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: 1775264
Sex: M
Age: 63
State: TX

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

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

Lab Data: Unknown, no tests were performed under our care.

Allergies: None reported

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient was waiting for 15 minutes after vaccination outside of the pharmacy. He came up to the pharmacy looked like he was going to say something and then lost consciousness. He fell and landed on his head. He was bleeding from his head we put pressure on the wound and waited on EMT to get here. He was very sweaty and cold to the touch. He had trouble talking but was able to get across that he was diabetic and had not eaten anything today and that he had hypertension. EMS showed up and transported him to the hospital out of our care.

Other Meds: Unknown

Current Illness: None reported

ID: 1775265
Sex: F
Age: 37
State:

Vax Date: 10/06/2021
Onset Date: 10/07/2021
Rec V Date: 10/09/2021
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: Patient reported on 10/8/21, symptoms of pain and redness at injection site as well as swelling of the lymph node underneath the armpit of injection arm. She was informed that pain and redness at injection site is a typical adverse effect and that swelling of lymph node could be a sign of the body's immune response. Patient reported on 10/9/21, that swelling of lymph node had improved somewhat, but was still present.

Other Meds:

Current Illness:

ID: 1775266
Sex: F
Age: 54
State: CA

Vax Date: 10/01/2021
Onset Date: 10/06/2021
Rec V Date: 10/09/2021
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: none

Allergies: not known

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

Symptoms: patient received flu vaccine 10/1/2021 . one week later she called and informed us she felt sore, bruising and pain at injectionsite

Other Meds: not known

Current Illness: not known

ID: 1775267
Sex: F
Age: 22
State: NJ

Vax Date: 07/26/2021
Onset Date: 10/04/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: PCR + for Covid on 10/7/2021

Allergies: none known

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Client was vaccinated with Pfizer vaccines in July and August 2021 (client not sure of dates). Symptoms started 10/4: nasal congestion, cough, fatigue, fever 102 x 2 days, myalgia, sore throat. Went to hospital ER on 10/8 and was given IV electrolytes and Tylenol and sent home. Reported as breakthrough Covid illness in previously vaccinated person

Other Meds: none known

Current Illness: none known

ID: 1775268
Sex: M
Age: 49
State: NC

Vax Date: 10/01/2021
Onset Date: 10/02/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data:

Allergies: N/a

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

Symptoms: Difficulty breathing for up to 7 days afterwards, headache for up to 7 days afterwards, headache for up to 7 days afterwards

Other Meds: N/a

Current Illness: N/a

ID: 1775269
Sex: F
Age: 46
State: MN

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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 this far.

Allergies: None

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

Symptoms: Swollen and very sore Right arm, excessive tiredness, general malaise and nausea noticed within 3 hours after booster vaccination administration. Then, in the evening, at about 7-8 hours after booster administration, Right arm and axila tenderness and swollen. Pain felt all the way down the Right forearm, wrist and hand. Feverish and chills. Took 2-200mh ibuprofen before bed. Today( Day 2), continued above symptoms, began to worsen about 26 hrs post administration and if not resting, I felt weak and dizziness. Took 2-200mg of ibuprofen and took a nap.

Other Meds: Duloxetine 80mg Daily, cetirizine 10 mg tablet daily, CHOLEcalciferol 1000 UNITS tablet; Take 2 Tabs Daily,,

Current Illness: None

ID: 1775270
Sex: M
Age: 78
State: NJ

Vax Date: 10/05/2021
Onset Date: 10/06/2021
Rec V Date: 10/09/2021
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:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: patieht came in 10/9/2021 said that he had gotten 3 vaccines on 10/5/2021 as listed above and the next day 10/6 started developing signs of cellulitis, Patient went to his primary on 10/8/2021 and she sent him directly to the ER. HE was admitted overnight with IV antibiotics and released today 10/09/2021 on oral antibiotics

Other Meds:

Current Illness:

ID: 1775271
Sex: M
Age: 20
State: AZ

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

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

Lab Data: Troponin at 6.05 . Ref range of 0.00 to 0.03ng/ml

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: patient received vaccine within 48 to 72 hours from time of dose patient presented to the emergency department with chest pain and an elevated troponin of 6.05.

Other Meds: none

Current Illness: none

ID: 1775272
Sex: M
Age: 31
State: TX

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

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

Lab Data:

Allergies: Penicillin.

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Severe headache, fever, nausea, vomiting, tachycardia, lower back pain, testicular pain.

Other Meds:

Current Illness:

ID: 1775273
Sex: F
Age: 0
State: FL

Vax Date: 07/09/1974
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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: PCN, tetracyclines, Vicodin, Percocet,

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Extreme headache after the 2021 flu shot. Extremely persistent even 24 hrs later.

Other Meds: Venlafaxine, Gemfibrozil, Novalin 70/30, oxcarbazepine, meloxicam, ezetimibe, gabapentin

Current Illness: Diabetes, high cholesterol, mental health

ID: 1775274
Sex: M
Age: 48
State: VA

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 10/09/2021
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 injection arm. Stiffness in both knees starting the night of the injection and lasting for more than one week. Led to injury in right knee after a run. Diagnosis was: internal derangement of right knee, with possible medial meniscus tear

Other Meds:

Current Illness:

ID: 1775275
Sex: M
Age: 72
State: CA

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/09/2021
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: Muscle ache, lethargy, malaise

Other Meds: Amlodipine Elequis Hydrochlorothiazide Levothyroxine Metoprolol Probenecid Valsartan

Current Illness:

ID: 1775276
Sex: M
Age: 39
State: TX

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

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

Lab Data: n/a

Allergies: None

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

Symptoms: Patient was diaphoretic, nauseous and felt weakness. EMS attended and cleared patient.

Other Meds: None

Current Illness: None

ID: 1775277
Sex: F
Age: 59
State: NY

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: 3 MRI's. 2 on brain July 8 and early august do not show anything. 1 of spine early august.

Allergies: none

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

Symptoms: fever, aches, pains, headache by 10pm. Continuous dizziness, still 8 months later. I get Inner tremors from May through to now when nervous or tired. Jerkiness of arms/shoulders. Head nor body feeling right. severe fatigue. went to emergency room twice. JUly 8 and July 12 due to shakiness, slurred speech, feeling terrible. Thought i had stroke on the July 8th.

Other Meds: synthroid, women's multi vitamin, vitamin b

Current Illness: none

ID: 1775278
Sex: F
Age: 38
State: CA

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

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

Lab Data: unknown - transferred via ambulance to Hospital

Allergies: unknown

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

Symptoms: It is believed that this employee received HIGH DOSE flu vaccine (FLUAD). This is what is documented. There is some question as to whether or not this is a documentation error, or if she indeed received HIGH DOSE. This was an employee - after injection, she had walked back to her work area when she began to experience symptoms. She reported the following symptoms within 10 minutes of receiving injection: Dizziness, diaphoretic, convulsions, drop in blood pressure, difficulty swallowing, and body rash. The department called 911 and she was taken to Emergency department. For further details on the event, the patient is the best contact.

Other Meds: unknown

Current Illness: unknown

ID: 1775279
Sex: F
Age: 70
State: NC

Vax Date: 10/04/2021
Onset Date: 10/05/2021
Rec V Date: 10/09/2021
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: Vancomycin, Polysporin, Neosporin, bandaid adhesives

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

Symptoms: Inflammation at injection site, (redness, swelling, itching, warm). Cleansed w/alcohol pad, applied lavender oil. Still present Day 5 Headache on top of head as though had hit head on low-hanging door. Tylenol and Advil. Sill present Day 5 Fatigue similar to post-influenza. Present until Day 4

Other Meds:

Current Illness: None

ID: 1775280
Sex: F
Age: 69
State: RI

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 10/09/2021
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: No

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

Symptoms: My arm has never stopped aching since I received shot. My range of motion is limited and I wake up at night in psin

Other Meds: Nothing

Current Illness: None

ID: 1775281
Sex: M
Age: 49
State: TX

Vax Date: 08/06/2021
Onset Date: 08/07/2021
Rec V Date: 10/09/2021
Hospital: Y

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

Lab Data: Bone marrow biopsy and numerous lab tests for viruses and diseases ruled out everything except the Covid vaccine.

Allergies: Gluten, cow?s milk, almonds, cashews, eggs, chicken.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Bedridden for 3 days starting 8/7/21 with aches, chills, diarrhea, fever, headache, fatigue, and pain in the injection site. Then felt better but overall energy level continued to go down. Noticed easy bruising and rash, so had my PC run labs on 8/27/21 which showed platelet count at 7 and liver function above 1000. They sent me to ER and I was admitted to Hospital for 11 days with Pancytopenia and Aplastic Anemia.

Other Meds: No prescriptions. No other drugs.

Current Illness: No acute illnesses at the time.

ID: 1775282
Sex: F
Age: 29
State:

Vax Date: 04/02/2021
Onset Date: 06/01/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: 8/12/21 MRI CERVICAL SPINE WO CONTRAST

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 6/1/21 (approx.. two months after second dose of Pfizer/BioNTech vaccine) first went to my primary care doctor for severe headache that had lasted 3 weeks prior. Continuous headache with severe pain levels increasing throughout the day the longer I am awake. Felt like an ice pick was being driven into the right back of my head. The longer I am in pain the headache will wrap around the side of my head and into my temple. Tried Tylenol and muscle relaxers throughout June with no effect to symptoms. 7/13/21 visited primary care doctor again due to no improvement of headache symptoms. Headaches were constant from waking to going to bed and would wake me up in the middle of the night. Started amitriptyline. 7/21/21 referred to neurologist due to such severe and debilitating headaches. Was diagnosed with new daily persistent headache and Occipital neuralgia of right side. I have never had headaches this severe or this constant ever. Would go months between any kind of headache and it would always be mild and in the front of the head. Have since tried Topamax with no improvement to symptoms. Have had two right greater occipital nerve blocks with no improvement to symptoms. Have been going to physical therapy for two months with little improvement to symptoms. Have to take high doses of daily ibuprofen to take away pain of continuing daily headaches. Still working with neurologist to make a treatment plan for the new diagnosis. I am submitting this report due to new medical symptoms occurring after my covid-19 shot reported on my vsafe check in. I received a call saying I needed to fill this out to report the health problems I am experiencing.

Other Meds: KURVELO (birth control) Multi Vitamin

Current Illness: none

ID: 1775283
Sex: M
Age: 31
State: NY

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

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

Lab Data: Skin biopsy, mri, blood test, electro conductive. dates ranging from may-September 2021

Allergies: Sulfa drugs

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

Symptoms: Small fiber neuropathy, Tinnitus, vertigo, brain fog, fatigue

Other Meds: None

Current Illness: None

ID: 1775284
Sex: M
Age: 53
State: AL

Vax Date: 04/01/2021
Onset Date: 06/29/2021
Rec V Date: 10/09/2021
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: multiple blood tests

Allergies: grass, dust, etc.

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

Symptoms: Developed CLL with no prior history of high white count in established in regular blood test patterns, WBC seem to be about increasing 12% each 4 weeks, took vac in April by the end of June abnormal results if we reverse the 12% to the time of the immunization WBC would have been in normal range if the current % increase could be reversed, had normal bloodwork the year before and normal bloodwork a couple months before when being approved for life insurance

Other Meds: finesteride for hair growth

Current Illness: none

ID: 1775285
Sex: M
Age: 67
State: NY

Vax Date: 02/12/2021
Onset Date: 03/01/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: MRI Brain w/wo contrast: ((8/19/2021)) - Normal findings EKG ( 9/30/2021) - Normal Endoscopy (EGD with biopsy) (8/10/2021) - No acid reflex Blood tests for lyme disease, lupus - Negative (7/7/2021)

Allergies:

Symptom List: Unevaluable event

Symptoms: Slow and slurred speech Shortness of breath Slow chewing Fatigue and weakness Sometimes problem in swallowing liquids

Other Meds: Carvedilol 6.25 mg, twice a day atorvastatin 20 mg, once a day amlodipine 5 mg, once a day Baby aspirin Co Q10 Vit D

Current Illness: Bell's Palsy in Nov/Dec, 2020

ID: 1775286
Sex: M
Age: 74
State: WI

Vax Date: 10/05/2021
Onset Date: 10/05/2021
Rec V Date: 10/09/2021
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: Blood count Chest x-ray Covid swab

Allergies: None

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

Symptoms: Persistent frequent cough Loss of energy Loss of appetite Dramatic weight loss

Other Meds: Aspirin

Current Illness: None

ID: 1775287
Sex: M
Age: 48
State: VA

Vax Date: 10/05/2021
Onset Date: 10/05/2021
Rec V Date: 10/09/2021
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: Fever, body aches, strong pain in injection arm a few hours after injection. Herpes Zoster (shingles) outbreak covering the full injection arm and shoulder with strong pain (especially around arm joints) starting the day after injection (10/6). Visited the emergency room at 4:30 am on 10/8 due to worsening symptoms. Prescribed methylprednisolone 4 MG Tablets (6 tablets first day and decrease by 1 tablet each day for 6 days) and Valacyclovir HCL 1000 MG Tablets (3 tablets a day for 7 days). Continues to have rash and strong pain in arm and shoulder as of today (10/9).

Other Meds: Osteo Bi-Flex, Joint Health, Triple Strength; Pataday 0.1%

Current Illness: Internal derangement of right knee, with possible medial meniscus tear

ID: 1775288
Sex: M
Age: 66
State: WA

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

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

Lab Data: None

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: About 10-12 hours after the vaccination, I came down with severe flu-like symptoms: tiredness then extreme cold and shivering. That lasted for 5-6 hours into the night. . The next day, I was tired, but the other side effects were gone.

Other Meds: Biktarvy, metoprolol, atorvistatin

Current Illness: None

ID: 1775289
Sex: F
Age: 50
State: MA

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/09/2021
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: None disclosed by patient.

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

Symptoms: Patient was nervous about getting this vaccination specifically and additionally did not like needles. Husband reported that it was normal for patient to faint with vaccinations. Vaccine was administered and patient remained sitting in chair with husband and myself by her side. She stated that she was getting very warm so I provided her with some air (by opening door). Patiently fainted momentarily in chair and then recovered quickly. This happened twice with approximately 1-2 minutes in between fainting episodes. Patient was alert upon recovery. Patient fainted a third time (approximately 1-3 minutes after episode 2) however when she fainted a third time, the patient went rigid in the chair and seemed to seize a few times. Emergency services were contacted and arrived on scene. Patient was alert and had recovered. Patient did not remember the events that had occurred other than the fact that she told her husband and I that she was getting very warm. Patient was taken via ambulance to ensure stable status.

Other Meds: Unknown.

Current Illness: No other illnesses disclosed at time of vaccination

ID: 1775290
Sex: M
Age: 62
State: KY

Vax Date: 05/02/2021
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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: Janssen 5/2. Positive on 10/6

Other Meds:

Current Illness:

ID: 1775291
Sex: F
Age: 62
State: TX

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

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

Lab Data: 10/4 9:30 pm sodium 125, Cl 87

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 10/4 around 11:30 am, had difficulty urinating at PCP's office to provide a UA sample. Drank maybe 5-8 oz of water. UA was concentrated with spec grav 1.025 but negative for UTI. Within 1-2 hours of PCP visit, had diarrhea and vomiting. Became confused and had a seizure at 8:30 pm. In a local Medical Center, found to have Na 125 and Cl 87, BUN 11, Creatinine 1.1. CT head, CXR, CT abd negative. Received NS and 3% to raise sodium. Discharged home 10/8.

Other Meds: Amlodipine 10 mg daily, Bisprolol-hydrochlorothiazide 10-6.25 mg daily, tretinoin 0.1% cream applied topically daily

Current Illness: None

ID: 1775292
Sex: F
Age: 45
State: CA

Vax Date: 09/01/2021
Onset Date: 09/03/2021
Rec V Date: 10/09/2021
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: Ultrasound and surgeon consult

Allergies: no known allergy

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

Symptoms: Patient noticed swelling of her left supraclavical lymphnode 2 days after recieving influenza (FLULAVAL QUAD) vaccine. Patient recieved ultrasound. The ultrasound showed a significant increase in size at 1.5cm. The physician then ordered a surgeon follow up where the surgeon reviewed the ultrasound and also palpated the injury site of the patient. The physician noted the node was decreasing in size, was mobile and shrinking and decided to monitor for now. The physician called it a reactive node and scheduled a follow up appointment in 3 months with the patient. When patient recieved COVID-19 Booster on 09/30/2021, patient also experienced the same symptoms of her left node being reactive and increased in size.

Other Meds: Errin 0.35mg tablet

Current Illness: none

ID: 1775293
Sex: F
Age: 41
State: KS

Vax Date: 10/06/2021
Onset Date: 10/07/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: na

Allergies: penicllin allergy

Symptom List: Nausea

Symptoms: called today with itching all over her body starting early afternoon the day after the covid shot as of saturday afternoon was still having itching, has been taking zyrtec or claritin and has had improvement in symptoms

Other Meds: unknown

Current Illness: unknown

ID: 1775294
Sex: M
Age: 65
State: MN

Vax Date: 03/26/2021
Onset Date: 04/08/2021
Rec V Date: 10/09/2021
Hospital: Y

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

Lab Data: 4/8/21 and 11 days later CT scan the Clinic called me to Rochester.

Allergies: Penicillin and some others and get urinary retention.

Symptom List: Injection site pain

Symptoms: Traumatic pain-exasperating left groin impostor end one hour had one old oxycodon in cupboard and took twenty minute later calm enough to head to Urgency clinic. Second time could not stand up severe center of back pain never had ever and coworkers shocked how so looked.

Other Meds: 300 mg Gabapentin

Current Illness: I have Vascular Ehlers Danlos and thoracic aneurysms and hyperinflated lungs and sometimes Diverto

ID: 1775296
Sex: M
Age: 53
State: WI

Vax Date: 03/11/2021
Onset Date: 08/13/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: As above. The dates are approximate, but you can contact my doctor for copies of my records if you wish.

Allergies: None

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

Symptoms: Extreme fatigue, which continued for two weeks. I went to Urgent Care who gave me a COVID-19 test which proved negative, I was so tired, I was sleeping 16 hours a day and needed a nap during the day too. After about a week I went to my PCP who gave me tick-borne disease tests and also tested my TSH levels. They found that these were very low, so reduced my dose of Levothyroxine. After about a week, I seemed to recover a bit, but I am still fatigued. I have no idea if it is a long-term result of COVID-19 or not.

Other Meds: Amlodipine 5 Mg Tablet, Levothyroxine 125 Mcg Tablet, Atorvastatin 20 Mg Tablet, Alpha Lipoic Acid, Multvitamin, Aspirin 81 Mg Tablet,delayed Release, Lisinopril 20 Mg Tablet, Metformin Er 500 Mg

Current Illness:

ID: 1775297
Sex: F
Age: 30
State: WI

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

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

Lab Data: CT scan

Allergies:

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

Symptoms: Endocarditis on CT and high blood pressure

Other Meds: Gabapentin, protonix

Current Illness:

ID: 1775298
Sex: F
Age: 30
State: NC

Vax Date: 10/02/2021
Onset Date: 10/09/2021
Rec V Date: 10/09/2021
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: Covid arm- Red knot at injection site, itchy, warm to touch.

Other Meds:

Current Illness:

ID: 1775299
Sex: M
Age:
State: PR

Vax Date:
Onset Date:
Rec V Date: 10/09/2021
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: Bees; Cod

Symptom List: Erythema, Pruritus

Symptoms: Administration Error: "Off label" administration The nurse Administered the third dose of a patient on the report, without the due corroboration of the vaccination card, since the patient had been administered an initial series of the MODERNA vaccine the patient received a third dose of the pharmaceutical PFIZER, When they should receive the MODENRA. Guide establishment for third dose administration of Immunocompromised patients.

Other Meds: Patient refers not to be taking medications or supplements

Current Illness: Patient refers not suffering from diseases this past month

ID: 1775300
Sex: F
Age: 38
State: WA

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/09/2021
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: Bloodwork, blood pressure, and ECG came back normal

Allergies:

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

Symptoms: 2 minutes following vaccine I had chest pain, stomach pain, zaps throughout body, light headed. 20 minutes after vaccine had had chills that lasted about 30 minutes. Still have chest pain 10 days later. Went to urgent care. Bloodwork and ECG came back normal. 4 days following event I went to primary care. They believe the vaccine triggered a stress response in my body. While different than any panic attack I have ever had, my body had been in fight or flight mode for much of the past month. So the vaccine just might have tipped my body over. Still working to calm my body 10 days later.

Other Meds: Butterbur Migrelief Aller-tec Garlic Berberine Myrrh Forte

Current Illness: IBS and possible Sibo anxiety

ID: 1775302
Sex: F
Age: 26
State: OR

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

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

Lab Data: March 16th - Creatinine, CBC with Differential, Antinuclear Antibody, Hemoglobin A1C Screening, C4 Complement, C3 Complement, C-Reactive Protein, Cyclic Citrullnated Peptide Antibody, White Blood Cell Differential, Thyroid Stimulating Hormone, Serum Rheumatoid Factor, Serum Protein Electrophoresis, Urinalysis March 19 - White Blood Cell Differential, Troponin I, CBC with Differential, Basic Metabolic Panel, COVID test, March 22 - EKG March 24 - Echocardiogram March 26 - Follicle Stimulating Hormone, Luteinizing Hormone

Allergies: Monosodium Glutamate (MSG) Clotrimazole Clindamycin and Benzoyl Peroxide

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

Symptoms: Within 10 minutes of receiving my shot the fingers on my left hand (the same arm I got the shot in) turned white. They weren't painful, just a bit cold. A doctor came over and asked if I had Raynaud's, but I didn't prior to getting the shot. After about 40 minutes, my hand went back to normal. A few days later, I was on a walk, and one of my fingers on my left hand turned white and painful. It eventually went back to normal, but then a few days after that, both of my hands started frequently changing colors. I went to the doctor, and they diagnosed me with Raynaud's. To this day, whenever my hands get cold, they get painful and change colors. I had one of the common responses to the second dose of the vaccine - 24 hours of a high fever (103), racing heart, excessive sweating, fatigue. The intense symptoms wore off fairly quickly, but a few weeks later, I started having problems with my heart racing, and started having hot flashes as well. My doctor and I eventually determined that some of these symptoms were being caused by panic attacks (which I had never had before March of 2021), but I wonder if some of the symptoms could've been connected to the vaccine as well. My health was really poor throughout the month following my vaccine. I had COVID in July of 2020, and have had a variety of Long COVID symptoms ever since. When I got my first dose of the COVID vaccine, I felt ok, but after the second dose it felt like my system had been pushed into overload. In April of 2021 I started having extreme fatigue, and my doctor is unsure if it is being caused by Long COVID, or if I have developed Chronic Fatigue Syndrome. I don't know if the vaccine impacted this at all (although it did start after the vaccine), but I include it in case it might be useful information.

Other Meds: multivitamin probiotic

Current Illness:

ID: 1775303
Sex: F
Age: 68
State: TX

Vax Date: 09/16/2021
Onset Date: 09/25/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: None

Allergies: pineapple

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Reactivation of shingles 8 days after Covid-19 vaccine #3. 10 day treatment with Valacyclovir 1 gram, TID. Shingles resolved. Same thing happened after Covid-19 vaccine #2 Feb. 2021. Also, I experienced extreme hair loss after Covid Vaccine #2 and #3. Hair loss began to resolve by the time of Dose 3 and hair loss is starting all over again after dose #3.

Other Meds: Tirosint thyroid supplement

Current Illness: none

ID: 1775304
Sex: F
Age: 60
State: CO

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: Nine

Allergies: Penicillin Tetanus toxoid

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

Symptoms: Chills, fever, body aches, joint pain, head ache, fatigue, swollen lymph nodes in right arm/arm pit/breast/neck for 6 weeks

Other Meds: None

Current Illness: None

ID: 1775305
Sex: F
Age: 33
State: WA

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/09/2021
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: Vital signs EKG

Allergies: Unknown

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

Symptoms: Patient received her covid vaccine and 10 minutes following the vaccine she stated she was feeling light headed. She was already sitting down so the nurse took a set of vital signs at 6:14pm: oxygen saturation 98%, heart rate 104, respiration?s 18. She attempted to get a BLood Pressure on the patient?s forearm due to patient?s upper arm being too large to fit the Blood pressure cuff. The patient stated her heard was racing like it did when her asthma starts t act up. Nurse called the paramedics at 6:18pm. The paramedics arrived at 6:22pm and took vital signs and placed an EKG pads on the patient to monitor her heart. The patient continued to feel light headed. She stated that she has not had much water in the past days and often forgets to eat. She had a sandwich with morning and a muffin at 4:00pm. The paramedic did not feel like the patient needed to be taken to the ER unless the patient wanted to go. Shy patient attempted to stand up with the help of 2 paramedics and she started to sway. The patient decided to go the the ER vis ambulance. Her husband mark was waiting in his car and was altered to the news that patient would be going to the ER.

Other Meds: None

Current Illness: Unknown

ID: 1775306
Sex: F
Age: 31
State: TX

Vax Date: 08/21/2021
Onset Date: 08/21/2021
Rec V Date: 10/09/2021
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 shot: 07/14/2021 2nd shot: 08/21/21 I got "Covid Arm" 2 weeks after the 1st shot in the left arm. I got the 2nd shot in the right arm. I am getting itching and rashes on both arms months after receiving the vaccines. It gets worse after taking hot showers.

Other Meds:

Current Illness:

ID: 1775307
Sex: M
Age: 38
State: TX

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

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

Lab Data: October 13, 2020 lab tested for COVID-19 via PCR. Confirmed severe levels of disease process.

Allergies: No allergies

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

Symptoms: Symptoms began within 12 hours. Woke up from sleep drenched in sweat, body aches in every joint, muscle pain throughout the body when I?d move, 102 temperature. Symptoms did not subside for over 6 hours. Took 1000 mg Tylenol to break the fever and manage pain. Persisting feelings of arthritis in joints through the day. Symptoms started again no less than 10 hours later. Eyes pulsating, nausea, skin pulsing with beats of the heart.

Other Meds: Tylenol, lidocaine patches, naproxen, vitamin d, fish oil

Current Illness: No illnesses

Date Died: 10/02/2021

ID: 1775309
Sex: M
Age: 98
State: PA

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

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

Lab Data: Cxr Wbc

Allergies: Penicillin

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

Symptoms: Respiratory arrest Death

Other Meds: Melatonin 1mg Hytrin

Current Illness: Delirium Decubitus Open head wound as a result of necrotizing fasciitis

ID: 1775310
Sex: F
Age: 57
State: NY

Vax Date: 02/28/2021
Onset Date: 03/07/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: Holter Monitor, Echocardiogram Stress with exercise, prestress echo, pulmonary Dr. Visit, CT Corona Angio with contrast, Blood tests,

Allergies: None

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

Symptoms: One week after started with Shortness of breath, Chest pain, tachychardia, heart fluttering, pounding heart

Other Meds: Montelukast 10MG Valacyclovir 500mg, Synthroid 50 mcg Pravastatin 40 mg Fluoxetine 20mg Venlafaxine XR 225 mg ( Lorazepam 0.5 mg as needed (up to 3x day) Fluticasone propionate 50mcg nasal spray Metropolol succinate 25 MG XL

Current Illness:

ID: 1775311
Sex: F
Age: 43
State: WA

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

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

Lab Data: No medical test or labs were required. No adverse events were reported from the patient. Patient reported feeling fine and upon discussion with CDC we were informed patient should be considered complete with current moderna series with no additional doses required.

Allergies: no know drug allergies

Symptom List: Vomiting

Symptoms: Patient came in with appointment for second dose of moderna vaccine which they received on 4/16/2021. Patient mistakenly signed up for pfizer vaccine using an online scheduling tool. Mistake was not found until weeks after incident when patient came in looking for a booster dose for their vaccination series.

Other Meds: unknown

Current Illness: no known illnesses

ID: 1775312
Sex: F
Age: 76
State: CA

Vax Date: 02/06/2021
Onset Date: 10/01/2021
Rec V Date: 10/09/2021
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: +covid

Allergies: asa, PCN

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: none

Other Meds: aldactone,lasix,synthroid, aciphex Ursodiol, celexa

Current Illness: Chirrhosis, T cell lymphoma, depression, poly cystic kidney

ID: 1775313
Sex: M
Age: 28
State: TX

Vax Date: 07/20/2021
Onset Date: 08/17/2021
Rec V Date: 10/09/2021
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: Prednisone and doxycycline

Allergies:

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

Symptoms: Significant worsening of autoimmune symptoms Raynauds Joint pain Reflux Difficulty opening hands Splinter hemorrhages and cuticle hemorrhages

Other Meds: Hydroxychloroquine

Current Illness: Undifferentiated connective tissue disease (mild state)

ID: 1775314
Sex: F
Age: 74
State: MO

Vax Date: 10/05/2021
Onset Date: 10/06/2021
Rec V Date: 10/09/2021
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: All beta blockers

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pain in arm was immediate. Rash about 3" long extending down the arm and around injection site noticed the next day. Pain and rash went away by Friday, 10/8

Other Meds: Losartan, Chlorthalidone, Famotidine,loratadine, aspirin, fortify30 billion probiotic,D3, B12

Current Illness: none

ID: 1775315
Sex: M
Age: 69
State: CA

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

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

Lab Data: none

Allergies: none

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

Symptoms: injection site edema and pain for + 2 weeks since injection. Unusual time frame for long term pain at site and localized muscle pain making it difficult to use arms for regular occupational activities required daily since that injection . This is an adverse event reaction for me since I have had COVID injections prior to this 2nd dosing and many other vaccines for polio, MMR, DTaP, pneumonia,etc.....

Other Meds: none

Current Illness: none

ID: 1775316
Sex: F
Age: 41
State: OK

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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: Amoxicillin, PCN

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

Symptoms: Severe burning, searing pain in stomach, stabbing chest pains intermittently, 8/10 pain in major joints

Other Meds: Bystolic Levothyroxine

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am