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: 1686232
Sex: F
Age: 27
State: CA

Vax Date: 09/08/2021
Onset Date: 09/08/2021
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: Acetomenophen, hydrocodone. ibuprofen

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt received 1st dose J&J COVID vaccine right deltoid @ 1413. Around 1428, pt c/o chest tightness, lips feeling numb, tachypneic, and dizziness post vaccination. V/S: 102/85, HR 108, SPO2 95% RA, RR 26. EKG done in clinic. SPO2 93% noted, started on 2 LPM via nasal cannula. RRT notified. RN-to-MD report given to Dr. Pt transferred to UC via wheelchair via 2-person assist @ 1453.

Other Meds:

Current Illness:

ID: 1686233
Sex: F
Age: 43
State: MA

Vax Date: 08/28/2021
Onset Date: 09/01/2021
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:

Allergies: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: I got my period again only after 12 days. I?m usually 28+ days regular.

Other Meds: Multi vitamin Acidophilus Singular Vitamin C 1000mG

Current Illness: None

ID: 1686234
Sex: F
Age: 28
State: WA

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

Allergies: Muscle relaxer flexerail

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

Symptoms: I got super tired. Bad headache still to this day. I had swelling and pain in my left arm. All the way down my armpit and it burned. Still hurts. I got covid arm

Other Meds: No

Current Illness: No

ID: 1686235
Sex: F
Age: 44
State: NY

Vax Date: 08/19/2021
Onset Date: 08/19/2021
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: None at this time as I can not afford just walking into an er and asking for a full work up . Very little guidance

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Starting the night of the shot I had weird sensations that spread all over my body(not in joints or muscles) but mainly in neck, arms, legs, chest . It was a tightening that sometimes just got really tight, sometimes had slight burning or tingling feeling. This progressed and got worse for two weeks and are a little better at three weeks but still present, also never had headaches other than with normal causes . I started getting really bad headaches in the base of my head that were decently painful. All of these things come on out of nowhere and also end abruptly. Please not I contacted not only my doctor but also Heath department and got NO help or guidance other than ho to ER and get a full work up!

Other Meds: None

Current Illness: None

ID: 1686236
Sex: F
Age: 50
State: TX

Vax Date: 09/04/2021
Onset Date: 09/04/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Rash/ Hives over Head, face, arms, and torso.

Other Meds: Losartan, Fenofibrate

Current Illness:

ID: 1686237
Sex: M
Age: 22
State: OR

Vax Date: 09/08/2021
Onset Date: 09/08/2021
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: In the ER, I was seen by an on-duty doctor and diagnosed with vasovagal syncope. A nurse performed a series of blood pressure checks lying, sitting and standing. Those results were normal (this was done approx. 3 hours after the vaccination). I was then discharged.

Allergies: Peanuts, cashews, grass (seasonal)

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

Symptoms: First thing I noticed was that the index finger on my right hand was twitching. Then I started feeling extremely dizzy and I blacked out. When I came to, the first thing I registered was that my father and the pharmacist were waking me up and trying to talk to me. Then they laid me on the floor on my side and the pharmacist started to take my blood pressure while calling emergency services. On waking up, at first I almost couldn't talk, but later I was able to talk better. The paramedics came and took me to the hospital. My father's account: about 5 minutes after the shot, I heavily leaned to the left side in my chair, with my arms and legs stretched and trembling. My eyes were rolled up. When he and the pharmacist woke me up, I was extremely confused and could hardly talk. The pharmacist was continuously checking my blood pressure. It was about 90/70.

Other Meds: Abilify 5 mg, Sertraline 100 mg, Probiotic (HMF Forte)

Current Illness: Hives (2 days, in the morning)

ID: 1686238
Sex: M
Age: 61
State: NE

Vax Date: 04/12/2021
Onset Date: 07/01/2021
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: none

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: About 3 months after 2nd dose, noticed pvc's several per minute, including some short runs of trigeminy. Would notice occurring for several hours one day, then none for a few days. Then would experience repeat of this pattern. Normally have occasional pvc's, noticed once in a few days to weeks. The more frequent pvc's were happening every few days for about a month. Then went about a month with the more normal rhythm. Having some the more frequent pvc's again today.

Other Meds: Tamsulosin 0.8 mg qd, simvasatatin 40 mg qd, tadalafil 20 mg qod

Current Illness: none

ID: 1686239
Sex: F
Age: 31
State: AZ

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

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: 12 hours after her 2nd shot, patient complained of pain in her right arm near where she received the vaccine. 15 minutes later she woke up violently shaking. They appeared to be seizures but have since been identified by doctors as severe muscle spasms. These have continued for 2 days. She has been admitted to the hospital. The episodes seem to occurs 1-2 times per hour and remain fairly significant even after being administered Ativan.

Other Meds: Synthroid

Current Illness:

ID: 1686240
Sex: F
Age: 33
State: WI

Vax Date: 02/25/2021
Onset Date: 02/27/2021
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: LA

Lab Data:

Allergies: Amoxicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Flu like symptoms, fever, headache, chills, nausea, rash

Other Meds: None

Current Illness: None

ID: 1686241
Sex: F
Age: 24
State: OH

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:

Allergies: NONE

Symptom List: Diarrhoea, Nasal congestion

Symptoms: The patient began to experience severe dizziness. While laying flat the patient complained of pain in the arm that received the vaccination and complained of feeling hot. The patient decided to be transported to the hospital.

Other Meds: Unknown

Current Illness: None

ID: 1686242
Sex: M
Age: 56
State: TN

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

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

Lab Data: CT scan and MRI

Allergies: None

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

Symptoms: Had a brain stem stroke 5 days after shot.

Other Meds: Losartan Allopurinol

Current Illness: None

ID: 1686243
Sex: F
Age: 47
State: OH

Vax Date: 02/11/2021
Onset Date: 03/05/2021
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: Seen by ophthalmologist and rheumatologist on 9/8/21 to test for autoimmune disorders. Ophthalmologist diagnosed Sjogren?s Syndrome after performing tests. Rheumatologist agreed with Sjogren?s Syndrome.

Allergies: IVP dye NSAIDS

Symptom List: Rash, Urticaria

Symptoms: Began developing eye symptoms (dryness, irritation), fatigue and joint pain/swelling about a month after receiving the first dose of Moderna vaccine. Symptoms have continued to get worse over the past six months.

Other Meds:

Current Illness:

ID: 1686244
Sex: F
Age: 59
State: CA

Vax Date: 09/08/2021
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:

Allergies: codiene

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

Symptoms: After receiving the covid vaccine PT stated "I am feeling light headed and heart palpitations." I asked to take PT vitals, she declined for me to do so but wanted her pulse to be taken. After taking her pulse a couple of times PT stated "I am not feeling any better" so I immediately called RRT. They responded immediately and took her down to urgent for further assessment. Received RRT call from Covid vaccine clinic regarding pt feeling dizzy after Covid vaccine. Went to assess pt at the Covid vaccine clinic. Pt A&Ox 4. Pt stated has been feeling dizzy since yesterday. Pt stated in between chemotherapy. Pt was recommended by staff to move RA after the vaccine. Pt was pacing in the room and moving RA. Pt felt lightheaded. VS was 122/77 P 83

Other Meds:

Current Illness:

ID: 1686245
Sex: M
Age: 28
State: CA

Vax Date: 08/22/2021
Onset Date: 08/24/2021
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:

Allergies: I had an allergic reaction to SLS toothpaste eventually in my life around my mid twenties. Cankersores, gingivitis-like symptoms.

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

Symptoms: Initially after vaccination I felt fine, typical arm soreness maybe mild immune response. I was able to go to the gym for 2 days straight the following monday and tuesday. But on Tuesday, despite feeling completely fine after the gym (heavy weight lifting) and eating lunch, about an hour of elapsed time, I drank some coffee and noticed my heart beating faster and faster like I was having a panic attack (also shortness of breath). I also took a multivitamin that morning (single dose) and ate another 2-dose multivitamin after lunch since I figured that I might've been vitamin deficient that my body would just dispose of the excess vitamins if it couldn't absorb them. My hands, feet, neck, shoulder, and lower part of my face were buzzing, my vision was felt like it was fuzzy. Since then I've had symptoms of a pounding heart that have gotten better through the past 2 weeks but have plateaued somewhat. It only happens when I'm trying to exercise (have since paused), when I eat food past a certain limit, add salt to my meal, or am in a hot room for too long (81-82 degrees), so I think anything that can stimulate the heart. Other than that, as long as I'm conscious of those things I can feel pretty normal, though sometimes I get shortness of breath.

Other Meds: I was taking a kirkland multivitamin for the weeks leading up to vaccination and days after. I've always been taking another multivitamin before the recent one I switched to every day. Never had any allergic or negative reactions.

Current Illness: None, but I had symptoms of gingivitis probably due to vitamin deficiency. Was on vegan diet for several months. I saw a dentist who confirmed that I didn't have gingivitis or any negative dental issues and was probably something else. I'm currently taking a multivitamin and changed back my diet and my gingivitis-like symptoms have been reduced for over a month

ID: 1686246
Sex: F
Age: 39
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: Fully vaccinated employee developed symptoms 9/1/21 and resulted positive for Covid-19.

Other Meds:

Current Illness:

ID: 1686247
Sex: F
Age: 49
State: NV

Vax Date: 05/20/2021
Onset Date: 05/22/2021
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: Verbally explained to my gp primary care doctor.

Allergies: Compozine

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

Symptoms: I had a regular period that ended five days prior to my shot. 2 days after the shot I had another full period. It was well over three months until i had another period. A lot of ovarian pain and cysts after the shot.

Other Meds:

Current Illness: Reoccurring shingles

ID: 1686248
Sex: F
Age: 34
State: WI

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

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

Lab Data:

Allergies: n/a

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

Symptoms: I missed my period the month following receiving the vaccination. I am not pregnant and was not trying to get pregnant.

Other Meds: Multi vitamin, vitamin D, elderberry

Current Illness: n/a

ID: 1686249
Sex: F
Age: 29
State: GA

Vax Date: 09/02/2021
Onset Date: 09/04/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Dizziness, numbness in pinky finger of left hand, and large baseball size red rash around injection site

Other Meds:

Current Illness:

ID: 1686250
Sex: F
Age: 34
State: TX

Vax Date: 04/19/2021
Onset Date: 06/10/2021
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:

Allergies: N/A

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Miscarriage. Menstrual cycle has yet to resume.

Other Meds: N/A

Current Illness: N/A

Date Died: 09/05/2021

ID: 1686251
Sex: F
Age: 86
State: FL

Vax Date: 08/31/2021
Onset Date: 09/05/2021
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: n/a

Allergies: unknown

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

Symptoms: patients daughter reported to us that the patient died on 9/4 or 9/5. the patient was otherwise healthy. the patient told her daughter that her arm itched some at the injection site. the family is not doing an autopsy

Other Meds: unknown

Current Illness: unknown

ID: 1686252
Sex: F
Age: 66
State: NM

Vax Date: 04/01/2021
Onset Date: 05/01/2021
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: shell fish, Keflex (rash)

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

Symptoms: Dry mouth progressively getting worse since the first dose. Symptoms were minor at first and have gotten significantly worse over the last 5 months. Starting in July my taste buds have felt burned and I have lost the ability to taste normally.

Other Meds: Vitamin C, Testosterone compounded cream twice weekly, THC

Current Illness: none

ID: 1686253
Sex: M
Age: 68
State: IL

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

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

Lab Data: Saw my doctor 09/08/2021? Doctor could not prescribe ANY MEDICATION except Aspirin?!?! This is a Terrible Medication!!! The cure is certainly WORSE than the virus!!! I have never been sick until AFTER The SHOT!!! This is so Terrible that the government is Forcing this on its citizens!!!

Allergies: None

Symptom List: Unevaluable event

Symptoms: Shot arm is on left, the arm felt good for a few days, then I lost all feelings in my arm plus extreme pain and the pain was 24/7 days a week!!! My arm today is in extreme pain!, So much, that I regret ever having taken the shot? How long will this LAST-my whole LIFE?!?!

Other Meds: None

Current Illness: None

ID: 1686254
Sex: M
Age: 50
State:

Vax Date: 08/30/2021
Onset Date: 08/31/2021
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: LA

Lab Data:

Allergies: none

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

Symptoms: muscle aches, night fevers , pain in shot site head ache , fuzzy memory , blurry vison ,loss sense of smell skin is all broke out with white heads .

Other Meds: none

Current Illness: none

ID: 1686255
Sex: F
Age: 43
State: NC

Vax Date: 02/12/2021
Onset Date: 02/15/2021
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: Only test completed was antibody test. I had great immunity per Dr.

Allergies: Latex only.

Symptom List: Injection site pain, Pain

Symptoms: That evening pain radiating down let arm. By the 3rd day I had pain in my clavicle, neck and arm - couldn?t sleep on left side that night or the for next week or 2. Not sure when it started but a few days after shot I had a tingling/tickle on my left nostril and then numbness and paralysis of the left facial muscles. Right side was normal. This lasted a few days and then went away. However, the numbness lingered for a month or so. I have NEVER had an adverse reaction to any medication to my knowledge. This was scary and a first for me.

Other Meds: None taken that morning.

Current Illness: None

ID: 1686256
Sex: F
Age: 60
State: IL

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: SYR
Vax Site: LA

Lab Data: None

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Redness and itching

Other Meds: Unknown

Current Illness: None

ID: 1686426
Sex: F
Age: 40
State: MO

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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Lightheaded, dizzy, nausea, severe body aches, headache, swollen lymph nodes on left side of neck, extreme fatigue

Other Meds: Fluoxetine 10 mg

Current Illness: No

ID: 1686427
Sex: F
Age: 65
State: CA

Vax Date: 03/10/2021
Onset Date: 03/29/2021
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: I wouldn?t consider this an adverse reaction since it in the start right away but it does seem like it has become bothersome and I can trace it back to two weeks after my vaccination.

Allergies: Sulfa Drugs, Lisinpril, Doxycycline, Flagyl, Morphine Sulfate, Codine, Ranexa,

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I have just had three cases of bronchitis since my COVID-19 vaccination. I don?t seem to be able to get rid of a long-term productive cough. * also I was contacted in April by your service and did call back and leave my telephone number because I was having bronchitis issues and I never received a callback. I did give them my availability time and tried to call a few times and was unable to get a hold of anyone. I hope this information helps.

Other Meds: Levothyroxine, Metoprolol Tartate, Astorvastatin, Pantorprazole, Alendronate, Estadadiol, Asprin 81mg, Caltrate, Multi Vitamin

Current Illness: None

ID: 1686428
Sex: M
Age: 81
State: GA

Vax Date: 09/07/2021
Onset Date: 09/07/2021
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: No medical tests or laboratory studies were conducted. Two (2) full days later still have mild headache and feel sweaty (clammy)

Allergies: doxycycline, Sulfa drugs, augmentin, grasses

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: - Severe headache - behind my eyes, temples, down the back of the neck and into the shoulders - Severe muscle and joint pain and aches all over my body. - Severe chills and shivering. - The feeling of being "hot" but without an abnormal temperature - mine usually runs about 97.6 and that is what I measured. - Totally "stuffed up" with some breathing difficulty - like you had a really bad cold that included your lungs. - Bloating or "fullness" in the stomach but no nauseousness. - Dizziness to the point of not being able to get out of bed or walk without hanging on to something - extreme "unbalance" and some "spaciness." - An elevated pounding heart-rate - running over 110 bpm all night and sometimes spiking at 125 bpm - - today, at about 8pm - after slowly declining all day - this has pretty much returned to normal which for me is about 60 bpm +- when resting. - Insomnia followed by night sweats - By 4:30 the next day most symptoms were gone except for a lingering mild headache

Other Meds: Tramadol, Gabapentin, Meloxicam, Atorvastatin, Tylenol, vit B12, vit B2, D3, Mg, Miralax

Current Illness: Idiopathic pulmonary fibrosis

ID: 1686429
Sex: M
Age: 64
State:

Vax Date: 09/03/2021
Onset Date: 09/04/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: 101.5F fever for two days, fatigue, headache, subnormal fever on day 3, allergic skin reaction, severe tenderness

Other Meds:

Current Illness:

ID: 1686430
Sex: M
Age: 54
State: NC

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

Lab Data:

Allergies: PCN

Symptom List: Nausea

Symptoms: Pt had a seizure for about 2 to 3 minutes following administration

Other Meds: N/A

Current Illness: None

ID: 1686431
Sex: F
Age: 22
State: CA

Vax Date: 09/07/2021
Onset Date: 09/07/2021
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:

Allergies: None

Symptom List: Injection site pain

Symptoms: Client reported a history of syncope after vaccinations to RN prior to receiving the vaccine today. The client was vaccinated while seated in the anti-gravity chair. At 7:35 PM the client reported feeling lightheaded. RN responded. RN reclined the anti-gravity chair to a low-fowler's position. RN noted the client close her eyes and her body relax for about one second. The client opened her eyes and RN provided the client with an alcohol swab to smell. The client reported "dizziness, tingling on ears, and seeing spots." The client stated all of these symptoms are normal for her after receiving and injection. Vitals obtained at 7:35PM were as follows: automatic BP 93/58, HR 68, O2 99%. The client reported a history of hypotension. The client stated that her systolic blood pressure is usually under 100. Repeat vitals obtained at 7:45 PM were as follows: BP 111/66, HR 70, O2 99%. The client denied any symptoms at that time. RN provided education regarding s/s of anaphylaxis and when to seek EMS. The client voiced understanding of this education. RN adjusted the anti-gravity chair to a high fowler's position. Repeat vitals obtained at 8:01PM were as follows: BP 105/70, HR 75, O2 99%. The client denied any symptoms at that time. The client left the vaccination site at 8:05PM. The client ambulated unassisted with a steady gait.

Other Meds: None

Current Illness: Unknown

ID: 1686432
Sex: F
Age: 66
State: NJ

Vax Date: 09/03/2021
Onset Date: 09/04/2021
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: Specific tests and results unknown to me. Blood, CSF and urine cultures sterile. CSF PCR pathogen panel: negative Echocardiogram ejection :fraciton of 40% COVID-19 PCR: negative

Allergies: N/A

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

Symptoms: Within ~12 hours of receipt of 3rd dose of vaccine on 9/3/21, patietn( who has advanced multiple sclerosis) was noted to be moaning in sleep. Throughout 9/4/21, she was lethargic, somnolent, unresponsive, not verbalizing. On 9/5/21, these symptoms persisting, she was noted to be encephalopathic and to have right hemiparesis and was taken to medical center where she was febrile, experiencing SVT and having electrical status epilepticus (per VEEG). A CT scan of the brain w/wo contrast did not reveal evidence of a CVA. Serum lactate=12. LP (? traumatic) was performed. Empiric broad-spectrum antibiotics (including acyclovir) initiated. Hospitalized in Medical Step-Down Unit. Developed not-specific sparce macular-papular rash on 9/6/21. Seizures treated with Keppra and resolved. Sensorium and right hemiparesis improved/improving; remains hospitalized as of date of this report (9/9/21). Awaiting MRI of the brain (to assess status of MS and acute encephalopathy).

Other Meds: Aubagio, Lexapro, Synthroid, Mirapex

Current Illness: multiple sclerosis; h/o acute COVID-19 (04/2020; pulmonary)

ID: 1686433
Sex: M
Age: 13
State: AL

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: N/A

Allergies: none stated

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

Symptoms: PT FELT NUMBNESS/TINGLING IN HIS LEFT HAND/FINGERS

Other Meds: unknown

Current Illness: none stated

ID: 1686434
Sex: F
Age: 66
State: GA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PENECILLIN

Symptom List: Tremor

Symptoms: 2ND SHOT OF SHINGLE VACCINE IN THE EVENING ON 9/8/21, IN THE MORNING OF 9/9/21 BLOOD PRESSURE WENT UP 226/197. SEVERE BODY ACHES, BACK PAIN, FATIGUE

Other Meds: RECOMBINANT ZOSTER (SHINGLES)

Current Illness: BLOOD PRESSURE

ID: 1686435
Sex: M
Age: 50
State: TN

Vax Date: 08/23/2021
Onset Date: 08/25/2021
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:

Symptom List: Erythema, Pruritus

Symptoms: Ringing in ears

Other Meds:

Current Illness:

ID: 1686436
Sex: F
Age: 0
State: IL

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

Allergies: No know allergies

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

Symptoms: Patient mother fraudulently wrote DOB as 09/03/2009 on a vaccine consent form, vaccine was administered under the assumption that this was the correct DOB. Upon processing the RX, an exact patient match was found, but the birthday was listed at 12/03/2009. The patient received at influenzas shot at a different pharmacy, so patient's previous records was available. Upon reviewing the registry, the same patient was listed with the DOB of 12/03/2009, and the influenzas shot matches previous our previous records. Additionally when submitting the claim for the COVID shot to third party, the claim rejected saying non- matched card holder ID, and rejection typical present when there is a mismatched DOB. Patient has no adverse events following the vaccine, and further communcation with the patient has not be conducted.

Other Meds: No know other medications

Current Illness: No know illnesses

ID: 1686437
Sex: M
Age: 58
State: FL

Vax Date: 08/20/2021
Onset Date: 08/23/2021
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: NKA

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

Symptoms: Patient reported vaccine coming out of arm 3 days post vaccination. Patient was working out and noticed white substance coming out of injection site.

Other Meds: Unknown

Current Illness: N/A

ID: 1686438
Sex: F
Age: 103
State: WA

Vax Date: 02/18/2021
Onset Date: 09/07/2021
Rec V Date: 09/09/2021
Hospital: Y

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

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

Allergies: Penicillin, Tetanus Toxoid

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient received Pfizer COVID vaccine on 1/23/21 and 2/28/21 and has been living in adult family home resident with recent COVID-19 outbreak. Patient developed symptoms and tested positive for COVID-19 on 9/3/21. On 9/7/21, patient's had rapidly progressive shortness of breath, was found to be hypoxic, and was admitted to our facility for acute hypoxic respiratory due to COVID-19. As of 9/9/21, patient is still admitted in the med/surg unit.

Other Meds: Amlodipine, glimepiride, losartan

Current Illness:

ID: 1686439
Sex: F
Age: 0
State: GA

Vax Date: 08/13/1992
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:

Allergies:

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

Symptoms: Patient reported feeling hot, having headache and feeling "funny". I monitored patient's temperature and Blood Pressure. Patient applied cold compress. Patient's blood pressure dropped from 144/103 to 133/97. Patient stated she did not need medical attention and left with her boyfriend.

Other Meds:

Current Illness:

ID: 1686440
Sex: F
Age: 24
State: PR

Vax Date: 09/09/2021
Onset Date: 09/09/2021
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: Latex

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

Symptoms: A 24 year old female patient was found in the observation area after receiving the second dose of Moderna at 6:20 pm. While waiting the 30 minutes in the observation area started to feel itchy on neck and extremities and dizziness. The patient had not notified the paramedic and became aware the moment the patient was discharged. The patient reports that at approximately 5:20 pm they took Benadryl 50mg since it was her first dose. Afterward, was taken to the incident observation area at 7:00 pm to take vital signs which were 110/70 B/P, 94 DXT, 95 saturation and 73 frequency. Newly, at 7:45 pm vital signs were taken which were: 100/60 B/P, 79 DXT, 99 Saturation and 55 frequency. Case was consulted with Dr. and was authorized to administer Dexamethasone 4mg/ ml intramuscular.

Other Meds:

Current Illness:

ID: 1686441
Sex: M
Age: 27
State: VA

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: None

Symptom List: Pain in extremity

Symptoms: Started getting lightheaded immediately after, after another minuet I started having spotty vision and slowly faded to complete blindness. In addition to that I could not hear anything, complete deafness. Profusely sweating, slow breathing, and overall restlessness. When the paramedics arrived my vitals were fine except blood pressure had dropped into the low 50s which is very abnormal.

Other Meds: None

Current Illness: None

ID: 1686442
Sex: M
Age: 30
State: WA

Vax Date: 09/04/2021
Onset Date: 09/04/2021
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: EKG, X-ray, UA, and blood work done in the ER.

Allergies: None

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

Symptoms: Dizziness about 5 minutes after shot, general tiredness for two days. Monday started getting some random chest pains, Tuesday I was having chest pains and tightness and went to the ER. Currently still getting random chest paints and feeling very tired and fatigued.

Other Meds: Ibuprofen

Current Illness: None

ID: 1686443
Sex: F
Age: 49
State: WA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: NONE

Allergies: none

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

Symptoms: Fever and chills, muscle and joint aches, shot site sore. No headache. Began around 12:00 am Sept 9th , took 3 ibuprofen at 5:30 am, went back to bed, woke up at 8:00 am and felt good. Went to work. Did not take more ibuprofen. Began feeling mild fever and fatigue about 1:20 pm. Feeling subsided by 4:00pm drove home, 20-25 mins felt fine until I got out of truck. Chills, minor aches, fever returned. Drank large glass of water, went to bed, approx 5:00 pm. Awoke around 6:00 pm, condition same, no headache. Ate French dip sandwich, large glass of milk, 3 ibuprofen. Now at 7:05 pm, fever and chills minor aches.

Other Meds: Armodifinil Citalopram Ritalin Multi Vitamin for over 50

Current Illness: none

ID: 1686444
Sex: M
Age: 40
State: VA

Vax Date: 08/01/2021
Onset Date: 08/13/2021
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

Allergies: none

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

Symptoms: chest pain that I never felt before. felt short of breath and it lingers almost daily for short periods when I am just sitting or driving the car. I just got the second dose and am feeling chest pain in the heart 7 hours after receiving the shot.

Other Meds: vibriyd, wellbutrin

Current Illness: none

ID: 1686445
Sex: M
Age: 68
State: IN

Vax Date: 02/04/2021
Onset Date: 07/03/2021
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: MRI on 8/24, CT on 9/29

Allergies: Not that I know of.

Symptom List: Vomiting

Symptoms: I experienced a sudden partial hearing loss on my right ear on July 3, 2021. It was accompanied with discomfort on my head. I didn't realize it was a hearing loss until the following day. I had a hearing test on July 19. The result is that I lost hearing on my right ear for both high frequency and low frequency. I could still hear medium range frequency. I visited my ENT doctor on August 2 who read the hearing test report. He examined my ears and said he could see nothing that could explain my hearing loss on my right year. He tentatively gave 4 possibilities: inflammation, fluid in my inner ear, blood vessel clog, tumor in my inner ear. He prescribed Prednisone 20mg. Following his order, I took 3 tablets daily (2 in the morning, 1 in the evening) for 10 days. It was steroid to cure inflammation, I was told. That medication had no effect on my hearing loss. At the same time, he ordered an MRI, which I took on August 24. Three days later, the doctor told me that the MRI did not show anything that can explain my hearing loss But he notice a cyst in my nose, which must be removed. I will take a CT test on 9/29 before he removed the cyst in my nose. But that is unrelated to my hearing loss--according to the doctor. I plan on visiting clinic for second opinion and treatment.

Other Meds: 1. Calcium 1200 mg (1 pill daily); 2. Glucosamine Chondroitin MSM (2 pills daily); 3. Lutein 20mg (1 pill daily); 4. Vitamin D (1 pill daily).

Current Illness: Eczema. I started from top of my left eye. Then it moved ever so slowly through left cheek to left ear. Right now, it is still in left ear. I visited a dermatologist about a year ago. She prescribed Triamcinolone Acetonide Cream USP, 0.025%. As this prescription did not stop the itching, I didn't use it regularly until August when the itching was very bad inside my left ear. It used it everyday to my left ear. It still didn't stop the itching. The itching relaxed a little, currently.

ID: 1686446
Sex: F
Age: 49
State: AL

Vax Date: 08/27/2021
Onset Date: 08/28/2021
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:

Allergies: Penicillin, sulfa, Keflex, erythrymicin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Had vertigo symptoms for 72 hours, when turning my head would lose balance, also fatigue

Other Meds: None

Current Illness: None

ID: 1686447
Sex: F
Age: 46
State: CA

Vax Date: 08/27/2021
Onset Date: 09/08/2021
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: The patient developed cellulitis.

Other Meds:

Current Illness:

ID: 1686448
Sex: F
Age: 32
State: FL

Vax Date: 08/18/2021
Onset Date: 08/20/2021
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: ED visit on 8/28/21, Doctor visit on 9/9/21

Allergies: Sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Burning sensation and fluttering in chest, facial redness and burning

Other Meds: None

Current Illness: None

ID: 1686449
Sex: M
Age: 70
State: CO

Vax Date: 08/10/2021
Onset Date: 08/10/2021
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:

Allergies:

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

Symptoms: Vaccine administered outside guidelines. Patient presented as though he had not received any Covid19 vaccine previously and was administered one dose of Pfizer Covid19 vaccine. It was later discovered that the patient had actually received the 2-dose series of Moderna Covid19 vaccine in Feb/Mar '21. Patient did not report any adverse events.

Other Meds: Sodium Bicarb 650mg, atorvastatin 40mg, chlorthalidone 25mg, amlodipine 5mg

Current Illness:

ID: 1686450
Sex: M
Age: 39
State: IL

Vax Date: 05/13/2021
Onset Date: 05/20/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data: pericarditis; on September 9th.

Allergies: Allergic to panicilin

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

Symptoms: in one week after vaccination, frequent urination were found, follows with short of breath, and constantly fatigue after two weeks. With this condition for several months, I decided to see doctor, and diagnosed with pericarditis.

Other Meds: after one week of vaccination, found frequently urination. And if two weeks follows with short of breath and constantly fatigue. Condition keep going one month, and went to see doctor. After fully examination, doctor diagnosed me as pericar

Current Illness: Fever, fatigue, chills, tiredness

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am