VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 0917852
Sex: M
Age: 32
State: NY

Vax Date: 12/24/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Swollen axillary lymph node, tender

Other Meds: None

Current Illness: None

ID: 0917853
Sex: F
Age: 36
State: WV

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

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Moderns COVID-19 Vaccine Sat at about 8pm started to have arm pain in the arm vaccinated. Throughout the night muscle, aches, headaches, fever, chills and fatigue started. Treated with Tylenol. Sunday moring fever, headache and chills were gone. Noon on Sunday, chillw and fever came back. 4pm checked temp and it was 103 degrees. Took Tylenol.

Other Meds:

Current Illness:

ID: 0917854
Sex: F
Age: 57
State: PA

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/03/2021
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: NKA

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

Symptoms: Patient received vaccine and was fine through her 15 minute observation period. She left the clinic and came back about 40 minutes later complaining of tingling in her tongue and weakness in her legs and felt like she needed to sit down. Her blood pressure was taken and it was elevated and a decision to take her to the ED was made. In the ED, she denied shortness of breath and did not have any other signs of anaphylaxis. She was given diphenhydramine 50 mg (at 11:36AM), famotidine 20 mg (@11:36AM) and prednisone 50 mg (at 11:43AM). At 12:23PM, documentation from the ED notes that tongue symptoms resolved, but patient still felt weak.

Other Meds: Unknown

Current Illness: N/A

ID: 0917855
Sex: F
Age: 47
State: CA

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
Hospital: Y

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: ON 1/1/21 THE DAY AFTER I RECEIVED THE VACCINE I WAS TAKING A NAP AND MY WATCH KEPT SENDING ME ALERTS. HOWEVER I DID NOT CHECK MY WATCH UNTIL 5:30 WHEN I WOKE UP AND I FELT LIKE I WAS HAVING HEART PALPITATIONS. I WENT TO THE EMERGENCY ROOM WHERE I WAS TREATED. I WAS TOLD THAT I WAS FEBRILE WITH A TEMPERATURE OF 102. I WAS GIVEN IV FLUIDS, CHEST X-RAY, EKG AND LAB WORK. I WAS RELEASED ON 1/2/21 AT APPROXIMATELY 0030 (MIDNIGHT).

Other Meds: NONE. HOWEVER I DID TAKE BENADRYL PROPHYLACTICALLY JUST IN CASE BECAUSE I HEARD OF PEOPLE HAVING ADVERSE REACTIONS TO BOTH MODERNA AND PFIZER COVID VACCINE.

Current Illness: NONE

ID: 0917856
Sex: F
Age: 39
State: MN

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 01/03/2021
Hospital:

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

Lab Data:

Allergies: Tree nuts, ground nuts, mangos, sunflower seeds

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

Symptoms: 23rd: hot flash/sweating within 15 minutes of receiving vaccine, Sore am, itchy throat, horse voice; 24th: sore arm, headache, fatigue, congestion; 25th: headache, nausea, fatigue, congestion. 26th through today - daily Headache w/nausea (OTC's not helping headaches).

Other Meds: None

Current Illness: none

ID: 0917857
Sex: F
Age: 51
State: VA

Vax Date: 11/05/2020
Onset Date: 11/26/2020
Rec V Date: 01/03/2021
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: Allergic to apples.

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

Symptoms: Develop skin rashes and itchiness around both eyelids. Severe left eyelid twitching. Several twitches within a minute throughout the day starting on November 24, 2020. Around Dec 24, the muscle around the right armpit area started to twitch, several twitches.

Other Meds: Entecavir 0.5 mg tablet daily

Current Illness: Had a cold sore about a week prior.

ID: 0917858
Sex: F
Age: 45
State: OH

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
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: PCN (anaphylactic), metals, mint

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Day 1: within 30 min - severe sharp temporal headache (worst of my life); developed within a couple hours in this sequence: cold hands/feet, chills (no fever), much worsened vision, slight confusion/dizziness, weakness (had to lay down), both knee joint pain, swollen neck glands, moderate nausea and intestinal cramps, complete loss of smell/taste; all night - severe acidic stomach pain (barely relieved with anti-acids). Day 2: residual headache (50%), tiredness, weakness, sweating if doing things, residual knee joint pain, sense of smell/taste returned and heightened. Day 3: residual headache (25%), still not 100%, residual knee joint pain. Day 4 (today): residual knee joint pain (comes and goes). I realize that these are not symptoms of an allergic reaction, but severe side effects.

Other Meds: just vitamins, supplements, herbs no any OTC or prescription drugs

Current Illness: none

ID: 0917859
Sex: M
Age: 65
State: NY

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
Hospital:

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

Lab Data:

Allergies: Flaygel

Symptom List: Pharyngeal swelling

Symptoms: High Fever. 101+, thermometer could read it. Severe joint pain, especially in shoulders, knees.

Other Meds: Numerous

Current Illness: Covid

ID: 0917860
Sex: F
Age: 44
State:

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: slight/mild soreness at site of injection.

Other Meds:

Current Illness:

ID: 0917861
Sex: M
Age: 62
State: NY

Vax Date: 12/22/2020
Onset Date: 12/29/2020
Rec V Date: 01/03/2021
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: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: After eating lunch on 12/29, he felt nauseated and dizzy, vomited within 10 mins and felt dizzy, there was some orthostatic BP changes clinically, he was at work in the hospital on that day, he was taken to ED, kept under observation for 24 hours, cardiac workup was done, non specific EKG abnormality was noted and he got a stress test on the 30th, which showed a normal stress perfusion study and normal cardiac function. He was discharged from observation status. No further dizziness.

Other Meds: Mogamulizumab Bactrim Acyclovir Synthroid

Current Illness: N/A

ID: 0917862
Sex: F
Age: 29
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Slight/mild soreness at site of injection

Other Meds:

Current Illness:

ID: 0917863
Sex: M
Age: 26
State: VA

Vax Date: 12/17/2020
Onset Date: 12/18/2020
Rec V Date: 01/03/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Myalgias starting within 1 hour after vaccination, worsened throughout day that radiated to ipsilateral trapezius and rhomboid areas. Starting around 16 hours after vaccination, severe subjective fevers and chills with severe headache that worsened with lying down. The headache was the most concerning symptom with tinnitus when laying flat in supine. It awoke me from sleep and prevented me from laying flat so I had to sleep upright on the couch. I took tylenol 500mg around 0200 and was able to sleep for a few hours. By 24 hours post vaccine, the headache and fevers/chills significantly improved so I could attend work the next day.

Other Meds: None

Current Illness: None

ID: 0917864
Sex: M
Age: 23
State: OH

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Fever for around 24 hours without use of fever-reducing medication; Chills; Headache; slight nausea

Other Meds: None

Current Illness: None

ID: 0917865
Sex: F
Age: 18
State: NJ

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
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:

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

Symptoms: intense chills and arm pain starting ~5 hours after shot (child faded within 24 hours) arm soreness lasted ~3 days general intense fatigue and light-headedness/ headache; decreased and went away after 48 hours

Other Meds:

Current Illness: viral cold 3 weeks before (throat pain, chills, fever, fatigue) - NOT COVID (tested negative), or Flu (symptoms only lasted 48 hours and lower fevers)

ID: 0917867
Sex: F
Age: 32
State: TN

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/03/2021
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: Apples, cherries, strawberries, pears, peaches, nectarines, apricots, almonds, carrots

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

Symptoms: Pfizer-BioNTech COVID19 Vaccine EUA The muscles in my arm where the vaccine was objected started hurting about 5 hours after the vaccine. Two hours later the pain had gotten so intense I could not move my arm more than in inch from my body and had to get help performing simple tasks. The next morning, the pain is less intense and I can move my arm, but there is no pain in my elbow and wrist joints on the same arm.

Other Meds: Gilenya, synthroid, vitamin D, Zyrtec, birth control

Current Illness: Strep throat

ID: 0917868
Sex: F
Age: 41
State: TX

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/03/2021
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: NKDA

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

Symptoms: A few minutes after receiving her vaccine she reported dizziness and an itchy throat. She was observed for a few minutes and she stated that the dizziness was worse and that she felt flushed so she was given 0.3mg of IM epinephrine after which she began to immediately improve. She was also given 50mg PO diphenhydramine. She was observed for 60 minutes after the epinephrine dosing without any recurrence of her symptoms and she was discharged home with strict ER return precautions.

Other Meds: Vitamin D, Iron, Multivitamin

Current Illness: None

ID: 0917869
Sex: F
Age: 46
State: IN

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/03/2021
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: Iodine, sulfur, levaquin, compazine, propafill, loratab, Xanax, egg, fish shellfish pork orange mango chocolate avacado

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

Symptoms: Started to lose voice and clearing throat- took benedryl as suggested , stayed an extra hour for observation, left on my own. Noticed face was swollen and red after showering- took photo. Cough and clearing throat like when I eat something I?m allergic to. Took another benedryl four hours later as well as Tylenol for headache. Ate dinner went back to sleep notice arm hurts a bit. Next morning 9 am face no longer swollen but arm hurting to the slightest touch. 4:30 pm still resting arm very painful . Headache and facial swelling under control. At no time did I have trouble breathing, slight itching

Other Meds: Zyrtec singular symbicort nasocort azelastine spirolactone Hydroxychloriquinine edotolac pantaprozole button- acetaminophen-caff promethazine clonazapam vitamin C Xyponex abuterol

Current Illness: Sinus infection just finished cefadroxil and mucinex

ID: 0917870
Sex: F
Age: 42
State: MA

Vax Date: 12/22/2020
Onset Date: 12/24/2020
Rec V Date: 01/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Woke up with severe chills, shaking, fever of 100.8, generalized body aches, generalized sensitive skin, and mild headache. All symptoms resolved after 1 day.

Other Meds:

Current Illness:

ID: 0917871
Sex: M
Age: 27
State: FL

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
Hospital:

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

Lab Data:

Allergies: Ceclor Wellbutrin Shellfish

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Body Aches Chills Headache Low Grade Fever Arm Soreness Swollen Lymph Nodes GI Upset

Other Meds: Effexor XR 75 MG QD Adderall 20 MG QD

Current Illness: N/A

ID: 0917872
Sex: F
Age: 62
State: AL

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
Hospital:

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

Lab Data:

Allergies: None known

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

Symptoms: I started feeling just slightly sick by bedtime on the date of the vaccine. For the next 24 to 36 hours, I experienced: low grade fever (101.1), muscle aches and pains, bad headache, diarrhea ... and felt extremely tired ... felt much the same as when I had been diagnosed with Covid 19 back in October of 2020. By the day, I was feeling better.

Other Meds: Losartan 50 mg Low Dose Aspirin 81 mg Glucosamine Chondroitin (Triple Strength) Calcium 600 mg & Vitamin D3 800 IU Iron 65 mg Vitamin D3 (either 1000 or 2000 IU ) Multivitmin (like One-A-Day for Women) Vita

Current Illness: None known

ID: 0917873
Sex: F
Age: 29
State: MA

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/03/2021
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: Nut allergy

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

Symptoms: Approximately 5 hours after administration, I developed severe pleuritic chest pain and tachycardia that self resolved after about an hour. This was followed by about 2 days of fatigue and myalgias that interfered with my daily activities that also self resolved. Had a large tender reaction on my left bicep for about 5 days after the injection.

Other Meds: None

Current Illness:

ID: 0917874
Sex: F
Age: 29
State: TX

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/03/2021
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: Unevaluable event

Symptoms: 8 hours post injection: headache, joint pain and body aches progressively worsened through 48 hours after injection. Arm was sore but nothing compared to joints (especially hips). Temperature was only slight at 98.7. Headache and body aches, joint pain were severe enough that I was forced to rest and unable to continue daily activities. Ache symptoms quickly dissipated after 48 hours, but a 2 inch diameter welt appeared, slightly raised and itching mildly like a mosquito bite. Welt is still present now, 5 days post-injection.

Other Meds: Nutrifol and melatonin

Current Illness: None

ID: 0917875
Sex: F
Age: 31
State: MD

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/03/2021
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: Rash to tetracycline

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

Symptoms: Febrile to 100.1 F with chills requiring Tylenol 500mg to sleep through the night after getting the vaccine .

Other Meds: Zyrtec, glucosamine and chondroitin

Current Illness:

ID: 0917876
Sex: F
Age: 36
State: MI

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/03/2021
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: Medication: Fenofibrate: severe myalgia Food sensitivities: allspice, Lima bean, String bean, Beef, pepper (all kinds/ varieties/ forms), Casein, Cod, Coffee, Corn, Cranberry, Flounder, Garlic, White grapes, green beans, Sesame seed Environmental: Queen Palm trees, Rye, Mixed grass, cut grass, Goldenrod, Trichophyton Mentagrophytes, Early Tress, cotton wood

Symptom List: Injection site pain, Pain

Symptoms: Started with throat and chest tightness, followed by cough and unable to catch breath, wheeled to ER given nebulizing treatment, 0.3mg of Epi, 50 mg IV Benadryl and 125mg IV solumedrol, chest tightness, tachycardia, and cough seemed to abate for aprox 15 minutes before return of symptoms, but worse. HR 140-150, BP 180/104, tachypneic high 30's, feeling like unable to breath, throat did not close, duoneb inhalant treatment given with 02, sx seemed to calm after 15 minutes. Pt d/c home after 3 hours in ER with bp 138/98, HR 134, 20 resps, SP02 @ 97%. SP02 never dropped below 95% throughout severe allergic reaction

Other Meds: Metformin XR, Metoprolol ER, Celebrex, Chlorzoxazone, Aciphex, Singuliar, Xyzal, Vitamin D3, Benadryl

Current Illness: Sinus Infection, Asthma attack

ID: 0917877
Sex: F
Age: 66
State: CO

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

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

Lab Data:

Allergies: Allergic to sulfa drugs, tetracycline, strawberries, pineapple, spearmint

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache, low fever 99.9-100, chills, fatigue started 1/3/2021

Other Meds: Elderberry supplement, lysine with vitamin C supplement, B12 vitamin, ibuprofen, acetaminophen

Current Illness: Sinus , migraine

ID: 0917878
Sex: F
Age: 62
State: FL

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/03/2021
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: theophylline , plaquenil, many food allergies but no anaphylaxis, many environmental allergies but no anaphylaxis

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

Symptoms: Within minutes of receiving the injection I began to feel dizzy, a nursing provider took my bp approx 5-6 min after receiving the vaccination with a wrist cuff and it was 191/125 , she obtained a manual cuff and took it about 3- 5 min after the initial bp and it was 180/100. I felt more dizzy and laid down. I also had a rapid HR but did not take my pulse. The dizziness fluctuated and gradually cleared over 20-30 min. A third bp was 146/84 and a last bp approx 30min after the injection was 124/76 and I felt well enough to get up and walk.

Other Meds: celebrex 100mg BID, methotrexate injection weekly. propranolol 10mg BID, zovirax 400mg BID, wellbutrin 300mg XL daily, estrogen patch, progesterone 200mg daily, multivitamin daily, vit D3 2,000 units, folate 800mcg 2 days of week, fish o

Current Illness: no acute illness

ID: 0917879
Sex: F
Age: 64
State: WV

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
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: Penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Right side of lip started swelling about 7:30 pm on 12/31/2020. Took Benadryl and picked up Epi pen at pharmacy. Swelling increased overnight up into right cheek and jaw. Right side eye and cheek and mouth drooping with a crooked smile. On 01/02/2020 started itching from up under right ear down towards neck with redness and hives. Got RX from pharmacy for Prednisone and am currently taking that

Other Meds: Lisinopril. Ellura.

Current Illness: 2 weeks prior. Had some swelling in jaw area

ID: 0917880
Sex: M
Age: 45
State: MT

Vax Date: 12/24/2020
Onset Date: 12/24/2020
Rec V Date: 01/03/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Moderna COVID-19 Vaccine EUA Headache for about 16 hours.

Other Meds: None

Current Illness: None

ID: 0917881
Sex: F
Age: 59
State: WV

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
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: PCN, Sulfa, Keflex

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

Symptoms: Had the vaccine at 11am; started diarrhea within the hour. Restless during the night and about 3am woke with diarrhea, nausea and having dry heaves, general feeling of malaise. Symptoms continued to get worse and finally went to the emergency room about 9am the next morning. I was given fluids for dehydration and Zofran for the nausea. Lab work was performed as well as x-rays and a CT Scan.

Other Meds: Xarleto, Lexapro, Carafate, Calcium, Vitamin D, Arthrotec, Klonipin

Current Illness: COVID, Dec 19

ID: 0917882
Sex: F
Age: 49
State: NJ

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/03/2021
Hospital: Y

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

Lab Data:

Allergies: cefuroxime (shortness of breath), gadolinium (anaphylaxis, March 2018), iodine (anaphylaxis), quinolones (shortness of breath, "paralyze"), gabapentin (hallucinations), vancomycin (itching)

Symptom List: Nausea

Symptoms: Patient is hospital employee who completed screening form for COVID-19 vaccine by answering "no" to all contraindication questions. Approx 10 minutes after receiving COVID-19 vaccine dose # 1, patient was still in vaccine clinic area and complained of dizziness, palpitations and flushing. I observed patient fanning herself with papers. She was escorted out of the immediate clinic room, and assessed by paramedics present as having an anaphylactic reaction. Epinephrine 0.3 mg IM and diphenhydramine 50 mg IV given in clinic, Rapid Response was called overhead and patient immediately transported down the hall to the Emergency Dept. In ED, pt was noted as having swollen tongue, large areas of erythema on face, arms and chest, shortness of breath, nausea, dizziness (per ED physician notes). Pt reported being hospitalized in ICU with COVID disease more than 3 months ago, including intubation (not treated at this hospital), and has been back at work since August 2020. ED physical exam noted bilateral wheezing and patient in acute distress. In ED, pt administered racemic epinephrine 2.25% 0.5 mL via neb, epinephrine 0.3 mg IM, diphenhydramine 50 mg IV, Solu-Medrol 125 mg IV, famotidine 20 mg IV and epinephrine 5 mg/250 mL IV drip (started at 0.118 mcg/kg/min). Acute symptoms reported to resolve in ED. COVID test was negative. ED physician discovered that pt had history of multiple medications, including previous anaphylactic reaction to radiocontrast dye requiring intubation (which was not disclosed on the vaccine screening form). Pt admitted to Telemetry floor for observation. Overnight course was unremarkable, and patient was discharged the following day with prescription for Prednisone taper and prescription for Epi-pen. Advised not to return for second dose of COVID vaccine. EMR updated to reflect possible anaphylactic reaction to Moderna COVID-19 vaccine.

Other Meds: Biotin 1 mg PO daily, Levothyroxine 112 mcg PO daily, MVI tablet PO daily, Paroxetine 20 mg PO QHS

Current Illness: none reported

ID: 0917883
Sex: F
Age: 50
State: KS

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

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

Lab Data:

Allergies: Celebrex

Symptom List: Injection site pain

Symptoms: After vaccination in exam room, client sent to observation room for 30 minutes. About 5 minutes in the observation room, client started to feel light headed. Client sent back to exam room to lie down. At 2pm, client's blood pressure 107/70 with 98 pulse. At 2:15pm, client's blood pressure 128/79, 99 pulse, and O2 sat at 99%. Cold compress place on client's forehead with knees elevated. Water and snack provided.

Other Meds:

Current Illness:

ID: 0917884
Sex: F
Age: 35
State: NC

Vax Date: 12/21/2020
Onset Date: 12/28/2020
Rec V Date: 01/03/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Hives began one week after vaccine. Went to urgent care on two different occasions, initially told to continue Otc antihistamines, given prescription at second visit.

Other Meds: Birth control pill

Current Illness: Na

ID: 0917885
Sex: M
Age: 56
State: MO

Vax Date: 12/28/2020
Onset Date: 01/02/2021
Rec V Date: 01/03/2021
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: Allergy to gabapentin- nausea/vomiting

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

Symptoms: Fatigue, lightheadedness, Fever (99.9-100.1), nausea and weakness.

Other Meds: Morning 1. Zoloft 200mg 2. GLUCOSAMINE AND CHONDROITIN 3. Magnesium Oxide - 200mg Nighttime 1. Singulair - 10mg 2. Omeprazole - 40mg 3. Lorazepam - 2mg 4. Magnesium Oxide - 400mg 5. Trazodone - 100mg

Current Illness: None

ID: 0917886
Sex: F
Age: 58
State: PA

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
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: PCN

Symptom List: Tremor

Symptoms: Vomiting, Fever 101.4, myalgias, fatigue-unable to work for 24 hours sit of injection erythema for 4 days, soreness These were similar symptoms to when patient had COVID in November

Other Meds: Enalapril

Current Illness: COVID infection verified by PCR November 12,2019

ID: 0917887
Sex: F
Age: 23
State: MD

Vax Date: 12/31/2020
Onset Date: 01/02/2021
Rec V Date: 01/03/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: About 5:45 pm on Saturday, January 2, 2021 my inner left eye began to feel itchy and irritated like there was something in it. I touched my eye and rubbed it for approximately 30 minutes, but it still felt like I had something poking my inner eyelid. I looked in the mirror and saw my inner, upper, left eyelid was swollen and slowly getting worse. I tried applying a warm compress for 10 minutes, but it did not seem to help. I was getting ready for a shower and saw hives on my hips and inner thighs. I felt itchy in other places of my body as well. I saw hives on both of my upper arms, my back, and my neck. I took one 25 mg Benadryl and got in the shower. As I was showering, I felt my left upper lip begin to tingle and swell. I rushed to the ER immediately. I arrived around 7:25 pm. As I was waiting for the ER doctor, I noticed my lip and eye swelling were almost back to normal, but I still had hives and they were spreading. The ER doctor gave me Benedryl and Solumedrol in an IV around 9 pm. I left the ER around 10 pm. I had no more swelling on my eye and lip and my hives were slowly diminishing.

Other Meds: Junel 1/20

Current Illness: None

ID: 0917888
Sex: F
Age: 35
State: NM

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/03/2021
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: No

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

Symptoms: I am breastfeeding my 15 month old son and he got a rash on his abdomen and face that has progressed more over past several days. He has had no fever but acts like he doesn?t feel great as he was not eating like his normal self. I don?t know if the rash is related or not but it is during the time of the vaccine.

Other Meds: Vitamin D, multivitamin

Current Illness: None

ID: 0917889
Sex: M
Age: 61
State: CO

Vax Date: 04/27/2020
Onset Date: 04/27/2020
Rec V Date: 01/03/2021
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: Most Opioids, Doxycycline, Cipro

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

Symptoms: General Flu-like symptoms and left arm pain immediately following the injection. Left arm pain with muscle weakness has never gone away and has gotten much worse as of early January 2021. Simple everyday tasks such as putting on and removing off my belt and driving are very painful and are getting worse. I have had several follow up appointments (5/26/2019 and 9/28/2019) for this lingering issue.

Other Meds: Levothyroxin 150 mcg, Multi Vitamin, ProBiotic

Current Illness: None

ID: 0917890
Sex: M
Age: 41
State:

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

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

Lab Data:

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Chill-1 episode; fatigue; muscle ache; headache

Other Meds: None

Current Illness: None

ID: 0917891
Sex: F
Age: 41
State: CT

Vax Date: 01/02/2021
Onset Date: 01/03/2021
Rec V Date: 01/03/2021
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: Sweated through my clothes at almost 12 hours to the exact time of dose, nausea to the point of trying not to vomit, diarrhea, shivers, very sore arm (difficult to lift). Lasted approximately 4 hours. Drank water, took 1 Advil. Waited it out until symptoms reduced. Did not sleep most of the night.

Other Meds: Pristiq 50mg, xyzal 5mg, The Big One multivitamin, Turmeric, Vitamin D 1,000, Vitamin C 1,000, elderberry syrup, probiotic 25 billion, Flonase nasal spray, Azelastine HCI nasal spray

Current Illness: No

ID: 0917892
Sex: F
Age: 66
State: NY

Vax Date: 12/31/2020
Onset Date: 01/02/2021
Rec V Date: 01/03/2021
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: PCN, Ceftin, Ciprol

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

Symptoms: Received vaccine on Thursday arm was sore on Friday, Saturday morning @5:OO AM woke with horrendous headache and slept most of the day, very tired. Woke in the middle of the night to go to the bathroom and had horrible vertigo actually bouncing off the walls. Took Meclizine and benadryl for relief. Wondering what my immune system will do on the second dose!

Other Meds: Carvedolol, escatalapram, HTZT, St. John's Wort, adrenal tonic, turmeric, chelated multiple vitamin

Current Illness: none

ID: 0917893
Sex: M
Age: 28
State: TX

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/03/2021
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 reported

Symptom List: Pain in extremity

Symptoms: approximately 10 minutes after vaccination, the individual began complaining of difficulty breathing. Presented to onsite EMS personnel with diaphoresis, pallor, rapid respiratory rate, and sounds from throat similar to stridor. The individual was in obvious distress. Patient was given oxygen via NRB mask, Epinephrine 1:1,000 0.3 mg IM. A second dose of Epinephrine 1:1,000 0.3 mg IM was given approximately 4 minutes after the first one. Transporting ambulance arrived and transported the patient to emergency room. The patient's had marked improvement within 5 minutes of the second Epinephrine dose. Patient was still tachypneic but was able to speak in complete sentences and was alert and oriented.

Other Meds: Unknown

Current Illness: None reported

ID: 0917894
Sex: F
Age: 42
State: CO

Vax Date: 12/26/2020
Onset Date: 01/02/2021
Rec V Date: 01/03/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, sulfa

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

Symptoms: My husband noticed my that my arm near the injection site was red and raised last night, January 2nd - over one week after the vaccine. Then I was woken up around 1 in the morning January 3rd (today) with fairly intense itching at that site. Today it is raised, red, and mildly itchy. We took pictures to show the difference in arms. Of note, the pain from the vaccine was so severe I couldn?t even pick up a water glass or put a shirt over my head with that arm. It was only that bad on 12/27 and rapidly improved. I am just mentioning this in case people who have had itching over one week also had severe pain after the injection.

Other Meds: Lexapro, vitamin B, trazodone

Current Illness: None

ID: 0917895
Sex: F
Age: 36
State: MI

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

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

Lab Data:

Allergies: NKDA

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

Symptoms: Pt experienced tachycardia and was monitored. This returned to normal in a few minutes.

Other Meds: birth control, vitamins, Lexapro

Current Illness: none known

ID: 0917896
Sex: F
Age: 68
State: AZ

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Nausea, fever, muscle aches, headache, dizziness, body pain.

Other Meds: none

Current Illness: none

ID: 0917897
Sex: F
Age: 65
State: CA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/03/2021
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: Benadryl- causes tachycardia

Symptom List: Vomiting

Symptoms: Injection was at 12:00 Pm on 12/29/2020. At 12:20 PM i started to feel faint, slightly nauseous . I layed down on my office floor, , my heart rate went up to 140 BPM and BP was around 140/76. My MA checked it . One of my physician colleague's that was nearby checked on me as well as the nurse that gave me the injections. it took about 30-40 minutes for the symptoms to subside. I was sent to our Urgent care dept in the same clinic by wheelchair at around 12:30-12:40 pm. I was evaluated and my symptoms subsided in 30-40 minutes. I was out of Urgent care at 1:25 pm, able to walk upstairs back to my office and felt okay and was seeing patients again at 1:30 PM. This reaction was similar to getting a shot of Novocaine w/ epinephrine for a dental procedure I received a few years ago, so if I were to sum it up it was like getting a shot of epinephrine. it was not a vasovagal reaction as my BP was high. I have felt fine since. I plan to get the second vaccine. Any suggestions to avoid these symptoms w/ the second one would be appreciated.

Other Meds: 1. Celebrex, 100 mg per day 2. Pepcid AC 10 mg per day 3. Combipatch, 0.05mg/0.14 mg, 1/2 patch every 3 weeks for hot flashes

Current Illness: none

ID: 0917898
Sex: F
Age: 50
State: NH

Vax Date: 12/23/2020
Onset Date: 12/30/2020
Rec V Date: 01/03/2021
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: amoxicillin bactrim

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 7 days after receiving the vaccine, my arm became very itchy at the site of the injection. That evening, I noticed a golf ball size red swollen area around the injection site. The next morning, the reddened area had increased to the size of a baseball. It remained itchy, red, swollen, and warm. By that evening, the area had increased to the size of a canteloupe. I presented to the local Urgent Care. I was diagnosed with "cellulitis" and prescribed an antibiotic. I did not take the antibiotic, as by the time I picked it up from the pharmacy the next morning, the redness and swelling had already started to decrease. At this time, (10 days after vaccine), the redness and swelling are gone, and my arm just remains a little itchy.

Other Meds: None

Current Illness: none

ID: 0917899
Sex: F
Age: 34
State: NE

Vax Date: 12/24/2020
Onset Date: 12/27/2020
Rec V Date: 01/03/2021
Hospital:

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

Lab Data:

Allergies: No known drug allergies

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

Symptoms: Patient was COVID + on 11/7/20, but had fully recovered by the vaccination date 12/24/20. The vaccination was unremarkable and the patient tolerated. Approximately 72 hours post-vaccination, the patient developed widespread hives, that were most severe on her face and cheeks. Patient did not have any respiratory effects. Hives resolved within 24 hours with the use of oral diphenhydramine. The patient is concerned with obtaining the second dose, whether it would be appropriate to receive the vaccine as long as appropriate medical interventions are available.

Other Meds: No medications

Current Illness: No recent illness or vaccination within prior month.

ID: 0917900
Sex: F
Age: 20
State:

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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Slight/mild dizziness and slight/mild numbness sensation of left arm, five minutes after vaccine administration (left deltoid). Patient stated she had not sleep last night. Patient reported feeling better after sitting in the clinic. Vital signs within normal limits. Advised to follow up with PCP. ER precautions given.

Other Meds:

Current Illness:

ID: 0917901
Sex: F
Age: 49
State: TX

Vax Date: 12/01/2020
Onset Date: 01/02/2021
Rec V Date: 01/03/2021
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: High blood pressure. I normally have low blood pressure. My readings have been up to 190/127. I've never had a reading over 140 before. Last reading was 149/100.

Other Meds: None

Current Illness: None

ID: 0917902
Sex: F
Age: 45
State: CO

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/03/2021
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: Moderna COVID-19 Vaccine EUA Fever, joint pain, headache, nausea. Treated at home with OTC meds Severe rash on torso, arms, neck, thighs. TakingSteroid dose pack, Benedryl, Ibuprofen. Not yet resolved.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm