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: 1821378
Sex: M
Age: 71
State: FL

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

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

Lab Data: none

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: High Fever, chills, extremely sore arm and strong headache

Other Meds: Rosuvastatin COQ10,Fish Oil, Zyrtec Vitamin d3

Current Illness: None

ID: 1821379
Sex: M
Age: 39
State:

Vax Date: 04/23/2021
Onset Date: 10/26/2021
Rec V Date: 10/27/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Pt had a positive covid test

Other Meds:

Current Illness:

ID: 1821380
Sex: F
Age: 34
State: MI

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: tingling mouth, tightness in throat, itchy neck

Other Meds: Multivitamin; Flonase; Celexa

Current Illness: none

ID: 1821381
Sex: M
Age: 57
State: MA

Vax Date: 04/23/2021
Onset Date: 04/28/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Developed a rash on arms and ankles approximately 5-7 days after both the first and second dose.

Other Meds:

Current Illness:

ID: 1821382
Sex: M
Age: 37
State: CA

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 10/27/2021
Hospital: Y

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

Lab Data: mri and ct scans. 13/14 October 2021

Allergies: Lactose Allergy

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

Symptoms: initially extreme headache and stomach indegestion. Pain in pancrease and liver. Fast forward six moths and a cyst has been identified on my pancrease and blood clots in veins of my liver.

Other Meds: B Complex, Milk Thistle, CoQ10, Vitamin D, Zinc, Advil, Omepra

Current Illness: n/a

ID: 1821383
Sex: M
Age: 73
State: IA

Vax Date: 03/11/2021
Onset Date: 08/05/2021
Rec V Date: 10/27/2021
Hospital: Y

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: see above

Allergies: penicillins - upset stomach aspirin - upset stomach caffeine - unknown fentanyl - agitation

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

Symptoms: Pfizer Dose 1 2/17/21 (en6201) Pfizer Dose 2 3/11/21 (EN6204) COVID Positive 8/6/21 8/6/21: Presented to ED for COVID. 8/9/21: 74-year-old male with current tobacco use, prostate cancer on Lupron, remote history of colon cancer status post colectomy, hypertension, hyperlipidemia, aortic aneurysm presented with 5 day history of progressive shortness of breath. Patient reports symptoms started about 5 days ago with generalized weakness, muscle aches, joint pain associated with shortness of breath and the intermittent cough. He was diagnosed with COVID-19 on 08/06 and sent home with COVID safe at home program he was on room air at the time, returned on the day of hospitalization with progressive worsening shortness of breath and increased generalized weakness. Was found to be hypoxic 85% on room air 96% on 4 L of oxygen, apparently was in AFib with RVR with low normal blood pressure which improved after bolus of IV fluid in the ED. patient was tachycardic and tachypneic as well. ABG pH 7.38 with pCO2 34 and PO2 81. Lactic acid was 2.4 improved to 1.5. EKG showed atrial fibrillation with rapid ventricular response and nonspecific ST changes in the anterolateral leads, converted to sinus rhythm with resolution of nonspecific ST changes on repeat EKG. Chest CT showed no pulmonary embolism, noted infiltrates in the lingula and bilateral lower lobes, stable right lung nodule. Patient received 1 and 25 mg of IV Solu-Medrol, 1 or long DuoNeb, 1 g of IV ceftriaxone 1 L of NS in the emergency room. 8/12/21: Patient admitted for acute hypoxic respiratory failure 2/2 covid 19 pneumonia. He was treated with Dexamethasone, antibiotics and oxygen. Subsequently weaned off oxygen and symptoms improved. He had streptococcus epidermidis in 1/2 bottles of blood culture considered contaminant. Patient was deemed stable and discharged home to complete 10 day course of steroids with oral dexamethasone and 7 day course of antibiotics. He had transient afib on admission which converted to sinus rhythm with improvement of his respiratory status. Given his history of aneurysm and bleeding and transient/reversible cause of afib anticoagulation was deferred after discussion with the patient. On discharge patient was afebrile and hemodynamically stable. He was discharged home.

Other Meds: atorvastatin 40 mg PO QD leuprolide per Urologist lisinopril 20 mg PO QD

Current Illness: AA BPH Common iliac aneurysm H/o colon cancer h/o prostate cancer HTN

ID: 1821384
Sex: F
Age: 41
State: MD

Vax Date: 09/08/2021
Onset Date: 10/04/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: Negative home pregnancy test x 2

Allergies: Latex, Naproxen

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient missed a period. Two negative pregnancy tests.

Other Meds: Magnesium, MVI

Current Illness: None

ID: 1821385
Sex: F
Age: 35
State: NC

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

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

Lab Data:

Allergies: Erythromycin

Symptom List: Pharyngeal swelling

Symptoms: Covid arm. Hot red itchy welt at the site of the injection. About the size of a half baseball. Neck ache, shoulder ache, headache, burning sensation in and down my entire left arm and settling in the top of my hand that has not gone away. The same thing happened with my first injection, (hot red, itchy welt at the injection site, which even a month later has left a large dollar coin-sized discoloration in my arm.) Minus the burning sensation, the neck ache, and shoulder ache. This time, with the second dose I have all of that and more. The burning sensation in the top of my hand is terrible. combined with the neck ache, shoulder ache, and headache, I can't seem to get comfortable enough to sleep at night or type well without having to stop every few moments and rub my hand to make the sensation go away. The burning I felt right away with the injection. The first dose I got on 9/28/21 (lot number 006c21a) didn't burn at all. The second shot burned a lot, and it only got worse as time went on.

Other Meds: Buspirone, Hydaclorithizide, Ibuprofen, flexeril

Current Illness: high blood pressure, anxiety, IBS

ID: 1821386
Sex: M
Age: 77
State:

Vax Date: 03/04/2021
Onset Date: 10/26/2021
Rec V Date: 10/27/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

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: 1821387
Sex: F
Age: 89
State: CO

Vax Date: 10/15/2021
Onset Date: 10/01/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: NA

Allergies: NA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: THE PATIENT HAD MODERNA HER FIRST TWO SHOTS. THE NURSE GAVE HER A PFIZER FOR HER 3RD SHOT SERIES. SHE HAD NO ADVERSE REACTION .

Other Meds: NA

Current Illness: NA

ID: 1821388
Sex: F
Age: 73
State: OH

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

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

Lab Data:

Allergies:

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

Symptoms: Patient came in for a Moderna booster (.25) but received full dose(.5)

Other Meds:

Current Illness:

ID: 1821389
Sex: M
Age: 62
State: ID

Vax Date: 08/29/2021
Onset Date: 09/03/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: Macula scarring, Cataracts

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Blurry vision started with first dose. After Eye appointment found Cataracts formed since last annual visit in both eyes. Still having dizziness, Brain Fog, Memory issues, ringing in ears, watery eyes, head aches.

Other Meds: Olmesarten, Wixela, Montelukast, Rosuvastatin, Testosterone

Current Illness: None

Date Died: 09/20/2021

ID: 1821390
Sex: F
Age: 86
State:

Vax Date: 02/24/2021
Onset Date: 09/07/2021
Rec V Date: 10/27/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: pt presented with SOB, HA, non-productive cough, anorexia, weakness x 5dys; positive for COVID; dx with COVID pneumonia; started on decadron and remdisivir; given monoclonal antibodies; hx of HTN; went into septic shock, hypotensive despite vasopressor treatments; pt expired in the hospital

Other Meds:

Current Illness:

ID: 1821391
Sex: F
Age: 34
State: KS

Vax Date: 09/11/2021
Onset Date: 09/12/2021
Rec V Date: 10/27/2021
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: No medical tests done following first dose, medical consult/follow up was done with local health care facility.

Allergies: No known drug or food allergies.

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

Symptoms: Roughly 12 hours following my first dose my left arm became very sore and difficult/uncomfortable to lift or move. At about 15 hours following the dose (2:30am on 9/12/2021) I woke up with: rigors (shivering, feeling cold, copious sweating), fever of 101.8F, nausea, vomiting, retching that lasted 16 hours, subsiding around 6:00-7:00pm on 9/12/2021. During that time I also had intense muscle spasms/contractures in bilateral lower extremities that lasted for about six hours beginning around 02:30am on 9/12/2021. I also experienced significant changes in my smell and taste that lasted roughly 3 days. Within a week of getting the vaccine my hair began to fall out from the root at about a couple handfuls per day. My hair fell out at this rate for 3-4 weeks and began slightly improving up until the time i received my second dose of vaccine at which time the hair loss returned to falling out at handfuls a day and at this time has not resolved or improved.

Other Meds: Meloxicam 15mg once daily, women's multivitamin (smarty pants brand), nature's way women's probiotic.

Current Illness: No illnesses at time of vaccination or one month prior.

ID: 1821392
Sex: F
Age: 60
State: WA

Vax Date: 06/15/2021
Onset Date: 06/18/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: 7/20/2021--ECG--normal rhythm; TSH--normal; hemogram--normal

Allergies: NKA

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

Symptoms: 6/18/2021: numbness, tingling in hands, feet and face; fuzzy tongue; numb chin and lips; joint paoin in hands; less dexterity in left hand especially 6/25/2021: (approx.)--unsteady on feet--hips and arms did not feel "connected" to my body--decreased coordination and balance mid July 2021--tremors in hands and legs, left worse than right; symptoms still present symptoms still present and slowly improving, but came down with a cold around Oct. 14-20, 2021 and symptoms intensified again. Still dealing with decreased coordination, balance and tremors. Possibly some strength loss in legs, but not super noticeable.

Other Meds: probiotics, multi vitamins, krill oil, flax seed oil, CoQ10, B2

Current Illness: had a cold the week before

ID: 1821393
Sex: F
Age: 40
State: AZ

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: none

Allergies: None

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

Symptoms: S/S started 6 hours after receiving second dose. Including headache, confusion, full body aches, chills, nausea, migraine, sore and swollen arm at injection site. S|S were constant, lasting for about 4 days. Felt better as of 10-27-2021 morning.

Other Meds: None

Current Illness: None

ID: 1821395
Sex: F
Age: 27
State: NC

Vax Date: 09/03/2021
Onset Date: 09/06/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: A diagnostic biopsy of two areas on 10/19/2021 show Interface Dermatitis consistent with drug reaction.

Allergies:

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

Symptoms: On 09/04/2021, patient reports fever, chills and fatigue that resolved within 24 hours. On 09/06/2021, patient reports rash and swollen lymph nodes under both arms. Her swollen lymph nodes resolved within 1 week, but her rash still persists.

Other Meds: Flonase nasal spray

Current Illness:

ID: 1821396
Sex: M
Age: 12
State: KY

Vax Date: 10/23/2021
Onset Date: 10/23/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt was given Pfizer vaccine that had a BUD of 10/16/2021.

Other Meds: None

Current Illness: None

ID: 1821397
Sex: M
Age: 52
State: NJ

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

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

Lab Data: I went to my primary care physician yesterday (10/26/21) because of the allergic reaction I suffered from the 2nd Pfizer dose. He believed it is an allergic reaction, and initially recommended Benadryl. However, after a full day of taking Benadryl, my condition has worsened. My left eyelid is drooping to a point where it is nearly fully closed. The swelling around my eye has also worsened. The doctor still believes it is an allergic reaction, but I fear it could be Bells Palsy. The doctor prescribed Prednisone, and he wants me to follow up with him tomorrow. If my condition has not improved, he wants to see me in his office again.

Allergies: None known (however, I did suffer an allergic reaction after my first Pfizer COVID-19 dose)

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: When I took my 1st Pfizer dose on 6/2/21, I suffered an allergic reaction (lymph glands swelled & my throat closed, making it difficult to swallow). This made it very difficult to use my CPAP, which my job requires me to use for my sleep apnea. The CDC website recommends not taking Pfizer or Moderna for the 2nd dose if you had an allergic reaction to the 1st dose. So, I delayed receiving another dose. However now, as a federal employee, I am required to become fully vaccinated. I have a family history of blood clotting (my mother suffered a massive stroke as a result), so the J&J vaccine is not a viable option due to the multitude of reports of blood clotting as a side effect. I consulted with my FAA medical examiner who I go to for my annual physical (for my job) and he recommended taking the 2nd Pfizer dose, but to also take 50mg of Benadryl before and after, which I did. I took the 2nd dose two days ago and had an even worse allergic reaction. In addition to my lymph glands swelling and throat closing, my left eyelid is swollen and drooping. I went to the doctor yesterday for a diagnosis, which is outlined in Item 19.

Other Meds: Metformin, Finasteride

Current Illness: None

ID: 1821399
Sex: F
Age: 66
State: UT

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

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

Lab Data: no

Allergies: Sulfa antibiotics

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

Symptoms: That evening, I started getting achy and chills and a bad headache. I already had vertigo history on and off from the last 10 years, but I never had it this bad. My fever was 100.4. My boyfriend was worried about me. That night, chills, aches and weird nightmares. When I got up in the morning, my body ache and I felt stiff. I was super dizzy with vertigo when I moved or stood up. My temp was 101. I treated temperature and aches - started with aspirin and then changed it to Ibuprofen. I slept and continued to have the bad aches and my fever went up to 102 over the next 48 hours. The horrible nightmares started to subside and the stiffness in body in about three days. but I slept for four days - off and on. The vertigo got worse though as time went on. It was really bad the first couple of weeks and then it subsided a little bit but it hasn't gone away. It wakes me up in the night, when I turn over. My head spins and I have fallen a couple of times getting up to go to the bathroom. If I give it a minute, it will ease up. but if I get up in the night with it, I will fall. It's still happening and it's still worse than when I had it previous to the vaccine but not as bad as it was initially. I have an audiologist I could go to for the vertigo - to move the crystals in my inner ear - have to sleep sitting up for 48 hours - but it doesn't ever last. I haven't done that yet because it seems like it's getting better gradually as time goes one. Note: I had a flu vaccine two weeks after the dose of this vaccine. I didn't have any problems after that and I didn't notice a worsening of any of my symptoms I have noted here.

Other Meds: Venlafaxine - 300 mg a day; Pantoprazole - 40 mg at bedtime; PRN med: Clonapin -.5 mg at bedtime; calcium and Vit D3 twice a day

Current Illness: no

ID: 1821400
Sex: F
Age: 44
State: MN

Vax Date: 04/23/2021
Onset Date: 10/07/2021
Rec V Date: 10/27/2021
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: Rapid COVID test, blood test drawn.

Allergies: Penicillin; sulphur; sulphate; duo-film adhesive

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

Symptoms: Found out I had COVID on 10/07/2021. Also was experiencing a right ear infection, also while receiving the COVID test I found out I had bronchitis for the infections I was prescribed two rounds of the antibiotics. After receiving the vaccine I didn't have a reaction I just felt very fatigued, I still feel fatigued after catching COVID, and bronchitis and ear infection.

Other Meds: Cetirizine; levonorgestrel and ethinyl estradiol; Ramelteon; amitriptyline; ropimetlie; gabapentin; quetiapine; vitamin; Methocarbamol; sertraline; Ambien; coronatine; Ambien; oxycodone

Current Illness: N/A

ID: 1821401
Sex: M
Age: 58
State: IA

Vax Date: 08/16/2021
Onset Date: 08/23/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: 12-Lead EKG showed PVCs. 8-25-2021

Allergies: Floxin

Symptom List: Unevaluable event

Symptoms: PVCs around 3 per minute, constant. Mild pleuritic chest pain, constant. Started at date/time reported on this form, lasted until sometime the following Monday (one week) and resolved with no treatment. Instructions for follow-up if symptoms continued into the following week to come back and start wearing a Holter monitor. No cardiac history, baseline treadmill within the last 5 years was negative.

Other Meds: Skyrizi, Singulair, Wixella, Prilosec, Vit D, Vit C, Zinc

Current Illness: None

ID: 1821402
Sex: M
Age: 64
State: OR

Vax Date: 10/27/2021
Onset Date: 10/27/2021
Rec V Date: 10/27/2021
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: Iodine, and bee sting

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

Symptoms: Moderna booster vaccine (received J&J 3/27/21) given @0930 out of an expired punctured vial. Vial set to expire at 10/26/21 @2130 (12 hours after initial puncture). Pt did not show any symptoms.

Other Meds: Sildenafil, lipitor, lamisil, triumeq,

Current Illness:

ID: 1821403
Sex: F
Age: 66
State: IN

Vax Date: 10/13/2021
Onset Date: 10/14/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: Doctor made note, recommend compression socks for the leg problem and said that since the under arm swelling had diminished since I got the second shot,ok. The same events happened with the second dose as with the booster.

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Swelling and soreness under arm armpit., Left leg muscle soreness, headaches, racing heartbeat,acid indigestion, body soreness and fatigue.

Other Meds: Thyroid medication

Current Illness:

ID: 1821404
Sex: F
Age: 38
State: NC

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data:

Allergies: tramadol

Symptom List: Injection site pain, Menorrhagia

Symptoms: after the injections experienced severe muscle spasms , back , neck, shouder arms and legs, pain levels 9-10 severe fatigue , pain at injections site left arm, headaches , severe fatigue, nausea, muscle pain joint pain, super sensitive to touch and clothing hurt by touch, worse pain ever bowel issues, after 1st dose took a couple days off of work to recover then tried to work through 2 days thinking it was a normal fibro flare, when I went back to work after taking a couple days and it was no improvement it got worse couldnt concentrate , had to take many breaks , constantly shifting , wasnt able to focus with the extreme pain , headache nausea , stomach issues and severe muscle spasms, severe fatigue, ending up going out of work since then, treated like normal fibro flare, rest, many epsom salt baths, aleve, trigger point injections , physical therapy went to dr as normal to report flare up

Other Meds: vitamin b12 , duloxetine, vitamin b complex, aleve, ibuprofen

Current Illness: fibromyalgia

ID: 1821405
Sex: M
Age: 73
State: MN

Vax Date: 07/15/2021
Onset Date: 10/25/2021
Rec V Date: 10/27/2021
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: Patient had received Janssen vaccine on 7/15/21, but was admitted for COVID infection issues.

Other Meds:

Current Illness:

ID: 1821406
Sex: M
Age: 33
State: AL

Vax Date: 10/19/2021
Onset Date: 10/19/2021
Rec V Date: 10/27/2021
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: CT SCAN

Allergies: NKA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 2 hours after vaccination started having numbness in R face, jaw and neck, R eye blinking slower than left

Other Meds: ibuprofen

Current Illness: None

ID: 1821407
Sex: M
Age: 60
State: NY

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: ekg - ok

Allergies: aloe

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: hot flashes, difficulty breathing, intolerable arm pain, slight fever, breathing worsened, followed by chest pains, fatigued, ankles and legs swollen

Other Meds:

Current Illness:

ID: 1821408
Sex: M
Age: 8
State: CT

Vax Date: 10/26/2021
Onset Date: 10/26/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: None required

Allergies: None

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

Symptoms: No adverse outcomes. No treatment needed

Other Meds: N/A

Current Illness: none

ID: 1821409
Sex: F
Age: 73
State: TX

Vax Date: 07/28/2021
Onset Date: 08/01/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: I have not seen a doctor or visited a doctor.

Allergies:

Symptom List: Nausea

Symptoms: Pain and fever in the site injection area. This continues to this day. Soreness. Inability to push up from a sitting position with my left arm/hand. Pain that runs down my arm. I have to take my right hand to move my left arm. I just had pains that caused me to lose control of my left arm...left arm slid off the arm of my chair. These pains have been extreme today...continuously. I am really concerned as I had no pains with the first shot...a little soreness that was completed gone by the third day. The second shot was/is still painful.

Other Meds:

Current Illness:

ID: 1821410
Sex: M
Age: 31
State: PA

Vax Date: 10/25/2021
Onset Date: 10/25/2021
Rec V Date: 10/27/2021
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: Patient came in for a Moderna booster (.25) but received full dose(.5)

Other Meds:

Current Illness:

ID: 1821411
Sex: F
Age: 29
State: CA

Vax Date: 01/15/2021
Onset Date: 02/14/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: CU Index Urticaria Lab Panel

Allergies: pistachios

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

Symptoms: Anaphylaxis - Hives -Throat/Esophagus swelling -Red Eyes-Hypertension- Tachycardia - Sinus Issues The hives are continuous and only reside with antihistamine. If antihistamine is not in my system, the anaphylaxis will re-appear. Benadryl (Feb - October 8 tablets 25mg per occurrence) - Hives occur every 2-3 days New treatment - (Oct unitl ) Zyretec nightly 20mg nightly; increase dose in response to tolerance build-up

Other Meds: Biotin Tri-Sprintec

Current Illness: n/a

ID: 1821412
Sex: M
Age: 56
State: CA

Vax Date: 03/23/2021
Onset Date: 04/24/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data:

Allergies: PCN

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

Symptoms: I have had Harpies' since I was in my 20's but was at a point I rarely ever had breakouts anymore. I had breakouts maybe once every two years. Unfortunately, I do get bad reactions during a breakouts . Reactions similar to the severe flu plus heart palpitations. Since receiving the vaccine, I have had breakouts almost every two weeks. Some of them have been short and light side effects and others have lasted a while and came with bad side effects.

Other Meds: None

Current Illness: None

ID: 1821413
Sex: F
Age: 33
State: NY

Vax Date: 10/15/2021
Onset Date:
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Tremor

Symptoms: Received Moderna vaccine as dose #1. Received Pfizer vaccine as dose #2 in error prior to the approval of mix and match,

Other Meds: None

Current Illness: None

ID: 1821414
Sex: F
Age: 77
State: NY

Vax Date: 10/23/2021
Onset Date: 10/23/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: N/A

Allergies: Penicillin, Codeine, phenobarbital, sulfa, betadyne

Symptom List: Erythema, Pruritus

Symptoms: Severe Nausea (5 days) ? OTC Nausea medication, crackers and milk, peppermint tea; muscle/joint pain - left arm, both hands (4 days); extreme fatigue, lethargy (5 days)? bed rest

Other Meds: Pregabalin, Atorvastatin, Xarelto, Bupropion, multivitamin, Ocuvite, Omega 3, B-Complex, calcium, magnesium,

Current Illness: None

ID: 1821415
Sex: F
Age: 48
State: TX

Vax Date: 10/25/2021
Onset Date: 10/25/2021
Rec V Date: 10/27/2021
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: n/a

Allergies: n/a

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

Symptoms: Patient was accidental given Pfizer as a second dose instead of Moderna. Quality of care report was completed and also Incident report. Patient was assessed and RN cleared patient at 11:55 am. The were no signs or reactions since administering of vaccine was done at 11:25 am until 11:55 when patient was cleared.

Other Meds: n/a

Current Illness: n/a

ID: 1821416
Sex: M
Age: 61
State: CO

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/27/2021
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: SEVERE MUSCLE PAIN RUN DOWN NO STAMNIA HAVEING TO REST AFTER 15 MINIUTES OF WORK HEAVY PAIN IN KNEES ANKLES AN A SHOLDER REPLACEMENT NEVER ANY ISSUES WITH SHOULDER IN PAST HEAD ACHES BLURD VISION OFF AND ON OFF BALANCE HAVE NEVER HAD A REACTION TO SHOTS OR VACCINES 23 YEARS IN job THIS CRAP HAS SCREWED ME UP HAD TO TAKE IT TO KEEP MY JOB FORCED THIS HAS BEEN ONGOING FOR 3 WEEKS NOW

Other Meds: lisenapril

Current Illness: none

ID: 1821417
Sex: F
Age: 53
State:

Vax Date: 10/22/2021
Onset Date: 10/23/2021
Rec V Date: 10/27/2021
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: Penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Vomiting, diarrhea, intense nausea

Other Meds: Cevimelline Progesterone BioTe Spirinolactone Valtrex

Current Illness:

ID: 1821418
Sex: F
Age: 67
State: OH

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

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

Lab Data:

Allergies:

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

Symptoms: Patient came in for a Moderna booster (.25) but received full dose(.5)

Other Meds:

Current Illness:

ID: 1821419
Sex: F
Age: 58
State: MA

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/27/2021
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: I just called and left messages with the on call nurse, my primary care provider and my cardiologist.

Allergies: Pain medication and some forms of ATB

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

Symptoms: Within a few hours my chest started hurting with spasms and I got a headache, shortness of breath, had a low grade fever for a few days, night sweats and fatigue.

Other Meds: Metropolol ER 50 MG, asp 81 MG, Atorvastatin 40 MG, vitamin D 1000 IU,

Current Illness: None

ID: 1821420
Sex: F
Age: 46
State: MN

Vax Date: 01/11/2021
Onset Date: 10/22/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: 10/26/21 SARS/COV-2, NAAT, Positive

Allergies:

Symptom List: Pain in extremity

Symptoms: Breakthrough COVID

Other Meds:

Current Illness:

ID: 1821421
Sex: F
Age: 41
State: CA

Vax Date: 10/18/2021
Onset Date: 10/18/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: emergency room visit, antihistamines and steroids given EKG done, chest x-ray done, labs done

Allergies: Sulfa meds contrast dye penicillin walnuts

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

Symptoms: small rash at injection site fever, body aches severe nerve pain (burning) in entire body started 4 hours after injection and still continues 10 days later with no sign of ending

Other Meds: Plaquenil

Current Illness:

ID: 1821422
Sex: M
Age: 70
State: SC

Vax Date: 10/15/2021
Onset Date: 10/18/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: None

Allergies: Hypnotic drugs Raw onion Parsley

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

Symptoms: Felt like I had the flu for two days

Other Meds: Fentanyl patch Promethazine Clonidine Acetaminophen Ibuprofen

Current Illness: None

Date Died: 08/04/2021

ID: 1821423
Sex: M
Age: 51
State:

Vax Date: 05/26/2021
Onset Date: 07/26/2021
Rec V Date: 10/27/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: pt with hx of DMT2, heart and liver transplant; previous CMV viremia; previously tested positive for COVID, placed on antibiotic for pneumonia; presented to ED due to O2 sats at home in the 70s; Optiflow 50L and 70% FiO2; pt's O2 sats worsened; intubated; transitioned to comfort care measures; pt expired in the hospital

Other Meds:

Current Illness:

ID: 1821424
Sex: F
Age: 44
State: WI

Vax Date: 04/06/2021
Onset Date: 07/01/2021
Rec V Date: 10/27/2021
Hospital: Y

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

Lab Data: heart test- coronary artery disease

Allergies: Solabex, Morphine, Sulfa antibiotics, Clindamycin, Prednisone, Cortisone, Ultram, IVP dye, Aspirin, Ibuprofen, Voltaren, red pepper seasoning, latex, Lyrica

Symptom List: Vomiting

Symptoms: After my first shot, my throat felt a little bit tighter and a little itchy. They think it might have been an anxiety attack. They had me laid down and they kept checking my pulse and stuff. About 45 mins later they let me go home. I was feeling better. In the middle of July I felt pressure in my chest. They thought it was my asthma They did some heart test and they found a coronary artery disease, it was mild. I had a hard time. I still feel pressure in my chest. I cannot walk as far because I end up winded. I get tired very easily. It is not asthma because my breathing is clear. They put me on hard medications and high cholesterol medications after that. I was at the hospital for 3 days. They did a lot of medical tests. I also had issues with my thyroid. It was ginormous so I had that removed. They gave me thyroid medications. I am still winded and tired. One of my heart doctors said his wife was feeling the same way and he is thinking it might be because of the vaccine. I cannot take my booster shot yet because right now I have a sinus infection that I cannot seem to get rid of. They also found I have sleep apnea.

Other Meds: Tylenol, Albuterol inhaler, Buspirone, Epi Pen as needed, Hydroxyzine, Claritin, Methocarbamol, Singulair, Oxybutynin, Zoloft, Imitrex, Imitrex injection as needed, Trazadone, Valerian root

Current Illness: None

ID: 1821425
Sex: M
Age: 17
State: TN

Vax Date: 10/20/2021
Onset Date: 10/20/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: decadron, steriods

Allergies: severe grass allergys,

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 3:14 Blurred vision, 126/80 high pulse 90.tightness in neck 3:23 , 3:24 called 911, legs felt numb and tingle, 3:31 EPI pen, 3:32 breathing easier.

Other Meds: none

Current Illness: none

ID: 1821426
Sex: F
Age: 43
State:

Vax Date: 09/23/2021
Onset Date: 10/01/2021
Rec V Date: 10/27/2021
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: -referral to dermatology

Allergies: no known allergies

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

Symptoms: Rash started as a little patch on her neck on October 1, 2021. It slowly spread down her trunk to her shoulders and her back and chest and now abdomen. She has only applied lotion to it. It really does not bother her much but has very mild itching only. She just does not like the way it looks and feels it people may think she is infectious. She denies fevers or chills or joint aches or fatigue or any other new symptoms. She actually had her second Covid vaccine on September 23, 2021. This was about a week prior to the onset of the rash. With this shot she felt fatigued and achy for 1 day and then felt fine after that until the rash developed. Her first shot for Covid went fine. She did have the Pfizer vaccine both times

Other Meds: -Fibercon

Current Illness: unknown

ID: 1821427
Sex: F
Age: 52
State: UT

Vax Date: 09/15/2021
Onset Date: 09/16/2021
Rec V Date: 10/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None yet. I called the doctor and they couldn't get me right in, but said I should report it to the CDC. I'm still working on getting an appointment. Hopefully I can get in by the end of the week.

Allergies: Pennicillian, yeast, dairy

Symptom List: Injection site swelling, Limb discomfort

Symptoms: The day after the injection I got sick- nausea, headache, fever, rash on my cheeks and eyelids and nervous jitters. I thought it would pass, and all of it did except the rash on my face that has gone down a lot, but is still present. I called the doctor today and they said that I should report it to the CDC.

Other Meds: Multi vitamins

Current Illness: None

ID: 1821428
Sex: M
Age: 34
State: AZ

Vax Date: 04/24/2021
Onset Date: 08/20/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: observed my eyes ta the eye doctor with her instruments

Allergies: no

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

Symptoms: Over the past few months, my vision has gotten worse. I went to my eye doctor (October 1) and she said I had dry eyes. She ended up giving me Punctal plugs which has seemed to improve things for me.

Other Meds: Probiotics; Vit D; Vit B12

Current Illness:

ID: 1821429
Sex: M
Age: 31
State: NY

Vax Date: 10/22/2021
Onset Date: 10/25/2021
Rec V Date: 10/27/2021
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: none

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

Symptoms: Soreness in arm, cold in throat preventing me from breathing properly and extreme dizziness.

Other Meds: ibuprofen,oxycodone

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am