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: 1757493
Sex: F
Age: 19
State: MI

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
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: Certified immunizing tech gave vaccine to patient at 3.49pm, patient immediately fainted and starting shaking for about 10 seconds. Certified immunizing tech called out for help and by the time the pharmacist arrived, patient was waking up on her own with a confused and blank look on her face. We asked if she felt okay and she only nodded her head "yes". After about 30 seconds patients' eyes started to roll and head fell down towards her chest with some mild shaking as stated previously. Again patient experienced this for around 5-20 seconds and then woke up on her own. Patient was pale in her face, eyes were drooping and patient was stating that she was tired and hot. After we got a verbal confirmation that she was understanding us we gave patient water, ice pack and a granola bar. Upon further questioning, patient stated she did not eat anything since the morning which was a small snack which was normal for her. Patient also told pharmacist before vaccine was given that she has had episodes of fainting previously. Patients parent was called to come to the store. Parent knew of the history and refused contacting a paramedic or taking patient in to see medical professional.

Other Meds:

Current Illness:

ID: 1757494
Sex: F
Age: 53
State: WI

Vax Date: 08/17/2021
Onset Date: 08/19/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: Labs drawn on 9/27/21 all came back normal.

Allergies: Citalopram

Symptom List: Anxiety, Dyspnoea

Symptoms: Developed uncontrollable muscle twitching and spasms after 1st dose, after 2nd dose twitching and spasms got worse. Seen my PCP and she put me on tizanidine for spasms. Helps mostly at night when trying to sleep.

Other Meds: Multivitamin, Sertraline, Alprazolam, Aspirin

Current Illness:

ID: 1757495
Sex: F
Age: 42
State: MA

Vax Date: 01/09/2021
Onset Date: 01/20/2021
Rec V Date: 10/03/2021
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: Intermit dates of acupuncture beginning of feb2021 2/16/21 paravert facet injection (spine injection) 3/09/21 trigger point injections in back 3/23/21 paravert facet injection (spine injection) Chiropractor care ra going from 1-2 times a week to now once a month since March.

Allergies: Pcn, sulfa, neomycin, demerol, bees

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

Symptoms: Roughly 1-2 weeks after COVID-19 vaccine developed burning/pain in rt side of spine upper back. Pain progressed. Pt tried to do acupuncture but didn't help, ended up getting trigger point injection didn't help, ended up needing steroid injections (2) in my spine. This has made pain manageble with intermittent Ibuprofen/Diclofenac however pain has not gone away. I now see a chiropractor since March.

Other Meds: Citalopram 20mg daily, Allegra 180mg daily, Adderall 5mg daily.

Current Illness: None

ID: 1757496
Sex: F
Age: 36
State:

Vax Date: 10/01/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Fever, chills, fatigue. Took OTC ibuprofen 600mg 2 or 3 times in a 24 hour period. Helped to alleviate symptoms, but completely resolve.

Other Meds:

Current Illness:

ID: 1757497
Sex: F
Age: 29
State: TX

Vax Date: 10/01/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies: Sertraline

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

Symptoms: Fever, chills, body aches, swollen lymph nodes in L underarm, headache, fatigue

Other Meds: Lexapro 20 mg Ibuprofen 800 mg

Current Illness:

ID: 1757498
Sex: F
Age: 23
State: WV

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: None

Allergies: Benedryl

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

Symptoms: Around 12 pm there were several hives that appeared on the right side of my body. They appeared on my right wrist, arm, thigh, calf, and ankle. I am allergic to Benedryl so I did not take anything besides Acetaminophen to calm down the pain and swelling in my arm.

Other Meds: Buspar

Current Illness: Sinusitis

ID: 1757499
Sex: F
Age: 23
State: LA

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: N/a

Allergies: Penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 1st vaccine side effects- initial and rapid onset arm soreness that lasted 2 days post vaccination. 4 hours after vaccine, fever occurred, headache, tiredness and major fatigue 2nd vaccine side effects (MAJOR)- 10 hours post vaccine, major/severe cold sweats occurred , major/severe shivers, chills, severe head ache, severe fatigue, severe tiredness, fever of 101.0 F that lasted 4 hours until I took 400 mg Ibuprofen. Lastly, a severe stomach ache/diarrhea occurred for 3 hours. All severe symptoms have lasted 30 plus hours since vaccination and will most likely continue to persist. I am in major discomfort and pain and wish I had never taken this.

Other Meds: Adderall, 25 mg XR, bupropion 300mg XR, zyrtec, womens multivitamin, 1000 mg vitamin C

Current Illness: None

ID: 1757500
Sex: M
Age: 59
State: TX

Vax Date: 09/26/2021
Onset Date: 09/27/2021
Rec V Date: 10/03/2021
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: Pharyngeal swelling

Symptoms: pt stated that his gout flared up the next morning and his feet were swollen and it lasted about 6 days

Other Meds:

Current Illness:

ID: 1757501
Sex: F
Age: 62
State: NY

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies: clyndimycine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Difficulty breathing. Heaviness in chest and between shoulderblades.

Other Meds: Lisiniprol

Current Illness:

ID: 1757502
Sex: F
Age: 12
State: WI

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
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: No adverse event, Flublok gave in error to a 12 year old and should have been Fluzone. Very busy store with one RPh and 1 tech with 3 people waiting and we were busy helping other patients. Mom and her 12 year old Daughter gave the RPh the insurance card for a covid shot. Screened patient, Pfizer covid, claim paid, measured the Pfizer immunization and went to immunization booth to give the shot. Mom said that the 12 year old (weighing 150-160 lbs) had her flu shot scheduled at pediatrician Dr. office at medical center tomorrow. I said that she should either wait to get the covid shot or get both the flu and covid shot the same day. Mom wanted her to get both shots the same day. Went to the fridge to grab the Fluzone Quad but the boxes were mixed up withe the Flublok quad. Using the handheld, scanned the Flublok quad in error and screend the Handheld clinical questions. Added the Flublok to the hand held and waited a long time for the handheld to process the Flublok. While we were waiting for the internet, gave the patient the shot: eft arm was Covid and the right arm was Flublok. After administration the hand held finally updated and said there was an error. Went to computer F6 and found that NDC was only for 18 years and older. Told the mom what happened and called her later. On phone call counseled mom that Flublok adult dose was given in error. If the child was ached, tired or had fevers she could use ibuprofen or Tylenol. If ibuprofen or Tyelonol did not work, mom should call pediatrician or go to the urgent care or emergency room because of this adult dose situation and to have a low threshold for calling for assistance. The child is taller than her mother and roughtly 150-160 Lbs so almost adult size but that I would would call pediatrician about the Flublok adult dose administration. Technician and I re-arranged the fridge so the BLUE and WHITE boxes of FLUBLOKs were complete SEPARATED from the BLUE and WHITE boxes of FLUZONE Quad (they were mixed up because they look so similar). Filled out report and contacted RPh. Also completed a VAERS error report to the CDC.

Other Meds: unknown

Current Illness: none

ID: 1757503
Sex: F
Age: 21
State:

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: pain in injection site

Other Meds: melatonin, remeron, prazosin

Current Illness: none

ID: 1757504
Sex: F
Age: 36
State: AK

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 10/03/2021
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: That night following vaccine, I had chills. The next day, I had injection site soreness and a headache. As the day progressed, I experienced a fever of 101, headache, nausea, muscle weakness. Tylenol was required around 4p. That evening, I continued to have all symptoms. Fever came back up around 11p. Addition Tylenol was taken. Sunday, I had a headache. Muscle weakness was better. Injection site pain was better. Still had a fever. I was very dizzy all day Sunday. On Monday, I felt much better but was fatigued.

Other Meds:

Current Illness:

ID: 1757505
Sex: M
Age: 33
State: GA

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: Negative COVID test

Allergies: N/a

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

Symptoms: First day I had fever, chills , cold sweats three days headaches, body aches

Other Meds: N/a

Current Illness: N/a

ID: 1757506
Sex: F
Age: 23
State: UT

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
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: pt briefly slumped in her chair after receiving vaccine ffor about 30 seconds to 1 minute shortly after receiving vaccination

Other Meds:

Current Illness:

ID: 1757507
Sex: M
Age: 53
State: OH

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Chills, swimmy head, extreme tiredness, soreness throughout entire body, headache, weird after taste in mouth, no appetite

Other Meds: None

Current Illness: None

ID: 1757509
Sex: F
Age: 45
State: NY

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: -XR Chest 2/18/2021 - normal -POCT Breathing capacity 2/18/2021 - normal

Allergies: unknown

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

Symptoms: The next day after my second dose of vaccine I developed: -gross hematuria x3 days -tremors / shakes for about 5 weeks -chest discomfort when taking a deep breath -palpitations for about 5 weeks -high blood pressure for about 5 weeks -headache for about 1 week Findings: -abnormal EKG - seen by Cardiologist -urine test showing hematuria, proterinuria - seen by Nephrologist - diagnosis of IgA Nephropaty

Other Meds: Levothyroxine

Current Illness: Covid +

ID: 1757510
Sex: M
Age: 30
State: IN

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient fainted within 5 minutes of administration

Other Meds:

Current Illness:

ID: 1757511
Sex: F
Age: 34
State: OR

Vax Date: 10/01/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: N/a

Allergies: Only known allergy to imitrex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 36 weeks pregnant, no complications. Woke up at about 7am and noticed lips significantly swollen and tender. Previous history of dermal filler in lips, last application approx Feb 2020. Swelling continued to increase, took generic Claritin which seemed to help.

Other Meds: Daily prenatal

Current Illness: Covid end of August

ID: 1757512
Sex: F
Age: 37
State: IN

Vax Date: 09/28/2021
Onset Date: 10/01/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Swelling of lymph Node above clavicle bone

Other Meds:

Current Illness:

ID: 1757513
Sex: F
Age: 71
State: NV

Vax Date: 09/29/2021
Onset Date: 09/30/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies: Mold, dog fur, cat fur, rabbit fur, chicken feathers, ragweed, dust, horse hair, crab, mushrooms, penicillin, darvon, gentamicin, I?ve dye, floro dye, lactose intolerance, vancomycin, vicomycin, Percocet, sulfur drugs

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

Symptoms: I woke up with a red rash about 3 inches long and 1 inch across below the injection site. The injection site was blood red. The rash has been itching for the last three days. It is hot to the touch. I have been putting Benadryl cream on the site.

Other Meds: Multaq, Toprol, Synthroid, Rebeprazole, Eliquis, Vitamin D3, Vitamin C, Multivitamin

Current Illness:

ID: 1757514
Sex: F
Age:
State: AL

Vax Date:
Onset Date:
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Lump the size of tennis ball under arm

Other Meds: Azo; vitamins, potassium; aspirin; atorvastatin; omepraziole; norvasc; pregabalin; ziac

Current Illness:

ID: 1757515
Sex: F
Age: 52
State: CA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: Allergy tests Sept 8 2021

Allergies: Sulfa, Dog Dander, Cat Dander, Rye Grass

Symptom List: Unevaluable event

Symptoms: Itching. feels like something crawling under my skin. for about three weeks. Then after second dose 9/30/2021, severe blurred vision, peripheral vision blocked, front vision blurred. Stubbed toe on 10/2 bc of blurred vision and peripheral obstructed vision.

Other Meds: Metformin, Atorvastin, Glipizide, Lisinopril

Current Illness: Diabetes, Hypertension

ID: 1757516
Sex: M
Age: 46
State: TX

Vax Date: 05/06/2021
Onset Date: 07/11/2021
Rec V Date: 10/03/2021
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: Saw Dr. about it and is sending me to a dermatologist to investigate it.

Allergies: None

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

Symptoms: Alopecia on the back of the head and it looks like hair is growing back white.

Other Meds: None

Current Illness: None

ID: 1757517
Sex: M
Age: 13
State: CA

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: client reported to EMT feeling a headache within 10 minutes in observation. EMT notified PHN . Upon arrival at 1409, client sitting up on anti-gravity chair, alert and oriented x4. Client here today with Father who stated client had breakfast 4hrs ago. Vitals at 1410: blood pressure 159/79, pulse 98, oxygen sat 99%. Client described headache as "needles" on right side of head and pain 4/10. Client denied dizziness, blurry vision, or nausea. RN gave client Goldfish and water at 1412. Client was instructed to eat and drink slowly. PHN spoke with Father who stated client has no relevant medical history, no medications, and no allergies. Per Father, first covid vaccine went well. At 1412 client reported headache was beginning to improve. Vitals at 1414: blood pressure 150/76, pulse 104, oxygen sat 98%. Per client headache was returning and no other symptoms. Vitals at 1420: blood pressure 137/82, pulse 102, oxygen sat 98%. Client stated he felt "a lot better." PHN spoke with Father and client of when to seek medical help, ER precautions, and following up with primary provider. At 1426 client stated "almost nothing left of headache." Vitals at 1428: blood pressure 139/80, pulse 93, oxygen sat 98%. Client stood up from chair and walked a few steps with steady gait. Per client he "felt better." PHN discussed with Father client's blood pressure and importance of following up with medical provider.

Other Meds: none

Current Illness:

ID: 1757518
Sex: M
Age: 77
State: MI

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: I am not sure but: EKG, BP, Temp, OX level, CT of head, CT of chest area. Not sure what drugs were administered

Allergies: Penicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: The morning after the shot I went to the bathroom, took my AM meds and took my BP which was low 103/66 pulse 95. I felt a major push to throw up and so I turned to the commode. As I started to put my head down, I passed out. A short time later (minutes) I was trying to stand up but was too weak so I called my wife to assist. We called 911 and within minutes I was off to the hospital.

Other Meds: Benazepril 40 mg 1 Tab, PM Xarelto 20 mg 1 Tab, PM Pravastatin Sodium 40 mg 1 Tab, PM Metoprolol succ 25 mg 1 Tab, PM Chlorthalidone 25 mg 1 Tab, AM Multi-vitamin 1 Tab, AM Vitamin C 500 mg 1 Tab, PM Calcium+D3 600 mg 1 Tab, PM Tamsulosin

Current Illness: Hypertension Overweight High BP Controlled Afib

ID: 1757520
Sex: M
Age: 89
State: MI

Vax Date: 01/01/2021
Onset Date: 05/01/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: Blood tests, brain scan

Allergies: Penicillin

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

Symptoms: Stroke affecting a large portion of the back left area of the patient brain

Other Meds: Lipitor, Multivitamin, Blood pressure lowering med, injected insulin

Current Illness: None

ID: 1757521
Sex: F
Age: 46
State: WV

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
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: NKDA Environmental allergies including: White Ash, Black Walnut, Boxalder/Maple, Pine Mix, Ragweed G/S, Plantain, Alternaria, Fusarium, Mucor, DP Mite, DF Mite, Feathers, House Dust, Cockroach

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: At 1036 (approximately 13 minutes post injection), I felt a tingling/burning sensation in my left cheek area. Over the next hour it spread to the left side of my cheek and bottom lip. This sensation remained constant until approximately 1900, when it became an intermittent sensation that is on-going at the time of this report. (Still limited to the left side of my face - cheek/chin/lip area, and occasionally my left ear lobe.) At approximately 1345 I took asa in hopes of alleviating the headache I developed over the past hour or so. Also noted I started feeling hotter than normal at this time, but thought it was our office. (My co-workers didn't comment on the heat, though, and they usually do.) At 1658 I was so hot I was concerned I developed a fever. My temperature as only slightly elevated over my normal (~1 degree), but I felt very hot, like I was burning up. At 1810, while eating dinner, I felt chills and started shivering; this lasted approximately 45 minutes. I also notice my arm around the injection site had become extremely sore, to the point it hurt to lift it to shoulder height. At approximately 1900 I began feeling extremely hot, again. This lasted all night - to the point that I slept outside in my car (car camping) in a tank top without a blanket or other covering in 60 degree weather all night and still woke up a little sweaty. This finally started letting up a little bit around 1900 on 3-Oct-21 (i.e. 24 hours later), but I'm still feeing warmer than usual.

Other Meds: Vitamin C Vitamin D3 Asa (for pain, as needed)

Current Illness: None

ID: 1757522
Sex: F
Age: 19
State: CA

Vax Date: 08/28/2021
Onset Date: 09/17/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: A patchy rash formed that covered nearly all of my right hand and some of my left, and chronic headaches almost every day

Other Meds: none

Current Illness: none

ID: 1757523
Sex: F
Age: 68
State: CA

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 10/03/2021
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: None. Will monitor for s/s of purpura and take bp bid to see if elevated levels will be self correcting or continue. Plan is to f/u with Dr. and call prn. Thanks.

Allergies: Indocin/codeine

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

Symptoms: Addendum to report number 663668 filed last week. After improving through 9/29, am 9/30 I had elevated BP. SBP 160-181 and DBP 88-103. My usual BP is < or 120/60-70 and has been for years. Proprieception distorted. Where my body was in relation to the environment and movement impaired. Had to be very careful. 10/1 and 2 good. 10/3 am rush of itchy sensation inside primarily on my face. skin hot. SBP 131-146 DBP60-78. Affected finger had been back to normal coloration but today a very small skin hemorrhage appeared again at the base of my R hand ring finger again. Pea sized.

Other Meds: Levothyroxine, Losartan, calcium, D3, Vit C, AERDS2, Red Yeast Rice, MVI and probiotics

Current Illness: None

ID: 1757524
Sex: F
Age: 89
State:

Vax Date: 10/01/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
Hospital: Y

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

Lab Data: CT Abdomen/Pelvis, chest x-ray, complete chemistry panel, CBC, lactate, troponin, 12-lead EKG (10/2 and 10/3)

Allergies: NKDA

Symptom List: Nausea

Symptoms: Complete heart block and cardiac arrest. Occurred 1 day after COVID vaccine.

Other Meds: Amlodipine, Pantoprazole, Bumetanide, Bisoprolol, Tramadol, Advair Diskus, Meprobamate

Current Illness: None

ID: 1757525
Sex: F
Age: 61
State: WV

Vax Date: 09/11/2021
Onset Date: 09/18/2021
Rec V Date: 10/03/2021
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: Widespread itchy rash resembling measles All over torso from neck to lower abdomen and back & buttocks & upper arms Lasted over two weeks , still experiencing recurring rash & itching after prednisone prescription

Other Meds: Cymbalta Xanax Tramadol Synthroid

Current Illness:

ID: 1757526
Sex: M
Age: 62
State: ID

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

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

Symptoms: He did not have any of these symptoms except the ones describe in the previous regarding covid 19 that is still in effect since March 2021 Wednesday September 29, 2021 dizziness and light headed Thursday September 30, 2021 feeling hot and dry about 10 a.m., dryness and irritation in back of throat, burning in sinuses, weakness and fatigue, 2:00 or 3:00 p.m. went to bed with chills and dryness and fever symptoms. 4:00 or 5:00 could not roll or move from one side or another, pain in joints, swelling in shot area. Loss of bladder control and unable to get out of bed and unable to move out of position. Couldn't reach for the phone to call for help or device to message reporter to let her know. Lack of taste. When wife came home around 7 p.m. I found him propped up on the bed not able to talk and his mouth of slanted. I went and got him water and he took it and drank some. I tried to call Health Department but no answer. I was going to call the ER but could not find a phone number and by the time the internet came back up he could talk and was able to get out of bed. His feet was hot and his body was hot but when I check his temperature it was only 97.7. Friday, October 1, 2021: All day weakness, dizziness, loss of appetite, lost of taste, muscle and joint ache, difficult sleeping (he does wear a cpap machine and has never had a previous problems since having the machine) Saturday, October 2, 2021 showing improvement most of Saturday until late afternoon where chills, muscle and joint pain, weakness, and dizziness occurred again. In the evening again started having raspy throat and sinuses. He had a nose bleed where he never had that problem before. He could not sleep more than one hour at a time. Sunday, October 3, 2021: He called into work. He is showing more improvement from last night but still has raspy throat and sinuses. He is planning on going back to work tomorrow and we will be calling the dr to report this and asking about second shot. His taste is still off.

Other Meds: citalopram hbr 10 mg citalopram hbr 20 mg lisinopril-hctz 20-25 mg levothyroxine 25 mgc atorvastatin 80 mg aleve

Current Illness: none

ID: 1757527
Sex: F
Age: 63
State: WI

Vax Date: 09/12/2021
Onset Date: 09/12/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: None

Allergies: Penicillin, pineapple, vinegar, sulfa, msg, gluten

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

Symptoms: Difficulty focusing eyes, vomiting, sticky eyes, inability to concentrate, head pain

Other Meds: Serevent Diskus, Flovent, Montelukast, Ritual +55

Current Illness: None

ID: 1757529
Sex: F
Age: 28
State: NC

Vax Date: 10/02/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
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: NKA

Symptom List: Tremor

Symptoms: Lip swelling (previous fillers 12/2020)

Other Meds: Trazadone Desvenlafaxine

Current Illness: N/a

ID: 1757531
Sex: F
Age: 70
State: NJ

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 10/03/2021
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: N/A

Symptom List: Erythema, Pruritus

Symptoms: None stated.

Other Meds: Lipitor

Current Illness: N/A

ID: 1757532
Sex: M
Age: 17
State: CA

Vax Date: 11/04/1992
Onset Date: 11/05/1992
Rec V Date: 10/03/2021
Hospital: Y

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

Lab Data: Hospitilization approx 8 years ago

Allergies: n/a

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

Symptoms: Intermittent headaches ever since, some requiring hospitalization.

Other Meds: n/a

Current Illness: n/a

ID: 1757533
Sex: F
Age: 46
State: WA

Vax Date: 06/09/2021
Onset Date: 06/11/2021
Rec V Date: 10/03/2021
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: No

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

Symptoms: Half of my hair fell out in three months after I got the vaccine.

Other Meds: No, but between 1st and 2nd shot, I had a surgery and took Tylenol.

Current Illness: Uterine fibroid

ID: 1757534
Sex: F
Age: 44
State: FL

Vax Date: 10/01/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
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 at this time

Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: First vaccine 9/10/2021. Patient developed burning of tongue and lips. Occasional numbness of left arm and left leg. Second dose 10/01/2021. Patient developed Severe back pain. Thoracic and Lumbar with Radiculopathy of bilateral arms and legs. Left axillary lymphadenopathy and breast pain and swelling. As of Today, this symptoms are still present.

Other Meds: none

Current Illness: none

ID: 1757535
Sex: M
Age: 21
State:

Vax Date: 10/01/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
Hospital: Y

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

Lab Data: Troponin I = 3.73 ng/ml

Allergies: NKDA

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

Symptoms: Chest pain with elevated troponin concerning for myocardititis.

Other Meds: Denies

Current Illness: Denies

ID: 1757536
Sex: M
Age: 28
State:

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: pt appeared to have syncope to me, within 60 seconds of vaccine pt seized up per wife and blacked out very briefly, said he had tight chest and heart pain, did not fall, we got him to ground with legs up and he improved, vomited on his way home, felt dizzy and nauseas that night, doing significantly better today per wife, pt told me he never got childhood vaccinations because his immune system is "so strong", told me he has a history of fainting when they draw blood (after he got vaccine), has not had vaccination for long time if i understood correctly

Other Meds:

Current Illness:

ID: 1757537
Sex: F
Age: 68
State: PA

Vax Date: 03/27/2021
Onset Date: 05/05/2021
Rec V Date: 10/03/2021
Hospital: Y

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

Lab Data: I HAD SEVERAL APPOINTMENTS IN WHICH I WAS EXAMINED FOR THE CRPS IN MAY AND THEN AND MRI IN JULY BECAUSE THE HIP PAIN WAS NOT RESOLVING. IT WAS THOUGHT TO BE A BURSITIS. NOT BURSITIS. AVN OF LEFT AND RT HIPS

Allergies: GLUTEN, LATEX, CIPRO

Symptom List: Pain in extremity

Symptoms: AFTER A DAY, I DEVELOPED A HEADACHE AND PAIN IN MY LEFT ARM AND SHOULDER, THEN IT BEGAN TO MOVE DOWN INTO MY LEFT SIDE. WITHIN A WEEK MY ENTIRE LEFT SIDE WAS IN PAIN. I WENT INTO A CRPS FLARE UP OF MY ENTIRE LEFT LOWER EXTREMITY. I WAS BEING TREATED FOR THIS BY PHYSICIAN BECAUSE SHE IS AWARE OF THAT DISORDER AND KNOWS HOW TO TREAT THIS. SHE AGREED IT COULD HAVE BEEN BROUGHT ON BY THE VACCINE. I DID REPORT THIS TO THE CDC ON MY PHONE AND I HAVE BEEN IN CONTACT SINCE THEN. I DEVELOPED A AVN ACUTE VASCULAR NECROSIS IN THREE MONTHS IN WHICH I HAD TO HAVE MY LEFT HIP REPLACED 8/30. I ALSO HAVE AVN IN MY RIGHT HIP. THE SURGEON HAS NO IDEA HOW THIS HAPPENED. I HAVE NO ARTHRITIS AND THIS HAPPENED LITERALLY IN THREE MONTHS POST COVID VACCINE. I HAD AN MRI IN JUNE WHICH CONFIRMED THIS DIAGNOSIS. I HAD PERFECTLY PERFECT HIPS THAT WERE CLEAN WITH NO ARTHRITIS AT ALL PRIOR TO VACCINE. I AM A NURSE AND I AM EXTREMELY UPSET BECAUSE I AM AWARE THAT PTS WITH NEUROLOGICAL DISORDERS WERE NOT FIELD TESTED BEFORE THE VACCINES WERE DISTRIBUTED TO THR PUBLIC. WAS IT BECAUSE IT WOULD CAUSE A RED FLAG, OR DISRUPT THE RESULTS TO GET THIS APPROVE BY THE EMERGENCY ACT. THIS WAS NOT EVEN GIVEN APPROVAL BY THE FDA AND THE PHARMA COMPANIES ARE EXEMPT FROM ANY LAW SUITS. I HAVE LOST ALL RESPECT FOR THE CDC AND THE PHARMA COMPANIES AND ANYONE ELSE WHO DECIDED THIS WAS ACCEPTABLE. THANK GOD I AM RETIRED BECAUSE I AM NOW FACING ANOTHER HIP REPLACEMENT . I WAS TOTALLY FINE BEFORE THIS VACCINE..TOTALLY FINE.

Other Meds: NEXIUM 20 MG ONCE A DAY AND VITAMIN D3 2,000 UNITS A DAY,

Current Illness: NONE

ID: 1757538
Sex: F
Age: 49
State: MD

Vax Date: 06/08/2021
Onset Date: 09/27/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: HSV 2 IgG, Type Spec Learn more about this HSV 1 IgG, Type Spec Learn more about this 51.90 (High) Date:Sep 28, 2021 10:09 a.m. EDT > 23.60 (High) Date:Sep 28, 2021 10:09 a.m. EDT

Allergies: seafood trees mold mildew grass Cock roaches

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

Symptoms: Tested positive for Herpes STD/ I have never had a STD in 49 years of living. I have been with the same male partner for 10 years. The . most he does is masturbate daily. I don't have any other partners. I have never had the chicken pox. I took a blood test 2 months prior to the vaccine because I was having knee surgery done and also because my doctor ordered a full workup on me. I have NEVER seen any results come back from the lab as positive for any STD. I have alsways been negative for STD's. NOw, after the 2nd vaccine, a pap smear, and blood workup. I'm positive for Herpes. . I don't even have any symptoms for Herpes. No blisters anywhere, no cold sores anywhere, nothing. No fevers, no chills.

Other Meds: Caberogline( Cyst on Pituatary)( Once a week) Flonase Nasal Spray Simibicort ( Tablet) Allergies Albuterol Inhaler Verapamil ( Migraine headaches) Nasonex ( Nasal Spray) Vitamin D 25,000 ( Once a week) Epi Pen (As Needed)

Current Illness: Right knee surgery 4 cardiac ablations 3 c sections 3 carpal tunnel releases Parotidectomy ( Benign) ( Non Cancerous) White Matter Brain Lesions Spinal Taps for MS

ID: 1757541
Sex: F
Age: 48
State: WA

Vax Date: 04/17/2021
Onset Date: 04/25/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: Lab C IADNA, GI PATH, 3-5 TARGETS Sep 27, 2021 Lab FECAL OCCULT BLOOD (DIAG) Sep 27, 2021 Lab O STOOL SPECIAL ADDITIONAL PATHOGENS Sep 27, 2021 Lab OVA AND PARASITE EXAM Sep 27, 2021 Lab O C. DIFFICILE TOXIN PCR Sep 27, 2021 Imaging US ABDOMINAL R-T W/IMAGE DOCUMENTATION Sep 7, 2021 Lab WHEAT IGE Jun 18, 2021 Lab MOLD IGE MIX Jun 18, 2021 Lab O FOOD ALLERGY 2 REFLEX Jun 18, 2021 Lab O FOOD ALLERGY 3 REFLEX Jun 18, 2021 Lab MILK IGE Jun 18, 2021 Lab O A-LACTALBUMIN IGE Jun 18, 2021 Lab O B-LACTOGLOBULIN IGE Jun 18, 2021 Lab O CASEIN IGE Jun 18, 2021

Allergies: None known at the time

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

Symptoms: Within a week following receipt of the first vaccine, I began having chronic loose stools, which to date have not been resolved. I have not had a solid bowel movement since April.

Other Meds: Pirmella birth control pill, over the counter Tylenol & ibuprofen, Balance One probiotic supplement.

Current Illness: n/a

ID: 1757542
Sex: F
Age: 50
State: VA

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/03/2021
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: N/A

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

Symptoms: Arm ache, chills, severe headache, fever, muscle aches for 2 days; then headaches and muscles aches 2 days after.

Other Meds: Multivitamins

Current Illness: Nausea

ID: 1757543
Sex: F
Age: 45
State: CA

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
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: Face swelling and throat closing with pregabalin.

Symptom List: Vomiting

Symptoms: EMT noticed the client coughing as she walked into the restroom. The client returned from the restroom and reported feeling "hot and a headache" to EMT. The client ambulated and sat down in the anti-gravity chair. RNs responded. RN noticed the client sitting in the anti-gravity chair, leaning forward, with her eyes closed. The client reported "head pounding" and feeling "dizzy, like it's going around." The client localized the pain to the right side of her head, diffusely. Vitals obtained by EMT at 1:33 PM were as follows HR 102, automatic BP 206/90, and O2 96%. The client denied any history of hypertension. The client had acrylic nails and nail polish on all of her fingers. The client denied any s/s of anaphylaxis. The client reported a history of rheumatoid arthritis and takes calcor, vitamins, and iron daily. The client also reported a history of asthma and is prescribed an inhaler. The client reported that she receives an IV therapy treatment for her rheumatoid arthritis, and last received the medication two weeks ago. The client stated that the medication she received two weeks ago was a new treatment. The client stated her doctor recommended she receive the COVID vaccine Pfizer. The client has a history of face swelling and throat closing with Pregabalin. The client is not prescribed an Epi-Pen. The client stated that today she initially started feeling a dry throat, started coughing, walked to the bathroom, felt hot, and splashed water on her face. The client stated that she has previously experienced similar symptoms after taking a new medication and that the symptoms usually resolve after 30 minutes. Vitals obtained at 1:39PM were as follows: automatic BP 169/80, HR 91, and O2 95%. The client reported "my eyes are better." RN noted the client was holding her eyes open instead of closed. The client stated that she did eat today. The client localized the headache to the anterior right side of her head and near her right eye. The client denied any persistent dizziness. RN educated the client regarding her blood pressure and recommended she follow up with her PCP. RN provided education regarding s/s of anaphylaxis. The client voiced understanding of this education. Vitals obtained at 1:54 PM were as follows: automatic BP 166/79, HR 91, O2 95%. The client reported a persistent "lingering headache" but stated that it was "manageable." The client's husband drove her to the vaccination site, and was planning on driving the client home. At 1:56 PM the client stood up unassisted and walked around the observation area.

Other Meds: Calcor, vitamins, iron, inhaler

Current Illness: Unknown

ID: 1757545
Sex: F
Age: 54
State: OR

Vax Date: 10/01/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: injection site pain

Other Meds:

Current Illness:

ID: 1757546
Sex: F
Age: 36
State: MO

Vax Date: 09/14/2021
Onset Date: 09/16/2021
Rec V Date: 10/03/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Began menstruation 9/16/21 before due for period. Had excessive bleeding and clots from 9/16/21 through 10/1/21. Very heavy bleeding throughout 16 days, multiple clots passed.

Other Meds: Prenatal vitamin, vitamin d, vitamin k

Current Illness: Covid 19 8/16/21

ID: 1757547
Sex: F
Age: 47
State: GU

Vax Date: 10/01/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
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: No

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Generalized Hives

Other Meds: Zyertec, Yaz, Omeprazole

Current Illness: No

ID: 1757548
Sex: M
Age: 39
State: AK

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: None

Allergies: Allergic to Morphine, ampicillin and penicillin

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

Symptoms: Sore arm in the injection site, similar to second dose reaction. Have developed swollen lymph nodes in my left armpit with irritation and pain. Did not seek treatment after researching the effects. After 24 hours of onset, the pain started to decrease. 48-60 hours after onset, the pain is nearly gone and swelling has started to decrease. I will be seeing my doctor tomorrow for another reason and will discuss the situation with him. I wanted to report the event even though it has not fully dissipated.

Other Meds: Daily multi-vitamin; chanca piedra at meals, Vitamin C (500 mg), Vitamin D (1000 iu every other day); 3mg melatonin at night

Current Illness: None

ID: 1757549
Sex: M
Age: 36
State: PA

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/03/2021
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: None

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

Symptoms: My lymphatic system on my right side swelled in my neck, under arm and right pectoral to the point that all 3 areas were twice the size of left. It became very painful and difficult to move my neck, arm and chest from the swelling . This did not happen after the first 2 shots given on 12/28 and 1/18/2021

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am