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: 1776503
Sex: M
Age: 98
State: WI

Vax Date: 02/19/2021
Onset Date: 09/01/2021
Rec V Date: 10/11/2021
Hospital: Y

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

Lab Data:

Allergies: Statins-hmg-coa Reductase

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient hospitalized due to COVID-19 with weakness. Low grade temp noted in the ER 99.9. Infrequent loose cough noted, on room air, pulse ox is 94%. Work-up in ED showed procalcitonin 0.19, BNP 8275, d-dimer 619. CRP 6.0, WBC 12.8, COVID-19 was positive. CXR with no pneumonitis. ECG with rate controlled afib. O2 sats at 94-96% on RA. CT head negative for ICH.

Other Meds: Acetaminophen, apixaban, clotrimazole, Docosahexanoic, furosem

Current Illness:

Date Died: 03/24/2021

ID: 1776504
Sex: F
Age: 81
State: NM

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: 03/24/2021

Allergies: See attached list

Symptom List: Anxiety, Dyspnoea

Symptoms: Loss of consciousness; fall; injury - over about 1 hour

Other Meds: See attached list

Current Illness: See attached list

ID: 1776505
Sex: F
Age: 75
State: OH

Vax Date: 10/10/2021
Onset Date: 10/10/2021
Rec V Date: 10/11/2021
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: Contrast dye, Iodine.

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

Symptoms: Headaches, muscle and joint aches, chills, temp of 102.4, no apetite.

Other Meds: None.

Current Illness:

ID: 1776506
Sex: M
Age: 60
State: MS

Vax Date: 04/16/2021
Onset Date: 09/22/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: Covid-19 Positive 09/22/2021

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I noticed a slight cough for about two days. I thought it was my Sinuses and on the third day I got a fever and chills. My fever was 102.5. I went to the clinic because I had a terrible headache and I was having trouble breathing. I woke up in the Hospital ER. I was treated and released. I was prescribed prescribed Asthma medication and I took Tylenol and checked my Oxygen levels. I was not very fatigued but my coughing was the worst. My wife did not get sick and I quarantined. I tested positive for Covid-19 on 09/22/2021. It has been three weeks and I am still experiencing constant coughing. I have Bronchial Asthma but this is a constant cough. I take Albuterol every six hours and use a Nebulizer. I still tested positive after two weeks.

Other Meds: Lipitor, Synthroid, Valsartan

Current Illness: N/A

ID: 1776507
Sex: M
Age: 52
State: MD

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: -

Allergies: NKDA, JUST BEE STINGS.

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

Symptoms: NUMBNESS/LOSS OF SENSATION IN RIGHT ARM.

Other Meds: NONE

Current Illness: NONE

ID: 1776508
Sex: F
Age: 30
State: TN

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/11/2021
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: She received the COVID vaccine on 9/24/21 at 8am she had "chills, fever, weakness, fatigue, body aches, joint pain, and left arm swelling. States left arm swelling did not resolve until 9/27/21. She states she had these reactions with the first 2 vaccines but with the booster the reaction was the worst.

Other Meds:

Current Illness:

ID: 1776510
Sex: F
Age: 56
State: KY

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

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

Lab Data: None yet

Allergies: Allergic to bee sting, shellfish

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Shortness of breath, Extreme pain like arthritis all over body, migraine like headache, pain all over muscles and skin like fibromyalgia, sick to stomach, no appetite, fever of 102 for several hours that could not go down with Tylenol every four hours, drank plenty of fluids, rested, and took hot showers. Headache subsided after two days. Arthritis and muscle aches still here as of today. Not puking anymore but still no appetite. Honestly, this was worse than what experienced while surviving Covid two times.

Other Meds: Multivitamin, Zyrtec allergy medicine

Current Illness: None; but two months prior I survived the Delta variant of Covid. And seven months prior I survived the Covid.

ID: 1776511
Sex: F
Age: 24
State: PA

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

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

Lab Data:

Allergies: diazepam

Symptom List: Pharyngeal swelling

Symptoms: I got the COVID booster on 10/8/21 at 12 pm. I had a vagal response, which is normal for me. Staff responded appropriately and I was fine. I stayed for approximately 15 minutes. I left and within 5-10 minutes of driving home I began to feel my lips, hands, and face tingle, I felt very hot, and my tongue felt full in my mouth. I got home in about 30 minutes. I took 25 mg of Benadryl. I still did not feel better, so I went to the. They gave me a round of Epinephrine and called 911. Paramedics noticed audible wheezing, SpO2 was decreased, but still above 92%. They gave me a breathing treatment, along with IV 25 Benadryl. Once I got to the hospital, I was fine. I no longer had wheezing. I was sent home with a prescription of Epinephrine (2 injectors) and Prednisone for 3 days. I had no symptoms since. My home medications include Keppra 1,500 BID, metoprolol 25 XR BID, Nexplanon implant RA, and Amoxicillin (for current ear infection).

Other Meds: keppra, metoprolol XR, Nexplanon, Amoxicillin for ear infection

Current Illness: active ear infection

ID: 1776512
Sex: F
Age: 52
State: AL

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: MRI

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I experienced cramps and an infection in my gut.

Other Meds: Yes

Current Illness:

ID: 1776513
Sex: M
Age: 52
State: MO

Vax Date: 05/04/2021
Onset Date: 10/05/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Tightening and pain in esophagus for 6 weeks. Lost 12-15 pounds due to lack of appetite and pain.

Other Meds:

Current Illness:

ID: 1776514
Sex: M
Age: 30
State: SC

Vax Date: 10/08/2021
Onset Date: 10/10/2021
Rec V Date: 10/11/2021
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: Irritated eyes Itchy throat Dry nose Fatigue Heart felt like it was going to burst at times.

Other Meds:

Current Illness: Hypertension Major depressive disorder Bipolar disorder

ID: 1776515
Sex: M
Age: 49
State: NY

Vax Date: 03/25/2021
Onset Date: 05/29/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: Ophthamologist & primary physician, MRI; nothing abnormal found. But have not had symptoms or similar problem prior to receiving vaccine.

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Partial temporary blindness in peripheral field of view in right or left eye that last about 45 minutes, experienced 4 different times over a period of 4 months.

Other Meds:

Current Illness:

ID: 1776516
Sex: M
Age: 25
State: NY

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/11/2021
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: WITHIN 3 HOURS OF RECEIVING THE FIRST DOSE OF PFIZER COVID VACCINE MY BODY WAS COVERED WITH HIVES AND RASHES. IT HAS BEEN 4 DAYS AND THE HIVES AND RASHES HAVE STARTED TO FADE BUT ARE NOT GONE.

Other Meds: LAMOTRIGINE 200MG 2X/DAY CEPHALEXIN 500 MG (LAST PILL TAKEN THAT MORNING)

Current Illness: I TOOK MY LAST PILL OF CEPHALEXIN ON DAY OF VACCINATION FOR AN INFECTION FROM A CUT ON MY HAND

ID: 1776517
Sex: F
Age: 79
State: KS

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

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

Lab Data:

Allergies:

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

Symptoms: arm got sore, very fatigued, all joints are painful

Other Meds: varegamin, prylocet, lipitor, omnipresol,

Current Illness:

ID: 1776518
Sex: F
Age: 51
State: KY

Vax Date: 05/17/2021
Onset Date: 09/19/2021
Rec V Date: 10/11/2021
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: COVID PCR positive on 9/19/21

Allergies: codeine levothyroxine gabapentin

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

Symptoms: a 51 y.o. female with a PMH of ALL on active treatment, anemia, type 1 diabetes on insulin pump, HTN, Sjogren's syndrome, Parkinson's disease, chronic nausea complicated by GERD with esophagitis, gastroparesis, active chemo regimen, sleep apnea, anxiety, and vitamin D who presents with a chief complaint of worsening symptoms regarding COVID. She states that she was diagnosed on 09/17 but has had symptoms for one week since coming to the ER and reports that she was told to come for further work-up. She states that she initially thought her fatigue was caused by recent chemo infusion (10 days ago) but it continued, and her symptoms worsened throughout the week. She reports that she began to have shortness of breath, chest pain, cough, fever (patient reports it was 103), diaphoresis that began 3-4 days ago. Respiratory: Positive for cough, chest tightness, shortness of breath and wheezing. Cardiovascular: Positive for chest pain and leg swelling. Negative for palpitations. Acute Hypoxic Respiratory Failure secondary to COVID-19 infection | Immunocompromised due to dasatinib therapy - Diagnosed on 09/17, symptomatic starting 09/12. On admission, dexamethasone and remdesivir were prescribed. Given her immunocompromised state, infectious disease was consulted for consideration of prolonged remdesivir course. She received supportive care with supplemental oxygen, albuterol and anti-tussive medications as needed. Per ID recommendations she was continued on remdesivir for the duration of her stay, 8 days, during which time her inflammatory markers were trended and noted to steadily fall. On day 8 of hospitalization patient no longer required supplemental oxygen at rest or with ambulation. She welcomed and requested discharge and was given strict return precautions. She was discharged to complete 3 additional days of dexamethasone, for 10d total as well as with antitussive medications and albuterol to use as needed. Discharged home

Other Meds: acyclovir (Zovirax) 400 MG tablet buPROPion XL (Wellbutrin XL) 300 MG 24 hr tablet busPIRone (Buspar) 30 MG tablet carbidopa-levodopa (Sinemet) 25-100 MG tablet carbidopa-levodopa CR (Sinemet CR) 50-200 MG ER tablet cholecalciferol (Vit

Current Illness: None

ID: 1776519
Sex: F
Age: 35
State: MI

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

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

Lab Data: n/a

Allergies: no

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

Symptoms: 10/11/21 - #3 COVID vaccine on 10/9. started experiencing chest pain and body aches. Chest pain is gradually subsiding. Denies SOB or other cardiac symptoms

Other Meds: BCP

Current Illness: no

ID: 1776520
Sex: F
Age: 36
State: KS

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

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

Lab Data: unknown

Allergies: no know allergies

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

Symptoms: woke on 10/11/21 with swollen upper lip, puffy face, itching on gums and face, patient has taken otc antihistamine and after two hours was feeling a little better

Other Meds: nothing new to patient

Current Illness: none

ID: 1776521
Sex: F
Age: 68
State:

Vax Date: 02/17/2021
Onset Date: 10/05/2021
Rec V Date: 10/11/2021
Hospital: Y

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

Lab Data: Covid + 10/03/2021

Allergies: SulfAdiazine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Breakthrough Covid + a 69y.o. female presents to the EDwith worsening dyspnea and cough for the last 2-3 days. Admission CXR in the ED demonstrates chronic elevation of the left diaphragm but no obvious infiltrates. ABG in the ED demonstrates both hypoxemia and hypercapnea.

Other Meds:

Current Illness:

ID: 1776522
Sex: F
Age: 50
State: MI

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data:

Allergies: Ceftin, gluten

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 2nd vaccine kicked off a two-month-long brutal fibro flare causing severe all-over shooting pain and dysesthesia in my feet. I contacted Covid on August 5, 2021 and immediately the flare ceased.

Other Meds: topiramate, phentermine, allergy medication

Current Illness: None

ID: 1776523
Sex: M
Age: 35
State: OR

Vax Date: 09/24/2021
Onset Date: 09/26/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: I LOST HEARING IN BOTH EARS. I AM EXPERIENCING TINNITIS IN ONE EAR WHICH IS ABOUT HALF VOLUME W MUFFLED SOUND AND SHARP PAIN AND EVEN LESS HEARING WITH EVEN MORE MUFFLED IN LEFT EAR.

Other Meds:

Current Illness:

ID: 1776525
Sex: M
Age: 80
State: IN

Vax Date: 09/01/2021
Onset Date: 09/18/2021
Rec V Date: 10/11/2021
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: 9-29 DOPPLER ULTRASOUND REVEALS 2 DVT'SONE IN SAPHENOUS VEIN AND 2 ND ONE IN TIBIAL VEIN. 10-8 LABS BY HEMATOLOGIST

Allergies: Levaquin

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

Symptoms: DEVELOPED 2 DVT'S IN RIGHT LEG. VERIFIED WITH DOPPPLER ULTRASOUND ON 9-29 . REPORT FROM DOPPLER IS AVAILABLE IF NEEDED. THE FIRST 2 MODERNA SHOTS WERE HERE AND BOOSTER ON SEPT 1 ST WAS IN ANOTHER STATE, AS WE LIVE THERE IN THE SUMMER. I AM CURRENTLY BEING TREATED BY HEMATOLOGIST AS LISTED ABOVE.

Other Meds: Eliquis valsartan fish oil glucosamine tikosyn

Current Illness: none

ID: 1776526
Sex: F
Age: 67
State: IL

Vax Date: 10/06/2021
Onset Date: 10/07/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Unevaluable event

Symptoms: Received booster at 0930 10/6/2021. Symptoms 12 hours of chills, fever, muscle weakness, nausea, jittery, felt like had to urinate , did void 3-4 times urine colorless; 22 hours after booster approximately 0745 am I got up to use bathroom, I remember seeing fading light. Fell on carpeted floor. Do not know how long I was out. Husband assisted me back to bed. Weakness resulted but no further fainting. Legs felt heavy until about 2:30 pm 10/7/ 2021. Other symptoms of chills/ fever and feeling need to urinate and jitters subsided approximately 3:30-4 pm 10/7/2021. The next day felt weak but no other symptoms.

Other Meds: Amlodipine 5 mg daily Armour Thyroid 60 mg daily Quinapril 40 mg daily Amitriptyline 5 mg daily Baby Aspirin 80 mg daily

Current Illness: None

ID: 1776527
Sex: M
Age: 87
State: MN

Vax Date: 10/05/2021
Onset Date: 10/10/2021
Rec V Date: 10/11/2021
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: RT-PCR Covid-19 Test

Allergies: Lisinopril

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

Symptoms: Tested Positive for COVID-19 While fully vaccinated.

Other Meds: Protonix, Ultram, Naproxen, Multivtamin, Hydrochlorothiazide, Calcium with Vit D, Mobic, Aspirin, Senokot, Crestor, Uroxatral, Cozaar

Current Illness: N/A

ID: 1776528
Sex: F
Age: 50
State: FL

Vax Date: 05/30/2021
Onset Date: 08/26/2021
Rec V Date: 10/11/2021
Hospital: Y

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

Lab Data: blood work EKG CAT scan Ultrasound Stress test on 10/11/2021

Allergies: No

Symptom List: Injection site pain, Pain

Symptoms: I had chest pains. I ended up in the emergency room and diagnosed with tachycardia.

Other Meds: Yes

Current Illness: No

ID: 1776529
Sex: F
Age: 31
State: WA

Vax Date: 08/06/2021
Onset Date: 08/08/2021
Rec V Date: 10/11/2021
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: Decrease in milk supply in lactating mother

Other Meds: Prenatal vitamins, vitamin d

Current Illness:

ID: 1776530
Sex: M
Age: 32
State: FL

Vax Date: 09/13/2021
Onset Date: 10/04/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: N/A

Allergies: N/A

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

Symptoms: Bell's Palsy

Other Meds: N/A

Current Illness: N/A

ID: 1776531
Sex: M
Age: 59
State:

Vax Date: 07/29/2021
Onset Date: 10/08/2021
Rec V Date: 10/11/2021
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: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series

Other Meds:

Current Illness:

ID: 1776532
Sex: F
Age: 69
State: WA

Vax Date: 10/05/2021
Onset Date: 10/06/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: none

Allergies: hydroxychloroquine and methotrexate

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt rcv'd COVID vaccine Moderna 1st dose 01/28/2021, 2nd Moderna 02/25/2021, then rcv'd in error Pfizer for 3rd dose on 10/05/2021. Pt then seen here at clinic on 10/09/2021 with what provider states trigger of pt' s arthritis inflammation response. Hands swollen, pain in joints especially hands and knees. Pt rcv'd RX prednisone and toradol for inflammation and pain.

Other Meds: Pt's routine meds

Current Illness: chronic arthritis

ID: 1776533
Sex: F
Age: 47
State: NM

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/11/2021
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: None

Allergies: Phinegran Religran

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

Symptoms: Swollen lymph node underneath right arm the size of a golf ball. Painful and numb

Other Meds: None

Current Illness: Strep

ID: 1776534
Sex: F
Age: 51
State: FL

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

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

Lab Data:

Allergies: none known

Symptom List: Nausea

Symptoms: Woke the next morning with hives, swollen lip and throat. My doctor prescribed methylprednisolone 4mg 21s and Benedril and I started taking Saturday afternoon. The next morning the hives and swelling had gone down

Other Meds: Wellbutrin; Prozac; Terbinefine 250mg; Birth Control- Nortel

Current Illness: no

ID: 1776535
Sex: F
Age: 60
State: LA

Vax Date: 10/01/2021
Onset Date: 10/03/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: I had bloodwork done and a chest x-ray done.

Allergies: Strong immune reaction to wheat at times

Symptom List: Injection site pain

Symptoms: I had the flu shot on the same day in the same arm. The day after I was fine. On the second day I could not get out of bed. I had a very high fever (enough to not make sense when talking; highest recorded was 102.6), abdominal swelling, other generalized swelling, joint pain, muscle pain, couldn't breathe well (I think from the abdominal swelling), severe chills, pain under my left rib which seemed to be at my spleen (perhaps enlarged), complete exhaustion, back pain, found it difficult to turn over in bed, could hardly get out of bed. This lasted for eight full days. Only today, day nine, am I starting to feel better.

Other Meds: Tumeric, baby aspirin, daily vitamin

Current Illness: None

ID: 1776536
Sex: F
Age: 59
State: NY

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

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

Lab Data: none yet....going to doctor today to see my primary

Allergies: no allergies to meds, allergies octopus, mildew, smoke, dust, and mosquito bits and some plants

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

Symptoms: symptoms started the same day approximately around 6 pm. I stated feeling bad, wasn't able to stand being up much longer and wanted to day down the soon as possible started having body aches, muscles soreness, chest discomfort, sore hands and feet, back pain, knee swelling, arm soreness with swelling and able to move injected arm, chills/shakes, extreme headaches, felt hot, with fever, my urine was dark and warmer then normal with no appetite. I just curled up in bed, and had a rough night of rest.

Other Meds: no prescription, Tylenol for current symptoms, no supplements

Current Illness: none

ID: 1776537
Sex: M
Age: 59
State: AZ

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

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

Lab Data: CATSCAN of arm for blood clot, diagnosed the blood clot. Xrays of lungs, and scan for abdominal region (all done at honor health

Allergies: N/A

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

Symptoms: Immediately after vaccine began experiencing symptoms of high fever, chills, was consistently high. Arm swollen and painful. Did a telehealth visit with the doctor. Went to hospital for 1 week because diagnosed as blood clot, given eliquis, in the hospital was given steroids and IV fluids for COVID. The symptoms seemed to get better. Also had a flu shot in my right arm at the same time. Admitted on 9/27/21. Note I was also diagnosed with COVID-19 a week after the vaccine.

Other Meds: Diabetes Medicine (metformin and glyphosate); High Blood Pressure; Affilin; Multivitamin

Current Illness: N/A

ID: 1776538
Sex: F
Age: 32
State: CA

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/11/2021
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: Sharp back pain while sitting, BP 106/84 (according to patient this is baseline for her BP) Patient complaints of sharp back pain while sitting in observation area. Advised patient to lay down but she refused and said that she is more comfortable standing and walking. Patient stated she has epidural in back 7months ago during delivery. Advised her to take pain medicine OTC Patient stayed 30 minutes in observation area. Patient had jaw pain with 1st dose of covid pfizer vaccine. Advised to talk to PCP in case pain stays longer. Patient states she felt better and left for home .

Other Meds:

Current Illness:

ID: 1776539
Sex: M
Age: 26
State: CT

Vax Date: 10/11/2021
Onset Date: 10/11/2021
Rec V Date: 10/11/2021
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: NKDA

Symptom List: Erythema, Pruritus

Symptoms: PT CAME IN TO PHARMACY TO GET MODERNA #1. PT WROTE AND STATED ALOUD HE HAD NEVER HAD "ANY" COVID VACCINE. AFTER SHOT GIVEN, GOT AN ALERT FROM INSURANCE COMPANY THAT PT HAD PREVIOUSLY RECIEVED HIS COVID JOHNSON AND JOHNSON. PT STATES HE "LIED BECAUSE HE WANTED A MODERNA VACCINE ALSO"

Other Meds: ALLERGY SHOTS ONLY

Current Illness: SEASONAL ALLERGIES

ID: 1776541
Sex: F
Age: 31
State: WA

Vax Date: 09/29/2021
Onset Date: 10/01/2021
Rec V Date: 10/11/2021
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: Decreased milk supply in lactating mother

Other Meds: Prenatal vitamins, vitamin d

Current Illness:

ID: 1776542
Sex: F
Age: 49
State: TX

Vax Date: 09/15/2021
Onset Date: 09/17/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: N/A

Allergies: Seasonal Allergies

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

Symptoms: Pt. states that after receiving the 1st dose of Moderna 09/15/2021, started experiencing symptoms 09/17/2021 of Chills, headache, nausea, arm throbbing in pain, skin rash (abdomen area), face *cheek area with lumps. Still continuing the experience symptoms. No noted Primary visit.

Other Meds: Armor thyroid

Current Illness: N/A

ID: 1776543
Sex: F
Age: 64
State:

Vax Date: 03/17/2021
Onset Date: 10/06/2021
Rec V Date: 10/11/2021
Hospital: Y

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

Lab Data: Covid + 09/05/2021

Allergies: Enbrel

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Breakthrough Covid + 65-year-old female who was brought to the emergency room by her daughter for chief complain of change in mental status. Patient continues to describes symptoms as cough and shortness of breath, and with a well known history of chronic obstructive pulmonary disease and cardiac conditions patient was referred approximately 2 days ago for IV concentrated antibodies treatment.

Other Meds:

Current Illness:

ID: 1776544
Sex: M
Age: 36
State: MN

Vax Date: 10/11/2021
Onset Date: 10/11/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: None

Allergies: penicillin, bees

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

Symptoms: I gave Patient his Janssen COVID19 vaccination today at about 10:10 A.M. today Oct. 11th, 2021. I had him wait in front of pharmacy, after about 5 min he said he felt light-headed so I went out to him. I asked him if he could lay on the ground and put his feet up on the chair. He said yes but that instance he lost consciousness and started to seize. His seizure lasted about 30 seconds then he slowly returned to a conscious state. He was really sweaty and sleepy. He was yawning. He was able to say his name and what day it was. As soon as he had lost consciousness I had had Staff call 911. EMS arrived at about 10:30 A.M. and by then he was said he was feeling a lot better. EMS stated he was a bit tachycardic. Pt reported no diabetes, heart issues, h/o stroke or seizures and no allergies except for penicillin and bees. Said when he was 6-7 years old he had a condition of vaso-vega (fainting condition) which he was told he grew out of by around 7 years old.

Other Meds: unknown

Current Illness: none

ID: 1776546
Sex: M
Age: 59
State: AL

Vax Date: 09/08/2021
Onset Date: 10/11/2021
Rec V Date: 10/11/2021
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: CBC; CMP; Troponin-I; Influenza A; Influenza B; COVID-19; NT-proBNP; ECG; CXR

Allergies: NKDA

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

Symptoms: Pericarditis, causing chest pain. Pt seen and treated in ED. Pt discharged home. Flu/SARS tests were NEGATIVE on date of diagnosis of his pericarditis. Pt discharged on anti-inflammatories.

Other Meds: esomeprazole gabapentin mesalamine semaglutide sodium bicarbonate sulfasalazine

Current Illness: Cough

ID: 1776548
Sex: F
Age: 33
State: TX

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/11/2021
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: Got vaccine and now has a base ball size nodule on her arm where the vaccine was administered. she said the nursing student administered it wrong, it was not in her deltiod, where it should be, was more lower of the arm near the elbow. Reports body aches chills, fatigue, low grade fever.

Other Meds:

Current Illness:

ID: 1776549
Sex: M
Age: 57
State: MN

Vax Date: 02/05/2021
Onset Date: 09/21/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: slight congestion, Headache, Positive Exposure starting Sept 21

Other Meds: Simvastatin; Allergral Protopic 1%; Fluticasone; Triamcinolone; Aspirnin low

Current Illness: none

ID: 1776550
Sex: F
Age: 15
State: GA

Vax Date: 10/11/2021
Onset Date: 10/11/2021
Rec V Date: 10/11/2021
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: patient experienced numbing/ locking in her fingers after receiving a flu vaccine

Other Meds:

Current Illness:

ID: 1776551
Sex: F
Age: 30
State: IA

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/11/2021
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: Bee Venom

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

Symptoms: Pt presenting to ER with reaction to COVID vaccine. She states she got the vaccine on Friday and noted a sore R arm with a burning sensation on Saturday. She then awoke at 0300 Sat morning with R sided facial swelling. Here R eye was swollen completely shut, she had upper and lower lip swelling, tongue swelling and a fire-like burning sensation to the R side of her body. She states she started taking benadryl. She states she was drooling which did improve with the benadryl. She has continued the benadryl and the swelling to the eye and lip improved. She is noted to have marked swelling to the R side of the face. She is able to speak and swallow without issues at this time. She is noted to have tachycardia and a temp of 100.

Other Meds: Effexor, Inderal, Remeron, Clonazepam, Abilify

Current Illness: Migraine

ID: 1776552
Sex: F
Age: 67
State: ME

Vax Date: 10/07/2021
Onset Date: 10/08/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: none

Allergies: Prednisone/Oxycodone/Imipramine HCI tabs/Gabapentin

Symptom List: Vomiting

Symptoms: Severe headache, chills, 102 fever, joint and body aches, weakness for 3 days

Other Meds: multi vitamin/Q10/calcium no prescripton drugs

Current Illness: None

ID: 1776553
Sex: F
Age: 18
State: WI

Vax Date: 10/11/2021
Onset Date: 10/11/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: None.

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: PT received her covid-19 vaccine. approx 5mins into the observation period, pt stood up to use the rest room. PT then had syncopal episode. PT was cared for and placed in a supine position with her legs elevated. PT explained some ABD pain but no other symptoms. Pt was not injured from her standing fall. Vitals were monitored and pt was eventually able to ambulate on her own and care for herself.

Other Meds: none

Current Illness: None

ID: 1776554
Sex: M
Age: 62
State: MI

Vax Date: 03/01/2021
Onset Date: 03/06/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: I had a CT scan performed to rule out a stroke. I also had blood drawn. I was diagnosed with Bells Palsy.

Allergies: I do not have any allergies.

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

Symptoms: On the 5th of March, in the morning, I was going about my normal day and I noticed that I didn't feel right. I did my normal morning routine. I started to drink my coffee and it started dribbling out of my mouth. I went to the bathroom and saw my face in the mirror. It appeared as if I could not smile on the left hand side of my face. I stuck my tongue out and it came out straight. Since it came out straight, I thought that maybe I was in the beginning stage of a stroke. I got in my car and drove myself to ER. I was taken to the back right away after explaining that I thought I was having a stroke. They performed a CT scan and knew right away that it was not a stroke that I was having. I was released with a prescription for prednisone and diagnosed with Bells Palsy. When I spoke with my pharmacist, and told her about my prescription, she told me that she has not ever seen this many cases at one time of Bells Palsy. I am currently having persistent double vision. I will see my optometrist again in November.

Other Meds: I was taking gabapentin 300mg (3x daily), Bupropion 75mg, glipizide 2.5 mg, metoprolol 50mg, Advair 250 (2x per day), pro-air, losartan 50mg and metformin 500 mg (2x daily)

Current Illness: I was not experiencing any illness.

ID: 1776555
Sex: M
Age: 84
State: NJ

Vax Date: 10/04/2021
Onset Date: 10/06/2021
Rec V Date: 10/11/2021
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: None

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: On Wednesday 10/4/2021 (2 days after my Pfizer booster shot) I had a bowel movement and noticed a great deal of blood in the bowl. I was extremely nervous until I realized I had a similar experience 6 months earlier. That?s when I had my second shot. I immediately googled ?Covid vaccine blood in spool?. The search returned Thrombocytopenia or a drop in platelets. In both instances it only occurred once. Needless to say I was very relieved.

Other Meds: Losartan, metoprolol,pantoprozole,atorvastatin

Current Illness: None

ID: 1776556
Sex: F
Age: 76
State: NY

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

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

Lab Data: Physical Therapy , Occupational therapist Blood work - C6 was high was out of range no rhematitis arthritis

Allergies: Sulphur, suphites, sodium laurel sulphite, raw onions, raw broccoli, lactulose intolerance , Sulphur dioxide .

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

Symptoms: At first I was feeling dizzy after the vaccine, Fatigues, no fever. I got severe muscles aches and pains, vertigo, stabisvus ( eye muscles problems) 6 -16. My hands duprincans ( Tendons /hand problems soft muscle issue). I cant walk far and garden, trouble climbing the stairs. Did virtual doctor's appointment. Oncologist .

Other Meds:

Current Illness: treated for joint and muscle pain, physical therapy

ID: 1776557
Sex: F
Age: 91
State: MN

Vax Date: 01/27/2021
Onset Date: 10/09/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: Covid-19 PCR test

Allergies: None Known

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

Symptoms: Tested positive for covid on outbreak testing 10/8/21. 10/11/21 diminished sense of taste and smell.

Other Meds: ASA, carbedilol, escitalopram oxalate, Lasix, levothyroxine, lisinopril, melatonin, mirtazapine, oyster shell ca-Vit D3, Preservision AREDS-2, simvastatin, spironolactone, senna,

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am