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: 1679722
Sex: F
Age: 25
State:

Vax Date: 03/23/2021
Onset Date: 09/01/2021
Rec V Date: 09/07/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: PATIENT HAD COVID-19 VACCINE ON Dose 1 date: 03/23/2021, Dose 2 date: 04/13/2021, AND TESTED POSITIVE TO COVID.

Other Meds:

Current Illness:

ID: 1679723
Sex: F
Age: 52
State: MO

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Around 10pm I started to feel weird. I woke up very ill (fatigue, headache, nausea, weakness, chills). I had the worst headache and my eyes were hurting for over 24 hours. My chills turned into a high fever on the night of the 24th and I had a high fever, sweating and vivid, strange dreams that night. I continued to feel sick until Saturday August 29th with my symptoms diminishing a bit each day.

Other Meds: Armour Thyroid

Current Illness: None

ID: 1679724
Sex: F
Age: 20
State:

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 09/07/2021
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: Per mom, -whole Right arm felt paralyzed, fever and in bed for 2 days- symptoms resolved after tylenol and advil

Other Meds:

Current Illness:

ID: 1679725
Sex: F
Age: 45
State: NY

Vax Date: 03/24/2021
Onset Date: 08/31/2021
Rec V Date: 09/07/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: stoke, weakness/numbness rightside of body, 3 stents placed in carotid artery

Other Meds: atorvastatin, tri-lo-sprintec

Current Illness: none

ID: 1679726
Sex: F
Age: 13
State: WA

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/07/2021
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: PT received 2nd dose Pfizer at 1617, c/o gradual onset headache7/10 and dizziness at 1635. PT was transferred to WC, then to cot. Reported feeling better lying down. No LOC noted. VS at 1637: BP 102/70 laying, HR 76, SPO2 99% on RA. No s/s respiratory distress. 1640: 120/54 BP laying, HR 72, SPo2 99% RA. PT was provided cold compress at 1644, accepted and drank juice. PT denies nausea and reports she ate lunch and had fluids last at 1300. VS at 1643: BP 108/62, HR 74, SPO2 99% RA. 1647: BP sitting is 124/78, HR 83, SPO2 99% RA, RR 18. Reports HA is 5/10 at 1649. PT reports she had no problems, SE after first dose. At 1651, PT stood without difficulty, verbalized that he head felt 'good' and pain was 2/10. Denies dizziness, reports that she feels 'back to normal. VS at 1651: BP 164/84 standing, HR 92, SPO2 99% RA. 1655: BP 140/86 sitting, HR 72, SPO2 99%. Standing BP at 1655 is 128/64. PT reports that she is back to baseline, denies further headache, dizziness, walks a short distance at 1700 with no difficulty. PT educated on vasovagal reaction, verbalized understanding. Exited facility with mother at 1702.

Other Meds: Unknown

Current Illness: None

ID: 1679727
Sex: F
Age: 46
State: OR

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 09/07/2021
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: sore arm

Other Meds: Simvistatim, Celexa, VD2

Current Illness: none

ID: 1679728
Sex: F
Age: 37
State: NC

Vax Date: 08/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient reported a small red spot at injection site (left arm) after receiving her first dose of the Moderna COVID-19 vaccine. This red spot grew in size over the course of that week and became red, hot, and itchy. Since that time, the redness and swelling has decreased into a scaly, irregular red rash that is itchy and warm to the touch. Patient reports that the symptoms worsen with exercise.

Other Meds:

Current Illness:

ID: 1679729
Sex: F
Age: 41
State: UT

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: Bloodwork came back normal without clotting issues. Later went to doctor. Doctor said he was sure it was from the vaccine.

Allergies: Morphine

Symptom List: Pharyngeal swelling

Symptoms: Headache for 7 days straight, ongoing headaches 2-3 times a week. Large blood clots in stomach fat. Significant bruising of stomach. Left with large knots that become inflamed and bruise. As small as peas but some as large as a small fist.

Other Meds: Insulin Metformin Olmestatin Lasix Prednisone Ibuprofen Tramadol Estrogen

Current Illness:

ID: 1679730
Sex: F
Age: 47
State: MS

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 09/07/2021
Hospital: Y

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

Lab Data: unknown

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt went to hospital due to vaccine given too high and was in lymphatic system. thought she had a stroke. she was in hospital for the last week

Other Meds: cyclobenzaprine, metoprolol tartrate, sildenafil, Percocet

Current Illness: Pt was on Ciprofloxacin but not sure for what infection

ID: 1679731
Sex: F
Age: 67
State: TX

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

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

Lab Data:

Allergies: NKA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient complaining of swelling, pain, area is hard, can't sleep due to pain in arm

Other Meds: pantoprazole 40mg, simvastatin 40mg

Current Illness:

ID: 1679732
Sex: M
Age: 75
State: CA

Vax Date: 03/23/2021
Onset Date: 04/06/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: I had blood tests taken at the emergency room but they reported that all appeared normal.

Allergies: None

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

Symptoms: Two weeks after my second injection, I had sever muscle inflammation, stiffness and pain. The pain made it difficult to walk or stand. I went to the emergency room and was given a steroid that cleared up the pain, but three days later the symptoms returned, A week later I went to an urgent care clinic and was prescribed Prednisone. I was using 20mg daily for 16 days this finally cleared up all symptoms and I no longer need the medication.

Other Meds: None

Current Illness: None

ID: 1679733
Sex: F
Age: 16
State: IL

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/07/2021
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 known

Symptom List: Rash, Urticaria

Symptoms: patient passed out but was able to recover upon getting her on the ground and lifting her feet.

Other Meds: none

Current Illness: no

ID: 1679734
Sex: F
Age: 45
State: RI

Vax Date: 08/24/2021
Onset Date: 08/27/2021
Rec V Date: 09/07/2021
Hospital:

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 Bladder and Kidney Ultrasound-unremarkable 9/3 Urine-negative except presence of non-hemolyzed blood 9/3 Vaginal Culture-normal 8/27/21 UA-mixed-treated for UTI for a second time. Also RBC's present.

Allergies: Latex, codeine, Novocain with epi

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

Symptoms: Symptoms of UTI are still present despite multiple negative urines, two cycles of antibiotics, bladder and kidney ultrasound, and vaginal exam and cultures. All tests are now negative despite symptoms and the presence of non-hemolyzed blood in my most recent urine sample from 9/3/2021.

Other Meds: Macrobid

Current Illness: UTI on 8/21/2021

ID: 1679735
Sex: M
Age: 41
State: PR

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 09/07/2021
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: Unknown

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

Symptoms: Male patient 41 years old went to the vaccination center September 1 of 2021 to get his second dose MODERNA. He reports that after his first dose on August 11, of 2021 he had an adverse effect swollen nodules under his axilla and rash on the lower limb. Patient refers the next day he had red dots and muscular pain. Patient informed not getting any treatment during that time. Reports having the same type of allergy before.

Other Meds: Unknown

Current Illness: Unknown

ID: 1679736
Sex: F
Age: 76
State: PA

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/07/2021
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 states she had the following symptoms -throat swelling -rash neck/chin -fever -diarrhea -swollen lymph node She said all this happened the day before and that she slept for the rest of the day. 4 days later she is much better and not showing any symptoms

Other Meds:

Current Illness:

ID: 1679737
Sex: F
Age: 19
State: UT

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/07/2021
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: Pt bobbed her head while seated, appearing to briefly pass out during the 15 minute monitoring period after receiving a dose of moderna covid-19 vaccine. Pt remained upright sitting in chair and did not fall. Pt was given juice and water, and offered to call 911 several times; pt refused each time. Pt was told to remain under observation for 30 minutes instead of 15. After 30 minutes pt stated she felt better, still did not want us to call an ambulance and left the store. Although on the VAR form pt indicated that she has never had a reaction after receiving a vaccination, the pt later told technician that she had a similar reaction after getting a HPV vaccine. today's event has been reported through the VAERS system. I called pt an hour and a half after, pt states she was doing okay, I encouraged pt to contact her primary care physician with any further questions or concerns. I also contacted pt's primary care provider listed on VAR sheet, the prescriber's MA said she would reach out to the pt tonight or tomorrow to follow up with the pt.

Other Meds:

Current Illness:

ID: 1679738
Sex: M
Age: 68
State: ID

Vax Date: 03/02/2021
Onset Date: 05/14/2021
Rec V Date: 09/07/2021
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: SEASONAL POLLEN

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

Symptoms: on may 14 started itching and headache went to dr on may 17 diagnosed with shingles

Other Meds: PRAVASTATIN SODIUM 20MG, OXYBUTYNIN CHLORIDE ER, LORATADINE 10MG, BAUSCH AND LOMB AREDS 2, TADALAFIL 5MG, BABY ASPIRIN

Current Illness:

ID: 1679739
Sex: M
Age: 34
State: NY

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data:

Allergies: Ceclore

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Jansen COVID-19 Vaccine EUA Next morning - 101 Fever - Body aches - Eye pain Four days later - significant lower eyelid swelling

Other Meds: EGCG, Zinc, Vitamin C, Vitamin D

Current Illness: None

ID: 1679740
Sex: M
Age: 59
State:

Vax Date: 08/26/2021
Onset Date: 09/01/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: none. Will seek medical help if symptoms continue or worsen

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: In the first couple of days - some fever. tiredness. Persisting arm pain (for about a week). Then (till present time) Abdominal discomfort; occasional sharp pains. Tiredness. Slight shortness of breath, occasionally throughout the day. Mouth dryness and a feeling that reminded me of when I was infected with Covid (sometime 1st Q. 2020). Sleep disruption; anxiety. My main worry is the abdominal pains and the shortness of breath.

Other Meds: none

Current Illness: none

ID: 1679741
Sex: F
Age: 53
State:

Vax Date: 07/24/2021
Onset Date: 07/30/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: Jul 30, ER - no tests, nasal packing procedure only Jul 30, ER - blood test 2x, ECG (referred to a cardiologist) Aug 1, ER - blood test, ECG (went to ER as advised by medical hotline due to vaccine reactions) Aug 18 - holter monitor for 48 hours Aug 28 - blood test, ECG (referred to an internist) Sep 8 - appointment with the internist Oct 15 - appointment with an ENT Still waiting for the cardio appointment confirmation

Allergies: none

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

Symptoms: Severe nosebleed on 6th day that lasted for 2 hours without slowing-stopped after nasal pack procedure fainted the same morning had to be rushed to ER by paramedics; BP dropped to 88/68; bouts of dizziness from day 2 until now, unusual heartbeat recorded on holter monitor, unusual rise of BP 182/117. Blood test from Aug. 28 showed low haemoglobin.

Other Meds: Synthroid .025

Current Illness:

ID: 1679742
Sex: M
Age: 48
State: IL

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/07/2021
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: Chest X ray, blood tests, CT scan of chest

Allergies: Beans, Benadryl

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

Symptoms: Five minutes after receiving injection , I felt lightheaded, faint, and a fast, pounding heart beat. I also felt an overwhelming feeling of anxiety. I reported my symptoms to the nurse, and she came and gave me a bottle of water and checked my pulse. She did not disclose to me my heart rate at the time. Within 15 minutes of receiving I decided to go home and rest. On Saturday I felt body aches and exhaustion . At times , I felt the fast, pounding heartbeat. I therefore rested. On Sunday, 09/03/2021, while shopping, I again , felt lightheaded, anxious, fast, pounding heart beat. I requested for ambulance service and they came and performed an assessment. My initial blood pressure was 160/110. But upon being in ambulance it was re assesesed and was 146/70, approximately. My blood sugar was 97. I therefore decided to attempt to go home and rest. Upon driving approximately 1 mile, I again felt lightheaded, anxious, and a fast, pounding heart beat. I therefore parked my car near by and contacted my parents to drive me home. I went to the Hospital for assessment and they discharged me stating my labs and test were ok. I do not have any history of cardiac issues.

Other Meds: None

Current Illness: None

ID: 1679743
Sex: F
Age: 66
State: GA

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

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

Lab Data:

Allergies: Penicillin

Symptom List: Unevaluable event

Symptoms: Approximately 10 minutes after I gave the patient her Moderna vaccine, she got my attention and said her cheeks felt flushed. I went out to her and 1 cheek was definitely red and the other slightly pink. She took a couple of drinks of water that she had and said she felt ok, just flushed. She said her tongue and lips did not feel funny, but she had her dentures in and said it was hard to "sense" anything. I asked her to stay in the store longer than the 15 minutes just to make sure everything was ok. The patient stayed for around 40 minutes and her cheeks returned to normal while she was here. She said she felt fine. I asked the patient to call me after she got home and let me know how she was feeling. She called me at 8:05pm and said she was feeling fine.

Other Meds:

Current Illness:

ID: 1679744
Sex: F
Age: 79
State: TN

Vax Date: 09/01/2021
Onset Date: 09/02/2021
Rec V Date: 09/07/2021
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: None

Allergies: Nothing really.

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

Symptoms: I just want to let you know that I had a third dose of Pfizer vaccine on September 1. This time on the second day after, I noticed I had redness about 3 inches below the injection site and it's about an inch wide and about 4 inches around the outside of my arm. Doesn't itch or hurt but has been sore. No other symptoms.

Other Meds: Amlodipine Benaz 5/20 mg, Metoprolol FR Succinate 50mg, Januvia 100mg, Rosuvastatin 20mg, AmLodipine Besylate 5mg, Asprin 81mg, D3 2000 IU, multivitamin, Fluticasone Propionate, Azelastine HCI.

Current Illness: None

ID: 1679745
Sex: M
Age: 29
State: FL

Vax Date: 09/05/2021
Onset Date: 09/06/2021
Rec V Date: 09/07/2021
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: Allergic to amoxicillin

Symptom List: Injection site pain, Pain

Symptoms: Chest pains in center of chest, lasting over the course of a few hours followed by a fever.

Other Meds:

Current Illness:

ID: 1679746
Sex: F
Age: 16
State: CA

Vax Date: 09/04/2021
Onset Date: 09/07/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: n/a

Allergies: n/a

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pt and her mother came to pharmacy 09/4/21 and asked for vaccine covid-19. Pharmacist gave her Pfizer for her age. 09/07/2021 when reporting her vaccine into immunization registry, Pharmacist found that pt. already completed her series of 2 and second dose was 06/22/21. Pharmacist contacted the pt's. family and her sister, she stated that she already knew that pt. got the 3rd dose of Pfizer. Sister stated that her pt. and mother needed to go for COVID testing but ending up got vaccinated; this was due to the miscommunication between pharmacy and pt. Pharmacist failed to check the immunization registry prior to giving vaccine as well as the in completed questionnaire sheet According to sister, pt. is Ok at this time, no adverse reaction experienced. Pharmacist will further follow up Pharmacist contacted pt. primary care doctor and was advised that her doctor will discuss with family about the extra dose she received in the next visit.

Other Meds: n/a

Current Illness: n/a

ID: 1679747
Sex: F
Age: 64
State: MA

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: None

Allergies: None known

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

Symptoms: Intermittent sharp, crappy abdominal pain, followed by loose stools. Several hours later shaking chills, low grade fever (100). Fatigue. Symptoms resolved within 36 hours.

Other Meds: Levothyroxine 50 mcg Aspirin 81 mg Vitamin D 3 1000 units Osteo Biflex Ibuprofen 600 mg

Current Illness: Mone

ID: 1679748
Sex: M
Age: 86
State: WA

Vax Date: 06/09/2021
Onset Date: 09/02/2021
Rec V Date: 09/07/2021
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: COVID status positive 9/2/21.

Allergies: NKDA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient received Pfizer COVID vaccine on 5/19/21 and 6/9/21. Patient presented to our facility on 9/3 with severe weakness, fatigue, increased cough, SOB, increased confusion, and positive COVID test. He was found to have COVID pneumonia with no O2 requirement. He was initially in shock required pressors. He improved and diuretics were able to be resumed. He was found to have significant acute kidney injury and atrial fib with RVR. Patient was admitted from 9/2/21 to 9/6/21 and discharged home with hospice.

Other Meds: apixaban, bisoprolol, carvedilol, febuxostat, levothyroxine, metformin, Dytor, Ferro-Flo rotocap, rosuvastatin, torsemide, vitamin B complex

Current Illness:

ID: 1679749
Sex: F
Age: 43
State: NJ

Vax Date: 09/01/2021
Onset Date: 09/03/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: None to report at this time.

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: After the second Pfizer vaccine I experienced a very painful menstrual period in-between my cycle. My period had just ended on 8/25 and should not begin until 9/18. The period itself was not super heavy but extremely painful almost contraction like. I have reported this to my primary doctor and I will follow up with my Gyno. Nothing about this seems normal to me so I felt I needed to report this.

Other Meds: Natures Bounty Biotin - Hair, Skin & nails

Current Illness: None

ID: 1679750
Sex: M
Age: 0
State: IL

Vax Date: 02/05/1954
Onset Date: 09/07/2021
Rec V Date: 09/07/2021
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: 911 called patient is sent to emergency rooms in stable condition be a 911 ambulance

Allergies: NKA

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

Symptoms: Patient returned to vaccine clinic at 11 AM and reported that he was dizzy with associated chest pain and shortness of breath.

Other Meds: Fluoxetine Trazadone Hydroxyzine

Current Illness: Polysubstance Abuse

ID: 1679751
Sex: M
Age: 68
State: TN

Vax Date: 04/01/2021
Onset Date: 08/29/2021
Rec V Date: 09/07/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Past medical history of COPD on home CPAP/BiPAP, personal device at the bedside initially came to the ER with complaints of shortness of breath after starting to feel bad on Sunday 8/29/2021. His vital signs were within normal limits and he was sent home from our emergency department. Initially he had a productive cough of clear sputum and had run temperatures up to 101 degrees. Patient was scheduled for COVID monoclonal antibody infusion 9/3/21. This appointment was cancelled. He took some Tylenol for relief of his fever and body aches but became increasingly short of breath and so came back to the ER and was admitted under the hospitalist service 9/5/2021. He believes that he was exposed to someone he works with whose child and wife had been sick with Covid. He was vaccinated earlier in the year "as soon as it became available." His wife is also sick at home with Covid. Patient complained of upper abdominal/lower chest discomfort especially with taking a deep breath. Denies any radiating quality to his chest discomfort but has been having murky looking diarrhea without melena or black tarry stools. He feels like he has lost some of his sense of smell but that his taste is now back. He is not normally on oxygen and is currently requiring 12 L high flow nasal cannula to maintain saturations of 93%. Patient completing oral steroids, IV antibiotics, IV remdesevir, COVID-19, antigen + 8/30/2021 at first ED visit and then again 9/5/2021 when admitted. Patient still admitted at time of report.

Other Meds:

Current Illness:

ID: 1679752
Sex: M
Age: 43
State: CO

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Patient was accidently given Pfizer for second COVID dose instead of Moderna. He did not have any apparent adverse events.

Other Meds:

Current Illness:

ID: 1679753
Sex: M
Age: 62
State: OR

Vax Date: 06/15/2021
Onset Date: 07/15/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: Entire report listed on Item 18.

Allergies:

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

Symptoms: ED Provider Notes at 07/15/21 0625 Procedure Orders 1. Electrical Cardioversion (ED) [409525162] ordered by Dr Post-procedure Diagnoses 1. Ventricular fibrillation seen on cardiac monitor (HCC) [I49.01] Chief Complaint: Chest Pain History: 62 y.o. male with hx of HTN and HLD who presents to the ED BIB wife with intermittent worsening central burning CP beginning a couple weeks ago now feels constant associated with dizziness today. CP is worsened with movement. He went to bed last night with CP, then woke up at 5:45Am with worsened pain. Last night he took pain medication, swallowed grape gum and then had CP. Denies SOB, N/V, hx of smoking or hx of DM. Denies FHX of early death due to MI. He has never had a heart attack before. The history is provided by the patient. The history is limited by the condition of the patient. Chest Pain The chest pain began 1 - 2 weeks ago. Duration of episode(s) is 1 week. Chest pain occurs constantly. The chest pain is worsening. The severity of the chest pain is severe. The quality of the pain is described as burning. Chest pain is worsened by certain positions. Primary symptoms include shortness of breath and dizziness. He describes the dizziness as a sensation of spinning. The dizziness began today. The dizziness has been unchanged since its onset. His past medical history is significant for hyperlipidemia and hypertension. Pertinent negatives for past medical history include no diabetes. Pertinent negatives for family medical history include: no early MI. Home Medications Not on File Allergies: Patient has no known allergies. Past Medical History HTN and HLD. No hx of DM or MI. Past Surgical History Charts reviewed, the patient has no surgical history on file and none reported. Social History No reported use of tobacco products, alcohol or illicit drugs. Family History No reported family history. No early MI in family. ROS: Review of Systems Unable to perform ROS: Acuity of condition Respiratory: Positive for shortness of breath. Cardiovascular: Positive for chest pain (burning constant ). Neurological: Positive for dizziness. Physical Exam: BP (!) 161/92 | Pulse 108 | Resp 27 | SpO2 100% Pulse rate pulse OX: 96 bpm Physical Exam Procedures: Electrical Cardioversion (ED) Sedation: Patient sedated: no Cardioversion basis: emergent Pre-procedure rhythm: ventricular fibrillation Patient position: patient was placed in a supine position Chest area: chest area exposed Electrodes: pads Electrodes placed: anterior-lateral Number of attempts: 1 Attempt 1 mode: synchronous Attempt 1 waveform: biphasic Attempt 1 shock (in Joules): 150 Attempt 1 outcome: conversion to normal sinus rhythm Post-procedure rhythm: normal sinus rhythm Complications: no complications Patient tolerance: patient tolerated the procedure well with no immediate complications EKG: EKG time (0626). sinus tachycardia. Rate: 101 bpm. P waves Normal. Normal PRI. Normal QRS complex. Normal axis. ST Segments: elevation in v1, v2, v3 and v4 . T Waves: non specific changes . The study has been independently viewed by me. The study has been interpreted contemporaneously by me. The EKG appears to be a good tracing. Clinical Impression: myocardial infarction anterior Rhythm Strip #1: Time (0638). Lead II. Rate= 200. Rhythm: ventricular tachycardia. Narrow QRS complexes. Ectopy: none. The study was interpreted by me. EKG #2: EKG time (0646). sinus tachycardia. Rate: 110 bpm. P waves Normal. Normal PRI. Normal QRS complex. Normal axis. ST Segments: elevation in v1, v2, v3, v4 and v5 . T Waves: non specific changes . The study has been independently viewed by me. The study has been interpreted contemporaneously by me. The EKG appears to be a good tracing. Clinical Impression: myocardial infarction anterior when compared to earlier ECG Decision Support: ED Course: 62 y.o. male with hx of HTN and HLD presents with intermittent worsening central burning CP beginning a couple weeks ago now feels constant associated with dizziness today. Initial exam notable for hear regular lungs clear and trace pitting edema. VS reviewed, hypertensive at 171/97, tachycardic at 116 and SPO2 is WNL. DDx includes ACS including STEMI, tension pneumothorax, pulmonary embolism, ruptured esophagus, pneumonia, pericardial tamponade, traumatic hemothorax. 06:26 STEMI activated. Plan to obtain CBC, CMP, troponin and CXR. 06:30 I spoke with Dr. who accepts pt for transfer to cath lab. All transfer paperwork completed. 06:35 Pt suddenly went into V-fib then went into cardiac arrest, one round of compressions was done and he was shocked once into sinus rhythm. We gave magnesium, one ativan then pt's rate increased to 190, so then we shocked at 150 then pt went back to sinus rhythm, and started an amiodarone bolus 150. --magnesium 2 g IV --amiodarone 1.5 mg/mL IV --heparin BOLUS 5,000 Units IV --heparin 1,000 Units infusion IV --amiodarone 150 mg IV --amiodarone 1 mg IV --Ativan 2 mg IV Critical care time was provided for 35 minutes by the attending physician, exclusive of separately billable procedures and treating other patients. This was necessary to treat or prevent further deterioration of the following condition(s) Circulatory failure which the patient had and/or had a high probability of suddenly developing. Labs and Imaging Reviewed: CBC is WNL. CMP shows elevated BUN at 24, elevated CR at 1.32 and hyperglycemia at 155. Troponin is elevated at 0.04. Covid PCR negative. X-RAY of chest, a 1-view study, image reviewed by me, read by radiology, shows: No evidence of acute chest pathology. Diagnosis and Disposition: Impression: 1. Chest pain, unspecified type 2. Ventricular fibrillation seen on cardiac monitor (HCC) 3. Cardiac arrest (HCC) Condition: stable Disposition: Transfer to Hospital to Cath Lab Scribing for and in the presence of, Dr. Dr., personally performed the services described in this documentation, as scribed ED Notes Nurse at 07/15/21 0626 EKG Nurse at 07/15/21 0627 EKG completed and given to dr. Patient brought directly back to room ED Triage Notes Nurse at 07/15/21 0633 Patient presents to the emergency department with chest pain. Patient states he feels like his pain has been going on for a "couple weeks", worse this morning. States he has been taking tums and peptobsimal with no relief. Patient states the pain is sternal and burning in nature. States palpation made his pain worse. States he feels slightly short of breath "no more than normal." Patient skin is warm and dry.

Other Meds: Vitamin D3, Amlodipine

Current Illness:

ID: 1679754
Sex: F
Age: 47
State: CA

Vax Date: 08/05/2021
Onset Date: 08/23/2021
Rec V Date: 09/07/2021
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: No.

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

Symptoms: Shortness of breath, heart fluctuations, tightness of chest and lungs, dizziness, soreness in heart and lungs.

Other Meds: None.

Current Illness: No.

ID: 1679755
Sex: U
Age: 12
State: OR

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/07/2021
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: None

Symptom List: Tremor

Symptoms: Pt gave birthdate a year later than birthdate given in the medical record. Possibility exists pt was 11 instead of 12 years when given first dose of Pfizer.

Other Meds: None

Current Illness: Unk

ID: 1679756
Sex: F
Age: 38
State: WI

Vax Date: 02/23/2021
Onset Date: 02/25/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: EKG, Chest X-ray, Labs - Troponin, D-Dimer

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Woke up in the middle of the night day #2 after my second Moderna vaccine with severe heartburn/chest pain. No history of heart burn/GERD. Could not go back to sleep so severe. Tried Tums. No relief. After hours- pain calmed down. For the next three weeks continued to have chest pain. Worsened with taking a deep breath. Did not keep me from work or ADLs but bothersome because was persistent. After 3 weeks and ongoing intermittent chest pain went to see my MD. MD considered muscular pain or pleuritis. CXR negative. EKG normal. Given one week course of prednisone. Pain continued intermittently after prednisone completed but was starting to dissipate. After week 5 - pain resolved. My thought - Consider myocarditis. More information has since come out regarding Moderna and myocarditis.

Other Meds: MVI

Current Illness: None

ID: 1679757
Sex: M
Age: 70
State: CO

Vax Date: 02/12/2021
Onset Date: 03/25/2021
Rec V Date: 09/07/2021
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: Biopsy negative. 2nd bacterial in culture.

Allergies: Possible allergic reaction to betadyne.

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

Symptoms: Severe Auricular vasculitis and necrosis progressive over 6 months.

Other Meds: HGH

Current Illness: Weird leg wound after reaction to betadyne or fungus

ID: 1679758
Sex: F
Age: 38
State: TN

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

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

Lab Data: Several blood tests to rule out other things. CBC, C reactive protein, ANA, vitamins levels including D3 and magnesium all came back normal. Seeing Neurologist soon.

Allergies:

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

Symptoms: 2nd shot was rough. Took my body about a week to regain strength. Pain was at injection site, with a heavy aweful sensation moving down my left arm, while moving up the left side of my neck into my left jaw bone, and left ear, at the same time, the same sensation moved across both shoulder blades and went into my right arm and down the right arm. Pain set in, and this intense heavy feeling stayed in both my arms for about 2 weeks. I could not lift my arms very well and had a hard time holding on to things. The heavy feeling started leaving left arm, but the right arm took longer. Once the heavy feeling left, this horrible pain set in to my right arm, at different spots. Some days it's more intense than others. It it hard to lift things like a milk jug and pour a cup of milk, or lift laundry out of washing machine. I still have intense right arm pain and just last week the heavy feeling returned to both arms, almost like I have done a million push ups and can't lift them up. I saw my doctor and she asked me to report this.

Other Meds:

Current Illness:

ID: 1679759
Sex: F
Age: 78
State: KS

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/07/2021
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: Penicillin class antibiotics, iodine, sulfa class antibiotics, sucralfate, quinolones, clindamycin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Approximately 8 hours after receiving the booster shot, hives became present all over the body. She took 1 Zyrtec, but there was no relief. Because hives had not let up by the next morning, she took 2 Bendaryl. The Benadryl made the hives tolerable, but the hives are still present (though better) as of 9/7 (4 days post-injection).

Other Meds: metoprolol, Hydrochlorothiazide, Plavix, aspirin, losartan

Current Illness:

ID: 1679760
Sex: F
Age: 64
State:

Vax Date: 02/02/2021
Onset Date: 09/01/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: PCR COVID test was Positive on 9/03 @ Medical center on 9/03/2021

Allergies:

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

Symptoms: Patient tested positive for COVID after completing the Pfizer vaccine series > 14 days prior to illness

Other Meds:

Current Illness:

ID: 1679761
Sex: M
Age: 44
State: OK

Vax Date: 03/30/2021
Onset Date: 06/08/2021
Rec V Date: 09/07/2021
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: Penicilin

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

Symptoms: Constant dull pain with moments of intense sharp pain in elbow and forearm of left arm (injected arm). Loss of grip in left hand, intense pain while gripping or lifting with left arm/hand.

Other Meds:

Current Illness:

Date Died: 08/27/2021

ID: 1679762
Sex: M
Age: 63
State: WV

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: Upon calling emergency services, first responders arrived on the scene and called the Examiners office. They were advised that he had received the covid vaccine earlier in the day; however, they declined sending a ME / coroner and also declined an autopsy even though it was requested by his family and it was an unattended death. His body was then transported to Funeral Home in. The next day, his family requested that the funeral home reach out a second time to the ME office to request an autopsy. The request was denied a second time and the family proceeded with burial. No physician had an opportunity to examine his body. His primary care provider who he hadn't physically seen since January reluctantly signed the death certificate.

Allergies: None

Symptom List: Pain in extremity

Symptoms: Received the vaccine at approx 8:45 am on 8/27. Spent the day at the house with his son and claimed to be feeling totally fine throughout the day. Was last seen alive by his son at 2:30 pm and advised that he felt fine at that time. He was found deceased at 4:00 pm by his son sitting in his workshop with his tools still in his hands and sitting upright.

Other Meds: Finasteride - 5mg (1 per day) - prostate medication Flomax - .4mg (1 per day) - prostate medication Losartan Potassium - 50mg (1 per day) - Blood pressure medication MegaRed - (1 per day) over the counter krill oil for cholesterol Celecoxi

Current Illness: None

ID: 1679763
Sex: F
Age: 50
State: NC

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

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

Lab Data: Pending results of endometrial biopsy.

Allergies: NKDA

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

Symptoms: Postmenopausal bleeding started 17 hours after 2nd dose, lasting 3 days which caused me to go to gynecologist and endometrial biopsy was performed. Currently still having bleeding but not as severe as days 1 and 2.

Other Meds: Allopurinol 100mg Daily

Current Illness: None

ID: 1679764
Sex: F
Age: 67
State: WA

Vax Date: 03/12/2021
Onset Date: 09/03/2021
Rec V Date: 09/07/2021
Hospital: Y

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

Lab Data: COVID status positive on 9/3/21.

Allergies: Amoxicillin

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

Symptoms: Patient received Pfizer COVID vaccine on 2/10/21 and 3/12/21. Patient presented to the ED on 9/3/21 with positive COVID symptoms (nasal congestion, mild cough and loss of taste/smell) for consideration of monoclonal antibody on. In the ED, she was afebrile with normal oxygenation. Patient was not hypoxic and not candidate for targeted treatment such as Remdesivir/Dexamethasone. Patient also did not meet criteria of reduced ability to form immunity in vaccinated individuals to receive REGEN-COV treatment. She was, however, found to be in new onset Afib and was admitted for treatment of Afib with RVR (diltiazem drip). Patient was discharged the next day on 9/4/21.

Other Meds: acyclovir, calcium carbonate, vitamin D, denosumab (Prolia) SQ, diclofenac gel, magnesium, methocarbamol, MVI

Current Illness:

ID: 1679765
Sex: F
Age: 29
State:

Vax Date: 12/23/2020
Onset Date: 09/02/2021
Rec V Date: 09/07/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: PATIENT HAD COVID-19 VACCINE ON Dose 1 date: 12/23/2020, Dose 2 date: 01/12/2021, AND TESTED POSITIVE TO COVID.

Other Meds:

Current Illness:

ID: 1679766
Sex: F
Age: 43
State: NJ

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: CT scan of lungs - negative. Chest x-ray x2 - negative. Test for blood clots - negative. Thyroid panel - normal. CBC/CMP - normal. Lipid panel - normal; Exercise stress test - positive for ischemia

Allergies: latex, contrast dye, rag weed, (dog/ cat) animal dander, histamine, and grass and pollen,

Symptom List: Vomiting

Symptoms: (Immediately) Day 1 - itching and swelling. (Day 1 - 7) - fever, chills, fatigue, shortness of breath, nerve pain/ burning, achy joints and rash. Day 8 -30 - shortness of breath, heart palpitations, chest pain/ pressure nerve pain/ burning, achy joints and rash, malaise, burning soles of feet, headache, dizziness, lightheaded, loss of appetite, sweating and clammy and difficulty sleeping and concentrating. Day 30 to present - heart palpitations, chest pain/ pressure nerve pain/ burning, achy joints and rash, malaise, burning soles of feet, headache, dizziness, lightheaded, loss of appetite, sweating and clammy and difficulty sleeping and concentrating.

Other Meds: Synthroid 0.05 mg

Current Illness: allergic asthma and hypothyroidism

ID: 1679767
Sex: M
Age: 53
State: NV

Vax Date: 09/01/2021
Onset Date: 09/03/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: No

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fever, body aches, shortness of breath, chills and sweats Loss of tastes and weird dreams

Other Meds: Fish oil,Fenofibrate,Zoloft,famotidine,pantoprazole

Current Illness: None

ID: 1679768
Sex: M
Age: 53
State: NM

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/07/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: 9/4/21 4:00AM mild fever 99.6F and soreness at site of injection.; treated with Ibuprofen 9/4/21 12:00PM mild fever, soreness at site of injection and swelling and tender lymph nodes in left armpit 9/5/21 3:00AM moderate fever 100.8F soreness at site of injection and swelling and tender lymph nodes in left armpit 9/5/21 5:00PM no fever, soreness at site of injection and swelling and tender lymph nodes in left armpit 9/6/21 8:00AM no fever, soreness at site of injection and swelling and tender lymph nodes in left armpit 9/7/21 7:00AM no fever, no soreness at site of injection, lymph node swelling decreasing.

Other Meds: Lisinopril, 10 mg/day

Current Illness: none

ID: 1679769
Sex: F
Age: 51
State: FL

Vax Date: 09/03/2021
Onset Date: 09/05/2021
Rec V Date: 09/07/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Right armpit nodules swollen sharp aching pain striking and radiating in armpit towards right breast

Other Meds: Losartan100mg , Remicade IV treatment was on 8/17/2021

Current Illness: None

ID: 1679939
Sex: F
Age: 71
State: WA

Vax Date: 02/01/2021
Onset Date: 05/12/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: Blood work lot ?off?. Put on antibiotics. Ultrasound of abdomen looked clear. Endoscopy & Ct & PET scans.

Allergies:

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

Symptoms: Pain in stomach area & under left ribs. Ultra sound of abdomen, put on antibiotics no certain cause cleared. Possible pancreatitis or uti. Follow up CT scan from last years pneumonia showed new growth in lung. Had PET scan which showed some shrinkage & ?did not glow?. Follow up in 3 mo. - Nov.

Other Meds: Blood pressure meds.

Current Illness:

ID: 1679940
Sex: F
Age: 48
State: KY

Vax Date: 08/28/2021
Onset Date: 08/29/2021
Rec V Date: 09/07/2021
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: red spot that itches at the injection site- no course of action has been taken yet

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am