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: 1049579
Sex: F
Age: 60
State: VA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/23/2021
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: Fever, Body ache, headache

Other Meds:

Current Illness:

ID: 1049580
Sex: F
Age: 47
State: LA

Vax Date: 01/12/2021
Onset Date: 01/23/2021
Rec V Date: 02/23/2021
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: At approximately 42 hours after vaccination developed a rash covering approx. 50 to 60% of body. resolved in less then 12 hours after taking oral Benadryl and Benadryl cream.

Other Meds:

Current Illness:

ID: 1049581
Sex: M
Age: 70
State: SD

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/23/2021
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: no known allergies

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

Symptoms: Veteran reported he was dizzy with flu-like symptoms for 2 days

Other Meds: Pimavanserin, Tamsulosin, Carbadopa/Levadopa, Pantroprazaol, Tramadol, Docusate/Sennosides, Amitriptiline, Certrizine, Aspirin, Zolpidem, Baclofen, Diclofenac, Allopurinol, Simethicone, Polyethylene Glycol, Fish Oil, Garlic, Senior Multi-v

Current Illness: none

ID: 1049582
Sex: F
Age: 42
State: CO

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Site: Pain at Injection Site-Medium, Systemic: Weakness, Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1049583
Sex: F
Age: 66
State: IL

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 02/23/2021
Hospital:

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

Lab Data:

Allergies: Latex Iodine

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

Symptoms: Emergency room 1/25/21 HPI patient is a 66 y.o. female who presents with dizziness, nausea, and vomiting. Patient reports that she began having acute episodic dizziness and vertigo early this morning when she rolled over in bed. She states the dizziness became so bad it made her nauseous and she began vomiting. Patient reports she tried to take a Dramamine but was unable to keep it down, and thus it did not help. ? Patient denies any ringing in the ears, decreased hearing, or ear pain. Patient does report she has had episodes of dizziness and vertigo like this in the past. Patient denies any fevers or chills. Patient does report mild frontal headache. Patient denies any chest pain, palpitations, or shortness of breath. ?

Other Meds: Current Outpatient Medications: ? calcium-vitamin D (CALTRATE 600+D) 600-400 mg-Unit per tablet, Take 1 Tab by mouth daily., Disp: , Rfl: ? Cod Liver Oil 10 MINIM CAPS, Take 1 Cap by mouth daily., Disp: , Rfl: ? Coenzyme Q10 (CO Q 10)

Current Illness:

ID: 1049584
Sex: M
Age: 78
State: IN

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/23/2021
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: Sulfa, Bactrim.

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

Symptoms: The following day after the vaccine at 5:00 AM he had joint and muscle pain and weakness, not able to move his legs. He would sit down in a chair and needed help to get back up. Headache, dizziness. He had a low grade fever of 100.1. This got progressively worse and then by evening got better. His wife called the visiting nurse that they had coming who she believes notified the doctor, and told them it would go away. By the next morning it was basically gone. He took Tylenol for the symptoms.

Other Meds: Bupropion XL, Tamsulosin, Duloxetine, Lamotrigine, Lisinopril, Donepezil, Olanzapine, Oxybutynin, Memantine. Multivitamin, low dose aspirin, Vitamin B complex,

Current Illness: Went into the hospital on 12/3/21 and diagnosed with COVID-19, then discharged from there and went to the nursing home for rehab. He came home 12/22/2020.

ID: 1049585
Sex: M
Age: 49
State: NM

Vax Date: 01/20/2021
Onset Date: 01/30/2021
Rec V Date: 02/23/2021
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: Seasonal allergies - juniper, grasses, trees, food - peaches, mild pet allergies

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: L shoulder pain with pain abducting arm at shoulder

Other Meds: Xarelto, Levothyroxine, MVI, Loratidine, symbicort

Current Illness: none

ID: 1049586
Sex: F
Age: 33
State: TN

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
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: Pharyngeal swelling

Symptoms: Whole body aches, fatigue, headache, weakness

Other Meds:

Current Illness:

ID: 1049587
Sex: M
Age: 35
State: NY

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/23/2021
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: Pt experienced back ache about 8 hours after receiving the vaccine. He described the pain as being stabbed in the kidneys. At 4 am on the day after his vaccine he woke up to a temp of103. He used a cold bath to reduce his temp and pain. Pt experienced more back pain latter in the day. He woke up the next day with more back pain and a temp of 104. Pt utilized a cold bath again.

Other Meds: Claritin D, Bystolic,

Current Illness: None

ID: 1049588
Sex: F
Age: 54
State: NJ

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/23/2021
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: sulfa

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 1/8 vaccination. My arm became tender, sore, hard at the injection site, red, hot, tender to touch. I went home. Fever over 101. I didn't feel well; fever chills, general malaise. Symptoms lasted for 2 weeks with sore arm. Probably 4-5 days with the flu-like symptoms. *took Tylenol

Other Meds: n/a

Current Illness: n/a

ID: 1049589
Sex: F
Age: 24
State: AK

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
Hospital:

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

Lab Data:

Allergies: Toradol Injection= Caused lip swelling

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

Symptoms: Visible lip smelling under lower lip margin 1.5 cm x .25 cm. Pt. also c/o tongue tingling. Pt. had no other symptoms. VS stable and lungs were clear. No other swelling. Responded well to benadryl orally with reduced lip swelling within 20 minutes. Sent home with instructions to RTC for any increase in sx. and to continue benadryl through the night. Allergy to COVID 19 vaccine Moderna added.

Other Meds:

Current Illness: No. Patient is BF.

ID: 1049590
Sex: F
Age: 30
State: OK

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
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: NONE

Symptom List: Rash, Urticaria

Symptoms: PATIENT BEGAN TO HAVE SHORTNESS OF BREATH AND PASSED OUT AFTER ADMINISTRATION

Other Meds: NONE

Current Illness: NONE

ID: 1049591
Sex: M
Age: 15
State: MA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/23/2021
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: Error: Patient Too Young for Vaccine Administered

Other Meds:

Current Illness:

ID: 1049592
Sex: M
Age: 65
State: DC

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
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: Woke at 1 am with chills, fever and severe headache. Chills subside after 45 minutes. Woke at 4 am with severe headache and 102 degree fever. Headache and fever resolved approximately 7 am.

Other Meds: None

Current Illness: None

ID: 1049593
Sex: M
Age: 69
State: CA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/23/2021
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: NKA

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

Symptoms: The pt began to have chills, fever, body aches, followed by acute urinary retention. His history of benign prostatic hyperplasia was well controlled prior to retention. He required catheterization for 800cc urine and needed Foley cath for 7 days. He has now recovered.

Other Meds: finasteride, Tamsulosin, lisinopril

Current Illness: BPH, controlled

ID: 1049595
Sex: F
Age: 39
State: MO

Vax Date: 02/09/2021
Onset Date: 02/17/2021
Rec V Date: 02/23/2021
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: N/A

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

Symptoms: Left arm sore for a couple days after the shot. Then woke up on day 9 after receiving and had hot, red, swollen, itchy rash. Rash is getting bigger as the days go on.

Other Meds: N/A

Current Illness: N/A

ID: 1049596
Sex: F
Age: 66
State: PA

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/23/2021
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: Fluoroquinolones Opioids Adhesives

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

Symptoms: Fever 102.6. Fever lasted 36 hours with a downward trend Achy lasted 2 days Headache lasted 2 days Nausea lasted 2 days Chills lasted 36 hours Site pain level 8 lasted one week with less pain each day Fatigue lasted 36 hours Tiredness lasted 36 hours Dizziness- lasted 5 days All adverse reactions have resolved

Other Meds: Lotrel 5/20 qd Magnesium Citrate qd Super -B Complex qd Vitamin D3 2500 IU qd Cranberry 4200 mg qd Calcium tab 600mg qd Centrum Women 50+ qd

Current Illness:

ID: 1049597
Sex: F
Age: 37
State: NY

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Low grade fever for 4 days, relieved by Tylenol.

Other Meds: Synthroid, lexapro, birth control pills

Current Illness: None

ID: 1049598
Sex: F
Age: 73
State: LA

Vax Date: 01/28/2021
Onset Date: 02/04/2021
Rec V Date: 02/23/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Left arm was red, itching after 7 days around injection site. ( lasted 4 days.) After 11 days top and bottom lips on inside of lips got fiver blisters. fiver blisters were still there after 3 weeks.

Other Meds: Triamterene 37.5 mg - Lisnopril tab 10 mg - Metformin850 mg - Meloxican 7.5 mg

Current Illness: none

ID: 1049599
Sex: F
Age: 34
State: SC

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 02/23/2021
Hospital:

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

Lab Data:

Allergies: Topamax

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

Symptoms: I started experiencing high fever, (103) body aches, muscles, nauseated, diarrhea, and migraine.

Other Meds: None

Current Illness: None

ID: 1049600
Sex: F
Age: 77
State: ID

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

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

Symptoms: Large local reaction to the injection site starting day of injection and worsening over 4 days time. Secondary cellulitis developed requiring antibiotic treatment.

Other Meds:

Current Illness:

ID: 1049601
Sex: F
Age: 66
State: IL

Vax Date: 01/12/2021
Onset Date: 01/28/2021
Rec V Date: 02/23/2021
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: Unevaluable event

Symptoms: Emergency room 1/28/21 HPI Patient is a 66 y.o. female who presents with complaints of left hip pain reports is moderate severe sharp ongoing over the past few days and aggressive worse reports symptoms is moderate

Other Meds: CURRENT MEDICATIONS No current facility-administered medications for this encounter. ? Current Outpatient Medications: ? aspirin 81 MG chewable tablet, Take 81 mg by mouth daily, Disp: , Rfl: ? Cholecalciferol (VITAMIN D3) 1000 units ta

Current Illness:

ID: 1049602
Sex: F
Age: 36
State: VA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/23/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: "Sick for a while"

Other Meds:

Current Illness:

ID: 1049603
Sex: F
Age: 59
State: OH

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

Symptom List: Injection site pain, Pain

Symptoms: Error: Wrong Patient (documentation in EMR)

Other Meds:

Current Illness:

ID: 1049605
Sex: F
Age: 32
State: HI

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 02/23/2021
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: Injection site pain, Menorrhagia

Symptoms: Tenderness on the injection site left arm, Right hip pain, Right elbow pain, Headache and fatigue

Other Meds:

Current Illness:

ID: 1049606
Sex: F
Age: 62
State: PR

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 02/23/2021
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: Septra.

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

Symptoms: Body aches, low blood pressure, tingling sensation in hands, symptoms lasted for a week.

Other Meds: Unknown.

Current Illness: Unknown.

ID: 1049607
Sex: F
Age: 61
State: KS

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/23/2021
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: Ultram

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The patient reports that the day following her 2nd vaccination she developed a fever (lasting 48 hrs) up to 101.1F, headache, abdominal cramps, nausea, diarrhea and numerous sores in her mouth.

Other Meds: Metformin, Effexor, Singulair, Tenoretic

Current Illness: Strep throat (dx'd shortly after receiving 1st dose on 1/20/2021). Diagnosed with internal shingles on 2/22/2021.

ID: 1049632
Sex: U
Age: 67
State: TX

Vax Date: 04/13/2009
Onset Date:
Rec V Date: 02/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: shingles; Information has been received from a lawyer regarding a case in litigation and refers to a currently 79-year-old patient (pt) of unknown gender. The patient's pertinent medical history, concurrent conditions and concomitant medications were not provided. On or about 13-APR-2009, pt was vaccinated with zoster vaccine live (ZOSTAVAX) for the long-term prevention of shingles and zoster-related conditions (strength, dose, route of administration, anatomical location, lot # and expiration date were not reported). Subsequently, on an unknown date, pt had shingles (herpes zoster) and received treatment for this injury. At reporting time, the outcome of herpes zoster was unknown and this event was considered to be related to zoster vaccine live (ZOSTAVAX).

Other Meds:

Current Illness:

ID: 1049636
Sex: M
Age: 93
State: NC

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/23/2021
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:

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

Symptoms: Very harsh dysrhythmia; Parkinson's symptoms got worse with joint contractions, stiffening, and confusion; Napping more; Blood pressure has been haywire, sometimes going high and sometimes low; A spontaneous report was received from a consumer, who was also the daughter of a 93-year-old male patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced a very harsh dysrhythmia (arrhythmia), Parkinson's symptoms got worse with joint contractions, stiffening, and confusion (Parkinson's disease); he has been napping more than before (somnolence), and blood pressure has been haywire, sometimes going high and sometimes low (hypertension, hypotension). Medical history, as provided by the reporter, included COVID in July 2020 from which he fully recovered, slight dysrhythmia, Parkinson's (tremors only), and slightly elevated blood pressure. The reported stated the patient's baseline health had been pretty good and he was usually mobile, active, cognitive, and had speech. Concomitant medications included carbidopa monohydrate (+) levodopa, losartan, beta blocker (unspecified), and liquid morphine. On 20 Jan 2021, one day prior to the onset of events, the patient received their first of two planned doses of mRNA-1273 (lot number: 028L20A) intramuscularly in his right (dominant) arm for prophylaxis of COVID-19 infection. On 21 Jan 2021, around 2 pm, the patient had "a very harsh" dysrhythmia and his Parkinson's symptoms worsened with joint contractions, stiffening, and confusion. He had also been napping more than before. Since getting the vaccine, his blood pressure "has been haywire", sometimes going high and sometimes low. Treatment information was not provided. The action taken with mRNA-1273 in response to the events was unknown. The outcome of the events, a very harsh dysrhythmia, Parkinson's symptoms got worse with joint contractions, stiffening, and confusion; napping more than before, and blood pressure has been haywire, sometimes going high and sometimes low, were considered not recovered/not resolved at the time of this report.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds: CARBIDOPA + LEVODOPA; LOSARTAN; BETA BLOCKING AGENTS; MORPHINE

Current Illness: Blood pressure increased (slightly); Dysrhythmias (slight); Parkinson's disease (tremors only)

ID: 1049637
Sex: M
Age: 65
State: CA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/23/2021
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: miembro viril esta muerto-virile member is dead; bad taste in mouth; loss of taste; legs are very weak especially in the knees, sometimes not able to stand in his feet; pain in the arm; A spontaneous report was received from a consumer who was also a 65-year-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced a little pain in the arm, bad taste in the mouth, loss of taste, legs are very weak, specially in the knees, not able to stand on his feet, and "miembro viril esta muerto" meaning "his virile member is dead" or having erectile dysfunction. The patient's medical history included a hernia intervention on 20 Jan 2021, HIV positive, and has headaches. Products known to have been used by the patient included a multivitamin and HIV medicines. Patient states that he received "injections for headaches in his brain, " however no medications are specified. Patient has no known allergies. On 25 Jan 2021, prior to the onset of the events, the patient received one of two planned doses of mRNA-1273 (Lot number: 042L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 25 Jan 2021, one day after the mRNA-1273 vaccine was given, the patient noted that he had a little pain in the arm but nothing to worry. On 28 Jan 2021, the patient stated that he started to have a bad taste in the mouth, loss of taste, legs are very weak, specially in the knees, not able to stand on his feet, and erectile dysfunction. Treatment information was not provided. Action taken with mRNA-1273 was not reported. The outcome of the events, little pain in the arm, bad taste in the mouth, loss of taste, legs are very weak, specially in the knees, not able to stand on his feet, and having erectile dysfunction is unknown.; Reporter's Comments: Based on the current available information, the absence of an other etiologies and temporal association between the use of the product and the start date of the reported event, a causal relationship cannot be excluded. Vaccination site pain is consistent with the known safety profile of the vaccine

Other Meds: MULTIVITAMIN [VITAMINS NOS]; HIV Medicines

Current Illness: Headache NOS; HIV positive

ID: 1049638
Sex: F
Age: 46
State: AZ

Vax Date: 01/13/2021
Onset Date: 01/15/2021
Rec V Date: 02/23/2021
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: Pneumonia; Loss of taste; Loss of smell; stared into space for hours; Covid Positive Test; Felt Spacy; Cough; A spontaneous report was received from a consumer concerning a 46 year-old female patient who experienced Covid-19 positive test [COVID-19], felt spacy [dizziness], stared into space for hours [staring], and pneumonia. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 13 Jan 2021, approximately five days prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided) intramuscularly for prophylaxis of COVID-19 infection. On 15 Jan 2021, the patient started experiencing symptoms of coughing. On 17 Jan 2021, the patient tested positive for Covid-19. The patient reported she felt spacy and stared into space for hours. On 19 Jan 2021, the patient experienced symptoms of loss of taste and smell. On 24 Jan 2021, the patient's oxygen levels were going down. Treatment for the event of Covid-19 included azithromycin, prednisone, albuterol, and cough medicine. On 28 Jan 2021, the patient tested positive for pneumonia. Treatment for the event of pneumonia included levofloxacin. Action taken with mRNA-1273 in response to the events was unknown. The event of pneumonia was considered resolved on an unknown date. The outcome of the event of Covid-19 was unknown. The events, felt spacy and stared into space for hours, were considered resolved on an unknown date.; Reporter's Comments: Based on the concurrent Covid-19 infection, the events are assessed as unlikely related to mRNA-1273.

Other Meds:

Current Illness:

ID: 1049639
Sex: F
Age:
State: NM

Vax Date: 01/26/2021
Onset Date: 02/05/2021
Rec V Date: 02/23/2021
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: swelling on the left side of my face; Bell's palsy/ left side can not function properly. I have little eye, mouth and forehead movement; This is a spontaneous report from a contactable consumer (patient). A 40-year-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: EL8982), via an unspecified route of administration (at the age of 40-years-old) on 26Jan2021 10:15 at a single dose in Left arm for COVID-19 immunization. Medical history was not applicable (N/A). The patient was not Pregnant at the time of vaccination. The patient's concomitant medications were not reported. The patient experienced swelling on the left side of my face and Bell's palsy/ left side can not function properly. I have little eye, mouth and forehead movement on 05Feb2021 10:30. The patient reported, "I have swelling on the left side of my face as well as Bell's palsy. My left side cannot function properly. I have little eye, mouth and forehead movement." The events resulted in Doctor or other healthcare professional office/clinic visit, Disability or permanent damage. The outcome of the events was not recovered. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. No other medications received within 2 weeks of vaccination. Therapeutic measures were taken as a result of the events which included anti-viral medication and a steroid. The events were assessed as serious (Seriousness criteria-Disabling/Incapacitating). Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19.

Other Meds:

Current Illness:

ID: 1049640
Sex: F
Age:
State: AR

Vax Date: 02/06/2021
Onset Date: 02/01/2021
Rec V Date: 02/23/2021
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: diarrhea and it was just all bright red fresh blood/bright red blood with diarrhea; bright red blood coming from her anal area; feel heaviness, she just feels that heaviness.; she lost weight; This is a spontaneous report from a contactable consumer (patient). A 81-year old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE lot number EM9809) (at the age of 81-years-old), via an unspecified route of administration on 06Feb2021 between 12:30 and 1PM as a single dose for covid-19 immunization. The facility where COVID-19 vaccine was a doctor's office and administered anatomically located on the right arm. The patient medical history included: She has been diagnosed years ago 10 years ago, which was since she smoked with COPD and she is on breathing medication, but she has not had it due to getting in a donut hole with insurance and she cannot afford it, her hands also won't let her use it, She hasn't had it for 2 months. Arthritis. She has had no other vaccines on the same day or in the past 4 weeks, she had the flu shot back in Oct2020. Family Medical History: Her dad had heart problems and cancer. Her brother had cancer. Her mother had heart conditions. Concomitant medications included: Acetaminophen and Naproxen sodium. She was taking a lot of acetaminophen and Naproxen sodium for arthritis pain, but she has not had any since Friday night 05Feb2021. She did not want to take anything before the shot. She hasn't been weighed in a while, she lost weight. On 06Feb2021, at 8 o clock on the night, she experienced bright red blood coming from her anal area; then, she had diarrhea and it was just all bright red fresh blood, it was fresh new blood not dark at all. Today she is still having bright red blood with diarrhea; the blood seems like it is decreasing, it's being colored by diarrhea. She felt maybe in so many years is like when you have a period at times and feel heaviness, she just feels that heaviness. Caller reports that she does have a standing appointment with her provider tomorrow. The clinical outcome of the events bloody diarrhea and anal bleeding was not recovered, heaviness and weight decreased was unknown. She is scheduled for the second dose on 10Feb2021.

Other Meds: ACETAMINOPHEN; NAPROXEN SODIUM

Current Illness:

ID: 1049642
Sex: F
Age:
State: SC

Vax Date: 12/30/2015
Onset Date:
Rec V Date: 02/23/2021
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: face was really red like an allergy; blood pressure went up to 170; face was really red like an allergy and neck was very red; Initial information regarding an unsolicited valid non-serious case was received from a consumer/non-health care professional. (Reference number- 00457128) and transmitted to Sanofi on 02-Feb-2021 This case involves a 68 year old female patient who had face was really red like an allergy (hypersensitivity), while she received INFLUENZA USP TRIVAL A-B HIGH DOSE SUBVIRION VACCINE [FLUZONE HIGH DOSE]. Medical history, medical treatment(s), past vaccination(s) concomitant medication and family history were not provided. On 30-Dec-2015, the patient received a dose of suspect INFLUENZA USP TRIVAL A-B HIGH DOSE SUBVIRION VACCINE (lot UI517AA and expiry date: 23-Jun-2016) via unknown route in unknown administration site for prophylactic vaccination. On an unknown date, the patient developed face was really red like an allergy (hypersensitivity) with their symptoms face was really red like an allergy and neck was very red (erythema) and blood pressure went up to 170 (hypertension) (unknown latency) following the administration of INFLUENZA USP TRIVAL A-B HIGH DOSE SUBVIRION VACCINE. Laboratory data was not provided. Patient was given 4 shots of steroids and her symptoms resolved after a few days. Patient also had to take Benadryl and went to a dermatologist because the redness on her face would not go away. At the time of reporting, the patient was not recovered from erythema and recovered from rest of the events.

Other Meds:

Current Illness:

ID: 1049644
Sex: F
Age: 68
State: OH

Vax Date: 02/12/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
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: Colgate toothpaste with the bubbles. Lip swelling and rash around mouth. Went to urgent care after 3 days as my symptoms had worsen. Given prednisone injection and tablets to take for 7 days. This was 4 or 5 years ago. Can still use Colgate but not that variety.

Symptom List: Erythema, Pruritus

Symptoms: Noticed redness at injection site and and just below injection site around 2 am Tuesday, February 23, 2021. It's not painful to the touch and does not itch. Some areas look like "welts".

Other Meds: Hydrochlorothiazide 12.5 mg 1 Every Monday, Wednesday, Friday (Did not take until after vaccination) Atorvastatin 10mg 1 at bedtime

Current Illness: No

ID: 1049645
Sex: F
Age: 76
State: TN

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
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: Argon gas

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

Symptoms: PATIENT PRESENTS TO COVID SITE FOR COVID VACCINATION. PATIENT'S PFIZER FORM INDICATES A FIRST DOSE NEEDED AND NO DOSE PREVIOUSLY GIVEN. PATIENT IS ADMINISTERED ONE PFIZER VACCINE LOT # EL9269 EXP 5/21 IN R DELTOID. UPON ENTRY INTO TENNIIS, IT IS DISCOVERED THAT THE PATIENT HAD IN FACT RECEIVED A FIRST DOSE OF MODERNA VACCINE LOT# 011J20A ON 1/11/21.

Other Meds: unknown

Current Illness: unknown

ID: 1049646
Sex: F
Age: 49
State: FL

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/23/2021
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: mushrooms, doxycillin, Zoloft, Nexium

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

Symptoms: redness and swelling at injection site, hematoma in lower abdomen, hematoma in right forearm

Other Meds: Zofran ODT 4mg; Bentyl 10mg; clonazepam .5 mg; Humolog 75/25; Duoneb; Singulair 10 mg; Protonics 40 mg; Prozac 20 mg; Atorvastatin

Current Illness: none

ID: 1049647
Sex: F
Age: 37
State: CO

Vax Date: 01/19/2021
Onset Date: 02/15/2021
Rec V Date: 02/23/2021
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: no

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: On 2/15 I begin to have chill, body aches, headache, fatigue and breast pains which continued into the next day. I was again prescribed the same 7 day antibiotic and disagnosed again with Mastitis but this time the symptoms lasted a little longer and after about day 5 I began to feel myself again. A mammogram and an ultrasound has been ordered to see why I developed the Mastitis so frequently but is not scheduled for another few weeks out from today.

Other Meds: Singular, Flovent Inhaler, Nexplanon BC Implant, doxclimine

Current Illness: nothing besides the AE to the 1st vaccine

Date Died: 02/20/2021

ID: 1049648
Sex: M
Age: 87
State: WA

Vax Date: 02/02/2021
Onset Date: 02/20/2021
Rec V Date: 02/23/2021
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: unknown

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

Symptoms: I was notified on 2/22/21 that this patient passed away over the weekend. I do not know the details, nor can I confirm anything beyond what I was told. I believe the death occurred on 2/20/21 due to a massive stroke.

Other Meds: unknown

Current Illness: unknown

ID: 1049649
Sex: M
Age: 65
State: NE

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
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: None

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

Symptoms: During observation, patient stated he was lightheaded. Denied any other symptoms. No SOB, no oral or facial swelling, no rash or swelling. Vitals stable- BP 100/62, pulse 62, RR 12. Ate breakfast but had not had lunch. Patient was observed for 30 minutes and given water. Symptoms resolved by end of observation period.

Other Meds: None

Current Illness: None

ID: 1049650
Sex: F
Age: 37
State: NY

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
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: Pain in extremity

Symptoms: Low grade temp. Body aches, head ache, and fatigue

Other Meds: Synthroid, Lexapro, Birth control

Current Illness: None

ID: 1049651
Sex: F
Age: 78
State: IN

Vax Date: 01/27/2021
Onset Date: 02/02/2021
Rec V Date: 02/23/2021
Hospital:

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

Lab Data:

Allergies: Iodine Codein, Tramadol, Percoset, Persantine, Tape, Cinnamon,

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

Symptoms: Started turning red on 2/2/21. Noticed when getting dressed. Red circle around injection site about size of half of orange. Later in day started itching a little. Next day size of half a grapefruit. Itching off and on. Didn't disappear until 2/7/21. Read online to use arm and apply cold. So i did this. every so often. N

Other Meds: Atenolol, Chlorthalid,, Losartan, Synthroid, Rosuvastin, Mometasone Furoate Spray, Arthritis Tylenol, Zyrtec, Centrum Silver, Bayer Regimen, Phytomega with Fish Oil, CoQ10, Preservision, Refresh Eye Drops, Pain-A-Trate Pain relieving topic

Current Illness: Tooth extraction on 1/2021

ID: 1049652
Sex: F
Age: 43
State: NY

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: pt initially noted palpitations and shortness of breath. After several minutes improved and then pt developed lip and tongue swelling

Other Meds: Biotin

Current Illness: none

ID: 1049653
Sex: M
Age: 35
State:

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
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:

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

Symptoms: pt felt a lump in sternum like he swallowed something and it was stuck.

Other Meds:

Current Illness:

ID: 1049654
Sex: F
Age: 66
State: NJ

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/23/2021
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: SULFA , IODINE, SHELL FISH

Symptom List: Vomiting

Symptoms: Headache, felt like I was starting a bad cold , chills, low grade fever and every joint ached for 36 hours. Then it just went away.

Other Meds: RABEPRAZOLE SODIUM 20 MG

Current Illness: NONE

ID: 1049655
Sex: M
Age: 38
State: PA

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/23/2021
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: Severe and debilitating lower back pain that lasted roughly 3 hours. Use of a heating pad for an extended period of time assisted with recovery.

Other Meds: Famotidine and singular.

Current Illness: None

ID: 1049656
Sex: F
Age: 54
State: VA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
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:

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

Symptoms: C/o feeling itchy on arms, neck, knee. No rash noted at injection site or on arms. Blotchy essential noted neck right clavicle area. Denies pain, SOB, dizziness, nausea. P76. Checked by EMT. EMT instruct ti take oral benadryl when she gets home. Client stated that perfums,perfume, lotions can set off itchy feeling when shesmells perfume.

Other Meds:

Current Illness:

ID: 1049657
Sex: F
Age: 59
State: WI

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/23/2021
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: Keeflex

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Flu like symptoms 24 hours after shot. Fever, chills, sick to stomach, uncontrollable shaking!

Other Meds: Levothyroxine

Current Illness: None

ID: 1049658
Sex: F
Age: 77
State: VA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/23/2021
Hospital:

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

Lab Data:

Allergies: pneumonia vaccine, sulfa

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

Symptoms: bilateral lower leg edema started 24 hours after vaccine, associated with dizziness, leg spasm/tremors, unable to walk, resolved in 4 days. no prior history, no other new medications taken

Other Meds: amlodipine, vitamin D3, benazepril, carvedilol, hydrochlorothiazide, relafen, trazodone, Flonase

Current Illness: none

ID: 1049659
Sex: F
Age: 45
State: TX

Vax Date: 02/12/2021
Onset Date: 02/21/2021
Rec V Date: 02/23/2021
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: Sulfa antibiotics

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

Symptoms: Moderna COVID-19 Vaccine EUA. Minor and expected tenderness the day after injection. Noticed 9 days after vaccination that the injection site is getting swollen and very itchy. Increasing redness. Taking OTC antihistamines and ibuprofen as needed. No need for additional intervention yet, but felt obligated to report and help provide information. Currently on injection day +10, increased redness, swelling, and itching.

Other Meds: Azathioprine, cetirizine, vitamins A and D

Current Illness: Nothing acute that I know of.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm