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: 1694606
Sex: F
Age: 56
State: OR

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

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Syncopal event several hours after vaccination followed by right sided weakness, sensory loss and aphasia later found to have a left M1 occlusion requiring tPA but no thrombectomy after patients symptoms completely resolved with tPA. At this point we think the likely etiology of the event was paroxysmal atrial flutter.

Other Meds: -atorvastatin

Current Illness: palpitations

ID: 1694607
Sex: M
Age: 4
State: GA

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/13/2021
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: none

Symptom List: Anxiety, Dyspnoea

Symptoms: Developed one hive in the evening, same day as vaccine given. Developed a few more hives by morning. Had hives to abdomen and back by the end of that evening. Given Children's Zyrtec and applied topical hydrocortisone 1%. Rash was gone by the following day. Never had difficulty breathing, swelling, drooling, or difficulty swallowing.

Other Meds: none

Current Illness: Acute upper respiratory infection 08/12/2021.

ID: 1694608
Sex: F
Age: 60
State:

Vax Date: 01/13/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient tested positive for COVID on 9/11/2021

Other Meds:

Current Illness:

ID: 1694609
Sex: F
Age: 56
State: AR

Vax Date: 01/15/2021
Onset Date: 09/12/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: None

Allergies: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Sudden and severe vertigo when getting out of bed. Improved throughout day except when bending over. Continues at a mild level 2 days later

Other Meds: OTC omiprazol

Current Illness: None

ID: 1694610
Sex: F
Age: 48
State:

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

Lab Data:

Allergies:

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

Symptoms: Vaccine expired

Other Meds:

Current Illness:

ID: 1694611
Sex: F
Age: 62
State: VA

Vax Date: 09/10/2021
Onset Date: 09/12/2021
Rec V Date: 09/13/2021
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: NONE

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

Symptoms: SITE SORENES; BUT OF CONCERN IS SMALL RED HIVES ON BOTH PALM OF HANDS FROM PINKY FINGER DOWN TOWARDS WRIST

Other Meds: NONE

Current Illness: NONE-RECOVERED FROM COVID 1 WEEK PRIOR W/O MED INTERVENTION

ID: 1694612
Sex: F
Age: 28
State: CO

Vax Date: 05/25/2021
Onset Date: 06/05/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: RASH ON FACE, CHEST, BACK, LEGS STILL SPREADING

Other Meds: N/A

Current Illness: N/A

ID: 1694613
Sex: M
Age: 79
State: MI

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

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Pt. came in with fever of 102.1, and cough. Pt. is on zinc, vitamin C, pantoprazole, cefcriaxone, lisinopril, aspirin

Other Meds:

Current Illness:

ID: 1694614
Sex: F
Age: 82
State: TX

Vax Date: 09/10/2021
Onset Date: 09/11/2021
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: LA

Lab Data: None

Allergies: Musels

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Blood pressure,. On 9/11: 8:01 am 81/66 8:56 am 73/61 9:15am 104/78 9:50 am 111/73 10:12 m 87/73 10:20 am 80/66 2:56 pm 87/67 5:20 pm 110/3 9:00 pm 115/83

Other Meds: Boniva Anastrozole Metoprolol Tartrate Succinate Eliquis Atrovastatin Lasix Vitamin D3 Oscal + D Miralax Cranberry with vitamin C Omega 3s

Current Illness: Follicular lymphoma. Not progressing

ID: 1694615
Sex: M
Age: 63
State: CA

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: I did not have any medical testing done. I knew the side effects were from the vaccine since they took place in a short period of time and were logically on the left side of the body. I took three days off work to recover.

Allergies: Allergies to grass pollen and other pollens from blooming plants. Seasonal allergy handled with rare over the counter medications and utilizing tissues to blow my nose.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Stroke like effects. Left side of my body from the top of my head to my knee went numb for three days. It was as if a line was drawn down the center of my body, left hemisphere was numb and insensitive. Severe pain in the left arm that left it unusable for two weeks. Then the injection site had scabbing after two weeks. Three weeks later I had a blood test to address pain that was in lower right intestinal area, the phlebotomist said my veins were hard and difficult to puncture. This has not been a problem for me in the past. The intestinal problem was diagnosed as gall stones. No treatment necessary, otherwise normal.

Other Meds: Was off all herbal supplements at the time, no prescriptions

Current Illness: None

ID: 1694616
Sex: F
Age: 63
State: AR

Vax Date: 08/11/2021
Onset Date: 08/25/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: None

Allergies: Codeine Erythromycin

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

Symptoms: Huge red rash down left arm, heart flutter with fast heart rate

Other Meds: Synthroid 125mcg (one daily) Potassium Chloride 20mg (3 times daily) Valsarten HCT 160/25 mg (once daily) Metapropol 50mg (3 times daily)

Current Illness: High Blood Pressure Heart Conditions

ID: 1694617
Sex: F
Age: 39
State:

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/13/2021
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:

Symptom List: Rash, Urticaria

Symptoms: vaccine expired

Other Meds:

Current Illness:

ID: 1694618
Sex: F
Age: 60
State:

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

Lab Data:

Allergies: Cymbalta, atorvastatin, lisinopril, protonix

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

Symptoms: Patient called on 9/13/2021 with c/o of N/V and joint pain following COVID vaccination (Pfizer) on 9/2/2021. She states these symptoms are similar to when she received flu vaccine in the past, and was wondering if they are a result of COVID vaccination. LG also states she felt she had a "cold" the past 2 weeks.

Other Meds: Citalopram, trulicity, Jardiance, furosemide, levothyroxine, linzess, losartan, metformin, omeprazole, tramadol

Current Illness:

ID: 1694619
Sex: F
Age: 60
State: KY

Vax Date: 06/26/2021
Onset Date: 09/06/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Covid positive contact unknown

Other Meds:

Current Illness:

ID: 1694620
Sex: F
Age: 34
State: CO

Vax Date: 03/11/2021
Onset Date: 06/14/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: 07/08/2021 chest x-ray clear. 07/08/2021 blood work normal. 07/20/2021 chest x-ray or CT scan diagnosed with pneumonia.

Allergies: Narcotic pain medication all of them; sulfa drugs; codeine; atenolol; imipramine; Topamax

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

Symptoms: On Monday, I started feeling like I had a cold, runny nose, sore throat, a little bit of a cough. By Wednesday, I started having trouble breathing. My PCP could not see me, so they told me to go to urgent care. I went on 07/08/2021. They did nothing. They did a chest x-ray and it was clear. They did a lot of blood work and everything was normal. They told me to take my inhaler and sent me home. That following Wednesday things were getting really bad. I went back to urgent care. I went on 07/14/2021. At that point they had just given me prednisone. I went back that Friday on 07/16/2021. They gave me antibiotics. Then I saw a doctor on 07/20/2021 and she sent me for another x-ray or CT scan, I cannot remember, and they diagnosed me with pneumonia. They gave me another antibiotic. On 07/25/2021 I went to the emergency room. They gave me another 2 antibiotics. By Tuesday 07/27/2021 I was feeling ok. It was not great but I did not feel like I was dying. I still have a lot of trouble breathing.

Other Meds: Trileptal; Lamictal; propranolol; Flexeril; Seroquel; birth control; pantoprazole.

Current Illness: None

ID: 1694621
Sex: F
Age: 28
State:

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

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

Lab Data:

Allergies: NKDA

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

Symptoms: Received first Pfizer dose on august 13th, 2021. Three days later my tongue started to feel numb and tingly. The next day my calves and left forearm became numb and tingly. The sensation has improved but it is still there.

Other Meds: Mirena IUD

Current Illness: Nonw

ID: 1694622
Sex: F
Age: 36
State:

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

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

Lab Data: NA

Allergies: NONE

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

Symptoms: APPROX 24 HRS POST INJECTION, DEVELOPED SWELLING AND ERYTHEMA MASS THAT WAS BELOW INJECTION SITE. SITE WAS HOT TO TOUCH AND NOTICEABLE SWOLLEN AND PAINFUL AXILLARY LYMPHNODES.

Other Meds: LOESTRIN

Current Illness: NONE

ID: 1694623
Sex: F
Age: 41
State: CO

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

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

Lab Data:

Allergies: NKDA.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pain, rash, bulla.

Other Meds: None.

Current Illness:

Date Died: 09/12/2021

ID: 1694624
Sex: M
Age: 91
State: MN

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Lot numbers not available for vaccines. Pt died on 9/12/2021 of aspiration pneumonia and respiratory failure. This is not a covid related death

Other Meds:

Current Illness:

ID: 1694626
Sex: F
Age: 50
State:

Vax Date: 09/13/2021
Onset Date: 09/13/2021
Rec V Date: 09/13/2021
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 passed out within 5 minutes of getting the vaccine. Administered ammonia inhalants to stimulate consciousness. Gave juice, water and snacks. Patient was able to stand up and leave 45 minutes after vaccine administration.

Other Meds:

Current Illness:

ID: 1694627
Sex: M
Age: 51
State: AZ

Vax Date: 08/31/2021
Onset Date: 09/13/2021
Rec V Date: 09/13/2021
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: N/A

Allergies: none

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

Symptoms: Patient called to let us know that today 9/13/21 he has started to have pain on his arm. He also states that his arm is yellow. Called primary care and made them aware of the adverse events that were relayed to me. I asked the patient if he could call his primary care MD.

Other Meds: N/A

Current Illness: none

ID: 1694628
Sex: M
Age:
State: PR

Vax Date:
Onset Date:
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: LA

Lab Data: Unknown.

Allergies: None.

Symptom List: Unevaluable event

Symptoms: Mother says that her son is 12 years old, and got the vaccine even though he is 11.

Other Meds: None.

Current Illness: None.

ID: 1694629
Sex: F
Age: 45
State:

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

Lab Data: troponin normal, EKG showed sinus tachycardia but otherwise normal

Allergies: erythromycin, tetracycline, sulfa

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

Symptoms: chest tightness, itching, dyspnea

Other Meds: aspirin, albuterol, propranolol, metformin, lisinopril, ferrous sulfate

Current Illness:

ID: 1694630
Sex: F
Age: 54
State: WI

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

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

Lab Data:

Allergies: Sulfa.

Symptom List: Injection site pain, Pain

Symptoms: A little over 24 hours after the shot suddenly I felt weak, brain foggy, my face was hot and extreme exhaustion. I am not a napper but took a 1 1/2 nap. Went back to bed and had chills and sweats all night. I took Advil but it did not help. The next morning my joints were achy but the fever symptoms were gone. Took more Advil and this time it seemed to help a bit. Was excessively tired the whole weekend. Had the shot on a Thursday.

Other Meds: None

Current Illness: None

ID: 1694631
Sex: F
Age: 31
State: CA

Vax Date: 06/05/2021
Onset Date: 06/21/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data: 8/23 - I have all of the medical documentation. Had emergency surgery.

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Three weeks after my second shot of the Covid Vaccine I became pregnant with an ectopic pregnancy. I am 31 years old and have never been pregnant in my life or had a pregnancy scare. I believe there is a direct correlation between the vaccine and what happened to me. I received my 2nd vaccine on Saturday 6/5. On Monday 8/23 I went to the hospital and ended up having emergency surgery. They said I was 9 weeks pregnant, which puts my conception date 3 weeks after the last vaccine.

Other Meds: None

Current Illness: None

ID: 1694632
Sex: F
Age: 50
State: TX

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

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

Lab Data: 08/22/2021 and 08/24/2021 COVID-19 rapid test- both positive 08/30/2021 COVID- 19 Rapid test- negative

Allergies: penicillin sulfa antibiotics

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

Symptoms: The evening of the vaccination, 03/09/2021, I started to develop chills, fever, sweats, a metallic taste in my mouth and nausea and that lasted for 24 hours. So I thought I had a nice robust human response. I tested positive for COVID- 19, 08/22/2021 Via rapid test, but I already had a fever of 102 fever at that point. My fever went up to 103.8 that evening. And I had fever on and off, up to 102 for five days. I contacted my provider on the 08/24/2021, he said I was not high risk so continue to take over-the-counter meds. I think I have recovered. I have not had a physical. I believe I have recovered .

Other Meds: multivitamin

Current Illness: no

ID: 1694633
Sex: F
Age: 31
State: PA

Vax Date: 09/12/2021
Onset Date: 09/13/2021
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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Fever of 103 extremely bad chills, seizure like activity

Other Meds:

Current Illness:

ID: 1694634
Sex: F
Age: 65
State: NC

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

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

Lab Data:

Allergies: All narcotic pain killers

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Severe headache that over the counter medication, like a aspirin powder did not help. Was bedridden for the day. Vomiting and diarrhea.

Other Meds: elavil 2 MG, Amitriptyline 25 MG, Vitamin D, Zinc, Vitamin B, Bone Calcium Supplement, Blue Green Algae supplement, selenium supplement, melatonin

Current Illness: none

ID: 1694635
Sex: M
Age: 79
State: IN

Vax Date: 02/04/2021
Onset Date: 09/11/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data: COVID-19 Sofia antigen test with a positive result.

Allergies:

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

Symptoms: Patient received the Pfizer COVID-19 vaccine on 1/14/21 and 2/4/21 so was fully vaccinated when they tested positive for COVID-19 on 9/11/21. The patient was admitted to the Med/Surg unit at Hospital with a diagnosis of COVID-19.

Other Meds:

Current Illness:

ID: 1694636
Sex: F
Age: 43
State:

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

Symptom List: Nausea

Symptoms: vaccine expired

Other Meds:

Current Illness:

ID: 1694637
Sex: F
Age: 36
State: MD

Vax Date: 03/31/2021
Onset Date: 04/14/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: Chest X-ray, MRI

Allergies: None

Symptom List: Injection site pain

Symptoms: Started with chest pain because I work out a lot. Had to stop running. Been to ER 4 times. Cartilage inflammation. Had 24/7 headache. Everything came back normal. But headache has not gone away.

Other Meds: Ibuprofen

Current Illness: None

ID: 1694638
Sex: M
Age: 49
State: MO

Vax Date: 03/11/2021
Onset Date: 03/19/2021
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: LA

Lab Data: no

Allergies: Shellfish; iodine - doctors say but can use it on my skin and I take iodized table salt

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

Symptoms: Had mild cellulitis at the injection site - 10 days of Augmentin was the treatment - saw doctor on the 19th. I also experienced stiffness and swelling in my joints as well as ringing in my ear and dizziness. Those symptoms cleared on their own after about 1-2 hours. By the time I got into see my doctor they had stopped. The medicine cleared the cellulitis. I was using coconut oil on dry skin at the time of the symptoms starting to deal with eczema.

Other Meds: Lisinopril - 20 mg for hypertension; Men's one a day vitamin; B12 vitamin; Krill Oil; Vit E; Vit C; Loratadine; Fluticasone - nasal spray for allergies

Current Illness: no

ID: 1694639
Sex: M
Age: 19
State: GA

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 09/13/2021
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 reported

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

Symptoms: Patient presented to vaccine clinic on 9/8/21 for second dose of Moderna COVID19 vaccine. Second dose was administered. After dose given, vaccine staff realized when entering into state immunization registry that the first dose of Moderna was given on 8/18/21,and that is second dose should have been given on 9/15. This meant patient received second dose on day 22 instead of day 28, and was recognized to be a dosing interval error. Patient was contacted and notified of error. Reported subjective fever and myalgia for one day after vaccination, but all vaccine side effects resolved within 36 hours. Patient instructed that a repeat second dose is not needed.

Other Meds: none reported

Current Illness: none reported

ID: 1694640
Sex: F
Age: 61
State:

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

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: vaccine expired

Other Meds:

Current Illness:

ID: 1694641
Sex: F
Age: 78
State: CA

Vax Date: 01/07/2021
Onset Date: 09/05/2021
Rec V Date: 09/13/2021
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: 09/05/2021, COVID-19 (NAA), Positive

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Patient is fully vaccinated for COVID-19, one dose documented 01/07/2021, date of other isn't documented. 78 YO F with PMHx dementia, chronic anemia, GERD, hypothyroidism, depression sent to the ED from nursing facility for ALOC. She was seen at this hospital yesterday for 2 days of insomnia, increased agitation, at which time her work-up was unremarkable. She was D/C back to nursing facility and then returned today for persistent AMS. She was Dx with COVID in the ED and will be admitted to COVID medical floor since she is medically stable...On 9/7 I called patients' relative, who is the POA, informed him of the patient's poor prognosis, and he agreed to switch the patient to comfort care.

Other Meds:

Current Illness:

ID: 1694642
Sex: F
Age: 73
State: CA

Vax Date: 02/23/2021
Onset Date: 08/10/2021
Rec V Date: 09/13/2021
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: 08/10/2021, COVID-19(NAA), positive

Allergies:

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

Symptoms: Patient received her COVID vaccines on 2/3/21 and 2/26/21. She was admitted to the hospital for COVID-19. HOSPITAL SUMMARY Patient is a very pleasant 74 yo F with PMH of End stage COPD, SCC Lung Cancer on Palliative Care visiting from out of town who contracted COVID, and presented to ED in Acute on Chronic Respiratory Failure on August 10th. She was treated for Covid 19 with remdesivir and dexamethasone with oxygen support and BiPAP. And responded better than expected. However during her work-up she was found to have blood cultures positive for actinomyces and given her medical of history of lung cancer the case was discussed with infectious disease who agreed it was best to treat with 14 days of IV Rocephin followed by 6 months of penicillin orally. This treatment began on the first negative blood culture on 13 August. Her hospital course was complicated by Klebsiella Pneumoniae UTI and urinary retention requiring foley catheter placement. Her acute illnesses resolved, so she was admitted to Swing bed status 8/20 to finish her IV antibiotic course. During her Swing bed admission she remained relatively stable, but did develop some oropharyngeal candidiasis likely due to prolonged antibiotics use which resolved with treatment. Hospital course was also complicated by oversedation with opiate pain medication and failed bladder training requiring continued use of foley. After patient completed course of IV Rocephin with decrease in pain medication to home Tramadol plans were being made to transfer patient to her new home. Then on 9/1 she developed some mild hypotension to Diltiazem was held. This in turn seemed to result in A-fib with RVR which contributed to ongoing hypotension. She was then given IV fluid bolus followed by continuos IVF. With IV Diltazem bolus and resumption of oral Diltiazem heart rate was controlled. However her Hgb trended down, suspected to be dilutional given IV fluids receive. Her stool was however guaiac positive and patient was transfused 2 units of blood. During this time patient was re-admitted from Swing bed on 9/3 due to unstable and downtrending condition. Upon readmission condition appeared worse characterized by worse respiratory mental status. However patient began to return to baseline aided presumably by gentle diuresis (Lasix) resumption of steroids. This return to baseline was complicated by CO2 retention, likely related to over oxygenation, which improved when patient was adherent to BiPAP. At time of discharge mental status was improving and respiratory status was at expected baseline.

Other Meds:

Current Illness:

ID: 1694643
Sex: F
Age: 77
State: FL

Vax Date: 08/16/2021
Onset Date: 08/24/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: .-

Allergies: Oreomycin, Zithromax

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

Symptoms: Full body rash, puffy, red, extremely itchy Atarax has helped to a degree, but I am totally groggy and dizzy.. Please help!

Other Meds: Losartin,, Vitamin D, multi vitamin

Current Illness: None

Date Died: 07/31/2021

ID: 1694644
Sex: F
Age: 66
State: GA

Vax Date: 03/15/2021
Onset Date: 07/19/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: 07/22/2021 PCR+ COVID-19 test at Health center; 07/31/2021 PCR+ COVID-19 test at Hospital

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Breakthrough COVID-19 case with symptom onset 7/19/2021: Fever >100.4, Chills, Muscle or body aches, Runny nose/Congestion, Sore throat, Cough (new onset or worsening of chronic cough), Shortness of breath or difficulty breathing, Fatigue or tiredness, Headache. Death 7/31/2021, from vital records: CARDIAC ARREST, COVID 19 POSITIVE, Per vital records, Other Significant Conditions include: HYPERTENSION. place of death: HOSPITAL-EMERGENCY ROOM/OUTPATIENT.

Other Meds:

Current Illness:

Date Died: 09/08/2021

ID: 1694645
Sex: M
Age: 66
State: CA

Vax Date: 07/22/2021
Onset Date: 09/04/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data: 09/04/2021, COVID-19 (NAA), Positive

Allergies:

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

Symptoms: HOSPITAL COURSE: This is a 66-year-old male with history of hep C cirrhosis, BPH with chronic retention, methamphetamine/tobacco/PTSD/homelessness, mesothelioma and non-small cell carcinoma of the lung s/p chemo/XRT, and middle lobectomy/thoracotomy at medical facility in 2013. He had a hospitalization in July 2020 where he was noted to have recurrent pulmonary malignancy, but was not a surgical candidate. He was counseled to discharge to Transitional Care but he instead requested discharge to the street. He repeated has declined appropriate care when in the hospital, and he has repeatedly left the hospital against medical advice and without appropriate follow-up plan in place. He was interviewed by Dr. on 7/2 who documented fixed delusions but capacity to make his own medical decisions, feeling patient's interpretation of facts "did not appear to be unduly influenced by delusion". I discussed the patient's care with admitting physician, and we agreed that in the combination of social and medical chaos, and noting a prior decision by another Dr. not to proceed with surgical intervention of a pulmonary mass, that heroic resuscitative efforts would be futile, and patient should be limited code - no compressions or intubation. Dr., palliative care, reviewed chart and also agrees that No Code is appropriate. On the last day of hospitalization, September 8, 2021, this patient was seen and examined at the bedside and he was comatose and did not respond to voice, touch, or a sternal rub. For maintenance of an adequate blood pressure this patient was on a maximal dose of vasopressin at 20 mL/h. This patient was noted with severe acute kidney injury on admission and on the day of discharge his sodium was 139, potassium 5.6, BUN 144, and creatinine 5.22. This patient was seen in consultation by the nephrology service but his blood pressure was too low to allow hemodialysis. If the patient's white blood count was 16.7 on the day of discharge. Total bilirubin was elevated at 3.7, AST 49, ALT 74, and serum albumin was low at 1.4. Blood cultures on admission September 4, 2021 were positive for Streptococcus pneumonia a and Staphylococcus hominis. This patient was receiving appropriate IV antibiotic therapy during this hospitalization. The patient again was comatose and given the constellation of the severe end organ damage in the setting of severe sepsis the patient was subsequently transitioned to comfort care and end-of-life care. I discussed this case with Dr. with the nephrology service and Dr. with the palliative care service and we all agreed that a transition to comfort care was the best treatment plan for this patient. In the morning on September 8, 2021 I did not renew the patient's treatment with IV vasopressin and I discontinued all IV antibiotic therapy. Telemetry was also discontinued. IV morphine and IV Ativan were ordered for treatment of pain and anxiety respectively. This patient subsequently expired at 12:45 PM on September 8, 2021. I was unable to make contact with any family members or any possible DURABLE POWER OF ATTORNEY for this patient. The mortuary on duty was contacted this afternoon. This patient was pronounced expired on September 8, 2021 at 12:45 PM.

Other Meds:

Current Illness:

ID: 1694646
Sex: M
Age: 13
State: NY

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

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

Lab Data:

Allergies: Amoxicillin

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

Symptoms: Presented with acute chest pain and diagnosed with COVID-19 Vaccine adjacent myocarditis. Elevated high sensitivity troponin to 447. Normal EKG. Treated with around the clock motrin. Symptoms resolved ~ 1 day after admission. The symptoms started 3 days after administration of the vaccine.

Other Meds: None

Current Illness:

ID: 1694648
Sex: F
Age: 70
State: CA

Vax Date: 03/10/2021
Onset Date: 08/31/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data: 08/31/2021, COVID-19 (NAA), DETECTED

Allergies:

Symptom List: Pain in extremity

Symptoms: Patient received COVID vaccine on 3/10/2021 and was admitted to the hospital for COVID-19. Discharge date: Sep 3, 2021 Admitting diagnosis(es): (1) Acute respiratory failure with hypoxia **DISCHARGE DIAGNOSIS: (1) COVID-19 (2) Acute respiratory failure with hypoxia

Other Meds:

Current Illness:

ID: 1694649
Sex: M
Age: 15
State: OH

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

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

Lab Data: none

Allergies: none

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

Symptoms: Patient was given Moderna, was only eligible for Pfizer, no adverse reaction noted, no signs or symptoms of any allergic reaction

Other Meds: unknown

Current Illness: unknown

ID: 1694650
Sex: M
Age: 74
State: CA

Vax Date: 03/10/2021
Onset Date: 08/25/2021
Rec V Date: 09/13/2021
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: 08/25/2021, COVID-19 (NAA), Positive

Allergies:

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

Symptoms: Patient received his Pfizer COVID vaccines on 3/10/21 and 3/31/21 and was admitted to the hospital on 8/25/2021 with COVID-19. Due to MD note #COVID19 PNA #Acute hypoxic respiratory failure Continued on Dexamethasone (started 8/25 in ER), Ceftriaxone (started 8/30), Azithromycin (started 8/30). 5-day course of remdesivir was completed on 8/29. Now on BiPAP. Desaturating with any activity. Baricitinib was going to be started on 9/3 but just before giving Tocilizumab was delivered. He received 600 mg Tocilizumab. Baricitinib was not given. Duoneb q6h sch. I have concern of occult underlying infection such as fungal or other lung disease that is worsening with immunosuppression due to COVID treatment. It is odd to

Other Meds:

Current Illness:

ID: 1694651
Sex: M
Age: 41
State: CA

Vax Date: 07/16/2021
Onset Date: 09/01/2021
Rec V Date: 09/13/2021
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: 09/01/2021, COVID-19 (NAA), positive

Allergies:

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

Symptoms: Patient received vaccine 7/16/2021 and was admitted to the hospital with a Corneal Abrasion. At the time of admit he tested positive for COVID-19. Homeless

Other Meds:

Current Illness:

ID: 1694652
Sex: M
Age: 90
State: MI

Vax Date: 01/19/2021
Onset Date: 09/05/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Pt. came in with medical history of Myocardial infarction, dyslipidemia, dimentia; Presented with worsening weakness, lethargy, and low grade fever; Pt is on Remdesivir, cefepime, dexamechasone; aspirin; pantoprazole; Inpatient

Other Meds:

Current Illness:

ID: 1694653
Sex: F
Age: 70
State: MN

Vax Date: 02/17/2021
Onset Date: 09/08/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data: POSITIVE SARS-COV-2 BY PCR

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: This case meets vaccine breakthrough criteria . PATIENT ADMITTED AFTER BECOMING UNRESPONSIVE POST DIALYSIS

Other Meds:

Current Illness:

ID: 1694654
Sex: F
Age: 47
State: NJ

Vax Date: 03/10/2021
Onset Date: 03/11/2021
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: CAT SCAN

Allergies: NONE

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

Symptoms: SORENESS AT INJECTION SITE

Other Meds: NONE

Current Illness: NONE

ID: 1694655
Sex: M
Age: 67
State: CA

Vax Date: 04/28/2021
Onset Date:
Rec V Date: 09/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: 8/27/2021, COVID-19 (NAA), positive

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient received vaccine 4/28/2021 and was admitted to the hospital on 8/28/2021 (presented to the ED 8/27/21).

Other Meds:

Current Illness:

ID: 1694657
Sex: F
Age: 36
State:

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

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

Symptoms: vaccine expired

Other Meds:

Current Illness:

ID: 1694658
Sex: F
Age: 65
State: MO

Vax Date: 08/12/2021
Onset Date: 09/01/2021
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: Aspirin

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

Symptoms: Acute Severe Vertigo for 24 hours then Severe Vertigo for another 24 hours then Mild Vertigo for another 24 hours now only from rising Blood pressure readings on the top number of 145 or more when all of the other 65 years of my life my top number of BP never rose above 130

Other Meds: Wellbutrin Levothyroxine Omeprazole Lovastin

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am