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: 1779092
Sex: F
Age: 66
State: CA

Vax Date: 10/11/2021
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: NONE

Symptom List: Dysphagia, Epiglottitis

Symptoms: CONSENT FORM SAYS MODERN VACCINE 3RD DOSE ; WAS GIVEN PFIZER BIOTECH VACCINE INSTEAD WAS OK NO SIGNS OR SYMPTOMS AND MD NOTIFIED AND SAID NOTHING WILL HAPPEN

Other Meds: NONE

Current Illness:

ID: 1779093
Sex: F
Age: 49
State: CA

Vax Date: 09/21/2021
Onset Date: 09/23/2021
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:

Allergies: minocycline

Symptom List: Anxiety, Dyspnoea

Symptoms: severe mentrual cramping now for two months in a row ( I haven't had severe mentrual cramping since by ablation several years ago)

Other Meds: none

Current Illness: none

ID: 1779094
Sex: F
Age: 22
State: AZ

Vax Date: 02/01/2021
Onset Date: 06/01/2021
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: Bloodwork 07/2021 Bloodwork 10/21 EKG 08/2021 Halter Monitor 08/2021 XRay of Heart 08/2021

Allergies:

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

Symptoms: Daily muscle twitches, as well as palpitations and chest pain. My doctor is doing tests currently to figure out what?s wrong. Been happening since around June

Other Meds: Zyrtec, Flonase, Blisovi FE

Current Illness:

ID: 1779095
Sex: F
Age: 47
State: AK

Vax Date: 10/08/2021
Onset Date: 10/10/2021
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: None

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Very swollen and sore lymph glands under left arm. Tennis-ball size lump persisting five days after vaccine with no change. Treatment has been OTC ibuprofen. I have not yet contacted my doctor.

Other Meds: Lamotrigine, Metoprolol, Spironolactone

Current Illness: None

Date Died:

ID: 1779096
Sex: U
Age: 74
State:

Vax Date: 03/03/2021
Onset Date: 09/15/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: fully vaccinated pt died of covid after getting remdesivir.

Other Meds:

Current Illness:

ID: 1779097
Sex: M
Age: 73
State: TN

Vax Date: 10/07/2021
Onset Date: 10/08/2021
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: 10/8/21 EKG, CAT scan, x-rays, blood work all came back normal. I was discharged with Rx's for lidocaine patch and hydrocodone 5-325. No broken bones/dislocations.

Allergies: none

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

Symptoms: I got up to use the bathroom about 4am. I got dizzy and the next thing I know I was on the floor in extreme pain in my left shoulder and arm. I was also hurting in my ribs. When my wife heard the fall, she rushed in to the bathroom to see what happened. She checked on me to see what was wrong. Within a minute or two she also got very dizzy and sick to her stomach. She sat down on the commode and put her head down between her knees. The next thing I know she is falling off the commode. I called to her several times before she answered. She finally got up but got dizzy again. I took several minutes before it began to wear off. We had to figure out how to get me off the floor as I am twice the size of my wife. I propped my foot against the door. I was finally able to get on one knee. There was no way I was going to use my left arm/shoulder. I was in too much pain. I was eventually able to get up on both knees and then to my feet. She helped me back to the bed. We both laid back down. That morning (~10am) we went to Hospital ER to get checked out. I was still in extreme pain. My wife seemed to be doing okay. She also filed an adverse reaction report.

Other Meds: Saw Palmetto 450 mg whole herb. 1-2x/day Centrum Silver 1/day in AM Super B Complex B 1/day in PM Zyrtec (Aller-Zyr) 1/day in PM Vitamin D3 gummy 50 mcg 200 IU. 2/day at PM Probiotic Gummies 500 Million CFU Anti-Diarrheal PRN GlipiZIDE 10 M

Current Illness: none

ID: 1779098
Sex: M
Age: 60
State: IA

Vax Date: 04/13/2021
Onset Date: 05/19/2021
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: LA

Lab Data: 5/21/21: echocardiogram EF 45-50%, small to moderate pericardial effusion 6/1/21: Echo EF 40%, large circumferential pericardial effusion with diastolic compression of the RV suggestive of cardiac tamponade 6/1/21: Successful pericardiocentesis, over 1200 mL withdrawn. Complicated by Rapid atrial fibrillation, Amiodarone initiated. 6/3/21: Echo EF 40-45%, no pericardial effusion 7/12/21: Echo EF 51%. Minimal circumferential pericardial effusion, not hemodynamically significant. 7/26/21: Cardiac MRI. EF 49%, idiopathic dilated cardiomyopathy with mild LV systolic dysfunction without any cardiac MR evidence of myocardial edema, infiltration, or prior infarction. Normal pericardial thickness with trivial circumferential pericardial effusion. Inflammatory Markers: CRP 1.5 on 6/18/21, CRP 4.0 6/24/21, CRP 0.7 7/2/21, CRP 5.6 7/8/21, CRP 0.4 10/11/21

Allergies: No Known Drug Allergies

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pfizer dose #1 administered 3/17/21 Lot EN6208, Dose 2 administered 4/13/21. Patient presented to Hospital 5/21/21, hospitalized, and ultimately diagnosed with pericarditis and discharged on NSAID. During this hospitalization, an echocardiogram revealed a reduced ejection fraction of 45-50% and a small pericardial effusion thought to be secondary to Pericarditis. He was readmitted 6/1/21 after presenting with progressive shortness of breath and edema. He was found, at that time, to have a large compromising pericardial effusion with cardiac tamponade requiring pericardiocentesis for 1200 ml.

Other Meds:

Current Illness:

ID: 1779099
Sex: M
Age: 53
State: GA

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:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Low grade headache, Injection site soreness, log grade body aches, moderate fatigue.

Other Meds: Prilosec (40 Mg), Krill Oil (30 MG), Low-dose aspirin.

Current Illness: None

ID: 1779101
Sex: F
Age: 58
State: GA

Vax Date: 09/08/2021
Onset Date: 09/09/2021
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: Self reported to physician on 9/24/21

Allergies: Keflex, betadine tincture

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Loss of balance, sensory deficits, fuzzy thinking, confusion, ADHD behavior, depression, fever, fatigue

Other Meds: Oxybutynin, Pravastatin, Doxycycline

Current Illness: Side effects at 1st Pfizer dose on 7/31/21

ID: 1779102
Sex: F
Age: 71
State: NC

Vax Date: 10/12/2021
Onset Date: 10/12/2021
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:

Allergies: NKA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: about 5 minutes after having her first COVID vaccine. When she all of the sudden fell back and started shacking. Patient had altered mental status, slurred speech and was unable to move or respond to staff. EMS was called and patient was transported to hospital.

Other Meds: Zanafelx, atenolol, quetiapine, ibuprofen, aspirin, hydrocodone,

Current Illness: Left wrist fracture, High blood pressure, back pain, arthritis,

ID: 1779103
Sex: F
Age: 69
State: CA

Vax Date: 04/03/2021
Onset Date: 08/01/2021
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

Allergies: Anything gluten

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

Symptoms: 08/01/2021 that evening I thought I contract poison ivy, there was a rash between my fingers. I went to my local clinic 08/02/2021 the doctor prescribed prednisone. 08/03/2021 It spread around my hip and to the spine. I spoke with my local doctor on 08/12, and I was prescribed a topical cream and told me to take Zyrtec. It had spread to my head by that point. It began to clear up 08/27/2021.

Other Meds: Vit C; Centrum for 50+; AREDS; probiotics; turmeric; D3; omega 3; calcium; vit B complex; glucosamine chondroitin.

Current Illness: Stress

ID: 1779104
Sex: M
Age: 89
State: MI

Vax Date: 01/28/2021
Onset Date: 10/01/2021
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:

Allergies: no known allergies

Symptom List: Rash, Urticaria

Symptoms: Pt received Moderna vaccines on 01/28/2021 and 02/25/2021. Pt presented to the ED on 10/04/2021 after testing positive for COVID-19 outpatient on 10/01/2021. Pt complained of fatigue, weakness, myalgias, cough, congestion, and SOB. He was diagnosed with COVID pneumonia and was started on Remesivir for 5 days. Pt was discharged back to his nursing home on 10/08/21. Pt presented back to the ED on 10/11/2021 with complaints of hypoxia. Pt was admitted to the ICU and was intubated secondary to hypoxia.

Other Meds: Imdur, lopressor, coumadin, tylenol, duoneb, lipitor, proscar, prinivil, miralax, flomax, multi-vitamin

Current Illness:

ID: 1779105
Sex: M
Age: 34
State: TX

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Received vaccine on the 29th. That night I had a fever, body aches, and headache. On the 30th I woke up to my left arm being swollen underneath. It was painful and very large, fluid filled. I was told it was lymphedema by Dr. who was in my department, the OR, at the time. It last about two weeks and has finally subsided. Nobody knew exactly why this happened after my vaccine.

Other Meds: Men's One a day Vitamin Advil

Current Illness: None

ID: 1779106
Sex: F
Age: 28
State: UT

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: none

Allergies: none

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

Symptoms: Toward the evening and night of that same day I started to feel sick. I took some ibuprofen, and then went to bed. Around that time I started my period and it was a lot heavier. However, I did get a birth control implanted in my arm a few months before getting the vaccine. Since then my period has gotten less and less. After about a week of getting the vaccine, I started to feel back pain with two muscles in my back that would hurt.

Other Meds: none

Current Illness: unknown

ID: 1779107
Sex: F
Age: 32
State: MA

Vax Date: 09/15/2021
Onset Date: 09/15/2021
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: 9/29/2021

Allergies: Penicillin

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

Symptoms: The night I got my vaccine, I started to experience muscle twitching in my left leg. This was a month ago and I experience muscle twitching daily all around my body - leg, buttocks, feet, eye, face. I went to my doctor about this and got blood work done and all my labs were normal. My doctor suggested I see a Neurologist if the twitching doesn't stop. I have never experienced muscle twitching before the vaccine.

Other Meds: None

Current Illness: None

ID: 1779108
Sex: F
Age: 45
State: VA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data: 7-1-21 PCP Evaluation, 7-13-21 Ortho Evaluation, 7-13-21 X-rays (negative for breaks), 9-8-21 Shoulder Manipulation Surgery, 9-24-21 Ortho Evaluation

Allergies: Aspirin, Prednisone, Bee Stings, Seasonal

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

Symptoms: The first dose of the vaccine was fine. Just felt a little ill. The second dose was terrible. I woke up the next day and felt like there was a block of concrete in my arm and shoulder. I couldn't move it at all. I had flu-like symptoms for about 5 days, which resolved on its own with no issue. The arm and shoulder, on the other hand, did not resolve. I had very little range of motion, painful shooting pains when the arm and shoulder were used, and there was swelling. I could not get dressed, wash or brush my hair, cook or clean, lift anything or complete even the most simple tasks at work. Driving was very difficult. Sleeping was nearly impossible. After 4 months and deciding that my arm and should were not going to get better on their own, I went to my PCP where I was told I had bicep tendonitis and adhesive capsulitis (frozen shoulder). My PCP thought it was caused by the vaccine being injected into the joint in the shoulder rather than the muscle. She provided me with pain medication and I was referred to an orthopedist. Dr did a thorough examination, took ex-rays, gave me a cortisone injection, and sent me to physical therapy. He didn't know if the issue was caused by giving the vaccine in an incorrect location or if it was just my body's reaction to the vaccine. After several weeks of physical therapy and very little improvement, I had shoulder manipulation surgery and another injection of cortisone. I was provided with pain medication and I had physical therapy every day for another two weeks. I'm at about 90% mobility now. It is extremely unlikely I'll ever be back to 100%. I can perform most day-to-day tasks with little to no pain. I continue with daily physical therapy exercises at home. My pocket book is still hurting.

Other Meds: Valacyclovir, Rosuvastatin, Metformin, Citalopram, Bupropion, Montelukast, Mirena, Nexium, Pepcid, Xyzal, Probiotics, Lysine, Calcium, Zinc Quercetin, Vitamin D3, Multivitamin, Fiber, Vitamin C, and Melatonin.

Current Illness:

ID: 1779109
Sex: F
Age: 61
State: NJ

Vax Date: 02/10/2021
Onset Date: 02/18/2021
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: none

Allergies: none

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

Symptoms: 1. muscle cramps/spasms in legs and feet. Do not remember exact timing. Usually at night. In the past, prior to my Covid vaccine I've had this however it was linked to a medication (Metformin) which I had stopped taking several weeks prior to the vaccine and have not restarted. 2. unexplained bruise - I didn't pay attention to this at first however it continued after my 2nd vaccine (will report again)

Other Meds: Enalapril, Montelukast, Januvia, Mybetrig, Vitamens C & D, Magnisium, zinc, Curalin, Kalmegh (tea)

Current Illness: none to the best of my recollection NOTE: Date event started is approximate, do not remember exactly

ID: 1779110
Sex: F
Age: 79
State: KY

Vax Date: 02/09/2021
Onset Date: 10/11/2021
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: Postive Covid-19 Antigen Test

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Lost taste and Smell , Cough, sinus drainage and got tested for Covid-19

Other Meds:

Current Illness:

ID: 1779111
Sex: F
Age: 74
State: IN

Vax Date: 10/08/2021
Onset Date: 10/09/2021
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: None

Allergies: Unknown

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Hard Red lump at injection site. Not resolved by heat or ice.

Other Meds: Unknown

Current Illness: Unknown 3rd dose

ID: 1779112
Sex: F
Age: 68
State: IA

Vax Date: 08/30/2021
Onset Date: 09/08/2021
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: Lab tests Sept 30

Allergies:

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

Symptoms: Dizziness, fainting, brain fog, hands shaking, internal vibration, tinnitus right ear, pressure in chest, feeling disconnected from self to such a degree felt suicidal (one day only). On all days to date, doing smallest things like writing a simple email for 10 minutes, or any kind of focus-- talking on phone, etc , will suddenly make me feel panic and I feel lightheaded and start to pass out (note this side effect is ongoing in week 6 but to lesser degree). Feel very rundown--this is ongoing. All side effects are ongoing in week six except chest tightness.

Other Meds: None

Current Illness: None

ID: 1779113
Sex: F
Age: 71
State: IN

Vax Date: 02/06/2021
Onset Date: 10/11/2021
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: COVID-19 test with a positive result.

Allergies:

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

Symptoms: Patient was vaccinated for COVID-19 on 1/16/21 and 2/6/21, so was fully vaccinated when testing positive for COVID-19 on 10/11/21.

Other Meds:

Current Illness:

ID: 1779114
Sex: F
Age: 20
State:

Vax Date: 09/22/2021
Onset Date: 09/30/2021
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:

Allergies:

Symptom List: Unevaluable event

Symptoms: feather

Other Meds: feather

Current Illness:

ID: 1779115
Sex: M
Age: 32
State: MI

Vax Date: 03/26/2021
Onset Date: 04/23/2021
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: Since the visit to the Emergency Room in June 2021 and an ultrasound of the affected area, I have been in physical therapy trying to recover and have not had improvement. My physical therapist as of last week informed me to reach out to my doctor for further study to include an MRI with contrast. I am still awaiting for an appointment.

Allergies: None

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

Symptoms: 1 dose: soreness that did not go away. 2 dose: Severe pain that resulted going to the emergency room several weeks later. It kept me awake and I cannot sleep on my left side. Pain comes and goes sporadically. Shap pains with burning sensations.

Other Meds: None

Current Illness: None

ID: 1779116
Sex: M
Age: 69
State: CA

Vax Date: 04/04/2021
Onset Date: 08/26/2021
Rec V Date: 10/12/2021
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: Patient describes 2 weeks with high fevers and diaphoresis. He has been having temperatures over 100 for several days despite taking extra strength Tylenol 2 tabs every 4-6 hours. Patient has also been having body aches and headache. Also with productive cough of clear phlegm. Denies shortness of breath

Other Meds:

Current Illness:

ID: 1779118
Sex: F
Age: 63
State: CA

Vax Date: 04/07/2021
Onset Date: 09/20/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: EKG; MRI; COVID - Negative.

Allergies: No

Symptom List: Injection site pain, Menorrhagia

Symptoms: No reaction to vaccine but had diagnosed with sepsis. I left the hospital and went back 4Oct2021, sounded like I had pneumonia and had sepsis. Patient left the hospital. Pt did not have lot number, has no vaccination card.

Other Meds: Potassium; Vitamin D3; Coreg; Lialda; Statin; Zocor; Norvasc; Protonix; Lasix; Neurontin

Current Illness: Yes, at the hospital - cellulitis.

ID: 1779119
Sex: F
Age: 72
State: IN

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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: None

Allergies: Supfa

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

Symptoms: Fever of 101 for 3 days Body aches Significant headache for 4 days Vomiting X3 day after shot Loss of appetite Deep fatigue Loss of taste which continues And metallic taste with some foods which continues

Other Meds: Metoprolol-50 mg. 2x/day Warfarin- 2.5 mg 4 days/week & 5 mg 3 days/week Ropinirole-2mg 1 hs Pantoprazole-40 1x/day Famotidine? 20 mg 2x/ day Potassium? 99 mg 1x/day Atorvastatin?10 mg 1x/day Areds 2 Eye Caps ?2x/day Bupropion-SR 100 mg 2x

Current Illness: Had a UTI 3 weeks prior to vaccination

ID: 1779120
Sex: M
Age: 48
State: MI

Vax Date: 04/08/2021
Onset Date: 09/24/2021
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: PCR COVID positive on 10/5/21

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: COVID Vaccine Breakthrough. COVID+ on 10/5/21. Symptom onset 9/24/21. Patient is not hospitalized due to COVID, but due to other factors. At this time, the patient has no fevers and is on room air.

Other Meds:

Current Illness:

ID: 1779121
Sex: F
Age: 67
State: MI

Vax Date: 03/01/2021
Onset Date: 09/23/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data:

Allergies: iodine, sulfa antibiotics, ciproflaxacin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt received Pfizer vaccines on 03/01/2021 and 03/22/2021. Pt presented to the ED on 09/30/21 with complaints of difficulty breathing and found to be at 71% oxygen saturation on room air. Pt noted to test positive with COVID on 09/23/21. ID diagnosed pt with COVID pneumonitis requiring supplemental oxygen.

Other Meds: xanax, celexa

Current Illness:

ID: 1779122
Sex: F
Age: 57
State: MA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: neuro exam (balance etc) physical therapy for vertigo

Allergies:

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

Symptoms: Immediately after getting the vaccine, I felt a rush. I felt a little lightheaded, but I was okay on my drive home I felt very lightheaded and dizzy. I almost fainted in the car. I felt like my vision was weird. I don't see double, but I feel that my vision doesn't line up like it used to. I think this is permanent. This happened within 20 minutes. I also got vertigo within 20 minutes as well. After that, it felt like I was on a boat. If I turned my head too fast things moved too quickly. I felt off balanced as if I was in a boat. I felt tired and sick as well. After the vaccine I also got severe headaches and head pressure. I also experienced tinnitus and my ears felt as if they were spasming inside. This has gotten better over a few months and went away. I do still get headaches more often. The vertigo waned over a few months and is now basically gone. The first night after the 1st dose, I also had a pounding heart palpitation which I usually get when I am really sick. For my second shot, within 24 hours, I had sore arm, nausea, fatigue etc which all went away in a few days. I saw an NP for the vertigo who told me to take Ativan which helped significantly. I then found out that you need to stop taking the Ativan in order for your brain to cure the vertigo. So, I stopped taking the Ativan and within 3 days, it had improved and eventually went away. I am supposed to go for a full vestibular testing (4hrs) but I feel I am okay for now so I have put it off. Based on his full evaluation, he suggested I have vestibular neuritis. He said that this happening so soon after the vaccine, it was possible the vaccine could've caused it. One morning in August, I had blurred vision in my right eye. I went to the ER but it had resolved by the time they evaluated me.

Other Meds: Albuterol; Diltiazem

Current Illness: bad cold sore in my mouth accompanied with headache, tingling/burning, ill feeling

ID: 1779123
Sex: F
Age: 44
State: IN

Vax Date: 04/24/2021
Onset Date: 10/08/2021
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: Sofia Antigen COVID-19 test with a positive result.

Allergies:

Symptom List: Nausea

Symptoms: Patient was vaccinated for COVID-19 on 4/3/21 and 4/24/21, so was fully vaccinated when testing positive for COVID-19 on 10/8/21.

Other Meds:

Current Illness:

ID: 1779125
Sex: F
Age: 71
State: MI

Vax Date: 09/18/2021
Onset Date: 09/19/2021
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:

Allergies:

Symptom List: Injection site pain

Symptoms: Patient complains of prolonged tenderness to the shoulder area especially when raising her hand above the shoulder level. The patient doesn't complain of any tightness of the shoulder itself however. I explained that it could possibly be bursitis caused by the vaccine but couldn't be sure without her seeing a doctor. I recommended ice multiple times a day and, if needed, over the counter antiinflammatories. I also recommended she monitor it and if it gets worse or doesn't get better over the next month, to see contact us again and reach out to a doctor for evaluation.

Other Meds:

Current Illness:

ID: 1779126
Sex: F
Age: 65
State: CA

Vax Date: 10/07/2021
Onset Date: 10/09/2021
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:

Allergies:

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

Symptoms: Patient reports site redness and itching 2 days after injection given; patient denies any fever, no pain, just itching at site.

Other Meds:

Current Illness:

ID: 1779127
Sex: M
Age: 79
State:

Vax Date: 02/23/2021
Onset Date: 10/11/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data:

Allergies:

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

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: 1779128
Sex: F
Age: 39
State: MO

Vax Date: 10/06/2021
Onset Date: 10/07/2021
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: Penicillins, difinity

Symptom List: Tremor

Symptoms: On 10/7/21 about noon started with pain in the L armpit that continued to worsen and move into the L breast. Got home from work around 7 pm and took a shower and noticed my armpit was swollen and tender to touch. Continued with pain and swelling to the area which was the size of a baseball. Woke up around 0300 10/8/21 with what felt like my chest pounding. It didn?t hurt just felt like my heart was beating abnormally. Check my watch and it showed frequent pvc?s. This continued to worsen and nausea started. Pvc?s are still continuing and are more frequent. Nausea has persisted still at date of writing this. Swelling and pain in armpit has gone down. Had ekg done at work which showed frequent pvc?s also on 10/11/21.

Other Meds: None

Current Illness: Migraines

ID: 1779129
Sex: F
Age: 59
State: TN

Vax Date: 10/06/2021
Onset Date: 10/06/2021
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:

Symptom List: Erythema, Pruritus

Symptoms: body aches, headache, nausea, chills, fever

Other Meds:

Current Illness:

ID: 1779130
Sex: U
Age: 47
State:

Vax Date: 01/29/2021
Onset Date:
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:

Allergies:

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

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1779131
Sex: F
Age: 20
State: NY

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: N/A

Allergies: N/A

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

Symptoms: Parosmia. Initially lost taste and smell after COVID infection In December 2020. 3 days after COVID vaccine, she developed abnormal smell/taste. Food smelled and tasted like garbage or sewage. Patient lost a significant amount of weight. Symptoms are only somewhat better 6 months later.

Other Meds: OCP only

Current Illness: N/A

ID: 1779132
Sex: F
Age: 70
State: MN

Vax Date: 01/27/2021
Onset Date: 10/08/2021
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: Codeine: GI upset; Crestor: joint/bone pain/aches; Darvon: rash; Demerol: rash; Vicodin: rash; Darvocet A500: Rash - Allergy Tramadol HCl: terrible dreams - Allergy

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: cough, cold, congestion, diarrhea, headaches x 5 days. starting 10/8/21. LOT #1 is not available

Other Meds: Acyclovir 400 MG Tablet 1 tablet Orally Twice a day x 5 days prn cold sores Albuterol Sulfate (2.5 MG/3ML) 0.083% Nebulization Solution 3 ml as needed Inhalation every 4 hrs as needed Prochlorperazine Maleate 10 MG Tablet 1 tablet Ora

Current Illness: none

ID: 1779133
Sex: M
Age: 45
State: AZ

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: SYR
Vax Site: LA

Lab Data: none

Allergies: morphine - unknown reaction

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

Symptoms: Vaccinator went to check on pt at the end of the 15 mins wait post-Pfizer COVID vaccine 3rd dose. Pt reported "tingling" in throat, but denied swelling, itching, difficulty breathing. HR 74. O2 98%. Had pt wait for full 30 mins. Pt reported symptoms resolved, denied any other symptoms, and he went home. Advised to go to ED for any worsening symptoms.

Other Meds: unknown

Current Illness: unknown

ID: 1779134
Sex: M
Age: 17
State: MN

Vax Date: 06/17/2021
Onset Date: 08/01/2021
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: EKG, hemoglobin, and thyroid testing. (EKG 9/10/2021 and thyroid and hemoglobin tests 9/7/2021)

Allergies: None.

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

Symptoms: After the first and second shots I was sore and tired, which I expected. Later, however, in August 2021 I noticed my resting heart rate seemed to be higher than normal and on my job as a volunteer firefighter there were rare occasions when I felt like I might not be able to go on and that my heart couldn't keep up (it didn't come to a medical emergency, and I was able to rest and feel better). Although these calls were particularly fatiguing incidents for everyone and it's to be expected that I'd feel awful with the smoke and exertion, I don't remember ever feeling like that in any other instance. In addition, in my EMT class when we would have our pulse rates taken constantly so others could practice, mine was consistently in the high 80s at best to low 100s at its worst. None of that was normal for me a year ago or before my shots. My only guess is that I either screwed something up through firefighting, I'm having side effects from the shot, or a combination of both. I feel totally and completely fine otherwise. It hasn't slowed me down or caused pain, I just have noticed an increased heart rate which isn't normal but does not seem to negatively affect me or my abilities.

Other Meds: None.

Current Illness: None.

ID: 1779135
Sex: M
Age: 71
State: OK

Vax Date: 03/05/2021
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:

Allergies: Seasonal Allergies

Symptom List: Pain in extremity

Symptoms: Dose 2#017B21A About two weeks after the vaccine I had one shot of Limoncello and I think I fainted. I have never had a reaction to any food except for Beets once as a child. It has been six months and I have been occasionally have dizzy spells since that incident. It happens about twice a day. I went to my Primary care physician and he noticed recommended I see a Cardiologist due to the dizzy spells. I wore a Heart Monitor for two weeks. They noticed that I had a Bundle Blockage. I had one incident of dizziness while I was wearing it. I was told once that I had a Medusa Artery. I am scheduled to see the Cardiologist. Dr.

Other Meds: Blood Pressure Cholesterol Prostate two medications

Current Illness: N/A

ID: 1779136
Sex: F
Age: 62
State: FL

Vax Date: 04/09/2021
Onset Date: 08/11/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin, Cipro

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

Symptoms: Admission to critical care hospital with COVID-19 diagnosis on admission

Other Meds:

Current Illness:

ID: 1779137
Sex: F
Age: 27
State: MN

Vax Date: 10/08/2021
Onset Date: 10/08/2021
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: SULFA Drugs

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

Symptoms: Coarse tremor in right arm primarily in a pronation supination pattern that is intermittent and aggravated with certain movements to include typing, driving, and lifting objects. Symptoms improving with time. Patient has tried heat and ice as well as Tylenol and ibuprofen as needed.

Other Meds: Ibuprofen, Tylenol

Current Illness: Mild tachycardia

ID: 1779138
Sex: F
Age: 47
State: CA

Vax Date: 10/11/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: none known of

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

Symptoms: red, swollen and warm at and around the site of injection

Other Meds: birth control pills

Current Illness: none

ID: 1779139
Sex: F
Age: 61
State: NJ

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

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

Lab Data: Spoke to my Gastroenterologist about the abdominal issues; he was not concerned. Saw Primary care physician on Sept 1. He did not think anything was impressive to follow up on. Bruising is less frequent. Leg cramps gone away. Abdominal sensation still occurs, less frequent.

Allergies: none

Symptom List: Vomiting

Symptoms: 1. Muscle cramps/spasms in legs and feet 2. Unexplained bruising - about 6-8 episodes 3. Abdominal spasms - upper left side of stomach; feels like a ball rolling around or a baby kicking!

Other Meds: Enalapril, montelukast, Januvia (stopped taking April 30th), Mybetriq, Curalin, Vitamens C & D, Magnisium, Zinc, Kalmegh tea (stopped taking March 21).

Current Illness: none to the best of my recollection

Date Died: 10/09/2021

ID: 1779140
Sex: F
Age: 66
State: TN

Vax Date: 06/11/2021
Onset Date: 10/09/2021
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:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: COVID RELATED DEATH; BREAKTHROUGH CASE

Other Meds:

Current Illness:

ID: 1779142
Sex: F
Age: 92
State: IL

Vax Date: 03/11/2021
Onset Date: 09/30/2021
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:

Allergies:

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

Symptoms: SOB, confusion, COVD-19 pneumonia

Other Meds:

Current Illness:

ID: 1779143
Sex: F
Age: 27
State: TN

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: N/A

Allergies: N/A

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Early period after just having one two weeks prior. Heavy bleeding and cramping with large blood clots.

Other Meds: Duloxetine

Current Illness: N/A

ID: 1779144
Sex: M
Age: 44
State: MA

Vax Date: 04/06/2021
Onset Date: 08/25/2021
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: 18th of September, 2021- Lung x-rays - looked ok; tested for COVID - negative result

Allergies: Singulair

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

Symptoms: Persistent cough. We tried Prednisone and a course of Augmentin along with some cough suppressant - Benzonatate 100 mg as needed to help with the cough. That course didn't work. We tried Albuterol - just doing some of that with the cough suppressant. It's still there (the cough). I was told it was a viral or bronchitis since it didn't respond to the previous treatment. Was told to give it some time. The facility that I went to initially gave me the antibiotic and the prednisone did lung x-rays and COVID test. After the course of the prednisone and antibiotics and I was referred to my doctor's telehealth NP and she put me on Albuterol - 24th of September.

Other Meds: Multi-Vitamin; zinc; Vit D

Current Illness: none

ID: 1779145
Sex: M
Age: 47
State: MI

Vax Date: 03/22/2021
Onset Date: 10/02/2021
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: SARS-COV-2 positive on 10/02/21

Allergies: no known allergies

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

Symptoms: Pt received Moderna vaccines on 03/22/21 and 04/19/21. Pt presented to the ED on 10/02/21 with complaints of a cough, fever, headache, and body aches. Pt was found to be COVID positive

Other Meds: effexor, motrin, lotrel

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am