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: 1713515
Sex: M
Age: 59
State: TX

Vax Date: 09/05/2021
Onset Date: 09/06/2021
Rec V Date: 09/18/2021
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: Penicillin, Vancomycin, Bactrim

Symptom List: Dysphagia, Epiglottitis

Symptoms: In addition to the 2 previous adverse event reports, upon wakeup on 09/06/2021 around 7:00am.....severe headache was experienced after elevated fever/chills experienced, and broken, the night before.

Other Meds: None

Current Illness: None

ID: 1713516
Sex: F
Age: 51
State: OH

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/18/2021
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: Patient reported about 10 minutes after getting vaccine she was having numbness on ear and decreased vision. Patient was with family and was advised to seek care from her physician or ER , but she did not say if she was going to seek care. Patient was asked to follow back up with us with outcome.

Other Meds:

Current Illness:

ID: 1713517
Sex: F
Age: 52
State: NY

Vax Date: 09/04/2021
Onset Date: 09/11/2021
Rec V Date: 09/18/2021
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: CT with contrast - 9/13/21 Bloodwork - 9/13/21 MRA - 9/14/21

Allergies: Aspirin

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

Symptoms: Numbness/tingling right arm/hand, numbness right side of face, dizziness, confusion, nausea, vision disturbance, vertigo, headache, lethargy

Other Meds: Levothyroxine, Clopidogrel, Cetirizine, Vitamin C, Vitamin D-3, Fish Oil, Centrum Silver, Biotin, PreserVision

Current Illness: None

ID: 1713518
Sex: M
Age: 39
State: CA

Vax Date: 09/01/2021
Onset Date: 09/15/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Fever, chills, swollen tonsils, body aches, sweating, nausea, fatigue. 5 days after vaccine.

Other Meds:

Current Illness:

ID: 1713519
Sex: M
Age: 44
State: CA

Vax Date: 08/04/2021
Onset Date: 09/14/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: None to report

Allergies: None

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

Symptoms: Symptoms of Bells Palsy. Facial paralysis on the left side of my face. Cannot smile on the side and some slight drooping. Mild pain behind my ear and a headache only in the left temple area. Odd mouth sensations as well.

Other Meds: None

Current Illness: None

ID: 1713520
Sex: M
Age: 17
State: TX

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/18/2021
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: None

Allergies: None

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

Symptoms: Vaccinated with expired vaccine by 7 days. No adverse reaction.

Other Meds: None

Current Illness: None

ID: 1713521
Sex: F
Age: 39
State: NC

Vax Date: 08/27/2021
Onset Date: 09/18/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I am a nursing mother. I started nursing June 22, 2021. The first shot gave me a reduction in breastmilk. I?ve never really been able to get back to where I was even with additional pumping. I exclusively pump and Measure after each pump. Fire king vaccine, I was pumping 16 to 18 ounces per day. I dropped is low and 12 ounces and I?m currently between 14 and 16 ounces per day. It has been four weeks since my first vaccine.

Other Meds: Bariatric prenatal Vitamin Calcium Magnesium Protonix 40mg Cymbalta 60mg Lamictol 100mg Trazadone 25mg

Current Illness:

ID: 1713522
Sex: F
Age: 26
State: AZ

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 09/18/2021
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: Pharyngeal swelling

Symptoms: Ringing in my ears (tinnitus)

Other Meds: None

Current Illness: None

ID: 1713523
Sex: F
Age: 52
State: NY

Vax Date: 09/12/2021
Onset Date: 09/15/2021
Rec V Date: 09/18/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Wednesday 09/15/21 overnight into Thursday morning, patient noticed a rash developed at the injection site and started to spread up until Friday. The rash was about 6-7 inches long and 2-3 inches wide, red/warm to touch. Patient also experienced Monday afternoon malaise and fever of about 100F for couple hours. By Tuesday afternoon, patient "felt fine". On Friday afternoon, patient was unable to reach her PCP but left a message. Instead, patient went to see an urgent care doctor and was told the rash was a giant hive that had developed at the injection site. She was prescribed Levocetirizine 5mg and Triamcinolone 0.1% cream to treat the rash. On Saturday afternoon, patient has since applied the cream three times and taken one tablet of the Levocetirizine. She says the rash at the exact injection site is fading but minimal change overall since just started treatment. Patient will see a dermatologist on Tuesday and will have a consult.

Other Meds: Levothyroxine 50mcg

Current Illness: None

ID: 1713524
Sex: F
Age: 13
State:

Vax Date: 09/04/2021
Onset Date: 09/04/2021
Rec V Date: 09/18/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Attendee received first dose Pfizer vaccine at shortly before 16:45 in the arm. Lot# unknown. Attendee was watching her father get vaccinated, when she fainted and hit her head with a loss on consciousness of 10 seconds in duration. No fall injuries noted. 16:45 - Attendee's skin was Cool, clammy and pale. Complains of dizziness/lightheadedness. HR: 75 BP: 96/58 RR: 20 O2Sat%: 99 16:47 ? 911 called 16:50 - Attendee laying down on the floor waiting for EMS. Alert and oriented x 4. HR 91 BP: 108/66 RR: 20 O2Sat%: 98 16:55 - Attendee laying down on the floor waiting for EMS. Alert and oriented x 4. HR: 92 BP: 112/74 RR: 20 O2Sat%: 96. 17:00 - Attendee laying down on the floor waiting for EMS. Alert and oriented x 4. Attendee has developed a headache. HR: 93 BP: 118/76 RR: 20 O2Sat%: 97 17:04 - EMS arrived on scene and took over care of the attendee. HR: 96 BP: 122/72 RR: 20 O2Sat%: 100 17:09 - EMS attempted to get standing vital signs and the attendee fainted again, so she was placed on the gurney and taken via ambulance to the emergency room.

Other Meds:

Current Illness:

ID: 1713525
Sex: F
Age: 41
State: CA

Vax Date: 05/29/2021
Onset Date: 06/06/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: NKA. Mentioned to doctor.

Allergies: NKA

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

Symptoms: Menstrual cycle active bleeding lengthened to 13 days. Bleeding started a week earlier than due and was very heavy. This occurred for three cycles in a row. Two of the cycles were anovulatory for no other reason. Ovulation resumed in early September.

Other Meds: Multivitamin

Current Illness: None

ID: 1713526
Sex: F
Age: 78
State: AZ

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/18/2021
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

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Nausea upon waking, no vomit, passed out, profuse sweating. Feeling ill most of the day. Slow recovery next day.

Other Meds: Sertraline 25mg Calcium 1200mg Multivitamin

Current Illness: None

ID: 1713527
Sex: F
Age: 30
State: PA

Vax Date: 02/11/2021
Onset Date: 05/17/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Long Menstruations. Menstruations lasting 4+ weeks

Other Meds: None

Current Illness: None

ID: 1713528
Sex: F
Age: 61
State: MO

Vax Date: 09/15/2021
Onset Date: 09/17/2021
Rec V Date: 09/18/2021
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: NKA

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

Symptoms: Deltoid area of left arm had large red, itchy rash. Patient reported temperature of 99.3F during the night after her immunization.

Other Meds: OMEPRAZOLE 20MG; LISINOPRIL/HCTZ 10/12.5; LEVOTHYROXINE 50MCG

Current Illness: NONE

ID: 1713529
Sex: M
Age: 45
State: OH

Vax Date: 04/20/2021
Onset Date: 04/23/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Blood work, xrays, urine

Allergies: None

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

Symptoms: Very lethargic, pain on both sides of lower back seemingly Kidney area, developed pneumonia.

Other Meds: None

Current Illness: None

ID: 1713530
Sex: F
Age: 38
State: TX

Vax Date: 01/27/2021
Onset Date: 04/15/2021
Rec V Date: 09/18/2021
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: 4/18/21 - 4/22/21 several labs and visual evidence of swollen lymph nodes and lesions confirmed shingles

Allergies: None

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

Symptoms: On 4/15/21, I woke up to a largw swollen lymph node on base of neck (left side). Neck was sore and couldn?t move it for days. Days later I began experiencing shocks in my head and lesions forming in abs in my left ear. On 4/22/21, I went to the hospital where I was diagnosed with shingles. As a 38 year old, I couldn?t understand why I had a shingles outbreak but the doctors explained that they gave seen an increase in younger patients who had chickenpox as children have the herpes zoster virus reactivated in them within 3 months after getting the vaccine.

Other Meds: Metoprolol 100mg daily Velophoro 800mg w/every meal Vitamin D 50mg Daily

Current Illness: None

ID: 1713531
Sex: F
Age: 34
State: VA

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/18/2021
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: none

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

Symptoms: Patient was here for 2nd dose of COVID-19 shot, I went over with patient whether there was any reaction after first shot she said no she was fine, I then administered the shot. After about 5 minutes of patient waiting in the post vaccination area she came to the window and stated that she felt faint and at that point I asked that she have a seat while I spoke with her and she stated that she now felt that her throat was itching. I offered her a bottle of water after her initial comment that she felt faint however when she stated that her throat was itching I gave her one dose of 5ml Benadryl and asked that she continue to wait in the post vaccination area. After another 10 minutes she stated that she no longer felt faint but her throat was still scratchy, I offered her another dose of Benadryl but she stated that she would buy some oral tablets and then she left.

Other Meds:

Current Illness: none

ID: 1713532
Sex: F
Age: 41
State: NC

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/18/2021
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: Latex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Bad pain and swelling under left armpit still there today. Cannot touch. Headache and body ache in bones and muscles.

Other Meds: Multivitamin (no other meds).

Current Illness: None

ID: 1713533
Sex: M
Age: 35
State: PA

Vax Date: 09/13/2021
Onset Date: 09/14/2021
Rec V Date: 09/18/2021
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: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient called pharmacy 9/14/21@9:30 am and stated that he just cooked eggs around 9:00 and about 20 minutes later he was having SOB. He could only take about 1/4 breath, vision was not normal, couldn't move, went to ER. ER did not think this was related to shot though. However, Patient believes it is related to shot. The ER diagnosed him with dehydration and sent him home. Followed up with patient on 9/15/21 @7pm and he said that overnight has had fever from 101-102, hot and cold, sweats, joint pain, back pain, diarrhea, dizzy, tired, muscle aches, no appetite, throwing up, headache, ear pain, very foggy brain, lightheaded, his primary doctor made an appointment for him for 5 days, they require a negative covid test to be seen. I called Moderna also to report and was given a case # MOD21-143961, patient was not interested in calling the company to update them on his symptoms. Patient was ok with Moderna dose #1, just happened with #2.

Other Meds: unknown

Current Illness: none reported

ID: 1713534
Sex: F
Age: 27
State: OR

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: My period shortened in length starting the month after I was vaccinated. Specifically, the luteal phase of my period shortened from 14 days to 9 days and has stayed consistent at 9 days ever since.

Other Meds: Zoloft 50mg

Current Illness:

ID: 1713535
Sex: F
Age: 25
State: OH

Vax Date: 09/01/2021
Onset Date: 09/11/2021
Rec V Date: 09/18/2021
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: Chest X-ray ECG DDimer CBC & differential Troponin Sept 16, everything normal except higher WBC

Allergies: N/a

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

Symptoms: I went to pharmacy to get my shot in. All was well until 3-4 days after when I began having chest pain and weird sensations in my extremeties. I started having tingling in my hands and legs that turned to numbness. I would get shoots of pain throughout my body, legs, hands, arms, feet, head. I also began feeling weak. I ended up going to the hospital to get checked out and the doctor said I was probably having an adverse reaction to the vaccine.

Other Meds: Progesterone Blisovi Metformin ( For pcos ) Lexapro Buspar

Current Illness: N/a

ID: 1713536
Sex: M
Age: 40
State: MO

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Patient described pain in extremities, difficulty breathing consistent with GBS. Patient was advised to wait to get 2nd dose until seen by his PCP. Patient stated he just started feeling back to normal after 3 weeks

Other Meds:

Current Illness:

ID: 1713537
Sex: M
Age: 74
State: KS

Vax Date: 08/12/2021
Onset Date: 08/16/2021
Rec V Date: 09/18/2021
Hospital: Y

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

Lab Data: I do not know.

Allergies: Drixoral, prednisone

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

Symptoms: Patient received vaccine 8/12/2021. Beginning 8/16/2021, he experienced SOB and was not able to walk comfortably, even for short distances. He contacted doctor on 8/19 or 8/20/2021. Discovered blood clots throughout his entire body. Hospitalized from 8/27 to 8/31/2021. Released on blood thinner; however, patient is unable to say which medication.

Other Meds: Baby Aspirin but patient refuses to provide any other information. He is not a customer here, so I am unable to provide additional information.

Current Illness: none

ID: 1713538
Sex: F
Age: 17
State: CO

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

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

Lab Data:

Allergies: PENICILLIN

Symptom List: Injection site pain, Pain

Symptoms: PATIENT WAS WALKING OUT TO HER CAR WITH HER FATHER AFTER GETTING HER SHOT AND BEGAN TO FEEL LIGHTHEADED. SHE PASSED OUT ON THE PAVEMENT AND WAS UNCONSCIOUS FOR APPROXIMATELY 3 MINUTES. HER FATHER WHO IS A NURSE ENSURED SHE WAS SUPPORTED. SHE RECOVERED SHORTLY AFTER AND REPORTS THAT SHE IS FEELING OK NOW. PATIENT DID NOT WAIT THE 15 MINUTES RECOMMENDED AFTER RECEIVING HER VACCINATION BEFORE LEAVING THE STORE.

Other Meds: SERTRALINE 25 MG DAILY

Current Illness: NONE

ID: 1713539
Sex: M
Age: 32
State: CA

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

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

Lab Data: n/a

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: On Saturday, September 18, 2021 client came to vaccination POD for his first Covid-19 Pfizer dose. Client stated to staff during check-in process that he was vaccinated with Cansino Covid-19 vaccine four months ago without proof of vaccination. At this time Cansino Covid-19 vaccine is not a vaccine approved by the WHO. Elevated to Medical team who approved client to get the Pfizer vaccine as it has been more than 28 days since receiving the one dose of non-FDA-authorized Covid-19 Cansino vaccine. Client has no history of allergies or previous adverse reactions to other vaccines. Client was to be a 15 minute wait in the Observation Area. Client received his first dose of Covid-19 Pfizer dose (LOT #: FF8839) at approximately 11:30am in his left arm. Client experienced no adverse reaction while waiting in Observation Area and left vaccination site with a steady gait at 11:55 am.

Other Meds: n/a

Current Illness: n/a

ID: 1713540
Sex: F
Age: 28
State: FL

Vax Date: 09/16/2021
Onset Date: 09/18/2021
Rec V Date: 09/18/2021
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: Avocado

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

Symptoms: Severe fatigue, nausea, vomiting, diarrhea, confusion, moderate headache and complete inability to move left arm/shoulder/hand.

Other Meds: Symbicort; Singulair; DuoNeb nebulizer (as needed); Albuterol (as needed); Tylenol (as needed); Diazepam (as needed)

Current Illness: Status asthmaticus (resolved, hospitalized 9/7/2021-9/8/2021).

ID: 1713541
Sex: F
Age: 41
State: PR

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 09/18/2021
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: CBC, urinalysis, semi plastic, videos 250 J&J videos 4600, lipid panel 07/07/2021, same analysis 7/20/2021, x-ray 7/16/2021, CT-scan 8/18/2021, neck sonogram 8/17/2021, x-ray 8/18/2021, CBC 8/18/2021; X-ray 8/18/2021; CBC-8/18/2021

Allergies: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Tachycardia, fatigue, chest pain continued left arm. fatigue, neck pain left side, nose bleed right nostril. Blood-violet color bruises on both arms, both thighs and legs, bleeding from anus and urethra, extreme tiredness, swelling on both wrist and fingers and ankles and feet, dizziness, swollen lymph nodes left arm, both swollen breast, swollen face and neck

Other Meds: N/A

Current Illness: N/A

ID: 1713542
Sex: M
Age: 73
State: WA

Vax Date: 03/02/2021
Onset Date: 04/06/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Aug 27, 2021: COMPREHENSIVE METABOLIC PANEL; CBC WITH DIFFERENTIAL; UA, MICROSCOPIC IF INDICATED; PROTEIN/CREAT RATIO,URINE; C-REACTIVE PROTEIN; TSH; SEDIMENTATION RATE, MANUAL; HEMOGLOBIN A1C; URINALYSIS, MICROSCOPIC; SED RATE; Jul 27, 2021: C_REACTIVE PROTEIN; COMPREHENSIVE METABOLIC PANEL; CBC (HEMOGRAM) Jul 16, 2021: BASIC METABOLIC PANEL; THYROID STIMULATING HORMONE; LIPID PANEL; A1C RAPID, ONSITE; BASIC METABOLIC PANEL Jun 15, 2021: X-Ray; ECG 12-LEAD Jun 12, 2021:CORONAVIRUS-19 Jun 11, 2021: Ultrasound May 28, 2021: MICROALBUMIN/CREAT URINE RATIO; PROTEIN/CREAT RATIO,URINE; COMPLETE UA, CULT IF INDICATED; URINALYSIS, MICROSCOPIC; CBC; BASIC METABOLIC PANEL; PROTEIN/CREAT RATIO,URINE; PHOSPHORUS; HEPATIC FUNCTION PANEL; ANA SCREEN (REFLEXIVE); ANTI NEUTROPHIL CYTOPLASMIC ANTIBODY; GLOMERULAR BASEMNT MEMBRANE AB; C3 COMPLEMENT; C4 COMPLEMENT; KAPPA/LAMBDA, FREE, SERUM; PROTEIN ELECTROPHORESIS, URINE; PROTEIN ELECTROPHORESIS SERUM; HEPATITIS B SURFACE ANTIGEN; HEPATITIS B SURFACE ANTIBODY; HEP B CORE ANTIBODY, TOTAL; HEPATITIS C ANTIBODY; IMMUNOFIXATION, URINE RANDOM; POCT PERFORM URINE DIPSTICK Apr 21, 2021: CREATININE, URINE; URINALYSIS WORKUPC; SODIUM & POTASSIUM, URINE; URINALYSIS MICROSCOPIC Apr 21, 2021: SED RATE; C_REACTIVE PROTEIN; COMPREHENSIVE METABOLIC PANEL; CBC (HEMOGRAM) Apr 6, 2021: SED RATE; C_REACTIVE PROTEIN; COMPREHENSIVE METABOLIC PANEL; CBC (HEMOGRAM) Feb 20, 2021: VITAMIN D (25 HYDROXY) May 12, 2020: THYROID STIMULATING HORMONE May 5, 2020: CBC, DIFF; COMPREHENSIVE METABOLIC PANEL; C_REACTIVE PROTEIN

Allergies: penicillin, strawberries

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: During routine COMPREHENSIVE METABOLIC PANEL on 04/06/2021 due to treatment with NASID and Infliximab treatments for ANKYLOSING SPONDYLITIS a sudden drop in KIDNEY FUNCTION from EFGR >60 mL/min/1.73 to 41 mL/min/1.73 was noted. Subsequent tests have shown marked loss of KIDNEY FUNCTION to most recent low of 28 mL/min/1.73. In addition CBC indication for RBC (3.92) Hemoglobin (11.4) and Hematocrit (33.5) have all moved below minimal standards. No other procedures or changes in medication occurred during this period.

Other Meds: Levothyroxine, Amlodipine, Atorvastatin, Clopidogrel, Furosemide, Metoprolol Succinate ER, Potassium Chloride ER, Montelukast, Cyclobenzaprine, Tramadol, Infliximab, Celecoxib (stopped), Vitamin D3. All taken on advice of doctor.

Current Illness: ankylosing spondylitis

ID: 1713543
Sex: F
Age: 34
State: CA

Vax Date: 09/04/2021
Onset Date: 09/13/2021
Rec V Date: 09/18/2021
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: Dairy, eggs

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

Symptoms: Initial listed reactions began an hour after receiving injection on 9/4/2021. One side affect I experienced that was not listed was an extreme hunger and strong food cravings which is very out of the ordinary for me. I have a small appetite and eat extremely healthy, avoiding most salt, all fried foods, oil, and sugar that does not come naturally from fruit and vegetables. After a few days of extreme fatigue, nausea, and body aches, I began to feel normal again. On 9/13/2021, 9 days after receiving the vaccine, I began experiencing extreme stomach pain, nausea, severe diarrhea, extreme fatigue, headaches, and nasal and chest congestion. All of these symptoms except for the diarrhea, which lasted for about 12 hours the night of 9/13, have continued for a week. I am due for my second dose on 9/25 and I am still very ill from the first one.

Other Meds: Adderall 20mg XLR Clonazepam 1mg

Current Illness:

ID: 1713544
Sex: F
Age: 62
State: CA

Vax Date: 07/28/2021
Onset Date: 08/02/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Movement in vacinated arm is limited. When trying to extend my arm in certain positions, it feels like my muscle is ripping.

Other Meds:

Current Illness: None

ID: 1713545
Sex: F
Age: 51
State: NH

Vax Date: 06/11/2021
Onset Date: 08/24/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: 8/24/2021 ran CT scan and blood work. Determined that I had a stomach bug. Incidentally found Tarlov cyst on spine of tailbone.

Allergies: unknown

Symptom List: Injection site pain

Symptoms: Went to ER 8/24 - several weeks after last Moderna shot. Intense stomach and back pain.

Other Meds: Flonase.

Current Illness: no

ID: 1713546
Sex: F
Age: 0
State: OH

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

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

Lab Data:

Allergies:

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

Symptoms: itching

Other Meds:

Current Illness:

ID: 1713547
Sex: F
Age: 48
State: IN

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

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

Lab Data: Went to Clinic negative Covid test 9/18 and Rx Zofran. Tyl for days Supplemental vitamin C

Allergies: Cipro Amoxicillin

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

Symptoms: SOB, lips swollen and peeled, felt like I had swallowed acid. My heart rate has been in the 50?s for days (have photo on my pulse ox), fever and chills first 3 days with muscle aches fatigue and feeling like I want to pass out.

Other Meds: None at time of vaccine Didn?t take any of my daily medications that day

Current Illness: No new illnesses one month prior

ID: 1713548
Sex: F
Age: 67
State: AK

Vax Date: 01/17/2021
Onset Date: 09/08/2021
Rec V Date: 09/18/2021
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: None

Symptom List: Tremor

Symptoms: Had what looked to be a superficial blood cot right under the skin on my right hand, in the soft flesh right above my thumb joint. It was purple, enlarged and painful. It lasted 2 days, then went down in size and turned purplish brown like an older bruise. I did not injure myself there. My husband had a similar thing happen before mine, about a week before. He had a purplish raised vein also at the base of his small finger and his finger was numb. It also went away within a few days.

Other Meds: Simvastatin, baby aspirin, multivitamin, 1/2 tablet metoprolol

Current Illness: None

ID: 1713550
Sex: F
Age: 57
State: LA

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/18/2021
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: NSAIDs Penicillin Aspirin Chocolate

Symptom List: Erythema, Pruritus

Symptoms: Swelling of face and ears, itching and urticaria

Other Meds: Levo thyroxine 100mc, Simvastatin 10 mg, Hydroxyzine HCI

Current Illness: Sciatica pain

ID: 1713551
Sex: F
Age: 49
State: PA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 09/18/2021
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: Vicadine

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

Symptoms: Dizziness and heart palpitations upon receiving injection. Red rash, bruising, sore & swollen arm. Fever and masses knot in arm.

Other Meds: None

Current Illness:

ID: 1713552
Sex: F
Age: 41
State: NY

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Blood pressure was 88/58 this morning

Allergies: Penicillins, Cephalosporins, Atovaquone, Dapsone, Bactrim, Azathioprine.

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

Symptoms: Dizziness, near syncope, low blood pressure, headache, body aches, chill, and arm pain

Other Meds: Prednisone, Cell Cept, Adderall, Protonix, Pepcid, Symbicort, Albuterol, Probiotic.

Current Illness: E-coli infection in August

ID: 1713553
Sex: F
Age: 76
State: CA

Vax Date: 01/23/2021
Onset Date: 01/25/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Was placed on Cephalexin 500mg

Allergies: Tetracycline Peanuts

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Cellulitis in injection site, Red swollen and hot at site

Other Meds: Benazepril 5mg T/4T/3 85.5/20.25MCG Allegra 180mg Vit.C 500mg PREG/DHEA 25/10mg Metformin 500mg Vit. D-3 5000iu K2 50mcg MetaGlycemX B-Supreme Fish Oil 1200mg CoQ10 200mg Cholestblend Probiotic Ocuvite Calcium 600mg Benadryl 25mg

Current Illness: No

ID: 1713555
Sex: M
Age: 66
State: NC

Vax Date: 02/26/2021
Onset Date: 05/01/2021
Rec V Date: 09/18/2021
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: Runny nose, even during summer months

Other Meds: Dorzolamide and Timolol ophthalmic,Famotidine,Latanaprost 0.005%,Magnesium,Multi Vitamin,Myrbetriq,Tamsulosin,Vitamin D3,Calcipotriene Cream,Triamcinolone Ontmt.,Oxybutynin,

Current Illness: EPICONDYLITIS, MEDIAL AND LATERAL

ID: 1713556
Sex: M
Age: 57
State: CA

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies: Penicillin.

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

Symptoms: Heart Pain comes and goes.

Other Meds:

Current Illness:

ID: 1713557
Sex: F
Age: 13
State: VA

Vax Date: 07/30/2021
Onset Date: 09/07/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: X-ray - unremarkable.

Allergies: none

Symptom List: Pain in extremity

Symptoms: Severe nerve pain in sole of right foot out of the blue with no injury or other warning or prior pain or injury. Nerve pain spread up right leg to thigh. Unable to walk or put any weight on foot/leg.. X-ray was unremarkable.

Other Meds: None

Current Illness: none

ID: 1713558
Sex: F
Age: 30
State:

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 09/18/2021
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: Soreness at injection site, headache, fever 100 degrees, body aches, fatigue

Other Meds: Escitalopram 10mg, prenatal multi-vitamin, vitamin b-12, vitamin C, collagen

Current Illness: Sinusitis

ID: 1713559
Sex: F
Age: 42
State: WA

Vax Date: 07/30/2021
Onset Date: 07/30/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Will be starting physical therapy and may have tests later

Allergies: Apples, most nuts, soy and other kidney shaped beans

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

Symptoms: Injection site pain, inability to raise arm above shoulder height or lift more than 4 pounds or pull open a door or put on and off shirt without increase in pain and it has not gotten any better in the weeks that have followed. The pain and limited range of motion and use has not improved.

Other Meds: Metformin Multuvitamin and mineral daily supplement

Current Illness: No

ID: 1713560
Sex: F
Age: 63
State: OR

Vax Date: 04/23/2021
Onset Date: 05/18/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Medical testing covering many pages was done. Please see doctor and medical records for details

Allergies: None

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

Symptoms: My Wife appears to have developed SICCA(HCC) AKA: Sjogren's syndrome with the following symptoms: Rapid weight loss, Dry Mouth, Dry Eyes, Abdominal Pain, Interstitial Cystitis, Skin Lesions, and Irregular heartbeat.

Other Meds: Krill Oil, Vitamin B12, Vitamin C, Magnesium Citrate

Current Illness: None

ID: 1713561
Sex: M
Age: 17
State: TX

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Vomiting

Symptoms: Vaccinated with expired vaccine. No adverse reaction.

Other Meds: None

Current Illness: None

ID: 1713562
Sex: F
Age: 29
State: FL

Vax Date: 09/13/2021
Onset Date: 09/15/2021
Rec V Date: 09/18/2021
Hospital: Y

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

Lab Data: Blood Work: 9/16/21 Echocardiogram: 9/17/21 Cardiac catheter: 9/17/21

Allergies: Penicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pericarditis/Myocarditis. Treatment still ongoing. Frequent ingestion of anti-inflammation medication

Other Meds: Wellbutrin

Current Illness: None

ID: 1713563
Sex: F
Age: 64
State: WA

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/18/2021
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: No adverse reactions yet. Just accidently gave a high dose shot to someone who won't be 65 until ~2 months from now. Will be more diligent about checking ages in the future. Also our third party doesn't have a hard stop for this age restriction anymore

Other Meds:

Current Illness:

ID: 1713564
Sex: F
Age: 52
State: FL

Vax Date: 08/30/2021
Onset Date: 08/31/2021
Rec V Date: 09/18/2021
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: As above.

Allergies: Septra and Erythromycin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Approximately 12 hours after the immunization the patient began having common symptoms of myalgia, fatigue, headache, and nasuea. Over the course of the next number of hours the patient began noticing a wobbly sensation and unsteadiness with walking. She also began noticing some urinary retention and bowel urgency. Also, symptoms of tingling, numbness, and weakness was noted in all extremities. Starting on day #2 post-immuniaztion the majority of symptoms began to slowly and steadily resolve. At one week out, however, the bowel, bladder, and left-sided numbness, decreased pain and temperature sensation, and mild generalized weakness still remained. On the 7th of September the patient saw her primary care provider who spoke with a neurologist on the same day. A non-con CT of the skull was obtained on the same day without specific findings. On September 19th a follow-on MRI of the brain and cervical spine was obtained with and without contrast. Again, the Brain was reassugingly without findings, but white-matter disease was noted at the C-2 level; T-2 signal partially enhanced anterolaterally to the right. That same day the patient started three days dosing of IV methylprednisolone, 1 gram daily. She has since continued on a month-long oral prednisone taper. Some symptom improvement still continues, while complete resolution is not near yet. PT& OT are starting in about one week.

Other Meds: Ortho-Tricyclen, Vitamin C, Vitamin D, Multivitamin, Magnesium

Current Illness: None

ID: 1713565
Sex: M
Age: 56
State: CA

Vax Date: 09/15/2021
Onset Date: 09/16/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: COVID test at 2:30 on Sep17

Allergies: None

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

Symptoms: Headache and chills around noon on Sep16. Left work early. Shivering, muscle pain, joint pain at about 4 pm that day. Nausea, altered sense of taste and low grade fever by 6 pm. Treated with acetaminophen and bedrest. Isolated self due to concern for COVID infection. Improved the following morning, but still had mild headache and muscle/joint pain. Symptoms completely resolved by 5 pm on Sep17.

Other Meds: Loratadine, aspirin, Losartan, Fluticasone nasal inhaler, mometasone inhaler

Current Illness: None

ID: 1713566
Sex: F
Age: 51
State: VA

Vax Date: 08/14/2021
Onset Date: 08/22/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Emergency room visits 8/22/2021 and 9/6/2021. Both times my nose bled profusely for an hour at a time three or four times each day . I had another bleed 9/15/2021 and I went to my ENT

Allergies: Allergic to pollen and outside conditions

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

Symptoms: Massive nose bleeds

Other Meds: Meloxicam, vitamind3, venlafaxine, singular,nexium, triameterene with htc, amlodipine,Pepcid, trelegy Ellipta, mometasone furdate, pantanese , enstillar, Voltaren, b12, glucosamine with chondroitin, prosynbiotic, azithrymycin.

Current Illness: High blood pressure, gerd, allergies, asthma, obesity, psoriasis

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am