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: 1737514
Sex: F
Age: 78
State: IL

Vax Date: 01/27/2021
Onset Date: 09/15/2021
Rec V Date: 09/27/2021
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: 9/19/21 COVID19: positive 9/19/21 chest xray: Patchy ground-glass opacities and airspace disease is seen at the left lung base and within the right upper lobe compatible with COVID pneumonia. No consolidation or pneumothorax is appreciated. No collapse is identified. 9/20/21 US: Neg for DVT 9/20/21 CTA chest: Findings was suggest COVID pneumonia. The reticulation raises a concern for developing fibrosis.

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Sent from urgent care to ER on 9/19/21 after being found to have confusion. Patient presented to the urgent care for 4 days of fever, diarrhea and malaise. During evaluation in the ED she was found to be positive for covid test done in the urgent care, found to be hypoxic 85% on room air, was put on 5L oxygen. XR suggestive of covid pneumonia. COVID tested positive 09/19/2021. Vaccinated for COVID-19 February 2021, Pfizer. Started on antibiotic, dexamethasone, remdesivir. Patient had Elevated D-dimer, CT angio negative for PE, ultrasound leg negative for DVT. Cr worsened to 1.5 but later on improved with IV hydration to normal. Given 5 dose of remdesivir. Started on dexamethasone 6 mg daily to be completed 10 days of for course. And required oxygen will ranging between 4 L minimum of later with gradual decrease in the need. Through the end of the course patient was on room air saturating at 93, required minimal oxygenation on nasal cannula with exertion and and patient will be requiring home oxygen accordingly. Home oxygen is arranged to be followed up with her primary physician regarding further assessment of home oxygenation as outpatient. Patient developed better bradycardia with heart rate ranging in the 40s that that required adjustment of her medications and to be followed up with Cardiology as outpatient to further adjust her medications. Had altered mental status improved which is most likely due to respiratory failure from COVID pneumonia versus medication induced. Her diabetes was managed with sliding scale and resume the home medications upon discharge Restless leg syndrome was stable. Discharged on 9/24/21

Other Meds: Amlodipine, cetirizine, clonidine, furosemide, gabapentin, metformin, oxybutynin, simvastatin, metoprolol succinate

Current Illness:

ID: 1737515
Sex: F
Age: 75
State: SC

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

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

Lab Data: Blood work to rule out any bloodborne pathogens.

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Pharmacy technician had a needle stick from used needle.

Other Meds:

Current Illness:

ID: 1737516
Sex: F
Age: 23
State: NY

Vax Date: 09/01/2021
Onset Date: 09/25/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Bad migraines, fever, chills for the 72 hours after.

Other Meds: Zoloft, Claritin, vitamin B and C

Current Illness: None

ID: 1737517
Sex: M
Age: 19
State: TX

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/27/2021
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: Patient had a seizure almost immediately after administration and recovered within seconds

Other Meds:

Current Illness:

ID: 1737518
Sex: F
Age: 70
State: MO

Vax Date: 03/01/2021
Onset Date: 09/21/2021
Rec V Date: 09/27/2021
Hospital: Y

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

Lab Data: COVID-19 +9/21/21

Allergies:

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

Symptoms: Patient is a 70-year-old female with past medical history significant for seasonal allergies, HTN, bicuspid aortic valve with stenosis, MVP, DM 2, gout, HLD, and osteopenia. She prevent presents to Hospital with symptoms of COVID-19. She states that her symptoms had started last Wednesday. She thought it was a cold or sinus related as she was having mainly sinus congestion, runny nose, sneezing, cough for a few days. She went to her PCP and was tested for covid this past Tuesday 9/21 with a result of a positive Covid test. Her PCP told her that she had any worsening symptoms to come to the emergency department. She states that she has been having increasing nausea, vomiting and diarrhea, she has not been eating much and only been drinking some water and Sprite. She states that she was vaccinated it back in March with the Pfizer vaccine for COVID-19. She has not been having much dyspnea, but she is having some cough on deep breathing. Pt also states she is having some abd pain worse in the Left upper quadrant. She has not tried anything for the symptoms.

Other Meds:

Current Illness:

ID: 1737519
Sex: F
Age: 44
State: NY

Vax Date: 09/21/2021
Onset Date: 09/22/2021
Rec V Date: 09/27/2021
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: I ORDERED LABS (BNP, CBC, CMP_) EKG REVEALED POSSIBLE LAE ECHO PENDING

Allergies: PCN , Clindamycin, Sulfa abx,, Macrodantin, Levaquin

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

Symptoms: PATIENT REPORTS CHEST TIGHTNESS, PALPITATIONS.

Other Meds: no active meds

Current Illness: none

ID: 1737520
Sex: F
Age: 65
State: MO

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/27/2021
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: n/a

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient came to receive a COVID vaccine (Pfizer), the high dose flu shot was administered. She came back to the pharmacy saying that she received the wrong immunization and had brought in her paper work from home which stated that she wanted the Covid shot. She also mentioned that she received her flu shot earlier last week.

Other Meds: Patient stated that she received her flu shot a week before the second flu shot was accidentally administered.

Current Illness: n/a

ID: 1737521
Sex: F
Age: 37
State: TX

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

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

Lab Data:

Allergies: None known.

Symptom List: Pharyngeal swelling

Symptoms: Missed period. I had terrible cramps and headaches about a week after the vaccine but never had my monthly cycle.

Other Meds: Prenatal, Vitamin D3, Vitamin C, Probiotic, Vitamin E, P5P, B complex, Collagen, Levothyroxin 75 MCG, Metformin 1000, Cabergoline .25 mg

Current Illness: None

ID: 1737522
Sex: M
Age: 50
State:

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/27/2021
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: High feva 1st nite (102),. , lite HA.

Other Meds:

Current Illness:

ID: 1737523
Sex: F
Age: 28
State: MN

Vax Date: 09/24/2021
Onset Date: 09/25/2021
Rec V Date: 09/27/2021
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: Penicillin, Augmentin , cephalosporin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Every night since getting the vaccine I have not been able to sleep I am woken up to what feels like my heart racing I have taken my pulse during these moments and have had a pulse over 100 at resting, I have not seeked medical treatment yet due to looking on the internet and finding that this is said to have happened to other people. But if it continues I will be seeking a doctor to see what the recommendation would be.

Other Meds: None

Current Illness: None

ID: 1737524
Sex: M
Age: 88
State: MN

Vax Date: 03/03/2021
Onset Date: 09/26/2021
Rec V Date: 09/27/2021
Hospital: Y

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: Hospitalization weakness and GI distress.

Other Meds:

Current Illness:

ID: 1737525
Sex: F
Age: 67
State: OH

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data:

Allergies: latex, penicillin, Levaquin, Baine

Symptom List: Rash, Urticaria

Symptoms: I was very tired. I wake up the next day with vision impaired. I have wiggly lines in my vision when I look at something.

Other Meds: vitamins, balance of natural, pentopril 40mg

Current Illness:

Date Died: 09/24/2021

ID: 1737526
Sex: M
Age: 96
State: CO

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

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

Lab Data: None due to end of life wishes.

Allergies: TB Skin test

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

Symptoms: Resident was administered 3rd dose d/t immunocompromising condition. He was on hospice at the time of vaccination living in a nursing home. He was observed to have a blood pressure lower than normal on 9/21/21 and hypoxia and tachycardia. The resident received morphine. He continued to decline and was provided comfort/end of life care.

Other Meds: Voltaren Gel 1 % (Diclofenac Sodium)Apply 1 application transdermally two times a day, Acetaminophen Liquid 160 MG/5ML give 30 ml by mouth three times a day, Refresh Optive Advanced Solution 0.5-1-0.5 % (Carboxymeth-Glycerin-Polysorb)Instil

Current Illness: Resident had been admitted to hospice in April 2021 d/t terminal diagnosis of Alzheimer's dementia. He continued to have issues with dysphagia and needed a mechanically altered diet. He had increase difficulty was speech and making needs known. He was w/c bound and required total assistance.

ID: 1737527
Sex: M
Age: 28
State: CA

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/27/2021
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: Swollen tongue, hands, wrist, armpits, feet. Itchy throat/caugh, itchy wrists, palms, ears, buttocks, feet, armpits. Developed hives on wrists, armpits, buttocks, left arm around injection site. Received 1 shot left arm 09:30 A.M. first sign of reaction was itchiness left palm and injection site 1 minute after injection. Within 5 minutes itchiness spread to palms, wrists, ears, throat, feet, armpits, buttocks. After 5 minutes noticed swelling in hands, feet and tongue followed with hived around armpits, both wrists, buttocks, left arm.

Other Meds: Topamax, Zyrtex, Omeprazole

Current Illness: Covid pos

ID: 1737528
Sex: F
Age: 30
State: GA

Vax Date: 09/22/2021
Onset Date: 09/23/2021
Rec V Date: 09/27/2021
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: Shellfish

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

Symptoms: Full on anaphylaxis. Full body hives, swelling of hands and feet and lips, tightness in chest.

Other Meds: None

Current Illness: None

ID: 1737529
Sex: M
Age: 65
State: TX

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/27/2021
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: 1st vaccine was Moderna . 2nd vaccine was Pfizer

Other Meds:

Current Illness:

ID: 1737530
Sex: F
Age: 79
State: WI

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/27/2021
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: none

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

Symptoms: redness - 3"x4" oval down tricep. can still see injection site injection site on arm warm pain - feels like a bruise when touched. can't sleep on that side started 2 days after vaccination (9/24), called pharmacy to report on 9/25 upon follow up with patient on 9/26, area is not as big/red/warm, but just as painful. pt took ibuprofen 200mg twice with some relief

Other Meds: Vitamin C, Calcium, Magnesium, Zinc, Vitamin D, Amlodipine, Fenofibrate, Benazepril, Allopurinol, Clonidine, Gabapentin, Levothyroxine, Omeprazole, Simvastatin, Lorazepam

Current Illness: none

ID: 1737531
Sex: M
Age: 59
State: IL

Vax Date: 09/23/2021
Onset Date: 09/24/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Rash on both arms and upper torso. Clammy feeling during sleep hours Mostly resolved today 9/27

Other Meds: Oxycodone, Norco, Movantik, Medrol, Simvastatin, Metoprolol, Aspirin, Lisinopril, Valim

Current Illness:

ID: 1737532
Sex: F
Age: 93
State: IL

Vax Date: 02/05/2021
Onset Date: 09/18/2021
Rec V Date: 09/27/2021
Hospital: Y

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

Lab Data: 9/18/21 COVID19: positive 9/18/21 chest xray: Left lower lobe and right middle lobe pneumonia with a left parapneumonic effusion. This is new when compared to a February 1, 2021 study. 9/19/21 CT chest: Findings most compatible with CHF with pulmonary edema and bilateral effusions

Allergies: Atenolol, carvedilol, adhesive tape

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Presented to the ER on 9/18/21 with Cough sputum production shortness of breath. Today she presented to the ER tested positive for COVID requiring oxygen to maintain oxygen saturation in the ER. She denies chest pain abdominal discomfort urinary discomfort. She states she is fairly active drives by herself and is independent to activities of daily living. She has been able to eat and drink. Denies fever chills nausea vomiting. She does not have any other symptoms per patient. She reports she does not want to be resuscitated or intubated she states she has paperwork. Blood pressure 148/77, pulse 66, temperature 97.8 ?F (36.6 ?C), temperature source Oral, resp. rate 20, height 5' 1" (1.549 m), weight 126 lb (57.2 kg), SpO2 96 %. Patient on nasal cannula Appears comfortable at present Appears to be hard of hearing Lungs are moving air there are occasional crackles no use of accessory muscles S1-S2 systolic murmur rate and rhythm appears to normal Abdomen is soft nondistended it did not appreciate any tenderness Legs are nonedematous Patient appears to be alert oriented and giving a good story no focal neurological deficits appreciated . Started on antibiotic, dexamethasone, remdesivir CXR-Left lower lobe and right middle lobe pneumonia with a left parapneumonic effusion. This is new when compared to a February 1, 2021 study. Lasix dose increased IV . Other cardiac med dose decreased. Pulmonology and ID recommendation appreciated. Continue improving. Plan to continue remdesivir 5 days. If clinically stable home with oral antibiotic and steroid. 6 minute walk test prior to discharge. Was on room air on 9/25. Discharged 9/25/21

Other Meds: Amlodipine, apixaban, aspirin, furosemide, tresiba insulin, isosorbide mononitrate, losartan, metformin, metoprolol tartrate, nitrostat PRN, simvastatin, zolpidem PRN

Current Illness:

ID: 1737533
Sex: M
Age: 81
State:

Vax Date: 08/30/2021
Onset Date: 09/02/2021
Rec V Date: 09/27/2021
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: Pt was schedule for 3rd dose of vaccine Modern for 9/2/21. Pt stated he had only received his covid vaccine series at North star health clinic. At the time of appointment pt verbally stated he had not received his 3rd dose of moderna. after the fact it was fount that he had received a 3rd dose at another clinic according to vac track.

Other Meds:

Current Illness:

ID: 1737534
Sex: F
Age: 31
State: NY

Vax Date: 09/26/2021
Onset Date: 09/26/2021
Rec V Date: 09/27/2021
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: n/a

Allergies: n/a

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

Symptoms: diarrhea, vomiting, diffuse urticaria

Other Meds: n/a

Current Illness: n/a

ID: 1737536
Sex: U
Age: 0
State:

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

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: ADMINISTRATION ERROR MIXED SERIES mRNA VACCINE PFIZER AND MODERNA.

Other Meds:

Current Illness:

ID: 1737537
Sex: F
Age: 67
State: MO

Vax Date: 03/12/2021
Onset Date: 09/13/2021
Rec V Date: 09/27/2021
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: COVID-19 PCR+9/13/21

Allergies:

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

Symptoms: 9/26: History of Present Illness PT is a 67 yo female transferred from Moberly on 9/26 for worsening AHRF due to COVID PNA. Patient on BiPAP upon arrival, 90% FiO2 (60% FiO2 when she left at Moberly per transfer note). sx onset and diagnosis on 9/11, vaccinated with Moderna x2 in March. went to the ED at Moberly, sent home on 2 L O2. Returned on 9/15 for worsening symptoms, admitted. s/p Dexamethasone, Remdesivir, and a single dose of Tocilizumab there. s/p Rocephin, discontinued due to low inflammatory markers per OSH notes. OSH BLE doppler US negative for clots. No CT done per OSH records. CXR with Patchy bilateral airspace opacities, consistent with known COVID-19 Pneumonia. Superimposed pulmonary edema is within consideration. Remarkable admission labs: CRP wnl. procal 0.11.Ferritin, LDH, D-dimer elevated. Mild LFT elevation. Leukocytosis. LA 3.3 Cr 1.02. Potassium 5.2. Patient had PICC line placed 9/15 due to hard stick. 9/27: Due to persistent hypoxia despite BiPAP, patient was intubated on 9/27. She became hypotensive, believed to be distributive shock. Infectious work-up as noted below, initiated broad spectrum coverage for hospital acquired pneumonia and possible PJP given her underlying immunosuppression. Right sided radial arterial line placed, which was replaced with a right sided femoral arterial line after this line failed. The patient was paralyzed, received additonal INO treatment, received an esophageal balloon, and was proned on 9/27.

Other Meds:

Current Illness:

ID: 1737539
Sex: M
Age: 80
State: IL

Vax Date: 01/13/2021
Onset Date: 09/17/2021
Rec V Date: 09/27/2021
Hospital: Y

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

Lab Data: 9/21/21 chest xray: Interstitial prominence at the lung bases, some which may be atelectatic, some which may be inflammatory. 9/21/21 CTA chest: No evidence of pulmonary embolism. Extensive bilateral ground-glass opacities in the lower lobes, upper lobes, lingula. Findings are consistent with COVID pneumonia. Overall, severity appears to be moderate. No focal consolidation to suggest a superimposed bacterial pneumonia. Cholelithiasis.

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Presented to the ED on 9/21/21 from NH for confusion x3-4 days, found to have covid pneumonia. Vitals remarkable for tachycardia, SBP >170, afebrile, Saturating 91% on room air, later requiring 4L. Labs remarkable for sodium 152, Cl 124, SCR 1.40, AST/ALT 46/120, alk phos 143, glucose 275, troponin 0.091, Hgb 17.6, dimer 1.16, CRP 114, PCT 0.42. ABG ph 7.431, PO2 50.8, PCO2 28.4, bicarb 19.9. CT PE negative for PE, consistent with covid pneumonia, cholelithiasis. Patient started on dexamethsone and remdesivi, but d/c'ed after three doses as doing well on room air. Started on rocephin and azith, which were discontinued at discharge. Dishcarged on 9/24/21

Other Meds: Atorvastatin, cholestyramine, apixaban, insulin lispro, lantus solostar, metoprolol succinate, mirtazapine, pantoprazole, tamsulosin, tramadol PRN

Current Illness:

ID: 1737540
Sex: F
Age: 23
State: ME

Vax Date: 09/15/2021
Onset Date: 09/17/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data: See item 18

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Became having heart palpitations and elevated heart rate both resting and on exertion. Would increase in severity on exertion. On 9/23/21 began feeling chest pain that was a heavy feeling on my left side with extreme tightness. I tried going to primary care but was referred to ER. Went to ER approx 5:30pm that day. ER at EMMC ran labs including a d dimer, CMP, Troponin, CBC, thyroid, electrolytes, and urinalysis. No abnormal findings. They also did a chest x ray and EKG which also came back normal. Covid test also negative. Upon asking, they denied filing a VAERS and said I was primary cares responsibility to determine if they wanted to file one. They said to possibly follow up with primary care to possibly get a Holter monitor or possible echocardiogram for re-evaluation.

Other Meds: None

Current Illness: None

ID: 1737541
Sex: F
Age: 73
State: MN

Vax Date: 09/21/2021
Onset Date: 09/22/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, Bees, Ragweed, aspirin

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

Symptoms: Fever, body and joint pain, terrible Headache, chills, unable to sleep through night, gland pain

Other Meds: Klonepin Gabapentin

Current Illness: Autoimmune multiple diseases: RA, Sjorgens, autonomic dysfunction

ID: 1737542
Sex: M
Age: 55
State: TX

Vax Date: 08/20/2021
Onset Date: 08/21/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data: N/A

Allergies: Crab

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Non stop ringing in both ears day after my second dose.

Other Meds: None

Current Illness: None

ID: 1737543
Sex: M
Age: 32
State: FL

Vax Date: 09/22/2021
Onset Date: 09/23/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data: TROPONIN I, CBC w/ Auto Differential, Comp Metabolic Panel all on 25 Sept 21 Chest X-Ray Single View 25 Sept 21 EKG Study 25 Sept 21

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Head ache, feaver, muscle cramps, muscle pain, chest pain (possible pericarditis), shortness of breath, fatigue

Other Meds: N/A

Current Illness: none

ID: 1737544
Sex: F
Age: 28
State:

Vax Date: 09/26/2021
Onset Date: 09/26/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Headache, fever, chills, muscle pain, back pain, swollen lymph nodes

Other Meds: Junel Fe 1/20, Aleve, Ibuprofen

Current Illness:

ID: 1737545
Sex: F
Age: 58
State: CA

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 09/27/2021
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: Latex sensitivity - gets very very red and itchy but not an allergy; lactose intolerant

Symptom List: Nausea

Symptoms: After the injection (day after), it was swollen - a little bit and hot to the touch (at the injection site) and it lasted a day or so. The following week, I started to get back pain and I hadn't experienced back pain before and it was mostly lower back pain and I was feeling tired day after day and then I started feeling better but then I started having back pain again. I saw Dr. (Sept 9th) for a routine appt and I told her about my lower back pain issues. She prescribed a muscle relaxer and she said I had arthritis in my back - she pulled up my old x-rays to see about it. She said we could do further tests later if it doesn't resolved. The muscle relaxers worked and she recommended me to do ice and hot and stretching and I'm doing health care at home and it's much improved. Seems to be resolving at this time.

Other Meds: Lisinopril - 10 mg daily; Etodolac - 400 mg; Folic Acid - 1 mg; Methotrexate 2.5 mg - 8 tablets once a week; Zoloft - 50 mg daily; Prilosec - 20 mg twice a day; Requip - 1 mg tablet a day; Lopressor - 25 mg a day - 1 tablet a day; Levothyro

Current Illness: no

ID: 1737546
Sex: F
Age: 71
State: MA

Vax Date: 02/15/2021
Onset Date: 03/02/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Severe Tinnitus, severe sweating attacks

Other Meds:

Current Illness:

ID: 1737547
Sex: F
Age: 37
State: NY

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

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

Lab Data:

Allergies: PPD injection

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

Symptoms: after about 5 min or so my arm where I received injection started itching very badly. rash formed and spread down my arm

Other Meds: vitamin b 12

Current Illness: neuropathy due to vitamin b12 deficiency

ID: 1737548
Sex: F
Age: 80
State: MN

Vax Date: 01/22/2021
Onset Date: 09/21/2021
Rec V Date: 09/27/2021
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: Cephalexin; Fosamax; Isorbide; Zetia; Zocoarl Lipitor

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

Symptoms: Patient states started feeling ill on 9/21/21 with chest tightness, dry cough and overall achiness. Tested on 9/24, and positive results on 9/26/21. Patient's husband tested positive on 9/23/21

Other Meds: Alprazolam; Lisinopril; Metoprolol; Acetaminophen; multivitaminsl Torsemide; Escitalopram; Trazodone; Ibuprofen

Current Illness: none

ID: 1737549
Sex: F
Age: 64
State: MN

Vax Date: 04/07/2021
Onset Date: 09/24/2021
Rec V Date: 09/27/2021
Hospital: Y

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: Tremor

Symptoms: Hospitalization cough, vomiting, diarrhea, headache, and chills tested positive for COVID at HCF on 9/18.

Other Meds:

Current Illness:

ID: 1737550
Sex: F
Age: 36
State: MD

Vax Date: 01/06/2021
Onset Date: 04/01/2021
Rec V Date: 09/27/2021
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: CT Scan, MRI, Abdomen X-ray - 04/21 CT Scan, MRI, 2 Endoscopy and 2 ERCPs, Stent placement - 06/21 ERCP / Stent Removal - 08/21 Liver Biopsy - Currently in process of being scheduled Gallbladder removal - Currently in process of being scheduled

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: I was hospitalized with pancreatitis on April 1st due to ongoing nausea, vomiting, abdominal pain. My AST/ALT were in the 1700s and I was admitted to manage the symptoms via morphine and IV fluids. I was discharged 3 days later, however, I still had ongoing nausea, vomiting, extreme weight loss, and reduced appetite. I was hospitalized again on June 6th due to similar symptoms and my liver function levels were in the 1400s again. According to a Physician, they believe my pancreatic episode was never resolved from April to June. They found a blockage and narrowing in my biliary duct, so a GI doctor placed a stent in my biliary duct. The stent was too small and ended up backing bile back into my body, making me worse, so they placed a larger stent (10cm). I still suffered from nausea and reduced appetite due to vomiting. I had the stent removed in August 2021 and they determined possible autoimmune hepatitis as an underlying issue and I am in the process of getting a liver biopsy currently. The GI doctors do agree there could be a correlation from gallbladder issues due to a strong family history of gallbladder attacks (mother, maternal grandparents, and maternal uncle)

Other Meds: Fiber supplements, Women vitamins

Current Illness: None

ID: 1737551
Sex: F
Age: 65
State: FL

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/27/2021
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: none

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

Symptoms: The patient left the pharmacy fine but came back a few minutes later feeling overheated and needed to set. The she started to breath shallowly and go in and out of consiousness. An ambulence was called and she was taken to the hospital

Other Meds: gabapentin

Current Illness: none

ID: 1737552
Sex: F
Age: 59
State: CA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data: none

Allergies: smoke, fragrance, corn, pineapple

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

Symptoms: 1. arm soreness - started 5 am Apr 9; no treatment; resolved in about 3 days 2. chills - started 5 am Apr 9; no treatment; intermittent; resolved in 24 hrs 3. body aches - started 5 am Apr 9; no treatment; intermittent; resolved in 24 hrs 4. nausea - started 5 am Apr 9; no treatment; intermittent; resolved in 24 hrs 5. vertigo - started Apr 12; Epley maneuver; resolved in about 7 days 6. cluster headaches (with light sensitivity) - started 5 am Apr 9; several treatments: Excedrin, oxygen, verapamil increased, sphenopalatine nerve blocks, occipital nerve block, Emgality injections; ongoing at Sep 27.

Other Meds: verapamil 120 mg, mometasone nasal spray, vitamin D, omega 3,

Current Illness: cluster headache cycle/episode ended about 3 weeks prior

ID: 1737553
Sex: M
Age: 19
State: WI

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

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

Lab Data: glucometer check

Allergies: seasonal

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: patient was given vaccines at 2:52. Mother asked how he was doing. he said fine. this was his second dose. i asked how he did with his first vaccine and said no issues. told patient he is supposed to wait 15 minutes but since he had no issues with fist he could leave. pcp told me to give vaccine on opposite arm as last time because he was sore arm and a localized rash. patient walked out to lobby to check out and he asked for a chair. patient said he couldn't see, was pale in color, 911 was called , crash team was called , bp, pulse and sugar level were checked and monitored.

Other Meds: Zyrtec, Allegra, Zoloft

Current Illness:

ID: 1737555
Sex: F
Age: 63
State: MO

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data: N/A

Allergies: N/A

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

Symptoms: Pt. states that after receiving the 2nd dose of Phizer 04/08/2021, started experiencing symptoms immediately of tongue swelling, self-treated with EPI-PEN. Primary visit noted 04/2021 treated with Anti-Viral and steroids. Pt. has recovered with slight weakness and lingering fatigue.

Other Meds: Fercimide, Ibuprofen, Laraxidine, Magnesium, Vitamin B-12, Matolaprol, Tixanidien, Tramadol, Triampritien, Hydrochlorothiazide, Vitamin D3, Voltaren, Arazlipan, Aspirin, Bactrum, Cannabidiol 100mg, Olive Leaf, Dietary Supplement, Probiotic

Current Illness: N/A

ID: 1737556
Sex: M
Age: 65
State: AK

Vax Date: 01/12/2021
Onset Date: 02/26/2021
Rec V Date: 09/27/2021
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. Patient treated empirically with home remedies.

Allergies: none

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

Symptoms: Patient had MODERNA COVID-19 vaccine on 01/12/2021 . 3 days later developed severe left great toe gout flare. Had second shot on 02/23/2021 and within 24 hours developed bilateral foot gout symptoms.

Other Meds: Metformin

Current Illness: none

ID: 1737557
Sex: F
Age: 40
State: TX

Vax Date: 09/13/2021
Onset Date: 09/13/2021
Rec V Date: 09/27/2021
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: Shot 9/13 @ 11:30am Fever 10pm 101.5 lasting 24 hours Body aches 9/14 am, skin sensitive to touch Rash on arm below injection site, red, hot to touch and sore Rash on both sides of lower front neck 9/15am, swollen and sore supraclavicular lymph node on right side. 9/16 Rash wrapping around upper arm, splotches on both forearms 9/18 rash resolved, no longer sore to touch

Other Meds: None

Current Illness: None

ID: 1737558
Sex: F
Age: 34
State: ME

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

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

Lab Data: None

Allergies: NKA

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

Symptoms: I received the second Moderna vaccine on 9/24/21. About an hour after receiving the vaccine, I started to get a sore arm and headache, this continued to worsen as the even progressed. I awoke at 0530 on 09/25/21 (approximately 13 hours post vaccine) and was unable to move, it took 3 hours to get out of bed. I was severely weak, lightheaded, dizzy, nauseous, severe muscle and bone aches, severe headache, SOB, and severe deltoid pain. Once I was able to physically get myself out of bed, I was furniture surfing and barely able to walk. I was extremely light headed and dizzy, and felt near syncope. I rested in bed all day with these symptoms as well as extreme fatigue. I woke on 9/26/21, and felt generally better, however still had lightheadedness and dizziness with worsening SOB, and slight fatigue. I attempted to do routine Sunday chores, but often had to rest due to worsening SOB and feeling lightheaded and dizzy. I was able to shower, and noticed that my torso was covered in hives. I proceeded to walk in care. Upon arrival, walking from the care into the facility, I was quite SOB and my HR was 129. I was brought into the room where I was able to sit. After sitting my HR did decrease to 99. I was treated with 60mg of PO prednisone. Within one hour the hives, lightheadedness, dizziness, fatigue, HR and SOB had decreased. Within 2 hours the SOB had resolved. I was prescribed a regimen of prednisone and famotidine and instructed to purchase and take loratadine. I did present to work on 9/27/21, however did have to take an extended break due to dizziness/lightheadedness and nausea.

Other Meds: Mirena IUD, multivitamin, coQ10

Current Illness: None

ID: 1737559
Sex: M
Age: 13
State: OK

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

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

Lab Data: EKG (09/07/2021)- Normal sinus rhythm, T wave inversion in V2, ST elevation

Allergies:

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

Symptoms: Four days post 2nd dose of COVID-19 (Pfizer-BioNTech), patient had severe bilateral chest pain with rest or activity. Came in for evaluation 10 days post vaccine, EKG showed he has diffuse ST elevations c/w acute pericarditis. OU Pediatric Cardiologist wanted patient to be seen in ER.

Other Meds:

Current Illness:

ID: 1737560
Sex: F
Age: 65
State: MO

Vax Date: 02/02/2021
Onset Date: 09/18/2021
Rec V Date: 09/27/2021
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: COVID+ 9/18 and 9/25

Allergies:

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

Symptoms: 9/24: History of Present Illness Patient is a 66-year-old female with PMH DM type II, neurosarcoidosis with C-spine granulomatous tumor tx with CYC in 1980's, Sjogrens syndrome (negative ANA, but strong positive SSA), adrenal insufficiency, anemia of chronic disease, CKD, DDD/DJD with chronic pain syndrome, muscular twitching, incomplete bladder emptying, anxiety, GERD, HTN, HLD, COVID positive 9/18 who presented after being found unresponsive at her nursing home with Sp02 of 76%. Patient was placed on 6L NC by EMS and saturation increased to 92-93%. Patient remained non-alert and oriented x1 (self) in the department. Saturations decreased to 88% on 6L NC and patient was started on 15L Non-rebreather. Pulmonary consulted, patient put on HFNC and weaned from Fio2 of 60% to 40%. Patient was headed for IM stepdown admission, however, it was noted that patient desaturated while asleep so accepted for ICU admission. Per the record, patient's husband came to ER after multiple missed calls and ER provider discussed code status, which husband decided full code for now till he can speak with family members. Nursing home states that she was diagnosed with covid last Saturday (but vaccinated in December) and has had URI symptoms the past 3 days. Patient has been febrile up to 102.2 per facility and she reports feeling feverish. Patient unable to answer questions intelligibly 2/2 AMS and gives mixed non-verbal gesturing to yes or no questions so further history unable to be obtained. 9/27: Currently on Room air

Other Meds:

Current Illness:

ID: 1737561
Sex: F
Age: 50
State: WI

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data: These are the exact same adverse events I had after my second COVID vaccine which was 4/28/21. But with the COVID vaccine I had a heavy period then no period for 2 months. Still waiting to see if the flu shot changes my periods.

Allergies: PCN

Symptom List: Vomiting

Symptoms: left axilla and breast pain grade 3 left lymph node pain grade 3 left axilla and bilateral breast lymphedema grade 3 back pain grade 3 flu like symptoms grade 2 chills grade 1 night sweats grade 3 started on prednisone 20mg BID. I am now day5 and can put on a bra swelling and pain beginning to lesson

Other Meds: Xanax 1 mg at HS Venlfexin 75 mg for migraine prevention

Current Illness: none

ID: 1737562
Sex: M
Age: 54
State: AL

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/27/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: NO ADVERSE EVENT - The patient was given an expired dose of Moderna that had expired on 9-20-2021

Other Meds: Eliquis 5mg, Vitamin B12 1000mcg, Flecainide 100mg

Current Illness: Obstructive Sleep Apnea, Atrial fibrillation, B12 deficiency

ID: 1737563
Sex: F
Age: 28
State: MN

Vax Date: 01/20/2021
Onset Date: 09/25/2021
Rec V Date: 09/27/2021
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:

Allergies:

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

Symptoms: Hospitalized for induction of labor asymptomatic COVID 19 . Gestational hypertension, EDD 9/23/2021, Birth 9/26/2021, 40w3d gestational age, wt 3.63 kg.

Other Meds:

Current Illness:

ID: 1737564
Sex: M
Age: 39
State:

Vax Date: 05/08/2021
Onset Date: 05/22/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Within two weeks of vaccination reporting severe right shoulder pain, osteonecrosis.

Other Meds:

Current Illness:

ID: 1737565
Sex: M
Age: 37
State: CO

Vax Date: 09/20/2021
Onset Date: 09/24/2021
Rec V Date: 09/27/2021
Hospital:

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

Lab Data: NA

Allergies: NA

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

Symptoms: Ringing in left ear that started 3 days after receiving the second dose of covid 19 vaccine.

Other Meds: Escitalopram & Rivoroxaban

Current Illness:

ID: 1737566
Sex: F
Age: 65
State: AZ

Vax Date: 03/21/2021
Onset Date: 04/01/2021
Rec V Date: 09/27/2021
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: Biaxin Bffient Endomethasine Sulfa Drugs Vicodin Coycon

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

Symptoms: I did not have any symptoms right after vaccine. I started to know afterwards I was getting short of breath. I talked to my PCP about it, and they referred me to a pulmonologist, and they diagnosed me with CPOD. I am currently taking an inhaler.

Other Meds: Wellbutrin 40mg xl per day Vicertlin Edtoprazol Toparol Lazatrin 100mg per day Elmelaprin 10 mg per day Vitamins Vitamin D3 3000 iuc 3 times a week Calcium 600 mg Benadryl

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am