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: 1063329
Sex: M
Age: 71
State: NY

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

Symptom List: Dysphagia, Epiglottitis

Symptoms: Body temperature 101.9 Uneasy feeling

Other Meds: Allopurinol /Montilucast/Atenolol allopurinol /Atenolol/montilocust

Current Illness: None

ID: 1063330
Sex: F
Age: 74
State: CA

Vax Date: 02/27/2021
Onset Date: 03/01/2021
Rec V Date: 03/01/2021
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: none

Symptom List: Anxiety, Dyspnoea

Symptoms: Covid Arm, Red rash, itching and swelling

Other Meds: Metformin, Tamoxifen, Simvastatin, One a day Women 50+, D3 mcg, Fexofenadine Hydrochloride.

Current Illness: Noine

ID: 1063331
Sex: F
Age: 63
State: FL

Vax Date: 01/30/2021
Onset Date: 02/07/2021
Rec V Date: 03/01/2021
Hospital: Y

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: sulfa, baclofen, amitriptyline

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

Symptoms: Acute Pancreatitis

Other Meds:

Current Illness: none

ID: 1063332
Sex: M
Age: 63
State: HI

Vax Date: 02/10/2021
Onset Date: 02/14/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Extreme vertigo requiring ambulance transport and 2.5 day staying in hospital, Still suffering dizziness/imbalance through 03-01-2021 but improving. Also, experienced intermittent fatigue but improving as well.

Other Meds:

Current Illness:

ID: 1063363
Sex: F
Age: 87
State: WY

Vax Date: 01/19/2021
Onset Date: 02/11/2021
Rec V Date: 03/01/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: cellulitis; A regulatory report was received from a Non-Health Professional on 16Feb2021, which refers to a 87-year-old female who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced cellulitis. The patient's medical history was not provided. No relevant concomitant medications were reported. On 19Jan2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (batch: 027L20A) intramuscularly in the left upper arm for prophylaxis of COVID-19 infection. On 19Jan2021, the patient experienced cellulitis. As a result, she was hospitalized on 11Feb2021 and then again on 15Feb2021. She was treated with antibiotic IV infusion. The Non-Health Professional did not declare any relatedness between cellulitis and Moderna COVID-19 Vaccine.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the onset date of the reported event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1063364
Sex: F
Age: 70
State: NJ

Vax Date: 01/28/2021
Onset Date: 02/10/2021
Rec V Date: 03/01/2021
Hospital: Y

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: peripheral neuropathy with no feeling in her toes, feet and up to her waist; tremors to the 5th digits to bilateral hands; imbalanced gait; severe upper back pain; Severe neck pain; transverse myelitis with significant involvement; A spontaneous report was received from a physician concerning a 70-year old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced transverse myelitis with significant involvement, peripheral neuropathy with no feeling in her toes, feet and up to her waist, upper back pain, neck pain, tremors to the 5th digits to bilateral hands, and imbalanced gait. The patient's medical history included breast cancer. No relevant concomitant medications were reported. On 28 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided) for prophylaxis of COVID-19 infection. On 10 Feb 2021, the patient began to experience severe upper back and neck pain. The patient's pain progressed to peripheral neuropathy with no feeling in her toes and feet, and up to her waist. She also had tremors to the 5th digits in both hands. On 12 Feb 2021, the patient was admitted to the hospital. The patient had transverse myelitis with significant involvement. She had an imbalanced gait and had involvement from C3-7 and T1. She was taking high doses of steroids- Dexamethasone 10mg/day. It is believed the patient had an exacerbated autoimmune reaction and that she will require surgical repair. Action taken with mRNA-1273 in response to the events was not provided. The outcomes of the events were not reported.; Reporter's Comments: Very limited information regarding these events has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1063365
Sex: U
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: sick; Initial information was received on 15-Oct-2020 regarding an unsolicited valid non-serious case from a consumer/non-healthcare professional via social media. This case involves an patient (demographics unknown) who was sick (illness), when received INFLUENZA VACCINE. The patient had no medical history, concomitant disease or risk factor Medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer (lot number: not reported; expiry date not reported) via unknown route in unknown administration site for prophylactic vaccination. On an unknown date, the patient was sick (illness) (unknown latency) following the administration of INFLUENZA VACCINE. It was weird how the patient always got sick with it. It is unknown if the patient experienced any additional symptoms/events There were no lab data/results available It was not reported if the patient received a corrective treatment. At, the time of report the outcome of the event was unknown. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1063366
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: always got sick after having a shot; Initial information received on 15-Jan-2021 regarding an unsolicited valid non-serious case from a non health care professional (consumer's wife) via media. This case involves male patient of unknown age who always got sick after having a shot (illness), after receiving INFLUENZA VACCINE. The patient had no medical history, concomitant disease or risk factor. The patient's past medical treatment(s), vaccination(s), concomitant medication(s) and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer (lot number and expiration date not reported) via unknown route in unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious sickness (illness) (unknown latency) following the administration of INFLUENZA VACCINE. No laboratory data reported. It was not reported if the patient received a corrective treatment. At the time of reporting, the outcome was not reported for the event illness. It was unknown if the patient's physician provided consent to be contacted. There will be no information on the batch number for this case.

Other Meds:

Current Illness:

ID: 1063367
Sex: F
Age:
State:

Vax Date: 10/12/2020
Onset Date:
Rec V Date: 03/01/2021
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: had a bad reaction to her Flublok Vaccine; Initial information was received on 11-Dec-2020 regarding an unsolicited valid non-serious case from a other health professional. This case involves an unknown age female patient who experienced had a bad reaction to her INFLUENZA QUADRIVALENT RECOMBINANT VACCINE [FLUBLOK QIV] (vaccination complication). Medical history, medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On 12-Oct-2020, the patient received a dose of suspect INFLUENZA QUADRIVALENT RECOMBINANT VACCINE (lot number and expiry date not reported) via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed non-serious had a bad reaction (vaccination complication) (unknown latency) following the administration of INFLUENZA QUADRIVALENT RECOMBINANT VACCINE. The reporter had a question, since this reaction was new to us, we want to know if you have ever seen this type of reaction? And also, is she covered for this year's flu season? Details of laboratory data were not reported. It was not reported if the patient received any corrective treatment. At the time of report, the outcome was unknown for the event. There will be no information available on the lot number for this case.

Other Meds:

Current Illness:

ID: 1063368
Sex: F
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: serum sickness; headache; puffy face; puffy eyes; nausea; fever; achy joints; bronchitis; Initial information was received on 19-Feb-2021 regarding an unsolicited valid non-serious case from a consumer/non-healthcare professional. This case involves a 70-year-old female patient who had serum sickness, headache, puffy face (swelling face), puffy eyes (periorbital swelling), nausea, fever (pyrexia), achy joints (arthralgia) and bronchitis, while she received INFLUENZA VACCINE. The patient's past medical treatment(s), vaccination(s), concomitant medications and family history were not provided. It was unknown if the patient had any medical history, concomitant disease or risk factor. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer) (batch number and expiry date not reported) via an unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious serum sickness, headache, puffy face (swelling face), puffy eyes (periorbital swelling), nausea, fever (pyrexia), achy joints (arthralgia) and bronchitis (unknown latency) following the administration of INFLUENZA VACCINE. The patient was in bed for almost two weeks. The patient wanted to get the Pfizer (coronavirus disease of 2019) Covid 19 vaccine. She did not know if there was a specific component of the influenza vaccine that caused her reaction. She knows of other people who had serious vaccination problems with the pneumonia vaccine who received the Moderna Covid 19 vaccine with no issues. She was concerned she might have a serum sickness with the Pfizer Covid 19 vaccine. It was unknown if the patient experienced any additional symptoms/events. It was unknown if there were lab data/results available. It was not reported if the patient received any corrective treatment. At the time of reporting, the outcome was unknown for all the events. There will be no information available on batch number for this case.

Other Meds:

Current Illness:

ID: 1063370
Sex: F
Age:
State:

Vax Date: 12/19/2014
Onset Date: 12/19/2014
Rec V Date: 03/01/2021
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: Felt a gripping sensation around her rib cage that radiated down her body/gripping feeling on the side of her body where it started at the rib cage(breastbone) and went all the way down; Felt a gripping sensation around her rib cage that radiated down her body/gripping feeling on the side of her body where it started at the rib cage(breastbone) and went all the way down; Felt the back of her throat was swelling/having a little swelling in the back of her throat; This spontaneous case was received on 11-Feb-2021 reported by other health professional (nurse) to Agency (reference number: SEQW21-00462) with additional documents received on 16-Feb-2021 reporter to Novartis (reference number: NUS2021US022355) and on 22-Feb-2021 reported to Agency (reference number: SEQW21-00682) by same reporter and concerned a female patient of an unreported age. The patient's medical history and concomitant medications were not reported. On 19-Dec-2014, the patient was vaccinated with influenza virus vaccine polyvalent (brand not specified; dose, anatomical location, route of administration: not reported) for influenza prophylaxis. The batch number reported was 1412001 and expiry date reported was May-2015. On the same day, within a half hour after receiving influenza virus vaccine polyvalent, the patient experienced a reaction. The patient felt a gripping sensation around her rib cage that radiated down her body and felt the back of her throat was swelling, this was not an anaphylactic reaction. This was also reported as, the patient felt this gripping feeling on the side of her body where it started at the rib cage(breastbone) and went all the way down, which eventually did subsided. The patient also experienced having a little swelling in the back of her throat and not severe where she wasn't able to breathe. The patient was advised to not receive another flu vaccine. The patient was going to see an allergist. On the same day, after half hour, the patient recovered from the events. The reporter did not provide causality assessment. The case was assessed as non-serious. Company comment:The patient developed chest pain, pain and pharyngeal swelling on the same day after vaccination with the suspect product, influenza virus vaccine polyvalent. Chronology is suggestive. The patient's medical history and concomitant medications were not reported. On the same day, after half hour, the patient recovered from the events. Causal relationship for all other events is assessed as possibly related (defaults to ''related'' in the safety database for reporting purposes).; Sender's Comments: The patient developed chest pain, pain and pharyngeal swelling on the same day after vaccination with the suspect product, influenza virus vaccine polyvalent. Chronology is suggestive. The patient's medical history and concomitant medications were not reported. On the same day, after half hour, the patient recovered from the events. Causal relationship for all other events is assessed as possibly related (defaults to ''related'' in the safety database for reporting purposes).

Other Meds:

Current Illness:

ID: 1063371
Sex: F
Age: 61
State:

Vax Date: 10/17/2014
Onset Date: 10/17/2014
Rec V Date: 03/01/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Throat was closing; Allergic reaction; This spontaneous case was received on 19-Feb-2021 from other non-health professional (consumer) to Med Communications (reference number: SEQW21-00642) and concerned a 61-year-old, female patient. The patient's medical history and concomitant medications were not reported. On 17-Oct-2014, the patient was vaccinated with Afluria (TIV) (reported as Afluria Quad) (influenza vaccine, route of administration, anatomical location, dose: not reported) for prevention of seasonal influenza. The batch number was not reported. On the same day, after receiving Afluria (TIV), the patient experienced the allergic reaction. Her throat was closing, and an ambulance came to her house. The patient was treated with Benadryl (diphenhydramine hydrochloride) by Emergency Medical Technicians (EMTs). On an unspecified date, the patient's throat slowly opened back up again and the patient recovered from events. The reporter assessed events as related to Afluria (TIV). The patient had an allergic reaction to the Afluria (TIV). Company comment: A 61-year-old patient was vaccinated with Afluria (TIV). On the same day, after receiving Afluria (TIV), the patient experienced the allergic reaction and throat tightness. The patient was treated with Benadryl (diphenhydramine hydrochloride) by Emergency Medical Technicians (EMTs). The patient's throat slowly opened back up again and the patient recovered from events. Chronology is highly suggestive and no alternative aetiology provided. Causality is assessed as possibly related.; Reporter's Comments: The patient had an allergic reaction to the Afluria (TIV).; Sender's Comments: A 61-year-old patient was vaccinated with Afluria (TIV). On the same day, after receiving Afluria (TIV), the patient experienced the allergic reaction and throat tightness. The patient was treated with Benadryl (diphenhydramine hydrochloride) by Emergency Medical Technicians (EMTs). The patient's throat slowly opened back up again and the patient recovered from events. Chronology is highly suggestive and no alternative aetiology provided. Causality is assessed as possibly related.

Other Meds:

Current Illness:

ID: 1063372
Sex: M
Age: 42
State: GA

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
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: He first reported feeling dizzy and that his lips were tingling. His vital signs were monitored every 5 minutes, and he was given 20 mL (50 mg) liquid Diphenhydramine. At 11:50 A.M., his heart rate dropped from 99 to 51, and he experienced a brief loss of consciousness for about 3 seconds. He also became diaphoretic and very pale at the same time. His pulse was weak but present, and his eyes rolled back in his head. 911 was immediately called, and a sternal rub was provided to help patient regain consciousness. EMS arrived at 11:56 A.M. and transported patient to the hospital for further evaluation. Patient was alert and talking upon transport.

Other Meds: Unknown

Current Illness: Unknown

ID: 1063373
Sex: F
Age: 65
State: CA

Vax Date: 02/16/2021
Onset Date: 03/01/2021
Rec V Date: 03/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Starting the morning of March 1, almost 2 weeks after my first vaccine injection, I have a large slightly swollen rash area around the injection site which is tender to the touch. The only other reaction I have had is soreness around the injection site for the first 3 days after the initial injection which kept me awake at night.

Other Meds: Synthroid, Estradiol, Progesterone, Erythromycin

Current Illness: None

ID: 1063374
Sex: F
Age: 40
State: CA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/01/2021
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: Metformin, Benadryl, MS, PCN

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

Symptoms: Dizziness and tingling

Other Meds: UNKNOWN

Current Illness:

ID: 1063375
Sex: F
Age: 43
State: CA

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
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: Sensitive to vicodin and morphine, celiac disease- can?t consume gluten

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

Symptoms: On 2/28 around 6pm. I started feeling some flu like symptoms start. Mild headache, fatigue, chills, slight runny nose, mild sore throat. My left eye suddenly felt awful. I told my husband my eye is stuck (open). It was very scary and I felt like I had to hold my hand against it tightly. Meanwhile my right eye just wanted to stay closed, so then I couldn?t see at all. My husband guided me into the kitchen and I tried to flush my eye with water to see if that would help whatever was going on with my eye lid. My husband gently rubbed the skin above my eye. He couldn?t see my eye lid at all. All that was visible to him was the tip of my eyelashes. He was able to grab the tip of my eyelash and release my eyelid. It was very uncomfortable and scary. After the eyelid was released the eye was very sore . I called the nurse line and they recommended I be seen within 24 hours. I saw the doctor this morning not related at all to the vaccination facility. She said it sounded like an ocular muscle spasm. She said she didn?t see anything in the vaccine literature about this type of response but recommended I report it in case it?s a rare response. I have never had that happen before and I hope to never have it happen again.

Other Meds: Pantaprozole, flovent, b-complex, daily vitamin, fiber, magnesium, vitamin D and calcium, fish oil

Current Illness: None

ID: 1063376
Sex: F
Age: 43
State: TX

Vax Date: 02/25/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
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: none

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

Symptoms: headache

Other Meds: none

Current Illness:

ID: 1063377
Sex: F
Age: 65
State: MO

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/01/2021
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: Bilateral numbness, headache, tongue feels weird, really tired, hx liver transplant

Other Meds:

Current Illness:

ID: 1063378
Sex: F
Age: 32
State:

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Septra, Ceclor

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: After about 12 hours of second vaccination, began to feel achy and soreness at the Injection site. About 24 hours after second vaccination, noticed a rash on the inside of both arms. Took Benedryl, rash on arms wasn?t as noticeable. Around 18 hours after second vaccination, noticed rash on both ankles and feet.

Other Meds: Prenatal Vitamin

Current Illness:

ID: 1063379
Sex: F
Age: 75
State: FL

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: PCN, Cipro, Tetracycline

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

Symptoms: Adverse reaction began around midnight with chills, continued throughout the night alternating chills and hot flashes, severe backache, muscle aches in thighs and general malaise. Got up around 8 to try to take a warm shower to ease muscle aches but as soon as I got into the bathroom I felt very hot, very nauseated and lightheaded. I suspected hypotension but of course I wasn't able to prove it at the time. I attempted to get back to my bed but had syncopal episode a few feet from the bed where I collapsed onto the floor. I just stayed on the floor and rested because it actually felt better lying down. I am a retired RN and suspect this adverse event was related to orthostatic hypotension. Nothing like this has ever happened to me before.

Other Meds: No RX Supplements: Vit C, Fish oil, folic acid, vit D, biotin, magnesium, selenium, K2, Cholestoff, zinc, glucosamine/chodroitin,B12

Current Illness: None

ID: 1063380
Sex: F
Age: 61
State: NC

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 03/01/2021
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: None

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

Symptoms: Had shot on 2/17/21. No side effects at all. Took Stelara shot on 2/26/21, Arm started itching terribly where i had Moderna shot. next day, a friend looked at it. Had a round red circle around where the shot was and it was hard. Today (3/1/21) just a little red, no itching.

Other Meds: Pristiq, Valsartan, Hydralazine, Meloxicam, Gabapentin, Fexofenadine, Tizandine, Stelara

Current Illness: None

ID: 1063381
Sex: F
Age: 54
State: CA

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
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: Unevaluable event

Symptoms: Itchy, and heart racing turned over care to AMR was given oral Benadryl transported to hospital.

Other Meds:

Current Illness:

ID: 1063382
Sex: F
Age: 42
State: NY

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
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: Had a rash when on a high dose on Amoxicillan.

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

Symptoms: Itchy welt 1 inch in diameter about 10-12 hours after vaccination. It then grew to about 6 inches in diameter by about 36 hours after vaccination. (Covid arm).

Other Meds: No

Current Illness: No

ID: 1063383
Sex: F
Age: 44
State: MA

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
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: Erythromycin, doxycycline

Symptom List: Injection site pain, Pain

Symptoms: A burning, tingling sensation went up my right arm, across my chest and down my right arm. It lasted about 40 mins and my bp rose to 160/92. After 40 mins, it went away and my bp returned to 125/72. About an hour later it happened again from my stomach up to my throat lasting about 5 mins.

Other Meds: Omeprazole, lisinopril, sertraline, atorvastatin, dauly Multivitamin, iron vitamin

Current Illness: None

ID: 1063385
Sex: F
Age: 76
State: IL

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List: Injection site pain, Menorrhagia

Symptoms: Developed pain of 10/10 in arm the day after the vaccine which continues to today. MD office visit scheduled.

Other Meds:

Current Illness:

ID: 1063386
Sex: F
Age: 59
State: AR

Vax Date: 02/25/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
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: denies any

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

Symptoms: Moderna COVID-19 vaccine EUA difficult time gathering all information due to poor cell reception. Called about 42 hours 1/28/21 after first dose, reported she fainted in her driveway, was instructed by nurse to call ambulance or go to her PCP. She had an appointment the next day so she waited until the next day and saw APRN. 1/29/21 called to follow up on initial report and get infor for health checker website, she had sore arm and chills AM 1/26/21 at aprox. 24 hours after first dose, right ear was itchy, hot and swollen. 36 hours later B/P dropped and stated she fainted in driveway. 1/29/21 feeling okay. Dose 2- she had a box of benadryl chewable with her in case she needed, administered 2/25/21 and waited in clinic for 30 minutes no issues. 3/1/21 she called clinic and reported 2/27/21 AM she had welts on upper body and face. In the PM her ear gor itchy and her throat swelled some, but was able to swallow. Stated she did not take benadryl as she wanted to see what was happening to her. Sunday AM noticed her upper lip swollen some and stayed that way most of the day. 3/1/21 she called today to report reactions,

Other Meds: Multi Vitamin, D3 Acidophylis

Current Illness: denies any

ID: 1063387
Sex: M
Age: 88
State: NJ

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

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I came home and found my father on the floor in his bedroom just after 8am. He was disoriented and unable to get up. I had to lift him up and he was still off balanced. I asked him if he had fallen and how long he was on the floor. He couldn't give me a clear answer and I don't know how long he was on the floor. I noticed he seemed very weak and I asked him when was the last time he had something to eat and he wasn't sure. He said maybe 1 or 2 days. I asked if he didn't have an appetite and he couldn't answer me or give me a reason.

Other Meds:

Current Illness: Hay Fever/seasonal allergies

ID: 1063388
Sex: F
Age: 78
State: CT

Vax Date: 02/28/2021
Onset Date: 03/01/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Chills and then fever and lack of appetite. No energy

Other Meds: Pyridostigime Alendronate atorvastatin

Current Illness:

ID: 1063389
Sex: F
Age: 29
State: KY

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

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

Symptoms: Within 5 minutes after 1st dose I became dizzy and hot. This went away after 30 minutes. This continued each day for a week. I?m dec 29 I was treated for Bell?s palsy. My face was numb on the right side, later progressed to my entire right side of my body. A few days later I wasn?t able to get out of bed I was extremely weak, fatigue. Had a hard time walking. Went to the er on January 3rd. Treated for migraine with paresthesia. Continued to have vertigo, numbness, weakness, fatigue. Also, had anxiety and panic attacks. Vision is now blurry, a s constantly seeing floaters. Also, I now have issues with fluid in my ear that won?t go away.

Other Meds: Nothing

Current Illness: None

ID: 1063390
Sex: F
Age: 65
State: NY

Vax Date: 02/19/2021
Onset Date: 02/24/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: No allergies.

Symptom List: Nausea

Symptoms: Swollen site on my right arm at the injection site, red round circle and itching also note upon touch there is no pain but the area is hard to the touch.

Other Meds: Entresto 97 mg 2x a dayCarvedilol 6.25 2x a day,Aspirin 81mg, Atorvastatin 10 mg 1x a day, Metformin 500mg 2x a day, Jardiance 25 mg 1x a day, furosemide 20 mg 3x a wk. I have a pacemaker

Current Illness: Heart failure hypertension and diabetes

ID: 1063391
Sex: F
Age: 69
State: TX

Vax Date: 02/04/2021
Onset Date: 02/24/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: shingles on right trunk

Other Meds: ambien10mg q pm. hydrochlorothizide 25mg qd loatadine 10mg qd melatonin `0 mg q pm levotyroxin 50mcg qam b12 5000mcg qpm

Current Illness: none

ID: 1063392
Sex: F
Age: 60
State: LA

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: large area of arm swollen , red, itchy at injection site

Other Meds: Lotensin Allegra Vitamin D Zinc Estrodil Multivitamin for women

Current Illness: None

ID: 1063393
Sex: F
Age: 70
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: My body became so very weak that I could not roll over or walk on my own. I experienced a lot of joint pain. I was so worried that my MS was becoming active. This conditioned lasted about 24 hours , but the weakness and fatigue lasted for several days. It has been 4 days since my vaccine and am feeling myself again. This was my second vaccine. The first vaccine, I experienced weakness and difficulty walking, but it was no where as bad as the second vaccine.

Other Meds:

Current Illness:

ID: 1063394
Sex: F
Age: 45
State: NC

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

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

Lab Data:

Allergies: no known allergies

Symptom List: Tremor

Symptoms: Chest pressure 10 min after injection Throat tightness couple mins later

Other Meds: Gabapentin 200mg TID Tegretol 300mg BID 150mg HS

Current Illness: n/a

ID: 1063395
Sex: F
Age: 75
State: WA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
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: fever chills headache sore arm

Other Meds: multi vitamins glucosamine MSM

Current Illness: none

ID: 1063396
Sex: F
Age: 59
State:

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 03/01/2021
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:

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

Symptoms: Nausea and vomiting, diarrhea. Coughing eyes are burning.

Other Meds:

Current Illness:

ID: 1063397
Sex: F
Age: 56
State: TX

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
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: Codeine and Pepcid

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

Symptoms: I feel achy, bad headache, slight cough, chills, feverish, and soreness on right arm where vaccine was administered.

Other Meds: B12, D3, omega 3, vitamin c, and omeprazole.

Current Illness: Allergies

ID: 1063398
Sex: F
Age: 48
State: NC

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 03/01/2021
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: I have been Post menopausal for over 3 years now. And I woke up around midnight with the worst abdominal pains ever. Then I stared spotting and I haven't stopped. My stomach cramps are not as bad but I still have them along with the spotting.

Other Meds: none

Current Illness: none

ID: 1063399
Sex: F
Age: 67
State: AZ

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

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

Symptoms: Naseau, headache, body aches, fatigue, sore arm, clamy

Other Meds: levothyroxine and sertraline

Current Illness: none

ID: 1063400
Sex: F
Age: 39
State:

Vax Date: 02/16/2021
Onset Date: 02/19/2021
Rec V Date: 03/01/2021
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:

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

Symptoms: The vaccine caused my menstrual period to start very early. This happened after the first dose as well. My period is tremendously regular, so this was quite odd.

Other Meds:

Current Illness:

ID: 1063401
Sex: F
Age: 47
State: TX

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

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

Lab Data:

Allergies: Bentyl Statins Warfarin

Symptom List: Pain in extremity

Symptoms: itching, hives, rashes at different locations of body, overstimulation of histamines (congestion build up) nurse at site said to use Benadryl (still using daily at day 6) and drink lots of water.

Other Meds: zinc multi-vitamin Vitamin D Zyrtec Singular Albuterol birth control pills (generic of ortho-tricyclene)

Current Illness: none

ID: 1063402
Sex: F
Age: 45
State: WA

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: yes - penicillin; allergic to tree nuts and pitted fruits

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

Symptoms: Constricted throat. I was given Zyrtec. Observed for an hour. Got discharged. Throat constriction didn't go away until 2 hours afterwards. Puffy, itchy eyes (both eyes) with rash came and lasted about two weeks. Monday or Tuesday, I noticed a rash all over my body - red and blotchy. That went away in a day. I got chills, fever, weakness, nausea, vomiting, diarrhea and that lasted 48 hours (16th in pm-17th and got better evening of 18th). When I had the rash was all over the body, I took a Zyrtec. The weekend I was really sick I didn't take any medication. Phone visit with Doctor - January 15th - allergist - I followed up with him about the throat constriction. He just was monitoring symptoms. After the weekend that I was really sick, I told him and he ordered bloodwork.

Other Meds: For both First and second dose I took vitamins - Multi-vitamin; Vit D; Magnesium; Cranberry pills; Glucosamine; Citrucel for digestion/bowel movements

Current Illness: Adverse symptoms after dose of Pfizer vaccine - puffy itchy eyes

ID: 1063403
Sex: M
Age: 82
State: OH

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 03/01/2021
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: penicillin - rash anti-inflammatories - become dizzy

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

Symptoms: 1-21-21. Got first COIVID-19 vaccination at 7:15 AM (Phizer). No reaction whatsoever. Pfizer Lot:EL3249 2-11-21. Got second vaccination at 7:05 AM. Felt normal all day. Pfizer Lot:EL9264 2-12-21. Felt good early. Played tennis and worked out. About 2 PM, started feeling very poorly. Took 90 minute nap. Woke up nauseous and dizzy. Threw up several times. Could not drink or eat dinner. 2-13-21, Continued to feel badly. Threw up after arising. Couild not drink or eat breakfast. About 1:30 PM, was able to keep yogurt and cottage cheese down. Nibbled off and on. Ate light supper. 2-14-21. Woke up dizzy. Was able to eat normally. Still felt badly. Had bad headache (very unusual for me) before supper. Ate normal supper. Canceled tennis for following week. 2-15-21. Started feeling much better than day before. 2-16-21. Felt much better than the day before. 2-17-21. Best day since 2-11 ? the last 5 days. 2-18-21. Began to feel rocky. Slightly dizzy. Low energy 2-19-21. Felt worse than the day before. Low energy, short dizzy spells, little appetite. 2-20-21. Felt really bad. Very dizzy all day. Drippy nose for 5 hours, but nose okay by bedtime. Very tired all day. 2-21-21. Felt a little better. Still dizzy when I got up. Recovered enough to go to church at 10 AM. Note that it had been 10 days (at 7:05 AM) since I had my second shot. 2-22-21. Got up to the bathroom at 2 AM. Was dizzy. Got back to sleep until 6:30 AM. Was and am better than the last 4-5 days. Still feel a little shaky if I move quickly or get up out of my chair quickly. Very tired all day. 2-23-21, Doing better. Still wobbly on my feet. Only mildly dizzy. 2-24-21. Best day since 2-17. Still a little weak. Worked out in the late AM. 2-25-21. Felt a little dizzy in the AM. Better after lunch. Did light workout. Good day overall. Felt fine. 2-26-21. Felt good in the AM. Worked out. Feeling stronger than yesterday even. 2-27-21. Felt good 2-28-21. Felt tired all day 3-1-21. Did not sleep well. Worked out in the AM and then was very tired. Felt a little dizzy after returning home from the gym. Took short nap before lunch and am doing better in the PM.

Other Meds: 50 mg levothyroxine 2.5 mg amlodipine 5.0 mg lisinopril. ? mg backtrim (sulfametho-xazole-TMP DS (half dose) 1000 IU D3 1000 IU glucosamine 1200 IU chondroitin 1200 mg fish oil

Current Illness: none

ID: 1063404
Sex: F
Age: 55
State: TN

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 03/01/2021
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: severe pain and swelling in left lower leg. Diagnosed with 2 DVTs 3 days later in emergency room.

Other Meds: probiotic, multivitamin

Current Illness: none

ID: 1063405
Sex: F
Age: 68
State: MN

Vax Date: 02/12/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
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: Penicillin Latex Codeine

Symptom List: Vomiting

Symptoms: 2 weeks following first Moderna vaccine noticed red rash and tenderness in vaccine arm. Redness extended toward elbow. Headache and arm achiness. No fever.

Other Meds: Bactrim Lisinopril HCTZ Omeprozaole Atenolol Singulair ASA Elavil Multivitamin Viactiv with D Tylenol

Current Illness: UTI treated at time of vaccination

ID: 1063406
Sex: F
Age: 66
State: MN

Vax Date: 02/25/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
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: Iodine, latex, penicillin, erythromycin, cocoa butter, blueberries

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 2 days after shot I had itchy palms and tingling in both index fingers from the last joint to the tip of my fingers lasting about 48 hours

Other Meds: aspirin, metaprolol, rosuvastatin, losartan, amlodipine, omeprazole, calcium with vitamin D, magnesium

Current Illness: None

ID: 1063407
Sex: F
Age: 74
State: MD

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
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

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

Symptoms: SORE LEFT ARM, UNWELL FEELING, TIREDNESS

Other Meds: ld aspirin, multi vit, vit C, vit D, estroven, synthroid, calcium, glucosamin-chond, tylenol arthritis, zinc, fametodine, atorvastatin

Current Illness: none

ID: 1063408
Sex: F
Age: 59
State: VA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/01/2021
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: While pushing the moderna vaccine in left arm the medication leaked out of the syringe and dripped down patients arm. Gave another dose in the right arm.

Other Meds:

Current Illness:

ID: 1063409
Sex: M
Age: 42
State: TX

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

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

Lab Data:

Allergies: No

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

Symptoms: Blood glucose levels elevated to over 300 with in 4 hours of vaccination, and staying high, over 180 on an average. Fasting levels at 190-200. No change in medication, diet or health condition.

Other Meds: Elevated Blood glucose level since vaccination.

Current Illness: None

ID: 1063410
Sex: F
Age: 38
State: GA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 03/01/2021
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: None

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

Symptoms: She began feeling dizzy with some nausea, apprehension, and numbness/tingling in her tongue. Her vital signs were monitored every 5 minutes for 20-25 minutes, and she was given 20 mL (50 mg) liquid Diphenhydramine. Her symptoms subsided, and she was ambulatory and stable without distress at dismissal from clinic.

Other Meds: Unknown

Current Illness: Unknown

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm