VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
PLEASE CHECK BACK SOON
Download the files above while you wait.







Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1758887
Sex: M
Age: 23
State: LA

Vax Date: 05/10/2021
Onset Date: 06/02/2021
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: LA

Lab Data: Patient was advised to f/u with PCM for further evaluation.

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: 2 JUN 2021: Patient reported upset stomach and diarrhea; onset in June 2021. Patient was evaluated by provider while in theatre. Patient reported symptoms slightly improved; no longer watery per Patient. Patient stated that he continues to have multiple bowel movements per day; described stools to be loose. 1 OCT 2021: Patient reported that he can not keep an erection; "no morning erection" per Patient. Patient given permission to report this finding into VAERS.

Other Meds: None

Current Illness: None

ID: 1758888
Sex: F
Age: 30
State: WI

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Azithromycin, Ceclor

Symptom List: Anxiety, Dyspnoea

Symptoms: Received my Pfizer booster at 2pm on Thursday, started having intense intermittent chills and hot flashes around midnight through the morning. When I woke up, I felt as though taking a shower would help and when I was in the shower, I felt as though I was going to pass out and quickly rushed to the toilet and vomitted. I had intense chills, fatigue, hot flashes, loss of appetite, and a minor headache on Friday. At around 3pm on Friday, I started to develop joint pains in my hips and knees making it almost impossible to walk up a flight of stairs. I still had chills on Friday night, into Saturday morning. My joint pain has almost subsided nearly 4 days later, but I developed lymphedema (swelling of lymph nodes) in the armpit of the injection side (right arm). This has continued since Saturday evening and is ongoing. I am also still feeling fatigued.

Other Meds: Ortho tri-cyclen (birth control), multi vitamin, elderberry.

Current Illness: No

ID: 1758890
Sex: F
Age: 34
State: NJ

Vax Date: 09/24/2021
Onset Date: 10/01/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies: Allergy to Reglan medication, sensitivity to latex

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

Symptoms: Hives/rash present over faces, eyes, upper and lower extremities, and back. Symptoms noticed the evening of 10/1, one week after first dose. Reaction currently remains with no change in diminishing.

Other Meds: Birth control

Current Illness:

ID: 1758891
Sex: F
Age: 47
State: IN

Vax Date: 09/16/2021
Onset Date: 09/24/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: Medical facilities will not recognize these symptoms as vaccine related. Appointments continue to be disclosed as not conclusive

Allergies: Latex, Rubber, Petroleum, multiple food allergies

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Numbness of left pinky finger, heart palpitations, loss of smell, metal taste, lymph nodes on left side of neck, under arm, and chest swollen. Heavy feeling in left leg and arm with pain.

Other Meds: Vyvanse

Current Illness: ADD

ID: 1758892
Sex: F
Age: 51
State: IN

Vax Date: 09/29/2021
Onset Date: 09/30/2021
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: LA

Lab Data: Still waiting to hear from primary health care provider

Allergies: Penicillin

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

Symptoms: Chest pain, itching from my head to top of my feet. Lightheaded and when I focus everything words run together.

Other Meds: None

Current Illness:

ID: 1758893
Sex: M
Age: 57
State: IN

Vax Date: 10/01/2021
Onset Date: 10/03/2021
Rec V Date: 10/04/2021
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: None

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

Symptoms: Swollen sore lymph nodes and armpit and chest muscle on left side

Other Meds: 30 mg Buspirone .4 mg Flomax 10 mg Ezetimibe 10-325 Hydrocodone-Acetaminophren 500 mg Valacyclovir 1400 mg fish oil Daily vitamin Super B - Complex with electrolytes Osteo Bi-Flex 200 mg CoQ10 120 mg Gino's Biloba 10 mg Loratadine table

Current Illness: None

ID: 1758894
Sex: F
Age: 74
State: PA

Vax Date: 02/26/2021
Onset Date: 09/11/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data: 09/13/21 1958 Respiratory virus detection panel Collected: 09/13/21 1812 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result Detected Critical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected Procedure Component Value Ref Range Date/Time X-ray chest 1 view - Portable Resulted: 09/14/21 1009 Order Status: Completed Updated: 09/14/21 1009 Narrative: XR CHEST 1 VW PORT IMPRESSION: No acute findings. NB: Radiography can be negative in the early of stage of COVID 19 pneumonia. END OF IMPRESSION: INDICATION: syncope, vomiting, cough Cough. COVID 19 positive 9/13/2021. TECHNIQUE: Portable AP projection of the chest was acquired. COMPARISON: 4/20/2021. 10/20/2017. 11/14/2008. FINDINGS: EKG wires and tubing project over the thorax. An implanted geometric metallic device again projects at the base of the neck on the left, and has been present since 2008. The heart size is normal. The vascular distribution is normal. Aortic calcifications are present. Splenic arterial calcifications including calcified splenic aneurysm are again seen. The lungs are clear. No pleural effusion is identified. There is no evidence of pneumothorax. Mild thoracic dextrocurve and bilateral AC arthrosis are noted. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT angiogram chest pulmonary embolism with and without contrast (Abnormal) Resulted: 09/13/21 2247 Order Status: Completed Updated: 09/13/21 2247 Narrative: PROCEDURE INFORMATION: Exam: CTA Chest Without And With Contrast Exam date and time: 9/13/2021 9:03 PM Age: 74 years old Clinical indication: Shortness of breath; Additional info: Syncope, elevated d-dimer covid+. Syncope, covid positive, elevated d-dimer TECHNIQUE: Imaging protocol: Computed tomographic angiography of the chest without and with contrast. 3D rendering (Not supervised by radiologist): MIP and/or 3D reconstructed images were created by the technologist. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. Contrast material: Contrast volume: 80 ml; Contrast route: INTRAVENOUS (IV); COMPARISON: CT CHEST WO CONTRAST 11/17/2020 10:57 AM FINDINGS: Pulmonary arteries: Normal. No pulmonary emboli. Aorta: Moderate atherosclerotic changes within the aorta. Lungs: Patchy airspace disease identified at left base as well as both upper lobes, may represent early developing covid pneumonia. Underlying pul

Allergies: Keflex [Cephalexin]Other (document details in comments)

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: ED to Hosp-Admission Discharged 9/13/2021 - 9/15/2021 (2 days) MD Last attending ? Treatment team Syncope and collapse Principal problem Presenting Problem/History of Present Illness/Reason for Admission Syncope and collapse [R55] AKI (acute kidney injury) (CMS/HCC) [N17.9] Syncope, unspecified syncope type [R55] COVID-19 virus infection [U07.1] 74-year-old female past medical history of stable cerebral aneurysm, routinely follows in the outpatient setting, COPD, essential hypertension, polymyalgia rheumatica, vertigo presented to the ER with near syncopal episodes. Still feeling very weak for the past 3 to 4 days she was going to the bathroom she felt dizzy and was about to pass out. In the ED she was tested positive for COVID-19, CT angiogram of the chest was negative for PE given her elevated D-dimer, her orthostatic vitals were positive, she was hydrated her blood pressure medications were adjusted. She was told to follow-up with her PCP in the outpatient setting for further blood pressure medication adjustment if required. Also a Zio patch was placed on her to rule out any arrhythmia while in the hospital telemetry and EKGs were unremarkable. She was discharged home in a stable condition. Patient does not require any oxygen for her COVID-19.

Other Meds: ALPRAZolam (XANAX) 0.5 mg tablet aspirin 81 mg tablet atorvastatin (LIPITOR) 40 mg tablet levothyroxine (SYNTHROID) 88 mcg tablet lisinopriL (ZESTRIL) 5 mg tablet omeprazole (PriLOSEC) 20 mg capsule predniSONE (DELTASONE) 10 mg tablet

Current Illness:

ID: 1758895
Sex: F
Age: 44
State: FL

Vax Date: 10/03/2021
Onset Date: 10/04/2021
Rec V Date: 10/04/2021
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: Small bumps around the injection site, hives on chest and neck.

Other Meds: None.

Current Illness:

ID: 1758896
Sex: M
Age: 28
State: OH

Vax Date: 09/23/2021
Onset Date: 09/23/2021
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: LA

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Immediately had soreness in arm making it very difficult to drive home, and then symptoms worsened over the next 30 hours, or so. Overall, the symptoms included exhaustion, muscle weakness, loss of appetite, severe dizziness, jolting pain in shoulders, neck, and , head, nasal congestion, and drastic temperature fluctuations (sweating to freezing, back and forth). I was drinking lots of fluids, eating healthy foods (fruits and vegetables, soup, etc.), and eventually took some ibuprofen (about 26hrs after the injection) that significantly helped with the pain and dizziness. I had fully recovered (aside from some minor lingering pain around the injection site for a few more days) by the next morning (~38hrs after the injection).

Other Meds: None

Current Illness: None

ID: 1758897
Sex: F
Age: 18
State: KY

Vax Date: 07/30/2021
Onset Date: 09/27/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1758898
Sex: M
Age: 74
State: NJ

Vax Date: 08/22/2021
Onset Date: 08/22/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: pain in arm at site of injection

Other Meds: levoxyl, hydrochlorithizide, centrum , viamin c, vitmain d, lutein, zinc

Current Illness:

ID: 1758899
Sex: F
Age: 76
State: PA

Vax Date: 03/27/2021
Onset Date: 09/06/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data: 09/21/21 1727 Respiratory virus detection panel Collected: 09/21/21 1621 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result Detected Critical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected 09/13/21 2004 POCT COVID-19 PCR Collected: 09/13/21 2004 | Final result | Specimen: Swab from Nares POC COVID-19 PCR Detected Abnormal Lot # 1000285225 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 8/21/22 Procedure Component Value Ref Range Date/Time Ultrasound lower extremity venous bilateral [3304394900] Resulted: 09/22/21 0721 Order Status: Completed Updated: 09/22/21 0721 Narrative: US LOWER EXTREMITY VENOUS BILATERAL IMPRESSION: Bilateral lower extremity venous Doppler ultrasound is positive for deep venous thrombosis in the left posterior tibial vein. The remaining deep veins of the left leg and the deep veins of the right leg are patent. END OF IMPRESSION: INDICATION: Deep venous thrombosis. Shortness of breath. TECHNIQUE: Multiple longitudinal and transverse 2D real-time ultrasound images were performed from groin to knee, and at the calf and ankle. Color and grayscale and duplex Doppler imaging was also performed. Permanently recorded images were obtained and stored. COMPARISON: January 18, 2017. FINDINGS: Right leg: No evidence of deep venous thrombosis. There is normal flow, compressibility and augmentation in the common femoral, greater saphenous, superficial and deep femoral veins and popliteal veins. There is also normal flow, compressibility and augmentation in the posterior tibial veins, peroneal veins and small saphenous veins in the calves. Left leg: The patient has deep venous thrombosis in the left posterior tibial vein. There is normal flow, compressibility and augmentation in the common femoral vein, profunda, femoral vein, popliteal vein and peroneal vein. The superficial veins are patent bilaterally. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT angiogram chest pulmonary embolism with and without contrast [3304358600] Resulted: 09/21/21 2039 Order Status: Completed Updated: 09/21/21 2039 Narrative: CTA CHEST PULMONARY EMBOLISM W WO CONTRAST IMPRESSION: Small peripheral left lower lobe pulmonary artery embolus. END OF IMPRESSION: INDICATION: COVID-19. Evaluate for PE. Assess for pulmonary artery embolism. TECHNIQUE: Enhanced helical CT scan of the chest was performed from the lung apices to below the diaphragm. 2 mm axial reconstructions with MPR coronal, oblique and sagittal images were created. 3D shaded surface images also created on a separate workstation

Allergies: Cefuroxime AxetilNausea Only MorphineOther (document details in comments), Nausea and Vomiting

Symptom List: Rash, Urticaria

Symptoms: ED to Hosp-Admission Discharged 9/21/2021 - 9/24/2021 (3 days) Last attending ? Treatment team Pneumonia due to COVID-19 virus Hospital Course This is a 77-year-old lady with history of asthma, hypertension, hyperlipidemia who came to Hospital emergency department with chest pain and shortness of breath. She was admitted for work-up and she was recently diagnosed with COVID-19 infection on September 13. Her repeat test was also positive. CT scan of the chest showed bilateral pneumonia as well as pulmonary embolism. Ultrasound scan of the leg shows left leg DVT. She was initially treated with heparin infusion now changed to oral Eliquis which she needs to take 10 mg twice a day for 5 days then change to 5 mg twice a day. She was also started on dexamethasone due to COVID-19 pneumonia. Her oxygen saturation remained stable on room air. On day of discharge her chest pain is better. She still has trouble having deep breaths. Denies any cough sputum. Afebrile. Denies any pain swelling in the legs. Denies any nausea vomiting or abdominal pain. No unusual bleeding. No other new symptoms or acute event as per nursing staff

Other Meds: albuterol HFA (PROAIR HFA) 90 mcg/actuation inhaler amLODIPine (NORVASC) 5 mg tablet amoxicillin 500 mg oral tablet apixaban (ELIQUIS) 5 mg tablet atorvastatin (LIPITOR) 10 mg tablet calcitrioL (ROCALTROL) 0.25 mcg capsule lansoprazol

Current Illness:

ID: 1758900
Sex: M
Age: 42
State: MO

Vax Date: 08/05/2021
Onset Date: 08/05/2021
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: LA

Lab Data:

Allergies: none

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

Symptoms: very ill for ~1 week. Fatigue and headache. Similar to when I contract COVID Fall 2020. Have had continued shortness of breath since.

Other Meds: cetirizine hydrochloride allergy nasal spray

Current Illness: seasonal allergies

ID: 1758901
Sex: F
Age: 40
State: NY

Vax Date: 10/03/2021
Onset Date: 10/03/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Red and itchy face and neck. Extreme dry eyes

Other Meds: None

Current Illness: None

ID: 1758902
Sex: M
Age: 68
State: AZ

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/04/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Extreme pain and limited range of motion in right shoulder

Other Meds: famotidine 20 MG tablet, fluticasone 50 MCG/ACT nasal spray, Multiple Vitamins-Minerals

Current Illness: None

ID: 1758903
Sex: F
Age: 41
State: FL

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: Recently went for an MRI and am awaiting a doctors review

Allergies: None

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

Symptoms: Limited range of motion in left arm, very weak, pain in arm and shoulder from the very first dose of injection on 7/27/21 ongoing as of today 10/4/21

Other Meds: 20mg fluoxetine

Current Illness: None

ID: 1758905
Sex: F
Age: 32
State: NJ

Vax Date: 09/28/2021
Onset Date: 10/02/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: Various Test Ran

Allergies: Lamictal

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

Symptoms: Fever of 102, severe distress sounds(unable to speak), uncomfortable, agitated, crying, congested and tiredness. Lactic acid was high.

Other Meds: Keppra 500mg per 5ml (two times daily) Depakene 250mg per 5ml (7 daily) Levocarnitine 300mg per 3 ml (3 times daily) Oxcarbazepine 300mg per 5ml (9 times daily) Robinul 1mg (once daily) Famotidine 40mg per 5ml (6 times daily) VSL 3 (1 packa

Current Illness: None

ID: 1758906
Sex: F
Age: 23
State: FL

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/04/2021
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: pt was innoculated with #3 dose of Phizer at 11:12 on Oct.2,2021. At 11:25 pt was sitting in observation when pt c/o chest pain,dizziness, weakness with slight shortness of breath- PT was A/OX3- EMS was notified by staff member - BP was 118/60 hr 68. at 11: 30 pt reported no change in s/s, BP 130/67 hr 60. at 11:34, EMS arrived on the scene- vital signs were taken:BP 133/84 hr97, 99% on RA, NSR on monitor- pt stated no change in s/s to EMS, who with pt consent. transported pt via stretcher to local hospital. Pt remained A/OX3 throughout incident.

Other Meds: unk

Current Illness: anemia

ID: 1758907
Sex: F
Age: 60
State: VA

Vax Date: 10/01/2021
Onset Date: 10/02/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: they took a blood test to determine electrolyte level and kidney assessment due to the dehydration as a precaution. 10/3 all seemed fine

Allergies: Flexerill - muscle relaxer

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: The day of the shot I was fine, Friday 10/1. The very next day, 10/2 at 7am I began throwing up and diarrhea that didn't stop for 3 hours. I also had a fever of 100.4 along with extreme headache. My head felt like a watermelon and my eyes felt incredibly heavy/full. I had to go to the emergency room due to dehydration - that was aroun 10:15 am. I got an IV with anti-nausea. My fever of 100.4-100.5 persisted all night into the early morning hours of 10/3. I also experienced extreme heart pounding late on 10/2 and acute chest pain the evening of 10/3. I am still experiencing on/off fever and headache

Other Meds: Synthroid, .50mg Lisinopril/Hctz 20-12.5mg

Current Illness: none

ID: 1758908
Sex: F
Age: 30
State: GA

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies: UNKNOWN

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

Symptoms: AFTER TAKING THE VACCINE IN THE AFTERNOON, THE NEXT DAY I HAD A HEADACHE AND MY NOSE STARTED DRIPPING, SO I WENT TO THE BATHROOM. IMMEDIATELY WHEN I STOOD UP, I FELT FAINT AND NAUSEOUS. CONSTANT SYMPTOMS THAT HAVE DISSIPATED : SHORTNESS OF BREATH (I FIND MYSELF WAKING UP B/C I LOSE MY BREATH IN THE NIGHT WHEN I SLEEP AND/OR WHEN AWAKE, I'M HAVING TROUBLE BREATHING) I'VE BEEN TERRIFIED TO SLEEP, NOT KNOWING IF I'LL WAKE UP THE NEXT DAY. MY PARTNER STAYS ON THE PHONE WITH ME AND CALLS ME IF HE DOESN'T HEAR ME BREATHING/SNORING. I ALSO HAVE A PAINFUL SORE THROAT (PHARYNX) . BOTH ISSUES I AM STRUGGLING WITH FOR THE PAST THREE WEEKS WITHOUT RELIEF. I'VE TRIED TAKING A VITAMIN FOR THE SORE THROAT, BUT IT HAS NOT HELPED SINCE.

Other Meds: NONE

Current Illness: NONE

ID: 1758909
Sex: F
Age: 35
State: NJ

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 10/04/2021
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: Penicillin, Sulfa drugs

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

Symptoms: Headache bursts all around eyes and in both temples, Comes on suddenly at multiple points throughout the day, lasting anywhere from 5-30 seconds. Happens daily since the second dose of the vaccine.

Other Meds: Women's daily multivitamin, Vitamin D (2,000 IU's), Daily probiotic

Current Illness: None.

ID: 1758910
Sex: F
Age: 96
State: IN

Vax Date: 10/02/2021
Onset Date: 10/03/2021
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: LA

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Chills, muscle and body pain

Other Meds: Gabapentin

Current Illness:

ID: 1758911
Sex: F
Age: 83
State: OH

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/04/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Headache, soreness at injection site, shivers, body aches, nausea.

Other Meds:

Current Illness:

Date Died: 10/02/2021

ID: 1758912
Sex: M
Age: 79
State: TN

Vax Date: 02/26/2021
Onset Date:
Rec V Date: 10/04/2021
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: Patient tested positive for COVID-19 9/23/2021. Hospitilized 9/23/2021. Patient was fully vaccinated 2/26/21 and 04/03/2021 with Moderna. Paitnet expired 10/02/2021

Other Meds:

Current Illness:

ID: 1758913
Sex: M
Age: 29
State: KY

Vax Date: 06/13/2021
Onset Date: 09/26/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Tested positive for Covid

Other Meds:

Current Illness:

ID: 1758914
Sex: F
Age:
State: SC

Vax Date: 09/18/2021
Onset Date: 09/20/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Became sick Monday after shot. Threw up 3 to 4 times daily for 7 days. Stopped but very slow recovery. Have major brain fog and dizziness.

Other Meds: None

Current Illness: None

ID: 1758915
Sex: M
Age: 80
State: OH

Vax Date: 02/11/2021
Onset Date: 09/22/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Breakthrough COVID-19 case.

Other Meds:

Current Illness:

ID: 1758917
Sex: F
Age: 22
State:

Vax Date: 06/24/2021
Onset Date: 09/14/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I was feeling completely fine until September 30 around 5pm I began to notice my heart was racing and pounding on my chest, my arms and legs felt weak and wouldn't stop shaking. I felt nauseous and as if I could not breathe almost like something was sitting on my chest. I did go to Emerge and did 3 ECGs (all missed the heart palpitations and now I will be getting a Holter Monitor) I did lots of bloodwork and everything came back normal. October 3 was the worst day by far, my heart would spike to 147 randomly and it felt almost impossible to breathe. I can just be sitting there watching TV or making something to eat and it just happens out of nowhere. I have never had anything like this happen before

Other Meds: 75 mg of sertraline 25mg of trazodone

Current Illness:

ID: 1758918
Sex: M
Age: 30
State: TN

Vax Date: 09/23/2021
Onset Date: 09/24/2021
Rec V Date: 10/04/2021
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: Fish and nuts.

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

Symptoms: Chest pain and pressure on left side. Symptoms are ongoing at time of reporting.

Other Meds: None

Current Illness: None.

ID: 1758919
Sex: F
Age:
State: NY

Vax Date:
Onset Date: 09/29/2021
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:

Allergies: iodine shellfish

Symptom List: Nausea

Symptoms: 12 hours after vax she woke up frezzing cold and shaking, was dizzy, upset stomach, says she has all covid symptoms, muscle pain, weakness

Other Meds: insulin losthartin

Current Illness:

ID: 1758921
Sex: M
Age: 79
State: OH

Vax Date: 02/08/2021
Onset Date: 10/03/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Breakthrough COVID 19 case. Pt contracted COVID after being fully vaccinated

Other Meds:

Current Illness:

ID: 1758922
Sex: F
Age: 66
State: IN

Vax Date: 10/01/2021
Onset Date: 10/03/2021
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: LA

Lab Data: none

Allergies: none

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

Symptoms: swelling and soreness in lymph nodes under left arm. today (October 4 is the 2nd day of swelling and soreness) I had the same results when I received my 2nd shot on February 19, 2021. That was results of the 2nd Pfizer vaccine. the swelling and soreness went complete away after the 3rd day.

Other Meds: none

Current Illness: none

ID: 1758923
Sex: M
Age: 31
State: FL

Vax Date: 08/06/2021
Onset Date: 10/04/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: At the hospital, I did blood work, EKG, and Xray on chest/lungs.

Allergies: None

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

Symptoms: Immediately after the shot, I sat down and became hot, sweaty and dizzy. After a few moments, I had a seizure in the waiting room of the pharmacy while sitting in the chair. Pharmacists and former EMT were in the vicinity to help immediately. I was then taken by ambulance to the hospital.

Other Meds: None

Current Illness: None

ID: 1758924
Sex: F
Age: 63
State: VA

Vax Date: 07/28/2021
Onset Date: 09/01/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: COVID test, CAT Scan, Lung X-ray, Blood work

Allergies: Other sulfa drugs

Symptom List: Tremor

Symptoms: My arm was sore and a little itchy after. I did not experience any fever or anything like that. It wasn?t that bad. On 9/22, I had a fever of about 101, moderate to severe fatigue and my right leg was unable to support me. I was told to go to the ER where they gave me saline solution via IV, they took blood, they did a Cat scan, covid test and a lung xray. They did say it was some kind of viral issue and suggested Tylenol. The Tylenol did help along with fluids. I use the cane or walker but I am able to walk again.

Other Meds: Nothing new or different from what I usually take

Current Illness: Common cold

ID: 1758925
Sex: M
Age: 27
State: MS

Vax Date: 09/30/2021
Onset Date: 10/04/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: none

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: patient is having elevated BP readings (without history of BP issues), weakness (generalized), fatigue (severe) and nausea/vomiting.

Other Meds: none

Current Illness: none

ID: 1758926
Sex: F
Age: 15
State: IL

Vax Date: 06/22/2021
Onset Date: 07/01/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: 2 weeks after completing second COVID vaccine, previously regular menses became extremely irregular, with bleeding every 2 weeks instead of every 4 weeks

Other Meds: none

Current Illness: none

ID: 1758927
Sex: F
Age: 23
State: VA

Vax Date: 03/04/2021
Onset Date: 03/08/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data: Endoscopy, colonoscopy (May 4th, 2021)

Allergies: Penicilin

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

Symptoms: Shortness of breath, palpitations, dizziness, pounding in ears, paleness, fatigue, weakness - admitted to emergency room hospital due to a hemoglobin level of 2.8 - recieved 4 bags of blood transfusion. Was admitted early may but had been feeling the symptoms since 2 days after second dose of vaccine.

Other Meds: Birth control, paroxetine

Current Illness: N/A

ID: 1758928
Sex: M
Age: 97
State: KY

Vax Date: 01/17/2021
Onset Date: 09/23/2021
Rec V Date: 10/04/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Tested positive for COVID-19.

Other Meds:

Current Illness:

ID: 1758930
Sex: F
Age: 0
State: OH

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

Allergies:

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

Symptoms: Breakthrough COVID-19 case. Pt contracted COVID after receiving both doses of the Moderna Vaccine.

Other Meds:

Current Illness:

ID: 1758931
Sex: F
Age: 43
State: TX

Vax Date: 09/29/2021
Onset Date: 10/03/2021
Rec V Date: 10/04/2021
Hospital: Y

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: MRI, Echo, Labs, carotid

Allergies: ASA

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

Symptoms: $ days after vaccine patient experienced TIA

Other Meds: None

Current Illness: NONE

ID: 1758932
Sex: F
Age: 75
State:

Vax Date: 09/27/2021
Onset Date: 09/27/2021
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: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: 1st dose was Moderna and 2nd dose was given of Pfizer

Other Meds:

Current Illness:

ID: 1758933
Sex: F
Age: 78
State: MI

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

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

Lab Data:

Allergies: Aleve

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

Symptoms: fevers as high as 101 ?F as well as worsening left lower quadrant abdominal discomfort and a worsening cough and shortness of breath. Patient's oxygen saturation was 73% on room air on presentation. 9:56 AM patient was placed on supplemental oxygen at 3 L and immediately went to 94%. Remaining vitals are stable. She will have some repeat abdominal labs as well as chest x-ray. She will also be tested for Covid. Patient will be given Decadron for her breathing. Further disposition is to follow. 11:07 AM patient's x-ray is unremarkable however she is positive for Covid. Patient will be admitted for further care and treatment with supplemental oxygen and continued treatment of her diverticulitis.

Other Meds: Current Home Medications 1. atorvastatin 40 mg oral tablet : 1 tab(s) orally once a day 2. bisoprolol 10 mg oral tablet : 1 tab(s) orally once a day 3. clopidogrel 75 mg oral tablet : 1 tab(s) orally once a day 4. fenofibrate 160 mg oral ta

Current Illness:

ID: 1758934
Sex: M
Age: 48
State: OK

Vax Date: 09/09/2021
Onset Date: 09/10/2021
Rec V Date: 10/04/2021
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: NKDA

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

Symptoms: Patient states he had the first moderna covid vaccine on 6/7/21, he had his second moderna covid vaccine on 8/27/21. Patient states that on 9/9/21 and had a third Moderna Vaccine. patient states within 24 hours he had side effects of shob, body aches, he felt like his bronchials were inflammed, he couldn't smell anything and lost the taste of somethings. he states since this date he had the horrific smell of metal, he wakes up with the smell and sometimes he can taste it. He feels a fatigue.

Other Meds: duloxetine, omeprazole

Current Illness: none

ID: 1758935
Sex: F
Age: 53
State: CO

Vax Date: 10/02/2021
Onset Date: 10/03/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: non-did not go to doctor, would've had to go to ER or urgent care and didn't need or want those expenses

Allergies: penicillin

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

Symptoms: 26 hours after 2nd dose, 80? outside and I'm shivering uncontrollably and feel cold despite wearing 2 layers clothing and being under blankets, yet skin is hot to the touch, numb arms and hands/fingers, extreme exhaustion, upper back pain, injection arm is super painful from elbow all the way up and into that side of my head, muscle sore everywhere to point of being hard to move, some joint pain where I'm arthritic, dizzy and generally feeling completely out of it. 28 hours after, switch from being freezing to very hot, face flushing bright red (which is an allergic reaction for me), hot flashes for next 3 hours. Wake up day 2 after vax and still dizzy, slightly nauseaus

Other Meds: Vit D, B complex, elderberry, collagen, magnesium, CoQ10, clariton

Current Illness: none

ID: 1758936
Sex: F
Age: 52
State: RI

Vax Date: 05/12/2021
Onset Date: 06/29/2021
Rec V Date: 10/04/2021
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: Crustaceans/Cat Scan Dye

Symptom List: Vomiting

Symptoms: Extremely swollen feet

Other Meds: Synthroid

Current Illness: None

ID: 1758937
Sex: M
Age: 76
State: OH

Vax Date: 02/25/2021
Onset Date: 09/29/2021
Rec V Date: 10/04/2021
Hospital: Y

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: Breakthrough COVID-19 case. Pt contracted covid after receiving both doses of the vaccine.

Other Meds:

Current Illness:

ID: 1758938
Sex: F
Age: 47
State: HI

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/04/2021
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 have none. I bought some ibuprofen and slept

Allergies: No

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

Symptoms: Injection site pain-still sore Tiredness Whole body was in pain Injection site swelling Nausea Decreased appetite Headache Diarrhea Arm pain Almost fainted when I got injected My hand got swollen I?m still dealing with headaches arm pain site pain. I have a lump where I got vaccine

Other Meds: No

Current Illness: I got sick on 8/30/21. Felt like the flu and pneumonia at the same time. Lasted til 9/13/21

ID: 1758939
Sex: F
Age: 41
State: NY

Vax Date: 09/17/2021
Onset Date: 09/17/2021
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: Various Test Ran

Allergies: Penicillin Codeine

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Throat started closing, entire body swollen and is blotchy and red. Unable to walk.

Other Meds: None

Current Illness: None

ID: 1758940
Sex: F
Age: 78
State: MI

Vax Date: 04/08/2021
Onset Date: 10/01/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: PT came in with weakness, shortness of breath and cough for 4 days prior to coming in. PT is on remvesivir; cescriaxone, doxycycline PT is still in hospital

Other Meds:

Current Illness:

ID: 1758941
Sex: F
Age: 65
State: KY

Vax Date: 03/19/2021
Onset Date: 09/10/2021
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: Tested Positive for Covid

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am