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: 1086340
Sex: F
Age: 43
State: OR

Vax Date: 02/19/2021
Onset Date: 03/07/2021
Rec V Date: 03/09/2021
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: NA

Symptom List: Dysphagia, Epiglottitis

Symptoms: Loss of taste

Other Meds: Cosentyx Fluoxetine

Current Illness:

ID: 1086341
Sex: F
Age: 42
State: MN

Vax Date: 02/18/2021
Onset Date: 02/25/2021
Rec V Date: 03/09/2021
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: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: On the night of February 25 (day 6/7) I woke up in the middle of the night with my hands itching and right butt cheek. In the morning, there were a couple small hives between my fingers on left hand and a larger one on right butt cheek. I was able to go about my day, periodically itching. That night, I woke up more frequently in the night with both hands itching. Primarily in between my fingers and a few small hives on both ankles. At 11 AM, I noticed a lesion on my tongue. By Friday night I had several more spots and the itching continued to become more bothersome. I took benadryl before bed. I woke up Saturday morning at 1 AM with my tongue swollen and lower right lip swollen as well. These did not itch nor hurt. My hands itched and burned very intensely, I put ice on them for some relief. There were more hives on my hands, ankles, left shin and left knee and right elbow. I went into urgent care at 9 am. Dr prescribed Prednisone and benadryl. Dr. only looked at my hands and mouth. When I got home I noticed I had a large hive bout 2" by 4"above the injection site on my right arm. This did itch, however was not a major concern because my hands hurt quite severely. I took benedryl at noon on Saturday and that did bring the swelling of my lips and tongue down. I could not sleep at all on Saturday night due to the pain and itching. Once the prednisone took effect, I finally got some relief. Monday I went to see the allergist and he also prescribed zrytek twice a day. He suggested I take that for a few weeks to make sure the hives do not return. It is March 9 and some of the hives are still there and bothersome, but the majority have resolved.

Other Meds: One-A-Day women's multi vitamin Fiber gummy

Current Illness: N/A

ID: 1086342
Sex: F
Age: 27
State: CA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/09/2021
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: none

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

Symptoms: pt stated to the nurse that she feels like she will pass out. She lost consciousness soon after for about 10-15 seconds. Afterwards, she woke up and was alert and oriented. Vital signs within normal limits. Dr assessed, pt stated she has history of syncope with needle procedures.

Other Meds: none

Current Illness: none

ID: 1086343
Sex: F
Age: 78
State: MI

Vax Date: 02/24/2021
Onset Date: 03/04/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: metronidazole

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: arm rash with redness and itching - 8 days after injection which lasted 5 days

Other Meds: atenolol, gabapentin, atorvastatin, acetaminophen, Vitamin C, Vitamin D

Current Illness:

ID: 1086344
Sex: F
Age: 60
State: WA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/09/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Pt reported have a feeling similar to how she feels prior to a seizure, although she did not progress into a seizure. In addition to an aura, she felt sluggish and felt like she was not thinking clearly. The feeling began "shortly after" her vaccination and has not completely gone away as of several hours later.

Other Meds:

Current Illness:

ID: 1086345
Sex: F
Age: 44
State: CA

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
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: Opioids, tramadol

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

Symptoms: 4 days ago. Severity level is moderate. It occurs constantly and is worsening. Location: left foot (midfoot). The pain radiates to the left side of body. The pain is burning. Context: there is no injury. The pain is aggravated by walking. Associated symptoms include numbness. Hand Dominance: right. Additional information: 44 y/o female started to experience these symptom's since her vaccination on Sat 3/6/2021

Other Meds: fluticasone propionate 50 mcg/actuation nasal spray,suspension gabapentin 300 mg capsule ProAir HFA 90 mcg/actuation aerosol inhaler AeroEclipse II Nebulizer ipratropium 0.5 mg-albuterol 3 mg (2.5 mg base)/3 mL nebulization soln ibuprofen 8

Current Illness: n/a

ID: 1086346
Sex: F
Age: 26
State: KS

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Cluster headache behind right eye that turned into eye pain around/behind eye (not the eye itself) Headache subsided with ibuprofen and Tylenol but pain around/behind eye persisted (currently on day 4, discomfort has subsided some but still noticeable)

Other Meds: Fluoxetine 20 mg Cryselle Zyrtec 10 mg Famotidine 10 mg

Current Illness: None

ID: 1086347
Sex: F
Age: 49
State: NV

Vax Date: 01/06/2021
Onset Date: 02/03/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: PCN, Sulfa, & Clidamycin

Symptom List: Pharyngeal swelling

Symptoms: Jan 6, 2021 - on the day of the shot I had arm pain, moderate to severe headache, body aches and lethargy which continued for the next 3 days. Then on the 4th day I lost my sense of taste, but only for the day and also experienced shortness of breath going up stairs for the next 2 days. Jan 26, 2021 @0 Days after my first dose I had an episode of Super Ventricular Tachycardia and went to the hospital because it wouldn't stop. After about 2 hours my heart rate converted on its own. Feb 3, 2021- I received my 2nd dose of the Covid vaccine. Feb 4, 2021- I had a low grade fever of 99.6 with the chills and body aches. Feb 17, 2021- I returned to the ER with SVT that again would not stop. This time they had to convert my heart rhythm using Adenosine. March 4, 2021- had an Echocardiogram to check heart because the hospital doctor said the chest x-ray they took showed an enlarged heart and the ultrasound they did showed fluid around my heart. The echocardiogram showed a moderate Pericardial Effusion I am attributing these issues to the Covid Vaccine since I have not had any SVT or other issues since 2008. AND my personal nurse practitioner said she had the same reaction.

Other Meds: none

Current Illness:

ID: 1086348
Sex: F
Age: 56
State: IL

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: Pencillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I had a headache and sudden lethargy. I ended up sleeping for 3 hours. Throughout that time, I woke up several times with 'cotton mouth' and a strange feeling that the back of my mouth, roof of my mouth and maybe a bit of my throat had a numb and tingly feeling. I drank quite a bit of water, but kept falling back to sleep. I can only compare it to when you receive novacane at the dentist but the sensation starts to goes beyond your mouth and a bit into your throat. This feeling stayed about the same for 3 hours and then over the next 3 hours started to dissipate. After that I just hand a mild lingering headache and general feeling of tiredness. By the next morning I just had a slight headache and physical feeling of tiredness.

Other Meds: Metformin, Wellbutrin, Lisinopril, L-5 MTHF (folate), Vitamin D, Omega 3. All approximately 3 hours before the vaccine.

Current Illness: None

ID: 1086349
Sex: F
Age: 52
State: NC

Vax Date: 01/01/2021
Onset Date: 02/15/2021
Rec V Date: 03/09/2021
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: Nka

Symptom List: Diarrhoea, Nasal congestion

Symptoms: About 2 weeks after 2nd dose... extreme fatigue and brain fog

Other Meds: Thyroid meds

Current Illness: None

ID: 1086350
Sex: F
Age: 38
State: OH

Vax Date: 03/06/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
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 known

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

Symptoms: Vaginal spotting began two days after with increased volume each day (no reason for spotting and have never spotted). Neck pain started on day three. Took ibuprofen to reduce pain. Pain returned after medication wore off.

Other Meds: Zyrtec

Current Illness: None

ID: 1086351
Sex: M
Age: 88
State: VA

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/09/2021
Hospital: Y

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: -Rapid onset shortness of breath (10-20 minutes after vaccine administration). -Required ICU admission for acute respiratory failure and acute heart failure. -Acute reduction in ejection fraction (EF20-25%) in a patient that otherwise had a normally documented EF (>65%), see below. -Hospital course required BiPAP and dobutamine support and treatment for pulmonary edema with Lasix. -Cardiology consulted for acute heart failure management. Eventual wean of oxygen and dobutamine requirement and discharged on oral heart failure regimen. -Hospital course complicated by ICU delirium. -Total length of hospital stay 8 days

Other Meds:

Current Illness:

ID: 1086352
Sex: F
Age: 73
State: TX

Vax Date: 02/26/2021
Onset Date: 03/05/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: X-ray Dye, Xanax, Peanuts, Tree Nuts, Pineapple, Oats, Egg Whites and Yolks, Lamb, Peaches

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

Symptoms: Raised red rash about 4 inches in diameter at the injection site on my upper right arm of 7 days before. No rash had occurred before 3/5/2021 since the vaccination. This lasted about 3 days before fading out almost completely by 4 days (3/9/2021. No pain or itching.

Other Meds: Rosuvastatin, Lisinopril, Fluticasone Propionate, Cetirizine, Fish Oil, Vitamin C, Vitamin D3, Daily Probiotic Gummies, Guaifenesin

Current Illness: None

ID: 1086353
Sex: M
Age: 86
State: NY

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 03/09/2021
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: The patient reported that he had severe weakness following the shot, stating that he actually fell down at home on his way back from the bathroom and couldn't move for over an hour.

Other Meds:

Current Illness:

ID: 1086354
Sex: F
Age: 66
State: CA

Vax Date: 02/21/2021
Onset Date: 02/25/2021
Rec V Date: 03/09/2021
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: As a teenager I had an allergic reaction to penicillin with hives.

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

Symptoms: Skin Itching on back abdomen arms legs neck and chest. Initially Atarax one every 6 hours plus anti itch creams (Sarna - Gold Bond) then Zyrtec for three days . I discontinued all anti itch lotion and applying only aloe vera gel. Warm showers help. Itching seems to have decreased only slightly. Strangely it flares up after a meal. I drink a lot of water and feel very thirsty.

Other Meds: nothing

Current Illness: nothing

ID: 1086355
Sex: F
Age: 46
State: NY

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 03/09/2021
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: keflex

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

Symptoms: I received dose one of Covid vaccine on 3/6/21. The next morning I awoke at 8 am and had a fever of 100 degrees and I felt like my body had been literally run over. I had muscle aches and a headache that lasted about 24 hours. I did not feel 100% 2 days following the vaccine but felt slightly better. Now, 3 days past dose one and I am starting to feel a little under the weather again.

Other Meds: Prozac Labetalol Multi vitamin Vitamin D/K Klonopin

Current Illness: no illnesses at the time of the vaccine; had a fever/viral about a month prior; negative COVID and negative flu/strep

ID: 1086356
Sex: F
Age: 41
State:

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/09/2021
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:

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

Symptoms: Soreness on arm, increased migraines, some light headedness, fatigue- all lasted for 3 days Slight bruising on point of injection (still present)

Other Meds:

Current Illness:

ID: 1086357
Sex: F
Age: 57
State: IN

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Arm/shoulder pain, chills, low-grade fever (100.2) from approximately 3:30 a.m. - 3:30 p.m.

Other Meds: Levothyroxine, pravastatin, acetazolamide, aspirin

Current Illness: None

ID: 1086358
Sex: F
Age: 37
State: NY

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: Allergic to Lipstick and scented hair products

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Janssen COVID-19 Vaccine EUA High fever started 9 hours after vaccination, continued until 24 hours after vaccination. Nausea and dizziness started 9 hours after vaccination, continued until 12 hours after vaccination. 5 weeks pregnant- spotting started 25 hours after vaccination. No proven correlation between potential miscarriage and Vaccine. Generalized, spotty red rash, slightly raised, no itch, on the front torso, from top of legs, groin area, up to shoulders, on front torso only (not on arms or back) 33 hrs after vaccination.

Other Meds: Pre-natal vitamins L Theanine CoQ10 Fish Oil

Current Illness: None

ID: 1086359
Sex: F
Age: 74
State: MA

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: sulfa

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

Symptoms: about 15 hours after shot developed fever (99.5) and chills and headache. This laster about a day. Then I felt like I had a cold and had ntermittent slight sore throat. On the third day after shot experienced mild nausea. Headache disappeared as did sore throat. At no time was there soreness at injection site, and I had no arm pain at all. So in toto, I was out of commission for 3 days.

Other Meds: Tapazole (.5mg 2x week), multivitamin, calcium, vit.D3, biotin, cetrizine

Current Illness: Kidney stone 12/31/2020

ID: 1086360
Sex: F
Age: 58
State: IN

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
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: Penicillan, Ceclor, Keflex

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

Symptoms: Spiked a temperature of 102 degrees 4 hours after getting the shot. Had severe chills where my body was shaking. Next day was down to 99.7 but had to stay on the couch all day due to body aches, head ache, etc. On Monday (Got the shot on that Saturday) I felt like myself around 10am.

Other Meds:

Current Illness: None

ID: 1086361
Sex: F
Age: 24
State: TX

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

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Patient came in for Janssen COVID vaccine that was scheduled electronically online. All appropriate prescreening was done and patient had no previous allergies or issues. Patient was instructed to sit in one of the chairs designated for post vaccine observation for 15 minutes after her vaccine. Within a minute or so patient felt light headed and like she might pass out. She notified the technician who was right there and he notified me. I assisted her to a sitting position on the floor from her chair and I was able to ease her back to a lying down position from there with her head on the floor and feet elevated above heart on a chair. Patient was able to talk the whole time. She told us at that point when she was younger she was scared of shots and had fainted when having them, but thought she was past that and did not mention it during screening. She said she was surprised to feel this way because she was so excited about getting her COVID vaccine. She had not eaten much today (a small snack) and had rushed here for her appointment without getting food. I checked her blood pressure while she was lying down and it was 94/63 and pulse of 75. She said she normally had lower end of normal blood pressure. She was pale when I started checking her, but her color began to return to normal within minutes. After 5 minutes she felt well enough to sit up and we got her a granola bar and water. She remained this way for 5 minutes and felt good, so we moved her to sitting in a chair and got her a pepperoni and cheese snack tray from the cafe. She ate this and waited for 10minutes and felt good. We walked her to her car and she felt fine. I called to verify she got home fine and she did.

Other Meds: None known

Current Illness: None

ID: 1086362
Sex: F
Age: 64
State: TX

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/09/2021
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: pollen and dust

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

Symptoms: Face turned red, and then numb, hard to breathe, and felt like heart beat quicken, and felt like passing out. Lasted for about 3 minutes.

Other Meds: metformin, pantoprazole, atorvastatin, and pioglitazone, bayer baby aspirin, multivitamin, Coq10, krill oil, and osteo bi-flex.

Current Illness:

ID: 1086363
Sex: F
Age: 31
State: NY

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
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: Fever started at 12:30pm on 3/8 and finally subsided at around 12:30pm on 3/9. The fever went up to 101? at times in the middle of the night. Excruciating pain in joints that started around 3pm on 3/8 and finally subsided on 3/9 at around 12:30pm. Extreme fatigue and getting winded doing menial tasks like showering all day on 3/9. Pain at the injection site.

Other Meds: None

Current Illness: None

ID: 1086364
Sex: F
Age: 70
State: IN

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: K-Flex

Symptom List: Injection site pain, Menorrhagia

Symptoms: 2nd dose shot was given at 10:50am on Sat. 3/6/21 , that evening my left arm started hurting, during the night it woke me up with throbbing pain. Next day Sunday, my arm was really sore. I had chills off and on all day plus a fever of almost 100 at times. Felt a little strange, hard to explain. No energy, just the blobs. Spent a few hours in bed during the day which was Sunday. The next day Monday, I felt much better. Today 3/9/21 I am back to normal. I was not too worried because I had heard a lot of people had issues with the 2nd dose. First dose, no problems except a sore arm for a day or two.

Other Meds: No

Current Illness: None

ID: 1086365
Sex: F
Age: 66
State: TN

Vax Date: 02/27/2021
Onset Date: 03/04/2021
Rec V Date: 03/09/2021
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: None

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

Symptoms: None stated.

Other Meds: Crestor 10mg. Lexpro 10 mg. Ladin 25 mg Zinc potassium vitamin c.

Current Illness: I had Covid between my two Pfizer shots. I was advised by 4 drs to go ahead n take the second shot after I came out of Covid and 10 days of quarantine

ID: 1086366
Sex: F
Age: 52
State: NJ

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 03/09/2021
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: Demerol

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Itchy rash, red bumps in and around injection site. Injection site soreness four days later. Hard callously feeling around injection site on left arm where vaccine was given.

Other Meds: B12 vitamin, Biotin, Multivitamin with a Probiotic

Current Illness: None

ID: 1086367
Sex: M
Age: 58
State: WA

Vax Date: 02/08/2021
Onset Date: 02/13/2021
Rec V Date: 03/09/2021
Hospital: Y

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: Guillian Barre Syndrome

Other Meds:

Current Illness: None

ID: 1086368
Sex: F
Age: 70
State: CA

Vax Date: 03/05/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
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: A rash started by armpits, went to under breasts, then stomach, then crotch, then knees. The rash seemed to travel down my body over a period of 1 day. Severe itching. Swelling with heat. Extremely uncomfortable.

Other Meds: amoxicillin 500mg for gum infection from bad tooth although the last day was of this antibiotic was the day of the Moderna vaccination 03/05/2021

Current Illness: gum infection from bad tooth

ID: 1086369
Sex: M
Age: 37
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient came in for Janssen COVID vaccine that was scheduled electronically online. All appropriate prescreening was done and patient had no previous allergies or issues. Patient was instructed to sit in one of the chairs designated for post vaccine observation. Within minutes (less than 3), patient was very dizzy, clammy (cold sweats), pale and said he did not feel right. I assisted him to a sitting position on the floor from his chair and we were able to ease him back to a lying down position from there with his head on the floor and feet elevated above heart on a chair. Patient said that the cold floor actually made him feel better instantly. At 4:18pm after lying down for about 3 minutes we checked his blood pressure with him still lying down. It was 110/88 and pulse of 104 (so slightly elevated pulse). He said he was feeling better and we kept him lying down. Patient's wife was also there so she was able to provide information in addition to him doing it also. She did state that he occasionally had panic attacks and she thought this might be one, the patient was adamant that it was not. At 4:24 pm we checked his blood pressure again and it was 100/90 and Pulse of 104. He was feeling quite a bit better so we had him come to a sitting position on the floor and he had not eaten in a while so we got him a granola bar and water. Pt slowly ate these and begin to feel clammy and sweaty again within 3-4 minutes. We checked his blood pressure again and it was 104/90 and pulse of 100. He wanted to stay sitting to see if it would pass. We did continuously observe injection site and screen for any other symptoms of an allergic reaction (nausea, cramping, swelling, and none of these were occurring). Since he was still not feeling well we gave the patient 50mg of benadryl (20 mls of 12.5mg/5ml liquid benadryl) with his approval. After about 10 minutes of sitting total he was still having cold sweats and feeling dizzy so we had him lie back on his back with his feet elevated while the benadryl kicked in. By 4:50pm he was feeling well enough to sit back up and we got him some wraps and a coke from the cafe to eat. Pt continued to consistently improve and was ready to leave about 5:20pm. We advised him and his wife of signs and symptoms of allergic reaction and to have those treated to immediately at urgent care or and ER. We also told him to follow-up with his PCP. I had a manager help walk them to their car. They were very kind and grateful. I will follow-up with a call tomorrow and again on Friday to make sure he continues to do well.

Other Meds:

Current Illness:

ID: 1086370
Sex: F
Age: 29
State: IL

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Injection site pain

Symptoms: For Dose 1, I had the "COVID Arm" after 7 days of receiving the FIRST dose. My initial rash was HUGE (10cm), super red, swollen, itchy, and hot to touch. For Dose #2, the rash was much smaller. It is still painful (e.g. to lift my arm and to touch), but not as itchy or red. I got the rash the day after Dose #2. The symptoms were much better & reduced. I did not have any other symptoms outside of feeling very tired and I had a headache.

Other Meds: Mononessa Birth Control

Current Illness: No

ID: 1086371
Sex: F
Age: 40
State: WA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: Fluticasone nasal- headaches Latex- contact dermatitis All pollen, mold, dust, and many danders

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

Symptoms: Migraine Right otalgia Cervicalgia Numbness around right eye All continuing at present time

Other Meds: Prenatal 1 cap daily Vitamin d3 5000 units daily Hydroxychloroquine 200mg daily Ibuprofen 600mg PO bid prn

Current Illness: Stopped lactation less than one month ago

ID: 1086372
Sex: M
Age: 34
State:

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/09/2021
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: Not Known Alllergies

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

Symptoms: Patient entered to observation after receiving the covid vaccine. started to report feeling dizzy and fainted. patient began to keel over, and was escorted by two nurses on the floor. Patient did not hit his head, and no sustain injury on the way down. Patient was placed on supine position with legs elevated. Peep breathing exercises encouraged. Vitals were initiated and recorder. Patient had a syncopal episode, responded to sternal rub. Patient lost consciousness again and once again responded to sternal rub. Vitals were initiated and EMS was activated. Patient vitals were stable with one orthostatic hypotension. Patient reported feeling better and refused to go to the hospital with EMS. Patient was escorted out of building visibly looking better, no pale noted, left site at 1:30 PM.

Other Meds:

Current Illness:

ID: 1086373
Sex: M
Age: 51
State: IN

Vax Date: 03/07/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
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: Tremor

Symptoms: Chills, aches and pains - lasted approximately 12 hours

Other Meds: Tadalifil, citalopram, aspirin, lisinopril, albuterol, pravastatin,

Current Illness: None

ID: 1086374
Sex: F
Age: 30
State: TN

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
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: Septra and sulfa drugs

Symptom List: Erythema, Pruritus

Symptoms: 20 minutes after injection inner ear pressure, light headedness, dizziness, faintness. Three hours after injection low grade fever, dizziness, fatigue. 24+ hours after injection headache, fever, arm soreness, inner ear pressure, hot flashes, neck tension, eye "floaters"

Other Meds: Lamotrigine, oxcarbazepine, propranalol, mirtazepine

Current Illness:

ID: 1086375
Sex: F
Age: 46
State: CO

Vax Date: 02/27/2021
Onset Date: 03/07/2021
Rec V Date: 03/09/2021
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: Sulfa drugs, seasonal allergies

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

Symptoms: Day 8 post vaccine #1, itchy around injection site with red and warm circle area approximately 2-3 inches in diameter.

Other Meds: B-3, Calcium

Current Illness: None

ID: 1086376
Sex: F
Age: 66
State: NY

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
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: Chills, severe fatigue, weakness, dizziness, unstable on feet , nausea , GUM SWELLING, roof of mouth burning and pain Tingling in hands and feet, loss of appetite.

Other Meds: Omeperzole Flinstone vitamins

Current Illness: None

ID: 1086377
Sex: M
Age: 62
State: SC

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/09/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Severe rigors.

Other Meds: Benicar, plavix, aspirin, metoprolol, xanax, ambien, omeprazol

Current Illness: None. Had covid 19 on January 4th. Recovered completely in 3 weeks.

ID: 1086378
Sex: M
Age: 26
State: NC

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/09/2021
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: Vision blurring, cold sweat, racing heart rate, flushing and syncope 5 minutes post-injection. EKG showed ventricular arrhythmia which converted to normal sinus rhythm with regaining consciousness approximately 5 minutes later.

Other Meds: Humira

Current Illness: None

ID: 1086380
Sex: M
Age: 24
State: NC

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
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: Quick onset of fever (peaked at slight above 100 deg F), chest pains, shortness of breath, and severe chills about 11 hours after vaccine was taken. These symptoms were mild the next morning and afternoon and I was able to work fine from home. This evening, my fever once again flared up to 100 deg F.

Other Meds: None

Current Illness: None

ID: 1086381
Sex: F
Age: 28
State: TN

Vax Date: 03/03/2021
Onset Date: 03/07/2021
Rec V Date: 03/09/2021
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: Pain in extremity

Symptoms: Redness, swelling, and itching at site of injection starting 5 days after injection and ending 6 days after injection.

Other Meds: None

Current Illness: None

ID: 1086382
Sex: F
Age: 71
State: TX

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: ASA, Fentanyl, Pyridium, Morphine, Reglan, Zofran, Vicodin, Lyrica, Neurotin, Propofol, Imitrex, Hydrocodone, Band Aids, Tape

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

Symptoms: Anxious, Shaking, Jittery ,fast heart beat. ill at ease.

Other Meds: Entresto, Eliquis, Carvedilol, prilosec, Demadex, MethylPrednisolone, Dilaudid, Vitamin D, Vitamin B Super Complex,Extra Strength Tylenol, Xanax,Anti Diarrheal, Promethazine HCL,

Current Illness: Abdominal Problems, High Blood Pressure, Chronic Kidney Disease, Hernia,Total shoulder replacement/with constant pain, Really bad headaches, Neck pain, and constant back pain. Heart Problems/with aorta leakage.

ID: 1086383
Sex: F
Age: 51
State: NC

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/09/2021
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: Seafood Anaphylaxis Almonds-getting worse...throat swelling, hives, mouth and lip swelling Aspirin Most things on skin-very sensitive Wool Ragweed Bird feathers(quite bad) Cockroaches(and their little leftovers) dust Etc...

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

Symptoms: Severe pain and swelling of arm. Unable to eat, stand up, had intense headache, ringing in ears and had some itching. I was lethargic and slept most of 3 days. Extremely exhausted for entire week. Still recovering and tired even today 3/9. I had to take my rescue inhaler and then took benydrl every 4 hours for a week.

Other Meds: Symbicort Inhaler Albuterol Inhaler Lamictal 200mg Bupropion 300mg D3 Multivitamin Flovent Nasal Inhaler Ubrelvy

Current Illness: None

ID: 1086384
Sex: F
Age: 36
State: TX

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 03/09/2021
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: Mushroom allergy

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

Symptoms: On the following day after receiving my first dose of the vaccination, my arm was throbbing, completely swollen, decreased ROM and skin was RED and severely tender to the touch. Took OTC Tylenol (2) po and had no signs of relief. Pain , swelling, and skin redness lasted for 3 days. On February 10th, 2021 I had a positive pregnancy test (confirmed by bloodwork and urine) which indicated I was 6-7 weeks pregnant and had a miscarriage on March 2021, after giving live births 3 prior times. The cause of the miscarriage is unknown. I also developed a blood clot on the arm that was inserted for an IV. I have no family history or personal history of needing blood thinners.

Other Meds: Supplements: Vitamin D3 k2 Iron Prescriptions: Adderall 20mg Adderall 30mg

Current Illness: None

ID: 1086385
Sex: F
Age: 74
State: OH

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
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: diarrhea and vomiting for about 18 hours, aches and fatigue.

Other Meds:

Current Illness: none

ID: 1086386
Sex: F
Age: 43
State: TX

Vax Date: 02/25/2021
Onset Date: 03/05/2021
Rec V Date: 03/09/2021
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: Cephalexin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: On day 8 I got Covid Arm at the injection site. Lasted for 3 days. On 3/721 6:30am I woke up for work and had terrible chest pain. It knocked me back a few steps. Examined my chest and only experienced the pain when I moved a certain way. Thought I had pulled a muscle. Went to work feeling exhausted and my eyes burned. Came home early from work and passed out. Noticed that when I lay down my hands swell. Next morning I work up fine. No pulled muscle. No pain. Never experienced anything like it. I started my monthly cycle that morning. It is over a week early.

Other Meds: Doxepin Taltz Phentermine Wellbutrin Nalotrexone

Current Illness: None

ID: 1086387
Sex: F
Age: 44
State: CA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/09/2021
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: Yes 27 allergies

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

Symptoms: Patient began to experience tickle in throat and right side throat itching. Benadryl 25 mg oral solution was given and Benadryl 25 mg po was given. Patient improved and was discharged at 2:18pm.

Other Meds: None

Current Illness: DVT, Diarrhea, Staph Aureus Bacteremia, Migraines

ID: 1086389
Sex: M
Age: 54
State: NV

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/09/2021
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: Demerol allergy

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I developed a pain in my neck on the right side, joint pain, headache, and sorness in my left arm pit. Felt all of these symptoms as well as feeling crummy for 3 days

Other Meds: Farxiga 10mg, Ezetimibe 10mg, Lisinopril 5mg, Bayer Aspirin 81mg, Vitamin D3 25mcg, Mens one a day Vitamin, all daily. Bydureon BCise 2mg once a week.

Current Illness: Type II diabetes and had open Heart surgery to replace my Aortic heart valve.

ID: 1086390
Sex: M
Age: 26
State: TN

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 03/09/2021
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: Fever of 102.5, chills, rigors, and nausea starting 12 hours after the injection lasting 24 hours

Other Meds: None

Current Illness: None

ID: 1086391
Sex: F
Age: 23
State: IL

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: During administration, needle was advanced into deltoid. Approximately half of the vaccine liquid was administered however remainder seemed to shoot out outside the patient's skin.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm