VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1003182
Sex: F
Age: 64
State: ME

Vax Date: 01/23/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: left arm rash developed 8 days after injection around the injection site. Rash still present 4 days later. No itching and no pain in the area.

Other Meds: supplements and herbal remedies too long to list here

Current Illness:

ID: 1003183
Sex: F
Age: 92
State: FL

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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: "ALL PAIN MEDICATIONS"

Symptom List: Anxiety, Dyspnoea

Symptoms: PATIENT WAS MONITORED FOR 15 MINUTES AFTER RECEIVING INJECTION. AFTER LEAVING, RETURNED TO VACCINE POD COMPLAINING OF SWELLING OF TONGUE AND THROAT AND SHORTNESS OF BREATH. EMS EVALUATED PATIENT AND SHE WAS TAKEN TO HOSPITAL WHERE SHE WAS TREATED FOR ANAPHYLAXIS AND RELEASED.

Other Meds: TYLENOL, LEVOTHYROXINE, METOPROLOL, ALLOPURINOL, AMIODARONE, ASPIRIN, LISINOPRIL, B COMPLEX WITH C VITAMIN, VITAMIN E

Current Illness: N/A

ID: 1003184
Sex: F
Age: 35
State: VA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
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: Ceclor drugs and Sulfa drugs

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

Symptoms: After receiving the shot at approximately 1600 (and waiting the 15 minutes at the clinic site), I returned to my desk for work. Around 1740, I noticed a slight headache, which are abnormal for me, so I thought I might have been slightly dehydrated and increased my water intake, as well as ingested 8 ounces of gatorade. The headache gradually got worse and by the time I left work at 2000 (8PM), it was so bad on the (primarily) right front part of my head (around my temple and behind my right eye), noise, light, and even my own walking hurt terribly. I have never had a migraine in my life and rarely even get headaches, but the pain of this headache far surpassed any I have experienced before and based on what others tell me, might have been a migraine. By the time I got home around 2100 (9PM), I took two extra strength Tylenol tablets and went to bed. When I awoke in the morning around 0900 (9AM), I had a slight headache that dissipated after I took two more Tylenol tablets and did not return.

Other Meds: Multi-vitamin, Adderall, Zyrtec, Prozac, Nexium

Current Illness: None

ID: 1003185
Sex: F
Age: 35
State: TX

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: latex amoxicillin erythromycin ethylsuccinate

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Palpitations, increased HR, mild temp, elevated bp, itchy red rash body-wide, very weak, intense headaches

Other Meds: Singulair 10mg, Fluticasone Propionate 50mcg

Current Illness:

ID: 1003186
Sex: F
Age: 31
State: CA

Vax Date: 01/23/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: On day 8 my left arm swelled at the site it was red hot and itchy. Today I woke up with a ring of red around the injection site and 6 quarter sized itchy red bumps under the site.

Other Meds:

Current Illness:

ID: 1003187
Sex: F
Age: 56
State: ME

Vax Date: 01/14/2021
Onset Date: 01/23/2021
Rec V Date: 02/04/2021
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: Wellbutrin, Dye

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

Symptoms: On 1/23/2021 Patient initially seen at clinic, she was told to watch and see. On the Second visit the physician recommended ice and ibuprofen. Then the patient reported to hospital for a third visit and they treated for cellulitis with a rocephin injection and oral antibiotics.

Other Meds: unknown

Current Illness: unknown

ID: 1003188
Sex: F
Age: 25
State: MA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/04/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Urticarial rash over whole body including face, moderate swelling of lips eyes beginning 8pm 1/30/21. Rash most concentrated over trunk and thighs, center of face around nose. Worsened overnight (1/30/21-1/31/21)despite use of benadryl 2 tablets (50mg) night prior and every 4-6 hours following. care provider seen 1/31/21 9AM, prescribed prednisone (first dose 11AM) and advised continuing benadryl 2 tablets 4-6 hours. Prednisone 10mg TID x 3 days, 10mg bid x 3 days, 10mg qd x 3 days. Continued Benadryl every 4 hours. Rash on body and face peaked 1/31/21 3pm, mild improvement overnight to 2/1/21. 2/1//21: Rash increased in intensity on distal LEs (feet/ankles) and UEs (wrists). Appearance of petichiae on trunk, lateral thighs. 2/2/21: Rash improving, fatigue. 2/3/21: rash nearly resolved, petichiae remain 2/4/21: Rash resolved petichiae improving.

Other Meds: Kyleena IUD Vitamin D Fish Oil

Current Illness: none

ID: 1003189
Sex: F
Age: 68
State: IN

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Erithromycin

Symptom List: Pharyngeal swelling

Symptoms: I started getting very cold about 8 PM on 2/2/2021. Soon started chilling and tremors were pretty violent. I put on warm clothes and went to bed about 10 pm. I didn't sleep very well because I was very cold until I woke up about 11:30 pm and I was warm, except my feet. It wasn't until about 12:30 am that my feet were warm. I was very tired all day on Wed and muscle aches, too.

Other Meds: Carvedilol Vit D3 Zinc Warfarin COQ10 Niacin Spironolactone Lutein Cetirizine Montelukast

Current Illness:

ID: 1003190
Sex: F
Age: 34
State: CT

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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: Moderna COVID-19 Vaccine EUA Swollen, painful lymph nodes in left armpit, headache, body aches

Other Meds: Ortho-tricyclin

Current Illness: None

ID: 1003191
Sex: F
Age: 66
State: CA

Vax Date: 01/26/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Ibuprofen

Symptom List: Diarrhoea, Nasal congestion

Symptoms: For several days after the injection, experienced pain, swelling , redness and a linear blue bruise at the injection site. These symptoms improved . Then on February 3rd, noted itchy red bumps measuring about 2.5 by 1.5 inches and a deep sharp pain at injection site. Today, the red bumps have been replaced by a confluent red itchy area.

Other Meds: Vitamin C, vitamin B complex, multi-vitamin, fiber pills, tylenol, naproxen, alendronate, latanoprost eye drops, estrogen vaginal cream

Current Illness: None

ID: 1003192
Sex: F
Age: 69
State: MS

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: According to her medical records: Codeine (Anaphylaxis, Nausea And Vomiting, Swelling), Floxin (Anaphylaxis), Rocephin (Shortness Of Breath), Sulfa Antibiotics (Anaphylaxis), Latex (Swelling), Lidocaine (Swelling), Penicillins (Rash)

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

Symptoms: The patient was referred by her primary care provider's office to receive COVID-19 vaccination. She received her first dose of Pfizer-BioNTech COVID-19 vaccine at approximately 15:07 hrs. Due to her history of allergic reactions to multiple medications (including sulfa antibiotics and ceftriaxone), she was advised to extend her monitoring period to at least 30 minutes post-injection. At around 15:50 hrs I was notified that the patient was feeling a tingling sensation in her throat, itching, and a change in her voice. She was transferred to a stretcher for acute management of suspected anaphylaxis. Airway, breathing, circulation, and mentation were assessed immediately. EMS was called immediately via 911. Her vital signs were obtained, with a BP 168/90 mm/Hg, HR 105/min, RR 24/min. She reported shortness of breath at the time. There was no stridor or wheezing on exam. She appeared in mild respiratory distress. At 15:54 hrs she was given an intramuscular EpiPen injection (0.3 mg autoinjector) in her left thigh. At 15:58 she was given an intramuscular methylprednisolone injection (125 mg) in her right thigh. Immediately after that EMS team arrived and took over her care with plans to administer diphenhydramine intramuscularly, and will transfer to ED for further management. Throughout the event the patient remained awake, alert, and fully oriented.

Other Meds: According to her medical records: ALPHA LIPOIC ACID, ALPRAZolam, Ascorbic Acid, Calcium-Magnesium-Vitamin D, Cranberry, Cyanocobalamin, Estradiol-Estriol-Progesterone, ibuprofen, ketoconazole cream, KRILL OIL, loratadine-pseudoephedrine, M

Current Illness:

ID: 1003193
Sex: F
Age: 62
State: CA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: sulfa, ampicillin, norco

Symptom List: Rash, Urticaria

Symptoms: Patient with headache, muscle aches, nausea. then developed palpitations and dull constant nonexertional chest ache for several hours resolved with fluids and Tylenol/motrin.

Other Meds: none identified

Current Illness: COVID Disease diagnosed December 21, 2020 , was symptomatic starting Dec 17th 2020

ID: 1003194
Sex: F
Age: 43
State: NY

Vax Date: 01/27/2021
Onset Date: 01/30/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: DIARY INTOLERANCE

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

Symptoms: METALLIC TASTE IN MOUTH, ITCHINESS / RASH TO LATERAL APECTS OF TONGUE TOWARDS TONGUE'S APEX BEGINNING 1/30/2021 GENERAL MALAISE 2/2-2/3/2021; TEMP ON THESE DAYS 99.4 DEGREES AND 99.7 DEGREES RESPECTIVELY I TOOK ACETAMINOPHEN ON 2/2/2021 BENADRYL 2/4/2021 - ITCHINESS SUBSIDED POST (1) DOSE TONGUE RASH PERSISTS AT THIS TIME

Other Meds: NONE

Current Illness: NONE

ID: 1003195
Sex: F
Age: 36
State: KS

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Tachycardia, Hypertension, Light headed, dizzy, hot, flushed on neck and chest.

Other Meds: Collagen peptides, Vitamin D3, Vitamin C, Loratadime 10mg

Current Illness: None

ID: 1003196
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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: NKDA

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

Symptoms: Pt received vaccine at 1645. Pt sitting in observation for 15 min post vaccination. After 13 minutes patient reports dizziness, fatigue, eye lids are getting heavy with pressure, throat with burning sensation, difficulty breathing and clearing throat. At 1700 patient given Benadryl 25mg PO and obs for 1 hr. Symptoms resolved.

Other Meds:

Current Illness:

ID: 1003197
Sex: F
Age: 61
State: CA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
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?s, Amoxicillin, Cyclobenzaprine, Sulfur

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

Symptoms: Swelling in joints with pain and swelling in bilateral knee, bilateral lower leg, bilateral shoulder, bilateral hand and fingers. Pain in neck and base of skull. Severe fatigue, hot flashes and cold chills.

Other Meds: Rabeprazole 20 mg tablet, LisinopriL 40 MG tablet, AtenoloL 100 MG tablet, Duloxetine 30 MG capsule, Furosemide 20 MG tablet, Alprazolam .5 MG tablet (at night). For Pain: Hydrocodone-acetaminophen 10-325 mg per tablet, Diclofenac Sodium

Current Illness:

ID: 1003198
Sex: M
Age: 55
State: MS

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Fever, nausea, lethargy. Swollen right arm at the site

Other Meds: None

Current Illness: Diabetes

ID: 1003199
Sex: F
Age: 68
State: MA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: TETRACYCLINES SULFUF CONTRAST DYE

Symptom List: Ear pain, Hypoaesthesia

Symptoms: FEVER, HEADACHE AND FATIGUE

Other Meds: METOPRLOL ER SUCCINATE 25 MG ATORVASTATIN 10 MG LISINOPRIL 10 MG COQ-10 200 MG ASPIRIN 81 MG

Current Illness: NONE

ID: 1003200
Sex: F
Age: 68
State: CA

Vax Date: 01/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Milk,

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Slight swelling and redness after injection that went away. 8 days later, a nickel size redness and silver dollar size swelling/hardness with tenderness at the injection site suddenly came back. No other symptoms. By day 10, tenderness and swelling going away.

Other Meds: Praluent Flonase

Current Illness: No ne

ID: 1003201
Sex: F
Age: 19
State: IN

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Gluten, Milk, Dairy, Soy, Cashews

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

Symptoms: Patient with burning at injection site, irritation to throat, and shortness of breath. Patient also with sense of flushing.

Other Meds: Lamictal, Venlafaxine

Current Illness:

ID: 1003202
Sex: M
Age: 48
State: NV

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/04/2021
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: NKDA

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

Symptoms: On approximately the evening o 01/21/21 the patient began to experience headaches. The headaches have been intermittent continuing on till the date of this report (02/04/21). The patient has been taking acetaminophen with relieve. On approximately 02/01, it was noted by coworkers that the patient's right side of the face would not move when he would talk. Around the same time, the patients right eye became watery and the patient's wife stated she noted some gurgling. Due to the onset of these new symptoms, the patient went to see the doctor on 02/04/21. Per the patient's wife, the doctor diagnosed the patient with a very mild form of Bell's Palsy and prescribed steroids to the patient. The name of the steroid was not disclosed.

Other Meds: Metformin, saxagliptin

Current Illness: None

ID: 1003203
Sex: F
Age: 50
State: NC

Vax Date: 12/22/2020
Onset Date: 12/23/2020
Rec V Date: 02/04/2021
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: The day after the injection, I woke up will all of the common complaints along with pain in the soles of my feet. I also experienced it the second time as well. The 5th day, I had chest tightness and developed a bad cough, which resulted in full asthma flair. I then had to seek care. I was tested for COVID and the flu, both negative. It took about 3 weeks to settle down, which is normal for me.

Other Meds: Singulair Symbicort inhaler Zinc Magnesium Calcium tablet

Current Illness:

ID: 1003204
Sex: F
Age: 39
State: MI

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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: Pine derivatives, Nightshade such as potatoes, eggplants, zucchini, bell peppers

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

Symptoms: Patient lips begin to swell 20 minute after receiving covid19 Vaccine. Patient had left clinic and returned due to the swelling of lips. At the time of return swelling to lips were slightly visible with some redness. Client refused treatment of benadryl intramuscular due to driving to site. She stated she felt fine after additional observation period of 30 minutes. Vital signs Heart rate 89 BP 132/64 Sp02 98% Resp. 18 . Followed up with client on 02/04/2021. Client stated she took OTC benadryl once returning home w/ no complaints today.

Other Meds: none

Current Illness: n/a

ID: 1003205
Sex: F
Age: 69
State: AK

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: wasps/hornets Cat dust all opioids and antidepressants

Symptom List: Injection site pain, Pain

Symptoms: Reports sleeping more that normal (18-20 hrs first night), and sleeping more that normal past week. reports fatigue, poor appetite some nausea. Dizziness that comes and goes.. Denies fever. States S/S have improved but still there after 1 week.

Other Meds: Acid reducer PRN Tylenol PRN None taken day of vaccine Losartan Qvar Albuterol inhaler Slutiscone

Current Illness: Chronic Asthma Hypertension Allergies

ID: 1003206
Sex: F
Age: 55
State:

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital: Y

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

Lab Data:

Allergies: Cat dander, seafood

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient felt she had warmth at site of injection,89 HR 81. Patient says normal BP 120's/80's. Patient states she is not anxious. She then started feeling like her throat and chest were getting itchy. Continued monitoring and she felt she needed to be evaluated in ER. Taken to ER. ED notes as follows: 55 y.o. female who arrived by to the emergency department for Throat and chest discomfort associated with voice change and pruritic rash. Past medical history of food and environmental allergies, Addison's disease, thyroid disease, primary immune deficiency disorder. Half an hour ago, the patient received her first injection the Covid vaccine. Seconds later, the patient started having a pruriti rash where the site of the injection was. She then noticed her chest getting red and warm. About 15 minutes later, the patient noticed her voice becoming hoarse her and associated with throat and chest discomfort. Reports that she is unable to take a deep breath. Denies any noisy breathing, nausea, vomiting, abdominal pain, shortness of breath, difficulty swallowing, drooling. She has never been hospitalized for anaphylaxis. She denies any past medical history of asthma or COPD Vital signs demonstrate hypertension with systolic blood pressures into the 180-190s. No oropharyngeal swelling. Hoarse voice. Scleral injection present bilaterally. Chest wall nontender. Mild, blanching, erythematous, pruritic rash on anterior chest. Shallow breathing when asked to take a deep breath. Injection site covered with bandaid with no other obvious rashes or swelling patient arrived to the ED in no acute distress and in stable condition. She was complaining of throat discomfort with voice changes. She has never had an anaphylaxis reaction before. She was given benadryl, famotidine, and methylprednisolone initially for her reaction. With her hypertension and reported chest discomfort, epinephrine was not given initially. Her symptoms mildly improved with the initial treatment. Patient complained of chest discomfort and EKG showing T wave inverted in leads V4-5. She was given aspirin. Initial troponin negative and repeat was ordered. After four hours of observation, the patient reports her voice change has resolved but continued to have pruritis in different, migrating areas of the body such as ears, neck, and arms. 1330: patient complaining of increasing chest and abdominal pain. Described as a cramping chest pain that radiated to her abdominal. Denies nausea, vomiting or diaphoresis. Continues to deny shortness of breath. Given morphine for her pain and aspirin for her nonspecific EKG changes. Internal Medicine consulted for admission due to allergic reaction. Patient is agreeable to this plan. Patient was transferred under stable condition to the IM service. Initial Vital Signs [02/03/21 1159] Blood Pressure 168/101 Heart Rate 73 Respiratory Rate 15 Temp 36.8 ?C (98.3 ?F) Temp src Oral SpO2 96 % Following one day admission she was discharged to home with Zio patch monitoring while on new beta-blocker therapy for symptomatic PVCs with plan for PCP follow-up. Regarding adverse drug reaction, she was advised to follow-up with PCP and immunologist for further discussion on benefits:risk of subsequent vaccine in series.

Other Meds: albendazole, alprazolam, vitamin D, duloxetine, estradiol, ibuprofen, oxycodone/acetaminophen, prednisone, restasis, levothyroxine

Current Illness:

ID: 1003207
Sex: F
Age: 51
State: HI

Vax Date: 01/22/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Sulfa Diphenhydramine

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

Symptoms: Left arm redness 10 days after administration. Swelling and numbness to the arm

Other Meds: Adderall Tramadol

Current Illness:

ID: 1003208
Sex: F
Age: 36
State: CA

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Employee describes fever of 103.2 and nausea on night of vaccination (02/01/21). 02/03 developed blood in urine and body aches, nausea, fever continued.

Other Meds: Losartan 100mg, Hydrochlorathiazide 12.5mg

Current Illness: Hypertension,

ID: 1003209
Sex: F
Age: 57
State: NY

Vax Date: 01/27/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: NOne

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Are has round red rash near injection site - itcy and slightly painful. Occurred after week of first dose

Other Meds: Lexapro

Current Illness: None

ID: 1003210
Sex: F
Age: 40
State: CA

Vax Date: 01/27/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
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: erythromycin

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

Symptoms: 6 days after receiving injection, left upper arm became hot to touch with erythema, sharp pain and itchiness.

Other Meds: on and off antihistamine and tylenol, none taken yesterday nor today.

Current Illness: intermittent "hives" since October

ID: 1003211
Sex: F
Age: 28
State: MI

Vax Date: 01/04/2021
Onset Date: 01/19/2021
Rec V Date: 02/04/2021
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: Nausea

Symptoms: Pt received COVID vaccine at hospital 01/4/2021. She was seen in PCP office 01/19/2021 and given Hep A and Tdap vaccines, which now prevents her from receiving her 2nd COVID vaccine. 1/21/2021 Called pt and left her a detailed message letting her know that she should wait the full 14 days to get the COVID vaccine and that even though she will be a day past the 28 day window for her COVID vaccine series, she should still be able to get it and not have to restart the series.

Other Meds:

Current Illness:

ID: 1003212
Sex: F
Age: 31
State: OH

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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: Severe fatigue, generalized myalgia, weakness, sleep disturbance, mild shortness of breath Onset of sx were ~10-12 hours after receiving shot, symptoms lasted ~24h. Did not seek any medical care. Took 2 doses of Tylenol 500mg about 8 hours apart, Tylenol provided some relief but still felt very poorly.

Other Meds:

Current Illness:

ID: 1003213
Sex: F
Age: 21
State: NY

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fever, chills, headache, nausea

Other Meds:

Current Illness:

ID: 1003214
Sex: U
Age: 48
State:

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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:

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

Symptoms: Pt reports that she has started feeling itchy (no rash noted) and has and has a metallic taste in her mouth. Placed on stretcher and vital signs taken, Benadryl 25 mg given orally with juice. At 1450 Pt feeling better, itchiness decreased and pt discharged

Other Meds:

Current Illness:

ID: 1003215
Sex: F
Age: 64
State:

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 02/04/2021
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: Large redness on the injection site about 5 inches in length

Other Meds:

Current Illness:

ID: 1003216
Sex: F
Age: 45
State: CT

Vax Date: 12/22/2020
Onset Date: 12/23/2020
Rec V Date: 02/04/2021
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: Sulfur medications

Symptom List: Erythema, Pruritus

Symptoms: There was pain, swelling of the arm and body, redness of the entire upper portion of the arm lasting a week including a long blister, a low grade fever lasting three days, muscle aches that traveled throughout the body, tiredness and the strangest headache.

Other Meds: Trazadone, Medical marijuana, multi vitamin

Current Illness: None

ID: 1003217
Sex: F
Age: 56
State: CA

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 02/04/2021
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:

Allergies: no

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

Symptoms: Just a sore throat that first evening along with aches and pains and chills. Got a Fever about three days later (on about day four). Sore throat and coughing. I had a video DR visit on January 4th. January 5, - COVID test - positive. Bedrest and quarantine. Had symptoms about 10 days.

Other Meds: no

Current Illness: no

ID: 1003218
Sex: M
Age: 29
State: AL

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: patient complained of tightness in chest; vitals - bp 132/83, hr82, rr20, o2 sat 98%; patient denies any past medical history; complained of dizziness and feeling like he was gonna pass out. 911 was called; transported patient to hospital er.

Other Meds:

Current Illness:

ID: 1003219
Sex: F
Age: 51
State: SD

Vax Date: 01/31/2021
Onset Date: 01/31/2021
Rec V Date: 02/04/2021
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: Fragrances

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: On the day of the vaccine at 11:00 PM started had a lymph node under her left arm that swelled up and got sore. Her arm felt like somebody ripped off. Fever of 102.6 the following day, and all through the day. The fever did not break until Monday on 2/1/21. It also made her quesey and ate crackers and apple sauce. These symptoms lasted through Tuesday. She ended up working 1/2 day on Tuesday due to exhaustion. By Wednesday 2/3/21 got her energy back. Today she is better, feels good.

Other Meds: Atenolol, Claritin, Pepcid AC. Emergen-C.

Current Illness: Sore throat week before, strep test and COVID test, both negative.

ID: 1003220
Sex: M
Age: 29
State: CA

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/04/2021
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: none

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

Symptoms: Belong to program and had to go back home since he got shingles 1 to 2 days following the covid vaccice Moderna. He came over to ask us if it was safe for him to get the second shot after 28 days since he got shingle 1 day after the first shot. He also had a rx from ER for 3 medidations prescribed for shingles. We did not fill his rx since he wanted to fill them in a pharmacy close to his family's home.

Other Meds: na

Current Illness: n/a

ID: 1003221
Sex: M
Age: 38
State: CA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/04/2021
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: Ceftin, Prednisolone

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

Symptoms: Pt reported feeling warm, mouth feels funny, feels nervous. Given Benadryl 50 mg PO. Reported resolution of symptoms

Other Meds:

Current Illness: Chronic sinusitis

ID: 1003222
Sex: M
Age: 39
State: TX

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Pain in extremity

Symptoms: Fever, nausea, chills, body aches, diarrhea, and feeling like a truck hit me. 36 hours

Other Meds: Ativan, clonazepam, vitamin C, D3, Zinc, montelukast, zyrtec

Current Illness: None

ID: 1003223
Sex: F
Age: 49
State: SD

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: Doxycycline, Duloxetine, Omeprazole, Pregablin, Latex, Broccoli

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

Symptoms: Around 1325 starting having chest pain and nausea. States pain is similar to heart burn and is constant.

Other Meds: None

Current Illness: Right shoulder pain, hx of fall January 2020, Chronic neuropathic pain, Methamphetamine use disorder, Iron deficiency anemia, Hx of mental illness, Asthma, mild.

ID: 1003224
Sex: F
Age: 88
State: WI

Vax Date: 01/30/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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: CODEINE

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

Symptoms: BLACK STOOLS 2 days ago (Tuesday) she started with watery, black stools It was very frequent. Wednesday - it was still black but not as often Thursday - This morning it has been brown. No pain or cramping. No dizziness.

Other Meds: Rx: cyanocobalamin (vit B-12) ER 1,000 mcg tablet,extended release Ref: 0 Instructions: Take 1 Tablet ORAL DAILY. Rx: PROBIOTIC PRODUCT ORAL Tablet, Ref: 0 Instructions: Take 1 Tablet ORAL DAILY. Rx: biotin 10 mg tablet Re

Current Illness: NONE

ID: 1003225
Sex: F
Age: 53
State: TX

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
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: Knot under the right arm. Soreness if moved a certain way. It is the size of an egg.

Other Meds: Losartan

Current Illness: 1/2/21 +COVID

ID: 1003226
Sex: M
Age: 68
State: NY

Vax Date: 01/22/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
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: Fatigue, muscle soreness in neck and shoulders, chills, burning sensation in eyes--generally flu-like symptoms; no fever; no congestion, no sore throat. Waxes and wanes. Slight flu-like symptoms off and on from 24 hours after vaccination, but primary onset at day 12 after vaccination. 2 days duration thus far.

Other Meds: Atorvastatin 10mg daily; Ramipril 10mg daily; Metoprolol ER 75mg daily; Hydrochlorothiazide 25mg daily; Prilosec O/C daily; Zolpidem 10mg 2 times weekly on average; Lorazepam .05 mg nightly.

Current Illness: None

ID: 1003227
Sex: F
Age: 57
State: RI

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
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: NKDA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: pt experienced dizziness, hotflash and heart palpitations, vitals taken, BGL noted low for pt. pt given 2x oral glucose, water and snacks to increase BGL. pt BGL increased to 99. pt accept treatment and refused transport

Other Meds: insulin

Current Illness: diabetes type 2

ID: 1003228
Sex: F
Age: 61
State: CA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
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: Penicillin?s, Amoxicillin, Cyclobenzaprine, Sulfur

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

Symptoms: Swelling in joints with pain and swelling in bilateral knee, bilateral lower leg, bilateral shoulder, bilateral hand and fingers. Pain in neck and base of skull. Severe fatigue, hot flashes and cold chills.

Other Meds: Rabeprazole 20 mg tablet, LisinopriL 40 MG tablet, AtenoloL 100 MG tablet, Duloxetine 30 MG capsule, Furosemide 20 MG tablet, Alprazolam .5 MG tablet (at night). For Pain: Hydrocodone-acetaminophen 10-325 mg per tablet, Diclofenac Sodium

Current Illness:

ID: 1003229
Sex: F
Age: 67
State: MO

Vax Date: 01/25/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
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: Lopressor; NSAIDS; Scopolamine; tape, lanolin; Lysol spray

Symptom List: Injection site swelling, Limb discomfort

Symptoms: The vaccine is metabolized through CYP450 same as the topiramate. On day 7 after the second vaccination, my migraines returned. They have been under complete control for over 5 years. I have had to increase the dose of topiramate in order the stop the migraines somewhat. My main concern is that topiramate is also used for seizures. If a person taking this for seizures has the same reaction as I did, they may have seizures shortly after their second dose of the MRNa vaccination (either Pfizer or Moderna).

Other Meds: Topiramate 75 mg BID; Allegra 180 mg daily; Losartan 25 mg daily; Levoxyl 112 mcg 1/2 tab daily; Celexa 40 mg daily; Multivitamin daily; Vitamin B Complex daily; Aspirin 81 mg daily; Niacin 500 mg 2 tab daily; famotidine 40 mg daily; Medte

Current Illness: Chronic Daily Migraines treated by the topiramate; Hypothyroidism; coronary artery disease; Osteoarthritis; Eczema and allergic rhinitis;

ID: 1003230
Sex: M
Age: 68
State: NC

Vax Date: 01/26/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

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

Lab Data:

Allergies: sulfa

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

Symptoms: On day 7 post Modena No. 1, patient developed erythematous pruritic rash that has progressed into large confluent patches. Rash remains intensely pruritic. It is blanchable. Spares palms and soles. No enanthem identified. No associated fever. Images are available in EMR upon HIPPA compliant request. Of note, patient has several furuncles in various stages of development and resolution and in 2010 had a similar presentation of a skin eruption associated with MRSA infection. As noted above patient is polypharmic with numerous medications although none were recently started on adjusted prior to symptoms aside from receiving the maternal vaccine.

Other Meds: ? acetaminophen? albuterol HFA ? Atorvastatin ? butalbital-acetaminophen-caff ? cetirizine? cholecalciferol ? colchicine ? docusate sodium ? DULoxetine ? gabapentin ? lisinopriL-hydrochlorothiazide ? magnesium oxide ? methocarba

Current Illness: no acute illness

ID: 1003231
Sex: M
Age: 77
State: MT

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/04/2021
Hospital: Y

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

Lab Data:

Allergies: neosporin

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

Symptoms: 6 days ago he got his first COVID-19 vaccination. 5 days ago he started to feel ill. Generalized body aches. Progressive shortness of breath. More recently dry cough. Diminished sense of taste and smell. His symptoms progressed and today, due to shortness of breath, he presented to the ED. In the ED he was found to be hypoxic and have tachypnea. COVID-19 test was positive. He was given intravenous dexamethasone and is referred to the hospitalist service for admission. Patient denies ill contacts. He denies diarrhea. No nausea or vomiting. Since arriving to the ED and getting on oxygen he feels significantly better.

Other Meds: amlodipine, clopidogrel, fosinopril, hydrocholorothiazide, isosorbate mononitrate, metoprolol, rosuvastatin, Xarelto

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm