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: 1808508
Sex: F
Age: 29
State: FL

Vax Date: 10/12/2021
Onset Date: 10/22/2021
Rec V Date: 10/22/2021
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: Cipro, Sulfa-drugs, Prozac, seasonal allergies.

Symptom List: Dysphagia, Epiglottitis

Symptoms: Rash around injection site. Approx 6cm wide and 4.5cm long. Not raised, no bumps. Red ring, slightly itchy and warm to touch.

Other Meds: Birth Control (Sprintec), temazepam 30mg, medical marijuana.

Current Illness: Strep positive 1 month before vaccine.

ID: 1808509
Sex: M
Age: 33
State: AZ

Vax Date: 10/05/2021
Onset Date: 10/05/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Extreme Fatigue, Extreme Body Aches, Fever over 101 degrees, Sweating, Chills, Extreme headache, Sensitive to Light, Loss of appetite, Extreme soreness and pain at injection site for 7 days,

Other Meds: None

Current Illness: None

ID: 1808510
Sex: F
Age: 41
State: IL

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/22/2021
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: N/A

Allergies: None

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

Symptoms: Patient came in to receive standard flu shot but got COVID Pfizer dose instead. Patient stated that she received the Janssen & Janssen vaccine back in March.

Other Meds: None

Current Illness: None

ID: 1808511
Sex: F
Age: 51
State: SC

Vax Date: 10/01/2021
Onset Date: 10/02/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: MRI-nothing abnormal; Referral for the neurology

Allergies: GI from KEFLEX

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: My lymph nodes in my right arm, arm of injection, swelled up, in the whole area of the axilla. It lasted about a week and then went back to normal. On 10/02/2021, the morning after the vaccine, around 09:00AM -10:00AM, I woke up with a horrible headache, from my left temple to behind my ear. That whole area just throbs. Sometimes its duller than other times. Other times its severe and makes me lay down. I never had a migraine headache, but to me its a very bad headache. I never had a migraine, but it feels like what other people who do have migraines describe. Sometimes it wakes me up and I feel like I have to get up and take something. I have taken Tylenol and ibuprofen it dulls it down and makes it manageable, but it doesn't get rid of it. Its just not as pronounced. About a week ago, I contacted my doctor and she wants me to get an MRI because she feels it was a sudden onset, and that is not normal for me, so she wanted me to have an MRI, which I just had last Tuesday, 10/19/2021. The MRI came back negative. The vessels looked fine. They did not see anything abnormal, no masses, no blood clots, nothing abnormal. They put me on Topomax 50 mg tablet, bd, but they are slowly ramping me up. I am starting at 1/2 tablet at night, as of now. I just filled it yesterday, 10/21/2021. She wants me to take 400 mg of magnesium with it. The gave me a neuro counsel, which I have not scheduled yet. I have not recovered from the AEs. I am still having the headache now, everyday. I am still being monitored by a a doctor.

Other Meds: NORVASC; vitamin D; vitamin B-12 complex; magnesium

Current Illness: No

ID: 1808512
Sex: M
Age: 57
State: TX

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/22/2021
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: ADMINISTERED FLUZONE HIGH-DOSE 0.7 ML TO PATIENT UNDER THE AGE OF 65.

Other Meds:

Current Illness:

ID: 1808513
Sex: M
Age: 72
State:

Vax Date: 08/01/2021
Onset Date: 08/01/2021
Rec V Date: 10/22/2021
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 xray: 10/16/2021 CBC/CMP/Stool studies: 10/20/2021

Allergies: none

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

Symptoms: Cough, SOB, wheezing, intermittent fever, body aches, diarrhea onset after Moderna vaccine August 2021.

Other Meds: Adult Low Dose Aspirin 81 mg tablet,delayed release Take 1 tablet every day by oral route. Advair Diskus 250 mcg-50 mcg/dose powder for inhalation USE 1 INHALATION ORALLY TWICE DAILY albuterol sulfate HFA 90 mcg/actuation aerosol inha

Current Illness: none

ID: 1808514
Sex: F
Age: 51
State: PR

Vax Date: 04/20/2021
Onset Date: 04/22/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: N/A

Allergies: Hydrocortisone

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient refers having some type of rash or severe pruritus all over chest area. Patient reports started 24 hours after vaccine administration (2nd dose) MODERNA. Patient did not see a doctor and took Benadryl the rash lasted 6 days. Patient reports about a month and half ago it happened again in the same area with the same intensity but less days (don't know how many) and it was after sun exposure.

Other Meds: N/A

Current Illness: N/A

ID: 1808515
Sex: M
Age: 63
State: VA

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

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

Lab Data: N/A

Allergies: NKDA

Symptom List: Pharyngeal swelling

Symptoms: Injection site was visibly swollen with warmth and bleeding right after the administration of the vaccine. Patient was monitored on the site for 25 minutes to ensure there was no further adverse effects. Patient reported patient tolerated the first two doses of Pfizer vaccines well with no issues. During the monitoring period, patient did not report any shortness of breath or chest pain. Patient was instructed to call 911 right away if he develops any allergic reactions later in the day. After the monitoring period was over, patient confirmed he felt comfortable to leave the facility and had no further reactions. Patient was under no distress upon the writer's investigation. The writer instructed patient may leave the facility and contact 911 if any symptoms arise at home. The writer communicated with the patient in another language.

Other Meds: Unknown

Current Illness: Prostate adenocarcinoma

ID: 1808516
Sex: F
Age: 33
State: CA

Vax Date: 10/21/2021
Onset Date: 10/21/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data:

Allergies: nkda

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Vaccination Error. Patient was scheduled for covid 3rd booster dose. However, at registration window, BOOSTER dose was mistaken to FLU SHOT and somehow patient's insurance went through. Patient was administered FLU SHOT. However, after the shot, patient reported she already got flu shot 2 weeks ago and she actually wanted booster dose. After monitoring patient for 30 minutes, since patient still wanted booster dose, 3rd covid pfizer vaccine was administered. Additional monitoring time of 15 minutes was allowed. Patient did not have any reaction. Patient tried to be reached today (10/22) but unable to reach.

Other Meds: unknown

Current Illness: none

ID: 1808517
Sex: F
Age: 39
State: MN

Vax Date: 10/19/2021
Onset Date: 10/21/2021
Rec V Date: 10/22/2021
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: Seasonal allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Sore arm. Tender swollen lymph node over left clavicle.

Other Meds: Multivitamin Zyrtec iron

Current Illness: Mild cold symptoms started later in the day

ID: 1808518
Sex: F
Age:
State: WY

Vax Date: 10/07/2021
Onset Date: 10/10/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: Went to ER on 10/21/21 and discharge with oxygen, the patient had CT of heart to rule out blood clot with no blood clot. The patient states in the ER that she got sick because of the Pfizer vaccine.

Allergies: N/A

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

Symptoms: After third day of first Pfizer vaccine the patient states she ended in bed for three days with cough, fever, chills, body aches, no taste or smell, SOB, brain fog and very tired.

Other Meds: N/A

Current Illness: N/A

ID: 1808519
Sex: M
Age: 60
State: WA

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 10/22/2021
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: Raging headache, neck ache, muscle soreness, fatigue lasting two days

Other Meds: none

Current Illness: none

ID: 1808520
Sex: F
Age: 37
State: WV

Vax Date: 10/08/2021
Onset Date: 10/10/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: none

Allergies: none

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

Symptoms: patient has been breast feeding x 22 months, and has not had a menses. 2 days after her second Pfizer shot she got her menses and is concerned.

Other Meds: unknown

Current Illness: none

ID: 1808521
Sex: F
Age: 17
State: TX

Vax Date: 04/19/2021
Onset Date: 04/23/2021
Rec V Date: 10/22/2021
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 work (April 2021); ultrasound of joints (May 2021)

Allergies: none

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

Symptoms: rash all over body, pain in entire body, pain to touch skin, sores in the mouth, light headed, weakness - all started a few days after vaccine; vertigo started 5 months after vaccine

Other Meds: Sertraline 50mg

Current Illness: none

ID: 1808522
Sex: M
Age: 38
State: GA

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: Went to local medical center. Several tests were ordered.

Allergies: ciprofloxacin

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

Symptoms: 12/21/20 - First shot at local Medical Center, aches in the injection site, minor headache 12/24/20 - woke up at 2:45 am with night sweats, headache and head pressure; had upset stomach/diarrhea. 1/9/21 - second shot at another hospital, fatigue all afternoon 1/10/21 - low grade fever and chills 1/11/21 - joint pain all over 1/12/21 - lower GI symptoms, and achy headache that felt like pressure in the head, insomnia 1/13/21 - all symptoms except for head pressure and insomnia subsided

Other Meds: Multivitamin, NatureMade Triple-Flex

Current Illness:

ID: 1808523
Sex: F
Age: 64
State: MI

Vax Date: 09/30/2021
Onset Date: 10/18/2021
Rec V Date: 10/22/2021
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:

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

Symptoms: Patient came in to subsequent vaccine clinic and had a second dose of the same flu vaccine. Patient previously had a flu shot administered on 9/30/21 by a different immunizer. It was unbeknownst to second immunizer until after the clinic/administration that she had been there prior for a flu shot. Patient and the patient's primary care doctor have been contacted and patient is experiencing no adverse effects.

Other Meds:

Current Illness:

ID: 1808524
Sex: M
Age: 35
State: AR

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

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

Lab Data: UNKNOWN

Allergies: none

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

Symptoms: UNKNOWN

Other Meds: unknown

Current Illness: none

ID: 1808525
Sex: F
Age: 93
State: WA

Vax Date: 10/21/2021
Onset Date: 10/21/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient's son, called PCP office at Healthcare and reports that patient was given an erroneous, extra booster dose of Pfizer on 10/21/21 at her rehab facility. He said that the rehab facility called him and asked for his permission for the booster dose and he gave permission, not realizing that patient received a booster dose on 10/11/21 while an inpatient at Healthcare Hospital.

Other Meds:

Current Illness:

ID: 1808526
Sex: F
Age: 14
State: NC

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient started menses in April 2020. She had a period every 7-8 weeks from April 2020 to May 2021. Mom reports that pt received first COVID vaccine in May 2021 and second in June 2021. Mom reports that that pt went from May 2021 to August 2021 without menses. She had a short menses in August 2021 and has had no menses since (today is October 22, 2021). Mom is concerned this could be an adverse effect from COVID-19 vaccine & asked me to report it.

Other Meds:

Current Illness:

ID: 1808527
Sex: F
Age: 39
State: NY

Vax Date: 06/01/2021
Onset Date: 07/28/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data:

Allergies: Fish

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

Symptoms: I'm having uncontrollable muscle spasms in my jaw. My jaw also locks causing my speech to slur. My hands have muscle spasms as well. They also shake uncontrollably. As a result I've spilled hot coffee on myself, it's cost me lucrative job offers at the time of the interview my jaw locks causing me to slur my speech.

Other Meds:

Current Illness:

ID: 1808528
Sex: F
Age: 25
State: KY

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/22/2021
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: slight allergy to latex (gets a rash if latex gloves are used)

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

Symptoms: The patient received the 3rd dose of pfizer COVID-19 on 10-22-21 at 4:51 pm. The patient was feeling ok and was in the store waiting the allotted 15 minutes. After about 10 minutes, she returned to the immunization room saying she did not feel ok. She started to faint and had a what appeared to be a small seizure. 911 was called, an Epi-pen was administered and her vitals were monitored. She began to respond immediately to the epi-pen and was directed to go to the emergency room by EMS and staff. The patient's mom picked her up and took her to the ER.

Other Meds: lo loestrin

Current Illness: none

ID: 1808529
Sex: F
Age: 51
State: CA

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

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

Lab Data:

Allergies: Aspirin, Bee Venom, Albuterol, Benadryl, erythromycin base, hydrocodone, ibuprofen, latex, legumes, peas, sevoflurane, soya lecthin, soyacal, soybean, soybean oil, succinylcholine chloride

Symptom List: Unevaluable event

Symptoms: 15 minutes after Jansen COVID vaccine, patient complaining of being hot and began wheezing. SPO2 of 91 when wheezing. Unable to get a BP read. Patient taken to ED via wheelchair.

Other Meds: Advair, Zyrtec, Atrovent, Ativan, Xopenex, Claritin, Singulair, Xolair, Protonix, Ventolin, Zantac

Current Illness:

ID: 1808530
Sex: M
Age: 74
State: IL

Vax Date: 04/27/2021
Onset Date: 10/12/2021
Rec V Date: 10/22/2021
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: 10/9/21 COVID19- positive 10/10/21 chest xray: Mild interstitial prominence may reflect interstitial edema or inflammation 10/11/21 chest xray: Worsening changes of COVID pneumonia 10/11/21 CTA chest: Findings compatible with COVID pneumonia.

Allergies: Niacin, statins, zetia

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

Symptoms: Presented to hospital on 10/10/21 with 1-week history of shortness of breath. Accompanied with a cough that is productive in sputum. He has also been dizzy and lightheaded. Upon arrival, he was noted to be hypoxic with oxygenation of 86% on room air. Previously, he was vaccinated against COVID in April and May 2021. Symptoms have been present for approximately 7 days. He did a self test at home, on 10/09/2021, found to be positive. Patient is being admitted for acute hypoxic respiratory failure secondary to COVID pneumonia. Chest x-ray does show COVID pneumonia. CT angio has been ordered for him. He denies any significant chest pain at this time. His oxygenation has improved up to 94% on 4 L nasal cannula. He is a full code. He did receive Decadron in the emergency room. He is agreeable to hospitalization at this time. He is in no obvious distress. He was managed with Remdesivir , Decadron. Oxygen requirements have improved , he is not in any respiratory distress, Discharged on 10/16/2021

Other Meds: Acyclovir, centrum silver, fish oil, glucosamine, loratadine PRN, naproxen, omeprazole, paroxetinue, SM CoQ-10, triamcinolone ointment, vitamin D-3 400 units

Current Illness:

ID: 1808531
Sex: F
Age: 50
State: CA

Vax Date: 09/13/2021
Onset Date: 09/14/2021
Rec V Date: 10/22/2021
Hospital: Y

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

Lab Data: CT scan - splenic infarction - basically my spleen was "killed" ; urine test; blood test - ER tests When they admitted me, they gave me two CT scans; MRI; echo of the heart; a TEE; an EGD; a colonoscopy plus all the bloodwork and urine. I was getting fevers every night from 6-8 - they thought I was septic. They didn't know where it came from. There was nothing wrong with my heart or anything else. I am still not recovered. I have to be on blood thinners and followed by a Hematologist. They don't know what has happened.

Allergies: Intolerant to Percocet - but not allergic to it

Symptom List: Injection site pain, Pain

Symptoms: Started out I was having fevers of 101; shortness of breath; chest pain; left upper abdominal pain; I was nauseas but not a lot; night sweats really bad; have a dry cough that I have since the second vaccine. Lymph nodes under left arm were painful for three days. Had a lot of really bad belly pain. I ended up in the hospital. October 4th, I had my flu shot for work - I got it through medical center through my work. I still wasn't feeling well. within a couple of days. I got so sick. I had a fever; I couldn't eat (was eating baby food because it was so uncomfortable and I felt full. I went to Urgent Care on the 9th of October. They did a urine test and they said there was something going on but he sent me to ER. I went straight there. I was having left upper abdominal pain. Was hospitalized for 7 days. They don't know where the blood clot came from. I have a blood clot in my spleen that has damaged my spleen - they are looking into blood cancer or lymphoma or something. I still have a lot of pain in my abdomen. They put me on blood thinners at the hospital. Infectious disease doctor came in and she said it looks suspicious but she said I didn't need to be on antibiotics. They sent me home with prescription for blood thinners to take. I can never take ibuprofen or anything like that again. I still have a lot of pain and tenderness in my left upper abdomen where my spleen is. I get really tired in the evening and the afternoon. I kind of get the night sweats still but not as bad. I'm not getting fevers that I know of. I saw my regular doctor today and he explained that they don't know. Dr., Hematologist - I have to make an appt for a PET scan and then make an appt to see him. I might have to have my spleen removed. I don't know yet.

Other Meds: three medications on a regular basis: Levothyroxine; Effexor; Prilosec (for GERD); Vit C

Current Illness: In August, I was very sick. I tested negative for COVID but positive for Strep. I was still trying to get over that. And after the first vaccine, I hadn't been feeling well either.

ID: 1808532
Sex: F
Age: 42
State:

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data:

Allergies: Allergies: Bee/ant sting

Symptom List: Injection site pain, Menorrhagia

Symptoms: <15mins post vaccination pt c/o numbness around her lips Vitals: BP 147/93, HR 94, RR 19. Pt stable and released from vaccination site.

Other Meds: Medications: albuterol 90mcg/act, 1-2 INH Q4hrs PRN Fioricet 50-325-40mg 1-2tabs PO Q4hrs PRN Pain Vitamin D3 400units PO Daily diclofenac 50mg EC PO BID PRN Pain Relpax 40mg PO PRN migraine Famotidine 40mg PO Daily HCTZ 12.5mg PO daily Ibu

Current Illness:

ID: 1808533
Sex: F
Age: 69
State: SD

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

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

Lab Data:

Allergies: none.

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

Symptoms: Gave 0.5ml dose instead of the 0.25ml dose for the 3rd dose.

Other Meds:

Current Illness: none

ID: 1808534
Sex: F
Age: 51
State: CA

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/22/2021
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: Vital signs taken. Contact ED physician. medicated with Benadryl 25 mg PO and Cetirizine 10 mg PO. Pt stated that she felt better but the itchiness and chest tightness is still there but subsides. received another 25 mg PO Benadryl order to be given and prescribed her to take 50 mg PO Benadryl very 6 hour for 3 days, If the symptoms not improve, she needs to contact PCP. pt verbalized understanding.

Allergies: Ibuprofen, Erythromycin base, Hydrocodone, Lyrica, PCN class, Horses

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pt started with nausea and dizziness and having a flushed feeling. Then developed chest tightness and itchy all over the body and throat is swollen up.

Other Meds: Hair and nail vitamin, Turmeric capsule, Zofran, Percocet, Flexeril, Savella, Topamax, Imitrex, trazodone,

Current Illness: CRPS in the left leg.

ID: 1808535
Sex: F
Age: 53
State: IL

Vax Date: 09/25/2021
Onset Date: 10/13/2021
Rec V Date: 10/22/2021
Hospital: Y

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

Lab Data: 10/16/21-CT Scan in the ER Room, Hospital indicating Appendectomy and Ovarian Vein Blood Clot 10/17/21-Appendectomy performed 10/18/21-Started on lovenox injections for ovarian vein clot/thrombophlebitis via Dr, Hospital gynecologist

Allergies: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 10/11/21-Uncertain how pain was related to the other events, but experienced severe right deltoid/shoulder pain (in opposite arm shot was given); pain was an intense, deep ache that became severe with movement of the arm in certain positions. 10/13/21 Left upper abdominal pain, bloating and nausea occurred; right arm pain seemed to immediately and completely resolve 10/14/21-Left upper abdominal pain very gradually moved downward to middle abdomen 10/15/21-Focal area of right medial chest pain developed overnight; pain was more noticeable when lying down or breathing in moderately or deeply. Abdominal pain became more diffuse and across entire lower abdomen. Was seen by Dr; EKG was normal and no further diagnostic testing was indicated. 10/16/21-Lower abdominal pain; fullness; pressure; frequent urination continued, worsened and became more notable the lower right abdomen.

Other Meds: VITAMIN C, D3, MULTIVITAMIN

Current Illness: COVID-19 9/9/2021

ID: 1808536
Sex: M
Age: 45
State: IL

Vax Date: 03/25/2021
Onset Date: 10/14/2021
Rec V Date: 10/22/2021
Hospital: Y

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

Lab Data: 10/14/21 COVID19- positive 10/14/21 chest xray: No acute cardiopulmonary findings.

Allergies: Morphine, triptans

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

Symptoms: Admitted to hospital on 10/14/2021. This is an obese 45-year-old gentleman with a known history of prior perirectal and perianal abscess x 6 in the past, several times requiring I and D, last episode being almost 2 years ago. The patient says that he has had at least 2 colonoscopies in the past, the last one being more than 2 years ago and that he has been ruled out for having any inflammatory bowel disease, like Crohn disease or ulcerative colitis. No family history of IBD as well. Comes to the emergency room complaining of rectal pain going on for about 3 days now, which was worsening. CT of the abdomen and pelvis shows a perirectal abscess. Dr., the surgeon, was called and saw the patient in the ER, but during his rectal examination the patient had significant pain so he wants Dr. not to see him again, so another Dr. will take the patient for examination under anesthesia and possible I and D or surgical intervention. The patient will be kept n.p.o. The patient is fully immunized against COVID-19, but incidentally his COVID-19 test came back as positive and on a CT lung windows, he has bilateral ground-glass opacities, but he is currently saturating 100 to 99% on room air. Denies any fever, chills, cough, chest pain, or shortness of breath. No loss of taste or smell. He says at work he wears the mask, but none of his customers do. He will be admitted as an inpatient for at least 2-3 days until we get his cultures back.He was started on IV antibiotics with IV Levaquin and Flagyl,and analgesics. Incidentally patient also tested positive to COVID 19 however he denies any respiratory symptoms except muscle aches and pains. He is not hypoxic. Chest x-ray was unremarkable however the chest abdomen did capture the lower portion of the lungs with showed some ground-glass opacities on the right side. He underwent rectal exam under anesthesia with rigid proctoscopy, incisional drainage of ischio-rectal abscess by MD on 10/15/21. Clinically he has done well. Surgical and blood cultures still pending . He was cleared for discharge on 10/16/21 by surgery service, and will complete 7 days of oral antibiotics (Levaquin and Flagyl), will follow up[ with MD in 2 weeks as swell as his PCP. Prescription for Norco 5/325 mg (#20) was provided.

Other Meds: Cyclobenzaprine, nexium, mens multivitamin, orphenadrine

Current Illness:

ID: 1808537
Sex: F
Age: 60
State: FL

Vax Date: 04/20/2021
Onset Date: 04/22/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: Many MRIs (4/24/2021); EKG (4/25/2021); Bloodwork (4/25/2021) Neurologist Dr.

Allergies: Penicillin

Symptom List: Nausea

Symptoms: On April 22nd and 23rd I was having constant migraines. I wasn't eating because I wasn't hungry. I was also throwing up for 3 days. The morning of April 24th I had been talking with my mama over the phone. During the phone call I wasn't making any sense or articulating words correctly. My mother terminated the call and then called my husband who was a mile away at the store. Participant's husband is talking now: Her mother told me, "There is something wrong with my daughter. She isn't making any sense over the phone. You need to get home." I went back home. I talked to patient while she was sitting on the couch with her computer in her lap. She was frustrated and crying because she couldn't remember her password to her computer, as she was speaking to me she wasn't able to articulate anything and make any sense of what she was saying. I called the doctor and took the computer away. I told her to smile, and when she did both sides of her face went up. I told her to lift both of her hands, feet, and toes. She was able to do that but still not able to articulate properly. I explained to her that she may be having a stroke and that I would need to call 911. Patient became upset about calling 911 and did not agree. I told her I would either call 911 or take her down the road to the ER. She did not want to do either, and she was being argumentative. I kept her distracted mentally about continuing to call 911. I told her that's fine I'm not going to call 911. I told her I would take her for a ride. I convinced her we were leaving and that I was not going to call 911. I then drove to the Urgent Care/ER. When I pulled up and put the car in park, I told her to get out of the car. She started crying and getting frustrated because she didn't know how to unbuckle her seatbelt so I unbuckled it for her. As we are walking into the ER patient had to vomit. I took her aside to the grassy area and then left her there. Then I went into the ER and told the nurse to come outside to help because patient may of been having a stroke. The ER team came and got her, and then immediately admitted her in and then ran protocol for a stroke. In doing that, they did check on her blood pressure which was 229 over 117. The staff believed she was having a stroke. The team there briefed with the doctor about patients test and that her cognitive abilities where not normal. The doctor confirmed that she is having a stroke. During this time patient could not remember her middle name, last name, or names of her children. She had difficulty spelling her first name. The doctor said we need to give her the injection to stop the stroke. They had to ask permission from me because patient wasn't able to make that decision herself because of her not having her cognitive ability. I asked the doctor if they were sure that it was a stroke. The doctor said she believed more than 50% that it was a stroke, but if given the stroke injection and it not be a stroke then that could cause instantaneous death. Patient heard what the doctor said. In tearful eyes she said please do not do this. The doctor told me that she may have a full on stroke at this point which will be no way to recover the damages that would be done. During that time we were in the hospital for 3 hours. Patients blood pressure did not come down at all so the doctors were confused. They told me the only thing that they could do is watch her for 90 minutes to 2 hours then get her to the appropriate ER the stroke had worsened. There are 2 ER hospitals. The one locally they will send patients who have an active stroke at Hospital. The other hospital, for non stroke patients. They determined it was not a stroke and sent her to the Hospital. The senior nurse said I definitely made the right decision about the injection. Patient went to that hospital and left the day after. I contacted her cardiologist and neurologist and then they wanted to see her right away. These two doctors are not a part of the same team, but we met with the both of them over the next 3 days and both of those doctors said the same thing. They said that there are not 100% certain that this was caused from the COVID vaccine, but informed to not take the 2nd dose. They said if it was a stroke it was small but she is in the fast line for a massive stroke. I was informed to be within 20 mins of patient at all time which caused me to resign from my job which is 45 minutes away from the house. I resigned 2 days later. There is one long term effect from what happened which is some of patients long term memory is non existent which causes her to be frustrated and me frustrated sometimes as well until I remember why she doesn't remember things. The doctors had prescribed patient a small dosage of medication for her blood pressure but it was only 5mg and temporary because she is no longer on that medication. They told her to change her diet and reduce her sodium and caffeine intake. The reason patient has migraine headaches is because she started getting them after being exposed to the burn pit while working.

Other Meds: Mega Red; Magnesium; Co-Q10; Atorvastatin; Omeprazole; Levothyroxine; Losartan; Pregabalin; Duloxetine; Vitamin B2; Vitamin D; Diclofenac; Onzetra; AJOVY Injection; Ondansetron; REYVOW; CBD; Trulieve TRUNANO

Current Illness: None

ID: 1808538
Sex: M
Age: 61
State: CO

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/22/2021
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: Injection site pain

Symptoms: Intended to give Influenza and Moderna Booster. Gave two doses of Influenza vaccine instead. Discussed with patient and provider and booster Moderna dose administered. Patient observed with no reaction.

Other Meds:

Current Illness:

ID: 1808539
Sex: F
Age: 65
State: CO

Vax Date: 10/19/2021
Onset Date: 10/20/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data:

Allergies: gabapentin

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

Symptoms: tired

Other Meds:

Current Illness:

ID: 1808540
Sex: M
Age: 85
State: MI

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/22/2021
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 reported yet.

Allergies: no known allergy

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

Symptoms: patient given 0.5 ml instead of .25 ml as a booster. Patient has chronic conditions but not immune compromized.

Other Meds: spironolactone , pravastatin, atenolol, furosemide,

Current Illness: none reported

ID: 1808541
Sex: F
Age: 57
State: KS

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: I did see my primary care physician and explained to her my symptoms. I had routine blood tests to check my thyroid levels, they were normal. No fever or external chills.

Allergies: Flagyl and Sulfa drugs

Symptom List: Tremor

Symptoms: Internal chills that run up my right arm and through my shoulders and down my left arm. I had the first internal chill experience when I got my 1st Pfizer vaccine on 1/2/21. Internal chills have been ongoing and increased in frequency after my 2nd Pfizer vaccine on 1/21/21 and again with my Pfizer booster on 9/30/21.

Other Meds: BP medication, allergy medication, hormone therapy medication (progesterone and estrogen)

Current Illness: none

ID: 1808542
Sex: F
Age: 71
State: AR

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

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

Lab Data: UNKNOWN

Allergies: UNKNOWN

Symptom List: Erythema, Pruritus

Symptoms: UNKNOWN

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1808543
Sex: F
Age: 42
State: AK

Vax Date: 09/11/2021
Onset Date: 09/13/2021
Rec V Date: 10/22/2021
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: First reported my symptoms on September 14th, on Sept. 17th I was seen and evaluated - had blood work, Chest X-ray, EKG done with no issues found, went ahead and had a Mammogram accomplished since I was due for one on Sept 23rd, on Oct 1st more bloodwork and EKG was done for precaution, I was finally seen by Cardiology on October 6th with Ultrasound done on my heart with no findings, the Cardiologist suggested that I take 800 miligrams of ibuprofen for three days to treat "inflammation" and I'm currently pending to be evaluated by Internal Medicine Allergy/ Immunology Clinic on November 3rd for further evaluation and testing. I made sure to have a covid test prior to my first dose and also did another test two weeks after vaccine to make sure that I was dealing due to other symptoms.

Allergies: doxycycline, azithromycin, amoxicillin, sulfamethoxazole-trimethoprim

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

Symptoms: Felt moments of dizziness and sore arm for two days following the first dose that turned into a mild constant ongoing pressure type of pain that has lasted for over five weeks that started at the heart (with moments of pressure at the upper left and bottom right abdomen, upper throat at each side of neck a pressure tightness/ as well as at the left side of my heart/ chest area. My symptoms are slowly getting better but have been feeling overall week with no issues detected/ found/ diagnosed/ determined. Currently being evaluated by Medical Doctors, Cardiologist, and will see an Allergy/ Immunologist.

Other Meds: Prescriptions: Vitamin D3 , Folic Acid, and Metronidazole Topical Cream (for face if needed for rosacea .)

Current Illness: None

ID: 1808544
Sex: M
Age: 71
State: SD

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

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

Lab Data:

Allergies: none.

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

Symptoms: Gave 0.5ml for the 3rd dose instead of 0.25ml.

Other Meds:

Current Illness:

ID: 1808545
Sex: M
Age: 73
State: IL

Vax Date: 03/15/2021
Onset Date: 10/07/2021
Rec V Date: 10/22/2021
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: 10/14/21 COVID 19: positive

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Admitted on 10/7/21 With MS changes encephalopathy. Creat 7.2 baseline 1.4 . Uremia with MS changes. US bilateral hydro. Has stent in left for hydro from the past. .started on AB , nephrology consult , urology consult. Dr did cysto, removal of left sten (old) and attempted bilateral ureteral stent. Unsuccessful. IR called and nephrostomy was placed. His encephalopathy improved with treatment of AKI. Ammonia was 108, treated with lactulose - even small amount caused diarrhea. He has not had any CT changes of cirrhosis on evaluation. Hepatitis screen negative. He had a prolonged hospital course due to significant acute kidney injury, see Nephrology notes for detail. Patient's has days progresses became a normal to baseline. He was up and ambulatory with assistance but does have generalized weakness. On day of discharge he was found to have incidental finding of COVID positive. Is actually vaccinated. He had no symptoms of COVID. Due to this the discharge was held for a day. Inflammatory marker shows actually improvement in a ferritin. Patient had no new symptoms of respiratory problem etcetera. He had no abdominal pain nausea vomiting at this time. Discharged on 10/15/21

Other Meds: Calcium 1200 mg, multivitamin, norco, ondansetrone, orgovyx

Current Illness:

ID: 1808546
Sex: M
Age: 37
State: CA

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

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

Lab Data: None. Will contact doctor next week of continues.

Allergies: None

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

Symptoms: High grade fever 104.2 degrees first night, started at 2230 hrs with extreme chills, felt freezing, then fever started around 2 AM. Fever lasted till mid afternoon, then subsided to low grade fever. During high and low fever duration, extreme fatigue and headache. Symptoms subsided by third day, however fatigue and headache and still consistent as of reporting time of 10/22/2021 3pm

Other Meds: None

Current Illness: None

ID: 1808547
Sex: M
Age: 73
State: AL

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/22/2021
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: none

Allergies: none

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

Symptoms: Patient is experiencing continued soreness in left shoulder. Pain started 1 hour post injections and began to resolve after about 1 week. Then pain came back and has continued until present day. His arm is not red or swollen and he has no limitations in range of motion.

Other Meds: n/a

Current Illness: none

ID: 1808548
Sex: M
Age: 78
State: SD

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

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

Lab Data:

Allergies: none.

Symptom List: Pain in extremity

Symptoms: Gave 0.5ml for the 3rd dose instead of the 0.25ml.

Other Meds:

Current Illness:

ID: 1808549
Sex: M
Age: 68
State: AR

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

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

Lab Data: UNKNOWN

Allergies: unknown

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

Symptoms: UNKNOWN

Other Meds: unknown

Current Illness: unknown

ID: 1808550
Sex: F
Age: 29
State: NV

Vax Date: 04/21/2021
Onset Date: 05/10/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: EEG- mild seizures; chest XR- normal; MRI- still awaiting results; blood work- normal except for low vitamin D

Allergies: None

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

Symptoms: About 3 weeks after my vaccine I started hearing a noise in my ear that sounded like air coming out. I also felt pressure. It prevented me from sleeping/working. I went to the doctor and they attributed it to the vaccine. They ran multiple tests and all were normal. I started getting frequent headaches in August. Since September I have had headaches with aura every day. I had an EEG and they found I have mild seizures. Sometimes when I get the headaches my face goes numb. I have had a number of imaging done including chest X-ray, MRI's and EEG. I have also had blood work done.

Other Meds: None

Current Illness: None

ID: 1808551
Sex: M
Age: 17
State: LA

Vax Date: 08/05/2021
Onset Date: 09/12/2021
Rec V Date: 10/22/2021
Hospital: Y

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

Lab Data: elevated Troponin, CK enzymes, and BNP. MRIs and CTs completed

Allergies: NKA

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

Symptoms: Healthy athletic male, symptoms(HA, mayalgias, fatigue) developed 09/12/21. syncopal episode at home. ER Hospital, cardiac symptoms. myocarditis with acute heart failure. Hospitalized from 09/17-09/24/21. Responded well to milrinone and IVIG. Was discharged to home on lisinopril. EF 40-45% at discharge. Not sure if fully recovered but not strenuous exercise for 6 months

Other Meds:

Current Illness: Healthy

ID: 1808552
Sex: F
Age: 31
State: CA

Vax Date: 03/26/2021
Onset Date: 05/19/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Vomiting

Symptoms: All my life I have always had normal, regular menstrual cycles. After receiving my covid-19 vaccinations, my periods became heavier, worse and absent. I am now 70 days late on my period, not pregnant, and nothing has changed except the covid vaccine. When I got my last period, in July, I had the worst pain in my legs, my joints, everywhere. This has never happened before the shot. I am not 70 days late!

Other Meds: Escitalopram 15 mg a day

Current Illness: no

ID: 1808553
Sex: M
Age: 35
State: TX

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 10/22/2021
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: N/A

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Symptoms lasted for a couple of weeks after the second dose of the Pfizer COVID19 vaccine. Symptoms included: Full body aches, joint pain, hot and cold flashes, headache, soreness at injection site, heart palpitations (thought to be from myocarditis after Drs visit), slight chest pain/tightness when breathing deeply, fatigue, neck pain, dizziness, light headed, fever, light sensitivity.

Other Meds: vitamin D

Current Illness: N/A

ID: 1808555
Sex: F
Age: 49
State: MN

Vax Date: 03/22/2021
Onset Date: 10/18/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: cough, congestion, sore throat, headache, ear pain, sinus congestion starting on 10/19/21

Other Meds: NP thyroid, Otezla

Current Illness: none

ID: 1808556
Sex: F
Age: 65
State: CA

Vax Date: 02/19/2021
Onset Date: 02/24/2021
Rec V Date: 10/22/2021
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: The second specialist i saw diagnosed me with dry eye, blepharitis, and meibomitis. The dry eye and blepharitis had been previously diagnosed, but the meibomitis was new. I was treated with a chemotherapy injection. We discussed the possibility that the inflammation could be due to my immune system reacting to the Covid-19 vaccine. Subsequent treatment has consisted of daily warm compresses on the eyelids, and cleansing with avenova and ocusoft. The swelling subsided but minor bumps remain on the eyelid. I have had 3 subsequent flare-ups, once after exposure to fumes, once after 3 days of severely interrupted sleep, and once more after my 3rd Pfizer dose, although this last flare-up was not as severe.

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: My lower right eyelid became itchy and irritated. Two days later it became swollen and bumpy. I made an appointment at my eye doctor. Initially he thought it might be a stye but it did not react to treatment like a stye. He referred me to two eyelid specialists.

Other Meds: albuterol, singulair, symbicort, lunesta, restasis, omega blend, magnesium, d3, b12

Current Illness:

ID: 1808557
Sex: M
Age: 73
State: SD

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

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

Lab Data:

Allergies: none.

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

Symptoms: Gave 0.5ml for the 3rd dose instead of the 0.25ml.

Other Meds:

Current Illness:

ID: 1808558
Sex: F
Age: 41
State: IL

Vax Date: 10/18/2021
Onset Date: 10/19/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: They ran a strep throat test and it was negative. They tested me for covid and xray, they did a rapid test and PCR test.

Allergies: Latex; atorvastatin copanine; contrast dye

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

Symptoms: On Tuesday 19 October, I had the normal adverse reaction, to the covid vaccine. I had body aches, temperature and chills. Later that night until Wednesday I started coughing and had a runny nose. I started coughing up blood. By Wednesday I went to an ER. I was tested for covid, and today I'm even worse. They called in a prescription for exampro and an inhaler to help with my cough and breathing. They told me to go back to the doctor next Tuesday if I don't get better. Today the 22nd I've been coughing blood. I tested negative for covid.

Other Meds: Topiramate; levothyroxine; gaceatintine; amlodipine; venlafaxine; buspirone

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am