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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1063462
Sex: F
Age: 75
State: GA

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

Lab Data:

Allergies: carvedilol, Bactrim

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt was brought to ED due to altered mental state, apparently after pt received first Covid vaccine, she didn't feel quite well, fatigued; after recent 2nd Covid vaccine, pt had been noted to be confused with poor appetite. Pt also with recent dx hypopituitarism - has been on desmopressin/ prednisone - per report from family members, pt had been drinking a lot of water. In ED, Pt was noted with hyponatremia - NA 124, Lactic acidosis 2.1, low grade temp - PCT wnl.

Other Meds: Eliquis, Zyrtec, Vit D3, desmopressin, diltiazem, famotidine, glimepiride, levothyroxine, macular health formula, omeprazole, pravastatin, sitagliptin, prednisone

Current Illness: Pt also with recent dx hypopituitarism - has been on desmopressin/ prednisone - per report from family members, pt had been drinking a lot of water. In ED, Pt was noted with hyponatremia - NA 124, Lactic acidosis 2.1, low grade temp - PCT wnl.

ID: 1063463
Sex: M
Age: 74
State: FL

Vax Date: 02/15/2021
Onset Date: 02/19/2021
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: no

Symptom List: Anxiety, Dyspnoea

Symptoms: I got the shot and went to work for four days straight and had no problems, then that weekend I had a fever, chills, and felt kind of week, and dizziness, and severe fatigue. It has been two weeks since then, and I'm still feeling fatigue, and I have not had a proper bowel movement in two weeks. Diminished appetite.

Other Meds: multivitamin fish oil folic acid tamsulosin 0.4 mg pravastatin 40 mg methotrexate 2.5 mg omeprazole 20 mg amlodipine besylate 10 mg finasteride 5 mg aspirin 81 mg calcium+d3 1200 mg zinc 15 mg vitamin 125000 IUs

Current Illness: No

ID: 1063464
Sex: M
Age: 55
State: MA

Vax Date: 02/19/2021
Onset Date: 02/26/2021
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: None

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

Symptoms: Patient had the first dose of the Pfizer COVID vaccine (LOT# EL9264) on 1/29/21 at the vaccination center at Medical Center (set up in Hotel). He had the second dose on 2/19/21 (LOT# EN6201) at 12:30pm, and reported leg pain and difficulty breathing on 2/26/21 as he was going to bed. He presented to the ER at Hospital that day, and was diagnosed with a deep venous thrombosis and pulmonary embolism. He is currently taking Xarelto, and will schedule an appointment with Hematology, as he has no family or personal history of clotting disorder.

Other Meds: Amlodipine Besylate 2.5 MG Tablet 2 tablets Orally Once a day Atorvastatin Calcium 20 mg Tablet 1 tablet Orally Once a day Famotidine 20 MG Tablet 1 tablet at bedtime as needed Orally Once a day Ferrous Gluconate 324 (38 Fe) MG Tablet 1

Current Illness: None

ID: 1063465
Sex: F
Age: 65
State:

Vax Date: 02/18/2021
Onset Date: 02/18/2021
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: right arm redness with hives. got benadryl 25 mg po

Other Meds:

Current Illness:

ID: 1063466
Sex: F
Age: 45
State: PA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
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: pennicillin

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

Symptoms: after having the fever of 102, fainting and throwing up I had horrible vertigo and nausea. had to go on anti vert and anti nausea meds, now 1 month later, I am still dizzy in the morning, my muscles ache terrible , especially my lower leg muscles , joint pain, and I am so exhausted

Other Meds: lexipro and birth control

Current Illness: none

ID: 1063467
Sex: F
Age: 92
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Chest pain, palpitations-cleared by EMS.

Other Meds:

Current Illness:

ID: 1063468
Sex: F
Age: 66
State: IL

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: tape, ragweed, grass, mold

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: sore arm, left sided headache, chills, no fever, painful lump, sore throat 2/13 2/14 less intense headache, less pain in arm-2/15 dull red circle is itchy, no pain-hydrocortisone cream for 2 days 2/17-2/18 felt better, tender breasts 2/19 circle faded, bright pink and swollen 3x4 cm, panful to touch and itchy, 2/20-prominent red color, headache, 2/21 sore throat, burning pain couldn't swallow 2/22-2/25 intense soar throat, roof of mouth was irritated, ear pressure

Other Meds: atorvastatin 75mg, multi vitamin, tumeric

Current Illness: n/a

ID: 1063469
Sex: F
Age: 69
State: FL

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

Lab Data:

Allergies: Iodine, vespid bites, fire ants

Symptom List: Pharyngeal swelling

Symptoms: I have Post Herpetic Neuralgia as a result of severe non-erupting Shingles in 2017 and it is controlled with 300 mg Gabapentin 2x day. I can be sensitive to touch and fabric throughout my entire back and across my midriff and sides below by bra line. The sensitivity varies day to day and I live with it. When I woke up the at 3:30 am the day after the 2nd dose of vaccine my entire back, midriff and sides were significantly aggravated and it was difficult to move against the sheets in bed. Today is day 18 post second dose and every day since 2/11 I remain in increased sensitivity and discomfort. I have to keep changing to one piece dresses after 5 hours of daylight that just drape over me with no seams. I have not increased my Gabapentin dosage (I could but try not to) and in when there are VERY sore locations, applying CBD cream will relieve the pain in 20 minutes. The pain/sensitivity locations change daily.

Other Meds: Hydrochlorathorazide, Gabapentin, Myrbetriq, Calcium, D3, Guclosomine with MSM, Black Cohosh, vaginal cream

Current Illness:

ID: 1063470
Sex: F
Age: 32
State: OH

Vax Date: 02/19/2021
Onset Date: 02/27/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Rash at injection site - present 2/26 (8 days post injection). Large, hot to touch, red hive-like rash began as a few small bumps and developed into a large rash from approximately injection site to mid-upper arm. Needle stick also reappeared and scabbed. Physician prescribed antibiotic and steroid.

Other Meds: Amitriptyline 25mg, Estradiol 1mg

Current Illness:

ID: 1063471
Sex: F
Age: 75
State:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Near syncope-dizzy, lightheaded, diaphoretic, blurred vision, decreased responsiveness. Evaluated by EMS-BP 100 palp, BS 110, decreased responsiveness. 2:36 pm-transported by rescue squad.

Other Meds:

Current Illness:

ID: 1063472
Sex: F
Age: 39
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: 15 minutes after the vaccine she started getting dizzy. lasted about 5 minutes and resolved on it's on. She was given a bottle of water, O2 sat 98% HR-72 no other issues noted. Instructed to follow up with MD as needed.

Other Meds: 15 minutes after the vaccine she started getting dizzy. lasted about 5 minutes and resolved on it's on. She was given a bottle of water, O2 sat 98% HR-72 no other issues noted.

Current Illness: no

ID: 1063473
Sex: F
Age: 67
State: MI

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: N/A

Symptom List: Rash, Urticaria

Symptoms: I started to get cold/chills about 10:00 p.m. by 12:00/midnight I had uncontrollable chills and shivers (I've never been so cold in my life. I felt like my bones were going to break). At 1:00 a.m. my arm started to hurt and then throb. At injection area Simultaneously I started to get a headache and the pain and discomfort traveled down my entire body/shoulders-arms-HANDS (ached terribly)-chest-legs-feet At 4:00 a.m. everything all subsided and I was able to sleep 'til 7:30 a.m. On Saturday I took a 2 hr. nap n the afternoon and went to bed at 7 p.m. and slept for 11 hrs. Felt winded all day Sunday and joints ached Monday, still easily winded

Other Meds: Amlodipine Besylate 5Mg Lisinopril 20Mg

Current Illness: N/A

ID: 1063474
Sex: F
Age: 75
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA 2" diameter red and itchy area around injection site and 3" long by 1/4" wide red line from injection site to arm pit, that lasted 1 week. Also, 101 temp, some chills, light headache, upper teeth hurt (like in sinus infection) and tired that lasted 1 day.

Other Meds:

Current Illness:

ID: 1063475
Sex: M
Age: 51
State: GA

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: SYR
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: Pt. reported back to the HD front window after waiting 15 minutes post vaccination and leaving the HD. He reported that after he was finished with his 15 waiting period he was about to leave and he had a stinging sensation in the middle of his chest. Pt. denies any shortness of breath or any other symptoms. Pt. BP was taken at 10:09 and was 144/88 and again 5 minutes later and it was 137/ 85. Pulse was regular at 61 BPM. Pt. wife came to HD and stayed with husband while he was observed for another 20 minutes. Pt. reported that stinging pain was gone but he was just worried because he had never had a pain like that before. Denies any problems with first Moderna Covid-19 Vaccine EUA. Pt. was advised to contact primary care provider for further evaluation and follow up for his stinging chest pains. Pt left health deparment with wife unassisted and no distress on 03/01/2021 at 10:25 AM.

Other Meds: Mobic PRN

Current Illness: None

ID: 1063476
Sex: F
Age: 71
State: SC

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: LA

Lab Data:

Allergies: Quinine

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

Symptoms: Within first 30hrs of receiving vaccine: chills (twice), body aches, diarrhea (twice); fatigue, fever (did not exceed 100 degrees). Underarm pain, enlarged lymph node began within 2 days post 2nd vaccine. ( Friday-Sat. Feb. 26-27) Within four days (Sunday Feb. 28) redness, swelling, pain and itching began in upper arm. ....neck pain reduced. By Monday, March 1, I contacted my family practice clinic and received a video consult with Dr.

Other Meds: Synthroid 5x wk 88MCG and 2x wk 75 MCG Losartan/HTCZ (Hyzaar EQ)- - PO 50-12.5 MG daily- Zoloff 50mg daily Fosamax 1 x wk Calcium Vit D 200 IU Red Yeast Multi-vitamin

Current Illness: None

ID: 1063477
Sex: M
Age: 59
State: VA

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

Lab Data:

Allergies: none

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

Symptoms: injection site pain, tiredness, injection site swelling.

Other Meds: Valtrex, Zetia, Crestor, colase, lisinopril, hydrochlorthiazide, coqu10, vitamin D, vitamin E, fish oil, flaxseed oil, multivitamin, potassium.

Current Illness: none

ID: 1063478
Sex: F
Age: 66
State: MI

Vax Date: 02/17/2021
Onset Date: 02/26/2021
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: beef, cats

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

Symptoms: I received the first dose of the Moderna covid-19 vaccine at on February 17. My arm was a bit sore for a day or two, which is typical for me after I receive vaccinations. I had no other symptoms -- no fever, tiredness, or achiness. Then 10 days after the vaccination, on Feb. 26, my arm at the vaccination site began to itch, and I noticed a slightly raised, red patch about 2.5-3 inches in diameter there. I still do not have any other symptoms, and the redness appears to be fading.

Other Meds: bupropion SR, 200mg twice daily; multivitamin for adults 50+, once daily; estradiol vaginal cream, 0.01%, 1g twice per week.

Current Illness: none

ID: 1063479
Sex: M
Age: 59
State: MI

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

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient received covid shot, was sitting in chair after shot, felt sudden urge to have BM, stood up and passed out. Bradycardia (Per ems reading of 58 and then 41, current in hospital 62), and Hypotension (Per ems 88/64 and then 68/42) He was required to stay for 15 mins afterward for symptom monitoring. He then proceeded to feel ill after the vaccine, became sweaty, lightheaded, and felt gassy. He then stood up to use the restroom, and stated he felt he was going to pass out and fell to the ground, hitting his head against the ground. He denies any full LOC. Did sustain a laceration to L forehead. He denies any preceding vertigo, chest pain, or DIB.

Other Meds: aspirin atorvastatin metoprolol pantoprazole ticagrelor

Current Illness: None

ID: 1063480
Sex: F
Age: 67
State: WI

Vax Date: 02/19/2021
Onset Date: 02/23/2021
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: PCN, sylpha, TCN

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Extreme fatigue lasting 5 days. Arm swelling, tightness, redness and itching which still persists 8 days following injection.

Other Meds: none

Current Illness: none

ID: 1063481
Sex: F
Age: 43
State: KS

Vax Date: 12/20/2020
Onset Date: 12/20/2020
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: Codeine, Penicillin

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

Symptoms: I exp shortness of breath and sore arm (right). The shortness of breath lasted couple hours and soreness of right arm few days.

Other Meds: No

Current Illness: No

ID: 1063482
Sex: M
Age: 47
State: VA

Vax Date: 01/18/2021
Onset Date: 01/31/2021
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: SVT, heart rate at rest was over 200bpm, I laid down for 30 mins and couldn't get it under 180. Felt pressure in head and not very stable. Concerned, sweating, Bp was very high at that point. Don't have the exact number. Called for ambulance, paramedics ruled out WPW and gave me iv drug that brought rate down to 120 fairly quickly, Over the next hours resting rate slowly normalized to around 80 (normal for me is 72). For 2-3 days afterwards had some high resting pulses up to 118 but never as bad and normalized in a few days.

Other Meds: lisinopril, celebrex, trujeo, tradgenta, glimiperide, benedryl, zanaflex

Current Illness:

ID: 1063483
Sex: F
Age: 77
State:

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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: Unevaluable event

Symptoms: Admitted to hospital on 1/28/21 from nursing home with altered mental status and UTI. PMH of heart failure, CKD, afib, COPD. discharged on 2/2/21. COVID negative during this admission. Readmitted on 2/28/21 for AMS, family was unable to wake patient up for an hour prior to calling EMS. Upon admission, found COVID positive.

Other Meds:

Current Illness:

ID: 1063484
Sex: F
Age: 63
State: MO

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: Lisinopril

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

Symptoms: Top of mouth and tongue tingling and full. No meds given. Refused to go to ER

Other Meds:

Current Illness:

ID: 1063485
Sex: F
Age: 53
State: CA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: orange juice zilactin

Symptom List: Injection site pain, Pain

Symptoms: First muscle soreness at site of injection, then severe redness at site, cherry electric red and pink, severe muscle aches, severe joint aches, severe headache, diarreah, dizzyness, the extreme rapid heart rate of 205 BPM. SEVERE SVT, SUPREVENTRICULAR TACHYCARDIA lasting from 9 p.m. Friday evening through the a.m. until I was transported from Urgent Care via Paramedics to Emergency Hospital. I was given an IV of a Medicine to restart my heart twice. I felt like I was dying.

Other Meds: tamoxifen

Current Illness: none

ID: 1063486
Sex: F
Age: 61
State: MI

Vax Date: 02/01/2021
Onset Date: 02/27/2021
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: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Nothing too horrible... Nasseau periods, and diarrhea for 2 days, slight headache. I took some pepto bismol today. Hope it helps. I am still not sure if these are due to the vaccine or not?

Other Meds: 1200 mg Calcium daily, Glucosamine Hydrochloride 1500 mg daily, Vitamin D 2000 mg daily, and a probiotic with 10 strains.

Current Illness: None

ID: 1063487
Sex: F
Age: 63
State: NC

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

Lab Data:

Allergies: Penicillin, Latex, and Sulfa

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

Symptoms: Patient reported tingling lips at about 20 minutes post injection. Her lips were also noted to be swollen. She was given Decadron 10 mg IM @ 0905. She was then given Benadryl 50mg IM @ 0915. She was monitored another 20 min. Her lip swelling and tingling resolved. She left the facility and was driven home by a friend.

Other Meds:

Current Illness: none

ID: 1063488
Sex: F
Age: 43
State: WI

Vax Date: 02/11/2021
Onset Date: 02/13/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Shingles flare starting 2 days post immunization to right neck, pain and soreness started next day but patient thought it was tenderness of lymph nodes due to immunization and typical muscle soreness from sleeping wrong.

Other Meds: Venlafaxine 75mg daily

Current Illness: None

ID: 1063489
Sex: F
Age: 78
State: PA

Vax Date: 02/24/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Prochlorperazine, Bactrim, Phenergan, Statins, Sulfa Antibiotics, Tegaderm

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Red raised rash under arms and torso, resident skin flushed and warm

Other Meds: Metformin, Abilify, Lyrica, Tums, Melatonin, Xanax, Prozac, MVI, Dicyclomine, Xarelto, Simethicone, Oxycodone, Fentanyl, Olopatadine, Vit D, Flonase, Senna, Protonix, Ducosate, Zofran

Current Illness: UTI,

ID: 1063490
Sex: M
Age: 75
State: AZ

Vax Date: 02/20/2021
Onset Date: 02/21/2021
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: none

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

Symptoms: 7 a.m. the morning following the 2nd vaccination, pt. got out of bed, walked a few steps to the master bathroom. He was having some difficulty breathing so reached for his BREO & his legs wouldn't hold him up. He collapsed to the floor. His wife got him to bed where he stayed for a few minutes. He got up again & walked a few steps to the master bathroom, started brushing his teeth & his legs collapsed again where his wife caught him & helped with controlled descent. He could not remember some of the first collapse & none of the second collapse. He crawled to bed & stayed for 1/2 hour. Got up & felt fine the rest of the day & since then.

Other Meds: BREO Ellipta, Ipratropium Bromide Nasal Solution, Acetaminophen, Cilostazol, NifedipineER, Vision Formula 50+, Vitamin D3

Current Illness: none

ID: 1063491
Sex: M
Age: 68
State: GA

Vax Date: 01/25/2021
Onset Date: 01/26/2021
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: RA

Lab Data:

Allergies: peanuts

Symptom List: Nausea

Symptoms: Chills , Night Sweats, aches, collapsed a week after 2nd dose and then diagnosed with DVT - entire right leg involved.

Other Meds:

Current Illness: none

ID: 1063492
Sex: F
Age: 38
State: MD

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Patient noted chest tightness, has had this before related to MS medication, no other symptoms. Declined any intervention but monitoring.

Other Meds:

Current Illness:

ID: 1063493
Sex: M
Age: 34
State: WI

Vax Date: 02/02/2021
Onset Date: 02/02/2021
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: Approximately 12 hours after the shot I developed symptoms including, brain fog, chills, aches, and pain at the sight of the injection. Over the course of the night, I fell more ill and finally took my temperature in the morning around 7 AM and had a fever of around 100.4 F. I took Tylenol about every 6 hours for the next 24 hours with my temperature fluctuating between normal and 100.4 F. During this time, I was too ill to do anything more than sleep or lay in bed. The following day, my temperature broke, but I was still experiencing aches, chills, and brain fog, along with the pain at the injection site. After about 84 hours from the time of the vaccination, I felt normal enough to resume my daily activities.

Other Meds: None.

Current Illness: None.

ID: 1063494
Sex: F
Age: 64
State: IN

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: IM
Vax Site: RA

Lab Data:

Allergies: Itchiness with hydrocodine

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

Symptoms: Within 30-45 minutes after injection, I started to feel a tingling around my jaw area. Then 3 days later I have had several episodes of dizziness, weakness and nausea. This has continued until today (4 days) along with aching across sholders and behind eyes.

Other Meds: Simvastatin40mg, Levothyroxine Sodium 75Mcg, Vitamin D3, LipoFlavanoid

Current Illness: none

ID: 1063495
Sex: F
Age: 66
State: AL

Vax Date: 02/16/2021
Onset Date: 02/17/2021
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: non known

Symptom List: Tremor

Symptoms: headache, muscle and joint pain, nausea vomiting, diaraha, very hard chills shaking, bp 138/113 pulse 122- I took a water pill -around 5 am I had vilant vomiting at 8:15 am bp 130/76 pulse 107 I went to sleep and on 2/18 at 9:24 am bp 117/73 pulse 82 --my friend called and she call the pharmacy for me to see if I could take anything and said for me to take benyadryl after going back to sleep I felt much better

Other Meds: 1/2 tab Dicofenac sod 75mg, 1/2 tab Hydrochlorothiazide 25 mg, vit c

Current Illness: knee pain

ID: 1063496
Sex: F
Age: 60
State: TX

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

Lab Data:

Allergies: DENIES ALLERGIES

Symptom List: Erythema, Pruritus

Symptoms: 1030am, 10 minutes after vaccine; Patient states "feeling hot", feeling a 'rush" through chest, lips felt tingling sensation, and had burping. Also felt like she needed some air. 10:45am vital signs taken. Temp-97.7, BP- 138/90 ( elevated, states normal for her and has not taken blood pressure medication today) , Pulse- 72. Patient observed in my office for another 15 minutes. 10:55 Patient states feeling better and symptoms have subsided. 11:00 am Pt states ready to go home. States will self- monitor for post- immunization symptoms. ER precautions given and confirmed verbal understanding. Released home.

Other Meds: Losaartan/HCTZ (100mg/25mg) QD, Albuterol HFA 90mcg omhaler, Advair Diskus Rabeprazole SOD 20mg

Current Illness: HTN, ASTHMA, GERD

ID: 1063497
Sex: F
Age: 37
State: CT

Vax Date: 02/16/2021
Onset Date: 02/19/2021
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: None

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

Symptoms: 2/19/21 patient notice lump under Lt arm (painful), which resolved in 1 week. On 2/25/21 she felt tightness and pressure on Lt side of the neck and behind Lt ear which was progressing to numbness. On 2/28/21 she noticed LT facial droop and consulted her MD, who diagnosed her with Bell's Palsy and informed her that could be a side effect from Covid 19 vaccine.patient says that her Lt side of face is still numb and she cannot close her Lt eye, which causes dryness and discomfort. She was started on antiviral medication and steroids by mouth.

Other Meds: Multivitamins, fish oil, Vitamin C

Current Illness: none

ID: 1063498
Sex: F
Age: 77
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Started with chills, fever. Next morning could hardly get out of bed. Very weak and throwing up black liquid. Could not take care of self for 2 and one-half days. Very weak for 4 days. I was sick with the 1st vaccine for a day one-half with chills and fever but nothing compared to the 2nd one. I will not taken another Pfizer vaccine ever.

Other Meds: Synthroid, Losartan, Atorvastatin, Tramadol

Current Illness: None

ID: 1063499
Sex: F
Age: 25
State: IL

Vax Date: 02/01/2021
Onset Date: 02/03/2021
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: Sister and mom allergic to kiwi and augmentin, so I avoid both

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Excruciating neck pain beginning at ~5:00am on 2/3. Turned into debilitating nerve pain down my left arm and eventually my right as well. Pain went down the back/side of both arms and into my hands (chilled hands, electric shock feeling, tingling and pain). Now on gabapentin 2x/day, nerve pain is still there (one month later) but much better than it was.

Other Meds: Paxil (20 mg daily), Linzess (145mcg daily), OrthoFlora Yeast Support (3 capsules/day, away from food), Saccharomyces boulardii (2 capsules/day, with food) , Multivitamin (1/day), Magnesium Citrate (150mg/day) Biomega 1000 (2 capsules/day

Current Illness: SIBO diagnosis

ID: 1063500
Sex: M
Age: 32
State: OH

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

Lab Data:

Allergies: bee sting

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

Symptoms: Moderna COVID-19 Vaccine EAU. The following day at 3AM I woke up with chills, a mild fever of 100.0, a headache, and back pain. Towards the end of the day I felt tired, however not sure if that was from the vaccine or because I did not sleep well. Tylenol reduced symptoms and they did not greatly interfere with my day. The following morning all side effects were gone and I was back to completely normal.

Other Meds: vitamin d supplement, "Emergen-C powder

Current Illness: none

ID: 1063501
Sex: F
Age: 54
State: TX

Vax Date: 02/27/2021
Onset Date: 02/28/2021
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: None

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

Symptoms: Throat closing, severe headache, low grade fever, muscles and joint aches, chest pains, and stomachache

Other Meds: Symbacort Fluoxetine Albuteral Omega 3 vitamins

Current Illness: None

ID: 1063503
Sex: F
Age: 70
State: NY

Vax Date: 02/01/2021
Onset Date: 02/01/2021
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: Meclyzine, PCN

Symptom List: Pain in extremity

Symptoms: 2/14/21 experienced soreness at site of injection. 2/15/21 & 2/16/21 experienced flu-like symptoms (fever, extreme fatigue, muscle aches). 2/17/21 severe disorientation, feelings of dementia, nausea, difficulty walking, affecting L side, feelings of panic & agoraphobia, extreme fatigue, unable to complete any meaningful tasks. 2/18/21, 2/19,2/20,2/22 - continuation of symptoms on 2/17/21. 2/22/21 symptoms lessened but continued fatigue followed by 2/17/21 symptoms. These symptoms have continued intermittently until present day. (3/1/21)

Other Meds: Synthroid .75mcg daily, Vit D 5000iu BID, Depakote 250 mgs 9pm, Omeprozole 20 mgs 9pm, Klonopin 1mg HS, MCT oil, CBD oil,

Current Illness: none

ID: 1063504
Sex: F
Age: 68
State: NJ

Vax Date: 02/20/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: None

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

Symptoms: a red lesion developed on vaccinated arm and rash developed after that. At times rash was itchy. Currently 3 days of lesion and rash.

Other Meds: Labetalol, Simvastatin

Current Illness: None

ID: 1063505
Sex: F
Age: 44
State: AK

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

Lab Data:

Allergies: Ceflex

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

Symptoms: Tongue and lips tingling 10-15 mins after vaccine, the nurse on site took pulse/ox, blood pressure, blood sugar, and looked at my face and neck to see if she could see a reaction from the outside. These symptoms stopped 1 hr after vaccine. Then, very slight rash on neck and chest the next day (2/28) red spots (no itching), no treatment. Today (3/1) the rash is lighter and many spots are gone.

Other Meds: Novolog, Lantus

Current Illness: None

ID: 1063506
Sex: M
Age: 69
State: CA

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

Lab Data:

Allergies: ? Sulfasalazine EC ? full body maculopapular rash with itching ? Tape Adhesive (use paper tape only) ? contact dermatitis ? Tamsulosin Hydrochloride (Flomax) -- hypotension ? Venlafaxine (Effexor) -- somnolence & hypotension (including fainting) ? Raw Apples

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

Symptoms: The day after dose I experienced an unpleasant taste in my mouth of onions/garlic. This continued for 3 days. It still happens intermittently.

Other Meds: ? Ustekinumab (Stelara) 90mg sq QO Month ? Mesalamine (Apriso) 2.4gm po BID ? Atenolol (Tenormin) 50mg po QAM ? Pantoprazole Sodium (Protonix) 40mg po QAM ? Montelukast Sodium (Singular) 10mg po QAM ? Triamterene/Hydrochlorothiazide (Dya

Current Illness: ? Crohn?s Disease ? Sleep Apnea with GERD (on CPAP at 14cm of water pressure) ? Seasonal Asthma secondary to Mold Allergies ? Peronial Tendon Inflammation

ID: 1063507
Sex: M
Age: 52
State: NM

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Ibuprophen

Symptom List: Vomiting

Symptoms: Nausea, fever, controlled shaking, body aches - 24hrs nex day aches - 24hrs Aleve and fluids

Other Meds: Tamsulosin 4mg, Furosemide 40mg, Omeprazole 40mg, Potassium CL Micro 20mg, Gabapentin 300mg, Atorvastatin 10mg, Losartan 50mg, Levothyroxine 50mcg, B12 Vit Complex 1000mg, Vit D 1000 IU, Probiotic.

Current Illness: Cirrohsis

ID: 1063508
Sex: F
Age: 55
State: MI

Vax Date: 02/25/2021
Onset Date: 02/25/2021
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: KNA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Tingling on lips noticed right after vaccine on 02-25-21 then 02-26-21 reported tired and dizzy when bending over, lips still tingling then on 02-28-21 swelling of lips and inside roof of mouth took Benadryl at 9:30 am and every 4 hours until 11 pm, on 03-01-21 still some lips and mouth swelling but not as bad.

Other Meds: Ramipril 2.5mg, iron tablet, vitamin D, vitamin C, magnesium

Current Illness: no

ID: 1063509
Sex: M
Age: 17
State: MD

Vax Date: 02/26/2021
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:

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

Symptoms: Patient is 17 years old but received vaccination that is approved for 18 years and older under EUA

Other Meds:

Current Illness:

ID: 1063510
Sex: F
Age: 61
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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Iodine (contrast): numbness

Symptom List: Injection site swelling, Limb discomfort

Symptoms: generalized myalgia, pruritus

Other Meds: montelukast 10mg qd buspirone 15mg qd duloxetine 60mg qd levothyroxine 75 mcg qd quetiapine 25mg qd metoprolol SR 25mg qd rosuvastatin 20mg qd hydroxychloroquine 200mg qd anastrozole 1mg qd

Current Illness:

ID: 1063512
Sex: F
Age: 31
State: IL

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

Lab Data:

Allergies: None

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

Symptoms: Unbearable pain in should joint; No OTC medications help. Limited range of motion still, 48 hours after injection. Cannot lift over head or behind me without excruciating pain and I had FULL function of my arm prior to this injection.

Other Meds: Desvenlafaxine, Mirtazapine, Omeprazole, Adderrall

Current Illness: None

ID: 1063514
Sex: F
Age: 43
State: OK

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: RA

Lab Data:

Allergies: All NSAIDS (aspirin, naproxen, ibuprofen, etc)?Anaphylaxis Codeine ?Hives Hydrocodone ?Hives Tramadol?Serotonin syndrome Cefdinir Nickel Topical salicylic acid Acne products?redness and swelling Topical benzoyl peroxide Acne products?redness and swelling Flexeri?Serotonin syndrome Pepto-bismol (subsalicylate)?Anaphylaxis Carmex (salicylic acid?Redness and swelling

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

Symptoms: 30 minutes after injection I started itching (ears, nose, face, scalp, lips, various other body parts) Treatment: Benadryl 25mg, I?ve continued to take as needed for itching.

Other Meds: Am dose ??Pristique 100mg (1x daily) ??Lisinopril 10mg (1x daily) ??Xyzal 5mg (1x daily) Noon ??Metformin 500mg (2x daily) ??Women?s multivitamin (1x daily) ??Calcium citrate +D (1x daily) Dinner ??Metformin 500mg (2x daily) ??Crestor 5mg

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm