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: 1685767
Sex: M
Age: 27
State: DE

Vax Date: 08/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/09/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever, flu, vomiting, aches, dizziness, heart racing, weakness of the body, shortness of breath

Other Meds: None

Current Illness: Nine

ID: 1685768
Sex: F
Age: 71
State: WA

Vax Date: 01/28/2021
Onset Date: 05/18/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: Cat Scan .... normal

Allergies: Gluten sensitivities

Symptom List: Anxiety, Dyspnoea

Symptoms: Headaches usually early am more of head pressure. Coming and going but lasting most of the day

Other Meds: Metoprolol 12.5 mg Multi suppliment 1000mg. Lupe-Spherical vitaminC CoQ10 Omega 3. Calcium

Current Illness: None

ID: 1685769
Sex: F
Age: 37
State: OH

Vax Date: 08/03/2021
Onset Date: 08/14/2021
Rec V Date: 09/09/2021
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: Visited dermatologist 9/8/2021; diagnosed with immune response to vaccine

Allergies: Nickel, bacitracin, cats

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

Symptoms: 10 days after first vaccination, itching, burning rash on forearms and hives/itching around knees, ankles, and hands. Lasted 7-10 days then cleared. Recurred in same areas within 24 hours of second vaccine dose.

Other Meds: None

Current Illness: None

ID: 1685770
Sex: F
Age: 44
State: MA

Vax Date: 03/06/2021
Onset Date: 07/24/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: MRI -08/12/2021 to eliminate MS- results were normal

Allergies: no

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: On 07/24/2021, just if I were turning around on a bench I would get really dizzy and was not able to stand up. When I did stand up I was dizzy. I only threw up one time. It's more when I bend down and I stand up, I get dizzy. Some days I wake up feeling dizzy and on those days I walk crooked, but the days are inconsistent. On 07/28/2021 at 01:00 PM I went to see a doctor, she had me stand with my feet close together and had my hands down my thighs and across my chest and I was like sweaty, and with my eyes closed and I was even more sweaty. She had me my head quickly side to side and up and down and that made me feel dizzy. She diagnosed me with vertigo. She also had me do vestibular physical therapy, once a week for 4 weeks and then they will reassess. The vestibular PT is helping. I would say I have recovered 60 % from the AE's. I am feeling positive that the vestibular PT will end the symptoms. I have never had any dizziness prior to the vaccination.

Other Meds: vitamin D od; melatonin od; magnesium od; levothyroxine 125mcg od; lisinopril hctz 120-125 mg tablets od; bupropion hcl xl 300 mg od; pravastatin sodium 40 mg od; Lexapro 20 mg od

Current Illness: no

ID: 1685771
Sex: F
Age: 41
State: TX

Vax Date: 07/23/2021
Onset Date: 08/30/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: Positive covid test 08/31/2021

Allergies: Pencilin

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

Symptoms: Got covid 19 Allergy like symptoms, aches, loss of taste and smell

Other Meds: Lo loestrin Low dose naltrexone NP thyroid Vitamin d3 Quercitin B12 Omega 3 Neprinol

Current Illness:

ID: 1685772
Sex: M
Age: 73
State: CA

Vax Date: 06/10/2021
Onset Date: 06/12/2021
Rec V Date: 09/09/2021
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: positive troponin, coronary angiogram: no new disease, echo 55% EF

Allergies: GABAPENTIN

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

Symptoms: right chest wall pain -- started 2days after 2nd shot -----persisted and in ER on 08/31/2021, dx of non-st myocardial infarction . there had been no change in symptoms. echocardiogram OK and symptoms have improved

Other Meds: ATORVASTATIN, LOSARTIN, BUPRENORPHINE, ASPIRIN, lINCESS

Current Illness: NO

ID: 1685773
Sex: F
Age: 36
State: ID

Vax Date: 05/20/2021
Onset Date: 06/15/2021
Rec V Date: 09/09/2021
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 developed numbness and tingling in feet followed by weakness. Nerve conduction and EMG showed evidence of a sensory neuropathy with absent sural response and prolonged F-waves. Lumbar puncture did not show elevated protein or cells. Her symptoms have persisted since June. She has been unable to return to work. She packs and ships orders. She is recovering her strength with physical therapy and plans to return to work in October.

Other Meds: Gabapentin

Current Illness:

ID: 1685774
Sex: F
Age: 50
State: TX

Vax Date: 08/28/2021
Onset Date: 08/30/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: no

Allergies: no

Symptom List: Pharyngeal swelling

Symptoms: I had a little bit of a headache and my right arm where the injection is - was kind of hurting a little bit (which is a normal reaction to the vaccine). Also, I had a little bit of fatigue. Those symptoms lasted a day or two. Those symptoms did come back - came and went - but they are not doing that anymore. I just let it pass - as far as letting symptoms run it's course- no treatment.

Other Meds: High blood pressure medicine Lisinopril; Ciprilapram - for anxiety and depression; Prednisone for arthritis

Current Illness: no

ID: 1685775
Sex: M
Age: 61
State: OR

Vax Date: 08/12/2021
Onset Date: 08/16/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data: Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago Troponin T 0.00 - 0.03 ng/mL <0.01 Encounter Summary Related to Troponin T Component 08/24/21 08/24/21 08/12/21 08/05/21 07/19/21 06/05/21 Troponin T <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 Contains abnormal data Sedimentation rate, automated Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago Sed Rate 0 - 25 mm/hr 31 High Encounter Summary Related to Sedimentation rate, automated Component 08/28/21 08/25/21 08/24/21 08/21/21 07/19/21 Sed Rate 121 High 96 High 31 High >140 High 46 High Contains abnormal data C-Reactive Protein Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago CRP 0.00 - 0.74 mg/dL 5.38 High Encounter Summary Related to C-Reactive Protein Component 08/28/21 08/27/21 08/25/21 08/24/21 08/17/21 07/19/21 CRP 10.80 High 9.49 High 7.37 High 5.38 High 16.20 High 3.65 High Contains abnormal data RENAL FUNCTION PANEL Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago Sodium 135 - 147 mmol/L 135 Potassium 3.5 - 5.0 mmol/L 4.1 Chloride 96 - 108 mmol/L 102 CO2 22 - 32 mmol/L 23 Calcium 8.6 - 10.6 mg/dL 8.8 Glucose 82 - 115 mg/dl 102 Creatinine 0.7 - 1.2 mg/dL 0.7 BUN 8 - 20 mg/dL 21 High Albumin 3.5 - 4.8 g/dL 3.0 Low Phosphorus 2.4 - 4.7 mg/dL 3.3 Anion Gap 7.0 - 16.0 mmol/L 10.0 eGFR >60 mL/min/1.73m? >60 Encounter Summary Related to RENAL FUNCTION PANEL Component 08/31/21 08/28/21 08/25/21 08/24/21 08/22/21 08/21/21 Sodium 138 136 138 135 137 140 Potassium 3.9 3.8 4.4 4.1 4.3 4.0 Chloride 101 103 104 102 103 105 CO2 22 23 23 23 24 23 Calcium 9.1 8.6 8.9 8.8 8.9 8.9 Glucose 160 High 119 High 168 High 102 160 High 132 High Creatinine 0.8 0.7 0.8 0.7 0.6 Low 0.7 BUN 18 20 23 High 21 High 20 17 Albumin 3.4 Low 2.9 Low 3.2 Low 3.0 Low 2.9 Low ? Phosphorus ? ? ? 3.3 4.0 ? Anion Gap 15.0 10.0 11.0 10.0 10.0 12.0 eGFR >60 >60 >60 >60 >60 >60 View all related data Contains abnormal data Antinuclear Antibodies, HEp-2 Substrate, IgG, Serum Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago Comments Antinuclear Ab, HEp-2 Substrate, S <1:80 (Negative) Positive 1:160 Abnormal -------------------ADDITIONAL INFORMATION------------------- Method: Immunofluorescence using HEp-2 cellular substrate. ANA Titer 1:160 ANA Pattern Speckled Encounter Summary Contains abnormal data CBC (Hemogram) no Auto Diff Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago WBC Count 4.0 - 10.0 k/mcL 13.7 High RBC 3.90 - 5.80 M/mcL 3.76 Low HGB 13.0 - 17.3 g/dL 10.8 Low HCT 38.0 - 51.0 % 33.7 Low MCV 81.0 - 95.0 fl 89.6 MCH 26.5 - 34.0 pg 28.7 MCHC 32.0 - 36.0 g/dL 32.0 RDW 11.5 - 15.0 % 13.4 Platelets 140 - 450 k/mcL 479 High MPV 9.4 - 12.4 fl 8.4 Low Encounter Summary Related to CBC (Hem

Allergies: nkda

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: crippling polyarthritis and polymyalgia's with elevated inflammatory markers.

Other Meds: amlodipine, asa, symbicort, metoprolol, atorvastatin, nitroglycerin, clobidogrel , singulair

Current Illness: CAD, asthma, obesity

ID: 1685776
Sex: F
Age: 55
State:

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

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

Lab Data: None, have no medical doctor

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Tingling in legs and arms and back of neck, feeling of needles in legs and arms, headache, frequent urination every 15 minutes that started 3 hours after vaccination and continues now which it has been 8 hours now since the vaccine, numbness in checks, burning soar throat, mucus feeling in throat making it hard to swallon, depression, difficulty breathing upon minor exertion such as walking about 500 square feet.

Other Meds: None

Current Illness: None

ID: 1685777
Sex: F
Age: 53
State: CA

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

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

Lab Data:

Allergies: several severe allergies

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

Symptoms: Body aches, migraine, break out over entire body. dizzy and extreme exhaustion for 6 days

Other Meds: n/a

Current Illness: HTN

ID: 1685778
Sex: M
Age: 59
State: SD

Vax Date: 03/21/2021
Onset Date: 03/25/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: Images of my heart, breathing tests, etc.

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Symptoms started 3-4 days after vaccine. Began by having rapid, violent coughs. It then progressed into a shortness of breath. I would walk very short distances (50 steps) and then would have to sit for two hours to try to catch my breath. If felt during that time like a pneumonia. Very shallow breathing and difficulty speaking.

Other Meds: Valsartan 80 mg, muti-vitamin, zinc

Current Illness: None

ID: 1685779
Sex: M
Age: 66
State: FL

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/09/2021
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: DIZZINESS AND NAUSEA/VOMITING 1 HOUR AFTER RECEIVING DOSE

Other Meds:

Current Illness:

ID: 1685780
Sex: F
Age: 27
State: CA

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

Allergies: Penicillin, Amoxicillin, Toradol, Morphine, Ibuprophen, Pfizer

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

Symptoms: Moderna COVID-19 Vaccine EUA Patient came to vaccine clinic with her family member and received J&J vaccine at 1245. I took her to the back room to observe her for 30 minutes. She reported history of anaphylaxis to Pfizer in January of 2021. I took her vitals at 1253. BP 119/64; HR 96, SpO2 97 % on RA. At 1301 she reported difficulty breathing. I administered 3 mg of Epi via left lateral thigh. Vitals after first dose of Epi was: BP 120/63; HR 91, SpO2 99% on 6 liters via nasal cannula. Patient reported that her breathing was getting better. At 1310 patient stated that she was having difficulty swallowing her saliva. I administered 50 mg IM Benadryl. I called Dr.and reported patient had Anaphylaxis and was not improving. Dr. and his team came right away. Nurse called urgent care. Nurse called emergency services. At 1315 second dose of Epi was given. Vital signs at 1318 were BP 92/73; HR 111, SpO2 100% on 6 liters via nasal cannula. She was shivering and coughing out phlegm. Silver blanket was applied to keep patient warm. At 1320 the third dose of Epi was given and patient reported some relief. Paramedics came around 1325. Patient BP was 160/100. Patient had two episodes of nausea and vomiting. She was taken to Medical Center via ambulance. Nurse manager was notified.

Other Meds: During the code the patient's family member stated that she used an inhaler. She has a history of Asthma and bronchitis.

Current Illness: Asthma, Bronchitis

ID: 1685781
Sex: M
Age: 51
State: MN

Vax Date: 02/11/2021
Onset Date: 09/01/2021
Rec V Date: 09/09/2021
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: tested positive after covid vaccine

Other Meds:

Current Illness:

ID: 1685782
Sex: M
Age: 53
State: FL

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

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

Lab Data: None as of this date. I will be seeking more medical care next week when I see my Primary Care doctor.

Allergies: medication allergies: Penicillin, Cipro, Levaquin, Clindamycin.

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

Symptoms: Severe pressure headache in back of head; peripheral neuropathy in lower legs; weakness in arms and legs; night sweats; cognitive deficiencies; nausea. Treatments have consisted of Tylenol and Meloxicam anti-inflammatory medication. While some symptoms have somewhat decreased over the past 10 days, headache, peripheral neuropathy, fatigue, and body weakness have remained.

Other Meds: Vitamin C, Vitamin D, Super Vitamin B-Complex, Zinc, probiotic, multi-vitamin

Current Illness: None

ID: 1685783
Sex: F
Age: 39
State: IL

Vax Date: 05/22/2021
Onset Date: 05/31/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data: As above, admitted on 5/31/21

Allergies: none

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

Symptoms: 9 days after vaccine, presented to ER with syncopal spells. Workup revealed reduced ejection fraction from dilated cardiomyopathy EF 30-35%, uncontrolled diabetes with glucose >500, A1c 11.3, and hypothyroid TSH 12.7. Brain CT was negative for any acute findings.

Other Meds: Aspirin, levothyroxine, sumatriptan

Current Illness: none

ID: 1685784
Sex: M
Age: 24
State: IA

Vax Date: 03/28/2021
Onset Date: 08/27/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Heart palpitations for several days in a row. Specifically premature atrial contractions.

Other Meds: N/A

Current Illness: N/A

ID: 1685785
Sex: F
Age: 50
State: FL

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

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

Lab Data: N/A

Allergies: Allergic to Iodine and All fish

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: When I was given vaccine, in that moment I became flush and felt as if I would pass out. It only lasted seconds and I was fine. Within a couple hours I became extremely tired. For the next two weeks I was overly tired. I can only liken it to being pregnant. At midpoint of the day I was extremely exhausted and couldn't keep my eyes open. I did not seek any treatment as being tired didn't seem to be an extreme enough side affect.

Other Meds: Estradiol .5mg 1X a day Zolpidem 10mg 1X a day Fiorcette 2 every 6 hours as needed for migraines Vitamin D, C, E, B

Current Illness: N/A

ID: 1685786
Sex: M
Age: 71
State: WA

Vax Date: 03/02/2021
Onset Date: 03/13/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: ENT referral on 6/11/21 with MRI of brain on 7/12/21 with no abnormal findings

Allergies: None

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

Symptoms: Loss of taste 10 days following second dose of Moderna COVID-19 vaccine. For 10 days after second dose he experienced heightened taste and then overnight he loss all sensation of taste. Several weeks prior to his 3rd dose of Moderna on 8/16/21 he had noticed some improvement in taste. On 8/17/21 pt lost all taste again. Pt states history of some decreased taste and smell months prior following a tooth extraction.

Other Meds: Allopurinol 100 mg BID, aspirin 81 mg EC daily, B Complex-C, citalopram 10 mg daily, doxazosin 4 mg 1.5 tablets nightly, Lantus 100 units/mL injection 35 units nightly, lisinopril 10 mg daily, metformin 1000 mg BID, pravastatin 20 mg nightl

Current Illness: Headache with some decrease in sensation of taste and smell following tooth removal months prior but sense had returned prior to vaccination.

ID: 1685787
Sex: M
Age: 66
State: CA

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 09/09/2021
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: None.

Allergies: None.

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

Symptoms: On 1/13/2021, I received my first dose of the Moderna vaccine. On1/23/2021, I developed a rash at the injection site, which went away within 10 days. On 2/13/2021, I received the second dose. On about 2/20/2021, I developed a rash over various parts of my body. They look like spider bites and are pimple-like bumps filled with clear liquid. It looked like acne, but the bumps had no pus. The bumps would pop up from nowhere in random places. Every part of my body has been affected at some point, save for the palms of my hands, the soles of my feet, and my genital area. My face has mostly been unaffected, though I have had a few bumps on my nose. I went to my PCP, and I was referred to a dermatologist. The dermatologist gave me steroidal cream. The bumps would disappear after a few days when I put the cream on them. To this day, I still have bumps that pop up, and I treat them with the cream the dermatologist gave me.

Other Meds: Costco Multivitamins; CQ10; Simvastatin; Omeprazole

Current Illness: None.

ID: 1685788
Sex: M
Age: 58
State: NC

Vax Date: 03/03/2021
Onset Date: 03/06/2021
Rec V Date: 09/09/2021
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: Unevaluable event

Symptoms: Excess Fatigue Reduced Stamina Cognitive Problems - Memory, Organization Hearing deficit Severe Allergic Reaction to Poison Oak

Other Meds: Mydayis 25 mg Vitamin C, D, E, One a Day CoQ10

Current Illness:

ID: 1685789
Sex: F
Age: 48
State: TX

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 09/09/2021
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: none

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

Symptoms: Weekly Migraines from 4/24/2021 through the end of June 2021 when I had my Neurologist give me a shot to stop them. I am still getting them at least once per month. I also had menstrual bleeding for one day. I have not had my period in almost three years after an uterine ablation stopped my periods completely.

Other Meds: Singulair and Zyxal

Current Illness: none

ID: 1685790
Sex: M
Age: 29
State: UT

Vax Date: 08/02/2021
Onset Date: 08/11/2021
Rec V Date: 09/09/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Heart pounding for several beats then softly for several beats. Light headed, felt like I was going to pass out. Chest pain that felt like a cramp under my left pec. Couldn't catch my breath, very forced breathing like I couldn't just go on autopilot with my breath, i had to force each one to be very deep and deliberate.

Other Meds: Adderall

Current Illness: None

ID: 1685791
Sex: F
Age: 76
State: OH

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

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

Lab Data: Xray right hip and leg results showed no fracture

Allergies: penicillin streptomycin codeine shellfish pineapple

Symptom List: Injection site pain, Menorrhagia

Symptoms: weakness in right hip and leg. Xray showed no problem. Physical therapy with no good outcome

Other Meds:

Current Illness:

ID: 1685792
Sex: F
Age: 56
State: NC

Vax Date: 08/31/2021
Onset Date: 09/01/2021
Rec V Date: 09/09/2021
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: egg /milk/grasses /peanut/ some sinus meds and a muscle relaxer i cant remember the name

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

Symptoms: 103.7 fever 3 days / swollen arm 4 days/ every joint muscle in exstreme pain 3 days/ fatigue all day for 4days alternated tynol and advil got fever down to only 101 /stayed in bed for 72 hours arm and shoulders are still sore this is second time in my life that this has happened to me first time was at age 23

Other Meds: Zink /vitamin D

Current Illness: none

ID: 1685793
Sex: M
Age: 29
State: VA

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Skin rash/reddish welts that resembles hives, almost entirely concentrated on my scalp, some on my chest, neck, and arms. Very itchy and bothersome. It feels hot/warm.

Other Meds: Gabapentin, Adderall, Seroquel, Finasteride, Duloxetine.

Current Illness: None.

ID: 1685794
Sex: M
Age: 26
State: MS

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

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

Lab Data: BP: 122/96 Pulse: 137

Allergies: nkda

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient received Moderna second dose at 4:45 pm and began complaining of a racing heartbeat at 4:55. I administered two ice packs to the back of his neck. He stated he was nervous about receiving the vaccine. At 5:00 he was still complaining of a racing heart, tingling in his arms and in his stomach, and he was visibly agitated and nervous. He asked for an ambulance to be called and the pharmacy called a code white. His blood pressure was taken in between this time and it 122/96 and his pulse was 137. The ambulance arrived at 5:10 and EMS checked his pulse and BP. They told him it was likely anxiety induced and offered to take him to the hospital if he wanted to go. He stated he wanted to go but wanted his girlfriend to drive him. EMS left the store and the patient left with his girlfriend.

Other Meds: unknown

Current Illness: unknown

ID: 1685795
Sex: F
Age: 73
State: NC

Vax Date: 08/10/2021
Onset Date: 08/12/2021
Rec V Date: 09/09/2021
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: none

Allergies: allergic to brazil nuts

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

Symptoms: Pain in right arm and shoulder for 4+ weeks. Difficult to lift things, even my purse. I never experienced this before as far as I can remember.

Other Meds: none

Current Illness: none

ID: 1685796
Sex: F
Age: 40
State: NY

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

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

Lab Data: ER performed xray of chest and blood work. They also did a ekg which I do not have the results too.

Allergies: erythromycin, vitamin b12

Symptom List: Nausea

Symptoms: Immediately started tasting saline. Ten minutes later my chest felt weird and started hurting like a burning sensation. I called my doctor and was told to go to the er. I went to the ER and waited over 4 hours and eventually left due to them being under staffed.

Other Meds: none

Current Illness: autoimmune disease scleroderma

ID: 1685798
Sex: F
Age: 41
State: CO

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

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

Lab Data: None.

Allergies: Sudafed

Symptom List: Injection site pain

Symptoms: Everything happened pretty quickly after vaccine. Within 25 minutes my brain felt cloudy and I called a couple friends to see if their face went numb but they said no. I called ask a nurse and my health department and asked what I should do. I went to ER and they just gave me ibuprofen but I had a hard time filling out my forms and answering basic questions. I was also coughing and my throat was tingly. The next day I was in bed all day long with a headache. On the Thursday I went to see my PCP and she did a thorough assessment and started me on steroids to help with drooping of eye and mouth. For 3-4 weeks I was able to work from home but I was just in and out of it and had headaches and completely wiped out by 3 PM every day and could not function with my three children. I was getting bloody noses and my head just hurt so bad. That's how it was for awhile and the headaches and nose bleeds got better after a month or two. In march I was on day 6 of period which is usually the end and I bled through my pants while on a zoom call. I have had that pretty consistently since March. That's not normal for me. I feel like my brain is not as foggy as it was but I am still fairly forgetful and numbness in face has not gone away. I feel like my face is permanently numb and I can't feel where my mouth is so I cant even put on lipstick. I was in a bad space for awhile because no-one was listening to me and being in public health it is hard. My brain is just foggy and my memory was out of whack because I'm usually detail oriented.

Other Meds: Melatonin

Current Illness: None.

ID: 1685799
Sex: M
Age: 68
State: CA

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

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

Symptoms: Client received 3rd dose on 09/07/2021 and saw a lump on left side of the chest on 09/08/2021. Client was seen in Urgent Care and a biopsy was recommended. Client came to notify us in case issues with vaccine. Client schedule to see primary MD next week.

Other Meds: NONE

Current Illness:

ID: 1685800
Sex: F
Age: 68
State: VA

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 09/09/2021
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: Pollen; dust; animals; sulfa drugs; Percocet; morphine; Darvocet; Dilaudid; MRI contrast dye; Trazadone; Altizide

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

Symptoms: On 03-06-2021, when I received my second vaccine my left arm was again swollen, and my joints also were hurting. Today I still have some pain shooting through where the vaccine was given to me on my left arm. I can say that it all started when I received the first vaccine on 02-06-2021. My left arm at the injection site was sore. I woke up middle of night, my joints and body aching. The next day, my joints were hurting more. On 02-08-2021, my left arm was slightly swollen from the joints to the elbow and it was also red at the injection site, and there was a red welch approximately 2 inches in diameter and I also developed nausea. On 02-10-21, I had diarrhea in the morning and my left shoulder was very red and bruised. The headache I experienced was like having fireworks, flashes of light would come and go.

Other Meds: Levothyroxine; Metoprolol; Pravastatin; Ipratropium

Current Illness:

ID: 1685801
Sex: F
Age: 22
State: TX

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

Symptom List: Tremor

Symptoms: This patient has no adverse event. An Outreach Covid-19 vaccine clinic was organized at a church event this pharmacy had attended on a number of occasions. came up to get her second dose shot. She verified that she has received first dose shot of Pfizer Covid-19 vaccine. She could not provide her card of prior shot and her shot record could not be verified on the spot. The best information the pharmacy had was from her. She was taken for her words that it had been more than three weeks already and since every effort is geared toward not creating any barriers she got a second dose shot. On getting back to pharmacy and logging onto ImmTrac2 it was discovered that it was earlier for her to have received the second shot. The telephone number she provided was contact and it was confirmed that she has no adverse reaction or event.

Other Meds:

Current Illness:

ID: 1685802
Sex: M
Age: 53
State: CA

Vax Date: 09/09/2021
Onset Date:
Rec V Date: 09/09/2021
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: Erythema, Pruritus

Symptoms: there are no adverse events at this time

Other Meds:

Current Illness:

ID: 1685803
Sex: F
Age: 30
State: PA

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 09/09/2021
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: Hospital visit on Friday august 27th I received an EKG and bloodwork and was given anti anxiety medication. All tests came back negative. I went back to hospital Sunday august 29th and received the same tests. All again negative. On Monday august 30 I contacted primary care dr and was given script for anti anxiety. When I took the medicine I was very energetic and bouncing on the sofa. I stopped taking it because coming down off worsened the anxiety attacks greatly. Later that week I was given a script for Zoloft but also couldn?t take it because it made my anxiety worse. On Sunday sept 5 I went back to the Er for vertigo, numbness in my left arm, blurred vision, head pressure, and ringing in my ears. I had more tests done and all came back negative. Later that night I went back in because the vertigo, blurred vision, and head pressure was too much. I was kept for observations and given an MRI to rule out any other possible causes. All came back fine. The anxiety attacks are beginning to dissipate all together but I am still experiencing vertigo.

Allergies: None

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

Symptoms: Debilitating anxiety attacks. No prior history of anxiety attacks. The first week after the shot the anxiety attacks lasted 3 hours and happened at least 3 times a day. During those attacks I could not breath and every muscle contracted. I believed I was having a heart attack. After the first week the anxiety attacks went down to about one a day and lasted about an hour or two. For a full two weeks I had debilitating vertigo, nausea, ringing in my ears, heaviness in my left arm and left jaw, and spells of uncontrollable shaking.

Other Meds: None

Current Illness: None

ID: 1685804
Sex: F
Age: 44
State: NJ

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

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

Symptoms: Menstrual bleeding when I have not had a period in over 6 months. Early menopausal pre-menopause.

Other Meds: Levothyroxine 125mcg

Current Illness: None

ID: 1685805
Sex: F
Age: 36
State: SC

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

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

Lab Data: No

Allergies: Sulfa, hydroprodon

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Diarrhea, nausea, fatigue

Other Meds: No

Current Illness: No

ID: 1685806
Sex: F
Age: 35
State: UT

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

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

Lab Data: Troponin, D-dimer, ct angio chest with contrast, ekg, CMP, CBC

Allergies: None

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

Symptoms: Pericarditis, elevated d-dimer, abnormal ekg

Other Meds: None

Current Illness: None

ID: 1685807
Sex: F
Age: 35
State: GA

Vax Date: 08/26/2021
Onset Date: 09/03/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: On day 8 after vaccination a 1.5-2 inch large red circle formed. It was hot to the touch and was very itchy. On day 9 the large circle was now just a large raised ring with a smaller raised red circle in the middle (it resembled a bullseye) . Both areas were very hot to the touch and very itchy. There was also a hard lump in the center of the smaller red circle but it was not directly over where the vaccine was given. I took over the counter Zyrtec and ibuprophen. I placed a cold pack on the spot as well. I also applied topical anti-itch cream. They lessoned the symptoms but not completely. On day 10 the bullseye shaped raised area was almost completely gone. My left arm was back to normal on day 11.

Other Meds:

Current Illness:

ID: 1685808
Sex: F
Age: 29
State: CO

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

Symptom List: Pain in extremity

Symptoms: Redness and itchiness at the injection site

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1685809
Sex: F
Age: 61
State: WA

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

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

Lab Data: A1C, Magnesium, TSH reflex, lipid panel, CBC, CMP, EKG. Waiting on results

Allergies: CITALOPRAM, WELLBUTRIN, BROMFENAC, CELEBREX, NONSTEROIDAL ANTI-INFLAMMATORY PROLENSA

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

Symptoms: patient reports pounding in chest. Palpitations. EKG shows a-fib and a heart rate of 138. Palpitations kept patient up at night, and she did not rest well because laying on her side increased the feeling of pounding in her chest. By 1130 on 9/8/21, she had converted to normal sinus rhythm per EKG.

Other Meds: Atorvastatin, Metformin

Current Illness: none

ID: 1685810
Sex: M
Age: 38
State: LA

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

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

Lab Data: n/a

Allergies: n/a

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

Symptoms: patient received their second dose today. during the 15 minute wait period, the patient started to begin sweating a lot. we gave him a couple of water bottles and sat him in front of a mini fan. patient then began to feel chills so we gave him 2 tylenol tablets.

Other Meds: gave patient 2 tylenol tablets while patient was experiencing adverse reaction--patient was sweating a lot and then started to feel chills

Current Illness: n/a

ID: 1685811
Sex: F
Age: 42
State: NY

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

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

Symptoms: Rash and itching. Fever of 101. Swelling in armpits and breasts. Severe Fatigue

Other Meds:

Current Illness:

ID: 1685813
Sex: F
Age: 65
State: MA

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

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

Lab Data: none

Allergies: nkda

Symptom List: Vomiting

Symptoms: immediately following the vaccine, the patient started feeling hot and became unresponsive. Patient was still breathing, but looked to be having a partial seizure or had fainted with her eyes partially opened. 911 was contacted and arrived on the scene within several minutes. Just prior to the medics arrival, the patient started to come back to consciousness and acted as if she was going to vomit, but only produced dry heaves. She was then transported to the hospital by the EMS.

Other Meds: unknown

Current Illness: none reported

ID: 1685814
Sex: F
Age: 71
State: MD

Vax Date: 03/04/2021
Onset Date: 05/01/2021
Rec V Date: 09/09/2021
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: Penacillin, sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Hives

Other Meds: No

Current Illness: No

ID: 1685815
Sex: F
Age: 46
State: NY

Vax Date: 03/16/2021
Onset Date: 03/31/2021
Rec V Date: 09/09/2021
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:

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

Symptoms: Palpitation, arterial blood pressure, confusion, concertation head pressure, vibration, palpitation, and ringing in the ear, anxiety, back pain, leg numbness.

Other Meds:

Current Illness:

ID: 1685947
Sex: M
Age: 31
State: NC

Vax Date: 09/05/2021
Onset Date: 09/06/2021
Rec V Date: 09/09/2021
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. I had a virtual medical consultation to confirm with a doctor the side effects I was experiencing are often experienced by vaccine-takers.

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Adverse effects after taking the second dose of the Pfizer vaccine. 1) Non-stop brutal convulsions starting 15-16h after the shot and lasting 1h30 combined with fever (alternation of extreme heat and extreme cold feeling). 2) Then shaking and feeling that my body was being electrocuted and my organs were trying to continually resist the electric shock, all combined with muscle pain diffused through my body. Lasted for at least 10 hours after the start of the side effects. 3) General exhaustion and mild muscle pain throughout the body for the next 48 hours. I have a great immune system, eat healthy (mostly vegan), don't have any diseases nor take any medications/prescriptions. No genetic health concerns in my family.

Other Meds: None

Current Illness: None

ID: 1685948
Sex: M
Age: 79
State: CA

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

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

Lab Data: None at this time.

Allergies: No

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

Symptoms: This was the Booster Pfizer shot given to those with serious health issues. About a week later, 9/2/21 he had red blotches on both arms starting at the top of his hands to his shoulders on both sides of both arms. They are not itchy.

Other Meds: Praluent, metropolol, Xrelto, Trelegy, Levetiracetam, Levothyroxine, Glipizide, Furosemide, Linzess, Calcium, Claritin

Current Illness: Lung cancer is why he was recommended for the Booster Vaccine.

ID: 1685949
Sex: F
Age: 50
State: FL

Vax Date: 07/29/2021
Onset Date: 07/30/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: Chest X-Ray 8/11/2021. per Doctor she said "showed my lungs cloudy but did not see pneumonia".

Allergies: Iodine, Fish, Environmental

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

Symptoms: The day of vaccine I was very tired. The next day I felt fine but by dinner time just felt like I was getting a cold. The fever and body aches began. By Monday the 2nd I began to feel as if I had a bad head cold. I had a fever and could barely move. By Thursday the 5th I was very ill and the coughing had begun. I saw the doctor who believed it was merely bronchitis. By Monday the 9th the cough had been so bad, even with medication, I had pulled all muscles in my back and torn something in my stomach. I had called the doctor again on the 11th and my doctor's associate had then given me a second dose of a different antibiotic. She also ordered a chest X-ray which she said "showed my lungs cloudy but did not see pneumonia". I felt a bit better after 3 days of the new antibiotics. To date I am still coughing but not what I had suffered during the 3 weeks of suffering. Furthermore my left arm is in constant pain and I am unsure if I have pulled a muscle, pinched a nerve or caused damaged to my neck due to the excessive coughing.

Other Meds: Estradiol .5mg 1X day; Zolpidem 10mg 1Xday; Alderol 30mg 1X a day; Fiorcette 2 every 6 hours as needed for migraines; Oxygen hi-flow as needed for Cluster Headaches; Vitamin C, D, E, B

Current Illness: N/A

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am