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: 1795369
Sex: M
Age: 43
State: IA

Vax Date: 09/25/2021
Onset Date: 09/25/2021
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:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: no adverse reaction reported. patient got a 4th dose of covid vaccine. got 2 moderna at one place then got 2 Pfizer here

Other Meds:

Current Illness:

ID: 1795370
Sex: M
Age: 40
State: CA

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: n/a

Allergies: no

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient received the 2nd COVID vaccine Moderna Lot #011F21A, expiration date 11-06-2021 at 12:33PM. PHN administered vaccine and upon vaccination observed vaccine leaking from syringe HUB. PHN completed vaccination but was unable to retract syringe. PHN was unable to determine the amount of vaccine administered to patient. PHN notified PHN who then notified Clinical Educator . Clinical Educator notified PHN to complete Incident Report and VARES. Patient verbalized no concerns or questions regarding efficacy and was confident with receiving 2nd dose.

Other Meds: unknown

Current Illness: unknown

ID: 1795372
Sex: F
Age: 62
State: PA

Vax Date: 09/21/2021
Onset Date: 09/22/2021
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: None

Allergies: None

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

Symptoms: The day after I got the shingles shot, I experience severe pain in my right hip. This lasted for a few days and then I got a very painful shingles rash on my right hip. This lasted for 3 weeks.

Other Meds: Lisinopril, Simvastatin, Cingular, glucosomine, Allegra, Flonase

Current Illness: None

ID: 1795373
Sex: M
Age: 62
State: OH

Vax Date: 04/13/2021
Onset Date: 09/23/2021
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: None yet.

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Had an issue with vertigo after the vaccine. Its really sickening. I haven't seen the doctor yet but in the process of seeing one. It limits what I can do on the daily. I've never had vertigo last this long.

Other Meds: Aspirin; IMMODIUM AD; calcium; vitamin k2; vitamin d3; Algae Omega; Lycopene; Magnesium; Vitamin; NATUREMADE CHOLESTOFF; TRELIEF plus 12

Current Illness: No

ID: 1795374
Sex: F
Age: 75
State: FL

Vax Date: 09/30/2021
Onset Date: 10/03/2021
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: None

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

Symptoms: Patient has pain radiating down arm and into neck that began 3 days after vaccination. Patient took Tylenol which did not alleviate the pain. Patient is still experiencing arm/neck pain 3 weeks later.

Other Meds: Losartan, Amlodipine, Metoprolol, Furosemide

Current Illness: none

ID: 1795376
Sex: F
Age: 27
State: NC

Vax Date: 10/18/2021
Onset Date: 10/18/2021
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:

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

Symptoms: Patient presented with itching and redness on left arm, which is the arm that the immunization was given. Upon alerting the pharmacy of the reaction, the patient was given a 25mg dose of Diphenhydramine. Shortly after taking the medication, the patients symptoms began to subside.

Other Meds:

Current Illness:

ID: 1795377
Sex: M
Age: 67
State: MI

Vax Date: 02/17/2021
Onset Date: 10/09/2021
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: wine

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Hospitalized 10/10/2021; COVID-19 positive 10/9/2021; fully vaccinated Discharge Summary General Medicine BRIEF OVERVIEW: Admission Date: 10/10/2021 Discharge Date: Oct 15, 2021 Discharge Disposition: home or self care Active Issues Requiring Follow-up: DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia HOSPITAL COURSE: Patient is a 67M with h/o CAD with ischemic cardiomyopathy s/p ICD, CHF, PAF on chronic Coumadin, HTN, HLD, COPD on 2L home O2, OSA and obesity who presented to ED for SOB that started 10/3 with associated palpitations. He has had increased edema, but no orthopnea. He reports dry , non-productive cough for a couple days without associated fevers, chills, sweats or rigors. He reports episode of diarrhea In the ER, he was febrile with temp 38.1, normotensive, tachycardic with HR up to 136, and tachypneic with RR up to 31. He was hypoxic to 88% on baseline 2L and is now on 3L. COVID 19 positive ( he is vaccinated against COVID) CXR showed patchy opacity of the posterior LLL. He was treated for AFib with RVR using IV Cardizem pushes, but became hypotensive and was subsequently cardioverted. He also received CAP coverage with Rocephin/Zithromax

Other Meds: acetaminophen (TYLENOL) 500 MG tablet albuterol (PROVENTIL, VENTOLIN, PROAIR) 108 (90 BASE) MCG/ACT inhaler allopurinol (ZYLOPRIM) 300 MG tablet aspirin 81 MG EC tablet atorvastatin (LIPITOR) 40 MG tablet budesonide/formoterol (SYMBICORT) 1

Current Illness:

ID: 1795378
Sex: M
Age: 18
State: IN

Vax Date: 09/28/2021
Onset Date: 09/28/2021
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: They tested me for covid turned out negative and did blood work last week on me.

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: Hours after my shot my throat started to close in and grasp for hair. Fever was taken at 303.7 F. Extreme cough, I was sweating extreme to then having severe chills. I felt like I was honestly dying. After 48hrs of the shot I still had a fever of 303F throat swollen and chills. This went on for more than a week after my shot. I still have a bad cough or when I take a breathe I need to cough and my temp flex between a normal to low fever. I was prescribed Benxonatate due to the severe cough from my after shot symptoms. My doctor said that she has seen many of the younger patients that got the booster are having a hard time to recover from the shot. I am currently on day 21 of still feeling not normal but def better than the first week. Again I was tested for covid on oct 3 and came back negative. My doctor is thinking of putting me on a heart monitor during mid November because my blood pressure hasn't been the best and I feel my heart beating a lot and faster than normal.

Other Meds: none

Current Illness: none except felt ill weeks after the shot

ID: 1795380
Sex: M
Age: 59
State: TX

Vax Date: 03/04/2021
Onset Date: 03/07/2021
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: I had my blood pressure checked at the hospital. It was verified that my blood pressure was elevated 190/100.

Allergies: Sulfa.

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Three days after receiving my second dose, I started to notice I wasn't feeling right. I was experiencing nose bleeds and had flu like symptoms. I got up from bed, it was 1 AM, and I started feeling very dizzy. My walls looked like they were moving and I definitely knew something was off. I checked my blood pressure at home and it was showing 205/110. I checked it three times and received the same result (general range). I went to the hospital ER, where they checked my blood pressure and confirmed that my blood pressure was elevated. I was given clonidine 1/10 mg every 6 hours as needed. My cardiologist gave me Bystolic (Beta Blocker). I took both medications for about three months before my blood pressure returned to normal range. I was taken off clonidine and Bystolic, but continued with olmesartan medoxomil.

Other Meds: Olmesartan medoxomil; Plavix; simvastatin.

Current Illness: I was not experiencing any illness.

ID: 1795381
Sex: F
Age: 41
State: NJ

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: PATIENT WAS GIVEN HER FLU VACCINE IN HER LEFT ARM AT 2PM. A FEW MINUTES LATER SHE CALLED ME AND TOLD ME SHE WASN'T FEELING WELL. HER NECK AND SCALP BECAME RED. EYES WERE BLURRY. SHE FELT LIKE, "HER HEAD WAS GOING TO EXPLODE". BLOOD PRESSURE BECAME ELEVATED FROM HER NORMAL BP. CALLED 911. SHE STARTED TO FEEL BETTER BEFORE 911 CAME. SHE WENT TO GET CHECKED OUT AT HOSPITAL.

Other Meds:

Current Illness:

ID: 1795383
Sex: F
Age: 45
State: VA

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

Lab Data:

Allergies: PENICILLIN

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

Symptoms: IMMEDIATELY AFTER RECEIVING THE VACCINE PATIENT REPORTED FEELING TINGLING IN THE ARM THAT RECEIVED THE INJECTION. PATIENT SAID IT FELT LIKE THEIR ARM FELL ASLEEP. THERE WAS NO REDNESS AT THE INJECTION SITE. NO INDICATION OF HIVES, SWOLLEN LIPS OR TONGUE, OR DIFFICULTY BREATHING.

Other Meds: PHENTERMINE 37.5 MG TABELTS

Current Illness: NO KNOWN HEALTH CONDITIONS

ID: 1795384
Sex: F
Age: 34
State: FL

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: None

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Extremely itchy palms, red/swollen eyelids, hives all over chin, some on chest, hairline, inner elbow; paleness.

Other Meds: Trazodone, Norylda

Current Illness: None

ID: 1795385
Sex: F
Age: 20
State: PA

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

Lab Data: None to our knowledge

Allergies:

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

Symptoms: Patient returned to pharmacy after vaccination to question if we had given her the wrong paperwork or vaccine. Upon review, it was discovered that the patient had intended to request first COVID-19 vaccination, but had received flu vaccination. She did not note any side effects at that time and proceeded with COVID-19 first dose.

Other Meds:

Current Illness:

ID: 1795386
Sex: M
Age: 72
State: CO

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:

Allergies: none

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

Symptoms: SEVERE auto-immune disorder about 3-4 weeks after second shot.

Other Meds: Losartin, hydocloraquin

Current Illness: none

ID: 1795387
Sex: F
Age: 72
State: SC

Vax Date: 10/05/2021
Onset Date: 10/13/2021
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: none, observed clinically

Allergies: Bactrim DS

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

Symptoms: Patient developed shingles 8 days after receiving both influenza vaccine( Unknown which flu vaccine) IM and Pfizer COVID vaccine dose #3. She has flank pain, itching, and vescular rash to left flank. She has been rx valtrex and gabapentin.

Other Meds: ASA 81mg daily Carboplatin 50mg/5ml IV Cetuximab 100mg/50ml IV Calcium 600mg daily Vitamin D3 2000units daily Ferrous sulfate 325mg daily Mag Ox-Vit D3-Tumeric 400mg BID Pravastatin 40mg daily Levothyroxine 100mcg daily metoprolol tartrate

Current Illness: none

ID: 1795388
Sex: F
Age: 65
State: OH

Vax Date: 09/22/2021
Onset Date: 10/06/2021
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: N/A

Allergies: N/A

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

Symptoms: Pt. states that after receiving the 2nd dose of Phizer 09/22/2021, started experiencing symptoms 10/06/2021 of rash at the injection site and (10) Blemishes around the left arm. Blemishes are still currently appearing, Clinic visit 10/17/2021 with recommendations of observation. No noted Primary visit.

Other Meds: N/A

Current Illness: N/A

ID: 1795389
Sex: M
Age: 51
State: TX

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: EKG normal

Allergies: No

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

Symptoms: 1st, started with hiccups, GERD. Medicine worked, omeprazole Dr 40 milligram. No hiccups, will the 2nd vaccine and then got 2nd it got weird. 4hrs after the vaccine. The acid will come up and my esophagus tightened up and I can't breathe. I went to urgent care. Asked to go to emergency, gave Zofran and GI tonic for GERD.

Other Meds: Triumeq; vitamin D

Current Illness: No

ID: 1795390
Sex: F
Age: 33
State: IA

Vax Date: 09/13/2021
Onset Date: 09/14/2021
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: Chest x-ray, D-dimer, CBC, cardiac enzymes, filmarray, covid rapid test all negative

Allergies: Sulfa

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Low grade fever (99.6-9) daily since injection, fatigue, malaise, weakness, paresthesia, chest pain. Symptoms ongoing, worse 3 weeks after initial dose, slowly resolving

Other Meds: Multi-vitamin, vitamin C, beta TCP

Current Illness: None

ID: 1795391
Sex: F
Age: 45
State: IL

Vax Date: 08/31/2021
Onset Date: 09/02/2021
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: H pylori test negative 9/10/2021 Pregnancy test negative 9/10/2021

Allergies: Allergic to Vicodin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe nausea for several weeks after the injection. The symptoms started on that Thursday evening.

Other Meds: Xarelto Zoloft Zyrtec

Current Illness: No illness

ID: 1795392
Sex: F
Age: 63
State: AZ

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

Allergies: none

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

Symptoms: Tachycardia, resting HR approximately 112, started at 11am and continued for next 36 hours.

Other Meds: vitamin D, estroven

Current Illness: none

ID: 1795393
Sex: F
Age: 38
State: WA

Vax Date: 10/15/2021
Onset Date: 10/15/2021
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:

Allergies:

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

Symptoms: Patient presented to clinic to receive Pfizer booster dose of COVID vaccine. Vaccine order has been placed per standing order. Consent form signed, COVID vaccine card, EUA Fact Sheet, and V-Safe information given. Patient tolerated procedure well. After receiving vaccine, patient was instructed to wait 15 minutes minutes in waiting room and report to the front desk with any symptoms and/or questions. Patient advised they may leave if no symptoms occur and have no further questions after recommended wait time. I followed appropriate precautions, and wore proper PPE during this patient encounter. Received verbal attestation from patient that she received Pfizer but after injection administration, upon trying to reconcile the health maintenance, nurse sees that patient has documentation of Moderna as first two doses, not Pfizer. Immediately returned to patient and verified which COVID vaccine she previously received. She states that she is 95% sure it was Pfizer but she does not have her card with her today. After some more thought, she realizes that she thinks she mixed up her husband and her cards and she truly did receive Moderna. Patient apologizes for the mix up and understands that her verbal attestation was incorrect. Incident report filled out and supervisors contacted for help with documentation.

Other Meds:

Current Illness:

ID: 1795394
Sex: F
Age: 47
State: SC

Vax Date: 01/09/2021
Onset Date: 01/14/2021
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: ekg ultra monitor chest ct-negative cardiac ultrasound-mild pulmonary hypertension chest x-ray- negative blood work-all was fine PBC every 2-3 weeks Currently 2 heart medications

Allergies: Sulphur codeine give mild reaction

Symptom List: Unevaluable event

Symptoms: shortness of breath and heart palpitations usually happens around midday and when patient is in the heat Chest pains

Other Meds: None

Current Illness: Covid-19 i- tested positive in December

ID: 1795395
Sex: F
Age: 61
State: PA

Vax Date: 04/12/2021
Onset Date: 10/05/2021
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: Molecular COVID test

Allergies: None

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

Symptoms: Head cold;Chest cold.

Other Meds: Flonase Zyrtec Clobetasol Prevident Multi-Vitamin Vitamin B-12 Calcium Biotin Iron D3 Lutein Dexcom G-6

Current Illness: Hypoglycemic Unawareness

ID: 1795397
Sex: F
Age: 63
State: MD

Vax Date: 04/16/2021
Onset Date: 09/14/2021
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: see above plus CT scan; bone density test; labwork and others

Allergies: Allergies to antibiotics: Cephlex; Amoxicillin; CoTrimoxazole (I think it is Bactrim); Cephalexin; Bacitracin; Oxycodone; Romadidine; Dorzolamide

Symptom List: Injection site pain, Pain

Symptoms: Symptoms - Normal screening mammogram; diagnostic mammogram with ultrasound ;needle biopsy - breast cancer was confirmed at that point. Diagnosis was Invasive Ductal Carcinoma. I had a lumpectomy with removal of four lymph nodes at an outpatient center. No other treatment yet. I need to get radiation next.

Other Meds: Multi-Vitamin; Vit D; Fish Oil; Glucosamine & Chondroitin combo pill; Vit C; Vit E; Zinc; Garlic; Estrace Cream; Clobetasol; Metronidazole Gel; OC Eye drops (Refresh brand).

Current Illness: no

ID: 1795398
Sex: M
Age: 44
State: VA

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

Lab Data: NONE

Allergies: NO KNOW ALLERGIES

Symptom List: Injection site pain, Menorrhagia

Symptoms: IMMEDIATELY AFTER RECEIVING THE VACCINE PATIENT REPORTED FEELING TINGLING IN THE ARM THAT RECEIVED THE INJECTION. PATIENT SAID IT FELT LIKE THEIR ARM FELL ASLEEP. THERE WAS NO REDNESS AT THE INJECTION SITE. NO INDICATION OF HIVES, SWOLLEN LIPS OR TONGUE, OR DIFFICULTY BREATHING.

Other Meds: NO PRESCRIPTIONS, OR OTC MEDICATIONS ON PATIENT PROFILE

Current Illness: NO KNOWN HEALTH CONDITIONS

ID: 1795399
Sex: F
Age: 61
State: NY

Vax Date: 03/01/2021
Onset Date: 03/01/2021
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: had a uterine biopsy to make sure bleeding was not due to cancer. biopsy was negative. provider and I both feel that these episodes are due to the vaccine.

Allergies: sulfa drugs; aspirin and NSAIDs; bell peppers, chilis, and jalapenos

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

Symptoms: menstrual spotting a few days after injection; spotted again after the 2nd dose, a month later (April). please note that I have been post-menopausal for at least a decade. I then experienced some vaginal bleeding for three days--like a mini-period--each month in May, June, July, August, and September. don't know yet if I will have the same experience in October. I'm also wondering this: if I stop bleeding, does that mean I no longer have immunity to COVID-19? also note: I had COVID-19 in 2020 and did not have any bleeding during or after the illness.

Other Meds: Flonase

Current Illness: none

ID: 1795400
Sex: F
Age: 87
State:

Vax Date: 01/05/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: breakthrough case

Other Meds:

Current Illness:

ID: 1795402
Sex: F
Age: 65
State: CT

Vax Date: 04/13/2021
Onset Date: 04/14/2021
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: none

Allergies: Sulfa Drugs Amlodipine latex iodine wheat peanuts

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Within half an hour, the area around where the vaccine was injected started to swell. I had swelling the size of a grapefruit in my left arm. It was red, hot, and distinctly sore. The next morning my fever was elevating. I called my daughter and asked if she could come home with me. I had a fever that was about 102 degrees at the highest and then 101.8. It stayed that way for an extend period of time. I was cold and hot then hot and cold. I was dizzy, nauseated, and had no appetite. I slept a lot which I usually don't do. Just going to the bathroom was a major effort. I didn't eat for a few days. I only drunk water. I was really sick. I just called the nurse hotline, and she said it was normal for people in my age group to experience those symptoms. She told me to just rest and take some Tylenol.

Other Meds: ProSal Amlodipine Pantoprazole Nasacort Spiriva Symbicort Mucinex Vitamin D3 Calcium Albuterol

Current Illness: none

Date Died: 09/13/2021

ID: 1795403
Sex: M
Age: 63
State: KY

Vax Date: 02/22/2021
Onset Date: 09/13/2021
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 EXPIRED ON 09/13/2021

Other Meds:

Current Illness:

ID: 1795404
Sex: F
Age: 85
State: MI

Vax Date: 02/12/2021
Onset Date: 10/09/2021
Rec V Date: 10/18/2021
Hospital: Y

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

Lab Data:

Allergies: Ciprofloxacin

Symptom List: Nausea

Symptoms: Hospitalized 10/9/2021; COVID-19 positive 10/9/2021; fully vaccinated BRIEF OVERVIEW: Discharge Provider: DO Primary Care Provider at Discharge: MD Admission Date: 10/9/2021 Discharge Date: 10/13/2021 DETAILS OF HOSPITAL STAY: HOSPITAL COURSE: Patient is an 86 y.o. female with past medical history of RA on prednisone, DM II, HTN, hypothyroidism, and remote hx of right sided breast cancer who lives with her husband at independent living facility. Patient presented to the ED with chief complaint of generalized weakness and cough. She was subsequently found to be positive for COVID-19. Vaccinated in Feb 2021. Upon arrival to the ED, the patient was afebrile, hypertensive 196/83 and hypoxic to 87% on room air requiring 2L oxygen. She was admitted for acute hypoxic respiratory insufficiency secondary to COVID 19 pneumonia. She was started on decadron to complete a 10 day course. Also found to have a Klebsiella UTI for which she received Rocephin x 3 days then was restarted on home prophylaxis macrobid. Given generalized weakness, multifactorial but likely due to concurrent infections, therapy recommended subacute rehab. She improved throughout her hospitalization and therapies changed recommendation to home with therapies. She was seen by pulmonary rehab and discharged on 2L oxygen around the clock. She was also set up with the COVID at home program to continue to monitor her closely at home. She was discharged home in stable condition. She was instructed to restart her home prednisone once she completes her course of decadron.

Other Meds: acetaminophen (TYLENOL) 500 MG tablet amLODIPine (NORVASC) 5 MG tablet Bioflavonoid Products (ESTER C PO) bisacodyl (DULCOLAX) 10 MG suppository Calcium Carbonate (CALCIUM 600 PO) carvedilol (COREG) 6.25 MG tablet cevimeline (EVOXAC) 30 MG

Current Illness:

ID: 1795405
Sex: F
Age: 72
State: AZ

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 10/18/2021
Hospital: Y

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

Lab Data: Heart test(Afib)

Allergies: Erythromycin, Cucumber, Dyclonine, Neosporin

Symptom List: Injection site pain

Symptoms: The next day after the vaccine I started feeling lethargic. On the second day I was running a low grade fever. I went to the ER on October 7, 2021 I started exp Afib.

Other Meds: Norvasc 5mg as needed, Atenolol 50mg once daily, Eliquis 5 mg twice daily, Eye drops 1 drop each eye at night

Current Illness: No

ID: 1795406
Sex: F
Age: 63
State: TN

Vax Date: 10/13/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: latex, sulfa drugs and some anti biotics

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

Symptoms: On second day I started having tightness in my chest and trouble breathing with heart flutter. I could not lay down to sleep, Had to sleep in chair for 2 days. Horrible headache, clogged sinus and nausea. Put ice pack on my head off and on for a couple of days. Trouble breathing lasted 4 days and I still have headache and clogged sinus.

Other Meds: Blood Pressure meds and Thyroid meds. Multi Vitamin and glocosamine.

Current Illness: none

ID: 1795407
Sex: F
Age: 73
State: NJ

Vax Date: 02/16/2021
Onset Date: 03/01/2021
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: MRI, Blood work

Allergies: None

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

Symptoms: Mobility and balance were off. Couldn't walk properly without assistance with 2nd vaccine. Went to primary care, went to ENT. Went to physical therapy. 20 sessions of physical therapy. Went to Neurologist. Ruled out Pakinsons and MS. Took Booster on 10/4/2021. Same symptoms came back, not as severe as with 2nd shot.

Other Meds: None

Current Illness: None

ID: 1795408
Sex: M
Age: 90
State: MN

Vax Date: 02/12/2021
Onset Date: 10/15/2021
Rec V Date: 10/18/2021
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: Hospitalized with COVID pneumonia (diagnosed 10/12) 10/15 monoclonal antibody therapy in with fever and severe weakness. Remdesivir IV to complete 5 day course, first dose on 10/15. Monitoring labs per orders. - Dexamethasone 6 mg daily for up to 10 days, first dose on 10/15.

Other Meds:

Current Illness:

ID: 1795409
Sex: F
Age: 73
State: IL

Vax Date: 03/25/2021
Onset Date: 07/06/2021
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: She's seen her GP, her podiatrist, her orthopedist (also has back issues; he thought this was related to her back problems & gave her injections which didn't help) and they weren't able to find anything. She mentioned this to her gynecologist, who told her that she has seen patients experiencing ongoing cramping with increased severity after getting vaccinated. She is about to go see a neurologist concerning this symptom.

Allergies: No allergies.

Symptom List: Erythema, Pruritus

Symptoms: Primarily nocturnal intense leg cramping for 9-10 minutes in the front of her lower leg from foot to mid-leg. Her muscles seize up to the point where she can't put weight on the leg or walk. Symptoms don't seem to happen during the day but it happens almost every single night, sometimes up to 3 or 4 times a night.

Other Meds: Pitavastatin, Clonazepam, Levothyroxine

Current Illness: Spinal Stenosis

ID: 1795410
Sex: F
Age: 59
State: MA

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

Allergies: Unknown

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

Symptoms: Vaccine booster given 2 months early last dose was 6/14/2021

Other Meds: Unknown

Current Illness: Unknown

ID: 1795411
Sex: M
Age: 37
State: VA

Vax Date: 03/26/2021
Onset Date: 06/11/2021
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: none

Allergies: NONE

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

Symptoms: On 11 June 2021, developed zoster on R side of face at V1 distribution. Prior to this time and after his vaccination on 26 March 2021, he reported no adverse reactions. He was treated in June 2021 with valacyclovir and subsequently has been treated with gabapentin for post herpetic neuralgia.

Other Meds: NONE

Current Illness: NONE

ID: 1795412
Sex: F
Age: 84
State: AK

Vax Date: 10/17/2021
Onset Date:
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:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: A Pfizer vaccine vial was reconstituted with the incorrect amount of NS (0.3 ml instead of 1.8ml) and a 0.3ml dose was administered to the patient.

Other Meds:

Current Illness:

ID: 1795413
Sex: F
Age: 75
State: MI

Vax Date: 08/17/2021
Onset Date: 10/17/2021
Rec V Date: 10/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 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: PATIENT RECEIVED A "BOOSTER" DOSE OF THE PFIZER VACCINE BUT HER ORIGINAL SERIES WAS COMPLETED WITH 2 MODERNA DOSES.

Other Meds:

Current Illness:

ID: 1795414
Sex: F
Age: 24
State: PA

Vax Date: 10/18/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: After receiving a 2nd dose of Moderna vaccine, patient started feeling a tingling sensation in her whole body. Patient stated she is not feeling good and rolled her eyes back. Patient became unresponsive for about 15-20 seconds. Pharmacist was about inject epinephrine that's when patient mumbled and started to get her consciousness back. Patient was profusely sweating upon awaking. Paramedics were called at pharmacy. Upon arrival, they checked patients vital signs. Patient was responding fine and declined to go to an emergency room. Patient's vital signs were normal.

Other Meds:

Current Illness:

ID: 1795415
Sex: M
Age: 46
State: MN

Vax Date: 05/12/2021
Onset Date: 10/16/2021
Rec V Date: 10/18/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Covid infection hospitalized but for other reasons.

Other Meds:

Current Illness:

ID: 1795416
Sex: F
Age: 39
State: WA

Vax Date: 10/15/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: No

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

Symptoms: After the 2nd shot on 10/15, I had a bad headache on 10/16 and 10/17. On 10/17 my arm had red blotches going down to my elbow underneath the injection site and hurt like bad bruises.

Other Meds: 50 mg levothyroxine, prenatal vitamin, fish oil vitamin, and sunflower lecithin for breastfeeding

Current Illness: No

ID: 1795417
Sex: M
Age: 27
State: VA

Vax Date: 09/10/2021
Onset Date: 09/11/2021
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: CBC/TSH normal, BMP without clinically significant findings

Allergies: none to food or drug, just seasonal type

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

Symptoms: axillary lymphadenopathy b/l (resolved as of exam 18 OCT 2021), also with persistent generalized fatigue / non progressive and worsening of previously well controlled (with allergy shots for) seasonal allergies

Other Meds: olopatadine HCl, 0.1 %, DROPS, OPHTHALMIC INSTILL 1 DROP INTO BOTH EYES TWICE A DAY AS NEEDED Cetirizine 10mg Tablet, Oral TAKE 1 TABLET BY MOUTH ONCE A DAY

Current Illness: none

ID: 1795418
Sex: F
Age: 17
State: IA

Vax Date: 08/17/2021
Onset Date: 08/17/2021
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: None

Allergies: No

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

Symptoms: Patient was 17 years of age at the time the vacine was given.

Other Meds: Unknown

Current Illness: No

ID: 1795419
Sex: F
Age: 18
State: MI

Vax Date: 05/04/2021
Onset Date: 09/20/2021
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: Covid test positive

Allergies: Penicillin

Symptom List: Vomiting

Symptoms: I started having symptoms on 09/20/2021. I am a freshman in college and I started experiencing some like Covid 19 symptoms. Some people were having the same symptoms and they tested negative for Covid. 4 days after I lost my smell and taste. I went to urgent care and got tested for Covid and it came back positive. I did not have a fever but I had a really bad cough, a lot of pressure in my head, stuffy nose, a lot of headaches. About a week and a half later I got the monoclonal infusion treatment. After that everything started to clear out. I have diminished lung capacity. I can definitely tell I cannot breathe as well.

Other Meds: Birth control pills

Current Illness: None

ID: 1795420
Sex: M
Age: 25
State: TN

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 fainted after a few minutes sitting after immunization. Patient reports he thinks it was an anxiety attack.

Other Meds:

Current Illness:

ID: 1795421
Sex: F
Age: 73
State: PA

Vax Date: 03/26/2021
Onset Date: 08/30/2021
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: 09/14/2021 -ultrasound of my head and neck region - results abnormal- lymph nodes were bilaterally enlarged on both sides. 09/29/2021-CT scan of the neck with IV contrast- results were bilateral abnormality of tissues of numerous enlarged lymph nodes. 2 - blood test - routine; 09/18/2021- COVID-19 test- negative; 10/21/2021 -scheduled ultra sound; 10/26/2021- presumably a biopsy.

Allergies: No

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

Symptoms: Around the end of August 31, 2021- bilaterally my salivary gland lymph nodes were swollen but not painful and firm, hard. It may have been going on longer than that, but I was not paying attention and it was not painful. 09/07/2021 in the morning, at my dentist appointment for my regular cleaning, the dentist was concerned there was excessive swelling or fullness in the neck region. He said there was an unusual fullness and that I should contact my primary care doctor. 09/14/2021 at 08:00 AM, I saw my primary care doctor, he referred me to have an ultrasound on my head and neck region on 09/23/2021. The results were abnormal. Lymph nodes were enlarged on both sides, bilaterally enlarged on both sides. The primary doctor referred me on 9/29/2021 @ 9:15, for a CT of the neck with IV contrast. The results were bilateral abnormality of tissues of numerous enlarged lymph nodes. I saw the ENT 10/14/2021 @ 08:00 AM - seems to me the swelling had gone down, but lymph nodes were presumably still enlarged. She scheduled an ultrasound for 10/21/2021 just to make sure something hasn't changed, or to see which lymph nodes are more concerning. Presumably there will be is a biopsy on 10/26/2021, depending on the ultra sound result. 09/18/2021- COVID-19 Test - result was negative. I was exposed to a friend who had COVID-19.

Other Meds: Calcium; fluoxetine; tolterodine; extra vitamin D; multivitamins; MAXALT

Current Illness: No

Date Died: 10/18/2021

ID: 1795422
Sex: F
Age: 79
State: TX

Vax Date: 10/16/2021
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: IM
Vax Site: LA

Lab Data: unknown

Allergies: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Family notified healthcare professional on 10/18/2021 that patient died on 10/18/2021

Other Meds: unknown

Current Illness: none

ID: 1795423
Sex: F
Age: 34
State: TN

Vax Date: 10/13/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: insects: anaphylactic reaction to yellow jacket or hornets

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

Symptoms: pins and needles sensation from left mid-upper arm to fingers (rated 3/10) that began the morning after receiving her 2nd dose of COVID-19 vaccination (Pfizer). intermittent aching at dorsal side of right forearm just distal to elbow and at radial aspect of right wrist rated 5/10 on pain scale. Denies any limitations in ROM or weakness. intermittent tingling in left upper thigh anterolateral and anterior shin just distal to knee. No treatment will follow up to be evaluated in 1 week from 10/18/2021

Other Meds: albuterol inhaler nuvaring

Current Illness: None

ID: 1795424
Sex: F
Age: 37
State: NC

Vax Date: 08/26/2021
Onset Date: 08/27/2021
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: MRI

Allergies: Fungus Medication

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

Symptoms: Right arm and leg tingly and numb 2 weeks out. Right hand and foot numb 2 weeks out. Dizziness, sore arm, neck and back sore immediately after shot. Joint pain consistent even after 6 weeks. Ended up getting an MRI of my brain to rule out anything else but it was a vaccine effect. Started taking medications which lessened the inflammation.

Other Meds: Progesterone, Natur-Thoid, Vitamin D, Vitamin C, Colostrum, Magnesium, Fish Oil, Glutathione, Boswellia, Multi-Vitamin

Current Illness: N/A

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am