VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
PLEASE CHECK BACK SOON
Download the files above while you wait.






Manufacturers

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

Incidents per State

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

ID: 1089357
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: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: CIMBALTA

Symptom List: Dysphagia, Epiglottitis

Symptoms: Headache, chills, fatigue, slight nausea, dry mouth/dehydrated

Other Meds:

Current Illness: None

ID: 1089358
Sex: F
Age: 50
State: NJ

Vax Date: 02/03/2021
Onset Date: 02/03/2021
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: Acetaminophen (hives) NSAIDS (anaphylaxis to torodol)

Symptom List: Anxiety, Dyspnoea

Symptoms: Temp 102 x2 days, extreme fatigue, difficulty walking due to all over joint and muscle pain, hot flashes 42-50times per day until one week ago , dizziness and nausea during hot flashes, all over body bloating ....especially abdomen, still have joint pain and bloating . Hot flashes were thru the day and night. Soaking clothes and causing severe dizziness and nausea. Vomited a few times. Hot flashes at night woke me up just before coming on and so I rarely slept for more than 40 min at a time for a month. Depression and mood swings were difficult to deal with. Elevated ALT

Other Meds: Just completed a course of amoxicillin for a possible sinus infection. Stopped all other Meds due to not feeling well. Took zofran as needed for nausea

Current Illness: Generalized not feeling well......low grade temp with random hot flashes, nausea, headache, bloating. Extreme fatigue, increased neck/ back pain; new knee pain . Was placed on amoxicillin by urgent care for possible sinus infection

ID: 1089359
Sex: F
Age: 59
State: WA

Vax Date: 03/05/2021
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: some pollen, bee stings, bug bites, some topical products

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

Symptoms: Day 1 and 2 - expected lethargy, sore arm, muscle aches Day 3-present - dizziness and (sometimes) nausea. It's been 4 days of dizziness to the point that I can only be up for 10-15 minutes at a time, can't drive. Any exercise at all (even going up a single flight of stairs) makes me dizzy. There is also a general feeling of "unwell", but it's hard to describe, like a brain fog.

Other Meds: None

Current Illness: none

ID: 1089360
Sex: F
Age: 28
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient fainted 5 minutes after immunization. Patient hit head upon falling out of chair. Pt regained consciousness immediately. Ambulance was called due to hitting head. Patient refused treatment by ambulance. Patient felt passing out was due to low blood sugar. She drank 7-up and was helped cleaning up blood and given band aid.

Other Meds: unknown

Current Illness: unknown

ID: 1089361
Sex: F
Age: 69
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:
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: Patient received dose of undiluted vaccine. No adverse reaction at this time.

Other Meds:

Current Illness:

ID: 1089362
Sex: F
Age: 74
State: CA

Vax Date: 02/04/2021
Onset Date: 03/05/2021
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: sulfur

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

Symptoms: Vaccine was given on left arm. Approximately five hours later, my left arm starting to hurt. It hurt so badly, I could not lift my arm. The pain was a level 10 (ten being the worse). This is day five and I am still experiencing pain. Friday thru Tuesday was the worst, I could not sleep, the pain kept waking me up.

Other Meds: none

Current Illness: n/a

ID: 1089363
Sex: F
Age: 47
State: AZ

Vax Date: 02/13/2021
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: turkey

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: February 13,2021 I got the vaccine and everything was fine but on March 06,2021 I woke up with my mouth a little turned to the right and my left eye irritated. As the day went by, I got worse and went to the hospital and they told me I had bell's palsy and to go to my primary doctor. And my doctor told me that it could be a side effect of the vaccine and to make the report.

Other Meds: Euthyrox 100MCG

Current Illness:

ID: 1089364
Sex: F
Age: 64
State: IN

Vax Date: 03/03/2021
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: Sulfa meds

Symptom List: Pharyngeal swelling

Symptoms: On day 3-5 I was very fatigued. I could continue doing my daily routine, but had to stop and take a lot of breaks. I felt winded and just the way I do after giving blood, just wiped out. Today, a week after, I feel back to normal.

Other Meds: Ibuprofen

Current Illness: Nothing

ID: 1089365
Sex: F
Age: 54
State: TX

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: NKA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Funny feeling/sensation on both sides of jaw, dizzy and heaviness of both eyes. BP 192/109, 182/115 O2 sat - 100%

Other Meds: Metmorfin, Losartan, Loperamide

Current Illness: S/P c-spine fusion 2/1/2021

ID: 1089366
Sex: F
Age: 80
State: MI

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

Lab Data:

Allergies: sulfa and penicillin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: upper arm red, warm and severe itching spots breaking out. doctors office said maculopapular rash and prescribed triamcinolone ointment. went to dr. office on 03/10/2021

Other Meds: triamterene/hctz, Pravachol,levothyroxine, osteoarthritis bi-fllex,krill oil, vitamin d3

Current Illness: none

ID: 1089368
Sex: F
Age: 42
State: TX

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: SYR
Vax Site: LA

Lab Data:

Allergies: Tetanus vaccine (as a child)

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

Symptoms: 4 minutes after the vaccine my heart rate increased drastically. I also felt faint. I stayed with EMTs for 1.5 hours until I was comfortable to leave. Heart rate came back to normal over this time period. There were still moments when I felt flush/faint-like.

Other Meds: None

Current Illness: None

ID: 1089369
Sex: U
Age: 50
State: CA

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: n/a

Symptom List: Rash, Urticaria

Symptoms: dizziness, and throat irritation.

Other Meds: n/a

Current Illness: n/a

ID: 1089370
Sex: F
Age: 73
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:
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: Chills, nausea, aches and slight dizziness with some fatigue. These lasted for approximately 14 hours.

Other Meds: Raloxifene 60mg once a day. Lisinopril10mg once a day, Sertraline 25mg once a day, Centrum Silver for Women over 55.

Current Illness: None

ID: 1089371
Sex: F
Age: 76
State: GA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: NKA

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

Symptoms: ?Patient came to pharmacy to get her 2nd dose of Moderna vaccine. During screening process patient disclosed she had injection site reaction on left arm including rash, redness, itching and swelling on her arm that had resolved. She also disclosed a similar area occurred occured on right side of abdomen that has somewhat resolved; however she still has sporadic occurences of redness and itching. Due to the patients reported adverse event; patient was advised to hold therapy of 2nd dose of Moderna vaccine; and if she needed to continue therapy the 2nd dose should be given under medical supervision.

Other Meds: UNKNOWN

Current Illness: OSTEOARTHRITIS, VERICOSE VEINS, CHOLESTEROL

ID: 1089372
Sex: M
Age: 64
State: NC

Vax Date: 03/05/2021
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: N/A

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

Symptoms: Vertigo

Other Meds: Krill oil and centrum silver

Current Illness: None

ID: 1089373
Sex: F
Age: 35
State: TX

Vax Date: 02/25/2021
Onset Date: 03/08/2021
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, sulfas, Vicodin, shellfish, latex, medical adhesive

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

Symptoms: Shingles

Other Meds: None

Current Illness: None

ID: 1089374
Sex: F
Age: 61
State: IN

Vax Date: 03/04/2021
Onset Date: 03/05/2021
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: Hives swollen lips

Other Meds: Atenolol, fenofibrate

Current Illness: None

ID: 1089375
Sex: F
Age: 37
State: AK

Vax Date: 03/01/2021
Onset Date: 03/08/2021
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: NKA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Days 2-4 following vaccination patient experienced muscle aching and tenderness at injection site. Pt states there was a small red/swollen circle at injection site, about the size of a quarter. Day 8 following vaccination pt felt severe fatigue, discomfort, and chills (no temperature was recorded) Day 9-10 following vaccination pt's injection site redness enlarged to size of an orange, become swollen, warm and tender to touch. The injection site was itchy and painful. Pt reported to clinic on day 10 after vaccination, was diagnosed with cellulitis and prescribed antibiotic for treatment.

Other Meds: Vitamin D3

Current Illness: None

ID: 1089376
Sex: F
Age: 51
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: Allergic to Various metals - skin contact irritation

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Chills lasting 4 hours Extreme Fatigue lasting 24 hours All over body aches lasting 30 hours Treated with over the counter acetaminophen which helped relieve symptoms

Other Meds: None

Current Illness: None

ID: 1089377
Sex: F
Age: 60
State: ME

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: Mold, mildew, plants, pollen, animals

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

Symptoms: First a cough that produced massive amount of mucus as I would have with a severe allergic reaction to mold. Pain in my left arm that spread to my finger tips and upper back. Both lasted all day. Mucus and cough in to the next day (today). On second day (today) severe pain in my left chest that started in the afternoon and by 6:30 pm spread to my left back. Feels like massive muscle cramping. Head aches on day one and the first half of day two. Head aches in spurts and lasted a short while but were intense.

Other Meds: levothyroxin 75 mcg, citalopram 20 mg

Current Illness: fatigue. Tested negative for Covid 3 times since 6/2020

ID: 1089378
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: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin Sulfas Myacins Keflex Ceclor Soy Strawberries Cod White beans

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

Symptoms: Fever, chills, nausea, headache

Other Meds: 100mg topimax 300 mg Wellbutrin

Current Illness: None

ID: 1089379
Sex: F
Age: 33
State: GA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
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: Soy, nuts, carrots, apples, environmental/seasonal allergies, IV contrast, combivent

Symptom List: Unevaluable event

Symptoms: About 90 min post vaccine, my vision became extremely blurry. My heart rate and BP was elevated and remained elevated with any physical activity or exertion. I became "swollen" in the face and arm but did not break out in hives. My BP and pulse remained elevated for 4 days. By day 3, my lymphnodes in my armpit became extremely swollen. I have remained slightly swollen and periodically break out in hives without regular Benadryl and famotidine/cetirizine doses.

Other Meds: Famotidine 10mg BID; Cetirizine 10mg BID; Escitalopram SID; Cyclobenzaprine 5mg PRN

Current Illness: N/A

ID: 1089380
Sex: F
Age: 39
State: OK

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: Sulphites, sulpher drugs, yellow dye, aspirin, abutetol

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

Symptoms: Within 5 minutes of injection,, Red rash strip down middle of face from forehead to chin, Face Flushing, Face itching. Within 1 hour of injection,, Sore joints. Treated with OTC benadryl and Ibuprophen Symptoms Resolved in 2 hours

Other Meds: Norethindrone, Nexium Guaifenesin Zyrtec Ultram Vit. D3 Buspar Cozaar Flonase Trudoza Cranberry

Current Illness:

ID: 1089381
Sex: M
Age: 54
State: WY

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

Lab Data:

Allergies: Seasonal allergies to outdoor antigens

Symptom List: Injection site pain, Pain

Symptoms: Patient came back to our office about 1 hour and 45 minutes after having his first Moderna shot saying that his throat was feeling a little bit itchy. 25 mg of Benadryl was given, patient waited in clinic for 30 minutes and reported that itching had resolved. Patient was encouraged to seek medical care if he had any other problems. Sign and symptoms of anaphylaxis were reviewed and pt was advised to call emergency responders if he had any symptoms. Patient has a appointment scheduled with his primary care doctor tomorrow morning, and will also follow up with patient tomorrow,.

Other Meds: Zyrtec, Crestor, Prilosec, Lisinopril

Current Illness:

ID: 1089382
Sex: M
Age: 59
State: CA

Vax Date: 02/17/2021
Onset Date: 02/23/2021
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: Injection site pain, Menorrhagia

Symptoms: 2/17/21 - Moderna vaccination taken at approximately 4:45pm 2/23/21 - Approximately 3:30 pm right ear is stuffed, ear and nasal passages feel pressure, 5:00 pm right hear has lost hearing, 10:00pm experiencing severe vertigo, 10:30 admitted to Emergency Department, 11:30pm CT Scan taken, prescribed Meclazine 25mg tab and Lorazepam 0.5mg tab, 5:00 am released with instructions to see family physician and ENT 2/25/21 appointment with family physician, prescribed Amoxicillin-clav 875-125mg 3/5/21 appointment with Dr., ENT , informed of profound hearing loss in right ear, prescribed Prednisone 10mg tab 3/9/21 appointment with Dr., ENT, confirms total hearing loss of right ear 3/11/21 pending appointment for an MRI 3/12/21 pending appointment for 2nd audiology test

Other Meds: Hydrochlorothiazide 25 mg tab Losartan Potassium 100 Mg tab Potassium CL ER 20 MEQ tab Atorvastatin 20 mg tab Montelukast SOD 10mg tab

Current Illness: None

ID: 1089383
Sex: F
Age: 62
State: OH

Vax Date: 03/07/2021
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: Sulfa

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

Symptoms: Rash - raised red and itchy all over face - mostly on left side of face (same side as shot given). On cheeks, forehead, nose, and neck

Other Meds: Toprol 50 mg. q day Lexapro 25 mg q day.

Current Illness: None

ID: 1089384
Sex: F
Age: 58
State: ID

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: Celebrex Doxycycline Benadryl Erythromycin eggs food sensitivities Flue shot causes fatigue

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Dizzy/ Lightheaded Vitals: B/P: 140/70 HR: 77 Resp.: 14 O2Sat: 99% Skin signs: Warm and dry Circulation: Cap refill <2sec Treatment: Pt placed in supine. States she still feels dizzy but room not spinning. Had patient sit up, no noted increase or decrease in symptoms. LOI 2 hours. Toast with peanut butter. No Hx of anaphylaxis. @ 11:30 pt states she feels "jittery" Repeat Assessment @11:32 Vitals: B/P: 134/70 HR: 68 Resp.: 14 O2sat: 98 % Skin signs: Cool/ dry Resp.: No noted increase in effort AOx4 Cap refill <2sec Treatment Pt remained supine. Pt states gradual return to normal. Vitals stable. Repeat Assessment @11:47 Vitals: B/P: 121/82 HR: 69 O2sat: 97%

Other Meds: estradiol - Patch valacyclovir glotropin Ambien

Current Illness: None listed

ID: 1089386
Sex: F
Age: 64
State: TX

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: Sulfa drugs, aspirin and strawberries (salicylate allergy), codeine, sunflower seeds, honey dew melon, kiwi

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Face flushing within 1/2 hour that then subsided within another 1/2 hour. 6 1/2 hours after inoculation, at 7pm, I began to feel unwell. I felt a burning all over my body (especially my back), and body aches, and began a fever which grew from 97.3 (my normal) to a high of 100.1 (+2.8 degrees) within 2.5 more hours (by 9:30pm). Very bad chills and fever. By 9:30 took 1 500mg Tylenol. Little sleep that night. Felt very unwell next day (3/9) including headache. At noon I could get up and get some food. By 1pm fever subsided completely, but temporarily. Fever came back by 4pm, but only to 98.6 (+1.3 above normal). Took another 500mg Tylenol. Night 2 slept well. Woke up 3/10 no fever, headache gone, but balance still peculiar. I noticed the first night that my sense of balance was off.

Other Meds: Losartan (12.5mg 7AM, 12.5mg 2PM), Flonase (1 spray each nostril 7AM, 7PM), Azelastin (1 spray each nostril AM), Spironolactone (12.5mg 7AM), Magnesium (200 mg capsule 7AM), Vitamin D3 (500mg with lunch), Nature's Way Bifidus (1 capsule,

Current Illness: genital herpes outbreak

ID: 1089387
Sex: M
Age: 46
State: PR

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: Milk, shrimp,

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

Symptoms: Received vaccine at 9:00am, 9:15am light headache 10:30am felt light headed when walking. 12:00pm headache slightly stronger and discomfort in knees. 4:00pm joint aches specially in the knees, ankles and finger joints. 6:00pm tingling sensation on cheeks and headache persist. Walking uncomfortably because of joint aches.

Other Meds: None

Current Illness: None

ID: 1089388
Sex: F
Age: 74
State: CA

Vax Date: 03/02/2021
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: RA

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Painful red swelling rashes/hives on left ankle and left pelvis area. Not itching but painful to move. High feverish state. Tylenol and painkillers taken.

Other Meds: None

Current Illness: None

ID: 1089389
Sex: F
Age: 45
State: CA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain

Symptoms: Client had a vasovagal reaction x 3 seconds within 5 minutes post vaccination. Hx of fainting with blood draws and vaccination during her college years. client stated tingly on left upper chest for just a few seconds. denies chest pain, shortness of breath or dizziness. Client vitals were take at 15:26 with spo2 97, pr 54, BP 147/62, vital #2 at 15:31 spo2 98, pr 67, BP 140/85, vitals #3 15:48 spo2 98, pr 71, bp 150/88. Client was advised to go to an urgent care/ emergency room for further monitoring. Client's son will be transporting.

Other Meds: N/A

Current Illness: N/A

ID: 1089390
Sex: M
Age: 65
State: UT

Vax Date: 03/02/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Narcotic Analgesics, shellfish, lisinopril

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

Symptoms: fatigue, headaches, injection site pain, vomiting, chills, body aches

Other Meds: Fluoxetine, bupropion-naltrexone, rosuvastatin, losartan-hydrochlorothiazide, Metformin, celecoxib, aspirin

Current Illness: n/a

ID: 1089391
Sex: M
Age: 27
State: NJ

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: no

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

Symptoms: patient received vaccination, then immediately said they felt lightheaded and this always happens when they get injections or blood drawn. They requested and were given a bottle of water. They asked to lay down, and laid on the floor for about 10 minutes then said they felt better, sat the remainder of their wait time, then grabbed something to eat in the store, re-established they felt fine now, then proceeded to leave

Other Meds: unknown

Current Illness: none

ID: 1089392
Sex: F
Age: 32
State: MA

Vax Date: 01/23/2021
Onset Date: 01/23/2021
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: Sulfa-based medications, MRI contrast dye, dust, mold, pet dander, bananas, plantains, melons, apples, peaches, nectarines, cherries, coconut, pineapple, other fruits.

Symptom List: Tremor

Symptoms: After receiving my first shot, I sat in the waiting room. My tongue started feeling somewhat funny, my whole body felt very warm, I had some pain in my abdomen on the left side (the side I had the shot), facial flushing, dizziness, headache. I was checked out by the medical staff at 11:25, they determined that I was probably safe to go home. On the way out, I developed itchy lips and hives on my upper lip. The dizziness lasted three days, and was accompanied by severe chills. I took Benadryl after a very nervous ride home. Everything up to the dizziness subsided.

Other Meds: Ventolin, Symbicort, Fluoxitine, Baclofen, Claritin, multi-vitamins.

Current Illness: None.

ID: 1089393
Sex: F
Age: 34
State: CA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
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: Codeine

Symptom List: Erythema, Pruritus

Symptoms: Increased resting heartrate of 140 bpm Fever of 102.4 for 48 hrs Severe Body aches to the point I could not walk to the restroom without assistance Severe Migraine

Other Meds: N/A

Current Illness: N/A

ID: 1089394
Sex: F
Age: 47
State: MI

Vax Date: 02/19/2021
Onset Date: 02/19/2021
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: Keflex

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

Symptoms: swollen and tender lymph nodes in throat, difficulty swallowing, predominantly on left side causing impaired breathing especially early morning after sleeping. lasting 5 days approximately and now intermittently continues to flare up with less intensity as the onset side effects. Also accompanied by extreme fatigue. Have an appointment to follow up with doctor to see if any treatment is possible.

Other Meds: birth control, allegra, lysine

Current Illness: none

ID: 1089395
Sex: F
Age: 47
State: IL

Vax Date: 03/08/2021
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: NKA

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

Symptoms: Bell's Palsy House-Brackmann class V 2 days after 1st dose

Other Meds: unknown

Current Illness: unknown

ID: 1089396
Sex: F
Age: 64
State: MI

Vax Date: 03/03/2021
Onset Date: 03/10/2021
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: Vasotec, Biaxin, Crestor

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Mild swelling in oval shape around injection site, itching, warm to touch

Other Meds: Vitamin B12, Vitamin C, Vitamin D3, Multivitamin, Tumeric

Current Illness: none

ID: 1089397
Sex: F
Age: 59
State: IN

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: nausea chills throwing up dry heat lasted for four hours

Other Meds: flonase

Current Illness:

ID: 1089399
Sex: F
Age: 50
State: TN

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: Five minutes after received Pfizer Covid-19 vaccine at 5:51 p.m., patient was sweaty and unable to verbalize thoughts. Blood pressure was 95/ 58, heart rate was 51. One dose of Epipen 0.3 mg was adminstered at 5:56 pm, EMS was called, patient was placed on the floor with feet elevated, blood pressure was checked at 6:00 p.m and was at 116 /79 and heart rate was 66. At this time patient became responsive and EMS arrived to check patient out. Patient declined to go with EMS. We monitored patient at the store for 30 minutes at which time she left with husband who was instructed to dial 911 if symptoms returned.

Other Meds: vitamin b12 and vitamin D Take 1 tablet by mouth daily for both.

Current Illness: Gravis disease

ID: 1089400
Sex: F
Age: 77
State: MD

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: body aches, chills

Other Meds: Rosuvastatin Calcium; Olmesartan Medoxcomil and Hydrochiorothiazide; aspirin; Anoro Ellipta

Current Illness:

ID: 1089401
Sex: M
Age: 73
State: OR

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: none

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

Symptoms: Purkinje Tree and Covid-19 Vaccine. During the current COVID-19 pandemic and massively increased vaccinations, there have been few ocular side effects reported with the vaccine. 1) However conjunctivitis has occurred with Covid-19 infection and very rarely endophthalmitis has been reported. I wish to mention an otherwise unreported association with visualization of a Purkinje Tree and Pfizer Covid-19 second vaccine. I am a 73 year old otherwise healthy retired male. I had an entoptic experience after I received my second vaccine. With the first vaccine I had no visual side effects. The afternoon of my second dose I took an hour long nap, which was unusual for me. When I woke up and opened my eyes I noticed a bilateral arborizing, interlacing dark pattern that lasted less than a second. This was opaque but without a ghost image and otherwise the wall, sheet, and ceiling were seen clearly behind that network. I experimented with opening and shutting either and both eyes looking at a white sheet beneath me, and found that especially with my dominant left eye I saw a pattern resembling my left eye retinal vascular tree. The branches originated as single vessels superiorly and inferiorly that branched down to smaller vessels all on the right side of a disc type structure without duplication into an identifiable arteriolar and venous system. Even with a light source moving over my left shoulder, the image never lasted longer than a fraction of a second and fatigued quickly with repetition. I laid back down and repeated the experiment of opening and shutting either eye while looking at a white ceiling. Then the image changed to a horizontally oriented pattern with two single black vessel type structures coming off a disc type structure. The dark lines further branched and narrowed as they extended to the right and left off the disc type structure. Again this lasted less than a second. It faded away rather than floated away. The image always appeared in the same area of my field of vision. It was peri-central when I looked at the wall and inferior to fixation when I looked at the ceiling. The image would immediately move with eye movement, unlike a vitreous floater. Opening and shutting my left eye could refresh the image very briefly but that fatigued with repetition and could not be reproduced after 3-4 trials or without several hours between attempts. I did translations of Purkinje?s description of the Tree (described here later.) and had short term partial success with his methods, except for pushing on my eye, and using galvanic current, which I did not attempt. I declined a full exam but did remember a lecture about Purkinje images. He had the residents hold pen lights to the side of their eyes and move the light back and forth while he described the Purkinje Tree. Afterwards he quizzed the residents about whether they could see it or not, with the ?humorous? disclaimer that it was a means of IQ testing if they could see it. Half could. It was of interest to me that before I retired, occasionally patients would mentions seeing the tree after an ophthalmoscopic exam. I hoped to delight those patients by telling them it was a form of IQ quiz and they had done well. Two weeks later I was disappointed that I could no longer see the tree, but again declined an exam. I am optically conversant, but physically adverse in seeking self care. Purkinje first described the ?Tree?2) in his doctorate thesis in 1819. It was included in descriptions of other entoptic phenomena, performed mostly on himself. This was before the ophthalmoscope was discovered and before quality histological, serial sections were available. He described holding a candle or using galvanic illumination in front of his eyes individually and moving it around. He could see black lines in a network that came off a central pit structure. There were two lines inferiorly and superiorly with adjacent shadows and ultimately had size reducing branches. He recognized these branching lines as retinal blood vessels, but could not discern any blood flow. In 1825 he published a further volume 3) that dealt with experiments he subsequently had performed. He found that by holding a sheet of paper with a hole in it that he moved around, he could get a better view of the blood vessel pattern. He could discern the macula and described anastomosing blood vessels superior to inferior. A significant improvement in his discerning the blood vessel pattern was obtained with a safe amount of pressure on the superior lateral aspect of the eye. With this he could recognized blood corpuscles and flow patterns and then labeled the lines as veins. He did not describe arteriole patterns. So this leaves us with the question why this sudden awareness of the Purkinje Tree appeared in the time frame of a second Covid-19 vaccine. This will require further reports to determine coincidence versus cause-effect. This is a high stress time with Covid-19 deaths so prevalent. I had immediate relief after my second shot with a reduction of tension and increase in awareness of my general physical status as in the feeling of being hot or cold, sleepy or just fatigued, improved calmness, and the pertinent Purkinje Tree. At sign in for the second series of Pfizer injections the RN on duty asked about side effects from the first shot. She asked us to send a report in of any potential side effect then of the second shot and notified us that people were having more problems with the second shot than the first. Arm soreness, swelling, fever, chills, headache, malaise, fatigue. She gave us a print out list of known side effects, mostly systemic and all mild, but nothing ophthalmic. With these things in mind I was especially vigilant of any thing new in my general health or condition. Most of the patients getting the shots were students and the congregating area was in a wing of a hospital. This brought back the pleasant memory of my time in training and my chief?s description of Purkinje?s Tree and perhaps enhanced the brief ability to see the entoptic image. In between times playing with this image my vision was normal and my general health remained good, without symptoms of vascular compromise.

Other Meds: none

Current Illness: none

ID: 1089403
Sex: F
Age: 30
State: DC

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

Lab Data:

Allergies: nkda

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

Symptoms: systemic hives, treated for 7 days with benadryl with no longterm improvement, hives keep returning.

Other Meds: spironolactone 100mg, triamcinolone cream for face

Current Illness:

ID: 1089404
Sex: F
Age: 35
State: WA

Vax Date: 01/12/2021
Onset Date: 03/12/2021
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: Pediazole Cecor

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

Symptoms: About six minutes after vaccination I started to fell flush and tingly. Elevated heart rate which lasted for 23 hours. After second vaccination elevated heart rate for a few hours and flu like symptoms. Remained in observation for 45 minutes to make sure. Morning sickness which may be related to early pregnancy.

Other Meds: Plaquenil

Current Illness:

ID: 1089405
Sex: M
Age: 60
State: OH

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

Lab Data:

Allergies: Penicillin

Symptom List: Vomiting

Symptoms: Vomiting, diarrhea, shaking, difficulty breathing, OSat down to 90, whole body sensitive to touch, pain in left arm

Other Meds: Pridone, Simethicone, Iron Ferrous Sulfate, Low Dose Aspirin, Fluticasone Propionate Nasal Spray, Metoprolol, Pantoprazole Sod, Mag Oxide, Fluoxetine, Vitamin C, Omega-3s, Multi-Vitamin, Humalog, Basaglar

Current Illness: Post Covid 3 mo hospitalization

ID: 1089406
Sex: F
Age: 24
State: MN

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: Bactrim, Prozac

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 10min after getting her first dose of Pfizer, patient started experiencing dizziness. No shortness of breath, no numbness/tingling. Stated she 'felt like she was drunk and that she couldn't read the paper in front of me." BP 132/86, P88, O2 on room air 99%. Patient was escorted to Emergency Room where she was evaluated by provider.

Other Meds: none

Current Illness: none

ID: 1089407
Sex: F
Age: 71
State: CA

Vax Date: 03/04/2021
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: Lisinopril , Hydrochlorothiazide, Amlodipine, Co-trimoxazole

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

Symptoms: Rectangular rash below injection site about 3"x4", hot, itchy, remained for three days, outcome good

Other Meds: Losartan, Clonidine, Atenolol, Nifedipine Multivitamin, Vitamin D3, Baby aspirin, Chelated Magnesium, Vitamin E, Omega 3 Salmon Oil

Current Illness: None

ID: 1089408
Sex: F
Age: 54
State: LA

Vax Date: 02/17/2021
Onset Date: 02/20/2021
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: Peanuts

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Extreme fatigue & extreme joint pain

Other Meds: Ibuprofen, Tylenol, daily supplement

Current Illness:

ID: 1089409
Sex: F
Age: 65
State: NM

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: RA

Lab Data:

Allergies: None

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

Symptoms: My concern is that the hydroxychloroquine will prevent the vaccine from developing antibodies and that the vaccine will be ineffective.

Other Meds: Hydroxychloroquine fit rheumatoid arthritis and lupus Losartan for BP

Current Illness: Rheumatoid arthritis Lupus High BP Glaucoma Cataracts Overweight

ID: 1089410
Sex: F
Age: 24
State: TN

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

Lab Data:

Allergies: Nuts, shellfish

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

Symptoms: Vomiting light brown stomach bile consistently for three hours, cold skin while sweating, and feeling like I was burning from the inside out while still having cold skin.

Other Meds: Adderall XR, Microgestin 1.5/30, excedrin extra strength

Current Illness: N/a

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm