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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1745671
Sex: M
Age: 56
State:

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1745672
Sex: M
Age: 19
State: KY

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient received Moderna as first dose and Pfizer as second dose.

Other Meds:

Current Illness:

ID: 1745673
Sex: F
Age: 31
State:

Vax Date: 07/21/2021
Onset Date: 07/24/2021
Rec V Date: 09/29/2021
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: SKIN BIOPSY DIAGNOSED PSORIASIS

Allergies:

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

Symptoms: RASH PATCHES, PEELING SKIN, AND ITCHING ON THE FEET, HAND, BREAST UNDER ARMS, AND GENITAL AREA

Other Meds:

Current Illness:

ID: 1745674
Sex: F
Age: 76
State:

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1745675
Sex: F
Age: 33
State: NY

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: I went to urgent care on Wednesday 9/29 and they only checked vitals and listened to my stomach and my lungs. The doctor said it was common for patients to experience these side effects to the vaccine and said to continue taking tylenol and drinking fluids.

Allergies: None

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

Symptoms: The first vaccine I had a headache for 2 days. The second vaccine: By 9pm the same night i had a migraine Saturday 9/25 I woke up with upper back pain and a headache Sunday 9/26 i had the same symptoms and also woke up with a swollen lymph node in my left armpit and had armpit pain. Monday and Tuesday I continued to have all 3 symptoms.. Tuesday night 9/28 around 7pm I started having stomach cramping Wednesday 9/29 I woke up with an upset stomach and had diarrhea as well as back pain.

Other Meds: Pantoprazole

Current Illness: Migraines IBS-D Gallstones Hiatal Hernia

ID: 1745677
Sex: F
Age: 57
State: OR

Vax Date: 09/02/2021
Onset Date: 09/21/2021
Rec V Date: 09/29/2021
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: Doctor examined my face and concluded that I had Bell's Palsy.

Allergies: sulfa, penicillin

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

Symptoms: On 09/21/2021 I started to feel a numbness to my tongue and pain to my left ear when I woke up in the morning . Went to see doctor on 09/22/201 due to face starting to feel numb. Doctor determine that I had contracted Bell's Palsy.

Other Meds: no

Current Illness: none

ID: 1745678
Sex: M
Age: 28
State: CO

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/29/2021
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: Dimetapp

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Sore arm for 3 days. Nausea vomiting SOB body aches joint pain skin pain headache neck pain for approximately 24 hours chest pain currently ongoing.

Other Meds: Lisinopril, amitryptaline rizatripran omeprazole

Current Illness:

ID: 1745679
Sex: M
Age: 46
State: CA

Vax Date: 05/13/2021
Onset Date: 09/19/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data: 9/29/2021 15:01 9/23/2021 23:15 NA: 130 (L) K: 3.9 CL: 90 (L) CO2: 33 BUN: 32 (H) CREAT: 0.77 ANION GAP4 SERPL: 7 GLUC: 480 (AA) COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE 9/24/2021 05:31 NA: 130 (L) K: 4.0 CL: 91 (L) CO2: 32 BUN: 33 (H) CREAT: 0.70 ANION GAP4 SERPL: 7 CA IONIZED: 1.17 MG: 2.2 PHOS: 2.1 (L) GLUC: 374 (H) LDH: 157 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE CRP, SER QL: 2.0 (H) FERRITIN: 302 WBC: 12.2 (H) RBC'S: 4.25 HGB: 10.4 (L) HCT: 33.1 (L) MCV: 78 (L) RDW, RBC: 15.9 PLT: 387 IMMAT GRANULO % AUTO: 1 NRBC: 0 NEUTROPHILS % AUTO: 89 (H) ANC: 10.8 (H) LYMPHS % AUTO: 5 (L) MONOS % AUTO: 5 EOS % AUTO: 0 BASO'S % AUTO: 0 D-DIMER: 1.09 (H) 9/25/2021 05:49 NA: 136 K: 3.9 CL: 97 (L) CO2: 32 BUN: 40 (H) CREAT: 0.74 ANION GAP4 SERPL: 7 CA IONIZED: 1.20 MG: 2.1 PHOS: 2.1 (L) GLUC: 132 LDH: 133 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE CRP, SER QL: 1.3 (H) FERRITIN: 302 WBC: 13.1 (H) RBC'S: 4.20 HGB: 10.3 (L) HCT: 33.2 (L) MCV: 79 (L) RDW, RBC: 16.0 PLT: 384 IMMAT GRANULO % AUTO: 1 NRBC: 0 NEUTROPHILS % AUTO: 77 (H) ANC: 10.0 (H) LYMPHS % AUTO: 13 (L) MONOS % AUTO: 9 EOS % AUTO: 0 BASO'S % AUTO: 0 D-DIMER: 1.26 (H) 9/26/2021 05:48 NA: 137 K: 4.6 CL: 102 CO2: 29 BUN: 41 (H) CREAT: 0.71 ANION GAP4 SERPL: 6 CA IONIZED: 1.22 MG: 2.5 (H) PHOS: 3.5 GLUC: 141 LDH: 131 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE CRP, SER QL: 1.0 (H) WBC: 13.9 (H) RBC'S: 4.46 HGB: 10.8 (L) HCT: 34.5 (L) MCV: 77 (L) RDW, RBC: 16.3 PLT: 422 (H) IMMAT GRANULO % AUTO: 1 NRBC: 0 NEUTROPHILS % AUTO: 81 (H) ANC: 11.3 (H) LYMPHS % AUTO: 11 (L) MONOS % AUTO: 7 EOS % AUTO: 0 BASO'S % AUTO: 0 D-DIMER: 1.19 (H) 9/27/2021 05:35 CREAT: 0.68 CA IONIZED: 1.21 MG: 2.4 (H) PHOS: 2.9 LDH: 141 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE CRP, SER QL: 0.8 FERRITIN: 327 WBC: 10.8 RBC'S: 4.25 HGB: 10.3 (L) HCT: 34.3 (L) MCV: 81 RDW, RBC: 16.9 (H) PLT: 427 (H) IMMAT GRANULO % AUTO: 0 NRBC: 0 NEUTROPHILS % AUTO: 83 (H) ANC: 8.9 (H) LYMPHS % AUTO: 9 (L) MONOS % AUTO: 7 EOS % AUTO: 0 BASO'S % AUTO: 0 D-DIMER: 1.01 (H)

Allergies: NKDA

Symptom List: Pharyngeal swelling

Symptoms: 46yo male with h/o HLD, DM2, recent admission 9/8-9/13 for L foot abscess c/b osteomyelitis now s/p L BKA (9/11), found 9/13 to be COVID+, who presented with SOB, cough, fever and was admitted 9/19 for AHRF requiring HFNC 2/2 COVID 19 vs secondary PNA. Afebrile on admission, no leukocytosis, started on covid treatment (steroids, Remdesivir, Toci in ICU) and empiric abx (Vanc, Cefepime), but with worsening respiratory status requiring HFNC 50L/80% FiO2. Received Decadron 9/19, Solumedrol 125 q6 x4 days, Remdesivir x5 days, Toci x2 in ICU. CT chest showed moderate b/l effusions (exudative - gram stain/KOH neg for organisms), had b/l chest tube placement with drainage. Now s/p b/l chest tube removal 9/24. MRSA swabs neg, Vanc dc'ed (9/20-9/22). BCx NGTD. Pt weaned down to NC, transferred to floor. Completed Cefipime course (9/20-9/26). Weaned steroids from Solumedrol 125IV BID to 60IV BID to Prednisone 50mg with 10mg taper daily - pt currently on Prednisone 40mg. Insulin regimen adjusted accordingly to control sugars, now decreasing regimen given steroid taper. Pt also noted to be very anasarcic on presentation, diffuse b/l edema to scrotum and abdomen. BNP not elevated, lower c/f HF as etiology (EF 9/20 , thought to be more 2/2 poor nutrition/hypoalbuminemia. Received albumin while in ICU, diuresed aggressively with marked improvement in edema. Will discharge on 20mg PO Lasix. Foley placed d/t urinary retention 2/2 scrotal edema while in ICU, removed while on floor now with condom cath in place voiding well. Pt cleared for facility by PT to improve strength. Wound care evaluated patient. Patient has sacral/coccyx decubitus ulcer. Per surgery recs, too dry for debridement. Continue wound care recs at facility and e-consult was placed for outpatient surgery f/u. Please see hospital course by problem below: #ACUTE HYPOXEMIC RESPIRATORY FAILURE (9/19/2021) #CORONAVIRUS COVID-19 DISEASE (+Test 9/13/2021) #?SECONDARY BACTERIAL PNEUMONIA Presented from facility for cough, SOB, recent covid (+9/13) and RLL consolidation on CXR c/f secondary bacterial PNA. Afebrile and w/o leukocytosis on admission, started on covid treatment (steroids, Remdesivir, Toci) and empiric abx (Vanc 9/20-9/22, Cefepime 9/20-23), but with worsening respiratory status requiring HFNC 50L/80% FiO2. Now s/p Decadron 19/19, Solumedrol 125 q6 x4 days, Remdesivir x5 days, Toci x2 in ICU. CT chest showed moderate b/l effusions (exudative - gram stain/KOH neg for organisms), now s/p b/l chest tube placement with drainage. MRSA swabs neg, Vanc DC'ed. BCx NGTD. Pt now on 4L NC satting well, inflammatory markers improving. 9/24- s/p b/l chest tube removal, satting well on 4LNC, SOB and inflammatory markers improving. Cont Cefipime and steroid taper, wean O2 as able. S/p Cefepime 2g q8 x 7d (9/20-9/26). Inflammatory markers trending down. Breathing comfortably on RA. -Cont steroid taper- Pred 50mg with daily 10mg taper as prescribed -Follow up Toci labs: TB, strongyloides, Cocci -Continue COVID isolation precautions until 10/3 -Wean O2 as tolerated, goal SpO2 >94% #ANASARCA #SCROTAL EDEMA Diffuse anasarca on initial presentation with significant scrotal and b/l LE edema. Cr at baseline (0.6-0.7), BNP baseline on admission.TSH wnl. ?Possibly 2/2 hypoalbuminemia, poor nutrition. Net (-)17L this admission at time of transfer to floor. 9/24- neg 6L yesterday, with LE and scrotal edema improving significantly. DC'd Diamox and Spiro, cont Lasix at current dose. Ctm Cr. Swelling continuing to improve, still net neg 1-2L yest without Lasix. Patient to discharge on reduced Lasix dose, 20mg PO daily. -Continue Lasix 20mg PO daily -Chem 7 in 2-3 days #DM2 c/b osteomyelitis s/p L BKA on 9/11/2021 Last A1c 13.5 on 7/2021. Patient on PTA insular glargine 15 units BID, Metformin 500 4 tab QD. Increasing insulin requirement on high dose steroids. 9/24 - sugars 300-400s overnight 2/2 high dose steroids. Pt on 18u BID NPH, 8u regular TID prior and required 58u over past 24 hours in addition. Will increase basal to 38u BID, increase bolus to 10u TID, ctm sugars closely as we taper steroids. 9/25 - sugars 120s -- >80s this AM, decreased Insulin to 25 BID NPH, 10 TID regular mealtime. Hold AM mealtime given 80s. Ctm as steroids decrease. Sugars stable 140s, cont current regimen and ctm sugars. -Insulin regular 10u TID qAC -NPH 25u BID basal -Continue to monitor sugars, taper steroids as abovel #URINARY RETENTION S/p outpatient placement of indwelling foley 9/15. Swelling improving gradually per patient. S/p unsuccessful voiding trial yesterday, now with condom cath in place draining well. -Continue PTA Tamsulosin 0.4 mg PO daily #HTN -Continue Lisinopril 2.5 mg PO daily (SBP 130s-140s, Cr WNL) #HYPERLIPIDEMIA -Continue Lipitor 10 mg PO daily #Wound Care To coccyx wound will use wound gel to soften the eschar , but will protect periwound from moisture. Wound 1: Sacrococcyx - Clean using Easicleanse washcloths, gently wash skin, pat dry. To periwound : protect with Critic aid barrier paste. To dark eschar: Apply Hydrogel wound gel and cover with xeroform gauze. Secure with Mepilex sacral border dressing. Change BID and prn soiling. Waffle cushion under coccyx when in bed and up in chair. Turning / Offloading every 2 hours in bed. Left BKA - defer to Ortho recs, assess and cover with dry gauze daily . Right heel - offload with pillow off the mattress. Primary Procedures: None Secondary Procedures: None Reason for Hospital Admission (Admitting Diagnosis): AHRF 2/2 COVID PNA

Other Meds: Prior to Admission Medications Outpatient Home Medications Taking? Atorvastatin (LIPITOR) 10 mg Oral Tab Stopped Taking Sig: Take 1 tablet by mouth daily for cholesterol Patient not taking: No sig reported metFORMIN (GLUCOPHAGE XR) 500 mg O

Current Illness: None

ID: 1745680
Sex: F
Age: 78
State: NY

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Hydrocodone, Clindamycin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: The patient called stating she had random hives and joint pains that began several hours after receiving both the Fluzone HD and the Pfiizer Covid vaccine. She was not having any swelling of the mouth or throat and no difficulty breathing. I advised her to contact her doctor but she does not have one currently. I then advised her to keep an eye on the reaction and go to the ER if she does experience difficulty breathing.

Other Meds:

Current Illness:

ID: 1745681
Sex: F
Age: 37
State: WI

Vax Date: 09/23/2021
Onset Date: 09/26/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: After the second shot, the same severe back spasms that occurred after the first shot, came back overnight/early morning hours of Sept 26. This is lasting even now on Sept 29. The spasms were non-stop Sept 26 & 27 and have been intermittent Sept 28 & 29. I have never had muscle spasms like this before the shot. After I recovered from the first dose, the spasms stayed away, until I received my second dose of the COVID-19 vaccine.

Other Meds: Vitamin D; multivitamin

Current Illness: I caught COVID-19 between the two injections. I was symptomatic from Sep 13th through Sept 19th, and had a positive COVID-19 test on Sept 16th.

ID: 1745682
Sex: F
Age: 34
State: CA

Vax Date: 04/16/2021
Onset Date: 04/18/2021
Rec V Date: 09/29/2021
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: Symptoms: Elevated heart rate at rest and with minimal exertion; shortness of breath; light headed/ pre syncope events; increased fatigue Treatment: Increased once daily Bisoprolol Fumarate 10mg dose (POTS treatment) to 5mg in AM and 10 mg in PM for 2 weeks. Increased dose helped symptoms, but when tried to go back to original dose after 2 weeks symptoms returned. Returned to taking 5mg Am and 10mg PM daily and subsequent attempts to decrease dose since have resulted in incresed symptoms. Currently still taking 5mg AM and 10mg PM.

Other Meds:

Current Illness:

ID: 1745683
Sex: M
Age: 42
State: CA

Vax Date: 09/26/2021
Onset Date: 09/27/2021
Rec V Date: 09/29/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Fever 103, sweats, chills, diarrhea, confusion. Loss of appetite. Full body aches

Other Meds:

Current Illness:

ID: 1745684
Sex: F
Age: 28
State: CO

Vax Date: 09/27/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
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: peanuts, cefdinir, bactrim

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

Symptoms: large purple bruise at injection site, chills at 30 hours post vaccination resolving in 2 hours, axillary swelling (in same arm as vaccine) at 40 hours after vaccination and has not resolved as of 50 hours post vaccination, general malaise and mental fogginess starting at 30 hours post vaccination and has not resolved

Other Meds: vitamin D3 2000 IU, desogestrel/ethinyl estradiol, duloxetine, Focalin, methylphenidate

Current Illness: none

ID: 1745685
Sex: M
Age: 81
State: MN

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
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: N/A

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

Symptoms: Patient was given an expired dose a Moderna Covid-19 vaccine. Technician drew up a dose from an expired vial from yesterday. No adverse events reported.

Other Meds: N/A

Current Illness: Cancer

ID: 1745686
Sex: F
Age: 50
State: NE

Vax Date: 09/21/2021
Onset Date: 09/22/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data: EKG- okay Lab work Chest x-ray- normal Hemoglobin A1C- 5.2 Troponin 1- less than 0.04 (3x) Magnesium- 2.3 Comprehensive metabolic Panel- (all normal range) CBC-( all normal range) Covid Test- negative Lipid Panel- Cholesterol-176 Magnesium 2.2

Allergies: Adhesive Dye (when giving a CT Scan)

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

Symptoms: At first I felt like my heart was beating out of my chest. That lasted for several hours. Around 5:30 PM I got a bloody nose that was pretty bad. I decided that that was more than my body could take so I went to a urgent care clinic. They took my blood pressure and said I needed more care then what they could provide so I went to the ER at Medical Center and my blood pressure was 231 over 109. They did an EKG that came back okay. They admitted me for observation and gave me nitro under my tongue to bring my blood pressure down. They kept me overnight and since then my blood pressure has been high but not that high at it was at first. I have been extremely tired. My heart rate is still fast. Last night I started feeling like I could function normally for about two hours. Yesterday and today I could stay awake. I feel about 80% good. My blood pressure today was 125 over 80. I keep pushing fluids, sleeping, and waiting for things to go back to normal. Also last night I had woke up because I had horrible pains in legs.

Other Meds:

Current Illness:

ID: 1745687
Sex: F
Age: 60
State: SD

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: none

Allergies: Milk, eggs, apples, dairy, nuts, shell fish and many more.

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

Symptoms: Patient complaints of throat, tongue and lip numbness approximately 15 minutes after vaccine. After a stable assessment and stable vitals signs, Benadryl 50 mg po given with noted decreased in symptoms in 30 minutes. Patient monitored another 1 hour after issues. Husband called to pick up patient. Lungs clear, BP 120-130's/70-80, pulse 70-80's, res 20-24, Spo2 98-99% o room air. Patient to call Dr. in am, her PCP to updated her and her recommendations of further COVID vaccines. Patient discharged home with husband, to go home. To take additional 50 mg of Benadryl this evening and if any concerns to follow up at . Patient and husband verbalized understanding of the above instructions and treatment plan. CNP

Other Meds: Takes Zyrtec 10 mg daily and singulair 10 mg daily. History of asthma and multiple allergies.

Current Illness: None.

ID: 1745688
Sex: F
Age: 72
State: CA

Vax Date: 09/24/2021
Onset Date: 09/25/2021
Rec V Date: 09/29/2021
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: I?m urban, Remicade, Hydrochlorothiazide

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

Symptoms: 100 degree fever & body aches started 26 hrs after injection (injection on 9/24/21 @ 3 PM, adverse event on 9/25/21 @ 5 PM). Fever ended 5 AM on 9/26/21. Felt fatigued the rest of the day, then totally fine on 9/27/21.

Other Meds: Atenolol, Amlodipine, Lomotil, Atorvastatin, Restasis, mature multi vitamin, vitamin D, calcium, Ferrous Sulfate, ZyrTEC

Current Illness: None

ID: 1745689
Sex: M
Age: 73
State:

Vax Date: 03/21/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
Hospital: Y

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: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series

Other Meds:

Current Illness:

ID: 1745691
Sex: M
Age: 14
State: ND

Vax Date: 09/29/2021
Onset Date:
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: J&J given to 14 year old. Patient observed for 25 minutes. Department of Health contacted.

Other Meds:

Current Illness:

ID: 1745692
Sex: F
Age: 79
State: PA

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
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: Patient received the Moderna series. She came in to get an additional dose because she has cancer and was inadvertently given Pfizer as the additional dose instead of Moderna.

Other Meds:

Current Illness:

ID: 1745693
Sex: F
Age: 51
State: OK

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: Oranges and Star Gazer Lilly>anaphylaxis a. Penicillin-Rash b. Pfizer COVID Vaccine-Anaphylaxis c. Codeine-Severe gastric distress d. NSAIDS- Severe gastric distress e. Erythromycin- Severe gastric distress f. Avalox-Insomnia, food aversion, nausea, restlessness g. Caffeine- Severe gastric distress

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

Symptoms: It started with itching in the throat. Progressed to coughing, bronchial spasms, nose running, choking sensation. Took albuterol inhaler, 2 puffs. Administered Epipen. Took albuterol inhaler, 2 puffs again. Given 50 mg Benadryl. Initially better after first dose of epi. Then started bronchial spasms again. Given second round of epinephrine and solu cortef and pepcid IV. Was stable after those medications. The whole event took about 45 minutes.

Other Meds: Atorvastatin; Montelukast; Pepcid; Allegra; Multivitamin; Pantoprazole

Current Illness: None

ID: 1745694
Sex: F
Age: 31
State: IN

Vax Date: 09/27/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Xray

Allergies: Tramadol, robaxin, benzoyl peroxide

Symptom List: Unevaluable event

Symptoms: High fever 102.4 max, severe body aches started 9/28/21. Syncopal episode x2 on 9/29/21 and was seen at ER for treatment, had badly sprained ankle from the syncopal episodes.

Other Meds: Duloxetine 60 mg daily, metformin 2000 mg daily, omeprazole 40 mg daily, levothyroxine 75 mcg daily, propranolol 10 mg bid, gabapentin 400 mg tid, baclofen 20 mg tid, morphine er 15 mg tid

Current Illness: None

ID: 1745695
Sex: F
Age: 66
State: OK

Vax Date: 03/05/2021
Onset Date: 03/10/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: None.

Allergies: Sulfa Drugs.

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

Symptoms: My arm was sore but it wasn?t terrible and I was a bit fatigue and about 5 days after the vaccination, my right hip and right shoulder were bothering me. My right shoulder was bothering me more than right hip, so I went to chiropractor and that didn?t help right away but it did help and it?s still bothering me. That was all I really notice after the first vaccine. I did have a slight headache, muscle aches, and fatigue. Later I stumbled into a rocking horse and I thought maybe that had messed me up.

Other Meds: Levothyroxine, Prestik, omeprazole, Singulair, Metformin, Vitamin D Complex, Vitamin C, Fish Oil, Zinc, Melatonin, eye Vitamin.

Current Illness: None.

ID: 1745696
Sex: M
Age: 14
State: WI

Vax Date: 07/08/2021
Onset Date: 09/12/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: POS COVID19 9/15/21

Allergies: NONE

Symptom List: Injection site pain, Pain

Symptoms: BREAKTHROUGH/PREVIOUSLY VACCINATED

Other Meds: NONE

Current Illness: NONE

ID: 1745697
Sex: F
Age: 34
State: GA

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/29/2021
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: aspirin, eggs

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient experienced severe nausea and vomiting that started about 1 hour post second Moderna vaccine. Patient became severely dehydrated due to the vomiting and went to Emergency Room that evening. The physician decided to admit the patient to administer fluids and monitor patient. The patient stated she recovered after about 48 hours post-vaccination and has not had any symptoms since.

Other Meds:

Current Illness:

ID: 1745698
Sex: F
Age: 37
State: LA

Vax Date: 09/22/2021
Onset Date: 09/23/2021
Rec V Date: 09/29/2021
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: None

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

Symptoms: Pain, swelling under armpit, body aches, blurry vision, fatigue, chest pain, diarrhea.

Other Meds: Synthroid, customer, pristiq

Current Illness: None

ID: 1745699
Sex: M
Age: 77
State: MO

Vax Date: 03/30/2021
Onset Date: 08/31/2021
Rec V Date: 09/29/2021
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: CT Scans Hospital Testing

Allergies: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: During the night after I got the vaccine I got up to go to the bathroom. I got sick to my stomach and I started throwing up. I crawled back to bed but I got sick again and I woke my wife up. She noticed that I was not speaking clearly and she could not understand what I was saying. She was worried and she called 911. The ambulance came right away and they took me to the hospital within an hour of the first symptoms. I was diagnosed with a stroke right away and I was given tPA. I was in ICU for a few days and then moved to a regular room. After that I was moved to a rehabilitation facility. I have been having some vision problems as well as a problem with controlling my blood pressure. I have also been diagnosed with Parkinson's since I got the vaccine. The doctor explained that my Rheumatoid Arthritis may have been triggered to cause extra problems. I was in rehab until July of 2021 but my recovery has been slow. Some days are better than others and my speech is better sometimes than others.

Other Meds: Atenolol 50mg, statin Aspirin 325, Omeprazole 20 mg Finasteride Lisinopril 10mg morning and 20mg at night Aleve 2 per day

Current Illness: N/A

ID: 1745700
Sex: F
Age: 68
State: CA

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: None as sensation subsided after approximately two days.

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: After receiving the second dose of Pfizer, I began to feel an ache in my chest area around location of heart. It did not feel like what I have read a heart attack feels like, just an intermittent ache to the heart area. This sensation lasted approximately two days.

Other Meds: Prescription - Levothyroxine Supplements - Omega 3, Vitamin D, Turmeric, Policosanol, Psyllium, Liposomal Vitamin C

Current Illness: None

ID: 1745701
Sex: M
Age: 53
State: GA

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/29/2021
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: N/A

Allergies: N/A

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

Symptoms: Extreme chills/shakes, fever, and migraine.

Other Meds: Lipitor, Flomax

Current Illness: N/A

ID: 1745702
Sex: F
Age: 66
State: OK

Vax Date: 03/29/2021
Onset Date: 04/03/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: CRP; X-rays; Sedrate; Strep; Rheumatoid Arthritis Factor Test; ANA screen; DNA Antibody; Glucose; BMP; Creatinine; Sodium; Liver function tests; AST; ALT; Proactive protein; TSH; CBC with Diff and Platelets; Calcium; Neutrophils; AMCA screen; Multiple antibody tests; Hep B; Multiple labs.

Allergies: Sulfa Drugs

Symptom List: Nausea

Symptoms: 04/03/2021 I experienced fatigue, and the joint paint was not any better. The Saturday after that I stepped onto a kitchen step ladder and I had excruciating pain in right hip joint and that scared me, so that following Monday I called our orthopedic clinic and saw him on 04/09/21 and by that time my shoulders were beginning to bother me and they looked at my shoulders and did an X-ray and thought it would be polymyalgia rheumatica and everything was OK except the CRP was high (18 or 19) so he put me on steroids and by Saturday I was better and then my pain just went away. On 04/19/2021 my right shoulder began to hurt again and left shoulder and both hips and things were getting worse. It got to the point it hurt so bad that I couldn't position myself in bed or if I tried to it was a big ordeal and would hurt to pull covers up over me and I was having trouble getting up and down and everything hurt really bad, so I was able to borrow rest chair and I slept in that chair until a couple of weeks ago. I still can't lie completely down in bed but I can have a lean back pillow and sleep in bed at least. When I seen PCP in May he did a lot of tests with immune diseases that came back negative but the CRP was 25 and last time checked was 71. He thought it might be the polymyalgia rheumatica but he wasn't sure because I had diabetes and couldn't take a lot of prednisone but they wanted to get inflammation down. I was able to see rheumatologist July 6 and she did a lot more tests and the only thing that showed abnormal was the CRP but she felt like based on symptoms that I had rheumatoid arthritis, so she started me on hydroxychloroquine and that has helped. I am better but, in the meantime, my wrists, hands, and fingers started being affected and not just my hips and shoulders, and as far as being able to do things I've been finding other ways to do things. Most of the time I can get dressed and I have trouble getting my pants up all the way I can't reach behind me, I have trouble getting shirt on but I've kind of figured out how I've done it al my life. I can't really cut things up with cooking. I have trouble getting my grandsons shoes on him and it hurts my shoulders and I can't push him in a swing and I cant open cans and I cant always unscrew lids and I have to get a knife to cut around it, I cant open sippy cups either. I can't fix my hair because I cant brush the back of it. I get really tired easily and some of that might be because of the rheumatoid arthritis. I can't clean the house, can't scrub, but I can wash stuff that are easy but I can't scrub dishes. I don't drive. I can't put sheets on the bed. The prednisone I was prescribed, the inflammation went away in shoulders and hips.

Other Meds: Levothyroxine; Prestik; Omeprazole; Singulair; Metformin; Vitamin D Complex; Vitamin C; Fish Oil; Zinc; Melatonin; Eye Vitamin

Current Illness: None

Date Died: 08/21/2021

ID: 1745703
Sex: M
Age: 81
State: MT

Vax Date: 01/02/2021
Onset Date: 08/21/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data: SARS-CoV-2 PCR test collected on 8/14/2021

Allergies: Sulfonamide antibiotics, Avodart, Flomax, doxycycline, losartan, trimethoprim

Symptom List: Injection site pain

Symptoms: Patient was a breakthrough case diagnosed on 8/14/2021 and died of COVID-related conditions on 8/21/2021.

Other Meds: acetaminophen, Maalox, Sinemet, Coreg, Docusoft, donepezil, Cosopt, Lexapro, loperamide

Current Illness:

ID: 1745704
Sex: M
Age: 42
State: CA

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: X-Rays

Allergies: None

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

Symptoms: After taking the 2nd dose, I felt like I couldn't fully bend my arm. It hurt really badly. Its hard for me to pick up my child. Its also difficult for me to exercise or surf. I can't do the normal activities that I used to do. I thought the pain was going to go away, but it hasn't. I went to the doctor and took X-Rays. I did some physical therapy for my arm, but that didn't help much. My doctor could not figure out the root cause of the pain, but all of this started after taking my 2nd shot. I was given Diclofenac Sodium, but that did not help much either.

Other Meds: None

Current Illness: None

ID: 1745705
Sex: M
Age: 65
State: CA

Vax Date: 09/01/2021
Onset Date: 09/06/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data: More blood transfusions performed in the next week with more blood loss

Allergies: Shellfish ,tylenol

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

Symptoms: Thrombocytopenia, was the result of getting this vaccine. Symptoms began during routine dialysis treatment with spikes in blood pressure and steady drop in hemoglobin values over a two week period. I was notified by my dialysis clinic that I was loosing blood some where. I went to the emergency room at Hospital on 9-16-2021 and was given three blood transfusions. An esophagogastroduodenoscopy was performed with no significant signs of bleeding and was told by Dr. at Hospital (Dignity )to schedule a colonoscopy as an outpatient

Other Meds: Abacavir, Tivicay, Lamivudine-iron

Current Illness: Kidney Failure (dialysis ) HIV

ID: 1745706
Sex: F
Age: 60
State:

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/29/2021
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: Fluzone 1993-1994 - Anaphylaxis Sulfa - Rash Benzocaine - hives, rash

Symptom List: Tremor

Symptoms: Pt presented to ED with concern for an allergic reaction after she had the Covid vaccination. The patient had a severe Covid infection with prolonged ICU stay and intubation in December. She states that she has been trying to get back to walking and exercise. She is followed by pulmonology due to shortness of breath. She has not yet had an oxygen requirement. The patient states she had the Covid vaccine today and shortly after began having a sense of swelling around her eyes itching on her back and down her arms as well as shortness of breath. She states that she felt she had a vagal episode immediately after the shot and then the other symptoms started. The patient denies sense of swelling of her throat tongue or lips. The patient states that with her asthma she does not typically wheeze. pt treated with 2 doses of Benadryl, Ativan.

Other Meds: According to records, Pt receive faraheme infusion on the same morning. after infusion, pt c/o chest tightness, resolved by Tylenol. She also used her albuterol inhaler. med list: albuterol (PROVENTIL HFA, VENTOLIN HFA) 90 mcg/actuati

Current Illness: Gastric erosion determined by endoscopy 6/28/2021 egd 6/28/21, small erosion without bleeding, likely due to nsaid use ? History of 2019 novel coronavirus disease (COVID-19) 1/11/2021

ID: 1745707
Sex: F
Age: 70
State: IA

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: Severe headache, fever 101, body aches, fatigue lasting about 1 day.

Other Meds:

Current Illness: none

ID: 1745708
Sex: M
Age: 32
State: OH

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
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: None

Allergies: Gluten

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

Symptoms: 09/29/2021 2:00 AM: Onset of fatigue, muscle weakness, general aches and pains, chills, headache, general feeling of weakness, and fever.

Other Meds: None

Current Illness: None

ID: 1745709
Sex: M
Age: 52
State: CA

Vax Date: 03/17/2021
Onset Date: 03/24/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: It is exceedingly difficult to test for these effects.

Allergies: None.

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

Symptoms: I am reporting ongoing adverse effects of the Moderna vaccine that warrant further investigation and analysis. Now at more than six months after the first dose on 3/17/2021, I continue to experience persistent pain and swelling in the connective tissue in both arms. This manifests as tendinitis in the elbows, forearms, and wrists. I have been exercising and weight training for 40 years--it has never been so painful to do so. The Moderna vaccine has caused permanent damage that cannot explained by any other proximate cause. This adverse effect has reduced my ability for certain exercise and thereby undermines my physical and mental well-being. Hot flashes are an additional adverse effect and they appear to be cyclical (every third week) and often occur during sleep.

Other Meds: Lithium; low-dose naltrexone.

Current Illness: None.

ID: 1745710
Sex: M
Age: 40
State: WI

Vax Date: 04/08/2021
Onset Date: 09/15/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: COVID19 POS 9/15/21

Allergies: NONE

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: BREAKTHROUGH COVID INFECTION

Other Meds: LISINOPRIL 40 MG ATORVASTATIN 20 MG

Current Illness: NONE

ID: 1745711
Sex: M
Age: 76
State: NY

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: unknown

Allergies: none allergy

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

Symptoms: Patient received a Pfizer booster shot in his left arm then a fluad in his right arm He then went to stand up and put his sweater back on and he fell over onto the table then he slowly went down to the ground and he collapse maybe a foot and a half off the ground Someone shouted please help I ran out and realized he was unconscious then I said call 911 and checked him tried to get him to respond over realized he was out I performed maybe 2 sets of chest compressions I then saw he was breathing still not responsive The person on 911 was very helpful then patient started to gag he told me to roll him on his side and keep him there then ems came

Other Meds: torsemide, triamcinolone, sotalol, nadolol, clopidogrel, lisinopril, rosuvastatin, jantoven, metolazone

Current Illness: unknown

ID: 1745712
Sex: F
Age: 65
State: FL

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: None

Allergies: Levaquin, codeine

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

Symptoms: Severe abdominal cramps, diarrhea, nausea, dry heaves, fever over 102

Other Meds: Glimepiride 2mg, omeprazole 40mg, estradiol 2mg, ropinerole 2 mg, montelukast 10mg, magnesium 250mg, multiple vitamin,

Current Illness: None

ID: 1745713
Sex: F
Age: 75
State: TN

Vax Date: 09/24/2021
Onset Date: 09/27/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies: Butorphanol, Codeine, Hydromorphone, Ketorolac, Morphine, Promethazine, Propoxyphene, Darvon, Nubain, Penicillins, Sulfa Antibiotics, iodine contrast oral and IV

Symptom List: Pain in extremity

Symptoms: LOCALIZED REACTION IN ARM REQUIRING MEDICAL ATTENTION

Other Meds:

Current Illness:

ID: 1745714
Sex: F
Age: 62
State: CA

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: CBC, CMP, troponin - elevated, BNP - elevated

Allergies: Penicillin, seafood

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

Symptoms: Initial dizziness, watched in hospital for 30 mins, discharged home in stable condition. Over subsequent 48hrs developed chills, sob, lightheadedness, palpitations. Pt with incomplete control of SLE w/ occasional myocarditis. Has had SLE flare w/in past 6 months. Now w/ sx concerning for recurrent myocarditis & sick sinus syndrome. Site Left Deltoid Route Intramuscular Dose 30 Unit mcg Expiration Date FEB 28, 2022 Manufacturer Pfizer Inc. Covid-19 (Pfizer) Published AUG 23, 2021 Given SEP 27, 2021

Other Meds: aspirin 81 mg oral tablet, chewable, 81 mg= 1 tabs, Chew, QDAY atorvastatin 80 mg oral tablet, 80 mg= 1 tabs, Oral, NIGHTLY atovaquone 750 mg/5 mL oral suspension, 1500 mg= 10 mL, Oral, QLUNCHAC, 1 refills Bactrim DS 800 mg-160 mg oral t

Current Illness: Drainage of hip abscess from spider bite earlier same day (9/27/21).

ID: 1745715
Sex: M
Age: 44
State: OR

Vax Date: 03/26/2021
Onset Date: 07/09/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Beginning 100 days after vaccine, experienced an episode of sensory disturbances of the skin diffusely over the whole body to include the trunk, face, and limbs. Symptoms inluded: electric shock-like brief painful sensations, pricks, and itchy skin. Symptoms were consistent with Idiopathic Non-Length-Dependent Small Fiber Sensory Neuropathy. Symptoms were most acute on the first day and progressively improved over 8 weeks.

Other Meds: Synthroid 150mcg daily

Current Illness: None

ID: 1745716
Sex: F
Age: 32
State: TX

Vax Date: 08/14/2021
Onset Date: 08/15/2021
Rec V Date: 09/29/2021
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: Adhesive tape

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

Symptoms: 1st dose: skin rash and itchiness on arms presenting the day after injection was received. Duration: 3 days. No treatment needed; 2nd dose: skin rash and itchiness across arms, shoulders, face, neck and back presenting morning after injection. Duration: 9 days. Treatment included use of hydrocortisone cream. Steroids were recommended but turned down as patient was breastfeeding.

Other Meds: Lovenox injections; Nifedipine; Ferrous Sulfate tablets; Sertraline; Pantoprazole; Prenatal vitamins

Current Illness: None

ID: 1745717
Sex: F
Age: 36
State: CA

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: metallic taste in mouth 2 hours after vaccine, like "sucking on a penny". Next noticed sores in mouth and fatigue the next day. On day 7 sores had nearly resolved.

Other Meds:

Current Illness:

ID: 1745718
Sex: F
Age: 37
State: CA

Vax Date: 08/17/2021
Onset Date: 08/18/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: None. I called location a week after my vaccination and talked to someone over the phone. I work in an clinic and had the doctor's looking at it from time to time to make sure it was not infected.

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: The day after my vaccination, my arm was swollen with a large mass running about 2" long down from the injection site and about 1/2" wide (like the size of my thumb). It was red and hot to the touch. I had this for about 2 weeks. I started getting what I would describe as bone pain the day after the vaccination as well. I was getting bolts of pain in my jaw when talking that would take my breath away. That only lasted for the one day and only happened a handful of times. I also started getting somewhat severe, achy pain in my shoulder joint and sharp bolts of pain from my shoulder to my collar bone and down to my wrist. This has not stopped. It happens a few times a day or a few times a week and is more of an achy pain and not as sharp of a pain as before. It is worse when doing manual labor such as working in my yard. I type all day at work and think that aggravates it as well. My injection site is still a little sensitive to the touch, but not that bad. It is more the bone pain that catches me off guard at time.

Other Meds: None

Current Illness: None

ID: 1745719
Sex: F
Age: 65
State: FL

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
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: hctz

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

Symptoms: cold, shivering, can't get warm, headache, fatigue, arm much sorer then previous two vaccines

Other Meds: losartan, amlopidine, levothyroxine, omeprazole, calcitriol, ambien, multi-vitamin, iron, zinc, lutein, reservatrol

Current Illness:

ID: 1745720
Sex: F
Age: 51
State: WV

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
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: unknown

Allergies: no known allergies reported

Symptom List: Injection site swelling, Limb discomfort

Symptoms: While pt was sitting in waiting area about 10 minutes after vaccine, pt's head dropped, she turned grayish, and became unresponsive. After several seconds, she lifted her head and responded to my questions and asked for cold water. I asked for someone to call 911 and an ambulance was dispatched. A technician brought her cold water. She sat for a few minutes, then expressed an urgent need to use the restroom. Her son took her to the restroom. I checked on her a moment later. She said she was doing ok. She came back to the waiting area to wait for the EMTs. The EMTs assessed her and advised her of their recommendations and her options. She was going to go home with her son as the driver. As the EMTs turned to leave, she dropped the open bottle of water, her head fell back and she became unresponsive for a short time. The EMT expressed that this looked like seizure activity. They loaded her on a gurney and headed for the emergency room.

Other Meds: unknown

Current Illness: none reported

ID: 1745721
Sex: F
Age: 59
State:

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: NONE

Other Meds:

Current Illness:

ID: 1745722
Sex: M
Age: 29
State: HI

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Oral Temp: 100.0 degrees F.

Allergies: No known allegeries

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

Symptoms: Symptoms started 9 hours post vaccination. Started feeling feverish, chills, body aches, headaches, and general malaise. After 8 hours of suffering, brought myself to ER to be seen. Fever at that time was recorded at 100 degrees Fahrenheit.

Other Meds: None of these taken at the time of vaccination.

Current Illness: No illness prior to vaccination

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am