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: 1778782
Sex: F
Age: 26
State:

Vax Date: 10/10/2021
Onset Date: 10/11/2021
Rec V Date: 10/12/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Chest pain, difficulty breathing

Other Meds:

Current Illness: Stomach ulcer

ID: 1778783
Sex: F
Age: 85
State: NE

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: None

Allergies: Penicillin Codeine Sulfa

Symptom List: Anxiety, Dyspnoea

Symptoms: Small rough bumps on right arm, raised whelps that itched and spread through the body, joint aches in legs and arms, sensitivity in lymph nodes in neck, fluid retention underneath both eyes

Other Meds: Losartan 100mg (once daily)

Current Illness: None

ID: 1778784
Sex: M
Age: 12
State:

Vax Date: 08/27/2021
Onset Date: 09/17/2021
Rec V Date: 10/12/2021
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: fever and cough

Other Meds:

Current Illness:

ID: 1778785
Sex: F
Age: 46
State: PA

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

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: received my flu shot on Tuesday 10/5 at the POD. Received my 3rd Covid booster on 10/8 @11:30. Typical arm pain at injection site (received both vaccines in the right arm). Headache on Saturday and Sunday. Sunday morning woke up (actually so painful it woke me up) with underarm pain and a lot of swelling. Swelling can fit into the palm of my hand (baseball sized). Very sore today (under arm) when moving my arm. I know that it can swell but didn?t have this before and never had Lymph swelling under my arm from a vaccine. Headache now gone. No fever or anything. I am sure this will go away with time. Just wasn?t sure if I needed to report it or not. Haven?t had it before.

Other Meds:

Current Illness:

ID: 1778786
Sex: M
Age: 80
State: KY

Vax Date: 03/03/2021
Onset Date: 09/21/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data: COVID PCR positive on 09/21/21

Allergies: NKDA

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

Symptoms: 81 y.o. male presenting with hypoxia and increased work of breathing for 2 days. He has a 6 day history of myalgia, SOA, and increased weakness. He reports testing positive at a clinic for COVID 6 days ago. He was seen there for rhinorrhea, nasal congestion, he thought to be regular seasonal allergies, and was tested for COVID which resulted as positive, as did his wife. His symptoms progressed and on Friday he called his PCP who gave him a Z-pack and Prednisone 20mg to take daily. He says his respiratory status declined over the weekend and today felt as though he needed additional treatment. Constitutional: Positive for activity change (due to SOA/hypoxia) and fatigue. Negative for appetite change, chills and fever. HENT: Positive for sore throat (raw mouth/throat hurts to brush teeth). Negative for congestion and voice change. Reports redness with burning noted in mouth/tongue with brushing teeth and some foods x2-3 days. Eyes: Negative. Respiratory: Positive for cough and shortness of breath. Negative for wheezing. an 81 y.o. male previously vaccinated for COVID who is admitted (on 9/21) for hypoxic resp failure 2/2 COVID, diagnosed 6 days PTA. He was started on dexamethasone and remdesivir for COVID on admission. He suffered from rapidly increasing oxygen requirements and after being placed on HFNC was started on baricitinib on 9/22. His O2 requirements stabilized and he was slowly weaned off oxygen and on RA on 9/27. While acutely ill he developed frequent PVCs and was started on coreg 3.125, but was unable to be titrated up to due to bradycardia. Discharge Disposition/Condition Disposition: Home with Home Health Condition: Stable (s/sx potential problems absent or manageable)

Other Meds: albuterol 108 (90 Base) MCG/ACT inhaler; aspirin 81 MG chewable tablet; benzonatate (Tessalon) 100 MG capsule; glipiZIDE XL (Glucotrol XL) 2.5 MG 24 hr tablet; azithromycin (Zithromax) 250 MG tablet; predniSONE (Deltasone) 20 MG tablet; all

Current Illness: none

ID: 1778787
Sex: M
Age: 37
State: TX

Vax Date: 09/30/2021
Onset Date: 10/02/2021
Rec V Date: 10/12/2021
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: Chest xrays, throat culture, and flu swab

Allergies:

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

Symptoms: Pneumonia, headache, breathlessness, chest pain, restless

Other Meds: Synthroid

Current Illness:

ID: 1778788
Sex: F
Age: 77
State: MI

Vax Date: 10/09/2021
Onset Date: 10/09/2021
Rec V Date: 10/12/2021
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: Client received a Moderna vaccine as a booster. Moderna was not approved for booster at the time of the vaccine administration. No adverse reaction was observed.

Other Meds:

Current Illness:

ID: 1778789
Sex: M
Age: 68
State: OH

Vax Date: 10/11/2021
Onset Date: 10/12/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: None

Allergies: Pennicillin

Symptom List: Pharyngeal swelling

Symptoms: Diarrhea Severe cramping gas loose stool

Other Meds: Allopurinol (Zyloprim)100mg Amlodipine besylate (Norvasc) 5mg Losartan potassium (Cozaar) 100mg Tamsulosin (0.4mg) Toprol (100mg) Allegra (seasonal allergies) Imodium to control proctitis symptoms 1x daily per doctor Low dose aspirin (8

Current Illness: None

ID: 1778790
Sex: M
Age: 69
State: FL

Vax Date: 02/09/2021
Onset Date: 07/20/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: Stress Test showed I was in Afib, EKG , echocardiogram, blood work showed calcium levels were high, they shocked me to get me out of Afib, I went right back into Afib.

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I had no problems and no symptoms, I could tell I was short of breath at times. I saw a cardiologist my calcium levels were high so I had a stress test and I was diagnosed with Afib. I'm going to have an ablation in about 3 weeks.

Other Meds: latanoprost eye drop, atorvastatin 40 mg, allopurinol 300 mg, metoprolol 25 mg, lansoprazole 30 mg, olmesartan 20 mg , vitamins

Current Illness: blood in my urine around 2nd shot, ended up being nothing

ID: 1778791
Sex: F
Age: 62
State: MD

Vax Date: 03/01/2021
Onset Date: 04/30/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: Brain MRI - negative Video Swallow - unremarkable Speech Consult - continuing upcoming appt 11/22 with Neurologist

Allergies: PCN, Elavil, Flagyl, Rocephin, Lamictal, Depakote, Latuda......swordfish

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Began w/ low grade temp X 1 week after 2nd inj. Then sore throat.... By mid May voice change (Dysarthria) Saw Neurologist 8/31

Other Meds: Lithium Carbonate 300mg 1 @ hs, Crestor 10 mg 1 @ am...... Fish Oil 1200, Zinc 100mg, Selenium 200mcg, D3 200mcg, Calcium 1000mg

Current Illness: Bipolar Disorder(dx at age 30) CKD3, Hashimoto Syndrome, Hypoglycemia Post Menapausal

ID: 1778792
Sex: M
Age: 65
State: VA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data:

Allergies: nka

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

Symptoms: pain in hands since vaccine; unresolved

Other Meds: allopurinol, Zocor, ASA, Vitamin D3, and vitamin D2

Current Illness:

ID: 1778793
Sex: F
Age: 47
State: PA

Vax Date: 02/24/2021
Onset Date: 08/10/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data: Blood work, ultrasound of Kidney and Heart, CAT scan, EKG (all 8/10, 8/11 and 8/12)

Allergies: Wellbutrin

Symptom List: Rash, Urticaria

Symptoms: Upset stomach, back pain, fever with quick onset. Went to ER 8/10 - was Septic. Admitted to hospital. Fluids. Course of Antibiotic. Discharged on 8/12. Diagnosed as kidney infection.

Other Meds: Amlodipine/Benazepril 5-40mg/ HCTZ 25mg

Current Illness: None

ID: 1778794
Sex: M
Age: 69
State: KY

Vax Date: 03/13/2021
Onset Date: 03/17/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: Chest x-ray; Bloodwork; COVID test.

Allergies: Sulfa; Tricor; Niacin

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

Symptoms: I was fine for the first 4 days after the vaccine aside from a sore shoulder. On the 4th day, I started having chills. I had a temperature of 102.3. My skin got very blotchy and white, which they called mottling. It would last 3-4 hours. As quickly as it started, it went away, and I felt like I was on fire. My temperature dropped to 94 and I was shaking. Then 3-4 hours after that I was halfway back to normal. I had an upset stomach and couldn't eat. Over the 15 days this lasted, I lost 15 lbs. I went to the doctor and a COVID test which was negative. The doctor advised to continue with the Tylenol and Advil because he was unsure what to do. Every 3-4 hours, this cycle would start all over again. During the fever, my hands would turn white as if they got frostbite all the way up my arms. All of this went away miraculously about 3 days before my 2nd dose. I was feeling good for those few days. Since then, I have had difficulty breathing, pain in my back and center of my chest. I also have lack of energy, and headaches. I went to the doctor where a chest x-ray was done. The x-ray came back as possible pneumonia. I was sent for a CT which showed thickening in the lungs. I was then sent for a stress test, echocardiogram which both came back normal.

Other Meds: Multivitamin; Regular Aspirin; Tylenol Arthritis

Current Illness: No

ID: 1778795
Sex: M
Age: 27
State: PA

Vax Date: 10/09/2021
Onset Date: 10/10/2021
Rec V Date: 10/12/2021
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: n/a

Allergies: apples

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

Symptoms: -fever persisting at roughly 100 degrees for multiple days -chills and overheating -fatigue -soreness -injection site sore

Other Meds: none

Current Illness:

ID: 1778796
Sex: M
Age: 56
State: VA

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/12/2021
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: Morphine Naloxegol

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

Symptoms: Patient received injection at a pharmacy, then came to my office to sit in the waiting room to monitor for reactions. Within a few minutes of arriving, he begin to have seizures. He was unresponsive. His wife reported that this was not unusual for him, although he had not had one in awhile. We moved him to a room. After a second seizure, we called 911. He was briefly lucid before a 3rd episode. He had a 4th episode prior to EMS arriving. They administered medications which appeared to resolve the seizures. He was transported to the ED, monitored, and discharged later the same day.

Other Meds:

Current Illness: Seizure Disorder.

ID: 1778797
Sex: F
Age: 38
State: FL

Vax Date: 03/14/2012
Onset Date: 08/12/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: 08/11/2021 PCR test done, 08/13/2021 Tested positive for Covid

Allergies: Penicillin, Aspirin

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

Symptoms: 03/21- Soreness in arm, 03/22- Fatigue, 08/11/2021- fever, chill, 08/13/2021 Loss taste and smell for a month, 09/13/2021- Sharp pains everywhere. Difficult to walk,

Other Meds: Symbicort asthma inhaler, vitamin D, Zinc

Current Illness: None

ID: 1778798
Sex: F
Age: 49
State: VA

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: EKG

Allergies: sulfa

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

Symptoms: Palpitations, SOB, dizziness, nausea

Other Meds: Vitamin D3

Current Illness:

ID: 1778799
Sex: F
Age: 44
State: CA

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 9/17/2021 lethargic, chills, foggy memory, light headed, rash on fire arms out of work til 9/24/2021 9/24/21 still lethargic 9/26/21 no prior symptoms ER with severe Kidney infection- peeing out blood clots out of work 9/28/21 9/28/21 back into ER tingling sensation in hand ,severe migraine 9/30/2- still continued sever headaches, lower back pain, out of work, fatigue, neck pain until Oct 5th, 2021 Until present time 10/12/21 still have fatigue, lower back pain, laying down breathing hurts more on left side, sore neck pain, lethargic still, head aches mild

Other Meds: Multi vitamins, vitamin C, osteo-flex, zyrtec

Current Illness: None

ID: 1778800
Sex: F
Age: 73
State: NC

Vax Date: 02/15/2021
Onset Date: 03/01/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: I had an MRI and a CT scan. All tests came back normal.

Allergies: I do not have any allergies.

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I was talking to my daughter on the phone and my right eye felt like I had something in it. My vision started getting dim. It would go back to normal, black, white, dim then back to normal. At one point I saw something round and white in my eye and a speck of blood attached. This last through the night into the next morning. In the afternoon, of the next morning, everything just stopped. I have not had any problems since that day.

Other Meds: I was taking atorvastatin 40mg, Meloxicam 7.5 mg, lisinopril 5mg, amlodipine 5mg, a multivitamin for over 50 years, calcium and baby aspirin 81 mg.

Current Illness: I did not have any illness.

ID: 1778801
Sex: F
Age: 42
State: NJ

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Pressure in left side of chest lasted about 15 seconds every four to five minutes for about 1 hour. No taquicardia. No heart pain.

Other Meds: None

Current Illness: None

ID: 1778802
Sex: F
Age: 55
State: CO

Vax Date: 10/11/2021
Onset Date: 10/12/2021
Rec V Date: 10/12/2021
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: None

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

Symptoms: Pt reports fever of 101 the day after vaccination. Pt advised to Proceed to PCP for evaluation

Other Meds: ASA, lipitor, prilosec, metformin, losartan, humalog, tresiba, breo ellipta, jardiance, trulicity, celxa

Current Illness: Not mentioned

ID: 1778803
Sex: F
Age: 27
State: OR

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: No Tests on Hives - Smart online Exam and diagnosis of Allergic Reaction. 10.11.21 Chest X Ray and EKG. - EKG Normal Range but High Resting Rate Chest X Ray no Results to date.

Allergies: Diagnosed - Allergies to Penicillin, Nuts (all but pine). Undiagnosed - Reactions to Wheat, Dairy, and other Inflammatory foods

Symptom List: Unevaluable event

Symptoms: I In office - Tightness of Chest. Pressure in Left Chest. Same Day Evening - Headache, Nausea, and shortness of breath. Next Day Morning - Headache, Nausea, randomized Tightness in chest breathing normal, normal heart rythum Next Day Evening - Headache, Nausea, randomized Tightness in chest ,Welts on legs itchy. Friday Morning - Burning sensation throughout the legs, HIVES all over the legs, felt like Fire. Tightness in Chest Friday - forward - Random sets of Chest Pressure, concern of Heart palpatations, and lung capacity.

Other Meds: Wixela - Daily Asthma Medication Biotin - Daily Unknown Dosage Collagen - Daily Unknown Dosage

Current Illness:

ID: 1778804
Sex: M
Age: 69
State: KY

Vax Date: 04/10/2021
Onset Date: 04/13/2021
Rec V Date: 10/12/2021
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: Pulmonary function test COVID test

Allergies: sulfa, niacin, tricor

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

Symptoms: About 3 days after the 2nd dose, I started having fever and chills with blotchy skin. I was having difficulty breathing s well. I would have fever and chills for 3-4 hours. Then extreme heat for 3-4 hours. The same cycle as the 1st dose. This lasted 8 days. Then, it pretty much cleared up except for the difficulty breathing. I also had a COVID test done which was negative. I had a pulmonary function test regarding the difficulty breathing. This came back normal. It was about the same as the first dose, but it cleared up a lot quicker. I still have a cough, runny nose, pain in my back, and difficulty breathing.

Other Meds: Multivitamin, Tylenol, aspirin

Current Illness: No

ID: 1778805
Sex: F
Age: 34
State: KY

Vax Date: 08/23/2021
Onset Date: 09/22/2021
Rec V Date: 10/12/2021
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: COVID PCR confirmed positive on 09/22/21

Allergies: haloperidol ibuprofen trazodone

Symptom List: Injection site pain, Pain

Symptoms: Pt is a 34 y.o. female with PMH significant for HIV not on treatment, bipolar disorder, schizoaffective disorder presented to hospital due to generalized lethargy/myagia with fever and cough. Noted to be hypotensive on initial presentation and was started on empiric antibiotics coverage for potential sepsis. COVID-19 Positive Constitutional: Positive for chills, fatigue and fever. HENT: Negative for congestion. Eyes: Negative for visual disturbance. Respiratory: Positive for cough. Negative for shortness of breath. #COVID-19 infection - Febrile and tachycardic on presentation with cough, fever and general malaise, but not hypoxic, good saturation on room air. - Unknown onset date of symptoms. - COVID PCR 9/22/21. - Blood cultures in lab. -Inflammatory markers are low. - Per chart reviewed, patient received J-J vaccine a month before. - Chest X ray without consolidations. - Not a Candidate for remdesivir or dexamethasone at the time. - Not a candidate for Barcitinib at this time. Discharge Disposition/Condition Disposition: Homeless, tentatively temporary shelter arranged Condition: Stable (s/sx potential problems absent or manageable)

Other Meds: olanzapine

Current Illness: admitted to 9/4 to 9/6/21 for sepsis 2/2 UTI vs LLL PNA

ID: 1778806
Sex: M
Age: 42
State: CA

Vax Date: 08/12/2021
Onset Date: 09/28/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: None so far just a hospital visit with no doctor examination

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Weeks after I receive the second dose I started feeling heart flutters and pain in my chest as well as some trouble breathing went to the hospital but did not see a doctor because of the 12-hour wait but I'm pretty worried about the outcome of the results when I do .

Other Meds: None

Current Illness: None

ID: 1778807
Sex: F
Age: 41
State: SD

Vax Date: 10/10/2021
Onset Date: 10/11/2021
Rec V Date: 10/12/2021
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:

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

Symptoms: I have a huge welt elbow to shoulder all the way around my arm that is extremely red, hot, and painful. Very swollen and sore.

Other Meds: Adderall 30mg

Current Illness:

ID: 1778808
Sex: U
Age: 44
State:

Vax Date: 01/25/2021
Onset Date:
Rec V Date: 10/12/2021
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 stated.

Other Meds:

Current Illness:

ID: 1778809
Sex: F
Age: 57
State: OH

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: EKG, chest X-Ray, blood tests

Allergies: Coedine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: The day after vaccine, I started experiencing cardiac arrhythmia, which continued to get worse. On Thursday night, (2 days after vaccine) it was so bad I couldn't sleep and thought I might be having a heart attack. Friday morning I went to the ER. A chest X-Ray showed my heart was enlarged, but they said it was probably a reaction to the vaccine, I wouldn't die and they sent me home

Other Meds: Magnesium, Calcium

Current Illness: none

ID: 1778810
Sex: F
Age: 74
State: WI

Vax Date: 09/27/2021
Onset Date: 09/28/2021
Rec V Date: 10/12/2021
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: Normal cardiac echo. CT did not show emboli, Extensive infectious and fungal studies negative. Peak CRP 24.8

Allergies: mirtazepinie causes rash

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

Symptoms: Fever and dyspnea within 24 hours, then acute respiratory failure with hypoxia. Admission 9/30 to 10/3. CT chest showed non-cardiogenic edema and effusions. DID NOT require intubation. . Started on methylpred. Now on oral prednisone taper. Improving as of 10/12/2021

Other Meds: pantoprazole, trazodone

Current Illness: UTI with treatment nirtofurantoin 9/23 to 9/30

ID: 1778811
Sex: F
Age: 90
State:

Vax Date: 03/15/2021
Onset Date: 10/11/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data: COVID + 10/11/21

Allergies:

Symptom List: Nausea

Symptoms: Hospitalized with breakthrough infection

Other Meds:

Current Illness:

ID: 1778813
Sex: F
Age: 40
State: MI

Vax Date: 08/30/2021
Onset Date: 09/02/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: ECG on 9/11 and 9/15, an echocardiogram on 9/28 , and am awaiting a cardiac MRI and stress test.

Allergies: gluten sensitivity

Symptom List: Injection site pain

Symptoms: 3-4 days after vaccination my heart beat started to be irregular and I breathed harder while active, this escalated until I went to urgent care 11 days after vaccination. I have been diagnosed with pericarditis, pleuritis, and overactive neutrophils. In addition to heart inflammation which causes chest pain, especially after any activity, I have had post-covid syndrome. This includes: headaches, brain fog, extreme fatigue. I also have had some nerve numbness in my arms and leg. These symptoms will occasionally lessen with high doses of ibuprofen, but have come back after stopping ibuprofen.

Other Meds: multivitamin, fish oil, Mg citrate, zinc, quercetin

Current Illness: none

ID: 1778814
Sex: M
Age: 85
State:

Vax Date: 09/30/2021
Onset Date: 10/11/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data:

Allergies:

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

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: 1778815
Sex: M
Age: 56
State: MI

Vax Date: 05/04/2021
Onset Date: 09/30/2021
Rec V Date: 10/12/2021
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: Contains abnormal data SARS-COV-2 (COVID-19)

Allergies: Ace Inhibitors; Codeine; Dabigatran; Dicloxacillin; Erythromycin; Fentanyl; Hydrocodone-acetaminophen; Ketorolac Tromethamine; Oxycodone-acetaminophen; Penicillins; Sulfa Antibiotics; Tramadol; Tramadol-acetaminophen; Bentyl; Penicillins; Rivaroxaban; Eliquis [Apixaban]

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

Symptoms: 9/30/21 COVID Test Resulted Positive, tested due to fever spike. 10/2 ED Visit: Pt to ED via EMS c/o generalized body aches and chills, + COVID, pt reports he was standing and began shaking all over with chills causing him to fall, unknown LOC, pt reports posterior neck and back pain. C-Collar applied at time of triage.

Other Meds: albuterol; bictegravir-emtricitabine-tenofovir ALAFENAMIDE; famotidine; fluticasone; LEVOthyroxine; loratadine; montelukast; ondansetron; pregabalin; promethazine; warfarin

Current Illness: 4/19/21 Acute bilateral deep vein thrombosis (DVT) of femoral

ID: 1778816
Sex: M
Age: 46
State: KY

Vax Date: 05/12/2021
Onset Date: 10/06/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: Antigen test taken on 10/08/2021

Allergies: Unknown

Symptom List: Tremor

Symptoms: Patient contracted COVID-19

Other Meds: Unknown

Current Illness: None

ID: 1778817
Sex: F
Age: 47
State: NC

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 10/12/2021
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: Penicillin, Demerol, hydrocodone

Symptom List: Erythema, Pruritus

Symptoms: I developed a numbness in my tongue and left hand fingers that night of injection and I still have it even after my second vaccine.

Other Meds: D3, folic acid, zinc, tumeric, biotin, magnesium, vitamin c, ambien, topiramate, omeprazole, adder adderall, digestive enzymes

Current Illness:

ID: 1778818
Sex: M
Age: 26
State: GA

Vax Date: 09/01/2021
Onset Date: 09/06/2021
Rec V Date: 10/12/2021
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: trop pending EKG normal BNP, CBC, lipid, CMP normal ESR mildly elevated for age, 19 Echo pending 14 Oct 21

Allergies: none

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

Symptoms: dev chest pain, dyspnea, exercise intolerance starting 4-5 days after second shot. Symptoms progressed over the next couple weeks.

Other Meds: none

Current Illness: none

ID: 1778819
Sex: F
Age: 70
State: FL

Vax Date: 10/01/2021
Onset Date: 10/06/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: Dr at walk-in clinic gave me a tetanus-diphtheria

Allergies: nka

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

Symptoms: Wednesday night I started experiencing pretty severe chills (had happened with dose #2 so I was expecting it). Chills off and on through Thursday. Headaches. Tiredness. At some point Friday I fainted (had not happened before), but do not remember many details. I called a friend to pick me up & take me to walk in clinic. I do not remember much from that visit. My friend would be very happy to provide additional details as my memory is foggy. The gash required 3 stitches which come out Thursday. I have a black eye, swollen nose (not broken), contusions on both elbows, and a huge bruise on one hip. My permanent damage will be an unsightly scar across my forehead.

Other Meds: ASA 81 mg Omeprazole 20 mg Lutein 20 mg Amlodipine 2.5 mg Ambien 10 mg Gabapentin 100-300 mg bisphosphonate calcium/vitamin D azelastine flonase

Current Illness: none

ID: 1778820
Sex: M
Age: 62
State: TX

Vax Date: 04/01/2021
Onset Date: 08/10/2021
Rec V Date: 10/12/2021
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 - this is very visible and easy to search for what it is

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sudden circular patches of hair falling out - left side of head. Appears to be sudden Alopecia Areata with no family history of such.

Other Meds: 81mg aspirin, CoQ10, Krill Oil

Current Illness: None

ID: 1778821
Sex: M
Age: 31
State: MO

Vax Date: 09/29/2021
Onset Date: 09/30/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: Complete blood work taken on 10/04/21 due to employment requirements with no outliers or reason for ongoing pain starting after second dose.

Allergies: None

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

Symptoms: Moderate to severe pain in joints to include wrists, elbows, ankles, and knees. No previous history of ongoing pain in any joint. Lingering pain causing difficulty completing common tasks and the inability to sleep through a night.

Other Meds: None

Current Illness: None

ID: 1778822
Sex: F
Age: 44
State: OH

Vax Date: 10/12/2021
Onset Date:
Rec V Date: 10/12/2021
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: Pt has follow up appt in our office on 10/15/21 Antibody test 3 weeks after incident

Allergies: NKA

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

Symptoms: Pfizer was reconsituted with 0.8 ml diluent instead of 1.8 ml. Pt received a 0.3 ml dose before error was discovered.

Other Meds: Albuterol HFA Nicotine patch prednisone Spiriva Lamictal Oxybutynin Paxil Ventolin

Current Illness: SOB

ID: 1778823
Sex: F
Age: 48
State: TX

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: Chest X-ray, Covid 19 test (negative)

Allergies: Penicillin drugs and sulfa drugs

Symptom List: Pain in extremity

Symptoms: I had a metallic taste in my mouth for about two days. My immune system went completely haywire. My oxygen saturations dropped to 95. I had trouble breathing and my allergy asthma doctor had to put me on additional medication's. This included a steroid shot a round of steroids and anabiotic's. That didn't work so I had to be put on a nebulizer treatment of albuterol, that didn't work so I had to be put on a twice a day nebulizer treatment of Pulmicort. I had to receive a chest x-ray to see if I had pneumonia. I had to Have a COVID-19 test to see if I had Covid. So one urgent care visit to physician visits a visit to get an x-ray and multiple new medication's all of which on this date I still don't feel 100% over a week later. I have missed 3 to 4 days of work which I normally do not miss any days due to not feeling well.

Other Meds: Symbicort, singulair, lexapro

Current Illness: Seasonal allergies

ID: 1778824
Sex: F
Age: 64
State:

Vax Date: 04/06/2021
Onset Date: 10/09/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: COVID 19

Other Meds:

Current Illness:

Date Died: 10/10/2021

ID: 1778825
Sex: M
Age: 74
State:

Vax Date: 10/07/2021
Onset Date: 10/10/2021
Rec V Date: 10/12/2021
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: Pt received COVID booster shot (3rd dose) on 10/7/21. On 10/10/21 pt was found unresponsive/ no pulse/no resp. Hospice nurse pronounced death at 0820 on 10/10/21

Other Meds:

Current Illness:

ID: 1778826
Sex: F
Age: 87
State: MI

Vax Date: 09/15/2021
Onset Date: 09/19/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: Ultra sound 10/6/21 and 10/13/21

Allergies: Macrobid, compazine, percocet, morphine sulfate

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

Symptoms: blood clot in leg 4 days following 2nd dose

Other Meds: Levothyroxin, nexium, Venlaxine

Current Illness: none

ID: 1778827
Sex: M
Age: 70
State: TN

Vax Date: 10/08/2021
Onset Date: 10/10/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data: EKG, heart catheterization on 10/11/21

Allergies: pseudophed

Symptom List: Vomiting

Symptoms: Symptomatic, sustained ventricular tachycardia

Other Meds: Amlodipine, aspirin, atorvastatin, CoQ-10, diclofenac, docusate, hydrochlorothiazide, pantoprazole, psyllium husk, turmeric, valsartan

Current Illness: none

ID: 1778828
Sex: F
Age: 61
State: NJ

Vax Date: 10/10/2021
Onset Date: 10/12/2021
Rec V Date: 10/12/2021
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: The day after the shot, I developed a fever of 102.4. During the night, I developed a headache so bad I couldn't sleep. When I got up to take Tylenol, I fainted on the bedroom floor.

Other Meds: None

Current Illness: None

ID: 1778829
Sex: F
Age: 69
State: MO

Vax Date: 10/05/2021
Onset Date: 10/06/2021
Rec V Date: 10/12/2021
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:

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

Symptoms: skin rashes on both arms, groin area and legs . Patches of itchy bumps and area of raised, red itchy hives. Still have thse bumps today 10/12/2021 Fever over 100 degrees the following day 10/7/2021. gnawing headache for 4 days 10/7/2021 to 10/10/2021

Other Meds:

Current Illness:

ID: 1778830
Sex: F
Age: 31
State: KY

Vax Date: 10/01/2021
Onset Date: 10/08/2021
Rec V Date: 10/12/2021
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: at home mobile ecg test

Allergies: NA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: severe daily headaches, episodes of sudden onset tachycardia possible SVT for less than 15 min.

Other Meds: celexa 20mg Drospirenone

Current Illness: NA

ID: 1778831
Sex: M
Age: 12
State: KS

Vax Date: 09/06/2021
Onset Date: 09/08/2021
Rec V Date: 10/12/2021
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: NKA

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

Symptoms: First Covid Vaccine: Aug 15 Second Covid Vaccine: Sept 6 2-3 days after second dose couldn't walk because of leg fatigue. Dragging legs because he felt like he could not move. Muscle cramps. Leg tingling in the morning and throughout the day. Bilateral jaw pain. Tylenol given. Running and jogging helps alleviate the pain. He is not having difficulty breathing. I advised the following: Ibuprofen as needed for pain. Take a daily multivitamin. Continue to exercise as tolerated. Report his symptoms to the vaccine adverse effects hotline. Seek medical attention if he is having difficulty breathing. Mother aware and in agreement with this plan.

Other Meds: None

Current Illness: NA

ID: 1778832
Sex: M
Age: 50
State:

Vax Date: 10/08/2021
Onset Date: 10/11/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Vertigo. Couldn't walk straight. Nausea Called doctor's office. I was told it likely wasn't a result of the vaccine since it had been 3 days since shot. It was suggested to take Meclizine. I got Meclizine 25mg from a family member and took it. Felt better after a few hours.

Other Meds: Alfuzosin Hcl Er, 10mg. I have been taking this for 3 weeks. No issues

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am