VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
PLEASE CHECK BACK SOON
Download the files above while you wait.







Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1674968
Sex: F
Age: 48
State: GA

Vax Date: 08/27/2021
Onset Date: 08/31/2021
Rec V Date: 09/05/2021
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: I went to the ER and was thinking I had a possible TIA but CT was negative and so was MRI. Lab work was good as well.

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Four days after vaccine I started experiencing neurological symptoms. I was having dizziness, tingling, drooping of right side of the mouth, internal tremors. I also had hypertension (first blood pressure done at ER was 182/112). I also experienced migraines and numbness in extremities. Two days later after being released from hospital, experienced facial numbness, burning in neck and shoulders, burning in ears and still having numbness and tingling and internal tremors are worse.

Other Meds: Wellbutrin, armour thyroid, zinc,Vitamin D,Vitamin C, elderberry , advil

Current Illness: None

ID: 1674969
Sex: F
Age: 28
State: PR

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

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

Lab Data: No

Allergies: No

Symptom List: Anxiety, Dyspnoea

Symptoms: PFIZER 2nd dose. After waiting 15 minutes, started feeling dizzy, feeling a ringing sound in the ear and dots. Manager was told and I sat her down in the vaccination office with legs raised in another chair and with a cold pack in the back of her head. She said that her arm felt sleep and that she has a strong headache. White code was thrown, and the assistant arrived at the pharmacy. Patient was conscious, alert and would respond to all my questions all the time. We called her husband to come and pick her up. Mean while she was not feeling better so I laid her down on the floor with legs elevated using a chair and a cold pack on the back of her head. She started to feel better (the ringing in the ear went away and vision dots). She did not have a numb arm anymore, only a strong headache but was able to sit and walk to the exit with the assistant, until her husband came (garden exit). All this happened between 5:50 and 6:40pm.

Other Meds: No

Current Illness: Asthma; Anemia

ID: 1674970
Sex: F
Age: 12
State: NY

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

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

Lab Data:

Allergies:

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

Symptoms: Army medic did not dilute the vial of Pfizer and patient received a full vial of Pfizer vaccine undiluted

Other Meds:

Current Illness:

ID: 1674971
Sex: M
Age: 14
State: NY

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

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: Army medic did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted

Other Meds:

Current Illness:

ID: 1674972
Sex: M
Age: 70
State: VA

Vax Date: 03/31/2021
Onset Date: 04/02/2021
Rec V Date: 09/05/2021
Hospital: Y

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

Lab Data: Medical Records from his current hospitalization confirm the above diagnoses. The bacteria isolated in blood cultures for the endocarditis was Strep Mitis. We are please to share medical records to confirm the above diagnoses including inpatient labs, pathology, doctor notes and diagnostic test results (such as CT Scan, MRI, Echocardiogram, TEE).

Allergies: None

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

Symptoms: began not feeling well two days aster receiving his second Pfizer COVID-19 vaccine. He had a 4 month decline in exercise tolerance, ending with fever, chills and URI. On 8/26/2021 had a stroke, MI and was taken to Hospital Center after being found down at home by his family. was diagnose with bacterial endocarditis, stroke, MI, spleen mass and underwent open heart surgery on 9/1/2021 to replace his Mitral Valve and remove the bacterial endocarditis. remains in the CV ICU at Hospital Center under the care of Dr. , expecting discharge to home this coming week.

Other Meds: Micardis 40 mg PO Daily Crestor 20 mg PO Daily Vitamin D3 1,000 mg PO Daily Vitamin C 500mg PO Daily

Current Illness: None

ID: 1674973
Sex: F
Age: 0
State: NY

Vax Date: 09/05/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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: Medic did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted

Other Meds:

Current Illness:

ID: 1674974
Sex: M
Age: 67
State: NY

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data: Tiny complex cystic areas could represent spermatoceles or epidydimal fluid collection. Also from urine culture: Staphylococcus epidermidis.

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: From ultrasound report: Acute right-sided epididymitis . Tiny complex cystic areas could represent spermatoceles or epidydimal fluid collection. Also from urine culture: Staphylococcus epidermidis. Treated with 500mg of ciprofloxacin twice a day for 14 days and a Medrol dose pack

Other Meds: Lisinopril 10MG and Calcium D3 2000MG

Current Illness: Prostate cancer, reoccurrence after prostatectomy

ID: 1674975
Sex: F
Age: 33
State: NY

Vax Date: 09/05/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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: Army medic did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted

Other Meds:

Current Illness:

ID: 1674976
Sex: M
Age: 73
State: TX

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/05/2021
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: penncilin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: the vaccine was given at 11 am at 1am pain in joints severve chills

Other Meds: yes

Current Illness: arthritis

ID: 1674977
Sex: F
Age: 51
State: NY

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data: blood panel -- normal covid test (2 pcr) -- negative urine test -- negative tick born disease panel -- awaiting results

Allergies: mangos

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 8/30 large (5 x 2.5 inch), sore, risen, hot, red patch at injection site, fatigue 8/31 fatigue, red patch worse, headache, diarrhea 9/1 symptoms still present but improved some 9/2 still a red patch, more fatigue, fever of 99.5, bad body aches 9/3 smaller red patch, fever up to 100.4, very bad body aches, chills, sweets 9/4 fever up to 101.6, sweets, red patch more off color, darker but still visible (like when a shingles blister has healed but the skin is discolored), body aches improved some 9/5 fever broke, fatigue, patch faded but still present

Other Meds: forteo armour thyroid levoxyl progesterone estrogel baby aspirin calcium vitamin d metho folate

Current Illness: none

ID: 1674978
Sex: F
Age: 30
State: CA

Vax Date: 06/13/2021
Onset Date: 07/04/2021
Rec V Date: 09/05/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Menstrual cycle disruption. Period came 14 days after previous period. It was at least 10 days earlier than expected. Bleeding was heavier than usual, for days. My menstrual cycle timing and length has shifted since then.

Other Meds:

Current Illness:

ID: 1674979
Sex: F
Age: 20
State: NY

Vax Date: 09/05/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Staff did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted

Other Meds:

Current Illness:

ID: 1674980
Sex: F
Age: 22
State: OH

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 09/05/2021
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 received the 2nd Hepatitis B dose 7 days too soon from the scheduled date. Patient denied adverse symptoms, she was told to come back at the 28th day from first dose to repeat the second dose.

Other Meds:

Current Illness:

ID: 1674981
Sex: M
Age: 25
State: NY

Vax Date: 09/05/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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: medic did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted

Other Meds:

Current Illness:

ID: 1674982
Sex: F
Age: 50
State: NY

Vax Date: 09/05/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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: medic did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted

Other Meds:

Current Illness:

ID: 1674983
Sex: F
Age: 24
State: NY

Vax Date: 09/05/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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: Vial of Pfizer was not diluted and patient received a full vial of pfizer vaccine undiluted

Other Meds:

Current Illness:

ID: 1674984
Sex: F
Age: 12
State: NY

Vax Date: 09/05/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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:

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

Symptoms: Army medic did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted

Other Meds:

Current Illness:

ID: 1674985
Sex: F
Age: 54
State: MA

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data:

Allergies: Mantoux TB Test.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Severe chills, temperature of 101, excessive urination (every 45 minutes -1 hour), constant, ever headache, scratchy throat, weakness, sporadic pain in lower right side; all afore-mentioned symptoms lasting for approximately 12 hours, except temperature of 99.7 carried over through the subsequent several hours.

Other Meds: Vitamin C, D, and B12. Imitrex as needed.

Current Illness:

ID: 1674986
Sex: M
Age: 17
State: WI

Vax Date: 08/10/2021
Onset Date: 08/27/2021
Rec V Date: 09/05/2021
Hospital: Y

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

Lab Data: Normal EKG and Echo. Normal CB and CMP. Elevated Troponin levels.

Allergies: Possibly Salmon - reaction occurred while eating salmon shortly after the first Covid Vaccine dose administered on 7/6/2021

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient presented to the ER with chest pain, fatigue and sense of palpitations.

Other Meds: None

Current Illness: None

ID: 1674988
Sex: F
Age: 74
State: CO

Vax Date: 01/18/2021
Onset Date: 01/29/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data: Covid PCR test - negative Spirometry for asthma - breathing at 94%

Allergies: Codeine

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

Symptoms: Long covid symptoms recurred--fatigue, cough, joint aches, body aches, herpes outbreak, back pain, anxiety, shortness of breath. Brain fog, forgetfulness, paper cuts became very infected for 2 weeks each, vaginal infections, I felt like my immune system had shut down, or become so overly active, it couldn't protect me against very minor infections. I did not have brain fog, brain inflammation before the vaccines.

Other Meds: Famciclovir Omeprazole Famotadine Livalo

Current Illness: Long Covid after Covid-19 in 3/9/2020 - improving

ID: 1674989
Sex: M
Age: 52
State: VA

Vax Date: 08/15/2021
Onset Date: 08/17/2021
Rec V Date: 09/05/2021
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: Seen in the Emergency room on 8/25/2021. D dimer, Troponin, EKG - normal

Allergies: No

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

Symptoms: Constant pain in the left arm, pain in the elbow, and wrist

Other Meds: No

Current Illness: No

ID: 1674990
Sex: F
Age: 52
State: CT

Vax Date: 07/31/2021
Onset Date:
Rec V Date: 09/05/2021
Hospital: Y

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

Lab Data: CAT scan of the brain Mri

Allergies: Antibiotics I had two anaphylactic episodes for no reason that required a epi pen and a ER visit

Symptom List: Unevaluable event

Symptoms: I felt like I was going to pass out . I got really dizzy . That night I had bad vertigo , headache , body aches and just felt like the flu . Everyday after that the vertigo , left sided headache , left eye blurred vision and fatigue was getting worse. On 8/6/21 I went to the ER because it was so bad . They wanted to admit me and I said let me see how it goes for the next day . I?m a single mom. On 8/9/21 I couldn?t walk a all bilateral gate was off . Then it was just on the left . Left side headache, face was numb on. The left side , left sided weakness ,my left eye was in and out of being blurred and I saw lights flash. My body felt like it was a hundred degrees inside like a crazy hot flash. They admitted me did a MRI and heart ehco they were fine and a day and a half I regain the strength in my left side . I still get the left sided headache but not as bad and have the optical migraines. I called Pfizer and they said not to get the second vaccine. My antibodies are still over 400 just 3 days ago . I work for a hospital and they are making me get the second vaccine they are not taking too many exception. Please help me and tell me what I can do . I don?t want to have a stroke and cause damage. I have to do it by 10/1 The hospital said it?s per CDC

Other Meds: Concertsa 36mg Methylated B complex D3

Current Illness: I had COVID on 1/6/2021 and still had large lymph nodes in my neck and joint pain I had breast cancer in 2018 A double mastectomy And my ovaries out

ID: 1674991
Sex: F
Age: 39
State: CA

Vax Date: 09/04/2021
Onset Date: 09/04/2021
Rec V Date: 09/05/2021
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: I had covid at the end of July, but I never actually took a test until I was feeling better a couple weeks later. I was unvaccinated at the time. At around 10:pm the day of the 2nd vaccine, I had slight runny nose and was tired, slight body aches. I woke up around 1am and literally started crying, I felt so sick, I couldn?t move, I had the chills so bad it felt like my blood was being mixed with dry ice and on fire, boiling. I was shaking profusely, and could not get warm. This was way worse than when I was unvaccinated and had covid, way worse. My body aches are double the intensity of when I had covid, I can barely move. There was some talk I got vaccinated too early after having covid. In fact, pharmacy down the street refused me, and said I had to wait longer. They asked me who told me to get vaccinated so early after having covid, and I told them the county health department, and he just shook his head and said I should wait at least 1 month from testing positive or for a negative test. Meanwhile I?m receiving emails and texts from the county to get vaccinated ASAP, if I need help scheduling appointment or need transpo, reach out to them. The whole thing was confusing, do I wait, do I get vaccinated ? So I got vaccinated somewhere that didn? t ask me if and when I?ve had covid. Now I?m thinking I?m feeling this sick because I?ve had covid too close to the vaccination and my body is way over reacting, and I feel miserable and more sick than actually being unvaccinated and having covid.

Other Meds:

Current Illness:

ID: 1674993
Sex: F
Age: 33
State: KS

Vax Date: 08/27/2021
Onset Date: 08/31/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data:

Allergies: Morphine, Eggs, Dairy

Symptom List: Injection site pain, Pain

Symptoms: Growing red spot around injection site, hot to touch, itchy, growing skin depression immediately surrounding injection site.

Other Meds: Levothyroxine, Cytomel, Adderall XR

Current Illness:

ID: 1674994
Sex: M
Age: 78
State: OH

Vax Date: 01/20/2021
Onset Date: 03/17/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data: Chest x-ray ---clear 08/25/2021 (?)

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Symptoms started approximately 30 days later and have gradually gotten worse.

Other Meds: Centrum Silver Multi-Vitamim, Alogliptin 12,5mg-once a day, Clopidogrel 75mg once a day, atorvastain calcium 80mg 1/2 tablet per day, rivaroxabnan 2.5mg twice a day, azelastine HCL once a day

Current Illness: lymphona

ID: 1674995
Sex: F
Age: 40
State: IL

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

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

Symptoms: Second dose of Moderna COVID19 Vaccine was given 5 days early on 9/1/21. First dose was administered 8/9/21. Scheduling error was made. Team members were coached. Patient was informed of event.

Other Meds:

Current Illness:

ID: 1674996
Sex: M
Age: 79
State: NJ

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/05/2021
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: covid PCR negative

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: headache, myalgia, sore throat, low grade fever starting about 3 1/2 hours after the immunization

Other Meds: rosuvastatin, tamsulosin, certirizine, niacin, multiple vitamin

Current Illness: none

ID: 1674997
Sex: F
Age: 39
State: NH

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 09/05/2021
Hospital: Y

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

Lab Data: ER and admission 5/16/21 ER 5/20 MRI brain, neck, spine, spinal tap, labs, CT abd pelvis

Allergies: Procaine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Within 5 minutes of having vaccine administration both times , my right arm experienced pins and needles as well as burning sensation. ( my L was the vaccine site. ) Accompanied by right arm feeling weak and slight slurred speech. This stopped after 10-15 minutes. Since 1/7 though I have had daily sensations of pins and needles in bilateral lower extremities as well as upper extremities that is not constant but intermittent throughout the day , there is also daily joint pain or discomfort and muscle weakness. I have intermittent episodes of extreme fatigue, slurred speech, weak heavy right arm, cognitive brain fog issues with word recall . My heart rates have been as low as 40's daily since january which is new as im usually mid to high 50's and 60's. GI distress daily, abd pain or discomfort , loose stools

Other Meds: Synthroid 100 mcg Ctytomel 2.5 mg

Current Illness: none

ID: 1674998
Sex: F
Age: 43
State: NC

Vax Date: 09/01/2021
Onset Date: 09/04/2021
Rec V Date: 09/05/2021
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: latex, codeine

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

Symptoms: swollen armpit, painful to touch

Other Meds: women multivitamins, vitamin D

Current Illness: none

ID: 1674999
Sex: M
Age: 23
State: FL

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

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

Lab Data: Elevated Troponin

Allergies: none

Symptom List: Nausea

Symptoms: Myocarditis

Other Meds: none

Current Illness: no

ID: 1675000
Sex: F
Age: 48
State: WA

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

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: I got am extreme headache right after receiving the shot, also alot of arm soreness. The following morning I felt pretty good until 10:00 am and then it got bad for me. Very fatigued with headache, arm pain, nausea and diarrhea. It has continued till the present day. 9/5/2021.

Other Meds: Atacand 32 mg

Current Illness: None

ID: 1675001
Sex: F
Age: 57
State: IN

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 09/05/2021
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: Tetracycline

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

Symptoms: Stabbing chest and abdominal pain, nausea, diarrhea, fatigue, severe headache, body aches

Other Meds: Wellbutrin, Armour Thyroid, Oxybutinin, vitamin D, Magnesium

Current Illness: None

ID: 1675002
Sex: F
Age: 20
State: MI

Vax Date: 09/01/2021
Onset Date: 09/04/2021
Rec V Date: 09/05/2021
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: none

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

Symptoms: first dose resulted in hives 2 hours after receiving vaccine, second dose resulted in full body rash of tiny red raised bumps that are very itchy and not responding to any sort of antihistamine meds

Other Meds: Amoxycilin for strep throat

Current Illness: strep throat

ID: 1675003
Sex: F
Age: 54
State: WI

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data: Heart monitor - 7/7/21 x 8 days EKG's Head CT Many labs All normal

Allergies:

Symptom List: Tremor

Symptoms: have periods of "neurologic short circuiting" - entire body freezes up for 3-10 seconds. Cannot move, blink, breath. I can see whatever is in my line of vision at the time of freezing up but cannot move my eyes. Have worn heart montor which shows corresponding ventricular tachycardia at same time as the neurologic episodes. 6/3/21 - 1st episode 4pm (while sitting at my desk working) 6/4/21 - 5pm (watching nephews baseball game) 6/26/21 - 8pm (at wedding reception) 7/2/21 - 10:25am (working - started to black out) 7/8/21 - 11am -4 separate episodes ~ 20 seconds apart (working) 7/9/21 - 1:52pm (working) 7/9/21 - 2:42pm (working) 8/19/21 - 10:52am felt like brain shaking/head exploding (working)

Other Meds:

Current Illness: NONE

ID: 1675004
Sex: F
Age: 37
State: FL

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

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

Lab Data: N/A

Allergies: NKDA

Symptom List: Erythema, Pruritus

Symptoms: Acute back pain started day after shot. Acute back pain remains as current as today, 09/05/21. Acute back pain in same spot, approximately bra line area) daily.

Other Meds: N/A

Current Illness: N/A

ID: 1675006
Sex: F
Age: 40
State: CO

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 09/05/2021
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: Penicillin, Mold, dust, cats, horses, trees, grass, weeds.

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

Symptoms: Moderna COVID-19 Vaccine EUA. 7 days after receiving first dose I developed a large red spot at the injection site that was itchy like a bug bite and swollen. The skin felt very hard and hot to the touch. The next day the spot had more than tripled in size and covered most of my upper arm. It didn't cause much pain but it did ache and hurt if I touched it. The skin was very hard and hot to the touch, the itching was mild. Today is the third day since the reaction started and the swelling seems to have lessened, but the red spot is still there and itches.

Other Meds: Spironolactone 75mg/day, Cymbalta 60mg/day, Loratadine 10mg/day, Nature's Bounty Hair/Skin/Nails gummies 2/day.

Current Illness: Positive ANA test, first thought to be Lupus but changed diagnosis to possible Fibromyalgia pending test to confirm.

ID: 1675007
Sex: F
Age: 56
State: WV

Vax Date: 09/04/2021
Onset Date: 09/04/2021
Rec V Date: 09/05/2021
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: Staydol

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

Symptoms: Immediate Itching at site , tingling in fingers on right hand within 10 mins, tingling in right side -including face and tongue?a few hours after injection, headache evening of injections, body aches through the night, headache continues next day, soreness at injection site

Other Meds: Progesterone, vividot patch, mobic, Allegra 12 hr, osphena

Current Illness:

ID: 1675008
Sex: F
Age: 52
State: CA

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/05/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Extreme soreness, itching, redness, swelling, and heat on right arm at shingles vaccination site. Area of swelling approx 3 inch diameter. I am not certain which Hep B vaccine I received; my paperwork doesn't say so I just picked one.

Other Meds: Azathioprine, Ondansetron, Acetaminophen, Bupropion, Inflectra. Multi-vitamin, calcium supplement, Biotin

Current Illness: Crohn's flare-up.

ID: 1675009
Sex: M
Age: 14
State: FL

Vax Date: 08/13/2021
Onset Date: 08/14/2021
Rec V Date: 09/05/2021
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: no known

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

Symptoms: patient reports painful swelling in the armpit starting the day after vaccination and lasting for a total of 2 days

Other Meds: no known

Current Illness: no known

ID: 1675011
Sex: F
Age: 41
State: IL

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 09/05/2021
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: N/A

Allergies: Vicodin, sulfa drugs, Doxepin, bananas, latex, environmental allergies, pollen, grass, trees

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

Symptoms: Light headed, headache, severe wheezing, multiple asthma attacks, used nebulizer treatments, rescue haler did not work to alleviate asthma attacks or severe wheezing.

Other Meds: Hydroxychlorequine Imuran Adderall Aspirin Propranolol B-12 shot

Current Illness: Asthma, Lupus, RA, migraine, hypertension

Date Died: 08/30/2021

ID: 1675012
Sex: M
Age: 69
State: FL

Vax Date: 03/12/2021
Onset Date: 08/18/2021
Rec V Date: 09/05/2021
Hospital: Y

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

Lab Data: SARS-COV-2, NAA, Detected: 08/18/21.

Allergies: NKDA

Symptom List: Pain in extremity

Symptoms: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary: Hospital Course: HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care. 8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns. 8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated. 8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC. 8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status. 8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%. 8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed. 8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC. Today, patient changed from PRVC to PS with improvements in oxygenation. Patient on 14/10 75% PS satting mid 90's. 8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions. Neosynephrine infusion added. Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure. Patient with increasing O2 requirements. ABG performed showing Hgb 6.5. Patient type & screened, crossmatched, transfused 1u PRBC's. Vancomycin added for broad spectrum antibiotic coverage. Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation. 1957: Maxed on 4 vasopressors. GCS 3T. HR trended down to asystole. No heart tones auscultated. Time of death 1957. Significant other notified. Discharged Condition: deceased

Other Meds: PROAIR HFA; VENTOLIN HFA 12/18/15 ELIQUIS 5 MG Information, Historical ZITHROMAX 250 MG 12/21/18 PULMICORT 0.5 MG/2ML 3/10/18 Keflex 500 MG 1/17/20 1/24/20 CeleXA 10 MG 3/5/17 VIBRA-TABS 100 MG 7/29/21 8/8/21 FLONA

Current Illness:

ID: 1675013
Sex: M
Age: 25
State: PA

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

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

Lab Data: NONE

Allergies: NONE

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

Symptoms: PT WAS FINE IMMEDIATELY FOLLOWING VACCINE. ABOUT 5 MINUTES LATER, STATED HE WAS FEELING A BIT LIGHT HEADED. WE HAD HIM LIE DOWN FOR A FEW MINUTES. HE STATED THAT HE DOES GET NERVOUS/ ANXIOUS WITH SHOTS AND THIS HAS HAPPENED TO HIM BEFORE FOLLOWING HIS FLU SHOTS. HE REPORTED NO TACHYCARDIA, SWEATING, SWELLING OF THROAT/MOUTH, ETC. HE ALSO STATED HE DID NOT EAT YET TODAY. HE DRANK SOME WATER AND HAD A PIECE OF CANDY. WE CHECKED HIS BLOOD PRESSURE WHICH WAS NORMAL AT 121/79. HEART RATE WAS ALSO NORMAL AT 68. HE SAT IN VIEW OF THE PHARMACY FOR ABOUT 10 MORE MINUTES AND STATED HE FELT FINE AT THAT POINT. I DID CALL HIM ABOUT 45 MINUTES LATER. HIS MOTHER SAID HE WAS GETTING SOMETHING TO EAT AND THAT HE FELT FINE. NO FURTHER FOLLOW UP NEEDED.

Other Meds: NONE

Current Illness: NONE

ID: 1675014
Sex: M
Age: 16
State: TX

Vax Date: 09/03/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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: n/a

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

Symptoms: woke up with heart palpitations. felt chest pain and pain in right arm from shoulder to wrist

Other Meds: n/a

Current Illness: possible sinus/cold

ID: 1675015
Sex: F
Age: 55
State: VA

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data: Received Flu vaccine QUAD 6 mos & up PRESERVED on same day but in right arm

Allergies: Ciprofloxacin HCL

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

Symptoms: Zoster Vaccine Recomb,Adjuvanted (IM) - Arm pain for days. Fever, aches, Chills for 2-3 days. Severe pain behind left eye (overnight) - shooting pain behind eye when I coughed or sneezed for several hours. Headache finally went away by noon the next day.

Other Meds: Levoxyl, Zyrtec, Mucinex, Vitamin D, Black Cohash

Current Illness: Received flu shot the same day

ID: 1675016
Sex: M
Age: 68
State: OH

Vax Date: 03/17/2021
Onset Date: 07/11/2021
Rec V Date: 09/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: ER observation only.

Allergies: None before. That is the reaction. I now seem allergic to bee stings and other unknown sources.

Symptom List: Vomiting

Symptoms: Vaccinated March 17, 2021. In July I started noticing allergic reactio on hands. (Itching). In August I was stung by a honey bee and had allergic reaction. Had to take epinephrine. Never before in 68 years have I ever had any allergies. Don't know if related to vaccine or not. Just thought it was notable.

Other Meds:

Current Illness: Diabetic, heart patient

ID: 1675017
Sex: F
Age:
State: NJ

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

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

Lab Data: None.

Allergies: Sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Chills, bad headache, fairly large rash on upper arm with soreness and swelling. Stomach pain, fatigue and weakness. Lasted 5 days.

Other Meds: Effexor, Pravastatin, clonazepam, fish oil, Allegra, astelin, ipratropium bromide, breo, calcium , multi vitamin.

Current Illness: None.

ID: 1675018
Sex: F
Age: 60
State: PA

Vax Date: 09/02/2021
Onset Date: 09/03/2021
Rec V Date: 09/05/2021
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 known

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

Symptoms: Severe leg cramp from left toes up to hip at 11:00 am lasting approximately 3 minutes. Relaxed again to wake to another severe cramp on right side leg that lasted approximately 1 1/2 minute. Made it to bathroom where I could not even sit. Still pain in calf area today and unable to walk steps normally. I am finally able to move foot and toes on both legs today.

Other Meds: Clonazepam 1/2mg Risedronate Sodium Tablets 35mg

Current Illness: N/A

Date Died: 08/31/2021

ID: 1675019
Sex: M
Age: 81
State: FL

Vax Date: 04/14/2021
Onset Date: 07/31/2021
Rec V Date: 09/05/2021
Hospital: Y

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

Lab Data: SARS-COV-2, NAA, Detected: 07/31/21.

Allergies: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient required hospitalization due to breakthrough infection. He received the Pfizer vaccine (2nd dose in series) on 04/14/21. Patient was hospitalized from 07/31/21 - 08/31/21. Below is copied from discharge summary: Discharged Condition: deceased Hospital Course: Patient is a 82 y.o. male with a PMH of recurrent UTIs, BPH, COPD, bicytopenia (leukopenia and erythropenia), DDM2, HTN, and HLD who presented to the ED on 7/31 for AMS. He was found down by family and EMS was called. SpO2 was 68% and pt was placed on NRB. He was brought to the ED and was COVID + (despite previous Pfizer vaccination on 3/24 & 4/14). CT C/A/P showed bilateral opacities. He also had a brief episode of afib RVR treated w/ metoprolol w/ subsequent hypotension requiring levophed gtt. He later was intubated d/t hypercapnic respiratory failure and admitted to the MICU. His course was complicated by hypernatremia elevated CK, AKI, PSAR UTI and enterococcus bacteremia. Abx were de-escalated to levoflaxacin and ampicillin.Of note he did not receive Remdesivir or Toclilizumab d/t bacteremia. He completed a 7 day course of solumedrol. He was extubated to HFNC on 8/6 and was transferred to the floor on 8/8 and only requiring 5L NC at the time. While on the floor pt had increased lethargy. On the evening of 8/11 pt was noted to have tachypnea and use of accessory muscles. Pt was placed on a VM and on the morning of 8/12 placed on BIPAP.CTH was obtained and showed new bilateral SDH/hygromas. IM team spoke with team and they recommended MRI brain stroke protocol. Patient continued to have respiratory decline remain on ventilator his symptoms continue to escalate was shortness of breath desaturation to patient was ventrally placed on 100 percent was on flow land saturation still remains low family meeting with palliative Care patient was made DNR with no escalation.

Other Meds: ACCU-CHEK AVIVA PLUS VI STRIP USE ONE STRIP TO CHECK BLOOD SUGAR THREE TIMES DAILY BEFORE MEALS ACCU-CHEK AVIVA PLUS W/DEVICE DOES NOT APPLY KIT 3 times daily. AMLODIPINE (NORVASC) 10 MG ORAL TABLET TAKE ONE TABLET BY MOUTH ON

Current Illness:

ID: 1675020
Sex: F
Age: 36
State: VA

Vax Date: 09/04/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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

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

Symptoms: Uncontrollable sobbing for no apparent reason. Started morning after shot and there are no triggers whatsoever. Crying and sobbing at anything.

Other Meds: Zinc, multivitamin

Current Illness:

ID: 1675021
Sex: F
Age: 76
State: CA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 09/05/2021
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: no

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

Symptoms: None stated.

Other Meds: The pain in my right breast is intermittent and radiating. use Amoxicillin

Current Illness: no

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am