VAERS 2021 Database www.vaers.hhs.gov

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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: 1050127
Sex: M
Age: 42
State: CA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: Immediate reaction - "not feeling well", dizzy to the point that he was not safe to walk Blood pressure had been a little above normal prior to vaccination and remained high during the half hour of observation, but had started to come down a few points by the time he was taken in a wheelchair to family to go home and rest.

Other Meds:

Current Illness:

Date Died: 02/14/2014

ID: 1050128
Sex: M
Age: 70
State: WV

Vax Date: 02/06/2021
Onset Date: 02/07/2021
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: Penicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: 02/07/21 through 2/13/21 slightly fatiqued, took all his prescribed medications, ate breakfast, lunch and dinner was drinking eight 10 oz bottles of water. On 02/14/21 was very tired had a difficult time breathing after taking the normal meds. He took a breathing treatment with his prescribed Ipratropium Bromide and Albuterol Sulfate via home nebulizer. This did not improve his breathing. He was very weak and breathing was labored. 911 was called by wife. 911EMTchecked pulse and breathing. Informed him they would give him a breathing treatment.He started to go limp. EMT's got him to Ambulance and to Medical Center to the ER. Heroics done. He died. Pulmonary and Cardiac Arrest

Other Meds: Eliquis 5MG, Carvedilol 6.25MG, Ramipril 2.5 MG, Atorvastatin 80 MG 1 tab daily ,Stiolto Respimat Inhalation spray 2 puffs per day; Albuterol Sulfate Inhaler as needed, Ipratropium Bromide 0.5 mg and Albertol Sulfate0.3mg inhalation soluti

Current Illness: none

ID: 1050130
Sex: F
Age: 79
State: GA

Vax Date: 02/20/2021
Onset Date: 02/21/2021
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: Codeine

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

Symptoms: Woke up Sunday morning 02/21/2021 with cold chills, quickly turning to hot flashes, continuing with a severe headache,vomiting,diarrhea ,and nausea. Continuing thru Monday 02/22/2021 and Tuesday 02/23/2021. Called my Dr?s office at 9:00;AM 02/23/2021. Have not heard back. There message recording asks not to duplicate calls, which I did not do.

Other Meds: Levothyroxin 100MCG Vitamin D3 2000 IU Pantoprazole SOD 40 MG Vitamin B 12 2500 mcg Atorvastatin 40 MG Magnesium 500 mg AMlodipine 5 MG

Current Illness: None

ID: 1050131
Sex: M
Age: 38
State: TX

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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: Sulfa

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Over 3-4 days had the expected flu-like symptoms (headache, fever, body ache, chills, etc.). On the second day had intense pain in base of lungs that would intensify in waves alongside elevated heart rate (just under 100bpm, measured oxygen level was still 98%). The pain lasted about 4-6 hours and then subsided.

Other Meds: Advair, Allegra, Nasonex

Current Illness: None

ID: 1050132
Sex: M
Age: 52
State: MN

Vax Date: 02/03/2021
Onset Date: 02/03/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: > 48 hours of intractable hiccups 5 days of fever, peaking at 102.6 F Debilitating headache

Other Meds: Ibuprofin & Amoxicillin for recent dental surgery

Current Illness: None

ID: 1050133
Sex: F
Age: 74
State: CA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: Na

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

Symptoms: 13 hours after injection I developed fever or chills bodyaches and fatigue which lasted until the next morning. Then all reactions were completely gone and I was back to normal

Other Meds: HRT

Current Illness: Na

ID: 1050134
Sex: F
Age: 45
State: CO

Vax Date: 01/16/2021
Onset Date: 01/23/2021
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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Nausea, vertigo, ataxia, falls, change in vision persisting currently

Other Meds:

Current Illness:

ID: 1050135
Sex: M
Age: 67
State: MA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Patient fainted when walking to bathroom after observation.

Other Meds:

Current Illness:

ID: 1050136
Sex: F
Age: 65
State: CO

Vax Date: 02/14/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Large red blotch has developed on arm where shot was given, appearing about a week after the shot, itchy and about 2.5" in diameter. Has looked this way for 4 days now.

Other Meds: Atorvastatin 10mg day Alendronate Sodium 70mg / once per week (generic Fosamax) Also: multivitamin

Current Illness: None

Date Died: 02/23/2021

ID: 1050137
Sex: M
Age: 89
State: LA

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Shrimp, Red Man Syndrome, Cleocin, Clindamycin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pt received second Moderna Vaccination on 2/21/21 at 1:00 pm at Pharmacy. Pt present on 2/22/21 to ER via ambulance at 1940. Upon presentation C/C hypotension Post COVID vaccine. Nurse notes states that Home Health nurse sent patient to ER secondary to hypotension and hyperglycemia. Pt states back ached and was holding his head. Nurse noted pt had random petechiae over body and bruising to abdomen following injections received during recent hospitalization. (unknown hospitalization). Patient was treated with IVF bolus in addition to initiating Dopamine for hypotension, patient became agonal and daughter at bedside presented Adv. Directive, pt was DNR. Pt pronounced time of death was 2110pm. (Pt only reported a sore shoulder secondary to vaccine).

Other Meds: Entresto, Metoprolol, Spironolactone, Vit D, Lasix, Flomax, Digoxin, Eliquis, Tradjenta, ASA, Novolog Flex pen, Levothyroxine, Vit B12, Lipitor, Aricept, Temazepam, Lorazepam, Glucose prn.

Current Illness: Fall on 2/15/21 pm resulting in skin tear requiring dressing. Pt Seen on 2/16 for skin tear repair secondary to fall the pm prior. Vital signs WNL. Pt returned on 2/20/21 for dressing change. Vital signs WNL. Pt received second Moderna Vaccination on 2/21/21 at 1:00 pm at Pharmacy. Pt present on 2/22/21 to ER via ambulance at 1940. Upon presentation C/C hypotension Post COVID vaccine. Nurse notes Home Health nurse sent secondary to hypotension and hyperglycemia. Pt states back ached and was holding his head. Nurse noted pt had random petechiae over body and bruising to abdomen following injections received during recent hospitalization. (unknown hospitalization)

ID: 1050138
Sex: F
Age: 38
State: CA

Vax Date: 02/11/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: 7 days after receiving the vaccine, I developed intense, deep muscle pain and swelling. The arm where I received the vaccine was very hot to the touch. The next day, I had chills and a mild fever, along with swollen and sore arm. Through the weekend, I developed redness in splotches that were similar to hives in appearance. My arm has been intensely itchy. On Saturday, 2.20.21, the lymph node under my left arm became very swollen and painful. I am currently still experiencing a mildly sore arm (pain has lessened since yesterday), arm is still very hot to the touch, still have red rash/hives and my lymph node is still very painful.

Other Meds: Levothyroxine Nora B

Current Illness: N/A

ID: 1050139
Sex: M
Age: 34
State: NY

Vax Date: 02/04/2021
Onset Date: 02/16/2021
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: N/a

Symptom List: Rash, Urticaria

Symptoms: Heaviness in my chest, sensation of not getting a full breath, extreme lack of energy and exhaustion

Other Meds: Pantoprazole Singular Propecia Echinacea

Current Illness: N/a

ID: 1050140
Sex: F
Age: 41
State: WA

Vax Date: 02/20/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Humira, amoxicillin

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

Symptoms: Pfizer shot #1: She received the 1st COVID vaccine Pfizer on January 24th at 7:00 p.m.. The following day she noted a low-grade fever. On January 26 she noted edema of her eyes and lips associated with facial redness and itching that she treated with Benadryl intermittently for the past 2.5 weeks. She was seen in follow-up by her dermatologist who suspected an inflammatory reaction and prescribed anti-itch facial cream. She was also seen by her primary care who suspected angioedema and prescribed her an EpiPen which she has not needed to use. Pfizer shot #2: 2nd shot delayed due to snow. Above sx resolved before shot #2. She had her 2nd COVID injection February 20 at 3:50 p.m. About 1.5-2 hours later she noted onset of itching to her eyes and nipples along with itching of the skin in the locations of her usual eczema. She noted that her lips and eyes were a little puffy but less severe swelling to the eyes and lips than the 1st injection. She took 2 Benadryl shortly after onset of these symptoms. This seemed to lessen symptoms about 50%. Later she noticed that her voice sounded raspy and hoarse and she had a sensation of swelling to her tongue and throat but she was able to swallow. Her throat felt scratchy. She denies having lightheadedness, urticaria or GI symptoms. She went to the ED and was treated with benadryl, solumedrol and pepcid, monitored for a few hours and then discharged on 60 mg prednisone X 3 days and advised to continue benadryl 50 mg Q6h. She takes zyrtec 10 mg BID for seasonal/perennial allergies. Allergy history: She has a history of both idiopathic urticaria in early childhood and idiopathic angioedema in her early 20's. States she had extensive testing but the cause was never exposed. Took high dose prednisone for 4-5 months, angioedema resolved spontaneously and then flared again a few months later. Finally resolved with n additional 3 months of prednisone. She has both seasonal (feb-may) and perennial allergies to cat and dust, asthma and allergy to ampicillin--rash in childhood, and humira--fevers.

Other Meds: CYMBALTA, 20 mg, PO, BID diphenhydrAMINE 50 mg oral capsule, 50 mg= 1 cap(s), PO, QID hydrOXYzine hydrochloride 10 mg oral tablet, 20 mg= 2 tab(s), PO, QID, PRN metoprolol succinate, PO, Daily predniSONE 20 mg oral tablet, 60 mg= 3 tab(

Current Illness: ADD (attention deficit disorder) Allergic reaction to COVID-19 vaccine Depression GERD (gastroesophageal reflux disease) Rheumatoid arthritis

ID: 1050141
Sex: F
Age: 63
State: PA

Vax Date: 02/02/2021
Onset Date: 02/02/2021
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: Sulfa

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

Symptoms: Fever, all joints ached, fatigue, headache, shivering

Other Meds: Levothyroxine

Current Illness: None

ID: 1050142
Sex: F
Age: 42
State: CA

Vax Date: 01/15/2021
Onset Date: 01/16/2021
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:

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

Symptoms: Paralysis for 2 days. Unable to use either arm, barely able to bear weight or walk. Had to be fed, given water, and helped to go to the bathroom.

Other Meds:

Current Illness:

ID: 1050143
Sex: M
Age: 87
State: MA

Vax Date: 02/10/2021
Onset Date: 02/15/2021
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: Allergic to eliquis- itching

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

Symptoms: Rash at the injection site almost down to elbow and around to the underside of the arm with extreme itching. Started 5 days after injection at initial injection site, was as big as tennis ball and has increased substantially every day since. Used cortisone to subdue itching but went to pcp Dr to examine the site. She prescribed cetirizine and cephalexin for 5 days. Itching has stopped but rash is still large and present. Will revisit with Dr on 2/25/2021.

Other Meds: Warfarin, D3, B6, B12, saw palmetto, red yeast rice, turmeric, miralax

Current Illness: None

ID: 1050144
Sex: F
Age: 65
State: MD

Vax Date: 02/20/2021
Onset Date: 02/21/2021
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: dilaudid, ace inhibitors, sulfa, ceftin, zanaflex

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

Symptoms: First vaccine on 1/30, 10 days later started with a few hives. Thought it was new medication, took benadryl but lasted on and off for 10 days. Didn't think it was related to the vaccine. On 2/18 had more severe hives called my dr. She didn't see a reason not to get the second vaccine. 2 vaccine on 2/20 at 1:15. Sunday around 9:00 the hives started again. By 2:00 am it was severe, took benadryl everyd 4 hours after a few hours of sleep decided to go to the ED. Hive were severe from ankles to collar bone. very itchy. Was given epi injection and iv solumedrol and pepcid. Stopped itching and was discharge with prescriptions for Prednisone and pepcid. No more hives or itching at this time.

Other Meds: Gabapentin Synthroid Xarelto Celexa lipitor losartan onglyza

Current Illness: none

ID: 1050145
Sex: F
Age: 89
State: CA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: yeast, dairy, ephedrine, codeine, corticosteroids, Levaquin, metoprolol, lisinopril, tramadol,

Symptom List: Ear pain, Hypoaesthesia

Symptoms: rt arm swollen, neck pain, headache

Other Meds: xarelto 15mg, spironolactone 25mg, dilitazam 240mg, azopt, lumigan, tylenol

Current Illness: n/a

ID: 1050146
Sex: F
Age: 58
State: CA

Vax Date: 02/05/2021
Onset Date: 02/07/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Chills, weak, headache started on 2/7/21 (day3) unable to work from 2/8/21 through 2/12/21. Teleheath visit with PCP on 2/9/21. Symptoms resolved by 2/12/21. Self care with meds (allergy and pain meds) rest, fluids.

Other Meds:

Current Illness:

ID: 1050147
Sex: F
Age: 48
State: IN

Vax Date: 02/06/2021
Onset Date: 02/16/2021
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: Sulfa drugs

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

Symptoms: The day of the injection, approx. 3-4 minutes after getting the injection, I almost passed out. I became hot, sweaty, dizzy and my head starting to buzz. The nurse on-site provided me a couple cold packs and after about 30 minutes, I felt better. The nurse described my response as a "vascular" reaction. Later that night, I got a headache and night sweats and bouts of nausea. They only lasted a day. Approx. 10 days after the injection, the injection site became red, swollen, itchy and uncomfortable to the touch. Then it traveled down my arm and created a large red, swollen, itchy area on my entire upper arm. I advised my doctor and she provided me a Rx for a topical steroid and oral steroid. After 5 days of treatment, it is 90% better. The injection site still hurts.

Other Meds: Allegra - 1x/day; Bijuva 1/100 daily; Daily Vitamin

Current Illness: None

ID: 1050149
Sex: F
Age: 61
State: CA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
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: penicillin

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

Symptoms: Right side upper arm ache spread to right side of neck and into headache at back and top of skull. Persisted through night and spread down into right side of neck to left arm ache. Throat became red and right, then left side of tonsil became pus filled. Chills but no fever. Fatigue every day. Took 2-3 hour naps every couple of days and slept 8-10 hours through the nights. Headache off and on for 10 days. Throat remained red, becoming most sore late afternoons, voice hoarse. On and off drippy nose. On the 13th day I felt normal energy level in the morning but today, my 15th day at nearly 3pm, my normal energy is waning and throat becoming sore again.

Other Meds: Replens vaginal moisturizer

Current Illness: N/A

ID: 1050150
Sex: F
Age: 74
State: CA

Vax Date: 02/19/2021
Onset Date: 02/01/2021
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: LEVAQUIN TABS

Symptom List: Unevaluable event

Symptoms: PATIENT REPORTED ON DAY #4 POST-VACCINE THAT HER NECK AND CHEST VEINS WERE PROMINENT BILATERALLY, MORE SO ON SIDE OF VACCINE SITE (RIGHT). HAD AUDIO TELEHEALTH APPOINTMENT WITH PROVIDER ON POST-VACCINE DAY #3, 02/22/2021. DID NOT BECOME AWARE OF SYMPTOM UNTIL AFTER APPOINTMENT HAD CONCLUDED. ALSO REPORTED THAT INITIALLY HAD LOCALIZED REDNESS, RED STREAK, SWELLING AND ITCHING AT VACCINE SITE, BUT THAT THOSE SYMPTOMS WERE NOW RESOLVING. ADVISED EVALUATION BY PROVIDER, REPORTING TO CDC's V-SAFE, AND SEEKING URGENT/EMERGENT CARE IF NEEDED.

Other Meds:

Current Illness:

ID: 1050151
Sex: F
Age: 72
State: UT

Vax Date: 02/10/2021
Onset Date: 02/11/2021
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: Received COVID vaccine 2/10, the morning of 2/11 woke up with stiff neck, continue to get worse, on 2/14 neck muscles started spasming around 11am, was unable to move, had to have friend take her to the emergency room around 3 pm,. The spasms continued for 11 1/2 hrs, and stiffness gradually resolved over the next 3 days, was given muscle relaxant and ibuprofen. She has discussed this with her PCP, he encouraged her to get 2nd vaccine.

Other Meds:

Current Illness:

ID: 1050152
Sex: F
Age: 66
State: WA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
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: ondansetron (unknown) Desipramine Hydrochloride (Flushing or Hives) Flagyl (Flushing or Hives) NSAIDs (GASTRITIS AND DUODENITIS) Vicodin (PRURITUS AND RELATED CONDITIONS, PRURITUS AND RELATED CONDITIONS)

Symptom List: Injection site pain, Pain

Symptoms: She received her 2nd shot on 2/20/2021. Within minutes she noticed that she could not see, due to localized swelling around her eyes. She began to feel itchy and her tongue felt swollen. She was taken to ED and was given Benadryl and Solu-Medrol, her symptoms continued and she was administered epinephrine about an hour later which immediately cleared up her symptoms. She has some residual generalized itching and has been taking Benadryl 50 mg every 6 hours until 9:00 p.m. yesterday. She also takes Zyrtec 10 mg daily starting yesterday. She denies having any dizziness or lightheadedness, hives urticaria, nasal congestion, weepy eyes, diarrhea or abdominal cramping. She does endorse nausea and was administered Phenergan in the emergency department. She also endorses that her eyes felt itchy. She also endorses that she was able to swallow. Takes celebrex but paused this prior to the vaccine to prevent possible anti-inflammatory interrupting vaccine efficacy. Her ED record is available for review. Exam findings endorse she is tolerating secretions, speaking in full sentences and her tongue was not enlarge. No labs were drawn during her visit. She denies historical reactions to vaccines. She does get itching with some medications. Historical angioedema/urticaria post pistachio and bran muffin were singular events and have not recurred. She had a normal tryptase in 2014

Other Meds: albuterol CFC free 90 mcg/inh inhalation aerosol, 2 puff(s), ORAL INH, QID, PRN, 3 refills BENADRYL, 25 mg to 50 mg, PO, Q4 Hours, PRN budesonide 0.5 mg/2 mL inhalation suspension, See Instructions, 3 refills budesonide-formoterol 80 mcg

Current Illness: chronic rhinitis, URI with sequalae Oct '20, mild intermittent asthma

ID: 1050153
Sex: F
Age: 63
State: WI

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: At 11am on 2/16, my arm began to get sore. I took Advil at 4pm and it wasn't so bad. At about 10pm when I went to bed, I had issues falling asleep because my heart felt like it was pounding through my chest. That pounding came off and on during the next day. I woke up twice and my feet were ice cold and my body was very hot. The second time I woke I thought I would take some tylenol and was extremely dizzy walking to the bathroom. I was so weak I couldn't open the bottle. I slept nine hours, very unusual. I felt very under the weather all day until around 5pm. I woke up the next morning feeling pretty normal. The arm pain was completely gone by the 18th.

Other Meds: Multi-vitamin with mineral, vitamin D with K, krill oil, potassium, calcium, berberine

Current Illness: none

ID: 1050154
Sex: M
Age: 77
State: AZ

Vax Date: 02/03/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Pulmonary Embolism right lung and blood clot in right leg. No travel or other events or activities are known that might have contributed to blood clots in leg and lung. Symtoms of embolism first appeared about 10 days following 2nd dose of Pfizer vaccine.

Other Meds: Zocor, Flomax

Current Illness: None

ID: 1050155
Sex: F
Age: 68
State: AK

Vax Date: 01/30/2021
Onset Date: 02/08/2021
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: several eye drops, Quinolones

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Feb 8,2021 wokeup around 6am and noticed slightpain and small area of redness around area on left arm I had covid-19 injection Jan 30,2021. It was there daily , appeared hot and the reddened area appeared to widen. The area was more itchy than painful. I looked for similar symptoms/side effects on the internet and found photos of "covid arm" that resembled mine. I eventually applied some topoical benadryl around the 15 February which by this time was looking better-less redness and area. Back to normal by February 16th.

Other Meds: Dorzolamide HCL 2% eye drops Losartan Potassium 100mg tab Chlorthalidone 25mg tablet

Current Illness: none that I am aware of

ID: 1050156
Sex: F
Age: 57
State: FL

Vax Date: 02/17/2021
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: RA

Lab Data:

Allergies: No

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Nausea, diarrhea, headache

Other Meds: Rinvoq

Current Illness: None

ID: 1050157
Sex: F
Age: 43
State: CA

Vax Date: 02/21/2021
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: RA

Lab Data:

Allergies: None

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

Symptoms: Swelling of the lips- angioedema

Other Meds: Multi-vitamins, turmeric, collagen, biotin

Current Illness: None

Date Died: 02/23/2021

ID: 1050158
Sex: M
Age: 83
State: CA

Vax Date: 01/28/2021
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: No known allergies

Symptom List: Nausea

Symptoms: Resident is a Hospice patient. On 1-23-2021 am shift resident was observed by nursing have chest congestion and had a emesis times 1 with SOB, Zofran 4 mg was given. HOB (02 sats 88%) was elevated resident on 02 via nasal canula with 02 sat now @ 90% . no respiratory distress noted. MD was called with response pending for orders. @ 1400 resident with no signs of life. vs 90%-24-97/71-97.6. Hospice on site and time of death 1436

Other Meds: Tramadol HCI tab 50mg po Qday, Ambien titrate 5 mg PO QHS PRN, Promethazine DM Syrup 6.25-15mg/5ml give 5ml Q4hrs prn, Zofran 4mg 1 tab PO Q 4 hours PRN, Morphine sulfate 15mg give 0.5mg PO Q 4hours PRN , Bowel care

Current Illness: Dementia, History of CVA affecting left side, history of COVID 19 in December 2020, Aphasia.

ID: 1050159
Sex: F
Age: 36
State: KY

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

Lab Data:

Allergies: azithromycin hygroton

Symptom List: Injection site pain

Symptoms: Red rash appeared 7 days post vaccination, has continued for 5 days so far. Rash has grown in size from about 1/2 inch to 4 or more inches in diameter. large, warm and flat rash on upper left arm at injection site. Rash has spread to underside of upper arm and unto forearm but appears "lacey" and is raised. Mild itchy. Swollen lymph node notice on 2/23/21 in left armpit. This is 11 days post vaccination.

Other Meds: labetalol junel colestid B-12 Lexapro omeprazole

Current Illness:

ID: 1050160
Sex: F
Age: 76
State: CA

Vax Date: 02/01/2021
Onset Date: 02/09/2021
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

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

Symptoms: Apparent COVID Arm: Large red blotchy patch (3 inches in diameter) at the site of the injection that appeared approximately 9 days after first dose shot. Extremely itchy!! Applied cortisone ointment to the area 2-3 times a day for approximately 3 days. Saw personal physician on 2/16/21 to discuss my reaction and to confirm that there was no need for concern and it would be safe to receive my second dose. As of this reporting, my arm has cleared up completely and I am no longer experiencing any itch or pain. At the time of the injection, I experienced pain as the vaccine was being administered and subsequently a very painful arm for approximately a week and a half.

Other Meds: Trimethoprim, Atenolol, Crestor, Imvexxy Eye Science Macular Health Vitamin, CoQ10, Omega-3, Viactiv Calcium Chew, B12 2000, Phillips Probioyic, Liquid Vitamin D3 with K2, low dose aspirin, stool softener, Beta Plus

Current Illness: None

ID: 1050161
Sex: F
Age: 91
State: AL

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: RA

Lab Data:

Allergies: none known

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

Symptoms: stomach pain and other common symptoms were completely gone by the morning of 2/17/21

Other Meds: albutererol sulfate inhalation solution 2.5mg every 4 hrs, advair 500/50 , Spiriva Respimat,

Current Illness:

ID: 1050162
Sex: F
Age: 68
State: CA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Amoxicillin/Penicillin (tachycardia), ibuprofen (tachycardia)

Symptom List: Tremor

Symptoms: Felt severely depressed for at least 5 hours --completely resolved when she awoke the next morning.

Other Meds: Keppra, levothyroxine, omega 3 fish oils, Vitamin C, Vitamin D, Magnesium, Multivitamin, Calcium

Current Illness:

ID: 1050163
Sex: M
Age: 65
State: CA

Vax Date: 01/23/2021
Onset Date: 01/29/2021
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: Penicillin

Symptom List: Erythema, Pruritus

Symptoms: Rash around the injection area

Other Meds: Advil, claritan

Current Illness:

ID: 1050164
Sex: M
Age: 71
State: AZ

Vax Date: 02/13/2021
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: Penicillin

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

Symptoms: Rash, swelling, soreness , itch at injection site

Other Meds: Trazodone, Losaran , levothyroxine, metformin,

Current Illness: None

ID: 1050165
Sex: F
Age: 52
State: CO

Vax Date: 02/09/2021
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: NKDA

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

Symptoms: Stiff neck, neck pain 8/10 with looking side to side and up. Sometimes goes down center of cervical spine when looking up. No swelling/redness. History of neck pain but nothing like this or this long.

Other Meds: Sumatriptan, topiramate

Current Illness: None

ID: 1050166
Sex: M
Age: 30
State: IN

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: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient experienced light headedness and symptoms consistent with syncope, as well as nausea. the syncope event occurred in the chair without a fall. per patient reporting patient had not eaten 8 hours prior to administration time and also experienced anxiety with vaccines. patient was given supportive care including assisting to the floor carefully with a pillow provided and feet elevated. patient was also provided with juice to support any potential low blood sugar.

Other Meds:

Current Illness:

ID: 1050167
Sex: F
Age: 47
State: WA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
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: none

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

Symptoms: Initially I had soreness,swelling and redness in my left arm. after about four days soreness disappears but the swelling still there and circumferential red blotch with itching persist

Other Meds: amlodipine,lipitor,aspirin

Current Illness: none

ID: 1050168
Sex: F
Age: 23
State: NY

Vax Date: 02/20/2021
Onset Date: 02/21/2021
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: n/a

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

Symptoms: Fever, achiness, nausea, and then vomiting 5 times, unrelated to food. Most of it was bile. At 12:30 AM Feb 21 I woke up with violent chills and took an tylenol to break the fever. At 3:00AM I threw up for the first time, then again at 5:00AM, then again at 6AM, 7AM, and the last one was at 7:30AM.

Other Meds: omeprazole, cranberry supplements

Current Illness: n/a

ID: 1050169
Sex: F
Age: 68
State: TX

Vax Date: 01/21/2021
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: penicillin

Symptom List: Pain in extremity

Symptoms: Diamond shape red skin belowinjection shape

Other Meds: Amlodipine Besylate/valsartan,Atorvastatin calcium Nitrofurantain,lioyhyronine , Amitropyline

Current Illness: none

ID: 1050170
Sex: M
Age: 29
State:

Vax Date: 01/28/2021
Onset Date: 01/28/2021
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: Headache, arm soreness and muscle pain, chest tightness

Other Meds: None

Current Illness: None

ID: 1050171
Sex: F
Age: 50
State: OR

Vax Date: 02/20/2021
Onset Date: 02/20/2021
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 reported

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

Symptoms: Nausea, Vomiting, SOB, Palpitations, Fatigue, Headache

Other Meds: unknown

Current Illness: None reported

Date Died: 02/09/2021

ID: 1050172
Sex: F
Age: 96
State: WA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: Unknown

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

Symptoms: Individual developed severe body aches, severe shoulder discomfort, high fevers (documented max temp. 103.7 F). Daughter reported that she became non-responsive with high fevers, and when the fevers decreased she was more lucid. Her condition rapidly progressed to nausea vomiting, diarrhea and patient died on 2/9/2021.

Other Meds: Unknown

Current Illness: Inpatient admission to Medical Center 12/26/2020 - 01/07/2021 for Congestive Heart Failure

ID: 1050173
Sex: F
Age: 64
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Pt complained of swelling of left side of face and feeling as if her throat was swelling.

Other Meds:

Current Illness:

ID: 1050174
Sex: F
Age: 63
State: UT

Vax Date: 02/18/2021
Onset Date: 02/18/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient was vaccinated 1/18/21 and 1/28/21. 1st dose was not indicated on vaccination card so another dose was given on 2/18/21 under the assumption that it was the 2nd dose. Upon talking to Care Center, Patient was not at their facility on 1/18/21. She was at another Care Center. They did not get any vaccination card or vaccine history from center upon transferring patient to care center.

Other Meds:

Current Illness:

ID: 1050175
Sex: M
Age: 64
State: NM

Vax Date: 02/17/2021
Onset Date: 02/21/2021
Rec V Date: 02/23/2021
Hospital: Y

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: vancomycin

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

Symptoms: Worsening pneumonitis, hypoxemia, hypotension requiring hospital admission. Had had mild hypoxemia without other symptoms starting 1/25/2021, shortly before first dose of COVID19 Pfizer on 1/27/2021 and after he had been considered clinically recovered from acute COVID19 illness on 1/14/2021.

Other Meds: insulin, omeprazole, pregabalin, aspirin, carvedilol, canagliflozin, atorvastatin, metformin, ferrous gluconate, loperamide

Current Illness: acute COVID19 disease; test + 1/4/2021; considered recovered 1/14/2021

ID: 1050176
Sex: M
Age: 73
State: FL

Vax Date: 02/19/2021
Onset Date: 02/20/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Severe pain at injection site. Fever to 100.8, averaging 99.6 over one day - starting on second day after injection. Fatigue.

Other Meds: Rx ? Vicodin, 5-325 ? ? tablet in afternoon Rx ? Zolpidem, 10mg/night Rx ? Pravastatin, 40 mg/day Rx ? Metoprolol ER Succinate, 50 mg/day Rx ? Pantoprazole, 40 mg/day OTC ? Fluticasone Propionate 200 mcg (2 sprays each nostril before bed)

Current Illness: Oral surgery for bone graft on 2/1/2021 with Augmentin and Metronidazole through 2/9/2021. Knee pain ongoing - possibly meniscus bruise or arthritis. Shoulder pain from dislocation, tears to biceps, deltoid, rotator cuff, supraspinatus and resulting surgery in 2019. Recurring bouts of neuropathy.

ID: 1050177
Sex: F
Age: 49
State: CA

Vax Date: 02/11/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

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

Symptoms: Redness, heat and swelling in large area around injection site - 9 days after vaccination

Other Meds: enalapril, verapamil, HCTZ/triamterene

Current Illness: none

ID: 1050178
Sex: F
Age: 55
State: OR

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

Lab Data:

Allergies:

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

Symptoms: the day after vaccine, 2-22-2021, shills, nausea, extreme fatigue, headache, and muscle pain. 2-23-2021, only extreme fatigue and some muscle pain

Other Meds: effector, omepprizol, Claritin

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm