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: 1782290
Sex: F
Age: 64
State: MI

Vax Date: 10/13/2021
Onset Date: 10/13/2021
Rec V Date: 10/13/2021
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: unknown.

Symptom List: Dysphagia, Epiglottitis

Symptoms: A error in administration occurred, as patient was given six doses instead one.

Other Meds: unknown.

Current Illness: unknown.

ID: 1782291
Sex: M
Age: 47
State: KY

Vax Date: 05/26/2021
Onset Date: 08/26/2021
Rec V Date: 10/13/2021
Hospital:

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

Lab Data: SARS CoV + SARS CoV 2 Antigen Positive on 8/27/2021.

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Breakthrough case after Covid vaccination. Dose # 1 5/26/2021. C/O loss of taste/smell, fatigue, cough, and nausea/vomiting. Onset 8/26/2021.

Other Meds:

Current Illness:

ID: 1782292
Sex: F
Age: 72
State: TX

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Bruising around injection site accompanied by redness and soreness.

Other Meds:

Current Illness:

ID: 1782293
Sex: F
Age: 84
State:

Vax Date: 03/20/2021
Onset Date: 10/11/2021
Rec V Date: 10/13/2021
Hospital: Y

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

Lab Data: COVID pos 10/11/21

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Admitted with breakthrough COVID

Other Meds:

Current Illness:

ID: 1782294
Sex: F
Age: 46
State: PA

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

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

Lab Data: UNAVAILABLE/NOT APPLICABLE

Allergies: UNKNOWN

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

Symptoms: SORE ARM, AND LYMPH NODES UNDERNEATH ARM IN WHICH VACCINE ADMINISTERED SWOLLEN. BOOSTER DOSE OF VACCINE FOR PATIENT -- DOSES 1 AND 2 IN SERIES DID NOT CAUSE THIS SIDE EFFECT (PRIMARY SERIES DATES 1/19/2021, 2/9/2021)

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1782295
Sex: M
Age: 50
State: TX

Vax Date: 12/29/2020
Onset Date: 03/15/2021
Rec V Date: 10/13/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Meripex, Hydrocodone

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

Symptoms: Intermittent severe vertigo. Spatial Disorientation.

Other Meds: Testosterone, Anastrozole

Current Illness: None

ID: 1782296
Sex: F
Age: 53
State: FL

Vax Date: 10/11/2021
Onset Date: 10/12/2021
Rec V Date: 10/13/2021
Hospital:

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

Lab Data: None

Allergies: Penicillin Iodine

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Excruciating head ache from neck to the front of the head, pulsating throbbing pain, tiredness

Other Meds: Vitamin D Zinc

Current Illness: None

ID: 1782297
Sex: F
Age: 52
State: MN

Vax Date: 10/11/2021
Onset Date: 10/11/2021
Rec V Date: 10/13/2021
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: heart palpitations

Other Meds: none

Current Illness: none

ID: 1782298
Sex: F
Age: 62
State: MI

Vax Date: 03/19/2021
Onset Date: 10/02/2021
Rec V Date: 10/13/2021
Hospital: Y

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

Lab Data: Coronavirus 2 PCR Detect, V symptomatic POSITIVE

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: REASON FOR ADMISSION COVID-19 Infection HOSPITAL COURSE Patient is a 62 y.o. female who presented to the Emergency Department (ED) on 10/08/2021 for worsening diarrhea in the setting of a COVID-19 infection. Patient has significant medical comorbidities chronic pouchitis on rotating flagyl and cipro 2/2 total proctocolectomy w/ ileal pouch-anal anastomosis (2014) d/t ulcerative colitis, PSC s/p liver transplant (11/2017), pyoderma gangrenosum, and CKD III (baseline creatinine unclear, but has ranged from 1.4-2.3 in the last year). Per chart review, patient has been in town for her four year posttransplant follow-up appointments. She underwent a pouchoscopy for for surveillance on 10/06/2021 that was uncomplicated. She then contacted the on-call liver transplant pager around 2300 on 10/07/2021 with complaints of chills, shakes, nausea without vomiting, decreased oral intake, and increased bowel output. On arrival to the ED patient was hemodynamically stable and in no acute distress. She was found to have an SpO2 of 89% and was placed on 2 L supplemental oxygen via NC with subsequent improvement. Laboratory studies were obtained. CBC revealed WBC 16.9 with neutrophils 13.82. CMP was notable for a bicarbonate of 21, BUN of 31, creatinine of 2.38, and a total calcium of 10.5. Lipase was 46. Lactate was 1.2. Urinalysis was notable for trace ketones, trace blood, and 30 protein. COVID testing was positive. Recent imaging including CXR and liver ultrasound were unremarkable/stable from previous examinations. Pouchoscopy on 10/06/2021 revealed anal canal stenosis and a single erosion in the neoterminal ileum with known inflammation and the ileoanal pouch 2/2 pouchitis. Patient was given 1 L NS in the ED and is being admitted for ongoing evaluation and management. On arrival to the medical floor patient was hemodynamically stable. Regarding her current COVID infection, patient was vaccinated against COVID-19 with the Pfizer series on 03/19/2021 and 04/13/2021. She states that she had not attended any large social gatherings or public events in the last several weeks. She noted that she consistently wears a mask when out in public. However, patient noted that her daughter and son-in-law do not "believe in COVID" and so they are not vaccinated and do not take safety precautions while in public. Patient visited with her daughter and son-in-law on 09/29/2021 who were feeling ill with symptoms of headache and upper respiratory congestion at the time of their visit. Patient then began to feel fatigued, weak and noted muscle aches on 10/02/2021. Given her transplant status, Infectious Diseases was consulted and recommended remdesivir, and dexamethasone if indicated. Respiratory status, inflammatory markers and labs were monitored closely. Collateral workup was obtained and excluded other acute COVID-related complications. Fortunately, her respiratory status improved. Weaning from O2 was successful. Home oxygen evaluation was performed by RT on 10/11. She was found to NOT quality for homegoing oxygen therapy. Overall, her hospital course was uncomplicated. Medical staff was consulted to assist with her immunosuppression medications. Her Tacrolimus trough was elevated at 9.2. Her Tacrolimus dose was decreased and a repeat trough is trending. Of note, her urine cultures were checked due to a high WBC. They came back positive but because she was asymptomatic, no antibiotics were administered. She remained hemodynamically stable throughout her stay on the medical unit. She completed a 5 day course of Remdesivir. She demonstrated progressive improvement on the aforementioned therapies. Care Management consulted and assisted with discharge planning. Discharge to hotel with friend who will drive back to home with her was arranged on 10/12. She was assessed for Monitoring Program for which she is a candidate. Isolation precautions and criteria for discontinuation are outlined below. Additional ambulatory follow-up with PCP, dermatology, transplant, and GIH was arranged prior to dismissal.

Other Meds:

Current Illness:

ID: 1782299
Sex: M
Age: 74
State: AR

Vax Date: 02/25/2021
Onset Date: 09/27/2021
Rec V Date: 10/13/2021
Hospital: Y

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

Lab Data: Tested positive on 9/11/2021 at unknown location

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Chief Complaint covid + on the 11th, arrived via ems c/o increased lethargy, n/v, and "not acting like himself" per family. recieved monoclonal antibodies at hospital recently. 88%RA - 96%2L History of Present Illness 75-year-old male presents emergency room complaining of shortness of breath fever for the past couple weeks. Patient was diagnosed with COVID on 09/11/2021. He is unsure as to how long he had had symptoms prior to this time. Patient states that he has had nausea vomiting and diarrhea over that period of time. Patient is a very vague historian. I am suspicious that he has some element of dementia but he currently seems oriented to time place and person. He states that he did receive History has been obtained from the emergency room physician that the patient received monoclonal antibody therapy last week. When asked about this the patient did not know what I was talking about but does remember receiving 4 subcutaneous injections in his abdomen which he thinks was at the 1st of the week. The patient's wife was admitted earlier in the day after a fall. The patient is hypoxic in the emergency room with pulse ox readings of 89% on room air. On ABG the patient has a PO2 of 50 on room air. Patient has a past history of diabetes mellitus type 2, hyperlipidemia, hypertension, BPH. Review of Systems Constitutional: [Patient denies fever, chills, sweats, and weight changes.] Eyes: [Patient denies any visual symptoms] ENT: [No difficulties with hearing. No symptoms of rhinitis or sore throat.] Cardiovascular: [Patient denies any chest pain, palpitations, orthopnea, or PND.] Pulmonary: As in HPI Gastrointestinal: As in HPI GU: [No urinary hesitancy or dribbling. No nocturia or urinary frequency. No abnormal urethral discharge.] Musculoskeletal: [No myalgias or arthralgias. No hot, swollen joints.] Neurologic: [No headaches, no seizures. Patient denies numbness, tingling, or weakness on either side of the body. There are no visual symptoms.] Psychiatric: [Patient denies problems with mood disturbance or anxiety.] Endocrine: [No excessive urination or excessive thirst noted. No heat or cold intolerance. No weight gain or changes in skin or hair.] Dermatologic: [Patient denies any rashes or skin changes.] Physical Exam Vitals & Measurements T: 99.8 ?F (Oral) HR: 68(Peripheral) HR: 74(Monitored) RR: 26 BP: 132/68 SpO2: 93% WT: 81 kg VITAL SIGN LAST CHARTED MINIMUM MAXIMUM Blood Pressure 132/68 (09/27 00:45) 125/76 (09/26 22:45) 149/76 (09/26 22:00) Heart Rate 68 (09/27 00:45) 68 (09/27 00:45) 85 (09/26 20:48) Respirations 26 (09/27 00:45) 20 (09/26 20:48) 27 (09/27 00:00) Temperature 99.8 (09/26 20:48) 99.8 (09/26 20:48) 99.8 (09/26 20:48) SpO2 93 (09/27 00:45) 89 (09/27 00:00) 96 (09/26 21:45) O2 Flow Rate 4 (09/27 00:45) 2 (09/27 00:15) 4 (09/27 00:45) Weight 81 (09/26 20:48) 81 (09/26 20:48) 81 (09/26 20:48) DIAGNOSTIC STUDIES: 1. Multiple chest x-rays showing patchy perihilar left-sided airspace disease. 2. CT angiogram of the chest showing bilateral patchy airspace opacities. HOSPITAL COURSE: A 75-year-old male, primary care patient of Dr., presented to the emergency room with shortness of breath. He actually states he was feeling fine and did not want to come to the ER, but his son insisted and dropped him off. In the ER, he was COVID positive with infiltrates on x-ray and was 89% saturating on room air. He was therefore admitted, was started on supplemental oxygen. He was not given any specific treatments and monitored and did not have any worsening of his oxygenation. He was saturating 93% to 94% on room air at the time of discharge. With ambulation his oxygen saturation went down to 84% and so he did qualify for home oxygen temporarily. It is felt to be stable for discharge home on this. Dexamethasone was withheld due to non-severe disease and his already profound hyperglycemia from diabetes. DISCHARGE DISPOSITION: CONDITION: Stable.

Other Meds:

Current Illness:

ID: 1782300
Sex: F
Age: 49
State: KY

Vax Date: 04/01/2021
Onset Date: 09/10/2021
Rec V Date: 10/13/2021
Hospital: Y

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

Lab Data: PCR Test administered on 09/10/2021 at the Hospital

Allergies: Unknown

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

Symptoms: Patient Contracted COVID-19

Other Meds: Unknown

Current Illness: Unknown

Date Died: 10/13/2021

ID: 1782301
Sex: M
Age: 82
State: TN

Vax Date: 02/08/2021
Onset Date: 10/13/2021
Rec V Date: 10/13/2021
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: COVID RELATED DEATH; BREAKTHROUGH CASE

Other Meds:

Current Illness:

ID: 1782302
Sex: F
Age: 87
State: NY

Vax Date: 01/27/2021
Onset Date: 10/10/2021
Rec V Date: 10/13/2021
Hospital: Y

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

Lab Data: Positive COVID-19 test

Allergies: Oxycodone, Percocet

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

Symptoms: Patient admitted to hospital with positive COVID-19 breakthrough case. Only received 1st dose per vaccine database.

Other Meds: unknown

Current Illness: unknown

ID: 1782303
Sex: F
Age: 65
State: SD

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

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

Lab Data:

Allergies:

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

Symptoms: PFIZER VIAL SHOULD HAVE BEEN RECONSTITUTED WITH 1.8 ML NOMAL SALINE AND WAS ONLY RECONSTITUTED WITH 0.8ML NS. PATIENT RECEIVED ULTRA CONCENTRATED VACCINE DOSE. PATIENT AND DOCTORS WERE NOTIFED AND INFORMED OF POTENTIAL INCREASED RISK OF SEVERE SORE ARM FOLLOWING INJECTION.

Other Meds:

Current Illness:

ID: 1782304
Sex: M
Age: 57
State: GA

Vax Date: 10/06/2021
Onset Date: 10/13/2021
Rec V Date: 10/13/2021
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: none noted

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

Symptoms: pt states 1 week after receiving vaccination that the area surrounding the injection site is red, swollen, and itchy he states it resides from the top of his shoulder to his elbow he has attempted to resolve it with oral diphenhydramine

Other Meds: unknown

Current Illness: unknown

ID: 1782305
Sex: M
Age: 14
State: IL

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 10/13/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Moderna given to a child less than 18 years old. No adverse reaction reported.

Other Meds:

Current Illness:

ID: 1782306
Sex: M
Age: 43
State: OH

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

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

Lab Data: 10/11/2021- uterine/ cervical biopsies 11/5/2021 abdominal and vaginal US scheduled

Allergies: None

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

Symptoms: Had menstrual bleeding / clots that started 2 days after vaccine. Menstrual cycle last 3 days, changing tampons hourly passed large clots. Have had menstrual cycles every 10-15 days since receiving vaccine.

Other Meds: Multi-Vitamin's

Current Illness: None

Date Died: 10/12/2021

ID: 1782307
Sex: M
Age: 78
State: MN

Vax Date: 02/06/2021
Onset Date: 10/10/2021
Rec V Date: 10/13/2021
Hospital: Y

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

Lab Data: 10/11/2021 Influenza A/B, SARS CoV-2, PCR, Rapid, Varies- Sars CoV-2 PCR, Rapid DETECTED

Allergies: NKA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: transferred to hospital on 10/10/2021, Passed away on 10/12/2021 REASON FOR ADMISSION Stroke HOSPITAL COURSE Patient is a 79-year-old male admitted to the hospital on 10/10/2021 after he was found to have multiple focal ischemic strokes, mainly a left cerebellar stroke due to left vertebral artery and PICA occlusion. Past medical history if significant for atrial fibrillation on Xarelto, OSA on CPAP, and diabetes (on metformin). On 10/4/2021 he developed COVID-19 infection and presented to the ED for evaluation of shortness of breath and weakness. He was admitted to the medical floor and given supplemental oxygen, remdesivir, and dexamethasone. Around midnight on 10/10/2021 he became unresponsive and bradycardic with heart rates in the 30s with oxygen desaturation. He was initially placed on BiPAP but required intubation shortly thereafter. CT/CTA chest was obtained after intubation, negative for acute PE but did show findings consistent with Covid-19 pneumonia. Around 0200 a head CT was obtained which showed an acute left cerebellar infarct with effacement of the 4th ventricle and hydrocephalus with dilated 3rd ventricle and lateral ventricles. He was transferred to another hospital on 10/10/2021. Recommended starting barcitinib (JAK inhibitor) for COVID pneumonia. He was started on Lovenox 30 mg subcutaneous b.i.d. for D-dimer greater than 3000. Lower extremity ultrasound was negative for DVT. Neurology was consulted who recommended a repeat head CT with CTA 12 hours from the initial. CT/CTA at 1500 showed bilateral inferior cerebellar infarcts with an occluded left vertebral artery and left PICA. There is progressive edema with worse effacement of the 4th ventricle and the prepontine cistern. Given worsening mass effect and brain compression he was transferred to another hospital for management. His initial neurological exam was poor, although confounded by sedative medications. He was started on mannitol with improvement early in the day on 10/11/2021. Neurosurgery was consulted and evaluated. They discussed neurosurgical options with his family, who conveyed that surgical options would not reverse injury already sustained and therefore not be consistent with his wishes. His neurological exam worsened overnight on 10/11/2021 where he was not following commands in the left hemibody. Despite hydration and careful monitoring he developed acute kidney injury. Family including wife and three sons were updated via telephone regarding the severity of his strokes. After discussion they agreed that he would not want to live with neurological disability and losing any part of his independence would not be consistent with his wishes. He also had a living will stating that he would not want artifical means prolonging his life if recovery consistent with his wishes was not able to be achieved. Therefore, he was transitioned to comfort care measures after discussion with patients family on 10/12/2021. He passed away peacefully with family at the bedside at 4:44 pm.

Other Meds:

Current Illness:

ID: 1782308
Sex: F
Age: 19
State: SD

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: PFIZER VIAL SHOULD HAVE BEEN RECONSTITUTED WITH 1.8 ML NOMAL SALINE AND WAS ONLY RECONSTITUTED WITH 0.8ML NS. PATIENT RECEIVED ULTRA CONCENTRATED VACCINE DOSE. PATIENT WAS UNABLE TO BE REACHED TO DISCUSS POTENTIAL ADVERSE REACTIONS. NO PCP LISTED FOR PATIENT.

Other Meds:

Current Illness:

ID: 1782309
Sex: F
Age: 46
State: KY

Vax Date: 04/01/2021
Onset Date: 09/05/2021
Rec V Date: 10/13/2021
Hospital:

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

Lab Data: Antigen Test administered on 9/7/2021

Allergies: Unknown

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

Symptoms: Patient Contracted COVID-19

Other Meds: Unknown

Current Illness: Unknown

ID: 1782310
Sex: F
Age: 38
State: NJ

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

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

Lab Data:

Allergies: n/a

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

Symptoms: My last mentrual cycle was prior to receiving the vaccine and I am always regular. Nothing else in my life had changed. I have missed 2 consecutive cycles and will be contacting my doctor if I miss 1 more. There is no reason for my cycle to have just stopped, I have not changed anything to cause this.

Other Meds: n/a

Current Illness: n/a

ID: 1782311
Sex: F
Age: 42
State: MI

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 10/13/2021
Hospital:

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

Lab Data: N/A - two urgent care visits

Allergies: Sulfa, Darvasat

Symptom List: Unevaluable event

Symptoms: First seven - 14 days: swollen lymph nodes under arm pits, shortness of breath, heart palpitations, swollen lymph nodes in neck, ear and head swelling, ear pressure, ear ringing, internal hot/cold rush, tingling and numbness in arms, legs and hands. Still ongoing/present: heart palpitations, ear, head ressure, ear ringing, internal hot/cold rush, tingling and numbness in arms, legs and hands.

Other Meds: N/A

Current Illness: N/A

ID: 1782312
Sex: F
Age: 58
State: KY

Vax Date: 01/25/2021
Onset Date: 10/06/2021
Rec V Date: 10/13/2021
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: Shingles diagnosis by Dr. on 10/12/2021

Allergies: None

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

Symptoms: Eleven days after receiving the Pfizer booster shot I developed a painful rash on the left side of my back. This was diagnosed as Shingles. My Doctor does not think this was caused by the vaccine, however I felt the need to report. I am a healthy individual with no underlying health conditions.

Other Meds: None

Current Illness: None

ID: 1782313
Sex: M
Age: 77
State: NY

Vax Date: 10/11/2021
Onset Date: 10/12/2021
Rec V Date: 10/13/2021
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 DEVELOPED A BLISTER NEXT TO VACCINATION SITE ON LEFT ARM. PATIENT APPLIED WARM COMPRESS TO SITE, NO PAIN . I TOLD PATIENT TO SEE DERMATOLOGIST. PATIENT MAKING APPT. AND WILL ADVISE AS TO OUTCOME.

Other Meds:

Current Illness:

ID: 1782314
Sex: F
Age: 50
State: FL

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 10/13/2021
Hospital:

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

Lab Data: Friday 8/27/2021 I experienced increased flashes and floaters. I went to my eye doctor for an exam and was diagnosed with a posterior vitreous detatcnhmemt.

Allergies: Latex

Symptom List: Injection site pain, Menorrhagia

Symptoms: Thursday 8/26/2021 I started to experience flashes of bright white light on the left side of my vision in my left eye. The following day I began to experience increased flashes of light and numerous floaters affecting my vision causing to to be blurry

Other Meds: Melatonin, Vitamin D, Multi vitamin, Zinc Picolinate

Current Illness: None

ID: 1782315
Sex: F
Age: 43
State: MA

Vax Date: 10/11/2021
Onset Date: 10/12/2021
Rec V Date: 10/13/2021
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: Swelling and soreness in right armpit. Aches and pains in whole body.

Other Meds: Buspirone 7.5 2x/day Welburtrin XL

Current Illness:

ID: 1782316
Sex: F
Age: 37
State: SD

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

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: PFIZER VIAL SHOULD HAVE BEEN RECONSTITUTED WITH 1.8 ML NOMAL SALINE AND WAS ONLY RECONSTITUTED WITH 0.8ML NS. PATIENT RECEIVED ULTRA CONCENTRATED VACCINE DOSE. PATIENT AND DOCTORS WERE NOTIFED AND INFORMED OF POTENTIAL INCREASED RISK OF SEVERE SORE ARM FOLLOWING INJECTION.

Other Meds:

Current Illness:

ID: 1782317
Sex: F
Age: 28
State: NY

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

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

Lab Data: Patient had Vitals done, and received PO diphenhydramine 25 mg x 1 dose

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient experienced itching on arms, legs and below ear on their booster dose.

Other Meds:

Current Illness:

ID: 1782318
Sex: F
Age: 36
State: KY

Vax Date: 03/26/2021
Onset Date: 08/31/2021
Rec V Date: 10/13/2021
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: PCR administered on 09/06/2021.

Allergies: Unknown

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

Symptoms: Patient Contracted COVID-19

Other Meds: Unknown

Current Illness: Unknown

ID: 1782319
Sex: F
Age: 70
State: WI

Vax Date: 09/28/2021
Onset Date: 10/01/2021
Rec V Date: 10/13/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Nausea

Symptoms: Rash turned to hives on back, chest, stomach, inner thighs. triage nurse said to take antihistamine which I did. It took two days to go away. Skin continued to itch 1 more day.

Other Meds: Venlafaxine, adderall, levothyroxine, nefedipine, , losartan, Linzess,ducosate sodium sennocide, vitamin D 3

Current Illness: None

ID: 1782320
Sex: F
Age: 57
State: IL

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 10/13/2021
Hospital:

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

Lab Data: 3/7/2021 Labs and Ct scans done at ER were all in normal range. Ruled out Bells Palsy

Allergies:

Symptom List: Injection site pain

Symptoms: Left side of face went numb. I went to Urgent Care they referred me to the ER at Medical Center. Spent approx 5 hours at the ER with multiple labs run, Neuro exams, CT scans. They were unsure what was causing it (possible vaccine as that was the only thing within that time frame) and told me to follow up with my dr. The whole event lasted approx 24 hours and face went back to normal within 48 hours. The same symptoms after 2nd shot, but length was only 3-4 hours.

Other Meds: Rosuvastatin, Fish oil, Multi vitamin 50+, Allegra, Estrodial

Current Illness:

ID: 1782321
Sex: F
Age: 34
State: FL

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

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

Lab Data: Scheduled to see Obgyn on 9/25/21.

Allergies: None

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

Symptoms: I received the second Moderna shot on 9/10/21 and have yet to get my period. My period usually starts on the 3rd day of each month. It?s now 10/13/21. It?s 11 days late. Took 4 pregnancy tests and all were negative. No spotting. No major PMS symptoms to report. Hoping it comes back.

Other Meds: Daily vitamin and probiotic

Current Illness: None

ID: 1782323
Sex: M
Age: 58
State: MI

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 10/13/2021
Hospital:

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

Lab Data: none

Allergies: iodine contrast

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

Symptoms: SOB and total body itching. flared up asthma needed inhalers and steroids

Other Meds: ProAir hfa, qvar 40

Current Illness: none

ID: 1782324
Sex: F
Age: 92
State: NY

Vax Date: 02/15/2021
Onset Date: 10/09/2021
Rec V Date: 10/13/2021
Hospital: Y

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

Lab Data: COVID-19 positive

Allergies: Morphine

Symptom List: Tremor

Symptoms: Patient admitted to hospital with breakthrough COVID-19 case. Increasing SOB. 87% on room air.

Other Meds: Unknown

Current Illness: unknown

ID: 1782325
Sex: F
Age: 59
State: NY

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

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

Lab Data: None

Allergies: Flouroquinolones, salmon

Symptom List: Erythema, Pruritus

Symptoms: Fever 101.2 beginning day after vaccines and lasting to following day. Headache, muscle and joint aches, exhaustion the night of vaccines. Chicken pox like bumps and swollen gland appeared under and around arm that received shots two days after shots. Chills and shaking from first to third day.

Other Meds: Covid Booster (Pfizer) One a day vitamins, preservision, Prozac, Wellbutrin, toprol xl,

Current Illness: None

ID: 1782326
Sex: M
Age: 39
State: IL

Vax Date: 04/01/2021
Onset Date: 07/01/2021
Rec V Date: 10/13/2021
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: Comments from the Provider's Office This looks like a benign process. We will see what ENT recommends, but imaging is reassuring. Study Result Narrative Accession Exam Completed Date/Time CT3214201 CT SOFT TISSUE NECK WITH CONTRAST 09/13/2021 09:16 Requesting: ---------------------------------------------------------------------------- EXAM: CT SOFT TISSUE NECK WITH CONTRAST. COMPARISONS: 9/1/2021 ultrasound CLINICAL INDICATION: Solid subcutaneous RIGHT submandibular mass for one month. QUALITY OF STUDY:Good CONTRAST: 80 mL of Isovue 300 mg/mL was injected intravenously. TECHNIQUE: Contiguous axial slices acquired. Coronal and Sagittal reformatted images were obtained. FINDINGS: The bilateral parotid and submandibular glands are symmetric. No sialolithiasis, dilated ducts, or inflammation identified. The palpable lump corresponds to asymmetric subcutaneous fat overlying the RIGHT mandible, just anterior to the RIGHT masseter. There is no capsule or soft tissue component. This is most likely a nonencapsulated lipoma. That measures approximately 4.0 x 1.4 x 4.0 cm. Underlying bone shows no erosion or periosteal reaction. No lymphadenopathy is present. No retropharyngeal collections. The airway is patent and symmetric. There is no oral or parapharyngeal mass. Thyroid is unremarkable. There is minimal biapical pleural-parenchymal scarring. Limited evaluation of the infra tentorial brain is unremarkable. No bony erosions. The carotid vessels show no hemodynamically significant narrowing. . There is mild mucosal thickening in the bilateral maxillary sinuses. IMPRESSION: 1. 4.0 x 1.4 x 4.0 cm nonencapsulated subcutaneous lipoma in the RIGHT cheek/jaw area. ---------------------------------------------------------------------------- Electronically Signed and Authenticated by Component Results There is no component information for this result. General Information Collected on 09/13/2021 8:01 AM Resulted on 09/13/2021 10:25 AM Result Status: Final result

Allergies: none

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

Symptoms: I noticed a mass along my right jawline in late July 2021. After an ultrasound and CT in September, it was diagnosed as a lipoma. I am currently waiting about 5 months to see if it grows any further, then I will likely have surgery to have it removed.

Other Meds: Ferrous gluconate 325mg once daily

Current Illness: none

ID: 1782327
Sex: F
Age: 74
State: FL

Vax Date: 10/04/2021
Onset Date: 10/04/2021
Rec V Date: 10/13/2021
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: NONE

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

Symptoms: Patient stated that she has extreme diarrhea. Has been having body aches, lot taste, had a bad taste in mouth, fever, headaches, chills, lightheaded, skewed thinking, sweating, has to change clothes at least three times a night due to sweating. Patient couldn't move out of bed for at least a day and a half. Every time she eats, she has to go to the bathroom. She stated that she's unable to eat things that used to like.

Other Meds: Blood pressure meds Metformin Motulukast Losartin Hydrochlrcide Nasal spray Zinc Maxi hair plus, biotin Cinnamon Ometprozole Cymbacourt

Current Illness: NONE

ID: 1782328
Sex: F
Age: 44
State: CT

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

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

Lab Data: None at this time. Did get looking at by a medical doctor.

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: After two days I noticed I had a large bulge in my right armpit. Warm to the touch. Tenderness and painful.

Other Meds: Birth control, multivitamin, fluticasone, claritin, thyroid

Current Illness: None

ID: 1782329
Sex: F
Age: 77
State: NY

Vax Date: 03/24/2021
Onset Date: 10/09/2021
Rec V Date: 10/13/2021
Hospital: Y

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

Lab Data:

Allergies: Aceon, Jardiance

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

Symptoms: Patient admitted to hospital with breakthrough covid case. Fever, cough, sore throat, SOB.

Other Meds:

Current Illness: unknown

ID: 1782330
Sex: F
Age: 35
State: MD

Vax Date: 04/06/2021
Onset Date: 08/29/2021
Rec V Date: 10/13/2021
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: positive COVID-19

Allergies: NKA

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

Symptoms: diagnosed with COVID-19 on August 31, 2021 Symptoms started on August 29, 2021 - headache, mild sore throat, mild congestion, complete loss of taste and smell

Other Meds: Mirena IUD Daily Vitamin Probiotic Fiber supplement

Current Illness: none

ID: 1782331
Sex: M
Age: 58
State: MN

Vax Date: 03/17/2021
Onset Date: 10/06/2021
Rec V Date: 10/13/2021
Hospital: Y

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

Lab Data: 10/9/2021 Patient reported +Covid test results from outside facility

Allergies: NKA

Symptom List: Pain in extremity

Symptoms: CHIEF COMPLAINT/REASON FOR VISIT Shortness of Breath (Pt reports testing positive for Covid yesterday. Pt states he feels as though his SOB is getting worse and rates his body aches 8/10.) HISTORY OF PRESENT ILLNESS 58-year-old male past medical history of end-stage renal disease secondary to diabetic nephrosclerosis status post kidney transplant 2010 on triple immune suppression therapy, history of hypertension who is COVID positive day 4 of illness who presents with myalgia and dyspnea. Patient states over the past 3-4 days he has had progressive fatigue myalgias and weakness. Today developed some dyspnea fever and chills. He states he has had some intermittent mild chest pain. Has no history of PE DVT, CHIEF COMPLAINT/REASON FOR VISIT Shortness of Breath (Pt reports testing positive for Covid yesterday. Pt states he feels as though his SOB is getting worse and rates his body aches 8/10.) HISTORY OF PRESENT ILLNESS 58-year-old male past medical history of end-stage renal disease secondary to diabetic nephrosclerosis status post kidney transplant 2010 on triple immune suppression therapy, history of hypertension who is COVID positive day 4 of illness who presents with myalgia and dyspnea. Patient states over the past 3-4 days he has had progressive fatigue myalgias and weakness. Today developed some dyspnea fever and chills. He states he has had some intermittent mild chest pain. Has no history of PE DVT, unilateral leg swelling or redness, no recent immobilization or surgery. He has had decreased oral intake over the past several days and states he feels dehydrated. Patient has received all 3 COVID vaccines Additional information for Item 12: Hospital Hypertension Essential Primary Diabetes Mellitus Type 1 Transplant Renal Reflux Esophageal Immunodeficiency Due To Drugs Hyperlipidemia On Treatment Neuropathy Peripheral Pneumonia Due To COVID-19 Nodule Pulmonary Hyponatremia Thrombocytopenia Non-Hospital Chronic Kidney Disease NOS Hyperlipidemia Fitting Or Adjustment Of Insulin Pump

Other Meds:

Current Illness:

ID: 1782332
Sex: F
Age: 47
State: OH

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 10/13/2021
Hospital:

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

Lab Data: none reported

Allergies: Dilantin: hives

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

Symptoms: Client received 2 doses of Moderna at a different facility and then presented as a first dose at the health department in order to receive $100 gift card incentive (per her statement: "I needed the money.". Moderna dose #1: 05-10-2021; Lot # 033B21A; RIGHT deltoid at Moderna dose #2: 06/07/2021; Lot # 033B21A; LEFT deltoid at Pfizer dose: 08/24/2021: Lot EW0172; RIGHT deltoid at

Other Meds: none reported

Current Illness: none reported

ID: 1782333
Sex: F
Age: 31
State: SC

Vax Date: 08/13/2021
Onset Date: 08/27/2021
Rec V Date: 10/13/2021
Hospital:

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

Lab Data: 10/13/2021: CBC, CHEM 20, Sed rate, CRP

Allergies: NKDA

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

Symptoms: @ weeks after vaccination developed left body pain, including arm, leg and torso

Other Meds: None

Current Illness: None

Date Died: 10/12/2021

ID: 1782334
Sex: F
Age: 50
State: TN

Vax Date: 04/13/2021
Onset Date: 10/12/2021
Rec V Date: 10/13/2021
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: Codeine, vancomycin

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

Symptoms: 9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT. CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away.

Other Meds:

Current Illness:

ID: 1782335
Sex: F
Age: 71
State: AR

Vax Date: 02/12/2021
Onset Date: 10/01/2021
Rec V Date: 10/13/2021
Hospital: Y

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

Lab Data: MANA on 09/26/2021

Allergies:

Symptom List: Vomiting

Symptoms: 72-year-old female presents to the emergency room tonight complaining of cough congestion shortness of breath. Her symptoms started 5 days ago. She reports that 4 days ago she went to her primary care physician and was tested for COVID and was negative. She has not improved with her symptoms in fact she has gotten more short of breath so she returned today and today she tested positive. Due to her hypoxia she was referred to the emergency room. The patient did receive the vaccination for COVID in March. She has not had any treatment as an outpatient as today was the 1st day she has had a positive test. She is a nonsmoker. She does report having fever for the past 5 days intermittently. She reports that her granddaughter who she has been around tested positive 5 days ago. Review of Systems Constitutional: [Patient denies fever, chills, sweats, and weight changes.] Eyes: [Patient denies any visual symptoms] ENT: [No difficulties with hearing. No symptoms of rhinitis or sore throat.] Cardiovascular: [Patient denies any chest pain, palpitations, orthopnea, or PND.] Pulmonary: As in HPI Gastrointestinal: [No nausea, vomiting, diarrhea, constipation, abdominal pain, hematochezia, or melena.] GU: [No urinary hesitancy or dribbling. No nocturia or urinary frequency. No abnormal urethral discharge.] Musculoskeletal: [No myalgias or arthralgias. No hot, swollen joints.] Neurologic: [No headaches, no seizures. Patient denies numbness, tingling, or weakness on either side of the body. There are no visual symptoms.] Psychiatric: [Patient denies problems with mood disturbance or anxiety.] Endocrine: [No excessive urination or excessive thirst noted. No heat or cold intolerance. No weight gain or changes in skin or hair.] Dermatologic: [Patient denies any rashes or skin changes.] Physical Exam Vitals & Measurements HR: 94(Peripheral) HR: 94(Monitored) RR: 24 BP: 126/91 SpO2: 92% WT: 91 kg VITAL SIGN LAST CHARTED MINIMUM MAXIMUM Blood Pressure 126/91 (10/01 22:30) 86/59 (10/01 22:15) 198/94 (10/01 17:45) Heart Rate 94 (10/01 22:30) 79 (10/01 18:30) 108 (10/01 22:15) Respirations 24 (10/01 22:30) 18 (10/01 16:41) 32 (10/01 18:30) Temperature 100.1 (10/01 16:41) 100.1 (10/01 16:41) 100.1 (10/01 16:41) SpO2 92 (10/01 22:30) 81 (10/01 17:45) 99 (10/01 18:00) O2 Flow Rate 4 (10/01 18:00) 4 (10/01 18:00) 4 (10/01 18:00) Weight 91 (10/01 16:41) 91 (10/01 16:41) 91 (10/01 16:41) HOSPITAL COURSE: A 72-year-old female, primary care patient of Dr. presented to the emergency room with 5 days of symptoms of shortness of breath and cough. She was mildly hypoxemic in the emergency room. She was admitted, given dexamethasone and remdesivir. By hospital day #2, she was feeling markedly better, and was wishing to go home. She seemed very stable from an oxygen standpoint, did qualify for home oxygen with 2 L since she desaturated to 86% with ambulation. This was set up and she was felt to be stable for discharge home to complete a course of oral dexamethasone. She also had a followup scheduled the following day. DISCHARGE DISPOSITION: CONDITION: Stable and improved.

Other Meds:

Current Illness:

ID: 1782336
Sex: M
Age: 77
State: KY

Vax Date: 03/19/2021
Onset Date: 10/12/2021
Rec V Date: 10/13/2021
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:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Janssen on 3/19. Positive on 10/12

Other Meds:

Current Illness:

ID: 1782337
Sex: F
Age: 42
State: KY

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 10/13/2021
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: neosporin

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

Symptoms: 1st injection: after 15 minute monitor neck started to itch, hives on L arm and all over my neck and chest. About an half hour after that when I received Benadryl and shot of Solumedrol I started to get a rash around my lips and my lips swelled. I took another dose of benadryl. I went home and by the end of the day had 125mg of Benadryl. 2nd injection: PCP advised me to pre medicate and I took Benadryl and Clariton. I was fine thru my shift with taking 50mg of benadryl. When I got home around 9pm I laid in my chair and fell asleep. I woke up around 3am and was freezing and aching. I went to bed and when I woke up my eyes, jaw, lips and L arm were swollen. I could barely walk. I took a benadryl throughout the day. I had a severe headache. The Left lymph node was very sore and hard in the side of my neck. My facial swelling finally went down Sunday into Monday. I will not be receiving the booster. I was made to take the vaccine in the first place. I did not want to take but was afraid it was going to come down to me getting fired.

Other Meds: zoloft, gabapentine,wellbutrin, diazapam, amoxicillin had two doses left, centrum vitamin

Current Illness: had a upper respiratory infection prior to vaccine. That was why I was on the antibiotic

ID: 1782338
Sex: M
Age: 85
State: MN

Vax Date: 02/03/2021
Onset Date: 10/08/2021
Rec V Date: 10/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: SARS Coronavirus 2, PCR Rapid, V Symptomatic DETECTED 10/8/2021

Allergies: NKA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: CHIEF COMPLAINT/REASON FOR VISIT Weakness - Generalized HISTORY OF PRESENT ILLNESS An 86-year-old gentleman history of coronary artery disease status post CABG, abdominal aortic aneurysm, hyperlipidemia, chronic kidney disease, hypertension, history of prostate cancer, central sleep apnea. He lives alone and independently. He is brought to the emergency department by EMS with concerns of generalized weakness with a syncopal event today. Patient reports that for the past week he has been feeling generalized malaise, weakness, and upper respiratory symptoms including a cough. He has had 3 episodes of diarrhea in the past week which have been nonbloody. He has been tolerating food and fluids, though admits he has not been hydrating well because he did not feel good. Earlier today the neighbors him taken him to the clinic for outpatient COVID testing given his persistent symptoms. These results are pending. When he was returning back to his home in walking up the stairs he had a near syncopal episode where he collapsed. He denies preceding lightheadedness or palpitations at the time His neighbor assisted him to the ground in the only injury he sustained was an abrasion to the left elbow. However the neighbor states that he was in and out of consciousness for about a minute while he was on the ground. The neighbor also reports that he has noticed that the patient breathe severe with any amount of exertion though the patient himself denies shortness of breath. The patient denies any chest pain, fever. He reports that his cough has been nonproductive. No abdominal pain or headache. Denies preceding nausea and vomiting but did state that he vomited once in the ambulance EN route and was given 4 mg Zofran and started on 1 L of IV fluids.

Other Meds:

Current Illness:

ID: 1782339
Sex: M
Age: 89
State: FL

Vax Date: 02/20/2021
Onset Date: 08/15/2021
Rec V Date: 10/13/2021
Hospital: Y

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

Lab Data:

Allergies: Atorvastatin, Simvastatin

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

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

Other Meds:

Current Illness:

ID: 1782340
Sex: F
Age: 71
State: KY

Vax Date: 02/08/2021
Onset Date: 10/12/2021
Rec V Date: 10/13/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Moderna on 1/12 and 2/8. Positive on 10/9

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am