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: 1795155
Sex: F
Age: 33
State: DE

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: I can provide results beyond mentioned above if needed,

Allergies: n/a

Symptom List: Dysphagia, Epiglottitis

Symptoms: After my second Covid shot, I have noticed that I have a low grade fever. It was about 99.5F (ANDER ARM) on the day after the shot. I did not think much of it but decided the check my temperature the following day to make sure it normalized. The following day it was about 99.1F. Since then, it has been over 6 months and my temperature never normalized, it is around 99F most of the time (I always take it under arm). I am not sure if it started after this vaccine (I did not check my temperature in the weeks before vaccination) but in general my temperature had always been 97.8F (under arm). My doctor recommended that I report this. I had various blood work done in May and in October. Nothing significant was found, though my recent ESR was high (41). Blood culture showed "no aerobic or anaerobic growth in five days" and also negative for Lyme disease. I also have increased cholesterol since last year (220+), with LDL at 99. The cholesterol increase is of unknown origin because I have always eaten well and exercised, am not overweight etc. I also would like to mention that I receive a combined Hepatitis A+B vaccine in 3 shots at the doctor's recommendation in September and October 2020 and May 2021 (3rd shot).

Other Meds: Amlodipine besylate 5 mg, magnesium glycinate 200 mg, vitamin D3 (1-4 IU), vitamin C/Emergen-C (occasional).

Current Illness: n/a

Date Died: 10/09/2021

ID: 1795156
Sex: F
Age: 55
State: TX

Vax Date: 04/24/2021
Onset Date: 09/08/2021
Rec V Date: 10/18/2021
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: CTA 9/13 showed No CT angiographic evidence of pulmonary embolus is seen. There are bilateral lower lung subsegmental atelectasis. Mild bilateral pulmonary infiltrates are seen.

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms. She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral. On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths. This spontaneously resolved. Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes. 9/12 she felt great then played at the beach with her grandkids running around. Then 9/12 in the evening she felt ill and took a home Covid test that was positive. Husband took a home Covid test that was negative. She did not initiate any outpatient care other than Mucinex and vitamin C. 9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand. She was not drinking or caring for herself. She was able to walk to the truck. Her family brought her to the ER freestanding. At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens. Covid PCR later returned negative. She was transferred to the main ER and desaturated during the transport and stopped breathing. She maintained a pulse. In the ER she was intubated. Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA. She was started on heparin drip. ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine.

Other Meds: buproprion 150mg ER daily, hydroxychloroquine 400mg daily

Current Illness: none

Date Died: 10/17/2021

ID: 1795158
Sex: F
Age: 75
State: MN

Vax Date: 03/04/2021
Onset Date: 10/17/2021
Rec V Date: 10/18/2021
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: dose 1 moderna 2/4/2021 lot # 016M20A patient has a cardiac arrest at home and died in the ED

Other Meds:

Current Illness:

ID: 1795159
Sex: F
Age: 34
State: TX

Vax Date: 10/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: n/a

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Localized Reaction to left deltoid. Pain scale 7/10, redness, swelling, warmth and pain to move arm. Will be referred to ER for treatment if needed.

Other Meds:

Current Illness:

ID: 1795160
Sex: F
Age: 67
State: PA

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Site: Pain at Injection Site-Medium, Additional Details: reaction to fluad flut shot on 9/23, arm sore for 3 weeks after

Other Meds:

Current Illness:

ID: 1795161
Sex: F
Age: 73
State: TX

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/18/2021
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: Vicodin.

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

Symptoms: Fatigue, brain fogs.

Other Meds: None.

Current Illness:

ID: 1795162
Sex: F
Age: 27
State: CA

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/18/2021
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: n/a

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: When she was driving home after her vaccination, she started feeling like her lips and tongue were swollen all the way up to her nose. It lasted about 20minutes then it went away and didn?t comeback anymore. Denies any other accompanying symptoms.

Other Meds: Junel fe (birth control)

Current Illness: no

ID: 1795163
Sex: M
Age: 53
State: CA

Vax Date: 10/17/2021
Onset Date: 10/17/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1795164
Sex: F
Age: 37
State: NM

Vax Date: 04/20/2021
Onset Date: 10/11/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: CBC CMP MRI

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I have been experiencing extreme pain in my face, throat, tongue, and ear. I went to the Emergency Room at Hospital. I was diagnosed with glossopharyngeal neuralgia. I was prescribed with Prednisone, Gabapentin, and Valacyclovir.

Other Meds: Trazadone Sertraline Ambien Enbrel

Current Illness: None

ID: 1795166
Sex: F
Age: 70
State: KY

Vax Date: 02/03/2021
Onset Date: 10/13/2021
Rec V Date: 10/18/2021
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:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: COVID - 8L HFNC- dex start 10/13 6mg IV q12h ( on chronic prednisone at home) Enoxaparin 100mg q12h afib PPI 40mg daily Remdesivir 10/14-10/17

Other Meds:

Current Illness:

ID: 1795167
Sex: F
Age: 65
State: NY

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Additional Details: allergic reaction initially she's doing fine now

Other Meds:

Current Illness:

ID: 1795168
Sex: F
Age: 73
State: CA

Vax Date: 10/15/2021
Onset Date: 10/17/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: N/A

Allergies: Tricor

Symptom List: Rash, Urticaria

Symptoms: Broke out in hives. I have never had an allergy so wasn't quite sure what to do. After some soaking baths and lotion ,which didn't work, I finally thought to take an Allegra about 5:30 Monday morn. (10-18). I could sleep then and when I woke, itching had stopped. I still hav some welts, but hopefully it's over. I am going to e-mail my Doctor later.

Other Meds: Amlodopine, Hydrodiuril, Ursodiol, Caltrate 600+400 D, B complex(2,6 &12) liquid, Vitamin D, Kyolic aged garlic extract for cholesterol with Lecithin, and milk thistle liquid.

Current Illness: None

ID: 1795169
Sex: F
Age: 54
State: VA

Vax Date: 02/23/2021
Onset Date: 02/26/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: spirometry

Allergies: penicillin, sulfa

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

Symptoms: shortness of breath, chest heaviness

Other Meds: ASA, Crestor, pantoprazole, Fioricet, Flonase

Current Illness:

ID: 1795170
Sex: M
Age: 22
State: KY

Vax Date: 10/18/2021
Onset Date: 10/18/2021
Rec V Date: 10/18/2021
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: Blood sugar and blood pressure were checked on site by EMS. We do not know the exact numbers, but blood sugar was not unusually low, but he was experiencing some orthostatic hypotension and began feeling faint again when they stood him up

Allergies: Penicillin, seasonal and environmental

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

Symptoms: Patient was walking around the store shortly after vaccination, when he lost consciousness and began shaking. This lasted approximately 1 minute per store employee whom was present. Patient regained consciousness and sat upright on the floor, he was alert for a short time (less than 1 minute), then again lost consciousness and experienced labored/gurgled breathing. Employee laid patient on his side and called for pharmacy and EMS> When I arrived at patient side his skin was very pale/grey and he did not appear to be breathing. After checking for responsiveness for a few seconds, patient began breathing again and regained consciousness. He was sat upright and we checked for alertness, medical history, contact info and stayed with patient until EMS arrived and took over. Per EMS, patient did not have low blood sugar, but was experiencing some orthostatic hypotension.

Other Meds: None known

Current Illness: None known

ID: 1795171
Sex: F
Age: 70
State: NJ

Vax Date: 09/19/2021
Onset Date: 10/07/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: COVID test positive.

Allergies: No

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

Symptoms: I was sneezing and had a headache. Very mild sore throat and no fever. Urgent care and did a rapid test COVID 3 weeks after booster from. Regenerome infusion on 10Oct2021.

Other Meds: Yes

Current Illness: No

ID: 1795172
Sex: M
Age: 32
State: CA

Vax Date: 10/17/2021
Onset Date: 10/17/2021
Rec V Date: 10/18/2021
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: Systemic: Chills-Mild, Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Hypotension-Mild, Systemic: Weakness-Mild, Additional Details: PT fainted for 1 second and regaine consciousness right away. he declined 911/paramedics and asked for water and something to fan himself with. pts bp taken was 92/68 , pusle 69. pt stated his level of uncomfortability was 10 (worse) to 2,4, then 1. dad/sis came pick him up after monitoring him for 30 mins

Other Meds:

Current Illness:

ID: 1795173
Sex: F
Age: 40
State: MN

Vax Date: 01/25/2021
Onset Date: 10/11/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: positive Covid rapid test and PCR

Allergies: amoxicillin bactrim biaxin ceclor duracef erythromycin zithromax

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

Symptoms: positive covid test on 10/12. fever, body ache, headache, cough, congestion, fatigue, loss of sense of smell

Other Meds: none

Current Illness: none

ID: 1795174
Sex: F
Age: 65
State: FL

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: EKG and blood work (10/16/21)

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 15 minutes after getting the vaccine the patient stated she was feeling a tingling sensation in her mouth. I told her to wait a few more minutes just in case. Then she stated her mouth was numb. I gave her a dose of benadryl. A couple of minutes later she fainted and was paled and lethargic. She stated her tongue was numb and swelling. A shot of Epipen was given due to tongue swelling. 9-1-1 was called. Few minutes after Epipen she said her tongue was feeling better, but she was feeling cold. Paramedics checked her vitals and said they were within normal levels (including blood sugar). She had difficulty walking so, they brought her to the hospital. At the hospital she was diagnosed with Syncope.

Other Meds:

Current Illness:

ID: 1795175
Sex: M
Age: 48
State: GA

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: Pt reports he did not seek any medical assistance.

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pt reports - same day "extreme headache began"- stopped up sinuses - next day lump found (same arm as rec'd vaccine) R. Deltoid. Pt states "felt like coming down with something, reporting feeling "tired and weak every couple of days" , "but I never got sick".

Other Meds:

Current Illness:

ID: 1795176
Sex: M
Age: 61
State: ID

Vax Date: 04/14/2021
Onset Date: 09/10/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: Regular Blood test that came back normal.

Allergies:

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

Symptoms: 6 months later I had a Pinch sciatic nerve on my Buttocks'.

Other Meds: N/A

Current Illness: N/A

ID: 1795177
Sex: M
Age: 46
State: MO

Vax Date: 10/13/2021
Onset Date: 10/18/2021
Rec V Date: 10/18/2021
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: Ultrasound performed 10/18/21 Labs drawn

Allergies: Lisinopril

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

Symptoms: Patient arrived to ER per physician reccomendation after blood clot found on ultrasound

Other Meds: Amlodipine 10mg daily Hydrochlorothiazide 25mg daily

Current Illness: None known

ID: 1795178
Sex: F
Age: 65
State: WV

Vax Date: 10/14/2021
Onset Date: 10/15/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Site: Pain at Injection Site-Severe, Systemic: pain/stiffness in shoulder and neck-Severe

Other Meds:

Current Illness:

ID: 1795179
Sex: F
Age: 56
State: PA

Vax Date: 09/24/2021
Onset Date: 09/25/2021
Rec V Date: 10/18/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: exacerbation of her chronic neck pain and migraine symptoms the day after she got dose 1

Other Meds:

Current Illness:

ID: 1795180
Sex: F
Age: 43
State: WA

Vax Date: 04/12/2021
Onset Date: 05/03/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: Blood tests Cortisol tests

Allergies: Zithromax Lactose intolerant

Symptom List: Injection site pain, Pain

Symptoms: In May I had and am currently suffering from severe joint pain and fatigue. I have seen 3 different doctors for this and have been prescribed different meds or treatments. I have had numerous blood tests and antibody tests to check for what this cause is. I have not felt the same since my second Covid vaccine.

Other Meds:

Current Illness: Non

ID: 1795181
Sex: M
Age: 65
State: WY

Vax Date: 05/05/2021
Onset Date: 05/07/2021
Rec V Date: 10/18/2021
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: Penicillin, Vancomycin No food allergies

Symptom List: Injection site pain, Menorrhagia

Symptoms: Runny nose within 48 hours - no infection 5/14 (9 days post injection) - patient got sick enough to not get out of bed, could not walk, loss of muscle strength, and 104 degree fever, vomiting that continued for 7 days. Patient went to doctor and got promethazine after this but did not feel any better. Stopped vomiting though. Couldn't walk more than 10 stairs in patient's home for 3 weeks.

Other Meds: Ursodial, Oxycodone, Diazepam, Synthroid, Omeprazole, Calcium, Vitamin D, Tacrolimus, Buspirone, Promethazine, Ondansetron

Current Illness: None

ID: 1795182
Sex: M
Age: 62
State: OH

Vax Date: 04/13/2021
Onset Date: 10/04/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: SARS-CoV-2 Antigen collected on 10/06/2021 and resulted positive on 10/06/2021

Allergies:

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

Symptoms: Headache and congestion

Other Meds:

Current Illness:

ID: 1795183
Sex: M
Age: 32
State: TX

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/18/2021
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: Approximately 9 hours after administration, chills and body aches began. Within an hour or so was shivering uncontrollably and entire body was hurting. until approx 33 hrs post admin, fluctuated between chills and burning up all the while body aches including a headache continued. approx 43 hours later all that remains is a headache. (all hours referring to initial injection)

Other Meds:

Current Illness:

ID: 1795184
Sex: F
Age: 34
State:

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: report of feeling of impending doom, flushing, weakness, tachycardia, and shortness of breath

Other Meds:

Current Illness:

Date Died: 09/29/2021

ID: 1795185
Sex: F
Age: 80
State: MN

Vax Date: 09/01/2021
Onset Date: 09/06/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient passed away on 09/29/2021

Other Meds:

Current Illness:

ID: 1795186
Sex: M
Age: 55
State: CA

Vax Date: 10/09/2021
Onset Date: 10/13/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data:

Allergies: quinolones

Symptom List: Nausea

Symptoms: Numbness starting in left forearm, 50% of hand strength in lt hand loss, achy injection site, numbness rt forearm, bottom 2 digits of hand, neve ailment

Other Meds:

Current Illness:

ID: 1795187
Sex: F
Age: 71
State: NJ

Vax Date: 02/22/2021
Onset Date: 02/25/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: currently follow up with MD

Allergies: flu shot, antibiotics, gluten, dairy,

Symptom List: Injection site pain

Symptoms: bone/ joint pain 3 days after getting vaccine for all 3 doses. Pain everywhere. Rash was primarliy on elbows with white coating on it.

Other Meds: none

Current Illness:

ID: 1795188
Sex: M
Age: 31
State: PR

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 10/18/2021
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

Allergies: N/A

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

Symptoms: Patient oriented in time and place comes to of observation and express that work is forcing him to get vaccinated but he does not want to do it. Patient indicates having multiple conditions which they are not treated because he does not have medical plan he has high pressure and leukemia and it has not been treated for 4 months because he does not have medical plan. Doctor is consulted and indicates to vaccinate patient without a problem. Time is up in the area of observation and patient indicates feeling dizzy and head pain, vitals are taken, we talk to patient and give him water and candy, he did not eat since early today. Patient looked pale since he came into the center. Vitals BP 130/80, Sat 99, P 67. Dex 88.

Other Meds: N/A

Current Illness: High Pressure; Leukemia

ID: 1795190
Sex: M
Age: 16
State: NY

Vax Date: 10/18/2021
Onset Date: 10/18/2021
Rec V Date: 10/18/2021
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: none

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

Symptoms: Error in dose given undiluted 0.3cc dose. Observed for 35 minutes while paper work and information was gathered. denied symptoms

Other Meds: none

Current Illness: none

ID: 1795191
Sex: F
Age: 65
State: AL

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/18/2021
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, didn?t think I could leave my house, couldn?t work very much on Friday 10/15/2022 actually worked less than 2 hours of my 8 hour shift, on 10/18/2021 could not work due to the adverse reaction. I make $15 per hour, so this has cost me. I am notifying the pharmacy today.

Allergies: Soma, reclast, penicillin, erothomycian, sulfur drugs, multivitamin, atoravastin

Symptom List: Tremor

Symptoms: Evening after injection, 6:00 pm on 10/14/2021, body aches and headache, 10/15/2021 7:00 a.m. very fatigued, nausea and vomiting and then terrible diarrhea, the nausea, headaches and diarrhea and fatigue continued on 10/16/2021 and 10/17/2021. Have taken zofran and over the counter anti-diarrhea meds on each of the days that symptoms were present. 10/18/2021 still fatigued, nauseated and some diarrhea as well as headaches continue but a little less severe at 1:15 p.m.

Other Meds: Amolodephene, Premarin, vitamins E and D and iron, neurotin, oxymorophine, Percocet

Current Illness: High blood pressure, high cholesterol, stomach ulcer, arthritis

ID: 1795192
Sex: M
Age: 43
State: PA

Vax Date: 10/14/2021
Onset Date: 10/15/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Clindamycin

Symptom List: Erythema, Pruritus

Symptoms: About 12 hours later, began with ache and mild fever. At 24 hour mark, increased ache. At 27 hour mark, chills and fever. At 30 hour mark, fever hit 105.2 and then broke.

Other Meds: Welbutrin, Zocor, Lexapro, Multivitamin, Fish Oil

Current Illness: None

ID: 1795193
Sex: F
Age: 31
State: NM

Vax Date: 10/07/2021
Onset Date: 10/08/2021
Rec V Date: 10/18/2021
Hospital: Y

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: MRI on 10/12/21

Allergies: None

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

Symptoms: I am breastfeeding and the day after my booster my 3 month old stopped using her right arm. She has had MRIs which were negative. She has not recently been sick, nor had trauma. There is no explanation for the lack of use

Other Meds: Pre-natal vitamin

Current Illness: None

ID: 1795194
Sex: F
Age: 68
State: MI

Vax Date: 02/17/2021
Onset Date: 10/10/2021
Rec V Date: 10/18/2021
Hospital: Y

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

Lab Data:

Allergies: LatexRash Norco [Hydrocodone-acetaminophen]Rash Shellfish AllergyItching, Rash

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

Symptoms: Hospitalized 10.10.21; COVID-19 positive (10.10.21); fully vaccinated Admission Date: 10/10/2021 Discharge Date: Oct 12, 2021 PRESENTING PROBLEM: Hypoxemia Hypokalemia Acute hypoxemic respiratory failure due to COVID-19 COVID-19 HOSPITAL COURSE: Patient is a 68-year-old female who presented for evaluation of nausea, vomiting and weakness. The patient has a history of Addison's disease, hypothyroid, GERD and recent lumbar lami and spinal fusion. In the ER the patient was found to have a positive UA, no leukocytosis and hypokalemia. She was treated with rocephin. She was also hypoxic and a CXR showed possible edema vs infectious process. Her BNP was normal and she was found to be COVID positive. She was started on dexamethasone and given a dose of IV hydrocortisone and admitted to the hospitalist for further management. She was quickly weaned from oxygen and not treated with further dexamethasone or remdesivir. Her nausea and vomiting resolved however she continued to feel very weak. She was treated with additional stress dose steroids. PT/OT evaluated the patient and felt she was appropriate to return home to resume home health. On the day of discharge she was feeling better. She was encouraged to follow up with her PCP for continued monitoring after discharge and to quarantine for 10 days after symptom onset. She verbalized understanding of these instructions and discharged home in stable condition. * Pneumonia due to COVID-19 virus Assessment & Plan Symptoms began 1 day before admission Patient is fully vaccinated CXR showing pulmonary edema vs infectious infiltrates BNP normal and COVID positive Hypoxic in the ER on room air requiring 2L NC initially, weaned to room air today Will stop dexamethasone and remdesivir Monitor daily CRP, CMP, CBC, D dimer Lovenox for VTE prophylaxis Supportive care Wean oxygen as tolerated Acute hypoxemic respiratory failure due to COVID-19 Assessment & Plan Resolved Now on room air Weakness Assessment & Plan Patient feeling weaker than baseline Will continue to monitor today and ask PT/OT to eval Will treat with stress dose steroids given Addison's disease

Other Meds: benzocaine-menthol (CEPACOL) 15-3.6 MG LOZG benzonatate (TESSALON) 100 MG capsule cephalexin (KEFLEX) 500 MG capsule fludrocortisone (FLORINEF) 0.1 MG tablet fluoxetine (PROZAC) 40 MG capsule guaiFENesin (MUCINEX) 600 MG 12 hr tablet hydroc

Current Illness: 9.15.21: consult pre-operatively - Patient was not able to reach her endocrinologist regarding steroid use in perioperative. Going off which she has done with previous spinal procedure (2009) I would recommend she receive hydrocortisone 100 mg just prior to her procedure. Monitor blood pressure and fluid status closely during surgery and administer hydrocortisone 50 mg and her home Florinef immediately after the surgery 9.20.21: Admitted for surgery 9.20.21 - 9.24.21: posterior lumbar 1-4 decompressive last. Interbody fusion. Local bone, bone morphogenic protein crest calcinosis allograft bone on 09/20/21.

ID: 1795195
Sex: F
Age: 79
State: NC

Vax Date: 10/04/2021
Onset Date: 10/07/2021
Rec V Date: 10/18/2021
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 listed

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient called our COVID hotline number and states she was fine for the first 3 days after the booster dose but then on the 3rd day she started having arm pain, shoulder pain and wrist pain. Patient did say she did some yard work the day before but her other arm is not bothering her. States there is not redness or swelling at injection site. Had her vaccine on 10/4/21 and today is 10/18/21. States she was up last night with pain in her arm. Referred to call her Primary care doctor for follow-up.

Other Meds: Xarelto

Current Illness: unsure

ID: 1795196
Sex: M
Age: 36
State: NY

Vax Date: 10/01/2021
Onset Date: 10/09/2021
Rec V Date: 10/18/2021
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:

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

Symptoms: About 8 days after COVID booster shot patient reported full body hives. Patient also reports he got redness that started on scalp and then migrated to another location. Rash usually lasts 24h then moves. Patient tried Zyrtec and Benadryl 50mg qhs. Prednisone 40mg prescribed on 10/15/2021 for 5 days.

Other Meds:

Current Illness:

ID: 1795197
Sex: F
Age: 19
State: GA

Vax Date: 04/20/2021
Onset Date: 04/01/2021
Rec V Date: 10/18/2021
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:

Allergies: none

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

Symptoms: Pt. with normal cycles prior to vaccine, had a very heavy cycle right after getting her shot, then did not have a period for 6 weeks, then had a cycle that lasted 22 days, followed by another cycle 6 weeks later. Now had had amenorrhea since August. No cycle in the last 2 months.

Other Meds: claritin, fluoxetine, hydroxyzine

Current Illness: anxiety

ID: 1795198
Sex: M
Age: 68
State: NC

Vax Date: 09/30/2021
Onset Date: 10/07/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: ER- They took a CT scan. I don't remember if they took a blood sample.

Allergies: no

Symptom List: Pain in extremity

Symptoms: Passing of a kidney stone - started that Thursday (a week after the shot or so); pain in the lower back area where the kidney is. This particular one made me a little nauseous so I haven't been feeling good. 1st kidney stone I passed was two years ago. I went to ER - they prescribed meds to help with the pain and nausea. The medication helped with the symptoms resolved. Symptoms after the vaccine: Experienced fatigue and some aches and pains. Nothing to keep me from doing what I needed to do. I am having pain currently because the kidney stone but by the third of October I was fine from the immediate side affects of the vaccine. Will have a follow up tomorrow with my doctor.

Other Meds: aleve - 200 mg once a day; Vit C - 500 mg once a day; Vit D3 - 5000 IU one time a day; Loratadine with Claritin - 10 mg one time a day

Current Illness: no

ID: 1795199
Sex: M
Age: 30
State: TX

Vax Date: 10/15/2021
Onset Date: 10/16/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: None

Allergies: None of which I am aware

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

Symptoms: The morning after receiving the 1st dose of the Pfizer COVID-19 vaccine, I noticed redness and inflammation at the injection site. The next day (48hrs following the injection) the redness and inflammation grew in diameter on my arm. I am not sure if it is related, but it feels like I am also having troubles regulating my body temperature (hot/cold waves).

Other Meds: None

Current Illness: None

ID: 1795200
Sex: F
Age: 45
State: CA

Vax Date: 04/14/2021
Onset Date: 09/02/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: fasting full panel blood work 09/29/2021- all normal

Allergies: amoxicillin arythromiacin Sulfa dairy wheat

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

Symptoms: 0n 9/2/2021, within 24 hours I had two nose bleeds that lasted 30 min-1 hour. I went to urgent care both times. They put cotton balls up my nose that were drenched in epinephrine and aspirin and told me not to mess with it for a few days to let it heal. I haven't had one since. A couple days after I felt shaky, dizzy and weak and my blood pressure was up. I asked my doctor to do bloodwork. Everything was normal. I will be following up with an ENT soon.

Other Meds: multivitamin- once daily probiotic- once daily

Current Illness: none

ID: 1795201
Sex: F
Age: 69
State: HI

Vax Date: 10/13/2021
Onset Date: 10/13/2021
Rec V Date: 10/18/2021
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: sulfa drugs

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

Symptoms: Received pfizer booster vaccine and experienced chills, myalgias, nausea, and headache 2-3 hours following vaccine administration. Twelve hours following vaccine, pt had a witnessed syncopal episode lasting seconds. She hit her left maxilla as a result of syncope. She had resolution of symptoms two days following vaccine.

Other Meds: acetaminophen, atorvastatin, colchicine, ferrous sulfate, omeprazole, sertraline, ambien

Current Illness: None

ID: 1795202
Sex: F
Age: 55
State: FL

Vax Date: 09/23/2021
Onset Date: 10/10/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: MRI scheduled.

Allergies: None.

Symptom List: Vomiting

Symptoms: She got her vaccine, had no reaction, basically felt fine. Then about on 10/10/21, her body started vibrating and woke up with whole body vibration. She went to the hospital and said that they could not help her. She went to the doctor to ask him what he can do, and ordered an MRI of the brain, and advised to go to a neurologist. She has had a frozen shoulder and has a neck issue. She has neuralgia of her face but takes no medication for that. They gave her Neurontin and the neuralgia comes and goes. She has not had any symptoms for a year and a half. She is trying to see about the vibration.

Other Meds: None.

Current Illness: Frozen shoulder, left ( undergoing treatment with Cortisone injection in August).

ID: 1795203
Sex: M
Age: 74
State: MA

Vax Date: 10/18/2021
Onset Date: 10/18/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received 3rd dose of Pfizer vaccine instead of Moderna (patient's previous 2 COVID-19 vaccine doses were Moderna). This discovery was made when patient came back with card to get vaccination recorded as he did not have it at the time of vaccination. Patient did not report any adverse effects and had no reaction during his recommended 15 minute waiting period before leaving to get his card. Patient was made aware of the situation and told to contact PCP if any adverse effects arise.

Other Meds:

Current Illness:

ID: 1795204
Sex: F
Age: 59
State: MI

Vax Date: 10/15/2021
Onset Date: 10/16/2021
Rec V Date: 10/18/2021
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: NA

Allergies: PNC, Strawberries, Latex, Bee stings

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

Symptoms: exacerbation of joint pain, headache, fatigue, febrile

Other Meds: Prilosec, Claritin, Estrogen, Tetracycline, Lexapro, Requip, Fish oil, Lasix, Multi vitamin for women. Testosterone, Progesterone.

Current Illness: NA

ID: 1795206
Sex: M
Age: 78
State: IN

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/18/2021
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: None

Allergies: Lisonopril, Bactrin, Erythromycin, Combigan, Cosopt

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Late the night of the vaccination I woke up with shaking from an elevated temperature. I am ashamed to say I did not take my temperature. By the next morning my temperature was down to about 1 degree above normal. I felt "wiped out" most of the following day. However, the second night I slept well and felt much better the next morning. Other than this the only other symptom was a fair amount of pain at the injection site. That has alleviated a great deal.

Other Meds: Trintellix, Atovastatin, Bursirine, Amlodipine, Timolol, Latanaprost, Azelastine, Fluticasone, Econozale, Aclometasone, Colace, Melatonin, Gabapentin, Centrum Silver, Glucosamine, Chondroitin, Turmeric, Loratadine

Current Illness: None. However, I am being tested about a cyst on pancreas.

ID: 1795207
Sex: M
Age: 71
State: CA

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient had 2 doses of Moderna Covid vaccine from another facility. Patient came in for a booster shot and Pfizer was given. Patient says he had fever and dizziness for 2 days after the shot.

Other Meds:

Current Illness:

ID: 1795208
Sex: F
Age: 28
State: CA

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 10/18/2021
Hospital:

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

Lab Data: negative Covid test on child

Allergies: penicillin, amoxicillin, ampicillin

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

Symptoms: The patient developed covid flu symptoms included, fever, chills, swollen limbs, achy, coughing up mucus and had swollen lymph nodes under her arms and breast. Pt was breast feeding and her 2 month old baby developed these same symptoms as well as difficulty breathing due to the congestion. She took her baby to her Pediatrician and was told to use the nose sucker and saline solution only. Mother and child were both sick for over 3 weeks. Pt was forced to get 2nd vax on October 1st, 2021 (IM Right Arm- Lot # 30130B7) were she was sick for about 3 or 4 more days. Mother states her milk supply dropped to about 1/3 of normal supply and is still not back to normal. Both Mother and child are better now.

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am