VAERS 2021 Database www.vaers.hhs.gov

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

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

Incidents per State

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

ID: 1087426
Sex: F
Age: 40
State: WI

Vax Date: 03/02/2021
Onset Date: 03/05/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: I had an abnormal headache, and I had excruciating pain in the left arm 24 hours after the injection. BUT, I was more concerned with the "Covid Rash" or "Covid Arm" i had developed. I noticed Friday morning after my injection a large red splotch under my injection site. It didn't itch or hurt, but was abnormal. We looked up vaccine reactions and found realized I had the covid rash.

Other Meds: Lisinopril and Metformin

Current Illness: none

ID: 1087427
Sex: M
Age: 70
State: MO

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/10/2021
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: codeine based pain meds, lactose intolerant

Symptom List: Anxiety, Dyspnoea

Symptoms: Monday evening 11:20 pm nausea and stomach pain which dissipated 2 hours later: dark brown urine continues into day 2

Other Meds: Losartan 25 mg, levythyroxine 125 mcg, calcium 600 mg

Current Illness: none

Date Died: 02/11/2021

ID: 1087428
Sex: M
Age: 89
State: OH

Vax Date: 01/29/2021
Onset Date: 02/01/2021
Rec V Date: 03/10/2021
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: NKDA

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

Symptoms: Documentation in death summary noted patient expired 2/11/21. Clinical diagnosis; respiratory failure due to pneumonia, GI bleed due to duodenal bulb ulcer, renal failure, uncontrolled atrial fibrillation, protein calorie malnutrition, community acquired pneumonia. SARS-COVID-19 not detected per documentation found on DNA molecular diagnostics laboratory report collected 2/2/21. Patient had received covid vaccination 1/29/21 prior to arrival at ED on 2/1/21. No documentation found of which brand or dose number patient had received. No lot number available for documentation.

Other Meds: tiotropium bromide inhalation, fluticasone furoate =-vilanterol inhalation, albuterol sulfate inhalation, metoprolol tartrate, furosemide, digoxin, doxazosin, finasteride, tamsulosin, warfarin, allopurinol, levothyroxine

Current Illness: GI bleed, Hgb 7.1 supratherapeutic INR

ID: 1087429
Sex: M
Age: 59
State: IN

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: About 36 hours after the injection (Sunday 3/9 8:00am), I started getting a headache mostly at the base of my skull. It got progressively worse and spread to the front of my head too. By that evening (Sunday 3/9) it was throbbing like one of the worst headaches I have had. Monday was so bad that I called in and didn't work. Tuesday 3/9 was still bad. Finally, Tuesday night is started letting up and was able to sleep. I still have a little headache at the back of my head, 9:00am 3/10. Also, I couldn't sleep Sunday 3/8 and Monday 3/9 night . I had a Tylenol 3 prescription and used it. I was taking 2 at a time and it was not helping much. Also mixed in some ibuprofen.

Other Meds: Levothyroxine 150mcg, Nortryptiline 25mg, Benadryl, Fluticasone nose spray

Current Illness: Nothing

ID: 1087430
Sex: M
Age: 48
State: MA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 03/10/2021
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: Positive Covid PCR test after 2nd dose of vaccine

Other Meds:

Current Illness:

ID: 1087432
Sex: F
Age: 64
State: IN

Vax Date: 03/02/2021
Onset Date: 03/03/2021
Rec V Date: 03/10/2021
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: Dizziness/light-headed, feeling like I was about to faint started morning after vaccine along with severe neck pain. Possible intermittent fever. Dizziness continued for 2 days. Neck pain improved somewhat but is still bothering me, woke me up at night. Now a week later and my neck still hurts. I called my primary care office on March 3 and they said call 211. That made no sense so I asked again and they finally said I could see a nurse practitioner the next day. However I didn?t go because I couldn?t drive. I am a little worried about the second dose.

Other Meds: Labetalol, Otezla, methimazole, calcium with vitamin D

Current Illness:

ID: 1087433
Sex: F
Age: 56
State: FL

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: sulfur, morphine

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Client c/o headache and dizziness. Client seen and assessed by EMD and vital signs are: BP 164/92, HR 76, O2 100%. Client stated that symptom has decreased and cleared to go home.

Other Meds:

Current Illness:

ID: 1087434
Sex: F
Age: 23
State:

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: Allergic to kiwis (if consumed).

Symptom List: Pharyngeal swelling

Symptoms: Severe headache (to the point where it was affecting my vision), dehydration, sweats and chills as though I had a fever, muscle aches, and difficulty sleeping. All of these symptoms lasted for approximately 9 hours. They started 10 hours after the vaccine itself.

Other Meds: Oral birth control Pills

Current Illness:

ID: 1087435
Sex: M
Age:
State: IN

Vax Date:
Onset Date: 03/04/2021
Rec V Date: 03/10/2021
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: Severe vertigo

Other Meds: Toprol, xarelto, cialis, tylenol

Current Illness: None

ID: 1087436
Sex: F
Age: 86
State: NC

Vax Date: 02/13/2021
Onset Date: 03/08/2021
Rec V Date: 03/10/2021
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: Resident received 2nd dose of Mederna vaccine on 2/13/2021. During routine testing, they tested positive on 3/8/2021. Resident is asymptomatic. They are a previous COVID positive on 11/30/2020 and had recently started retesting.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Resident received 2nd dose of vaccine 2/13/2021. During routine testing, resident tested positive for COVID-19 on 3/8/2021 - 24 days out from vaccine date. Resident is asymptomatic. This resident was a previous COVID positive on 11/30/2020 and had just started retesting this month.

Other Meds:

Current Illness:

ID: 1087437
Sex: F
Age: 70
State: NH

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: Environmental, ragweed and dust mites.

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

Symptoms: She received the vaccine, and went to bed at midnight and felt great all day long. She believes about 5 minutes later started having chills. She has a weighted blanket and had that with 2 other blankets on her, and started shaking, and then her teeth started chattering and could not prevent them from banging together. She was afraid she was going to break a tooth. This lasted for almost an hour. She finally fell asleep and normally does not move when sleeping, and tossed and turned all night. She usually gets up a couple of times a night to use the bathroom, and did not get up until 6:00 Am, and when she tried to get up she was woozy, and was not able to walk due to feeling like she was going to fall over and almost fell in the bathroom but has grab bars that she was able to grab. She normally gets up at 4:00 Am, and got up at 8 after getting up at 6. She was not able to sit up and when she got up for the day was listing like a drunken sailor and not able to eat and managed to get some water down. She did take a Tylenol, and took her VS which were normal. She had tried to call her doctor but due to weakness was not able to. She was still uneasy from a deep sleep last night, but today she is feeling better but afraid of losing her balance. Her arm is still a little sore, but pretty good right now.

Other Meds: Gabapentin, Levothyroxine, Metoprolol. B12, Vitamin C, Vitamin D3, Vitamin E, garlic, Magnesium, potassium, zinc.

Current Illness: Did have COVID in December 30th, and had a severe reaction and just starting to get taste back now with low pulse ox of 83, high fevers, etc.

ID: 1087438
Sex: F
Age: 79
State: MD

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 03/10/2021
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: Client developed soreness in the arm the day after receiving vaccine. It seemed to improve, but now almost 4 weeks later continues with a lump & pain at injection site. Encouraged client to take Tylenol or Ibuprofen as per norm meds taken, measure lump & redness & Benadryl prn with precautions for increased drowsiness.

Other Meds: Insulin

Current Illness: None

ID: 1087439
Sex: M
Age: 42
State: OH

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: Bentol - Causes allergies

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

Symptoms: Fever, Chills, diarrhea, fatigue. Lasted about 15 hours

Other Meds: None.

Current Illness:

ID: 1087440
Sex: F
Age:
State: FL

Vax Date: 02/27/2021
Onset Date: 03/05/2021
Rec V Date: 03/10/2021
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: pt had been fine since vaccine 8 days ago until yesterday evening she noticed a small red bruise on her lt lower eyelid. she woke up today and noticed got larger to half inch sized. pt denies blurred vision, vision loss, or difficulty with extra ocular eye movements or trauma.

Other Meds: takes amitriptyline and xanax only

Current Illness:

ID: 1087441
Sex: F
Age: 48
State: NE

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/10/2021
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: NA

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

Symptoms: headache for ~15hours body aches for ~15 hours fever 100.1 - 7 hours

Other Meds: Simvastatin 10 mg

Current Illness: NA

ID: 1087442
Sex: F
Age: 54
State: TX

Vax Date: 03/02/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: Red rash about 2 inches in diameter at injection site. Sore, warm to the touch, slightly itchy.

Other Meds: None

Current Illness: None

ID: 1087443
Sex: F
Age: 29
State: IL

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

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

Symptoms: Swollen armpit

Other Meds: Tri Ness Lo

Current Illness: None

ID: 1087444
Sex: F
Age: 53
State: IN

Vax Date: 03/07/2021
Onset Date: 03/10/2021
Rec V Date: 03/10/2021
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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Left ear buzzing followed by dizziness , headaches

Other Meds: Nexium 40 mg

Current Illness:

ID: 1087445
Sex: F
Age: 53
State: CT

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 5:30AM (time I got up) Injection site soreness and stiffness, headache and body aches (skin sensitivity). Took Ibprophen and hot shower; symptoms subsided in about 30 to 60 minutes.

Other Meds: Omeprazole, Estroven, Bioten gummies

Current Illness: None. COVID-19 positive January 18, 2021

ID: 1087446
Sex: F
Age: 51
State: DE

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: Aspirin, Coca cola, coconut

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

Symptoms: Around 11pm, i started experiencing leg cramps in my right lower leg. I applied a heating pad to ease the pain. I am still experiencing leg cramps but not as bad now.

Other Meds: Claritin, multi vitamin

Current Illness:

ID: 1087447
Sex: M
Age: 35
State: CA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 03/10/2021
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: NKA

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

Symptoms: Just over 24 hours after receiving the second Moderna vaccine I started to break out in hives all over my face and neck. 24 hours later my whole body was covered in hives. I was able to finally get the hives to dissipate after taking about 150 mg of Benadryl over a 8 hour period. I went to an Urgent Care the next week when the hives started to come back and the doctor said it was an adverse reaction to the second vaccine. The doctor informed me to keep taking the Benadryl as needed. The hives came back a few days later and one of the doctors I work with told me to start taking an H2 blocker on top of the H1 blocker I was already taking. It worked well. Now a month later I am still getting bad hives all over my body and the H1 and H2 blockers are not working. Heading back to the Urgent care to received better treatment.

Other Meds: None

Current Illness: None

ID: 1087448
Sex: M
Age: 50
State:

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

Symptom List: Unevaluable event

Symptoms: Headache. Low grade fever. Body aches. Exhaustion. Started 24 hours after shot. And lasted less than 24 hours. Symptoms are totally gone now.

Other Meds: Lomotil. Xanax. metoprol tartrate. Lisinopril Allupuranol. Vitamin b212. Vitamin d3. hydrochlorothiazide. Trazadone. Lexapro.

Current Illness:

ID: 1087449
Sex: F
Age: 58
State: FL

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/10/2021
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: Niacin, Oxycodone, Hydrocodon, Venlaflaxine

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

Symptoms: Received my Covid shot yesterday at a Mall Testing Site.About 8pm I began having severe chills. I went to bed at 9:30pm, woke up at 1:00am and took some Motrin. This morning at 6:40 am I still had chills so I took my temperature and it was 100.0 degrees. It has remained 100 degrees this morning. I took some more Motrin. My right arm is also sore at injection site.

Other Meds: Zinc, D-3, Vit C, Magnesium, Multi-vit

Current Illness: Non at time of vacination. Tested positive for covid in early February.

ID: 1087450
Sex: F
Age: 41
State: FL

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: sulfa, penicillin, latex, epinephrine

Symptom List: Injection site pain, Pain

Symptoms: After 7 hours, I started to feel like I had a migraine. Then my whole body ached horribly, I had chills, a fever, difficulty breathing

Other Meds: Multi-vitamin

Current Illness: None

ID: 1087451
Sex: F
Age: 47
State: TX

Vax Date: 03/04/2021
Onset Date: 03/10/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: penicillin, bee stings, hydrocodone, flagyl

Symptom List: Injection site pain, Menorrhagia

Symptoms: Skin on both arms and face got red like a bad sunburn, burning and raised welts and intense itching. Treated with topical hydrocortisone on one arm and Benadryl cream on the other arm to see if one of them will provide relief. Ongoing redness and welts.

Other Meds: Lamictal, Latuda, Depakote, Phentermine, Zyrtec, Lorazepam

Current Illness: none

ID: 1087452
Sex: F
Age: 48
State: NJ

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/10/2021
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:

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

Symptoms: Approx 1/2 hour after receiving the vaccination I began to itch on my ears, arms, and feet. I then notices small red bumps or hives in these areas. It is now eight days after my shot and I am still experiencing hives and itching which is only relieved by taking benadryl. After the benadryl wears off the symptoms return.

Other Meds: Setraline 100 Mg

Current Illness:

ID: 1087453
Sex: M
Age: 37
State: NJ

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: At 5p, started to get a headache and body aches. By 6p, fever was 99.5. At 8p, fever was 101. The rest of the night featured a headache, body aches, chills, fever of 100.5 to 102.5 and nauseated (dry heaved twice) Took tylonel every 6 hours to try and help. Next morning (current as of writing this), felt a little better as fever dropped to 99.5 and nausea significantly lowered. Still have a headache and aches in legs

Other Meds:

Current Illness:

ID: 1087454
Sex: F
Age: 31
State: IL

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: HEADACHE BODY ACHE BURNS ON TONGUE ARM SWOLLEN ARM REDNESS AT INJECTION SITE

Other Meds: HYDROXYCLOROQUINE VITAMIN D LEVOXY FLAX SEED OIL VITAMIN C CMYBALTA

Current Illness: NONE

ID: 1087455
Sex: M
Age: 52
State: FL

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/10/2021
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: nkda

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

Symptoms: paresthesias and hyperesthesia from hips up to scalp. slowly improved over next week, no treatment provided

Other Meds: none

Current Illness: none

ID: 1087456
Sex: F
Age: 62
State: FL

Vax Date: 01/02/2021
Onset Date: 01/04/2021
Rec V Date: 03/10/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: A 63-year-old female with a medical history of Hashimoto?s Disease, on Levothyroxine 88 micrograms (4 days per week) and 100 micrograms (3 days per week), presented to the emergency department with a 7-day history of acute onset of severe, debilitating, fatigue, weakness, anorexia and malaise. She had no clear precipitating events, stated that she was in her usual states of health, active, working as an optometrist at a University hospital. Stated that 1 week before symptom oncer she had her first dose of Moderna COVID-19 Vaccine EUA. Stated that 24hrs later her symptoms started associated with low grade subjective fever, however her fever disappeared, and she persisted with severe fatigue. She was unable to do her regular activities of daily living and was hoping her symptoms would resolve but upon persistence and given the severity of her complains she presented to evaluation. She denied recently starting any new medications/supplements, or recent change in her levothyroxine dose. There were no headaches, cough, diarrhea, sore throat, rhinorrhea, myalgia, arthralgia, weakness, recent infectious illness or sick contacts. She was diagnosed with Hashimoto?s Disease over 10 years prior and had been on the same dose for more than 2 years. VS were stable and within normal limits, physical exam was only remarkable for weakness on 4 extremities 4/5, lethargy, bradylalia, bilateral ptosis, no focal neurologic deficits, sensation intact. Laboratory workup revealed normal Hb 14.8, normal renal and kidney function, normal cortisol level, TSH normal 3.7, normal FT4: 1.2, normal CPK, negative tox screen. ESR and CRP were performed, and both were found to be elevated ESR 74, CRP 28, at that moment we decided to do immunologic workup showing high titers of ANA >1:320 with a nuclear speckled pattern, and a positive rheumatoid factor 60. At this point a full rheumatologic panel was performed which was negative for anti-Ach receptor Abs, negative anti-CCP, anti- dsDNA, anti-smith, negative anti-Jo1, anti-RNP, negative anti-TPO, negative anti-SCL70, normal C4 and C3 however elevated total CH50 > 60, positive anti-SSA and anti-SSB. Her symptoms of severe fatigue persisted throughout her admission and it was decided to give her a course of prednisone 40mg for 5 days and follow up as outpatient with a Rheumatologist. Repeat workup 2 weeks after discharge showed still elevated ESR at 72, high CRP 17, rheum factor elevated again at 67. At this point no clear cause was identified as she did not have any symptoms of Sjogren or anything else other than severe persisting fatigue. Another course of steroids was given and 1 month later she stated that she was much improved and was able to go back to work. Stated that she would not take her second covid MODERNA vaccine dose due to fear of recurrence of symptoms. It appeared that this vaccine triggered a severe inflammatory and autoimmune reaction in this patient with history of Hashimoto?s disease. The association between MODERNA vaccine and development of autoimmunity and inflammatory reaction needs to be assessed.

Other Meds: levothyroxine 88mcg QD

Current Illness: hypothyroidism

ID: 1087457
Sex: F
Age: 30
State: NY

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: Lactose intolerant

Symptom List: Injection site pain

Symptoms: Fever Chills Sweats Light arm pain Headache Horrible muscle Aches Horrible muscle fatigue Low grade fever while taking extra strength tylenol 99.7 Nauseousness Light headed Tossed and turned all night in such pain and chills and sweats Felt like I was going to pass out on my commute home could barely walk my limbs were so heavy and tired and numb

Other Meds: Birth control Levoxyl

Current Illness:

ID: 1087458
Sex: F
Age: 50
State: IN

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

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

Lab Data:

Allergies: N/a

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

Symptoms: At 4pm I spoke a fever and chills- lasted until 2am. Skin had spots on left arm, left calf and face that felt like a bad sunburn

Other Meds: Taltz and hydrochlorothiazide

Current Illness: None

ID: 1087459
Sex: F
Age: 38
State: IN

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: fish and latex

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

Symptoms: Chills, headache, body ache, start 1am-9pm, took ibuprofen

Other Meds: Methylphenidate LA 20mg

Current Illness:

ID: 1087460
Sex: F
Age: 65
State: NC

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/10/2021
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: Adhesive

Symptom List: Tremor

Symptoms: Experiencing high pitched tinnitus since receiving shot.

Other Meds: Vitamin D3 , zinc, multivitamin

Current Illness: NA

ID: 1087468
Sex: M
Age:
State: OH

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

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: Erythema, Pruritus

Symptoms: Norovirus with Diarrhea; Throwing up; Had dehydration; Diarrhea; Was shaking so bad; Soreness in arm; This case was reported by a consumer via other manufacturer and described the occurrence of gastroenteritis norovirus in a 77-year-old male patient who received Herpes zoster (Shingles vaccine) for prophylaxis. The patient's past medical history included heart transplant. Concurrent medical conditions included diabetes, asthma and immunocompromised (has compromised immune system). On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced gastroenteritis norovirus (serious criteria hospitalization and GSK medically significant), vomiting (serious criteria hospitalization), dehydration (serious criteria hospitalization), diarrhea (serious criteria hospitalization), tremor (serious criteria hospitalization) and pain in arm. On an unknown date, the outcome of the gastroenteritis norovirus, vomiting, dehydration, diarrhea, tremor and pain in arm were unknown. It was unknown if the reporter considered the gastroenteritis norovirus, vomiting, dehydration, diarrhea, tremor and pain in arm to be related to Shingles vaccine. Additional details were reported as follows: This case was reported by the patient himself. The age at vaccination was not reported. The patient's parents had heart problems, his mother recently passed last year and was 100 years old. The mother of the patient did not have too much going on expect age. The patient had the Shingles shot, had soreness in arm and it was worst. The patient had Norovirus prior to the report and was hospitalized with diarrhea and other symptoms. The patient was throwing up, had dehydration and diarrhea. The gastro physician took sample of stool and he ended up in the hospital with Norovirus. The patient was shaking so bad because of the dehydration and diarrhea. The reporter consented to follow up. The case had been linked with case US2021AMR057562, reported for the same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR057562:Same reporter, same patient, different vaccine (Flu shot)

Other Meds:

Current Illness: Asthma; Diabetes; Immunocompromised (has compromised immune system)

ID: 1087469
Sex: M
Age: 77
State: OH

Vax Date: 12/01/2020
Onset Date:
Rec V Date: 03/10/2021
Hospital: Y

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Norovirus; Had dehydration; Diarrhea; Shaking; Throwing up; Soreness in arm; This case was reported by a consumer via other manufacturer and described the occurrence of gastroenteritis norovirus in a 77-year-old male patient who received Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent 2020-2021 season) for prophylaxis. The patient's past medical history included heart transplant. Concurrent medical conditions included diabetes and asthma. Concomitant products included Herpes zoster (Shingles vaccine). In December 2020, the patient received Influenza vaccine Quadrivalent 2020-2021 season. On an unknown date, less than 2 months after receiving Influenza vaccine Quadrivalent 2020-2021 season and an unknown time after receiving Shingles vaccine, the patient experienced gastroenteritis norovirus (serious criteria hospitalization and GSK medically significant), dehydration (serious criteria hospitalization), diarrhea (serious criteria hospitalization), tremor (serious criteria hospitalization), vomiting (serious criteria hospitalization) and pain in arm. On an unknown date, the outcome of the gastroenteritis norovirus, dehydration, tremor, vomiting and pain in arm were unknown and the outcome of the diarrhea was not recovered/not resolved. It was unknown if the reporter considered the gastroenteritis norovirus, dehydration, diarrhea, tremor, vomiting and pain in arm to be related to Influenza vaccine Quadrivalent 2020-2021 season. Additional details were provided as follows: The reporter is reporting for himself. The age at vaccination was not reported. The patient had issues since COVID-19 shot. He was trying to determine if the issues were from the shot or if he had something else was going on. On 25th January 2021, the patient received Pfizer Covid 19 vaccine, batch number EK4176. The patient had the soreness in his arm for three days like most people. On the first day, he had diarrhea. The patient was heart transplant patient and had a compromised immune system. The patient had diabetes and asthma. The patient's arm soreness was worse on 1st and 2nd day, by the third and fourth day it was better. The patient clarified as it was his left arm. The patient received COVID-19 vaccine in left arm because he was a heart transplant patient, he wanted to bring it to attention. The patient asked, if there was a problem with heart transplant patients who were not having the same immunity or protection as a person who did not have those problems and clarified he was not referring to specific person. He only wanted clarification on this information. After receiving Flu vaccine, the patient experienced soreness in arm. The patient's gastro doctor took the patient's stool sample and he ended up in the hospital with Norovirus. The patient was hospitalized with diarrhea and other symptom s. The patient was throwing up, had dehydration and diarrhea. He was shaking so bad because of the dehydration and diarrhea. For the tolerance of Shingles vaccine dose, refer linked case US2021AMR057551.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR057551:Same reporter.

Other Meds:

Current Illness: Asthma; Diabetes

ID: 1087472
Sex: F
Age: 61
State: AZ

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: increasing symptoms of preexisting myasthenia gravis.; was unable to swallow / have gotten worse / it now takes 45 minutes to eat dinner; speech have gotten worse / speech / are still worse; speech have gotten worse / speech / are still worse; now takes 45 minutes to eat dinner; received her first dose of Shingrix and flu vaccine in same (right) arm on 13 JAN 2021; body shakes; pain racing up and down her legs; body aches; could not lift her right (injected) arm; This case was reported by a consumer via call center representative and described the occurrence of myasthenia gravis aggravated in a 61-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent 2020-2021 season) for prophylaxis. The patient's past medical history included herpes zoster (had shingles). Concurrent medical conditions included myasthenia gravis. Concomitant products included mycophenolic acid (Mycophenolate) and prednisone. On 13th January 2021, the patient received the 1st dose of Shingrix and the 1st dose of Influenza vaccine Quadrivalent 2020-2021 season. On 13th January 2021, less than a day after receiving Shingrix and Influenza vaccine Quadrivalent 2020-2021 season, the patient experienced tremor, leg pain, general body pain, injected limb mobility decreased and vaccine administered at inappropriate site. On 1st February 2021, the patient experienced myasthenia gravis aggravated (serious criteria GSK medically significant), dysphagia aggravated, speech disorder, condition aggravated and activities of daily living impaired. On 16th January 2021, the outcome of the tremor, leg pain, general body pain and injected limb mobility decreased were recovered/resolved. On an unknown date, the outcome of the myasthenia gravis aggravated, dysphagia aggravated, speech disorder, condition aggravated and activities of daily living impaired were not recovered/not resolved and the outcome of the vaccine administered at inappropriate site was unknown. It was unknown if the reporter considered the myasthenia gravis aggravated, tremor, leg pain, general body pain, injected limb mobility decreased, dysphagia aggravated, speech disorder, condition aggravated and activities of daily living impaired to be related to Shingrix and Influenza vaccine Quadrivalent 2020-2021 season. Additional details were provided as follows: The reporter reported for herself. The patient received dose of Shingrix and Influenza vaccine Quadrivalent 2020-2021 season in the right arm. The patient experienced body shakes, pain racing up and down her legs and body aches and could not lift her right (injected) arm. These resolved after 3 days. 2 weeks after the injection of Shingrix and flu (around 1st February 2021) the patient experienced increasing symptoms of preexisting myasthenia gravis. The patient was unable to swallow mycophenolate pills. Her swallowing and speech have gotten worse, it now takes 45 minutes to eat dinner. The prednisone dose had been increased but speech and swallowing are still worse. The patient's neurologist stated that, the patient would not get the second dose of Shingrix until all symptoms of worsening myasthenia gravis have gone away. The reporter consented to follow up.

Other Meds: MYCOPHENOLATE; PREDNISONE

Current Illness: Myasthenia gravis

ID: 1087473
Sex: F
Age: 25
State: MA

Vax Date: 01/12/2021
Onset Date: 02/23/2021
Rec V Date: 03/10/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Positive Covid PCR test after second dose of vaccine

Other Meds:

Current Illness:

ID: 1087475
Sex: F
Age: 68
State: PA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/10/2021
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:

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

Symptoms: sore arm, fever, body aches, body chills, fatique, sleeplessness lasted 30 hours

Other Meds: Lisinopril 5mg

Current Illness:

ID: 1087476
Sex: F
Age: 45
State: CT

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 03/10/2021
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: ASA, Iodine Contrast Media

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

Symptoms: On 2/18/2021 at 10 am the Pt received the Maderna Vaccination IM to her right deltoid and 8 hours later the Pt developed nausea with a rash on chest, shoulders, front and back of neck that went down to her right arm to her wrist, the Pt also c/o SOB and was not able to lift her right arm. Today 4 days later the Pt still has slight right upper arm pain a vaccination site with minimal rash on her chest, with a slight sore throat, stuffy nose, with minimal nausea , will f/u with Pt in one week for f/u, sent note to Dr (ID Specialist)

Other Meds: Cyclobenzaprine (FLEXERIL) 10 mg tablet PO TID Gabapentin (NEURONTIN) 100 mg capsule PO QID Ibuprofen (ADVIL,MOTRIN) 800 mg tablet PO TID Mirtazapine (REMERON) 15 mg tablet PO HS Ondansetron (ZOFRAN) 4 mg tablet PO TID PRN Prazosin (MINIPR

Current Illness: On 2/18/2021 at 10 am the Pt received the Maderna Vaccination IM to her right deltoid and 8 hours later the Pt developed nausea with a rash on chest, shoulders, front and back of neck that went down to her right arm to her wrist, the Pt also c/o SOB and was not able to lift her right arm. Today 4 days later the Pt still has slight right upper arm pain a vaccination site with minimal rash on her chest, with a slight sore throat, stuffy nose, with minimal nausea , will f/u with Pt in one week for f/u, sent note to Dr (ID Specialist)

ID: 1087477
Sex: F
Age: 54
State: FL

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/10/2021
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: Pain in extremity

Symptoms: Caller states that she was concerned because she had read about the reaction on the paperwork given to her by pharmacist. Caller states that MD that prescribed the AB was not made aware by her that she had gotten the COVID Vaccine. When asked why she did not share this with the MD caller skirted the issue and changed the subject. CSPI attempted again to ascertain why caller had not shared this information with ED MD and again caller was evasive with response. CSPI adv that no intx found and that this AB unlikely to have any effect on the MODERNA COVID Vaccine. Q518. adv to continue with plan provided by PCP to take her AB and to rcv 2nd COVID vaccine at appointed time/place. call back if any questions. Caller got the first dose of Moderna vaccine yesterday. she is well, no reactions. This am she went to the Clinic and was prescribed Neomycin 500mg 1tab BID for 14days for "bacterial overgrowth". She took the first dose, but now was reading on the paper that came with the rx Neomycin that during this antibiotic therapy it is contraindicated to get immunizations. caller also asked if the benefit of Moderna vaccine could be lowered by the antibiotic therapy? The vaccine is unlikely to be affected by the antibiotic therapy, since she does need the antibiotic she should continue it. She will have a 2nd dose of the vaccine to boost immunization.

Other Meds: Neomycin

Current Illness:

ID: 1087478
Sex: F
Age: 37
State: NJ

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: Nuts Sulfa Latex

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

Symptoms: the right side of my face was numb starting at 20 min post injection and lasted 6 hours.

Other Meds: Clairtin Mirena Iron 65mg Vitamin D3 2000 CoQ-10 Vitamin B12 1000mcg

Current Illness: none

ID: 1087479
Sex: F
Age: 55
State: IN

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/10/2021
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: Sulfa

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

Symptoms: Soreness of arm, low-grade fever, chills, body aches, sore throat started around 8 AM the day after the vaccine. Felt progressively worse throughout the day. Took ibuprofen, slept and after a several hours started feeling better. Day #2 felt fine; asymptomatic Day #3 felt tired, slight headache Day #4 normal

Other Meds: Topril, lorsartan, doxycycline, prozac

Current Illness: n/a

ID: 1087480
Sex: F
Age: 76
State: NJ

Vax Date: 02/25/2021
Onset Date: 02/27/2021
Rec V Date: 03/10/2021
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: sulfa, ragweed pollen hay fever

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

Symptoms: I developed arm pain, up my arm to my neck, Then 2 days later developed a rash on my wrist, arm and top of my back.

Other Meds: atorvastatin 20mg,eliquis 5mg,fexofenadine 100mg,hydrochlorothiazide 25mg levothyoxine88msg,metropolp ER50mg, oxybutynin 5mg,pantroprazoledr 40mg, sertraline 100mg

Current Illness: afib, diabetes, high cholestereol, high blood pressure, OSA cpap

ID: 1087481
Sex: F
Age: 51
State: NY

Vax Date: 03/06/2021
Onset Date: 03/10/2021
Rec V Date: 03/10/2021
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: Remicaid serum reaction

Symptom List: Vomiting

Symptoms: 1st day just sore arm. 2nd day just felt off, 3rd day mild headache chills, 4th day sever headache, vomitting, nausea, stiff neck and shoulders.

Other Meds: B-12, Tylenol

Current Illness: Had a shingles vaccine and same thing happened within 3 to 4 day - sever headache, sore muscles but was unsure if related or not.

ID: 1087482
Sex: F
Age: 62
State: IL

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

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Headache, fatigue, loss appetite, light head,

Other Meds: Medication for high blood pressure, vitamin d and vitamin c

Current Illness:

ID: 1087484
Sex: M
Age: 37
State: CO

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: no

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

Symptoms: pt stated that after getting the vax his are was sore. He woke up next day and had developed a severe itchy red rash all of his entire body. His face and eyes are swollen. He took some Benadryl and went to work. His boss sent him home from work and told him to go to a Doctor. Pt called us to make a report and is on his way to Urgent Care in . He is continuing to get more reds dots on his body as we speak that are starting to blister.

Other Meds: Benadryl in AM

Current Illness: no

ID: 1087485
Sex: F
Age: 66
State: FL

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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, Codine

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt. c/o experiencing light head immediately after receiving vaccine. Pt. seen and assessed by EMT. VS are: BP 129/79, O2 97, HR 92. Pt. states that she had experienced headache after the first dose. MD was made aware and pt. cleared to take second dose. Within 20 mins. of observation client verbalized a decrease in symptom and as cleared to go home by EMT.

Other Meds: amlodipine

Current Illness: none

ID: 1087486
Sex: F
Age: 55
State: TX

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 03/10/2021
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: Evening of 2nd vaccination - uncontrollable chills/tremors/shakes, fever with burning eyes & ears, took 2 tylenol, 3am (01/27) heavy blood in urine, went back to My Urgent Care so they could record side effects, they said not side effects but possible UTI although culture was negative, prescribed 5 days of Keflex, 01/27 blood pressure high and incredible headache started in the evening, blood in urine gone by Sunday 01/31, televisit with primary care on 02/03 for sudden change in BP and discuss the "UTI", Primary care prescribed a second dose of losartin, by Sunday, 02/07 - BP so elevated, trip to ER and blood back in urine, ER did CT Scan to make sure no kidney stones, negative, and bladder/kidneys look fine, however, still have IUD, so may want it taken out since post menopausal, 02/08 in office visit with primary care, administered clonidine to get BP down because was up again, he had me do 24 hr urine collection, said go ahead and have IUD taken out, but also see a nephrologist as well as prescribed clonidine as need for BP issues, since that visit BP has seemed to regulate with a few spikes requiring clonidine, IUD removed 03/09 and will see nephrologist on 03/15, when I saw Gynecologist, she mentioned a doctor's wife who had similar issues with Moderna, and that I should report

Other Meds: losartin - 1 per day

Current Illness: none

ID: 1087487
Sex: M
Age:
State: FL

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/10/2021
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: morphine

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

Symptoms: shivering and body aches.

Other Meds: clopidogrel farxiga strivpiond supplement blood balance supplement seracare supplement

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm