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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1696818
Sex: F
Age: 64
State: IL

Vax Date: 03/18/2021
Onset Date: 03/18/2021
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: 3/19/2021 ER, EKG, labs, CXR, wore Holter monitor x2wks.

Allergies: Mold Voltaren

Symptom List: Dysphagia, Epiglottitis

Symptoms: Shakiness, legs feeling like will give out, warm sensation to face. 3/19/2021 continued to note shakiness. In addition, irregular heart beat.

Other Meds: Evista Zyrtec

Current Illness: suspected COVID infection May 2020

ID: 1696819
Sex: F
Age: 12
State: CA

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

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

Lab Data: I will call her doctor

Allergies: Non known

Symptom List: Anxiety, Dyspnoea

Symptoms: My daughter has been having extreme headaches since her 2nd dose of the Pfizer COVID-19 vaccine and also lost of appetite she?s barely eating anything. I would say the good thing is that we have not got COVID

Other Meds: Tylenol

Current Illness: Non

Date Died: 09/08/2021

ID: 1696820
Sex: M
Age: 87
State: TX

Vax Date: 03/27/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: COVID Positive on 8/19/2021; CXR showed multifocal pneumonia 8/27/2021

Allergies: No known allergies

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/6/2021 and 3/27/2021. Patient was recently hospitalized for COVID-19 from 8/23/2021 to 8/26/2021. Patient presented to ED on 8/27/2021 due to repeated hypoxia. Dexamethasone and cefuroxime was administered. Throughout hospitalization, patient had significant change in mental status and continued weakness. Palliative care was consulted on 9/4/2021 and patient expired at 06:37 on 9/8/2021.

Other Meds: apixaban 2.5 mg twice daily atenolol 100 mg daily, amlodipine

Current Illness:

Date Died: 08/06/2021

ID: 1696821
Sex: M
Age: 83
State: WA

Vax Date: 03/10/2021
Onset Date: 07/03/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data: Hospitalization-testing, Pulmonologist Dr.

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: My husband and I both tested positive for Covid-19 after receiving the vaccine. He started to have symptoms like a cold, and it was like sinus symptoms. I also had sinus symptoms. He was prescribed Azithromycin and when it was gone a fever broke out. My husband throat was sore. He was admitted to the hospital and waited for a room for 24 hours. He was admitted directly to the Covid-19 ICU. He was tested again after being admitted on 07/10/2021 and he died on 08/06/2021. He had improved and he was supposed to come home and then I got a call that he had been intubated. He got Pneumonia after being on a ventilator. He lived for two more weeks but then he passed away.

Other Meds: Advair; Spiriva; Vitamin

Current Illness: N/A

Date Died: 09/09/2021

ID: 1696822
Sex: M
Age: 55
State: TX

Vax Date: 02/24/2021
Onset Date: 08/14/2021
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 Positive on 8/15/2021; CXR showed Patchy infiltrates mid & lower lung with focal consolidation right midlung on 8/14/2021; Positive bronchial wash for Candida on 8/21/2021

Allergies: Adhesive

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021.

Other Meds: amlodipine 5 mg Oral 2 times daily, aspirin 81 mg Oral Daily, atorvastatin 40 mg Oral Nightly, calcium carbonate 200 mg calcium (500 mg) 1 tablet Oral Daily, carvedilol 12.5 mg Oral 2 times daily with meals, ergocalciferol (vitamin D2) 50,0

Current Illness:

ID: 1696823
Sex: M
Age: 53
State: VA

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

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

Symptoms: Patient stated that he felt like his lips were swelling about 10 minutes after encounter. After 30 minutes there were no changes or reactions at the site. Patient wanted to go home, take a Benadryl and be observed by a family member/friend and would update us if necessary and follow up with medical provider if needed.

Other Meds:

Current Illness:

Date Died: 09/09/2021

ID: 1696824
Sex: F
Age: 94
State: TX

Vax Date: 02/02/2021
Onset Date: 09/09/2021
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: COVID Positive on 8/11/2021; CXR showed bilateral pleural effusions with lower lobe atelectasis and right middle lobe and lingular interstitial nodularity on 9/9/29021;

Allergies: Iodinated contrast, penicillins, shellfish

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/19/2021 and 2/2/2021. Patient was recently hospitalized for COVID 8/11/2021 to 8/17/2021. Patient presented to ED on 9/9/2021 with complaints of shortness of breath with increased oxygen requirements. Medications administered: levofloxacin and aspirin. Patient became unresponsive with no palpable pulse. Patient expired at 01:55 on 9/9/2021.

Other Meds: dexamethasone 6 mg; L. acidophilus/L.bulgaricus 100 million cell 1 g; sodium chloride 1,000 mg; furosemide 20 mg; metoprolol succinate 12.5 mg; aspirin 81 mg; atorvastatin calcium 20 mg; benzonatate 100 mg; cetirizine HCl 10 mg; cholecalcif

Current Illness:

ID: 1696825
Sex: F
Age: 57
State: MD

Vax Date: 02/05/2021
Onset Date: 04/02/2021
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: I have arthritis, waiting on xrays for neck and hand. I have RNP and SCL-70 proteins, Not the disease but proteins as of now. It has been a horrible last 6 months and Primary Dr. can't figure out what is going on. I have been seeing pain & management Dr. for shots in back and right leg from past injury's.

Allergies: N/A

Symptom List: Pharyngeal swelling

Symptoms: Entire body locked up like a zombie, could barley walk for 2 months. Pain, everywhere in my body. No appetite, ongoing for 6 months. Lost 25 lbs. Cant sleep more then 2 hours at a time, due to pain.. I've been diagnosed with Psoriatic arthritis in right knee. My markers for inflammation are high and stay high. I've been steroids twice, Only thing that seems to help pain. I'm using walker. My right hand and wrist are in extreme pain, Pain seems to move around, My neck locked up in August.

Other Meds: Lisinopril, Levothroxine,Montelukast,Citroplam, Pantoprazole, Atorvastatin, Xyzal, Fish oil.

Current Illness: N/A

ID: 1696826
Sex: F
Age: 59
State: FL

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: My SARS-COV2 IgG Antibody (spike) test came back POSITIVE (on 6/8/21) and showed high Abs to COVID-19. All other lab tests were normal.

Allergies: Latex allergy (contact dermatitis)

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: After my Pfizer vaccine on 4/2/21, I developed dizziness & feelings of head spinning within 30 minutes of vaccine and was unable to drive for 3 days after vaccine. Other immediate symptoms included: -GI symptoms including nausea, bloat, gas within 1 hour of vaccine which lasted nearly 4 weeks and diminished over time. -Fatigue and tiredness which lasted 4 weeks. -Sore arm from injection which lasted 2 weeks and became a general ache in left arm spreading into chest for 4-5 months and still feel occasionally. -Facial swelling 3 days post-vaccine which resolved within a week. Symptoms that appeared 4-5 weeks later and resolved after 2-3 months that include: -Two types of Skin rashes: Hives that sporadically appeared on the lower abdomen and extremities; and a 1-inch circular pink, plaque-like skin rash on forehead that did not respond to antibiotic or antifungal medications. -Black and blue marks on right arm and lower abdomen without any injuries to those areas. -Episodes of bleeding gums after brushing second month after vaccine. -Numbness and tingling (and weakness) in arms, legs, face and back. -Episodes of heart-racing, tachycardia, palpitations day and night (even when sleeping). -Headache and feelings of elevated blood pressure in my head. -Severe left arm and back aches. -Shaky with tremors in hands. -General irritability and anxiousness, strain and stress throughout the body, periodic chills, feeling sick. -Worsening insomnia (more than normal) Note: I was never diagnosed with active Covid-19 infection. My symptoms slowly improved over months and I did not have any treatment. I was too sick to get the second vaccine.

Other Meds: Ambien (zolpidem) as needed at bedtime Multivitamin, Vit D-3, Vit B-12 Topical Estrogen Topical Progesterone

Current Illness: none

ID: 1696827
Sex: F
Age: 47
State: NC

Vax Date: 03/10/2021
Onset Date: 06/28/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: no

Allergies: Diflucan ragweed and thing like that

Symptom List: Diarrhoea, Nasal congestion

Symptoms: On 06/28/2021, a rash on my back between my shoulder blades, upper back and it hurt. A couple of days later, my doctor, he diagnosed me with shingles. Treatments : oral-Valtrex and topical. He quarantined me for 10 days and went back to the doctor's on 07/16/2021 and got the all clear.

Other Meds: super C zinc female multivitamin gummy heartburn Allegra

Current Illness: no

ID: 1696828
Sex: F
Age: 12
State: IN

Vax Date: 09/11/2021
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: SYR
Vax Site: LA

Lab Data: None

Allergies: None

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

Symptoms: Swelling and rash/hives. Itching at rash sight and minimal redness.

Other Meds: Citrizine allergy tab 10mg

Current Illness: None

ID: 1696829
Sex: F
Age: 48
State: MA

Vax Date: 04/21/2021
Onset Date: 08/20/2021
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: Nasal Swabbed on 8.18.2021

Allergies: Unknown

Symptom List: Rash, Urticaria

Symptoms: Staff member had diarrhea, headache, pain in body and loss of taste and smell.

Other Meds: Unknown

Current Illness: Unknown

ID: 1696830
Sex: F
Age: 23
State: ND

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Pt received 2nd Moderna COVID-19 Vaccine on Friday 9/10/21 and had no issues until she noted on Saturday evening (9/11/21) that her arm started to swell up in 2 areas and was quite red. On Sunday she noted that arm was about the same but thought the redness was spreading. She took some OTC allergy relief pills, acetaminophen, and ibuprofen. Pt reports today (Tuesday 9/14/21) the swelling has improved but there is still some redness and warmth to the area.

Other Meds: No known

Current Illness: No known

ID: 1696831
Sex: M
Age: 66
State: NC

Vax Date: 02/12/2021
Onset Date: 02/14/2021
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: SYR
Vax Site: LA

Lab Data: no

Allergies: Atorvastatin

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

Symptoms: About 36hrs after the vaccine I woke up to a very irregular heartbeat associated by light pressure and extreme irregularity. Not much pain but pressure and gradually started to improve after about a week, but I could still bouts of the irregularity on various days

Other Meds: Amlodipine, aspirin, Vit C, B and D, Osteo-biflex, Zinc

Current Illness: no

ID: 1696832
Sex: M
Age: 46
State: NJ

Vax Date: 08/19/2021
Onset Date: 08/01/2021
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: None

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

Symptoms: Soreness at injection site. Within first week, swollenness in right eye. Blurring vision in right eye. With two weeks, blurring vision in left eye. Worsening blurring vision in right eye. Worsening vision in both eyes, and getting worse. PCP checked your vision, have appointments with eye doctors.

Other Meds: None

Current Illness: None

ID: 1696833
Sex: F
Age: 30
State: IN

Vax Date: 09/02/2021
Onset Date: 09/02/2021
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: Penicillin, Amoxicillin

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

Symptoms: I am currently 22 weeks pregnant. At the time of receiving the vaccine on 9/2/21, I was 20 weeks pregnant. My estimated delivery date is January 19, 2022. I received the first dose of the Pfizer vaccine on 9/2/21 at approximately 2:50pm at Pharmacy. I waited the 15 minute evaluation period at Pharmacy, then went home to finish my workday. I worked until 4:30pm, then took a nap. I woke up at 5:30pm and mentioned to my husband that my face was itchy, similar to how it's felt in the past when I've had allergic reactions to both penicillin and amoxicillin. We ate dinner and approximately 30 minutes later my body broke out into a full body rash and my skin was crawling (extremely itchy all over my body). My husband called the on-call OBGYN doctor who advised that I take Benadryl to see if the rash and itching subsided. Approximately one hour after taking Benadryl, the rash and itching had begun to subside. The OBGYN that we spoke with recommended that I not receive the second dose of the vaccine and to contact the pharmacy where I received the first dose of the vaccine for further direction. I spoke with the pharmacist on 9/3/21 and she also advised that I not receive the second dose of the vaccine, especially while being pregnant. She also advised that I report the allergic reaction on the vaers website.

Other Meds: Prenatal Vitamin

Current Illness: No illnesses

ID: 1696834
Sex: F
Age: 60
State: FL

Vax Date: 03/19/2021
Onset Date: 03/30/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data: CXR, Lab work.

Allergies: Compazine, phenergan.

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

Symptoms: Pt came to ER c/o fever, head pain, SOB, nausea. Tested covid positive 3/24/21.

Other Meds:

Current Illness:

ID: 1696835
Sex: M
Age: 35
State: UT

Vax Date: 08/03/2021
Onset Date: 08/06/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Heart inflammation, difficulty breathing, soreness & tiredness in chest and shoulder area.

Other Meds: None

Current Illness: None

ID: 1696836
Sex: F
Age: 52
State: IL

Vax Date: 08/24/2021
Onset Date: 09/11/2021
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: NONE

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: bottom half of my body, hips and below, became completely numb. All at once my hips, legs, feet, and toes did not respond to my muscles. They burned as if they were 'asleep'. I was sitting in a chair for 10 minutes eating lunch when this happened. I was able to use my arms and steady myself to walk to the couch, I tried sitting and laying down. I tried standing up with support but nothing seemed to lessen the pain and inability to move my lower body on its own. After 15 minutes my left leg felt normal and within a minute the rest of my lower body felt fine. Has not happened again.

Other Meds: none

Current Illness: none

ID: 1696837
Sex: M
Age: 53
State: TX

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

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

Lab Data: CBC, CMP, CXR, COVID positive

Allergies: NKDA

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

Symptoms: SOB, high flow N/C, CBC,CXR, CMP,

Other Meds: vitamin d, gabapentin, lisinopril, metformin, norco, pravastatin, tramadol, valsartan, vesicare

Current Illness: DM type 2, CAD, osteoarthritis,

ID: 1696838
Sex: F
Age: 67
State: AZ

Vax Date: 03/15/2021
Onset Date: 09/09/2021
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: Urgent Care 9/11/2021 - They did a COVID test - negative results ; blood pressure and oxygen

Allergies: codeine

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

Symptoms: I woke up with four am and I had diarrhea from that time until about noon. I was lethargic and had chills but no fever. I had the chills and a headache the next day. Saturday, I started feeling better with just a very mild headache. On the 11th, though, I called the doctor in the later afternoon. I went to Urgent Care - where I saw Dr. at 06:00 that night. No treatment. By Sunday, I was okay.

Other Meds: Novolog and an Insulin pump for diabetes; Gabapentin; Duloxetine; Levothyroxine; Lisinopril; Pramipexole Dihydrochloride; Multi - Vitamin; Low dose aspirin; Vit D3; iron; calcium, magnesium; zinc

Current Illness: no

ID: 1696839
Sex: M
Age: 59
State: IL

Vax Date: 06/05/2021
Onset Date: 06/15/2021
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: CT HEAD - clear MRI BRAIN - Clear US Doppler Carotid - Clear

Allergies: non

Symptom List: Unevaluable event

Symptoms: My tinnitus and dizzy spell start all the time after 2nd dosage of vaccine I start having sensitivity to noise some noise make me dizzy and Change into the vertigo, now it start if I am talking for little long and it make me dizzy. this condition keep for couple of hours even if I take anti vert med.

Other Meds: non

Current Illness: tinnitus with little dizziness

ID: 1696840
Sex: M
Age: 32
State: WA

Vax Date: 05/29/2021
Onset Date: 06/01/2021
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: Nickel Dairy Products

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

Symptoms: Flu like symptoms. Fever. Sweating. Body Aches. Stuffy nose. Headaches.

Other Meds: NA

Current Illness: NA

ID: 1696841
Sex: F
Age: 18
State: NJ

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: This morning (my vaccine was yesterday), I woke up feeling groggy. I attended a class in from 8:00am-9:00am, then went home since I felt bad. I took my temperature around 10:00am and it was 98, then 45 minutes later it was 99.8. I took some Ibuprofen and my fever reduced after a few hours, now I'm just left with a sore arm and a headache. I more or less feel fine now as of 3:00pm but I'm just very tired since I was feverish for a few hours straight. (I didn't think these were adverse reactions but I was recommended to report the symptoms)

Other Meds:

Current Illness:

ID: 1696842
Sex: F
Age: 58
State: MD

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

Lab Data: none

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Abnormal swelling around injection site. Size of a baseball, hard, itchy and severe redness. Unable to raise arm above head for several days. As of today, 9/14 swelling is still prominent and still itchy

Other Meds: Alprazolam o.5mg BID PRN

Current Illness: none

ID: 1696843
Sex: M
Age: 11
State: GA

Vax Date: 08/20/2021
Onset Date: 08/20/2021
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: None

Allergies: None

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

Symptoms: Patient was 11 years old and 3 months at time of vaccine No side effects was reported by parents. Vaccine Error due to age

Other Meds: None

Current Illness: None

ID: 1696844
Sex: F
Age: 16
State: LA

Vax Date: 09/14/2021
Onset Date: 09/14/2021
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: None

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Vaccine administered per order. Upon documentation, syringe noticed to have an expired expiration date (6/18/2021). The syringe was mistakenly located in a box with a valid lot/expiration date.

Other Meds: None

Current Illness: None known

ID: 1696845
Sex: M
Age: 79
State:

Vax Date: 08/20/2021
Onset Date: 09/06/2021
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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: onset of covid symptoms on 8/29/21, tested COVID + on 9/6/21, received Regeneron on 9/8/21, worsened symptoms - admitted to hospital on 9/13/21, requiring 2L nasal canula oxygen. started on steroids.

Other Meds:

Current Illness:

ID: 1696846
Sex: M
Age: 40
State: MI

Vax Date: 08/01/2021
Onset Date: 09/01/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Chest pain

Other Meds:

Current Illness: Multiple sclerosis

ID: 1696847
Sex: F
Age: 35
State: CA

Vax Date: 07/14/2021
Onset Date: 08/09/2021
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: Latex condoms

Symptom List: Nausea

Symptoms: Menstrual cycle has been affected. 37 days late. No menstruation or even a single symptom of menstruation. Currently trying to conceive a baby but cannot track ovulation or menstrual cycle.

Other Meds:

Current Illness:

ID: 1696848
Sex: M
Age: 69
State: NV

Vax Date: 01/30/2021
Onset Date: 06/01/2021
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: See above, plus pathology report on tissue type, PET scan for staging, and CT scans. Brain MRI showed no metastases..

Allergies: none

Symptom List: Injection site pain

Symptoms: Symptom onset difficulty passing solids, then fluids, into the stomach. Endoscopic then ultrasound and biopsy confirmed neoplasm, probably adenocarcinoma of the esophagus or surrounding structure.

Other Meds: Zetia, Singular, hydrocodone, Ambien, Ativan pas needed, omega 3,

Current Illness: L-5 nerve root inflammation

ID: 1696849
Sex: M
Age: 57
State: CA

Vax Date: 09/05/2021
Onset Date: 09/06/2021
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:

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

Symptoms: Headache in odd place and felt incredibly sleepy for 4 days

Other Meds:

Current Illness:

ID: 1696850
Sex: M
Age: 69
State: TX

Vax Date: 03/03/2021
Onset Date:
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: covid - positive

Allergies: no

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

Symptoms: Covid - symptoms started mid august . got test was negative and sample molecular test and it was positive. Attack of diverticular occurrence

Other Meds: Statin and bp medication

Current Illness: no

ID: 1696851
Sex: F
Age: 44
State: OK

Vax Date: 08/20/2021
Onset Date: 08/24/2021
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: EKG on 8/27/21 - Normal Echocardiogram on 9/2/21 - Normal Bloodwork on 9/10/21 - Normal PCP Doctor referring me on to ENT as of 9/14/21

Allergies: Penicillin

Symptom List: Tremor

Symptoms: Four days after Shot 8/24/21 - Started feeling dizzy and lightheaded. Felt a pressure in left side of chest and around left shoulder blade area on 8/26/21 that evening of 8/26/21 felt like heart was racing and very dizzy. 8/24/21 was the peak of all my symptoms. Felt dizzy 8/24/21 through 8/28/21 and did not exercise during this time and tried to rest and drink more fluids. On 8/29 the daily feeling of dizziness and lightheaded went away and was able to get back to normal daily activity. Still feeling the chest pressure at times but intermittently and not every day. 8/30/21 - Tried to start my daily walks again but became dizzy and had to stop. Felt dizzy upon waking up again on 8/31/21. Started feeling good and no more dizziness with normal daily activity but still feel the pressure in chest at times. Tried to start walking again on 9/13/21. Was able to walk my normal distance but felt lightheaded and still feel off but not dizzy like have been feeling. 9/14/21 - in the morning feeling lightheaded again but able to complete normal daily activities without feeling dizzy.

Other Meds: none

Current Illness: None

ID: 1696852
Sex: M
Age: 40
State: TX

Vax Date: 09/12/2021
Onset Date: 09/12/2021
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: Shellfish and some allergies to some plants

Symptom List: Erythema, Pruritus

Symptoms: I had a hard time breathing. Felt as if I had been running. Lasted about 24 hours slowly getting better as time passed. I fainted at one point. I?m not sure if this matters but I had covid twice last time was a few months ago. I keep seeing on the news hospitals are over run so I wanted to wait until I couldn?t wait any longer before doing that and about 16 hours later it started to ease. It?s been 2 days I still don?t have a appetite.

Other Meds: None

Current Illness: None

ID: 1696853
Sex: F
Age: 16
State: MN

Vax Date: 05/27/2021
Onset Date: 09/11/2021
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: 9/13 SARS/COV-2, NAAT, positive

Allergies:

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

Symptoms: Breakthrough COVID

Other Meds:

Current Illness:

ID: 1696854
Sex: F
Age: 75
State:

Vax Date: 04/08/2021
Onset Date: 09/12/2021
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: presented to ER for evaluation of vomiting. also complains of increasing shortness of breath over the past several days. found COVID+

Other Meds:

Current Illness:

ID: 1696855
Sex: F
Age: 68
State: WA

Vax Date: 03/08/2021
Onset Date: 03/21/2021
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: Biopsy showed non specific cause

Allergies: Clarithromycin 500mg Levofloxacin causes joint pain for sinus and sleeplessness Cupronickel causes a rash Penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Three weeks after the vaccine I developed a rash on my back, stomach, arms and thighs

Other Meds: Lisinopril 10mg Diltiazem 120 mg Flecanide 50 mg twice a day Pravastatin sodium 30 mg Metformin 500mg 2 times daily

Current Illness: Cataract surgery right eye

ID: 1696856
Sex: F
Age: 48
State: IN

Vax Date: 09/10/2021
Onset Date: 09/12/2021
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: no test, no doctor visit

Allergies: none - seasonal allergies

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

Symptoms: flu like aches, forehead headache, cramps (similar to menstrual cramps), very swollen lymph nodes, very enlarged and sore to touch breast, lethargic, no appetite

Other Meds: hydroxychloroquine, naproxen, women's daily vitamin

Current Illness: none

ID: 1696857
Sex: F
Age: 32
State: NC

Vax Date: 08/19/2021
Onset Date: 08/26/2021
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:

Allergies: N/A

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

Symptoms: Exactly one week after my first dose, a red itchy rash appeared at the site injection on my left arm. The rash grew larger over the next 3 days and then eventually faded. Also had some pain in my right calf muscle near some varicose veins.

Other Meds: Prenatal vitamin

Current Illness: N/A

ID: 1696858
Sex: F
Age: 41
State: IN

Vax Date: 08/10/2021
Onset Date: 08/10/2021
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: x-rays 9/14/2021

Allergies: Cipro, walnuts

Symptom List: Pain in extremity

Symptoms: Immediate burn with injection and painful after. Went to shoulder specialist on 9/14/2021 and diagnosed with SIRVA. Range of motion decreased more than 20% in all directions on left arm/ shoulder, pain when lifting arm, pushing arm, or reaching across body. Starting diclofenac for 4 weeks then will assess. If not any better in 2 weeks, will consider cortisone injection and MRI for treatment .

Other Meds: Levothyroxine, LoLoestrin, Tizanidine, Citalopram

Current Illness: n/a

ID: 1696859
Sex: F
Age: 48
State: KY

Vax Date: 07/29/2021
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: 2
Vax Route:
Vax Site:

Lab Data: None.

Allergies: None.

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

Symptoms: Heavy menstrual bleeding and extended menstrual cycle duration. Completely missed menstrual period (August) after first Pfizer vaccine. Then for 7 days this month (September) menstrual bleeding has been the most heavy in my entire life. Extreme weakness and fatigue with this menstrual cycle. I will be seeking medical help tomorrow if the bleeding doesn?t stop. Again, I?ve never experienced this much bleeding before and am frightened to receive second Pfizer vaccine due to this concerning inconsistency.

Other Meds: None.

Current Illness: None.

ID: 1696860
Sex: F
Age: 37
State: TX

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

Lab Data: NA

Allergies: Penicillin

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

Symptoms: Headache, swollen arm, rash on upper body

Other Meds: Benedryl

Current Illness: NA

ID: 1696861
Sex: F
Age: 40
State: UT

Vax Date: 05/14/2021
Onset Date: 05/18/2021
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: All hormone levels on 8/31/21 and all levels were fine. My Hemoglobin is low, MCV is low, MCH low, RDW high. And Vitamin D low. But hormones were normal.

Allergies: Sulfa Lactose intolerance

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

Symptoms: Just periods every two weeks since getting the last shot

Other Meds: Fluoxetine Hal 20 mg Rosuvastatin 40 mg Zolpidem Tartrate 10 mg

Current Illness: No

ID: 1696862
Sex: F
Age: 48
State: TX

Vax Date: 02/04/2021
Onset Date: 02/27/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data: MRI 4/21, 6/21. 7/21. 8/21, MRV 4/21, CT 7/21, visual tests 3/21, 7/21, labs 4/21 6/21, 7/21, 8/21

Allergies: Sulfa (not sure true allergy told was as kid, had 2nd & 3rd generation without problem) Morphine (not sure problem was after surgery could be that or in combo with anesetha) Plaquenil

Symptom List: Vomiting

Symptoms: Continuous migraine with severe nausea, vomiting, imbalance, vertigo, unable to bend over, ear fullness, pressure in head and ears, jaw pain, ringing in ears, constipation & diarrhea (chronic), weakness, photophobia, increased neck/shoulder pain, perception, ocular migraines, dizziness, insomnia, unretractable pain, anxiety, increased depression, brain fog, inability to work, inability to concentrate

Other Meds: Synthroid 100mcg dly Calcium 500mg dly Prilosec 20mg dly Xiidra 1 gtt each eye BID Vit D3 10000 unit dly Biotin 5000mg dly Glucosamine 2100mg dly

Current Illness: headaches, body aches, stress

ID: 1696863
Sex: F
Age: 28
State: MN

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

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Sore arm 5 hours after shot

Other Meds: None

Current Illness: None

ID: 1696865
Sex: F
Age: 54
State: GA

Vax Date: 08/12/2021
Onset Date: 08/13/2021
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: RA

Lab Data: Have not seen a physician for this as of yet.

Allergies: Erythromycin, Sulfa meds, Levaquin, Codeine, hay fever, bees

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

Symptoms: woke up with chills and fever at 3am morning after vaccination, took ibuprofen and helped, left work early that day due to fever, chills and weakness. Arm hurt for about a week at injection site. 3 weeks after vaccination I developed blood in my stool and diarrhea, it has cleared up now.

Other Meds:

Current Illness: none

ID: 1696866
Sex: F
Age: 45
State: WV

Vax Date: 08/12/2021
Onset Date: 08/13/2021
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: After dose 1, I became lethargic and dizzy. I left work and went home. I had a headache, nausea, stomach pains and diarrhea for 4 days. I missed a day of work. The injections site was red, hot, itchy and sore. It bruised and stayed that was for 3 weeks. After the 2nd dose, I became ill within an hour of receiving the vaccine. I left work early b/c I was dizzy, lethargic and had a bad headache. I missed work the next day b/c I had a fever of 102, chills, vomiting, diarrhea, body aches, dizziness and a headache. I stayed in bed all day and drank water and took Tylenol. By 6pm, my temp was finally down to 99.0. For the next 3 days, I have had diarrhea. The injection site bled alot this time but surprisingly, its not as sore as the first. It is red and slightly painful.

Other Meds: Zoloft, Claritin, Allegra, Prilosec and Norethindrone Acetate

Current Illness: None

ID: 1696867
Sex: F
Age: 44
State: NE

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

Lab Data:

Allergies: none

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

Symptoms: hives. pt has tried benadryl with no improvement

Other Meds:

Current Illness: none

ID: 1696868
Sex: M
Age: 39
State:

Vax Date: 03/10/2021
Onset Date: 09/13/2021
Rec V Date: 09/14/2021
Hospital: Y

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: COVID symptoms started on 9/7/21, tested covid+ on 9/8/21, scheduled to receive regeneron infusion but developed shortness of breath and oxygen saturations fell to 81 and 82% on room air, sent to ER for hospitalization

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am