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: 1709437
Sex: F
Age: 63
State: NY

Vax Date: 09/03/2021
Onset Date: 09/06/2021
Rec V Date: 09/17/2021
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: Propylthiouracil, cobalt

Symptom List: Dysphagia, Epiglottitis

Symptoms: Extreme inflammation and swelling - left knee

Other Meds:

Current Illness:

ID: 1709438
Sex: F
Age: 35
State: FL

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/17/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: WHEN THE TECHNICIAN GAVE THE PATIENT THE VACCINE AND PRESSED DOWN ON THE PLUNGER THE SYRINGE DETACHED FROM THE NEEDLE AND VACCINE LIQUID CAME OUT AND NEVER MADE IT INTO PATIENT ARMS. THE PHARMACIST READMINSTERED THE VACCINE BUT ONLY 0.4MLS JUST IN CASE THE PATIENT RECEIVED A SMALL AMOUNT OF VACCINE.

Other Meds:

Current Illness:

ID: 1709439
Sex: F
Age: 67
State: MN

Vax Date: 09/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/17/2021
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: none

Allergies: none

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

Symptoms: Redness/soreness on the site, body aches and low grade fever

Other Meds: on file

Current Illness:

ID: 1709440
Sex: F
Age: 41
State:

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Chills, fever, swelling and redness on left arm.

Other Meds: Vitamin D3

Current Illness: N/A

ID: 1709441
Sex: F
Age: 59
State: FL

Vax Date: 02/10/2021
Onset Date: 02/24/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: ecocardiogram stress test

Allergies:

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

Symptoms: heart palpitations, rapid heart beat, heart monitor provided

Other Meds: lasenopryl

Current Illness:

Date Died: 09/17/2021

ID: 1709442
Sex: M
Age: 90
State: CO

Vax Date: 09/03/2021
Onset Date: 09/05/2021
Rec V Date: 09/17/2021
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: 9/5 and 9/16/21- CXR 9/5/21 CXR indicated developing pneumona and worsening basilar aeration (compared to 2/2021 CXR). 9/16/21 CXR indicated the heart is modestly enlarged. mild pulmonary venous congestion and slight bilateral pleural effusions. A CBC was done on 9/7/21- WBC elevated at 12.4, RDW elevated at 15.6, PLT low at 125, NE% high at 88.9, and LY% low at 4.6.

Allergies: No Known Allergies

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

Symptoms: Resident was noted to have a low blood pressure on 9/4/21 89/47 and oxygen was less than 90% with usual supplemental oxygen at 2L. On 9/5/21 oxygen need was increased to 5-6LPM for saturations in the low 80s and redness and petechia was noted to his left leg. (Was already being treated for venous insufficiency in right leg). On 9/6/21 the resident was started on antibiotics (Levofloxacin) for pneumonia with pleural effusion. Daily INRs were initiated due to use of antibiotics and chronic Coumadin use. Coumadin was given on alternate days of the antibiotic. On 9/9 the INR was 5.4 and on 9/10 the INR was 5.8. He received a one time dose of Vitamin K. On 9/11/21 he was started on Doxycycline for cellulitis. He continued to decline and had decreased lung sounds. The resident was noted to have increase in pain and was started on morphine on 9/13/21. The resident passed away on 9/17/21.

Other Meds: Acetaminophen Tablet 500 MG 2 tablet by mouth three times a day, Artificial Tear Ointment Instill 1 ribbon in right eye at bedtime, Cetirizine HCl Tablet 5 MG give 1 tablet by mouth one time a day, Coumadin Tablet 1 MG every day, Fluticaso

Current Illness: Resident was exhibiting times of increased confusion. He was being treated for chronic conditions including bilateral lower extremity bilateral lower extremity edema.

ID: 1709443
Sex: F
Age: 25
State: CA

Vax Date: 04/22/2021
Onset Date: 04/24/2021
Rec V Date: 09/17/2021
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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Change in menstrual cycle Calf pain Chest pain Tiredness All symptoms started after 2nd dose

Other Meds:

Current Illness:

ID: 1709444
Sex: F
Age: 52
State: PR

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Demerol, and Codeine

Symptom List: Pharyngeal swelling

Symptoms: 52 year old patient goes to the vaccination center to receive her first dose of PFIZER suggested by her doctor, given that she suffers from COPD, high blood pressure and Thrombophilia. Within 2 minutes of receiving first dose of Pfizer, she verbalize feeling dizzy and scratchy in her throat. The patient was taken to the incident observation area and was attended by paramedic to take her vitals: 99% sat, 122FC, 180/90 BP, and 88% dextrose. At 11:25pm the case was consulted with Doctor and the patient was transferred to the hospital

Other Meds: Coumadin 5 mg, Norvasc 5 mg, Prilosec 20mg, Pepcid 40mg, Folic Acid 1mg and vitamin D 50, 000

Current Illness:

ID: 1709445
Sex: F
Age: 54
State: CA

Vax Date: 06/16/2021
Onset Date: 07/01/2021
Rec V Date: 09/17/2021
Hospital: Y

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

Lab Data: Unsure at this time. 5 MRIs have been done - on her brain. Copies are available if needed.

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Follow up or original: Surgery on the 17th. They are calling a cavernous malformation that erupted or hemorrhaged. That was from four different second opinions. Something got in there to plug it up. Eyelids will not open. Her eye is crossed aiming off to the side or she has double vision. SHe has no taste. Very little hearing on left side ear. She is numb inside her mouth - she keeps biting her lip. Her right leg drags - the same that the day we left the hospital on 7/19/2021. They sent her home with pain reliever but she didn't need much - she's not in pain. They put her on steroids two separate times. They sent her home with sodium tablets as well. She's having cognitive issues. Not remembering very well. Today she is in the hospital because we were at a doctor yesterday and she came home and lost her voice last night and this morning it got worse and then her eyes were getting worse. Then her voice got better later. Went and got COVID test at about 11:00. Then after that she complained about worsening symptoms and called advice nurse - and they said to take her to ER . Eyes were bothering her - she claims since the surgery she only has about 10% vision THey found a cut on her leg that was infected and causing low white blood cell count. They are keeping her overnight. Her second operation is set up for November 8th - this one will remove the eruption because it has moved. Last time it was in a place where they were unable to remove it. They did a CAT scan on her today - they said everything looked the same as far as the brain issue. No results yet from the COVID test.

Other Meds: Magnesium Citrate

Current Illness: none

ID: 1709446
Sex: F
Age: 78
State: AZ

Vax Date: 09/01/2021
Onset Date: 09/13/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Woke upon 9/13 to swollen knee . Aches all over fever 100.2 normally 97.8 on the 14th Knee was worse . unable to do normal activity.

Other Meds: Metoprolol, Aspirin, torsemide10mg

Current Illness: no

ID: 1709447
Sex: F
Age: 72
State: TN

Vax Date: 09/13/2021
Onset Date: 09/13/2021
Rec V Date: 09/17/2021
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: IVP dye, Pneumonia vaccine, statins

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

Symptoms: Right arm became hot, red and itchy 6 hours after injection into Other arm. Bumps appeared a few hours later that same evening. I began taking Benedryl, applying lidocaine cream for the itching and cold compresses. The next day the arm appeared about the same and I contacted Dr. who prescribed Valacyclovir HCL 1 Gr. TID. I took 1 around 6pm on 9/14 and the second one on 9/15 about 7am. By noon that day the redness was subsiding and the intense itch was improved. On 9/16 she had me see her PA who could not confirm my suggestion of Shingles. She sent me home with some Triamcinolone Cream. As of today, the bumps remain but are fading and the itching is much less.

Other Meds: Anastrozole, Aspirin, Budesonide Inhalation, Fenofibrate, Levothroxine,Losartan, Metoprolol, Omega 3 Fatty acid, Vitamin C

Current Illness: None

ID: 1709448
Sex: F
Age: 64
State: TX

Vax Date: 05/01/2021
Onset Date: 08/09/2021
Rec V Date: 09/17/2021
Hospital: Y

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

Lab Data: Venous US and CTA

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: DVT and PE

Other Meds: Atorvastatin

Current Illness: Arthritis

ID: 1709449
Sex: F
Age: 57
State: KS

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: I had to get put on additional medication for my breathing.

Allergies: None.

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

Symptoms: A hour after the vaccine I started having muscle aches and chills. Then I progressed into have a fever, and my body aches intensified. My asthma also became a probably I had to increase my medication. I also had bad headaches and diarrhea. I had swollen nymph lobes, that just went back to normal.

Other Meds: I was taking medication to control to asthma.

Current Illness: None.

ID: 1709450
Sex: M
Age: 33
State: MD

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 09/17/2021
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: none

Allergies: none

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

Symptoms: 1) Testicular pain, aching affecting both testicles last 48 hours. 2) Flu like symptoms, aches malaise - no fever.

Other Meds: none

Current Illness: none

ID: 1709451
Sex: F
Age: 43
State:

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
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: Fever 100 degrees, extreme body aches in every in of body, metal taste in mouth, soreness at injection site makes it painful to use arm, chills, no energy, significant stabbing pain in right knee and pain on left side of my chest. Eye balls feel very hot in the sockets and lungs feel inflamed but no cough.

Other Meds: None

Current Illness: None

ID: 1709452
Sex: F
Age: 24
State: OR

Vax Date: 08/25/2021
Onset Date: 09/16/2021
Rec V Date: 09/17/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Random swelling around elbow and inflammation spreading up the forearm and its painful and tender to the touch. Rash/swelling only on arms. No fever no itchiness just swelling and pain.

Other Meds: Doxycycline for acne.

Current Illness: Pre-diabetic

ID: 1709453
Sex: F
Age: 57
State: NJ

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/17/2021
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: Sulfa, penicillin and tramadol

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

Symptoms: Patient called and said she has rash on 70% of her body. It is itchy and red and painful when she scratches. The rash covers her arms, lower back, thigh, neck and chest. Patient stated she did have a much more milder rash from the first Moderna shot. Patient was advised go to convenient care as she doesn't have a primary care doctor. Pharmacist asked to follow up with patient tomorrow.

Other Meds: Levothyroxine and Wellbutrin

Current Illness: Patient reported a much milder rash from the first shot that never went away.

ID: 1709454
Sex: F
Age: 31
State: AZ

Vax Date: 08/05/2021
Onset Date: 08/06/2021
Rec V Date: 09/17/2021
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: Fatigue, fever, ear ringing, headache, muscle aches, chills

Other Meds: Nonr

Current Illness: None

ID: 1709455
Sex: F
Age: 58
State:

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies: Pt w/ hx of allergy to Sulfa medications (hives).

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: "Pt w/ hx of allergy to Sulfa medications (hives). PMH significant for Sjogren's disease, enlarged liver, hypothyroidism, DM. Other PMH/medications unknown to this writer. 3mins post vaccination, pt had a syncopal episode. Pt c/o feeling floppy, warm. Of note, the pt had nothing by mouth all day. Vitals: BP 169/98, HR 97, O2Sat 98% -- > 148/90, 78. Pt symptons self resolved w/ in 5mins of monitoring."

Other Meds: Unknown

Current Illness:

ID: 1709456
Sex: M
Age: 75
State: NV

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: NONE

Allergies: NKDA

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

Symptoms: NONE

Other Meds: YES

Current Illness: NO

ID: 1709457
Sex: F
Age: 28
State: GA

Vax Date: 09/13/2021
Onset Date: 09/14/2021
Rec V Date: 09/17/2021
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, treated at home

Allergies: Penicillin, doxycycline, propanalol

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

Symptoms: Dizziness, brain fog, fatigue, sore and swollen arm with raised red, hot lump, nausea

Other Meds: Zoloft, Zyrtec, hydroxyzine, protonix, probiotics, vitamins, rosuvastatin, Xanax

Current Illness: Sinus infection 1 week prior

ID: 1709458
Sex: F
Age: 61
State: CA

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: I have had a number of Xrays, a CT Scan, an MRI and blood work. The blood work has been normal with the exception of inflammation markers. Had a second MRI for which I am currently waiting on the results.

Allergies: Macrodantin (antibiotic)

Symptom List: Unevaluable event

Symptoms: I took the first Pfizer shot on 7/14 and have been experiencing challenging issues ever since. The issues began four hours after receiving the vaccine. I experienced the expected flu like symptoms for which I was not concerned, assuming they would soon subside. However, later that day, and in the days and weeks following I experienced horrible side effects. The first week, symptom included extreme spikes in blood pressure (i.e. 220+/130+), extreme drops in blood pressure, chest pain, arm and hand numbness, nauseousness, dizziness, inability to speak, severe headaches and head pressure. These symptoms would come in waves and sent me to the Emergency Room four times via paramedics with no resolution. In the weeks following, the symptoms continued and also included bouts of an adrenaline like feeling throughout my body resulting in nauseousness and sleeplessness. In addition, a wave of severe pain in my head, neck and spine accompanied by a severe spike in blood pressure sending me to the Emergency Room for the 5th time within four weeks. The doctors that have treated me do not know why I am having these issues since receiving the vaccine, and therefore are unable to diagnose and cure me of these symptoms. Multiple doctors have told me that the mRNA vaccine technology is ?new? and there are many unknowns. Let me tell you, this does not make me feel at ease at all. Aside from the ER and urgent care doctors, I have seen my primary doctor, an internal medicine doctor, and infectious disease doctor, a neurologist and am scheduled to see a cardiologist in the coming weeks. I have had a number of Xrays, a CT Scan, an MRI and blood work. The blood work has been normal with the exception of inflammation markers. It has now been a little over two months since I have had the vaccine and my episodes seem to be coming farther apart. I am cautiously optimistic that the worst if over, but have felt this way several times before, then hit with another wave. I honestly feel that if I ever receive shot #2, I would not survive.

Other Meds: vitamin C and vitamin D

Current Illness:

ID: 1709459
Sex: F
Age: 21
State: IN

Vax Date: 09/16/2021
Onset Date:
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: My arm broke out into a giant oval rash

Other Meds: Buspirone

Current Illness: None

ID: 1709460
Sex: F
Age: 53
State: FL

Vax Date: 04/07/2021
Onset Date: 07/12/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: 8/14/2021 Hospital, Dr. EKG and Ultra Sound of legs. No results just told to follow up with primary care. I mentioned the possibility it was the vaccine, they did not agree. 8/25/2021 Primary care who examined swollen ankles and ordered blood panel, received prescription for swelling Meloxicam 7.5mg 1xday, does not help much. 9/9/2021 sent me to ER because of EKG, saw Dr. there for 2 days many tests for heart and ankle swelling.

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: 7/12/2021 Extreme swelling of the ankles and joint pain in hands, ankles and knees. 8/13/21 MD Live video appointment with doctor, advice was to go to ER. 8/14/21 attended ER, received Ultra Sound of legs for blood clots and EKGs. Doctor stated it could be Edema. 8/25/21 visited primary care doctor, he ordered a blood panel for all possibilities (arthritis, gout, sugar/salt in the blood, red/white blood cells, viruses, disease = all negative). Received anti-inflamatory for ankles Meloxicam 7.5mg 1xday, helps swelling slightly. 9/9/2021: Primary care for follow up of blood work, ankle swelling and joint pain, following an EKG during check up, fluttering of the heart was severe, I was admitted to Hospital for 2 days of monitoring my heart rate, blood pressure, and possibility of lime tick disease or zyga disease (results have not returned). Discharged from hospital with no answers, prescription for Metoprolol 25mg 1xday for fluttering. EKG showed no damage in heart, not sure what the fluttering is from, would happen even while sound asleep.

Other Meds: Bupropion 150mg 1xday

Current Illness: None

ID: 1709461
Sex: F
Age: 49
State: WI

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: 9/13 xrays

Allergies: Sulfa drugs

Symptom List: Injection site pain, Menorrhagia

Symptoms: Day 1 shortness of breath, as soon as the vaccine went on my chest was tight. I had to use inhaler to breath. Day 3 body swollen and hip joint painful to the point that I could not walk. X-rays show no injuries or break. Day 7 body still swollen after 13 years of no vaginal bleeding as I had ablation surgery, I am spotting, breast swollen, skin itches due to being stretched due to swelling.

Other Meds: Zinc, Vitamin D and C

Current Illness: None

ID: 1709462
Sex: M
Age: 60
State: OR

Vax Date: 07/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
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: NONE

Other Meds: ### Got the first Moderna vaccination on 07/16/2021. Got the Janssen vaccination on 07/23/2021 and the second Moderna vaccination on 08/19/2021. I have had NO adverse reactions from the vaccinations at all.###

Current Illness: none

ID: 1709463
Sex: M
Age: 12
State: SC

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
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: N/a

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Chills, Fever, nausea, vomiting

Other Meds: None

Current Illness: None

ID: 1709464
Sex: M
Age: 9
State: NJ

Vax Date: 09/09/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies: Seasonal shell fish

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Had a rash on left arm next day late evening, asked mom to give benadryl This helped , rash is gone completely. MOm had applied ice on the arm

Other Meds: Benadryl liquid,

Current Illness:

ID: 1709465
Sex: M
Age: 59
State: WA

Vax Date: 09/10/2021
Onset Date: 09/16/2021
Rec V Date: 09/17/2021
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: Feet are noticeably swollen. Veins always visible, not feet are slightly puffy and smooth. Heart rate dropped from typical 60-62bpm to 50bpm.

Other Meds:

Current Illness:

ID: 1709466
Sex: M
Age: 42
State:

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
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: Keflex, erythromycin, amoxicillin, penicillin, Sulfa drugs, aspirin, antidepressants (all according to pt)

Symptom List: Nausea

Symptoms: Patient has history of allergies (confirmed no allergies to polysorbate or ethanol). Patient began to experience nausea, dizziness at end of 30 minute wait post-vaccination, and stated he did eat and was drinking water. Patient did not state he was experiencing any shortness of breath or anaphylactic symptoms. Asked patient to remain seated so I could monitor him further and to immediately report if he started experiencing any shortness of breath or anaphylactic symptoms. Patient started experiencing shortness of breath about 10 minutes later, and he self-administered an EpiPen prescribed to him that he brought with him. Pharmacy staff immediately called 911, patient was monitored and appeared in no acute distress and was talking normally. EMS arrived and examined patient. Patient was determined to have recovered and was cleared by EMS to return home without any further treatment, and patient was not taken to the hospital.

Other Meds: Promethazine

Current Illness: None reported

Date Died: 09/14/2021

ID: 1709467
Sex: F
Age: 36
State: CA

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: pending coroner report

Allergies: NKA

Symptom List: Injection site pain

Symptoms: Patient came in after an ER visit for a reported intentional opioid overdose. She was doing ok at the visit, some minor wheezes on exam. She had requested refills on meds and reported having worsening asthma after her first shot but no ER visits. We decided to give her the second moderna shot due to her high risk should she contract covid 19 and sent her home with a course of prednisone in case of exacerbation. RN administered injection and had her wait in the room after the visit per protocol, patient was doing fine and was sent home. We found out several days later she passed away at home according to a coroners report of reported possible asthma exacerbation versus drug overdose, still being investigated. coroner reported finding drug paraphernalia at the scene and case is pending tox screen results.

Other Meds: nicotine 21 mg/24 hr daily transdermal patch, Ventolin HFA 90 mcg/actuation aerosol inhaler, prednisone 20 mg tablet, albuterol sulfate 2.5 mg/3 mL (0.083 %) solution for nebulization, Advair Diskus 500 mcg-50 mcg/dose powder for inhalation

Current Illness: asthma exacerbation, drug overdose

ID: 1709468
Sex: F
Age: 18
State: CT

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
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

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

Symptoms: After giving patient the shot, a few minutes after she felt like she was going to pass out. Per mom who was with patient, patient passed out for a few seconds. I ran to the patient, who was pale but alert and oriented.

Other Meds: no

Current Illness:

ID: 1709469
Sex: M
Age: 69
State: NC

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: see doctors.

Allergies: sulfur

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

Symptoms: Injury from Pfizer vaccine for Covid 19. First vaccine on 1/29/21 caused a rash on leg and sick all over, when to urgent care for treatment.The second vaccine on 2/19/21 caused swollen lips, red gums, that causes me pain, and when I smile or laugh when ever lips are stretched. Behind lips feel like burned skin. When washing mouth out with listerline I see lose skin. Using a lip medicated numbing ointment for gums and lips . I take buprofen along with Benadry for my condition. Also tip of tongue turned red with lose of taste of food. My condition has not changed, expect for leg and I'm still sick. I have seen family doctor and dentist for my condition.

Other Meds: eliquis,rosurvastatin,furosomide,lurazspam,pnegabalin,ropininole,tadalafil

Current Illness: none

ID: 1709470
Sex: F
Age: 67
State: MI

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/17/2021
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: penicillin, aspirin

Symptom List: Tremor

Symptoms: Rash developed shortly after vaccine on right arm. About halfway between shoulder and elbow (not including the injection site). Rash is about 4 inches tall and 3 inches wide. Rash is itchy and warm. Pt informed pharmacy about the rash on 9/17/21 and is still present, not improving. Advised patient to take benadryl and call back if things develop further.

Other Meds: Metformin Trazodone Simvastatin Duloxetine Losartan Amlodipine Lyrica

Current Illness:

ID: 1709471
Sex: M
Age: 39
State: OK

Vax Date: 09/02/2021
Onset Date: 09/03/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: I had covid tests ran on 14Sep2021 rapid test was negative they also ran the long test and it came back negative on 17Sep2021. The 14th I had blood sample taken at same place. the 14th I also went to Urgent care at xpress wellness urgent care. they tested my blood sugar and it was 154, the previous blood tests showed 88. There was only about 3 hours difference.

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: On the 2nd i felt no symptoms. the 3rd i was aching and headache and dizzy when i stood up, plus was feeling slightly warm no raised temp. 4th started to run a 100 degree F temperature during the night and dizziness and headache. 5th headaches were gone. aches were gone. dizzy spells didnt start until after 3pm. 6th no dizzy spells. no headache. later in the afternoon i had tunnel vision really hard to concentrate. had no appetite. 7ththrough the 15th throughout the day had slight dizzy spells towards the evening had headaches and fatigue. 16th throughout the day had slight dizzy spells towards the evening had fatigue but didnt have headaches. 17th No fatigue only one or two dizzy spells no headache.

Other Meds: Vitamin D3 - 4000 units, fish oil - 1200 mg, magnesium glycinate chelate - 500mg, vitamin K2 - 100 mcg, famotidine - 20mg, atorvastin calcium - 20mg, vitamin c with rose hips - 1000 mg, bayer asprin - 81 mg

Current Illness: None

ID: 1709472
Sex: F
Age: 21
State: NM

Vax Date: 09/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/17/2021
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: Watermelon Cantaloupe

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

Symptoms: About 15 minutes after getting the shot I became extremely lightheaded and felt like I could not breathe. The medical staff on sight took my vitals and my BP was 138/89 and my HR was 140. They also saw narrowing of my airway. I took some Benadryl and my symptoms improved enough for someone to pick me up from the site. I also had swollen lips during the reaction and for about 3 hours after. I then went to the health center on campus and stayed there for about 3-4 hours for observation. At the clinic the doctor saw redness in my throat and swelling of my uvula. At the end of observation the swelling was down but my throat was still pretty red.

Other Meds: Pill birth control

Current Illness: N/A

ID: 1709473
Sex: F
Age: 28
State: OR

Vax Date: 09/12/2021
Onset Date: 09/12/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: Repeat covid test at urgent care, awaiting results. 9/17/2021

Allergies: Ciprofloxacin Ciprofloxacin Anaphylaxis, Itching High 7/10/2017 Past Updates Rocephin [Ceftriaxone] Rocephin [Ceftriaxone] Anaphylaxis High 8/19/2017 Past Updates Zithromax [Azithromycin] Zithromax [Azithromycin] Anaphylaxis High 8/19/2017 Past Updates Uncoded Nonscreenable Allergen Not Specified 4/16/2016 Past Updates Pt states "i'm allergic to some abx but i don't know what the names is. i get itchy and feel like it can't breath and get hot inside"

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

Symptoms: Patient complains of vaccine reaction after getting COVID vaccine on Sunday, "I just feel dumb", "I don't know what is happening", "it feels less today", "thinking and speaking were hard", "really drowsy" the next day, "feeling better today", "red lump where I got the injection", "swollen, itchy, warm" just noticed today in the morning, some swelling of face on Tuesday but resolved next day, "I took Tylenol with relief", "headache that doesn't go away" "5/10, not painful just annoying" "felt warm inside". 9/16/2021

Other Meds:

Current Illness:

ID: 1709474
Sex: F
Age: 28
State: PA

Vax Date: 09/12/2021
Onset Date: 09/13/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: pending.

Allergies: Augmentin, Papaya, Metrogel, Topiramate

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient began having blooding diarrhea the morning after vaccination. Has history of hemorrhoids with mild bleeding about 2 years prior. Patient reports that this was occurring with bowel movements only. was occurring about 6-7 times per day and then gradually decreased. Still having rectal bleeding with bowel movements, painless.

Other Meds: none.

Current Illness: chronic stomach discomfort (undiagnosed)

ID: 1709475
Sex: M
Age: 28
State: NY

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: none

Allergies: none

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

Symptoms: patient fainted after receiving his vaccine. we were able to get him onto the floor before he fell out of the chair. we gave him an ice pack and some water when he came to, he quickly regained his color and was feeling much better after the 15 minute wait time.

Other Meds: unknown

Current Illness: unknown

ID: 1709476
Sex: M
Age: 67
State: MN

Vax Date: 03/15/2021
Onset Date: 07/08/2021
Rec V Date: 09/17/2021
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: Unknown test and Labs, will follow up with Doc.

Allergies: NKA

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

Symptoms: 8th July early morning, pain in chest and left arm, loss of breath for 15-20 min. Advised to visit ER. Confirmed Heart Attack. Covid test given and came back negative, quickly gave IV and do not know what kind was given. Stint op.

Other Meds: Losartan; omeprazole; fish oil; Centrum Silver multivitamin; D3

Current Illness: None

ID: 1709477
Sex: F
Age: 25
State: ID

Vax Date: 09/14/2021
Onset Date: 09/15/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: Not yet taken

Allergies: None

Symptom List: Pain in extremity

Symptoms: Heart Palpitations

Other Meds: Lamictal Bupropion

Current Illness: None. Shortness of breath for a short time 2 days before vaccination but dispersed 1 day before vaccination

ID: 1709618
Sex: M
Age: 40
State: TN

Vax Date: 08/17/2021
Onset Date: 08/27/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Swollen lymph node in left armpit

Other Meds:

Current Illness:

ID: 1709619
Sex: F
Age: 37
State: FL

Vax Date: 08/06/2021
Onset Date: 08/07/2021
Rec V Date: 09/17/2021
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 received the Moderna vaccine, 1st dose on 8/6/21, staring 8/7/21 patient experienced severe abdominal cramping/pain and diarrhea that persisted for 2 weeks and led to an ER visit.

Other Meds:

Current Illness:

ID: 1709620
Sex: M
Age: 68
State: CO

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Patient informed pharmacy this was his first covid vaccine. After administration he then stated he had received the Jannsen months ago.

Other Meds: n/a

Current Illness: n/a

ID: 1709621
Sex: M
Age: 69
State: PA

Vax Date: 02/19/2021
Onset Date: 08/01/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: Sars CoV 2 RNA (Covid 19), Quallitative NAAT - Result DETECTED 08-04-2021

Allergies: None known

Symptom List: Vomiting

Symptoms: Came down with Covid 08-01-2021

Other Meds: Lipitor 20 mg, Alendronate, Prednisone 15 mg, Vitamin C 500 mg, Vitamin D3 2000 IU, Flaxseed Oil 2000 mg, Multi Vitamin, Co Q-10 100 mg

Current Illness:

ID: 1709622
Sex: F
Age: 21
State:

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: X-rays, CT?s, ultrasound and many blood tests

Allergies: No

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Severe chest pain, shortness of breath, dizziness, sore jaw. High d dimers with no clots on lungs. Inflammation of chest muscles. Painkillers and wait it out.

Other Meds:

Current Illness: No

ID: 1709623
Sex: F
Age: 28
State:

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: vaccine was administered after being improperly stored. vaccine should have been removed from the freezer on 9/3, but was not removed until 9/8 and was then administered to the patient.

Other Meds:

Current Illness:

ID: 1709624
Sex: M
Age: 64
State: ND

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 09/17/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Got light headed around 5. Went in the house and sat down. My vision was blurry for about 45 minutes. And the next day my vision got blurry around 10:00 am for about a half an hour. Then all was good.

Other Meds: Rosuvastatin,metformin,centrum multivitamin,b-12,magnesium

Current Illness: None

ID: 1709625
Sex: M
Age: 22
State: OH

Vax Date: 09/07/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: None known

Allergies: None known

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

Symptoms: The patient failed to mention that he had a previous dose of Johnson & Johnson COVID-19 vaccine earlier in 2021. He said his doctor told him to go ahead and get the Pfizer or Moderna vaccine since it posed no "contraindications". Patient has reported NO adverse event to this vaccine combination to date.

Other Meds: None known

Current Illness: None known

ID: 1709626
Sex: F
Age: 66
State: VA

Vax Date: 09/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: Cusstomer evaluated by primary care physician and given antibiotics for cellulitus

Allergies: codienes, xray dye

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

Symptoms: Customer arm started to hurt within first hour of receiving the shot, it worsedned overnight and "peaked" with immobility on 09/16/2021; customer presented with red swollen arm, warm to touch. The redness encompassed the whole upper left arm and appeared to me moving down past the elbow.

Other Meds: Yuvafem, losartan,atorvastatin, levothyroxine, vitamin D, loratidine,pantoprazole,advair,proair

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am