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: 1693444
Sex: F
Age: 22
State: OH

Vax Date: 09/10/2021
Onset Date: 09/11/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: None

Allergies: Tramadol

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever, chills, body aches, excessive sweating

Other Meds: Loryna, levothyroxine

Current Illness: None

ID: 1693445
Sex: F
Age: 64
State: KY

Vax Date: 03/11/2021
Onset Date: 03/30/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: Full Blood work panel, Vascular scan Ultrasound of my legs, echocardiogram

Allergies: codeine; sensitivity to Zyrtec

Symptom List: Anxiety, Dyspnoea

Symptoms: After my second vaccine I did not feel well, I did have weird shooting pain down my arm, I had a lot of fatigue. My legs started swelling. I got diagnosed with stage 3A kidney disease.

Other Meds: Melatonin; Vitamin B, D3, Stress B complex

Current Illness:

ID: 1693446
Sex: F
Age: 31
State: WI

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/12/2021
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: None at this time.

Allergies: None

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

Symptoms: Menstrual changes. Spotting started evening of vaccination date and has continued through 9/12/21.

Other Meds: Florajen women prenatal

Current Illness: None

ID: 1693448
Sex: F
Age: 76
State: KY

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

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

Lab Data: STAT CXR, CBC, And Covid Swab- ordered 9-9-2021

Allergies: Fentanyl, predniSONE, Milk & Milk Products, tape

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Temp 100.5 - O2 Sats fluctuating in the 80's. Scattered crackles noted. Alertness fluctuating as well.

Other Meds: Bacitracin Ointment 500 UNIT/GM Apply to hematoma on right shin topically every evening shift for laceration with stitches Clean hematoma area on right shin, apply bacitracin and cover with xeroform and wrap in kerlex. Pharmacy Active 9/2/

Current Illness: PARKINSON'S DISEASE (G20) 8/16/21 Primary/Principal/Admission (67) Primary/Principal/Admission CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED (J44.9) 8/17/21 Secondary #1 Primary/Principal/Admission HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE WITH HEART FAILURE AND STAGE 1 THROUGH STAGE 4 CHRONIC KIDNEY DISEASE, OR UNSPECIFIED CHRONIC KIDNEY DISEASE (I13.0) 8/16/21 Secondary #2 Admitting Dx (69) ACUTE ON CHRONIC DIASTOLIC (CONGESTIVE) HEART FAILURE (I50.33) 8/16/21 Secondary #3 Admitting Dx (69) CHRONIC KIDNEY DISEASE, STAGE 3 UNSPECIFIED (N18.30) 8/16/21 Secondary #4 Admitting Dx (69) DEMENTIA IN OTHER DISEASES CLASSIFIED ELSEWHERE WITHOUT BEHAVIORAL DISTURBANCE (F02.80) 8/16/21 Secondary #5 Admitting Dx (69) MAJOR DEPRESSIVE DISORDER, RECURRENT, UNSPECIFIED (F33.9) 8/16/21 Secondary #6 Admitting Dx (69) INSOMNIA, UNSPECIFIED (G47.00) 8/16/21 Secondary #7 Admitting Dx (69) DYSPHAGIA, UNSPECIFIED (R13.10) 8/16/21 Secondary #8 Admitting Dx (69) ALZHEIMER'S DISEASE, UNSPECIFIED (G30.9) 8/16/21 Secondary 9 Or More Admitting Dx (69) GENERALIZED ANXIETY DISORDER (F41.1) 8/16/21 Secondary 9 Or More Admitting Dx (69) INTERSTITIAL PULMONARY DISEASE, UNSPECIFIED (J84.9) 8/16/21 Secondary 9 Or More Admitting Dx (69) MUSCLE WEAKNESS (GENERALIZED) (M62.81) 8/16/21 Secondary 9 Or More Admitting Dx (69) NEED FOR ASSISTANCE WITH PERSONAL CARE (Z74.1) 8/16/21 Secondary 9 Or More Admitting Dx (69) OTHER INTERVERTEBRAL DISC DEGENERATION, LUMBAR REGION (M51.36) 8/

ID: 1693449
Sex: M
Age: 21
State: MA

Vax Date: 09/12/2021
Onset Date: 09/12/2021
Rec V Date: 09/12/2021
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: PATIENT EXPERIENCED SYNCOPE FOLLOWING VACCINATION WITHIN A FEW MINUTES. PATIENT WAS ABLE TO REMAIN SEATED, ALTHOUGH HE DID APPEAR TO LOSE CONSCIOUSNESS FOR A BRIEF MOMENT. PATIENT WAS SWEATING, HAD BLURRED VISION, AND HAD A LOW PULSE. PATIENTS MOTHER SAID HE WAS ANXIOUS OVER VACCINE. PATIENT DRANK SOME WATER AND STARTED TO GET COLOR BACK AND SWEATING STOPPED. HE SAT FOR 30 MINUTES AFTER AND SAID HE FELT BETTER.

Other Meds:

Current Illness:

ID: 1693450
Sex: M
Age: 24
State: MN

Vax Date: 09/02/2021
Onset Date: 09/10/2021
Rec V Date: 09/12/2021
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: None

Allergies: Suprax, some seafood, caragein

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

Symptoms: Maculopapular rash on both the palmar and dorsal surface of bilateral hands started one week after vaccination.

Other Meds: None

Current Illness: None

ID: 1693451
Sex: F
Age: 39
State: CA

Vax Date: 07/06/2021
Onset Date: 07/15/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: Scheduled for a sonogram

Allergies: No

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: First period following vaccine in July more bleeding with stronger cramping. Second period following vaccine I did not have normal cramping they felt like contractions, I could not perform my daily tasks, I had heavier bleeding and ended up passing two blood clots the size of cookies. My second period was also 9 days late and it is never late and there is no chance I?m pregnant. Awaiting my 3 rd period that is supposed to start tomorrow (Sept 13) . I will notify cdc again to inform you guys if it worsens even more.

Other Meds: No

Current Illness: No

ID: 1693452
Sex: F
Age: 56
State: KS

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/12/2021
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: none

Symptom List: Pharyngeal swelling

Symptoms: Shivering, chills and fever in addition to paid on arm

Other Meds: Fish Oil , Multivitamins

Current Illness: none

ID: 1693453
Sex: F
Age: 24
State: TX

Vax Date: 09/12/2021
Onset Date: 09/12/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data:

Allergies: Currently in assessment by ENT (prior to today)

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Immediately felt like her throat was swelling, hard to swallow. States this has been frequently happening to her since March, unrelated to illness or medications. Is under treatment by ENT to discover etiology.

Other Meds: Allergy medication and steroid nasal spray

Current Illness: Had throat closing sensation 5 days ago.

ID: 1693454
Sex: M
Age: 25
State: OH

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 09/12/2021
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

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Chest pain around the heart region. Pain lasted for one day. Will there by long-term effects?

Other Meds: None

Current Illness: None

ID: 1693455
Sex: F
Age: 85
State: KY

Vax Date: 09/08/2021
Onset Date: 09/10/2021
Rec V Date: 09/12/2021
Hospital: Y

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

Lab Data: STAT chest xray, STAT EKG, STAT BNP and to obtain rapid COVID 19 test- 09/10/2021

Allergies: Carbidopa, Etodolac, Iodine I 131 Tositumomab, Lovastatin, Metformin, Oxycodone, Cipro, Demerol, Januvia, Levaquin, Nexium, Valium, Vioxx, Sulfa Antibiotics

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

Symptoms: Resident not feeling well, very anxious, wants to go to hospital. All VS stable and WNL, BS 126. Family states resident has behavior like this when she has a UTI. she does have upper airway wheezes and bilateral lower lobe crackles, oxygen increased to 3LPM and is @ 96% whereas when she was on 1LPM she was Sat @ 86%. Residents skin color is very pale, she is lethargic and complaining of nausea and fatigue at this time. EKG done at this time per facility machine. Report reads as follows: atrial fibrillation with rapid mean ventricular response minor high-lateral and lateral repolarization disturbance, consider ischemia, LV overload or aspecific change, abnormal ECG, unconfirmed report. Dr. B returned call, requesting that EKG be uploaded into PCC, EKG was uploaded per request. Dr. B called the center and spoke to this writer, new orders to give additional one time dose of lasix 80mg now and then hold her 60mg dose of lasix in the morning and give her 80mg instead. Then resume normal dosing.

Other Meds: PARoxetine HCl Tablet 20 MG Give 1 tablet by mouth one time a day for GAD Pharmacy Active 9/4/2021 07:00 9/3/2021 Warning: Controlled Drug There is a black box warning associated with this order. Please click to view details. The Resident

Current Illness: UNSPECIFIED ATRIAL FIBRILLATION (I48.91) 5/4/21 Primary/Principal/Admission (67) Primary/Principal/Admission SHORTNESS OF BREATH (R06.02) 5/4/21 Secondary #1 Admitting Dx (69) CHRONIC COMBINED SYSTOLIC (CONGESTIVE) AND DIASTOLIC (CONGESTIVE) HEART FAILURE (I50.42) 5/4/21 Secondary #2 Admitting Dx (69) MUSCLE WEAKNESS (GENERALIZED) (M62.81) 5/5/21 Secondary #3 Admitting Dx (69) UNSTEADINESS ON FEET (R26.81) 5/5/21 Secondary #4 Admitting Dx (69) NEED FOR ASSISTANCE WITH PERSONAL CARE (Z74.1) 5/5/21 Secondary #5 Admitting Dx (69) HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE WITH HEART FAILURE AND STAGE 1 THROUGH STAGE 4 CHRONIC KIDNEY DISEASE, OR UNSPECIFIED CHRONIC KIDNEY DISEASE (I13.0) 5/4/21 Secondary #6 Admitting Dx (69) TYPE 2 DIABETES MELLITUS WITH HYPERGLYCEMIA (E11.65) 5/4/21 Secondary #7 Admitting Dx (69) DYSPHAGIA, UNSPECIFIED (R13.10) 8/1/21 Secondary 9 Or More During Stay KLEBSIELLA PNEUMONIAE [K. PNEUMONIAE] AS THE CAUSE OF DISEASES CLASSIFIED ELSEWHERE (B96.1) 7/19/21 Secondary 9 Or More During Stay URINARY TRACT INFECTION, SITE NOT SPECIFIED (N39.0) 7/19/21 Secondary 9 Or More During Stay OTHER SYMBOLIC DYSFUNCTIONS (R48.8) 7/16/21 Secondary 9 Or More During Stay ALLERGY STATUS TO UNSPECIFIED DRUGS, MEDICAMENTS AND BIOLOGICAL SUBSTANCES (Z88.9) 6/1/21 Secondary 9 Or More CONSTIPATION, UNSPECIFIED (K59.00) 5/5/21 Secondary 9 Or More Admitting Dx (69) HYPOTHYROIDISM, UNSPECIFIED (E03.9) 5/5/21 Secondary 9 Or More Admitting Dx (69) INS

ID: 1693456
Sex: F
Age: 30
State: FL

Vax Date: 05/25/2021
Onset Date: 06/20/2021
Rec V Date: 09/12/2021
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: PCN

Symptom List: Rash, Urticaria

Symptoms: For me, both the first pfizer covid-19 vaccines (dose 1 and 2)each caused me to have migraine and nausea, temperature increases, fatigue, anxiety and stomach problems for a few days. However, the most notable change is that my menstrual periods have changed significantly. I have been tracking my periods for years on an app and they averaged 5 or 6 days max in duration previously, with tolerable symptoms. As soon as I received the covid-19 vaccine, my periods became 8 days long with unbearable symptoms. I am not on oral contraceptives and have not been on them for at least 10 years, nor have I taken any injections or IUDs. We use condoms only, so there is no possible way that birth control could have affected this, and I have had all of my hormones checked by my doctors which have been historically within normal limits.

Other Meds: Prenatal vitamins only. No other prescriptions or medications.

Current Illness: none

ID: 1693457
Sex: F
Age: 56
State: PA

Vax Date: 06/23/2021
Onset Date: 06/23/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: N/A

Allergies: Latex, molds, fungi, sulfates, sulphites, citric acid, citrate, citrus, corn, banana, cantaloupe, almonds, hazelnuts, cashews, pecans, refined sugar...

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

Symptoms: Immediate injection site erythema, swelling, pain, x 5 days; fever within 30 minutes, 100.3 x 5 days, spiking to 100.3 x 5 more days (10 days total); body aches, joint pain, fatigue, malaise x 14 days.

Other Meds: Plaquenil; Lyrica; Vit D-2; Levalbuterol Tartrate prn.

Current Illness:

ID: 1693458
Sex: F
Age: 43
State: TX

Vax Date: 09/04/2021
Onset Date: 09/04/2021
Rec V Date: 09/12/2021
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: No

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

Symptoms: Dizziness. Diarrhea. Prolong brain fog. Stomach pain. Heating effects in body. Swollen lymph node. Extreme tiredness. Dry mouth. Upset stomach. Loss of appetite. Heavy head. Fever. Chills. Jitters in body. Anxiety.

Other Meds: Multivitamin

Current Illness: Sjogrens autoimmune

ID: 1693459
Sex: M
Age: 65
State: TX

Vax Date: 06/05/2021
Onset Date: 07/09/2021
Rec V Date: 09/12/2021
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: MRI, CAT Scans, blood work ups

Allergies: NKDA

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

Symptoms: Guillain-Barre' Syndrome; Paralysis from waste down to include bowel and renal functions, loss of muscular control - complete paralysis from knees down; no muscular movement or nerve stimulation. Neuropathy in feet, loss of muscular mass in legs. Nerve loss of stimulation and movement upward to right arm and hand; resulting in loss of muscular strength in fingers of patient's dominate right hand. Blood Pressure is not being controlled and maintained at a normal range with medication; continuing increasing Diastolic pressures with fluctuations. Heart Arrhythmia. Head aches. Visual changes in near ranges. Mood Swings and depression. Patient had onset of extreme pain and nerve stimulation radiating within upper abdominal and chest cavity.

Other Meds:

Current Illness: Rheumatoid Arthritis Heart Attack 04/22/2021

ID: 1693460
Sex: F
Age: 20
State: MI

Vax Date: 09/12/2021
Onset Date: 09/12/2021
Rec V Date: 09/12/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: A few minutes after vaccination, the patient began what appeared to be vasovagal syncope. Symptoms lasted for 1-2 minutes, and the patient awake from syncope and was alert and coherent. Patient felt flush and was sweating. She reported feeling completely normal approximately 5-10 minutes after awakening. Patient did not fall on the ground. She was sitting in a chair and dropped a few items from her hand and slumped into chair for entirety of symptoms. Patient reported no prior issues with vaccinations. Patient came with a friend/family member who was with her during the entirety of symptoms. Patient reported feeling anxious prior to vaccination. Patient also reported that she had nothing to eat prior to vaccination due to nervousness.

Other Meds: UNKOWN

Current Illness: UNKNOWN

ID: 1693461
Sex: F
Age: 57
State: FL

Vax Date: 03/09/2021
Onset Date: 08/06/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: Urine test 8/9/21 (see above)

Allergies: doxycycline, shellfish, environmental (ragweed, dust, mold, bahia, cats, roaches)

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

Symptoms: Bladder/urinary tract infection; symptoms started on 8/6/21 (fever, lower abdomen pain, fatigue); consulted physician's assistant via online appointment (with pharmacy) on 8/8/21, who recommended I see my primary care doctor or urgent care, since she could not diagnose/provide treatment without seeing me in person and conducting a lab test. I went to Urgent Care on 8/9/21 and was diagnosed with a UTI. Follow-up lab results confirmed an infection. I was prescribed a 5 day course of antibiotics (Bactrim) which I completed and the infection was resolved. I also took an at-home rapid COVID test on 8/10/21 and result was negative.

Other Meds: Estradiol, Ursodiol, multi-vitamins

Current Illness: None

ID: 1693462
Sex: F
Age: 43
State: IA

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

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

Lab Data: None

Allergies: Penicillin,Cephalon Outdoor allergens-E.plantain,ragweed,thistle,tree pollen, Molds-altern. ,asperg., fusarium, penicil.,Clado H,clado s, corn shut mix. Indoor allergens-dust mite,cat,cockroach

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Severe dizziness within 2 or 3 minutes. All of my allergy symptoms flared up for 2 days after vaccine.

Other Meds: Allergy shots, allegra,Flonase ,Tylenol, Valtrex, omeprazole, birth control pills,baclofen, clonazapam,Concerta

Current Illness: Allergy symptoms, like sinus,cough,sore throat, runny nose,itchy eyes

ID: 1693463
Sex: F
Age: 0
State: VA

Vax Date: 09/12/2021
Onset Date: 09/11/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: none

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: immediately following injection pt states "i fell dizzy and funny in the head". she also reports "itchy throat".

Other Meds: not known

Current Illness: not known

ID: 1693464
Sex: F
Age: 27
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Patient had PFIZER COVID-19 vaccine, Dose 1 date: 01/7/2021, Dose 2 date: 01/28/2021, AND TESTED POSITIVE TO COVID

Other Meds:

Current Illness:

ID: 1693465
Sex: M
Age: 45
State: RI

Vax Date: 05/05/2021
Onset Date: 08/08/2021
Rec V Date: 09/12/2021
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: Bloodwork and CAT scan

Allergies: None

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

Symptoms: Started experiencing chest pain and palpitations on 8/8. Admitted to Emergency Room on 8/11. Diagnosed with Pericarditis by Dr. and discharged on same day. Treated with 600 mg Ibuprofen, 3 times a day. Followed up with PCP Dr. who recommended reducing the dosage after 10 days. However, had a recurrence of the issue on 9/2. Still on Ibuprofen, 400 mg, 3 times a day. Follow up scheduled with Cardiologist on Oct 1st.

Other Meds: Nexium OTC

Current Illness: None

ID: 1693466
Sex: M
Age: 50
State: OH

Vax Date: 04/08/2021
Onset Date: 08/23/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: Covid 19 positive

Allergies:

Symptom List: Unevaluable event

Symptoms: I did not lose smell or taste, I would go from 104 to 94 every few hours with no meds, sweating, constant cough, mucus phlegm in lungs, could not sleep on stomach or back if I laid down I would wheeze. I had constant cough for 4-5 days

Other Meds: nethadaphine

Current Illness:

ID: 1693467
Sex: M
Age: 69
State: FL

Vax Date: 03/07/2021
Onset Date: 06/06/2021
Rec V Date: 09/12/2021
Hospital: Y

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

Lab Data: CT Scan lungs, various blood tests, COVID test all at hospital between 6/6/21 - 6/10/21.

Allergies: Chlorhexidine; Celebrex; Motrin; Tramadol ER; Bactrim

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

Symptoms: PMHx to include RA, history of + PPD treated with 6 mos INH therapy in remote past, COPD with questionable ILD and OSA. Hospitalized from 6/6/21 - 6/10/21 for worsening shortness of breath. Found to have hypoxemic respiratory failure. Question if this was progressive ILD related to his RA versus methotrexate ALI as his dose had recently been increased. He was treated with corticosteroids and discharged home with 02. On 6/30/21 he notes improvement in his dyspnea but remains winded with minimal exertion. HR goes up with activity as well. His methotrexate was discontinued. He was placed on Humira as per his rheumatologist.

Other Meds: Ajovy; Amolipine (Norvasc); Anoro Ellipta; Finasteride; Folic Acid; Gabapentin; Hydroxycloroquine; Lotemax; Humira; Prednisolone acetate; Prolia; Tamsulosin; Citracal/Vit D3; Fish Oil/EPA/DHA; Multivitamin; Vit D & K; Migranol; Probiotics/P

Current Illness:

ID: 1693468
Sex: M
Age: 81
State: MD

Vax Date: 02/15/2021
Onset Date: 06/22/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: EKG 6-24-21 Unremarkable Blood Tested 6-24-21 Unremarkable CT scan 7-1-21 - Inflammation and fluid found in Inner Ear MRI Brain 8-16-21 - Negative for new issues or results

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: On 6/22/21 with no advance symptoms right inner ear struck with terrible pain and hearing loss and immediate loss of balance. Approximately 2 weeks later... pain gone with help of antibiotics and prednisone. Currently (9-12-21) no improvement in hearing loss (90%) and imbalance has not improved despite PT. Could this inner ear virus been Covid-19?

Other Meds: Prednisone - 3MGs daily / Losartan-hydrochlorothiazide -100MGs daily / Amlodipine 2.5MG daily Vitamin D3 25MG daily Iron 65MG daily B12 1000MG daily

Current Illness: None

ID: 1693469
Sex: F
Age: 37
State: TN

Vax Date: 07/27/2021
Onset Date: 08/04/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: Pending

Allergies: Nitrofurantoin/Macrobid

Symptom List: Injection site pain, Menorrhagia

Symptoms: Severe Itch migrating all over body for several hours that culminated in Urticaria, diarrhea, loss of consciousness, nausea. Nausea persisted for 2 days. Urticaria /itch has been reducing dramatically over time but still persistent at 6 weeks since onset of symptoms. Treatments tried include- antihistamines. A course of steroids. Now on Zyrtec.

Other Meds:

Current Illness:

ID: 1693470
Sex: F
Age: 20
State: GA

Vax Date: 09/10/2021
Onset Date: 09/11/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Feverish 1pm following day Took 3,000 mg vitamin C and 2 Acetaminophen tablets Color turned pale/gray, lips lost all color, threw up 3 times between 5pm-9pm. Had severe chills after vomiting. Had congestion in chest and was taking deep breaths to breathe. Took pepto bismol at 9pm, ate some saltine crackers, and drank some Gatorade. Took 1 ibuprofen at 10pm, then slept for 11 hours. Woke up at 9am on 9/12/21. Got out of bed at 10am. Feeling better but still feeling out of breath and not breathing normally..

Other Meds: Norethindrone Acetate Ethinyl Estradiol & Ferrous Fumarate tablets, 1 mg/0.02 mg Spironolactone 100mg Vitamin D Garden of life Dr. Formulated probiotics once daily womens

Current Illness: None

ID: 1693471
Sex: M
Age: 53
State: MO

Vax Date: 08/16/2021
Onset Date: 08/17/2021
Rec V Date: 09/12/2021
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: 08/26/2021: Consultation at Dermatologist 09/07/2021: Consultation at ENT

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 1. Feverish symptoms (recovered after two days) 2. Body ache especially on the arm where the shot was administered (recovered after two days) 3. Skin rashes (recovered after approximately three weeks) 4. Skin itching (recovered after approximately three weeks) 5. Dry scalp (recovered after approximately three weeks) 6. Flutter/buzz in left ear on the side of the MVD surgery performed in 2010 for Hemifacial Spasm (this symptom still persists as of today)

Other Meds: Multi vitamin

Current Illness: None

ID: 1693472
Sex: F
Age: 46
State: FL

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: None, reported to my family physician the next day,

Allergies: Seasonal allergies

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Within a few minutes of injection, my left arm began itching, followed by neck and my face. I reported to the pharmacist and he instructed me to take Benadryl. I had no other symptoms at the time. After leaving I began to have a scratchy throat and some wheezing, I continued with the Benadryl and self monitored until symptoms began to subside within two hours.

Other Meds: Propranolol 10mg 2x daily, was not taken the morning prior to the vaccination. Last dose was 9/9/21.

Current Illness: None

ID: 1693473
Sex: F
Age: 40
State: WA

Vax Date: 05/01/2021
Onset Date: 08/10/2021
Rec V Date: 09/12/2021
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 I dont have medical insurance

Allergies: none

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

Symptoms: Severe Menstrual Bleeding and cramping to include major blood clots in menstruation so heavy that need to use adult diapers over menstrual pads

Other Meds: none

Current Illness: none

ID: 1693474
Sex: F
Age: 78
State: NY

Vax Date: 03/10/2021
Onset Date: 07/13/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: Basic metabolic test, normal

Allergies: Epinephrine; Ambien

Symptom List: Nausea

Symptoms: On 07/13/2021, I had blood drawn because I was having frequent urination and intense, unquenchable thirst. The doctor will do the 3rd round of blood test and urine test. The 1st basic metabolic test were normal. The 2nd test they didn't find anything. Everything was great. No weight loss, or nothing they can track down. The Lyme disease results have not come out. I had a very serious case of Lyme disease within the last 10 year, and I was hospitalized for 3 or 4 days and I went home with a pick line to my heart. In August 2021, I went to a health care facility for a tick bite and they with treated me 2 tablets Docy. I am very appreciative of the research CDC is doing.

Other Meds: Vitamins

Current Illness: No

ID: 1693475
Sex: F
Age: 15
State: MN

Vax Date: 10/04/2018
Onset Date: 10/04/2018
Rec V Date: 09/12/2021
Hospital: Y

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

Lab Data: EMG, EKG, tilt table test, spinal tap, blood work

Allergies: gluten, high fructose corn syurp, fructose, dairy, potatoes, ibuprophen

Symptom List: Injection site pain

Symptoms: Headaches, paresthesia, weakness, dizziness, twitches, body aches, brain fog, temperature intolerence, fainting. Treatment was ferritin infusion, medication, consuming lots of salat and water, iron supplement, vitamin D regimen. Outcomes are autonomic dysfunction and anemia.

Other Meds: omeprazole

Current Illness: none

ID: 1693476
Sex: M
Age: 90
State: MO

Vax Date: 02/13/2021
Onset Date: 09/06/2021
Rec V Date: 09/12/2021
Hospital: Y

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

Lab Data:

Allergies: unknown

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

Symptoms: tested positive for covid after being fully vaccinated

Other Meds: unknown

Current Illness: unknown

ID: 1693477
Sex: F
Age: 36
State: AZ

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: none

Allergies: None

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

Symptoms: Myalgias started around 8:30pm the same day (9/11/21) as administration of the flu vaccine. Low grade fever started around 9:30pm. Tylenol was taken around 9:30pm before going to bed, then I woke up with fever of 102 degrees F around 11:20pm. I also have a tender lump on the medial aspect of my left elbow (same arm as administration of the vaccine) with pain radiating about half way up my arm. Injection site is sore and warm to touch with no surrounding erythema. Fever subsided upon awakening this morning at 7:00am. I continue to have mild myalgias and tenderness and lump in by inner elbow have not changed.

Other Meds: Omeprazole, Prenatal vitamin, Vitamin D, Zinc

Current Illness: None

ID: 1693478
Sex: F
Age: 65
State: DE

Vax Date: 03/07/2021
Onset Date: 06/14/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: EKG 06/14/21 Sleep Apnea Test 06/14/21 Carotid Ultrasound 06/30/21 Stress Persantine 08/02/21 Echocardiogram - scheduled for November 2021

Allergies: Penicillin

Symptom List: Tremor

Symptoms: Diagnosed with A-Fib in June due to uneven heart rhythm. I am not totally attributing it to the vaccine, but did recall that there were some blood / clotting issues with the J&J vaccine. I just wanted you to be aware of this new diagnosis to see if others that had the J&J vaccine also started showing symptoms of heart disease. I am still in the process of undergoing various heart tests to see if a cause could be found.

Other Meds: Atvorstatin Lisinopril Calcium with Vitamin D Amlopodin Turmeric Curcumin

Current Illness: None

ID: 1693479
Sex: F
Age: 43
State: MD

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 09/12/2021
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. I did visit an urgent care center on 8/4/2021 and consulted with allergist a few weeks later.

Allergies: Diagnosed: grass, tree, & weed pollens, molds, mushrooms, & dust mites. Suspected: milk, mushrooms, spinach, refined sugars, preservatives & insect venom

Symptom List: Erythema, Pruritus

Symptoms: I had not been experiencing any regular allergy symptoms for at least a year before I got the vaccine - all of my symptoms were well controlled by the Cetirizine pills that I take daily. Approximately 45 minutes after I received the vaccine, my tongue started to feel numb, my tongue started to itch, and my throat started to feel like it I had a swollen and sore throat. So, I took a Cetirizine tablet. But, these symptoms continued for about 2 more hours so I went to an urgent care center and the doctor gave me a prescription for Medrol dosepak and an Epi-Pen. The steroids seemed to help relief my tongue itching & sore throat. A few days later, I noticed that the skin around my injection site was dark & discolored for a while and after a few days there was a rash from the injection site down the length of my arm that remained there for almost three weeks. There are still a few small flesh colored bumps near the injection site and my throat continues to feel sore - especially when my Cetirizine tablets wear off.

Other Meds: Cetirizine & Women's multivitamin

Current Illness: None

ID: 1693480
Sex: F
Age: 22
State: GA

Vax Date: 08/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/12/2021
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: N/A

Allergies: Amoxicillin

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

Symptoms: I received my first shot on August 13th, and about 4-5 days later I began experiencing spontaneous pain all over my body. It feels like a needle is stabbing me and it happens randomly without anything triggering it. It can start on my wrist, then start on leg, then on the back of my head, then on my chest, and really just anywhere on my body. It?s not a traveling pain so it doesn?t start on my wrist and travel to my ankle, it?s spontaneous. It doesn?t feel like numbness. The pharmacist advised me to report this since they had not heard anything like it.

Other Meds: N/A

Current Illness: GERD

ID: 1693481
Sex: F
Age: 46
State: FL

Vax Date: 03/10/2021
Onset Date: 03/18/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: Negative blood test for OA and RA

Allergies: Sulfa medications, shrimp

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

Symptoms: Intermittent pressure "headaches" beginning 2 hours after 1st Moderna dose and lasting 4 months. Bilateral joint pain in arms. Worst in CMC/MCP joints in thumbs, but affected all joints in fingers for 2 months after 1st dose. Intermittent joint pain in wrists, elbows and shoulders for 2 months after 1st dose.

Other Meds: Zyrtec, Pepcid

Current Illness: None

ID: 1693482
Sex: F
Age: 35
State: NY

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

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

Lab Data: Covid test, chest X-ray, complete blood panel, d dimer test.

Allergies: Sulfa, coconut, latex

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Difficult taking deep breathes. Hard to catch my breathe

Other Meds: Vitamins

Current Illness: N/A

ID: 1693483
Sex: F
Age: 25
State: IA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 09/12/2021
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: Sensitive to dairy, red meat, gluten

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

Symptoms: Day after 2nd dose I was weak, had chills, and this went on for 2 days. Long term: caused my period to be inconsistent for 5-6mo after shot where I got my period about 2x a month when it is always on the exact same day each month. It caused my ibs to flair up 2 mo after the shot and lasted for 3mo where I couldn't hold food for longer than 25min.

Other Meds: Daily vitamin, progesterone only birth control

Current Illness: None

ID: 1693484
Sex: F
Age: 35
State: NV

Vax Date: 01/29/2021
Onset Date: 02/02/2021
Rec V Date: 09/12/2021
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: During the month of August 2021 I had multiple ekgs, an echoocardiogram, a doppler of the blood flow of my arms and legs, stress test. Another EkG 9/8/21 Another echocardiogram on 9/9/21

Allergies:

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

Symptoms: Day 1 of shot- immediate dizziness and headache. Headache lasted 7 weeks straight nonstop. Day 4- 7 weeks after- dizziness came daily. Day 10 after shot- Day 17- Along with headache and dizziness, heart palpitation, diarrhea, tremors, chills, feeling of malaise. Heart palpitations, headache, and dizziness became intermittent every few weeks after the 7 weeks post-shot, lasting for about 3 weeks then going away so I thought it was getting better. At the end of July, my symptoms got worse- my heart palpitations became worse and more frequent and also being triggered by heat, sugar, and high carbs and becoming increasingly faster, irregular and paired with angina like sharp pain and squeezing of my heart, fatigue in legs and arms, frequent urination, high blood pressure. Before the shot I did not have these symptoms.

Other Meds: Lo Lo Estrin Fe birth control Mulitvitamin Famotidine

Current Illness:

ID: 1693485
Sex: F
Age: 63
State: TN

Vax Date: 08/24/2021
Onset Date: 08/26/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: None to date

Allergies: reglan Gabapentin Amnitriptilyne

Symptom List: Pain in extremity

Symptoms: Heart PVCs have increased exponentially.

Other Meds: Diltiazem, aproprizole, celebrex. 325 mg aspirin, simvastatin; hydroclorothiazide, clonazepam, vit, E, elderberry/sambuca, fish oil

Current Illness:

ID: 1693486
Sex: F
Age: 28
State:

Vax Date: 01/21/2021
Onset Date: 09/09/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: PATIENT HAD COVID VACCINE ON Dose 1 date:01/21/2021, Dose 2 date: 02/11/2021, AND TESTED POSITIVE TOCOVID.

Other Meds:

Current Illness:

ID: 1693487
Sex: F
Age: 47
State: FL

Vax Date: 04/08/2021
Onset Date: 04/20/2021
Rec V Date: 09/12/2021
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: Sulfa medications, shrimp

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

Symptoms: Hypersensitive skin on right thigh causing pain with light touch and sharp intermittent pain in right thigh lasting lasting 6 weeks after 2nd dose. In June 2021 right arm (site of both injections) became hot to the touch, pain across all joints in right arm, and r knee and foot pain lasting 24 hours.

Other Meds: Zyrtec, Pepcid

Current Illness: None

ID: 1693488
Sex: F
Age: 54
State: CA

Vax Date: 07/24/2021
Onset Date: 07/25/2021
Rec V Date: 09/12/2021
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, called GP and was told to take tylenol for fever

Allergies: Decadron, vicodin, raw tomatoes

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

Symptoms: Fever, bad headache, after 24 hours, droopy left side of face, numbness on left side of face (like the Bell's Palsey I had after contracting meningitis in 1992) after about 36 hours, extreme exhaustion for 3-4 days

Other Meds: Lisinopril, metformin, vitamin D, Vitamin C

Current Illness: None

ID: 1693489
Sex: F
Age: 23
State: DE

Vax Date: 07/07/2021
Onset Date: 07/10/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: n/a

Allergies: n/a

Symptom List: Vomiting

Symptoms: Pt. has never had an allergic reaction to eating fresh pomegranates. She has been eating fresh pomegranates since the age of 2. After receiving the vaccine for covid-19, she ate fresh pomegranate 3 days later, within 15 minutes she had an allergic reaction; her lips began to swell to double in size. It was treated immediately with over-the-counter Benadryl at home.

Other Meds: Multi-vitamin, slow release iron supplement

Current Illness: n/a

ID: 1693490
Sex: F
Age: 37
State: TX

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 09/12/2021
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: sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt having reaction in left arm, suspected to be bacterial in nature, will treat with abx, has only gotten worse since date of event.

Other Meds:

Current Illness:

ID: 1693491
Sex: F
Age: 62
State: CO

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/12/2021
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: Patient received 0.3 mL undiluted Pfizer vaccine x 1 injection. Facility contacted Poison Control center for direction. Contacted Medical Director for further instructions. No adverse effect resulted from adverse event.

Other Meds:

Current Illness:

ID: 1693492
Sex: F
Age: 54
State: CA

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 09/12/2021
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: decadron, vicodin, raw tomatoes.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Severe headache, return of Bell's Palsey (droopy left side of face, lower lip curled in, numbness on left side of face, focal pain at temple), exhaustion

Other Meds: lisinopril, metformin, vitamin D, Vitamin C.

Current Illness: None.

ID: 1693493
Sex: F
Age: 60
State: SC

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

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

Lab Data: N/A

Allergies: Penicillin as a child (bad rash)

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

Symptoms: The pt. said she felt fine at first after getting the vaccine. On days 8 and 9 she started having stomach issues with severe diarrhea. As of day 10, her diarrhea is better, but she awoke with a quarter-sized whelp with blisters at the injection site. She says it is hot to the touch and there is a lot of redness. I advised her to follow up with her doctor.

Other Meds: Sertraline

Current Illness: N/A

ID: 1693494
Sex: F
Age: 28
State: PR

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/12/2021
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: Shellfish, iodine and ants

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

Symptoms: 28 year old patient after receiving the second dose of Pfizer after 20 minutes started to feel a rash on the neck and then the skin turned red on the chest just like the left wrist. At 4:42pm, the patient took half of a Benadryl 25mg and her vitasls were verified which were: 107 pulse, 98 saturation, 120/70 B/P and clear lungs. Patient was kept in observation and later at 4:56pm took the other half of the Benadryl. At 5:10pm, the patient was re-evaluated and the vital signs were: 108 Pulse, 110/80 B/P, 99 saturation and 16 Respiration.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am