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: 1815012
Sex: F
Age: 67
State: PA

Vax Date: 10/22/2021
Onset Date: 10/23/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: N/A

Allergies: Zomax

Symptom List: Dysphagia, Epiglottitis

Symptoms: Large red rash upper left arm. Area affected was approximate size of a pancake. Area was sensitive to the touch but mostly itchy.

Other Meds: Meds (updated 12/11/2020) Baclofen. 10 mg. (3 in am/pm) Glatiramer Acetate injections (Copaxone) (3 shots/week) Metoprolol. 25 mg (1 in am/pm) Myrbetriq 25 mg. (am) Nitrofuratoin 100 mg. (a.m.) Oxybutynin 5mg. (a.m.) Synthroid. .05 mg. (a

Current Illness: No illnesses

ID: 1815013
Sex: F
Age: 67
State: TN

Vax Date: 04/21/2021
Onset Date:
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: Flu x2- Negative Covid x2- Negative EGD- Unknown Gastric Emptying Studying- Scheduled

Allergies: Shellfish- fatal, Iodine, latex, sulfur, codeine, dust

Symptom List: Anxiety, Dyspnoea

Symptoms: Over the summer I was sick to my stomach and kept throwing, and was achy all over. Burning from stomach to esophagus. Was running a low grade fever, normal temperature for me is in the 97's and I was in the 99's. I just felt bad. My ears were also throbbing. I saw Dr. a few times she tested me for flu and Covid and both times it was negative and had me up the dosage of omeprazole. She also put me on Promethazine 12.5mg 1tab every 8 hrs, Ondansetron 4mg 1 tab 3x daily, Famtine 20mg 1 tab 2x daily. The medications were not working and she referred me to a specialist. I saw the specialist, and she wanted to do an upper endoscopy. She scheduled me for the following week. Do not have the results yet, She also scheduled me for Gastric emptying studying since I am having trouble eating. It is scheduled and our appointment to go over the test results is later.

Other Meds: Simvastatin 20mg daily, Omeprazole 20mg 2x daily, Alendronate 70mg once a week, Melatonin 12mg at night, low dose aspirin 80mg daily, Calcium Magnesium 25mcg.

Current Illness: Allergies

ID: 1815014
Sex: F
Age: 39
State: WI

Vax Date: 10/15/2021
Onset Date: 10/16/2021
Rec V Date: 10/25/2021
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: Severe reaction to D-TAP as a baby, nothing else

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

Symptoms: Received first dose of Moderna, metallic taste in mouth, awoke on 10/16/21 with dime-sized hive at injection site, by 10/18/21 hive expanded to size of quarter and was itchy, by 10/23 it grew to the size of a plum.

Other Meds: Allegra, adderall

Current Illness: N/A

ID: 1815016
Sex: M
Age: 88
State: CA

Vax Date: 10/21/2021
Onset Date: 10/22/2021
Rec V Date: 10/25/2021
Hospital: Y

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

Lab Data: CPK 10/22 2,444 10/23/21 18,503 10/24/21 12,345 10/25 6246 Creatinine 1.03 10/25

Allergies: Clinoril

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Worse than baseline weakness x 1 day, fall (onto grass), could not get up ~3 hours

Other Meds: Famotidine 20 mg twice per day, atorvastatin 10 mg daily, Vit D3, Vit E, Multivitamin

Current Illness: Generalized weakness x 1 month.

ID: 1815017
Sex: F
Age: 43
State: KY

Vax Date: 10/25/2021
Onset Date: 10/25/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies: ALPHA-GAL, FLAGYL, SULFA, MORPHINE

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

Symptoms: PATIENT RECEIVED VACCINE AT 9:04AM. AT 9:37AM PATIENT RETURNED TO THE COUNTER WITH A RED RASH ON NECK AND CHEST. PATIENT DENIED BREATHING DIFFICULTY AT THE TIME. PATIENT WAS GIVEN 50MG OF DIPHENHYDRAMINE AT 9:38AM. AT 9:44AM PATIENT STATED TONGUE FELT NUMB AND TINGLY AND WAS PROGRESSIVELY GETTING WORSE. PATIENT WAS TAKEN TO IMMUNIZATION AREA AND PHARMACIST ADMINISTERED 0.3MG EPINEPHRINE IM. PATIENT WAS SEATED AND GIVEN WATER. PATIENT WAS MONITORED FOR ANOTHER 20 MINUTES BEFORE SHE FELT SHE WAS FEELING BETTER.

Other Meds:

Current Illness:

ID: 1815018
Sex: M
Age: 34
State: NC

Vax Date: 10/19/2021
Onset Date: 10/19/2021
Rec V Date: 10/25/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1815019
Sex: F
Age: 40
State: NY

Vax Date: 10/21/2021
Onset Date: 10/22/2021
Rec V Date: 10/25/2021
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: PCN

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: INTENSE PAIN FOR 5 HOURS STRAIGHT IN LEFT OVARY LESS THAN 24 HOURS LATER TO THE POINT THAT MOVING AND WALKING WERE VERY DIFFICULT. CHRONIC MIGRAINES CONTINUOUSLY SINCE VACCINATION. PAIN IN RIGHT OVARY ON DAY 4.

Other Meds: Regular vitamins

Current Illness: None

ID: 1815020
Sex: M
Age: 43
State: CA

Vax Date: 09/20/2021
Onset Date: 09/25/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: -Audiograms on 9/28/2021, 10/13/2021, 10/21/2021 -MRI on 10/14/2021

Allergies: N/A

Symptom List: Pharyngeal swelling

Symptoms: (i) Sudden sensorineural hearing loss (left ear), (ii) Vertigo, and (iii) Tinnitus - treatments including oral corticosteroid prescription (3 weeks), intratympanic steroid injections (3 injections to date), and hyperbaric oxygen therapy (13 sessions to date)

Other Meds: None

Current Illness: None

ID: 1815021
Sex: F
Age: 45
State: CA

Vax Date: 10/23/2021
Onset Date: 10/23/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies: unk

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: pt. received booster shot 5 months 4 days rather than 6 months

Other Meds: unk

Current Illness: unk

ID: 1815022
Sex: U
Age:
State: KY

Vax Date: 08/06/2021
Onset Date: 08/22/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: POSITIVE COVID ANTIGEN TEST ON 8/23/21. SYMPTOMS INCLUDED FEVER, CHILLS, ACHES, H/A, FATIGUE, COUGH, SOA, DIARRHEA, N/V

Allergies: UNK

Symptom List: Diarrhoea, Nasal congestion

Symptoms: POSITIVE COVID TEST AFTER BEING FULLY VACCINATED.

Other Meds: UNK

Current Illness: UNK

ID: 1815023
Sex: F
Age: 54
State: NC

Vax Date: 04/21/2021
Onset Date: 07/15/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: My Doctor - gave me a five day of tapered steroids; as soon as I stopped taking them the pain, stiffness started getting worse again and worse then when I took the steroids. I was taking Motrin - 800mg three times a day and she prescribed a Meloxicam medication for a week and it was not doing anything. I stopped that and went back to taking Motrin 800mg up the point that I went to the Rheumatologist and she put me on a 30 day low dose of steroids (in June, 5 mg pill - I took 20 mg a day for a week and then tapered down for four weeks) and that helped significantly. But when I stopped taking that, the pain in my knees was gone and the pain in my elbows was gone - but I still had the creaking and cracking in my joints - knees and ankles when going up and down the stairs. Neurologist appt coming up - tomorrow morning 10/26/2021 - Rheumatologist ordered a whole battery of tests (bloodwork etc )- things came back normal (before the second round of steroids) - no inflammation that would indicate inflammation

Allergies: Vioxx, Cipro, latex

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

Symptoms: Follow report: After not having a menstrual cycle for about 9 months, I started having extremely heavy periods - a SUPER tampon every hour for 12-16 days for the past 3 months. And I had severe cramps while having the menstrual cycle that I haven't had since before I had kids (my daughter is 32). Having trouble with word recall when speaking. And the other day I was looking at a box that said Triscuit and I kept saying Pringles - even though I was looking at the box while saying it. I work and I type at work - I am making typos that are like a row or two off from where they should be typed from. I sometimes right the word multiple times in a row: like "and and and and" or I repeat simple phrase in an email - going to the store going to the store going to the store - but not have a conscious feeling of doing that. And look back to proofread and see this or see the gibberish from having fingers on the wrong row of keys. I have been typing for years and these are not normal typos. I am still having extreme difficulty doing anything with my hands - with grip strength and fine motor skills. I did take two rounds of steroids that gave me some relief. I can't complete making a meal and feed myself - I can only do one task or the other because I lose my grip strength. I have a hard time doing any normal activities that need my hands (takes an hour for peeling potato) and hold on to something. I have had significant weight gain since having the second dose of vaccine - from when I got the vaccine to May 21st, I gained 12 pounds. It all feels like water retention/bloating. As of now, I've gained 20 pounds. I have worn a size 4 since high school so to have this weight gain overnight is not normal for me and my family genetics. I occasionally get itchy scalp; I have patches on my scalp, behind my ears, face and on my neck that are itchy. I have broken out in hives twice for no reason. I had to take Benadryl - once three weeks ago (September 8, 2021) and one was this weekend. If I had not had other people notice on me, I would not have known because I couldn't feel it but they could see it (Face and right side of neck and across my chest got red and blotchy all of a sudden). The Benadryl helped it go away. Also started taking Amdotripolene 10 mg in the evening- started taking after the second round of steroids; I started taking that to offer more relief so I could sleep. After the second round of steroids - hands/fingers tingling and burning - it would wake me up at night. I had to hold them under hot or cold water to distract them from the pins and needles going on in both hands from wrists and fingertips. One of both of my hands will be icy cold - I'll be sitting doing nothing or sitting at the keyboard and one of my hands will be like ice. When I hold my hand in front of me - my pinkie and my ring finger are positioned away from the other fingers. It take a conscious effort to get them positioned normally with my other fingers. I have a knot on the palm of each of my hands that is tender. It aches constantly so I am always rubbing my hands for it. I still have the numbness in my foot and leg that started the night of the vaccine - it is now numbness that is localized to half way down my calf to ankle and top of foot. (It had originally been from my knee down) and that changed after the 30 day course of steroids. But things are slowly starting to get worse again since then. This morning, my knees and ankles would not physically bend, had to walk sideways down the stair. I could have permanent damage but it's till unknown with that.

Other Meds: Calcium supplement

Current Illness: none

ID: 1815024
Sex: F
Age: 96
State: MI

Vax Date: 02/19/2021
Onset Date: 10/18/2021
Rec V Date: 10/25/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: weakness, decreased appetitie

Other Meds:

Current Illness:

ID: 1815025
Sex: F
Age: 16
State: WI

Vax Date: 04/21/2021
Onset Date: 10/23/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies: Omnicef Omni-Pac - Hives Zithromax - unknown

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

Symptoms: Patient contracted COVID after being fully vaccinated Congestion, Body aches, headache, chills

Other Meds: Albuterol q4hr prn for wheezing cetirizine 10mg daily prn for allergy symptoms Ortho Tri-Cyclene Lo Daily Fluoxetine 30mg daily fluticasone BID Fluticasone nasal Daily melatonin 2.5mg HS Multivitamin daily

Current Illness: 4/2021 - Dysuria

ID: 1815026
Sex: M
Age: 47
State: NC

Vax Date: 10/19/2021
Onset Date: 10/19/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1815027
Sex: F
Age: 34
State: TN

Vax Date: 10/18/2021
Onset Date: 10/20/2021
Rec V Date: 10/25/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Received the first doze of Pfizer vaccine on Monday, October 18, 2021. Beginning on Wednesday morning, October 20, at approximately 7:00 a.m. , I began experiencing twitching and spasms in both legs constantly, and twitching in both eyelids. As of today?s date, Monday, October 25, I am still experiencing all adverse effects mentioned above.

Other Meds: Omeprazole 40mg, Vitamin C, Vitamin D, Zyrtec, Probiotic

Current Illness: None

ID: 1815028
Sex: M
Age: 62
State: AZ

Vax Date: 09/25/2021
Onset Date: 09/01/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: PCP doctor visit scheduled for Oct 29, 2021.

Allergies: none

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

Symptoms: Modera COVID-19 Vaccine, chest pain, heart pain, heart congestion, headache continuous for weeks

Other Meds: none

Current Illness: none

ID: 1815029
Sex: F
Age: 40
State: NC

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: No

Allergies: No

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

Symptoms: Since I was vaccinated at the pharmacy with COVID vaccine I have more abundant menstruation from 4 days now it is 15 to 16 days with clots, it does not seem to end. I have never had problems with my female health.

Other Meds: No

Current Illness: No

ID: 1815030
Sex: M
Age: 40
State: CA

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1815031
Sex: M
Age: 47
State: GA

Vax Date: 10/25/2021
Onset Date: 10/25/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: unknown

Allergies: none/unknown

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I gave the patient their second dose of pfizer vaccine around 945 am and received a call from the patient around 1145 am stating the patient had nasal congestion and shortness of breath. I advised the patient to seek the nearest emergency room.

Other Meds: unknown

Current Illness: none/unknown

ID: 1815032
Sex: F
Age: 75
State: MN

Vax Date: 09/23/2021
Onset Date: 10/12/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: CBC

Allergies: Demerol; sulfa

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

Symptoms: I developed a little soreness in the arm at the injection site which only lasted a couple day. I suffer from Hypertension that has been under control for years but on 10/12 when I went to see my PCP my BP was elevated a little above normal. My PCP increased my Lisinopril dosage to 20mg day and night and an additional BP med to take if it goes over 140 on top. The other night it got so terribly high of about 205/101 which made me reach out to my PCP who advised I take the additional metoprolol med, which did lower it along with a Xanax because I was freaking out and scared.

Other Meds: Lisinopril; Prevacid; baby aspirin; Valtrex; folic acid; B12 complex; vit D; Areds; Imodium; Xanax

Current Illness: No

ID: 1815033
Sex: F
Age: 48
State: NY

Vax Date: 09/11/2021
Onset Date: 09/27/2021
Rec V Date: 10/25/2021
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: N/A

Allergies: N/A

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

Symptoms: Pt. states that after receiving the 1st dose of Phizer 09/11/2021, started experiencing symptoms 09/27/2021 of chest pain, rapid heart beat, swelling in the injection site, and soreness. Soreness still continuing, other symptoms lasting 24hrs. No noted Primary visit/communications.

Other Meds: N/A

Current Illness: N/A

ID: 1815034
Sex: F
Age: 41
State: CA

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

Date Died: 09/21/2021

ID: 1815035
Sex: M
Age: 80
State: TN

Vax Date: 04/27/2021
Onset Date: 09/21/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: COVID RELATED DEATH; BREAKTHROUGH

Other Meds:

Current Illness:

ID: 1815036
Sex: F
Age: 59
State: TX

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

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

Lab Data: EKG, Labs, ECHO, Cardiac cath

Allergies: Multiple food allergies and seasonal allergies

Symptom List: Injection site pain, Pain

Symptoms: The first vaccination I felt feverish and achy with bad headache and my knuckles swelled. My second vaccination I begin having terrible (spiratic) Chest pain and back pain two days after and a headache and nausea followed. This had been going on along with racing heart and palpitations. I have since been hospitalized with all these symptoms on 11/20/2021. The only issue I had prior to the vaccination was High blood pressure which was well controlled.

Other Meds: Cardia 300 once daily Effexor 150 once daily Trazadone 50 on tablet night

Current Illness: No

ID: 1815037
Sex: F
Age: 31
State: CA

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1815039
Sex: M
Age: 93
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series

Other Meds:

Current Illness:

ID: 1815040
Sex: F
Age: 72
State: KY

Vax Date: 10/15/2021
Onset Date: 10/16/2021
Rec V Date: 10/25/2021
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: CTscan- normal EEG- normal 2 different MRI?s- normal Numerous blood tests- normal

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The day I receive the booster, I felt weird. The next morning I had 5 seizures and began vomiting with waves of sickness at home and was taken by my husband to the Hospital. I was immediately given medication for nausea and for seizures. I have no history or family history of seizures. They did a CT scan, two different MRI?s, an EEG, and all were normal. I was hospitalized until, Monday, the 25th and sent home on seizure medication, LevETIRAcetam 500 mg, which I am not adjusting well to. I now have 3 months that I can?t drive, 6 months of medication I?m not tolerating well, and a huge hospital bill!

Other Meds: Simvastatin 20mg Citalopram 20mg Synthroid 88mcg Magnesium 500mg Omega-3 500mg Stool Softener D3 25mcg AllergyRelief 10mg

Current Illness: None

ID: 1815041
Sex: F
Age: 39
State: SC

Vax Date: 04/26/2021
Onset Date: 05/10/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: Echocardiogram, heart monitor, labs

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Terrible heart palpitations starting about 10 days after 2nd shot

Other Meds: Metformin, vitamin d, prenatal (breastfeeding), garlic, turmeric, magnesium

Current Illness: None

ID: 1815042
Sex: M
Age: 24
State: CA

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 10/25/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1815043
Sex: F
Age: 33
State: CO

Vax Date: 04/22/2021
Onset Date: 05/03/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: Ultrasounds- Uterine ultra sound- POS- Blood panels to test thyroid levels.

Allergies: Kiwi fruit

Symptom List: Nausea

Symptoms: About 74 days after vaccination is when I finally had my expected menstrual cycle. So it would have been 2 months late since expected. I only thought to report it when I had several friends who were experiencing the same problem. I went and saw my doctor in June and had several appointment after that like ultrasounds and other imaging to see what is going on with my body. I was was diagnosed with Polycystic Ovarian Syndrome. No treatment recommendations yet. Most treatment recommendations are to treat the comorbidity not the illness itself.

Other Meds: Fluoxetine

Current Illness: No

ID: 1815044
Sex: M
Age: 51
State: MI

Vax Date: 04/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/25/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Pt had body aches, fever, fatigue, no taste smell had a cough

Other Meds:

Current Illness:

ID: 1815045
Sex: F
Age: 66
State: NV

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 10/25/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Extreme fatigue, muscle aches, shortness of breath, chest pressure, chest pain. Myocarditis.

Other Meds: Low dose asprin, multi vitamins

Current Illness: none

ID: 1815046
Sex: M
Age: 30
State: IN

Vax Date: 10/11/2021
Onset Date: 10/21/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: Creatinine kinase: 999 U/L

Allergies: No known allergies

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

Symptoms: Patient was vaccinated with the second dose of Pfizer COVID-19 vaccine on 10/11/21 at an outside facility or pharmacy (unspecified). Patient presented to the ED on 10/22/21 with a chief complaint of tingling sensation and pins and needles "all over my body". Reported symptom onset was the night prior, 10/21/21 at 7:00 pm. He went to an urgent care first in which they prescribed him hydroxyzine without any resolution. He then went to another outside ED but left AMA. He denied any recent illness, nausea, vomiting, diarrhea, URI symptoms, headache, or vision changes. He denied any similar symptoms in the past. Patient's neurological exam was normal with no measurable deficits. Patient was discharged in stable condition with neurology follow up. Patient was called back later the same morning on 10/22/21 to return for MRI of brain, cervical, and thoracic spine after consulting with neurology. Upon return patient was unable to undergo an MRI due to inability to sit for very long despite IV sedation. Patient was encouraged to stay in the ED for continued monitoring, but patient preferred to go home. Patient was advised to return to the ED for any worsening symptoms and to follow-up with neurology as an outpatient.

Other Meds: No reported medications

Current Illness: N/A

ID: 1815047
Sex: F
Age: 61
State:

Vax Date: 10/23/2021
Onset Date: 10/23/2021
Rec V Date: 10/25/2021
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: Tremor

Symptoms: Patient was given a flu vaccine instead of the shingles vaccine she came in for. She did end up receiving the SHINGRIX shot as well. Pt was given the flu vaccine at another facility about 4 weeks ago

Other Meds: SHINGRIX

Current Illness:

ID: 1815048
Sex: M
Age: 62
State:

Vax Date: 03/13/2021
Onset Date: 10/22/2021
Rec V Date: 10/25/2021
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:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series

Other Meds:

Current Illness:

ID: 1815049
Sex: F
Age: 83
State: MI

Vax Date: 03/29/2021
Onset Date: 10/18/2021
Rec V Date: 10/25/2021
Hospital: Y

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: Codeine Penicillin Ciprofloxacin Dicyclomine Hydrocodone Iron Propoxyphene Sertraline Sulfa drugs Zinc

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

Symptoms: Hospitalized 10/19/2021; COVID-19 positive 10/18/2021; fully vaccinated CHIEF COMPLAINT: COVID-19 Assessment/Plan COVID-19 pneumonia Acute hypoxic respiratory failure - Admit as inpatient, anticipating >2 midnight hospital stay. - COVID+ on 10/18, symptomatic since 10/16. - Desaturating into 80?s on baseline RA, now on 2L. - CXR without e/o acute processes, noting only cardiomegaly. - Continue Decadron 6 mg daily x 10 days. - Consider remdesivir if O2 needs increase, infiltrates develop, and renal function allows. - Supportive care, symptom management, proning PRN, encourage IS/pulm toilet. - Monitor CPO and wean supplemental O2 as able. Acute encephalopathy-improving - Suspect 2/2 above, with no e/o acute process on CTH. - Hold potentially sedating home meds and avoid deliriogenic meds in hospital. - Treat underlying illness, regularly reorient, promote normal sleep-wake cycle. 10/21/21 note: CHIEF COMPLAINT: COVID-19 Assessment/Plan ASSESSMENT / PLAN: Acute hypoxic respiratory failure COVID-19 pneumonia Chest x-ray without acute process Continue Decadron 6 mg daily Repeat CXR 10/20 no acute cardiopulmonary process Incentive spirometry CRP 45-- >17 Procalcitonin 0.09 D dimer 520-- > 340 Continue to wean down oxygen Tessalon TID Acute encephalopathy improved CT head no acute intracranial process 10/25/2021 note: CHIEF COMPLAINT: COVID-19 Assessment/Plan Acute hypoxic respiratory failure resolved ( now on room air) COVID-19 pneumonia Chest x-ray without acute process Continue Decadron 6 mg daily Day 6 of 10 Repeat CXR 10/20 no acute cardiopulmonary process Incentive spirometry CRP 45-- >17 Procalcitonin 0.09 D dimer 520-- > 340 Tessalon TID Acute encephalopathy improved CT head no acute intracranial process PT/OT recommends SAR. Daughter updated 10/25. Medically stable for SAR once placement arranged First eligible clearing 10/27

Other Meds: acetaminophen (TYLENOL) 500 MG tablet amiodarone (PACERONE) 200 MG tablet Ascorbic Acid (VITAMIN C GUMMIES PO) atorvastatin (LIPITOR) 40 MG tablet Calcium-Phosphorus-Vitamin D (CALCIUM GUMMIES PO) dilTIAZem (CARDIZEM CD) 180 MG 24 hr capsul

Current Illness:

ID: 1815050
Sex: M
Age: 62
State: CA

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: Positive culture for shingles on 10/04/2021.

Allergies: Zithromax

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

Symptoms: High fever night after vaccination. Allergic rash on left side of face and on top of head, neck pain, headache, joint and muscle pain. Two days after vaccination developed shingles on head. Left eye extremely red with xloudy vision

Other Meds: Ibuprofen, thyroid, vitamins

Current Illness: None

ID: 1815051
Sex: M
Age: 42
State: NY

Vax Date: 10/18/2021
Onset Date: 10/18/2021
Rec V Date: 10/25/2021
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: lymph nodes swelling, under armpit.

Other Meds:

Current Illness:

ID: 1815052
Sex: M
Age: 37
State: NY

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/25/2021
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: right side headache, dizziness, fever, chills, near syncope after vaccine

Other Meds:

Current Illness:

ID: 1815053
Sex: F
Age: 69
State: CA

Vax Date: 10/25/2021
Onset Date: 10/25/2021
Rec V Date: 10/25/2021
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: NKDA

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

Symptoms: Patient was given Moderna vaccine and shortly after found out this lot (026C21A) is expired as of 10/24/21. Contacted Modera and they confirmed that the lot did expire. Patient did not experience and side effects at the time of this report. Awaiting on guidance from Moderna to see if dose needs to be repeated.

Other Meds: Unknown

Current Illness:

ID: 1815054
Sex: F
Age: 58
State: MN

Vax Date: 04/02/2021
Onset Date: 10/24/2021
Rec V Date: 10/25/2021
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: Pain in extremity

Symptoms: Tested NAAT positive for COVID 10/24/21 after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1815055
Sex: F
Age: 21
State: KY

Vax Date: 10/23/2021
Onset Date: 10/23/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-

Other Meds:

Current Illness:

ID: 1815056
Sex: F
Age: 52
State: MI

Vax Date: 02/05/2021
Onset Date: 10/23/2021
Rec V Date: 10/25/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Decreased appetite not eating for couple of days before presentation

Other Meds:

Current Illness:

ID: 1815057
Sex: F
Age: 46
State: VA

Vax Date: 10/22/2021
Onset Date: 10/24/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies: penicillin

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

Symptoms: Started feeling discomfort in the armpit by evening but could not find evidence of swollen lymph nodes. It has a very slight muscle soreness feel to it and it still feels this way at the time of reporting. However, on Sunday evening, I noticed a bulge above my collarbone which feels tender to the touch. No other symptoms appeared. Did not have any physical discomfort or swelling of any nodes with the first and second dosage of the same vaccine.

Other Meds:

Current Illness: minor cough. covid test negative

ID: 1815058
Sex: M
Age: 71
State: NY

Vax Date: 10/16/2021
Onset Date: 10/17/2021
Rec V Date: 10/25/2021
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:

Symptom List: Vomiting

Symptoms: Site: Pain at Injection Site-Medium, Systemic: Exhaustion / Lethargy-Severe, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: Patient is having sciatica like pain, nerve radiating pain down arm and up into the neck area. It comes and goes but is still persisting after 9 days.

Other Meds:

Current Illness:

ID: 1815059
Sex: F
Age: 33
State: WA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: I had X-ray's, an EMG, I've seen a neurologist, I've seen a had all kinds of blood work done. I've seen other doctors also please ask me specific next time we talk.

Allergies: Morphine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 5minutes after I was giving the first shot I had a Histamine reaction. And the Histamine reaction continued every day into February when I had to get the second dose of the moderna. I continued to itch every day. In March on the 12th I gave a massage and my right are hurt severely after wards. the next day I noticed swelling in my whole right arm and could not work the next day and Have not given a massage since. I had Lymphedema in my right arm and both Axillary regions. My upper lymph system down the center line of my body and across my back were extremely tender to the touch and cause sever discomfort. Before I took my EMG the Histamine stopped and It turned to nerve pain. There were days that all I could do was lay in bed and not move so that it wouldn't hurt. I still have burning nerve pain and pins and needles in my arms legs and sometimes my face.

Other Meds: B 12

Current Illness: N/A

ID: 1815060
Sex: F
Age: 46
State: NY

Vax Date: 09/28/2021
Onset Date: 09/01/2021
Rec V Date: 10/25/2021
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: October 26, 2021 I have an appointment with neurologist.

Allergies: None

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

Symptoms: Got the vaccine September 28 , 2021 and everyday since then I feel numbness in my fingers. It takes awhile to normalize and sometimes when it normalizes it comes back again. Sometimes I feel numbness on my right toes.

Other Meds: Losartan Potassium 25 mg

Current Illness: High blood pressure

ID: 1815061
Sex: F
Age: 94
State: WI

Vax Date: 02/16/2021
Onset Date: 10/19/2021
Rec V Date: 10/25/2021
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:

Allergies: Fosamax - Diarrhea, Muscle Aches Sulfa Drugs - Vomiting

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient contracted COVID after being fully vaccinated Runny nose, congestion, cough, fatigue, shortness of breath

Other Meds: Acetaminophen 650mg TID Vitamin C daily Vitamin D3 1,000 IU daily Lutein daily Multivitamin Daily Nystatin topical QID Ropinirole 2mg TID Sertraline 100mg Daily Zinc Acetate 50mg daily

Current Illness: None documented

ID: 1815062
Sex: M
Age: 59
State: FL

Vax Date: 10/23/2021
Onset Date: 10/23/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-

Other Meds:

Current Illness:

ID: 1815064
Sex: F
Age: 66
State: FL

Vax Date: 10/23/2021
Onset Date: 10/23/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am