159/94 and heart rate of 67 approximately 20 minutes post dose. Patient stated she felt better and she had a blood pressure monitor at home and would continue to monitor. Patients respiratory rate did increase immediately prior to getting 2nd blood pressure measurement.

Allergies: none disclosed

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

Symptoms: Patient reported being light-headed and dizzy within a couple minutes of vaccination and "light-headedness" continued for about 30 minutes.

Other Meds: none disclosed

Current Illness: none disclosed

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am