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: 1757550
Sex: F
Age: 30
State: NY

Vax Date: 09/23/2021
Onset Date: 09/23/2021
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: ORDERED ON 10/1- COVID SWAB, CBC, ESR, CRP, CMP

Allergies: ZITHROMAX

Symptom List: Dysphagia, Epiglottitis

Symptoms: MIGRAINE STARTING NIGHT OF VACCINATION NEXT DAY WITH CHILLS ALL DAY, 'BODY FELT LIKE I WAS HIT BY A TRUCK'. UNABLE TO LIFT YOUNGEST SON. FEELS WEEK AND UNABLE TO HOLD FOR LONG PERIODS WOKE UP SUNDAY WITH SORE THROAT MONDAY WITH DIARRHEA ALL DAY NO FEVERS + NAUSEA WITH EMESIS MONDAY - SHE THOUGHT DUE TO PHLEGM SHE WAS CHOKING UP PHLEGM CONTINUES BUT NOT AS BAD NO SNEEZING OR ITCHY EYES. + TROUBLE SWALLOWING ORGANGE JUICE DUE TO BURNING DIARRHEA HAS RESOLVED BUT FOOD RUNS THROUGH HER AND COMES OUT WATERY.

Other Meds: FLUTICASONE

Current Illness: NONE KNOWN

ID: 1757551
Sex: M
Age: 49
State: CT

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: None

Allergies: NSAIDS Dairy Shell Fish

Symptom List: Anxiety, Dyspnoea

Symptoms: Pain at injection site Pain in legs Very Tired Feeling like being stung by a bee. This lasted about 15 minutes Cold or Allergy like feelings Most of these issues unless time was about a day. By Saturday I was still a bit tired but started to get back to normal. Treatment was lots of rest, Drink water and Gatorade. Please note: states the vaccine was given in my left arm. I requested my right arm as that I am left handed. This request was granted.

Other Meds: Advair 250mg Allopurinol 300mg Montelukast Sodium 10mg Tylenol OTC

Current Illness: Seasonal Allergies

ID: 1757552
Sex: M
Age: 65
State: SC

Vax Date: 09/29/2021
Onset Date: 09/30/2021
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: N/A

Allergies: None

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

Symptoms: After restless night of sleep, I woke with a severe headache, lower backache, both knees ached, night sweats, dizziness and loss of appetite. Stayed home. Symptoms lessened the following day. Next day symptoms nearly gone.

Other Meds: Metoprolol 25mg, One-A-Day vitamin, Osteo Bi-Flex

Current Illness: None

ID: 1757553
Sex: F
Age: 87
State:

Vax Date: 02/11/2021
Onset Date: 09/18/2021
Rec V Date: 10/03/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient is an 87-year-old vaccinated female who lives at an independent living facility. She states she has been compliant with wearing a mask since the onset of the pandemic. About a week ago, she started having cough, fevers, nausea, vomiting, runny nose, and malaise. She tested positive for COVID on 9/18/21. Over the last few days, her daughter has checked on her and she has become lethargic, weak, and developed some delirium. She was brought to the ER. Patient was admitted to the hospital on 9/24/21. She had acute hypoxic respiratory insufficiency. She received remdesivir. She is allergic to steroids so she was not treated with steroids. Her oxygen requirement was stable and she was weaned off of oxygen and did not desaturate after walk test. However, she had a syncopal episode after walk test. BP, HR telemetry at the time was stable. Patient prefers to get stronger after current COVID illness and address moderate to severe aortic valve stenosis as outpatient. Isosorbide was discontinued, metoprolol decreased, and losartan decreased. Patient was discharged to rehab.

Other Meds:

Current Illness:

ID: 1757554
Sex: F
Age: 18
State:

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient fainted 5 minutes after shot.

Other Meds:

Current Illness:

ID: 1757555
Sex: F
Age: 26
State: MA

Vax Date: 08/29/2021
Onset Date: 09/01/2021
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: urgent care visit- 10/3/21. Doctor communication throughout September. I will now have to see a dermatologist and from what the urgent care doctor said, maybe a lifelong prescription of cetirizine to control the hives. This will result in numerous dermatologist tests that I cannot afford and a new medication that actually interacts with a medication I am on (Zoloft.)

Allergies: flu vaccine. No other allergies.

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

Symptoms: Ever since the I have recieved the vaccine, I have been breaking out in intermittent Hives- which i have documented pictures of. I have never had hives prior to this vaccine. I tried coming off my medication to see if that was the cause, coming off certain food to see if that was the trigger of the hives- but still Hives keep appearing and nothing triggers them. They use to come once a day, now every few hours and they are all over my body. To the extent that my doctor has had to put me on cetirizine BID to see if that can control the hives. There is no cause for the hives- I got the vaccine and now i am developing severe Hives that are getting worse.

Other Meds: Zoloft. No other medications.

Current Illness: no sickness. Never have had covid.

ID: 1757556
Sex: M
Age: 68
State: AZ

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Slight fever (<101.4); chills; shortness of breath (spO2 <90); lower backache; large joint aches; pronounced headache; fatigue.

Other Meds: Carvedilol 25mg 2X; Xarelto 10mg 1X

Current Illness: None

ID: 1757557
Sex: F
Age: 62
State: CA

Vax Date: 02/28/2021
Onset Date: 09/06/2021
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: None

Symptom List: Pharyngeal swelling

Symptoms: Shingles

Other Meds: None

Current Illness: No

ID: 1757559
Sex: F
Age: 33
State: NY

Vax Date: 06/24/2021
Onset Date: 07/20/2021
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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 1. Amenorrhea, period became irregular. Skipped 2 months of periods. 2. Migraines. Migraines became very frequent, happening every few days. Still currently happening and being treated with Topamax and Relpax but they continue. 3. Breasts tenderness and fullness. Every few days my breasts are extremely sore and heavy. No treatment. 4. Mood changes, depression. Still ongoing. O treatment.

Other Meds:

Current Illness:

ID: 1757560
Sex: M
Age: 63
State: NY

Vax Date: 08/23/2021
Onset Date: 09/29/2021
Rec V Date: 10/03/2021
Hospital: Y

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

Lab Data: MRI, MRA, CT scan, full panel blood work up, chest x-ray and covid rapid test. Test indicated that it was a TIA in the thalamus region.

Allergies: Penicillin, NSAID's, Gluten

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I am a teacher and was in class teaching on September 29, when I began having numbness and tingling on the my right side of my face and my entire right arm. the numbness lasted for 4 -5 minutes. It subsided for about 8-10 minutes after which I experienced a second, stronger numbness sensation. This event lasted about 5 - 7 minutes. Believing it might be a stroke I went to the school nurse. I was then transported to the local hospital ER for evaluation. The symptoms indicated it might be a stroke so I was rushed in and was given a CT scan, MRI and MRA.

Other Meds: Synthroid 150mg Daily vitamins

Current Illness: None

ID: 1757561
Sex: M
Age: 71
State: MN

Vax Date: 08/31/2021
Onset Date: 09/11/2021
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: Ultrasound of right leg from groin down performed on 9/15/2021. No other lab work related to this issue.

Allergies: None

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

Symptoms: Symptoms: swelling, pain and erythema of right lower extremity. Started on or about 9/11/2021. Urgent Care visited on 9/15/2021 at local HCF. Diagnosed as superficial thrombophlebitis. Treatments recommended: Elevate leg above level of heart, warm compresses, NSAID as needed (eg, ibuprofen), anti-embolism stocking. Leg slowly improved, but not yet back to normal.

Other Meds: Atorvastatin 10mg daily, cholecalciferol 4000 IU daily, ascorbic acid 1000 mg daily.

Current Illness: None

ID: 1757562
Sex: M
Age: 50
State: CA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
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: CT on 10/2

Allergies: none

Symptom List: Rash, Urticaria

Symptoms: pleural effusion

Other Meds: none

Current Illness: none

ID: 1757563
Sex: M
Age: 69
State: OK

Vax Date: 02/02/2021
Onset Date: 02/23/2021
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:

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

Symptoms: Headache - continuous, everyday since onset

Other Meds:

Current Illness:

ID: 1757564
Sex: M
Age: 33
State:

Vax Date: 09/24/2021
Onset Date: 09/24/2021
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: Physical exam only, no further testing or support needed.

Allergies: None known

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

Symptoms: Patient experienced local pain, erythema, swelling in the area of the Right deltoid, platysma, upper 2/3 of the trapezius, and upper 1/3 of the triceps. Onset was within 8 hours of vaccine administration. No systemic symptoms noted. Exam otherwise unremarkable. Symptoms resolved completely within 24 hours. He indicates similar response to previous dose of anthrax vaccine.

Other Meds: None

Current Illness: None

ID: 1757565
Sex: M
Age: 34
State: NJ

Vax Date: 05/20/2021
Onset Date: 05/24/2021
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: Consulted with primary care. Patient was referred to a rheumatologist. Patient currently has appointment scheduled for March 2022 (soonest available).

Allergies: none

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

Symptoms: In the days immediately following vaccination, Patient noticed joint pain/ tenderness while engaging in routine daily activities. First noticed in left elbow. Days to weeks later noticed in Left wrist. Weeks later in right elbow. Weeks later in right wrist. It has been over 6 months now. Pain is getting worse as time goes on.

Other Meds: none

Current Illness: none

ID: 1757566
Sex: M
Age: 87
State: IL

Vax Date: 09/19/2021
Onset Date: 09/20/2021
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:

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

Symptoms: arm pain immediately following vaccination that extends down the entire arm, unable to lift arm up all the way. Described vaccination site and said he took pictures before removing band-aid for documentation, it sounds like the vaccine may have been administered too high on the arm

Other Meds:

Current Illness:

ID: 1757567
Sex: F
Age: 67
State: NY

Vax Date: 09/12/2021
Onset Date: 09/13/2021
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: went to doctor to check symptoms as well as doppler test to see if there was blood clot went to neurologist will be getting brain scan

Allergies: codeine

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

Symptoms: severe pain in right arm, threw up, headache dizzy shakes, sweats, rash and swelling on both legs difficult to concentrate balance is off

Other Meds: Zoloft Hydroxichrolene

Current Illness:

ID: 1757568
Sex: F
Age: 54
State: UT

Vax Date: 09/30/2021
Onset Date: 09/30/2021
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:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I became feverish with chills, nausea, sever headache and body ache that left me unable to leave my bed except to use a commode next to my bed for approximately 60 hours. After 24 hours I developed significant pain at the injection site as well as in the arm pit of the arm where I received the injection. The fever, chills, nausea, sever headache and body ache have resolved however the pain at the injection site and in the arm pit have not. A bruise has formed at the injection site . Though I have not visited a health care provider because it of it being the weekend, if the pain in my arm and in the arm pit do not subside, I will attempt to get an appointment.

Other Meds: Quetiapine 12 mg at night

Current Illness: None

ID: 1757569
Sex: F
Age: 49
State: NY

Vax Date: 10/01/2021
Onset Date: 10/02/2021
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: High fever (103.3). I am usually low grade (approx 96.5). I also had a weird (metallic?) taste in my mouth beginning this morning, which is 2 days post vaccination. I have chest heaviness and last night I had some labored breathing.

Other Meds: Synthroid and statin

Current Illness:

ID: 1757571
Sex: F
Age: 63
State: IN

Vax Date: 08/11/2021
Onset Date: 08/12/2021
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: None

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

Symptoms: Heart palpitations, rapid beats on and off for about a week

Other Meds: Lisinopril, Atorvastatin

Current Illness: None

ID: 1757573
Sex: F
Age: 32
State: NY

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 10/03/2021
Hospital: Y

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: 9/5/21 - THS <0.030 (Ref: 0.27 - 4.20 u[IU]/mL)). Free T4: 5.63 (Ref: 0.93 - 1.70 ng/dL), Triiodothyronine: 330.00 (Ref: 80.00 - 200.00 ng/dL), Free T3: 16.60 (Ref: 2.00 - 4.40 pg/mL). 9/7/21 - Serum Thyrotropin Receptor Antibody: 5.81 (Ref: 0.00 - 1.75 IU/L). 9/5/21 - Thyroid Stimulating Immunoglobulin: 5.25 (Ref: 0.00 - 0.55 IU/L). Thyroid Peroxidase Antibody: 79.8 (Ref: <9.0 IU/mL). Thyroglobulin Ab: <0.9 (Ref: <2.3 IU/mL). 9/6/21 - Thyroid Ultrasound revealed mildly enlarged, heterogenous, hypervascular right and left lobes of thyroid gland.

Allergies: NKA

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

Symptoms: Patient started developing nausea & vomiting the same night of vaccine administration along with gradual progression of mood lability, agitation, restlessness, neck goiter. High blood pressure, tachycardia. All of which were difficult to control. She was diagnosed with Graves' Disease and was treated with Propranolol 360 mg ER, Methimazole 30 mg BID.

Other Meds: None

Current Illness: None

ID: 1757575
Sex: F
Age: 33
State: NV

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Myocarditis - Chest pain, heart palpitations, shortness of breath, blood pressure increased to 160/105, pulse increased to 115-120.

Other Meds:

Current Illness:

ID: 1757577
Sex: M
Age: 89
State: OH

Vax Date: 09/26/2021
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: LA

Lab Data: None.

Allergies: Sulfa drugs

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

Symptoms: Dad felt fine the day of the shot and had a normal morning the next day. However, while he was playing tennis on the 27th, he started to feel odd and went home. While in the bathroom, his legs gave way and he fell to the floor. He remained there, unable to move his arms or legs, for several hours. He managed to push his way to the staircase on his back and eventually was able to turn over and crawl up the stairs. He finally made it to a telephone at 5:30pm. Dad refused any medical care, so I called him every hour until 11pm. He was able to make it up to his bedroom and woke up the next day feeling better. By Friday, he was completely back to normal. Still, the partial paralysis was terrifying.

Other Meds: Two medications for heart issues and some vitamins and supplements. All of these items have been taken for at least five years at the same dosage and at the same time.

Current Illness: None

ID: 1757578
Sex: F
Age: 38
State: CA

Vax Date: 04/20/2021
Onset Date: 05/09/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Unprovoked throwing up and headaches. Slept it off. 2 other times - I had blurred vision in one eye, macular migraines. Went away with rest.

Other Meds:

Current Illness:

ID: 1757579
Sex: F
Age: 36
State: MI

Vax Date: 09/28/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Carbatrol - Aplastic anemia (blood Platelets drop) Codineb- H/A, Vomiting Vicodan - H/A, Vomiting Imitrex - Tingling in face and hands Propranolol - Increased heart rate, Inability to sleep Artificial Sweeteners - Migraine

Symptom List: Injection site pain, Menorrhagia

Symptoms: Feeling of tiredness and pain at injection site lasting 2 days after receiving the injection. 3 days after receiving the COVID vaccine the lymph nodes under right arm began to swell with mild pain and itchiness. Taking acetaminophen and ibuprofen at staggered times for pain. If pain and itchiness last longer than 10 days I will contact someone.

Other Meds: Current Prescription Medications: Ibuprofen 600 MG Tablet- PRN Cyclobenzaprine 10 MG Tablet- PRN Ventolin HFA 90 MCG Inhaler- PRN Cetirizine HCL 10 MG Tablet- 1 Tablet 1x Nightly Sprintec 0.25-0.035 MG Tablet- 1 Tablet 1x Nightly Famotidin

Current Illness:

ID: 1757580
Sex: F
Age: 48
State: PA

Vax Date: 04/01/2021
Onset Date: 08/01/2021
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:

Allergies: Seasonal

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

Symptoms: Tinnitus

Other Meds: Aciphex

Current Illness: None

ID: 1757581
Sex: F
Age: 34
State:

Vax Date: 09/17/2021
Onset Date: 10/03/2021
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:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Menstrual bleeding with clots and heavier bleeding

Other Meds: Vitamins

Current Illness: None

ID: 1757582
Sex: F
Age: 41
State: MA

Vax Date: 04/14/2021
Onset Date: 05/12/2021
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: PCP states BPPV and nystagmus

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: vertigo episode 1 month after vaccine (5/12) dizzyness for 8 weeks until 7/30. dizzyness re-occurs after respiratory cold 9/20

Other Meds: none

Current Illness: none

ID: 1757583
Sex: M
Age: 37
State: MI

Vax Date: 09/29/2021
Onset Date: 09/30/2021
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: Rapid COVID test - Negative (10-2-21)

Allergies: Morphine

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

Symptoms: after 17 hours of receiving the vaccine I developed joint pain, muscle aches, severe sinus inflammation requiring inhaled steroid spray, dizziness, headache and lymphadenopathy to left supraclavicular lymph nodes and posterior cervical lymph nodes which are still tender, enlarged, and sore currently.

Other Meds: Effexor, Cetirizine, Multivitamin, Migrelief, Relpax, Omeprazole

Current Illness: Osteoarthritis, migraine without aura

ID: 1757584
Sex: F
Age: 64
State: NJ

Vax Date: 09/05/2021
Onset Date: 09/08/2021
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 as of yet

Allergies: None

Symptom List: Nausea

Symptoms: Constant raised hives itching under my arms, breaststroke, trunk, thighs they come and go and move to different locations. They are very large patchy areas and I have not had one good day since taking the 2nd dose of the covid vaccine. Regardless of what is done there is no relief.

Other Meds: Lorsartan and hydrochlothiazide

Current Illness: Nonr

ID: 1757585
Sex: F
Age: 34
State: GA

Vax Date: 09/01/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data: Venous duplex scan of the left lower extremity, labs-CBC, CMP, PT/INR, PTT

Allergies: Clemastine fumarate, diphenhydramine, menthol, Phenylpropanolamine, pseudoephedrine, tripelennamine, tiprolidine, promethazine

Symptom List: Injection site pain

Symptoms: Symptoms: Sudden onset of pain in the left leg. Venous Duplex Scan: Deep vein thrombosis and superficial venous thrombosis throughout the left lower extremity including left distal superficial femoral, popliteal, posterior tibial, and peroneal veins with superficial venous thrombosis in the lesser saphenous veins Treatment : started anticoagulant therapy

Other Meds: Vitamin B12, tizanidine, metoprolol, famotidine, ondansetron, low Loestrin, duloxetine, hydrocodone-acetaminophen, Symbicort

Current Illness: none

ID: 1757586
Sex: F
Age: 75
State: AZ

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: None

Allergies: Codeine, Lactose sensitivity

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

Symptoms: Tender Left arm became sore by 9 PM. During the night, developed temp in the 99.1-99.5 range despite extra strength Tylenol every 8 hrs. with headache. On awakening, noted nerve pain I had related to Hamstring injury I finally thought I'd gotten rid of, resurfaced over multiple body parts as did eczema I hadn't seen in years on my arms. experienced underarm pain on attempting to raise arm. And although I know they are routine side effects ,I want to include the tiredness, decreased appetite and joint pain so that you know all facets of my experience. When the fever subsided about 1.5 days later, so did the symptoms although the tiredness lasted yet another day. Used ice packs, pushed fluids and rested in bed.

Other Meds: Levothyroxin, Zolpidem, Losartan, Aspirin 81 mg, Atorvastatin, Magnesium, Vitamin D3, L-Tyrosine, Vitamin B 6 & 12

Current Illness: Hamstring injury +

ID: 1757587
Sex: M
Age: 45
State: LA

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: RA

Lab Data: None

Allergies: Psuedochlolineterase Deficiency (Sp?)

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

Symptoms: Fever, violent chills, sweating, joint pain, back pain, nausea, arm pain, numbness in left fingers, left shoulder pain, soreness,(left shoulder), sleeplessness, frequent urination with little to no urine, rash (spread across neck collar region, up and down entire spine, and under pectorals).

Other Meds: None

Current Illness: None

ID: 1757588
Sex: M
Age: 1
State: MN

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

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

Lab Data: CT Scan, MRI, EEG, EKG, blood work 10/1/2021

Allergies: None

Symptom List: Tremor

Symptoms: -Facial swelling, runny nose, generalized body rash/hives 9/1/2021-9/6/2021 Diphenhydramine every 6 hours for 48 hours Symptoms cleared -Pale, vomiting with motion 9/13/2021 No treatment Symptoms cleared -Pale, dizziness, sweating, mild lip discoloration, crying 9/28/2021 no treatment -Pale, dizziness, sweating, loss of balance/coordination/mobility, near fainting, vomiting , crying 9/30/2021 hospitalized

Other Meds: None

Current Illness: None

ID: 1757589
Sex: F
Age: 37
State: NY

Vax Date: 09/25/2021
Onset Date: 09/25/2021
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: Tuesday 9-28-21 Hospital (Emergency Room) provided some blood tests, chest xray, CT scan of brain, EKG and provided IV for possible dehydration. Recommended to eat well and stay hydrated. Doctor could not tell why the hives appeared on my face.

Allergies: Food: honey

Symptom List: Erythema, Pruritus

Symptoms: Saturday 9/25/21- around 6pm I started feeling tingling on my left hand Sunday 9/26/21- woke up with tingling on my left hand, pain on my left arm, shortness of breath at night. Monday 9/27/21- tingling on my left hand, shortness of breath, chest pressure, lightheaded, Hives on my face and neck. Called my doctor whom advised to go to the hospital if symptoms persist. Tuesday 9/28/21- Went to the ER for shortness of breath, lightheaded, and tingling on both hands at this point. Got sent home , to drink lots of fluids and rest. Wednesday 9/29/21- tingling and cramps on both my hands, shortness of breath Thursday 9/30/21- tingling and cramps on my hands, shortness of breath Friday 10-1-21 - went to my doctor's office with shortness of breath & pressure on chest. Tingling on my hands stopped. Saturday 10-2-21 - shortness of breath and pressure on chest Sunday 10-3-21 still experiencing shortness of breath and small chest pressure.

Other Meds: Birth control - Junel

Current Illness: none

ID: 1757590
Sex: M
Age: 20
State:

Vax Date: 09/07/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
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: 10/2 EKG, BMP, CBC, D-dimer and Troponin were normal at this time

Allergies: None

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

Symptoms: Pericarditis. Patient has had multiple visits to ER and clinic for chest pain/dyspnea. Previously healthy

Other Meds: None

Current Illness: None

ID: 1757591
Sex: F
Age: 37
State: CA

Vax Date: 08/20/2021
Onset Date: 08/21/2021
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: None

Allergies: None

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

Symptoms: Joint pain started the following day after second dose of vaccine. Most noticeable in elbow joints, and knees. Still having fairly consistent joint pain in knees and elbows. I have a very physical job and have always been very fit and active and never experienced joint pain like this. Other joints become painful with strenuous use when that same kind of use never caused joint pain before. This very distinctly started the day after my second vaccine. Other reactions if relevant were a mild fever which also occurred after the first dose. And became sick with a sinus infection immediately following the second dose which resolved in about 12 days.

Other Meds: Probiotic, chaste berry supplement

Current Illness: None

ID: 1757592
Sex: F
Age: 51
State: LA

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: IM
Vax Site: LA

Lab Data: none, I am just letting you know my reaction.

Allergies: cortisone, hydrocodone,codeine

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: at 6:00 pm, my Uveitis flared up in my left eye, which has not happened in a year and a half. I put steroid drops in the eye for a week and it cleared up. eye still sensitive to bright light. My Psoriasis and arthritis have also flared up.

Other Meds: xanax, lexapro

Current Illness:

ID: 1757593
Sex: F
Age: 41
State: CA

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

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

Lab Data: Spoke to an allergist a few weeks after.

Allergies: None

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

Symptoms: Hives, swollen throat, tongue hives all over body started around my neck within 30 min of the vaccine . Took allergy meds and Benadryl along with cortizone. Still getting hi es snd need to take an allergy pill daily., apply cortizone on hives.

Other Meds: None

Current Illness: None

ID: 1757626
Sex: M
Age: 56
State: WA

Vax Date: 08/12/2021
Onset Date: 08/14/2021
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: None

Allergies: None

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

Symptoms: Extreme pain in knee, unable to bend knee, fear of clot but health professional confirmed it was an adverse reaction and not a blood clot. Pain persisted for more than 2 weeks where I was unable to bend my knee and I am a very fit, thin, healthy individual who exercises daily with cardio and strength exercises.

Other Meds: None

Current Illness: None

ID: 1757627
Sex: F
Age: 60
State: IN

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: Penicillin, Erythromycin, Cefdinir

Symptom List: Pain in extremity

Symptoms: Intense edema of feet and ankles. This is a reaction I have had to antibiotics in the past. I took 2 diuretic pills (8 hours apart), and the swelling was gone by the next morning.

Other Meds: Rovastatin, Metformin, Lisinopril, Bupropion, Calcium, Collagen, Vitamins C, B12, D3, E, Multi (Centrum 50+ Women)

Current Illness:

ID: 1757628
Sex: F
Age: 24
State: CA

Vax Date: 03/09/2021
Onset Date: 04/01/2021
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: I can share the link to the test results, if needed. Inflammation in the brain is clearly reported.

Allergies: None

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

Symptoms: March 9th - Took vaccine April 1st - started feeling tingling sensations and numbness in both arms, and sometimes the legs April 15th - a white plaque under tongue April 23rd - went to a doctor's office in Mexico to get blood test and a CAT scan of the brain to check neuro activity due to tingling sensations (they said nothing was found) July 7th - tested positive for COVID July 15th - tingling sensation and numbness started again, even worse August 25th - flew to see the best neurologist in town August 29th - discovered I was suffering from a viral inflammation that attacked my nervous system, caused by vaccines (ADEM) September 1st - started my treatment with corticosteroids for 5 consecutive days by IV injections September 5th - last day of treatment October 1st - no signs of betterment, started another treatment with corticosteroids

Other Meds: None

Current Illness: None

ID: 1757629
Sex: F
Age: 49
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: Sulfa drugs. Unknown food allergy (never determined).

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

Symptoms: Arm all the way up to neck was very sore for the first 2 days. This evening I noticed 3 welts about 4? away from the injection site that are painful to touch and have no other explainable cause..

Other Meds: Numerous. Provided upon written request.

Current Illness: Fibromyalgia, asthma, all chronic?.

ID: 1757630
Sex: F
Age: 59
State: AZ

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: My Dr ordered a CT scan of my right side(August1st 2021) Results were negative

Allergies: Sudophefrine

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

Symptoms: My right side where my liver is was so sore I could not touch my whole side. I was in severe pain.

Other Meds: Suboxone Aspirin Pantoprazole Diltiazem Pepsid

Current Illness: Severe sleep apnea

ID: 1757631
Sex: F
Age: 46
State: TX

Vax Date: 09/24/2021
Onset Date: 10/02/2021
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: Pcn

Symptom List: Vomiting

Symptoms: Pressure in ears, like after being on a plane

Other Meds: Depoprovera

Current Illness: None

ID: 1757632
Sex: F
Age: 62
State: NJ

Vax Date: 08/05/2021
Onset Date: 08/07/2021
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: 8/11 - Blood coagulation studies - normal 8/11 - CT Scan - showed stroke evidence 8/11 - MRI - showed evidence of stroke

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Lips became numb 30 minutes after vaccine and stayed numb for 3 hours - no treatment as it resolved on its own Blood pressure was elevated 40 mm Systolic and 25 mm Diastolic for ~3 weeks post vaccine. Saw Primary Care Physician who prescribed calcium channel blocker if it continued to rise. Fortunately, it resolved on its own. I had a headache that started about 2 1/2 days post vaccine. It was in the front of my head and would not resolve. I saw my Primary Care Physician who suggested I go to Emergency Room if it didn't resolve. I went to ER on 8/11, where I had a CT Scan and an MRI - both of which noted I'd had a stroke. I'm currently being evaluated by a neurologist. I'm still having headaches nearly every day.

Other Meds: olmesartan 20 mg, januvia 25 mg, lipitor 80 mg, Vitamin D 2000 IU

Current Illness: None

ID: 1757633
Sex: M
Age: 31
State: NY

Vax Date: 01/08/2021
Onset Date: 03/01/2021
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: I did have an echo 4/27/21 which showed an EF of 40-50% with global hypokinesis. Then cardiac MRI 5/5/21 which showed EF 49% with global hypokinesis. I then had a stress echo on 8/12/21 which showed resolution , normal wall motion and resting EF of 55-60%.

Allergies: none

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

Symptoms: I had the pfizer vaccine dose 1 on 18/21 and second dose 1/27/21. I had covid Dec 2 2020. my covid symptoms werevery mild. I had anosmia for 2 days. I had a fever of 101.5 on Dec 5 2020. I ran on the treadmill and lifted weights every day while on my covid quarantine. Shortly after the first dose (4-6 hours) of my pfizer vaccine I had body aches, chills, and severe fatigue. this lasted two days. 4-5 hours after my second dose on 1/27/21 I had similar symptoms, I did have chest pain that I believed to be acid reflux and was seen by a cardiologist in late April because my father has a congenital heart issue and wanted to be sure my chest pain was not cardiac in nature. I did have an echo 4/27/21 which showed of 40-50% with global hypokinesis. The cardiologist diagnosed me with cardiomyopathy. Then cardiac MRI 5/5/21 which showed EF 49% with global hypokinesis. I then had a stress echo on 8/12/21 which showed resolution , normal wall motion and resting EF of 55-60%. My cardiologist told me that my cardiomyopathy was possibly from covid. My concern is that my most significant symptoms and fatigue were only after the vaccine.

Other Meds: none

Current Illness: none

ID: 1757606
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 10/04/2021
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: Test Name: Body temperature; Result Unstructured Data: (Test Result:101 to 102,Unit:degree F,Normal Low:,Normal High:)

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 101-102?fever; This case was reported by a consumer via(Facebook) interactive digital media and described the occurrence of fever in a patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent unspecified season) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix and Influenza vaccine Quadrivalent unspecified season. On an unknown date, unknown after receiving Shingrix and Influenza vaccine Quadrivalent unspecified season, the patient experienced fever. On an unknown date, the outcome of the fever was recovered/resolved. It was unknown if the reporter considered the fever to be related to Shingrix and Influenza vaccine Quadrivalent unspecified season. Additional details were reported as follows: This case was reported by the patient for herself/himself. The patient was in bed with 101 to 102 degree fever for 3 days after shingrix shot. The patient reported that, he or she should not have listened to the pharmacist and a nurse who said it was fine to get the Shingrix shot one day and flu vaccine the next. The patient got the 2nd dose with no ill effects. For tolerance refer linked case US2021AMR202746, same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR202746:same patient US-GLAXOSMITHKLINE-US2021AMR202852:same patient

Other Meds:

Current Illness:

ID: 1757608
Sex: F
Age: 73
State: SC

Vax Date: 01/30/2021
Onset Date:
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: Test Name: Body Temperature; Result Unstructured Data: 100 F temperature

Allergies:

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

Symptoms: somewhat of a rash; 100 F temperature; extreme fatigue; pain at arthritis point; This spontaneous case was reported by a patient and describes the occurrence of RASH (somewhat of a rash), PYREXIA (100 F temperature), FATIGUE (extreme fatigue) and ARTHRALGIA (pain at arthritis point) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included DIAZEPAM (VALIUM) for Anxiety, DULOXETINE HYDROCHLORIDE (CYMBALTA) for Fibromyalgia, ASCORBIC ACID (VITAMIIN C), VITAMIN D NOS, CALCIUM and ZINC for an unknown indication. On 30-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced RASH (somewhat of a rash), PYREXIA (100 F temperature), FATIGUE (extreme fatigue) and ARTHRALGIA (pain at arthritis point). The patient was treated with PARACETAMOL (TYLENOL) for Rash, at an unspecified dose and frequency. At the time of the report, RASH (somewhat of a rash), PYREXIA (100 F temperature), FATIGUE (extreme fatigue) and ARTHRALGIA (pain at arthritis point) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: high (High) 100 F temperature. Patient reports that she has a genetic defect called MThfr compound heterozygous. It means sometimes she methylates, or absorb medications very quickly, and there are other times where she absorbs medications very slowly. They are not quite sure what will happen in either situation. Concomitant includes Thyroid medication. This case was linked to MOD-2021-329852, MOD-2021-329883 (Patient Link).

Other Meds: CYMBALTA; VALIUM; VITAMIIN C; VITAMIN D NOS; CALCIUM; ZINC.

Current Illness:

ID: 1757609
Sex: U
Age:
State: MO

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: This spontaneous case reported by a pharmacist, describes the occurrence of administered expired product (healthcare worker left a voicemail stating they gave an expired vaccine to a patient) in a patient, of an unknown age and gender, who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. No medical history reported. On Sep 25, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Sep 25, 2021, patient administered expired product (healthcare worker left a voicemail stating they gave an expired vaccine to a patient). At the time of the report, administered expired product (healthcare worker left a voicemail stating they gave an expired vaccine to a patient) resolved. The reporter did not provide any causality assessments. The expiration date for the 1st dose: Sep 18, 2021. Date the vial was initially stored in the refrigerator: Friday, Sep 24, 2021. They didn't know how much time the vial was exposed to room temperature, or whether the vial had undergone any temperature excursions. No concomitant medications or treatment information reported. Most recent follow-up information incorporated: On Sep 27, 2021: Follow-up received on Sep 27, 2021: Reporter information, vaccine start date, event date and details updated.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am