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: 1785591
Sex: F
Age: 34
State: NY

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/14/2021
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: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: FEver, Chills, Headache, fatigue

Other Meds: Vitamin D

Current Illness:

Date Died: 09/24/2021

ID: 1785592
Sex: M
Age: 60
State: GA

Vax Date: 04/19/2021
Onset Date: 09/10/2021
Rec V Date: 10/14/2021
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: She stated the PUI started to have symptoms on 09/10/2021 with cough, fatigue and brain confusions. She stated as of today the PUI is not doing so well. PUI is hospitalized at Hospital since 09/11/2021. She said she think the only reason why he still in the hospital is due to his brain cancer and since having COVID it has made things worse. Patient is fully vaccinated.

Other Meds:

Current Illness:

Date Died: 10/12/2021

ID: 1785593
Sex: M
Age: 77
State: TN

Vax Date: 01/28/2021
Onset Date: 10/12/2021
Rec V Date: 10/14/2021
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: none

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

Symptoms: Admitted to hospital on 10/2 with covid pneumonia with acute hypoxia respiratory failure. Also stated history of having bright red bleeding per rectum. Treated with covid bundle medications. Intubated on 10/4 due to Upper airway obstruction due to large volume posterior aspect epistaxis. Internal maxillary artery embolization on 10/7 but continued to have anemia and thrombocytopenia with continued melanotic stool and suctioning of bleeding in the setting of severe sepsis. Received 9 units platelets and over 3 units PRBC. Diagnosed with bilateral sub segmental PEs but not candidate for anticoagulation due to bleeding risk. Evidence of rhabdomyolysis with AKI. Treated with cefepime and zyvox due to sepsis and shock. Coagulopathy continued with cyanosis of the upper and lower digits. Decreased pulsations in the dorsal pedis and upper extremities. Ultrasound showed no flow in right dorsalis pedis and dampened flow in right and left ulnar arteries. Given prophylactic anticoagulation due to bleeding risk. Mucosal bleeding increased. A=complicated course with encephalopathy and unable to be weend from vent. Family aware and transitioned to comfort care.

Other Meds:

Current Illness:

ID: 1785595
Sex: M
Age: 52
State: MO

Vax Date: 08/25/2021
Onset Date: 09/15/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: uncontrollable shaking/twitching in fingers, hands, and arms when resting. Began when sick from second shot, and continuing to get worse and more frequent.

Other Meds: None

Current Illness: None

ID: 1785596
Sex: F
Age: 71
State:

Vax Date: 10/02/2021
Onset Date: 10/03/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: Ultrasound - Week and 3 days after

Allergies:

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

Symptoms: Swollen lymph gland - right side of neck

Other Meds:

Current Illness:

ID: 1785597
Sex: M
Age: 67
State: MA

Vax Date: 03/24/2021
Onset Date: 03/29/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: Chest X-ray, CAT Scan, PET Scan, Biopsy.

Allergies: -Allergic to Minocycline -Mild Seasonal/Pollen Allergies

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

Symptoms: I had had a dry cough that would come about after any bout with the flu, since Year 2000. Other than that, any coughing that came about was within what one would expect to be the norm. Obviously, it was not a serious lung cancer, or I would've perished after a few short years. Five days after receiving the Pfizer Covid-19 Vaccine, I felt a sudden on-rush of pressure rising into my head and IMMEDIATELY got tinnitus. The tinnitus is still with me to this day. Twenty-one days thereafter, I started to cough. But this time it persisted for months ( To this day ). After undergoing various tests, I was told that I had lung cancer. I had had no cough before receiving the vaccine. I feel as though there was a connection between the vaccine and my lung cancer.

Other Meds:

Current Illness:

ID: 1785599
Sex: F
Age: 38
State: NV

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

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

Lab Data: X Ray waiting MRI 16 lab test 10/07/2021

Allergies: Diflucan

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: My right foot balled up muscle spasms and body twitching daily headaches painful chest around my heart.

Other Meds: None

Current Illness: None

ID: 1785600
Sex: F
Age: 91
State: GA

Vax Date: 03/01/2021
Onset Date: 09/11/2021
Rec V Date: 10/14/2021
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: Patient hospitalized due to COVID. Fully vaccinate.

Other Meds:

Current Illness:

ID: 1785601
Sex: F
Age: 69
State: MO

Vax Date: 04/02/2021
Onset Date: 10/07/2021
Rec V Date: 10/14/2021
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: Ceclor, milk product, synvisc

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Chief Complaint Patient has been having nausea and vomiting for the last 5 days. Has not eaten in three days. "started running a temp saturday night". No tylenol or ibuprofen today. Exposed to covid 2 weeks ago, tested neg on a rapid. History of Present Illness Patient is a 69 year old female with pmh DM2, HTN, depression, hypothyroidism, sleep apnea and asthma presenting to the ED today with complaints of fevers, nausea and diarrhea. In the ED patient was saturating at 87% on room air, improved to 95% with 2L NC. Found to be covid positive, although patient is vaccinated. She received 1L bolus of NS and reglan for nausea. Labwork revealing elevated D-dimer, and glucose of 445 with anion gap w/o acidosis. She received 10U insulin in ED with improvement of glucose to 391, received an additional 5U insulin. Beta hydroxybutyrate Upon interview, patient reports that 5 days ago she started to feel bad. Describes have fatigue, myalgias, fevers, nausea and diarrhea. Denies any emesis. Has has poor oral intake due to the nausea and has subsequently missed taking some of her home medications. Has been feeling short of breath which has been worsening over the past day or so which promoted her presentation to the hospital today. Notes that she is vaccinated against covid, but was exposed by her daughter who is also admitted with covid currently. Denies any chest pain, headache, sore throat or leg pain. Review of Systems All systems reviewed, and is negative except as noted in the HPI. Physical Exam Vitals & Measurements T: 36.5 ?C HR: 72 RR: 18 BP: 151/71 SpO2: 94% WT: 108.7 kg General: NAD Head: Normocephalic, Atraumatic Eyes: EOM intact, sclera clear Mouth: mucous membranes moist Respiratory: Diminished breath sounds in the bases, mild coarse breath sounds upper lobes, unlabored, symmetric chest rise Cardiovascular: RRR, no murmurs, normal S1/S2, +2/4 peripheral pulses bilaterally. Trace pitting edema bilateral LE Abdomen: soft, nontender, nondistended MSK: no gross deformities Neuro: alert and oriented, CN intact grossly, no focal neurologic deficits grossly Psych: normal affect and mood, cooperative Assessment/Plan Pt is a 69 year old F pmh HTN, DM2, asthma, depression admitted for acute hypoxic respiratory failure in setting of covid-19 pneumonia. Pt is vaccinated against covi-19, +recent exposure. Requiring 2L NC in ED, will draw inflammatory markers and start Remdesivir and Dexamethasone while titrating oxygen to maintain spO2 > 92%. Also noted to have elevated glucose at 445 as pt missed medications at home, AG of 23 without acidosis. Glucose improved to 381 in ED after 10U insulin, given an additional 5U. Pt's BHB returned elevated at 2.9, suspect in early DKA - will send to PCU for close monitoring/ possible need for insulin drip if glucose fails to downtrend. COVID-19 Pneumonia: - symptom onset: 10/2; Date positive 10/7 - CXR showing findings consistent with multifocal atypical/viral pneumonia. - elevated d-dimer 0.58 - doppler US b/l ordered - Inflammatory markers ordered and pending - Start Dexamethasone 6mg daily x10 days (10/7-10/17) - Start Remdesivir x 5 days (10/7-10/12) - Continue home inhalers - Albuterol, Advair and Incruse - requiring 2L NC, titrate as needed to maintain saturations > 92% Diabetes Mellitus type 2 - home regimen metformin + insulin 70/30 50-55U BID - Glucose elevated on arrival 445, received 10U insulin ED with improvement to 381 - AG of 23, not acidotic on VBG - pH 7.33, HCO3 21.9 - BHB elevated 2.92 - Start Insulin Drip and DKA protocol - Hgb A1c ordered Asthma: - continue home inhalers: albuterol, Advair and Incruse HTN: - continue home amlodipine 10mg daily - continue home losartan 100mg daily Hypothyroidism - continue home levothyroxine Depression - continue home escitalopram, buspirone and amitriptyline - also takes minalciprin (Savella) at home, although not on formulary here so not continued Other chronic medical conditions: Muscle spasms - continue home tizanidine Code Status: Full Code Diet: Diabetic DVT ppx: Lovenox Disposition: PCU - likely downgrade in the morning if glucose controlled Patient staffed with attending physician Doctor.

Other Meds: unknown

Current Illness: unknown

ID: 1785602
Sex: M
Age: 48
State: IA

Vax Date: 10/13/2021
Onset Date: 10/13/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: none

Allergies: unknown

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 2nd dose given 14 days after 1st dose

Other Meds: unknown

Current Illness: unknown

ID: 1785603
Sex: F
Age: 50
State: CA

Vax Date: 09/25/2021
Onset Date: 09/27/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data:

Allergies: cipro

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

Symptoms: Bell's Palsy 48 hours after receiving vaccine

Other Meds: none

Current Illness: none

ID: 1785604
Sex: F
Age: 13
State: CA

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 10/14/2021
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: n/a

Symptom List: Rash, Urticaria

Symptoms: patient was feeling more tired then usual

Other Meds: n/a

Current Illness: n/a

ID: 1785605
Sex: F
Age: 54
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient c\o neck pain and being lightheaded s\p dose #1 of Pfizer vaccine. Patient's first recorded B\P at 1735 on 9/30/2021 s\p vaccination was 130/75. At time patient was sent out by EMS VS 81- 20- 205/109- 99% RA. Called patient X3 and left VM. Unable to get a hold of this patient to find out specifics of incident and what hospital said to her.

Other Meds:

Current Illness:

ID: 1785606
Sex: F
Age: 74
State: GA

Vax Date: 04/17/2021
Onset Date: 09/07/2021
Rec V Date: 10/14/2021
Hospital: Y

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: She's in the hospital and can't talk much, she has pneumonia and breathing issues. They are not sure how the virus was contracted. PUI had no appetitie and didn't eat for 3 days. They thought at first that she had sinus infection. PUI is on steroids and antibiotics. She was nauseated but never vomited. She had a heart attack years ago and has had bladder cancer.

Other Meds:

Current Illness:

ID: 1785607
Sex: F
Age: 55
State: MN

Vax Date: 02/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/14/2021
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: metformin and glimepiride

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

Symptoms: cough, fever (Tylenol needed to keep temp from going up to 102), covid (+) test last Friday., body aches, headache, loss of taste, loss of smell starting on 10/6/21

Other Meds: Venlafaxine HCl 75 mg 3 tablets daily Abilify 10 MG Tablet 1 tablet Orally Once a day BuPROPion HCl 300MG Tablet Tablet Extended Release 24 Hour 1 tablet daily Vitamin D High Potency 1000 UNIT Capsule 1 capsule Orally Once a day

Current Illness: none

ID: 1785608
Sex: F
Age: 73
State: PA

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/14/2021
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: none

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

Symptoms: vaccine was given after the 6 hours window of being mixed

Other Meds: na

Current Illness: na

ID: 1785609
Sex: M
Age: 62
State: WI

Vax Date: 09/14/2021
Onset Date: 09/22/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: CT Scan on 9/22/21

Allergies: none

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

Symptoms: blood clot on both lungs

Other Meds: Blood Pressure & Cholesterol

Current Illness: none

ID: 1785610
Sex: M
Age: 19
State: MN

Vax Date: 09/14/2021
Onset Date: 09/16/2021
Rec V Date: 10/14/2021
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: Presented with chest pain and weakness 2 days after Moderna vaccination for COVID. Diagnosed with pericarditis

Other Meds:

Current Illness:

ID: 1785611
Sex: F
Age: 78
State: CA

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

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

Lab Data: none

Allergies: monistat, seasonal allergies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe headache, shaking, and chills; also, nausea, tiredness, insomnia, and generally feeling cold when not having chills. Symptoms started Friday evening (day of injection) and persisted the following day (Saturday). Felt a little bit better on Sunday. Monday much better.

Other Meds: levothyroxine, intrarosa ,allegra, flonase, kyolic, melatonin, multivitamins, vitamin D,

Current Illness: rotator cuff tendonitis

ID: 1785612
Sex: F
Age: 63
State: UT

Vax Date: 04/07/2021
Onset Date: 10/08/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: COVID test - I went to site - had two tests and the rapid test - negative; saliva test was positive. I went on the day after I had the symptoms.

Allergies: Demerol

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

Symptoms: Sore throat; slight headache; congestion; upper respiratory congestion; cough; and feeling lousy; diarrhea, too. I have been taking like a dayquil gel pill. It usually gives me some relief.

Other Meds: Metformin; Trulicity; Tizanidine; Gabapentin; Simvastatin; Omeprazole; Vit D; Baby Aspirin

Current Illness: none

ID: 1785613
Sex: F
Age: 33
State: MN

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/14/2021
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:

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

Symptoms: Tested PCR positive for COVID 10/14/21 after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1785614
Sex: F
Age: 33
State: MN

Vax Date: 10/04/2021
Onset Date: 10/05/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: Covid PCR - positive on 10/13/21

Allergies:

Symptom List: Unevaluable event

Symptoms: Cold symptoms

Other Meds:

Current Illness:

ID: 1785615
Sex: F
Age: 55
State: MI

Vax Date: 03/24/2021
Onset Date: 04/26/2021
Rec V Date: 10/14/2021
Hospital: Y

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

Lab Data: June 2, 2021, overnight stay at hospital. Several tests completed to determine Pericarditis/myocarditis

Allergies: Keflex Codiene Sulfa

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

Symptoms: In addition to myocarditis/Pericarditis, I developed a rash, hive-like on my left arm that is still present. I am also severely fatigued a great deal.

Other Meds: Levothyroxine 0.100mg (100mcg) Tab Omeprazole 40mg Capsules

Current Illness: none

ID: 1785616
Sex: M
Age: 50
State: NV

Vax Date: 09/30/2021
Onset Date: 10/03/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Kidney pain low back both sides, fatigue, upset stomach, no appetite, constipation, chills, full body ache, temperature, full body joint ache, very dark urine, low abdomen cramps

Other Meds: None

Current Illness: None

ID: 1785617
Sex: F
Age: 17
State: TX

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: NONE

Allergies: NKA

Symptom List: Injection site pain, Menorrhagia

Symptoms: ACCORDING TO RECORDS, RECEIVED FIRST PFIZER DOSE 5/13/2021. RECEIVED SECOND DOSE TOO EARLY ON 5/28/2021.

Other Meds: NOT REPORTED

Current Illness: NOT REPORTED

ID: 1785618
Sex: F
Age: 42
State: MO

Vax Date: 03/19/2021
Onset Date: 10/07/2021
Rec V Date: 10/14/2021
Hospital: Y

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

Lab Data:

Allergies: seroquel

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

Symptoms: Chief Complaint pt seen in ER today for SOA, fever, sore throat, HA, N/D. Given fluids and d/c, pt has had no relief, took tylenol pta History of Present Illness Patient is a 43 year old Female with pmh DM, HTN, HLD, bipolar and schizoaffective disorder presenting for fevers, shortness of breath. In ED patient was put on 2L O2 via NC to maintain saturations. Found to be covid positive, despite being vaccinated. Patient was tachycardic so CT PE was obtained, negative for PE but showed findings consistent with COVID pneumonia. Labwork otherwise unremarkable with exception of elevated glucose at 199. Patient was admitted for new oxygen requirements. Upon interview, patient reports that 2-3 days ago she started to feel feverish/chills, reports headache, sore throat, myalgias. Also reporting cough and increasing shortness of breath over the last day, for which she presented to the ER today. She is nauseous and has been having diarrhea, but denies emesis. States she has not eaten much of anything in the last 2-3 days. Denies any She has taken her home medications as prescribed. She is vaccinated against covid, completed the series months ago. Denies any known sick contacts/exposure. Review of Systems All systems reviewed, and is negative except as noted in the HPI. Physical Exam Vitals & Measurements T: 36.8 ?C TMIN: 36.0 ?C TMAX: 36.8 ?C HR: 96 RR: 30 BP: 128/92 SpO2: 92% WT: 121.8 kg General: NAD Head: Normocephalic, Atraumatic Eyes: EOM intact, sclera clear Mouth: mucous membranes moist Respiratory: Dimished breath sounds throughout, no wheezes, rhonchi or rales, unlabored, symmetric chest rise Cardiovascular: RRR, no murmurs, normal S1/S2, +2/4 peripheral pulses bilaterally Abdomen: obese abdomen, soft, nontender, nondistended MSK: no gross deformities. No calf tenderness on palpation. No LE edema or redness. Neuro: alert and oriented, CN intact grossly, Psych: normal affect and mood, cooperative Assessment/Plan Patient is a 43-year-old female with DM, HTN, HLD, bipolar/schizoaffective admitted for acute hypoxic respiratory failure in setting newly diagnosed COVID-19 pneumonia. CT PE done negative for pulmonary embolism, findings consistent with Covid pneumonia. Labwork otherwise unremarkable, mildly hyperglycemic at 199. Inflammatory markers ordered and pending. Pt requiring 2-4 L oxygen via nasal cannula, may have component of underlying undiagnosed sleep apnea as desaturated while sleeping. Will start on dexamethasone, and titrate oxygen to maintain saturations greater than 92%. Acute Hypoxemic Respiratory Failure COVID 19 Pneumonia - sx onset 10/5; date positive 10/8. Is vaccinated against covid-19 - CT PE negative for PE but showing few bilateral patchy groundglass airspace opacities consistent with covid-19 pneumonia. - doppler US bilateral LE ordered - WBC wnl, Inflammatory markers ordered and pending - Requiring 2L via NC, initially requirement increased to 4L while sleeping (may have component of undiagnosed sleep apnea) - titrate supplemental oxygen to maintain sPO2 > 92% - Continue home inhalers - albuterol, Fluticasone-salmetereol - Bronchodilator protocol - Start Dexamethasone 6mg daily - could consider initiating Remdesivir DM2: - on home regimen metformin 500mg once daily - Glucose elevated 199 on arrival, no evidence of AG or metabolic acidosis - will start SSI - hgb A1C ordered HTN: - continue home lisinopril 10mg daily Asthma: - continue home inhalers albuterol and fluticasone-salmeterol Bipolar/Schizoaffective Disorder: - continue home risperidone, Lamotrigine, Diazepam Code Status: Full Code Diet: Diabetic DVT ppx: Lovenox Disposition: Floor Patient to be staffed with attending physician.

Other Meds: unknown

Current Illness: unknown

ID: 1785619
Sex: F
Age: 78
State: OR

Vax Date: 04/10/2021
Onset Date: 09/20/2021
Rec V Date: 10/14/2021
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: COVID test - 2 negative, 1 positive

Allergies: Azithromycin; BACTRIM; codeine; doxycycline; KEFLEX; lisinopril; oxycodone; OXYCOTIN; VICODIN; environmental allergies

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I started feeling nauseated 9/20/2021. And I could initially eat and drink a little. Those symptoms got worse. I was cold, could not get warm. All I wanted to do was sleep. I had diarrhea. Mostly, I was not interested at food at all. I was trying to keep hydrated, but that wasn't working at all. And then a couple of days after I started feeling sick, I expected I got COVID but those tests were negative. So by 9/27, I was feeling quite ill and called my doctor's office and they had me come right over and tested. And that's when I had the confirmed COVID diagnosis. They immediately asked if I knew about regenerance. It's not available in town at this time. So the doctor's nurse called around and asked if anyone had the infusion and they found a place in (Privacy). I called up there and they confirmed that they had the infusion and I asked if I could get up there to get the infusion. This was late in the afternoon and they set me up an appointment for 4:30pm. On a normal day without commute, I can't get there within an hour normally. But the doctor said he would wait for me and he did. I did not reach his office until after 5pm. And he was there by himself at the time. It took about an hour to infuse, and he kept checking in with me to make sure that I was okay. And then I was able to go home. After that I still continued to have nausea and diarrhea and of course the cough which I still have. My oxygen level was down to 91 when I got to the doctor's office for the infusion. And after he gave me the infusion it was up to 97. And then for about a week afterward, I continued to have nausea and diarrhea. I think the diarrhea was because I only could hold down fluids. I was very tired most of the time and I wanted to sleep most of the day. And that lasted for about a week. I have definitely gotten better throughout the week. And I'm able to stay up during most of the day and sleep through the night. High dose flu vaccine 9/17.

Other Meds: Alpha lipoic acid; low dose aspirin; calcium; fish oil; fluticasone; glipizide; hydrochlorothiazide; losartan; metformin; metoprolol tartrate; TYLENOL PM; omeprazole; pioglitazone; simvastatin; super B maxi complex vitamin; vitamin D3

Current Illness: N/A

ID: 1785620
Sex: M
Age: 12
State:

Vax Date: 09/02/2021
Onset Date: 10/14/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: PT received Moderna vaccine instead of Pfizer vaccine

Other Meds: N/A

Current Illness: N/A

ID: 1785621
Sex: M
Age: 72
State: PA

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: none

Allergies: na

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

Symptoms: vaccine was given after the 6 hour window of being mixed

Other Meds: na

Current Illness: na

ID: 1785622
Sex: F
Age: 25
State: SC

Vax Date: 09/02/2021
Onset Date: 09/20/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: TTE 10/13/21 Left Ventricle: ? Left ventricular ejection fraction was measured by Simpson's biplane method at 70 %. Pericardium: ? There is no pericardial effusion and no significant Doppler respiratory variation. Overall Conclusions: ? Normal 2D echo and Doppler study for patient's age. ? No prior study available for comparison. LABS Lab Results Component Value Date WBC 6.73 09/30/2021 HGB 13.7 09/30/2021 HCT 40.6 09/30/2021 PLT 264 09/30/2021 Lab Results Component Value Date NA 139.0 09/30/2021 K 3.7 09/30/2021 CL 109 (H) 09/30/2021 BUN 13 09/30/2021 CREATININE 0.9 09/30/2021 GLUCOSE 119.0 (H) 09/30/2021 CALCIUM 10.0 09/30/2021 Lab Results Component Value Date AST 20 08/05/2021 ALT 22 08/05/2021 ALKPHOS 68 08/05/2021 PROT 7.1 08/05/2021 Personal review of her ECG from 9/30/2021 shows sinus tachycardia with diffuse ST elevations and PR depressions. ECG today (October 5, 2021) shows normal sinus rhythm with sinus arrhythmia. Normal ECG. No evidence of ST elevations or PR depressions compared to previous.

Allergies: Gadolinium-containing Contrast Media Iodinated Contrast Media Shellfish Containing Products Sulfamethoxazole-trimethoprim Tioconazole Metronidazole

Symptom List: Nausea

Symptoms: chest pain, dyspnea, and what she describes as congestion shortness of breath, constant nonradiating central chest pain that she describes as "sharp" in nature that began Monday and has not changed in nature but has been persistent. Pericarditis

Other Meds: omeprazole

Current Illness: None

ID: 1785623
Sex: M
Age: 67
State: OH

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/14/2021
Hospital: Y

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

Lab Data: They drew blood four times, two chest X-rays and a CAT Scan 10/11/2021 & 10/12/2021.

Allergies:

Symptom List: Injection site pain

Symptoms: Pneumothorax in my left lung. I was having chest pains and thought it was my heart. The harder I breathed the more pain I felt. I drove myself to the hospital 10/11/2021.

Other Meds: Albuterol Sulfate

Current Illness:

ID: 1785624
Sex: F
Age: 26
State: AL

Vax Date: 10/13/2021
Onset Date: 10/13/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Nausea, joint pain, severe headache. Zofran is not helping with the nausea. Pain releaver is not working for headache or joint pain.

Other Meds:

Current Illness: None

ID: 1785625
Sex: F
Age: 66
State: WI

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/14/2021
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. Monitored vital signs.

Allergies: None

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

Symptoms: Co-administered the high dose flu and the booster dose of Covid had almost immediate full body flushing, bilateral red conjunctiva, low back pain, headache, and slight tightness in throat. Pulse rate - 112-119, R- 18, O2 sat - 95-96%. All symptoms resolved over 20-25 minutes. Called client to follow-up 4.5 hours later. She stated she was at home feeling completely fine.

Other Meds: Pseudoephed, Vit D, MVI, Nasonex, amlodipine, lisinopril, hydrochlorothiazide, celexa, timolol ophthalmic, and latanoprost ophthalmic

Current Illness: None

ID: 1785626
Sex: F
Age: 79
State: MI

Vax Date: 01/24/2021
Onset Date: 10/06/2021
Rec V Date: 10/14/2021
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:

Allergies:

Symptom List: Tremor

Symptoms: Pt has a history of dementia, COPD, DM2, and is being admitted for sepsis secondary to mild colitis. Chest xray showed possible infiltrate. Initial COVID testing was negative. Repeat testing done on 10/12 before discharge to HCF was positive.

Other Meds:

Current Illness:

ID: 1785627
Sex: F
Age: 56
State: MN

Vax Date: 01/26/2021
Onset Date: 10/14/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Tested PCR positive for COVID 10/14/21 after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1785628
Sex: F
Age: 52
State: MO

Vax Date: 04/08/2021
Onset Date: 10/02/2021
Rec V Date: 10/14/2021
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: 2 COVID-19 tests: negative.

Allergies: Morphine and pain medications

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

Symptoms: The next day after having the vaccine my arm was sore at the injection site and I felt a little achy. Like flu symptoms but they were very slight. My arm was sore after a week. On 10/02/2021 I started getting a sore throat. I thought it was allergies because of the weather. It did not go away. I started getting a runny nose, cough, headache, flu like symptoms, diarrhea, low grade fever. It went down to my chest. I never lost my sense of smell or taste. It felt like the normal flu. On Monday I called the doctor to make sure I did not have COVID-19. I took an antigen test that I got from Walgreens and the doctor ordered a PCR test and both were negative. She prescribed a steroid and an inhaler. I also took some over the counter medication.

Other Meds: Tylenol

Current Illness: None

ID: 1785629
Sex: M
Age: 14
State: CA

Vax Date: 10/11/2021
Onset Date: 10/12/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: laboratory studies included a normal comprehensive metabolic panel with the exception of a creatinine at 0.6, alkaline phosphatase at 245. Troponin I was seeing road 0.088 ng/mL (laboratory reference range less than or equal to 0.040 ng/mL). 15-lead electrocardiogram performed on 10/14/2021 showed normal sinus rhythm with a rate of 70 bpm. PR interval 142 ms. QRS 94 ms, QTC 434 ms. Normal axis at 69?. There was generalized ST segment elevation consistent with pericarditis. There was possible left ventricular hypertrophy based on voltage criteria. A complete echocardiogram performed on 10/14/2021 showed normal intracardiac anatomy. Both coronary arteries were normal in size without evidence of ectasia and or aneurysm formation. The function was hyperdynamic with a left ventricular fractional shortening of 42% and ejection fraction of 73%. There was no pericardial effusion.

Allergies: No know allergies

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

Symptoms: Patient presented with left sided chest pain about 12-24 hours after the administration of the first vaccine. He had chest pain that worsened with respirations. Laboratory studies included elevated troponin levels consistent with myocarditis. A 15-lead electrocardiogram showed pericarditis. By 48 hours the patient had reduction in pain while being treated with ibuprofen, 400 mg by mouth 3 times daily. 3 days after the vaccination he received an echocardiogram showing normal left ventricular function.

Other Meds: Albuterol HFA inhaler, as needed basis

Current Illness: None

ID: 1785630
Sex: M
Age: 60
State: CA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 10/14/2021
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

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 102 degree fever, chills, shakes, sweats, fatigue, nausea, headache. Only used Tylenol, resolved after about 40 hours.

Other Meds: Atorvastatin, levothyroxine

Current Illness: None

ID: 1785632
Sex: F
Age: 52
State: MI

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: I have not felt like myself since before the vaccine. After the vaccine, I felt very sick with a high temp, headache, forgetfulness/fogginess, temporal pain, fatigue and dizzy. I started to feel better, but still have headaches and forgetfulness/fogginess.

Other Meds: None.

Current Illness: None

ID: 1785633
Sex: F
Age: 61
State: MN

Vax Date: 01/19/2021
Onset Date: 09/01/2021
Rec V Date: 10/14/2021
Hospital: Y

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 TEST 9/1/21

Allergies:

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

Symptoms: MENTAL STATUS CHANGED

Other Meds: Aspirin 325 mg Atorvastatin 40 mg Cabergoline tablet 0.5 mg Synthroid 75 mcg Sevelamer 800 mg Midodrine 10 mg

Current Illness:

ID: 1785634
Sex: F
Age: 16
State: LA

Vax Date: 10/13/2021
Onset Date: 10/13/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data:

Allergies: NO

Symptom List: Pain in extremity

Symptoms: The patient received a Moderna vaccine but does not meet the age requirement.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1785635
Sex: M
Age: 78
State: NC

Vax Date: 10/13/2021
Onset Date: 10/13/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Erythema and edema to left upper arm

Other Meds: Lisinopril-HCTZ, Carvedilol, Simvastatin, Ketoconazole, Spriva

Current Illness: none

ID: 1785636
Sex: M
Age: 28
State: TX

Vax Date: 10/12/2021
Onset Date: 10/12/2021
Rec V Date: 10/14/2021
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

Allergies: None

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

Symptoms: 1245: Patient presented to clinic to receive Johnson & Johnson COVID-19 vaccine. Prior to administration, patient denied any allergies or allergic reactions to vaccines in the past. Vaccine was injected into left deltoid. After injection, patient told medical assistant "he was feeling woozy." Medical assistant informed nurse practitioner student and MD. Patient was instructed to continue waiting for 15 minutes post injection and lay down on exam table. After medical assistant left room, a loud thud was heard and staff entered exam room to find patient laying on floor, head down, with drops of blood on face. While attempting to stabilize patient, his muscles were tense and stiff to touch and patient was making slight jerking movements with eyes open. Patient no talking and unable to answer questions or follow commands. Staff attempted to lay patient down but patient resisted and requested to leave. Patient was unable to identify his name, date of birth, current place or time. Patient refused to sit. Staff unable to obtain vitals due to refusal. 1306: 911 called and patient was taken to emergency room.

Other Meds: None

Current Illness: None

ID: 1785637
Sex: F
Age: 73
State: WI

Vax Date: 09/08/2021
Onset Date: 10/10/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: Nerves in neck strained on right side.

Allergies: Allergy to real mushrooms, Sulpha drugs, MSG in foods.

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

Symptoms: Facial paralized on right side (same side as shot in arm) face drooping, cannot raise eyebrow, pain behind right ear, taste limited on foods, cannot close right eye, dry right eye and irritated, right side of mouth drooping, ear ringing. Went to Chiropractor Monday at 5 pm, eye able to close for sleep at night, 2nd appointment Weds. 9 am, ear not painful, head feeling better, eye still hard to close. 3rd appointment tomorrow morning. On going event as of today. Diagnosis Bell's Palsy.

Other Meds: Ibuprofen, tylenol, B vitamins, zinc, D, C, A, E, Tumeric, Apple Cider Vinegar, CoQ10, Elderberry, Preservision Areds2

Current Illness: None

ID: 1785638
Sex: M
Age: 65
State: KY

Vax Date: 10/13/2021
Onset Date: 10/13/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: N/A

Allergies: None

Symptom List: Vomiting

Symptoms: Patient called office today and stated yesterday afternoon, he developed a few small blisters on the dorsal aspects of both hands. Blisters are not itchy or painful. He stated he did a lot of yardwork yesterday. No signs of anaphylaxis present. Otherwise feeling fine. No chest pain, dyspnea, syncope, swelling.

Other Meds: Isosorbide dinitrate Pantoprazole Crestor Baby aspirin Vitamin B

Current Illness: None

ID: 1785639
Sex: F
Age: 17
State: NM

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient was 17 and received first Moderna vaccine, which was not approved for <18yo at the time of administration. No adverse effects noted.

Other Meds: n/a

Current Illness: none

ID: 1785640
Sex: F
Age: 27
State: OK

Vax Date: 10/13/2021
Onset Date: 10/13/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: NONE

Allergies: Pineapple, strawberries. NKDA

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

Symptoms: PFIZER COVID-19 VACCINE EUA: After receiving the Pfizer COVID-19 and Afluria vaccines on 101321, the patient called on 101421 complaining of arm soreness to the extent of "feeling like my arm is broken" on the side in which the Pfizer vaccine was administered. She also complained of persistent hiccups that began after receiving the vaccines. The patient was known to be pregnant at the time of vaccine administration, however, the estimated date of delivery is unknown.

Other Meds:

Current Illness:

ID: 1785641
Sex: F
Age: 38
State: ME

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/14/2021
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: COVID-19 Janssen

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient began to feel nauseas and light headed following vaccination. She was given some Gatorade and the pharmacist sat with her until she began to feel better. Symptoms resolved in a few minutes and she stayed for further observation until she was completely better.

Other Meds:

Current Illness:

ID: 1785642
Sex: M
Age: 16
State: TX

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 10/14/2021
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: NKA

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

Symptoms: CLIENT RECEIVED SECOND PFIZER DOSE TOO EARLY (5/28/2021) FIRST DOSE ADMINISTERED 5/13/2021.

Other Meds: NOT REPORTED

Current Illness: NOT REPORTED

ID: 1785643
Sex: F
Age: 62
State: NY

Vax Date: 09/29/2021
Onset Date: 10/01/2021
Rec V Date: 10/14/2021
Hospital:

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

Lab Data: n/a advised to see pcp to rule out other neurologic dz

Allergies: none

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

Symptoms: numbness and tingling to fingers to both hands started 2 days after vaccine administered and persists to today

Other Meds: vitamin d hydrochlorothiazide motrin metoprolol tylenol

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am