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: 1088842
Sex: M
Age: 77
State: CA

Vax Date: 02/14/2021
Onset Date: 02/17/2021
Rec V Date: 03/10/2021
Hospital: Y

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: The patient is a 77-year-old male with T2DM (not on medications), gout, and HTN who received the first dose of the Pfizer COVID-19 vaccine on 2/14. On 2/17 (three days after vaccination), he sought care in the emergency department for chest pain that worsened when he was supine and shortness of breath. EKG in the emergency room showed STEMI and troponin levels were normal. He was transferred to a different facility for cardiac catheterization. Cath showed mild circumflex disease and a stent was placed. He was diagnosed with pericarditis at that time (elevated inflammatory markers ESR/CRP). He was discharged home post cath on Plavix/ASA. He had an echocardiogram at his PCP?s office on 2/25, results still pending (as of 3/10). 2/25 ? televist with cardiologist who concurred with pericarditis, maybe mild coronary artery disease (follow-up scheduled 3/11). 3/3 chest pain symptom improved further, no cough, improved shortness of breath. Medications at home: statin, previously colchine for gout, likely BP medication (PCP will send records) Allergies: None known. Vaccine Indication: Age >75

Other Meds:

Current Illness:

ID: 1088843
Sex: F
Age: 51
State: GA

Vax Date: 03/02/2021
Onset Date: 03/03/2021
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: Penicillin, sulpha, erythromycin

Symptom List: Anxiety, Dyspnoea

Symptoms: Sore arm for a couple of days, fatigue for a couple of days, low grade fever ongoing (under 100) and this is day 8. Fever was 99.4 yesterday and 99.2 when taken today. Still a bit more tired than normal as well.

Other Meds: Multi-vitamin, Junel, Amlodipine 5mg, Hydrochlorothiazide 12.5 mg,, omeprazole, psyllium husk

Current Illness: None

ID: 1088844
Sex: M
Age: 51
State: FL

Vax Date: 03/07/2021
Onset Date: 03/07/2021
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: Seafood, Iodine

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

Symptoms: Injection site: pain, redness of the skin and swelling. In general: headache, feeling very tired, muscle aches, fever and chills. Duration: approx. 24 hrs

Other Meds: None

Current Illness: None

ID: 1088845
Sex: M
Age: 75
State: CO

Vax Date: 02/25/2021
Onset Date: 03/02/2021
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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Very tried and very dizzy. My mind went blank. I could not spell my name.

Other Meds: Ofev, Levothyroxine sodium, Simvastatin, Fluorometholone,

Current Illness:

ID: 1088846
Sex: F
Age: 23
State: TX

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Patient had vomiting after COVID vaccine was given.

Other Meds: None

Current Illness: None

ID: 1088847
Sex: F
Age: 47
State: NJ

Vax Date: 02/05/2021
Onset Date: 02/06/2021
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: No

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

Symptoms: Around 2pm on Saturday I felt warm, flu like symptoms while at work . I left work went home started exp chills slept for 6 hrs, no appetite. I woke up Sunday still running low grade fever, sweats and really drained. Also my lymph node left side exp swelling went to PCP was told could be the protein.

Other Meds: Ativan

Current Illness: Anxiety

ID: 1088848
Sex: F
Age: 33
State: MO

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

Lab Data:

Allergies: UNKNOWN

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: PATIENT FELT NAUSEAUS, WAS SWEATING, FELT DIZZY AND HOT, AND ALSO THIRSTY APPROXIMATELY 5 MINUTES AFTER ADMINISTRATION OF VACCINE. PATIENT WAS GIVEN 25MG OF DIPHENHYDRAMINE BY MOUTH APPROXIMATELY 10 MINUTES AFTER ADMINISTRATION OF VACCINE, AND COLD WATER TO SIP. PATIENT'S SYMPTOMS IMPROVED WITHIN 5 MINUTES AND CONTINUED TO IMPROVE OVER THE COURSE OF A 30 MINUTE OBSERVATION PERIOD.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1088849
Sex: M
Age: 57
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Around 5 pm patient got his first dose of the Moderna Covid-19 vaccine, and after 5 mins,he passed out while he was sitting in the observation area,his wife was with him, once that incident had been noticed, I ran quickly to him but when I reached him he started to wake up again, I brought the emergency kit , a bottle of water, also I asked pharmacy tech to call store manager to come over. I asked patient what happened and he stated that suddenly he felt dizzy and that he was anxious about the vaccine from the beginning and excited to get it at the same time, then I measured the blood pressure it was 125/61 with pulse of 45/min.I offered him and his wife to call 911 but they declined it. I asked him to go back to my consultation area so he could lie down on the floor and raise his legs up so we can bring back the blood pressure up, he did that, and he went with me over there and laid down on the floor and we raised his legs up,later I measured his blood pressure again, and it was 113/71 with pulse 51/minute, I offered again to call 911 but he refused and he said that he was feeling better. I left him about 10 more minutes,then he started to get up and sit by the chair and I re-measured the blood pressure and it was 121/76 with pulse of 54/minute, he started to drink water. He stated he felt better than he was about 20 minutes ago, then they left once their driver came to pick them up.

Other Meds:

Current Illness:

ID: 1088850
Sex: M
Age: 82
State: NJ

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Quarter size raised welt immediately after injection applied instant ice pak while still at pharmacy after 15 minutes welt reduced in size. Spoke to patient 3 hours later to follow up and he said no pain or welt in injection area

Other Meds: aspirin, alphagan, multi-vitamin

Current Illness: none

ID: 1088851
Sex: F
Age: 70
State:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient complained of a shingles flare the day after receiving vaccine and also described intensification of chronic pain, above and beyond normal, for the two days since her vaccine.

Other Meds:

Current Illness:

ID: 1088852
Sex: F
Age: 65
State: MO

Vax Date: 03/04/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Received 2nd Moderna shot on Thu 3/4 and on Saturday 3/6 had raised red rash on my right arm where I got the shot with extreme itching from around the shot site to about 3 inches above elbow covering the width of my front upper arm plus extremely sore arm. Also extremely achy on my right side, shoulder blade all the way down my back which lasted till Tues 3/9.. Some dizziness and occasional nausea feeling through Sunday 3/7 . It's March 10th, 6 days after and the red rash mark is still there though lighter in color and not raised with just light itchiness. No other side effects now.

Other Meds: Lisinopril HCTZ 10/12.5 mg Lisinopril 10mg Zyrtec Eliquis Montelukast Flonase Protonix

Current Illness:

ID: 1088853
Sex: F
Age: 59
State: IN

Vax Date: 03/01/2021
Onset Date: 03/02/2021
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: Sulfa Drugs and Neomycin

Symptom List: Rash, Urticaria

Symptoms: Lymph node swelling in left armpit

Other Meds: Levothyroxine Doxcycline

Current Illness: None

ID: 1088854
Sex: M
Age: 57
State:

Vax Date: 01/20/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: Patient tested positive for covid 19 6 days after vaccination.

Other Meds:

Current Illness:

ID: 1088855
Sex: F
Age: 50
State: NY

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Hydromorphone, Sulfa, Amoxicillin, Gluten

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

Symptoms: Patient reported to nurse that she was starting to develop hives. Upon inspection patient was seen to have red blotchy hives on her neck and chest. She reported that it felt hot but not itchy.

Other Meds: Fluoxetine 10mg, Nortriptyline 10mg

Current Illness: IBS, anxiety

ID: 1088856
Sex: M
Age: 65
State: NC

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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: Sulfa drugs

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

Symptoms: Extreme dizziness, chills, headaches, nausea, tiredness, injection sight pain.

Other Meds: Trulicity, Precobix, Emtriva, Edurant, Tizanidine HCL, Diphenoxylate, Zolpidem, Gabapentin, Centirize, Duloxetine, Clonidine, Gemfibrozil, Bupropion, Montelukast, Carvedilol, Hydrochorothiazide, Invokana, Complera, androgel

Current Illness: None

ID: 1088857
Sex: F
Age: 53
State: AZ

Vax Date: 01/12/2021
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: no

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

Symptoms: The next day, the lymph node on the left side on my underarm was swollen/enlarged. I felt feverish. I went to the Dr and she ordered an ultrasound and an mammogram but I didn't get it because I heard on news that they advised to wait until the swelling had a chance to go down before getting an ultrasound and mammogram. The swelling went down after a week. It was so swollen I couldn't put my arm down. I will get my tests done for six weeks.

Other Meds: cholesterol pills

Current Illness: no

ID: 1088859
Sex: F
Age: 54
State: OH

Vax Date: 03/01/2021
Onset Date: 03/07/2021
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: Cephalosporins, Codeine Demerol Macrolides Penicillins Morphine

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

Symptoms: Swelling in arm she received vaccine in, pain, red, itching

Other Meds: None

Current Illness: None

ID: 1088860
Sex: F
Age: 46
State: IL

Vax Date: 02/21/2021
Onset Date: 02/21/2021
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: NSAIDS

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Within 10 minutes I got very dizzy and nausea and vomiting which lasted over 12 hours. Also racing heart rate then episodes of chills and sweating. The next day I had a hard time holding my tooth brush, pain and swelling to both hands and severe pain in left foot. When I get up from sitting position to walking it feels like my bones in my left foot will shatter. The pain is very bad even in bed when I?m not moving.

Other Meds: Metoprolol

Current Illness: None

ID: 1088861
Sex: F
Age: 57
State: IN

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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: High fever, body aches, headaches, chills, uncontrollable shaking, stiff joints, tired

Other Meds: None

Current Illness: None

ID: 1088862
Sex: M
Age: 71
State: UT

Vax Date: 03/02/2021
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: only Sulfa antiobiotics

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

Symptoms: Minor tenderness on chest, about two inches below the left end of the left clavicle. A distinct small lump, tender to the touch, is felt just under the skin.

Other Meds: Allopurinol, aspirin, Finasteride, Tamsulosin, Gundry gut heal

Current Illness: none

ID: 1088863
Sex: F
Age: 32
State: MO

Vax Date: 03/02/2021
Onset Date: 03/07/2021
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: Iodine, Salicylic Acid

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

Symptoms: Painful swollen lymph nodes in right neck/shoulder

Other Meds: Tylenol

Current Illness: None

ID: 1088864
Sex: F
Age: 76
State: IN

Vax Date: 03/04/2021
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: Ciprofloxacin, sulpha drugs, macrobid

Symptom List: Unevaluable event

Symptoms: Total weakness. Could not get out of bed without being lifted. After getting up was able to walk with assistance. No appetite or thirst. Could not stay awake. Slept most of a 36 hour period. No treatment given. After that was tired for another 2 days but able to maintain a schedule.

Other Meds: Zyrtec, b12 vitamin, calcium chew

Current Illness: None

ID: 1088865
Sex: F
Age: 73
State: MI

Vax Date: 03/06/2021
Onset Date: 03/06/2021
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: unknown

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

Symptoms: Photo was emailed to director showing a 2.5" area in diameter of redness just below the puncture site which was clear on the picture. A bandaid residue was also noted around the puncture site. In the picture it appears the injection was given distal and slightly medial to the deltoid muscle into the biceps brachii muscle.

Other Meds: unknown

Current Illness: unknown

ID: 1088866
Sex: F
Age: 74
State: OR

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Moderna shot 1. Feb 8, 2021 Severe headaches and slight sore arm Moderna shot 2, Mar 8, 2021 Headaches within a few hours of the shot, next day around noon headache, nausea, light headed, then turned into body aches and felt feverish.. Flu like symptoms until apx midnight. Very large rash about 5? wide and 10? long around and below injection site. Day 3. No more side effects. I did not notify my doctor.

Other Meds: Alprozalam, Benadryl, Advil

Current Illness: None

ID: 1088867
Sex: M
Age: 38
State:

Vax Date: 01/18/2021
Onset Date: 01/27/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient positive for covid 19 9 days post vaccination.

Other Meds:

Current Illness:

ID: 1088868
Sex: F
Age: 39
State: VA

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: SYR
Vax Site: LA

Lab Data:

Allergies: NKDA

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

Symptoms: 24 hours after vaccination patient complains of arthralgias, fatigue, headache. 36 hours after vaccination complained of macular rash on the left breast above the areola. Seen in clinic on March 10, macular confluent erythema 9 x 5 cm, no induration, no pruritis, mild swelling, c/ pain in left axillary area. No nipple discharge. Afebrile. No adenopathy. BP 121/78, pulse 72, Resp. 17, T 36.1 C, Sat 91%. z

Other Meds: none

Current Illness: none

ID: 1088869
Sex: M
Age: 43
State: NY

Vax Date: 03/02/2021
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: LA

Lab Data:

Allergies: Ibuprofen

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Headache in back/right of head began on 3/5/2021, on 3/7/21 began experiencing facial paralysis in lips which progressed to the rest of right side of face. Went to Emergency Department that evening. CT scan was "unremarkable" and blood work was normal. Was diagnosed with Bells Palsy. Prescribed Valtrex and Prednisone. 3/10/2021 still experiencing partial facial paralysis and headache in same location.

Other Meds: hydrochlorothiazide

Current Illness: No

ID: 1088870
Sex: F
Age: 54
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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Approx 8 hours after the shot, 12:30am, I started to have chills. The chills prevented me from sleeping well. Also when I laid down for the night, I was accutely aware of my heartbeat, which according to my smartwatch was beating at a rate of 71. The next morning, I still was experiencing chills, and felt achy/stiff/sore muscles - possibly from tensing up and shivering all night. Pain at the injection shot also started the morning after the shot. By bedtime the day after the shot, the symptoms had eased up. The next morning the symptoms were gone, except for a little residual injection site discomfort.

Other Meds: RX: Levothyroxine 88mg, Progesterone E4M 75mg, BI-Est/DHEA/Test (Hormonal Cream), Rededronate Sod Dr 35mg Supplements: Omegas, Pro Nrg (Multi-Vitamin), Magnesium Citrate, Osteo Plus, Probiotic 100, Vit D3/K2, Glutathione, GI Detox, GABA

Current Illness: None

ID: 1088871
Sex: M
Age: 68
State: IN

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: RA

Lab Data:

Allergies: No allergies reported

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

Symptoms: The patient was here for his second Moderna vaccination and the administering pharmacist mistakenly gave a Pfizer vaccination.

Other Meds: Unknown

Current Illness: Unknown

ID: 1088872
Sex: F
Age: 41
State: KS

Vax Date: 02/26/2021
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: RA

Lab Data:

Allergies: dog hair, seasonal allergies, sensitivity to dairy

Symptom List: Nausea

Symptoms: I was 32 minutes past receiving the vaccine when my face felt hot. I looked in the mirror and saw that it was. After about thirty more seconds I had trouble breathing and eventually could barely breathe. My face was puffy and my eyes started to close. I received IV Benadryl and two other medications which I can't remember.

Other Meds: Prozac, Vyvanse

Current Illness: None.

ID: 1088873
Sex: F
Age: 67
State: NC

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

Symptom List: Injection site pain

Symptoms: Vaccine was at room temperature for>6 hours at time of administration.

Other Meds:

Current Illness:

ID: 1088874
Sex: F
Age: 64
State: FL

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: IM
Vax Site: LA

Lab Data:

Allergies: No

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

Symptoms: One week after 1st shot arm was sore and developed a red rash around the injection area was better within 2 days After 2nd shot developed fever up to 101.3. Bad headache, body aches, chills, arm sore sore under the arms and fatigued. This started about 12 hours after shot. Then about 36 hours after shot red rash appeared at site of second shot. It is still red and sore 48 hours after shot.

Other Meds: Bystolic Amlodipine Vit D Vit C Magnesium Fish oil Probiotics Multi vitamin

Current Illness: None

ID: 1088875
Sex: F
Age: 35
State: IL

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: Soy, shrimp

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

Symptoms: Nausea beginning 6pm yesterday, a few hours later diarrhea and vomiting. Throughout night consistent diarrhea, chills, and body aches. Woke up with fever of 100.9 (normal temp 97.6). Finally able to keep water down this morning and eat plain rice. Still have fever, headache, and chills.

Other Meds: Sertraline, bupropion

Current Illness: None

ID: 1088876
Sex: F
Age: 68
State: NJ

Vax Date: 02/17/2021
Onset Date: 02/18/2021
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: 11 hrs after shot I had a very bad case of diarrhea. A day later my left arm muscle was very sore (not the injection site, the whole upper arm muscle). Three weeks after the shot, my arm is still very sore and I can hardly use my left arm. It's very painful to get dressed, take off a jacket, shirt, etc. I can hardly use the left arm to hold anything due to the pain in the muscle.

Other Meds: Lisinopril 30mg

Current Illness: None

ID: 1088877
Sex: F
Age: 67
State: NC

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

Symptom List: Erythema, Pruritus

Symptoms: Vaccine was at room temperature for>6 hours at time of administration.

Other Meds:

Current Illness:

ID: 1088878
Sex: F
Age: 31
State:

Vax Date: 02/08/2021
Onset Date: 02/12/2021
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: Patient positive for covid 19 4 days after vaccination.

Other Meds:

Current Illness:

ID: 1088879
Sex: F
Age: 57
State: IL

Vax Date: 02/12/2021
Onset Date: 02/13/2021
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: Unknown

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

Symptoms: Pt developed large blister around shot (about 12 inches in diameter)

Other Meds: Unknown

Current Illness: Unknown

ID: 1088880
Sex: M
Age: 63
State: IL

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: wife's report "He said he was nauseated all night. at 5am this morning (3/10) he was vomiting and said his stomach felt bloated like it 'needed to pop'. He had a 100.8 temp this am, back pain. he took tylenol at 12:30p and now his temp is at 100."

Other Meds:

Current Illness:

ID: 1088881
Sex: M
Age: 19
State: UT

Vax Date: 03/04/2021
Onset Date: 03/06/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Adhesive bandages Intolerance (diarrhea only) with amoxicillin and clindamycin

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

Symptoms: 19 yo medically complex M with prior COVID infection in Dec 2020 who received first dose of the Moderna COVID vaccine on 3/4 as well as Epo shot (for chronic anemia secondary to CKD). Recently admitted for MRSA sacral abscess and had recently been discharged to complete treatment on oral Bactrim. On 3/6, developed worsening diarrhea, decreased urine output, facial and tongue swelling, and altered mental status. EMS was called and patient was brought to the ED. Upon presentation, noted to have hypotension and was fluid resuscitated. Initial blood gas with hypercarbia, and he was intubated for airway protection. CXR was non-focal. He was started on empiric vancomycin and ceftriaxone, although these were discontinued with negative blood and urine cultures. Repeat respiratory film array was negative. Patient intubated 3/6-3/10.

Other Meds: acetaminophen 160 mg/5 mL oral suspension, 640 mg= 20 mL, Oral, every 4 hr, 3 refills, acetylcysteine (NAC) 10% inhalation solution, 0.6 g= 6 mL, Nebulized Inhalation, BID, 1 refills, albuterol 90 mcg/inh aerosol inhaler, 4 puffs, Inha

Current Illness: MRSA sacral soft tissue abscess > s/p surgical I&D 2/25 > MRI with contrast 2/25 without evidence of deeper osteomyelitis > s/p vancomycin 2/24-2/28, Bactrim 2/28-3/9 Recent treatment for aspiration pneumonia > Completed ABX on 1/29 Recent steroid exposure with h/o prior adrenal insufficiency, not currently on steroids

ID: 1088882
Sex: F
Age: 67
State: PA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
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: Violent entire body chills approximately 12 hrs after vaccine. Chills lasted an hour with 3 blankets and heating pad. Then switched to fever for next 8 hours. Fever recorded 102 the only time I checked. Nausea, body aches, plugged nose making it slightly difficult to breathe, headache, and exhaustion. Unable to sleep through the night due to fever, aches, and breathIng discomfort. Slept off and on all following day. Able to eat minimally at dinner next day. Strong taste of food, ie chicken soup seemed way strong. Third day tired but appetite slightly returning and other side effects seem subsided.

Other Meds: Airborn

Current Illness: None

ID: 1088883
Sex: F
Age: 48
State: CA

Vax Date: 02/17/2021
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: Bee Venom

Symptom List: Pain in extremity

Symptoms: On 3/4/2021 developed fatigue, headache and back ache around 10am. By 2pm had developed chills and severe body aches. By 8pm, had also developed severe chills, sweating, body aches and fever of 100. by 3/5/2021 at 10am, all symptoms had resolved. on 3/6/21, I woke up with a pulse rate of 148 and hives on my arms. Went to Urgent care, where EKG showed no issues. on 3/6/21 at 12pm, I developed an adema on my chin which was hot, red, swollen and painful. At 5pm, my bottom lip began to swell and I returned to Urgent Care. Diagnosed with an Angioedema and provided steroids. My throat, face, eyes, lips and mouth swelled and it was difficult to talk and breath. The swelling continued off and on thru 3/9/21. On 3/9/21 I began to develop a sinus infection and phlemb began to cause me to cough.

Other Meds: Tramadol, Vitamin D3, Vitamin B-12, Potassium Gluconate, Amlodipine Besy-Benazepril, Lansoprazole

Current Illness: None

ID: 1088884
Sex: F
Age: 74
State: KS

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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: Progress Notes APRN (Nurse Practitioner) Family Medicine Cosigned by: MD at 3/4/2021, 8:45 AM Expand All Collapse All COVID VACCINE CLINIC 3/3/2021 Patient Date: 3/3/2021 Subjective Patient is a 74 y.o. female who was seen at COVID Vaccine Clinic today for her first dose of the COVID 19 vaccination. She was given the Pfizer vaccination in the right deltoid muscle. During her 15 minute waiting period after the injection, the patient began to experience diaphoresis. She denied rash, hives, difficulty breathing, difficulty swallowing, wheezing, throat tightness, hoarseness, stridor, itching, lightheadedness, dizziness, facial swelling, lip swelling and tongue swelling. This provider was notified of patient reaction and she was then assessed in the emergency bay area. Monitored patient for severe reaction symptoms, including but not limited to blood pressure abnormality , collapse, drooling, hypotension, rapid progression of symptoms, respiratory distress, skin changes and tongue swelling. Past Medical History: Diagnosis Date ? Allergy all year ? Anxiety ? Arthritis ? Asthma exercise induced ? Calculus of gallbladder without mention of cholecystitis or obstruction Cholelithiasis; ? Diabetes mellitus ? Diabetes mellitus, type 2; ? Diverticulosis of colon (without mention of hemorrhage) Diverticulosis without Hemorrhage ? Esophageal reflux GERD; ? Hearing loss ? Hypertension ? Irritable bowel syndrome Irritable Bowel Syndrome ? Past Hospitalization Diagnosis: Chest Pain, atypical; at: Health Center; Approximate Date: 18000101; ? Nextgen Comments Palpitations/SVT; Anxiety disorder; HRT; Microscopic hematuria ? Osteoarthrosis, unspecified whether generalized or localized, unspecified site Osteoarthritis; ? Other and unspecified hyperlipidemia Hyperlipidemia, Pure; ? Pancreatitis ? PONV (postoperative nausea and vomiting) ? Type II or unspecified type diabetes mellitus without mention of complication, not stated as uncontrolled; DM type II w/o comp; ? Unspecified essential hypertension Hypertension ? Unspecified hemorrhoids without mention of complication Hemorrhoids; ? Unspecified tinnitus ALLERGY REVIEW OF SYSTEMS: Patient complains of headaches (frontal, reports from using her hearing aids and is loud in the expo center. Present prior to vaccine today. ). Patient denies chills, fever and malaise/fatigue; Previous Reactions: none Pt reports she last ate around 10 am. She declines any food/snacks from bay today. Objective Vitals Vitals: 03/03/21 1355 BP: (!) 115/99 Pulse: 73 Resp: 16 SpO2: 97% Blood Sugar 134 collected at 1354 Physical Exam Constitutional: General: She is not in acute distress. Appearance: Normal appearance. She is well-developed. She is not diaphoretic (no visual diaphoresis. ) HENT: Mouth/Throat: Mouth: Mucous membranes are moist. Pharynx: Oropharynx is clear. Eyes: Extraocular Movements: Extraocular movements intact. Conjunctiva/sclera: Conjunctivae normal. Pupils: Pupils are equal, round, and reactive to light. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Pulses: Normal pulses. Heart sounds: Normal heart sounds. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No wheezing. Skin: General: Skin is warm and dry. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Gait: Gait normal. Psychiatric: Mood and Affect: Mood normal. Behavior: Behavior normal. Thought Content: Thought content normal. Judgment: Judgment normal. Assessment/Plan Treatment included: water Follow up response to treatment: excellent. Patient discharge: Stable to go home and follow up with PCP. Differential Diagnosis: Red flag symptoms (CP, SOB, NVD, Visual/Neuro concerns) Flushed sensation Pt observed for 15 minutes. t Symptoms resolved. BG good and pt able to ambulate w/o dizziness, lightheaded, sob, cp. Follow up with pcp if not improving or worsening. Continue to monitor BG and BP at home. Pt and pt's husband voices appreciation of care today. APRN Electronically Signed 3/3/2021 1:57 PM Division of Health.

Other Meds:

Current Illness:

ID: 1088885
Sex: F
Age: 70
State: FL

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

Lab Data:

Allergies: Statins

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

Symptoms: aches, tired, fever, chills, sweats in the night, diahrrea, no apetite, skin hurt, low energy. All increased over the next 3 days, and by 6 pm on March 6, I started feeling human again.

Other Meds: Atenolol, Fossamax, Zetia, Zoloft, Tramadol, Omniprazole, Estradiol, Amlodipine, Prevagen, Turmeric Circumin, Vitamin C, Calcium, Vitamin D, Multivitamin for women over 50.

Current Illness: none

ID: 1088886
Sex: F
Age: 45
State: NC

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

Lab Data:

Allergies: Amoxicillin, iodine & shrimp

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

Symptoms: Red bumpy rash around my neck. Treatment to Benedryl and applied Benedryl cream.

Other Meds: Magnesium, Vitamin D & C

Current Illness: None

ID: 1088887
Sex: F
Age: 60
State: NJ

Vax Date: 03/01/2021
Onset Date: 03/02/2021
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: Tree Nuts and Fruits. Medications: Codiene, Pennicillin. Seasonal Allergies Tree Pollen, ragweed, etc.

Symptom List: Vomiting

Symptoms: Dizziness started the afternoon the day after the vaccine. Has persisted 9 days now and continues.

Other Meds: Levothroxine 25 mcg

Current Illness: None

ID: 1088888
Sex: M
Age: 35
State: PA

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: protein allergy

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient stated he has a protein allergy however his physician informed him to get the COVID19 vaccination. After the vaccination he felt lightheaded, tingling on his tongue and swelling. Gave patient 50mL of liquid Benadryl and observed patient for 30 minutes. EMS followed up with the patient.

Other Meds: unknown

Current Illness: unknown

ID: 1088889
Sex: F
Age: 32
State: MO

Vax Date: 03/05/2021
Onset Date: 03/06/2021
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: 3/6/21 2:30 am- stiffness in neck, headache, soreness around injection site- Subsided after 1 hours with ibuprofen(400mg ibuprofen) 9:30 am-pain (muscle cramps) down both legs and in arms. Headache- subsided after an 2 hours. I took 400mg of ibuprofen. 12:00pm- dizzy, started to get tunnel vision. I quickly sat down and vision began to come back. I had to sit for around 20 minutes before I know longer felt dizzy. Pain began to come back in both legs. Aching and fatigue. This lasted for around 2-3 hours. I stretched my legs and arms a lot during that time frame. I began to feel better around 4:30pm. Still mild aching in legs and arms. 8:00 pm-pain in legs and arms, headache, dizziness (400mg Ibuprofen) I went to bed and when I would up the next morning all my muscle aches and pains were gone. My right arm was still sore for 3 days post vaccine. I noted a half dollar size redness around the injection site. by day 3 the redness was the size of a grape fruit. Day 4 post vaccine the soreness in the arm was gone and redness had began to fade.

Other Meds: Montelukast, celexa, phenteramine, metphormine, meloxicam

Current Illness: I had some mild dizziness 2 weeks prior

ID: 1088890
Sex: M
Age: 52
State: CA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Developed itchy rash on abdomen and chest

Other Meds:

Current Illness:

ID: 1088891
Sex: F
Age: 48
State: CA

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: RA

Lab Data:

Allergies: Penicillin Vicodin Cheese/mild MSG

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

Symptoms: Extraordinary pain in left arm/injection site but also in shoulder rotator cuff, same pain in right shoulder and right elbow rendering both arms immobile. Any slight touch or movement created a deep burning and ripping sensation. Lasted a full 72hrs

Other Meds: Lumigan Brimonidine Tartrate Timolol Maleate

Current Illness: None

ID: 1088892
Sex: F
Age: 70
State:

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

Lab Data:

Allergies:

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

Symptoms: Patient described a shingles flare the day after her injection and also described intensification of chronic pain, above and beyond normal pain, for the two days after her vaccination.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm