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: 1682667
Sex: M
Age: 71
State: NY

Vax Date: 03/14/2021
Onset Date: 09/05/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data: COVID-19

Allergies: amoxicillin, cipro, demerol, flagyl

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient admitted to hospital with positive covid-19 diagnosis

Other Meds: unknown

Current Illness: unknown

ID: 1682668
Sex: F
Age: 65
State: PA

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 09/08/2021
Hospital: Y

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

Lab Data: yes

Allergies: iodine

Symptom List: Anxiety, Dyspnoea

Symptoms: couldn't walk, problems with controlling her bowels, urine was coming out when it shouldn't be, had numbness in lower area

Other Meds: trulesity, homeolog, lantus

Current Illness: no

ID: 1682669
Sex: F
Age: 33
State:

Vax Date: 01/27/2021
Onset Date: 09/02/2021
Rec V Date: 09/08/2021
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: Fully vaccinated patient with Covid positive test results.

Other Meds:

Current Illness:

ID: 1682670
Sex: M
Age: 77
State: GA

Vax Date: 01/18/2021
Onset Date: 08/26/2021
Rec V Date: 09/08/2021
Hospital: Y

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

Lab Data: 08/26/2021 PCR+ COVID-19 test at Synergy Laboratories

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Runny nose/Congestion, Cough (new onset or worsening of chronic cough), Fatigue or tiredness, hospitalized

Other Meds:

Current Illness:

ID: 1682671
Sex: M
Age: 78
State: PA

Vax Date: 03/27/2021
Onset Date: 08/30/2021
Rec V Date: 09/08/2021
Hospital: Y

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

Lab Data: SEE BELOW 09/04/21 2341 Respiratory virus detection panel Collected: 09/04/21 2222 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected X-ray chest 1 view Resulted: 09/08/21 0923 Order Status: Completed Updated: 09/08/21 0923 Narrative: XR CHEST 1 VW PORT IMPRESSION: Mild interval increase of right lung pleural and parenchymal opacities with a stable mediastinal shift. Left basilar pleural and parenchymal opacities unchanged. END OF IMPRESSION: INDICATION: follow up chest tube Pneumothorax. TECHNIQUE: AP portable projection of the chest is acquired. COMPARISON: Portable chest dated 9/7/2021. FINDINGS: Right side chest tube and venous port access catheter are stable. Right side mediastinal shift and right lung volume loss remain unchanged. There has been a mild interval increase of the right side atelectasis. Mild left basilar pleural effusion and atelectasis are stable. Negative for pneumothorax. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT chest without contrast Resulted: 09/07/21 1715 Order Status: Completed Updated: 09/07/21 1715 Narrative: CT CHEST WO CONTRAST IMPRESSION: 1. New right pleural drain with moderate surrounding hemoperitoneum in the upper and mid right chest. 2. Persistent moderate loculated right hydropneumothorax and near complete collapse of the right lung. 3. Severe emphysema with small to moderate left pleural effusion. END OF IMPRESSION: INDICATION: Pleural effusion. TECHNIQUE: Helical CT scan of the chest without contrast was performed from the lung apices to below the diaphragm. 3 mm axial reconstruction with MPR coronal and sagittal images were created. CONTRAST: No contrast was administered. COMPARISON: 9/4/2021 FINDINGS: There has been interval placement of a right-sided pleural drain with new surrounding hemoperitoneum in the upper and mid right chest. There is a persistent loculated right-sided hydropneumothorax. The underlying right lung is completely collapsed with layering fluid and mottled contents in the right mainstem bronchus. The heart is shifted to the right chest. There is extensive coronary arterial calcification and atherosclerosis of the aortic arch. Redemonstration of severe diffuse emphysematous change throughout the left lung and a portion of aerated right middle lobe. Small to moderate left pleural effusion again noted. No pericardial effusion. There is a right-sided Mediport catheter which terminates at the junction with the superior vena cava. No axillary, mediastinal, nor hilar adenopathy. Lim

Allergies:

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

Symptoms: ED to Hosp-Admission Current 9/3/2021 - present (5 days) Hospital Hypoxia Principal problem Patient is an 78 y.o. male. Medical history of right hip fracture status post fixation and revision and eventual infection for which she was recently discharged on IV cefepime 2 mg every 12 hours until September 17 by infectious disease he was at rehab getting IV antibiotics when he became short of breath and hypoxic which been going on for about 4 days they Covid swab him and was positive he was sent here to Hospital. Here Hospital's Covid swab was negative he still feeling short of breath he is normally on 4 L nasal cannula he is on that now he initially was on a nonrebreather over at the rehab. Incidentally they did find this right pneumothorax which was there previously they did discuss with CT surgery who did not feel like any intervention was needed they will continue to follow. Patient denies any fevers chills nausea vomit abdominal pain dysuria polyuria diarrhea.

Other Meds:

Current Illness:

ID: 1682672
Sex: M
Age: 63
State: IL

Vax Date: 05/04/2021
Onset Date: 06/15/2021
Rec V Date: 09/08/2021
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: Blood tests several back ex ray

Allergies: Morphine

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

Symptoms: Cough got worse . Night sweats pain in back fatigue. Found I tested positive for tuberculosis Sept 7 2021.

Other Meds: Cbd zinc

Current Illness: High blood pressure overweight

ID: 1682673
Sex: M
Age: 59
State: MI

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

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

Lab Data: Not Reported

Allergies: NKDA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient reports the day of and up to 3 days following vaccination pain with urination. On day of report, patient stated painful urination no longer an issue but headache persisted. Patient states in the past they have had kidney stones but the pain was not similar to the pain they experienced with the stones.

Other Meds: Hydromorphine 4mg Gabapentin 600mg Pantoprazole 40mg Terazosin 10mg Duloxetine 60mg Belbuca 900mcg

Current Illness: N/A

ID: 1682674
Sex: F
Age: 27
State: OH

Vax Date: 03/01/2021
Onset Date: 04/01/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data: Ultrasound.

Allergies: No

Symptom List: Pharyngeal swelling

Symptoms: An inflamed lymph node on my left collar bone.

Other Meds: Birth control

Current Illness: No

ID: 1682675
Sex: F
Age: 28
State: MD

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/08/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: swelling of the tongue.

Other Meds: valacyclovir

Current Illness: soar throat. covid on 08/09/2021

ID: 1682676
Sex: F
Age: 53
State: WV

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

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

Lab Data: i advised patient to go to an urgent care TODAY.

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: patient experienced some normal post vaccine side effects (fever, aches) the day after her vaccine; however, she also experienced tachycardia (HR =120) the day after the vaccine as well. she has had trouble with heart palpitations since.

Other Meds:

Current Illness:

ID: 1682677
Sex: F
Age: 31
State: MI

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

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

Lab Data: no

Allergies: tordal, singular

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

Symptoms: headache persistant since day of Vaccine.

Other Meds: proventil, nuvaring, prenatal vit

Current Illness: none

ID: 1682678
Sex: F
Age: 68
State: NJ

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 09/08/2021
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: Aleve, Flagyl, Benadryl.

Symptom List: Rash, Urticaria

Symptoms: Pain and swelling at the injection site, severe pressure in head, body aches, cold and flu symptoms, temp of 104, Symptoms come and go.

Other Meds: None.

Current Illness:

ID: 1682679
Sex: M
Age: 68
State: KY

Vax Date: 01/25/2021
Onset Date: 09/01/2021
Rec V Date: 09/08/2021
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: No adverse reaction from vaccine. The pt. was a breakthrough case on 09/01/2021 and expired from COVID19 pneumonia on 09/08/2024.

Other Meds:

Current Illness:

ID: 1682680
Sex: F
Age: 33
State: CA

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/08/2021
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: Anaphalactic reaction to Benadryl

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

Symptoms: At approximately 15:20, client received 1st COVID vaccine (Janssen, lot #206A21A exp 09/21) at approximately 15:20. Client received vaccine in a zero gravity chair due to reports of history of dizziness during vaccines. Client remained in zero gravity chair for a 30 minute observation. At 15:35, client reported feeling lightheaded and experiencing left arm pain at injection site. Nurse responded. Client denies SOB, swelling of mouth, tongue, throat; denies itching; client does c/o headache to which she commented "probably because of my anxiety". Client commented "I think I'm feeling lightheaded"; We reclined patient in chair, offered juice and granola bar (client accepted juice, declined granola bar). Client commented "I'm having pain where I was vaccinated". Client is 6 months pregnant, reports a history of asthma and pregnancy-induced hypertension. Client takes Concerta 36mg once daily. Client has severe allergic reaction (anaphylaxis) to Benadryl. Vital assigns were measured: 15:38 - Blood Pressure 148/90; Pulse 70; Respiratory Rate 12 15:55 - Blood Pressure 138/90; Pulse 66, Repiratory Rate 10 Client Alert/Oriented to person, place, time, situation. Client reports feeling anxious about getting the vaccine, commenting "my family is anti-vaccine but I had to come get the vaccine so I could keep working at my job or I'll be out of compliance" and "I think I'm feeling lightheaded because of my anxiety about it". Nurse observed client appearing tearful 3-4 times throughout observation period. At 15:55, client reports lightheadedness resolved, continues to deny shortness of breath, swelling or itching; reports headache resolved. Client reported feeling able to stand and walk. Nurse assisted client to standing position and observed client walking. Client reported she felt ready to leave and safe to drive. Nurse observed client with steady gate out of the vaccine area and down the lobby corridor. Lead nurse provided education to client on when to seek care.

Other Meds: Concerta 36mg once daily

Current Illness: Pregnancy-induced hypertension

ID: 1682681
Sex: F
Age: 73
State: MN

Vax Date: 03/11/2021
Onset Date: 08/31/2021
Rec V Date: 09/08/2021
Hospital: Y

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

Lab Data: COVID-19 PCR Test on 08/31/2021

Allergies: ferrous sulfate, gluten meal, oxybutynin, prednisone, magnesium

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

Symptoms: Patient was admitted as observation status from 08/31/2021-09/01/2021 due to SOB for the last 3-4 days. Also has a cough, hypotention, abdominal pain and dysuria. Given Regeneron.

Other Meds: Singulair, diflucan, amoxicillin, prilosec, vitamin d3, klor-con, zaroxolyn, earelto, bevespi aerosphere, zyrtec, toprol-xl, albuterol HFA, detrol, vitamin b-12, nystatin, detrol LA, kayciel, Duo-neb,

Current Illness: NA

ID: 1682682
Sex: M
Age: 48
State: TX

Vax Date: 09/01/2021
Onset Date: 09/02/2021
Rec V Date: 09/08/2021
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: Also had flu vaccine same time, but unsure of specifics of that shot. Around 24 hours after vaccinations, began to feel lethargic and diarrhea (every hour or so) began. At 36 hours, fever rose to 103. Dizziness caused an overnight fall. Fever (mostly 100-101), weakness, chills, dehydration (received two liters of IV fluids on day 3) and chronic diarrhea continued next six days. On day 7, symptoms (all but occasional diarrhea) subsided.

Other Meds: Lisinopril 20mg, Descovy, Ozempic, multi-vitamin, vitamin D, vitamin E

Current Illness:

ID: 1682683
Sex: F
Age: 45
State: TX

Vax Date: 04/13/2021
Onset Date: 04/18/2021
Rec V Date: 09/08/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data: I saw cardiologist on May 27 about light-headedness, tachycardia, and A-fib events after first dose of Pfizer vaccine. He did bloodwork, Holter monitor EKG, and echocardiogram. Only PACs and PVCs found on tests. All other tests were normal.

Allergies: Benzoyl Peroxide

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

Symptoms: Light-headedness started a few days after first dose and continues to present day. First Tachycardia event April 30. Heart rate at rest was 140 bpm for 45 minutes, Intermittent tachycardia persists to present day. First A-fib event was May 4th. Second A-fib event was May 18. Tachycardia and A-fib events were measure by my Apple Watch. Heart rhythm irregularities continue to present day.

Other Meds: Women?s One A Day Multi-Vitamin

Current Illness: No

ID: 1682684
Sex: F
Age: 54
State: CO

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient arrived to receive Pfizer vaccination. RN obtained new vial of Pfizer vaccine. Lot #301358A Exp Date: 11/2021 Nurse drew 0.3 ml of medication, and confirmed with patient and assisting RN dosage, medication, and vaccine information. RN administered dosage to patient. Patient was given vaccination card and instructed to be monitored for 15 minutes. The administering RN read the Pfizer vial afterwards to discover that the medication should have been diluted with a saline solution. The patient received the concentrated amount of .03 of the Pfizer vaccination. Dr. CMO and OccMed Manager, was notified. The patient was immediately notified of the error, and Dr. closely monitored the patient. The patient declined to go the ED for overnight observation at the advice of Dr. Patient c/o headache and cervical muscle soreness, fatigue, sore throat, left earache, left jaw pain in right arm . 2nd Pfizer vaccine at the discretion of the patient and Dr. Patient has followed up with Occupational Medicine on 09/07/21 with Dr. No work restrictions. OccMed will follow up with patient on 09/20/21.

Other Meds:

Current Illness:

ID: 1682685
Sex: F
Age: 80
State: OH

Vax Date: 02/12/2021
Onset Date: 09/01/2021
Rec V Date: 09/08/2021
Hospital: Y

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

Lab Data: PCR + 9/1/2021 CXR: Findings of mild chronic CHF with trace bilateral effusions. Possible subtle patchy opacities in both lungs. Imaging features can be seen with COVID-19 pneumonia, though are nonspecific and can occur with a variety of infectious and noninfectious processes.

Allergies: ragweed, pollen

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: breakthrough case w/ cough fever, likely complicated by underlying COPD, thigh abscess, cellulitis and sepsis

Other Meds: abilify, ASA, atorvastatin, vit D, cardizem, diphenhydramine prn, docusate, fluticasone/salmeterol, furosemide, synthroid, lisinopril, melatonin, metoprolol, montelukast, MVI, omeprazole, percocet, iron, Kdur, pramiprexole, sertraline, traz

Current Illness: no

ID: 1682686
Sex: F
Age: 65
State: IL

Vax Date: 03/12/2021
Onset Date: 03/19/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data: Urgent care visit 3/19 given steriod pack and has resolved

Allergies: sulfa

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

Symptoms: Week after second vaccine Pitriasis Rosacae.

Other Meds: methotrexate, levothyroxine, amitriptyline

Current Illness: no

ID: 1682687
Sex: F
Age: 48
State: DE

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 9/1- cramping on the top of her stomach, 9/2 and 9/3 the cramping intensified and began to spread throughout her body. On 9/3 she took an antacid and immediately vomited, whole body was cramping, she was unable to bend her fingers and the left side of her face was drooping. hospitalization 9/3- 9/6. Employee stated that her doctor shared that he believed it was a negative reaction to the 2nd vaccination. However, the discharge paperwork states hypertension, hand-tingling and stroke-like symptoms.

Other Meds:

Current Illness:

ID: 1682688
Sex: M
Age: 78
State: FL

Vax Date: 03/04/2021
Onset Date: 03/12/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data: X-Ray

Allergies: Sulfa

Symptom List: Unevaluable event

Symptoms: Numbness in left arm, tingling in fingers.

Other Meds: Blood pressure

Current Illness: No

ID: 1682689
Sex: F
Age: 34
State: MN

Vax Date: 12/29/2020
Onset Date: 08/28/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Tested positive for covid, has been fully vaccinated

Other Meds:

Current Illness:

ID: 1682690
Sex: M
Age: 78
State: AR

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

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

Lab Data: PCR test positive on 09/07/2021. Hospitalized on 09/07/2021

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Developed Covid-19 after complete vaccination

Other Meds:

Current Illness:

ID: 1682691
Sex: F
Age: 32
State: OR

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Breakthrough menstrual bleeding. 24 hours. Light flow

Other Meds: Lutera

Current Illness:

ID: 1682692
Sex: M
Age: 47
State: WI

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/08/2021
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: Client came to a public vaccination clinic. On his administration form he marked that he had not received any COVID-19 vaccinations and was looking to get Johnson and Johnson. After he had left the clinic, and we were entering his vaccination, we noticed that he had received both of his doses of Moderna in February and March.

Other Meds:

Current Illness:

ID: 1682693
Sex: F
Age: 45
State: TX

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/08/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: 45-year-old female received her second dose of the Covid-19 vaccine mRNA Moderna on September 03, 2021. On September 03, 2021, the patient stated she felt dizzy after vaccine. Patient also complained of feeling very sore on her right arm after receiving vaccine and was in pain. Patient was given acetaminophen 325mg and recommended to rest. On September 07, I spoke with health care provider who state that patient is doing okay, and pain related to COVID-19 vaccine has resolved.

Other Meds:

Current Illness:

ID: 1682694
Sex: F
Age: 31
State: MN

Vax Date: 08/26/2021
Onset Date: 08/31/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Muscle spasms, facial nerve tingling, burning sensation on face and scalp, rapid heart rate

Other Meds: Magnesium

Current Illness:

ID: 1682695
Sex: F
Age: 42
State: NY

Vax Date: 03/09/2021
Onset Date: 07/10/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data: No

Allergies: CEQUA; PRAZOLE

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

Symptoms: I developed a condition a autoimmune disorder to the sun which is a ongoing chronic condition. When I'm exposed to sun my neck and chest break out.

Other Meds: NUVARING; sertraline; compound Q4Q3 thyroid; CLARITIN; probiotic; elderberry; vit C; vit D; B12; zinc

Current Illness: No

ID: 1682696
Sex: F
Age: 69
State: PA

Vax Date: 03/20/2021
Onset Date: 08/30/2021
Rec V Date: 09/08/2021
Hospital: Y

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

Lab Data: 09/02/21 1014 Respiratory virus detection panel Collected: 09/02/21 0901 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detect

Allergies:

Symptom List: Nausea

Symptoms: ED to Hosp-Admission Discharged 9/2/2021 - 9/4/2021 (2 days) Acute on chronic respiratory failure with hypoxia COVID-19 virus infection Acute on chronic systolic heart failure Presenting Problem/History of Present Illness/Reason for Admission COPD exacerbation [J44.1] Acute respiratory failure with hypoxia [J96.01] Acute on chronic respiratory failure with hypoxia [J96.21] Pneumonia due to COVID-19 virus [U07.1, J12.82] Hospital Course Pt. is an 70 y.o. female from home with history of CAD, O2 dependent COPD, CAD with stents, CVA, hypertension, hyperlipidemia, tobacco abuse, who presented to the ED via EMS with progressive d

Other Meds:

Current Illness:

ID: 1682697
Sex: M
Age: 70
State: OH

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

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

Lab Data: PCR + 9/7/2021 when planning dc to SNF following hospitalization for hip fx

Allergies: nkda

Symptom List: Injection site pain

Symptoms: breakthrough + but asymptomatic

Other Meds: albuterol, atorvastatin, budesonide/formoterol, metformin, MVI, senna, trazodone

Current Illness: no

ID: 1682698
Sex: M
Age: 37
State: CA

Vax Date: 02/05/2021
Onset Date: 02/25/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data: evaluated by dermatology. given meds to treat shingles.

Allergies: none

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

Symptoms: suddenly got shingles. unknown if related to vaccine. no history of shingles. No other know side effects. I still have a rash on my upper right arm at the injection site and rash on my right forearm that look like an old bruise that has not gone away.

Other Meds: none

Current Illness: none

ID: 1682699
Sex: M
Age: 37
State: MA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: All vitals with-in normal limits

Allergies: Amoxicillin, Ceftin, Clonidine, Depakote, Penicillin G Benzathine, Serraline

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

Symptoms: Approximately 10 minutes after injection patient's face became flushed, she then complained of being very tired. Patient acting lethargic. Patient after juice and laying down unable to keep awake .

Other Meds: Prozac 20mg, Ativan 0.5mg, Trileptal 150mg , Albuterol sulfate 108MCG/act

Current Illness: N/A

ID: 1682700
Sex: F
Age: 19
State: IN

Vax Date: 08/18/2021
Onset Date: 08/25/2021
Rec V Date: 09/08/2021
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: Patient states that about one week after vaccination she noticed tingling / weakness in her pinky and ring finger which radiates to her arm. Today is three week out and patient state it still is bothersome. Recommended patient not take 2nd dose until reviewed with a healthcare provider.

Other Meds: None

Current Illness: None

ID: 1682701
Sex: F
Age: 19
State: WV

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

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

Lab Data: 8/31/2021 EKG, cat scan with contrast, chest x-Ray, blood work, Nasal Covid test, rescue inhaler, oxygen, IV for dehydration.

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Headache, blacked out, throwing up to severe dehydration, chest pain, shortness of breathe, diarrhea, rash on arm of injection, caused issues with menstrual cycle

Other Meds: Low-ogestrel-28

Current Illness: None

ID: 1682702
Sex: F
Age: 50
State: KY

Vax Date: 02/24/2021
Onset Date: 03/01/2021
Rec V Date: 09/08/2021
Hospital: Y

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: Platelet Count 9/20 236 3/21 94 6/15/21 103 7/10/21 29 7/20/21 21 8/19/21 2

Allergies: rabeprazole, aspirin, erythromycin, minocycline, tetracycline, colestid, hydrochlorothiazide/triamterene, Glucophage, amlodipine

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

Symptoms: Patient is a 51-year-old lady with a past medical history of hypertension, GERD, anxiety, obesity who presented initially with thrombocytopenia. 92K in April/May 2021. She had previously had normal platelet counts in February 2021. She did not have any medication changes during the time but did note receiving the Covid?19 vaccination in January/February of this year. She has not had any easy bleeding or bruising but had noticed increased petechiae. Initially her platelet counts were watched until she trended down to 29K in July 2021. At that time she was started on pulse dose dexamethasone 40 mg x 4 days. She states that initially her petechiae went away however after about 3 days of being off the steroids she noticed the petechiae returning. She subsequently had a CBC checked which was notable for a platelet count of 2K on 8/19/2021. She was transfused 2 units of platelets . Given her severe thrombocytopenia she was admitted on 8/20/2021 to continue high-dose steroids as well as initiate IVIG and rituximab therapy. She initially had treatment response with a platelet count of 138K on 8/26/2021. She continued outpatient rituximab and has since completed 3 doses. She was started on a steroid taper and then started to have worsening petechiae on 9/3/2021. She had a CBC checked at that time which was noted for platelet count of 9K. Her steroids were increased at that time however she continued to have fatigue and petechiae and recheck CBC on 9/7/2021 was notable for platelet count of 1K. She was admitted and has started back on pulse dose Solu-Medrol and was given 2 units of platelets 9/8 with improvement of her platelet count of 26K. She overall feels well and denies any unexplained fevers, chills, headaches, chest pain, palpitation, shortness of breath, cough, nausea, vomiting, diarrhea, weakness/fatigue. Has noticed some easy bruising as well as some mild vaginal bleeding over the past 24-48 hours.

Other Meds: alprazolam, cetirizine, escitalopram, hydrochlorothiazide, metoprolol, omeprazole

Current Illness: none

ID: 1682703
Sex: F
Age: 40
State: TX

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

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

Lab Data: Temp 98.2 F

Allergies: None

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

Symptoms: About 2 weeks after receiving the vaccine, patient noticed a rash at the site of injection that was itchy and warm to touch. She applied an ice pack but no relief.

Other Meds: None

Current Illness: None

ID: 1682704
Sex: F
Age: 51
State: MD

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data: x-rays- found arthritis in a certain place in the clavicle area. The vaccine probably woke up a lot of preexisting conditions that were probably there. CT scan of my head

Allergies: amoxicillin; latex; iodine; penicillin; oxycodone; anything with sulfa; hydrochlorides; any adhesives; shellfish; pork; bananas; certain types of medical tape; levofloxacin; seasonal allergies; grass, mold, leaves, trees

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: On 06/25/2021 a couple of minutes after my vaccination. I started having reflex up and the muscles in my face started going numb, The muscles around my neck started getting really tight. my face started going numb, mostly on my right side. It was predominantly on the right side of my face. I gave myself Benadryl and Tylenol it helped within a few hours and relaxed my body. Within a few days later, I started having tremors. At the movies my legs and feet started moving, I started having involuntarily moving and shaking on my legs and feet. In the same week I started having issues on my left shoulder. Like it started shaking and grabbing., a weird sensation. I am having problems with my wrist and nerve pain down my arms. I went to the ER on 07/16/2021, I went to Hospital. I was having pain from my left arm down to my wrist, a little on the right, but mostly on my left where I had my vaccine. They did x-rays and evaluated me. They did a CT scan of my head. I was evaluated in the ER for over 24 hours. 3 weeks afterwards, I went to see my doctor, he gave me cortisone shots to calm down the spasms on my back. I still have spasms on my back, shoulders and wrist. I am still being monitored.

Other Meds: valsartan (Diovan) 80 mg bd; prilosec ; nose spray for allergies; vitamins; eye drops in my eyes to keep them moist; vitamin -D 50000; hydrocortisone for my hands; tylenol and Advil for pain as needed; inhaler for allergy asthma as needed

Current Illness: no

ID: 1682705
Sex: M
Age: 54
State: PA

Vax Date: 08/28/2021
Onset Date: 08/29/2021
Rec V Date: 09/08/2021
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:

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

Symptoms: Severe pain in left foot

Other Meds:

Current Illness:

ID: 1682706
Sex: F
Age: 56
State: NY

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 09/08/2021
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: Mushroom

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

Symptoms: Patient stated that after getting vaccination she had a light headache. The next day the headache got worse. She also noticed that her left foot is swollen. If she lifts anything she get light headed. Walking up stairs she is out of breath. She has a pin in the left arm like a stiff heaviness.

Other Meds:

Current Illness:

ID: 1682707
Sex: M
Age:
State: FL

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

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

Lab Data:

Allergies: Unavailable

Symptom List: Pain in extremity

Symptoms: Pt began to feel lightheaded. He stated that his heart was beating fast and that his lips and hands were tingling. Pt was alert the entire time. EMS was called pt was evaluated pt decided to remain in the store and wait for his wife after EMS evaluated him and found no medical emergency.

Other Meds: Unavailable

Current Illness: Unavailable

ID: 1682708
Sex: M
Age: 50
State: FL

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/08/2021
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: Symptoms started around 3-4 hours after vaccine, dizziness with mild vertigo. Led to vomiting due to severe vertigo whenever he moved. Proceeded to vomit uncontrollably for about 12 hours afterwards, tried meclizine and Pepcid to help with no real relief. Vomiting stopped after that, but still had profound dizziness leading to inability to get up, walk in a straight line or drive. This continued for several days, he went to MD on 9/7 and they did a physical exam and determined that the vertigo was vestibular neuritis due to the immune response he had to the vaccine. Started Medrol dose pak and Valium 2mg on 9/7, feeling minimally better but still unable to move much or drive.

Other Meds: none

Current Illness: cold/seasonal allergies earlier in the month

ID: 1682709
Sex: F
Age: 48
State: NY

Vax Date: 08/13/2021
Onset Date: 08/15/2021
Rec V Date: 09/08/2021
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: azithromycin, penicillin, sulfa, Levaquin, oxycodone, acetaminophen,

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

Symptoms: I started having Fever and chills, by Sunday morning I was mess I was over hydrating. The first place I notice when I'm having allergic reaction is my inner arms, started pink, then went to a rash to hives, and it spread like wildfire went to both arms, my stomach, my back just progressively started going all over my body. I went to Well Now Urgent Care, they gave me benadryl sent you home. I was worried about my airway so I went to my doctor 2 days later, High prednisone for 14 days. It helped, every once in a while the pink comes back on my arms. Dr. recommended to get the booster.

Other Meds: Aciphex, xyzal, Zofran, Meclizine, Scopolamine, Ambien, proair, Nucynta, Conopid, lexapro, aspirin, magnesium, biotin, zinc, hair growth supplement, elderberry, motrin

Current Illness:

ID: 1682710
Sex: M
Age: 72
State: CA

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/08/2021
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: Swollen tongue, unclear speech

Other Meds:

Current Illness:

ID: 1682711
Sex: M
Age: 63
State: SC

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data: Blood work

Allergies: Sulfa drug, Peanut, Seafood, Caffeine, Red dye

Symptom List: Vomiting

Symptoms: I experienced jittery, nervous, heart palpitations, trouble breathing, brain fog, and fatigue.

Other Meds: Zanax

Current Illness: No

Date Died: 09/08/2021

ID: 1682712
Sex: M
Age: 78
State: SC

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

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Approx 14 hours post-vaccination, patient's wife awoke to her husband struggling to breath. EMT was called, and he was transported to the hospital ED and passed away. ED physician believed death was related to CHF and not directly related to the Moderna vaccine.

Other Meds:

Current Illness:

ID: 1682713
Sex: F
Age: 59
State: MI

Vax Date: 06/07/2021
Onset Date: 06/21/2021
Rec V Date: 09/08/2021
Hospital: Y

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

Lab Data: Ekg blood work , ultra sounds echocardiogram

Allergies: no

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

Symptoms: Patient had a heart attack and enlarged heart .

Other Meds: no

Current Illness: no

ID: 1682714
Sex: F
Age: 46
State: AZ

Vax Date: 08/18/2021
Onset Date: 08/20/2021
Rec V Date: 09/08/2021
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: FLU shot

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Itching hives , sever rash all over , anxiety cough and chest congestion fever , bone ache

Other Meds: aspirin 81 m Vitamin D3 50 mcg (2,000 unit) capsule atorvastatin 10 mg tablet Xanax 0.5 mg tablet valsartan 160 mg tablet amlodipine 5 mg tablet ibuprofen 600 mg tablet

Current Illness: none reported

ID: 1682715
Sex: F
Age: 41
State: AZ

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

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

Lab Data:

Allergies: Tramadol; Varicella vaccination (unknown component)

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

Symptoms: Same day nausea, headache, dizziness, GI upset. Second day full body aches, general malaise, sore arm. 9/2 - menstrual cycle started (irregular, not expected for another week) and changes in mensuration 9/8 - Cold sore appeared again (just had one about two weeks prior to vaccination, normally YEARS in-between outbreaks)

Other Meds: Nexium

Current Illness: Cold sore - treated with one round of Acyclovir and OTC Abreva

ID: 1682716
Sex: M
Age: 49
State: OR

Vax Date: 09/01/2021
Onset Date: 09/02/2021
Rec V Date: 09/08/2021
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: penicillin

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

Symptoms: Symptoms started 24 hours after injection (Thursday evening) and lasted 48+hours (Sunday afternoon). Swelling of lymph node under left arm (armpit) (same arm as the injection) - Swelling was visibly noticeable, made it difficult (some pain) to put arm down at side of body. Treated with acetaminophen 2 extra strength tablets every 4-6 hours to manage the discomfort. Continued taking acetominophen from Friday thru Sunday. This seemed to make the discomfort manageable. Had other more minor side effects: 1- fatigue started Friday and lasted until Sunday 2. chills started on Thursday night and lasted for 24 hours 3. sore arm - started Wednesday night and lasted through Thursday

Other Meds: lovastatin 40 mg, sulfasalazine (200mg/day), olumiant 2mg/day, hydroxyclorquine 200mg/day, doxycycline 200mg/day, pimecrolimus 1% (applied in am on face), azelaic acid 15% (applied evening to face), methotrexate 8 tablets 1x/week, folic

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am