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

Date Died: 09/19/2021

ID: 1719230
Sex: F
Age: 50
State: CA

Vax Date: 08/27/2021
Onset Date: 09/05/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Symptom List: Dysphagia, Epiglottitis

Symptoms: On September 5 the patient started showing signs of a heavy chest cold. She was sick for the next week with heavy cough, on and off fever, extreme fatigue, shortness of breath. She kept insisting she just had a strong chest cold. On September 12 I found her barely conscious, foaming at the mouth, with extreme labored breathing. Emergency medical services took her to the ER. She was in ICU intubated for one week, then died on September 19.

Other Meds: High blood pressure medicine, lasix

Current Illness:

ID: 1719231
Sex: M
Age: 73
State: MI

Vax Date: 01/11/2021
Onset Date: 09/12/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Anxiety, Dyspnoea

Symptoms: Hospitalized (9.14.21); COVID-19 positive (9.12.21); fully vaccinated Discharge Provider: DO Primary Care Provider: None Physician, MD Admission Date: 9/14/2021 Discharge Date: 9/20/2021 Diagnosis Date Noted POA ? Pneumonia due to COVID-19 virus 09/14/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1] HOSPITAL COURSE: PT is a 73 y.o. male family medicine physician whom is relatively healthy with past medical history significant for HTN, HPL, and DM 2 that was admitted for COVID 19 PNA and associated acute hypoxic respiratory failure. He was fully vaccinated with 2 doses of Pfizer 19 COVID vaccination. He was started on supplemental O2, His therapies included Decadron, Remdisivir, Lovenox, IS, Acapella, Mucinex, Proning He was gradually weaned off supplemental oxygen and began feeling better 9/20/2021 Pt S+E. Alert, NAD, VSS on RA. Stable at discharge Rx for prednisone and Eliquis sent to his pharmacy Patient in agreement with instructions to pick up prescribed medications and take as directed.

Other Meds: Outpatient Medications apixaban (ELIQUIS) 5 MG tablet aspirin EC 81 MG enteric coated tablet dulaglutide (TRULICITY) 4.5 MG/0.5ML injection empagliflozin (JARDIANCE) 10 MG tablet insulin degludec (TRESIBA) 100 UNIT/ML vial insulin lispro (H

Current Illness: 9.12.21 - COVID-19 positive 9.12.21 - Went to ED = Shortness of breath; pneumonia due to COVID-19 virus; Patient signed out to me by Dr. pending monoclonal antibody treatment for COVID pneumonia. Patient developed a fever while in the emergency department. He was given Tylenol. He appears well on my re-evaluation. He saturates well on room air. He received the monoclonal antibody infusion. We discussed return precautions for worsening symptoms. He is discharged in stable condition. This is a 73-year-old man presenting with worsening dyspnea over the last 1 week. He was recently diagnosed with COVID-19. On exam he has some coarse breath sounds consistent with COVID-19 pneumonia. Chest x-ray also shows findings consistent with COVID-19 pneumonia. He would be a candidate for monoclonal antibodies given his age. Ambulatory oxygen saturation was 95%. Patient has some mild tachypnea but no severe respiratory distress. We will order monoclonal antibodies and I anticipate he will be discharged home. My shift and the patient was endorsed to Dr.

ID: 1719232
Sex: F
Age: 81
State: FL

Vax Date: 03/22/2021
Onset Date: 09/02/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Lab Data:

Allergies: NSAIDS

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

Symptoms: Fully Vaccinated patient admitted for COVID-19.

Other Meds:

Current Illness:

ID: 1719233
Sex: F
Age: 26
State: WA

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: none

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: about 3 hours after vaccine was administered i noticed lower back pain, over the course of about 3 days the pain became so severe that i had to go to the ER. I have had back pain in this location before but never so severe nor has it lasted as long as this did. i also noticed a very sharp pain in my abdomen. after consulting with my PCM he said he did not know why, but to come back in 2 weeks.

Other Meds: Nexplanon, omeprazole, sertraline

Current Illness: N/A

ID: 1719234
Sex: M
Age: 57
State: OR

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Patient came in for second dose of Covid shot. Patient circled Pfizer and did not have his vaccination card with him so was given a sticker to take home and update his own card. Patient's first shot was Moderna not Pfizer. Notified vaccine coordinator of this and then explained to patient that he had received a different type then his first dose. I offered for him to talk with someone, he declined and was ok with this.

Other Meds:

Current Illness:

ID: 1719235
Sex: F
Age: 80
State: OR

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 09/21/2021
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: no

Allergies: Sulfa

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

Symptoms: About a week after the vaccine I broke out in a rash and welts and was very itchy. This lasted about 8 or 9 days and went away on its own.

Other Meds: Losartan 50mg, Cal/Mag/Zinc tabs

Current Illness: no

ID: 1719236
Sex: F
Age: 39
State: ID

Vax Date: 09/16/2021
Onset Date: 09/18/2021
Rec V Date: 09/21/2021
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: Pyrexia, White blood cell count decreased

Symptoms: tingly, red, swollen, hot face/ears/neck started 48 hours after, got worse on day 3, same on day 4, a little better day 5

Other Meds: Amlodipine, Venlafaxine

Current Illness: None

ID: 1719237
Sex: M
Age: 28
State: AZ

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/21/2021
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: NKA

Symptom List: Pharyngeal swelling

Symptoms: Increased severity of headaches and erectile dysfunction since receiving vaccination

Other Meds: Celebrex 100mg prn for headaches

Current Illness: None

ID: 1719238
Sex: F
Age: 71
State: IL

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient received shingrix vaccine in her left arm first, she said her arm was already starting to feel sore as I was prepping for the flu shot to be injected into her right arm. Soon after getting the fluzone HD, patient tells me that she's dizzy and would like to stay seated. I noticed she was turning pale, so I gave her an extra chair to elevate her legs. I had my technician call 911 in the meantime. Patient was feeling hot and started to sweat, I gave her some water when she told me she "was coming back." she started to feel better but I noticed her fingers in the right hand were turning reddish-blue. That's when EMS came and took her blood pressure, her BP was 80/46 so they took her to the hospital immediately. Patient hadn't had anything to eat ever since she woke up in the morning

Other Meds:

Current Illness:

Date Died: 09/06/2021

ID: 1719239
Sex: F
Age: 68
State: TN

Vax Date: 03/26/2021
Onset Date: 08/30/2021
Rec V Date: 09/21/2021
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 known allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient Death

Other Meds: Medication Order Taking? Sig Documenting Provider Last Dose Status allopurinoL (ZYLOPRIM) 300 mg tablet 119314604 TAKE ONE TABLET BY MOUTH EVERY DAY Active cetirizine (ZyrTEC) 10 mg tablet 2034823 1 tab by mouth daily Historical Provide

Current Illness: Hyperlipidemia [E78.5] 6/22/2017 Sheehan syndrome (CMS/HCC) [E23.0] 6/22/2017 12:58 PM Hypertension [I10] 6/22/2017 12:58 PM Gout [M10.9] 6/22/2017 12:58 PM Glucocorticoid deficiency (CMS/HCC) [E27.49] 6/22/2017 12:58 PM Osteoporosis [M81.0] 6/22/2017 12:58 PM Chronic gastroesophageal reflux disease [K21.9] 6/22/2017 12:58 PM History of Rocky Mountain spotted fever [Z86.19] 2013 Hospitalized 2013 6/22/2017 12:58 PM Chronic kidney disease (CKD) [N18.9]

ID: 1719240
Sex: M
Age: 52
State: CA

Vax Date: 04/16/2021
Onset Date: 09/08/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Cough, Fever, sore throat

Other Meds:

Current Illness:

ID: 1719241
Sex: F
Age: 28
State: NC

Vax Date: 09/13/2021
Onset Date: 09/13/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: EKG 09/14/21 Chest X-ray 09/14/21

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Severe muscle pain, skin sensitivity, nausea, severe headache, neck and lower back pain, chest pain, fever

Other Meds: Jolessa, Zyrtec, protonix

Current Illness: None

ID: 1719242
Sex: M
Age: 21
State: IL

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: unable to contact patient.

Allergies: denies any

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

Symptoms: patient came into a mobile clinic organized at college where he was asked by registration staff if he had received any other COVID-19 vaccine, client denied ever receiving any previous COVID vaccine. When Client preceded to RN for his vaccine RN also asked him if he had received any other COVID-19 vaccine, again patient denied ever receiving any other COVID vaccine prior to the dose being administered on the day of the mobile clinic at College. Client also marked no for ever receiving any other COVID-19 vaccine on his registration form. after gathering his information RN proceeded to administer Janssen vaccine to the patient. During the registry entry process he was found to have received a Pfizer vaccine (04/23/2021) prior to the Janssen vaccine given by Public Health according to registry. RN attempted to call Patient multiple times on 2 different occasions. When calling clients number on his registration form the person answering the phone would hang up on RN as soon as the RN identified himself.

Other Meds: denied any

Current Illness: denied any

ID: 1719243
Sex: F
Age: 48
State:

Vax Date: 06/15/2021
Onset Date: 06/28/2021
Rec V Date: 09/21/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Tinnitus in both ears Instability - I have taken 2 hard falls since the vaccine and stumbled several time (particularly on the right side). This is absoltuely ABNORMAL for me as I have nver struggled with instbility. I am a runner, biker, water skier and stability is critical. It has affected all three areas of my active hobbies.

Other Meds:

Current Illness:

ID: 1719244
Sex: M
Age: 63
State: CA

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: CMP, CBC ordered on 9/15 did not do yet. EKG on 9/16 done in clinic was normal.

Allergies: NONE

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

Symptoms: 9/15 phone appt w/ PCP: " left arm- phizer, covid vaccine 2 weeks ago. 24 hours later, left arm pain and not able to use as well since. Starts at neck, getting worse. Is able to move arm. Feels like heart skips a beat sometimes, with pain and SOB since then. Declines ER. Feels like a "guinea pig". Vaccine required by pool hall, "if there's a fight, there's a fight. If there's blood, there's blood". Refusing getting vaccine #2. Think he had delta variant for 3 weeks already 8/2021, declined testing at the time. " 9/16 Office visit FNP- "63 y.o. male c/o pain, n/v, and all covid symptoms, pt stated that he got the Covid Vaccine on 9/3/21 and has been experiencing severe L arm pain, loss of feeling in both hands, vomited for several hours on 9/11. Pt states he received a dose of COVID vaccine and 3 weeks later received a 2nd dose. Pt states he became very ill after second dose. Voices no other concerns."...Received Toradol 30mg 0.5ml IM inj. Was prescribed Albuterol Sulfate HFA Aerosol Solution, 108 (90 Base) MCG/ACT, 2 puff as needed, Inhalation, every 4-6 hrs as needed, 30 days, 1, Refills 3 Start Flovent HFA Aerosol, 110 MCG/ACT, 1 puff, Inhalation, Twice a day, 30 days, 1, Refills 2 Start predniSONE Tablet, 20 MG, 1 tablet, Orally, Once a day, 5 days, 5 Tablet.

Other Meds: NONE

Current Illness: Bronchospasm, chest pain, covid-like symptoms, lt arm pain

ID: 1719245
Sex: M
Age: 71
State: CA

Vax Date: 02/27/2021
Onset Date: 09/04/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: SOB no energy loss of appetite no cough

Other Meds:

Current Illness:

ID: 1719246
Sex: F
Age: 43
State: CA

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/21/2021
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. I have not visited my doctor because I don't want to be prescribed any medication. I only have one kidney and acid reflux medication can be dangerous for my kidney.

Allergies: None

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

Symptoms: Within a few minutes of receiving first dose of Moderna Covid vaccine, I started experiencing acid reflux and it felt as if something was stuck in my throat. I thought it would have subsided by now, but have been experiencing a burning in throat and I am having to clear my through all day long. My throat has not felt the same since receiving the vaccine. I did a simple search and found that there are a lot of other people with the same experience and thought I should report my experience.

Other Meds: None

Current Illness: None

ID: 1719247
Sex: F
Age: 32
State: NY

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I had confirmed covid in april 2021. After my second shot yesterday, I have slept for about 16 hours, I can't raise my arm above my head because it's so sore, I've been coughing horrendously (which I didn't have a cough when I had covid). Slight fever at 100.2 on and off. Called into work today.

Other Meds:

Current Illness:

ID: 1719248
Sex: F
Age: 44
State:

Vax Date: 09/03/2021
Onset Date: 09/09/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe thrombocytopenia one week after the first dose of the vaccine

Other Meds: niraparib gabapentin miralax

Current Illness: ovarian cancer

ID: 1719249
Sex: M
Age: 24
State: NY

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 09/21/2021
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: 103 fever lasting 2 days. Extreme muscle pain and leg swelling for about a week after receiving the vaccine.

Other Meds:

Current Illness:

ID: 1719250
Sex: F
Age: 31
State: TX

Vax Date: 09/20/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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:

Allergies:

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

Symptoms: Employee calling to report a reaction after receiving a COVID-19 vaccine. Vaccine Name - Pfizer Vaccine Date - ? 9/20/2021 Is this your first or second dose- 1st Date of symptom onset - ? 9/21/2021 Symptoms - ? headache, body aches, and tiredness Last day of work and shift - ? 9/20/2021 Home remedies- NA Any improvement- NA Recommendation- Advised employee to Take Tylenol and/or Ibuprofen if not allergic per pack instructions as needed for headache and body aches. Also advised employee to monitor symptoms and if they worsen, new symptoms develop, or they feel like they need to be seen by a provider to call us. Employee voiced understanding Employee of information ? Yes Employee voiced any concerns ? No Employee?s questions answered to employee?s satisfaction -Yes

Other Meds:

Current Illness:

ID: 1719251
Sex: F
Age: 63
State: TX

Vax Date: 03/20/2021
Onset Date: 08/05/2021
Rec V Date: 09/21/2021
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 08/08/2021- positive

Allergies: Sulfonamides, betadine, wool, bee stings, powder gloves

Symptom List: Unevaluable event

Symptoms: I was travelling on an airplane and the person sitting next to me was congested, sneezing, and coughing. When I came back I got a Covid test and it came back positive on 08/08/2021. When I got the results I went to a clinic. On 08/10/2021 I was treated with a monoclonal antibody infusion. They prescribed Zpak, Albuterol inhaler, and Tessalon pearls.

Other Meds: Cabergoline

Current Illness: None

ID: 1719252
Sex: F
Age: 75
State: CA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 09/21/2021
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: Neurologist EMG - put needles into my legs to diagnose me with the neuropathy

Allergies: sulfa

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

Symptoms: Foggy head/cloudy head. Really severe weakness in my legs. I generally felt really bad for about fourteen days - was mostly in bed. I didn't feel like doing anything. I maybe got a little energy back and I was able to drive. I didn't have a lot of stamina -and I'm like that to this very day. My left arm is very weak at times - tingly. I have to force myself to exercise every day. I ride my stationary bike for 10 minutes at a time and some days I walk for 10 minutes in my apartment. But some days I can't do it at all. Generalized weakness in especially in left arm and legs. This has been life changing for me. I walked 30 minutes every day before but after the vaccines, everything has changed me. Neurologist diagnosis now for Peripheral Neuropathy. Wanted me to take Gabapentin for pain but I don't take it. If I do use anything I use Extra strength Tylenol. I started getting a rash between my breasts - right breast and right shoulder blade in my back. The pain shoots out from my spinal cord. I knew it was Shingles. I was vaccinated for that several years ago. I got the rash about three weeks ago. My doctor, PCP, put me on Anti-Viral - Acyclovir - I don't know if that helped me or not. I suffered with a lot of pain. It is a matter of it's running it's course. I still have pain from time to time. It was a really bad case - it kept me up at nights because of the pain. With the neuropathy, I had gone to ER - on June 3rd or June 6th - the doctor there had told me to go to a neurologist. I saw her within a couple of weeks after that.

Other Meds: Amlodipine 2.5 & 5mg ,enalapril 20mg 2x a day pravastatin 20 mg Synthroid Flovent inhaler monlutolukast sodium 10 elderberry vitamin c d3 magnesium echinacea Turmeric

Current Illness: no

ID: 1719253
Sex: M
Age: 51
State:

Vax Date: 09/03/2021
Onset Date: 09/11/2021
Rec V Date: 09/21/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: I felt very dizzy on the 8th day after getting the vaccination and have been feeling dizzy for 10 days now. It's not as bad as it was when it first started but I still don't feel like myself and feel like I have to move slower than I used to. A couple of days ago I felt almost normal again but dizziness returned the next day. I have a doctor's appointment scheduled on 9/30/2021

Other Meds: None

Current Illness: None

ID: 1719254
Sex: F
Age: 17
State: WI

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pfizer vaccine was diluted with .8cc of diluent instead of 1.8 cc dliuent. No signs or symptoms occurred during the 15 minute waiting period.

Other Meds:

Current Illness:

ID: 1719256
Sex: M
Age: 75
State: MI

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: ED Course as of Sep 18 0501 Fri Sep 17, 2021 2327 Normal white blood count 9.8. Otherwise unremarkable labs. White Blood Cell: 9.85 [KB] Sat Sep 18, 2021 0012 EKG interpretation indication confusion Sinus tachycardia rate of 114. QTC of 432. No acute ST segment abnormalities or ectopy. [KB]

Allergies: Morphine Oxycodone

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

Symptoms: Patient called through ED nurse line: Patient calling for Acute COVID-19 Vaccine Symptoms started today around 7pm. Symptoms include:confusion, difficulty breathing, disorientation, weakness, vomiting Constant Moderate . Pertinent negatives include: Afebrile. Pt. Got booster for COVID. 3rd shot of moderna, Today at 11:30 am. Symptoms started at 7pm. Pt. Is throwing up. Hands are cold as ice and he fell alseep. Pt. Breathing is shallow. He is too weak to stand and confused. Pt. Wife very concerned, "this is not normal for him." Pt. Drove home after shot and everything went to "hell in handbasket," at 7 pm. Pertinent Medical History: COPD Went to ED: (9.17.21): HISTORY OF PRESENT ILLNESS: Patient reports having his 3rd COVID vaccine shot today. Feeling febrile, achy, slower to respond, has not drink all day, nauseated. Wife describes him as confused and slower to respond. ED Disposition ED Disposition Discharge Upon arrival he appears to not be feeling well and is hesitant to answer questions. After Tylenol, Toradol, Zofran he appears to be feeling better, sitting up, moving around, and joking. Discussed that he is not actually contagious even though he has these viral symptoms. I do recommend he keep the fever down, and that should help with the confusion. Advised to: You are having viral symptoms as a side effect of the COVID vaccine. Continue overlapping Tylenol and ibuprofen to keep fever down and avoid further confusion. May overlap Tylenol 1000 mg and ibuprofen 600 mg, taking the other medicine after 3 hours so each medicine is 6 hours from its last dose. Drink plenty of fluids, even if not feeling like it. May take Zofran for nausea. Return for worsening confusion, weakness to an arm or leg, high fever that will not improve, or other problems.

Other Meds: albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler aspirin 81 MG tablet budesonide/formoterol (SYMBICORT) 160-4.5 MCG/ACT inhaler Calcium-Magnesium-Vitamin D (CALCIUM 500 PO) fluticasone (FLONASE) 50 MCG/A

Current Illness: Stage 2 moderate COPD

ID: 1719257
Sex: M
Age: 26
State: TX

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 09/21/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: TINNITUS-Ringing of the ear the day after the shot. Ringing hasn't stopped since. Also, a few days after the second shot, Evan started feeling Chest pain, Shortness of breath and pounding heart. Chest pain comes and goes

Other Meds: none

Current Illness: NONE

ID: 1719258
Sex: F
Age: 72
State: KY

Vax Date: 04/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Lab Data: White Blood Count 16.19 (H) 4.5 - 11.0 10*3/uL Red Blood Count 5.02 4.0 - 5.2 10*6/uL Hemoglobin 11.4 (L) 12.0 - 16.0 g/dL Hematocrit 38.1 36.0 - 46.0 % Mean Corpuscular Volume 75.9 (L) 80.0 - 100.0 fL Mean Corpuscular Hemoglobin 22.7 (L) 26.0 - 34.0 pg Mean Corpuscular HGB Conc 29.9 (L) 31.0 - 37.0 g/dL Red Cell Distribution Width-CV 15.3 12.0 - 16.8 % Platelet Count 405 140 - 440 10*3/uL Mean Platelet Volume 13.1 (H) 7.8 - 11.0 fL Neutrophils % 80.6 (H) 45 - 80 % Lymphocyte % 11.2 (L) 15 - 50 % Monocyte % 7.9 0 - 15 % Eosinophil% 0.2 0 - 7 % BASO% 0.1 0 - 2 % Neutrophil Abs 13.05 (H) 2.0 - 8.8 10*3/uL Lymphocyte-Absolute 1.82 1.2 - 3.4 10*3/uL Monocyte Absolute 1.28 0.0 - 1.7 10*3/uL EOS-Absolute 0.03 0.0 - 0.8 10*3/uL Basophil Abs 0.01 0.0 - 0.2 10*3/uL Ferritin Collection Time: 09/10/21 12:27 PM Result Value Ref Range Ferritin 6,179.9 (H) 5 - 204 ng/mL Iron and TIBC Collection Time: 09/10/21 12:27 PM Result Value Ref Range Iron 165 50 - 170 ug/dL Total Iron Binding Capacity UNABLE TO CALCULATE 265 - 497 ug/dL Iron-Saturation% UNABLE TO CALCULATE 15 - 55 % Comprehensive Metabolic Panel (CMP) Collection Time: 09/10/21 12:27 PM Result Value Ref Range Sodium 139 136 - 145 mmol/L Potassium 6.6 (HH) 3.5 - 5.1 mmol/L Chloride 106 98 - 107 mmol/L Carbon Dioxide 15 (L) 22 - 29 mmol/L Anion Gap 18 (H) 5 - 13 (arb'U) Glucose 338 (H) 74 - 99 mg/dL Blood Urea Nitrogen (BUN) 181 (H) 10 - 20 mg/dL Creatinine-Blood 4.83 (H) 0.55 - 1.02 mg/dL BUN/Creatinine Ratio 37.5 RATIO Estimated GFR 9 (L) >60 /1.73 m2 Estimated GFR if African-American 11 (L) >60 /1.73 m2 Total Protein 7.9 6.2 - 8.0 g/dL Albumin 3.3 3.2 - 4.6 g/dL Globulin 4.6 (H) 1.5 - 4.5 g/dL Albumin/Globulin Ratio 0.7 (L) 1.1 - 2.5 RATIO Calcium 10.0 8.4 - 10.2 mg/dL Total Bilirubin 0.2 0.2 - 1.2 mg/dL AST/SGOT 42 (H) 5 - 34 U/L ALT/SGPT 113 (H) 0 - 55 U/L Alkaline Phosphatase 97 40 - 150 U/L Thyroid Stimulating Hormone(TSH) Collection Time: 09/10/21 12:27 PM Result Value Ref Range Thyroid Stimulating Hormone 0.010 (L) 0.350 - 4.940 m(iU)/L Lipase Collection Time: 09/10/21 3:05 PM Result Value Ref Range Lipase 94 (H) 4 - 39 U/L Troponin Collection Time: 09/10/21 3:05 PM Result Value Ref Range Troponin 0.014 0.000 - 0.034 ng/mL CK Collection Time: 09/10/21 3:05 PM Result Value Ref Range CK 16 (L) 29 - 168 U/L Thyroid Stimulating Hormone(TSH) Collection Time: 09/10/21 3:05 PM Result Value Ref Range Thyroid Stimulating Hormone 0.010 (L) 0.350 - 4.940 m(iU)/L Lactic Acid Collection Time: 09/10/21 3:11 PM Result Value Ref Range Lactic Acid 1.9 0.7 - 2.0 mmol/L Glucose-Glucometer Collection Time: 09/10/21 5:06 PM Result Value Ref Range Glucose Glucometer 441 (HH)

Allergies: Smz-tmp Ds [Sulfamethoxazole-trimethoprim]: Hives Codeine: Nausea And Vomiting Penicillins Cross Reactors :Rash

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 72yo female hx GERD, CKD stage 3, alpha thalassemia trait, COPD, NIDDM2 presents with acute renal failure, hyperkalemia, AGAP metabolic acidosis, uncontrolled diabetes and hyperglycemia, and sepsis of unclear etiology. Acute kidney injury on chronic kidney disease stage 4: 72-year-old female with history of chronic kidney disease, anemia, GERD, COPD diabetes who presented with elevated creatinine not feeling well and was found to have acute kidney injury. During hospitalization patient required 2 sessions of hemodialysis. Patient's temporary hemodialysis catheter has been removed as per recommendation of Nephrology. Patient's creatinine is stable. Patient is to follow-up with nephrologist as an outpatient. Hypertension: It was uncontrolled, patient medication has been adjusted. Patient is currently on amlodipine, Coreg, losartan as per recommendation of nephrologist. Diabetes: Mostly uncontrolled, patient is currently on home medication, that will be resumed on discharge Physical exam: Constitutional: Patient is lying in bed, no distress Head/eyes: atraumatic, normocephalic ENT: moist mucous membranes Neck: non-tender Cardiovascular: regular rate and rhythm, no murmur, no rub Respiratory: decreased breath sounds, clear to auscultation, mild crackles Abdomen: non-tender, normal bowel sounds, soft, no rebound Extremities: No clubbing, no cyanosis, edema mild Skin: intact, normal turgor 1 Discharge condition: stable

Other Meds: ACCU-CHEK AVIVA PLUS test strip ACCU-CHEK SOFTCLIX LANCETS lancets amLODIPine (NORVASC) 5 mg tablet Blood Glucose Monitoring Suppl (ACCU-CHEK AVIVA) device Blood Glucose Monitoring Suppl (ONE TOUCH ULTRA SYSTEM KIT) W/DEVICE KIT carvedilol

Current Illness: Essential hypertension COPD without exacerbation (CMS/HCC) Thalassemia trait, alpha Acute renal failure superimposed on stage 4 chronic kidney disease (CMS/HCC) Uncontrolled type 2 diabetes mellitus with hyperglycemia (CMS/HCC) Hyperkalemia Acute metabolic encephalopathy Plasma cell dyscrasia

ID: 1719259
Sex: M
Age: 15
State: CA

Vax Date: 09/05/2021
Onset Date: 09/08/2021
Rec V Date: 09/21/2021
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: 9/8, 9/9, 9/12 - tropinins and ekg were all normal 9/12 - cbc, ferritin, TSH, CRP, Vitamin D all normal. 9/13 COVID negative

Allergies:

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

Symptoms: Had arm pain after the vaccine. Starting about 3 days after the vaccine, he developed chest pain, shortness of breath and fatigued after playing water polo. These symptoms were significant enough that his mother brought him to the ED for evaluation wherein tropinins, EKGs and chest xray were normal. These symptoms were severe enough to interfere with school and his sports. He now has symptoms of intermittent palpitations, chest pain and persistent fatigue.

Other Meds:

Current Illness:

ID: 1719260
Sex: F
Age: 63
State: WA

Vax Date: 09/01/2021
Onset Date: 09/06/2021
Rec V Date: 09/21/2021
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

Allergies:

Symptom List: Nausea

Symptoms: tested positive for Covid 19 - cough, shortness of breath, no smell, sinus pressure, back ache, very tired

Other Meds:

Current Illness:

ID: 1719261
Sex: F
Age: 41
State: OK

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: Ran covid test. Ultrasound in both legs for blood clots on 09/18/2021. Both tests negative.

Allergies: Sulfa, Penicillin

Symptom List: Injection site pain

Symptoms: Swelling of lower extremities with warm red skin, rash on lower extremities and abdomen. Site of injection was sore and raised. Next morning, fever of 99.6 degrees Fahrenheit, felt off balance/unwell. That night had thrush. Took a zyrtec and slept. Went to emergency room on 09/18/2021, symptoms better but not fully resolved. Gave nystatin for thrush and told to take allergy medication. April says she took the nystatin and more Zyrtec.

Other Meds: Nystatin, Zyrtec

Current Illness: None

Date Died: 09/18/2021

ID: 1719262
Sex: F
Age: 65
State:

Vax Date: 03/25/2021
Onset Date: 08/29/2021
Rec V Date: 09/21/2021
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: Patient fully vaccinated with pfizer COVID vaccine on 2/5/2021 and 3/5/2021. Pt has h/o advanced COPD and is chronically oxygen dependent, on 5L of O2 at home, multiple sclerosis, Afib, GERD, CHF. Required admission to hospital for COVID pneumonia on 8/29/2021, requiring mechanical ventilation, and ultimately patient expired on 9/18/2021.

Other Meds:

Current Illness: h/o advanced COPD and is chronically oxygen dependent, on 5L of O2 at home, multiple sclerosis, Afib, GERD, CHF.

ID: 1719263
Sex: F
Age: 33
State: OR

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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: paper tape

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

Symptoms: Following the administration of the vaccine, patient started vomiting, then she reported feeling hot all over her body. She was pacing and was not able to settle. Patient was given 50mg oral benadryl and was taken to the hospital by medics.

Other Meds: unknown

Current Illness: covid 21 days ago

ID: 1719264
Sex: M
Age: 21
State: VA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: CBC's, EKG's, blood pressure, pulse rate, Echocardiogram

Allergies:

Symptom List: Tremor

Symptoms: Heart fluttering, and hot flash the night of vaccine, then again several days later

Other Meds:

Current Illness:

ID: 1719265
Sex: F
Age: 46
State: GA

Vax Date: 04/04/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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: doplar ultrasound echo thrombectomy full coagulopathy workup

Allergies: sulfa, pcn, adhesive

Symptom List: Erythema, Pruritus

Symptoms: acute arterial thrombus left brachial

Other Meds: ropirinole, lovastatin, singulair, atenolol, valium, symbicort, effexor, prevacid, aspirin, topamax, flonase emgality, nurtec

Current Illness:

ID: 1719266
Sex: M
Age: 80
State: MI

Vax Date: 06/01/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Lab Data: COVID test was positive on 9/21/2021

Allergies:

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

Symptoms: Patient was vaccinated at outside facility, subsequently admitted to our facility on 9/20/2021 due to symptomatic COVID and COVID test was positive on 9/21/2021

Other Meds:

Current Illness:

ID: 1719267
Sex: F
Age: 80
State: OR

Vax Date: 01/15/2021
Onset Date: 01/17/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: no

Allergies: Sulfa

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

Symptoms: A couple days after the vaccine I broke out with a prominent rash and welts all over my body. It was extremely itchy and warm. It was so bad I went to the department and were I was given a prescription for nitrofurantoin mono mcr to take for 5 days to help with the discomfort. I was advised then I had developed a UTI was also treated for that as well. I then reached out to my PCP who then prescribed Benadryl which I took for about 3 mo. I saw my new dr. who stopped the Benadryl and had me start taking Losartan so I alternated the two for about 2 weeks until I was off the Benadryl and to date I have been off the Benadryl for about 1mo. No rashes has come back but I still break out in welts and anytime any pressure is applied to my body I break out in welts at the pressured site all over again as well

Other Meds: Losartan 50mg, Cal/Mag/Zinc tabs

Current Illness: no

ID: 1719268
Sex: M
Age: 18
State: LA

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: cbc panel

Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: severe nausea severe vomiting severe back ache severe muscle pain delirium convulsions

Other Meds: none

Current Illness: healthy

ID: 1719269
Sex: F
Age: 50
State: TN

Vax Date: 03/20/2021
Onset Date: 04/19/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: HIDA scan- gall bladder was not functioning normal - Bilary dyskinesia upper and lower GI test Ultra sound on my stomach-normal

Allergies: Augmentin

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

Symptoms: Around April 19, 2021 started feeling stomach sick--flank pain on my right side, pain on the upper center of my stomach and went around to my back and that continued for a week. I then I went to see my NP. I had ultrasound on my stomach- normal, blood test. She wrote a referral to have an upper and lower GI-test 06/15/2021- with Dr. Dr. ordered a Hida scan - 07/26/2021- then the next day the results were that my gall bladder was not functioning normal- Bilary dyskinesia. On 08/30/2021- I had surgery to have my gall bladder removed and I was out of work for 2 weeks. I do not think it is associated with the vaccine.

Other Meds: levothyroxine Euthyrox 88 mg od omeprazole 40 mg od Truant/ HCTZ 37.5 /24- mg od Vitamin D-5000 iu od Claritin loratadine od

Current Illness: no

ID: 1719270
Sex: F
Age: 41
State: MN

Vax Date: 01/11/2021
Onset Date: 09/19/2021
Rec V Date: 09/21/2021
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:

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

Symptoms: Tested NAAT positive for COVID 9/19/21 after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1719271
Sex: M
Age: 70
State: OK

Vax Date: 09/20/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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: Pain in extremity

Symptoms: VERY ACHY LIKE THE FLU, very sore arm, headache (not my migraine type), loose bowels, slight thick feeling in throat, and light fever.99.8.

Other Meds: * Celecoxib (Celebrex) 200mg - twice daily for joint pain * Duloxetine (Cymbalta) 60mg (one/day at waking) - started on Jan 25, 2021 * Amitriptylin (Elavil) 25mg (one/day at bedtime) - started Feb 8, 2021 * Metoprol ER (Toprol XL) 50mg dail

Current Illness: None

ID: 1719272
Sex: F
Age: 51
State: MA

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: None at this faciliity.

Allergies: NKA

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

Symptoms: The patient presented to the - and was vaccinated with a dose of the Johnson & Johnson (Janssen) vaccine. Approximately 5 minutes after administration, the patient called for the nurse. The nurse immediately ran over to the patient and the patient stated "i am feeling light-headed". The patient then slumped in her seat. A request for EMS was initiated. The patient was unresponsive for approximately 20 seconds. She came around after 20 seconds and was able to respond to questions (ex: Name, age, date). Her vitals taken were 94/60, HR-84, 02 98%. She was provided with an ice pack for the back of her neck and a bottle of water. The patient remained dizzy and vommited a small amount. EMS then arrived and assessed patient. The patient agreed to be transported to Hospital for evaluation,

Other Meds: Lisinopril daily

Current Illness: HTN, Vertigo

ID: 1719273
Sex: F
Age: 53
State: TX

Vax Date: 09/20/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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: Fruit, nuts, latex, seasonal allergies

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

Symptoms: Severe body aches, chills, bone pain,

Other Meds: Amphetimine Salts 15 mg, Clonazepam 0.5mg, Dextroamp-Amphet ER 20mg

Current Illness: N/A

ID: 1719274
Sex: F
Age: 50
State: KY

Vax Date: 09/15/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: BLOOD PRESSURE SELF CHECK HIGH

Allergies: HYDRALAZINE, SULFA

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

Symptoms: FIRST NOTICED SHORTLY AFTER 1ST DOSE ON 7/31/21. WAS TOLD BY URGENT TREATMENT PROVIDER TO "HOLD OFF FOR A WEEK OR SO TO GET 2ND DOSE" PER PATIENT. PATIENT STATES THAT SHE EXPERIENCED "WEIRD PAINS" IN FEET AND LEGS, NEUROPATHY IN LEGS, WAS DEHYDRATED AND BLOOD PRESSURE WAS EXTREMELY HIGH.

Other Meds:

Current Illness:

ID: 1719275
Sex: F
Age: 57
State: GA

Vax Date: 08/30/2021
Onset Date: 08/31/2021
Rec V Date: 09/21/2021
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: Have been having excruciating headaches since the morning after vaccines. They will dullen with Tylenol but will not go away. I have been sick to my stomach/nauseous since the morning after vaccines. Being a woman in menopause, I have now started having a period again since the morning after the vaccine.

Other Meds: Atorvastatin, Diltiazem, Estradiol, Progesterone

Current Illness: None

ID: 1719276
Sex: F
Age: 58
State: GA

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data:

Allergies: Sulfa antibiotice

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Headache and severe upper back pain

Other Meds: Synthroid 100mcg Vitamin D Multivitamin Vitamin C Omega 6

Current Illness: None

ID: 1719277
Sex: M
Age: 61
State: HI

Vax Date: 03/17/2021
Onset Date: 06/22/2021
Rec V Date: 09/21/2021
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: CT Scan 07/06/2021 Ultrasound 07/06/2021

Allergies: Bactrim-hives; Seasonal Allergies

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

Symptoms: I noticed that my endurance was diminished for two weeks and when I when I went to the hospital on 07/06/2021. I was diagnosed with multiple bilateral Pulmonary Emboli confirmed by ultrasound. I also had a DVT in my right leg slightly to the medial side of my knee. It was treated with anticoagulants. Currently I have no symptoms.

Other Meds: Lisinopril 20mg; Loratadine 10mg

Current Illness: N/A

ID: 1719278
Sex: M
Age: 51
State: NC

Vax Date: 09/07/2021
Onset Date: 09/08/2021
Rec V Date: 09/21/2021
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 as of yet

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Chest pains and shortness of breath, the first shot was given and the same symptoms but over the course of a couple weeks these went away and returned to normal. Now this has been 3 weeks and still having shortness of breath and pain in my chest

Other Meds: None

Current Illness: None

ID: 1719279
Sex: F
Age: 39
State: CA

Vax Date: 07/06/2021
Onset Date: 07/01/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: I am not on any birth control, and have never had periods like this. I had a sonogram today which showed everything was normal. If the clots continue to get worse I will definitely have to go to the ER with my next menstrual cycle

Allergies: None

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

Symptoms: (July)1st menstrual cycle since the vaccine heavier bleeding . /aug) 2nd menstrual cycle since the vaccine heavier bleeding, contractions and passing a golf ball size blood clot. Menstrual cycle was also 9 days late. (Sept) heavier bleeding with approximately 20 golf ball sized blood clots passed. Then next day I had sharp shooting pains on the left side of my head. I felt cold, & weak .

Other Meds: None

Current Illness: None

ID: 1719280
Sex: F
Age: 68
State: NH

Vax Date: 02/20/2021
Onset Date: 03/20/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: 4/2/2021, 4/20/2021 medication was prescribed by urgent care

Allergies: Compazine, sulfur

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

Symptoms: Yeast, herpes, urinary tract, have mental illness, anxiety

Other Meds: Metaformin, rouuvastatin, amlocipine, januvia, clonidine, paxil, levothyroxine

Current Illness: Have a viral of herpes in my body, diabetes, mental issues, PTSD

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am