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: 1081088
Sex: F
Age: 52
State: OK

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/08/2021
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: melons bananas: latex allergy throat swelling clauvenate : only reacts to augmentin due to clauvenate Boniva: itching Clindamycin HCl: very bad burning heartburn Erythromycin: nausea and vomiting Fosamax: not comfortable with taking Ketorolac Tromethamine: while on eliquis Lamictal: hives Rocephin: hives Latex Gloves NSAIDS: CKD Myrbetriq: itching/rash /whelps sulfa: hives/lupus - Side Effects Contrave: rash Midazolam: paradoxical effect Cipro: itching Spironolactone: lethargy

Symptom List: Dysphagia, Epiglottitis

Symptoms: low grade fever and headache, nausea , chills, exhaustion for 7 days

Other Meds: BD Allergy Syringe 28G X 1/2 Miscellaneous as directed sq once evey two weeks Hyoscyamine 0.15 MG Tablet 1 tab Orally qid prn Ondansetron 4 MG Tablet Disintegrating 1 tablet on the tongue and allow to dissolve Orally every 6 hours

Current Illness: Past Medical History bladder infections, chronic Yes, No, . Bleeding tendency with hx of blood transfusion. Chicken pox ,. History of pneumonia ,. TIA (transient ischemic attack). Kidney disease. Skin yeast infection. Falls frequently. stroke (thrombotic) approx 2012 r/t DVT. Asthma, unspecified asthma severity, unspecified whether complicated, unspecified whether persistent. Chronic diastolic congestive heart failure. Lupus. Lupus nephritis. Kidney disease. Anemia of chronic disease. Migraine without status migrainosus, not intractable, unspecified migraine type. Spondylarthritis. Ehlers-Danlos syndrome. Osteoporosis without current pathological fracture, unspecified osteoporosis type. OA (osteoarthritis). Low back pain. HLA-B27 spondyloarthropathy. Depression. Bipolar 1 disorder. Anxiety. B12 deficiency. Iron deficiency. Vitamin D deficiency. Mixed stress and urge urinary incontinence. Opioid dependence, uncomplicated. Massive large extensive DVT left LE approx 2013 - (femoral stents ).

ID: 1081089
Sex: F
Age: 68
State: MA

Vax Date: 02/26/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Supha Nitrofurantoin

Symptom List: Anxiety, Dyspnoea

Symptoms: Raised red rash just below injection site Metallic taste in mouth Slight nausea All started about a week after injection

Other Meds: Multi vitamin

Current Illness: None

ID: 1081090
Sex: F
Age: 86
State: CT

Vax Date: 03/04/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
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: extreme fatigue,nausea,some vomiting,loss of appetite.....no treatmene(rest).. mar8..symptoms declining...still some fatigue suggestion; caution patients re, possible side effects to prevent unecessary alarm and calls to mds

Other Meds: remicade,norvask,gabapentin,breo,prolia

Current Illness: none

ID: 1081091
Sex: F
Age: 39
State: CT

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Fatigue, dizzy, nauseous

Other Meds: none

Current Illness: none

ID: 1081092
Sex: F
Age: 68
State: AZ

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

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

Lab Data:

Allergies: seasonal pollen

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

Symptoms: Woke up at 3 so cold, I rolled my shoulders in to keep warm. So my chest is really hurting. I took my temp and it was 100. I was so cold I thought it was 102. I drank water and took nyquil. I was able to sleep better. I still have a fever of 100, however not feeling as bad. However my chest is very tight.

Other Meds: aspirin 81 mg Pantoprazole 20 mg x2 Potassium 20 Magnesium citrate 250 Fluticasone propionate 2 sprays Atorvastain 20 mg cholesterol Atenolol 25 mg blood pressure Flaxseed oil 1400 mg Coq10 100mg Fish oil omega 3 1.3g 2x Allerclear Clo

Current Illness: none

ID: 1081093
Sex: M
Age: 18
State: MI

Vax Date: 03/04/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
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: None

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

Symptoms: Saturday morning after vaccine was administered: Tennis ball size oblong lump noted between eyebrows at middle of forehead. Felt "funny", cheeks flushed, no apparent fever (not hot to touch). Lump itself was not red, painful or itchy. it was definitely "noticeable". Headache on the day he received vaccine, but no other reports of headache following. Tends to be anxious and has a history of "passing out" when leaving a dentist's office in the past.

Other Meds: None

Current Illness: None

ID: 1081094
Sex: F
Age: 76
State: IA

Vax Date: 02/28/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
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: Penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Red, hard slightly swollen, itchy 1.5 inches around site. Has been quite achy since day 1.

Other Meds: Valsartan Chlorthalidone

Current Illness: None

ID: 1081095
Sex: F
Age: 40
State:

Vax Date: 02/28/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: penicillin, codeine

Symptom List: Pharyngeal swelling

Symptoms: High Blood Pressure (170/78) I do not have hypertension. Irregular vaginal bleeding. Starting bleeding mid cycle for a day. This has never happened to me. I have a normal menstrual cycle.

Other Meds: none

Current Illness: none

ID: 1081096
Sex: M
Age: 71
State: MN

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Headache, joints hurt, no appetite, fever. Injection site painful

Other Meds: Multi vitamin, Amlodipine, Spironolactone, Cyclobenzaprine, Carvedilol, Hydrochlorothiazide, Atorvastatin, D3 and 81mg asprin

Current Illness: None

ID: 1081108
Sex: F
Age:
State: CA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/08/2021
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: Cellulitis in left leg may be acting up/Might have an infection in area of cellulitis in left leg; Cellulitis in left leg may be acting up/Might have an infection in area of cellulitis in left leg; Questioned if she might have a blood clot in left leg; Might have an infection in area of cellulitis in left leg; pain in the left leg; This is a spontaneous report from a contactable consumer. A 72-year-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/lot number: EL9262, expiration date 31May2021), via an unspecified route of administration on 01Feb2021 at left upper arm around 19:00 or a little later at single dose (at the age of 72-years-old) for covid-19 immunization. Medical history included bad knees and got injections for this and recurrent cellulitis of legs (cellulitis was not active at time of vaccine; but anytime her leg swells with bad knees she had a little episode with the cellulitis down around her ankles on both legs but left leg was more predominant. She had been keeping it at bay), mineral supplementation, bad knee pain, blood pressure medication (abnormal), urine output control (abnormal), dehydrated and dizzy. Concomitant medication included lisinopril as blood pressure medication, potassium for Mineral supplement, solifenacin succinate for urine output control, paracetamol (TYLENOL 4) for bad knee pain. She had taken potassium before and it calmed it down: she was little dehydrated, little dizzy, so was drinking some Pedialyte, water, and taking potassium. The patient had it once before but it kind of snuck up on her again. The patient called to ask if anyone had reported any type of blood clot on the same side of the body that the Pfizer COVID-19 Vaccine was administered. She questioned if she might have a blood clot in her left leg after having been administered the Pfizer COVID-19 Vaccine. She had recurrent cellulitis in both legs prior to Pfizer COVID-19 Vaccine. The doctor thought the cellulitis in left leg may be acting up and that she might have an infection in that area of cellulitis. She reported pain in the left leg when she rested her leg on a pillow; but did not feel any pain when she was standing and walking. The pain became a little too hard for her to bear so the doctor prescribed her Cephalexin 500m capsule every 12 hours-she was on the 3rd capsule now. Onset date for the events was approximately 03Feb2021 or 04Feb2021. The events were better since started Cephalexin. Second dose date scheduled for 22Feb2021 but did not give her time. The outcome of the events was recovering. Follow-up (23Feb2021): New information received from the product quality complaint group includes confirmation of lot number (EL9262) and new expiry date.

Other Meds: LISINOPRIL; POTASSIUM; SOLIFENACIN SUCCINATE; TYLENOL

Current Illness:

ID: 1081109
Sex: F
Age: 50
State: CT

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

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

Lab Data:

Allergies: Seasonal E-mycin

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

Symptoms: Started with chills. I was freezing for almost three hours. I could not get warm-with tons of blankets, heater, heat cranked up. Then I was seating. I had a fever and am still fighting this fever. It was at 103 on Sat. It was 101 this morning. I feel fluish-body aches, headache, eye sockets hurt, exhausted. On sat, after the chills, my legs hurt and felt like they were 100 pounds.

Other Meds: Breo Pravastatin Dyamista

Current Illness: None

ID: 1081110
Sex: F
Age: 66
State: NY

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/08/2021
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: I had a positive COVID test on 05/11/2020, My vaccine side effects were similar to the symptoms I had when I had COVID: body aches (initially worse with vaccine), temperature of about 101 (I run about 97 normally), headache, extreme fatigue. I was better on 03/01/2021, but not totally side effect free until 03/03/2021. Arm soreness lasted a couple more days,

Other Meds: omeprazole and olmesartan

Current Illness: none

ID: 1081111
Sex: F
Age: 50
State: CT

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: injection sight pain, fever, chills, body aches, exhaustion, migraine.

Other Meds: none

Current Illness: none

ID: 1081112
Sex: F
Age: 52
State: CA

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 03/08/2021
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: Received the vaccine in left arm, I think possibly the person gave it to me in the wrong area? My arm was warm, red, swollen, rash and it still itches. The site on arm still has pain, and feels like pins and needles if I touch it. My 2nd dose was done in same arm, but in a much higher spot and it is fine.

Other Meds: synthroid 50 mcg

Current Illness: None

ID: 1081113
Sex: F
Age: 67
State: IN

Vax Date: 02/01/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Bad pain the shoulder when straightening arms straight out are raising my arm above my head

Other Meds: None

Current Illness: None

ID: 1081114
Sex: M
Age: 67
State: NY

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
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: beef, pork, carrots, tomatoes, lentils, fish

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

Symptoms: Patient rested 30 min post COVID vaccine, and felt dizzy. VS were taken and he was slightly hypotensive [80/50 mm/Hg, HR 76 BPM.] had HD previous day, and took carvedilol that morning. After additional 15 min VS [70/46 mm/Hg HR 74 BPM.] no better

Other Meds: acetaminophen, atorvastatin, carvedilol, clopidogrel, humalog, levothyroxine, nifedipine XL, Xalatan opth, mometsone inh.

Current Illness:

ID: 1081115
Sex: F
Age: 36
State: CA

Vax Date: 03/01/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
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: Walnut trees, cat pelt, dog hair, mold, DF/DP dust mite mix, Mugwort/Sage, Balsam of Peru, D-Limonene, Limonene, Neomycin Sulfate, Nickel Sulfate, Thiuram Mix

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

Symptoms: Big red welts at the site of the injection that are super itchy and raised. Feels very uncomfortable

Other Meds: Gallin?e Skin & Microbiome food supplement

Current Illness: None

ID: 1081116
Sex: F
Age: 50
State: AL

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

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

Lab Data:

Allergies: sulfa, gold

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Approx. 1 hour after receiving vaccine I developed a high fever (102-104) which has persisted. I have had a headache, fever, fatigue, muscle and joint pain, chills, nausea and weakness. In addition the site of the injection is quite sore.

Other Meds: Omega-3 supplement, vitamin D supplement, daily vitamin, Prevarin Estrogren Cream

Current Illness: non

ID: 1081117
Sex: F
Age: 73
State: SC

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe breathing distress lasting 3 days Diarrhea 2 days. Injection site pain. Headache joint pAin Fatigue

Other Meds: Celebrix Pantaprazole Tylenol extra strength arhritis

Current Illness: Shortness of breath Pain

ID: 1081118
Sex: F
Age: 74
State: KS

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Progress Notes APRN (Nurse Practitioner) ? ? Family Medicine Cosigned by: MD at 2/28/2021 7:38 AM Expand AllCollapse All COVID VACCINE CLINIC 2/26/2021 Patient: Date: 2/26/2021 MRN: 10046638 Subjective Patient is a 74 y.o. female who was seen at COVID Vaccine Clinic today for her second dose of the COVID 19 vaccination. She was given the Pfizer vaccination in the left deltoid muscle. During her 15 minute waiting period after the injection, the patient began to experience difficulty breathing and heart racing. She denied rash, hives, welts, difficulty swallowing, wheezing, throat tightness, hoarseness, stridor, itching, lightheadedness, dizziness, facial swelling, lip swelling and tongue swelling. This provider was notified of patient reaction and she was then assessed in the emergency bay area. Monitored patient for severe reaction symptoms, including but not limited to blood pressure abnormality , chest pain, collapse, hypotension, rapid progression of symptoms and respiratory distress. PMH includes parkinson and items below. No hx of DM. Past Medical History: Diagnosis Date ? Depression ? GERD (gastroesophageal reflux disease) ? Hyperlipidemia ? Hypothyroidism ? Osteoarthritis ? Pain, chronic ? Unspecified cataract ALLERGY REVIEW OF SYSTEMS: Patient complains of shortness of breath (and feeling palpitations. ) Patient denies chills, fever, malaise/fatigue, sore throat, frequent throat clearing, eyes watering, eyes itching, puffy eyes, eye redness, cough, chest tightness, wheezing, muscle aches, dizziness and headaches Previous Reactions: none Objective Vitals Vitals: 02/26/21 0304 02/26/21 1457 BP: 123/72 123/62 Pulse: 76 73 Resp: 16 SpO2: 97% 97% Physical Exam Constitutional: General: She is not in acute distress. Appearance: Normal appearance. She is well-developed. She is not ill-appearing, toxic-appearing or diaphoretic. HENT: Mouth/Throat: Mouth: Mucous membranes are moist. Eyes: Extraocular Movements: Extraocular movements intact. Conjunctiva/sclera: Conjunctivae normal. Pupils: Pupils are equal, round, and reactive to light. Neck: Thyroid: No thyromegaly. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Pulses: Normal pulses. Heart sounds: Normal heart sounds. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No wheezing. Musculoskeletal: Cervical back: Neck supple. Skin: General: Skin is warm and dry. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Gait: Gait abnormal (walks with cane and uses seated walker). Psychiatric: Mood and Affect: Mood normal. Behavior: Behavior normal. Thought Content: Thought content normal. Judgment: Judgment normal. 0305 pm: pt walked around in bay with her cane. She was able to ambulate w/o difficulty. Reports slight lightheadedness but states this occurs with her intermittently /chronically. Nothing worse. Pt given snack after return to bed for further observation. She had water given to her earlier prior to ambulation. Assessment/Plan Treatment included: water and snacks Follow up response to treatment: good. Patient discharge: Stable to go home and follow up with PCP. Differential Diagnosis: Red flag symptoms (CP, SOB, NVD, Visual/Neuro concerns) Monitored in bay for approx 40 minutes. She reports great improvement after snack. She feels well. Suspect stress response to vaccine. No dizziness, lightheaded or palpitations/sob with ambulation. She would like to go home. Husband is with her today and is able to be with her. She left in her seated walker, pushed by husband. Accompanied out by staff member. Follow up with pcp if not improving. Discussed reasons for ED visit. APRN Electronically Signed 2/26/2021 3:11 PM

Other Meds:

Current Illness:

ID: 1081119
Sex: F
Age: 56
State: CO

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
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: Starting 2:30 am, woke up nauseated, severe chills. Vomited 3am, severe chills, headache, body aches all night. Severe Body aches and headache lasted all next day. Leg aches became extreme next night. Following night, I still had chills, body aches, headache. Second morning, I am still having headache, moderate body aches

Other Meds: Lisinopril

Current Illness: None

ID: 1081120
Sex: F
Age: 69
State: GA

Vax Date: 02/10/2021
Onset Date: 02/14/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: Naprosyn Ibuprofen Doxycycline Flagyl Hydralazine Gadolinium contrast dye Iodine, Betadine, Iodine contrast dye tapes and adhesives, steri strips

Symptom List: Unevaluable event

Symptoms: Vertigo, dizziness & nausea started 3 1/2 days after the first dose. Began at 2 AM in the morning on Feb. 14, 2021. Using meclizine 25 mg tablets 1-2 times a day since then. Had telemed conference with Dr, on Wed., Feb. 17, 2021. ENT appointment scheduled for April 2, 2021. Vertigo continues. Covid 19 (Pfizer vaccine) #2 on March 3, 2021.

Other Meds: Duloxetine 30 mg capsule once a day by mouth Losartan 100 mg tablet once a day by mouth Furosemide 20 mg tablet by mouth for edema as needed Pantoprazole Sodium 40 mg tablet by mouth once a day Claritin 10 mg tablet by mouth once a day Nexi

Current Illness: None

ID: 1081121
Sex: M
Age: 70
State: FL

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: red spots on different parts of my body, itching

Other Meds: baby asdprin,atorvastatin,clopidogrel,glipizide,lisinopril,mertformin,metroprolol,januvia,jardiance, diabetic multi vitamins

Current Illness: none

ID: 1081122
Sex: F
Age: 52
State: CT

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Severe chills/uncontrollable shaking for 4 hours beginning 10 hours after the shot After chills ended - headache for 1 hour, body fatigue for 6 hours

Other Meds: Toviaz, Centrum, Estrovin

Current Illness: None

ID: 1081123
Sex: F
Age: 32
State: CT

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
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: Fatigue, chills, fever, body aches, nausea. Lasted approximately 12 hours. Treated with advil, fluids, and rest. Onset of body aches and fever for second time about 36 hours after injection. Treated with advil.

Other Meds: Blisovi 24-FE, Levothyroxine 50 mcg, Escitalopram 10 mg

Current Illness: None

ID: 1081124
Sex: F
Age: 52
State: PA

Vax Date: 02/12/2021
Onset Date: 03/02/2021
Rec V Date: 03/08/2021
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 and Erythromycin

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

Symptoms: Skin irritation circling around the back of my neck from ear to ear , inclusive of top of neck down to the top of my shoulder. Post-nasal drip with swollen eyes.

Other Meds: aspirin 81mg, lisinopril 20mg, furosemide 40mg, carvedilol 25mg, nifedipine 60mg, Vitamin C, multi-vitamin with omega-3

Current Illness: N/A

ID: 1081125
Sex: F
Age: 50
State: IA

Vax Date: 01/07/2021
Onset Date: 01/10/2021
Rec V Date: 03/08/2021
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: Droperidol

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Developed acute diarrhea about 3 to 5 days post-vaccine. It has not stopped since. Had diagnostic upper and lower endoscopy on 3/2/21 with gastroenterology. The biopsies showed lymphocytic colitis which can be either induced by NSAID use (I take ibuprofen 1-3 times a month) or can be autoimmune in nature. Biopsies for celiac were negative. Stool studies were negative for O and P, giardia, crypto, and c.diff. Labs for autoimmunity are pending. Lymphocytic colitis is generally chronic but manageable and I have not yet had remission of symptoms but am managing with loperimide.

Other Meds: Cetirizine 10 mg once daily Furosemide 20 mg daily

Current Illness: None

ID: 1081126
Sex: F
Age: 71
State: IN

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: Iodine metoprolol

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Headache, muscle aches, chills, fatigue, weakness, dizziness

Other Meds: Curcumin Restasis Fosomax Gabapentin Losartan potassium Potassium chloride Chlorthalidone Levothyroxine Xarelto Nicotine Vitamin D3 Vitamin B12

Current Illness:

ID: 1081127
Sex: F
Age: 79
State: MO

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
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: Following the vaccine she noticed the same day fatigue. She was so tired that she didn't understand it. Then had headaches off and on, as well as muscle and joint pain everywhere, weakness all over her body. She also had a low grade fever Saturday and Sunday. She did have the Corona Virus in July of 2020. She is feeling better today as far as the weakness, just a little bit of muscle and joint pain. She did have a trace of nausea this morning, but took her medication and it subsided. The weakness was something like she had never had before. She took Tylenol for her symptoms. She did not call her doctor. Just has a small amount of symptoms, but still not feeling herself yet.

Other Meds: Dicyclomine, Trazadone, Simvastatin, Peroxotene, Meloxicam, Omeprazole, Morphine sulfate. Vitamin C, vitamin D and B, potassium, stool softener, Biotin.

Current Illness: None.

ID: 1081128
Sex: F
Age: 35
State: MI

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: Allergy status to other drugs, medicaments and biological subs

Symptom List: Nausea

Symptoms: Patient had an allergic reaction. onsite EMS was called vitals BP 170/96 100% O2 HR 88. Patient refused evaluation and care , released againt medical advice.

Other Meds:

Current Illness:

ID: 1081129
Sex: F
Age: 23
State: AR

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: Slight reaction to apples

Symptom List: Injection site pain

Symptoms: Vomiting 2 hours later and two days later. On Sunday, March 7 at 9:30 pm, in the vomit expelled everything, from breakfast to dinner and it was almost intact, as if the stomach had not worked in more than 14 hours. Upset stomach, constipation, and dizziness.

Other Meds: Metformin 500 Mg 1 tableta diaria Nortrel 1-35 1 tableta diaria

Current Illness: Nothing

ID: 1081130
Sex: F
Age: 66
State: FL

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Moderna COVID-19 Vaccine EUA Woke up with headache, chills, body aches, tiredness, upset stomach. On second day (03/08/21) felt better but still not completely recovered. Treated with aspirin.

Other Meds:

Current Illness:

ID: 1081131
Sex: F
Age: 56
State: OH

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 03/08/2021
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: Ultram, Phenergan, Mucinex, other

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

Symptoms: Extreme hot, sweating, rash and itching all over chest, neck, back, red and horrible itch on face and head, out of breath, fast heartbeat, dizzy

Other Meds: Folic acid

Current Illness: nerve damage

Date Died: 03/07/2021

ID: 1081132
Sex: M
Age: 58
State: NJ

Vax Date: 02/05/2021
Onset Date: 02/26/2021
Rec V Date: 03/08/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

Symptom List: Tremor

Symptoms: Severe thrombocytopenia approx. 10 days after vaccine administration.

Other Meds: Aspirin Adult Low Dose 81 MG Tablet Delayed Release 1 tablet Orally Once a day Lisinopril 5 MG Tablet 1 tablet Orally Once a day Vitamin B12 1000 MCG Tablet Extended Release 1 tablet Orally Once a day Rosuvastatin Calcium 5 MG Tabl

Current Illness:

ID: 1081133
Sex: F
Age: 63
State: CT

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

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

Lab Data:

Allergies: Penicillin

Symptom List: Erythema, Pruritus

Symptoms: Severe chills, body ,muscle, joint aches, fever and sweats. Some stomach cramping . These all lasted 7 hours. Next day still body aches, headache and fatigue.

Other Meds: Multi vitamin, vitamin d3, fish oil, calcium,

Current Illness: None

ID: 1081134
Sex: F
Age: 36
State: NY

Vax Date: 02/16/2021
Onset Date: 03/01/2021
Rec V Date: 03/08/2021
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: I had a skin rash, hives all over my body about 7 days after the first dose of Moderna. It went away with 3 days.

Other Meds: Vitamin C, birth control

Current Illness: none

ID: 1081135
Sex: F
Age: 56
State: CA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/08/2021
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: Bells Palsy on right side of face.

Other Meds:

Current Illness: None

ID: 1081136
Sex: F
Age: 64
State: MO

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
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: N/A

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I felt the left side of the inside of my lower lip felt as if I bit it (which I. did not) as time ticked away , I felt it as an annoyance but as it got a little later I felt it swelling some . This started in the 11 a.m. hour. by 4 p.m. the bottom left side of the lip was swollen a good bit. By 5:30 p.m. my entire lip was completely swollen so much I looked like the character Bubba off of Forest Gump. By 6;30 p.m. it was beginning to harden on the left side of my face by the mouth. By 7p.m the right side of my face is hard and my face is red. I did take pictures if you need me to send them to you . This morning swelling is down but not all the way. I have a picture from this morning the swelling is not as discomfort as yesterday but still is not back to normal.

Other Meds: FUROSEMIDE 20 MG A.M. LISNOPRIL 40 MG A.M. GABAPENTIN 600 MG 3X TIMES PHENTERMINE 15 M.G 1 ADAY AMITRIPTYLIN 25 M.G. P.M. 1 ATORVATATIN 40 M.G. P.M. 1

Current Illness: N/A

ID: 1081137
Sex: M
Age: 68
State: NV

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
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: chills, fever, headache, body ache, right arm hurts

Other Meds: none

Current Illness: none

ID: 1081138
Sex: M
Age: 71
State: FL

Vax Date: 01/26/2021
Onset Date: 01/29/2021
Rec V Date: 03/08/2021
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: Diarrhea - 1 week Cold sore - 3 weeks

Other Meds: Tamsulosin Atorvastatin Baby aspirin

Current Illness: None

ID: 1081139
Sex: F
Age: 68
State: FL

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Pain in extremity

Symptoms: tremors, tachypneic- husband states she has seasonal allergies and panic attacks

Other Meds: Celebrex, Zyrtec, amitriptyline, sertraline, progesterone

Current Illness: seasonal allergies, "panic attack" per husband

ID: 1081140
Sex: M
Age: 66
State: FL

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

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

Lab Data:

Allergies: na

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

Symptoms: A low grade fever (approx. 101 deg F) started about 11-12 hours post-injection accompanied by fatigue, head ache and general body ache. Adverse event began to subside after about 24 hrs. post -injection with all symptoms being gone after 36 hours post-injection.

Other Meds: Omeprazole DR 40 mg

Current Illness: na

ID: 1081141
Sex: M
Age: 44
State: NY

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Very sore at injection site, fever, body aches and fatigue

Other Meds: None

Current Illness: None

ID: 1081142
Sex: F
Age: 58
State: CT

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
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:

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

Symptoms: tired, slight headache (back of the neck area) lasted about 36 hours

Other Meds: Atorvastatin, 20 mg

Current Illness:

ID: 1081143
Sex: M
Age: 92
State: NH

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
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: None

Symptom List: Vomiting

Symptoms: 92 y/o M, hx of HTN, otherwise healthy and well here for second dose with no reported adverse rxn from first dose. VR was driving from the vaccination area and got app 250 meters away when he became lightheaded. He got out of the vehicle and had a syncopal episode, had an unwitnessed fall backwards and struck his head on the roadway causing a full thickness 5cm stellate laceration. Vitals: BP 215/98, HR 50 and regular, O2 93% on outdoor air. Reports taking BP meds this am. Pt was amnestic to the event but denies LOC. Had one episode of N without V. No midline C spine tenderness. Reports no blood thinners. EMS was summoned and transported him to a nearby hospital for further evaluation and treatment.

Other Meds: UNK Antihypertensive

Current Illness: None

ID: 1081144
Sex: F
Age: 37
State: NC

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
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: Gluten &. Topical Benzoid peroxide

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fever (100.2), lack of balance, body aches (mainly in legs), mild nausea, mild headache, brief period of incontinence, fatigue

Other Meds: Vitamin D, C, Sam E, Multivitamin, Birth control pills (Jolessa)

Current Illness: N/A

ID: 1081145
Sex: F
Age: 24
State: IA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
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 presented to recovery following vaccination with a red hive like rash starting at her chest and spreading upwards to the right side of her jawline. Diphenhydramine 25mg caps 2 caps given once. Vital signs were monitored and were within normal limits. Patient closely monitored one on one for about 50 minutes following vaccination and about 40 minutes after diphenhydramine administration. Rash was greatly improved. Instructions given including signs and symptoms to watch out for, where/how to seek care. Patient verbalized understanding and denied having any further questions or concerns at the time.

Other Meds:

Current Illness:

ID: 1081146
Sex: F
Age: 77
State: CT

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 03/08/2021
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: PCN, Ibuprofen, Procardia, Codeine

Symptom List: Injection site swelling, Limb discomfort

Symptoms: lightheadedness/presyncope, palpitations, racing heart, premature ventricular contractions with bigeminy, atrial tachycardia, fever 101, chills, myalgias, arthralgias, headache, right arm pain

Other Meds: Amlodipine, Aspirin, CoQ10, Dulera, Fish oil, HCTZ, Lisinopril, Loratadine, Lutein, Protonix, Simvastatin, Vit B12, C, D

Current Illness: Sore arm and arthalgias/myalgias from Covid vaccine #1 1/20/21

ID: 1081147
Sex: F
Age: 87
State: WI

Vax Date: 03/04/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
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: Chills, fever, headache, sore thort, myalgia

Other Meds: Azothioprine, Losartin, isosorbide, atorvastatin

Current Illness: None

ID: 1081148
Sex: F
Age: 46
State: NC

Vax Date: 02/26/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
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: Amoxicillin

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

Symptoms: Day 8 after vaccine, patient developed redness, swelling and itching at injection site. Notified nurse and was told to take what she normally takes for pain, to use Benadryl for itching (if not allergic) and to use ice packs on the site.

Other Meds: Zoloft, Aviane

Current Illness: Questionable stomach virus February 15-17th, 2021

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm