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: 1822007
Sex: F
Age: 47
State: CA

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

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

Lab Data: yes

Allergies: no

Symptom List: Dysphagia, Epiglottitis

Symptoms: Few days after taking the vaccine she went into acute liver and kidney failure and ended up in the hospital.

Other Meds: abilify 2.5mg, limixal 25mg,

Current Illness: no

ID: 1822008
Sex: F
Age: 68
State: FL

Vax Date: 03/14/2021
Onset Date: 05/01/2021
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: As above

Allergies: Penicillin, Onions, Fragrance, Dustmite

Symptom List: Anxiety, Dyspnoea

Symptoms: I developed extreme fatigue and pulsatile tinnitus in a gradually increasing level in the months following the vaccine. It got so very bad (with near fainting and extreme weakness) that I scheduled a physical with my PCP, She ordered routine bloodwork in advance and I had that at Clinic on Sept 10th and got an emergency call Set 11th that I was "critically anemic" with Hemoglobin at 4.9 (my annual testing "normal" is around 12+) and very low iron etc. Dr immediately put me on iron supplement 2X daily (ferrous sulfate 375/60) and sent me for CT scans of pelvis, abdomen (9/13) and chest xrays (9/14) which all came back normal. More bloodwork at clinic 9/16 still low HB at 5.3 I saw a GI doctor on (9/20) who said cannot schedule colonoscopy till Hb levels increase, but my previous Cologuard was normal. He could feel no abnormalities. Also have been seen by Hematologist Dr, (9/29) who ran extensive blood tests - all normal except for the previous markers, including Hb which was still low at 6.8 but somewhat improved from 2 weeks of iron supp. He increased the iron supplement to 3x daily (He offered iron infusion but I asked to wait a bit for iron supp to work. Returned to him today (10/27) and thankful Hb up to 10.8 and iron in normal range. I found a discussion on Clinic where many people are reporting same as me with no previous anemia that developed after Covid vaccine so am reporting this in case related

Other Meds: Metformin, Multivitamin/mineral, Omega 3-6-9 supplement, Vitamin B12, Vitamin D3, Olive Leaf Extract capsules, Boswellia/Curcumin supplement

Current Illness: Prediabetic

ID: 1822009
Sex: F
Age: 60
State: WA

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:

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

Symptoms: Patient requested HD flu shot due to misconception that she needed it because she has CHF. Mistake not caught by pharmacist who typed Rx and pulled vaccine from fridge. Vaccine administered by pharmacy tech. Patient informed. Patient should have received normal strength Fluzone rather than Fluzone HD.

Other Meds:

Current Illness:

ID: 1822010
Sex: M
Age: 71
State: TX

Vax Date: 01/23/2021
Onset Date: 01/27/2021
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: Blood test - normal; ECG - nothing important reported

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: On the night of the 27th, approx. at 5 pm, my heart was racing and tachycardia and afib. That's happened before but it's been very mild. It never lasted more than a couple minutes. That evening, the scale went from 1-2 to 100.. and It lasted for 2 ? hours and I called 911 and they took me to the hospital. I got to the hospital and what they did, they did all the blood tests. They put me on Diltiazem, 5% solution through IV bag. And so they monitored me all night and kept me in the ER because there was no room in the hospital until the next day until 10-11am. Things finally started settling down, but they weren't normal until about that time. I was released that afternoon and the doctor had time to see me around 3pm while I was at the hospital. When I was released, on the 28th, I saw the doctor. He increased Flecainide from 100 to 200mg in the evening and gave me diltiazem just in case that happened again. And that's how we left it until 2/23 when I had an event just the same as the first. Around 5-6 pm, so I took the diltiazem as instructed. And I remembered to wait a couple hours and things should be back to normal. I waited 2 ? hours and nothing was back to normal and called 911 again. So I was in the hospital again, and I told the guy what I did and they monitored for an hour and let me leave the hospital at 12am because I was back to normal and the medication did take care of the situation. So I saw my doctor on 2/24 and we needed a new plan. And so at that point in time, he took me off the Flecainide and put me on metoprolol 25mg once daily. Also put me on Mullaq 400mg twice daily. and I started the next day when I picked it up at the pharmacy. And that was the plan to keep things stabilized. Then at that meeting, he mentioned to do an atrial fibrillation ablation. And so that's the way it stayed until a follow up with July. We talked about the ablation more and I went back and had the ablation on 9/21/2021. So far so good.

Other Meds: Verapamil; levothyroxine; rosuvastatin; valsartan; ELIQUIS; flecainide; baby aspirin; COQ10; vitamin D

Current Illness: None

ID: 1822011
Sex: F
Age: 11
State: MA

Vax Date: 10/27/2021
Onset Date: 10/27/2021
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:

Allergies: NKA

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

Symptoms: patient felt dizzy and fell off the chair after getting the vaccine.she claimed having blurry vision and being tired. Ambulance being called and her vitals were checked and all her vitals were normal and she felt better upon drinking water . grandmother refused to have pt transferred to the hospital since she was stable when tthe ambulance arrived. followed up wih the patients grandmother over the phine and hour and she told me that patient was stable and she was just anxoius at the time of vaccine admininstration

Other Meds: N/A

Current Illness: N/A

ID: 1822012
Sex: F
Age: 30
State: MO

Vax Date: 06/17/2021
Onset Date: 09/27/2021
Rec V Date: 10/27/2021
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: no

Allergies: eggs and milk

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

Symptoms: On Monday: The first thing, I was really dizzy and was unable to stay standing. I felt like I had intense vertigo and I was wobbling and difficult to stay up straight - lasted about 48 hours where it was intense. I felt like I was on a boat still after that. I could stand but it still wasn't normal; still felt disorientated and that lasted the rest of the week. by Wednesday, I had extreme fatigue - no energy to get up or do anything. Saturday I felt like I had flu - nausea, dizziness and extreme fatigue and I went to Urgent Care (10/2) - they took vitals. When I told them about the dizziness they had me look to the corner of the room and they said my eyes weren't focusing. It was like I was drunk and my pupils moved back and forth really fast. They said it was clear I was having balance issues. they said they couldn't do much for me. They said to take Meclizine three times a day and Sudafed every 4 -6 hours and I did that for the next week. The dizziness is much less right now. There are still moment when I feel really disoriented but not as bad as that first week. I was probably in bed for three weeks with that fatigue and as of yesterday just starting to feel like I can sit up to my desk for a few hours at a time. My energy is still not back to normal yet.

Other Meds: no

Current Illness: no

ID: 1822013
Sex: M
Age: 70
State: NY

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

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

Lab Data: Echocardiogram and 24 hour monitor on 10/27/21 carotid doppler ordered had CBC, tick borne disease profile, TSH, CRP, sed rate, vitamin B12

Allergies: Penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Developed lightheaded episode on 10/26 then irregular heart rhythm noted and PVC's diagnosed with home cardio mobile machine, contacted doctor and was seen on 10/27/2021

Other Meds: Atorvastatin 10 mg daily, vitamin C 500 mg daily, vitamin D 2000 iu daily, tamsulosin 0.4 mg, singulair 10 mg daily

Current Illness: history of cirrhosis of liver, dyslipidemia, COPD

ID: 1822015
Sex: M
Age: 60
State: CA

Vax Date: 10/23/2021
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: None

Symptom List: Pharyngeal swelling

Symptoms: Extreme soreness upper left arm at vaccination site. Numbing of hands. Numbing of feet area. Painful small left toe.

Other Meds: Lamotrigine

Current Illness: None

ID: 1822016
Sex: M
Age: 17
State: ME

Vax Date: 09/13/2021
Onset Date: 09/13/2021
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:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Administered to a 17 year old patient in error

Other Meds: Unknown

Current Illness: Unknown

ID: 1822017
Sex: M
Age: 47
State: NJ

Vax Date: 09/21/2021
Onset Date: 10/20/2021
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: CT Upper and lower Abdomen Ultrasound of kidneys Ultrasound of live Echo of neck Ultrasound of abdomen And other tests

Allergies: Penicillin Beef Dairy

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pulmonary Embolism Pneumonia E-coli in bloodstream

Other Meds: Acetaminophen

Current Illness: None

ID: 1822018
Sex: F
Age: 35
State: NM

Vax Date: 04/27/2021
Onset Date: 09/24/2021
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: Positive COVID test on 9/24, negative on 10/5.

Allergies: Sulfa

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

Symptoms: Breakthrough positive COVID test (9/24/2021); symptomatic on 9/24, likely exposed in-transit from travel. Negative at-home nasal rapid test on 9/23 post-travel for surveillance, but became symptomatic on 9/24 and worsened by the hour. Began quarantine on 9/25 for ten days; tested negative via PCR test on day 11. Started steroids as Rx?d by Urgent Care facility on 10/13/2021. Completed on 10/22. Symptoms included (9/24-9/28): fever, chills, coughing, body aches, productive sputum cough, loss of sense of smell/taste, sneezing, nausea, diarrhea, and severe head/sinus congestion. Symptoms (9/29-10/8): persistent moderate cough and congestion, elevated heart rate with minimal exercise, and sneezing. Sense of taste and smell mostly returned to normal. Symptoms (10/9-present): sense of taste and smell mostly normal, elevated heart rate with moderate exercise, normal oxygen levels, began steroids (20mg prednisone 10 days), improved significantly, diminished cough, but dry.

Other Meds: Hormonal birth control

Current Illness: None

ID: 1822019
Sex: M
Age: 57
State: AZ

Vax Date: 10/08/2021
Onset Date: 10/10/2021
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: None

Allergies: Tramadol and anti-depressants.

Symptom List: Rash, Urticaria

Symptoms: Presenting sensitivity to sun/heat and cold by experiencing topical prickly skin sensations and itching . Symptoms began on 10/10/2021. Partial relief with Benedryl, however this medication isn't metabolized well and causes him to be "spun up". Seeking guidance for another anti-histamine or treatment option. *Doctor listed is PCP but did not give the vaccination. Clinic listed is where the shots were administered -not a patient. Doctor said to call Clinic to report adverse reaction. Clinic stated they are only responsible for the first 15-minutes after injection, since non-patient.

Other Meds: Olanzapine 2.5 mg tablets - takes 1/2 tab once daily at bedtime. Alprazolam 0.25 mg tablets - takes 1/2 tablet at bedtime, and can take 1/2 to 1 tablet as needed.

Current Illness: Bi-polar depression and anxiety

ID: 1822020
Sex: F
Age: 51
State:

Vax Date: 10/01/2021
Onset Date: 10/01/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: Loss of voice 1.5 hours after injection. Dysphonia has persisted for 4 weeks without improvement. She had a headache for 24 hours after the shot that resolved. No other associated symptoms. Flexible nasolaryngoscopy of her upper airway revealed erythema and irritation of the vocal folds.

Other Meds:

Current Illness:

ID: 1822022
Sex: F
Age: 57
State: CA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
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: SYR
Vax Site: LA

Lab Data: DUE TO THE SHORTNESS OF BREATH I WAS GIVEN AN ORDER TO DO A CHEST XRAY, WHICH CAME BACK SHOWING THAT MY HEART SIZE IS GENEROUS, MEANING POSSIBLE CARDIOMEGALY, I HAVE HAD CARDIAC WORK UP IN THE PAST AND I WAS NEVER TOLD THAT I HAVE AN ENLARGED HEART

Allergies: NONE

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

Symptoms: IMMEDIATE SHORTNESS OF BREATH, HEART RATE JUMPED TO 120 BPM, AFTER 10 MINUTES, I WAS TOLD BY THE MEDICAL ASSISTANT TO WAIT FOR 15 MINUTES AND HAD TO WAIT FOR MORE THAN 2 HOURS TO BE RELEASED BECAUSE I COULD NOT CATCH MY BREATH, EVER SINCE THEN I HAVE BEEN WITH BODY AND HEADACHES, EXTREMELY FATIGUED, AND EVERY DAY AFTER THAT I BEEN WAKING UP CONGESTED WITH A LOT OF MUCUS

Other Meds: NONE

Current Illness: NONE

ID: 1822023
Sex: F
Age:
State: KS

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

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

Symptoms: PRE TREATED WITH 25MG BENADRYL PO DUE TO A PREVIOUS ANAPHALACTIC REACTION WITH A TETNUS VACCINE.

Other Meds:

Current Illness:

ID: 1822024
Sex: F
Age: 25
State: CT

Vax Date: 10/27/2021
Onset Date: 10/27/2021
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:

Allergies: None-- no rxns ever to anything

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

Symptoms: Patient said she started to feel dizzy then passed out for ~1 minute, patient was hot, sweaty, color drained from face, felt sick, did not throw up. Recovered completely and left store after ~30min. Patient was with her boyfriend.

Other Meds: Birth control

Current Illness: None-- no rxns ever to anything

ID: 1822025
Sex: F
Age: 67
State: GA

Vax Date: 04/21/2021
Onset Date: 10/25/2021
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: I have had when this first start , A MRI ,

Allergies: Penicillin, Sulfa, Tetracyclyn

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

Symptoms: I started out with severe pain in my left butt check, then pain all down to the leg & numbness to the foot & i had trouble walking , sitting , standing, sleeping. Nothing helps. The doctor said the vaccine could have caused the damage to nerve pain.

Other Meds: I take Zovaric 400MG 1 a day, Benadryl 25MG a day, Melatonin 10MG A day, Ibuprofen 500MG a day

Current Illness: Epidural steroid injection on the 23rd of September

ID: 1822026
Sex: F
Age: 30
State: NM

Vax Date: 07/15/2021
Onset Date: 08/19/2021
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: Full blood panel, and CT scan of the head.

Allergies: Sulfa Drugs

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Extreme brain fog, diarrhea for four weeks, light sensitivity and blurred vision, kidney pain (cycled, some days hurt some days did not), Sinus pain, swollen lymph node (right side), muscle weakness in legs, jaw and tongue tremors, complete loss of appetite, lost approximately 10 lbs in three weeks, headaches daily, difficulty concentrating, sudden onset of nervousness and depression, late period., symptoms would worsen after eating or drinking. anti-biotics were given for two weeks, hoped it would clear up.

Other Meds: None.

Current Illness: None.

ID: 1822027
Sex: F
Age: 38
State: GA

Vax Date: 10/27/2021
Onset Date: 10/27/2021
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:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Flushing/rash on torso arms and neck. Slight tightness in chest.

Other Meds:

Current Illness:

ID: 1822028
Sex: M
Age: 65
State: NC

Vax Date: 10/03/2021
Onset Date: 10/03/2021
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:

Allergies: BACTRIM DS; PENICILLIN

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

Symptoms: Patient has a bruise and arm pain.

Other Meds: Losartan /HCTZ 100/12.5 MG; Amlodipine; Atorvastatin 5/20 MG; Tamsulosin 0.4 MG

Current Illness:

ID: 1822029
Sex: F
Age: 16
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: Pt was given the vaccine and it was not yet approved for her age. She did not have any problems, side effects, or issues but she was notthe recommended age for administration. Her mother was notified and she does want her to get the second dose. Waiting for guidance from Moderna on recommendation.

Other Meds:

Current Illness:

ID: 1822030
Sex: M
Age: 38
State: NC

Vax Date: 10/24/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Unknown

Symptom List: Unevaluable event

Symptoms: I have severe side effects from the Janssen COVID-19 Vaccine EUA. My face is itchy, swelling, has redness, has a burning sensation, some numbness on a swollen spot on my jaw, and the injection spot is swollen.

Other Meds: None

Current Illness: None

ID: 1822031
Sex: F
Age: 62
State: WA

Vax Date: 10/22/2021
Onset Date: 10/22/2021
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: None. Patient only seen in office for evaluation.

Allergies: Sulfa Drugs

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

Symptoms: Patient had swelling in her face an hour after vaccination. Had pain in entire arm later due to reflex sympathetic dystrophy so went to exercise as she says that helps. During exercise had palpitations. Face swelling has resolved and palpitations are improving markedly.

Other Meds: None

Current Illness: Autoimmune Disease - Reflex synthetic dystrophy.

ID: 1822138
Sex: F
Age: 55
State: TN

Vax Date: 09/24/2021
Onset Date: 10/01/2021
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: Biopsy was performed and I waiting on the results. I am waiting to rule out a Bullous Pemphigoid auto-immune skin disease.

Allergies: Lisinopril

Symptom List: Injection site pain, Pain

Symptoms: My right leg developed a itch and the itch turned in little blisters and raised places on my leg.

Other Meds: Levothyroxine; Trintellix; Estradiol; Vitamin D3

Current Illness: No

ID: 1822139
Sex: F
Age: 32
State: CA

Vax Date: 10/26/2021
Onset Date: 10/26/2021
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: n/a

Allergies: n/a

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient had a rapid heart rate, metallic taste in mouth and noticeably diaphoretic. Patient also reports slight numbness in lips. Patients vitals were taken; HR 115, BP 122/84, 18 RR. Patient was advised to take Benadryl and call 911 if symptoms worsen. Patient appeared well with steady gate. Accompanied home by husband

Other Meds: n/a

Current Illness: n/a

ID: 1822140
Sex: M
Age: 43
State: WA

Vax Date: 04/28/2021
Onset Date: 08/23/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: Xrays, blood tests

Allergies: KNDA

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

Symptoms: Patient is c/o of left shoulder pain including scapula and neck pain.

Other Meds: Diclofenac, Glipizide, Lisinopril, Pravastatin, Metformin, Hydrocortisone, Clotrimazole, Nicotine Gum

Current Illness: None

ID: 1822141
Sex: F
Age: 33
State: KS

Vax Date: 10/16/2021
Onset Date: 10/16/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: COUGHING, TROUBLE SWALLOWING, DIZZY, SWEATING

Other Meds:

Current Illness:

ID: 1822142
Sex: M
Age: 60
State: CA

Vax Date: 10/27/2021
Onset Date: 10/27/2021
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: none

Allergies: penicillin, ancef, prednisone, haldol, and phenobarbitol, states reacts with hives/rash only

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Client received Janssen (lot # 1822809 exp 03/07/2022) in left arm at 11:15 am. Client also received Influenza (Lot # 3NA4M exp 06/30/2022) in the right arm at 11:16 am. At 11:45 am PHN approached client sitting on the ground after moving from the chair at outreach. PHN noticed a small, bumpy, red rash on bilateral upper arms. Client denied feeling itchy however client was observed scratching arm. Client denies dizziness, nausea, swelling of throat, or chest discomfort. Vitals taken by PHN at 11:46 am: BP 140/78, pulse 104, RR 16, 97% SpO2. Client reports history of immediate hives and itching after receiving IV Ancef, Penicillin, phenobarbital, Haldol, and Prednisone. Client has history of epilepsy, reports he is not currently on medication, last seizure in 1996. Medical consult sent to Vaccine Operation Leads prior to vaccination. Reviewed by Dr., client approved to receive Janssen vaccine today. At 11:50 am PHN observed rash past client?s elbow on left arm. At 11:50 am, 50 mg Benadryl PO given to client to drink. Vitals taken at 11:55 am: BP 144/80, HR 101, RR 20, 97% SpO2. Client reports BP ?normally reads that high.? Client continues to deny feeling itchy, denies HA, denies dizziness, denies any discomfort. At 11:55 am, rash noted to stop at left wrist, no progression noted on right arm. At 12:00 pm vitals taken: BP 146/80, HR 98, RR20, 95 % SpO2. At 12:05 pm Vitals taken: BP 150/82, HR 95, RR 20, 95% SpO2. Rash on left arm less pronounced, appears lighter. At 12:10 PM Vitals taken: 150/85, HR 95, RR 20, 96% SpO2. Client continues to sit on the ground during this time, eating soup and drinking water. At 12:25 pm rash presents with no redness, only small pimple-like red spots. PHN educated s/s allergic reactions, when to call emergency. PHN educated to follow up with PMD in 24 hours, clinic referral provided. Client agrees to go in for follow up. Client stood up with PHN, denied dizziness, denies any discomfort. At 12:30 am client walked off with steady gait to wait for ride from outreach.

Other Meds: none

Current Illness: none

ID: 1822143
Sex: F
Age: 59
State: VA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
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: I had x-rays on my lower back on 9/2021.

Allergies: nuts, carrots, and turkey

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

Symptoms: After receiving the vaccine, later that night I started to have lower back pain and I am still suffering from the same pain.

Other Meds: Spironolactone/HCTZ, tramadol, and vitamin D

Current Illness: arthritis

ID: 1822144
Sex: F
Age: 43
State: CA

Vax Date: 10/16/2021
Onset Date: 10/17/2021
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:

Allergies: None

Symptom List: Nausea

Symptoms: Swollen /sore under armpit & on outer left breast treated with Advil & warm moist compresses. Resolved after 4 days. Malaise for 48hrs.

Other Meds: Multivitamins

Current Illness: None

ID: 1822145
Sex: F
Age: 39
State: KS

Vax Date: 10/27/2021
Onset Date: 10/27/2021
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 STATED BURNING SENSATION ON LEFT ARM AND BACK , DISORIENTED AND NUMBING AND TINGLING ON FACIAL BILAT CHEEKS AND AROUND LIPS. ADMINISTERED BENADRYL 50MG BY MOUTH

Other Meds:

Current Illness:

ID: 1822146
Sex: F
Age: 38
State: CA

Vax Date: 03/21/2021
Onset Date: 04/01/2021
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: LA

Lab Data: My thyroid, prolactin, and other test results from September of 2021 indicate that I do not have any medical problems that are the cause of not ovulating.

Allergies: Penicillin

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

Symptoms: I was pregnant at the time of the first injection and miscarried before the second. I do not think I miscarried because of the injection because the fetal tissue reflected a genetic issue. However, since my miscarriage I have had irregular cycles and mid-cycle bleeding. I also have not ovulated since I had the injections. My thyroid, prolactin, and other test results indicate that I do not have any medical problems that are the cause of not ovulating. Therefore, I wonder if the vaccine has anything to do with it.

Other Meds: Prenatal vitamin, vitamin D

Current Illness: None

ID: 1822148
Sex: M
Age: 63
State: PA

Vax Date: 04/27/2021
Onset Date: 09/29/2021
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: They did heart rate and blood pressure and weight - vitals. They were all within range. Looked up my nose and said my lungs sounded good.

Allergies: no

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

Symptoms: About four weeks ago, around the 29th, started getting scratchy throat and started coughing. Progressed to really heavy coughing fits. It went on for two weeks. I went to Hospital Urgent Center - doctor prescribed an antibiotic (2 pills a day for seven days) for Sinus Infection and said to take Flonase and do a Sinus flush periodically and take Claritin. I feel like I have post nasal drip constantly and get a build up of phlegm. For the most part it's done - I'm not coughing uncontrollably still but just every once in awhile. Immediately after the vaccine, I felt a little flu-ish for one day and then it was done.

Other Meds: Synthroid; various health vitamins

Current Illness: no

ID: 1822149
Sex: F
Age: 16
State: MD

Vax Date: 08/27/2021
Onset Date: 09/05/2021
Rec V Date: 10/27/2021
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: Blood tests, CT scans, Echocardiogram, EKG

Allergies: none

Symptom List: Tremor

Symptoms: MIS-C diagnosed along with a positive Covid infection. She went into shock from the MIS-C and was put on oxygen due to breathing difficulties. She was eventually treated with IVIG and made a complete recovery.

Other Meds: none

Current Illness: none

ID: 1822150
Sex: F
Age: 74
State: AZ

Vax Date: 10/26/2021
Onset Date: 10/26/2021
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: Sulfa IV and latex gloves

Symptom List: Erythema, Pruritus

Symptoms: With in 9 hours : dizziness. 10 hours of rigors, unable to get out of bed for 15 hours and temp 101.4. Joint pain(all over). Frontal headache. Unable to eat or drink for 16 hours.

Other Meds: Pradaxa, Hydrochlorizide, Sotalol, levothyroxin, Omeprazole, citalopram, Losartan, Wellbutrin, Colace, Vit B 12, Multi vit, Lutein and zrsxsnthin

Current Illness: One month ago sinus infection

ID: 1822151
Sex: M
Age: 68
State: WA

Vax Date: 01/29/2021
Onset Date: 02/13/2021
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: MRI and CT scan on February 24, 2021 Result showed intracranial atrophy, severe right and moderate left neural foramina stenosis and advanced cervical spondylosis

Allergies: none

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

Symptoms: After 1st covid vaccine, I had severe pain in my left side around neck and upper back.I lost more use of my left arm and it has not gotten better. After about 2 months this pain subsided and I got the second covid shot on 3/29/2021. Within about a week of getting the second shot I had extreme pain in my left leg that lasted about 1 month. My left leg seemed to lose strength and I have been under physical therapy from March until October20, 2021. The leg is better but still somewhat weak. I was so bad in February 2021 that I spent a night in the hospital. I saw a neurologist who said he thought the covid shot was the cause of the above symptoms.

Other Meds: tamsulosin,Xgduo,Bupropion XL,valsartan,simvastatin,onglyza,sertraline,adderal,atomoxetine,amlodipine, pilocarpine,risperidone, astragalus,bayer aspirin.

Current Illness: none

ID: 1822152
Sex: F
Age: 51
State: IL

Vax Date: 10/27/2021
Onset Date: 10/27/2021
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: NA

Allergies: codeine

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

Symptoms: Patient left the clinic after receiving the Moderna booster but returned about 5-8 minutes later stating that she feels "weird". She stated that she felt "hot and dizzy with wobbly legs". Patient was assessed and vitals are as follows: 138/88, 78bpm, 98.8 temp 98% O2 on RA, and 20rr. all vitals were per the patient. patient was given fluids and allowed to rest a little longer. patient was advised to remove the 2 coats she was wearing to allow her body to cool. before leaving patient stated that she felt back to normal and would like to go home. patient's BP was assessed while standing to assess for orthostatic hypotension, which was negative. Patient was escorted to her car by this writer and accompanied by her husband who was the driver. patient was able to walk to the car without further incidence.

Other Meds: unknown

Current Illness: HTN, DM

ID: 1822153
Sex: F
Age: 56
State: OH

Vax Date: 10/04/2021
Onset Date: 10/07/2021
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: Latex

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Before I even got out of bed on Oct. 7 at 4:00 am, I felt dizzy. I tried to get ready for work that morning, but felt very "drunk" and knew it would not safe for me to drive to work, or to be at work. So, I had to call off work. I felt "drunk" all day and laid on the couch all day and evening. By the next morning (Oct. 8) I felt about 80% better, so I did go to work, but as the day went on, I felt slightly worse. I felt basically normal by later that evening (Oct. 8).

Other Meds: Synthroid, L-lysine, Fish Oil, Magnesium Citrate, Selenium, Vit B Complex, Vit E. Vit C, CO Q-10, Folate, Vit D, Vit A, 5 HTP, Zinc, Choline Inositol

Current Illness: None

ID: 1822154
Sex: F
Age: 52
State: KS

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: 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: DIZZYNESS, METALIC TASTE IN MOUTH, NAUSEA, SYMPTOMS IMPROVED AFTER 30 MNUTES.

Other Meds:

Current Illness:

ID: 1822155
Sex: F
Age: 57
State: NH

Vax Date: 09/09/2021
Onset Date: 09/11/2021
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: Got a Nerve test done don't have results yet.

Allergies: Penicillin

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

Symptoms: Dizziness, off balance, pain shooting up legs into lower back none stop to point I couldn't walk. headache, dehydrated. Blood pressure was going to high. This has been none stop since the first shot and hasn't stopped. Working with a Doctor to try and figure this out..

Other Meds: deloxapan, lasarten

Current Illness:

ID: 1822156
Sex: M
Age: 26
State: NY

Vax Date: 10/27/2021
Onset Date: 10/27/2021
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: None

Allergies: None

Symptom List: Pain in extremity

Symptoms: The patient had waited their 15 minutes and was setting up their 2nd dose appointment when they fainted. His girlfriend caught him so he didn't hit the floor. By the time I got to him he was sitting up and was alert. I had a code white paged. I sat with him for 10 minutes on the floor then moved him to the chair for another 20 minutes. He didn't state he had issues with shots in the past (as per his consent form but said he hadn't eaten much today), I checked on him every 5 minutes. He stated he was feel better. I informed him that his girlfriend needed to drive home.

Other Meds: None

Current Illness: None

ID: 1822157
Sex: F
Age: 56
State: NY

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: 2
Vax Route:
Vax Site:

Lab Data: N/A

Allergies: bactrim, sulfa

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

Symptoms: Pt. got Pfizer at 3;25 PM. At 4?10 complained of heart palpitations. At that time her BP was 197/113, 02 sat was100 percent and pulse was 79. No chest pain, shortness of breath or dizziness. Pt. did not feel comfortable ambulating to ER. EMS was called. BP at 4:256 was 184/129, O2 was 97 and pulse was 66.EMS vehicle arrived with responders at 4:25 and took individual to ER>

Other Meds: amlodipine, HCTZ, statin

Current Illness: HTN, cholesterol, keloids

ID: 1822158
Sex: F
Age: 81
State: FL

Vax Date: 10/25/2021
Onset Date: 10/26/2021
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:

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

Symptoms: Sore arm Rash Painful under arm. Rt side

Other Meds: Nephedapine Benazapril

Current Illness:

ID: 1822159
Sex: F
Age: 40
State: NH

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: No.

Allergies: No.

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

Symptoms: 12 hours I start to have body aches and I experience fatigure.

Other Meds: No.

Current Illness: No.

ID: 1822160
Sex: F
Age: 51
State: MA

Vax Date: 10/07/2021
Onset Date: 10/16/2021
Rec V Date: 10/27/2021
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: None

Symptom List: Vomiting

Symptoms: Extremely heavy menstrual period, heavier than I've ever experienced.

Other Meds: Losartan, amlodipine

Current Illness: None

ID: 1822161
Sex: F
Age: 43
State: IN

Vax Date: 10/27/2021
Onset Date: 10/27/2021
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:

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received first dose of pfizer vaccine, approximately 10 mins following administration, patient reported feeling dizzy/lightheaded, palpitations. Blood pressure and heart rate were taken immediately and were 138/90 and 86 respectively. Patient was advised to continue sitting and given water. Blood pressure and heart were monitored every 5-10 mins. Patient remained sitting near pharmacy with continued symptoms for over 60 mins. Due to symptoms not resolving family took patient to urgent care to be assessed.

Other Meds: none

Current Illness: none

ID: 1822162
Sex: M
Age: 70
State: WA

Vax Date: 09/30/2021
Onset Date: 10/15/2021
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: Both 10/26/21: Rapid Strep A (negative) CBC (no abnormal results)

Allergies: None

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

Symptoms: Swollen lymph node under left jaw, no pain or fever, fatigue (Lymphadenitis)

Other Meds: Levothyroxine, Zolpidem, Metformin, Vitamins D, B12, CoQ-10, glucosamine

Current Illness: None

ID: 1822163
Sex: M
Age: 66
State: IL

Vax Date: 04/02/2021
Onset Date: 04/15/2021
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: Had a hearing test and found high frequency digression but no hearing loss at this time. Saw an ENT and went for MRI with and without contrast of the head, brain, with emphasis on right ear, which all came back normal.

Allergies: Caffeine, MSG, & Penicillin.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Notice ringing in my right ear.

Other Meds: Atorvastatin, Lisinopril/HCZ, Tamsulosin, Finasteride, fish oil omega 3, multi vitamin, turmeric, vitamin D3, Oste-Biflex Glucosamine, baby aspirin, vitamin K

Current Illness: Recovering from a March 12th, 2021 Rotator Cuff surgery on the right shoulder.

ID: 1822164
Sex: F
Age: 22
State: PA

Vax Date: 09/27/2021
Onset Date: 10/27/2021
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:

Allergies: none

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

Symptoms: Fainting about 2 minutes after vaccine administration, pale, nystagmus. EMS contacted and patient checked out. Patient was allowed to go home with a driver.

Other Meds: n/a

Current Illness: none

ID: 1822166
Sex: M
Age: 41
State: TX

Vax Date: 10/25/2021
Onset Date: 10/26/2021
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:

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

Symptoms: I had elevated heart rate all day. I had shooting pains all over my body all day. I was dizzy. I had fever, sweats, chills. I?ve had every vaccine known to man, this wasn?t a vaccine, this was poison. I have had Covid unconfirmed 2x prior. I know my body. This stuff is garbage.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am