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: 1693756
Sex: F
Age: 54
State: NY

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

Symptom List: Dysphagia, Epiglottitis

Symptoms: 12 hours after 2nd shot I was paralyzed for 36 hours. I wasn?t terrified because I am on a group for the medication ocrevus and I saw a few people where paralyzed after the 2nd shot. By paralyzed I mean I could not move

Other Meds: Ampyra, vitamin D and B, ocrevus last taken sept 29, 2020

Current Illness:

ID: 1693757
Sex: F
Age: 49
State: TN

Vax Date: 08/26/2021
Onset Date: 08/26/2021
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: None

Allergies: Fluoroquinolone antibiotics caused a achilles tendon issue

Symptom List: Anxiety, Dyspnoea

Symptoms: Within 20 min to half hour after this first vaccine dose I experienced sharp one second pains in what felt like uterus. Happened intermittently several times through day and faded away after 1st day. Also within half hour of vaccine both arms felt asleep or as if they had been in same position for a long time even though they were not. This continued first day or longer off and on. Within first half hour after vaccine experienced a brief one second strong headache in small section at back of head. On drive home after vax and first days my heart hurt. Brain for for first week. Worst affect was in days 6 and seven post first vaccine experienced moderate to severe continual headache. Lasted 2 to 3 days. I never get headaches like this. I did also experience sore breasts and mood swing as if my period was coming but it was not due to come for another 9 days. This is unusual for me as it usually only happens briefly the day before it starts now. My period did start on time on schedule 17 days after the vaccine. Also I had a weird thing happen on one day in which my earlobe itched and felt infected as they did many decades ago when I was allergic to metal from earring posts in my pierced ears.

Other Meds: Vitamin d3

Current Illness: None

ID: 1693758
Sex: M
Age: 69
State: NY

Vax Date: 09/10/2021
Onset Date: 09/11/2021
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: availible from the hospital

Allergies:

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

Symptoms: sixteen hours after following the vaccination I became incoherent and unresponsive. An ambulance was called and was taken to the local Hospital and treated for numerous isses.

Other Meds: NyQuil

Current Illness:

ID: 1693759
Sex: M
Age: 26
State: MN

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 2nd dose moderna given inadvertently at 21 days

Other Meds:

Current Illness:

ID: 1693760
Sex: F
Age: 24
State: RI

Vax Date: 04/10/2021
Onset Date: 04/24/2021
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: Vaginal ultrasound, CBC and physical exam on 4/24/2021

Allergies: NKA

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

Symptoms: Exactly two weeks after my first vaccine I started vaginally bleeding extremely heavy and started to experience cramping similar to a menstrual cycle which I have not experienced in 10 years since I received my first Nexplanon implant.

Other Meds: Dextro-amphetamine, lamotrigine, buspirone, vitamin d3, sertraline, latuda

Current Illness: None

ID: 1693761
Sex: F
Age: 29
State: OK

Vax Date: 09/01/2021
Onset Date: 09/02/2021
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:

Allergies: Gluten

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

Symptoms: Here a little first hand experience for you. I got my first shot a week ago. I?ve been super worried about catching it while in the hospital possibly exposing the baby plus our two child with low immunity. I have zero energy and I feel different not like myself. I have horrible brain fog and sometimes have a hard time putting a sentence together. One day out of the blue it was like I did a line of Adderall and cleaned the entire house. Yesterday was my first bike ride since getting my shot. My hands and feet swelled so bad that it felt like needles in my fingers and toes. I will not be getting my second shot! I?ve started having contractions and I?m not due until December 2021.

Other Meds: Prenatal vitamins

Current Illness:

ID: 1693762
Sex: F
Age: 30
State: AL

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: Amoxicillin penicillin azithromycin Zyrtec cclore ketek zpak coreg gentamicin vancomycin omnicef, rocephin, imitrex, amitriptyline, cymbalta,

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Left arm welts red all the way down to elbow, bumps on left and right arm, pain and rash that itches on left hand, left side of gums are really red and raw like a later peeled off very painful and burning. Fatigue, body aches.

Other Meds: Cymbalta 60mg bid Omeprazole 40mg daily

Current Illness: None

ID: 1693763
Sex: M
Age: 23
State: OH

Vax Date: 05/25/2021
Onset Date: 05/25/2021
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:

Allergies: N/a

Symptom List: Pharyngeal swelling

Symptoms: Fever, weakness, sleepiness

Other Meds: N/a

Current Illness: N/a

ID: 1693764
Sex: F
Age: 32
State: GA

Vax Date: 05/21/2021
Onset Date: 05/22/2021
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: Blood work and Physical evaluation on 7/16/21 All normal range T3 FREE normal T4 FREE normal TSH normal

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: One day following following vaccine, period started and went 12 days of flow or spotting (normally six) This same cycle went 32 days (normally 25) (negative for pregnancy) Subsequent cycle went 12 days (normally 25) Next cycle went 21 days (normally 25) Next cycle went 25 & anovulatory (normally ovulatory) Next cycle went 22 days (normally 25) At the time of this report this is the complete history, cycles have not returned to normal

Other Meds: None

Current Illness: None

ID: 1693765
Sex: F
Age: 26
State: CO

Vax Date: 09/10/2021
Onset Date: 09/10/2021
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:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fever of ranging from 100-100.7 from Friday evening and still continuing. Not responsive to ibuprofen. Other symptoms include chills, aches, loss of appetite, nausea, weakness and fatigue

Other Meds: Keppra ER Multivitamin

Current Illness: None

ID: 1693766
Sex: F
Age: 39
State: MD

Vax Date: 06/05/2021
Onset Date: 06/05/2021
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: Chest X Ray CPET 2D Echo

Allergies: Dust mites, white hickory tree

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

Symptoms: Approximately 2 hrs after being vaccinated on 6/5, I felt somewhat unwell. I checked my VS. My temp, SPO2, HR seemed to be WNL. My BP was somewhat higher then usual 141/96mmHg as I have no history of HTN and was not on medication except for over the counter antihistamine for my allergies. I continued to monitor throughout the rest of the day and it was gradually going up with the highest reading of 156/105mmHg with dizziness whether sitting or lying down. The dizziness/headache and high diastolic continued on for 3.5 weeks everyday with warm sensation on chest area around the heart on day 7 and day 8 from being vaccinated which I started taking Garlic extract 1000mg on day 7 with the hopes of bringing my bp down as I have no bp medication with me. I could not go back to working out as I was working out 3x/wk from 30-60mins prior to being vaccinated with my last workout day on 6/4. I was giving myself a week to let my body recuperate when my bp was not improving I scheduled an appointment with my primary. At week 5 close to week 6 after being vaccinated, I only experienced dizziness when my diastolic is higher than 100 and was able to tolerate more activities without unreasonable BP elevation with some random chest pain which is not activity or time specific as it happens briefly whether sitting, lying or walking.

Other Meds: Chlorpheniramine Maleate 4mg

Current Illness: None

ID: 1693767
Sex: F
Age: 60
State: PA

Vax Date: 01/20/2021
Onset Date: 01/22/2021
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: Evaluated by allergist who prescribed cetirizine qid and famotidine bid

Allergies: PCN, Bactrim, Tetracycline

Symptom List: Rash, Urticaria

Symptoms: Hives that lasted continuously for 7 months and continue intermittently. Treated with Medrol dose pack x2, triamcinolone cream, cetirizine 10 mg with escalating dose to 10 mg QID in addition to famotidine 20 mg BID

Other Meds: Multivitamin

Current Illness: None

ID: 1693768
Sex: F
Age: 30
State:

Vax Date: 08/13/2021
Onset Date: 08/20/2021
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 test- ag (swap) date: August 25, 2021

Allergies: NO.

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

Symptoms: The first three days after the application I only presented with arm pain and a little pain in the lungs like pulsing not in a prolonged way. At eight days I started with flu symptoms the next day with fever and extreme body pain. Third day with cough, fouth day I lost my sense and smell and I took a Covid-19 test, it was positive. I treated myself and stared having fatigue, tiredness, pain muscular, and very sleepy. I was in quarantine treating myself for covid unil now I'm still in quarantine. The doubt exist if this is the result after appying the first dose. I consider myself a heathy person. I do not suffer from any disease, I have respected the protocol from the moment my country had the first case of Covid-19, I consider myself prudent in the use of a mask, gel, distancing, etc. and during those eight days interval betweek the first dose August 13, 2021 to August 20, 2021 I had no contact with several people, I did not attend any massive events, I am an independent person an dI have my own office so I do not have co-workers nor do I live wit other people that week I was only form the office to my house. With the few people with whom I interact those days none were ill before or after being with me. Therefore, I have doubts that after being baccinated I will be one of the few cases that have a positive result for covid. I ask to please carify because I have doubts. Should I complete the sencond dose, or is it risky for me?

Other Meds: NO.

Current Illness: NO

ID: 1693769
Sex: M
Age: 29
State: OR

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: None

Allergies: NKDA

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

Symptoms: The patient was supposed to receive their second dose of Moderna vaccine but they were instead given a first dose of Pfizer vaccine by mistake.

Other Meds: None known

Current Illness: None known

ID: 1693770
Sex: F
Age: 35
State: IL

Vax Date: 09/10/2021
Onset Date: 09/10/2021
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: n/a

Allergies: LANOLIN, AZITHROMYCIN

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

Symptoms: Immediately after vaccine administration w/in <10mins. pt noted tingling and cold sensation in her left 4th and 5th digit with mild swelling, that extended laterally up to her left shoulder. Pt also noted cold sensation and tingling that started from her left hip that extended laterally down to her mid thigh. + bilateral hand shaking. Denied pain. Treatment: 45 mins of observation Outcome: Released w/o any interventions, reassurance provided and f/u with her Primary Care Provider the next business day.

Other Meds: Claritin, Prenatal Vitamins

Current Illness:

Date Died: 09/12/2021

ID: 1693771
Sex: F
Age: 87
State: CA

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

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

Lab Data: echo cardiogram 9/5, 9/6, 9/10/2021

Allergies: aspirin, HCTZ, penicillin

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

Symptoms: weakness, SOB, takotsubo cardiomyopathy , acute systolic heart failure, acute hypoxemic respiratory failure pt expired

Other Meds: metoprolol, methotrexate, folic acid

Current Illness: none

ID: 1693772
Sex: F
Age: 60
State: IL

Vax Date: 02/02/2021
Onset Date: 04/02/2021
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: X-ray - 06/21

Allergies: n/a

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

Symptoms: 1st vaccine 2/2/21 - 2 months later couldn't lift left rm or reach in back pocket. 2nd vaccine 2/23/21 - 2 months later couldn't left right arm or reach in back pocket. Identical pain & symptons. Like flapping your arms like a bird and can't. Easiest way to describe it. Pain is dissipating in right, but left arm still very painful.

Other Meds: n/a

Current Illness: n/a

ID: 1693773
Sex: F
Age: 14
State: WA

Vax Date: 09/12/2021
Onset Date: 09/12/2021
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: unknown

Allergies: unknown

Symptom List: Ear pain, Hypoaesthesia

Symptoms: PT 14 yo female, received Pfizer 1st dose LD. Once vaccinated PT attempted to get up from sitting at vaccinator table and slid from chair onto the floor unassisted. PT unresponsive RN immediately repositioned Pt on back and rolled to back with legs elevated, 1738 PT pale and A/O, BP 90/60 HR 39 O2sat 97. Parent reports child had not eaten prior to vaccine administration and had limited fluid intake. Pt alert, color returning to baseline, while talking given 11 oz of apple juice. Pt reports no nausea, HA, dizziness. Continue monitoring PT and reported improved status. Sitting BP 87/60 with heart rate 63, SPO2 99% at 1740. Pt assisted to standing position by RN and Mom without vertigo or lightheadedness, escorted and walked to post observation. Pt sitting in post observation eating a snack that parent provided and sipping juice. 1826 Pt denies vertigo and is asymptomatic when standing and discharged to home accompanied by mother. Recommended that with second dose to be well hydrated and ingest a recent meal. Encouraged her to have second dose in a supine position to avert a vasovagal response.

Other Meds: unknown

Current Illness: unknown

ID: 1693774
Sex: M
Age: 30
State: CO

Vax Date: 08/11/2021
Onset Date: 08/11/2021
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:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe soreness in left arm and wrist. The arm soreness dissipated after approximately one week. I continue to have severe soreness in my left wrist which prevents me from fully utilizing my left hand for everyday activities. Immediately after the vaccination I also felt tingling in the wrist area.

Other Meds: None

Current Illness: None

ID: 1693775
Sex: F
Age: 27
State:

Vax Date: 01/01/2021
Onset Date: 09/17/2021
Rec V Date: 09/12/2021
Hospital: Y

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: I received my vaccine while I was pregnant and did not know it, both doses. I have now had my baby at 29 weeks, and wanted to report what is going on.

Other Meds:

Current Illness:

ID: 1693777
Sex: F
Age: 44
State:

Vax Date: 01/18/2021
Onset Date: 09/11/2021
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:

Allergies:

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

Symptoms: 9/12/21: Called to report covid positive result from 9/11/21. Still symptomatic- runny nose, HA, body aches, fever. Advised to quarantine x10 days since s/s first appeared and at least 24hrs passed since fever without use of fever-reducing meds and s/s have improved/resolved. Pt to also f/u with PCP. Pt will need to clear for RTW when done with quarantine and s/s improved/resolved. Pt fully vaccinated. Antibodies testing ordered. Instructed pt. to complete covid antibodies testing when done with quarantine. HISTORY 9/11/21: Pt returned on 9/10. She started to experience s/s today, 9/11. Pt did not get preflight travel testing. States her family members had preflight testing done and were all negative. Pt instructed to quarantine while results are pending; however, if negative then no longer needs to quarantine. Pt will get results from healthcare portal within 24-72 hours. Pt informed to call the hotline as soon as results are available and at that time will get a date of when to get clearance for RTW. Pt to call hotline with date of symptom resolution. Pt instructed to update manager.

Other Meds:

Current Illness:

ID: 1693778
Sex: F
Age: 42
State: AL

Vax Date: 07/13/2021
Onset Date: 08/25/2021
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: None

Symptom List: Unevaluable event

Symptoms: No period since last vaccine

Other Meds: N/a

Current Illness: N/a

ID: 1693779
Sex: F
Age: 34
State: CA

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

Allergies: None

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

Symptoms: Immediate pain on the left side of my neck, still experiencing this almost 2 weeks later. Left jaw issues: tightness/ sore/unable to open completely. Mild headache daily, relieved with ibuprofen. Elevated heart rate for 12 days now. Fatigue by mid day. Joint pain. All these are new and ongoing symptoms for a young, healthy individual with no past medical issues. Nauseas and dizzy for 3 days post shot. Nickel size lump at injection site for 3 days.

Other Meds: Yaz-birth control Omeprizole

Current Illness: None

ID: 1693780
Sex: F
Age: 26
State: OR

Vax Date: 09/07/2021
Onset Date: 09/08/2021
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: None. I should have went to the doctor but I fear hospitals and didn't have anymore scary episodes.

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: As I was in and out of sleep with a high fever I woke up to a loud buzzing in my ears, eyes flickering/blinking uncontrollably, locked jaw, body convulsing for about 5 seconds then pulled out of it. Never had anything like that happen before. Wanted to yell for help but was unable to form words during the episode. After it happened I have terrible sweats but felt stable enough to not wake anyone up. Spent the next day resting with no energy.

Other Meds: 800mg Advil taken at 3:30am

Current Illness: None

ID: 1693781
Sex: M
Age: 43
State: GA

Vax Date: 08/26/2021
Onset Date: 09/03/2021
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: As mentioned above, I have not gone to the doctor for this; honestly, I can't afford to at this time.

Allergies: None known

Symptom List: Injection site pain, Menorrhagia

Symptoms: At first, a severe lingering pain in the arm (from the elbow to deltoid); so much so that I couldn't lift my right arm for several days after it onset; when the pain subsided, it was replaced with a constant (24/7) muscle spasm near my right elbow. Later (around 9/3 or 9/4), I noticed that my "taste" seemed off, but it has turned out to be a lack of feeling at the rear of my tongue & throat (I noticed, specifically, when I ate frozen yogurt ~ I couldn't feel the "cold"). Around this same time (9/3 or 9/4) I noticed that it seemed as though I had to put conscious effort into breathing. I can breath OK without thinking about it, but it's uncomfortable & causes me to cough occasionally, & has also caused light-headedness (as my O2 drops from shallow breath ~ I have an O2 monitor for my clot situation, but have been using it for this lately). As I didn't have a rapid heartbeat, my BP didn't change, & my chest hasn't hurt, I have not gone to the ER for myocarditis (I don't have the symptoms). With a past of lung damage, I can only assume it is an allergic reaction to the vaccine, causing my bronchial tubes (or similar) to inflame, making it harder for me to breathe. I am looking to become an EMT student, so I decided to get the vaccine. Prior to this, I've never had an issue with meds or shots. I'd like this to be noted at my pharmacy so that it doesn't interfere with my EMT pursuits.

Other Meds: Xarelto, Multivitamin

Current Illness: n/a

ID: 1693782
Sex: F
Age: 38
State: TX

Vax Date: 09/09/2021
Onset Date: 09/10/2021
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: Walnut, Cashew

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

Symptoms: Chills, joint pain, body aches, fever of 102 degrees, headache, dizziness

Other Meds: Zyrtec 20mg, Symbicort Inhaler 160/4.5, Ventolin Inhaler PRN, Tylenol 1000mg, Protonix 80mg

Current Illness: None

ID: 1693783
Sex: M
Age: 32
State: MS

Vax Date: 08/15/2021
Onset Date: 08/15/2021
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:

Allergies: Ceclore

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 30 minutes after: numbness in extremities, dizziness; 12 hours later: nausea, shortness of breath, high bp, low HR, dizziness, fatigue, shakes, sensitivity to light; Some lasting more than a week.

Other Meds: Sotalol 80mg Prilosec 20mg Aspirin 80mg

Current Illness:

ID: 1693784
Sex: F
Age: 29
State: CT

Vax Date: 09/08/2021
Onset Date: 09/09/2021
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: N/A

Allergies: Amoxicillin, Welbutrin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Within 5 minutes, my arm became itchy at the injection site. I don't think that was the shot, more maybe the band-aid. Thought I would mention just incase. The next day when my real symptoms began (9/09) - 10:00/11:00AM-EST: I fell asleep at my computer mid-email. I never do this or get THAT tired, especially after a coffee?! From there, I started getting intense cramping where I would if I were to get my period or right before getting it. I was experiencing HORRIBLE lower back pain along with the cramping, which is a symptom of pre-period signs for me. I had to lay down in the fetal position for a while to ease the pain, and use a heating pad. I began spotting lightly, not as heavy as the first shot post-symptoms; but it was there and should not have been; based my tight, never changing menstrual cycle schedule. I also never get these cramps, or haven't since I was a bit younger a few years ago. Lastly, my body felt hot to touch. No fever that I noticed/the thermometer caught normal 98 and below all day. My head started to hurt, and progressively went away after a few days. I had a rash on my arm (right forearm around to the top - itchy. Went away when I put an ointment on it. I have photos as well. Lastly, My arm was horribly sore. Which is common of course.

Other Meds: Adderall, Lexapro, Birth Control (Aurovela Fe 1/20)

Current Illness: None

ID: 1693785
Sex: F
Age: 32
State: NY

Vax Date: 05/28/2021
Onset Date: 09/05/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Severe neuromuscular pain in right side of uterus, hip and legs

Other Meds:

Current Illness:

ID: 1693786
Sex: F
Age: 27
State: CA

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

Lab Data:

Allergies: N/A

Symptom List: Nausea

Symptoms: Shot in left arm on Friday afternoon. Pain in arm Saturday afternoon. Extreme pain in arm, underarm/arm pit, and left breast Saturday night. Pain significantly worsened by Sunday morning in underarm that resting arm on side resulted in pain. By Sunday night noticed large bruise on armpit.

Other Meds: N/A

Current Illness: N/A

ID: 1693787
Sex: F
Age: 64
State: LA

Vax Date: 11/01/2017
Onset Date: 11/01/2017
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: Dr did not respond to adverse effect. Instead refuses to release medical record of vaccine that I think was admintered for back spasms And he lied to state medical board of examiners investigator that he never administered the shot. I have requested medical records from 2017 and all records during that time were omitted by him.

Allergies: Penicillin

Symptom List: Injection site pain

Symptoms: The vaccine caused my mother delirium hallucinations speaking to voices paranoia and feeling aggressively stalked. This went on for maybe 8 months.She could not sleep for days at a time until exhaustion and she kept seeing invisible animals and hairy men. She was devastated.

Other Meds:

Current Illness: Muscle spasms in upper buttocks due to 100mph car run into collision accident after conversation I had with a sheriff deputy about a male who currently has her medical info concerning being assaulted by a male nurse and investigation.

ID: 1693788
Sex: F
Age: 53
State: WI

Vax Date: 08/30/2021
Onset Date: 08/31/2021
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: At ER, CT, labs, EKG, 2 sets of pain meds and sent home once no fever and pain improved

Allergies: sulfa, kiwi

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

Symptoms: Woke at 6am the day after the 2nd covid dose, headache, numbness jow-neck-head pain, lathargic, nauseated, back pain, RHR 90, painful at injection site, stiff hands. Around 10 am ate 1/2 bagel, 1/2 banana and had been drinking water even though just rolling over in bed was a challenge. 1pm got up and walked 20 feet, stood and talked to daughter for a bit, began to sweat profusely, walked towards bathroom because thought to vomit and passed out and hit my head. Tried to rest back in bed and the head and neck pain was to bad and PCP recomended to go to ER. Temp 99 degree at ED.

Other Meds: anastrozole, vitamin D, zinc, multivitamin

Current Illness: none

ID: 1693789
Sex: F
Age: 33
State: FL

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

Allergies: N/a

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

Symptoms: Arm pain 1 hour after vaccine. Most severe (to touch to move and at rest) 6 hours post shot. Seemed that when noticed my fever around 7pm after the vaccination that morning and began drinking more water, the water spread the arm pain throughout my body. Fever onset 8 hours post vaccine. Fever range beginning at 100.9 and holding steady at 101-102 for 48 hours. Height of fever 09/10/2 pm at 102.7 Body pain onset 12 hours post vaccine. Worst in legs. Unable to walk due to pain in body and head. Headache onset with fever and remained in sync until offset Drunk feeling in head during entire onset of symptoms 9/12/21 onset of a different feeling headache entirety of day; partial loss of taste and smell

Other Meds: Methadone 95mgs 1/day Celexa 20mg 1/day

Current Illness: N/a

ID: 1693790
Sex: M
Age: 28
State: WI

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

Lab Data:

Allergies: Sulfa, cephelexon, ibuprofen

Symptom List: Tremor

Symptoms: Fever, fatigue, mental fogginess, difficulty breathing due to inflammation in my lungs, random sharp pain all over body, nausea. Treated by steroids and multiple duonebs at the er. At home I had to take 3 albuteral and 3 duonebs as well as 4 extra doses of my symbicort to try to control my breathing and get out under control

Other Meds: Albuteral, duoneb, symbicort, delta 8, kratom, percocet

Current Illness: Had teeth removed Wednesday September 8th, no other illnesses was in perfect health other then having to have two painful teeth extracted

ID: 1693791
Sex: M
Age: 32
State: PA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
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: 3-25-21 ER Visit. Provider Notes, MD at 3/25/2021 8:46 AM Procedure Orders 1. ECG 12 Lead Documentation Only [201497613] ordered by , MD History Chief Complaint Patient presents with ? Dizziness pt just got 1st pfizer vaccine and reports dizziness, chest tightness, and severe fatigue. 32 yo male with a history of asthma presents to the ED complaining of dizziness, generalized fatigue, chest tightness, and shortness of breath since receiving his COVID-19 vaccine this morning. The patient says he feels "wiped out". (+) Poorly localized anterior chest "tightness", nonradiating and nonexertional. (+) Dizziness "like I'm about to pass out". (+) Mild SOB. No syncope or falls. No diaphoresis. He denies N/V/D. No LE swelling/pain. All symptoms started within 30 minutes of receiving the vaccine. No other specific complaints. 3-29-21 Er visit. Doctors Notes 6:38 PM Patient is a 32-year-old male with past medical history of asthma who presents with multiple symptoms including fatigue, chest pain, shortness of breath, lightheadedness and near syncope which has been constant since receiving the first Covid vaccine 5 days ago. Patient left hospital after receiving the vaccine 5 days ago, felt lightheaded and tachycardic so 176 department received IV fluids and blood work, symptoms improved so went home but has been continuing to feel lightheaded and having this persistent chest pain ever since. Today, while he was at work, began developing worsening chest pain, lightheadedness, felt as though he was about to pass out so came to the emergency department by EMS. Denies any fevers, does describe nausea but no vomiting, no diarrhea or blood in stool. Dizziness appears to be worse when he is standing. Does not smoke cigarettes. No history of DVT or PE. Noted that his Watch said his heart rate was in the 170s, EMS reports that the only tachycardia baseline was in the 110s to 120s. On exam, patient is no longer tachycardic, and a normal sinus rhythm, no acute distress, texting on cell phone. Breath sounds are clear bilaterally, abdomen soft and nontender, has moist mucous membranes. He has bilateral horizontal nystagmus that fatigues after about 3 beats with extraocular motor testing, normal finger-to-nose testing and no focal neurologic findings. Could be a post vaccine dehydration. We will give IV fluids, do basic blood work. Given his recent hospital encounter for similar symptoms and his reports of tachycardia will send a D-dimer as well.

Allergies: Dairy, penicillium mold.

Symptom List: Erythema, Pruritus

Symptoms: Chest tightness and shortness of breath within an hour. Brain fog, muscle pain and muscle weakness ongoing.

Other Meds: Breo Ellipta

Current Illness: Joint pain

ID: 1693792
Sex: F
Age: 35
State: TX

Vax Date: 03/01/2021
Onset Date: 04/01/2021
Rec V Date: 09/12/2021
Hospital: Y

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data: All medical records on file.

Allergies: No

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

Symptoms: Gastrointestinal issues Constant pain along with multiple sensations from the soles of my feet to my groin. Numb/dead arm. Vision and peripheral decreased Loss of appetite Over the six to seven months these symptoms progressed. I am currently behind on bills due to missing work due to all the specialists I have had to see. Currently waiting for my appointment to meet the neurologist that I will have to see now for the rest of my life. Medications are being altered to help relieve the pain. This has taken a toll on me. Something I couldn?t afford. I am a single mother of five children who struggled to get herself through school to be a medical assistant after spending 10 plus years being a CNA/Home Health Aid. First it was fighting with my apartment complex to keep hot water on so we can bathe and begging for them to fix the ceiling and water that flooded my kitchen. Now on top of that and million and one things I have to worry about? I also have to worry about fighting to stay alive to see my children grow and marry and have babies.

Other Meds: Ibuprofen

Current Illness: PTSD and Depression from childhood.

ID: 1693793
Sex: F
Age: 33
State: MO

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 09/12/2021
Hospital:

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

Lab Data: Ultrasound 8/25/2021

Allergies:

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

Symptoms: First menstrual period after shot was delayed by about 10 days, subsequent periods have been very heavy with large clots and increasing each time

Other Meds: Probiotic, multi-vitamin

Current Illness:

ID: 1693794
Sex: F
Age: 57
State: KY

Vax Date: 08/30/2021
Onset Date: 08/30/2021
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: Three Covid tests-all negative. Blood drawn once at ER- white blood count elevated and low potassium Chest X-ray Urine test Blood drawn by doctors office Oxygen level, pulse rate and bp taken

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Vomited 30 minutes after receiving vaccine. Headache that night and severe nausea and stomach cramps. Diarrhea the next morning. No appetite, nausea, headache, fatigue, severe sore arm at injection site. As the week progressed I became sicker and sicker having vomiting, hot flashes, chest pressure, chills, dizziness, pain in left and right arms, pain in neck and shoulders. By the weekend I was unable to keep any food or liquids down, so I went to the ER and received tests and medicine. All this past week I have been fatigued, nauseous, had headaches, chest pressure, extreme tinnitus, stomach cramps, congestion, hot flashes, constipation. Went to family doctor on Friday, had more tests done and she said I had an adverse reaction to the vaccine. I also had three Covid tests done locally at the hospital and doctors office during this period. All were negative.

Other Meds: Dexilant, Topamax, Xanax, Pristiq, Lisinopril, Lipitor

Current Illness: Sinuses/allergies

ID: 1693795
Sex: F
Age: 28
State: AR

Vax Date: 09/05/2021
Onset Date: 09/12/2021
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: None

Allergies: No

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

Symptoms: One week after injection, injection site became red again & feels hard to the touch. Slight tenderness.

Other Meds: No

Current Illness: No

ID: 1693796
Sex: F
Age: 82
State: MD

Vax Date: 03/10/2021
Onset Date: 03/10/2021
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: None

Allergies: Penicillin

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

Symptoms: High fever - 101 degrees (my base line body temperature is generally very low, usually 96.8 - 97.4) Chills; Extreme Fatigue; Body aches and pains.

Other Meds: Hydrochlorothiazide; Ezetimibe; Centrum Silver; Cod Liver Oil; Magnesium

Current Illness: None

ID: 1693797
Sex: F
Age: 45
State: LA

Vax Date: 09/01/2021
Onset Date: 09/10/2021
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

Allergies: None

Symptom List: Pain in extremity

Symptoms: Fever, body aches, fatigue, headache, chest pain, lower back pain

Other Meds: Once daily multivitamin

Current Illness: None

ID: 1693798
Sex: F
Age: 58
State:

Vax Date: 09/01/2021
Onset Date: 09/01/2021
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: Headache, nausea, bad metallic taste in my mouth, tired.

Other Meds: Insulin, metoprolol, Lasix, losartan, lovastatin, pro biotic, magnesium, multi vitamins, D3, nac, niacin, coq10.

Current Illness: I haven't even had the sniffles since 2015

ID: 1693799
Sex: F
Age: 82
State: CO

Vax Date: 02/11/2021
Onset Date: 09/06/2021
Rec V Date: 09/12/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Fully vaccinated patient tested positive for COVID-19 on 9/6/21 and admitted to hospital for supportive care.

Other Meds:

Current Illness:

ID: 1693800
Sex: F
Age: 46
State: FL

Vax Date: 08/09/2021
Onset Date: 08/09/2021
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: I have not contacted a healthcare professional, have been trying to treat myself. I plan on going to see the Doctor or Urgent Care tomorrow.

Allergies: Latex Allergy, Contrast Dye Allergy, Cephlasporin resistance

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

Symptoms: Rash at injection site, tingling in both arms, hands, and feet. Diarrhea, dizziness, fatigue, muscle weakness, heavy menstrual bleeding earlier than usual with the largest clots I have ever seen (8/25/2021). Currently experiencing breakthrough spotting and mild bleeding 1 week early.

Other Meds: None

Current Illness: iron deficiency anemia

ID: 1693801
Sex: F
Age: 55
State: NM

Vax Date: 07/14/2021
Onset Date: 07/19/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies: Sesame and sunflower oils and nuts; pine nuts; adhesive tape; Benadryl

Symptom List: Vomiting

Symptoms: Within days of the first shot on July 11, I had a small itch bumps on my hands and small itch bumps on the back of my ankles, similar to hives I have previously experienced. These remained for weeks and I had some itching on my legs. Within days of 2nd shot on August 11, 2021, I had severe rash developing on my legs. I used anti-itch creams that did not help. The rash was itchy, bumpy, red dots that bled easily and some filled with white fluid. The rash covered below my knees by August 28 and continued to move up my body until it has covered legs, arms, shoulders, abdomen, rump, chest, neck. I contacted my doctor Sept 1 about the spreading rash. She prescribed 20 mg prednisone for 5 day, which I started on Sept 3. Rash continued to spread during this time. Last week it was difficult to do daily tasks and sleep because clothes irritated the rash. I am still covered with rash and calamine lotion is helping some.

Other Meds: hydrOXYzine HCL 25 mg for itching/hives; Tylenol arthritis 650 mg, Glucosamine Sulfate 1000 mg; Flonase child's dose 1/day

Current Illness: None

ID: 1693802
Sex: M
Age: 46
State: CA

Vax Date: 09/07/2021
Onset Date: 09/11/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: ER took blood while in ER room.

Allergies: Shellfish/ shrimp

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Hives all over entire body.

Other Meds: None.

Current Illness: None.

ID: 1693803
Sex: F
Age: 12
State: CO

Vax Date: 08/25/2021
Onset Date: 09/11/2021
Rec V Date: 09/13/2021
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: Patient has allergies to outdoor things (grasses and stuff) and cats, but has never shown allergic reactions to any foods or medications.

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

Symptoms: Large Marble-Sized lump at Vaccine site on upper Left Arm. Swelling and painful. No discoloration. Only hurts if pressed on, but even lightly touching site causes mild pain. Gave patient 400 mg OTC ibuprofen for pain and swelling, I will apply ice to her arm as well. I was just informed of the condition and have treated, but have not had time to see results of treatment.

Other Meds: No Prescriptions. Patient did receive 2 other vaccines (HPV & Hep A) the same day about 1 hour before Covid 19 Vaccine. One of the vaccines (HPV or Hep A) was in the same arm as the Covid 19 vaccine. Patient takes OTC Vitamins and Antih

Current Illness: None.

ID: 1693804
Sex: F
Age: 45
State: CA

Vax Date: 06/19/2021
Onset Date: 08/17/2021
Rec V Date: 09/13/2021
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:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Change in menstrual cycle

Other Meds:

Current Illness:

ID: 1693805
Sex: M
Age: 31
State: NY

Vax Date: 01/15/2021
Onset Date: 09/13/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies: Nka

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

Symptoms: Palpitations, shortness of breath, dizziness, tachycardia.

Other Meds: Multi vitamin

Current Illness:

ID: 1693806
Sex: F
Age: 38
State: CO

Vax Date: 07/17/2021
Onset Date: 07/18/2021
Rec V Date: 09/13/2021
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: Fragrance or perfume

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

Symptoms: Hives on arm, leg and abdomen. Dizziness and weakness. Rapid heartbeat

Other Meds: Birth control

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am