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: 1780115
Sex: M
Age: 44
State: CA

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: No Allergies on File

Symptom List: Dysphagia, Epiglottitis

Symptoms: LVN staff administered covid-19 vaccine on 10/12/21 at 1445 not knowing that pt already had J&J covid-19 vaccine on 3/12/21. Pt reported to the staff that he had received his first J&J covid-19 vaccine after the vaccine was administered by the staff. Pt was monitored by the staff and left the covid-19 vaccine clinic in a stable condition.

Other Meds: Unknown

Current Illness: Unknown

ID: 1780116
Sex: F
Age: 80
State:

Vax Date: 04/05/2021
Onset Date: 09/25/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: 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: 1780117
Sex: F
Age: 49
State: NJ

Vax Date: 10/07/2021
Onset Date: 10/08/2021
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: none, called the doctor and he said the vaccine provides many different reaction take benedryl.

Allergies: none

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

Symptoms: I received the vaccine on Thursday and on Friday underneath my left arm (my armpit) began to swell up and throbbing consistently all the way through end of day Sunday. The location was very hot and was dark where it was swollen

Other Meds: vitamin D 1000mg Vitamin C 500mg

Current Illness: none

ID: 1780118
Sex: F
Age: 39
State: AZ

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data: Too many to list?cta, chest x ray, ct scans, ekg, d dimers, covid panels, lower leg doplar, lung function tests, echo, pouchoscopy

Allergies: Remicade, morphine, levaquin, primaxin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Extreme tachycardia (176), hypertensive episode, short of breath, syncope, initially within 3 minutes and then episodically about 15 more times for the next 4-5 weeks. Also tachycardia?resting heart rate went from 50 to 100 and increased with even light activity. Bilateral arm weakness, lower leg weakness, numbness in right face started within 48 hours and lasted about 4 days, extreme inflammation in my gi tract which was previously fine, new diagnosis of asthma. Several ER visits, hospitalizations, etc.

Other Meds: Lovenox

Current Illness: None

ID: 1780119
Sex: F
Age: 71
State:

Vax Date: 03/29/2021
Onset Date: 09/25/2021
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: 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: 1780121
Sex: M
Age: 78
State: AZ

Vax Date: 09/25/2021
Onset Date: 10/03/2021
Rec V Date: 10/12/2021
Hospital: Y

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: HOSPITALIZED 10/6/21 - ? STILL IN HOSPITAL. FOLLOWING WERE DONE IN HOSPITAL LAB WORK - BMP, CBC, OTHER LABS, WEST NILE VIRUS-RESULTS NOT AVAILABLE YET CT BRAIN - NEG MRI BRAIN - NEG CTA CHEST & Abdomen - NEG US - ABDOMEN - NEG HIDA SCAN - NEG

Allergies: NONE

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

Symptoms: RASH BACK OF SHOULDERS, EXTREME FATIGUE, NAUSEA / VOMITING AT HOME X 3 DAYS. ADMITTED TO HOSPITAL 10/6/21 WHEN DEVELOPED SEVERE WEAKNESS, UNABLE TO GET UP, SHORTNESS OF BREATH, DIAPHORESIS, TEMP 99.7. ARRIVAL IN HOSPITAL - HAD TEMP > 101. ADMITTED TO HOSPITAL. WORKUP DONE AS BELOW. POSSIBLE ENCEPHALITIS WITH ENCEPHALOPATHY - IN ADDITION TO ABOVE SYMPTOMS - SOME CONFUSION, VERY LETHARGIC, VERY DROWSY

Other Meds: PLAVIX 75 MG DAILY LISINOPRL 20 MG DAILY TAMSULOSIN 0.4 MG DAILY FINASTERIDE 5 MG DAILY SERTRALINE 100 MG DAILY

Current Illness: NONE

ID: 1780122
Sex: F
Age: 64
State: FL

Vax Date: 06/26/2021
Onset Date: 06/26/2021
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: Headaches every day and I never get headaches. I have to take something every day. Fatigue. I have to go to bed by 9:00 every night. Chest congestion. Always feel like I?m on the verge of getting sick. I have to take Mucinex often.

Other Meds: Tirosint 75 mcg

Current Illness: None

ID: 1780123
Sex: F
Age: 87
State:

Vax Date: 02/18/2021
Onset Date: 09/25/2021
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: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

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: 1780124
Sex: F
Age: 12
State: WA

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

Lab Data: NA

Allergies: None noted by patient parent

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: administering vaccine punctured skin of left upper arm with needle, noted syringe did not contain any of the required dose of Pfizer vaccine and withdrew needle without engaging plunger. then administered confirmed dose of Pfizer vaccine in left deltoid. No adverse effects noted following dose administration.

Other Meds: Unknown

Current Illness: Unknown

ID: 1780126
Sex: M
Age: 48
State: IA

Vax Date: 10/02/2021
Onset Date: 10/05/2021
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: COVID test on Weds - Negative

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 99.5 fever started on Tuesday, Weds through Thursday sustained 102.6 fever, body aches, chills, tiredness, tightness in chest, slight shortness of breath

Other Meds: Flu vaccine day before, vitamin d3, calcium, iron, anastrozole, testosterone, tadalafil, pantoprazole, clomiphene

Current Illness: None

ID: 1780127
Sex: M
Age: 79
State: FL

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

Lab Data: na

Allergies: na

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

Symptoms: Fluad comes in a prefilled syringe. When I twisted the tube into a BD needle, it felt a little off. I looked at the loaded dose and everything looked normal. I went to administer the shot in the patient's left arm, and all the fluid came out of the piece that connect the Fluad to the BD needle. No liquid went into the patient. I told the patient what happened. I then re-administered in his right arm.

Other Meds: na

Current Illness: na

ID: 1780128
Sex: M
Age: 65
State: CA

Vax Date: 10/02/2021
Onset Date: 10/04/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient got a rash on extremities and whole body started 3 days after a vaccination and came back to pharmacy on 10/12/2021 to report it. Patient was advised to use OTC Zyertec 10mg and follow up with primaray care physician.

Other Meds: Aspirin 81mg

Current Illness:

ID: 1780129
Sex: M
Age: 20
State: SC

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

Lab Data:

Allergies: NKDA

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

Symptoms: Within 5 minutes after receiving 2nd Pfizer vaccine, patient started to become sweaty and light headed. Patient did not faint, but became unresponsive and mother had to help him sit in a chair. Gave patient water and took his temperature, since he was feeling warm/sweaty. Temperature was normal at 97.6. Inspected injection site and didn't notice anything abnormal. After about 30 seconds to 1 minute, patient became responsive again, was speaking like normal, and drinking water. Patient has cerebral palsy and mother states he has seizure-like activity where he becomes unresponsive due to his condition. Used to have physical seizures and was on medication previously, but hasn't had one in a long time so no longer taking seizure medication. Mom said these seizure-like episodes cannot be treated with medication, so they just help him through when they happen periodically. Patient did not have a reaction to first Pfizer vaccine, so mother and I think being nervous/excited triggered this episode and that it was unrelated to the actual vaccine. Patient and mother sat in pharmacy area for about 30 minutes before leaving.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1780130
Sex: F
Age: 68
State: TN

Vax Date: 10/05/2021
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: Clinical diagnosis in drs office

Allergies: None

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

Symptoms: Despite having had the shingles 2 part vaccine I developed shingles again.

Other Meds: Avrostatin Ramipril

Current Illness: None

ID: 1780131
Sex: M
Age: 31
State: TX

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient was sitting in the waiting area after his vaccination for the standard 10-15 minute observance period, when he became light-headed and fainted while seated in a standard height chair. 911 was immediately called and the patient was aroused after about 10-15 seconds. He remained in the recovery position until EMS arrived and escorted him outside of the building to their ambulance to check his vitals and check on him. He did report to me before EMS arrived that he has fainted several times in the past after giving blood. On his vaccine administration consent form, he did select "no" when asked if he had ever had a serious reaction after receiving a vaccination in the past.

Other Meds:

Current Illness:

ID: 1780134
Sex: F
Age: 41
State: VA

Vax Date: 04/01/2021
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: Kidney function.

Allergies:

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

Symptoms: Reduced kidney function as diagnosed by lab results. Will get rechecked in December.

Other Meds: Warfarin, Rosuvastatin, Bupropion, Buspar

Current Illness: Reduced platelets

ID: 1780135
Sex: F
Age: 71
State: TN

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

Allergies:

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

Symptoms: patient states she broke out in hives along her stomach, back and legs around 6 hours after receiving vaccination

Other Meds:

Current Illness:

ID: 1780136
Sex: M
Age: 27
State:

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: NO SYMPTOMS

Other Meds:

Current Illness:

ID: 1780137
Sex: F
Age: 50
State: NC

Vax Date: 10/10/2021
Onset Date: 10/11/2021
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: n/a

Allergies: n/a

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: patient reports that the day after receiving her covid vaccine, she had noticed some raised,red bumps on her back near her scapula/arm pit area (on the same arm as the covid vaccine

Other Meds: n/a

Current Illness: n/a

ID: 1780138
Sex: F
Age: 30
State:

Vax Date: 10/04/2021
Onset Date: 10/12/2021
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:

Allergies:

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

Symptoms: Cough

Other Meds:

Current Illness:

ID: 1780139
Sex: F
Age: 50
State:

Vax Date: 04/11/2021
Onset Date: 09/21/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Admitted to Hospital on Date of Adverse Event [recorded in regulatory authority] for treatment of Covid-19 Positive following completion of Covid Vaccine Series

Other Meds:

Current Illness:

ID: 1780140
Sex: M
Age: 23
State: LA

Vax Date: 04/03/2021
Onset Date: 05/01/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Unevaluable event

Symptoms: 1. SM reports worsening of tinnitus; onset JUN 2021. 2. SM reports multiple warts appearing on body; onset APR -MAY 2021. Initially noticed first wart on right foot, then noticed on back and penis. 3. SM reports frequent headaches with associated light sensitivity; onset MAY 2021. 4. SM reports prior wrist injury and back pain but states that he noticed both wrist ache, low back, and both knees ache. SM reports bilateral knee pain, right knee worse than left; onset July 2021. SM denies direct trauma to affected areas. 5. SM reports tongue with greyish/white build up, painless; states that he tried to scrape off tongue but unable to; onset MAY-JUN 2021. 6. SM reports frequent trouble sleeping and excessive worry; onset MAY 2021.

Other Meds: None

Current Illness: None

ID: 1780141
Sex: M
Age: 18
State: IL

Vax Date: 10/12/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: UNKNOWN

Allergies: NONE

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

Symptoms: PATIENT RECEIVED PFIZER VACCINE DOSE 1. A FEW MINUTES AFTER RECEIVING HIS VACCINE, PATIENT PASSED OUT AND HIT HIS HEAD, HE THEN BEGAN TO HAVE WHAT LOOKED LIKE A MINOR SEIZURE FOR 5 TO 10 SECONDS. PATIENT REGAINED CONSCIOUSNESS AND PARAMEDICS ARRIVED TO TAKE HIM TO THE HOSPITAL.

Other Meds: UNKNOWN

Current Illness: NONE

Date Died: 10/09/2021

ID: 1780142
Sex: F
Age: 69
State: WA

Vax Date: 04/22/2021
Onset Date: 10/04/2021
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 status positive 10/4/21 and 10/6/21

Allergies: Erythromycin, Penicillins

Symptom List: Injection site pain, Pain

Symptoms: Patient received Pfizer COVID vaccine on 3/17/21 and 4/22/21 at another facility. On 9/27/21, patient admitted to our facility for acute blood loss anemia from ostomy. COVID status was negative on 9/27/21 and 9/29/21. However, COVID status changed to positive on 10/4/21 and 10/6/21. Patient expired on 10/9/21 likely related to abdominal pathology. Here's the discharge summary from hospitalist: "Patient with recurrent bleeding episodes from her stoma requiring total of 8 U PRBC. CT for GIB was negative for active bleeding on admission. She was seen by GI service who felt there is no role for GI controlling bleed. Colorectal surgery was contacted after an other episode of large quantity bleed. Unfortunately she developed progressive hypoxic respiratory failure with abdominal distention, lactic acidosis, progressive hypotension requiring HFNC, vasopressor support, transfusion. CXR was surprisingly clear and felt that severe hypoxia likely related to abdominal pathology."

Other Meds: acetaminophen PRN, atorvastatin, citalopram, Lomotil PRN, loperamide, midodrine, omeprazole, ondansetron PRN, TPN, zolpidem PRN

Current Illness:

ID: 1780143
Sex: F
Age: 57
State: IN

Vax Date: 03/25/2021
Onset Date: 03/27/2021
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. I reported to doctor at time and pretty much got no response other to say no reports of tinnitus being side effect. I was expecting it to go away, so I tried to just take care of myself. If anything, it is worse now. Trying now to add supplements to reduce inflammation. Hoping it's not permanent.

Allergies: None.

Symptom List: Injection site pain, Menorrhagia

Symptoms: Tinnitus in left ear. High pitched and constant. Most of time I can ignore, but sometimes gets pretty loud.

Other Meds: None.

Current Illness: None.

ID: 1780144
Sex: F
Age: 71
State: GA

Vax Date: 09/22/2021
Onset Date: 09/22/2021
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: duplicate dose inadvertently given; tried to submit this form earlier, but received error message--this may be duplicate

Other Meds:

Current Illness:

ID: 1780145
Sex: F
Age: 71
State: IN

Vax Date: 09/30/2021
Onset Date: 10/02/2021
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: None

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Large 3"?3" bruise appeared around the injection site with muscle pain and aching and 12 days later there's not much change in the bruising and pain

Other Meds: Pravastatin,hydrochlorothiazide,coq10,aspirin,glucosamine, vitamins c,garlic, turmeric, vitamin d,b complex vitamin,

Current Illness: None

ID: 1780146
Sex: F
Age: 85
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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: PT CAME IN WITH NO VACCINE CARD AND ASKED TO GET PFIZER BOOSTER DOSE AND TECH TOOK A WARD FROM PT AND WE ADMINISTERED PFIZER SINCE PT WAS UNDER IMPRESSION THAT SHE HAD RECEIVED PFIZER IN THE PAST FROM DIFFERENT PLACE. IN FACT, WE DISCOVERED LATER ON THAT PT HAD RECEIVED MODERNA IN THE PAST FROM THE local HEALTH DEPARTMENT. SO SHE HAD 2 DOSES OF MODERNA BACK IN MARCH AND APRIL AND TODAY SHE GOT PFIZER FROM THE PHARMACY SO WE ARE REPORTING THIS AS AN ERROR TO VAERS.

Other Meds:

Current Illness:

ID: 1780147
Sex: F
Age: 37
State: NY

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

Allergies: None

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

Symptoms: Vertigo lasting 1 and a half months. Fever for 4 days. Large swollen patch at vaccine site. Menstrual period lasting since vaccine, 4 months and counting.

Other Meds: None

Current Illness: None

ID: 1780148
Sex: M
Age: 17
State: MA

Vax Date: 04/14/2021
Onset Date: 04/27/2021
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: Normal Brain MRI NORMAL EKG NORMAL ECHOCARDIOGRAM NORMAL RENAL ULTRASOUND

Allergies: Doxycycline

Symptom List: Nausea

Symptoms: My son (a very fit athlete. He is 6 feet tall, about 162 pounds and has a 29 inch waist- a healthly kid with a 21-22 BMI) developed high blood pressure and bad headaches/migraines pretty suddenly in April, which we saw for the first time within a couple of weeks of his first COVID vaccine. He is 17. He had a physical the month prior to this and had no issues (His blood pressure was 120/76 on 3/11/21). We have 2 older daughters who were vaccinated with no adverse reactions except the usual post vaccine fatigue. My son?s school was concerned about his blood pressure starting on April 27and made him do an EKG to be safe and it was normal, so we chalked it up to school stress and forgot about it. Throughout the summer, his headaches got worse and more frequent. We hadn't given his blood pressure another thought since school was out. He then got a COVID breakthrough infection mid July (but this was all happening and worsening before that). His case was very mild and no one else in our household got the infection (4 of us) from him. Before school started, I took him to his pediatrician to discuss the headaches, which went from 2 days a week to 3-4 days a week some weeks. To my surprise, his blood pressure was still high (160/90). He also had sugar in his urine and his glucose was 136 (he hadn?t eaten in hours, but it was not a true fasting test). We repeated that test days later and no glucose in urine and his fasting glucose was 100). We repeated a third time (fasting) and no sugar in urine and glucose was 93. We were sent to a cardiologist for the blood pressure. She first did a blood pressure study to confirm that the blood pressure was in fact high and not due to white coat syndrome. So ordered an echocardiogram and a renal ultrasound. Both were normal (as were kidney lab values). Meanwhile, his headaches continue to worsen and are migraine level about 5-6 days a week now and he can?t sleep and it?s interfering with school and sports. I have had to work with his school on several occasions because he would get 3-4 hours of sleep for 4 days in a row and could barely function. We saw a neurologist and she did a brain MRI and it was normal. The only finding was ?subcentimeter reactive cervical Lymph nodes?, which they said could be due to something as minor as a cold. We have a consult with an endocrinologist later this month. And may schedule one with a rheumatologist. The neurologist just ordered an MRI of the blood vessels. We may start him on beta blockers to try to lower the blood pressure which has now consistently been 155/100 or more every day with or without the migraine. I should mention he had no history of headaches or migraines or high blood pressure prior to late April. As I mentioned earlier in the note, almost exactly a month before the first vaccine, his blood pressure was 120/76. The cardiologist said sometimes this happens with no explanation. But, as I said, he is a super fit, active, healthy 17 year old boy. And I can?t believe this ?just happens?, especially so suddenly. When we tried to unravel this, we realized it started soon after the first Pfizer vaccine. I can?t find any information on this and no one can figure out what is going on. We have now consulted with 4 doctors (three are specialists), in addition to the emergency room once where we saw 2 ER doctors plus a neurologist. And we don?t have any hint of an answer. We live outside of the state and most of the specialists have been out of Hospital. We don?t even know if the blood pressure and migraines are related. And we don?t know if the vaccine is related. But it is certainly a strong coincidence at the least. My son (who is at boarding school) was sending me blood pressure readings last night of 155/104. We are getting very very worried. We don't have any idea where to turn for answers at this point. We are hesitant to only treat/mask symptoms without finding the cause of this, as it was so sudden. The neurologist won't give him abortive migraine medicine because they tend to raise blood pressure and, since we haven't seen a nephrologist, she is hesitant. Any direction or info you can give me would be very much appreciated. We are a very much pro-vaccine family, but we can?t ignore this coincidence and are worried that it could have triggered an underlying condition that we can?t find.

Other Meds: Strattera, Focalin

Current Illness: none

ID: 1780149
Sex: M
Age: 77
State:

Vax Date: 02/06/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

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: 1780150
Sex: M
Age: 55
State: SC

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:
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: Ras on upper chest and front of neck. Red swollen bumps, itchy.

Other Meds: Diktiazem, Gabapentin, Lorazepam

Current Illness: HBP

ID: 1780151
Sex: F
Age: 85
State:

Vax Date: 09/30/2021
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:

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: 1780152
Sex: F
Age: 33
State: CA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Previous reaction to Pfizer Covid Vaccine Hydrocodone

Symptom List: Tremor

Symptoms: Approximately 5 minutes after pt received her 2nd Pfizer vaccine, she came out of the room and caught the attention of vaccine staff stating she felt tightness in the chest. she was escorted to the exam room and laid down on exam table. BP 112/80. Patient stated her throat started to feel like it was tightening up, and she felt short of breath. Rapid Response was called:. 1102: RRT called and patient crying and c/o chest tightness and dizziness. Patient alert and oriented. SPO2 99% RA HR 87 BP 126/84. Patient denies chest pain, sob, lip/tongue swelling, palpitations. Dr. in room assessing patient and listening to heart and lungs. Per MD no medication needed at this time. 1105: SPO2 100% HR 85 Per MD order patient may be d/c home if feeling better and VSS. Will continue to monitor. 1116: SPO2 100% RA HR 61 BP 122/84. Patient reports feeling better and denies chest pain, sob, lip/tongue swelling, dizziness, or any other s/s distress. Patient states that husband in the parking lot. Patient offered UC appt but refuses at this time. ED and 911 precautions provided with any change or worsening in condition and patient verbalized understanding with intent to comply.She was discharged shortly after additional observation by their nurse. FYI, while I was giving her her vaccine, pt reported she ended up in the ED after her first dose back in March. She had similar symptoms almost immediately after the shot that lasted a couple hours, and then it happened again 3 days later which is when she went to the ED. They told her it was most likely a panic attack and that it was fine to get the second dose.

Other Meds:

Current Illness:

ID: 1780153
Sex: F
Age: 50
State: TN

Vax Date: 04/07/2021
Onset Date: 04/07/2021
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: June 7, June 22, August 6, August 12 Numerous Bloodwork ? June 8 diagnosed with Aggressive UTI- given Cipro- I seemed to get better. ? June 25 doctor called in 2nd round of Cipro- Again seemed to get better. ? July 13 Extreme weakness- Had to call husband to pick me up at store. Doctor called in 3rd antibiotic- different but was awful! ? July 22 Abdominal and pelvic ultrasound- nothing abnormal found ? August 12 CT scans on abdominal & pelvic- nothing abnormal found ? Sep. 1 MRI of brain and spine- Nothing abnormal found ? Sept. 30 Saw Neurologist- He prescribed PT 3x a week

Allergies: Iodine, Latex, Contrast Dye, Shellfish, Blue Cheese, adhesive on bandaids

Symptom List: Erythema, Pruritus

Symptoms: Symptoms: ? I can barely walk ? I cannot stand for very long ? I struggle with balance ? Extreme fatigue (has gotten better this week) ? Cannot drive or I get lightheaded and vertigo ? Increased motion sickness while riding in car ? My legs feel like they are swelling at night and will hurt all night long ? My toes have fallen asleep and are constantly numb ? I have brain fog and often struggle to find the right words ? Weakness all over. Started in legs but is also in upper body ? Back hurts ? Frequent Blurred vision ? Have had 3 instances of involuntary upper body "nodding" ? Nearly fainted a couple of times ? Time & Events ? first Pfizer vaccine on April 7. About 28 minutes in, my arm started to ache. It quickly went across my shoulders and into my neck. At 30 minutes, I got up to leave and pain shot down my back and brought me to tears. I sat down and the EMTs came to my assistance. They stayed with me until my heart rate was back down and the color came back into my face, my muscles hurt and I was extremely exhausted! ? I stayed exhausted. ? My back began to hurt and I was beginning to have a hard time walking. ? 2nd vaccine on May 3, person wheeled me in. It was difficult to walk but still didn't think it was from the vaccine. When I got the 2nd vaccine it hit me in the middle of the night like a ton of bricks. I felt like I had the flu with fever, body aches and extreme tiredness. ? My back and hips were hurting for several weeks and it was much harder for me to walk. It progressively got worse as the weeks went by. ? My legs started cramping often. ? On June 4 the day started with a leg cramp that wouldn't go away. ? June 5th my legs were not working properly. ? On June 7 I went to see my doctor and could barely walk. It wasn't really pain but EXTREME weakness. ? It has just gotten worse and worse until now I have weakness ALL over. I can barely function. I cannot stand for very long without getting out of breath. ? June 8 diagnosed with Aggressive UTI- given Cipro- I seemed to get better. ? June 25 doctor called in 2nd round of Cipro- Again seemed to get better. ? July 13 Extreme weakness- Had to call husband to pick me up at store. Doctor called in 3rd antibiotic- different but was awful! ? July 22 Abdominal and pelvic ultrasound- nothing abnormal found ? August 12 CT scans on abdominal & pelvic- nothing abnormal found ? Sep. 1 MRI of brain and spine- Nothing abnormal found ? Sept. 30 Saw Neurologist- He prescribed PT 3x a week October 12- began physical therapy

Other Meds: ? Levothyroxine 50MCG & 200 MCG ? Lo Loestrin 10mg ? Amlodipine and Olmesartan Medoxomil 5mg/20mg ? Mirtazapine 30MG- 2 1/2 everyday ? Ropinole 2MG ? OTC Prescribed ? Geritol (iron supplement) 1T everyday ? Vitaman D3 6000iu Aderall 40 MG

Current Illness: None that I knew of at the time, but learned I had an aggressive UTI on June 8,2021

ID: 1780154
Sex: M
Age: 83
State: CO

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

Allergies:

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

Symptoms: Lump, swelling and redness in injection site.

Other Meds:

Current Illness:

ID: 1780155
Sex: F
Age: 28
State: MA

Vax Date: 03/16/2021
Onset Date: 03/01/2021
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:

Allergies: Allergies to shrimp - gets hives

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

Symptoms: 1. Patient reports frequent dry eyes with associated headaches; onset in March 2021. Patient states that her headache worsened and was experiencing daily headaches; onset in July 2021. Patient denies head injury. Patient describes headaches band like across forehead with associated dizziness. 2. Patient reports prior history of bleeding gums but states that it has worsened during this deployment. Patient noticed bleeding gums when brushing or flossing everyday; onset June 2021. 3. Patient reports frequent headaches with associated pressure in ear drums, sensitivity to noises, dizziness, and eye pressure; onset April 2021. 4. Patient reports joint pain in shoulders and elbows after working out in gym; onset in April 2021. Patient was evaluated by medic; self-care with rest and OTC pain reliever. Patient states that her symptoms worsened in SEP 2021. Patient states symptoms improved with rest but flares up when she performs physical fitness training. 5. Patient reports left sided low back pain after working out in the gym; onset July 2021. Patient was evaluated by medic; self-care with rest and OTC pain reliever. Symptoms improved with rest but flares up when she performs physical fitness training. 6. Patient reports fingers joints sensitive to temperature; onset July 2021. Patient states that she would notice numbness/tingling in cool air condition room; joint pain in hands/fingers worsened in warm/hot temperature. Describes tingling and burning sensation in joints in bilateral hands/fingers in warm/hot temperature. Patient reports symptoms improved but not resolved. 7. Patient reports that her knees feels unstable when lifting weights; onset April 2021. Patient denies direct trauma or injury to affected areas. Self-care with rest and OTC pain reliever. Patient reports symptoms improved with rest but not resolved. 8. Patient reports weight gain, ~ 30 lbs, in the last 4 months despite changes in diet or exercise. Patient reports acne worsened as well. 9. Patient reports frequent trouble sleeping during this deployment. Patient states that she had trouble falling asleep and staying asleep; racing thoughts and thinking about work and assignment deadlines; and felt tired and sluggish during the day.

Other Meds: Birth control

Current Illness: None

ID: 1780156
Sex: M
Age: 38
State:

Vax Date: 09/09/2021
Onset Date: 09/13/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient reports subjective tinnitus developed without associated hearing loss.

Other Meds:

Current Illness:

ID: 1780157
Sex: F
Age: 68
State: SC

Vax Date: 09/27/2021
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: None

Allergies: None

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

Symptoms: Covid arm, delayed hypersensitivity, red blotchy spot, inflamed, warm, itchy, painful

Other Meds: None

Current Illness: None

ID: 1780158
Sex: F
Age: 69
State: GA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
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: Drug related on arm. Don?t remember date. Was in March of this year

Allergies: Cashews. Codeine, bacterim

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

Symptoms: Lightheaded, dizzy, feeling of euforia. At injection site became a blister and burst. Leftscaron arm. On face a large red circle appeared. Was rough to touch. Did not blister. Has not completely gone away or has the swelling. No medications prescribed helped. Have pics I took.

Other Meds: Metformin, gaberpentin, metertoporol, difluconac, atorvastorin, elevil

Current Illness:

ID: 1780312
Sex: F
Age: 80
State: CO

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: swelling and redness

Other Meds: swelling and redness in injection site

Current Illness:

ID: 1780314
Sex: F
Age: 61
State: PR

Vax Date: 10/05/2021
Onset Date: 10/05/2021
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: N/A

Allergies: Cephalosporin; MACROBID; Clindamycin.

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

Symptoms: High fever, intense head pain, (sensation of pounding in head) tiredness, enlarged neck nodules.

Other Meds: XARELTO; SYNTHROID; CARDIZEM; Lisinopril; CALTRATE; Vitamin D; Pantoprazole; EMGALITY; NURTEC

Current Illness:

ID: 1780315
Sex: M
Age: 62
State: MD

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: senior flu shot given to patient 62 years old

Other Meds:

Current Illness:

ID: 1780316
Sex: F
Age: 16
State:

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:

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

Symptoms: Client received her 1st Pfizer dose (Lot# FF2587) from RN . on 10/12/21 at 16:22. One to two minutes after receiving the shot, the client communicated to RN. she was feeling lightheaded and had a syncopal episode which lasted 2-3 seconds. RN happened to walk into the vaccination room at the same time the incident occurred and called out to Lead RN to retrieve an EMT. While the episode was occurring, RN. held up the client in her chair, and the client began to respond. Lead RN, went to the observation room to obtain EMT. He and Lead RN proceeded to vaccination station 2. Upon arriving, Lead RN observed that with the assistance of RN, the client was still seated upright in the chair, diaphoretic, and pale in color. RN was speaking with the client asking how she felt, when the client experienced a 2nd syncopal event that lasted 1-2 seconds. RN performed a sternal rub, and the client was responsive. EMT was also with the client asking her name and if she knew where she was, and the client was able to adequately respond. At 16:25 EMT applied a pulse oximeter on the client?s finger and let it reside there. The following vitals were noted: (16:25: HR: 142, SPO2: 93%, 16:28: HR:140, SPO2: 97%, 16:33: HR: 82, SPO2: 99%). EMT also gave the client an ice pack to apply to her forehead and back of her neck, which she utilized. Client stated she was hot and exhibited mild shakiness. Client was given a bottle of water, and crackers, which she ate/drank. Client stated she had a small snack before coming to get vaccinated, but had not had a full meal since 11:00. Client and her mother stated the client does not have any underlying conditions, no allergies, and takes no medications. Client stated she was a little anxious and hesitant about getting the vaccine. She was only getting it because it is mandated. Client stated she was starting to feel better. Client also stated she did not really remember having the syncopal episodes. She just remembered she was feeling lightheaded and then started to notice her range of vision narrowing. At 16:39 EMT took the client?s vitals (BP: 131/76, HR: 73, SPO2: 99%). Client was also given an orange soda, which she drank. Lead RN observed the color had come back to the client?s face and she was no longer diaphoretic. Client stated she was feeling a lot better and was ready to try standing up. Lead RN educated the client and her mother on both the potential side effects and adverse effects of the vaccine, when to seek medical attention, and ER precautions. Lead RN requested the client and her mother go to the observation room with EMT to be observed for an additional 15 minutes and they agreed. At 14:55, EMT took the clients vitals (BP: 122/80, HR: 61, SPO2: 99%. Client stated she felt fine. Lead RN recommended the client eat a full meal and ensure she is hydrated when coming back to receive her 2nd shot. Lead RN observed the client exit the observation room with her mother walking with a stead gait.

Other Meds:

Current Illness:

ID: 1780317
Sex: F
Age:
State: MI

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

Allergies:

Symptom List: Vomiting

Symptoms: Patient was given the Pfizer/Biotech Covid-19 Vaccine on 10/11/2021. It was discovered that the product was dispensed and administered on the 33rd day of being in the fridge. VAERS will be updated and filled with all pertinent information.

Other Meds:

Current Illness:

ID: 1780318
Sex: F
Age: 62
State: NY

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

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

Lab Data: 3/10/2021 CBC, CMP, Lipase, amylase 3/16/2021 Upper Endoscopy

Allergies: No allergies

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Developed gastritis. Gastric discomfort that prevented eating and drinking due to increased pain leading to dehydration and hospitalization. Upper Endoscopy showed gastritis. Treated with IV PPI and hydration.

Other Meds: None

Current Illness: None

ID: 1780319
Sex: M
Age: 52
State: MI

Vax Date: 10/10/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Patient was given the Pfizer/Biotech Covid-19 Vaccine on 10/11/2021. It was discovered that the product was dispensed and administered on the 33rd day of being in the fridge. VAERS will be updated and filled with all pertinent information.

Other Meds:

Current Illness:

ID: 1780320
Sex: M
Age: 71
State: IA

Vax Date: 10/07/2021
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:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Starting 10/8 patient complained of headaches, lightheadedness, sleeping stiff and dizziness. He said the headaches, lightheadedness and dizziness improved by end of day 10/9 but he is still very stiff when sleeping as of 10/12.

Other Meds:

Current Illness:

ID: 1780321
Sex: F
Age: 50
State: NC

Vax Date: 04/05/2021
Onset Date: 04/09/2021
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: RA

Lab Data: CT head, MRI of head, both were normal. ruled out temporal arthritis. Blood work - normal, See dates above

Allergies: N/A

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

Symptoms: Severe headache started on 4/9/2021, around 10 am. Didn?t respond very well to medication. Took nurtec & Imitrex, plus Advil, Tylenol, ice, not affective. Headache intensity Continued thru weekend. Called dr on Monday, started prednisone pack, headache continued, on wed (4/14) was advised by dr to go to ED for cat scan to check for blood clots. IV meds helped headache temporarily. CT scan was normal. 4/16/21 saw Doctor, severe headache again. Worst headaches of my life. Increased prednisone. MRI 4/19/21. Started PT to help with cranial pressure. Headaches almost daily since that don?t respond very well to medication.

Other Meds: Armor thyroid, Wellbutrin, progesterone, magnesium

Current Illness: N/A

ID: 1780322
Sex: F
Age: 34
State: IL

Vax Date: 10/03/2021
Onset Date: 10/06/2021
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 BECAUSE ASIDE FROM INTERMITTENT TACHYCARDIA, MY VITAL SIGNS HAVE BEEN OK

Allergies: NONE

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

Symptoms: RECEIVED THE SHOT ON 10/2/21, THREE DAYS LATER FACIAL NUMBNESS OCCURRED. NOT SWOLLEN, JUST NUMB. THIS DISAPPEARED AFTER A DAY AND THEN MY LIPS BECAME NUMB FOR THREE DAYS BEFORE SUBSIDING THEN LOWER LIP CONTINUED TO BE NUMB UNTIL THIS AFTERNOON. I HAVE ALSO EXPERIENCED OCCASSIONAL RAPID HEARTBEATS THAT CAUSE MY HANDS TO SHAKE/TREMBLE BUT IT HAS SUBSIDED.

Other Meds: MULTIVITAMINS, SYNTHROID

Current Illness: NONE

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am