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: 1761885
Sex: F
Age: 73
State: NJ

Vax Date: 09/26/2021
Onset Date: 09/27/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever, redness at injection site.

Other Meds: None.

Current Illness:

ID: 1761886
Sex: F
Age: 67
State: NJ

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1761887
Sex: F
Age: 65
State: IL

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 10/05/2021
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: Latex, Penicillin

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

Symptoms: I experienced bleeding gums, achiness, tiredness and headaches.

Other Meds: Doxepin, Propanol, Synthroid, Clorazepate

Current Illness:

ID: 1761888
Sex: M
Age: 18
State: OR

Vax Date: 09/12/2021
Onset Date: 09/15/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: seen at ER 9/15/21 with EKG done, given NSAID

Allergies: NKDA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Myocarditis

Other Meds: none

Current Illness: none

ID: 1761889
Sex: M
Age: 81
State: NJ

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 10/05/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1761890
Sex: F
Age: 31
State: CO

Vax Date: 03/31/2021
Onset Date: 05/03/2021
Rec V Date: 10/05/2021
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: MRI on brain - nothing. MRI on shoulders and spine - next week. Blood work - autoimmune factors checked and nothing out of the ordinary

Allergies: Phenergan

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

Symptoms: Increasing migraine. Spine, shoulders hips and knees fibromyalgia, dull pain and flare up on right shoulder, right hip and left knee. I have also chronic fatigue has got worse still the point I can sleep 18 hrs. a day. digestive issues - stomach upset and diarrhea. In my treatment I am doing dry needling with PT for 8 weeks and continuing with that . Started on Cymbalta. In June I was in ER.

Other Meds:

Current Illness: No

ID: 1761891
Sex: M
Age: 45
State: CO

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/05/2021
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 reported.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pt expressed apprehension about receiving vaccine, but was doing so because required by employer. While waiting in observation pt expressed a desire to lie down. Once pt was let back into immunization room and allowed to lay down he started to suffer an anxiety attack. Pt complained of tingling in extremities and lightheaded when moving from sitting to laying down. Paramedics were called and tested pt. All was good, pt just couldn't relax and get breathing under control. Ultimately pt was taken out side on gurney and paramedics observed him until anxiety subsided. Pt's spouse ultimately picked up pt. I phoned pt later that evening and he stated that he was feeling fine.

Other Meds:

Current Illness: None reported

ID: 1761892
Sex: M
Age: 90
State: SC

Vax Date: 09/01/2021
Onset Date: 09/18/2021
Rec V Date: 10/05/2021
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: Herpes zoster rash on ankle starting 9/18/2021.

Other Meds: Multaq, Metoprolol

Current Illness:

ID: 1761893
Sex: M
Age: 46
State: NJ

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 10/05/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1761894
Sex: M
Age: 21
State: NC

Vax Date: 10/04/2021
Onset Date: 10/04/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: None

Allergies: None documented.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Client had received 1st dose of moderna on 8/27/21. Client reported afterwords that he had minor throat swelling when he arrived home and took expired Benadryl. Client had contacted health dept multiple times wanting to receiving the 2nd dose of Moderna. He told us about his "minor throat swelling" and we instructed that we would not give the 2nd dose of Moderna since he had a minor anaphylatic event . He could try J/J. Client came in on 10/4/21 and filled out his paperwork for 2nd dose of Moderna. He put on paperwork that he did not have an adverse reaction to the 1st dose and denied it when asked by staff. 2nd dose of moderna was given by staff because they did not know he had a previous reaction. Client hung around in clinic from 2:40pm until 4:04pm and then c/o throat swelling. Dr assessed patient. 99% on room air. EMS was called at 4:15pm. Client refused epi and benadryl. Pt stated he wantedf to sign a refusal for tx/transport to hospital. At 4:35pm pt denied shortness of breath or any problems swallowing. Discharged home.

Other Meds: None documented.

Current Illness: None documented.

Date Died: 08/25/2021

ID: 1761895
Sex: F
Age: 63
State: MN

Vax Date: 03/04/2021
Onset Date: 08/25/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies: Penicillin's, tape

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

Symptoms: Patient passed away on 08/25/2021.

Other Meds:

Current Illness:

ID: 1761896
Sex: F
Age: 47
State: MN

Vax Date: 01/26/2021
Onset Date: 09/28/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: 10/4 SARS/COV-2, NAAT Positive

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Breakthrough COVID

Other Meds:

Current Illness:

ID: 1761897
Sex: F
Age: 59
State: TX

Vax Date: 09/22/2021
Onset Date: 09/23/2021
Rec V Date: 10/05/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Chills first, starting at 10 am next day; then headache starting about 11 am; fever of 101 by noon. All lasted through 2 doses of Tylenol, and one dose of Advil, until around 7:30 pm.

Other Meds: Acyclovir 800mg

Current Illness: None

ID: 1761898
Sex: F
Age: 59
State: VA

Vax Date: 04/01/2021
Onset Date: 05/05/2021
Rec V Date: 10/05/2021
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: Biopsy of lump

Allergies: None

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

Symptoms: Lump removed, biopsied and now just doing follow up

Other Meds: I started with a small lip that grew at injection site that had to be removed. Pathology was non specific.

Current Illness: None

ID: 1761899
Sex: M
Age: 74
State: VA

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/05/2021
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: Red, itch rash on torso, arms, and legs. Treated with Benedryl and Hydrocortisone cream. Improved overnight and continued improving.

Other Meds: Ceterizine, Azalastine, Omeprazole, Lumigan

Current Illness: None

ID: 1761900
Sex: F
Age: 74
State: NJ

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 10/05/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1761901
Sex: F
Age: 38
State: MA

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: 9/25/21 chest x-ray, ekg, labs.

Allergies: penicillin, amococillin, ceclor, bactrim, ceptrim - hives codine, clindamycin - anaphlaxis

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

Symptoms: 9/24/21 5:30 mild headache and backpain, by 6 pm back pain was so bad i could not sit up or stand. 8pm throat started to get scratchy. 9/25/21 8am still had headache & severe back pain. upper left side of back was swollen. left arm felt like it was on fire where injection site was. legs and toes very swollen, mild chest pain and shortness of breath. 1pm throat was swollen and had a lot of trouble catching breath. 4pm went to hospital because had difficulty breathing. blood pressure was very high when i arrived at the hospital 158/111. they administered benadryl and prednisone and fluids. i had chest xray, ekg, covid test and a bunch of labs done. by 9pm i was breathing better still in severe pain so i went home so i could take some tylenol because the hospital wouldnt give me anything for the pain. 9/26/21 mild headache, feet only were swollen, still had bad back pain and chest discomfort from time to time. very exhausted and lethargic. 9/27/21 to present day still having chest discomfort a few times daily.

Other Meds: 300mg buproprion

Current Illness: none

ID: 1761902
Sex: F
Age: 46
State: IA

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Within a minute of getting vaccine, patient stated not feeling well. Patient's spouse was with and alerted pharmacy. Patient states lost vision (dark and blurry), felt very warm, had slight tremor, and was unable to hold head up. Patient leaned head against booth and closed eyes. Was able to respond to questions, but wasn't able to make complete sentences. Patient then started to sweat and shiver. Patient wasn't able to open eyes and couldn't hold head up. Patient was drenched in sweat. Offered cold compress and kept talking with patient. Patient did not fully respond and continued to say was tired and unable to focus eyes. Took patient 15 minutes and like an on/off switch was suddenly fine. Patient could see again, no longer shivering, sweats stopped and felt normal.

Other Meds:

Current Illness:

ID: 1761903
Sex: F
Age: 52
State: IL

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: N/A

Allergies: Sulfa

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Swollen lymph node under left armpit starting about 24 hrs after vaccines and lasting 3-4 days.

Other Meds: Claritin and Junel BCP

Current Illness: None

ID: 1761904
Sex: M
Age: 33
State: IL

Vax Date: 09/09/2021
Onset Date: 09/10/2021
Rec V Date: 10/05/2021
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: Fever, Headache, Fatigue from the next morning (Friday) until the following morning (Saturday). I ended up sleeping about 8 hours total (not including morning and night). When awake I had a 102 fever on average with a terrible headache and fatigue.

Other Meds: None

Current Illness: None

ID: 1761905
Sex: F
Age: 71
State: CA

Vax Date: 09/01/2021
Onset Date: 09/30/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: None

Allergies: Brazil nuts

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

Symptoms: 1 hour after, injection I experienced tachycardia - rate 120's ( HR usually 60-68) and upper chest and throat pressure, not pain, but a definite felling of air hunger and pressure-felt as though I could not get enough air- the following day had extreme neuralgia (back, shoulder, and legs) plus the L upper deltoid was a 10/10 with movement - still experiencing discomfort today ( 5 days later). I had absolutely no reactions to the other 2 vaccines

Other Meds: Metroprol 25 bid, Lisinipril 10 qd, Atorvastatin 40 qd, Vitamens, D3, C, multivite ( over50), Calcium 600 with D,

Current Illness: None

ID: 1761906
Sex: F
Age: 53
State: NM

Vax Date: 02/03/2021
Onset Date: 02/24/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: Early March or Late Febuary X-ray was normal. Only a physical was given otherwise.

Allergies: NKA

Symptom List: Unevaluable event

Symptoms: Cough started soon after 2nd shot and is nagging and still going on. Cold and Hot foods tend to aggravate it. Not because of CoVid but may be because of vaccine. I had a loss of taste and smell that has not returned. Cough is congested and phlegmy. In March went to see the doctor. Rheumatologist did test by X-ray and found nothing. PCP visit was physical and no issue. Symbicort and Albuterol inhaler given but no change in cough. Antihistamine given Montelukast, usually taken as needed at night or early mornings when the cough is bad.

Other Meds: Hydroxychloroquine, D1, B12, Motrin, Fioricet

Current Illness: None

ID: 1761907
Sex: M
Age: 88
State: MI

Vax Date: 02/28/2021
Onset Date: 09/26/2021
Rec V Date: 10/05/2021
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: Turkey AllergyNausea and Vomiting

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

Symptoms: Patient is a 88 y.o. male who presents today with cough and SOB .He received COVID 19 Moderna Vaccine March of 2021. He has a known history of coronary artery disease, hypertension, peripheral arterial disease, hyperlipidemia, dilated cardiomyopathy, atrial fibrillation ascending aortic aneurysm. He is hard of hearing and resides at facility. He presented with cough, fatigue and shortness of breath with exertion that started 5 days ago ( 9/22/2021). He had a positive COVID-19 test 9/24. He reports significant weakness, lack of energy and cough. He denies fever, chest pain, abdominal pain nor diarrhea. He has poor appetite. He denies urinary nor bowel concerns. No flank pain Family reports a history ongoing tobacco use ( cigars) but reports no history of COPD or use of oxygen at baseline. He is also on Eliquis for his history afib. He was noted to be hypoxic at home at 70% saturations. He required 6lpm NC at the ED BP soft at 118/47 HR 54 Temp of 36.8. CXR + for bilateral infiltrates

Other Meds: Hospital Medications acetaminophen (OFIRMEV) 10 MG/ML IV 1,000 mg(Completed) L1 acetaminophen (TYLENOL) tablet 1,000 mg L1 acetaminophen (TYLENOL) tablet 500 mg albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 90 mcg inhaler (60 dose

Current Illness:

ID: 1761908
Sex: M
Age: 46
State: NJ

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 10/05/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1761909
Sex: M
Age: 46
State: PR

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: n/a

Allergies: N/A

Symptom List: Injection site pain, Menorrhagia

Symptoms: Mental confusion, itchy nose, pain in the bones behind the back when getting up, pain in the knees, itchy arm 2 days, pain in the arm, runny nose, pain in evacuation, one night with persistent cough, allergy follows.

Other Meds: N/A

Current Illness: N/A

ID: 1761910
Sex: M
Age: 42
State: MA

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/05/2021
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: NKA

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

Symptoms: thought he was going to die. Weak, general malaise, feeling like he was going to pass out. developed lump under L arm- painful.

Other Meds: Vit C Vit D Calcium

Current Illness: none

ID: 1761911
Sex: M
Age: 51
State: AZ

Vax Date: 09/22/2021
Onset Date: 10/02/2021
Rec V Date: 10/05/2021
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: CT scan, EKG, CBC (10/02/2021)

Allergies: Aspirin, Penicillin, Azithromycin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Rapid onset confusion (lasting less than 5 minutes). Followed an hour later by silent (absent) seizure lasting @ 3 minutes. mental disorientation (@30 minutes)Jaundiced coloration of skin. Lips absent of color. (@20 minutes) 911 emergency services dispatched to patient's home. Patient transported to ER via ambulance Extreme fatigue (continuing ). Headaches for several days following day of event and continuing.

Other Meds: no prescriptions. daily multivitamin. 1000mg fish oil, 1500mg glucosamine, 1200mg chondroitin, 100mg MSM, 10mg Cetirizine

Current Illness: none

ID: 1761912
Sex: F
Age: 43
State: MA

Vax Date: 04/26/2021
Onset Date: 05/27/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: 9/20, 9/29

Allergies: Allergic to prednisone

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I have not had my period since May 28, 2021, heart palpatations, insomnia, and fatigue. I have not had covid, I have been tested. I went to the ER on 9/20 for heart palpatations. I had onset of bad period right after both vaccine shots, Now I haven't had my period since. I am in a constant state of feeling unwell: tired and insomnia at night.

Other Meds: Acyclovir, latisse

Current Illness: none

ID: 1761913
Sex: F
Age: 73
State: TN

Vax Date: 09/26/2021
Onset Date: 09/27/2021
Rec V Date: 10/05/2021
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:

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

Symptoms: Systemic: blisters mainly on left arm and left leg-Medium

Other Meds:

Current Illness:

ID: 1761914
Sex: F
Age: 51
State: ID

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

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

Lab Data:

Allergies: Cephalexin, iodine, monosodium glutamate, penicillin, and promethazine

Symptom List: Nausea

Symptoms: Patient requested vaccine be given in gluteal upper outer quadrant as she can't have any injections in her deltoids because of her history of abscesses in that area from previous injections. Patient received her first dose in this site. States her PCP recommended all injections in this site including vaccines. Vaccine was given in left gluteal upper outer quadrant.

Other Meds: Aspirin, Chantix, Claritin, cyanocobalamin, estradiol, gabapentin, losartan, metoprolol, MS Contin, Vitamin D2, and Zoloft

Current Illness: Crohn's disease, chronic pain syndrome, essential hypertension, depression, vitamin D deficiency.

ID: 1761915
Sex: F
Age: 53
State: WI

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies: reports sensitivity to flu vaccine and TB test solution.

Symptom List: Injection site pain

Symptoms: She states, "left arm and both hands left arm hurts, and feels sharp stabbing pain both hands go numb cramping in both legs knees to ankle wakes up from sleep ."

Other Meds:

Current Illness:

Date Died: 10/04/2021

ID: 1761916
Sex: F
Age: 90
State: MA

Vax Date: 09/29/2021
Onset Date: 10/04/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: CXR DONE 10/1/21 SHOWED BILATERAL INFILTRATES

Allergies: Gabapentin, diclofenac, ibuprofen, morphine, ranitidine

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

Symptoms: Recieved Booster Pfizer Vaccine on 9/29/21, on 9/30/21 had temp of 106.0, then 103.0, 102.0. CXR showed bilat infiltrates, started on rocephin., temp down to 97.9 on 10/1/21. Multiple long standing chronic health conditions, active with Hospice Services. DNR/DNI. On Aspiration Precautions.

Other Meds: Multiple medications, recently started on IM Rocephin for dx of Pnuemonia on 10/1/2021.

Current Illness: Dementia, HTN, Malignant neoplasm of colon, hx of COVID-19, CKD, Atherosclerotic heart disease, Hx of MRSA pneumonia, GI Bleed. Plus many more diagnoses.

ID: 1761917
Sex: F
Age: 68
State: NJ

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1761918
Sex: F
Age: 24
State: NJ

Vax Date: 10/05/2021
Onset Date: 10/05/2021
Rec V Date: 10/05/2021
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: Penicillin

Symptom List: Tremor

Symptoms: throat swelling, hives, itching

Other Meds: Nexplanon

Current Illness:

ID: 1761919
Sex: M
Age: 25
State: UT

Vax Date: 10/04/2021
Onset Date: 10/04/2021
Rec V Date: 10/05/2021
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: Hives on arms 2-3 days after 1st Moderna Shot

Symptom List: Erythema, Pruritus

Symptoms: Patient was at the clinic for his 2nd dose of Moderna. Pfizer was accidentally administered instead of Moderna.

Other Meds:

Current Illness:

ID: 1761920
Sex: M
Age: 71
State: ID

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 10/05/2021
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: Not known at this time

Allergies: penicillins

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

Symptoms: Mr. called the Monday, October 4th complaining of severe shoulder pain and the inability to move his right arm. He explained that the shot was given about one inch beneath his should and that it has hurt since that time.. He was unable to sleep the night before due to the pain. I recommended that he visit his PCP to have his shoulder examined. His PCP gave him Prednisone, which he purchased at our pharmacy.

Other Meds: Not known

Current Illness: None

ID: 1761921
Sex: F
Age: 32
State: MN

Vax Date: 01/31/2021
Onset Date: 10/01/2021
Rec V Date: 10/05/2021
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:

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

Symptoms: Tested positive for COVID 10/1/21 after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1761922
Sex: F
Age: 59
State: IA

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 10/05/2021
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: Patient was asked about duplicate vaccination and confirmed doses. Initial Pfizer Covid vaccine was given where patient experienced extreme fatigue and was directed by doctor to not receive second dose. Patient was instructed by doctor to get Johnson and Johnson vaccination as given by the pharmacy. Patient did not indicate a history of vaccination nor adverse effect per screening questionnaire at time of vaccination. Patient has reported no other adverse effects as of today 10/5/2021

Other Meds:

Current Illness:

ID: 1761923
Sex: M
Age: 72
State: OR

Vax Date: 09/29/2021
Onset Date: 10/04/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: Complete Blood Count with Automated Differential; Comprehensive Metabolic Panel; Ethanol (alcohol); Medical POCT Glucose; Troponin I Sensitivity, 1 hour; EKG 12-lead Weakness; MR Head WO Contrast

Allergies:

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

Symptoms: Sudden onset profound Diplopia / double vision, followed by disorientation and dizziness, followed by pressure in head and ears with tinnitus. Diplopia and dizziness / disorientation lasted less than 30 seconds, but other symptoms persisted

Other Meds:

Current Illness:

ID: 1761924
Sex: F
Age: 45
State: NJ

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1761925
Sex: F
Age: 42
State: MN

Vax Date: 01/27/2021
Onset Date: 09/30/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: 10/4 SARS/COV-2, NAAT, Positive

Allergies:

Symptom List: Pain in extremity

Symptoms: Breakthrough COVID

Other Meds:

Current Illness:

ID: 1761926
Sex: M
Age: 26
State: DC

Vax Date: 10/02/2021
Onset Date: 10/04/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: N/A

Allergies: sulfa medications

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

Symptoms: Approximately 2 days after receiving the booster Covid Vaccine I noticed that the area below the vaccine site is swollen, tight, red, and warm to the touch. Lifting my arm is more difficult than normal and it feels as if may be in or spreading to my armpit.

Other Meds: emtricitabine-tenofovir disoproxil fumarate; cholecalciferol; acetaminophen, ibuprofen

Current Illness: N/A

ID: 1761927
Sex: M
Age: 81
State: MI

Vax Date: 02/23/2021
Onset Date: 09/26/2021
Rec V Date: 10/05/2021
Hospital: Y

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

Lab Data:

Allergies: ZolpidemHallucinations DemerolOther Gabapentin Pravastatin Topiramate

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

Symptoms: Patient is a 82 y.o. male with a past medical history of atrial fibrillation, cardiomyopathy, aortic and mitral valve replacement/repair, pacemaker, squamous cell carcinoma of lung with left-sided lung resection and PVD who presented to emergency department with chief complaint of increasing shortness of breath with nonproductive cough. He did receive COVID-19 vaccination. Stated that both he and his wife began feeling ill approximately 1-3 days ago. He is a difficult historian. Symptoms are somewhat vague but complained of cough, generalized malaise and possible fever. Did state that he had a fall onto a carpeted floor due to unknown reason sometime in the last few days. Reports no injury. Presented to Emergency Department at approximately 8:00 p.m. on 09/26/2021. During initial evaluation, he was found in acute kidney injury with a creatinine of 2.0 for, proBNP 1440, initial troponin 49 with repeat 44. Procalcitonin 0.13, lactic acid 2.1 with repeat lactic acid of 1.2. WBC 7.72. COVID-19 positive. Peripheral blood cultures drawn and pending. UA without evidence of urinary tract infection. Twelve lead EKG showed ventricularly placed rhythm. Initially, he was hypotensive and hypoxic. Received IV fluid bolus in supplemental oxygen. Blood pressure resolved without additional IV fluid past initial bolus. Lactic acid improved. No vasopressor needed. Hypoxia vastly improved on 2 L via nasal cannula. On arrival to another Hospital on 09/27/2021, hypoxia had improved. On room air with saturations 96-97% during examination. He is very concerned about his spouse, who has mental health issues. Unsure of patient's mental baseline. Due to recent fall and questionable status, care management, physical therapy and occupational therapy consultations requested. Although he was initially treated with COVID-19 pneumonia, dose have left lobe resection history which may have contributed to x-ray findings. Was treated with one dose of remdesivir which was then subsequently discontinued due to vast improvement of pulmonary status. Dexamethasone was continued. Throughout hospitalization, pulmonary status remained stable. Did not require supplemental oxygen. Was able to work with physical and occupational therapy. Although they recommended home health, this was declined by family. Appreciate care management exploration of services although there were declined. Of note, mental status was questioned. Patient, on multiple occasions, eluded to the fact that he wanted to die with his wife. He also alluded to euthanasia. He was evaluated by social work. Was not felt to be a danger or suicidal. Mental status was discussed with family who states that this is his baseline. Today, he is sitting up in bed no acute distress. No complaints of pain, difficulty breathing, dizziness, shortness of air. He is looking for to discharge home. Phone call was made to daughter to discuss discharge plan which she is agreeable to. Patient is stable for discharge home to the care of his family at this time. All questions and concerns were addressed. Please see discharge instructions for further information. BP (!) 110/46 | Pulse 63 | Temp 36.6 ?C (Oral) | Resp 22 | Ht 1.854 m | Wt 106.4 kg | SpO2 95% | BMI 30.94 kg/m? Physical Exam Physical Exam Vitals and nursing note reviewed. Constitutional: General: He is not in acute distress. Appearance: He is well-developed. HENT: Head: Normocephalic and atraumatic. Right Ear: External ear normal. Left Ear: External ear normal. Nose: No congestion or rhinorrhea. Mouth/Throat: Mouth: Mucous membranes are dry. Pharynx: Oropharynx is clear. Eyes: General: Right eye: No discharge. Left eye: No discharge. Conjunctiva/sclera: Conjunctivae normal. Pupils: Pupils are equal, round, and reactive to light. Neck: Trachea: No tracheal deviation. Cardiovascular: Rate and Rhythm: Normal rate. Rhythm irregular. Heart sounds: Murmur heard. No friction rub. No gallop. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No stridor. No wheezing, rhonchi or rales. Abdominal: General: Bowel sounds are normal. There is distension. Palpations: Abdomen is soft. Tenderness: There is no abdominal tenderness. There is no guarding or rebound. Musculoskeletal: General: No swelling, tenderness or deformity. Normal range of motion. Cervical back: Normal range of motion and neck supple. Skin: General: Skin is warm and dry. Coloration: Skin is not pale. Findings: No erythema or rash. Neurological: Mental Status: He is alert and oriented to person only. Mental status is at baseline per family (has baseline confusion). Sensory: No sensory deficit. Motor: No weakness. Psychiatric: Speech: Speech is tangential. Behavior: Behavior normal. Comments: Difficult to keep on task during conversation. Generally a poor historian. PERTINENT LABS AND STUDIES: All pertinent labs and studies were reviewed prior to discharge.

Other Meds: allopurinol (ZYLOPRIM) 300 MG tablet atorvastatin (LIPITOR) 10 MG tablet carvedilol (COREG) 6.25 MG tablet Cholecalciferol (VITAMIN D-3) 1000 UNITS CAPS clonazepam (KLONOPIN) 1 MG tablet ferrous sulfate 325 (65 Fe) MG tablet fluticasone (FL

Current Illness: Longstanding persistent atrial fibrillation

ID: 1761928
Sex: F
Age: 72
State: FL

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

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

Lab Data: NOTE: I was on chemo (Calquence) at the time of my two shots and 4 months after had NO antibodies (per labs from Leukemia Society in "Covid vaccine study". 9/11/21 - Called pharmacy & confirmed that delayed symptoms could be reaction. 9/13 - To Chiropractor (neck & back alignment for tingling & body aches) 9/15 - Called Oncology nurse; called Urgent Care & Primary dr. 9/15 - Tested NEGATIVE for Covid 9/15 - 9/20 - fever, in bed 9/20 - to Primary care Nurse Practitioner; slight cough (from post nasal drip). 9/22 - feeling much better - to Oncologist for pre-IVIG appt.

Allergies: None

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

Symptoms: 9/9 - 4P - Muscle sore and tingling in upper arm where shot was administered; 9/10 - 2p - Tingling radiated over and down arm; thought it was neurology acting up; took Gabapentin but did not help. 9/10 - 9/14 - Blood pressure 171/101 - thought from IVIG treatment for CLL; chills, sweats, achey, lethargy, lightheaded, went to bed. 9/14 - 9/21- Temp 100.-102 during night 4p to 4a ; seemed better during day. Didn't eat for three days.

Other Meds: Amlopidine, 5 mg Losartan, 100 mg Glipizide, 2/day @ 10 mg 81 mg Aspirin Bone-Up 1,000 mg D3, 2,000

Current Illness: Chronic Lymphocytic Leukemia (CLL) on Calquence 2x day, Aug 2019-June 2021 High Blood Pressure Borderline Diabetes GERD (occasional Tums only)

ID: 1761929
Sex: M
Age: 59
State: WV

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

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

Lab Data: 10/4: SPEP, CRP, CMP, CBC, Folate, B12, Lyme titer Pending: EMG, MRI right brachial plexus

Allergies: PCN

Symptom List: Vomiting

Symptoms: Patient comes in today for neuropathic pain. Patient is a new patient today. He reports that on September 3rd he he received his 1st dose of the Pfizer COVID vaccination in his left deltoid. The next day he had abnormal sensation in his right arm which developed into a flat rash from elbow to shoulder as well as a painful neuropathic type pain. The rash quickly subsided but the pain spread into the midline of the neck. Over the next week symptoms moved to the other arm legs and around the chest and back. The pain is worse at night. He presented to the ER where he was started initially on Percocet then on Lyrica for questionable herpes zoster though the rash has subsided and was never vesicular. He discontinued the Lyrica on his own and never use the Percocet. He continues to have symptoms though they are improving. Upon further questioning she also reports some weakness as well as blurred vision during that time. He never had a history of a vaccine reaction. He has received multiple vaccine but has not received 1 since. He does not routinely get the flu vaccine. He has no significant neurological history in the family.

Other Meds: None

Current Illness: None

ID: 1761930
Sex: M
Age: 79
State: NJ

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1761931
Sex: F
Age: 61
State: NJ

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 10/05/2021
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:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1761932
Sex: F
Age: 27
State: FL

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

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

Lab Data:

Allergies: PATIENT STATED THAT SHE HAS HAD SEIZURES WITH THE FLU VACCINE AND WAS ADMITTED TO THE HOSPITAL FOLLOWING A HEP B BOOSTER AND HER BLOOD PRESSURE DROPP[ED AFTER FISRT DOSE OF PFIZER COVID 19 VACCINE BUT WAS ADVISE BY NEUROLOGIST TO GET THE SECOND DOSE

Symptom List: Injection site swelling, Limb discomfort

Symptoms: PATIENT STATED THAT SHE HAS HAD SEIZURES WITH THE FLU VACCINE AND WAS ADMITTED TO THE HOSPITAL FOLLOWING A HEP B BOOSTER AND HER BLOOD PRESSURE DROPPED AFTER FISRT DOSE OF PFIZER COVID 19 VACCINE BUT WAS ADVISED BY NEUROLOGIST TO GET THE SECOND DOSE . ABOUT 30 SECONDS AFTER ADMINISTRATION OF THE VACCINE WHICH WAS THE PFIZER COVID 19 VACCINE PATINENT PASSED OUT AT WHICH TIME A CODE WAS CALLED IN THE HOSPITAL AND WHILE AWAINTING MEDICAL HELP THE PATIENT APPEARED TO HAVE A SMALL SEIZURE AFTER WHICH SHE CAME TO AND PRESENTED WITH NAUSEA BUT NO VOMITING AT WHICH POINT THE ER STAFF FROM THE HOSPITAL SHOWED UP TO TRANSPORT HER TO ER. SHE WAS RELEASED AFTER EVALUATION WHICH SHOWED HER BLOOD PRESSURE HAD DROPPED BUT SHE WAS NOT ADMITTED TO THE HOSPITAL.PATIENT STATES SHE IS FEELING FINE.

Other Meds: N/A

Current Illness: NA

ID: 1761933
Sex: M
Age: 16
State: NJ

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1761934
Sex: M
Age: 52
State: OH

Vax Date: 01/27/2021
Onset Date: 02/27/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: CT/ Angiogram

Allergies: NA

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

Symptoms: On the 27th of February I had severe intense chest pain it lasted for about 1 hour. I went to my PCP who ordered CT angiogram 3 days later, by time I had the test the symptoms had resolved. The results showed no signs of coronary disease. I was told that it was cardiomyositis.

Other Meds: NA

Current Illness: NA

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am