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: 1715908
Sex: F
Age: 72
State: CA

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 09/20/2021
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: none listed

Symptom List: Dysphagia, Epiglottitis

Symptoms: pt says that developed pain at the end of the tail bone, about 2 inches above the butt cheeks, in the middle of the night. She says it is tender to the touch and aggravated with movement. She states that she did not check for a rash but says it doesnt feel like there is one. Pharmacy told pt is unlikely to be from the flu shot but to follow up with md. Told pt to try tylenol and ice pack in the mean time.

Other Meds: unknown

Current Illness: none

ID: 1715909
Sex: M
Age: 64
State: WI

Vax Date: 03/19/2021
Onset Date: 03/26/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: Xray for foot injury was negative.

Allergies: None known

Symptom List: Anxiety, Dyspnoea

Symptoms: Head pressure located on perimeter of my head. Foot pain - planters faciatis or neuropathy

Other Meds: Daily Multi-vitamin

Current Illness: None

ID: 1715910
Sex: F
Age: 31
State: VA

Vax Date: 02/26/2021
Onset Date: 02/28/2021
Rec V Date: 09/20/2021
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: Not applicable

Allergies: Pollen Allergy

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

Symptoms: I experienced a full red circle raised 1cm after receiving the shot, warm to the touch but not itchy which grew to a total of 4inches in diameter 4 days after the shot. The tele-doctor described a a well defined Erythema with no crusting or streaking and recommended using cold compresses, Ibuprofen/Tylenol for discomfort, and it went away after 7 days.

Other Meds: I took my normal medications Lo Loestrin SE, Fluoxetine 40mg, Zyrtec (1 tablet daily), Trazodone 25mg, and Benadryl (2 tablets daily).

Current Illness: No

ID: 1715911
Sex: F
Age: 40
State: CA

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/20/2021
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: I got the flu shot and Hep B shot and I felt chills, nausea, and I started to vomit on this afternoon 9/17/2021.

Other Meds:

Current Illness:

ID: 1715912
Sex: F
Age: 69
State: NV

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: Covid Test; Blood Test; Folate Test (normal); Homocysteine level (slightly elevated); Intrinsic Factor Blocking antibody Test; Methylmalonic Acid Serum or Plasma Vitamin B12 (low)

Allergies:

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

Symptoms: After receiving the vaccine I experienced extreme fatigue. In August after seeing my physician we did a B12 test that came out very low. I had constant numbness and tingling in my lower leg and feet. I noticed occasional numbness in my forearm and hands, and also occasional very slight tremors in my hands. I have continued dizziness. On August 3rd I tested for Covid after being vaccinated and it was positive. On September 9th I did another Covid test and it was negative. I received the Covid tests from a drive thru testing site.

Other Meds: Supplements

Current Illness:

ID: 1715913
Sex: F
Age: 21
State: VA

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 09/20/2021
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: no

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

Symptoms: When I received the shot in my left arm my left arm became immediately sore down to my elbow. Shortly after this, my hand from my wrist down began shaking. My fingers were shaking and it was very noticeable, especially when drinking water with that hand. Additionally, the soreness stopped at my elbow and my arm from my elbow to my fingertips felt tingly, sometimes slightly numb, and it felt like it was vibrating even when it wasn't actively shaking. Additionally, my fingertips on my left hand, especially my ring fingertip hurt when touching things for the first few days. When I washed my hair it was especially noticeable. The pressure on my fingertips on that hand when washing my hair was painful to the touch. Now the shaking in my hand comes back on and off. There is still sometimes sensitivity in my left ring finger and my arm from my elbow down feels slightly asleep and quite frankly just "off."

Other Meds: Zyrtec, b-complex, vitamin d

Current Illness: End of a cold

ID: 1715914
Sex: F
Age: 69
State: MN

Vax Date: 02/11/2021
Onset Date: 09/18/2021
Rec V Date: 09/20/2021
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: positive covid test (breakthrough positiv)

Other Meds:

Current Illness:

ID: 1715915
Sex: F
Age: 41
State: OR

Vax Date: 05/07/2021
Onset Date: 05/10/2021
Rec V Date: 09/20/2021
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: eggs, lactose

Symptom List: Pharyngeal swelling

Symptoms: Chronic earaches usually beginning mid morning, have come routinely throughout the day ever since receiving the 2nd dose. Read that it could be inflammation so didn't report. It has now been 4 months since that dose, and I still get earaches every day. Menstrual cycles have shortened from 27 days to 16-20 days. Had been very regular until receiving COVID vaccine,. Figured this might also be due to inflammation, but 4 months out, this seems to be my new normal.

Other Meds: Armour Thyroid 60mg: once/morning for the past 8 years

Current Illness: none

ID: 1715917
Sex: F
Age: 25
State: MA

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: RPh gave vaccine to patient. Patient passed out shortly after. Her boyfriend was there and allegedly caught her as she fell off the chair. Patient was then laying on the floor. RPH called 911. EMS arrived shortly after and took her to hospital via ambulance.

Other Meds: unknown

Current Illness: unknown

ID: 1715918
Sex: M
Age: 52
State: CA

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: Dr office visit 8/28/2021 Audiology visit/testing 08/31/2021 MRI 09/09/2021

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Constant ringing in ears since second injection

Other Meds: None

Current Illness: None

ID: 1715919
Sex: F
Age: 45
State: IL

Vax Date: 04/24/2021
Onset Date: 04/30/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Previously was not having a regular period, now having a heavy period monthly.

Other Meds: None

Current Illness: None

ID: 1715920
Sex: F
Age: 67
State: AZ

Vax Date: 08/24/2021
Onset Date: 08/30/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: Aug 30, 2021 In the ER they did an EKG and Chest X-Rays. Nothing remarkable in results. Dr did a follow-up EKG at the office the next day. Said it was ok.

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Received shot on Tuesday, Aug 24, 2021. Noticed an increase in blood pressure in the days following. On Monday, Aug 30, 2021 at 10:30 PM blood pressure rose to 214/97 (taken at the ER). Some nausea, light headed, mild chest pain. No other symptoms. Released after several hours. Saw PCP next day. She prescribed 50 mg. Losartan to be taken once daily. I had the second shot on Tuesday, Sept 14, 2021. No symptoms other than sore shoulder. Blood Pressure is slightly elevated even with Losartan, but not like Aug 30th. Highest recorded was 162/92 since 2nd shot.

Other Meds: None

Current Illness: None

ID: 1715921
Sex: F
Age: 43
State: MT

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Patient stated that about 1/2 hour after vaccination she started "itching all over" and had a red rash on her chest. She states that her legs are also very itchy and red from scratching them.

Other Meds: None known to pharmacy

Current Illness:

ID: 1715922
Sex: F
Age: 45
State: SC

Vax Date: 05/22/2021
Onset Date: 05/23/2021
Rec V Date: 09/20/2021
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:

Allergies:

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

Symptoms: Fever and Headaches May 23rd, again on June 3rd and June 19. Fever continued until she was diagnosed with Aseptic Meningitis and hospitalized on 7/15 through 7/19. Consistent fever for months. Went back to ER 7/23 and then again admitted on 8/18 through 8/31. MRI, CT and Blood Work all negative. Treated symptoms with Prednisone. Pain in the right side of her head. Partial hearing loss still running low grade fever on 9/20. Follow-ip appointment with ENT on 9/21. Still no answers or relief.

Other Meds:

Current Illness:

ID: 1715923
Sex: F
Age: 66
State:

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/20/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: A vaccine administration error occurred. I went to a store on Saturday 09/18/21 to receive my third shot (because I am on an immunosuppressive drug). I gave the pharmacist my vaccine card with the dates of the primary vaccines. The vaccines were clearly listed as Moderna. I did not get the vaccine card back until after the vaccine was administered. The vaccine given was Pfizer. After I pointed this out to the pharmacist, she said she would speak to her supervisor and call me back on Monday 09/20/21. She did call me back and told me that her supervisor told her the vaccines are interchangeable and that a VAERS report does not have to be made. Because I am in healthcare, I knew that this was not true so I called your 800 number to verify this. I was told that administering a different vaccine as the third shot is an administrative error. I am filing this report because the store is not going to do so. You probably need to tell them that they should be reporting vaccine administration errors.

Other Meds:

Current Illness:

ID: 1715924
Sex: F
Age: 53
State: GA

Vax Date: 09/19/2021
Onset Date: 09/20/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Local angioedema with numb sensation left upper lip

Other Meds: Effexor, levothyroxine, Adderall

Current Illness: None

ID: 1715925
Sex: M
Age: 12
State: VA

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: None

Allergies: Amoxicillin

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

Symptoms: Days 1-2 after vaccine: Fever and chills and severe fatigue, muscle aches, loss of appetite, headaches, Tylenol better than ibuprofen for reducing fevers. Days 3: fever resolved, other symptoms still present Day 4-5 : same as day 1-2, fever and chills returned, headaches, photophobia, hard to leave bed. Days 6-10, continued severe exhaustion, headaches. Photophobia, no appetite, hard to get out of bed. Ibuprofen a little better than Tylenol for headaches. Day 6, appointment by Telehealth with pediatrics office, confirmed that some kids are this sick for up to 2 weeks after second vaccine dose, told to continued fluids and rest. Day 11-14, returned to school, but could hardly get through the day, exhausted, muscle aches, loss of appetite, headaches, had to nap after school. Day 15 -a little more energy, maybe 60% Day 16 - first day the he felt 90% back to himself

Other Meds: None

Current Illness: None

ID: 1715926
Sex: M
Age: 26
State: TN

Vax Date: 09/15/2021
Onset Date: 09/18/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Chest pain/shortness of breath and dizziness

Other Meds: N/A

Current Illness: N/A

ID: 1715927
Sex: M
Age: 43
State: GA

Vax Date: 04/08/2021
Onset Date: 04/22/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: I contacted my GP and was seen quickly where I had bloodwork done searching for underlying causes (nothing to indicate anything) and an MRI which looked good. These tests were performed on Jun 21st. I then saw a neurologist who gave me gabapentin and ordered an EMG. I saw the neurologist on June 8th and had the EMG on June 24th. The EMG did not show any issues. I went to a second neurologist and she requested I get a punch biopsy. This was requested on August 6th. The punch biopsy was positive for small fiber neuropathy in the distal areas. This was performed on August 24th and the results were received on September fourteenth.

Allergies: Allergy to doxycycline

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Two weeks following my second dose of Pfizer Covid19 Vaccine I began experiencing an acute onset of burning pains in both my hands and feet. Since the onset of symptoms the condition has only gotten worse and spread to other areas of my body. New symptoms such as electric zap sensations have appeared all over my body and happen sporadically. The burning has also spread to my face and affected my left eye. I am now in my 5th month of symptoms. I was treated with gabapentin but did not tolerate this medication very well and have since stopped. I am meeting with my Neurologist on September 30th to discuss trialing IVIg therapy in hopes to stop the spreading burning pains I am having.

Other Meds: Xanex for stress, regular multi-vitamins.

Current Illness:

ID: 1715928
Sex: F
Age: 61
State: TX

Vax Date: 02/26/2021
Onset Date: 09/08/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: Covid.

Allergies: None

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

Symptoms: Tested positive for Covid on 09/08/2021. I had Coughing and congestion. The congestion started going down into chest and I did have a severe case of bronchitis that turned into walking pneumonia in 2010 due to overwork. I was concerned about the possibility of Covid influenced pneumonia. No fever, no pulse oxygenation, copious amounts of drainage were all clear, lots of congestion, gunk going down and the beginning of congestion and coughing up from the upper respiratory tract. No muscle aches. I did receive monoclonal antibodies on September 10 and symptoms started getting better.

Other Meds: Atorvastatin; Metformin; lots of supplements (does not want to list)

Current Illness: None

ID: 1715929
Sex: M
Age: 25
State: OR

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/20/2021
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: COVID-19 Test (negative) on 9/19 Strep-A Rapid Test (negative) on 9/19

Allergies: None

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

Symptoms: Had normal (but very strong) vaccine side effects - 102 fever, bed ridden due to body aches, headache, and nausea. But starting around noon, I began to notice a sore throat. I never came out of lockdown, so I have no exposure to the outside world (work from home, rarely go out, mom does grocery shopping and hadn?t gone shopping in over a week at the time of my vaccine). It doesn?t seem feasible I would?ve caught a cold/flu from someone. The following day (9/18), my throat became extremely swollen and white patches developed on tonsils. My vaccine side effects (fever, headache, nausea, and body ache) diminished significantly, while the sore throat got exponentially worse. By that night, I had excruciating pain and difficulty swallowing. My fever was mostly gone (from 102 to 99-100), but the grogginess returned. The next day ( 9/19) I went to Urgent Care and was prescribed antibiotics. Overnight, I began having difficulty breathing. This morning, the pain worsened and I noticed both of my ears aching. Eventually, the pain became less consistent, except when I try to eat or drink anything other than warm tea with honey. I have been unable to force down soups and other easy to eat foods because even those hurt too bad, and make me not feel hungry anymore from the pain. OTC pain relievers aren?t doing much of anything aside from making my stomach extremely upset as they ravage my body, which is not receiving any nutrients other than chamomile tea and honey. I?m not ruling out the possibility that I got sick before I got my vaccine, but it seems unlikely considering my extremely low exposure to germs, my strong immune system (haven?t really gotten a severe sickness since middle school, my body usually fights things incredibly well), and the fact that I felt 100% healthy and peak performance before the vaccine, but began getting a swollen, infected throat a day after. My COVID-19 and Strep-A tests both came back negative today.

Other Meds: None

Current Illness: None

ID: 1715930
Sex: F
Age: 50
State: GA

Vax Date: 09/14/2021
Onset Date: 09/17/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: Bloodwork, EKG, chest X-ray, head CT scan, Covid test

Allergies: PTU, technetium 99

Symptom List: Unevaluable event

Symptoms: Face numbness, tongue tingling, severe headache, body aches, diarrhea, fever, chills for 4 days now Tylenol and Ibuprofen Er visit

Other Meds: Armour thyroid, progesterone, estrace, pantaprozole

Current Illness: None

ID: 1715931
Sex: F
Age: 45
State: CA

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Break through bleeding. My period ended two days ago

Other Meds: Hydrochlorothiazide

Current Illness: None

ID: 1715932
Sex: M
Age: 34
State: TN

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: CBC/CMP - WNL; troponin <0.02 Heart score of 1 cardiac workup- unremarkable VSS

Allergies: MORPHINE

Symptom List: Injection site pain, Pain

Symptoms: Pt with no known PMH got the 1st dose of vaccine (9/17) and had intermittent left-sided chest pain that started ~2 hours after the vaccine. He reports some right arm pain with the vaccination which is improving however his chest pain is sharp and intermittent. He reports it is left-sided with non-radiation. Reports mild shortness breath associated with chest pain. He reports the chest pain is sometimes worse with sitting up and leaning forward and better with recumbent in supine position. Pt went to an urgent care before coming to hospital ER and was referred here because of a right bundle-branch block seen on EKG. No right bundle-branch block present upon arrival to ER today (9/20).

Other Meds:

Current Illness: UNKNOWN

ID: 1716076
Sex: M
Age: 32
State: HI

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Numbness left side of body within one hour after first dose on August 27th. Lightheaded and dizziness started about four days after first dose and lasted for about two weeks.

Other Meds: None

Current Illness: None

ID: 1716077
Sex: F
Age: 51
State: MN

Vax Date: 08/27/2021
Onset Date: 09/02/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: Covid test 9/16/2021. Negative results

Allergies:

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

Symptoms: After receiving the second dose I had breakthrough menstruation five days later. I am continuing to have breakthrough menstruation with cramping every two weeks or less. September 16 I became extremely fatigued with a slight headache and nausea. Went in for a Covid test that came back negative. I continue to feel lethargic daily.

Other Meds:

Current Illness:

ID: 1716078
Sex: F
Age: 49
State: CA

Vax Date: 03/17/2021
Onset Date: 06/16/2021
Rec V Date: 09/20/2021
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: See above

Allergies: No

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: That morning, I saw blood in my stool. It wasn't a lot. I suffer from hemorrhoids so thought it was from that. I had diarrhea an hour later and then I had double the blood at that time. Another hour - no more diarrhea, but just blood. I went to ER - they actually did a CT scan - and that did not show internal bleeding. The doctor diagnosed it as Diverticulitis. He gave me a cream for hemorrhoids and said to go home. I was in there for four hours. I didn't make it to my car - I passed out in parking lot. I had been bleeding steadily - - going to the bathroom for it every 5 minutes - while I had been in ER. They admitted me. They did an MRI and a colonoscopy and endoscopy and they gave me a pill - electronic pill and it takes pictures of my inside. There was no findings in any of the tests. They started me on antibiotic - and gave me a stomach coating - Pantoprazole. I bled the rest of that day but the next day, the bleeding stopped. I was discharged from the hospital on June 23. I was also showing - white blood count. The white blood count, from when I had been admitted to the next day, it tripled, it got really high. By the time they tested for it though, nothing came back in the test for what the infection would have been - came back negative. I received a blood transfusion for the blood lost. Have had no more bleeding. Continuing still for two or three times a week, my stools are totally different - they are really diarrhea - really loose. Two weeks ago, I got what I thought was COVID - headache, more diarrhea, throwing up and a cough. I got tested and had COVID test - August 16 - result was negative on the 17th. Just quarantined a bit. Tylenol for headache and Robitussin for the cough. Those symptoms lasted for about 8 days. I think it was COVID.

Other Meds: Vit C; Zinc; Vit D

Current Illness: no

ID: 1716079
Sex: F
Age: 62
State: AZ

Vax Date: 03/10/2021
Onset Date: 06/13/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: See list of tests in continued response to #18 on continuation page

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: No effect at the time of the shot. On June 13, 2021 I developed a rash on my stomach that I thought was an insect bite at the time. Over the next few weeks I began to not feel good (fatigue, low-grade headache that came and went, malaise. Rash spread to my chest and face during this time and I developed bad mouth sores on my tongue and roof of mouth. Did a virtual visit on July 3, 2021 and got valacyclovir and amoxicillin. Didn't do anything. Saw my primary physician on July 8, 2021 and got predisone, miracle mouthwash, and clotrimazole ointment. The prednisone helped I think. The rash continued to spread, so I went to my dermatologist who performed a biopsy on the rash tha came back as 'consistent with lupus. I was diagnosed with sub-acute cutaneous lupus. My dermalotogist also ordered a series of blood tests to determine if the lupus was systemic. Tests included: Anti-DNA (DS) Ab Qn; Antichromatin Antibodies; ANA Direct; Anti-histones Abs; RNP antibodies; Smith antibodies; Sjogren's Anti-SS-A; Sjogren's Anti-SS-B; Antiscleroderma-70 antibodies; Anti-Jo-1; dilute prothrombin time; dPT confirm ratio; Thrombin time; Lupus anticoagulant reflex; PTT-LA; dRVVT; CBC with differential platelet, and complete urinalysis; G6PD, Qn, Bld, and Red Cell Count; Complement C4, serum; Complement C3, serum; Anti-Sm Ab (RDL); Anti-U2 RNP Ab (RDL); Sedimentation Rate -Westergren; and Complement, Total (CH50). Notes: 2- I wanted to report this event to the CDC although I don't know if the event is connected to the vaccines.

Other Meds: See list below in comments zyrtec (OTC), flonase, methyl B complex (50mg), magnesium L threonate (2,000 mg), lysine (1,000 mg), Algae Cal Plus, MacuHealth plus, turmeric curcumin

Current Illness: None

ID: 1716080
Sex: M
Age: 61
State: IN

Vax Date: 04/20/2021
Onset Date: 04/01/2021
Rec V Date: 09/20/2021
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: See item 18

Allergies:

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

Symptoms: -Skin rashes over face and neck -Total impotency. -June 6th I had a 3mm kidney stone that I have yet to pass. -July 11th I had a severe aura while driving, that lasted better than 30 minutes. -Aug 6th, I developed Bell's Palsy to the right side of the face. -Blood tests revealed that I now have only 50% functionality of my kidneys. -Blood tests revealed that I now have high PSA levels and require a prostate biopsy.

Other Meds: -Aimovig -Tizanidine -Acyclovir -Atorvastatin

Current Illness: -PTSD -Chronic Migraines -Cold sores -skin disorders that only come up during season changes -Hearing loss

ID: 1716081
Sex: F
Age: 54
State: NV

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: no

Allergies: sulfa, penicillium, 113 food allergies

Symptom List: Nausea

Symptoms: Felt dizzy , headache at base of neck . Face was swelling lymph nods armpits . All joints were hurting , chest and heart pain. Body was hot but no fever. Have not recovered form theses symptoms .

Other Meds:

Current Illness: no

ID: 1716082
Sex: F
Age: 58
State: PR

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Injection site pain

Symptoms: Pruritus Benadryl.

Other Meds: Losartan, Atorvastatin, Meloxicam

Current Illness: HBP, Hyperlipidemia

ID: 1716083
Sex: M
Age: 40
State: MI

Vax Date: 09/15/2021
Onset Date: 09/16/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: CBC, CMP, and lipase performed on 9/17/21. All normal with just low potassium.

Allergies: Tetanus vaccines, cetirizine, and slight allergy to milk

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

Symptoms: Nausea, lightheadedness, ringing in ears, body aches, tiredness, and headache leading to legs collapsing. Taken to ER, labs drawn, fluids given with zofran and sent home. Arm still red and swollen at vaccine site 5 days later and still having nausea, tiredness, body aches, and headache.

Other Meds: None

Current Illness: None

ID: 1716084
Sex: M
Age: 25
State: WA

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies: Grass/pollen

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

Symptoms: Patient developed significant facial urticaria which progressed to involved his lips and swelling of the tip of his tongue (at which point he was sent to the emergency department).

Other Meds: Allegra (fexofenadine)

Current Illness: Chronic idiopathic urticaria

ID: 1716085
Sex: F
Age: 13
State: WA

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: unknown

Allergies: unknown

Symptom List: Tremor

Symptoms: Incident: 09:30 Client given inaccurate dose of Pfizer, - LOT # EW0185-H administered Pfizer 0.3 cc of undiluted vaccine. Client given usual monitoring of 15 mins without any s/s of adverse reaction. Made aware of this incident upon arrival to next client's home which was an hour later. Notified Clinical Site Supervisor who reports that they will contact MD and parents of client.

Other Meds: unknown

Current Illness: unknown

ID: 1716086
Sex: F
Age: 35
State: CA

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: N/A

Allergies: N/A

Symptom List: Erythema, Pruritus

Symptoms: Client was found in restroom hovering over the sink by staff. Client stated she felt like throwing up and did not feel well. Client had completed 15 minute observation room and went into restroom because she did not feel well. Client was then safely ambulated back by staff to the observation room to where the client was provided interventions. Client appeared pale, had blank stare, and was visibly trembling. Client also stated "I have a knot in my throat." Client transferred into gravity chair, provided water, snacks, and emesis bag. RN Co Lead at vaccination site administered benadryl 50 mg Oral once to the client which alleviated her symptoms within 10 minutes. Vitals stable throughout incident. Client educated on when to call 911, when to go to urgent care, and to enroll in program and follow up with PCP within 24 hours. Client left facility safely with steady gait and verbally stating "I feel well now."

Other Meds: N/A

Current Illness: N/A

ID: 1716087
Sex: F
Age: 43
State: NV

Vax Date: 08/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pain at injection site, headache, stiff joints/legs, pain under chin/neck area, fatigue

Other Meds:

Current Illness:

ID: 1716088
Sex: M
Age: 56
State: MN

Vax Date: 09/14/2021
Onset Date: 09/15/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: I visited two separate emergency departments, had blood tests and a urine analysis. Gabapentin and Tylenol was recommended along with a healthy diet, more exercise and less stress. No measures have been taken medically to alleviate the numb quality or its sensitivity to touch when it is painful.

Allergies: pollen, dander, dust mites, strawberries, penecillin

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

Symptoms: numb upper right leg as if in neuropathy numb lower left leg as if in neuropathy

Other Meds: 900 mg lithium extended release 112 mcg levothyroxine

Current Illness: none known

ID: 1716089
Sex: M
Age: 48
State:

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/20/2021
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: All signs of heart problems. ER tests came out as heathy heart but the DR guessed it is nerve damage due to the vaccine. Chest tightness, chest pain, light headedness, numb tingling in right arm and fingers.

Other Meds:

Current Illness:

ID: 1716090
Sex: F
Age: 48
State: IL

Vax Date: 03/15/2021
Onset Date: 09/02/2021
Rec V Date: 09/20/2021
Hospital: Y

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

Lab Data: 9/2/21 COVID19- positive 9/9/21 Chest xray- Diffuse severe bilateral consolidative pneumonias 9/9/21 CTA chest: Extensive changes of COVID pneumonia. 9/10/21 US: negative 9/11/21 chest xray: Bilateral airspace disease is not significantly changed. 9/14/21 chest xray: Extensive pulmonary parenchymal consolidative changes concordant with history of COVID-19.

Allergies: None

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

Symptoms: admitted on 9/9/2021 for cough Short of breath,loss of taste for 7-8 days. Vaccinated for COVID in March 2021. SpO2 of 78%. Placed on OptiFlow. COVID tested positive 09/09/2021. Treated for COVID-19 pneumonia. Pulmonologist and ID specialist was on board. Completed antibiotics (ceftriaxone and azithromycin), dexamethasone, remdesivir. For chronic pain right knee post surgery, pain specialist was consulted. Pain medicine adjusted. Insulin dose adjusted. Clinically improving. 6 minute walk test done. Recommended oxygen administration is 1L at rest and 4L with exertion. Continue DVT prophylaxis 2 more weeks. Patient is medically stable to be discharge Home on 9/19/21

Other Meds: Amlodipine, escitalopram, famotidine, gabapentin, norco, levothyroxine, potassium, aspirin, celecoxib, clonidine, hydrochlorothiazide

Current Illness:

ID: 1716091
Sex: F
Age: 34
State: AZ

Vax Date: 07/03/2021
Onset Date: 07/23/2021
Rec V Date: 09/20/2021
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: None

Allergies: Eggs, dairy

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

Symptoms: Late heavy period

Other Meds: None

Current Illness: None

ID: 1716092
Sex: F
Age: 60
State: CA

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies: Keflex

Symptom List: Pain in extremity

Symptoms: Nausea, high fever, chills, brain fog, and disorientation all day for 2 days after being vaccinated. These symptoms continued thru 9/18/2021 AND 9/19/2021. Nausea, brain fog, dizziness and vertigo on 9/20/2021. Felt better on 9/21/2021.

Other Meds: Prempro, Levothyroxine, Trintellix

Current Illness: Hypothyroid

ID: 1716093
Sex: F
Age: 31
State: MS

Vax Date: 08/28/2021
Onset Date: 09/15/2021
Rec V Date: 09/20/2021
Hospital: Y

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

Lab Data: Sonogram

Allergies: None

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

Symptoms: 6 weeks 5 days pregnant. Due date: April 18, 2022. Miscarriage diagnosed: Sept. 15, 2021

Other Meds: Prenatal vitamin and iron supplement

Current Illness:

ID: 1716094
Sex: M
Age: 11
State: NY

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 09/20/2021
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: NKA

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

Symptoms: Vaccine administration error. The patient is 11 years old. The Pfizer COVID 19 vaccine is not indicated for pediatric patients under the age of 12. Mother called and informed to please do not bring the child in for their 2nd dose until the Pfizer COVID 19 vaccine is authorized for pediatric patients under the age of 12. The patients mother did not report any adverse side effects.

Other Meds: Not disclosed

Current Illness: Not disclosed

ID: 1716095
Sex: F
Age: 43
State: TN

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: none reported

Allergies: Ciprofloxacin and Penicillin

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

Symptoms: Patient reported hives, swelling, redness and blisters on feet. Her foot was completely red and covered in blisters. Nose bleeds and bleeding gums and blood in the urine.

Other Meds: None

Current Illness: None

ID: 1716096
Sex: M
Age: 82
State: NY

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/20/2021
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: NKDA

Symptom List: Vomiting

Symptoms: Pt C/O difficulty breathing, fever, headache, eyes hurt, sinuses acting up, rashes on chest during the evening hours of 9/18 or 9/19

Other Meds: N/A

Current Illness: N/A

ID: 1716097
Sex: F
Age: 78
State: IL

Vax Date: 07/26/2021
Onset Date: 09/07/2021
Rec V Date: 09/20/2021
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: 9/7/21 COVID19: positive 9/15/21 chest xray: Bilateral pulmonary opacities likely representing COVID-19 pneumonia. 9/15/21 CT abdomen: Bilateral ground-glass pulmonary opacities consistent with COVID-19 pneumonia.

Allergies: Aspirin, ciprofloxacin, penicillins, clopidogrel, sulfa, vytorin, bactrim

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Approximately a week ago on 9/7/21 patient tested positive for COVID-19 back then she was having URI like symptoms which patient reports are getting better. Patient has been undergoing chemotherapy for lymphoma and did receive her last chemotherapy on 9/3/21. For past few months patient has been having recurrent urinary retention. Currently on chronic foley, last urine culture was positive for Pseudomonas outpatient treatment with Keflex. Patient has some symptoms of abdominal discomfort. Patient reports at baseline she is able to stand using walker and ambulated. She has history of chronic compression fractures of vertebra. She has metastasis of lymphoma to her vertebrae. She denies fevers chills. Denies vomiting. Denies any focal neurological deficit. Denies breathing discomfort chest pain palpitation. Denies abdominal pain constipation. Patient reports improving symptoms, no difficulty in breathing, on room air. Admitted on 9/15/21. Radiological finding could be lagging clinical resolution or improvement. At the same time patient might get worse we need to observe. We will not start patient on steroids remdesivir. Continue to monitor clinically. Incentive spirometry. Discharged 9/20/2021

Other Meds: Multivitamin, probiotic, acetaminophen, cephalexin, lotrisone cream, vitamin b12, ondansetrone, miralax PRN, prochlorperazine PRN

Current Illness:

ID: 1716098
Sex: F
Age: 60
State: MI

Vax Date: 03/19/2021
Onset Date: 07/14/2021
Rec V Date: 09/20/2021
Hospital: Y

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

Lab Data: MRIs - Stroke in the right frontal lobe (fragments of blood clots scattered around my brain); CT Scans - Fragments around my brain's right frontal lobse. Blood Tests - Normal; Ultrasounds -Showed a starburst pattern in the right frontal lobe.

Allergies: I am allergic to Nerothmaicin..

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

Symptoms: I experienced a stroke on 07/14/2021 and had to be rushed to be hospital on 07/15/2021. The ER doctors checked me in and I was there for 3 to 4 days. A series of tests were performed and they confirmed that I suffered a stroke. I have been in physical therapy, speech therapy, and occupational therapy that has been ongoing since I suffered the stroke.

Other Meds: I was taking Allergist; Celexa; Flonase; and Multivitamins.

Current Illness: No

ID: 1716099
Sex: F
Age: 56
State: LA

Vax Date: 09/14/2021
Onset Date: 09/17/2021
Rec V Date: 09/20/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: Yes

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Fatigue, pain in legs and hands.

Other Meds: Magnesium, vitamin c, and zinc. Not every day

Current Illness: Not sure

ID: 1716100
Sex: F
Age: 59
State: WA

Vax Date: 03/18/2021
Onset Date: 05/07/2021
Rec V Date: 09/20/2021
Hospital: Y

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

Lab Data: Cardiac workup - and all sorts of test - ruled out heart attack. They did a rapid COVID test and that was negative. They did a heart monitor through the night, I believe.

Allergies: Penicillin; Codone; Morphine; Sulfa drugs - some of them.

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

Symptoms: The morning of May 7th, I started noticing a pressure in the center of chest - just below my sternum. The pain and pressure increased. Felt like a big cat sitting on me. I started to feel a pain sensation going up to my left jaw and under my ear. My husband took me to Hospital ER and they did a cardiac workup and all sorts of things. They decided to admit me for observation overnight after ruling out a heart attack. They admitted me because they did not cause the heart pressure and pain which was relieved by two doses of nitroglycerin. However, I had pain through the night and then it eased up the following morning. I was discharged the following morning. I had fluids and during the night I was given Oxygen because my saturation level was down to 85. No treatment other then lifestyle changes regarding diet and instructions to follow up for a echo-cardiogram and a stress test and a sleep study. I had sleep study done through Health Care - no results yet. Echo-cardiogram and stress test were done at Memorial and I also wore a heart monitor for two weeks and that was through the Memorial as well. All tests were negative. Just a follow up to review result and still waiting for sleep study result which is on October 6th.

Other Meds: Hydroxychloroquine - RA; Oxybutynin; Prozac; Multi-Vit; Vit B12 and Vit D

Current Illness: No

ID: 1716101
Sex: M
Age: 15
State: OR

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient wrote "19" on his immunization consent form and upon billing, we realized it was not "19" but "15". He had already received his dose.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am