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: 1696456
Sex: F
Age: 43
State: AL

Vax Date: 04/09/2021
Onset Date: 05/07/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: I got shingles for the first time less than a month after receiving my second shot. I then got shingles again 4 months later on 9/10/2021.

Other Meds: None

Current Illness: None

ID: 1696457
Sex: F
Age: 72
State: MN

Vax Date: 02/12/2021
Onset Date: 09/07/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data: ABBOTT ID NOW COVID-19 VIRUS MOLECULAR TEST POSITIVE 9/7/21

Allergies: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: COVID POSITIVE WITH HOSPITALIZATION WHILE FULLY VACCINATED

Other Meds: ACETAMINOPHEN, ALBUTEROL-IPRATROPIUM NEB, BROVANA, BUDESONIDE, KEPPRA, LINZESS, SPIRONOLACTONE

Current Illness: UNKNOWN

ID: 1696458
Sex: M
Age: 45
State: MA

Vax Date: 09/13/2021
Onset Date: 09/13/2021
Rec V Date: 09/14/2021
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: Petroleum product irritant

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

Symptoms: Within a few hours, the pain developed in my left arm at the injection shot. By morning it was extremely painful to move my arm in any direction. Pain feels like it's traveling through my arm to my hand.

Other Meds: Adderall

Current Illness: none

ID: 1696459
Sex: F
Age: 57
State: CT

Vax Date: 09/10/2021
Onset Date: 09/11/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data:

Allergies: amlodipine, amoxicillin, atorvastatin, Bactrim, codeine, erythromycin, Darvocet-n 100, hycodan, pravastatin, tylox, ultram and vicodin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pt states that the next morning after vaccine (9/11), she woke up with a slight fever of 101. Pt took Tylenol and the fever went away the same day. 9/13 pt states her Left arm was itchy and the vaccine site was red.

Other Meds:

Current Illness:

ID: 1696460
Sex: M
Age: 52
State: WI

Vax Date: 04/05/2021
Onset Date: 05/03/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: 5/3/21, 6/14/21

Allergies: none

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

Symptoms: thyroid levels increased significantly

Other Meds: Atorvastatin 10mg Tablet, FLUoxetine 20mg Capsule, Levothyroxine 450mcg total week

Current Illness: none

ID: 1696461
Sex: F
Age: 53
State: OR

Vax Date: 09/12/2021
Onset Date: 09/13/2021
Rec V Date: 09/14/2021
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: Levaquin

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

Symptoms: Fever, chills, severe headache, body pain and weakness

Other Meds:

Current Illness: Diverticulitis

ID: 1696462
Sex: M
Age: 75
State: NY

Vax Date: 09/13/2021
Onset Date: 09/14/2021
Rec V Date: 09/14/2021
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: Penicillin, codein, lactose intolerance

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Vomiting, clear fluid, before breakfast, 30 minutes after taking Doxycline casule (4th day of 7 treatment after oral surgery 4 days previously) -- I believe the Doxycline was the prime cause of vomiting.

Other Meds: Irbesartan 75 mg, Atorvastatin 40 mg, Aspirin 81 mg, fish oil 1000mg, vitamin D3 400 IU, vitamin C 500 mg, GNC MegaMen multiple vitamins and minerals (all former items taken once daily), Doxycline Hyclate 100 mg (two doses daily having been

Current Illness: None

ID: 1696463
Sex: F
Age: 51
State: MO

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: none

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: At 30 minutes post vac Pt c/o n/v and "feeling tingly, sweaty and feeling anxious" Pt. given Benedryl 25 mg po and put on stretcher. Initial vitals 200/89 99% HR 86. Pt then c/o heart fluttering. EMS called and pt taken to Hospital

Other Meds: None

Current Illness: unknown

ID: 1696464
Sex: F
Age: 66
State: OR

Vax Date: 03/10/2021
Onset Date:
Rec V Date: 09/14/2021
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.

Allergies: Sofia; Depakote; Keppra

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: My glands swelled up. I am a sore. In September I had a running nose, headache, and body ache. I got a Covid-19 test, was negative. My nose is still running. I wake up this morning my throat hurt and my ears hurt a little.

Other Meds: Metoprolol Tardive; Losartan; Antidote; Rosuvastatin; Mudhole; baby aspire; vitamin D; Garlic oil

Current Illness:

ID: 1696465
Sex: M
Age: 60
State: TX

Vax Date: 03/26/2021
Onset Date: 06/07/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data: echo- that part of my heart looked a little stiff. 2 cat scan of my head and neck; monitored my heart; I will have another echogram.

Allergies: latex; allergic to some pollen, pine trees

Symptom List: Diarrhoea, Nasal congestion

Symptoms: With the 1st Dose, my right arm hurt for a whole month. With the 2nd Dose, I did not have any symptoms and my arm did not hurt. When I was using a push mower, and I'm a barber, I noticed I had to stop, because I was feeling tired. Then I noticed the left side of my neck and shoulder blade had a sore spot and while I had been working on my weed eater. I went to my chiropractor and massage therapist. I just so happen to have a heart attack after the 3rd visit. I was taking my wife to work, I did not feel good, I was nauseated and had dizziness and I went back to my house to lay down. And after that I don't remember getting out of the truck. I hit my head on the cement and received a concussion, my wife told me. I don't remember any of it. I had to stay 2 extra days in the hospital because of the concussion. On 06/07/2021, Hospital, I had a heart attack in my front yard. The treatment they put in stents. They installed prox RCA was 4 mm by 23mm , and the 2nd stent distal circ 2.25mm by 18 mm. It was Abbott vascular and the XIENCE sierra. I am still recovering, I have 14 weeks of cardiac therapy. I have to take extra medicine Plavix , 81 mg baby aspirin , Atorvastatin, Clopidogrel od, metoprolol tartrate od, about 5 new medications to keep my stents from plugging up. I used to be able to do the elliptical for like 45 minutes now I can barely do 5 minutes. I am not the same guy with the same energy as I was.

Other Meds: high blood pressure pill amlodipine 5 mg od; vitamin C; Vitamin D-3 - prescription

Current Illness: I can't remember when I was sick in the last 30 years.

ID: 1696466
Sex: F
Age: 59
State: WA

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: None. Too sick to drive to doctor's office right after vaccination, then waited to see what would happen as symptoms improved.

Allergies: Sulfa antibiotics

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

Symptoms: High fever and unconsciousness on day following vaccination. Loss of short term memory: severe for one week, less severe for an additional week. Interfered with my ability to maintain my household and do basic chores while at home recovering from the vaccine, then interfered with my ability to do my job on return to work five days later on Tuesday June first, through the end of the following week.

Other Meds: For asthma & allergies-prescriptions: Albuterol/Spiriva/Advair/Fluticasone/Azelastine/Montelukast For allergies-over the counter: Allegra For blood pressure: Losartan Supplements: Multi-vitamin/vitamin D/L-lysine/B-12

Current Illness: No

ID: 1696467
Sex: F
Age: 46
State: NY

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: None yet.

Allergies: Sulfa based meds

Symptom List: Rash, Urticaria

Symptoms: Fever, Chills, Very Swollen Left Arm, Shooting Pains throughout body, very blurry vision, weakness, fatigue

Other Meds: None.

Current Illness: None

ID: 1696468
Sex: F
Age: 82
State: FL

Vax Date: 01/13/2021
Onset Date: 03/09/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data: Covid test, CXR.

Allergies: Ambien, codeine, eszopiclone, lunesta, modafinil, Neosporin, provigil, tape, zoledronic acid.

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

Symptoms: Pt came to ER c/o difficulty breathing onset just prior to arrival.

Other Meds:

Current Illness:

ID: 1696469
Sex: M
Age: 78
State: WI

Vax Date: 09/03/2021
Onset Date: 09/08/2021
Rec V Date: 09/14/2021
Hospital: Y

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: Amoxicillin, Nickel, Amlodipine, Penicillins

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

Symptoms: Admitted on 9/8 due to acute respiratory failure with worsening hypoxia secondary to covid pna. He is chronically immunocompramised secondary to dermatomyositis. On Prednisone 40mg daily (down from 60mg) chronically.

Other Meds: acetaminophen, albuterol,aspirin chewable, bisacodyL,carboxyme

Current Illness:

ID: 1696470
Sex: M
Age: 71
State: PA

Vax Date: 03/10/2021
Onset Date: 03/17/2021
Rec V Date: 09/14/2021
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 - just exercises

Allergies: Shellfish

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

Symptoms: Vertigo - 8 days after the 1st and 2nd shot. For the 2nd shot -I got up in the AM and out of balance, supposed to go out, but while driving, it hit me and I stopped to get Dramamine. I felt unsteady like I was drunk. I went back home...I was afraid of driving home. Got home safely. Took Dramamine. The next day, the doctor on Mar19.2021 got to do some exercise. Left ear - there was a white, freeze fluid. Been doing exercise. Metrozine pill was prescribed. When I am I laying on my left left and tilt a side and the room would spin. Most of the the problems are on the left side...

Other Meds: Quinapril; lovastatin

Current Illness: Cold a month before 1st vaccine 0n 2/10/2021

ID: 1696471
Sex: F
Age: 70
State: WV

Vax Date: 08/29/2021
Onset Date: 08/31/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: N/A

Allergies: N/A

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

Symptoms: Pt. states that after receiving the Booster 3rd dose of Moderna 08/29/2021, started experiencing symptoms 08/31/2021 of tightness in the chest, shortness of breath, severe cough with mucus, numbness began around the left ear spreading throughout the left side of the face, and blisters located in the mouth. Primary communications 09/14/2021, still waiting for recommendations.

Other Meds: N/A

Current Illness: N/A

ID: 1696472
Sex: M
Age: 67
State: NJ

Vax Date: 09/13/2021
Onset Date: 09/13/2021
Rec V Date: 09/14/2021
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: penicilin

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

Symptoms: difficulty breathing, chills, little weakness

Other Meds: toperol, clavix, zocore, delzon

Current Illness:

ID: 1696473
Sex: M
Age: 61
State: OR

Vax Date: 08/18/2021
Onset Date: 08/18/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: CMA administered second dose of Covid 19 vaccine using Pfizer manufacturer Lot 3EW0186. Patient reported reaction as "rash and burning up" on vaccine second dose consent form from receiving Moderna vaccine #1 dose given 12/29/2020. Patient was monitored and no adverse reaction to second dose was observed. Patient was released with no side effects.

Other Meds:

Current Illness:

ID: 1696474
Sex: F
Age: 31
State: PA

Vax Date: 09/10/2021
Onset Date: 09/12/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: 9/13/2021- date of all tests: Chest X ray (ok), CBC (ok), CMP (low potassium), Troponin (ok), ECG-12 Lead (adnormal ECG, sinus tachycardia, t wave abnormality, inferior ischemia), Covid Test (negative).

Allergies: No

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 2 days after receiving the first dose of the Pfizer-Biotech vaccine- started having chest pain, shortness of breath, and rapid heart rate. Went to the ER after symptoms worsened (on 3rd day after). I was treated in the hospital for the pain and low potassium, referred to a cardiologist. Still have chest pain after 4 days of getting the first dose of vaccine.

Other Meds: Hair, Skin, Nails vitamin, Vitamin D3, Vitamin C

Current Illness: No

ID: 1696475
Sex: F
Age: 25
State: ME

Vax Date: 08/18/2021
Onset Date: 08/19/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: 8/21/2021 EKG, CBC, CMP, D-dimer, troponin, chest xray 9/9/2021 CRP, D-dimer, TSH, CMP, CBC, chest xray, echo

Allergies: N/A

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

Symptoms: Chest pain, L arm paresthesias, and shortness of breath starting the day after vaccine was adminstered and persisting to the present

Other Meds: N/A

Current Illness: N/A

ID: 1696476
Sex: M
Age: 29
State: GA

Vax Date: 08/18/2021
Onset Date: 08/23/2021
Rec V Date: 09/14/2021
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: Blood work/ CT scan, PCP and ER visits (both agree that this is a response to the vaccine but have no clue how to fix it) Doctors have tried to prescribe me Diazepam, Ambien, and Nortriptyline to help with my sleep and anxiety/depression. All these medications seem to worsen my cognitive symptoms and I cannot take them.

Allergies: none

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

Symptoms: after getting the first dose of moderna on 8/18/21, I had muscle soreness and a little fatigue that night. On Monday morning 8/23 I woke up having trouble speaking, otherwise I felt fine. Tuesday (the next day) I woke up with vertigo, a headache, a very vague sense of disorientation, nausea, ringing in my ears, confusion and slow responsiveness. I felt intoxicated to the point that I couldn't work or complete daily tasks. On Wednesday 8/25 I went to see my primary care physician and he gave me a methyprednisalone taper. Over the course of the next week after the taper I felt no better, and I still felt very intoxicated, confused, lightheaded, constant headaches, I space out constantly and I generally feel like I'm about 20% of my typical mental baseline. Its hard to even function properly. I cannot handle more than one thing at a time and I have become very scared and depressed that I will never return to normal. I have a constant ringing in my ears and I have a lot of difficulty sleeping, its like my mind begins to panic when I start to doze off. I have been out of work for almost a month and I'm not seeing any improvement in my cognitive disability. I have been a work from home software developer for almost 2 years now and I have never had any health problems, or psychiactric issues before this. I didnt start becoming depressed until a week or so after this started and hearing multiple doctors tell me that they dont know whats causing this or how long I will be like this.

Other Meds: Adderall, caffeine

Current Illness: none

ID: 1696477
Sex: M
Age: 18
State: CA

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

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

Lab Data: Urgent Care

Allergies: none

Symptom List: Unevaluable event

Symptoms: Extreme testicle pain and up into the abdomen region.

Other Meds: none

Current Illness: none

ID: 1696478
Sex: F
Age: 28
State: MO

Vax Date: 08/09/2021
Onset Date: 08/10/2021
Rec V Date: 09/14/2021
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: on august 10th, the following day after receiving the first dose, i started having heart palpitations everyday. on august 26th i recieved the second dose and started having palpitations a few times a day. i do have an underlining heart condition where i would have palpitations every few months. this amplified after the very first dose of the covid vaccine. i reached out to my cardiologist and he suspects that the vaccine gave me inflammation on my heart and i now have to take medication to see if it helps the palpitations.

Other Meds: claritin 10mg qd

Current Illness: none

Date Died: 08/24/2021

ID: 1696479
Sex: F
Age: 55
State: TX

Vax Date: 04/02/2021
Onset Date: 08/02/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Hospitalized due to COVID-19. Died 8/24/2021

Other Meds:

Current Illness:

Date Died: 08/26/2021

ID: 1696480
Sex: F
Age: 62
State: TX

Vax Date: 02/11/2021
Onset Date: 08/25/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data: ABGs, CXR 8/26

Allergies: NKDA

Symptom List: Injection site pain, Menorrhagia

Symptoms: Covid positive week prior to admission, SOB, central line placement, intubation, vasopressors, patient expired

Other Meds: carvedilol, celecoxib, vit b-12, duloxetine, gabapentin, lorazepam, melatonin, metformin, potassium, ramelteon, rosuvastatin, tylenol

Current Illness:

ID: 1696481
Sex: F
Age: 19
State: MN

Vax Date: 04/19/2021
Onset Date: 09/10/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: 9/13 SARS/COV-2, NAAT positive

Allergies:

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

Symptoms: Breakthrough COVID

Other Meds:

Current Illness:

ID: 1696482
Sex: F
Age: 22
State: SC

Vax Date: 09/10/2021
Onset Date: 09/11/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data: MRA/MRI Brain - 09/11/2021 - normal exam Labs essentially normal.

Allergies: Egg

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The patient reports that she had a witnessed seizure event after having breakfast at a local restaurant. EMS was called and they administered Ativan for witnessed seizure activity. Patient was transported to the emergency department for further evaluation and treatment. Patient is seizure-free since her arrival to our emergency department. Coincidently the patient had her second Covid vaccination yesterday and there is concern that the seizure might be associated with her vaccination.

Other Meds: None reported

Current Illness: None

ID: 1696483
Sex: F
Age: 74
State: FL

Vax Date: 08/19/2021
Onset Date: 08/20/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data:

Allergies: Adhesive. Grass mold trees

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever, chills, headache, body aches, leg pain and encephalitis. I was bed ridden 11 days. I had to take narcotics to bear the pain. Fatigue loss of appetite.

Other Meds: Lisinipril Xanax. Cymbalta. Amitripiline. Plavix treshiba baby aspirin. Vit D3 K2. Multi vitamin

Current Illness: No

ID: 1696484
Sex: M
Age: 85
State: MN

Vax Date: 03/24/2021
Onset Date: 09/09/2021
Rec V Date: 09/14/2021
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 VIRUS MOLECULAR TEST POSITIVE 9/9/21

Allergies: NKA

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

Symptoms: COVID DIAGNOSIS AND HOSPITALIZATION AFTER BEING FULLY IMMUNIZED

Other Meds: ASPIRIN, FISH OIL, FLUTICASONE, GABAPENTIN, HYDROCHLOROTHIAZIDE, LISINOPRIL, METOPROLOL, MULTIVITAMIN, SIMVASTATIN

Current Illness: NONE

ID: 1696485
Sex: F
Age: 54
State: KY

Vax Date: 02/25/2021
Onset Date: 09/11/2021
Rec V Date: 09/14/2021
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: Tested positive for covid

Other Meds:

Current Illness:

ID: 1696486
Sex: M
Age: 86
State: GA

Vax Date: 02/22/2021
Onset Date: 08/31/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data: 08/31/2021 PCR+ COVID-19 test; 09/01/2021 PCR+ COVID-19 test

Allergies:

Symptom List: Injection site pain

Symptoms: Breakthrough COVID-19 case with symptom onset 8/31/2021: Chills, Muscle or body aches, Runny nose/Congestion, Cough (new onset or worsening of chronic cough), Shortness of breath or difficulty breathing, Fatigue or tiredness, Nausea or vomiting, Abdominal pain, and ringing in the ears. Patient started feeling very unwell on the first day with heavy coughing, congestion, ears were ringing, and had some pain in the diaphragm. On the first, went into the hospital because they were having trouble getting full breaths in and the other symptoms had not gone away. They cam back same she had evidence of pneumonia, a common concurrent illness linked to COVID-19. After receiving medication for the pneumonia, the breathing eased and the cough became less strong. Currently, PUI is at home, and PUI is struggling with nausea from the medications, feeling a little sore, and chills at night, so symptoms have not gone away completely. Hospitalized for 3 days 9/1/2021-9/3/2021.

Other Meds:

Current Illness:

ID: 1696487
Sex: F
Age: 41
State: TX

Vax Date: 08/10/2021
Onset Date: 08/14/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: N/A

Allergies: None

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

Symptoms: Seizures after, dr visit, waiting to see neurologist, smell sensation, shaking, dizziness, migraine, vision issue, bowl movement. From seconds to 1-3 minutes.

Other Meds: None

Current Illness: None

ID: 1696488
Sex: F
Age: 55
State: CA

Vax Date: 09/12/2021
Onset Date: 09/13/2021
Rec V Date: 09/14/2021
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: Erythromycin

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

Symptoms: Fever of 101 degrees Tingling in left arm from shoulder to fingers Swollen lymph nodes under left arm Severe aching pain from left shoulder across chest and under the left arm Extreme fatigue Dizziness, light headedness Arm tenderness at injection site

Other Meds: None

Current Illness: None

ID: 1696489
Sex: F
Age: 34
State: ND

Vax Date: 08/31/2021
Onset Date: 09/02/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: None

Allergies: Erythromycin

Symptom List: Tremor

Symptoms: Pt developed rash on neck and torso 48 hours after receiving 2nd dose of COVID vaccine. She did not seek medical care until 4 days following onset of rash. Unclear if COVID vaccine triggered rash. She was treated with oral Benadryl with no improvement. She was seen again by medical provider one week later and diagnosed with likely pityriasis rosea. She is currently being treated with topical steroid and continued oral Benadryl as needed.

Other Meds: Yaz 3mg-0.02 mg oral tablet po daily.

Current Illness: None

ID: 1696490
Sex: F
Age: 61
State: ND

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 09/14/2021
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: Informed by Moderna/State Health Department that vaccine was expired by 4 days.

Other Meds:

Current Illness:

ID: 1696491
Sex: F
Age: 47
State: NH

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/14/2021
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:

Allergies: sulfa allergy

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

Symptoms: Pt reports "weird sensation" on left side of neck and then her entire face went numb. She then reports feeling the "weird sensation" on the right side of her neck. She did not treat this and reports that it went away on its own after about 15 minutes.

Other Meds: multivitamin, omega 3 fatty acid, vitamin d3

Current Illness: no

ID: 1696492
Sex: F
Age: 44
State: MN

Vax Date: 07/23/2021
Onset Date: 08/01/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient presented to the ED for right ankle pain and agitation on 8/1/2021. Patient presented to the ED on 8/6/21 with depression with suicidal ideation. Patient was hospitalized on 8/9/2021. These visits are within 6 weeks of receiving COVID vaccination. Patient did receive second dose on 8/13/2021.

Other Meds:

Current Illness:

ID: 1696493
Sex: F
Age: 30
State: IL

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

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

Lab Data: pregnancy test- 9/12/13 - negative

Allergies: n/a

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 9/7/21: 12:00pm- extreme nausea 12:30pm- continued nausea, feeling overheated 1:00pm- continued nausea, feeling overheated, began getting confused (I was filling out paperwork and couldn't spell my middle or last name) 1:15pm- continued nausea, feeling overheated, still confused- threw up symptoms continued 4:00pm- continued nausea, extreme chills to the point of shaking 4:30pm- continued nausea, painful body aches, violent shaking from cold chills (was wearing 2 pairs of pants, long socks, shirt/hoodie, sock cap, covered in heavy blanket and sitting outside in 85 degree weather) symptoms continued 5:00pm- all symptoms above present, took temperature- 101.4 6:00pm - all symptoms above present, took temperature- 102.3 7:00pm- all symptoms above present, took temperature- 102.9 symptoms continued 9:00pm-continued nausea, painful body aches, feeling overheated and sweating everywhere, skin extremely hot to touch symptoms continued. extreme fatigue all day 9/8/21 8:00am- fever broke, nausea continued, extreme body aches continued symptoms continued all day and night extreme fatigue all day (10 hours of sleep) 9/9/21 6:00am- horrible migraine, extreme nausea 6:30am- skin began burning and itching after shower 7:00am- threw up 7:30am- took Benadryl and burning and itching stopped nausea and migraine continued all day extreme fatigue all day (8 hours of sleep) 9/10/21 6:00am- horrible migraine, extreme nausea, extreme fatigue 6:30am- skin began burning and itching after shower 6:40am- threw up nausea and migraine continued all day extreme fatigue all day (9 hours of sleep) 9/11/21 8:00am- horrible migraine, extreme nausea, extreme fatigue 9:00am- skin began burning and itching after shower 11:40am- threw up 1:00pm- threw up 9:00pm- threw up nausea and migraine continued all day extreme fatigue all day (8 hours of sleep) 9/12/13 8:00am- horrible migraine, extreme nausea, extreme fatigue 8:30am- skin began burning and itching after shower remained nauseous all day, did not throw up fell asleep by 5:00pm 9/13/21 5:30am- horrible migraine, extreme nausea, extreme fatigue 6:00am- skin began burning and itching after shower 9:00am- threw up nausea and migraine continued all day extreme fatigue all day (12 hours of sleep)

Other Meds: birth control- Yaz

Current Illness: n/a

ID: 1696494
Sex: F
Age: 31
State: NJ

Vax Date: 08/20/2021
Onset Date: 08/21/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: Yes to receive my results

Allergies: Shelly foods

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

Symptoms: I had the Moderna vaccine on the 08/20/2021, the next day I got my period with some body pains headache and tiredness. Then in 2weeks time (4th sept,2021) I experienced vaginal bleeding with clots which lasted for 9 days during those days I also experienced the following: Heavy breathing Headache Tiredness Cold Irritated throat, all these lasted for a week. During the course of these symptoms as I was waiting to c my PCM I was only taking painkillers and vitamin c .

Other Meds: Multivitamins

Current Illness:

ID: 1696495
Sex: F
Age: 61
State: WA

Vax Date: 06/17/2021
Onset Date: 09/13/2021
Rec V Date: 09/14/2021
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: n/a

Allergies: Unknown

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

Symptoms: Employee forgot that she already received COVID19 (Janssen) back in 6/17/21 and gave this reporter consent to administer her first dose of COVID19 (Pfizer) on 9/13/21.

Other Meds: Unknown

Current Illness: Unknown

ID: 1696496
Sex: F
Age: 46
State: OH

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data:

Allergies: Cephalexin, morphine

Symptom List: Pain in extremity

Symptoms: About an hour after receiving the vaccine I started to feel a weird sensation on the left side of my face and broke out in hives on the left side of my forehead, neck, and by my nose. Had to go to the hospital due to having an allergic reaction to the vaccine and had to take steroids and pepcin for the next two days because the hives kept coming back.

Other Meds: None

Current Illness: None

ID: 1696497
Sex: F
Age: 36
State: PA

Vax Date: 01/18/2021
Onset Date: 01/20/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: n/a

Allergies: penicillin

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

Symptoms: morbilliform rash occurred on torso & neck ~48 hrs after second dose only, persisted for 5 days, antihistamine medication did not resolve rash; slightly itchy & warm. Rash resolved on its own by 1 week post vaccine dose.

Other Meds: prenatal vitamins

Current Illness: n/a

ID: 1696498
Sex: F
Age: 20
State: OR

Vax Date: 09/13/2021
Onset Date: 09/14/2021
Rec V Date: 09/14/2021
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: latex

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

Symptoms: Period began that night, very heavy bleeding which is abnormal for me. Also extreme cramping

Other Meds: isbusporin birth control

Current Illness: none

ID: 1696499
Sex: M
Age: 11
State: IL

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: none

Allergies: none

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

Symptoms: Patient was given Pfizer COVID 19 vaccine at 11 years of age. No negative outcomes at this time

Other Meds: none

Current Illness: none

ID: 1696500
Sex: M
Age: 38
State: NJ

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: Mentioned pain and symptoms with primary care physician on 30 April 2021 during first visit. On 14 May 2021 had a follow up visit and primary care physician referred me to a neurologist to check for potential nerve damage. 17 June 2021 visited neurologist who prescribed a regimen of Naproxen to see if that would relive the pain. It did not and on 21 July 2021 he concluded that he is not certain if the pain is related to a nerve in the neck or arm itself and there would be a low yield to considering nerve testing for this issue. Primary care physician recommended on 21 July 2021 to see an orthopedic surgeon for follow on evaluation.

Allergies: none

Symptom List: Vomiting

Symptoms: Pain in left deltoid began immediately after receiving the second dose. The pain was similar to that experienced after the first dose. However, the pain continues to this day. Symptoms include: pain in shoulder without pressure applied, occasional pain in left arm that shoots down from shoulder, pain when pressing on shoulder (ie: when leaning on a door or wall).

Other Meds: vitamin D, Vitamin C supplements; Ambien;

Current Illness: none

Date Died: 09/12/2021

ID: 1696501
Sex: M
Age: 42
State: MI

Vax Date: 09/02/2021
Onset Date: 09/03/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: Unknown

Allergies: Unknown

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Received the the 1st Pfizer COVID vaccine on 08/12/2021 and the 2nd Pfizer COVID vaccine on 09/02/2021. The Decedent's wife had told Police that the Decedent was complaining about not feeling well ever since he got the 2nd vaccine. 09/12/2021 -- Decedent had an Asthma attack at 0400 hours. Per the Decedent's wife, the Decedent did at least 10 Albuterol and Nebulizer treatments before calling for an ambulance at 1857 hours. While in the ambulance, the Decedent went unresponsive and then into Cardiac Arrest. EMS started CPR & ACLS procedures, and worked the Decedent for 1 hour before calling Time of Death at 2015 hours.

Other Meds: Albuterol & Nebulizer treatments Per Decedent's wife, the Decedent does not have one particular PCP, but sees whoever is on duty at health clinic. Decedent's wife stated that the clinic took him off all of his medications awhile ago, e

Current Illness: Asthma, Diabetes, Hypertension, & only has 1 Kidney (other Kidney was donated to mother)

ID: 1696502
Sex: M
Age: 42
State: GA

Vax Date: 03/29/2021
Onset Date: 08/27/2021
Rec V Date: 09/14/2021
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: 08/27/2021 Antigen+ COVID-19 test

Allergies:

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

Symptoms: Breakthrough COVID-19 case with symptom onset 8/27/2021: Subjective fever (felt feverish), Chills, Muscle or body aches, New loss of taste or smell, Runny nose/Congestion, Sore throat, Cough (new onset or worsening of chronic cough), Shortness of breath or difficulty breathing, Fatigue or tiredness, Nausea or vomiting, Headache, Diarrhea (>/=3 loose/looser stools in 24 hr period), memory loss. Hospitalized from 8/30/2021-9/5/2021. Case said he was admitted to hospital for COVID. Case could not breathe, his stats were in the low 70's; he was on oxygen

Other Meds:

Current Illness:

ID: 1696503
Sex: F
Age: 68
State: NY

Vax Date: 09/22/2020
Onset Date: 10/06/2020
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: none

Allergies: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: severe pain with motion and reduced motion left shoulder unable to raise arm or move behind . treated with heat, aspirin and exercise. slowly improved over six months

Other Meds: multi-vitamins vitamin D and calcium

Current Illness: none

ID: 1696504
Sex: F
Age: 71
State: NJ

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: i cannot remember, but i think that an x-ray of my right wrist was taken by the orthopedic physician on March 10, 2021.

Allergies: Penicillin and Sulfa

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

Symptoms: After receiving the injection, I moved my right arm around. While driving home I noticed that my right wrist began hurting a great deal. I made an appointment with my orthopedic physician. I was examined by him and he said the pain was as a result of receiving the Moderna Injection. Through recent months since receiving the Moderna injection, i have pain in the right wrist from time-to-time. Presently I am having slight pain in the right wrist.

Other Meds: Rosuvastatin, Baby Aspirin, Calcitonin -Salmon, Centrum Multivitamins, CoQ, Biotin, Vit C, Magnesium, Probiotic, Vit D3, Calcium, Lutein, Lecithin, Glucosamine Condroitin, Tumeric, Boswellia Serrata, Fish Oil .Selenium,

Current Illness: None

ID: 1696505
Sex: M
Age: 70
State: KS

Vax Date: 03/09/2021
Onset Date: 03/21/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: Went to see doctor on May 6. Lab tests [bloodwork] specific to tingling were ordered but came back negative. Doctor recommended yoga-like exercises to strengthen back muscles. After weeks of exercise, pains have mostly disappeared but come back for short periods of time on nearly a daily basis. Tingling sensations are much, much less frequent [almost gone].

Allergies: none known

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

Symptoms: All-over tingling of body while laying down in bed to go to sleep . . . tingling not unlike that felt when an arm or a foot "falls asleep" but much more intense and sharp and almost electrified" in sensation. It did not dissipate but slowly decreased in intensity over the next few weeks. The epicenter of the feeling . . . nerve central . . . seemed to be those couple vertebrae between soldier blades. Sharp tingling sensation continued intermittently and sporadically in various body parts at different times. Back and shoulders and neck were particularly sore.

Other Meds: olmesartan medoxomil tamsulosin low-dose aspirin prilosec

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am