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: 1696869
Sex: M
Age: 41
State: CT

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: 2 or 3 minutes after getting the vaccine, the patient passed out for about 40 seconds. the pharmacist called him couple times then he waked up and started to talk. He was ok after that.

Other Meds:

Current Illness:

ID: 1696870
Sex: F
Age: 20
State: IN

Vax Date: 07/24/2021
Onset Date: 07/24/2021
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:

Allergies: NONE

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient's mom states that the patient (20 yr old) is still having arm/shoulder pain from her 1st dose on 7/24/21. Reported on 9/14/21

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1696871
Sex: F
Age: 33
State: MD

Vax Date: 09/05/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Nuts, seeds, banana, squash

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

Symptoms: Red tender circle at injection site appeared 9 days after vaccination.

Other Meds: Singulair, zyrtec

Current Illness:

ID: 1696872
Sex: M
Age: 60
State: TX

Vax Date: 04/09/2021
Onset Date: 09/05/2021
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: CBC, CMP, CXR, Cardiac Profile, EKG

Allergies: NKDA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Fatigue, Fever, positive COVID antibiotics given, fluids given

Other Meds: allopurinol, calcium, fosrenol, levothyroxine, lisinopril

Current Illness:

ID: 1696873
Sex: M
Age: 2
State: NY

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

Lab Data: None

Allergies: ibuprofen, apple

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

Symptoms: Patient received second Hep A vaccine, remained in office for routine lead testing. After immunization was given it was noted that patient had a large red area of hives around the area of immunization, as well as hives on face and back. Provider examined patient and he was free of edema and and difficulty breathing. Hives resolved with Benadryl treatment

Other Meds: none

Current Illness: viral gastroenteritis- 8/19/21

ID: 1696874
Sex: F
Age: 50
State: OH

Vax Date: 08/28/2021
Onset Date: 08/28/2021
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: Penicillin, codene

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

Symptoms: I received the J&J vaccine 4 months after I recovered from COVID-19. Within 10 minutes of receiving the vaccine, I became dizzy and developed mild stomach cramps, both of which lasted 4 hours. Later that day, I experienced uncontrollable shivering, body aches, and felt like I was burning up. The next day, I experienced extreme exhaustion, mild stomach cramps, shivering, body aches, and a headache, which lasted for three days total, improving each day. On days 4-6, I had pain in my lower abdomen and loose stools.

Other Meds: Singular, Lo Loestrin FE, One a Day for Women, melatonin, iron, biotin, and magnesium.

Current Illness: None

Date Died: 08/23/2021

ID: 1696875
Sex: M
Age: 62
State: CA

Vax Date: 04/07/2021
Onset Date: 05/05/2021
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: EMG/NCS and MRI of the Lumbar Spine.

Allergies: Shellfish containing products

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient developed ALS shortly after his vaccine. He passed away within 4 months. It is unclear whether or not there is any relation to his development of ALS and his taking the vaccine - other than the association of timing. His wife felt strongly that this should be reported.

Other Meds: None

Current Illness: None

ID: 1696876
Sex: F
Age: 23
State: FL

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

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: After receiving 2nd dose of Moderna vaccine, pt over to observation area to sit, About 10 minutes into a 15 observation wait time, pt stated" i am beginning to feel funny and light headed, and my heart is racing", Upon assessment not palpable fast heart rate. Pt put on pulse ox, and blood pressure, heart rated to be 170bs/min. denies any chest pain, oxygen 2 liters nasal cannula applied to pt and patient w/c to urgent care, report given to rn

Other Meds:

Current Illness:

ID: 1696877
Sex: F
Age: 28
State: NJ

Vax Date: 05/25/2021
Onset Date: 06/27/2021
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: Blood work processed on 7/1/21 to determine if hormonal irregularities were the cause. Tests all came back normal.

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Changes to menstrual cycle following the date of vaccination and continuing for 4 cycles so far. For context, I have been extremely regular and on schedule since I first started getting my period at age 11. I am now 28. I get my period once monthly, with a period coming typically every 27-30 days after the start of the previous period cycle. Occasionally the gap will be 26 days with most being 32 days, which is rare. I normally bleed for 7 days, but occasionally only for 6 and at most 9, which includes very light extended spotting. The first day of my period is some spotting, then second and third days consist of the bulk of bleeding with one of these days being considerably heavier than the other. The fourth and fifth consist of red blood but not heavy and the last 2-3 days consist of brown spotting. I experience breast tenderness within the week prior to starting my period and occasionally get pelvic cramps. I use an app on my phone to track the dates and flow of my period so I will be providing specific dates below. The only previous exception to my regularity was in April 2020 at the beginning of the pandemic, which I will detail below later to contrast the changes I have been experiencing since getting vaccinated. I would like to highlight that I have never experienced ovulation spotting between periods as some women do when an egg implants. I have also never been pregnant and am not currently trying to conceive if that info is needed. As indicated by the rest of the form, I do not have any health conditions that would effect my menstrual cycle and am not currently taking medications that might effect it either. I got the Moderna vaccine, receiving the first dose on 4/27/21 and the second dose on 5/27/21. My first menstrual cycle after getting the second dose was initially normal, starting and ending between 6/13/21-6/20/21, but followed only 14 days from the start of the previous period on 6/27/21 by another period which lasted for 9 days between 6/27/21 and 7/5/21. My flow was normal except my end of period spotting lasted about 4 days. These back to back periods mark the first time I have ever had periods occur so close together. I went to my gynecologist during the 6/27/21-7/5/21 cycle and had blood work done to determine the cause. My hormone levels were normal, as was my thyroid function, so she gave my a 10 day dose of Provera to try and regulate my cycle again. I started the prescription I believe on 7/3/21 and finished it on 7/12/21. I experienced light spotting from 7/9/21-7/10/21. According to the information that came with the prescription, I should have started a new period 3-7 days after finishing the pills. This did not occur and my next period came on 7/28/21. It lasted 4 days and consisted of only brown spotting between 7/28/21-7/31/21, marking 32 days between cycle start dates which as mentioned above is quite rare. From 8/15/21-8/20/21, which was a 6 day period coming only 19 days between cycle start dates, I experienced only brown spotting. My latest period came on 9/4/21, 21 days after the start of the last period. My flow returned to the normal flow pattern mentioned above between 9/4/21 and 9/9/21, but was followed by an extended time of spotting from 9/12/21 to 9/14/21 after a two day gap. Since the start of my menstrual changes, this past period has been more normal than the last few but still not fully back to normal. My other physical symptoms of breast tenderness and cramps have been irregular as well. I would sometimes get them and sometimes would not throughout these past 4 months My early pandemic abnormality in April 2020 consisted of extended spotting between periods. I had a normal period from 3/22/20 to 3/27/20, then on 4/7/20 I experienced 8 days of light spotting. On 4/15/20, about when I was due for my next actual period, I started what would be my usual period flow pattern and continued it to the period?s conclusion on 4/22/20. After this, my periods returned to their normal cycle pattern and continued to be normal until I was vaccinated for COVID-19. I strongly believe THIS abnormality occurring in April 2020 was due to either heightened stress from the uncertainties and dangers of the pandemic or the possibility that I had COVID but was otherwise asymptomatic and did not think to correlate this change with having the virus. I had no reason at the time to get tested so I have no way of knowing if the latter might be the case. Stress otherwise I believe would be the culprit. I was terrified to leave the house, very worried about my frontline worker friends and family, and the reported case and death tolls keep skyrocketing more and more each day. When I had to make a quick trip to my work office after we started working from home I was extremely anxious the entire ride there and back and especially so during the few minutes I was inside even though only one other person was present in the building. I was also not taking any medications at the time and no other changes to my life aside from the pandemic. As time went on, I like most people got used to the social distancing, mask regulations, and necessary caution in public and it?s long since became second nature. I bring this all up because I was NOT stressed out about getting vaccinated. I was glad I could get it when it became available to the general public and most people had be reported to respond well to the vaccine. I actually felt relieved that I would be safer in public now that I was vaccinated. So stress has no place in what I?m currently experiencing. The only major changes to my life have been the vaccine.

Other Meds:

Current Illness:

ID: 1696878
Sex: F
Age: 50
State: NJ

Vax Date: 03/02/2021
Onset Date: 09/10/2021
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: Rapid test for Covid 9/12 +

Allergies: none known

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Client was vaccinated with Pfizer vaccines for Covid on March 2 and March 30, 2021. Covid symptoms started 9/10/2021 - sinus congestion, cough, headache. Tested positive for Covid with rapid test on 9/12. Client vaccinated x 2 and reported as a case of breakthrough Covid.

Other Meds: none known

Current Illness: none known

ID: 1696879
Sex: F
Age: 56
State: MN

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: SYR
Vax Site: LA

Lab Data:

Allergies: Compazine Droperidol Lidocaine

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

Symptoms: Worsening of Eczema within 24 hours - unresolved

Other Meds: Magnesium Evening Primrose oil Levothyroxine

Current Illness:

ID: 1696880
Sex: F
Age: 57
State: TX

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: None known

Allergies: Penicillin, Iodine contrast, Covid shot (Anaphylactic reaction after 1st dose - Never got 2nd dose)

Symptom List: Rash, Urticaria

Symptoms: Patient was given Flublok quadrivalent flu shot. Patient had anaphylactic reaction to moderna shot in April for which an SCRT/Vaers were filled out. The only reason the flu shot was given to the patient is that she said, she has always had a flu shot with no issues. After given the flu shot, the patient was asked to wait for 30 minutes due to previous reaction to moderna shot; however, she walked around and came back and said she is experiencing itch/rash, difficulty breathing, and headache (per patient she experiences migraine). We called 911 immediately with patient permission and around 1120 am, while the pharmacist was on the phone with 911, the patient self-administered epipen with the help a technician. About 10 minutes later, the patient requested another dose. At about the same time, 911 team made it to the pharmacy and took over care. Member of management was notified. Also, DM was notified a few minutes later.

Other Meds: N/A

Current Illness: Migraine, mild diarrhea/vomiting due to eating enchiladas previous night

ID: 1696881
Sex: M
Age: 70
State: FL

Vax Date: 02/12/2021
Onset Date: 02/23/2021
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: None pure speculation

Allergies: None

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

Symptoms: Two After first dose started having pain in my surgically repaired shoulder start having a nasty pain . Before second shot I begged the Dr at the Pharmacy not to inject my left arm. He did, within an hour the pain got much worse. The pain lasted 3 months before it stopped. I?ve since has another shoulder surgery on other arm. I?m reluctant to get booster shot for fear of a reoccurrence. At my rehabilitation facility I mentioned the severe pain had to stop therapy for weeks until the pain subsided. Once I returned to therapy my Therapist told me there were a couple others experiencing shoulder pain after COVID 19

Other Meds: Lipitor, spirolactone, cardevol, entresto, Multi Vitamin, lexapro, Hydromorphone, Zetia Metformin 81 Aspirin Nexium

Current Illness: shoulder Surgery 1/7/2021

ID: 1696882
Sex: M
Age: 15
State: KY

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

Lab Data:

Allergies:

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

Symptoms: Moderna 0.5ml dose was administered to 15 year old patient.

Other Meds:

Current Illness:

ID: 1696884
Sex: M
Age: 23
State: OH

Vax Date: 08/23/2021
Onset Date: 08/24/2021
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: unknown

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

Symptoms: patient is still having muscle achiness and joint pain and he is getting tingling down his legs. Told patient to consult his physician.

Other Meds: unknown

Current Illness: unknown

ID: 1696885
Sex: F
Age: 46
State: MD

Vax Date: 07/26/2021
Onset Date: 08/08/2021
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: MRI

Allergies: Raw foot fruits vegetables most of them not all, bees, sulfa, cephalexin, synthetic pain medication,

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

Symptoms: Sunday night it started with restless legs and then I had horrible brain fog, I could not think total inability to think and concentrate. My lips started going numb I was slurring my speech. My hands started going numb and then having any additional weakness in my arms, I felt like I was having a relapse. MRI confirmed my fears and I kept progressing neurologically and they put me on 5 days strong aggressive steroids, solumedrol was IV infusion .

Other Meds: Vit B12, magnesium malate, omega 3 fatty acid, triphala, Ashwagandha,

Current Illness:

ID: 1696886
Sex: F
Age: 62
State: NC

Vax Date: 04/02/2021
Onset Date: 04/03/2021
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: N/A

Allergies:

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

Symptoms: Woke up in the middle of the night and her left arm was really hurting. The next morning, she noticed that the backside of her shoulder/arm all the way down to her wrist was discolored, darker than the rest of her skin. It does not hurt or each. She describes it as it looks like the vaccine ran down her arm.

Other Meds: Prescription: Enalapril 20 mg once daily Ibuprofen 800 mg twice daily Aspirin 325 mg once daily Supplements: Women's Ultramega Multivitamin twice daily Calcium once daily Glucofamine twice daily Vitamin D once daily Tumeric once daily E

Current Illness:

ID: 1696887
Sex: F
Age: 18
State: ND

Vax Date: 09/14/2021
Onset Date: 09/14/2021
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: Patient presents for her second COVID-19 vaccination, she did not have her vaccine card with her at the time of her second dose and she did not remember what vaccine she received for her first dose. It was written on a sticky note that she was due for Pfizer dose today 09-14-2021. Medication removed from fridge, mixed per directions, and administered per standing orders. Writer did not check system prior to administration of vaccine. Patient monitored for 15 minutes after administration with no adverse reaction and was released back to work. After patient was released, I went to put vaccine in system it was figured out that she was administered Moderna on 08-17-2021 and Pfizer was administered today 09-14-2021. Pt notified at this time.

Other Meds:

Current Illness:

ID: 1696888
Sex: M
Age: 30
State: MN

Vax Date: 01/28/2021
Onset Date: 09/04/2021
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: Covid-19 test

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Employee tested positive for COVID-19 after being fully vaccinated

Other Meds:

Current Illness:

ID: 1696889
Sex: F
Age: 59
State: GA

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

Allergies: N/A

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

Symptoms: Patient experienced a bumpy and swollen tongue, "raw" throat, arm tingle, cold sweats, "ant crawling itching", and heart palpitations

Other Meds: N/A

Current Illness: N/A

ID: 1696891
Sex: F
Age: 37
State: AL

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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: N/A

Allergies: No known allergies

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

Symptoms: About 2 to 5 min after vaccine administered became hot, red, dizzy, unable to focus, EMT's and RN came to aid and BP was escalated.

Other Meds: Multi-vitamin, Phytisone (stress and fatique), Berberine (BS Management), S.A.T, Vit D, Cod Oil, NAC

Current Illness: Flu shot administered 10 JAN 21

ID: 1696892
Sex: M
Age: 42
State: NY

Vax Date: 05/06/2021
Onset Date: 05/08/2021
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: None.

Allergies: None.

Symptom List: Unevaluable event

Symptoms: He got his vaccine, 2 days later he started having pains in the arms. He went to UC and the lady said that it would go away by itself, and that he may get some headache. He continues to have pain in his arm. If he lays on it it feels like a spider web it ripping and it hurts. If he lays close to a wall it goes away, but if he lays on it it bothers him. The UC did not give him anything for it, and said it was nothing that they could see.

Other Meds: None.

Current Illness: None.

ID: 1696893
Sex: F
Age: 52
State: FL

Vax Date: 01/25/2021
Onset Date: 02/01/2021
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: Urine and drug screen-normal; bloodwork-all normal

Allergies: Bactrum

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

Symptoms: 02/01/2021 I had vertigo all of a sudden, so bad I had to get on the floor. I was taken to the ER Hospital. Antivert and Zophran, medrodose pack of steroids'. It went away and came back from time to time over, it lasted for about three months.

Other Meds: no

Current Illness: no

ID: 1696894
Sex: F
Age: 83
State: TX

Vax Date: 04/01/2021
Onset Date: 09/07/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data: CBC, CMP, Cardiac Profile ,CXR, Echocardiogram, Respiratory panel

Allergies: NKDA

Symptom List: Injection site pain, Pain

Symptoms: syncope, fall, COVID positive

Other Meds: levothyroxine,triamterine, ramipril

Current Illness:

Date Died: 08/18/2021

ID: 1696895
Sex: M
Age: 70
State: GA

Vax Date: 02/17/2021
Onset Date: 08/05/2021
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:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient fully vaccinated and died of covid related causes. According to patient's wife, patient was in critical care at the hospital and also had cancer. Patient's wife says they haven't went anywhere except for their oncology visit on 8/2. Patient died 13 days later after admitted to hospital.

Other Meds:

Current Illness:

ID: 1696896
Sex: F
Age: 66
State: FL

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 09/14/2021
Hospital:

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

Lab Data: NA

Allergies: NA

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

Symptoms: I experienced pain in my left shoulder after the vaccine.

Other Meds: NA

Current Illness: NA

ID: 1696897
Sex: F
Age: 40
State: NE

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:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Nurse administered COVID Vaccine #2 @ 14 days after dose #1. EDD: 10/18/21

Other Meds:

Current Illness:

ID: 1696898
Sex: F
Age: 46
State: KS

Vax Date: 08/25/2021
Onset Date: 09/04/2021
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: Sulfa

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: facial twitching that has lasted 2 weeks and continues to be an issue.

Other Meds: None

Current Illness: None

ID: 1696899
Sex: F
Age: 50
State: CA

Vax Date: 04/08/2021
Onset Date: 04/15/2021
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: Bloodwork revealed all normal. Only test given.

Allergies:

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

Symptoms: I am in month 5 of an all over body rash that doctor originally diagnosed as Pitarysis Rosea. It has continued to cover my entire body. Doctor's last diagnosis was hives. Burning and itching, skin looks like it is sunburned. Huge red welts and patches all over entire body.

Other Meds:

Current Illness:

ID: 1696900
Sex: M
Age: 67
State: IL

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

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

Lab Data: 9/10/21 Covid Rapid Molecular positive, 9/11/2021 Covid Anti-Spike IgG positive, 9/11/21 D-Dimer 3,766

Allergies: none

Symptom List: Nausea

Symptoms: 67 yo male hx of bronchietctasis, ILD, presents to ED for shortness of breath, found to have COVID PNA with hypoxia requiring 15L NRB mask changed to 15L HFNC O2. Admitted to telemetry unit. Started on decadron and remdesivir 9/10/2021. Possible bacterial pneumonia. Started on cefepime and levofloxacin, bronchodilators, BiPAP at night for sleep apnea.

Other Meds: Albuterol inhaler, Breo inhaler, hydrochlorthiazide, Singulair, Spiriva, Fluticasone propionate nasal spray, Vitamin D

Current Illness:

Date Died: 09/14/2021

ID: 1696901
Sex: F
Age: 70
State: SC

Vax Date: 02/24/2021
Onset Date: 07/30/2021
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:

Allergies: none

Symptom List: Injection site pain

Symptoms: Hemorrhagic Stroke on 07/30/2021 died 08/03/2021

Other Meds: losartin, VitaminB, Gabapentin, montelukast, zoloft, donepezil,

Current Illness: dementia

ID: 1696902
Sex: F
Age: 30
State: MI

Vax Date: 02/01/2021
Onset Date: 02/01/2021
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: None

Allergies: Penicillin

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

Symptoms: Tactile hallucination of paralysis. High fever. Incoherence. Lasted a few hours.

Other Meds: Welbutrin Xl, tolterodine, amitryptyline, breo trelegy

Current Illness: None

ID: 1696903
Sex: F
Age: 42
State:

Vax Date: 08/16/2021
Onset Date: 08/16/2021
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: No medical testing was done. Just an office visit and checkup

Allergies: Loratab, aspirin, year round allergies, dairy allergies

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

Symptoms: I waited at the pharmacy for 20-25 minutes after I got the first dose. I have a history of reacting to almost every medication I have been given. When I have been vaccinated in the past I haven?t had any reactions. Within the first few minutes of getting the first dose I was itching over my entire body. After an hour, my breathing began to be restricted. Over the next two days the itching got worse, no rash, but my breathing was terrible though my oxygen levels were above 90. The pharmacy suggested I contact my allergy doctor so I got in to see Dr. on Thursday of that week I believe. She put me on steroids for 10 days. The steroid didn?t help my breathing so I ended up doing breathing treatments for 10 days. The first week I did the treatments every 4 hours during the day and after that I was able to get by with 1 treatment until I felt ok. It was suggested that even though my reaction was severe, it was immediate and I couldn?t get the second dose.

Other Meds: Loratadine

Current Illness: None

ID: 1696904
Sex: F
Age: 56
State: MO

Vax Date: 08/31/2021
Onset Date: 09/03/2021
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: H1N1 ANAPHYLACTIC REACTION IN PAST sulfa drugs

Symptom List: Tremor

Symptoms: Client called and reported, "having a Lupus flare up." Client reported feeling feverish and body feels like it is on fire. Client reported experiencing migraines, nausea, and weakness. Client reported having the same thing happen after the first dose for ten days, three weeks after the second dose, and still having symptoms up to date after the third dose. Client has had a follow up with doctor. No treatments at this time.

Other Meds: Plaquenil Imuran reported by client 15 other medications, but not named at this time

Current Illness:

ID: 1696905
Sex: M
Age: 17
State: IN

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: N/A

Allergies: N/A

Symptom List: Erythema, Pruritus

Symptoms: Chills, sweating, fever, severe body aches, headache, chest pains

Other Meds: Zyrtec, escitalopram (10 mg), biotin

Current Illness: N/A

ID: 1696906
Sex: F
Age: 51
State: GA

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

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

Symptoms: Accidentally administered the wrong flu vaccine to the patient. No adverse reactions have been reported so far.

Other Meds:

Current Illness:

ID: 1696907
Sex: F
Age: 65
State: FL

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

Lab Data:

Allergies: Prevnar 13, sulfadrugs, nifedipine

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

Symptoms: fever, dizziness, soreness, chills, fatigue,

Other Meds: nexium, singulair, atenolol, linzess, estradiol, lorazepam, niaspan, flonase

Current Illness:

ID: 1696908
Sex: F
Age: 53
State: MT

Vax Date: 03/10/2021
Onset Date: 06/01/2021
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: Prozac, seroquil

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Had my eyes checked for new eyeglass prescription and now have glaucoma in left eye. My optometrist has never mentioned this before - I never had glaucoma before the vaccine

Other Meds: Lamotrigine 300mg day//klonopin 1mg PRN to7,

Current Illness: None

ID: 1696909
Sex: F
Age: 57
State: PA

Vax Date: 09/07/2021
Onset Date: 09/10/2021
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:

Allergies:

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

Symptoms: reported swelling at injection site starting 2 to 3 days after vaccine. also redness that traveled down the arm (maybe halfway to elbow). took almost 5 days to mostly resolve.

Other Meds:

Current Illness:

Date Died: 08/25/2021

ID: 1696910
Sex: F
Age: 75
State: IL

Vax Date: 03/06/2021
Onset Date: 07/29/2021
Rec V Date: 09/14/2021
Hospital: Y

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

Lab Data: 7/29/21 chest xray: negative 7/30/21 US: Negative for clot 8/6/21 Chest xray: Bilateral patchy pneumonias which seems to have worsened slightly when compared to prior studies

Allergies: Penicillins

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

Symptoms: Came to ER for confusion and possible low blood sugar on 7/29/21. Blood sugar 124 on arrival. Patient was lethargic and tested positive for COVID. Stable vitals temperature 99.7? 0 blood pressure 137/64 below pulse of 93 and 98% on room air. Also found to have acute metabolic encephaloprathy likely secondary to UTI and COVID19. Placed on ceftriaxone for UTI . During her stay she developed acute hypoxic respiratory failure, requiring opti-flow 90% and 60L. Likely from COVID pneumonia. Placed on dexamethasone and remdesivir. Required precedex for BP. Patient went comfort and passed away on 8/25/2021

Other Meds: Aspirin, atorvastatin, vitamin B12, Fish Oil, Glucosamine-chondroitin, lisinopril-hydrochlorothiazide, multiple vitamin, ocuvite

Current Illness:

ID: 1696911
Sex: F
Age: 27
State: PR

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: 1
Vax Route: IM
Vax Site: LA

Lab Data: Does not apply

Allergies: patient refers not having any allergies to medication

Symptom List: Pain in extremity

Symptoms: Female patient refers feeling agitated and itchy in the throat. Patient refers feeling unsteady and feels a lump in the throat. Vitals are BP 120/80, Sat02 97%. Paramedic and voice personnel talked with the patient, and she was given prep alcohol treated with breathing exercises for 30min. They recommended to calm down and practice breathing exercises. She was referred to primary doctor.

Other Meds: patient refers not taking any medication

Current Illness:

ID: 1696912
Sex: F
Age: 54
State: NY

Vax Date: 09/13/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: ciprofloxin

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

Symptoms: Dizziness, headache, muscle ache, joint ache, fever

Other Meds:

Current Illness:

ID: 1696913
Sex: M
Age: 41
State: WI

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:

Allergies:

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

Symptoms: Patient requested a booster (third) dose of Covid-19 vaccine, the pharmacy did not provide his first dose. The pharmacy administered a Pfizer dose a. It is our understanding that the patient received Moderna series, however, we only were aware of this after the patient received the vaccination. Ultimately the patient received a Moderna series and a Pfizer third dose due to self-attesting he was immune compromised.

Other Meds:

Current Illness:

ID: 1696914
Sex: F
Age: 0
State: KY

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Temp 97.5 ?F Heart Rate 116 Resp 20 BP 94/72 SpO2 98 %

Allergies:

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

Symptoms: ED c/o allergic reaction the second Covid vaccine. Patient states she received her second dose of Pfizer Covid vaccine this morning and about 5 minutes later began to feel shaky, then lightheaded and dizzy and felt like she was going to pass out. She notified the nurse who felt the patient had some facial swelling and tightening of the throat and thus she was given an EpiPen. EMS was called and the patient was transported to the emergency room and states she is feeling much better but is not at baseline. Currently the patient denies headache, neck pain, sore throat, throat swelling, lip swelling, chest pain, fevers, chills, cough, shortness of breath, abdominal pain, vomiting, diarrhea, rash or focal neuro deficit

Other Meds:

Current Illness:

ID: 1696916
Sex: M
Age: 65
State: VA

Vax Date: 03/13/2021
Onset Date: 03/15/2021
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: x-rays- did not indicated what the problem was MRI- stenosis in cervical spine and lumbar vertebrae

Allergies: None, Hypotensive reaction to Benadryl

Symptom List: Vomiting

Symptoms: I started having lower back pain. It began with general pain that would radiate bilaterally down both of my legs into the calves? muscles. It was more acute rather than chronic pain. This pain got to the point where standing for a long time was difficult. Standing without moving was more painful than walking. I had x-rays that did not entirely indicated what the problem was. The physician referred me to a neurologist who ordered additional x-rays in different positions and MRI. This revealed stenosis in cervical spine and lumbar vertebrae. The recommended treatment for this was basically to put in replacement disk material for lumbar vertebrae and to anchor the vertebrae together in a fusion process. I am having surgery next month.

Other Meds: multi vitamin, melatonin, Atorvastatin, Tamsulosin, Flomax, Colchicine

Current Illness: None

ID: 1696917
Sex: F
Age: 34
State: IA

Vax Date: 08/25/2021
Onset Date: 08/25/2021
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: refer immunologist.

Allergies: sulfa, cephalosporins, trimethoprim, lisinopril, morphine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient presents today for evaluation of rash after receiving COVID vaccine. On 8/25/21 received Pfizer COVID vaccine at in left arm. Within 40min had a red, hot to touch rash around injection site and down most of left arm. The rash was not itchy or painful. No paresthesia. No swelling. Then last week, the rash has went to stomach, legs, right arm and face. Most spots have improved yet new areas develop. Again no itching or pain. Unsure if Zyrtec or Benadryl help which she already routinely takes for allergies. Has a history of multiple allergies but never to a vaccine. Prior to vaccine was feeling well and feels well besides rash. No fever. No lip, tongue, facial swelling, wheezing or SOB.

Other Meds: losartan, topirimate, Benadryl, Zyrtec, combo birth control, Dulera, albuterol, valacyclovir, calcium carbonate.

Current Illness: none

ID: 1696919
Sex: F
Age: 45
State: MI

Vax Date: 08/27/2021
Onset Date: 08/28/2021
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: 9/13/21 They did EKG, multiple blood tests including, d-dimer, urine, covid, chest extra x-ray, and CT

Allergies: Penicillin, morphine

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

Symptoms: Started feeling tired, fever, severe body aches. Drank lots of fluids and took Tylenol. Was told one fever was gone I could return to work per employee health (nurse at Ortho office). I went back to work after missing 2 days (short staff as everyone) because fever had come down but still could not get over the exhaustion. Came home went to sleep till morning which is completely abnormal for me. I made it through the next two days of work feeling like I couldn't breath well but figured it was hustling with the masks on and then I woke up with the post severe pain in my chest and struggling to breath. Went to Emergency Dept. And was diagnosed with pneumonia 3 lobes and what Dr. Called what looks to be an inflammatory response in addition which may be a results of the 3rd vaccine but no data to compare. I was the first in my health system to have the 3 vaccine

Other Meds: Methotrexate, propranolol, omeprazole,levothyroxine, Lasix, gabapentin, duloxetine, Vit d3, b12, multivitamin

Current Illness: None

ID: 1696920
Sex: F
Age: 40
State:

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Chills, fever, headache, nausea, weak and fatigue 8 hours after the 2nd dose

Other Meds:

Current Illness:

ID: 1696921
Sex: M
Age:
State: IL

Vax Date:
Onset Date: 09/08/2021
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: unknown

Allergies: None

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

Symptoms: hospitalized for fever, AMS, encephalopathy, hypomagnesemia

Other Meds: unknown

Current Illness: unknown

ID: 1696922
Sex: F
Age: 22
State: WA

Vax Date: 09/07/2021
Onset Date: 09/12/2021
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:

Allergies:

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

Symptoms: My menstrual cycle came 14 days earlier than what is normal. It also happened after my first dose.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am