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: 1700709
Sex: F
Age: 39
State: GA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Extremely heavy blood flow during periods. Excessive fatigue due to flow

Other Meds: None

Current Illness: None

ID: 1700711
Sex: F
Age: 51
State: SC

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data: None. Spoke with the pharmacist on 9/17/2021, who advised me that it was a rare reaction to this shingles vaccine, but not dangerous.

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Upper arm swollen and red about two inches below injection site, and warm to the touch. Did not clear up for a full week.

Other Meds: None

Current Illness: None

Date Died: 09/14/2021

ID: 1700712
Sex: F
Age: 68
State: TN

Vax Date: 04/14/2021
Onset Date: 09/08/2021
Rec V Date: 09/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient presented to hospital in full trauma alert after motorcycle crash on 9/8. Intubated with subarachnoid hemorrhage with base skull fracture and multiple other fractures. Covid test +. No improvement with multiple trauma appropriate treatments. Family agreed with comfort care on 9/13.

Other Meds:

Current Illness:

Date Died: 04/01/2021

ID: 1700713
Sex: M
Age: 63
State: TX

Vax Date: 01/27/2021
Onset Date: 02/06/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data:

Allergies: Aspirin, NSAIDS, Penicillins

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient received Pfizer vaccine (COMIRNATY) and wa admitted a week later with acute lung rejection and was attributed to antibody mediated rejection. Patient deteriorated rapidly requiring intubation, mechanical ventilation and ECMO and passed away eventually

Other Meds: acetaminophen (TYLENOL) 500 MG tablet Take 1,000 mg by mouth every 6 (six) hours as needed for pain. Provider, Historical, MD alendronate (FOSAMAX) 70 MG tablet Take 1 tablet (70 mg total) by mouth every 7 (seven) days azithromycin

Current Illness: Lung transplant recipient

ID: 1700714
Sex: F
Age: 62
State: PA

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/15/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: 30-40 minutes after receiving her Janssen Covid 19 vaccine she could not get out of the car and walk. Her legs collapsed and her son had to help her out of the car and hold her up and walk her up the stairs to her bedroom. She was having recent issues with muscle tremors and her Neurologist ruled out ALS, MS and Parkinsons. She also developed a metallic taste in her mouth.

Other Meds: Vitamin D3 Calcium Magnesium

Current Illness: Some balance issues but completely able to walk and climb stairs.

ID: 1700715
Sex: F
Age: 41
State: TN

Vax Date: 07/09/2021
Onset Date: 09/15/2021
Rec V Date: 09/15/2021
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, imitrex, bees

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

Symptoms: Involuntary muscle spasms, difficulty moving, Speaking

Other Meds: Metoprolol, Effexor

Current Illness: NA

ID: 1700716
Sex: F
Age: 24
State: CA

Vax Date: 05/04/2021
Onset Date: 09/01/2021
Rec V Date: 09/15/2021
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: MRI, LP

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 4/13/2021 EW0153 Pfizer, 5/4/2021 EW0173 Pfizer 9/2021 developed headache, double vision, diagnosed after MRI and LP with demyelination

Other Meds: none

Current Illness: none

ID: 1700717
Sex: F
Age: 69
State: FL

Vax Date: 08/24/2021
Onset Date: 08/31/2021
Rec V Date: 09/15/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfa

Symptom List: Pharyngeal swelling

Symptoms: Acute disseminated encephalomyelitis (ADEM) is a neurological condition characterized by a brief but intense attack of inflammation in the brain and spinal cord. Patient developed altered mental status, confusion and seizures, currently intubated. MRI Brain consistent with severe diffuse inflammation and vasogenic edema of cerebrum, bilateral cerebellum, brainstem and thalamus. NO hemorrhage no acute stroke, CSF did not show active Bacterial, viral or fungal infection. Getting Brain bx now.

Other Meds: Tums, Hydralazine, ASA, Rosuvastatin, Levothyroxine, Zetia, Carvedilol, Lasix, Allopurinol.

Current Illness: None

ID: 1700718
Sex: F
Age: 53
State: MN

Vax Date: 01/12/2021
Onset Date: 09/14/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data: 9/15/21 SARS/COV-2 Positive

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Breakthrough COVID

Other Meds:

Current Illness:

ID: 1700719
Sex: F
Age: 56
State: SC

Vax Date: 08/06/2021
Onset Date: 08/08/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data: VISUAL FIELD, EXTENDED CBC AND DIFFERENTIAL Details Component Results Component Your Value Standard Range Flag White Blood Cell Count 7.80 K/cumm 4.00 - 11.00 K/cumm Red Blood Cell Count 5.26 M/cumm 3.63 - 4.92 M/cumm H Hemoglobin 15.8 gm/dL 11.0 - 15.0 gm/dL H Hematocrit 46.9 % 33.0 - 47.0 % Mean Corpuscular Volume 89.2 fL 77.0 - 106.0 fL Mean Corpuscular Hemoglobin 30.1 pg 26.0 - 35.0 pg Mean Corpuscular Hemoglobin Conc 33.7 gm/dL 32.0 - 36.0 gm/dL Red Cell Distribution Width 13.4 % 11.6 - 16.4 % Platelet Count 276 K/cumm 140 - 440 K/cumm Mean Platelet Volume 8.8 fL 7.3 - 10.3 fL Nucleated Red Blood Cells 0.1 /100 WBC 0.0 - 0.2 /100 WBC Neutrophils Relative Percent 58.8 % 45.0 - 75.0 % Lymphocyte Relative Percent 29.0 % 20.0 - 45.0 % Monocytes Relative Percent 7.1 % 0.0 - 10.0 % Eosinophils Relative Percent 4.4 % 0.0 - 5.0 % Basophils Relative Percent 0.7 % 0.0 - 2.0 % Neutrophils Absolute Count 4.60 K/CUMM 2.20 - 7.90 K/CUMM Lymphocytes Absolute Count 2.30 K/CUMM 1.10 - 4.40 K/CUMM Monocytes Absolute Count 0.60 K/CUMM 0.00 - 1.60 K/CUMM Eosinophils Absolute Count 0.30 K/CUMM 0.00 - 0.50 K/CUMM Basophils Absolute Count 0.10 K/CUMM 0.00 - 0.20 K/CUMM Component Your Value Standard Range Flag CRP, Low Sensitivity <0.290 mg/dL 0.000 - 0.300 mg/dL Component Your Value Standard Range Flag Sedimentation Rate, Automated 16 mm/hr >0 - 30 mm/hr

Allergies: Food sensitivity testing through ELISA/ACT: carob cashew Cheese Nitrates/nitrites cane sugar coconut tangerine polysorbate 20 silicates/silicon dioxide feverflew broccoli whey palm oil D&C green #5 Prozac blueberry Rhubarb trichophyton rumbrum cyclohexylamine Plum umeboshi A sever allergy to fire ants

Symptom List: Diarrhoea, Nasal congestion

Symptoms: mild headache started on Aug 8th 2021 and has continued. Crescent floaters and black dot floaters started on Aug 17th. Headache has continued, sometimes getting worse. At first it was in the front of my head, as if I was wearing a tight visor. For the last week it starts from the back of the base of my head to behind my ears. Continues in the front of my forehead. On Aug 24th I woke up with a very sensitive temple area on the right side. I couldn't touch it. PCP referred me to Urgent Care or ER, went to Urgent Care. Was given a steroid injection with a diagnosis of possible temporal arteritis. Went to a Eye Institute on Sept 1. Eye tests suggest not temporal arteritis. Met with Endocrinologist on Sept Sept 14th. thyroid labs are all level, thyroid antibodies elevated from previous month. The first 3 weeks after 1st shot I was VERY tired, not able to articulate sentences well, stuttering and feeling very anxious. Currently waiting for Neurologist appointment. Receiving 2nd shot Friday Aug 17th.

Other Meds: Liothyronine 7.5 mcg Synthroid 100mcg D3+K2 Zinc Blackseed oil Nutrafol Selenium B-12 Chromium Polynicotinate NAC Intestinal repair complex Megapre-prebiotic Epilntegrity SunButyrate TG Liquid SBI Protect ION Gut health Enterovite Collagen

Current Illness: Hashimotos

ID: 1700720
Sex: F
Age: 25
State: NC

Vax Date: 08/28/2021
Onset Date: 09/05/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Around September 5, 2021, I started to have menstrual cramping outside of the normal cycle. By September 7, 2021 I had started a menstruating and it has progressed since. I should not have had menstruation until September 21, 2021. The cycle is different this time. Thicker and heavier. Acne has progressed during the week of September 12, 2021

Other Meds: None

Current Illness:

ID: 1700721
Sex: F
Age: 43
State: TN

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

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: rash-all over, shortness of breath, fever 103, body aches, severe injection site soreness

Other Meds:

Current Illness:

ID: 1700722
Sex: F
Age: 59
State: NC

Vax Date: 09/09/2021
Onset Date: 09/10/2021
Rec V Date: 09/15/2021
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: morphine

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

Symptoms: The next day, fever 102,5, severe body aches including headache, severe fatigue, shortness of breath, chest pain. Took tylenol for body aches, and one asprin because of chest pain. Most symptoms subsided by the next day. Fatigue continued for 2 more days. On Sunday, 9/12/21 awoke with TMJ symptoms on the right side, which I have NEVER had before. Inside of my mouth also began peeling. The TMJ continues to be a problem. Teeth do not close together properly. Chewing is extemely difficult.

Other Meds: metoprolol 25 mg singulair 10 mg multi-vitamin

Current Illness:

ID: 1700723
Sex: M
Age: 70
State: NY

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 09/15/2021
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: all kinds of infections, bloodwork, pet scans, ct and found nothing.

Allergies: no

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

Symptoms: 03/13/2021 I began to tingle in my fingers and feet. followed by numbness in legs and arms-gradually everyday, to the point where I could not stand or walk. It made me relapse on my CIDP.

Other Meds: I was taking Omeprazole, Gemfibrozil, Azathioprine, Finasteride, Cansolofyn, B-12, multivitamin, calcium, Metropole, baby aspirin.

Current Illness: no

ID: 1700724
Sex: F
Age: 29
State: OR

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/15/2021
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

Allergies: none reported

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

Symptoms: The patient requested to receive her first dose of the Moderna Vaccine. She was accidently administered a pfizer vaccine. There were no physical issues noted during her 15 minute observation period and no physical adverse reactions reported. The issue was just recieving the wrong vaccine. We attempted to notify her after leaving by phone and text.

Other Meds: unkown

Current Illness: unkown

ID: 1700725
Sex: F
Age: 41
State: OH

Vax Date: 09/11/2021
Onset Date: 09/12/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt said that she has a silver dollar size rash at the injection site that is very itchy. It is still getting worse and not getting better. She will be following up with her doctor.

Other Meds:

Current Illness:

ID: 1700726
Sex: F
Age: 50
State: FL

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

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

Lab Data:

Allergies:

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

Symptoms: Headache, nausea, dizziness, fever, muscle ache, chills, swelling of injection site, redness injection site, itching injection site.

Other Meds:

Current Illness:

ID: 1700727
Sex: M
Age: 66
State: FL

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

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

Lab Data: none

Allergies: PCN

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Medical treatment was sought for Rhinovirus infection 2 weeks prior to 3rd dose vaccination

Other Meds: Tacrolimus, Bactrim DS, valacyclovir,

Current Illness: I sought healthcare for Rhinorirus infection 2 weeks prior to vaccination because I am immunocompromised. Medical care was sought for this infection. Not post vaccine After recovery, I received 3rd dose Moderna, developed 30 hours fever, body aches, fatigue.

ID: 1700728
Sex: F
Age: 33
State: MA

Vax Date: 09/10/2021
Onset Date: 09/11/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data: Called my doctor and they said go to ER. Unable to go due to my young children

Allergies: Shellfish

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Intense Headache from shot #1 on August. Sight impairment and ringing in ears, headache/migraine for 3 days. Fever of 103 post shot.

Other Meds: Nothing

Current Illness: nothing

ID: 1700729
Sex: F
Age: 76
State: FL

Vax Date: 08/31/2021
Onset Date: 09/08/2021
Rec V Date: 09/15/2021
Hospital: Y

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

Lab Data:

Allergies: penicillin

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

Symptoms: Documented in H&P, patient expierinced fever, shortness of breath and fever shortly after being given the second dose of the COVID vaccine. Resulted positive for COVID on 9/8. Patient admitted on 9/8/21 for COVID 19 pneumonia. Patient is still admitted at this time.

Other Meds: Unknown

Current Illness: Uknown

ID: 1700730
Sex: F
Age: 45
State: OK

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/15/2021
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: None

Allergies: NKDA

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

Symptoms: pt called several hours after vaccine describing redness and some swelling around injection site. About 4pm she came to pharmacy and showed me the site. It was red and raised. She also mentioned her arm hurt and was a bit tingly. I called her before leaving work 09/14/21 and she reported the same. I called her 09/15/21 at around noon to check on her she reports the redness to be gone and the swelling down some but her arm does still hurt and periods of tingling. I will touch base again this evening

Other Meds: singular 10 metoprolol tart 25 sertraline 50 metformin 1000

Current Illness: None that we are aware of

ID: 1700731
Sex: F
Age: 66
State: CA

Vax Date: 10/07/2020
Onset Date: 10/10/2020
Rec V Date: 09/15/2021
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: Amoxicillin, Co-Trimoxazol, Iodine, Nitrofurantoin, Insulin

Symptom List: Unevaluable event

Symptoms: Pt. states that after receiving the Influenza vaccine 10/07/2020, started experiencing symptoms 10/10/2020 of vomiting, passing out, loss hearing in the left ear, and balance issues. ER visit admitted for Observation overnight, steroid injections in eardrum treatments. Hearing loss is still noted and balance issues.

Other Meds: N/A

Current Illness: N/A

ID: 1700732
Sex: F
Age: 53
State: IL

Vax Date: 09/07/2021
Onset Date: 09/08/2021
Rec V Date: 09/15/2021
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: Wheat allergy (gluten)

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

Symptoms: Fatigue, headache, bodyaches, lightheadedness and dizziness (possibly vertigo) These symptoms were present beginning 12 hours after vaccine through 36 hours after vaccine

Other Meds: Daily vitamin, vitamin D, evening Primrose oil, black coash, , vitamin C, Zyrtec, glucosamine

Current Illness:

ID: 1700733
Sex: F
Age: 16
State: KY

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

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

Lab Data: EKG, chest xray, CBC, Metabolic panel, Magnesium level, Troponin, D-Dimer qt all done 9/14/21

Allergies: cefzil

Symptom List: Injection site pain, Pain

Symptoms: chest pain during physical activity. cardiac workup. Currently wearing Holter Monitor until 9/16.

Other Meds: none

Current Illness: none

ID: 1700734
Sex: F
Age: 40
State: NM

Vax Date: 08/24/2021
Onset Date: 08/25/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data: thyroid panel-normal, respiratory viral panel- all negative, CMP, CBC, C-reactive protein, Mg, sedimentation rate, creatinine kinase CK- all normal

Allergies: Latex, onions, metroprolol

Symptom List: Injection site pain, Menorrhagia

Symptoms: 8/25-8/27 Pins & needles tingling that started in fingers & toes & progressed up all extremities and then started on the nose & cheeks. Extreme muscle fatigue in legs with some loss of strength & shaking with exertion head felt extremely heavy and neck was tierd just holding it up. On 27th, was immediately sent to ER to be evaluated for Gillian-barre during visit all blood work came back normal, negative stroke assessment, but was noted to have loss of "sharp" sensation when poked with a needle I could not feel it, tremor in hands & muscle weakness during my neurological exam. Was sent home to monitor my symptoms & told by the ER doctor it just seemed to be an adverse reaction to the

Other Meds: NatureThyroid taken daily (60)

Current Illness: N/A

ID: 1700735
Sex: F
Age: 55
State: KS

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

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

Lab Data:

Allergies: Clindamysin

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

Symptoms: When I woke up this morning (9/15/21), I noticed a large red rash around the injection site-above and below the injection site . I looked online and found that this is what?s called ?Covid Arm.? I went to the pharmacy, and the pharmacist said it will last 7-10 days.

Other Meds: Multi vitamin, fish oil, vitamin D, Singulair, Flonase, Zyrtec

Current Illness: Heart fluttering from the first Covid dose on 8/12/21

ID: 1700736
Sex: F
Age: 46
State: SC

Vax Date: 03/16/2021
Onset Date: 03/21/2021
Rec V Date: 09/15/2021
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: Full environmental and food allergy test performed on 6/3/2021, 6/7/2021, 7/2/2021. Also, discolored skin and rash examined.

Allergies: CLINDAMYCIN

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Painful arm (Left arm), extremely large rash (Left arm), difficulty breathing, and hives/rash/itching spreading to entire body.

Other Meds: TRAZODONE 100 MG, HYDROCHLOROTHIAZIDE 12.5 MG CP, ATORVASTATIN 10 MG, SERTRALINE HCL 50 MG, VALACYCLOVIR HCL 500 MG, OMEPRAZOLE DR 20 MG, LEVOTHYROXINE 112 MCG, METOPROLOL SUCC ER 100 MG

Current Illness:

ID: 1700737
Sex: M
Age: 66
State: FL

Vax Date: 08/24/2021
Onset Date: 08/27/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data: Urine culture

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Developed blood in urine three days after third shot; prescribed cipro, which cleared up the infection; the infection returned two weeks after second shot and was re-prescribed cipro, which cleared up the infection. I also developed a bladder infection (blood in urine) after first Pfizer shot in December 2020 (cleared up with Cipro as well).

Other Meds: Atorvastatin, losartan, amlodipin, baby aspirin, centrum

Current Illness: Perforated colon; reversal surgery on July 21, 2021

Date Died: 01/15/2021

ID: 1700738
Sex: M
Age: 72
State: GA

Vax Date: 01/06/2021
Onset Date: 01/15/2021
Rec V Date: 09/15/2021
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: None

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

Symptoms: Death

Other Meds: N/a

Current Illness: None

ID: 1700739
Sex: M
Age: 54
State: TX

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data: None

Allergies: Suspicion of allergy to penicillin

Symptom List: Nausea

Symptoms: Chest pain for approximately 24 hours

Other Meds: Losartan+HCTZ 100/25, Fluvastatin 20mg, Zinc, Quercetin, Multivitamin, Aspirin

Current Illness: None.

ID: 1700740
Sex: F
Age: 86
State: WI

Vax Date: 02/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/15/2021
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: Sulfa

Symptom List: Injection site pain

Symptoms: Reaction to mosquito bites never experienced before (I am 86 yo). A large area of skin around the bite swells and reddens. A blister-like swelling that is filled with liquid develops OR a hard knot develops at entry point. These last for days. Itching is intense. Topical Corizone 1% doesn?t faze it. A same-age female friend, who also received the Pfizer vaccine, is having the same atypical reaction.

Other Meds: Lisinopril 10 mg; aspirin 81 mg; one-a-day multi vitamin with minerals; 500 mg acetaminoophen; Glucosamine Chondroitin Comlx; ascorbic acid 1000 mg; PerserVision/Lutein cap; PreviDent 5000 Booster; Refresh Optive Advanced OPHTH; Turmeric 50

Current Illness: none You haven't asked what kind of vaccine I received. I received TWO injections of the Pfizer vaccine - one on 2/1/2021 and another on 2/22/2021.

ID: 1700741
Sex: F
Age: 66
State: AZ

Vax Date: 09/01/2021
Onset Date: 09/10/2021
Rec V Date: 09/15/2021
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: Sulfa, Penicillin, Rocephin IM Injection

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

Symptoms: Severe Large area of Redness approximately 8 inches in size, similar to a cellulitis, Area of injection is hot, very swollen, Headache x5 days so far , severe neck and back pain fatigue malaise Using Tylenol and Advil OTC pain medication

Other Meds: None

Current Illness: None

ID: 1700742
Sex: F
Age: 33
State: SC

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 09/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Echocardiogram

Allergies: Unknown

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

Symptoms: Started having chest pain the day of the 2nd dose. Went to the Emergency Room 9/13/2021. Released with a diagnosis of Myocarditis. Has appointment with Cardiologist Monday 9/20/2021.

Other Meds: Unknown

Current Illness: Unknown

ID: 1700743
Sex: M
Age: 13
State: MI

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/15/2021
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: None

Symptom List: Tremor

Symptoms: Pfizer lot EW0178 given to client. Vaccine was beyond the use by date.

Other Meds:

Current Illness: None

ID: 1700744
Sex: M
Age: 18
State: AK

Vax Date: 02/01/2021
Onset Date: 04/01/2021
Rec V Date: 09/15/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: None stated.

Other Meds: None

Current Illness: Healthy at time of vaccination. Starting having blood with stool for several months. Now diagnosed with SEVERE Ulcerative Colitis. Just wondering if vaccine related before any booster shots

ID: 1700745
Sex: F
Age: 82
State: GA

Vax Date: 03/22/2021
Onset Date: 09/05/2021
Rec V Date: 09/15/2021
Hospital: Y

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Fever, muscle ache, cough and fatigue.

Other Meds:

Current Illness:

ID: 1700746
Sex: F
Age: 52
State: OH

Vax Date: 09/13/2021
Onset Date: 09/14/2021
Rec V Date: 09/15/2021
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: PCN

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

Symptoms: Day after injection very heavy menstrual bleeding and my cycle isn't due for 2 weeks

Other Meds: None

Current Illness: None

ID: 1700747
Sex: F
Age: 67
State: TX

Vax Date: 08/24/2021
Onset Date: 08/25/2021
Rec V Date: 09/15/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: When I was giving patient her second Pfizer vaccine, she stated that on the first shot on 8/24/21, on the following day, she had side effects. She reported that she couldn't get out of bed and had to use restroom 3 times.

Other Meds:

Current Illness:

ID: 1700748
Sex: F
Age: 48
State: PR

Vax Date: 09/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/15/2021
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 medical study was performed

Allergies: patient is not allergic to anything

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

Symptoms: 48 year old patient female comes to center for her first dose of PFIZER Lot FF2589, it is administered at 2:37pm by agent. Patient at 2:43pm refers feeling dizzy and at 2:45pm she lost consciousness, quickly the paramedic takes vital signs.

Other Meds: patient is not taking any medications

Current Illness: None

ID: 1700749
Sex: F
Age: 28
State:

Vax Date: 09/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/15/2021
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: BP: 158/90, HR: 96% , RR: 24 BP: 138/90, HR: 100%

Allergies:

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

Symptoms: Patient stated that she was experiencing body itching that comes and goes.

Other Meds:

Current Illness:

ID: 1700750
Sex: M
Age: 78
State: MO

Vax Date: 03/11/2021
Onset Date: 09/10/2021
Rec V Date: 09/15/2021
Hospital: Y

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

Lab Data: unknown

Allergies: unknown

Symptom List: Pain in extremity

Symptoms: sxs onset 9/10 including fever, SOB, cough. admitted to hospital for 9/10 thru 9/11 for COVID symptoms.

Other Meds: unknown

Current Illness: Coronary artery disease, advanced dementia

ID: 1700751
Sex: F
Age: 36
State: MN

Vax Date: 01/30/2021
Onset Date: 09/14/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data: 9/15 SARS/COV-2, NAAT Positive

Allergies:

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

Symptoms: Breakthrough COVID

Other Meds:

Current Illness:

ID: 1700752
Sex: M
Age: 51
State: VA

Vax Date: 08/13/2021
Onset Date: 08/20/2021
Rec V Date: 09/15/2021
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: sulpha medications

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

Symptoms: Approximately one week after administration of second covid vaccine client, with no previous history of hallucinations, began to experience auditory, visual and tactile hallucinations. Hallucinations have been increasing in frequency and severity over the past three weeks.

Other Meds: buspirone 30mg BID paroxetine ER 37.5 mg daily gabapentin 600mg BID

Current Illness: none

ID: 1700753
Sex: M
Age: 66
State: ID

Vax Date: 03/12/2021
Onset Date: 04/23/2021
Rec V Date: 09/15/2021
Hospital: Y

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

Lab Data: Blood test. Triple A surgery.

Allergies: Neomycin

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

Symptoms: About a month afterwards on 4/23/2021, I developed shingles infection. I have not had my shingles vaccine. I had a terrible back ache on the 4/15/2021 and was diagnosed with shingles on 4/23/2021. I had a rash and some blisters on my back and a few on my groin area. On 6/18/2021, I had an aortic aneurysm. I had a very sharp pain across my lower back and I got very winded and called 911 and the fire department and ambulance came. I was taken to hospital in state. They ran a lot of tests and blood work and I was transported to another hospital in city, state which is more specialized and I had to have triple A surgery. The aortic artery had burst.

Other Meds: Ibuprofen; Metformin; Atorvastatin; Amlodipine; Losartan

Current Illness: None

ID: 1700754
Sex: F
Age: 31
State: MT

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

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

Lab Data:

Allergies: none

Symptom List: Vomiting

Symptoms: Pt has c/o Fast Heart rate, HA, dizziness

Other Meds: Topamax, Phentermine, spironolactone, singulair

Current Illness: unknown

ID: 1700755
Sex: F
Age: 75
State: MA

Vax Date: 03/10/2021
Onset Date: 03/24/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data: No

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I developed little itch red bumps on my body primarily my legs. At first it was a couple of them. Over time, it became more and more. I went to my dermatologist. I had photo therapy treatments. It took about 10 weeks of treatment 3x per week to clear up about 95%. It was something that was getting progressively worse at the end of March, beginning of April. Before the vaccine, there was no need for any treatments for the bumps for about 3 years. If I had the occasional bump, I'd put some ointment on it and it would be fine. I was nothing like what I experienced after the vaccine. I had also experienced what is now known as COVID arm. I went on 3/13. I went because the side effects of COVID arm were not as well known at that time and I was concerned. The doctor couldn't determine if it was related to the vaccine. I was given antibiotics. The COVID arm resolved in about 4-5 days.

Other Meds: Yes, multivitamin, calcium, vitamin D, vitamin C, dyazide, simvastatin, atenolol, verapamil (long standing medications, not recently introduced)

Current Illness: No

ID: 1700756
Sex: M
Age: 43
State: CA

Vax Date: 03/16/2021
Onset Date: 03/25/2021
Rec V Date: 09/15/2021
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; I had an MRI - didn't find any tumors; I met with a neuro-oncologist and through his testing: I had continuous Cortisol testing from April-July and in August at the 5th Cortisol test, my levels were down to normal ranges Severe chest pain/high blood pressure: on two separate occasions

Allergies: no

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

Symptoms: Initially it was irritable bowel or GERD - those were two weeks and that continued and then was followed by chest pain and hyper-elevated blood pressure 205/112. Thyroid numbers were super low. Super elevated ACTH levels and super elevated Cortisol - Cushing Syndrome was the diagnose. April - July I was pretty much bedridden. I am still on disability and out of work. I have gotten through the Cushing Syndrome - I'm most through the symptoms as numbers are coming down. My expected return to work date is November 5th. I was on three different heart medications to control the blood pressure - first started Lisinopril and then Metoprolol and then Amlodipine and then they just continued to up the doses of all three. Blood pressure has returned to normal - 130's/70's. I am weaning off the heart medications currently. My thyroid is now in the low normal range. I had follow up labs today. I'm also Gabapentin for Neuropathy in both of my feet. That happened before my vaccine. I am recovering - in the process and now it's a matter of getting off the heart medications. I am on physical therapy because I was in bed for so long.

Other Meds: Testosterone Replacement therapy;

Current Illness: no

ID: 1700757
Sex: F
Age: 44
State: CA

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 09/15/2021
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: Neurological testing, x-rays

Allergies: Penicillin; vitamin C

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Immediately after the shot, I got the feeling of light headed and dizzy. I took a deep breath and felt like a jolt in my body, I chalked it up to nerves. I waited for 30 minutes, I did feel dizzy still and pain in my arm. I sat in my car for another hour before I felt comfortable enough to drive. March 12 that night I felt tired. I woke up Saturday feeling sluggish and exhausted. By that afternoon it was full blown flu like symptoms, fever, chills, shakiness. Monday the 15th I went to work but was foggy in the head, I still felt like crap, complete exhaustion and no energy. I ended up taking sick days Monday the 15th and the 16th. By Wednesday I came back to work but kept noticing brain fog. I noticed shortness of breath, still feeling tired. I started having trouble and with my coordination. I had headaches of and on and still the brain fog. By April I still wasn't better. Three weeks after getting my vaccine I started using a cane. I went to my doctor by the end of April and my walking was getting worse, I felt like all the muscle strength in my body was gone. I have done physical therapy, but not better. I now use a walker. Just walking in my house gives me shortness of breath. I still have trouble with weight movements and shakiness. I have been off of work since May, my doctor took me off of work end of April.

Other Meds: Celexa; Trazadone; Lamotrigine

Current Illness: No

ID: 1700758
Sex: M
Age: 32
State: CA

Vax Date: 06/25/2021
Onset Date: 07/04/2021
Rec V Date: 09/15/2021
Hospital:

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

Lab Data: EKG CT scan of the head EKG lab work

Allergies:

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

Symptoms: I experienced migraine headaches after my vaccine. I went to the ER got a lab work, EKG test, CT scan of the head on 07-0-2021. On 07-05-2021 I went to urgent care I got IV because I was vomiting a lot. My symptoms of vomiting and migraines stopped around 07-17-2021. I also had extreme fatigue that kicked in after that and that fully subsided on 07-31-2021. I have no symptoms today.

Other Meds:

Current Illness:

ID: 1700759
Sex: U
Age:
State: IA

Vax Date: 09/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/15/2021
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: nkda

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

Symptoms: tingling and swelling of eyes and lips

Other Meds: buspar zoloft

Current Illness: n/a

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am