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: 1006007
Sex: M
Age: 51
State: MO

Vax Date: 01/14/2021
Onset Date: 01/26/2021
Rec V Date: 02/05/2021
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: naldecon, rondec

Symptom List: Dysphagia, Epiglottitis

Symptoms: Rash on left arm at site of shot

Other Meds: apixaban, cholchicine, HCTZ, lisinopril, metformin, rosuvastatin, tadalifil, fluticasone nasal spray

Current Illness:

ID: 1006008
Sex: F
Age:
State: CA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 02/05/2021
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: resurgence of Covid-19 symptoms experienced the month prior; I still feel sick; congestion; sore throat; This is a spontaneous report from a contactable other HCP (patient). A 41-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) (Lot #: EK9231) on 08Jan2021 17:00 at single dose in left arm for Covid 19. The patient was not pregnant at the time of vaccination. Facility where the most recent COVID-19 vaccine was administered was Hospital. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Medical history included sleep, had Covid back in Dec, early Dec. Concomitant medication within 2 weeks of vaccination included zolpidem tartrate (AMBIEN) to sleep. The patient experienced resurgence of Covid-19 symptoms experienced the month prior on 11Jan2021 12:00 AM. She had her first dose on 08Jan2021 and all of her Covid symptoms return except this time little bit worse than the first. It says 13 days since her dose and she still feel sick on 11Jan2021 12:00 AM, congestion on 9Jan2021, sore throat on 9Jan2021. No treatment received for all the events. All the events result in Doctor or other healthcare professional office/clinic visit. The patient have Covid test (Nasal Swab covid test) on 15Jan2021 but have not received the result yet. The outcome was not recovered. Prior to vaccination, the patient was diagnosed with COVID-19. Since the vaccination, the patient has been tested for COVID-19. The patient stated, "Advil, probably 400 mg maybe like two times a day at most but it wasn't every day. I did not take it every day, I take it for couple of days."; Sender's Comments: The 41-year-old female patient had Covid in early Dec2020. On 08Jan2021, she received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), and experienced resurgence of Covid-19 symptoms on 11Jan2021. The patient have Covid test (Nasal Swab covid test) on 15Jan2021 but have not received the result yet. No effect of the suspect vaccine could be reasonably achieved to protect from the targeted infection/disease due to the very short time lag. Instead, the resurgence of Covid-19 symptoms most likely represents a pre-existing infection prior to vaccine use. Further information is needed for full medical assessment. The case will be reassessed should additional information become available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics committees and Investigators, as appropriate.

Other Meds: AMBIEN

Current Illness:

ID: 1006009
Sex: M
Age:
State: TX

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 02/05/2021
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: woke up with a subconjunctival hemorrhage in right eye; This is a spontaneous report from a contactable consumer reporting for himself A 67-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EL9262) on 23Jan2021 at 01:00 a.m. at single dose via an unspecified route of administration on left arm for COVID-19 immunization. Relevant medical history included diabetes. Concomitant medications included empagliflozin (JARDIANCE), lisinopril, rosuvastatin, tamsulosin hydrochloride (TAMULOSIN). On 24Jan2021 the patient woke up with a subconjunctival hemorrhage in right eye. No Treatment was given for the event.

Other Meds: JARDIANCE; LISINOPRIL; ROSUVASTATIN; TAMULOSIN

Current Illness:

ID: 1006010
Sex: F
Age: 51
State: OR

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: Liquid Nifererex (iron supplement) hives

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 48 hours after vaccine, area became red, hard, painful, warm and swollen. Area was mapped at that time, measured 7x7 cm. Reddened area became bigger next day and more painful, measured 9x9 cm. Employee health called 72 hrs after vaccine who directed me to call PCP. On call provider directed me to take antihistamine, apply ice and OTC steroid cream. I took loratadine and diphenhydramine and used ice. Next days swelling and pain better. One week later, there is some remaining itchiness but no redness, pain or swelling.

Other Meds: Acetaminophen

Current Illness: None other than fever, chills, body aches and dizziness day after vaccine on 1/29/21

ID: 1006011
Sex: F
Age:
State: TX

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 02/05/2021
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: Miscarriage; The mother reported she became pregnant while taking bnt162b2; The mother reported she became pregnant while taking bnt162b2; This is a spontaneous report from a contactable consumer reported for herself. A 27-year-old female patient (Pregnant) received first dose of bnt162b2 (lot number: EL3248), via an unspecified route of administration in left arm on 16Jan2021 16:30 at single dose for covid-19 immunization. Medical history included asthma, covid-19 from an unknown date and unknown if ongoing. The patient's concomitant drug included prenatal vitamins. The patient experienced miscarriage on 21Jan2021 with outcome of recovering. The event was reported as non-serious. The adverse event result in emergency room/department or urgent care. No treatment received for the adverse event. The mother reported she became pregnant while taking bnt162b2. The mother was 8 weeks pregnant at the onset of the event. The mother was due to deliver on 19Aug2021. Last menstrual date: 22Nov2020. Facility where the most recent COVID-19 vaccine was administered: Hospital. The patient was not received any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was diagnosed with COVID-19. Since the vaccination, the patient hadn't been tested for COVID-19. Not known allergies to medications, food, or other products.

Other Meds:

Current Illness:

ID: 1006012
Sex: M
Age:
State: FL

Vax Date: 01/18/2021
Onset Date: 01/20/2021
Rec V Date: 02/05/2021
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:

Allergies:

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

Symptoms: swelling of spleen and liver; swelling of spleen and liver; Fever followed by unremitting abdominal pain; Fever followed by unremitting abdominal pain; This is a spontaneous report from a contactable Other HCP. A 33-year-old male Other HCP reported that he receive second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number EL8982), intramuscular at single dose into the left arm on 18Jan2021 at 10:45 am for COVID-19 immunization. The patient had received the first dose of vaccine (Lot number ElC9231) on 28Dec2020 at 11:30 am intramuscular into the left arm. Medical history was none. Concomitant drugs were none. On 20Jan2021 the patient experienced fever followed by unremitting abdominal pain that led to hospital admission for pain management and diagnostic imaging that revealed swelling of spleen and liver. Proton pump inhibitor via IV. Opioid IV in ER. the patient was hospitalized for 3 days. Unremarkable patient history prior to this even for GI and cardio. Non smoker non alcohol user. First ever hospitalization as an adult. On 21Jan2021 the patient had a negative Nasal Swab test for covid. The outcome of the event was recovering.; Sender's Comments: Based on the compatible temporal association and in absence of strong confounding factors, there was a reasonable possibility that the vaccination with BNT162B2 played a contributory role in triggering the onset of the events fever, abdominal pain and swelling of spleen and liver. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds:

Current Illness:

ID: 1006013
Sex: M
Age:
State: NY

Vax Date: 01/07/2021
Onset Date: 01/20/2021
Rec V Date: 02/05/2021
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: Pyrexia, White blood cell count decreased

Symptoms: meningioencephalitis; Severe headache; severe nausea; migraine; small subarachnoid hemorrhage postulated; This is a spontaneous report from a contactable Physician (patient). A 79-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration Left arm on 07Jan2021 at 02:30 PM as a single dose for COVID-19 immunisation, lot number: EL3249. Medical history included hypertension, hypercholesterolemia, hypothyroidism and dust allergy. Concomitant medications in two weeks prior to the vaccination included levothyroxine sodium (SYNTHROID), chlorthalidone and rosuvastatin calcium (CRESTOR). Patient did not receive other vaccine in four weeks prior to the COVID vaccine. On 20Jan2021 at 04:00 PM patient experienced severe headache with severe nausea requiring emergency room (E R) visit and intravenous (I. V) morphine, toradol and ondansetron. Computed tomography angiography (C T A) of head performed on unknown date was normal. Pain unbearable. Lumbar puncture (L P) not done. Pain persisted four days later, though diminished. Diagnosis (Dx) uncertain but possible migraine with right (r) eye preference or small subarachnoid hemorrhage postulated. Another troublesome possibility could be vaccine reaction (meningioencephalitis). Events resulted in Emergency room/department or urgent care. Treatments received included IV morphine, zophran (as reported), ketorolac tromethamine (TORADOL) and metoclopramide hydrochloride (REGLAN). Patient had no COVID prior vaccination. Patient was not tested for Covid post vaccination. Patient recovered with sequel from the reported events.; Sender's Comments: Based on temporal association, a possible contributory role of BNT162B2 cannot be excluded for events meningoencephalitis, headache, nausea, migraine and subarachnoid hemorrhage. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds: SYNTHROID; CHLORTHALIDONE; CRESTOR

Current Illness:

ID: 1006014
Sex: F
Age: 35
State: OH

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: mushrooms

Symptom List: Pharyngeal swelling

Symptoms: About 5 minutes after vaccination, patient reported tongue swelling and lightheadedness. Patient was closely monitored and tongue swelling resolved quickly. Patient also developed hives on face and was given 25mg Benadryl orally. Tachycardia was monitored and patient remained in clinic for 1 hour until symptoms resolved and she could demonstrate a steady gait to walk back to her car. No additional treatment provided.

Other Meds: Nexium, Warfarin, MVI

Current Illness: none

ID: 1006015
Sex: F
Age:
State:

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 02/05/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: headache; had chills; freezing; body aches; got really hot; passed out; This is a spontaneous report from a contactable consumer (patient) received via Medical Information Team. A female patient of an unspecified age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 23Jan2021 at 13:15 at single dose for COVID-19 immunization. The patient medical history included COVID-19 from Mar2020 to an unknown date. The patient's concomitant medications were not reported. On 24Jan2021, the patient experienced at 4:00 she was freezing and had chills and body aches. At 7:15, she felt body aches and a bad headache. Things started spinning and she passed out. After that, she got really hot and she went back to bed and stayed in bed until 14:00. It seemed very severe. She didn't have a fever, but her body hurt like she did. The patient outcome of the events was unknown. The information on the batch number has been requested.

Other Meds:

Current Illness:

ID: 1006016
Sex: F
Age:
State: PA

Vax Date: 01/22/2021
Onset Date:
Rec V Date: 02/05/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Hypothyroidism; Diabetes mellitus Type 1; Shortness of breath; Hyperlipidemia; This is a spontaneous report from a contactable consumer (patient). A 69-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date not reported), via an unspecified route of administration on left arm on 22Jan2021 01:00 at single dose for COVID-19 immunization. Medical history included known allergies to latex. There were no concomitant medications. The patient was not pregnant at the time of vaccination. The patient was not diagnosed with COVID-19 prior to vaccination and has not been testes for COVID-19 post vaccination. The patient experienced hypothyroidism, diabetes mellitus type 1, shortness of breath, hyperlipidemia, and had a heart surgery (triple bypass) on an unspecified date. The events resulted in visit to doctor's office or another health professional and hospitalization for 11 days. The patient received treatment for the events. The outcome of the events was recovered with sequels. Information on the Lot/Batch number has been requested.

Other Meds:

Current Illness:

ID: 1006017
Sex: F
Age: 68
State: OK

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: Hives on inside elbows both arms

Other Meds:

Current Illness:

ID: 1006018
Sex: M
Age: 0
State: TX

Vax Date: 12/01/2020
Onset Date: 12/01/2020
Rec V Date: 02/05/2021
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:

Symptom List: Rash, Urticaria

Symptoms: vaccines were exposed to 0.7 C for 25 hours and 24 minutes/ NO AE; Initial information received on 25-Jan-2021 regarding an unsolicited valid non-serious case received from a other health professional via call-center. This case involve a INFLUENZA QUADRIVAL A-B MULTIDOSE VACCINE PRESERVED [FLUZONE], DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL], DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL], MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA], IPV (VERO) [IPOL], DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE [PENTACEL] (batch number and expiry date not reported) which was exposed to 0.7 Celsius for 25 hours and 24 minutes (product storage error) excursion occurred in December-2020. Also one year patient administered post exposed 0.5 mL FLUZONE (batch number: UJ477AA and expiry date: 30-Jun-2021) via an intramuscular route at an unknown administration site on 06-Jan-2021 for prophylactic vaccination. The patient's medical history, past medical treatment, vaccination, concomitant medication and family history were not provided. It was an actual medication error case due to product storage error temperature too low. It was reported that 11 doses of Fluzone quadrivalent were administered post excursion. At the time of reporting, no adverse event was reported. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error. There will be no information available for DAPTACEL, ADACEL, IPOL, MENACTRA and PENTACEL on the batch number for this case.

Other Meds:

Current Illness:

ID: 1006019
Sex: F
Age: 80
State: PR

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: FISH

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

Symptoms: PATIENT STATED THAT AFTER 3 HOURS OF RECEIVING THE FIRST DOSE OF THE COVID-19 VACCINE, HER LEFT EYE BECAME RED AND PART OF HER CHEECK BECAME SWOLLEN, PT STATED THAT SHE TOOK BENADRYL AND IBUPROFEN. DIDN'T SEEK MEDICAL ATTENTION.

Other Meds: MELATONIN, VITAMIN C, CENTRUM, ZINC

Current Illness:

ID: 1006020
Sex: F
Age: 89
State:

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: temp of 100.2

Other Meds:

Current Illness:

ID: 1006021
Sex: F
Age: 41
State: TX

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: female with dizziness after Moderna, 2nd shot on 1/29. Cramping in stomach, nausea, and continued dizziness. Temp 99, minor chills, minor nasal sinus symptoms. "

Other Meds: Venlafaxine, Pantoprazole

Current Illness:

ID: 1006022
Sex: F
Age: 53
State: CA

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 02/05/2021
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

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

Symptoms: Rash all over body, light headedness, then the next day swollen hands and feet.

Other Meds: Metformin, Atorvastatin, vaginal estrogen

Current Illness: None

ID: 1006023
Sex: F
Age: 70
State: WA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/05/2021
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: Penicillin, Clindamycin, Plaquenil

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

Symptoms: Tickle high up in nose- right eye swelled- and face got puffy and bright red- occurred about 20 minutes after vaccine. Took Benadryl and puffiness remained or about two hours.

Other Meds: Losartan, Lyrica. Nexium, budesonide, Multivitamins, Lexapro, Metropolol Sussinate, Atorvastatin, Calcium

Current Illness:

ID: 1006024
Sex: F
Age: 48
State: VA

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Joint pain to right elbow and wrist area. "Bone" pain to right upper arm and right shoulder/shoulder blade and neck. Dull ache pain.

Other Meds: Wellbutrin 300 Lexapro 10 mg

Current Illness: n/a

ID: 1006025
Sex: F
Age: 76
State: NC

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: heavy duty antibiotics cause stomach problems

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: The day after the injection I was sore and the arm was bruised, purplish color, and hot to the touch. And this morning I got very itchy around the vaccine site and its still red and hard to the touch, like there was a lump under the skin. The bruise has faded a little but its not getting much better. Medical provider called to recommend benadryl and tylenol, and keep a warm pack on it, and also to seek help if it has not improved over the weekend.

Other Meds: Atenolol 2 mg daily aspirin escitalopram (lexapro) 5mg vitamin b12 injection every 3 weeks vitamin d3 crestor 5mg daily monteloukastsod 10 mg

Current Illness: None

ID: 1006026
Sex: M
Age: 88
State:

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: "didn't feel well"

Other Meds:

Current Illness:

ID: 1006027
Sex: F
Age: 56
State: PA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: Lisinopril, dilaudud

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

Symptoms: Extreme all over muscle pain for 24 hours. Seemed to have triggered a flare of my Ehlers-danlos syndrome.

Other Meds: Metformin, Glucophage, metoprolol, carvedilol, lorstatin, pantoprazole, Ropinerole, duoluxetine, vitamin D, multivitamin, levothyroxin

Current Illness: None

ID: 1006028
Sex: F
Age: 72
State: MA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: Cipro

Symptom List: Unevaluable event

Symptoms: Started with chills in early evening, but unable to sleep at all with crazy ? headache?, sweats, chills, slight nausea Slept all the next day and night, used Tylenol, no high fever however. 2/5 noticed peeling skin on chin, feeling improved

Other Meds: Hydrochlorothiazide Magnesium citrate Chinese herbs

Current Illness:

Date Died: 02/03/2021

ID: 1006029
Sex: M
Age: 5
State: TX

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 02/05/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Patient had a syncopal event at night about 2 1/2 weeks after vaccination. He was found unresponsive the next morning and taken to ER, where he could not be revived.

Other Meds: multivitamin

Current Illness: none

ID: 1006030
Sex: F
Age: 66
State: UT

Vax Date: 01/26/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: tetracycline, neomycin, metronidazole, compazine, oxycodone (rash), possible shrimp

Symptom List: Injection site pain, Pain

Symptoms: Raised, red vaccine site - 2 inches noted on Feb 5. Felt faint, short time - for approximately 10 minutes on Feb 4.

Other Meds: vitamin D, vitamin C, multivitamin, Forteo (teriparatide)

Current Illness: none

ID: 1006031
Sex: F
Age: 76
State: IN

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: macrobid : headache

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache from days 2 - 6 Injection site inflamed and itchy, days 8-10

Other Meds: 81 mg aspirin, every 3 days 400 mg calcium citrate, daily

Current Illness: none

ID: 1006032
Sex: M
Age: 80
State: OH

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: unknown, indicated no allergies to vaccine

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

Symptoms: Patient scheduled, arrived and consented to receive the first dose of the Pfizer Covid vaccine on Thursday Feb 4,2021 around noon. Patient received his vaccine and was directed to an observation seating area, accompanied by his wife and completed at least 15 minutes of observation prior to being released home. When patient stood up from his chair to exit the clinic , he fell and hit his head on the floor which caused substantial bleeding. He was immediately attended to and transported to the Emergency Dept on the campus of this vaccination site for treatment.

Other Meds: ASA daily

Current Illness: unknown

ID: 1006033
Sex: F
Age: 76
State: OH

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/05/2021
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: Sulfur, Gentamicin, Gabapentin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Rapid heartbeat, shaky, clammy skin, heavy perspiration, nausea, stomach cramps, pain throughout body along with pin and needle feeling mostly on the left side from my foot to the top on my head. Lips felt swollen. Itch in chest, neck with a rash, back legs, mostly all over.

Other Meds: Pantoprazole, Linzess, Bisoprolol/HCTZ, Hydrocodone/Acetaminophens 5-325, Albuterol Sulfate, Zinc, Magnesium, Fish Oil, Biotin, D3, Lidocaine

Current Illness:

ID: 1006034
Sex: F
Age: 33
State: IN

Vax Date: 01/28/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: area where injection was given is warm, hard, red, itches, and swollen

Other Meds: none

Current Illness: none

ID: 1006035
Sex: F
Age: 85
State: CA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: Shellfish, Iodine, Sulfa, Penicillin, morphine, keflex, cefuroxime, levofloxicin

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

Symptoms: Redness, swelling (hard lump) and itching at the injection site. Small white lesion 1" from injection site.(Not sure if it's associated. Not noticed before.)

Other Meds: latanaprost, combigan, tramadol, atorvastatin, nitrofurantoin, alondronate, vitamin D3, levothyroxin, liothyronine, losartan, multivitamin, low dose aspirin

Current Illness: None noted

ID: 1006036
Sex: M
Age: 37
State: ME

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/05/2021
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: Minutes after receiving vaccine reported feeling "high," this lasted for approximately a half hour then reported he felt hung over and began to feel fatigued. Reported a severe migraine that lasted 3 days and has continued to experience a lingering and pulsating headache for over 6 days. Did not have these symptoms prior to receiving vaccine.

Other Meds:

Current Illness:

ID: 1006037
Sex: F
Age: 50
State: NH

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: Shellfish, Mushrooms,

Symptom List: Injection site pain

Symptoms: Overnight woke to flu like symptoms with violent shaking, fever, chills, weakness, fatigue for about 7 days followed by lymph node swelling. Treated at Emergency Dept.

Other Meds: 75 mcg Levothyroxine

Current Illness: No

ID: 1006038
Sex: F
Age: 39
State: KY

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 02/05/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Fever of 102, body aches, extreme chills, extreme headache all that lasted for 24 hours.

Other Meds: n/a

Current Illness: n/a

ID: 1006039
Sex: F
Age: 55
State: NY

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
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: Peanut, Tree Nuts, Multiple Raw Vegetables

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

Symptoms: Tongue tingling /numbness Diaphoresis Clammy skin Lightheaded Facial flushing

Other Meds: Singulair, Protonix, Amour thyroid

Current Illness: None

ID: 1006040
Sex: M
Age: 90
State:

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/05/2021
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: "didn't feel well"

Other Meds:

Current Illness:

ID: 1006041
Sex: F
Age: 65
State: IN

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
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: Sulpha, Chocolate

Symptom List: Erythema, Pruritus

Symptoms: Chilling and headache, neck ache. These symptoms occurred the day after the vaccine.

Other Meds:

Current Illness: None

ID: 1006042
Sex: M
Age: 43
State: TX

Vax Date: 01/19/2021
Onset Date: 01/22/2021
Rec V Date: 02/05/2021
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: N/A

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

Symptoms: I have eye inflammation; both eyes. The optometrist prescribed Lotemax 4 times a day for the inflammation. I have my second shot in a week and would like to know if it's safe to get it.

Other Meds: Crestor 5 mg, Montelukast 5mg

Current Illness:

ID: 1006043
Sex: F
Age: 59
State: CT

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/05/2021
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: Penicillin

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

Symptoms: Insomnia, Temp 101.7

Other Meds: Valsartan

Current Illness: No

ID: 1006044
Sex: M
Age: 17
State: CA

Vax Date: 01/30/2021
Onset Date: 01/01/2021
Rec V Date: 02/05/2021
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: NONE

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: REDNESS, MILD PAIN, TENDER TO TOUCH AT INJECTION SITE

Other Meds: NONE

Current Illness: COVID-19

ID: 1006045
Sex: F
Age: 49
State: NY

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
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: chills, body ache, headache

Other Meds: otc multivitamin

Current Illness:

ID: 1006046
Sex: F
Age: 40
State: TX

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 02/05/2021
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: aspirin, mango, latex

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

Symptoms: Shortly after the vaccination I was still having the abdominal distention so I called to see if I could defer the 2nd vaccine because I wasnt feeling well and still experiencing AE from the 1st dose. I was advised I still had to get the vaccine so I did and by 2:30pm I begin to have severe facial swelling causing asymmetrical shaping of my face, my head was hurting extremely bad, fatigued and felt really bad. I had to lay down because my head was hurting, felt like I had pressure on the top of my head, neck and back. The pain was so bad I was transported to the ER and was isolated d/t previous COVID infection and all while there the my body felt as if it was steady swelling. I was hurting so bad I couldnt stand to be touched. I was given another round of steroids. I was advised I had COVID pnemonia and was given IM decadron, IM regalin and a subQ injection of immatrex for the headaches and administered ibuprophen and tynenol for the headache as well. I was discharged with a prescription of regalin and decadron. The ER dr. states I shouldnt have taken the 2nd vaccine because I was still suffering from COVID-19. The abdominal distention had dissolved but the congestion just will not clear up even after 3 rounds of steroids. Asoumedrol was prescribed by my ENT but it didnt help either so I have a CT Scan scheduled for next week with my ENT and has not been able to return to work since the 1st dose 12/22. I have be retested for COVID-19 on both 1/15 and 1/25 and both results are still positive for COVID.

Other Meds: Vit C, Vit D., Multivitamin, Claritin 10mg, Augmentin

Current Illness: no

ID: 1006047
Sex: M
Age: 92
State:

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: "didn't feel well"

Other Meds:

Current Illness:

ID: 1006048
Sex: F
Age: 56
State: CA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: mild headache tired

Other Meds:

Current Illness:

ID: 1006049
Sex: F
Age: 49
State: CA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
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: Pt felt warm, flushed, tingly, denied SOB but asked for oxygen and reported that oxygen helped relieve the feeling of warmth and tingliness. Could have possibly been anxiety rather than a true reaction to vaccine. Benadryl given IM 50mg. EMS called and assumed care of patient. Assessed her then took her to the hospital for further evaluation.

Other Meds:

Current Illness:

ID: 1006050
Sex: F
Age: 55
State: GA

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
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: Sulfa antibiotics

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

Symptoms: Hives on back of leg and hands

Other Meds:

Current Illness:

ID: 1006051
Sex: F
Age: 74
State: TX

Vax Date: 01/20/2021
Onset Date: 01/27/2021
Rec V Date: 02/05/2021
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: NKDA

Symptom List: Vomiting

Symptoms: 7 days after vaccine, patient developed redness, swelling and itching at left deltoid to just above left elbow. also itching around mouth. she took benadryl 3 times a day and finally had improvement of symptoms. No dyspnea, dysphagia.

Other Meds: rosuvastatin 40mg fenofibric acid 45mg magnesium 500mg Vitamin C 500mg Vitamin D3 5000 units Glucosamine 1500mg melatonin 5mg alendronate 70mg once a week

Current Illness: None

ID: 1006052
Sex: F
Age: 28
State: NM

Vax Date: 01/20/2021
Onset Date: 01/31/2021
Rec V Date: 02/05/2021
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: Latex and Naproxen

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Moderate rash and/or hives (unsure) flaring up on both hands this last week and now spreading to wrist and fingers. The bumps itch and then swell and then go back down and then flare up again. Benadryl has been taken with little relief. As well as applying hydrocortisone liberally. No other rash/hives have appeared anywhere else on my body.

Other Meds: None

Current Illness: None

ID: 1006053
Sex: F
Age: 23
State: MT

Vax Date: 12/30/2020
Onset Date: 01/02/2021
Rec V Date: 02/05/2021
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: N/A

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

Symptoms: For two days (the 4th and 5th day after the dose) I had constant dizziness, nausea and a headache. My dizzy spells were consistent throughout the 48 hours. The headache never fully went away, lasting over a week.

Other Meds: Escitalopram 5 mg. Started on December 31st.

Current Illness: N/A

ID: 1006054
Sex: F
Age: 29
State: TN

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
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: Varicella vaccine and citric acid

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Swelling of lips, tongue and throat. Numbness of her mouth and cheeks.

Other Meds: None

Current Illness: None

ID: 1006055
Sex: F
Age: 61
State: CA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/05/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA Approximately 3 mins after vaccination, pt reports nausea, dizziness, chest pressure, and profound weakness. Brought to Emergency Department by crisis RN where she remains achy with weakness, fatigue and had no energy. Pt reports "feeling tired" and "my speech is slower". On exam, slight R facial droop noted, tongue noted to be leaning towards the right, pronator drift noted in R arm. Code Brain activated with real time audio video interaction. MRI completed with normal results. Symptoms resolved. Stroke team ok with discharge to home with f/u with PCP.

Other Meds:

Current Illness:

ID: 1006056
Sex: F
Age: 50
State: CA

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 02/05/2021
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: penicillin and iodine

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

Symptoms: Left arm injection site, itcy and tingling on down both arms, flushed throughout body, 140/80 BP, HR 71 and RR 18. Headache later that night, with chills and fever for 2 days. Took Tylenol.

Other Meds: vitamin c, fish oil, vitamin d, tumeric

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm