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: 1695479
Sex: F
Age: 41
State:

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: Sulfa antibiotic

Symptom List: Dysphagia, Epiglottitis

Symptoms: Severe nausea, severe body aches (lower), severe kidney pain, weakness, chills, sweats, fatigue, low grade fever for 48 hours.

Other Meds: Effexor 75mg daily

Current Illness: None

ID: 1695480
Sex: M
Age: 27
State: AK

Vax Date: 09/03/2021
Onset Date: 09/04/2021
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: dilantin - rash

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient had a total of four GTC seizures starting 9/04/2021 at 12:14 am, 1:31 am, 6:31 am and then 6:30 pm.

Other Meds: briviact, onfi

Current Illness: None

ID: 1695481
Sex: M
Age: 39
State: NY

Vax Date: 09/13/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: finger stick 158

Allergies: none

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

Symptoms: presyncopal episode lasting 30 minutes

Other Meds: none

Current Illness: none

ID: 1695482
Sex: F
Age: 34
State: VT

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data: D-dimer at ER.

Allergies: Allergies to pertussis vaccine and amoxicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Arm swollen and extremely painful. Morning after vaccine same reaction on lower leg. Went to ER and they refused an ultrasound to check for blood clot but did a d-diner. Same place on leg has gotten worse, unable to walk right. Fatigue so bad I am unable to get out of bed to work. Had not ever felt this way prior to this vaccine.

Other Meds: Celexa 10mg

Current Illness: None

ID: 1695483
Sex: F
Age:
State: CO

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

Lab Data:

Allergies: N/A

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

Symptoms: Patient had received one dose of the Janssen COVID-19 vaccine. patient states that the injection site was sore, red, and hot to the touch after a few days after receiving the vaccine. patient's husband called on 09/11/2021 stating that there was bruising and redness around the site of injection. initially, the use of ibuprofen and benadryl was suggested, but after further investigation, the patient stated that the condition looks like it was worsening and/or spreading. upon hearing this, it was suggested that the patient may want to consider going to urgent care just in case. called the patient 09/13/2021 as a follow-up. at urgent care, the provider stated that it may possibly be an allergic reaction or an infection. patient was prescribed bactrim, had been taking for 2 days and the patient reports feeling a bit better.

Other Meds: N/A

Current Illness: N/A

ID: 1695484
Sex: F
Age: 76
State: OH

Vax Date: 09/10/2021
Onset Date: 09/13/2021
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:

Allergies:

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

Symptoms: Customer came in for a third Moderna dose with vaccination card showing she had received 2 doses of moderna. Upon billing, it was discovered that she received the J&J COVID vaccine. This was verified in information system. She withheld information to the pharmacy. She has not experienced any side effects that I am aware of.

Other Meds:

Current Illness:

ID: 1695485
Sex: F
Age: 22
State: PA

Vax Date: 09/10/2021
Onset Date: 09/12/2021
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: Two days following the first dose of the vaccine I experienced a fairly bad Lyme Disease flare up. While I already experience joint pain due to Lyme, it was greatly intensified after the vaccine, causing me to have to take off work. I?ve also been experiencing a persistent migraine starting two days after receiving the first dose and continuing into today (3 days after vaccination). This migraine is causing random, extremely painful ?stabs? in the left side of my head.

Other Meds: Birth control, CBD, Melatonin

Current Illness:

ID: 1695486
Sex: M
Age: 21
State: CA

Vax Date: 09/13/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Pharyngeal swelling

Symptoms: Pfizer COVID vaccine vial was punctured at 8:40 am on 9/13/21 and last dose from vial was administered to patient at 3:06 pm on 9/13/21, 26 minutes after expiration time. Patient was monitored for 1 hour. No adverse signs or symptoms occurred.

Other Meds: Vitamin D

Current Illness:

ID: 1695487
Sex: M
Age: 61
State: CA

Vax Date: 03/12/2021
Onset Date: 03/29/2021
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: MRI angiogram head 4/10/21 - posterior R dural AVM MRI lumbar 4/10/21 - no significant spinal or neuroforaminal stenosis MRI brain 4/10/21 - 15x10 mm cerebellar pontine mass Carotid doppler 4/9/21 no significant stenosis COVID PCR 4/9/21 - neg

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Neuropathy affecting bilateral feet starting 3/29/21 followed by bells palsy 4/9/21

Other Meds: none

Current Illness: none

ID: 1695488
Sex: F
Age: 26
State: CA

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

Allergies: NONE/ PT HAS SESEASONAL ALLERGIES ONLY PER PT.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: PT FAINTED A MIN OR LESS AFTER VACCINE ADMINISTRATION. PT SAID DID NOT HAVE ANYTHING TO EAT ALL DAY. 911 CALLED, CAME TO SEE PT AND LATER LEFT. PT WERE NOT TAKEN TO HOSPITAL OR ER.

Other Meds:

Current Illness:

ID: 1695489
Sex: F
Age: 43
State: NM

Vax Date: 08/20/2021
Onset Date: 08/31/2021
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: N/A

Allergies: N/A

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

Symptoms: Since receiving the vaccine, I have experienced two separate incidents of severe break through menstrual bleeding. This is extremely rare for me as my periods are typically very regular and predictable.

Other Meds: N/A

Current Illness: N/A

ID: 1695491
Sex: F
Age: 21
State: MI

Vax Date: 09/13/2021
Onset Date: 09/13/2021
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: N/A

Symptom List: Rash, Urticaria

Symptoms: Patient received first dose of covid 19 vaccine. About 2 minutes after receiving dose when she was waiting her 15 minutes patient passed out and fell on floor. Went out to take of patient, took her pulse which was 88 and her blood pressure which came back at 48/69. Patient then passed out again. Grabbed patient orange juice and patients mom wanted us to call emergency services which we had already done. Stayed with patient until EMS came. Her blood sugar was fine, and blood pressure went up after drinking the orange juice.

Other Meds: N/A

Current Illness: N/A

ID: 1695492
Sex: F
Age: 32
State: UT

Vax Date: 09/03/2021
Onset Date: 09/04/2021
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 yet

Allergies: none

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

Symptoms: Chest pain on left side: - daily occurrence - doesn't last long, but occurs regularly and frequently throughout the day Noticeable increase in difficulty hearing and understanding people. Noticeable decrease in vision. Blurred vision. Noticeable increase in headaches and tension across the entire skull.

Other Meds: Adderall XR 10mg Davigo 10mg Magnesium Threonate

Current Illness: none

ID: 1695493
Sex: F
Age: 67
State: AR

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

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

Symptoms: Extremely stiff arm with pain. Whelps across arm. Bad headache ,little fever. Also had pneumonia shot in the same arm.

Other Meds: Inderal,pravastatin, lexapro, gabapentin, Benadryl, B12, D3, melatonin, potassium

Current Illness: None

ID: 1695494
Sex: M
Age: 29
State: NV

Vax Date: 05/12/2021
Onset Date: 05/12/2021
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: Went to urgent care and I was just told that I was constipated.

Allergies:

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

Symptoms: Before going to bed began having intense body pain all over. Cold and hot episodes followed by sweating and shivering. Next day felt very bad pain in my abdomen and when using the restroom noticed a significant amount of blood in my stool and around the bowl of the toilet. It was very painful to use the restroom and continued for days. Stomach pain worsened to the point where waist bands from shorts or underwear were excruciating and I couldn't wear anything anymore. Body pain remained and I also noticed I could no longer get erections which was very concerning.

Other Meds:

Current Illness:

ID: 1695495
Sex: F
Age: 60
State:

Vax Date: 09/10/2021
Onset Date: 09/12/2021
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:

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

Symptoms: 2 days following injection, developed swelling and redness at injection site

Other Meds:

Current Illness:

ID: 1695496
Sex: M
Age: 49
State: CA

Vax Date: 08/14/2021
Onset Date: 08/14/2021
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:

Allergies:

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

Symptoms: 8-12 hours post vaccination (of second dose), experienced rapid heart rate at rest of ~165 bpm that lasted around 2-3 hours (a low of ~135bpm and average of ~145bpm). Lying down, elevated legs and slow breaths did not help. No pressure, pains or shortness of breath; only increased heart rate. Only mitigating factor was to sit erect and lean forward to reduce heart rate (help with tachycardia). No other related symptoms, no prior issue or illness existed. The tachycardia event followed the prior night's symptoms of chills, fever, and a minute amount of nausea. All symptoms resolved -- including rapid heart rate by 10am 8/15.

Other Meds:

Current Illness:

ID: 1695497
Sex: M
Age: 25
State: MI

Vax Date: 09/08/2021
Onset Date: 09/09/2021
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: None reported

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient stated about 24 hours after receiving his 1st Pfizer dose, he got up to use the bathroom and felt dizzy. He woke up laying on the bathroom floor and was mildly shaking - was concerned he may have had a seizure. He believes he was "out" for just a few minutes. No reports of prior fainting or seizure episodes. Patient did report marijuana usage. Patient has not seen a Dr since the incident and is feeling fine currently. I indicated he should follow-up with Dr before receiving a 2nd dose.

Other Meds: Marijuana

Current Illness: None reported

ID: 1695498
Sex: F
Age: 64
State: FL

Vax Date: 09/03/2021
Onset Date: 09/04/2021
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: N/A

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: PT CAME TO PHARMACY AND SAID JUST GOT OUT OF ER BECAUSE MYOCARDITIS

Other Meds: N/A

Current Illness: N/A

ID: 1695499
Sex: M
Age: 66
State: CO

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: NONE

Allergies: NONE

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

Symptoms: INJECTION WAS MADE WITH A 5/8 INCH NEEDLE INSTEAD OF A 1 INCH NEEDLE. NO ADVERSE SYMPTOMS OR SIGNS.

Other Meds: LIPITOR 40MG, LISINOPRIL2.5MG, TOPROL XL 50MG

Current Illness: UNKNOWN

ID: 1695500
Sex: M
Age: 20
State: NV

Vax Date: 09/13/2021
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:

Allergies:

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

Symptoms: On the consent form signed by the patient, patient marked the answer "No" to question 4 that asks if patient has ever received a dose of Covid - 19. Patient was given Moderna 1st dose, as requested, but when billing we discovered patient was given a dose of Janssen Covid - 19 vaccine on April 7, 2021

Other Meds:

Current Illness:

ID: 1695501
Sex: F
Age: 37
State: OK

Vax Date: 12/28/2020
Onset Date: 12/28/2020
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: Echocardiogram, CBC, Chem 8, eye exam (f/u done in May 2021)

Allergies: None

Symptom List: Unevaluable event

Symptoms: Sinus Tachycardia (sustained 150-160 bpm) Right orbital numbness Right eye blurred vision Right eye vision change and pupillary shape change

Other Meds: None

Current Illness: None

ID: 1695502
Sex: F
Age: 35
State: CA

Vax Date: 08/09/2021
Onset Date: 08/09/2021
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: 8/13 - ER visit to rule out chest pain. EKG, blood work, chest X-ray = normal 8/26 - blood work for d-dimmer = very elevated 8/27 - ER visit to rule out no blood cloth due to d-dimmer elevated. EKG, blood work, chest X-ray, ct scan =normal 9/3 - called 911, had similar effects as a anxiety attack, EKG, blood work, chest X-ray = normal

Allergies: No

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

Symptoms: 5-7 minutes into having the vaccine I felt a jittery heat rush all over my body and immediately my blood pressure went up, not sure if it was because I got nervous. Since then I?ve had a heat sensation across my chest like if I had icy hot. Middle of my chest is painful in the sternum area.

Other Meds: Birth control

Current Illness: No

ID: 1695503
Sex: F
Age: 53
State: AZ

Vax Date: 04/13/2021
Onset Date: 05/25/2021
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: 6/25/2021 Blood tests. Had to wait for apt to become all for ophthalmologist; 7/21/2021 Papilledema; 7/31/2021 CT scan negative of head for brain tumor; 9/2/2021 2nd opinion confirmed Papilledema; 9/9/2021 compared charts with prior DX no changes have follow up December 2021 to monitor for changes

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Approx 1-2 weeks after 2nd vaccine Moderna 024c21a 5/11/21 began to experience numbness tingling in left leg. June 10th eye exam noted vision problem with referral to ophthalmologist as original optometrist could not treat. On 7/21/21 was DX with Papilledema and CT scan ordered. CT scan negative, 2nd opinion agreed with Papilledema tumor of brain ruled out with CT scan. Have follow up to monitor for changes in Dec 2021, still have numbness of left leg, also right leg and left arm but mostly left leg.

Other Meds: None

Current Illness: Pre-diabetic

Date Died: 09/12/2021

ID: 1695504
Sex: F
Age: 90
State: KY

Vax Date: 06/08/2021
Onset Date: 09/12/2021
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:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Brief Hospital Course: # Acute Hypoxic Respiratory Failure 2/2 COVID-19 Pneumonia - vaccination status: Janssen - COVID-19 + on 9/4, out of isolation on 9/19 - continue dexamethasone 6mg x 10 days, final day 9/12 - completed remdesivir x5 days - albuterol HFA 2p q4-6hr prn cough, wheeze, SOA - Wean O2 as tolerated, titrate to goal saturations >88-90% - guaifenesin, benzonatate, APAP prn - Therapeutic Anticoagulation (PMID: 34351721) with heparin gtt, though lost IV access overnight and renal function precludes use of other agents - pulmonology following - being treated for CAP with azithro + ceftriaxone - on 9/11, discussions with family lead to decision to transition to comfort measures only. Patient died at 2020 PM on 9/11/2021

Other Meds:

Current Illness:

ID: 1695505
Sex: F
Age: 22
State: PR

Vax Date: 09/10/2021
Onset Date: 09/12/2021
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:

Allergies: Penicillin

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

Symptoms: Skin rash all over the body

Other Meds:

Current Illness:

ID: 1695506
Sex: F
Age: 50
State: IN

Vax Date: 09/04/2021
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: LA

Lab Data: Have a dr appt on the 24th of September

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: After a week I have started to itch throughout my whole body. On my head neck back, chest arms, legs , feet. I feel like I have head lice . Seems to be getting worse. Sometimes feels like needles pricking me or something biting me. Changed my hormone pills at the same time so I?m not sure if it is this

Other Meds: Just changed my hormone replacement from Bijuva to an estradiol and progesterone separate pills .

Current Illness: No

ID: 1695507
Sex: M
Age: 33
State: NJ

Vax Date: 05/08/2021
Onset Date: 05/08/2021
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: Vital signs and EKG taken when EMS arrived on the scene. 05/08/2021.

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I received the injection and within minutes I felt lightheaded and like I was going to pass out. I immediately laid down on the floor in the middle of the pharmacy. After that everything went black. When I woke up, I was told I had a seizure. By standards said I was having full body convulsions for around 30 seconds. EMS was called to the scene. My vitals were taken, along with an EKG. Paramedics suggested I be taken to the hospital. I refused to go. When I contacted the pharmacy about getting the second injection, the pharmacist advised I do not get the second dose due to the adverse reaction I had during the first one.

Other Meds:

Current Illness:

ID: 1695508
Sex: M
Age: 17
State: IN

Vax Date: 09/13/2021
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: RA

Lab Data: n/a

Allergies: nkda

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

Symptoms: Patient became pale, heavily perspirating, and felt faint within about 5 minutes of shot. Gave patient bottle of water, bottle of sunny d and cheese cracker to eat. Within 5-10 minutes, he was feeling much better. Patient said he still felt "weird" as if he was "high" but his other symptoms had disappeared after 20 minutes. I told mom to call if she needed anything.

Other Meds: n/a

Current Illness: none

ID: 1695509
Sex: M
Age: 19
State: CA

Vax Date: 09/02/2021
Onset Date: 09/04/2021
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: None

Allergies: None

Symptom List: Nausea

Symptoms: Swelling of hands and feet Large rash on arms, legs and back

Other Meds: None

Current Illness: None

ID: 1695510
Sex: M
Age: 41
State:

Vax Date: 09/12/2021
Onset Date: 09/12/2021
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: 14 Sep 21 @ 0851 (Coll) NASAL MUCUS SARS-COV-2 AG . . . . NEGATIVE 13 Sep 21 @ 2259 (Coll) URINE UA GLUCOSE. . . . . . NEGATIVE (<50) UA BILIRUBIN. . . . . NEGATIVE (

Allergies: dairy products, no known drug allergies

Symptom List: Injection site pain

Symptoms: left upper extremity, trapezius, and sternocleidomastoid myasthenia with 3/5 strength. Able to oppose gravity but not resistance.

Other Meds: Prevacid over-the-counter

Current Illness: none

ID: 1695511
Sex: M
Age: 26
State: WA

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:

Allergies: almonds, walnuts

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

Symptoms: chest tightness started 9/11, worse and 9/12 and worse on 9/13. Fatigue 9/11-9-13, achy muscles in legs 9/11-9/13.

Other Meds: Sertraline

Current Illness: None

ID: 1695513
Sex: F
Age: 43
State: WI

Vax Date: 09/07/2021
Onset Date: 09/07/2021
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: My work made me have a covid test due to my symptoms lasting over 48 hours. Covid test was negative.

Allergies: PENICILLINS, BEES, LATEX, METFORMIN, CEFDINIR, ENVIRONMENTAL

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

Symptoms: Vaccine given @ 5:20pm, at 5:27pm I started having palpitations and checked my pulse on Watch (read 95). Pharmacist that administered vaccine said that it was most likely due to anxiety (but I didn?t feel that it was) and to go walk around. At approximately 5:30 pm, I became lightheaded and had bilateral ear ringing, my Watch showed my pulse was 50. I had my husband help me to the chair as the pharmacist was busy with customers. I finished sitting for the remaining 5 minutes, checked my pulse which was 74 and my husband and I left. At 5:45pm, I started getting a severe headache followed shortly with mild chest pains and shooting pain down the right arm. Around midnight I woke up with chills, nausea, vomiting, fever of 102.8, fatigue, body aches and still had chest pain and headache. On 9/8/21, my temperature without the use of Tylenol or ibuprofen was averaging 104.8. I continued to have chest pain and headache, body aches, fatigue, trouble concentrating, diarrhea, and then started itching on both arms and on my chest (without noticing a rash). Contacted my PCP?s office for direction and was advised that if symptoms worsened to go to the ER for evaluation. Around 6 pm that evening the lymph glands in my axilla became swollen and painful to the point I couldn?t wear a bra and needed to apply ice packs. On 9/9/21 my fever had reduced to 102 without fever reducing medications and the chest pain lessened but sTill had headache, body aches fatigue.

Other Meds: RIZATRIPTAN PRN MIGRAINE, ALPRAZOLAM 1 TAB QHS PRN SLEEP, ONDANSETRON PRN MIGRAINE, TOPIRAMATE 1 TAB QHS, METOPROLOL 1 TAB QD, BUPROPION 1 TAB BID, ESOMEPROZOLE 1 CAP QD, FLORAJEN PROBIOTIC 1 CAP QD, EMGALITY INJECTION ONCE MONTHLY, MULTIPL

Current Illness: NONE

ID: 1695514
Sex: F
Age: 35
State: CA

Vax Date: 08/02/2021
Onset Date: 08/03/2021
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: NA

Allergies: Compazine Benzoyl Peroxide latex cilantro

Symptom List: Tremor

Symptoms: Day after 2nd dose of Pfizer COVID vaccine right breast turned red, warm to touch and swollen. I was checked by OB 3 days after the 2nd dose and she also noted redness and irritation on the breast. She suggested to apply hydrocortisone cream and keep an eye on it. It took almost 2 weeks for all the breast symptoms to go away, Currently 24 weeks pregnant, EDD 1/6/22.

Other Meds: Synthroid 50 mcg daily Fish oil 1000 mg daily Aspirin 81 mg daily Honest company once a day prenatal Pepcid 20 mg daily Risaquad 1 cap daily

Current Illness: N/A

ID: 1695515
Sex: F
Age: 32
State:

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

Symptom List: Erythema, Pruritus

Symptoms: 32 year old female attendee with preexisting condition of vasovagal response to needles, reacted within 4 minutes of receipt of vaccination. She was assisted to gurney, exhibited a lower muscle tone which initiated EMS. EMS arrived 5 minutes and monitored until event self resolved to point Attendee was able to stand and ambulate without assistance 55 minutes later. Discharged self to home with brother driving, declined EMS.

Other Meds:

Current Illness:

ID: 1695516
Sex: M
Age: 34
State:

Vax Date: 09/07/2021
Onset Date: 09/10/2021
Rec V Date: 09/13/2021
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: Na

Allergies: Cats

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

Symptoms: On the first day of symptoms, experienced pins and needles in right wrist and hand. In the following days, the sensation moved to full right arm and right leg. The symptoms are still persistent at the time of this submission.

Other Meds: -multi vitamin -zinc -vitamin d3

Current Illness: None

ID: 1695517
Sex: F
Age: 34
State: VA

Vax Date: 08/17/2021
Onset Date: 08/17/2021
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: I thought it was a UTI, but results are negative. Doctors are now taking me off of antibiotics and telling me to try to keep moving. 2 Visits 9.4.21, 9.11.21

Allergies: None

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

Symptoms: Severe headaches and mild fatigue, turned into body cramps all over. Joint pain is keeping me from being able to work and take care of my children and house responsibilities. I am hurting and very angry, as I only took the vaccine for upcoming travel (in Oct. 2021) and now I'm in very bad shape.

Other Meds: None

Current Illness: None

ID: 1695518
Sex: F
Age: 34
State: CA

Vax Date: 01/17/2021
Onset Date: 01/17/2021
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: Shellfish and Macrobid

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Client reported onset of "increased heart rate, feeling jittery, and tingling and numbness of her lips and tongue" about 5-10 minutes after receiving the 1st Moderna vaccine to RN. Client stated that she took Zyrtec and Pepcid. Approximately 1.5 hours after the 1st dose of Moderna, the client felt that her "throat started closing." The client took Diphenhydramine 50mg PO. The client states she went to sleep after taking the Benadryl. The client stated that she slept for 6-7 hours. The client denied any symptoms after she woke up. The client did follow up with her provider who recommended the client receive a dose of Janssen.

Other Meds: Pepcid and Zyrtec

Current Illness: Unknown

ID: 1695519
Sex: M
Age: 25
State: MI

Vax Date: 08/06/2021
Onset Date: 08/07/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: CT scan and Chest Xray approximately 4 weeks ago. Negative Brain MRI scheduled for 2 weeks from now.

Allergies: None

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

Symptoms: 12 hours post vaccination the worst headache of my life and severe flu symptoms which calmed down after 24 hours. At the 24 hour mark a cough developed and has not gone away since. It is a non productive dry cough that has not improved since onset. The headaches have also been consistent since the onset, but have toned down to a moderate headache. Headaches have been consistent for 5-6x per week since vaccination. Broken blood vessels in eyes and pain with eye movements was a symptom from week 1 to last week. Now my eyes are just full of broken blood vessels, but not as much pain with movement.

Other Meds: None

Current Illness: None

ID: 1695520
Sex: F
Age: 28
State: NY

Vax Date: 09/10/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Rash or hives all over my belly, first pregnancy and due date 10/19/2021

Other Meds: Prenatal, iron, insulin

Current Illness:

ID: 1695521
Sex: F
Age: 36
State:

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: CT Scan conducted on Sept 13, 2021- normal test results ECT Test conducted on Sept 13, 2021 - normal test results Blood Test conducted on Sept 13, 2021- normal Ear exam conducted on Sept 13, 2021 indicated ear inflamation

Allergies: no food allergies were not aware of medication allergy at the time of vaccine

Symptom List: Pain in extremity

Symptoms: -tingling/twitching of fingers and toes -dizzy -foggy thoughts/slow response time -rapid heartbeats -migraines -ear inflammation -ear ringing

Other Meds: no

Current Illness: none

ID: 1695522
Sex: F
Age: 40
State: OH

Vax Date: 05/01/2021
Onset Date: 05/01/2021
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: Went to Provider urgent care, then had to be seen by a dermatologist, and am still being treated with steroid creams and hydrocortisone creams to this day I was unable to control the breakout

Allergies: NKDA or NKA

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

Symptoms: After vaccination of 05/01/2021, after I started to itch not too bad immediately, I was able to ignore it. That same night I was scratching everywhere and everywhere I scratched I had rash bumps and hives that got worse and worse ended up spreading all over my body. I tried Benadryl and other allergy medicine's but it would not subside took Benadryl for a few weeks then went to provider, because I could no longer take the itching and I have marks all over my body I had hives spreading from my arm to my chest back butt legs head to toe even in my hair

Other Meds: prior to vaccination: Adderall, Prozac, and Propranolol ...after first Pfizer shot, Prednisone taken for 6 weeks, Mometasone still using to clear rash spots, hydrocortisone acetate 1% cream, ) Triamcinolone acetonide 0.1%, Benadryl, Zyrtec

Current Illness: Non-health issues mental health issues

ID: 1695523
Sex: F
Age: 53
State: PA

Vax Date: 08/02/2021
Onset Date: 08/03/2021
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: amoxicillin

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

Symptoms: Heart beating very rapidly on morning after vaccination. Pulse rate according to fitness tracker range from 90 - 110bpm right after waking up (and I was not walking around) lasting approximately 1 hour , dropping to around 85 bpm for about 3 hours afterward. Fever present. pulse returned to normal range around 69-72 bpm after that time.

Other Meds: Vitamin D, Women's multi-vitamin

Current Illness:

ID: 1695524
Sex: F
Age: 39
State: MN

Vax Date: 09/06/2021
Onset Date: 09/10/2021
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: MRI brain, CBC, metabolic electrolyte panel

Allergies: NKDA

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

Symptoms: Had facial parenthesis and weakness on right side with mouth and eye. Diagnosed as Bells Palsy. Given steroids and anti viral.

Other Meds: Flexeril, Sprintec, Vyvanse, Lasix

Current Illness: None

ID: 1695525
Sex: M
Age: 75
State: MO

Vax Date: 07/20/2021
Onset Date: 07/20/2021
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:

Symptom List: Vomiting

Symptoms: Janssen COVID-19 Vaccine EUA. I could not possibly fill out all the questions in 15 minutes. My usual arthritis joints were affected to an extent more painful than usual especially my right arm. The pain was akin to when both my rotator cuffs were torn. Some swelling in my hands. It lasted six weeks winding down as time went by.

Other Meds:

Current Illness:

ID: 1695526
Sex: F
Age: 88
State: MI

Vax Date: 03/13/2021
Onset Date: 09/01/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Hospitalized; COVID-19 positive (9.1.21); fully vaccinated Admission Date: 9/1/2021 Discharge Date: 09/02/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute hyponatremia Stupor Altered mental status HOSPITAL COURSE Patient had presented I was admitted for confusion/altered mental status which spontaneously resolved. She has remained awake alert oriented x3 under also been insistent on being discharged today. CT scan of the head and CTA of the head and neck done on admission with unremarkable with no acute abnormalities and no high-grade vessel occlusion. There was no symptoms of stroke, she had denied any speech or swallowing impairment no acute change in vision no focal weakness. ER physician had discussed with neurologist prior to admission and did not also think it was related to stroke. Patient's sodium was found to be low at 125 on admission. We subsequently discontinued hydrochlorothiazide, I substituted with 5 mg of amlodipine for blood pressure control. She received IV normal saline and the sodium level has improved to 131. It is also felt that dehydration could have contributed to hyponatremia as evident of defiance duct patient also had acute kidney injury on chronic kidney disease on admission. Creatinine was 1.10 with estimated GFR of 47 and this has improved with IV fluids to creatinine of 0.94 and GFR of 56. Patient has been very insistent on being discharged today as we advised to follow closely with the family physician on discharge. On admission patient was also found to be COVID-19 positive however she has remained asymptomatic for this. She denies any shortness of breath and she has remained on room air saturating at 97%. She denies any chest pain no significant cough. She is advised to continue social distancing at home H&P: ASSESSMENT / PLAN: 1. Hyponatremia, continue IV normal saline. Monitor sodium levels closely, will hold hydrochlorothiazide 2. Altered mental status/encephalopathy, unknown etiology in likely with hyponatremia contributing, CT scan of the head was unremarkable. This has resolved patient is awake alert oriented x3, will follow 3. Hypertension continue home meds but hold hydrochlorothiazide and monitor blood pressure 4. DVT prophylaxis 5. COVID-19 positive patient is asymptomatic no chest pain no shortness of breaths presently on room air I have spent a total of 75 minutes of patient care coordination HISTORY OF PRESENT ILLNESS: Patient is a 89 y.o. female who presents today with confusion, patient reports that she woke up this morning feeling disoriented and confused with slow thought process. She denies any difficulty in speech, denies any impairment of swallowing, no headache no acute change of vision no focal weakness. She reports that she feels much better no she is able to answer questions she is awake alert oriented x3. She denies nausea vomiting no abdominal pain no change in bowel movement. She denies chest pain no cough no shortness of breath no diaphoresis no fever. Denies dysuria hematuria no leg pains no leg swelling In the emergency room CT scan of the head was done which was unremarkable, CTA of the head and neck was also unremarkable, chest x-ray no acute abnormality. Blood work shows sodium level of 125 and a GFR of 50 below troponin is 23 but trended down once to 2

Other Meds: acetaminophen (TYLENOL) 500 MG tablet amLODIPine (NORVASC) 5 MG tablet apixaban (ELIQUIS) 5 MG tablet cholecalciferol (VITAMIN D3) 25 MCG (1000 UT) tablet ibuprofen (MOTRIN) 200 MG tablet lisinopril (PRINIVIL,ZESTRIL) 20 MG tablet metoprolo

Current Illness: NA COVID-19 positive 9.1.21

ID: 1695527
Sex: F
Age: 41
State: OR

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: RA

Lab Data:

Allergies: Medical tape

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

Symptoms: Over 24 hrs after my 2nd vaccine I have a very unwell feeling and temp of 100. Also lump and severe pain at injection site.

Other Meds: Clonazepam .05mg daily; Paxil 20mg daily

Current Illness: None

ID: 1695528
Sex: F
Age: 14
State: IN

Vax Date: 09/11/2021
Onset Date: 09/12/2021
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: Keflex, Penicillin, Amoxicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: On evening of day 2 after each of shots 1 and 2 patient presented with vomiting, diarrhea, all over sweating, stomach pain, and itching and rash on head/ears.

Other Meds: Birth control , zoloft, iron supplement

Current Illness: Anemia

ID: 1695529
Sex: M
Age:
State: MO

Vax Date: 02/01/2021
Onset Date: 02/01/2021
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: Itchy left injection site arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Itchy left injection site arm) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 01-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (Itchy left injection site arm). At the time of the report, VACCINATION SITE PRURITUS (Itchy left injection site arm) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No concomitant product use was provided by the reporter. No treatment medication was provided. This case was linked to MOD-2021-303330 (Patient Link).

Other Meds:

Current Illness:

ID: 1695530
Sex: F
Age:
State: FL

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

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

Symptoms: Perspiring; Covid arm; Itching; Covid arm/hot; Covid arm/swollen; Exaggerated flu like; Grapefruit size 10 days po; Body aches; I slept off and on for three days; Body aches; Fever; Chills; sleeping for 3 days; This spontaneous case was reported by a consumer and describes the occurrence of HYPERSOMNIA (sleeping for 3 days), HYPERHIDROSIS (Perspiring), VACCINATION SITE REACTION (Covid arm), PRURITUS (Itching) and VACCINATION SITE WARMTH (Covid arm/hot) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Latex allergy, Fibromyalgia, Spinal stenosis and Arthritis. Concomitant products included THYROID (ARMOUR THYROID), POTASSIUM, OMEPRAZOLE (PRILOSEC [OMEPRAZOLE]), MAGNESIUM and FUROSEMIDE (LASIX [FUROSEMIDE]) for an unknown indication. On 01-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced HYPERSOMNIA (sleeping for 3 days), HYPERHIDROSIS (Perspiring), VACCINATION SITE REACTION (Covid arm), PRURITUS (Itching), VACCINATION SITE WARMTH (Covid arm/hot), VACCINATION SITE SWELLING (Covid arm/swollen), INFLUENZA LIKE ILLNESS (Exaggerated flu like), UNEVALUABLE EVENT (Grapefruit size 10 days po), PAIN (Body aches), SLEEP DISORDER (I slept off and on for three days), MYALGIA (Body aches), PYREXIA (Fever) and CHILLS (Chills). At the time of the report, HYPERSOMNIA (sleeping for 3 days), HYPERHIDROSIS (Perspiring), VACCINATION SITE REACTION (Covid arm), PRURITUS (Itching), VACCINATION SITE WARMTH (Covid arm/hot), VACCINATION SITE SWELLING (Covid arm/swollen), PAIN (Body aches), SLEEP DISORDER (I slept off and on for three days), MYALGIA (Body aches), PYREXIA (Fever) and CHILLS (Chills) outcome was unknown and INFLUENZA LIKE ILLNESS (Exaggerated flu like) and UNEVALUABLE EVENT (Grapefruit size 10 days po) had resolved. Patient reported that the concomitant medication armour thyroid was indicated for use of rovustatin. Patient reported that the concomitant medication Lasix was indicated for use of gabepetin. No treatment medications were reported. 18 hours after receiving the second dose of the Moderna vaccine patient began to experience fever, chills, perspiring, body aches. Patient went to bed requesting more and more blankets. Patients husband reported that patient slept off and on for three days. Patient remember very little of this time. Patient enquired was it safe to receive booster. Most recent FOLLOW-UP information incorporated above includes: On 06-Sep-2021: Updated reporter information, patient demographics and added past relevant history, and concomitant medications and new events were added.

Other Meds: ARMOUR THYROID; POTASSIUM; PRILOSEC [OMEPRAZOLE]; MAGNESIUM; LASIX [FUROSEMIDE]

Current Illness: Arthritis; Fibromyalgia; Latex allergy; Spinal stenosis

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am