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: 1768922
Sex: F
Age: 43
State: MN

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/07/2021
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: seasonal allergies, birch, dogs, cats, allergy shots

Symptom List: Dysphagia, Epiglottitis

Symptoms: headache, nausea, throat tightening sensation, blurry vision

Other Meds:

Current Illness:

ID: 1768923
Sex: M
Age: 82
State: MS

Vax Date: 10/05/2021
Onset Date: 10/05/2021
Rec V Date: 10/07/2021
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: None

Other Meds:

Current Illness:

ID: 1768925
Sex: M
Age: 33
State:

Vax Date: 10/06/2021
Onset Date: 10/07/2021
Rec V Date: 10/07/2021
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:

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

Symptoms: Patient used fake names and received full series of all approved vaccines. It was not caught until he received his final dose of Moderna

Other Meds:

Current Illness:

ID: 1768926
Sex: M
Age: 45
State:

Vax Date: 10/05/2021
Onset Date: 10/05/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data: Labs: -=---------------------------< 07 Oct 2021 >--------------------------=- (time: 1025) Triacylglycerol Lipase = 27 Phosphate = 2.9 Troponin I Cardiac = <0.01 CMP 144 : 107 : 11 AG {?} Ca 9.1 AST 33 -------+-------+-------< 109 Prot 7.0 ALT 58 4.1 : 28 : 1.0 Alb 4.1 AP 56 Bili 0.4 LIPID PANEL Triglyceride = 31 LDL Cholesterol = 54 VLDL Cholesterol = 6 Cholesterol = 118 Cholesterol/HDL Cholesterol = 2.0 HDL Cholesterol = 58 CBC %N 65.5 \ 14.6 / MCV 85.6 %E 2.2 5.50 >----< 242 RDW 13.2 %B 0.9 / 42.1 \ MPV 9.4 %M {?} %L 23.6 (time: 0944) Glucose = 114 -=---------------------------< 06 Oct 2021 >--------------------------=- (time: 0150) DRUG SCREEN URINE Methylenedioxymethamphetamine = NONE DETECTED Oxycodone = NONE DETECTED Propoxyphene = NONE DETECTED Amphetamines = NONE DETECTED Barbiturates = NONE DETECTED Benzodiazepines = NONE DETECTED Cocaine = NONE DETECTED Opiates = NONE DETECTED Phencyclidine = NONE DETECTED Cannabinoids = NONE DETECTED Methadone Confirm = NONE DETECTED URINALYSIS Color = Yellow Clarity = Clear Specific Gravity = 1.024 Protein = Negative Glucose = NEGATIVE Ketones = 5 mg/dl Bilirubin = NEGATIVE Blood = Negative Nitrite = NEGATIVE Urobilinogen = Normal Leukocyte Esterase = NEGATIVE Epithelial Cells Squamous = <1/HPF Mucus = FEW pH = 6.0 WBC = <1 -=---------------------------< 05 Oct 2021 >--------------------------=- (time: 2258) Glucose = 105 (time: 2350) Magnesium = 2.2 Phosphate = 4.2 Troponin I Cardiac = <0.01 Thyrotropin = 4.01 Creatine Kinase = 149 CMP 143 : 108 : 15 AG {?} Ca 9.1 AST 35 -------+-------+-------< 105 Prot 6.6 ALT 63 4.2 : 28 : 1.1 Alb 4.1 AP 44 Bili 0.4 CBC %N 65.0 \ 14.0 / MCV 86.3 %E 2.6 7.29 >----< 230 RDW 13.4 %B 0.7 / 41.0 \ MPV 9.7 %M {?} %L 24.3 Rads: **********MRI, BRAIN (W/O CONTRAST)********** Status: Complete Procedure: MRI, BRAIN (W/O CONTRAST) Order Date: 07-Oct-2021 12:49:00 Order Comment: ED-16 Reason for Order: L face tingling, Hx L arm tingling

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient reports onset of symptoms after first vaccine 07SEP. Kept a log of symptoms in his phone. Notes that he was forced to receive vaccine. Recorded sx to include: "ear ringing, hearing loss, dizziness, mood fatigue, fatigue, sometimes sounds funny". 18Sep recorded "heart flutters while running, off balance, front of brain fuzzy, memory loss." 05OCT received second vaccination, recorded "Ringing in ear again, headache, front of brain feels numb, hard to focus, wife dropped off at hospital, heart flutters 1-2 min, show speaking, lost some feeling on left side of body, tremble shaking." Patient was evaluated at that time w/ CBC, CMP, CK, TSH, troponin, phos, mag, UA, UDS. CT head, CTA head, CTA neck performed w/o any abnormalities. All labs were WNL besides mildly elevated liver enzymes. EKG w/o any remarkable findings. Patient instructed to f/u with his PA. Had an appt with his PA this AM - afterwards noted "0915 numbness on L side of face, dull pain L chest, shot down arm (lasted 1 minute), subsided on its own. While in the waiting room had heartaches." Presented a second time to the ED. Upon further clarification - pt describes chest pain sx as a dull feeling in his L chest w/o associated nausea, diaphoresis, SOB or difficulty breathing. Lasted less that 1 min, not exertional. Describes numbness as "like goosebumps or when your foot goes numb." Currently has a headache, now 4-5/10 located at the center of his forehead. Has not taken any pain medications for this. No fevers/chills, nausea/vomiting, no weight loss or BM changes, no SOB, no abdominal pain. Feels like he's had "slight inflammation" - has seasonal allergies. Felt lightheaded a few times while standing up quickly from a squat or sitting, no syncope/presyncope, no rashes/sores, no weakness. Neuro exam: CN2-12 intact. Does note decreased sensation (50%) in L side of face in opthalmic, maxillary, and mandibular distributions of trigeminal nerve. Motor fxn of trigeminal nerve is symmetric. Strength symmetric in face and bilateral upper and lower extremities. Sensation decreased in LUE and LLE (50%) compared to right. Normal gait. No cerebellar signs. Patient is a 45 y/o M w/ left-sided weakness and numbness after COVID vaccine 2 days ago, endorsing similar sx after first dose in early September. Presented initally 05OCT, CT head, CTA head, CTA neck nml. Symptoms concerning for stroke vs. TIA vs. brain lesion. ABCD2 score of 3 (elevated BP, long duration of numbness), low risk of stroke. NIHSS of 1. Patient has had many brief, transient symptoms since receiving first dose of Pfizer vaccine. Symptoms appear to vary in terms of character, temporality, and severity. CT head, CTA head, CTA neck, MRI head were performed, no e/o vascular injury, infarction, or stenosis. No brain lesions or inflammatory changes. Patient w/ unremarkable labs and otherwise healthy. Does have unilateral decrease in sensation in left face, arm, and leg on exam which are not readily explained given imaging and otherwise unremarkable exam. Chest pain not consistent with angina, normal EKG and troponins negative. With very low likelihood of ischemic event, patient can discharge home w/ f/u with his PA (has an appt this Tuesday). Neurology consult was placed to further evaluate decreased sensation in left face and left arm/leg.

Other Meds: none

Current Illness: none

ID: 1768927
Sex: F
Age: 30
State: NJ

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

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

Lab Data: unknown. To see allergist today.

Allergies: PCN

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

Symptoms: Patient received vaccine at 1:45pm, at 2:15pm complained of numbness and tingling of lips, edema of lips noted. No complaints of shortness of breath, chest pain, no pruritus or hives noted. Benadryl 50 mg elixir given. To ER via 911. Per Patient, treated in ER with steroids. Sent home with steroids, Benadryl and Epi pen.

Other Meds: Ferrous sulfate Vitamin D

Current Illness: Received antibody infusion on 8/23/21 for COVID treatment. Patient states had similar reaction during infusion in which infusion had to be stopped and sent to ER. Patient medical record notes an updated Tdap vaccine on 7/16/21 for abrasion of right hand. Tx with Keflex 500mg po Q 8hrs x 7 days. No other medical information noted on health record.

ID: 1768929
Sex: F
Age: 83
State: MS

Vax Date: 10/05/2021
Onset Date: 10/05/2021
Rec V Date: 10/07/2021
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:

Allergies:

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

Symptoms: None

Other Meds:

Current Illness:

ID: 1768930
Sex: F
Age: 48
State:

Vax Date: 04/23/2021
Onset Date: 09/28/2021
Rec V Date: 10/07/2021
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: Pyrexia, White blood cell count decreased

Symptoms: PATIENT HAD MODERNA VACCINE ON 04/23/2021 and 05/21/2021, AND TESTED POSITIVE TO COVID.

Other Meds:

Current Illness:

ID: 1768931
Sex: F
Age: 44
State: TX

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

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

Lab Data:

Allergies: Cfedinir, tetanus, penicillin

Symptom List: Pharyngeal swelling

Symptoms: Swelling of hands and face. Cold feet

Other Meds: Multivitamin, calcium, vitamin e, metoprolol, lossartin, hydrochlorothiazide, duloxetine, turmeric, vitamin c

Current Illness: None

ID: 1768932
Sex: F
Age: 57
State: NH

Vax Date: 05/29/2021
Onset Date: 06/01/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data: Cortisone shots, xrays

Allergies: Penicillin, Dilantin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I was fine for a couple of days and as my husband was healing I was asking if his arm hurt and his was fine and mine just hurt. I went to the Doctor because I'm anemic and I couldn't get up that night off of the couch and I had to get a b12 shot and my arm locked. They said they couldn't give me shot because of my arm and they had to send me to ER and they determined it was due to vaccine and they injected it into the wrong area of arm that caused frozen shoulder and my shoulder locked and I'm in constant pain. I went to physical therapy and Dr. told me they think it's due to shot and they injected the vaccine into a calcium deposit in arm. Now my arm is sore with frozen shoulder and I've had two cortisone shots and it doesn't seem to be helping. After a year I might have to have surgery. I can't even sleep on that arm anymore. Now I can't use my arm. I don't think I had reaction from actual vaccine but the way it was administered.

Other Meds: None.

Current Illness: None.

ID: 1768933
Sex: M
Age: 51
State: AZ

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 10/07/2021
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: Iodine contrast, shrimp, salmon, naprosine,, morphine, I carry an epipen

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Face swelling/congestion, lymphnodes under my under arm breast left side, right arm nodes at elbow, left neck and sores in mouth. Earpain, inflamation, hard to hear on right ear and vertigo in both ears. vomiting, Visited urgent care on 9/28/2021 prescribed antibiotic, prednisone and meclazine for dizzy/motion sickness. I still have symptoms and follow up visit is on October 15, 2021.

Other Meds: Venaflaxine 150, Verapomil 240 ER, collagen, vitamin d, zinc and vitamin C. Amovig 140 injection

Current Illness: No

ID: 1768934
Sex: M
Age: 60
State: NH

Vax Date: 09/24/2021
Onset Date: 10/02/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Patient began experiencing adverse effects October 2 (8 days after the immunization). He reported uncontrollable trembling, chills, cough, nausea, back pain, headaches. On October 7th he came to the pharmacy with a raised circular rash solely at the injection site. His other symptoms have become less prevalent. He is still coughing and still has body aches in addition to the rash. Patient was referred to the local urgent care to undergo evaluation for his symptoms and rash.

Other Meds: Unknown

Current Illness: Unknown

ID: 1768935
Sex: F
Age: 55
State: CA

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Initially/same day patient had no adversities. The next day arm was extremely sore and had a small wheal in the area that she had been vaccinated in. According to the patient 9/29 It was about the size of a quarter. The following day it had increased to size 8cmx5cm the 30th. Patient complained it was inflamed and itchy and hot to the touch. The patient took ibuprofen and iced the area. Per the patient it eventually resolved and was much less visible by the 10/5. Patient had no other side effects.

Other Meds:

Current Illness:

ID: 1768936
Sex: U
Age: 61
State: GA

Vax Date: 09/18/2021
Onset Date: 09/28/2021
Rec V Date: 10/07/2021
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: Vaccine error-vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1768937
Sex: M
Age: 38
State: FL

Vax Date: 10/04/2021
Onset Date: 10/06/2021
Rec V Date: 10/07/2021
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: none

Allergies: NKA

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

Symptoms: Large red lump in axilla, appears to be swollen lymph node, painful to touch

Other Meds: metformin 1000mg bid vascepa 1gm bid prozac 40mg daily adderall 25mg daily atorvastatin 10mg daily asprin 81mg daily Fenofibrate 54mg daily glipizide 10mg daily Ozempic 0.5 q7days

Current Illness: none

ID: 1768938
Sex: M
Age: 87
State: MS

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/07/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: None

Other Meds:

Current Illness:

ID: 1768939
Sex: M
Age: 32
State: CA

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

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

Lab Data:

Allergies: N/A

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

Symptoms: Patient received vaccine, and during 15 minute post-vaccine waiting period, collapsed and experienced what appeared to be a seizure. Patient quickly regained consciousness and was provided supportive care according to company policy and procedures. Patient declined emergency services when asked. Patient was given Benadryl 25 mg PO x1 dose and observed for >1 hour prior to discharge from pharmacy waiting area.

Other Meds: N/A

Current Illness: N/A

ID: 1768940
Sex: F
Age: 16
State: GA

Vax Date: 09/21/2021
Onset Date: 09/28/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Vaccine error-vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1768941
Sex: F
Age: 61
State: MN

Vax Date: 01/30/2021
Onset Date: 10/03/2021
Rec V Date: 10/07/2021
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: sore throat, cough, runny nose, headache, sinus congestion, nasal congestion, wheezing, post nasal drainage, fatigue, nonproductive cough, body aches. starting on 10/3/21. First vaccine given through employer, unable to access LOT #

Other Meds: doxycycline; HTCZ; Losartan; Trazodone; Simvastatin

Current Illness: none

ID: 1768942
Sex: U
Age: 16
State: GA

Vax Date: 09/21/2021
Onset Date: 09/28/2021
Rec V Date: 10/07/2021
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: Vaccine error-vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1768943
Sex: F
Age: 63
State: PA

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data:

Allergies: penicillin

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

Symptoms: lt leg swollen and hurts, bruises on rt arm

Other Meds: aspirin 81

Current Illness:

ID: 1768944
Sex: M
Age: 12
State: KS

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 12 year old male light headed and feel like he was going to pass out. Patient taken to EMS room to lay down. Patient felt better after 5 minutes of rest on cot. @1415, Patient sat on edge of bed and tolerated without any problem. @1425, patient walked out without any trouble. P: 64, BP: 128/80, SAT 98%.

Other Meds:

Current Illness:

ID: 1768945
Sex: F
Age: 40
State: OH

Vax Date: 09/29/2021
Onset Date: 10/02/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Unevaluable event

Symptoms: Headache multiple times per day every day

Other Meds: Follistim, menopur, clomid, ganirelix, prenatal vitamin, coq10, vitamin d, methylfolate, vitamins B6 & B12

Current Illness: None

ID: 1768946
Sex: M
Age: 45
State: NV

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/07/2021
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: Oura ring which measured sleep, temperature, heart rate and HRV

Allergies: nkda

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

Symptoms: Muscle spasms in lower & mid back, lower back pain, pain front of hips, quads painful & weak, extremely painful headache, stiff neck, fever of 101.2, chills, night sweats, kept waking up throughout night, elevated heart rate (more than 10 bpm above normal), sinus pressure, no appetite, nausea, decreased heart rate variability

Other Meds: vitamin D, MVI

Current Illness: none

ID: 1768947
Sex: F
Age: 16
State: OR

Vax Date: 09/03/2021
Onset Date: 10/07/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data: no adverse events

Allergies: n/.a

Symptom List: Injection site pain, Pain

Symptoms: Patient was only 16 years old when she received Moderna vaccine

Other Meds: N/a

Current Illness: n/a

ID: 1768948
Sex: M
Age: 75
State: GA

Vax Date: 09/18/2021
Onset Date: 09/28/2021
Rec V Date: 10/07/2021
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: Vaccine error-vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1768949
Sex: F
Age: 55
State: CA

Vax Date: 09/29/2021
Onset Date: 09/30/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data: no

Allergies: Latex & to flu shots

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

Symptoms: complained of left arm numbness that occurred the day after vaccination that has spread to the fingers, which has continued to this date.

Other Meds: Benadryl

Current Illness: No

ID: 1768950
Sex: F
Age: 78
State: MS

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/07/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: None.

Other Meds:

Current Illness:

ID: 1768951
Sex: F
Age: 56
State: VA

Vax Date: 03/06/2021
Onset Date: 03/01/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data: Ankle brachial index - results normal Creatine Kinase - results normal Kappa Light Chains Free/Lambda Light Chains - results kappa light chains elevated Scleroderma - results normal Sjogren Antibody Panel - results normal ANA Panel - results normal Neuronal Nuclear Type 2 AB - results normal Rheumatoid Factor - results normal C Reactive Protein - results normal Vitamin B12 + Folate - results normal Lyme Disease DNA - results normal TP ELECTROPHORESIS AH - results abnormal retested and kappa light chains are elevated MYELIN ASSOCIATED GLYCOPROTEIN ANTIBODIES AH - results normal METHYLMALONIC ACID - results normal Nerve conduction test - showed abnormal reactions

Allergies: None known

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I have had a metallic taste in my mouth since mid to late March and I began developing neuropathies in my hands and feet at the same time. They would come and go, but now do not go. I lost weight without trying but because nothing tastes good.

Other Meds: Multi vitamin for women

Current Illness: I had no known illnesses within two months prior of the vaccination.

ID: 1768952
Sex: F
Age: 28
State: OH

Vax Date: 08/20/2021
Onset Date: 09/07/2021
Rec V Date: 10/07/2021
Hospital: Y

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: Recipients: None Discharge: Summary: Admission Date: .07-Sep-2021 16:20:00 Discharge Date: 11-Sep-2021 Admission Reason: Acute fatty liver of pregnancy Final Discharge Diagnoses: Acute fatty liver of pregnancy Procedures: Date: 08-Sep-2021 05:22:00 Procedure Name: 1. Exam under anesthesia 2. JADA placement 3. Second degree perineal laceration repair Condition at Discharge: Satisfactory Disposition at Discharge: .Home Vital Signs: T P R BP SpO2 Value 36.4 72 18 127/74 99% Date/Time 9/11 9:14 9/11 9:14 9/11 9:14 9/11 9:14 9/11 9:14 Range (36.4C - 37C ) (62 - 72 ) (16 - 18 ) (116 - 127 )/ (74 - 78 ) (96% - 99% ) Highest temp of 37 C was recorded at 9/11 4:34 Hospital Course: DOA: 9/7 DOD: 9/8 NSVD c/b PPH 2/2 LUS atony, hemabate, cytotec, second pit bolus, FFP x1, Mg paused, JADA with 140cc of fluid, total EBL 800cc Preop Hgb 14.8 -- > EBL 800cc -- > 2hr post-op hgb 13.2 -- > 14.1 -- > 13.8 -- > 13.0 28 y/o G1P1 now PPD#3 (9/11) s/p NSVD @ 38.5ga by 13 week US who initially presented for scleral icterus and was kept for induction due to concern for acute fatty liver or pregnancy. She denied HA, scotoma, CP, SOB, RUQ pain, ctx, LOF, VB, or decreased FM. Her pregnancy overall had been uncomplicated. On arrival, she had one severe range BP that resolved spontaneously. However she continued to have mild ranges and then was also noted to have abnormal HELLP labs (primarily elevated LFTs, Cr, t bili, and low fibrinogen). As a result, the concern was for severe PEC vs AFLP. She received 24 hrs of magnesium for the concern for severe preeclampsia. However, the clinical picture seemed more consistent with acute fatty liver of pregnancy. Hepatology was consulted and requested multiple hepatology labs. At time of delivery, patient did have uterine atony that required hemabate, cytotec, pit bolus x2, and placement of a JADA. After removal of the JADA, patient's bleeding was stable. Total EBL was 800ccc. She also received 2U of FFP due to her fibrinogen being 158 on admission. Meanwhile, the patient's blood work started to improve throughout her postpartum period (see trends below). She was deemed stable for discharge on PPD#3. Prior to discharge, hepatology requested an alpha-1-antitrypsin phenotype test which will be followed up with PCP. A PCP appointment was requested in 1-2 weeks. Patient will always have a BP check in 1 week with OB. She was discharged home with a BP cuff. ________________________________________________________________________________ ________ sPEC vs AFLP -Severe range BP x1 on admission, now normotensive to mild range (including mild range BPs > 4hr apart) -P:C 0.94 -To trend labs q4hr -To trend labs q4hr -Hgb 14.8 -- > EBL 800cc -- > 2hr post-op hgb 13.2 -- > 14.1 -- > 13.8 -> 13.0 -> 15.1 -- > 12.1 (9/10) -Plt 211 -> 205 -> 175 -> 135 -> 141 -> 161 -> 151 -> 181 -- > 139 (9/10) -Cr 2.77 -- > 2.92 -> 2.88 -> 3.0 -> 3.02 -> 3.04 -> 2.83 -> 2.79 -- > 2.01 (9/10) -ALT/AST 351/261 -- > 320/241 -> 273/196 -> 195/156 -> 166/149 -> 137/131 -> 132/131 -- > 63/63 -Tbili 5.4 -> 5.4 -> 4.8 -> 4.1 -> 4.8 -> 4.9 -> 4.5 -> 5.1 -- > 3.1 (9/10) -INR 1.2 -- > 1.1 -> 1.1 -> 1.1 -Fibrinogen 158 -- > FFP x1 -- > 169 -- > FFP x1 -- > 156 -- > 162 -> 167 -Amylase: 18, Lipase: 52 9/10 -s/p 4g Mg bolus, Mg level 4.39 -- > Mg @ 1g/hr -> Mg 4.47 -> 4.55 -> 5.27 -> 6.41; finished Mg 1 g/hr at 0300 on 9/9 -RUQ US with hepatic steatosis, limited by habitus Leukocytosis - WBC 14 on admission ->>> 27 -- > 28 -- > 26 -> 24 - Will draw blood cx per hep rec Blood glucose - Glucose 50s -- > amp D50 x2 -- > D5NS @ 75cc/hr with q1hr POCTs -- > improving 90-100s - Switch to fasting and 1 hr PP BG check Labor Course 1830 2.5/70/-2, for pit 2100 3.5/70/-2, AROM for clear 0200 9/90/+1 Discharge Information: and Continuing Care: Lab Results - Pending: Culture, Blood Drawn at 09-Sep-2021 14:36:00 Culture, Blood Drawn at 09-Sep-2021 14:34:00 Surgical Pathology Drawn at 08-Sep-2021 04:02:00 Alpha-1-Antitrypsin Phenotype, Serum Drawn at 07-Sep-2021 21:30:00 Radiology Results - Pending: None Columbia Suicide Risk: negative Discharge Instructions: Activity: Return to normal activity as tolerated Nutrition/Diet: Regular Additional Orders: Additional Instructions: pacifier use is best avoided during the initiation of breastfeeding and used only after breastfeeding is well established. In some infants, early pacifier use may interfere with establishment of good breastfeeding practices, whereas in others it may indicate the presence of a breastfeeding problem that requires intervention. Use of a pacifier may cause problems with latching, and lead to decreased milk supply by missing feeding opportunities. Pacifiers may be used during painful procedures, but are not otherwise recommended while the infant is learning to breastfeed.? Follow Up Appointments: Follow-Up - OB Provider: Physician/Dept/Service: OB Provider Call to Schedule in: 1 week Follow-Up Appointment 01: Physician/Dept/Service: Primary Care Reason for Referral: Acute fatty liver of pregnancy follow up Call to Schedule in: 1 week Discharge Medications: Home Medication Pepcid 20 mg oral tablet - 1 tab(s) orally 2 times a day ibuprofen 600 mg oral tablet - 1 tab(s) orally every 6 hours Tylenol Extra Strength 500 mg oral tablet - 2 tab(s) orally every 6 hours MiraLax oral powder for reconstitution - 17 gram(s) orally once a day PRN Medication Attestation: Note Completion: I am a: Resident/Fellow Attending Attestation I saw and evaluated the patient. I personally obtained the key and critical portions of the history and physical exam or was physically present for key and critical portions performed by the resident/fellow. I reviewed the resident/fellow?s documentation and discussed the patient with the resident/fellow. I agree with the resident/fellow?s medical decision making as documented in the note. I personally evaluated the patient on 11-Sep-2021 Electronic Signatures: Authored: Send Summary, Summary Content, Ongoing Care, Note Completion Authored: Ongoing Care, Note Completion Co-Signer: Summary Content, Ongoing Care, Note Completion

Other Meds:

Current Illness:

ID: 1768953
Sex: F
Age: 94
State: GA

Vax Date: 09/21/2021
Onset Date: 09/28/2021
Rec V Date: 10/07/2021
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: Nausea

Symptoms: Vaccine error-vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1768954
Sex: M
Age: 77
State: MD

Vax Date: 02/09/2021
Onset Date: 03/15/2021
Rec V Date: 10/07/2021
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: Injection site pain

Symptoms: Adverse event(s)-enjoyed normal activities including golfing, bowling, mowing, household repairs including climbing and lifting. Over night became unable to do any of these things due to pain, numbness, and tingling affecting back, spine, and legs. Walking gait became severely distorted. Started using cane, gait still distorted. Started using walker which helped mobility. Still distorted walking gait if walker not used. These abnormalities began within two weeks of second Covid-19 shot which was administered March 2, 2021. Medical expertise commenced March 29, 2021 which has continued as of this report dated October 7, 2021. This has included trips to primary care physician, physical therapists, neurosurge

Other Meds: Rosuvastatin Calcium, Metoprolol, Metformin HCL, Lisinopril, O

Current Illness: None

ID: 1768955
Sex: F
Age: 32
State: CA

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data:

Allergies: peanuts

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

Symptoms: patient complained of sharp pain from left inner ear radiating to upper left jaw, pain scaled 6/10 intermittent pain noted. Vital signs 100/60, P-69, O2 - 99%, RR-17. Patient given an ice pack to apply over the painful area. Pt verbalizes relief of pain. 20 mins after ice application > relief of pain noted and with reported pain scale of 3/10. Patient went home with relief of pain, reported pain scale 0/10 and stable vital signs, no dizziness, or headache noted. Vital signs BP 112/66, P-62, RR-18, 02 sat 99%

Other Meds:

Current Illness:

ID: 1768956
Sex: F
Age: 38
State: TX

Vax Date: 09/08/2021
Onset Date: 09/09/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data: Went to urgent care and EKG and labs normal. Seen in primary care office chest discomfort still present, with SOB elevated blood pressure and left arm discomfort Started on ACE and prednisone and has slowly improved

Allergies: Sulfa

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

Symptoms: The day after the vaccine she started having chest discomfort, feels like a pressure that will not go away. She also noticed that her blood pressure has been elevated.

Other Meds: none

Current Illness: none

ID: 1768957
Sex: F
Age: 66
State: IN

Vax Date: 10/05/2021
Onset Date: 10/06/2021
Rec V Date: 10/07/2021
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: Tremor

Symptoms: Lump and soreness in the armpit of the injected arm.

Other Meds:

Current Illness:

ID: 1768958
Sex: M
Age: 59
State: MS

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/07/2021
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: Erythema, Pruritus

Symptoms: None

Other Meds:

Current Illness:

ID: 1768959
Sex: F
Age: 15
State: GA

Vax Date: 09/18/2021
Onset Date: 09/28/2021
Rec V Date: 10/07/2021
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:

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

Symptoms: Vaccine error-vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1768960
Sex: F
Age: 89
State: IL

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/07/2021
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: patient's spouse reported fever and soreness and also "difficulty breathing" next day after the immunization . He had contacted pt's doctor and was advised to take her to the hospital. He has not taken pt to the hospital as of now.

Other Meds:

Current Illness: breathing problems per husband

ID: 1768961
Sex: M
Age: 87
State: CA

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

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

Lab Data: Patient was given Pfizer vaccine for 3rd dose even though he had Moderna for 1st and 2nd dosages. Patient waited for 30minutes and had no adverse reactions at time of injection.

Allergies: No known allergy

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient was given Pfizer vaccine for 3rd dose even though he had Moderna for 1st and 2nd dosages. Patient waited for 30minutes and had no adverse reactions at time of injection. Patient was given Pfizer vaccine for 3rd dose even though he had Moderna for 1st and 2nd dosages.

Other Meds: Flomax, Amlodipine, Furosemide

Current Illness: urinary incontinence, hypertension

ID: 1768962
Sex: F
Age: 39
State: MO

Vax Date: 04/05/2021
Onset Date: 05/02/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data: blood clot found 5/ 5/2021 nerve pain continued after and hasn't let up since getting diagnosed with blood clot

Allergies: codenine nepoxen

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

Symptoms: left arm blood clot and nerve damage

Other Meds: esteraylla- birth control for left side pain sprionolatone for acne on the face nifedepine for raynauds and a multi viatmin

Current Illness:

ID: 1768963
Sex: F
Age: 50
State: GA

Vax Date: 09/21/2021
Onset Date: 09/28/2021
Rec V Date: 10/07/2021
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: Vaccine error-vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1768964
Sex: M
Age: 40
State: MS

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/07/2021
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: None

Other Meds:

Current Illness:

ID: 1768965
Sex: F
Age: 55
State: IL

Vax Date: 04/01/2021
Onset Date: 04/18/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data: no because I've had this before and they recognize it as something that has happened to me before.

Allergies: Iodine; Cephalosporins

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

Symptoms: On 04/18/2021, I got vasculitis on my legs. I had it for several weeks. It was continuing to spread and get worse. They put on prednisone. But it coming back again. So they put me on a second round of Prednisone again. It's an autoimmune reaction that I have had before with antibiotics. The doctor believes it's from the shot but they are calling it idiopathic. And I have not had it before since my last round of antibiotics. I have not recovered from the AEs. I am currently being monitored. I am currently on Prednisone. It is being managed by Prednisone. I feel like my immune system was triggered by the vaccine. I have never had vasculitis before without the antibiotics triggering it. I feel it's a reaction to the vaccine that caused my immune system to flare up. I would completely get the vaccine again. I just happened to have had an adverse reaction to it.

Other Meds: Synthroid 150 mg od

Current Illness: no

ID: 1768966
Sex: F
Age: 34
State: GA

Vax Date: 09/21/2021
Onset Date: 09/28/2021
Rec V Date: 10/07/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Vaccine error-vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1768967
Sex: M
Age: 69
State: AZ

Vax Date: 03/08/2021
Onset Date: 03/10/2021
Rec V Date: 10/07/2021
Hospital: Y

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

Lab Data: CT scan head Neuro evaluate PT eval

Allergies: No

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

Symptoms: Extreme weakness Hypotension Transported by ambulance to Medical Center Hydrated and monitored Home on March 11 still weak and hypotensive

Other Meds: Xarelto Metoprolol Lasix Lisinopril Gemfibrozil Gabapentin Depakote Tamulosin Metformin

Current Illness: No

ID: 1768968
Sex: M
Age: 35
State: NV

Vax Date: 04/03/2021
Onset Date: 07/11/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data: (7/12/2021) PCR(neg) Pharmacy (7/14/2021) Swab for Mono and Strep type A(neg)

Allergies: Hazelnut, Onion

Symptom List: Vomiting

Symptoms: In the afternoon I had a odd feeling in my throat and woke up the next morning(7/12/2021) tired with a fever. Extreme exahustion w/ no appetite. PCR(neg) pharmacy. (7/14/2021) Sought care at Urgent care and was assessed with probability of pharyngitis, streptococcal pharyngitis w/ a fever of 103.0 Swab for Mono and Strep type A(neg). Was treated with 24 days of Augmentin. 7/28/2021 Revisted same urgent care for follow-up. Throat issues cleared up with no further complications after course of antibiotics.

Other Meds: None

Current Illness: none

ID: 1768969
Sex: F
Age: 74
State: MS

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/07/2021
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: None.

Other Meds:

Current Illness:

ID: 1768970
Sex: F
Age: 13
State: IA

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 10/07/2021
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: Right ear pain after vaccine.

Other Meds:

Current Illness:

ID: 1768971
Sex: F
Age: 30
State: KS

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 10/07/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient sitting in observation. c/o lightheadedness. Taken to EMS room. After lying on cot, states feels much better.

Other Meds:

Current Illness:

Date Died: 09/25/2021

ID: 1768972
Sex: F
Age: 59
State: TX

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

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

Lab Data: Positive COVID-19 test on 9/16/2021 using an unspecified platfrom using PCR or equivalent technology.

Allergies: Topiramate, Nortriptyline, NSAID, Hydromorphone, Phenytoin

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

Symptoms: Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable. Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis. She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021.

Other Meds: Aspirin 81 mg QD, Buspirone 5 mg BID, Calcium Citrate +Vit D; BID, Cholecalciferol 50 mcg QD, Duloxetine 60 mg QD, Esomeprazole 40 mg QD, Furosemide 20 mg QD, Lasmiditan 50 mcg QD, Mycophenolate 500 mg BID, Nitrofurantoin 50 mg QD, Prednis

Current Illness:

ID: 1768973
Sex: F
Age: 33
State: CA

Vax Date: 09/29/2021
Onset Date: 10/02/2021
Rec V Date: 10/07/2021
Hospital:

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

Lab Data: was not sent to do any medical test or lab work.

Allergies: none

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

Symptoms: I received my second Pfizer vaccine on 9/29/21 The following day, I had very bad body aches, the second day I was extremely tired and nauseous. On the third day October 2nd at 5:30am I woke up full of hives, I went to the urgent care on Sunday the 3rd and received a steriod shot and was put on Prednisone. I then had an appointment with my DR on Tuesday the 5th. I explained to him that I have had hives ever since I have taken the vaccine. I have never had a food allergy or an allergy to any medication. It is October 7th and I still have hives.

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am