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: 1049867
Sex: F
Age: 37
State: MD

Vax Date: 02/12/2021
Onset Date: 02/19/2021
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: Mild allergy to some shellfish and minor seasonal allergies.

Symptom List: Dysphagia, Epiglottitis

Symptoms: 7 days post vaccine, swelling and a rash appeared at the injection site and through day 8 this was present at the injection site and within a 4 inch radius of the. Site of Injection. Exterior layer of skin was in tact and the swelling , redness and itchiness reduced within 72 hours of onset without taking any medication

Other Meds: Xeljanz XR

Current Illness: None

ID: 1049869
Sex: F
Age: 46
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Flu vaccine

Symptom List: Anxiety, Dyspnoea

Symptoms: While Pt was sitting in the waiting area she began to has partial upper body "seizure" also breathing problem that included tightness in her throat, husband alerted staff who then alerted EMS, upon arrival to the Pt she was saying under her breath "EPI" Pt quickly moved to the back of the tent to the EMS area where EPI .3 administered in the left thigh, lung sounds where having wheezes in both sides. within minutes she stated she felt much better. As we obtained Pt demographic she again stated her throat was feeling tight, second dose of EPI .3 given, within minutes it happened again a total of three EPI .3 given and 50mg of Benadryl given, ambulance arrived to transport.

Other Meds: Unknown

Current Illness: None

ID: 1049870
Sex: F
Age: 49
State: IA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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:

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

Symptoms: I had a sore throat and white patches on tonsils lasting 2-3 days.

Other Meds: No

Current Illness: Strep throat

ID: 1049871
Sex: F
Age: 17
State: OR

Vax Date: 01/23/2021
Onset Date: 01/23/2021
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: Reporting a vaccine administration error: unauthorized age group. Vaccinated while not yet 18 years of age. No adverse event.

Other Meds:

Current Illness:

ID: 1049872
Sex: F
Age: 68
State: FL

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: sulfa drugs caused headaches

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

Symptoms: I started seeing stars after showering the morning after receiving my shot and eventually blacked out, fell, and struck my head. When I came to, my head was bleeding where it struck the floor and I was in a cold sweat. I crawled to my phone and called 911. They arrived and checked me out, settled me on the couch and gave me tylenol, spoke with a doctor on the phone, and eventually told me that I could get a friend to take me to the ER if I wished. However, my husband is disabled and could not be left alone, so I'd have had to find another friend to stay with him. Although I might have a concussion, my condition seemed OK and I have not had any other severe symptoms so I have not sought further medical attention.

Other Meds: synthroid, amlodipine, telmisartan

Current Illness: none

ID: 1049873
Sex: M
Age: 76
State:

Vax Date: 02/19/2021
Onset Date: 02/23/2021
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:

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

Symptoms: Patient had the Moderna vaccine 1st dose roughly 5 days ago. Overnight, his wife woke to him having an episode of what appeared to be a tonic clonic seizure around 5 am on 2/23/21, followed by a period of disorientation and unresponsiveness consistent with a post ictal state. The patient has no history of seizures. It is unclear if this had anything to do with the Moderna vaccine, but I am reporting it due to the timing of the episode in conjunction with the vaccine.

Other Meds:

Current Illness:

ID: 1049874
Sex: F
Age: 70
State: GA

Vax Date: 02/03/2021
Onset Date: 02/11/2021
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: Pyrexia, White blood cell count decreased

Symptoms: On February 11, 2021, eight days after my shot, my arm became itchy, warm, swollen and red patches. The same arm I received my vaccine in. I took a Benadryl and applied Benadryl cream on the patches. It got better in approximately two days with some residual discoloration.

Other Meds: Armour Thyroid Inderal Lipitor

Current Illness: None

ID: 1049875
Sex: F
Age: 73
State: LA

Vax Date: 02/05/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PCN Doxocyclin Reclast

Symptom List: Pharyngeal swelling

Symptoms: Covid arm. Light pink circle around the injection site

Other Meds: Amlodipine 2.5mg Aspirin 81 mg Atorvastatin 10 mg Calcium 600 Vitamin D3 Magnesium 400 mg Zyrtec 10 mg

Current Illness:

ID: 1049876
Sex: M
Age: 63
State: AL

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Fatigue, headache, muscle pain, and chills

Other Meds: Escitalopram

Current Illness: None

ID: 1049877
Sex: F
Age: 78
State: VA

Vax Date: 02/10/2021
Onset Date: 02/17/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: rash around the injection site. patient has taken benadryl and using topical cream. rash is still present

Other Meds:

Current Illness:

ID: 1049878
Sex: M
Age: 58
State: ME

Vax Date: 02/08/2021
Onset Date: 02/17/2021
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: Statins

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

Symptoms: On the morning of the 17th, a week after the immune reaction from the second shot, started off with a painful rash on the right foot and unable to bear weight. Advised Benadryl and Claritin by physician after sending him a photo. Along with that developed a sore throat and painful swelling at the right base of tongue, almost as if it had been bitten, on and off sweats, temperature on and off to 99 degrees, myalgias and arthralgias. The sore throat got a little better by 2/20, but then started with severe headaches, worse at night, along with intense pain and burning with the neuropathy in my feet flaring up. Dizziness along with the headaches and sharp stabbing pains from the neck on each side up to the back of the years and marked sensitivity of the skull. Almost went to the ER in the middle of the night on 2/21, but increased Tylenol to every 4 hours. the symptoms of the rash and body aches and fever have subsided, but chills come and go. Today, 2/23, the headaches are continuing to get better, but marked sensitivity of skull and head, particularly on the left side, and overall feeling of being tired. I expect over the next few days the headaches will be gone. Didn't expect this delayed reaction after over a week after the second shot, but I guess anything can happen. Have discussed with other coworkers in the medical field that have heard of similar issues, so we are guessing this is a delayed reaction. At least there was no shortness of breath or difficulty breathing.

Other Meds: Metoprolol 12.5 mg daily Fosinopril sodium 20 mg daily Aspirin 81 mg daily Vitamin D3 1000 units daily Red Yeast Rice 2400 mg daily Co Q-10 200 mg daily Omega-3 Krill Oil 300 mg daily Asparagus 800 mg daily Magnesium 500 mg daily Levothy

Current Illness: None

ID: 1049879
Sex: F
Age: 74
State: GA

Vax Date: 02/21/2021
Onset Date: 02/21/2021
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: Minocin tetracycline medicine

Symptom List: Rash, Urticaria

Symptoms: Headache first. Still off and on. Then fever. 101.4 around 5pm same day. 24 hours. Achy neck area. About 10 hrs later Arm redness still ongoing Tuesday 2-23-2021 large area .

Other Meds: lisinopril hctz. Pravastatin levothyroxine. Florstor probotic

Current Illness: None

ID: 1049880
Sex: F
Age: 85
State: AL

Vax Date: 02/17/2021
Onset Date: 02/17/2021
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: About 12 hours after the receiving the vaccine, I started running a fever. I had mild body aches. That lasted about 36 hours. I had a lost of appetite. The next day (2/18/2021) my arm became swollen and itchy. As of today it slightly swollen, slightly red in color and itching occasionally around the injection site.

Other Meds: Fish Oil 100MG daily, Losartan 100 MG daily, Vitamin D3 1000 IU daily, Tum's 1000 MG daily, Baby Aspirin 81 MG daily, Magnesium 250 MG daily, Atenolol 25 MG daily,

Current Illness:

ID: 1049881
Sex: F
Age: 45
State: IA

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Versed Haldol

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

Symptoms: The employee received her second COVID-19 Vaccine at 0744. At 820 she c/o dry mouth and a "funny feeling in her chest, but not pain." The employee was brought into the observation room and given 25mg of PO Benadryl. Her VS were 65-18-128/79-98%. Her lung sounds were clear. At 0825 Dr was notified and he came to the clinic. At 0831 the employee states that the chest feeling was improving, her lips and mouth were feeling better. 0910: 57-18-129/75-99% The employee states that she has had an allergic reaction to Versed and Haldol

Other Meds:

Current Illness:

ID: 1049882
Sex: F
Age: 33
State: NJ

Vax Date: 02/20/2021
Onset Date: 02/22/2021
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: None

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

Symptoms: Rash below injection site. Currently lasting 2+ days. Slight growth in size. Red, warm to touch, itchy, swollen.

Other Meds: None

Current Illness: None

ID: 1049883
Sex: F
Age: 78
State: AL

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: Allergy to Sulfa

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

Symptoms: Patient,had received second dose of Moderna COVID vaccine and was waiting the 15 minutes post injection for observation. Patient reported that she felt her tongue swelling and had difficulty swallowing. Patient anxious, but in no respiratory distress. BP 130/72. Patient was instructed to take some slow deep breaths. Patient continued to c/o tongue feeling thick and she had hacking cough and c/o difficulty swallowing. Patient was given Epinephrine 0.3 auto injector to right thigh at 1:32 pm by RN. BP 150/92, P 90 R 20, Patient also given Diphenhydramine 50mg IM to left deltoid by RN, Supervisor. Patient remained alert and oriented. BP 176/92 at 1:37 pm. EMS arrived on site and monitored patient with EKG, Pulse oximeter, BP and pulse. Patient had some shaking. She remained alert and oriented. Patient refused transport by ambulance to ER. She did agree to go to ER by private car. Patient's husband resent and to transport patient by car to Medical Center. EMS followed patient to hospital. Confirmed that patient was taken to Medical Center ER, by RN.

Other Meds: Multivitamin Aspirin 81mg Probiotic

Current Illness: none

ID: 1049884
Sex: F
Age: 53
State: CA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: Tingling in lips, slightly numb tongue and had to clear throat.

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

Symptoms: Waited 30 minutes due to history in 2000 of allergic reaction to food. Shot received at 12pm, waited 30 minutes & returned to work. At1:30pm I experienced tingling sensation in lips, slightly numb tongue and had to clear throat, this lasted for about 1 hour. Next day I experienced sore arm & swollen right lymph node for 2 to 3 days

Other Meds: None

Current Illness: Covid 19 mild symptoms (headache, light headedness and light)nausea.

ID: 1049885
Sex: F
Age: 66
State: CO

Vax Date: 02/13/2021
Onset Date: 02/22/2021
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: sulfa drugs

Symptom List: Ear pain, Hypoaesthesia

Symptoms: red patch 2" x 2" at edge of injection site; not itching : not raised; a little warm to the touch: no other symptoms, did not seek medical attention

Other Meds: unknown

Current Illness: unknown

ID: 1049886
Sex: F
Age: 72
State: CA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: Levaquin [levofloxacin], Percocet [oxycodone-acetaminophen], Amoxicillin, Bactrim [sulfamethoxazole w-trimethoprim], Hydrocodone-acetaminophen, Keflex [cephalexin], Norco [apap-fd&c yellow #10 al lake-hydrocodone], Oxycodone, and Tramadol

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient at Covid vaccine drive up clinic Patient with multiple medication allergies-confirmed with patient Allergies Allergen Reactions ? Levaquin [Levofloxacin] Hives ? Percocet [Oxycodone-Acetaminophen] Nausea and Vomiting ? Amoxicillin Nausea and Vomiting ? Bactrim [Sulfamethoxazole W-Trimethoprim] Other dizziness ? Hydrocodone-Acetaminophen Other ? Keflex [Cephalexin] Other Severe vertigo ? Norco [Apap-Fd&C Yellow #10 Al Lake-Hydrocodone] Nausea and Vomiting ? Oxycodone Nausea and Vomiting ? Tramadol Nausea and Vomiting patient reported tingling of face and lips after receiving vaccine @1630 States lips appeared more swollen then prior to vaccine Denies shortness of breath, wheeze, tongue/ throat swelling, chest pain, palpitation OBJECTIVE: Blood pressure :138/ 78 HR 77 Oxygen saturation 99% on room air Gen: sitting in car. No acute distress Eyes: Conjunctivae and sclera without injection/icterus and lids and lashes normal. Oropharynx moist and intact without lesions. HENT: Atraumatic. No facial droop. Minimal swelling of right upper lip without erythema. Oropharynx moist and intact without lesions. Neck: supple Pulm: No tachypnea, retractions or cyanosis. clear to auscultation bilaterally with symmetric air entry in all fields. Speaking in > 5 word sentences without difficulty. CV: regular rate and rhythm Psych: Speech fluent with normal volume, rate, and pitch alert and oriented x iii,pleasant affect/mood. Skin: Exposed areas warm,dry, without rash or jaundice ASSESSMENT/PLAN: 1. Tingling of face and lips 30 minutes after receiving Covid vaccine. No evidence of hypoxia or respiratory distress/ hemodynamic instability. Patient with history of multiple allergies to medications. Benadryl 25 mg orally x1 given @ 1640 Lot 201666 Exp 04/2023 Reassess in 15-20 minutes Addendum Reassessed at 1700 Patient reports increased swelling/tingling to lips and face right > left Denies shortness of breath, wheeze, difficulty swallowing , itching, hives Exam Gen: sitting in car- appears comfortable Eyes: Conjunctivae and sclera without injection/icterus and lids and lashes normal. HENT: Atraumatic. No facial droop -increased swelling to lips/ perioral right > left -mild erythema periorally -Oropharynx moist and intact without lesions. Neck: supple Pulm: No tachypnea, retractions or cyanosis. Speaking in > 5 word sentences without difficulty Psych: Speech fluent with normal volume, rate, and pitch alert and oriented x iii,pleasant affect/mood. Skin: Exposed areas warm,dry, without rash or jaundice ASSESSMENT/PLAN: 1. Increased edema and patient reports increased tingling of lips/ face ~ 60 minutes after receiving Covid vaccine. Not improved with benadryl 25 mg x1. Concerning for allergic reaction with history of multiple allergies. Urgent Care to continued monitoring and treatment Patient agrees Husband will transport via private care Urgent Care notified by clinic: Patient given EpiPen in case symptoms return. Instructed patient to go directly to the emergency department for any tongue swelling lip swelling trouble breathing or need to use of EpiPen. Patient is asymptomatic. Patient has additional Benadryl or will pick up from the pharmacy.

Other Meds:

Current Illness:

ID: 1049887
Sex: M
Age: 60
State: FL

Vax Date: 02/22/2021
Onset Date: 02/23/2021
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: No

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

Symptoms: Fever, muscle and joint pain, diarrhea, headache

Other Meds: No

Current Illness: None

ID: 1049888
Sex: F
Age: 66
State: NH

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: no

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

Symptoms: After vaccine she waited and was ok to leave. 11am she begin to feel cold and weak and went to bed, by noon she was so cold and couldn't get warm we put a heat blanket on her and around 2pm she started feeling nauseated and I gave her some nausea meds and Tylenol. It all lasted for 24 hours but the symptoms were identical to the virus she experienced.

Other Meds: Levothyroxine 25mcg, Losartan 50mg, Calafram HBR 10mg,

Current Illness: no

ID: 1049889
Sex: F
Age: 34
State: CA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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: NSAIDS

Symptom List: Unevaluable event

Symptoms: About 15 minutes later - body felt like it was on fire; shortness of breath; heart rate was pounding very fast. I stayed in an observation room for about 3 hours. Next day, I couldn't feel my right arm. I started getting fever, chills. I had all symptoms of the coronavirus. Saturday at 03:00 am - I woke up and I couldn't feel my arm or my fingers on my right side. I called the Emergency number. I stayed home and took Tylenol. Couldn't feel my arm at all that Saturday - dead. Sunday - same thing. Monday morning, I woke up, I could feel a little bit of my fingers but I noticed that I had blisters full of blood between your index finger and your thumb. I didn't go to work that day. The doctor wrote me out of work for the rest of the week. I didn't have any sensation on my pinkie or ring finger. I had a little bit of sensation on the rest of my fingers. I stayed at home and I didn't do anything with my arm and it slowly started getting better. That whole week I was having symptoms that were just like coronavirus. They came and went. the following Saturday, I started being able to move my arm around and doing more stuff and slowly it came back but I'm not 100%. I can't lay on the right hand side too long - it starts feeling like my arm is asleep. I got the second dose February 12th. I spoke to an allergy doctor and an anesthesiology doctor (video and telephone visits) - they told me I was having common side affects that people were having from the vaccine but they didn't know why.

Other Meds: no

Current Illness: no

ID: 1049890
Sex: M
Age: 87
State:

Vax Date: 02/08/2021
Onset Date: 02/22/2021
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: None

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

Symptoms: Extemely sore left fore-arm muscles for a few hours, followed by fatigue and chills the next morning for about six hours

Other Meds: Benazepril, Eliquis

Current Illness: None

ID: 1049891
Sex: M
Age: 88
State: TN

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PENICILLIN

Symptom List: Injection site pain, Pain

Symptoms: PATIENT RECEIVED FIRST MODERNA COVID VACCINE 1/18/21 AT PREMIER MEDICAL GROUP AND THEN SUBSEQUENTLY VISITED COUNTY HEALTH DEPARTMENT'S COVID VACCINATION SITE ON 1/26/21 AND RECEIVED A PFIZER COVID VACCINE. PATIENT THEN RETURNED TO MCHD ON 2/23/21 AND RECEIVED A SECOND DOSE OF PFIZER COVID VACCINE, RECEIVING A TOTAL OF 3 COVID VACCINATIONS WITHIN 5 WEEKS TIME.

Other Meds: UNK

Current Illness: UNK

ID: 1049892
Sex: M
Age: 69
State: CT

Vax Date: 02/21/2021
Onset Date: 02/21/2021
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: Penicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient was in to receive his second dose of the COVID vaccine. He reported no known issues after his first dose and remained in the pharmacy for the recommended 15 minute observation period following the vaccine without any problems. He reported to us today that around 45 minutes after having received the vaccine, he started to have a choking episode, something that he commonly experiences with his Parkinson's Disease, so he and his wife didn't think much of it. This seemed to evolve into nausea and dry heaves with excess mucus production that lasted for hours. Because of the duration, they decided to contact his insurance company's nurse line who recommended he go to the Emergency Department to rule out COVID and pneumonia He was admitted to the ED and ultimately found to be negative for both COVID and pneumonia, at which point they decided that his Parkinson's exacerbation might have been the result of having received the vaccine. He has since been discharged and is doing well.

Other Meds:

Current Illness:

ID: 1049893
Sex: F
Age: 65
State: CO

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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Lisinopril (cough), Verapamil (rash), Metroprolol (tachycardia)

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

Symptoms: 2/18: Slightly sore arm. Awoke with headache. 1 hour later nausea began. Chills, temp which spiked at 102.4 degrees. Extreme fatigue. Slept 12 hours. 2/19: decreased headache, nausea, fever. Fatigue continued X 3 days.

Other Meds: Losartan, ASA, multivitamin, cetirizine, simethicone, activated charcoal, Vitamin D3, magnesium glycerinate, calcium chews, polyethelene glycol.

Current Illness: None

ID: 1049894
Sex: F
Age: 74
State: NE

Vax Date: 02/22/2021
Onset Date: 02/22/2021
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: codeine

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Approximately 20+ minutes after the vaccination , little twinges like electric points all over. Very mild and then they went away in about 8 minutes. After that light fatigue and slight headache. When woke up this a.m. just had a sore arm. Everything else is fine.

Other Meds: nothing AT the time of vaccination. 10:30 a.m. took morning dose of Synthroid, biotin, glucosine/condroitin, caltrate,

Current Illness: n/a

ID: 1049895
Sex: F
Age: 66
State: CA

Vax Date: 01/18/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Codeine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Very achy joints for 1 day, took tylenol

Other Meds: Levothyroxine, Lisinopril, Bupropion

Current Illness: N/A

ID: 1049896
Sex: F
Age: 16
State: WI

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

Symptoms: Patient did not qualify for vaccine. She is 16 and she is a lifeguard.

Other Meds:

Current Illness:

ID: 1049897
Sex: F
Age: 67
State: IN

Vax Date: 02/08/2021
Onset Date: 02/19/2021
Rec V Date: 02/23/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: mild arm soreness at the injection site (none with 1st shot) small unformed/ soft bowel movements for several days at end of second week after 2nd shot (similar but shorter/ day plus symptom after 1st shot)

Other Meds: Paroxetine prn Miralax prn

Current Illness: none

ID: 1049898
Sex: F
Age: 79
State: NC

Vax Date: 01/22/2021
Onset Date: 02/20/2021
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: Morphine, Levaquin, Valproic acid

Symptom List: Injection site pain

Symptoms: allergic skin response with swelling and redness at the injection site and down the upper arm. fever, chills

Other Meds: Albuterol, Hydrocodone, Ambien, Atenolol, Paxil, Metformin

Current Illness: COPD, Diabetes

ID: 1049899
Sex: M
Age: 58
State: AR

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Patient stated no known allergies

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

Symptoms: Patient was to receive 2nd COVID 19 dose of vaccine today. Facility staff member instructed patient to receive dose after patient had refused initially. Patient verbally agreed. Vaccine was administered. Patient then reported that they had an additional Vaccination Record Card would we like to see it. The patient produced a card that had a dose record given. Upon looking into the records, patient was given a third dose of vaccine today as a result of facility confusion. Patient is doing well, no complaints at this time.

Other Meds: Unknown

Current Illness: Unknown

ID: 1049900
Sex: F
Age: 78
State: CA

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: epinephrine, Iron Dextran

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

Symptoms: patient stated she had chest pain while in observation area, patient was alert and oriented, patient stated that she was nervous, emergency services were called and patient was taken to ED

Other Meds: unknown

Current Illness: unknown

ID: 1049901
Sex: F
Age: 35
State: MN

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:

Symptom List: Tremor

Symptoms: patient was receiving 2nd dose of series, during the administration of dose, there was leakage from syringe and needle. Pharmacist proceeded to administer an additional dose without conversion with patient. Concerns regarding potential overdose.

Other Meds:

Current Illness:

ID: 1049902
Sex: F
Age: 17
State: VA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
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: Erythema, Pruritus

Symptoms: Patient is 17yo here for COVID 19 Pfizer Vaccine; Within 15 minutes of the shot, she developed unresponsiveness. She has snoring, seizure disorders, OSA, hypertension, developmental delay, elective mutism. Her mother called us to the room Per mother , She was unresponsive, her lips were blue and she was pale She has had no recent seizure; compliant with Keppra She was very anxious prior to the vaccine. She was at baseline this am per mom prior to the shot.

Other Meds:

Current Illness:

ID: 1049903
Sex: M
Age: 39
State: CA

Vax Date: 01/29/2021
Onset Date: 02/19/2021
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: None

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

Symptoms: Nurse/doctor hit blood vessel during vaccine injection. I bled afterwards but did not feel it. Immediately that evening I began to feel symptoms of fatigue. This grew into an overall feeling of sickness and 3 days later, I had major brain fog. This then developed into high anxiety. However after about day 6 I felt normal again. Then 20 days later, I am feeling the same symptoms again. My armpit is swollen and having brain fog and anxiety.

Other Meds: None

Current Illness: None

ID: 1049904
Sex: F
Age: 76
State: IA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: Thioridazine (reaction: hives, tongue swelling), Prolia (reaction: facial swelling), donepezil (reaction: severe head pain).

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

Symptoms: This patient received dose one of Moderna covid19 vaccine on 2/10/21 at 110pm. At 330pm pt c/o sharp abdominal pain, nausea, vomiting, and diarrhea. She developed a rash to left deltoid area on 2/12/21. She continued to have these s/s. She was evaluated at Clinic by Dr on 2/16/21. He increased her Nexium to 40mg twice daily. Upon TC to patient on 2/23/21 she relates still having nausea, diarrhea, and occasional sharp abdominal pains.

Other Meds: prednisone 10 mg one tab po daily, triamterene/hydrochlorothiazide 37.5/25mg one po daily prn severe fluid in legs, esomeprazole 40mg one cap po bid, sertraline 50mg one po daily, levothyroxine 125mcg one po daily, docusate sodium 100mg one

Current Illness: No illness at time of vaccination or one month prior. Of note patient was confirmed to have Covid19 on 12/9/20 by PCR test.

ID: 1049905
Sex: F
Age: 80
State: OH

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: aspirin, NSAIDS, morphine, dilaudid, tapes, cats, dogs, pollens, dust, scents, foods: almond family, squash family, bi-valves

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Asthma attack began about 20 minutes after injection, with throat tightening, slight mouth swelling sensation and immediate wheezing which grew progressively worse. I had my inhalers (Levalbuterol and Flovent) with me, used Levalbuterol at the direction of medical people who surrounded me after I reported wheezing. They gave me a Benadryl, then brought a wheel chair and sent me directly to the ER. I was there about 3 hours during which I had a heart monitor, a "breathing treatment" by a respiratory therapist, and DUONEB, famotidine (PEPCID), and (DELTASONE). I was given a 3 day Rx for 20 mg. of prednisone, and released. My lungs felt "twitchy" the next day and my voice was muted, but was well otherwise. The only "normal" side effect I had was some soreness at the injection site for a couple of days, with some light sensitivity there for a few weeks.

Other Meds: Monte Lukast, Flonase, Preservision, multi-vitamins, Citra-Cal,, Malic Acid+Magnesium Levabuterol and Flovent as needed

Current Illness: None

ID: 1049906
Sex: F
Age: 71
State: DC

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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Tylenol 3

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

Symptoms: The site where I received the shot is still giving me pain when I raise my arm. It has created a weakness or damage to my muscle perhaps.

Other Meds: Rovustatin, Vitamin D,Aleve when needed

Current Illness: None

ID: 1049907
Sex: F
Age: 17
State: VA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
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: No known medication allergies, peanut/seafood/seasonal allergies

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

Symptoms: female here with mom mom multiple siblings for Covid vaccine. Within 30 minutes of the Covid vaccine patient had a vomiting episode. Pulse ox was 99. There is no labored respirations. She did not respond to commands but according to his sibling she does not always respond to commands. However when I took her hand to get her to squeeze my hand and gave it back to her she purposefully put it back on a CD which she was holding to her chest. Blood pressure was stable heart rate was approximately 130. The home care aide was not able to tell me whether or not this was her baseline. Her brother said that she does not does not answer questions depending on the day. However I am not sure he is the appropriate historian. She has a history of multiple medical issues including autism, quadriplegia, asthma, and food allergies. As such she was kept here for a full 30 minutes. At no time was there any color change. No labored breathing or wheezing on exam. There is a little bit of nystagmus and appeared to focus when questioned about how she was doing but without a verbal response. She will be transferred to the emergency room in stable condition emergency room has been notified.

Other Meds:

Current Illness:

ID: 1049909
Sex: F
Age: 49
State: NY

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/23/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Pain in extremity

Symptoms: Employee received Moderna vaccine on 1/22/21 at 1:30 pm and later that day at about 5:00 pm she started having severe pain to her left leg and for three days she was dragging her left foot when walking. Today (2/23/2021) employee still have moderate pain to her left leg.

Other Meds: no

Current Illness: no

ID: 1049910
Sex: M
Age: 60
State: CA

Vax Date: 01/01/2021
Onset Date: 01/07/2021
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: None

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

Symptoms: Initially all joints (neck, shoulders, elbows wrists, etc) ached and stiff. Moved to Tendonitis/Arthritis wrists, hands, fingers and Left patellar knee tendon. SLOWLY improved but did not leave, despite treatment with Aleve, until 2nd vaccine 2/5/2021. Then, same symptoms worsened and included BOT patellar tendons, nd plantar tendons. Continues to present and are very painful at night, despite 2 Aleve BID daily, and cannot make fist or extend fingers on both hands and cannot walk on feet without pain at MTP's. Discussed with orthopedic surgeon who assured me that I was having "an immune reaction in tendons to vaccine. It should get better over time". It has not at present.

Other Meds: Albuterol, Aleve, Vitamin D, Antihistamine

Current Illness: none

ID: 1049911
Sex: M
Age: 60
State: IL

Vax Date: 01/28/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

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

Symptoms: Pt developed R arm rash concerning for herpes simplex vs herpes zoster, culture pending.

Other Meds:

Current Illness: None

ID: 1049912
Sex: F
Age: 76
State: WI

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: Patient received the Moderna vaccine as second dose in vaccine series, but first dose was utilizing the Pfizer COVID vaccine. No specific adverse events have occurred, but given that a vaccine administration error occurred, I am submitting a VAERS report.

Other Meds: Alprazolam, amlodipine, aspirin, atorvastatin, carvedilol, estradiol, losartan, multivitamin, tolterodine

Current Illness: N/A

ID: 1049913
Sex: M
Age: 76
State: VA

Vax Date: 02/08/2021
Onset Date: 02/13/2021
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: None

Symptom List: Vomiting

Symptoms: COVID Arm: Redness, swelling, ichyness

Other Meds: None

Current Illness: None

ID: 1049914
Sex: M
Age: 85
State: MT

Vax Date: 02/05/2021
Onset Date: 02/13/2021
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: Symptoms started approximately 1 week after vaccination, symptoms include fatigue, shortness of breath, water retention, swelling in feet and lower legs, high blood pressure, cough.

Other Meds: Baby aspirin, Spironolactone, Carvedilol, Clopidogrel, Pantoprazole, Tylenol, Super B Complex, Vitamin D3

Current Illness: None

ID: 1049915
Sex: F
Age: 39
State: TN

Vax Date: 01/22/2021
Onset Date: 01/23/2021
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: NONE

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

Symptoms: FEVER BEGAN 1/23, THE DAY FOLLOWING FIRST MODERNA INJECTION. I'VE HAD A FEVER BETWEEN 99-102.8 EVERY DAY SINCE THE VACCINE ALONG WITH A CONSTANT HEADACHE AND GENERALLY DON'T FEEL WELL. I'M EXPERIENCING LETHARGY AND BRAIN FOG. ALSO HAD A RASH SHOW UP ON MY CHEST - WARM TO TOUCH, BUT HAS SINCE RESOLVED. STILL FEELING QUITE UNWELL AND NONE OF MY DOCTORS KNOW WHAT TO DO. ADVISED TO HOLD OFF ON REMICADE INFUSIONS FOR MY AUTOIMMUNE CONDITIONS AND HOLD OFF ON 2ND DOSE MODERNA, ORIGINALLY SCHEDULED FOR 2/19 AT THE SAME LOCATION.

Other Meds: REMICADE INFUSION 400MG x6WEEKS ALPRAZOLAM 0.5 PRN AMLODIPINE 5MG ZEBETA 10MG WELLBUTRIN XL 150MG LISINOPRIL ZOLOFT 50MG

Current Illness: NO

ID: 1049916
Sex: F
Age: 45
State: CA

Vax Date: 02/23/2001
Onset Date: 02/23/2001
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: nkdaun

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Mistakenly gave Moderna vaccine for 2nd dose after receiving Pfizer vaccine as 1st dose

Other Meds: unknown

Current Illness: none known

ID: 1049917
Sex: F
Age: 75
State: CA

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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: HydrocodoneNausea/Vomiting Aspirin Ciprofloxacin Keflex [Cephalexin] Salicylic Acid

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

Symptoms: Sensation of swelling in throat and difficulty swallowing

Other Meds: Clobetasol (OLUX) 0.05 % Top Foam Levothyroxine (LEVOTHROID/SYNTHROID) 88 mcg Oral Tab Fluorouracil (EFUDEX) 5 % Top Crea Albuterol (Ventolin HFA) 90 mcg/actuation Inhl HFAA EPINEPHrine (ADRENACLICK/EPIPEN) 0.3 mg/0.3 mL Inj AutoInj

Current Illness: None

ID: 1049918
Sex: M
Age: 43
State: MA

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Patient states he had a typical reaction the day of the vaccine (low fever, chills, aches, injection site pain) and when to bed earlier than usual because he was tired. He didn't sleep well, and this morning his sleep app indicated his heart rate during the night was between 100-110. After noticing his heart rate was between 130-140, he called the clinic and was told to go to the ER. Hospital ER administered several tests and did blood work. The MD's determined his heart was fine and it is likely vaccine related. He is home again and is feeling better (no chills, etc.) and his resting heart rate is now in the low-90's.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm