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: 1087757
Sex: F
Age: 64
State: OH

Vax Date: 03/04/2021
Onset Date: 03/04/2021
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: pcn, small fussy animals, straw, dust, grass

Symptom List: Dysphagia, Epiglottitis

Symptoms: reports that she starting having a flutter in right side of chest ( a little catch) and then went away on the drive home from receiving vaccine. then 5 hours later her teeth and nose began to hurt. Fatigue, headache, nausea, continued pain in nose and teeth over the weekend. seen NP on Monday and was prescribed allergy meds and was told that this is symptoms of the vaccine. she reports today that the right side of her face is swollen and that she feels like there is a boil in her nose.

Other Meds: none

Current Illness: none

ID: 1087758
Sex: M
Age: 86
State: FL

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: /o fatigue, weakness around 1330. Beginning at 1700, caller c/o stomach cramps, diarrhea & nausea. Today, c/o intermittent mild cramps. Denies any other symptoms. Advised to increase fluids if possible, continue to take normal medications as prescibed. Follow up with PCP if you symptoms get worse, or UC/ER for severe symptoms

Other Meds: simvastatin levothyroxine metoprolol manitine pantoprazole colchicine aspirin vit D "blood pressure" allopurinol Plavix

Current Illness:

ID: 1087759
Sex: F
Age: 62
State: IN

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

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

Symptoms: Around 8pm on 3/8/21, I started having chills (teeth chattering), entire body in pain, extreme fatigue, extremely thirsty & headaches. I continue to have these issues & went to bed with my clothes on. At 3pm, I woke up, put on my pajamas & took 2 Aleves. Then started sweating. At 6 am, I called into work sick. Went back to sleep & woke up at 9:30am. I felt like I was in a fog, headache & some body aches. Felt that way the rest of the day. About 9 pm, I started getting hot & a headache, took 1 Aleve.

Other Meds: Taken in the morning of the vaccination. Allopurinol; Vitamin D; Sertraline Hydrochloride; Bupropion; Hrdrochlorothiazide; Synthroid.

Current Illness: None

ID: 1087760
Sex: F
Age: 59
State: PA

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: NKDA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: C/o warmth / flushed. Given a cold cloth and cold water. BP 101/67, HR 90. Declined to stay after 20 minutes. Symptoms resolved and released.

Other Meds: unknown

Current Illness: unknown

ID: 1087761
Sex: F
Age: 75
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: Penicillin

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

Symptoms: Got shot at 1:30pm. At 7:30 pm got very tired. Went to be at 8pm. Chills, headaches body aches, very tired

Other Meds:

Current Illness:

ID: 1087762
Sex: F
Age: 21
State: WI

Vax Date: 03/07/2021
Onset Date: 03/07/2021
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: NKA

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

Symptoms: 12:30PM ADMINISTERED MODERNA COVID-19 VACCINE INTRAMUSCULAR TO LEFT DELTOID 12:31PM APPEARED TO BE PALE POST VACCINE; MEDICS QUESTIONED PT, COMPLAINS OF BEING NERVOUS 12:35PM PT STARTED BREATHING HEAVIER AND JUST COMPLAINS OF CONTINUED NERVES 12:45PM PT COMPLAINED OF FAST HEART RATE TO MEDICS AT 146BPM 12:50PM PT INSTRUCTED TO TAKE SLOW, DEEP BREATHS. VITAL OBTAINED . HR 140, SPO2 100% LUNG SOUNDS CLEAR 12:55PM BP 131/77, HR 123, SPO2 100% PT HYPERVENTILATING RR 30'S. 1:00PM STATES THROAT AND CHEST ARE FEELING TIGHT. TACHYCARDIA CONTINUED. 1:02PM 0.3MG OF EPINEPHRINE ADMINISTERED 1:05PM PT APPEARS TO BE CHILLED AND IS SHAKING. 1:10PM BASE SECURITY/FIRE DEPARTMENT ARRIVES. VITAL SIGNS STABLE 1:15PM EMS ARRIVES. HR 129 SPO2 100% ROOM AIR. CARE TAKEN OVER BY EMS. 1:20PM TRANSPORTED TO HOSPITAL VIA AMBULANCE.

Other Meds: INHALER (UNKNOWN OF NAME) PRN PROPANOLOL (HASN'T TAKEN IN A COUPLE MONTHS)

Current Illness: NONE NOTED

Date Died: 03/10/2021

ID: 1087763
Sex: F
Age: 62
State: IA

Vax Date: 03/05/2021
Onset Date: 03/08/2021
Rec V Date: 03/10/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Difficulty breathing leading to organ failure and death

Other Meds:

Current Illness:

ID: 1087764
Sex: M
Age: 67
State: MI

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

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

Lab Data:

Allergies: penicillins

Symptom List: Pharyngeal swelling

Symptoms: Two hours after receiving the vaccine on 3/4/21, he started feeling very tired and had a 100.2 temp. By evening he was feeling very cold and not eating much. On 3/5/21 he was sleeping alot, had headache, chills and fever, no appetite, diaphoretic. At 8pm he could not get up out of his chair and was disoriented. Wife call an ambulance. He was admitted for altered mental status. Blood cultures showed streptococcus pneumoniae. He was hypoxic at 89%. BP 171/96, pulse 85, temp 37.3C. Chest xray showed bilteral infiltrates and a masslike density in the right lung apex. Encephalopathy, pneumonia and sepsis diagnosed. Ct of head normal.WBC count 19 and amonia 24. Wife told me he had a spinal tap on 3/9/21 and that it showed bacterial meningitis. I do not have the lab reports on that yet. THe infection control doctor told wife he is critical.

Other Meds: baby ASA; atorvastatin 20mg; eliquis;diltiazem ER daily; lasix; jardiance;lisinopril; metroprolol-HCTZ; novolog insulin; tresiba

Current Illness: none

ID: 1087765
Sex: F
Age: 29
State: TX

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

Lab Data:

Allergies: Food Allergies: tree nuts, avocados, cantaloupe, sunflower seeds No known medication allergies

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA. Severe and unusual skin itchiness, scratching resulted in immediate bruising, patchy red skin, itchy throat and ears, fatigue, soreness, achiness Took benadryl and napped. Later took tylenol and ibuprofen

Other Meds: Bupropion, fluoxetine, Spironolactone, Zyrtec OTC

Current Illness: None

ID: 1087766
Sex: F
Age: 16
State: NY

Vax Date: 01/14/2021
Onset Date: 01/14/2021
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: none listed

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Client received first dose of Moderna Vaccine. Consent signed by the client's father. Per manufacturer's guidelines, client was not eligible for the vaccine due to being under the age of 18. Dr notified Moderna and the Center for Disease Control and Prevention (CDC) of the incident. Parents were notified that the first dose that was given to the child was not in accordance with the CDC and manufacturer's guidelines. They were also informed that the CDC and Moderna were notified of the incident and that the CDC has allowed the second dose series to be administered to children 16 years and older in similar situations. The parent/guardian was given the option to return to the clinic at the scheduled interval and for their child to receive the second dose series to provide better protection against the COVID-19 infection.

Other Meds: none listed

Current Illness: none listed

ID: 1087767
Sex: F
Age: 35
State: PA

Vax Date: 02/19/2021
Onset Date: 03/07/2021
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: None

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

Symptoms: I had a low-grade fever, a painful arm, and fatigue within 24 hours of receiving the vaccine. On 3/7/2021, I felt this weird burning/sensitivity/tingling sensation around the trunk of my body. I also experience nervousness. On 3/10/2021 the area around my trunk started to have patches of bumpy red rashes.

Other Meds: None

Current Illness: None

ID: 1087768
Sex: F
Age: 64
State: OH

Vax Date: 03/06/2021
Onset Date: 03/07/2021
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: Janssen COVID-19 Vaccine EUA Injection site bruising, swelling, redness, burning General - headache, very very tired, bloating/puffiness, muscle aches, nausea, low grade fever, light dizziness Took ibuprofen and drank lots of water... cold compress on arm...rest when needed As of Wednesday morning, the reactions are lowering and slowing down. The site is still swollen some and bruised and red.

Other Meds: Duloxetine, D3, Sambucal, Loratadine, Senna S, Turmeric Curcumin, Probiotic

Current Illness: None

ID: 1087769
Sex: F
Age: 37
State: NJ

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

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

Symptoms: Here is my story. Part 1: I had my second Moderna vaccine on 2/16. 36 hours later I was laying In bed when I all of a sudden felt very strange- sort of faint - like I was going to pass out. Then I started feeling like my Body was going numb. We called 911. I was taken to the ER. What followed was about 15-20 ?neurological? episodes (every ten minutes or so) where my entire body from head to toe became paralyzed- I couldn?t move any of my limbs. I also had no sight. I was not blacked out Bc I could hear everything that was happening. It was also accompanied by extreme chest pain, numbness, contratcing of muscles in chest cavity that felt almost like a heart attack. Each individual episode lasted about 3-5 minutes and then slowly the paralysis would undo and I?d regain feeling. And then the full episodes would start over a few minutes later. This went on for a few hours repeatedly while in the ER. I was admitted for testing and monitoring for two days (EEG, EKG, MRI, Catscan) all clear. Once discharged I had lingering neurological symptoms but not the full paralysis episodes. Lingering symptoms included severe chest pain, numbness/weaknesses predominant on the left side as well as other random areas. I was very weak and tired. I started to improve very slowly - by day 10 post hospitalization I was starting to feel like things were turning the corner and maybe I was on my way to recovery. Part 2: I started to finally feel more improved from the lingering neurological issues and then all of a sudden around 5:30PM I was in the kitchen making dinner for my kids on 3/2 and the episodes started again. Called 911. Again, every ten minutes or so they came on (maybe 15-18 episodes) of complete paralysis- this time accompanied by seizure like rapid eye movement from side to side and fluttering of the eyes. I was readmitted to the hospital where the episodes repeated to happen again, maybe 15-20 times. I was admitted. They did a 24 hour video EEG which ?caught? the episodes on video and sound but did not appear negatively on the EEG in terms of abnormal brain activity. I?ve been released as they say there is nothing to do. I have lingering muscle weakness in my eyes- I can?t focus my eyeballs or ?track? on an eye exam and continued muscular chest pain. I also have a lot of PTSD from the trauma of the events.

Other Meds: Topamax, CBD pill, Xanax, Aimovig, Lo-Loestrin, Xyzal

Current Illness: none

ID: 1087771
Sex: F
Age: 51
State: WI

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: SYR
Vax Site: LA

Lab Data:

Allergies: Morphine, Cardec DM gold (reaction) Chlorine, Lactose, some metals, dust

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

Symptoms: After the vaccination, I felt a little dizzy waiting in the parking lot and had a sore arm, but felt fine otherwise. (12:00-1:00 pm) After returning home, I felt increasingly tired and warm. I laid down and took my temperature after walking the dog around 3:00 pm. My temperature read 99 degrees. I drank a lot of pedialyte to hydrate. Throughout the afternoon, I felt sluggish and the glands seemed to swell up on the side of my neck. I also got a headache. My temperature dropped down to 98.7 before I went to bed, but this morning, my glands under my jawline are a bit more swollen and I still have a slight temperature; 98.9 degrees. My eyelids are puffy and I feel a little feverish, but it is tolerable.

Other Meds: Multi--Vitamin, Omeprazole 20 mg 1 x/ day, Fluoxetine 10 mg 1x/per day.

Current Illness: Minor sinus issues

ID: 1087772
Sex: F
Age: 65
State: IL

Vax Date: 03/07/2021
Onset Date: 03/07/2021
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: Septra

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

Symptoms: My arm was throbbing with pain down into my hands. I could hardly lift my arm and could not sleep the first night. I had fever of 100.3, headache, rapid heart beat and joint pain throughout the night. Off and on, I iced my arm for hours. I finally took extra strength tylenol 23 hrs after the injection. It helped but my fever persisted until Tuesday, March 9th along with headache and arm pain. On the evening of March 9, i developed a huge red, warm rash all over my upper arm below the injection site. It is more than half way around my arm and about 3-4 inches long. I rubbed benedryl on it and took a Benedryl pill. It still appears on my arm and is warm and tender on the morning of March 11th.

Other Meds: Valsartan/hydrochlorthiazide Zinc Vitamin D Calcium

Current Illness: N/A

ID: 1087773
Sex: F
Age: 41
State: TX

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

Lab Data:

Allergies: penicillin (severe), chocolate (mild), latex (mild), amoxicillin (severe), oxycodone (moderate)

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

Symptoms: Within minutes after the vaccine I noticed my arm swollen and my fingers started swelling as well. It was moderate swelling though. the injection site swollen up and it was hard for me to breathe as well. Not sure if it was the shot itself or if I was just nervous, anxious about receiving the shot. I received the 1st dose on 01/13/21 and I was supposed to receive the second one on 02/10/21 and because I had a flare up on my face, my face swollen up around 01/21 - 01/24, and I found out that I had the infection on my gums and had to get the teeth extracted. It seems that after receiving the vaccine my overall health that is not at the best just got worse. I could not stand for a long period of time, it aggravated things that were already going on with my system. It affected my uterus, I already have bleeding issues but now I have very heavy periods since the vaccine. And they are lasting longer. I also had a lot of pain at the injection site and also a severe headache. I also am now battling 2 different kinds of yeast infection that are resistant to the meds given to me.

Other Meds: Centroid 300mcg, restasis, norethrodone acetate 5mg, diphenhydramine 50mg tab, dronabinol 5mg cap, viscosus mucosal solution, Tylenol extra strength 500mg tab, Celebrex 100mg, venlafaxine ER 150mg, lidocaine 5 topical patch, hydroxyzine HC

Current Illness: Infection of the sinus cavities due to erosion of the teeth from the medication (extraction of the tooth done at the ER)

ID: 1087774
Sex: M
Age: 69
State: VA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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: Poison Ivy Shellfish

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

Symptoms: Muscle Aches, Body aches, Lethargy, Headache, Lasted 24hours.

Other Meds: Various Vitamins

Current Illness: No

ID: 1087775
Sex: M
Age: 49
State: VA

Vax Date: 02/10/2021
Onset Date: 02/25/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 36 hours of flu like illness and then sudden onset of iritis.

Other Meds: None

Current Illness: None

ID: 1087776
Sex: F
Age: 30
State: PA

Vax Date: 03/04/2021
Onset Date: 03/05/2021
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: Red itchy circular rash around site of injection. 1-2 inches diameter. Resolved on own after ~2 days

Other Meds: multivitamin

Current Illness: none

ID: 1087777
Sex: M
Age: 59
State: LA

Vax Date: 03/05/2021
Onset Date: 03/06/2021
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: Iodine, Sulfa drugs, latex.

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

Symptoms: For many years, when I was younger, I must have had an over-active immune system, because I had those chronic red itchy rashes that wouldn't heal, on my knees, and elbows - the only places I got them. For years, though - many years - I have not had this. After my first injection of the Covid-19 shot I got a few patches - on my right side (knee and elbow) - the shot was on the left side. I am reporting this because I read that in a few countries only give ONE of these shots to people that have already had Covid-19 (I had the virus almost a year ago) - and was wondering if taking the 2nd shot (since this first one overstimulated my immune system a bit) was a good idea. Please email me about this concern.

Other Meds: Too a sinus pill earlier in the day, and an Aleve earlier in the day. Daily Testosterone gel in the morning.

Current Illness: none

ID: 1087778
Sex: F
Age: 67
State: LA

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Hazelnuts

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

Symptoms: Moderna COVID-19 Vaccine EUA Received vaccine at 9am. By 1pm extreme fatigue and pain in back of neck. Some muscle pain at site of vaccine. Then at 8pm high fever (99.5 - very high for me - I always record low temps.) Severe joint and muscle aches. Sweating. Couldn't sleep. Muscle weakness. Nausea, vomiting at about 2am. Severe pain at vaccination site. All continued until about 5am, when I finally slept for a couple of hours. Today, 10am on the 10th - pain at vaccine site, extreme fatigue and exhaustion. Just a terrible, terrible night.

Other Meds: Armor thyroid, multi-vitamin, calcium supplement, Omega fish oil

Current Illness: none

ID: 1087779
Sex: F
Age: 42
State: KY

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: After an hour I had the vaccine I started having fast heart palpitations and my chest started to compress. My blood pressure was 176/148 and I had to go to the ER.

Other Meds: None.

Current Illness: None

ID: 1087780
Sex: M
Age: 19
State: NY

Vax Date: 03/10/2021
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: NO

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

Symptoms: After receiving first dose and in the observation room, patient was feeling light headed and nauseated. Patient passed out briefly for 2-3 seconds and slumped in his chair. EMT was with the patient at all times. After syncopy episode, patient was alert and oriented. Patient was brought to tent in the supine position and was stable. Patient was still alert and oriented and given juice. Dr. looked patient over and determined to be vasovagal episode. Patient fine 20 minutes post episode. Patient was monitored until sister came to pick him up. Dr. recommended for patient get vaccine recumbrant in 3 wks for second dose.

Other Meds:

Current Illness:

ID: 1087781
Sex: F
Age: 61
State: WV

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin Sulfa Drugs

Symptom List: Injection site pain, Pain

Symptoms: Received vaccine at 2:15pm on Friday 3/5/21. At 7:15pm on Friday 3/5/21, began feeling slight throat tightness then Tingling sensation in Lips, Numb Nose, Rapid and Heavy Pounding Heartbeat, Tingling in front half of Tongue. Went outside to take breaths of cool air twice and then took 2 Bayer aspirin. Event lasted for about 30 minutes. After the issues passed, continued to have slight tingling in tongue and metallic taste in mouth until Tuesday morning 3/10/21.

Other Meds: Multi-Vitamin Vitamin D supplement Emergen-C supplement

Current Illness: None

ID: 1087782
Sex: F
Age: 68
State: NC

Vax Date: 02/02/2021
Onset Date: 02/02/2021
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:

Symptom List: Injection site pain, Menorrhagia

Symptoms: N/A

Other Meds:

Current Illness:

ID: 1087783
Sex: F
Age: 73
State: ND

Vax Date: 02/17/2021
Onset Date: 02/19/2021
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: sulfa drugs, penicillin, Crestor

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

Symptoms: Tightness of chest and short of breath. Lasted 3 days and then got better as time went on

Other Meds: clindamycin, clobetasol propionate, dilTIAZem, Eliquis, levothyroxine pravastatin, sotalol

Current Illness: none

ID: 1087784
Sex: M
Age: 57
State: GA

Vax Date: 02/23/2021
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: LA

Lab Data:

Allergies: NONE

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: ITCHY RASH /BUMPS ALL OVER BODY LASTING AT LEAST 2-3 DAYS FINGERS AND HAND SWOLLEN BURNING SENSATION ON CHEST DECLINED ANY DETERGENT OR SOAP CHANGES OR ANY CONTACT WITH OUTSIDE ALLERGENS/IRRITANTS

Other Meds: NONE

Current Illness: NONE

ID: 1087785
Sex: F
Age: 66
State: MI

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

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

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient had an allergic reaction. Onsite EMS was called vitals BP 130/76 HR 56 100% O2. Patient was treated and released against medical advise.

Other Meds: Diphenhydramine

Current Illness:

ID: 1087786
Sex: F
Age: 67
State: IA

Vax Date: 03/03/2021
Onset Date: 03/05/2021
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: Amlodipine, Cephalexin,Lisinopril, Losarten

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

Symptoms: Left arm pain itching, redness and swelling approx. 6cm/3cm.

Other Meds:

Current Illness: None

ID: 1087787
Sex: F
Age: 63
State: NY

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: I am allergic to sulpha drugs.

Symptom List: Nausea

Symptoms: I had a fever, fatigue and a headache. I became lightheaded and I became tachycardic with a heart rate of 140. I spoke with my PCP. I rested and she prescribed for me a beta blocker to lower my heart rate. Which was effective.

Other Meds: I take several medications. I take levothyroxin, omeprazole, triamterene.

Current Illness: No

ID: 1087788
Sex: M
Age: 76
State: IN

Vax Date: 02/12/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

Symptom List: Injection site pain

Symptoms: Chills, fever 100.7, total body pain

Other Meds: Omeprazole 20mg daily Finasteride 5mg 2 times per week Latanoprost .005 1 drop each eye daily Vitamins: zinc, potassium, magnesium, D3, B12

Current Illness: None

ID: 1087789
Sex: F
Age: 36
State: PA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
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: NKDA

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

Symptoms: Felt warm/flushed after vaccine. HR 128/68, HR 90. Given water. Reports having similar reaction with other vaccines - assumes anxiety related per patient. felt better and released after 30 minute observation.

Other Meds: unknown

Current Illness: unknown

ID: 1087791
Sex: F
Age: 55
State: SC

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: IM
Vax Site: RA

Lab Data:

Allergies: sulfa, Microzide, some penecillin related drugs but not Keflex

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

Symptoms: Fever, chills, nausea, headache

Other Meds: Lisinopril 20 mg

Current Illness: none

ID: 1087792
Sex: F
Age: 30
State: TX

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Night sweats, headache, fatigue. Fast and elevated heart rate beginning on 3/9/2021 and continuing on 3/10/2021.

Other Meds: Birth control pills

Current Illness: None

ID: 1087793
Sex: M
Age: 52
State: MD

Vax Date: 01/14/2021
Onset Date: 01/18/2021
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: Erythema, Pruritus

Symptoms: Rash on Right Elbow that spread to legs . Continue to have out breaks of spots that look like chicken pox's on approximately 50% of body with rash or scaly like skin that resemble shingles. Development of elbow looks like "Covid Arm" . I was treated it with Neosporin Visits to PCP 2/16/2021 for unrelated issue was given clindamycin, had severe reaction. Completed antibiotic as prescribed was then given oral steroid for reaction. Returned to PCP 3/2/2021 was given topical steroid, spots continue to spread, revisited 3/9/2021, prescribed topical steroid and oral steroid and advised to report as possible adverse events. Elbow rash stated after 1st dose give 1/14/2021. Spread of spots and rash continued and progressed throughout my body after the 2nd shot given 2/11/2021 along with stiffness of arm and shoulder where shots were given.

Other Meds: Vitamin C and Vitamin D

Current Illness: None

ID: 1087794
Sex: M
Age: 61
State: FL

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

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

Lab Data:

Allergies:

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

Symptoms: RLQ abdominal pain; less intense now than when it began but it still persists. We recommend that they be evaluated in an ER because this a/e is not common with the vaccine and there is need to rule out other causes of patient's symptoms such as appendicitis or other abdominal emergencies. Pt went to see doctor today as we rec'd and MD thinks is gallstones and patient will be having an ultrasound tomorrow.

Other Meds: metoprolol 25 mg hctz 12.5 fenofibrate 160 mg; lovastatin 20 mg. losartan 50 mg.

Current Illness:

ID: 1087795
Sex: F
Age: 69
State: ND

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

Lab Data:

Allergies: Cipro

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

Symptoms: Patient states that her legs and hips are extremely sore. She states that when standing, her legs feel like they are going to give out. Her joints in her hips hurt a lot. She states that it woke her up from a sound sleep. It hurts the most when lying down. She states that when on her feet it is a little better. It has been very bad every night, but each day it is a little better

Other Meds: Levothyroxine, Oxycode, Cymbalta, Aciphex, Pepcid, Macrobid, Oxycontin

Current Illness:

ID: 1087796
Sex: F
Age: 46
State: TX

Vax Date: 03/01/2021
Onset Date: 03/07/2021
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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Covid arm, redness of about 2 in in diameter,,inflammation, lots of itching

Other Meds: Vit C, Vit D, omega, Metformin 500 mg, Mylan birth control pills, Miralax

Current Illness: None

ID: 1087797
Sex: F
Age: 31
State: NJ

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: i have experienced head ache, fatigue, fever of 101.2, body ache for 24 hours now , i have been taking Tylenol for the past 24 hours but i cant brake the fever

Other Meds: chlorthalidone 25 mg

Current Illness:

ID: 1087798
Sex: M
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: 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: Fatigue, body ache, chills, headache. Chills starting Monday night/Tue morning while trying to sleep. Restless through night, then very tired Tue. Took Tue off from work and spent at home. All largely better by Tues evening. Wed morning, left arm still tender at injection site, but nothing serious.

Other Meds: Fluoxetine 10mg, loratadine 10mg, melatonin 5mg

Current Illness: none

ID: 1087799
Sex: F
Age: 71
State: IN

Vax Date: 02/26/2021
Onset Date: 02/27/2021
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: Compazine

Symptom List: Pain in extremity

Symptoms: Sore arm, big red bump, sore to touch, lasted one week. Headache started next day, lasted 2 days

Other Meds: Metformin, atorvastatin, Quinapril, multivitamins

Current Illness:

ID: 1087800
Sex: M
Age: 52
State: TX

Vax Date: 03/10/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Patient reports light pressure on his throat; no shortness of breath, nor flushing. The patient refused transport to hospital. EKG and Blood Pressure was performed and cleared by EMS. Blood Pressure read 156/98 Heart Rate 106 Oxygen level 97

Other Meds:

Current Illness:

ID: 1087801
Sex: F
Age: 33
State: UT

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: None known

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

Symptoms: The day following my second dose of the vaccine gave me severe body aches, chills and a massive headache. The 2nd day after the dose the body aches were gone but still had chills and headache and felt weak and short of breath. 3rd day after dose back to normal.

Other Meds: Adderall, lexapro, metformin, levothyroxine

Current Illness: None

ID: 1087802
Sex: F
Age: 61
State: ME

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

Lab Data:

Allergies: N/A

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

Symptoms: HEADACHE, CHILLS,BODY ACHES, NAUSEA, FATIGUE

Other Meds: N/A

Current Illness: NONE

ID: 1087803
Sex: F
Age: 83
State: IA

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

Lab Data:

Allergies: Gluten, Lactose, Mold, Penicillin, Sulfa

Symptom List: Vomiting

Symptoms: Pt. reports waking around 6am on Saturday, March 6th with a temperature, headache, body aches and nausea. She reports that this lasted all day on Sunday, March 7th as well. Woke Monday, March 8th and Tuesday March 9th fatigued and rested or slept most of the day. Pt. was advised that she could use Tylenol for fever and generalized achiness. Pt. woke today, Wednesday, March 10th with no symptoms and felt "like her normal self".

Other Meds: Aspirin 81mg, Biotin 5000mcg, Vitamin B12, Allergra, Flonase 50mcg, HCTZ 25mg, Xyzal 5mg, Multivitamin, Pantoprazole 40mg

Current Illness: None

ID: 1087804
Sex: M
Age: 37
State:

Vax Date: 03/10/2021
Onset Date: 03/10/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: patient received 1st Covid 19 vaccine, seated in observation and began to feel like he was going to pass out, and dizzy, He was diaphoretic. VS taken . BP- 140/75, P- 92, O2- 100%, T- 99.1, water offered and patient is drinking, He is arousable, alert and oriented X4, BP rechecked @ 1002, BP sitting- 124/79, P- 79, O2 100%, standing BP at 1004 111/79. P-78. He reports that he has a history of passing out with medical procedures, he reports no further issues with dizziness and diaphoresis , he was monitor for 40 minutes.

Other Meds:

Current Illness:

ID: 1087805
Sex: F
Age: 16
State: NY

Vax Date: 02/11/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

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

Symptoms: Client arrived to receive second dose of Moderna vaccine. Consent signed by the client's father. Client not eligible for the vaccine due to under age 18. Second dose of vaccine NOT administered due to ineligibility. Per manufacturer's guidelines, client was not eligible for the vaccine due to being under the age of 18. Dr. notified Moderna and the Center for Disease Control and Prevention (CDC) of the incident. Parents were notified that the first dose that was given to the child was not in accordance with the CDC and manufacturer's guidelines. They were also informed that the CDC and Moderna were notified of the incident and that the CDC has allowed the second dose series to be administered to children 16 years and older in similar situations. The parent/guardian was given the option to return to the clinic at the scheduled interval and for their child to receive the second dose series to provide better protection against the COVID-19 infection.

Other Meds: none listed

Current Illness: none

ID: 1087806
Sex: M
Age: 48
State: OK

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: Penicillan

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Within 30 minutes post vaccine administration, patient started having seizure like symptoms (Altered mental status, clenched jaw, non-verbal, right sided headache) - V/S WNL, Ambulance called and patient was taken to ED for evaluation. Responsive during transport to ED. Patient reported back to baseline after 1.5 hours.

Other Meds: Keppra, Xarelto, Atorvastatin

Current Illness: None stated

ID: 1087807
Sex: F
Age:
State: FL

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: RA

Lab Data:

Allergies:

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

Symptoms: received the vaccination at 0900 and has since developed bluing of the fingertips, chills, fever of 101 and tingling of the fingers. She has taken 2 Tylenol for her fever. Advised would recommend eval to HCF for symptoms. They will go to Medical Center. Followed up with caller who adv that they went to the ED. She was evaluated and discharged home.

Other Meds:

Current Illness:

ID: 1087808
Sex: M
Age: 77
State: MD

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

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

Symptoms: Chronic constipation, since receiving the first dose of the vaccination. My doctor has no explanation for it.

Other Meds: Prescription: Lovastatin, 20 mg/half pill/day. Over-the counter: Multi-Vitamin, Vitamin D, Super B Complex, Triple Flex, Fish Oil, Vitamin C, Lutein, Probiotic, one low dose Aspirin.

Current Illness: None, except bowel movement while regular could produce stringy or lumpy stool at times, as well as regular stool. Very occasional constipation.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm