VAERS 2021 Database www.vaers.hhs.gov

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VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 1066540
Sex: F
Age:
State: MI

Vax Date: 01/11/2021
Onset Date: 01/27/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Test Date: 20210210; Test Name: Rapid test; Test Result: Negative ; Test Date: 20210212; Test Name: Rapid test; Test Result: Negative ; Test Name: strep Test; Test Result: Negative ; Test Name: herpes test; Test Result: Negative

Allergies:

Symptoms: felt sick; sore throat with blisters/ vesicles; had a really bad sore throat; tired; achy; her necklines were swollen; redness in back; she was exposed to someone who previously had Covid-19; This is a spontaneous report from a Pfizer-sponsored program and from a Pfizer-sponsored program. A contactable nurse (reporting for herself) reported that a 59-year-old female patient, received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Lot number EL0142), via an unspecified route of administration on 11Jan2021 (at the age of 59) as a single dose for COVID-19 immunization. The patient's medical history included depression from an unknown date. The patient's concomitant medications included duloxetine hydrochloride (CYMBALTA) from an unknown date as an antidepressant. The patient previously received first dose of BNT62B2 (Lot number EJ1685) on 21Dec2020. The patient experienced feeling sick for 3 days after receiving the second dose. The patient may have been exposed to someone who previously had COVID-19 on 27Jan2021 and experienced really bad sore throat with blisters and tiny bubbles on the back of her throat, redness back there and there was little vesicle (called it "Covid throat"); was tired and achy and her necklines were swollen a week later on an unknown date in Feb2021. The patient underwent lab tests which included Rapid COVID Test on 10Feb2021 and 12Feb2021 with negative results; herpes test on an unknown date with negative results and strep test on an unknown date with negative results. Therapeutic measures were taken as a result of the event COVID-19 exposure which included tetracycline on the 10th (stopped on the 12th as the tests negative). The outcome of the events throat blister, malaise, sore throat, fatigue, achy, neck swelling, throat redness and exposure to COVID-19 was unknown. Follow up (16Feb2021): New information received from a contactable healthcare provider and from a Pfizer-sponsored program includes: product details (lot numbers, second dose information), new events (throat blister, malaise, sore throat, fatigue, achy, neck swelling, throat redness and exposure to COVID-19), and lab data.; Sender's Comments: Event blisters and tiny bubbles on the back of throat represents an intercurrent medical condition and unrelated to BNT62B2 . The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds: CYMBALTA

Current Illness:

ID: 1066541
Sex: M
Age:
State: IA

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

Lab Data: Test Name: CSF cell count; Result Unstructured Data: 2 lymphocytes. Normal.; Test Name: CSF glucose; Result Unstructured Data: Normal; Test Name: CSF protein; Test Name: Needle EMG testing of distal lower extremity muscles; Result Unstructured Data: Unremarkable; Test Name: Cranial MRI; Result Unstructured Data: Subtle enhancement of facial nerves.; Test Name: Electrodiagnostic findings/median motor; Result Unstructured Data: Distal motor latency (DL) (ms): 5.3 Amplitude (Amp): 3.5 Conduction velocity (CV) (m/s): 34.21 F wave latency (ms): 59; Test Name: Electrodiagnostic findings/median sensory amplitude; Result Unstructured Data: No response (NR); Test Name: Electrodiagnostic findings/peroneal motor; Result Unstructured Data: Rt: Distal motor latency (DL) (ms): 7.5 Rt: Amplitude (Amp): 0.8 Rt: Conduction velocity (CV) (m/s): 41.22 Rt: F wave latency (ms): No response (NR) Lt: Distal motor latency (DL) (ms): 6.4 Lt: Amplitude (Amp): 1.1 Lt: Conduction velocity (CV) (m/s): 30.42 Lt: F wave latency (ms): No response (NR); Test Name: Electrodiagnostic findings/sural amplitude; Result Unstructured Data: Rt: 11 ?V Lt: 13 ?V; Test Name: Electrodiagnostic findings/tibial motor; Result Unstructured Data: Rt: Distal motor latency (DL) (ms): 6.6 Rt: Amplitude (Amp): 3.7 Rt: Conduction velocity (CV) (m/s): 34 Rt: F wave latency (ms): 84 Lt: Distal motor latency (DL) (ms): 5.8 Lt: Amplitude (Amp): 5.6 Lt: Conduction velocity (CV) (m/s): 30 Lt: F wave latency (ms): 78; Test Name: Electrodiagnostic findings/ulnar motor; Result Unstructured Data: Distal motor latency (DL) (ms): 3.8 Amplitude (Amp): 8.6 Conduction velocity (CV) (m/s): 48, 43, 60 F wave latency (ms): 38; Test Name: Electrodiagnostic findings/ulnar sensory amplitude; Result Unstructured Data: No response (NR); Test Name: Examination; Result Unstructured Data: Showed weakness with grade 4 medical research council (MRC) strength in intrinsic hand muscles, hip flexors, and ankle dorsiflexion. Muscle stretch reflexes were diminished in the arms and absent at knees and ankles. Vibration and pin sensation were diminished in feet with preserved proprioception.; Test Name: Blink reflex test; Result Unstructured Data: Tendon reflex: Absent in legs. All tendon reflexes were absent. Sensations were normal. Absent R1 and R2 responses bilaterally and normal response with direct facial stimulation, suggesting a proximal conduction block.

Allergies:

Symptoms: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP); This literature case was received on 22-Feb-2021, concerning 46-year old, male patient. This short study was conducted at the neuromuscular clinic from 2001 to 2005. The patient had no relevant medical history. The patient was in good health prior to the onset of chronic inflammatory demyelinating polyneuropathy (CIDP), did not have any acute illness, systemic infections, diabetes mellitus, history of alcohol abuse, or exposure any known neurotoxins, and there was no family history of neuropathy. The patient's concomitant medications were not reported. On an unknown date, the patient was vaccinated influenza virus vaccine polyvalent (brand not specified; dose, anatomical location, indication and route of administration: not reported). The batch number was not reported. On an unspecified date, seven days after receiving influenza virus vaccine polyvalent, the patient experienced sensation of burning, tingling, and itching over the trunk. The patient underwent detailed history, general and neurological examinations, electrodiagnostic and laboratory studies, including spinal fluid, complete blood count, metabolic panel, serology for autoimmune disorders, Lyme serology, venereal disease research laboratory (VDRL), serum immune fixation, thyroid studies, glucose and HbA1C, and magnetic resonance imaging (MRI) of the brain and spine. On an unspecified date, over the next ten days, the patient developed difficulty chewing, bilateral facial weakness and diplopia, along with tingling and numbness in feet and hands, mild weakness in limbs, and gait difficulty. All tendon reflexes were absent, and sensations were normal. The cerebral spinal fluid (CSF) analysis revealed elevated protein (142 mg/dl) with two lymphocytes and normal glucose and cell count. Other laboratory and imaging studies were normal. Electrodiagnostic studies were unremarkable except for mild impersistence of median nerve F waves (four of ten) with normal latencies. Needle electromyogram (EMG) testing of distal lower extremity muscles was unremarkable. Blink reflex showed absent R1 and R2 responses bilaterally and normal response with direct facial stimulation, suggesting a proximal conduction block. Cranial magnetic resonance imaging (MRI) showed subtle enhancement of facial nerves. On an unspecified date, he was treated with a 5-day course of immunoglobulin (IVIG) at a dose of 0.4 g/kg per day. On an unspecified date, the patient improved. On an unspecified date, four weeks later, the patient noted increasing numbness in toes and hands as well as increasing weakness in ankles with decreased balance and gait difficulty. Examination showed weakness with grade four medical research council (MRC) strength in intrinsic hand muscles, hip flexors, and ankle dorsiflexion. Muscle stretch reflexes were diminished in the arms and absent at knees and ankles. Vibration and pin sensation were diminished in feet with preserved proprioception. Electrodiagnostic findings for median motor were: distal motor latency (DL) (ms): 5.3, amplitude (amp): 3.5, conduction velocity (CV) (m/s): 34.21 and F wave latency (ms): 59; for peroneal motor: right (rt): DL (ms): 7.5, amp: 0.8, CV (m/s): 41.22 and F wave latency (ms): No response (NR), left (lt): DL (ms): 6.4, amp: 1.1, CV (m/s): 30.42 and F wave latency (ms): NR; for tibial motor: rt: DL (ms): 6.6, Amp: 3.7, CV (m/s): 34, F wave latency (ms): 84, lt: DL (ms): 5.8, amp: 5.6, CV (m/s): 30 and F wave latency (ms): 78; and for ulnar motor: DL (ms): 3.8, amp: 8.6, CV (m/s): 48, 43, 60, F wave latency (ms): 38. Sural amplitude for lt was 13 ?V and rt: 11 ?V, median sensory amplitude and ulnar sensory amplitude were: NR. Electrodiagnostic studies showed widespread abnormalities, indicating a demyelinating polyneuropathy. Median and ulnar sensory potentials were absent, and sural sensory potentials were preserved. On an unspecified date, the patient was treated with intravenous Gammaglobulin (immunoglobulin g human) (IVIG) at a dose of 1 g/kg monthly for four months. On an unspecified date, the patient improved promptly. On an unspecified date, he experienced another relapse, which responded to pulse intravenous methylprednisolone at a dose of 1000 mg per week (mg/wk) and developed gastrointestinal side effects. Thereafter, he was treated with monthly immunoglobulin (IVIG), and oral Mycophenolate (mycophenolate mofetil) at a dose of 1 g two times a day (bid). On an unspecified date, at the 36-month follow-up, the patient showed no deficit. He had not required IVIG for one year and remained free of relapses. At the time of initial reporting, the patient recovered from event. The reporter assessed the event as related to influenza virus vaccine polyvalent. Physician reported that the patient who was otherwise healthy, developed CIDP with rapid onset in close proximity to influenza vaccination, suggesting a plausible relationship between the immunization and the induction of CIDP, however the plausible relationship was not clear. In conclusion, the relationship between immunization, particularly influenza vaccination, and the development of acquired demyelinating neuropathies has been discussed in the literature, mostly in the context of Guillain-Barre syndrome (GBS). Although the concern that CIDP might follow influenza vaccination similar to Guillain-Barre syndrome (GBS) might seem intuitive, there were no clearly documented cases in the literature of CIDP with abrupt onset within a few days after influenza vaccination. Our patient, who was otherwise healthy, developed CIDP with rapid onset in close proximity to influenza vaccination, suggesting a plausible relationship between the immunization and the induction of CIDP. Rapid onset resembling GBS occurs in about 15 percent to 20 percent of cases of CIDP. It was possible that antecedent events such as immunization are more likely in such patients, but that has not been systematically evaluated. In contrast to GBS, which was a monophasic illness, how a single event such as immunization may trigger induction of a relapsing or chronic immune-mediated disorder such as CIDP is not known. This case is linked to cases 202101474 and 202101475 (the same literature article). Company comment: A 46-year-old male patient developed chronic inflammatory demyelinating polyradiculoneuropathy after vaccination with the suspect product, influenza virus vaccine polyvalent. Chronology is plausible. The patient was in good health prior to the onset of chronic inflammatory demyelinating polyneuropathy (CIDP) and did not have any acute illness or systemic infections, diabetes mellitus, history of alcohol abuse, or exposure to any known neurotoxins. As reported, the patient had multiple relapses with varying diagnostic findings. Information regarding the concomitant medications have not been provided. Based on plausible time relationship, causality for the reported event cannot be totally excluded and is assessed as possibly related.; Reporter's Comments: Physician reported that the patient who was otherwise healthy, developed CIDP with rapid onset in close proximity to influenza vaccination, suggesting a plausible relationship between the immunization and the induction of CIDP, however the plausible relationship was not clear.; Sender's Comments: A 46-year-old male patient developed chronic inflammatory demyelinating polyradiculoneuropathy after vaccination with the suspect product, influenza virus vaccine polyvalent. Chronology is plausible. The patient was in good health prior to the onset of chronic inflammatory demyelinating polyneuropathy (CIDP) and did not have any acute illness or systemic infections, diabetes mellitus, history of alcohol abuse, or exposure to any known neurotoxins. As reported, the patient had multiple relapses with varying diagnostic findings. Information regarding the concomitant medications have not been provided. Based on plausible time relationship, causality for the reported event cannot be totally excluded and is assessed as possibly related.

Other Meds:

Current Illness:

ID: 1066542
Sex: M
Age:
State: IA

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

Lab Data: Test Name: CSF cell count; Result Unstructured Data: Normal; Test Name: CSF glucose; Result Unstructured Data: Normal; Test Name: CSF protein; Result Unstructured Data: 127.3 mg/dl; Test Name: Needle EMG; Result Unstructured Data: Fibrillation potentials and loss of motor unit potentials in the distal upper and lower extremity muscles; Test Name: Electrodiagnositic findings / Median Motor; Result Unstructured Data: Median Motor: Rt: Distal motor latency (DL) (ms): 9.3 Rt: Amplitude (Amp) (mV): 1.6 Rt: Conduction velocity (CV) (m/s): 24.26 Rt: F wave latency (ms): 54; Test Name: Electrodiagnositic findings / Peroneal Motor; Result Unstructured Data: Peroneal Motor: Rt: Distal motor latency (DL) (ms): 6.7 Rt: Amplitude (Amp) (mV): 0.4 Rt: Conduction velocity (CV) (m/s): 31.31 Rt: F wave latency (ms): No response (NR); Test Name: Electrodiagnositic findings/ median sensory amplitude; Result Unstructured Data: No response (NR); Test Name: Electrodiagnositic findings/ Sural amplitude; Result Unstructured Data: Lt: No response (NR) Rt: No response (NR); Test Name: Electrodiagnositic findings/ Tibial Motor; Result Unstructured Data: Tibial Motor: Rt: Distal motor latency (DL) (ms): 8.3 Rt: Amplitude (Amp) (mV): 0.7 Rt: Conduction velocity (CV) (m/s): 26 Rt: F wave latency (ms): No response (NR); Test Name: Electrodiagnositic findings/ Ulnar Motor; Result Unstructured Data: Ulnar Motor: Rt: Distal motor latency (DL) (ms): 4.3 Rt: Amplitude (Amp) (mV): 3.5 Rt: Conduction velocity (CV) (m/s): 43, 37, 43 Rt: F wave latency (ms): 47; Test Name: Electrodiagnositic findings/ Ulnar sensory amplitude; Result Unstructured Data: 2.6 mV; Test Name: Reflex test; Result Unstructured Data: Tendon reflex: All absent Absent muscle stretch reflexes

Allergies:

Symptoms: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP); This literature case was received on 22-Feb-2021 and concerned an 89-year-old male patient. The patient had no relevant medical history. He was in good health prior to the onset of chronic inflammatory demyelinating polyneuropathy (CIDP) and did not have any acute illness or systemic infections, diabetes mellitus, history of alcohol abuse, or exposure to any known neurotoxins. The patient's concomitant medications were not reported. There was no family history of neuropathy. On an unspecified date, the patient was vaccinated with influenza virus vaccine polyvalent (brand not specified; dose, route of administration, anatomical location and indication: not reported). The batch number was not reported. On an unspecified date, two days after receiving influenza virus vaccine polyvalent, the patient developed tingling in the hands, followed by progressive weakness, which progressed over two weeks, in his arms and legs. On an unknown date, the patient started five-day course treatment with intravenous immune globulin (IVIG) over four weeks. On an unknown date, patient improved. On an unspecified date, a month later, the patient experienced more gradual worsening of weakness over six weeks. The patient was unable to walk or stand, even with support. On an unknown date, the patient underwent detailed history, general and neurological examinations, electrodiagnostic and laboratory studies, including spinal fluid, complete blood count, metabolic panel, serology for autoimmune disorders, Lyme serology, venereal disease research laboratory (VDRL), serum immune fixation, thyroid studies, glucose and HbA1C, and magnetic resonance imaging (MRI) of the brain and spine. Examination showed marked weakness in proximal and distal muscles of all extremities, with absent muscle stretch reflexes. The patient's tendon reflexes were all absent. Vibration was diminished in the toes, and other sensations were intact. Electrodiagnostic findings for median motor were: right (rt) distal motor latency (DL) (ms): 9.3, rt: amplitude (Amp) (mV): 1.6, rt: conduction velocity (CV) (m/s): 24, 26 and rt: F wave latency (ms): 54; for peroneal motor: rt: DL (ms): 6.7, rt: Amp (mV): 0.4, rt: CV (m/s): 31, 31 and rt: F wave latency (ms): No response (NR); for tibial motor: rt: DL (ms): 8.3, rt: Amp (mV): 0.7, rt: CV (m/s): 26, rt: F wave latency (ms): NR and for ulnar motor: rt: DL (ms): 4.3, rt: Amp (mV): 3.5, rt: (CV) (m/s): 43, 37, 43, rt: F wave latency (ms): 47. Sural amplitude for left (lt) and rt: NR, median sensory amplitude was: NR and ulnar sensory amplitude was 2.6 mV. Needle Electromyography (EMG) showed fibrillation potentials and loss of motor unit potentials in the distal upper and lower extremity muscles. Electrodiagnostic studies showed widespread abnormalities, indicating a demyelinating polyneuropathy. Many nerves showed findings suggestive of primary demyelination namely temporal dispersion or conduction block, marked reduction of conduction velocity, prolongation or absent F waves, prolonged distal motor latencies, and met the commonly accepted criteria for diagnosis of CIDP. The cerebral spinal fluid (CSF) analysis revealed elevated protein (127,3 mg/dl), with normal glucose and cell count. Other laboratory and imaging studies were normal. On an unknown date, the patient was treated monthly with IVIG at dose of 1 g/kg and oral Mycophenalate (mycophenolate mofetil) at dose of 1000 mg, twice a day (bid). On an unknown date, after six months IVIG was discontinued. On an unspecified date, at the 16-month follow-up, the patient showed normal gait and only mild weakness of intrinsic hand muscles (grade 4 Medical Research Council (MRC)). At the time of initial reporting, the patient was recovering from event. The relationship between immunization, particularly influenza vaccination, and the development of acquired demyelinating neuropathies has been discussed in the literature, mostly in the context of Guillain-Barre syndrome (GBS). The plausible relationship between CIDP and vaccination was less clear than between GBS and vaccination. Patients, who were otherwise healthy, developed CIDP with rapid onset in close proximity to influenza vaccination, suggesting a plausible relationship between the immunization and the induction of CIDP. Rapid onset resembling GBS occurs in about 15 percent to 20 percent of cases of CIDP. It was possible that antecedent events such as immunization were more likely in such patients, but that had not been systematically evaluated. In contrast to GBS, which was a monophasic illness, how a single event such as immunization may trigger induction of a relapsing or chronic immune-mediated disorder such as CIDP was not known. The event of chronic inflammatory demyelinating polyneuropathy was considered to be medically significant by a Physician within Seqirus' Pharmacovigilance and Risk Management Department. This case is linked to cases 202101473 and 202101475 (the same literature article). Company comment: A 89-year-old male patient developed chronic inflammatory demyelinating polyradiculoneuropathy after vaccination with the suspect product, influenza virus vaccine polyvalent. Chronology is plausible. The patient was in good health prior to the onset of chronic inflammatory demyelinating polyneuropathy (CIDP) and did not have any acute illness or systemic infections, diabetes mellitus, history of alcohol abuse, or exposure to any known neurotoxins. As reported, electrodiagnostic studies showed widespread abnormalities, indicating a demyelinating polyneuropathy. Information regarding the concomitant medications have not been provided. Based on plausible time relationship, causality for the reported event cannot be totally excluded and is assessed as possibly related.; Reporter's Comments: The patient, who were otherwise healthy, developed CIDP with rapid onset in close proximity to influenza vaccination, suggesting a plausible relationship between the immunization and the induction of CIDP.; Sender's Comments: A 89-year-old male patient developed chronic inflammatory demyelinating polyradiculoneuropathy after vaccination with the suspect product, influenza virus vaccine polyvalent. Chronology is plausible. The patient was in good health prior to the onset of chronic inflammatory demyelinating polyneuropathy (CIDP) and did not have any acute illness or systemic infections, diabetes mellitus, history of alcohol abuse, or exposure to any known neurotoxins. As reported, electrodiagnostic studies showed widespread abnormalities, indicating a demyelinating polyneuropathy. Information regarding the concomitant medications have not been provided. Based on plausible time relationship, causality for the reported event cannot be totally excluded and is assessed as possibly related.

Other Meds:

Current Illness:

ID: 1066543
Sex: F
Age:
State: IA

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

Lab Data: Test Name: Glucose; Result Unstructured Data: Normal.; Test Name: Cell count; Result Unstructured Data: Normal.; Test Name: CSF protein; Result Unstructured Data: 136 mg/dl elevated.; Test Name: Electrodiagnositic findings; Result Unstructured Data: Evidence of demyelinating polyneuropathy Peroneal motor: distal latency (DL): 11 ms (right) and 12.2 ms (left) amplitude (AMP): 0.5 mV (right) and 0.3 mV (left) conduction velocity (CV) in different segments: 21,22 m/s (right) and 22,23 m/s (left) Tibial motor: distal latency (DL): 10.7 ms (right) and 9.9 ms (left) amplitude (AMP: 2 mV (right) and 2.3 mV (left) conduction velocity (CV) in different segments:: 27 m/s (right) and 34 m/s (left) F wave latency: no response (NP) (right) and 120 ms (left) Ulnar motor: distal latency (DL): 5.1 ms (right) and 95.1 ms (left) amplitude (AMP: 5.1 mV (right) and 3.8 mV (left) conduction velocity (CV) in different segments:: 37, 34 and 30 m/s (right) and 35, 36 and 38 m/s (left) F wave latency: 50 ms (right) and 48 ms (left); Test Name: Tendon reflexes; Result Unstructured Data: Absent in legs, reduced in arms; Test Name: Tendon reflexes; Result Unstructured Data: At 14-months follow-up Reflexes remain absent in the lower extremities.

Allergies:

Symptoms: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP); This literature case was received on 22-Feb-2021 and concerned an 84-year-old, female patient. The aim of this study was to describe three patients who developed chronic inflammatory demyelinating polyneuropathy (CIDP) with rapid onset in close proximity to influenza vaccination followed by relapsing or chronic course. Patients were evaluated at the neuromuscular clinic from 2001 to 2005. The patients underwent detailed history, general and neurological examinations, electrodiagnostic and laboratory studies, including spinal fluid, complete blood count, metabolic panel, serology for autoimmune disorders, Lyme serology, venereal disease research laboratory (VDRL), serum immune fixation, thyroid studies, glucose and HbA1C, and magnetic resonance imaging (MRI) of the brain and spine. The patient had no relevant medical history. The patient was in good health and had no acute illness or systemic infections. The patient had no diabetes mellitus, history of alcohol abuse, or exposure to any known neurotoxins and had no family history of neuropathy. The patient's concomitant medications were not reported. On an unknown date, the patient was vaccinated with influenza virus vaccine polyvalent (brand not specified; dose, route of administration and anatomical location: not reported) for influenza vaccination. The batch number was not reported. On an unknown date, 21 days after receiving influenza virus vaccine polyvalent, the patient experienced severe pain in a band like distribution in the mid thoracic region. On an unknown date, four days later, the patient experienced progressive weakness and numbness which progressed over six weeks, in her legs and hands. The patient was able to take a few steps with a walker, and she had marked weakness in proximal and distal muscles of upper and lower extremities. Muscle stretch reflexes were absent in the legs and diminished in the arms. Vibration was absent in the feet, but proprioception and pin sensation were intact. Gait was broad based and ataxic. On an unknown date, the patient started a five-day course of intravenous immunoglobulin (IVIG), but did not improve. The patient was then treated with weekly pulse oral prednisone starting at dose of 150 mg/wk for two months followed by a slow taper to 20 mg/wk. On unknown date, CSF protein was elevated (136 mg/dl), with normal glucose and cell count. Other laboratory and imaging studies were normal. Electrodiagnostic studies showed evidence of demyelinating polyneuropathy. These values indicated primary demyelination: sural amplitude showed no response, peroneal motor distal latency (DL) was 11 ms (right) and 12.2 ms (left), amplitude (AMP) was 0.5 mV (right) and 0.3 mV (left), and conduction velocity (CV) in different segments revealed 21, 22 m/s (right) and 22, 23 m/s (left). Tibial motor DL was 10.7ms (right) and 9.9 ms (left), AMP was 2 mV (right) and 2.3 mV (left), and CV in different segments was 27 m/s (right) and 34 m/s (left) while F wave latency showed no response (NP) (right) and 120 ms (left). Ulnar motor DL revealed 5.1 ms (right and left), amplitude was 5.1 mV (right) and 3.8 mV (left), CV was 37, 34 and 30 m/s (right) and 35, 36 and 38 (left), while F wave latency was 50 (right) and 48 (left). Many nerves showed findings suggestive of primary demyelination, namely temporal dispersion or conduction block, marked reduction of conduction velocity, prolongation or absent F waves, prolonged distal motor latencies, and met the commonly accepted criteria for diagnosis of CIDP. This patient had second relapse and progressive course. On an unknown date, at 14-months follow-up, the patient was able to ambulate without assistance, and she has mild weakness (grade 4 MRC) in deltoid, intrinsic hand muscles, and hip flexion. Reflexes remain absent in the lower extremities. On an unknown date, at 16-months follow-up, the patient was able to ambulate independently and had mild weakness in arms. At the time of initial reporting, the patient was recovering from the event. The author assessed the event as related to influenza virus vaccine polyvalent. The patient who was otherwise healthy, developed CIDP with rapid onset in close proximity to influenza vaccination, suggesting a plausible relationship between the immunization and the induction of CIDP. The event of CIDP was considered to be medically significant by a Physician within Seqirus's Pharmacovigilance and Risk Management Department. The relationship between immunization, particularly influenza vaccination, and the development of acquired demyelinating neuropathies had been discussed in the literature, mostly in the context of Guillain-Barre syndrome (GBS). The plausible relationship between CIDP and vaccination was less clear than between GBS and vaccination. Rapid onset resembling GBS occurs in about 15 percent to 20 percent of cases of CIDP. It was possible that antecedent events such as immunization were more likely in such patients, but that has not been systematically evaluated. In contrast to GBS, which was a monophasic illness, how a single event such as immunization may trigger induction of a relapsing or chronic immune-mediated disorder such as CIDP was not known. This case is linked to cases 202101473 and 202101474 (the same literature article). Company comment: A 84-year-old female patient developed chronic inflammatory demyelinating polyradiculoneuropathy after vaccination with the suspect product, influenza virus vaccine polyvalent. Chronology is plausible. The patient was in good health prior to the onset of chronic inflammatory demyelinating polyneuropathy (CIDP) and did not have any acute illness or systemic infections, diabetes mellitus, history of alcohol abuse, or exposure to any known neurotoxins. As reported, the patient had multiple relapses with varying diagnostic findings. More information regarding the concomitant medications. is needed. Based on plausible time relationship, causality for the reported event cannot be totally excluded and is assessed as possibly related.; Reporter's Comments: The patient who was otherwise healthy, developed CIDP with rapid onset in close proximity to influenza vaccination, suggesting a plausible relationship between the immunization and the induction of CIDP.; Sender's Comments: A 84-year-old female patient developed chronic inflammatory demyelinating polyradiculoneuropathy after vaccination with the suspect product, influenza virus vaccine polyvalent. Chronology is plausible. The patient was in good health prior to the onset of chronic inflammatory demyelinating polyneuropathy (CIDP) and did not have any acute illness or systemic infections, diabetes mellitus, history of alcohol abuse, or exposure to any known neurotoxins. As reported, the patient had multiple relapses with varying diagnostic findings. More information regarding the concomitant medications. is needed. Based on plausible time relationship, causality for the reported event cannot be totally excluded and is assessed as possibly related.

Other Meds:

Current Illness:

ID: 1066544
Sex: M
Age: 80
State: NC

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None.

Allergies: None.

Symptoms: Had shortness of breath, chills, and fever up to 102 for the first day and half. On Sunday it came back to normal finally. Night sweats that are still continuing. Just during the day and get hot flashes. Flushing, upper body clamminess and then goes away and then has chills. His breathing has improved but is still not real steady on his feet. He is about 80-85% on his balance, 95% on his breathing. His biggest problem at this point is the hot flashes and the chills. He also has had loss of appetite and has had weight loss.

Other Meds: Simvastatin, Chlorathiodone, Creon, Carvedilol, Lisinopril, Warfarin, multivitamin, Loperamide HCI, CoQ10, Tamsolusin, glucosamine chondroitin, vitamin D3, zinc.

Current Illness: None.

ID: 1066545
Sex: M
Age: 68
State: MI

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

Lab Data: 3/2/2021 - EMS contacted and transported. IV access, 3-lead, 12-lead EKG

Allergies: iodine dye

Symptoms: lower abdominal pain, diaphoresis, pale, nauseated, lightheaded, dizzy, bradycardic

Other Meds: unknown

Current Illness: unknown

ID: 1066546
Sex: F
Age: 67
State: NC

Vax Date: 02/15/2021
Onset Date: 02/21/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: none

Allergies: NKDA , no food allergies

Symptoms: Developed Bells Palsy on 02/21/2021. Presented to hospital 02/22/2021. Treated with Prednisone and Valacyclovir Is improved

Other Meds: Metformin 1000 po bid Simvastatin 40 mg nightly

Current Illness: none

ID: 1066547
Sex: F
Age: 46
State: ID

Vax Date: 02/20/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: none

Symptoms: I have reported to the program as well, but something else occurred after that was concluded. I had mild-moderate soreness in arm at injection site, red rash 24 hours later and welt. Treated with Cortizone and ibuprofen. Healed after day 4 of shot. Woke up day 10 after shot and it was back and much more red this time, as sore again as first time, even though had been pain/sore free. I'm hearing this happens a week or so after the Moderana shot specifically. Thought I would report. Treating with same as first treatment, at home.

Other Meds: None

Current Illness: None

ID: 1066548
Sex: F
Age: 42
State: NC

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

Lab Data: none

Allergies: Shellfish- anaphylaxis Penicillins-diarrhea

Symptoms: The patient presented to the Emergency Department today secondary to symptoms which she states started about 1 hour ago prior to arrival after she received her Covid vaccine first injection at 11:40 AM, states that she went back to work as a teacher and started to feel a sensation as if she had some swelling of her throat and a mild sore throat as well, she states that she developed some nasal congestion as well as lightheadedness, she denied any dyspnea, no coughing or wheezing, no chest pain, vomiting or diarrhea, she called her doctor and was told to present here for evaluation, she did not take any medication for symptoms prior to arrival and states that her symptoms are very similar to her previous allergic reactions but has never required epinephrine. Treatment required: NS1L IV bolus, Famotidine 20mg IV, Solu-medrol 125mg IV, and Diphenhydramine 50 IV all x1. The patient will be given a prescription for a short course of steroids at home and has been advised to take benadryl and pepcid at home if needed.

Other Meds: none listed in chart

Current Illness: none listed in chart

ID: 1066549
Sex: F
Age: 41
State: NC

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

Lab Data:

Allergies: remicade

Symptoms: excruciating headache front and back of head, fever 102.4, body aches, fatigue, weakness, nausea, inability to focus

Other Meds: adderrall tramadol xanax ambien flexeril

Current Illness: none

ID: 1066550
Sex: F
Age: 57
State: TN

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: codeine

Symptoms: Patient reports started having fever and chills at approximately 4:30 on Friday 2-26-21. Woke up on Saturday with arm itching and a rash at site(2-27-21). Rash gradually spread to all extremities by night on 2-27-21. Currently has rash on scalp and abdomen. Saw PMD today and was given a steroid shot to help dry up rash.

Other Meds: Protonic, lisinopril, levothyroxine

Current Illness: none

ID: 1066551
Sex: M
Age: 67
State: CA

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

Lab Data: None

Allergies: nka

Symptoms: He states he sit down pulled out his phone to play and he started to feel dizzy and clammy. Pt noted to be diaphoretic and noted to be slightly pale. Report s he has not ate yet today but did take his b/p med. 1049 HR-34, R-18, B/P 70/50, 02 sat 97% RA, he is sweaty to touch. 1057 HR-42, 02 sat 97%. 1104 B/P 130/82, HR 50-60, 02 sat 96%. 1110 B/P 120/78, HR-66-68, 02 96%RA. 1117-B/P 122/87, HR-60, 02 96% RA, R-18. 1123 walked pt to care and his wife was in the car, instructed her she needed to drive him home. Wife verbalized understanding. Pt instructed to f/u with MD as needed.

Other Meds: amlodipine

Current Illness: none

ID: 1066552
Sex: F
Age: 72
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/19/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Covid Arm

Other Meds: Levothroxine 100 MCG

Current Illness: none

ID: 1066553
Sex: F
Age: 30
State: CA

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

Lab Data: no

Allergies: no

Symptoms: I took 600 mg Ibuprofen before the vaccine. About three hours after and I felt soreness in arm but it wasn't bad. 7:00 pm - body aches and softness; chills, shivering and a fever at 2:00 am and lasted until about 6:00 am. Next day, I couldn't move because body pain was bad, and I still had chills and shivering and fever and arm rash came back - but it was less itchy and red and less painful as first dose of vaccine - used the cream from first dose and Tylenol. Saturday symptoms started going away. Sunday I woke up with no symptoms.

Other Meds: Almorone; Nasal Spray - Flonase; ibuprofen prior to vaccine

Current Illness: Adverse symptoms after dose 1 of the COVID 19 vaccine

ID: 1066554
Sex: F
Age: 45
State: MA

Vax Date: 01/08/2021
Onset Date: 01/11/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: no

Allergies: Cephalosporins, treenut, seasonal allergies

Symptoms: A few days after the same ecema type rash appeared again over both eyelids but was severly worse this time. I also had itchiness, redness and soreness at the injection site which lasted about a week after and I was administed the steroid cream again which made the rash disappear after about a week

Other Meds: Zyrtec, Vit. B & D. Fish Oil

Current Illness: nothing besides AE to the 1st vaccination

ID: 1066555
Sex: F
Age: 70
State: FL

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 2/24/21 with hives, 2/11/21 chills , muscle aches; 2/11/21 hives all over body, chills , muscle aches for day. Rash continued; dermatologist started zyrtec

Other Meds:

Current Illness:

ID: 1066556
Sex: M
Age: 76
State: TX

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

Lab Data: Hospital stay Too many tests to list.

Allergies: NKDA

Symptoms: Stroke, Pulmonary embolism, kidney failure

Other Meds: Sotalol 40mg twice daily Plavix 75mg once daily Amlodipine 5mg twice daily Rosuvastatin Calcium 10mg once daily Aspirin 325mg

Current Illness: None

ID: 1066557
Sex: M
Age: 56
State: NJ

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Inspection of ears at ENT's office today and tuning fork test, in office, that diagnosed nerve related hearing loss in right ear. They started me on Predisone today to try and restart hearing in ear. follow up Hearing test scheduled for 3/2.

Allergies: none

Symptoms: nerve related hearing loss that came on 24 hours after injection and progressed to total hearing loss in one ear after 72 hours

Other Meds: none

Current Illness: none

ID: 1066558
Sex: F
Age: 72
State: AZ

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

Lab Data: None

Allergies: Afrin nasal spray, lactose, celebres, Choletac dye, ibuprofen, iodine, Keflex, Lexapro, Skelaxin, Toradol, Vioxx Many agent cause allover body swelling and breathing difficulties shellfish, milk, garlic ,onions, broccoli, and cauliflower

Symptoms: weakness in 1 hour sore arm had to use rescue inhaler between 3 and 10 hours at 10 hours lympanedopthy and facial swelling on L side f face 11 hours after injection contaced MD

Other Meds: Bee Pollen, Co-Q 10 , Nettle leaves, probiotic 10, Singulair 5mg QD, TUmeric liquid 1000mg/day

Current Illness: none

ID: 1066559
Sex: F
Age: 68
State: VA

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

Lab Data: None

Allergies: Allergic to raspberries, blue contrast dye, neomycin, paraben mix, backtracking, cl+me isothiazolinone, gold sodium, thiosulfate. The raspberries and blue dye causes itching. The other causes itching and body rashes.

Symptoms: Felt light headed by the time I got home. About an hour or so later my arm started feeling sore with itching and aching. Took a hot shower, tylenol and relaxed for a while.

Other Meds: Took prescription meds about 7:30 that morning. Blood pressure, high cholesterol, potassium and 81mg asprin.

Current Illness: None

ID: 1066560
Sex: F
Age: 23
State: WA

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

Lab Data:

Allergies:

Symptoms: I had chills, low-grade fever, fatigue for over 24 hours. I was uncomfortable and struggling to focus for 36 hours.

Other Meds: Vitamin d, minipill

Current Illness:

ID: 1066561
Sex: F
Age: 79
State: AZ

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

Lab Data:

Allergies:

Symptoms: tingling lips, itchy red cheeks - on the way home Saturday muscle aches from neck to ankles - during the night Saturday to Sunday stuffy nose, dry cough, fatigue, chills (no fever), nausea, sore arm - Sunday and Monday on third day the only thing remaining are chills sought no treatment

Other Meds: Calcium citrate and half a dose of multiple vitamin

Current Illness:

ID: 1066562
Sex: M
Age: 72
State: MN

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: penicillins, clindamycin, teracycline, pseudoephedrine

Symptoms: left deltoid injection site pain, reports of not feeling well, chills, body aches, fatigue

Other Meds: Elavil, Tylenol, aspirin, Lipitor, Neurontin, metformin

Current Illness:

ID: 1066563
Sex: F
Age: 32
State: CA

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

Lab Data:

Allergies:

Symptoms: Itchy arm/throat, stinging eyes. BP 147/80 (pulse 96), O2 sat 99%. Benadryl 25 mg PO x 2. Stable.

Other Meds:

Current Illness:

ID: 1066564
Sex: F
Age: 24
State: KS

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: penicillin, codeine, bactrim

Symptoms: Lump and redness at the injection site appeared a day after receiving the vaccine, and then 3 days after the vaccine I had severe shoulder pain and I couldn't move my arm in certain directions and I couldn't sleep on my shoulder. I tried to rest and take ibuprofen but nothing was helping the pain and I went to my health center a week after I received the vaccine and they said I was having too much of a localized inflammatory response and to alternate between ibuprofen and tylenol and use heat but the pain is still there and it's been almost 3 weeks.

Other Meds: Women's probiotic, generic zyrtec, women's multivitamin

Current Illness: none

ID: 1066565
Sex: F
Age: 66
State: NY

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

Lab Data: Vitals: BP: 179/93, HR 83 @ 2:30pm 177/84 @2;36 pm 164/93 @ 2: 50 pm Blood Glucose: 91 Pulse Ox was 92

Allergies: Betadine Meloxicam Percocet Hydrocodone Oxycodone

Symptoms: Twenty minutes post 1st vaccine dose on her left arm, patient began feeling light headed, tingling, and warmth in her bilateral forearms. She then developed tingling at the tip of her tongue and had facial flushing. She developed rashes (hives in bilateral UE). She was brought for evaluation. Benadryl 50mg was given, Vitals taken and water was provided as well. She denies any SOB, CP, swelling or numbness. Physical exam: S1,S2, CTA, hives positive in bilateral UE, facial flushing, and neuro exam WNL. She reports her daughter had the Moderna vaccine a few weeks ago and developed full blown anaphylaxis. Her second daughter also had an allergic reaction to the MMR vaccine. She denies any history of allergic reaction to vaccines herself but does report allergies to several medications. About 10 mins post Benadryl administration, facial flushing resolved and the rashes in her forearms began to improve as well. Patient was recommended transport to the hospital/ER but she declined. She was instructed to contact her PCP for further evaluation. She was informed her second vaccine will have to be administered at an ER or facility that provides higher level of care. She was escorted to her vehicle to meet her husband.

Other Meds: Vitamin D

Current Illness:

ID: 1066566
Sex: F
Age: 51
State: FL

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: NONE KNOWN

Symptoms: Pt said she was experiencing tightness in her throat and facial tingling. This began at 3:30pm. Pt was kept on site and observed with Benedryl standing by. No meds were given and her symptoms did not progress. Pt was kept on site for approximately 30 mins until a friend arrived to drive her home. A follow up call was done next day, and pt reported that she felt fine.

Other Meds: UNKNOWN

Current Illness: NONE KNOWN

ID: 1066567
Sex: M
Age: 50
State: CA

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

Lab Data: N/A

Allergies: NKA

Symptoms: Patient given a stronger constituted dose of the vaccine.

Other Meds: Patient given a stronger constituted dose of the vaccine.

Current Illness: Unknown

ID: 1066568
Sex: F
Age: 66
State: LA

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

Lab Data:

Allergies: Penicillin

Symptoms: Within 3-5 Minutes, I got severe shooting pains in my left temple that went across my forehead with headache, Felt extremely hot and Red rash appeared on my face on both cheeks and when I got up to leave I had weakness in my legs and was dizzy. Was given benedryl by the pharmacist who stated it look liked I had a reaction. Still had pain in left temple, headache, rash and dizzyness the next day along with scratchy throat. Headache and pain in temple mild after 3 days. I am concerned about second dose only because of shooting pains in my left temple.

Other Meds: Cozaar, Hydrochlorothiazide, Zocor, Pantoprazole, Glyburide, Metformin, Aspirin 81 mg, Magnesium Oxide, Multi Vitamin, Vitamin B6, Vitamin C, Allopurinol, Potassium Citrate, Vitamin D, Percocet

Current Illness: None

ID: 1066569
Sex: F
Age: 68
State: CA

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None. Doctor was not notified.

Allergies: sulfer drugs, injected iodine, bacitracin, gentak, neosporin, gentacicin

Symptoms: Sore arm for first 2 days and then diarreha, chills, headache, fatigue. Exactly seven days after shot, got very itchy rash at site of injection. Within a day, turned into a large, bright red, raised patch on arm, approx 3"x4". Lasted about 5 days.

Other Meds: fish oil, multi-vitamin, calcium, B vitamins, iron, hydrochlorothiazide, omperazole, montelukast, alpha lipoic, oxybutynin, atorvastatin

Current Illness:

ID: 1066570
Sex: M
Age: 31
State: CO

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

Lab Data:

Allergies:

Symptoms: Fever of 100.7, moderate to severe headache, body aches everywhere, malaise

Other Meds:

Current Illness:

ID: 1066571
Sex: F
Age: 4
State:

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

Lab Data:

Allergies:

Symptoms: rash around vaccine site, will have parents watch area

Other Meds:

Current Illness:

ID: 1066572
Sex: M
Age: 49
State:

Vax Date: 02/17/2021
Onset Date: 02/24/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: No

Allergies: No

Symptoms: Acute vertigo occurred one week after vaccination. The feeling of dizziness has not gone away yet after one week.

Other Meds: No

Current Illness: No

ID: 1066573
Sex: F
Age: 63
State: NJ

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: n/a

Allergies: Codeine Phosphate, Motrin, Oxycodone HCl, Diclofenac

Symptoms: Pt reported having a urticaric rash and myalgias from 2nd COVID19 vaccine received 2/26/21. During provider visit on 3/1/2021, patient reports improvement with OTC anti-itch cream and tylenol. Denies SOB, worsening rash, f/c/ns. Reports improvement with OTC anti-itch cream and tylenol. Denies SOB, worsening rash, f/c/ns.

Other Meds: Taking Aspirin 81 MG Tablet Chewable, Sig: 1 tablet Orally Once a day Taking Crestor 10 MG Tablet, Sig: 1 tablet Orally Once a day Taking Amlodipine Besylate 5 MG Tablet, Sig: 1 tablet Orally Once a day

Current Illness: None reported

ID: 1066574
Sex: M
Age: 77
State:

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: generalized exfoliative rash on body - scalp, upper trunk, arms and thighs.

Other Meds:

Current Illness:

ID: 1066575
Sex: F
Age: 78
State: IA

Vax Date: 02/06/2021
Onset Date: 02/08/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: 2 days after receiving first dose of vaccine, patient called to report worsening shortness of breath, back pain, fatigue and a cough. She was sent to the emergency room for evaluation. At that time, she was given a 7 day course of antibiotics. Patient then presented to the ED on 02/25/2021, with worsening symptoms, and was found to be COVID positive.

Other Meds:

Current Illness: Pneumonia

ID: 1066576
Sex: F
Age: 89
State: NM

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: 1/23/2021: vitals

Allergies: Statins (muscle pain), sucralfate (unknown reaction), pantoprazole (unknown reaction), ipratropium (unknown reaction),

Symptoms: Patient received vaccine at 1100, placed in 30 minute observation area. 1105 alerted observer of sensation of numbness and swelling of tongue. Assessment of patients mouth shows tongue reddened to right side, no visible swelling, pt reports recently having a red cough drop. Covering attending present to take brief hx of patient and ordered patient to receive 12.5mg of Benadryl PO. Patient given Benadryl at 1110. Patient appears in NAD, hx of recent concussion after a fall. Resides in rehab center. After medication received patient monitored for additional 30 minutes and discharged back to rehab facility.

Other Meds: albuterol mdi prn SOB, vitamin c 1000 mg qday, calcium citrate 250mg qday, vitamin d3 2000international units qday, glipizide er 5mg qday, Jardiance 10mg qam, famotidine 20mg qday, mirabegron 50mg qday, levothyroxine 100mcg qday,

Current Illness: unknown

ID: 1066577
Sex: F
Age: 17
State: OH

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

Lab Data: None

Allergies: N/A

Symptoms: Syncopal episode lasting approximately 15 seconds after receiving the vaccine.

Other Meds: N/A

Current Illness: N/A

ID: 1066578
Sex: F
Age: 51
State: IL

Vax Date: 01/24/2021
Onset Date: 01/25/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: EKGs in emergency room on 1/28/21 Chest x-ray in emergency room on1/28/21 Blood work in emergency room on 1/28/21 On 1/28/21 went home with heart monitor EKG in Cardiologist office on 2/5 Echo on 2/25/21

Allergies: Bees

Symptoms: Symptoms: heavy chest, fluttering, increased awareness of heartbeat,. Symptoms started on Monday Jan. 25th and continued off and on. Contacted my PCP on 1/27 and 1/28 and went to hospital on 1/28. Diagnosed with PVS and sent home with heart monitor and prescription of Metoprolol Tartrate 25mg twice a day. Followed up with the cardiologist who said that 20% of heartbeats were PVC's in emergency room. Cardiologist ordered echo and have follow-up appointment this month.

Other Meds: Nutrafol, Vitamin D3 125MG, Zinc 50mg

Current Illness: None

ID: 1066579
Sex: F
Age: 51
State: TX

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: pending

Allergies: Codeine Phosphate Tetanus Toxoids Amitriptyline Hives Carbamazepine Eyelid drooping, insomnia, joint/bone pain Cholestatin Duloxetine Hcl hives Effexor [Venlafaxine] Hydrocodone-Acetaminophen Nsaids Tetanus-Diphtheria Toxoids Td

Symptoms: Patient has been experience severe thirst since second vaccine administraiton

Other Meds: gabapentin, skelaxin, synthroid, cytomel,

Current Illness: sinus infection

ID: 1066580
Sex: M
Age: 74
State: OH

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

Lab Data:

Allergies: None

Symptoms: Generalized weakness, dizziness, nausea, muscle aches. Treatment: Rest.

Other Meds: Aspirin, Clopidogrel, Metoprolol, Metformin, Ranolazine, Finasteride, Flomax

Current Illness:

ID: 1066581
Sex: F
Age: 74
State: FL

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

Lab Data:

Allergies: none

Symptoms: after 4 hours felt as though I was collapsing; 24 hours after Moderna covid vaccine, 2nd dose the inoculation site became extremely swollen and very red....I could not move my arm. It is now 72 hours after injection and I can barely get out of bed....I cannot pursue normal activities. I am nauseous all the time, a terrible upset stomach with multiple bowel movements. After 48 hours I have developed a bronchial cough when reclining.. I am dizzy, lightheaded, achy, overall feeling a malisse. However, I can move my arm although it remains red and swollen.....but redness is not as severe.

Other Meds: calcium, magnesium, strontium, vitamin D3, red rice yeast,ubiquinol,Vitmin D compels ,taurine, probiotic ,lupine cur cumin. prescriptions: singular and lunesta

Current Illness: none

ID: 1066582
Sex: F
Age: 46
State: GA

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

Lab Data: none

Allergies: codeine reglan phernegen amoxicillin

Symptoms: After about 30-40 min, I started to notice a quickening in my chest. It felt like heart palpitations. This sensation continued for a few days following the vaccine. I noticed 3 days following, while on a walk my heart rate was in a "peak zone" on my tracker for over 30 minutes. That evening, I did feel chest discomfort - and I was not sure if it was from heart burn or not. This all has resolved, and only lasted about 4 days in total. I am due for my 2nd shot on 3/4, and I am not sure if I should go or not?

Other Meds: Lipitor 10 mg Vitamin D - 2,000 IU Zinc 30 mg Vitamin C 500 mg

Current Illness: none

ID: 1066583
Sex: F
Age: 53
State: CA

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

Lab Data: NONE

Allergies: Peanuts, cats, Denied allergies to medications.

Symptoms: REPORTED TOUNGE SWELLING, SWELLING ABOVE B WRIST W/ TIGHTNESS FEELING AND PAIN. 11:30 AM; RECEIVED BENADRYL 50 MG IM WITH MINIMUM. 12:00 RECEIVED SOLUMEDROL 125 MG IM 12:30: REPORTED PAIN AND TIGHTNESS TO B WRIST HAS IMPROVED

Other Meds: Albuterol Inhaler Singular q night Lexaprol 20 mg daily Abilify 2 mg Vyvanse 20mg Advair diskis

Current Illness:

ID: 1066584
Sex: M
Age: 80
State: PA

Vax Date: 02/15/2021
Onset Date: 02/26/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: none

Allergies: iodine, penecillin , and plavix

Symptoms: sore arm, rash became larger covering the bicep, diareahha, naseau, fatigue, 99 degree temperature

Other Meds: warfarin, prilosec, lysinopril, prevastatin, vitamin D, vitamin C, CoQ10, magnesium oxide, and tamsulosin

Current Illness: none

ID: 1066585
Sex: F
Age: 40
State: CT

Vax Date: 02/28/2021
Onset Date: 03/02/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: Pink & red dyes

Symptoms: Near injection site is raised, red rash near injection site. Red marks above and below injection. Very hot to the touch.

Other Meds:

Current Illness: None

ID: 1066586
Sex: F
Age: 22
State: IL

Vax Date: 05/11/2018
Onset Date: 05/12/2018
Rec V Date: 03/02/2021
Hospital:

Lab Data: N/A

Allergies: None

Symptoms: Woke up with half of my face numb. (Bell's Palsy) Numbness, weakness, and tingling sensation and an aching headache that lasted the whole day. Site of injection- Throbbing/aching pain that lasted for week on my left arm. The same pain that I felt goes to different parts of my body randomly and goes away. For example, just happens in one extremity such as my arm, leg, foot, calf, shoulder, etc Each episode's can last for 15minutes to hours. Still currently dealing with this today.

Other Meds: None

Current Illness: None

ID: 1066587
Sex: F
Age: 31
State: TX

Vax Date: 02/26/2021
Onset Date: 02/28/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: none. I feel better mostly today (Tuesday). Neck is not as swollen now.

Allergies: penicillins, Erythromycin

Symptoms: Pfizer vaccine. Experienced nausea 3 hours after the vaccine. I took promethazine to relieve nausea. Went away 24 hours later. 3 days after vaccine, my lymph nodes on my neck became swollen. I am swollen after my surgery. but was not swollen in my neck I do receive 2 lymphatic drainage massages per week to try to get rid of it in other lymph node areas. Bad headache lasted only 5 hours after vaccine. Tenderness at vaccine site last 2 days. I also have body aches and sleepiness still (4 days later)

Other Meds: sertraline 25 mg 1 po daily levothyroxine 100 mcg 1 po daily vitamin d3 50 mcg - 1 po daily ____________ (supplements and vitamins taken 1 month pre op and post op currently - will no longer be taking once I am okay'ed by surgeon) folic

Current Illness: 24 days post op brazilian butt lift cosmetic surgeon

ID: 1066588
Sex: M
Age:
State: WA

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

Lab Data:

Allergies:

Symptoms: After my vaccine, experienced Covid-19 symptoms for ten days. I was exhausted, had a small fever, had muscle aches, headaches and extreme fatigue. I was in bed for seven days. I had a Covid test performed which was negative.

Other Meds:

Current Illness:

ID: 1066589
Sex: F
Age: 23
State: CA

Vax Date: 12/30/2020
Onset Date: 01/13/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: Bees Amoxicillin

Symptoms: It was about 2 weeks after the shot, the injection site was red, hot, huge ( a big red circle) . I went to the Dr and they gave me an allergy medication , and to ice it. Once I started taking the medication and icing it, it went down but didn't go away for about 1-2 weeks.

Other Meds: Cymbalta-60mg/daily Buspar-10mg /3x day

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm