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: 1033842
Sex: F
Age: 56
State: PA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/16/2021
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: Bactrim and bees Atmosphere allergies (dust, trees, animals, etc)

Symptom List: Dysphagia, Epiglottitis

Symptoms: Large red circle, very hot with lump in middle. Iced it which seemed to help along with taking a benedryl. Area stayed this way for 1 1/2 weeks with arm staying sore. Red circle went away and then few days later became itchy and noticed same red spot for 1 week. Then circle became like black and blue mark. Was going to call the doctor 2nd time around but then redness went away and just noticed black circle. Now all clear. I am Rh negative and carry a card that was given to me when I delivered my daughter in 1981. Also carry a Antibody Identification card that was given to me when I donated blood years ago. I have Lea antibodies. Not sure if any of this has to do with reaction but hope it doesn't happen with my second dose. My sister is a nurse and said she nor anyone in her family had that type of topical reaction. My friend gave me this paper with the information but I didn't receive it when getting mine and we both went to same place or I would have reported sooner.

Other Meds: Montelukast, 10 mg Famotidine, 40 mg Pantoprazole, 40 mg Allegra Flonase Multvitamin

Current Illness: N/A

ID: 1033843
Sex: M
Age: 94
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/16/2021
Hospital: Y

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

Lab Data:

Allergies: nka

Symptom List: Anxiety, Dyspnoea

Symptoms: 2/12/2021 @ 5:30 started to develop rapid heartbeat, high pulse of 175, called 911, transported to hospital, treated by shocking(incorrect term) kept overnight discharged 2/13 afternoon. Next incident was 2/15 @ 5:00am same series of events and is still currently at hospital still being treated as of 2/16/21 afternoon.

Other Meds: amiodarone, lisinopril, metorprolol, tamsulosin,

Current Illness: Tachycardia Ventricular

ID: 1033844
Sex: F
Age: 62
State:

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/16/2021
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: Chills, aching joints.

Other Meds:

Current Illness:

ID: 1033845
Sex: M
Age: 65
State: OH

Vax Date: 02/01/2021
Onset Date: 02/14/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Red eye and elevated heart beat

Other Meds: Bydureon metformin metropol amolodipine altrvastin Jardiance

Current Illness:

ID: 1033846
Sex: F
Age: 64
State: PA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/16/2021
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: At 6:30 p.m. I began with palpitations of heart, lasted about 90 minutes. The palpitations were intermittent. The night and next day I had musculoskeletal pains, and tiredness. The primary thing I would like to report is that starting on Saturday, Feb. 13th around 8 pm, I began with a cold sore, or fever blister of upper lip. Over the course of the next 24-36 hours, I developed at least 4 more fever blisters. I am not prone to fever blisters, and have never in my life had more than one, infrequently. They are on upper and lower lip, and one is even immediately below my lip, on my skin that is not mouth mucosa. They are painful .

Other Meds: No OTC or prescription medications. Daily: Mulltivitamin, Vit. C, , Calcium with Mg , Zinc and Vit. D

Current Illness: None

ID: 1033848
Sex: F
Age: 27
State: MD

Vax Date: 02/12/2021
Onset Date: 02/16/2021
Rec V Date: 02/16/2021
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: Bactrim

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

Symptoms: Within 15 minutes of receiving the vaccine, I was dizzy, nauseous, and elevated BP (140?s/90?s). After about 30 minutes, these symptoms subsided. At 1:30 AM on 2/13, I woke from sleep with severe epigastric pain, chest pain, and pain between my shoulder blades. My arm (where I received the vaccine) was throbbing and I had severe under arm pain on the same side. Symptoms lessened with 2 extra strength Tums, 500 mg Tylenol, and 30 mL of Pepto, but were still present. I was able to sleep, I woke up later in the morning with these persistent symptoms, as well as fatigue. All of these symptoms continued for 24h. On 2/14, I had lessened arm pain and fatigue but continued to have epigastric/chest/back pain. I was seen at the urgent care near me and my physical was normal, they indicated that the chest symptoms were likely from epigastric pain since I was not having shortness of breath. I?ve continued to have these seemingly random chest pains and back pains, they?re very intense throbbing sharp pains in my chest and back that do not always coincide with exercise or stress.

Other Meds: Pepcid AC daily, Allegra 24 hour allergy pill daily

Current Illness: N/a

ID: 1033849
Sex: F
Age: 32
State: CA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/16/2021
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: Cilantro & beer - migraines

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Severe shoulder pain, painful to touch, hard & swollen 24-48hours after injection- Treated with Tylenol, Ibuprofen, CDB oil, Ice. resolved to soreness 48-72 hours Delayed injection site rash 10 days after first dose

Other Meds: Breo- steroid inhaler, Singular, Aspirin, multivitamin

Current Illness: Chronic health issues since COVID 3/2020: Reactive airway, Chronic Fatigue Syndrome crash (1/8/21)

ID: 1033850
Sex: F
Age: 46
State: IA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to eggs and zoloft.

Symptom List: Pharyngeal swelling

Symptoms: By minute 5, I had numbness in the arm, numbness and tingling in the lips and tongue. By minute 12, I had flushing and passed out. I came back and all of the sudden my words started not making sense and I couldn't move my arms or legs. My speech got better but it continued to be slurred, lost use of my legs 3 different times.

Other Meds: I take dulara, singular, topamax, carafate, pantoprazole.

Current Illness: No

ID: 1033851
Sex: F
Age: 45
State: TX

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: Bactrum and Humira

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Extreme vomiting starting at 4:30am following the vaccination, extreme nausea and fever in excess of 102 degrees and up to 104.5 degrees lasting for over 24 hours even while taking Tylenol every 6 hours in an effort to try to. control it. Also experienced extreme diarrhea for 24-36 hours after vaccination with not as extreme diarrhea lasting for two to three days.

Other Meds: Synthroid, Hydrochlorothiazide, Losartan and Claritin

Current Illness: None I am aware of

ID: 1033852
Sex: F
Age: 44
State: MA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/16/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Increasing redness, swelling, heat and tenderness over the last 24 hours at the injection site. It is increasingly painful to move my arm involving muscles around the site.

Other Meds: Advair Pantoprazole Myrbetriq IC Bupropion Stool softener Polyethylene glycol 3350 Vitamin D Fish oil Hair skin and nails supplement Spirolactone Fiber laboring plus calcium VSL3 Noethindrone acetate and ethinyl/estradiol tablets

Current Illness: None

ID: 1033853
Sex: F
Age: 75
State: SC

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Profound fatigue and generalized soreness most severe on days 2 and 3 after vaccination, but lasting seven days. No fever or chills. Arm sore, warm and swollen, but not red. It is the severity of the reaction and its duration that prompts this submission.

Other Meds: ONCE DAILY: ? Cymbalta 120 mg QD (MUST BE LUPIN; dose increase 2/10/17; BID to QD 9/7/17) ? Bystolic 10 mg daily (restarted on 6/1/19 after Carvedilol failure) controlled tachys ? Wellbutrin XL 150 mg QD (started 5/6/17) ? Norvasc 5 mg dail

Current Illness: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

ID: 1033854
Sex: F
Age: 71
State: TX

Vax Date: 02/08/2021
Onset Date: 02/14/2021
Rec V Date: 02/16/2021
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: Aspirin

Symptom List: Rash, Urticaria

Symptoms: 2 1/2" X 2 1/2" red circle at the injection site. Itching and redness began on day 6 after the immunization. The red circle is puffy and very firm.

Other Meds: Benedryl

Current Illness:

ID: 1033855
Sex: F
Age: 58
State:

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/16/2021
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: Fatigue, headache, joint pain, fever.

Other Meds:

Current Illness:

ID: 1033856
Sex: M
Age: 75
State: OR

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/16/2021
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: fuzzy head. right leg thigh itching, first 1-1/2 hrs. went to bed at 9:30pm, restless night (woke up 30 plus times night long) after waking up next morning at 7:00am, no desire to eat, no energy and all around weakness, stiff neck, stomach cramps, dizzy-light headed, went back to bed at 8:30am, could not sleep, got up at 9:30am, felt almost normal again. Normal again at 10:00

Other Meds: none

Current Illness: Type II Diabetes

ID: 1033857
Sex: M
Age: 68
State: CA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/16/2021
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: unknown

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

Symptoms: Hx of vertigo, migraine associated, 5 days after 1 vaccine 1/4/2021 had an episode of vertigo 1/18, later in January had another episode of vertigo. Last night was the 3rd episode. #1 Moderna 12/30/20. Reports acute episode of vertigo 1/4 (5 days post vaccine). A second episode 1/18 (19 days post vaccine). Decided to delay getting #2 Moderna by one week. Received #2 Moderna on 2/3. c/o mild fatigue 24-48 hrs post vaccine. Reports a 3rd episode of acute vertigo 6 days post #2 Moderna on 2/9. Each episode of vertigo lasted 2-5 hrs associated with n/v/diarrhea. No meds taken to treat sx. vertigo following a URI 11/2017. Complete w/u by physician 3/2018 with audiology testing and brain imaging. Found to have some sensorineural hearing loss in left ear. Poss vestibular migraines vs Meniere's Disease. Remote hx headaches and ocular migraines with aura. No episodes of vertigo since 2018 until these recently described episodes in the 1-2 week period following vaccine administration.

Other Meds: unknown

Current Illness: unknown

ID: 1033858
Sex: M
Age: 88
State: MN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/16/2021
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: Severe Weakness, Fever up to 100.4, fall, chills Still occurring today but has improved.

Other Meds: Lisinipril, Prevacid, Glucosamine, Cinnamon, Flax seed oil

Current Illness: Has had some "sinus" problems, has a slight cough

ID: 1033859
Sex: F
Age: 93
State: TX

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 02/16/2021
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: In the morning following the shot, she could not get out of the bed without assistance. She was very weak and could not stand by herself. She did not want to eat very much. Then by lunchtime, she was running a fever of 102.5 fever for many hours. We put her to bed. On Sunday morning she was much better with a better appetite and no fever. She also had normal amount of energy. She had a rash on her arm that received the shot and it ran from her spot of injection to her elbow. It was hot with the rash for about 5 days.

Other Meds: 28mg Iron capsule, 81mg Aspirin, 25mg metoprolol tartrate tablet twice a day, 20mg simvastatin tablet, 5mg melatonin

Current Illness: none

ID: 1033860
Sex: F
Age: 69
State: NC

Vax Date: 01/31/2021
Onset Date: 02/05/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: No. Possibly allergic to wild mushrooms.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Tired for two days following vaccine, large red mark on arm, itching on arm. A week later fairly severe lymph node swelling under arm of the arm that had the vaccine shot. This lasted for three days.

Other Meds: Calcium, Vitamin D, macular degeneration vitamins

Current Illness: No

ID: 1033861
Sex: F
Age: 76
State: NY

Vax Date: 01/19/2021
Onset Date: 01/21/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs Had severe reaction to Reclast infusion for osteoporosis; ended up in hospital for five days

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I developed all the symptoms of Covid, except fever. The cough was the worst. Had taste, but it is still off; nothing tastes right. I had a Covid test on 01/24/2021 that came back negative. I had two more tests in the hospital on 2/9/2021 that also came back negative. I went to hospital on doctor's orders due to some blurry vision and concern about blood clots, which I did not have. Symptoms persisted until 2/12/2021.

Other Meds: Vitamin B Complex, Vitamin D

Current Illness: None

ID: 1033862
Sex: F
Age: 35
State: KY

Vax Date: 01/27/2021
Onset Date: 02/03/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: No allergies or previous vaccine reactions

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

Symptoms: Symptoms started 02/03, classic exacerbation of NMO. Saw MD on 02/08 and started steroids. Symptoms continued to progress. Hospitalized 02/14, now greeting high dose IV steroids and starting plasmapheresis tomorrow

Other Meds: propranolol, aspirin, duloxetine, enoxeparin, estrogen, and rituximab

Current Illness: NA

ID: 1033863
Sex: F
Age: 73
State: MI

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/16/2021
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: Ampicillin Penicillin Sulfa Tetracycline Erythromycin Cinnamon

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

Symptoms: Awoke at 1:34 AM and my left foot hurt. I had a marble-size lump and a few small lumps on the vertical bone above my heel that were tender to the touch. My foot on top was slightly swollen and shiny and red on the side and both were tender to the touch. I massaged my foot and went back to sleep. When I awoke the marble-sized lump was much smaller. I got up, ate, and in the afternoon after research, I realized it was gout and I had tophi for the first time ever. I had my first gout flare in November 2003 without tophi, and never had another flare until 2/14/2021! I walked and suddenly my Achilles? tendon hurt and my heel hurt a little. I took 2 Colchicine and took one more an hour later. It seemed much better and didn?t hurt but some of the pain returned. I couldn?t sleep until 4:05 AM and awoke around 6 according to my Fitbit watch. I contacted my doctor and he said to take one Colchicine every day until the pain is gone.

Other Meds: Escitalopram Allopurinol Levothyroxine Low dose aspirin D3 50 mcg Ocuvite

Current Illness: None

ID: 1033864
Sex: F
Age: 75
State: VT

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: amoxicillin latex & rubber neosporin

Symptom List: Unevaluable event

Symptoms: On 1/28/21, developed Shingles on left midriff. Dr. contacted on Friday, 1/29/21. Diagnosis was confirmed. Medication prescribed : Acyclovir 400 mg; 2 tablets (800 mg total) 5 times per day. Plus Acyclovir 5% ointment, apply to affected area as needed. Subsequently, developed severe pain in the affected area on 1/31/21. Prescribed Gabapentin, 100 mg. Dosage: 3 capsules ( 300 mg) 3 times per day. As of 2/16/21, developing numbness and tenderness in affected area.

Other Meds: Celebrex - 200 mg Estrace - 1 mg

Current Illness: none

ID: 1033865
Sex: F
Age: 73
State: IL

Vax Date: 01/29/2021
Onset Date: 02/01/2021
Rec V Date: 02/16/2021
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: Penecillin Sulfa

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

Symptoms: Three days after vaccine on Feb 1 headache, red and burning face and ears

Other Meds: Amlodopine Restasis Vitamin D3 Aspirin Lutein

Current Illness: None

ID: 1033866
Sex: F
Age: 46
State: NJ

Vax Date: 02/08/2021
Onset Date: 02/16/2021
Rec V Date: 02/16/2021
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: Idiopathic hives that seem connected to alcohol and some foods but not tested.

Symptom List: Injection site pain, Pain

Symptoms: I noticed red hives around the injection site today and my arm feels heavy, The injection site feels a little hard to the touch. It is a little warm as well.

Other Meds: Elderberry gummies

Current Illness: None

ID: 1033867
Sex: F
Age: 38
State:

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: PCN, Clindamycin,Lortab, Morphine

Symptom List: Injection site pain, Menorrhagia

Symptoms: Developed a red, raised, itching rash at the injection site 7 days after injection. Rash spread in a circular pattern over the course of 2 days, then began to resolve, clearing up from the center of lesion outward.

Other Meds: Vitamin D3, Singulair, Zyrtec

Current Illness:

ID: 1033868
Sex: F
Age: 68
State: NE

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/16/2021
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

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

Symptoms: swelling of arm under vaccination site, headache, fever, fatigue, joint pain, chills, dry heave cough, body aches, taste off

Other Meds: Hydrocodone, Aspirin, Tylenol, Vitamin C

Current Illness: Knee Surgery 1/5/2021

ID: 1033869
Sex: F
Age: 79
State: NC

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/16/2021
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: tree nut and MSG allergy (hives, swelling, pruritis),

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 91.2kg 79 yo nonsmoking/nonEtOH drinking M with PMH significant for Parkinson's disease, postural hypotension, recent hip surgery and eye problems was at the vaccine clinic for his 2nd Covid-19 vaccine with the product. Allergy history includes tree nut and MSG allergy (hives, swelling, pruritus) and Sinemet, midazolam and fentanyl causing nausea or vomiting. After IM injection of the vaccine (lot # EM9810) into his left arm, the patient felt lightheaded. Patient was diaphoretic and pale. BP was 64/49 with HR 66 and O2 sats 92% on room air which is near baseline. Patient was moved to a recliner chair with feet elevated and given something to drink and monitored

Other Meds: Zinc, viamins, acetaminophen, brimonidine ophth,

Current Illness:

ID: 1033870
Sex: F
Age: 66
State: AZ

Vax Date: 02/13/2021
Onset Date: 02/15/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: Tetracyclene, Flonase, Prednisone (DELTASONE) 20 mg

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Feeling of elevated temperature, rash, light headness, nausea, feeling of lump in the throat.

Other Meds: None

Current Illness: Inner ear infection

ID: 1033871
Sex: F
Age: 72
State: LA

Vax Date: 02/04/2021
Onset Date: 02/14/2021
Rec V Date: 02/16/2021
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: No known allergies

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

Symptoms: Covid arm. Baseball size red circle that is itchy and swollen.

Other Meds: Triamterene/HCTZ; Premarin; Omeprazole; Atorvastatin Nitrofur Mac Vitamin D3 Calcium Krill Oil

Current Illness: None.

ID: 1033872
Sex: F
Age: 66
State: IL

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: Bactrim Zetia Tape Lisinopril

Symptom List: Nausea

Symptoms: patient received covid vaccine. screening questions answered. administered vaccine at 1321pm. patient wheeled to vaccine waiting room. patient became lethargic and blacked out. patient not alert and awake for approximately 1 minute. patient came to, pulse 80, blood pressure 93/70, oxygen saturation 98%, husband at side, emergency cart and AED and oxygen brought to location of the patient. oxygen 2L nasal canula placed on patient. EMS called and Dr. came to site. assessment obtained with Dr. at site. patient awake, was able to speak full name but stated she was not aware of where she was. this reaction happened approximately 6 minutes post immunization. within approximately 3 minutes of episode where she states she felt she was going to "black out" she began to shake/ full body involvement. during this episode patient was following nurse commands. momements were rhythmic and lasted approximately 10 seconds then stopped. Patient brought back to exam room. at 138pm- temp 97.5, blood pressure 144/31, pulse 51, respiration 18. patient stated she felt warm and reports she felt she was going to black out. this episode lasted approximately 3 seconds and patient became alert at that time. vitals at 140 pm- blood pressure 124/60, pulse 75, respirations 16. vitals at 144pm- blood pressure 119/75, pulse 75, respirations 16. patient has dialysis 4 times a week for CKD stage 5. patient has lengthy medical history. patient reports her primary care doctor is Dr. who sees her frequently. patient reports she has an issue with internal bleeding with source unknown and at times has to have blood transfusions. no recent illnesses reported. patient states she ate breakfast around 10am today. patient states she has never had a vaccine reaction int he past or reaction to needles. EMS arrived on site approximately 1345. report given to EMS. patient alert with EMT. patient transferred from her personal wheelchair to EMS cot. patients husband left with patient to go to Medical Center. Patient tolerated vaccine well immediately after immunization. She reported no pain at injection site. Paper tape and 2x2 gauze placed at injection site due to allergy to tape. Allergy list was reviewed prior to administration of vaccine. Patient alert and oriented prior to vaccine to person place and time. Husband present in room. Verbal consent obtained by patient to receive covid vaccine today . Vaccine information handout and emergency use handout given to patient. Patient wheeled out of exam in wheelchair.

Other Meds: albuterol (PROAIR HFA) 108 (90 Base) MCG/ACT Aerosol Solution aspirin EC 81 MG PO TBEC atorvastatin (LIPITOR) 80 MG Tablet B Complex-C-Folic Acid (DIALYVITE TABLET) Tablet BAYER CONTOUR TEST Strip BAYER MICROLET LANCETS Misc calcitRIOL (ROC

Current Illness: None Reported

Date Died: 02/01/2021

ID: 1033873
Sex: F
Age: 25
State: IL

Vax Date: 01/20/2021
Onset Date: 02/01/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: UNKNOWN

Symptom List: Injection site pain

Symptoms: PATIENT PASSED AWAY ON 2-1-2021

Other Meds: VENLAFAXINE, LOSARTAN, TRAZODONE. THERE MAY BE OTHERS. SHE WAS PARTICIPATING IN A CLINICAL TRIAL

Current Illness:

ID: 1033874
Sex: F
Age: 49
State: VA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/16/2021
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: Started itching at injection site, feels warm,red blotches on neck, chest. Think from mask. Switched out mask. Will sit 10 more minutes per EMS. Take benadryl at home

Other Meds:

Current Illness:

ID: 1033875
Sex: F
Age: 52
State:

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/16/2021
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: right breast pain.

Other Meds:

Current Illness:

ID: 1033876
Sex: M
Age: 70
State: MO

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/16/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

Symptom List: Tremor

Symptoms: EMS reported around 3:30 pm, patient started not feeling right. He had some tingling sensation in his left arm. Per family patient had slurred speech was not acting right. He did slide out of the chair he was sitting in. He was ambulatory on scene. Symptoms lasted approximately 5 minutes and then gradually resolved. Upon arrival to the emergency department symptoms had significantly improved. Patient reports he is feeling a lot better. Patient did receive his second covid vaccination 2 hours prior to arrival. His never had a stroke in the past. Patient was otherwise feeling at baseline earlier today. No chest pain shortness breath nausea vomiting diarrhea comes patient fever chills headache.

Other Meds: Atorvastatin 20 mg daily glimepiride 4 mg BID lisinopril 20 mg bid metformin 1000 mg BID rivaroxaban 20 mg daily tramadol 50 mg q4h prn dofetilide 250 mcg bid carvedilol 6.25 mg po BID MVI daily

Current Illness:

ID: 1033877
Sex: F
Age: 54
State: AZ

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/16/2021
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: Erythromycin, bactrim, gluten, several foods & plants (grasses, trees)

Symptom List: Erythema, Pruritus

Symptoms: 24 hrs later - severe- headache, nausea, chills, aches - lasted about 6 hrs. No treatment

Other Meds: Ajovy, Sumatriptan, Loratadine, 0xcarbazepine. Vit d3, b12, multivitamin, fish oil, ginger, turmeric, oregano oil

Current Illness: Na

ID: 1033878
Sex: F
Age: 74
State: WA

Vax Date: 01/30/2021
Onset Date: 02/14/2021
Rec V Date: 02/16/2021
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: Nifedipine and Diltiazem both lowers Blood Pressure.

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

Symptoms: Itching and red circle appeared. Did not report , because I thought this was so minor. redness gone, itch a little still.

Other Meds: Metformin, Potassium cl, Vitamin B12, Aspirin, Clopidogrel, Chlorthalidone, Atorvastatin, Losartan, Pantoprazole, Januvia.

Current Illness: none

ID: 1033879
Sex: M
Age: 75
State: NJ

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/16/2021
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 known

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

Symptoms: soft lump on right elbow. Size of golf ball

Other Meds: Metoprolol. Tamsulosin. Centrum multivitamin

Current Illness: none

ID: 1033880
Sex: F
Age: 56
State: WA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 02/16/2021
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: sulpha

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Immediately, my arm was in pain. It was like I had been stung by 100 bees. I went back to school but I couldn't use my arm. It lasted two or three days. On second day, I took Ibuprofen and that helped. In the middle of the night (the night after I got my shot, it woke me up with terrible abdominal pains; chills; body aches. By the morning, the abdominal pain was gone - chills, aches and some fatigue. I went and taught school but it got progressively worse and I went home at lunch time. I had a slight fever - it was a high fever for me as I usually run low (96.5). It was about 100.9. I called the clinic the next day (Saturday) because my other symptoms had more or less abated but my left arm was very, very swollen from shoulder to elbow. My coat was too tight on my arm when I tried to put my coat. My arm was cold and my fingers were number. He is the one who told me to take Ibuprofen and elevate my arm and ice it. After the next three days, gradually my swelling went down and my doctor told me to keep using it and keep it moving which I did. Monday, the clinic called to have me talk to the doctor to see about taking the second dose. Doctor said to take the second dose. 2nd dose was much easier for me. My arm symptoms were resolved after about a week.

Other Meds: no

Current Illness: none

ID: 1033881
Sex: F
Age: 71
State: WI

Vax Date: 02/03/2021
Onset Date: 02/10/2021
Rec V Date: 02/16/2021
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: Sulfa

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

Symptoms: Large red itchy welt appeared at injection site, one week later. No treatment. It's still there 6 days later.

Other Meds: Magnesium, Vitamin D3, Senna, Vitamin B complex, iron, Vitamin C, Acetaminophen

Current Illness: None

ID: 1033882
Sex: F
Age: 56
State: IA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/16/2021
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 - hives Tegratol headache Novacaine rapid heart rate

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

Symptoms: Increased heart rate to 105 within 5-10 minutes after shot then a mild feeling of nausea. Heart rate decreased to 80 Within 20 minutes

Other Meds: Metformin Atrovastatin Losarton

Current Illness: None

ID: 1033883
Sex: F
Age: 34
State: UT

Vax Date: 01/13/2021
Onset Date: 02/01/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Pain in extremity

Symptoms: Dizzy from morning to night daily

Other Meds: Spironlactone, multi vitamin, vitamin d, calcium

Current Illness: None

ID: 1033884
Sex: F
Age: 21
State: MA

Vax Date: 02/04/2021
Onset Date: 02/13/2021
Rec V Date: 02/16/2021
Hospital:

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

Lab Data:

Allergies: Cat hair

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

Symptoms: After the shot, my arm was swollen for 3 days and a small rash but it went away. Then, on Feb 13th a rash started to reappear that was warm to the touch and itchy and burning. I applied cortisone but rash on injection site kept growing. On Feb 14th, I woke up and rash was a bit smaller but every two hours I would have a tingling sensation like when your foot falls asleep but it went up my shoulder and back area up to my neck and occurred every 2 hours. I then was advised to take claratin, add more cortisone, and take Benadryl as well. The itchiness stoped. My rash is still there but it?s very light compared to feb 13th.

Other Meds: Sprintec, birth control, 0.250mg

Current Illness: None

ID: 1033885
Sex: F
Age: 42
State: PA

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/16/2021
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: Food and environmental allergies, mild. Possible allergy to doxycycline.

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

Symptoms: I felt fine that day and waking up the next. Then as I moved around, I started to feel uneasy. I vomited forcefully several times. My neck and upper back became stiff and painful. Then came chills, shaking, and more nausea. My throat felt like there was a lump in it that was closing me off. I felt very weak and easily fatigued. I started to have visual issues, confusion, and was unable to focus. Neck pain continued to be severe. The next morning I woke feeling good, but within 2 hour again I went downhill. Symptoms are only about half as bad as the day before. Very very tired.

Other Meds: Singular, Zoloft, Nasonex

Current Illness: None

ID: 1033886
Sex: M
Age: 66
State: CA

Vax Date: 01/23/2021
Onset Date: 01/31/2021
Rec V Date: 02/16/2021
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: Unknown

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

Symptoms: Vaccinated 1/23, 1st dose COVID 1/31/21.

Other Meds: Unknown

Current Illness: Unknown

ID: 1033887
Sex: F
Age: 65
State: MI

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/16/2021
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: Allergic to bee stings

Symptom List: Vomiting

Symptoms: Had chest pain, difficulty breathing approximately 30 minutes after shot. Also sharp pain left forehead. Lasting approximately 15-20 minutes.

Other Meds: Victoza, lantus, metformin, cetirizine, montelukast, colestipol, lisinopril, biotin, coq-10, vitamin d3, d-mannose, hair skin and nails, cranberry, multiple vitamin, macrobid, estradiol vaginal insert

Current Illness: UTI

ID: 1033888
Sex: F
Age: 57
State: NY

Vax Date: 02/04/2021
Onset Date: 02/01/2021
Rec V Date: 02/16/2021
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: I was sore and extremely tired, also headache but now I have a bad sore throat that has not resolved. I am concerned because I took Tylenol before my second shot and have now heard that I shouldn?t have.

Other Meds: Caltrate, vitamin D with K2, Zyrtec, Tylenol

Current Illness: No

ID: 1033889
Sex: M
Age: 69
State: IL

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/16/2021
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: None

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

Symptoms: Severe muscle aches, joint pain, chills, return of cough

Other Meds: Praluent, Warfarin, Metoprolol Tartrate, Allopurinol, Ezetimibe, Furosemide, Pramipexole, Cyclobenzaprine, Promethazine, Lisinopril, Tamsulosin, Fenofibrate, Centrum Silver.

Current Illness: None (I did have Covid-19 5 weeks prior to the vaccination)

ID: 1033890
Sex: F
Age: 64
State: TX

Vax Date: 01/19/2021
Onset Date: 01/22/2021
Rec V Date: 02/16/2021
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: NKA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 1st day - patient reports everything was ok. 2nd day - patient reports pain at the injection site, and it was painful to move her arm. 3rd day - patient reports that it was painful to move her arm, that she had to move slowly to avoid causing pain. She reports intermittent pain, level 8-9/10, caused by motion, that irradiated to her back and it was controlled using Advil. She reports a 6-7/10 pain level after taking Advil. She refers to experiencing this kind of pain on day 3 to 4 post-injection, did not feel it on day 4 to 5, but again on day 5 to 6 experienced it again. Now she reports "feeling like it's coming" but she rests and it gets better. 4th-5th day - patient reports abdominal discomfort, like the one caused when a "baby moves in your womb". To this day, she refers feeling weak, sometimes when lifting her LT arm she feels intermittent weakness from her hand to her elbow and has to rest her extremity. Today she reports waking up with a discomfort in the back of her neck that lasted 10 minutes and then was able to move her neck/head side to side and up and down.

Other Meds: levothyroxine sodium 112 mcg take 1 tablet by oral route every day lovastatin 20 mg take 1 tablet by oral route every day with the evening meal NORVASC 10 mg take half tablet by oral route every day ZESTORETIC 10 mg-12.5 mg take 1 table

Current Illness: COVID19 Infection (07/2020)

ID: 1033891
Sex: F
Age: 22
State: RI

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/16/2021
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: Vaccine given at 3:30pm Left Arm; At 3:45 she reported that her right arm felt like she had the injection in it. It felt "heavy". She went upstairs to work and felt immediately her LEFT leg felt like it was "falling asleep" pins and needles up calf and back felt heavy.; 3:45 examined, no SOB, lips and mouth okay, right arm non remarkable. 4pm BP 236/80 HR 96 POX 98; 4:15 No change, had her have some water, go for a walk. 4:30 feels the same, pins and needle in leg, but otherwise fine. Working with nurses for next few hours. Told her to report any issues to nurses.

Other Meds: unknown

Current Illness: none known

ID: 1033892
Sex: F
Age: 89
State: CA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/16/2021
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: bp medicine

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

Symptoms: pt stated after she got her vaccine she had to use the bathroom right away. she went home and went to straight to the bathroom. When she urinated it was dark gold color. She thinks the vax medicine went straight to her kidneys. She has urinated since this episode and said her urine was back to normal. Pt has not contacted her PCP at this time since he urine returned to normal color.

Other Meds: Spiriva

Current Illness: no

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm