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: 1104591
Sex: F
Age: 60
State: ME

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/16/2021
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: Penicillin.

Symptom List: Dysphagia, Epiglottitis

Symptoms: This patient was vaccinated approximately 1 hour prior to presentation here with her first dose of the Pfizer COVID-19 vaccine. She felt fine right after her vaccination but as she drove to her destination where she was going to take a walk, she started to develop left-sided facial burning and swelling. That prompted her to call her PCP in that office recommended she come back to the vaccination clinic to be evaluated. I evaluated her at approximately 2 PM.. She was feeling well for the most part with the exception of left-sided facial burning and swelling and a little bit of redness over her left cheek. She denied fevers, chills, itching, other areas of rash, difficulty speaking, difficulty swallowing, tongue swelling, lip swelling, wheezing, chest pain, or difficulty breathing. She recalls a penicillin allergy at age 5 or 6 but cannot remember the reaction. She has never reacted to a vaccine before. Initial vital signs included a blood pressure of 134/73, a pulse that was 70 and regular, and an oxygen saturation of 100% on room air. She had normal mental status and her lungs were clear. The left side of her face was slightly swollen over her left cheek as compared to the right with some slight increased flushing on the left side. There was no stridor, she was speaking comfortably, and her lungs were clear with good airflow. Her heart demonstrated S1 and S2 with regular rate and rhythm. I administered 2 doses of Benadryl, 25 mg with each dose about 15 minutes apart with her last dose at approximately 2:25 PM. I rechecked her vital signs at 2:50 PM and her blood pressure was 138/79 with a pulse of 70 and regular and an oxygen saturation of 99% on room air. Her lungs were clear and she was moving good air. I did take a relook at her face which was improved with decreased swelling. At 3 PM, because she was doing much better, I discharged her to home with instructions to use Benadryl 50 mg when she got home and then 25 to 50 mg every 4 hours today. If she develops any respiratory symptoms such as difficulty swallowing, cough, breathing difficulty, swollen tongue or swollen lips, as well as increased facial swelling, she will call 911 to be evaluated. She should not get the second Pfizer COVID-19 vaccine.

Other Meds: Estradiol Patch, Progesterone.

Current Illness: No.

ID: 1104592
Sex: F
Age: 67
State: IL

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: codeine, latex

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient had slight panic attack post vaccine. Requested blood glucose check. BS 198

Other Meds: metformin, atorvastatin

Current Illness: diabetes

ID: 1104593
Sex: F
Age: 37
State: VT

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/16/2021
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:

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

Symptoms: Severe vertigo, tingling in both arms. Monitored for additional 30 minutes. Symptoms reduced but remain. Instructed to go to the ER if symptoms worsened.

Other Meds:

Current Illness:

ID: 1104594
Sex: F
Age: 44
State: NY

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Itching / Soreness of right breast. Started about 1 hour after vaccination and continued for approximately 48 hours.

Other Meds: Metformin ER

Current Illness: None

ID: 1104595
Sex: F
Age: 40
State: CA

Vax Date: 03/07/2021
Onset Date: 03/13/2021
Rec V Date: 03/16/2021
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: redness, swelling, warm to the touch, itchiness, soreness

Other Meds: Embrel

Current Illness:

ID: 1104596
Sex: F
Age: 71
State: KY

Vax Date: 03/10/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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: none

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

Symptoms: Vertigo

Other Meds: mirtazapine, simvistatin, pantaprazole, baby aspirin, escitalopram, famotidine, losartan.

Current Illness: none

ID: 1104597
Sex: F
Age: 24
State:

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: pt. experiencing tingling to the L hand/fingers and L. faces. patient advised to wait an additional 15 mins.

Other Meds:

Current Illness:

ID: 1104599
Sex: F
Age: 53
State: MA

Vax Date: 03/09/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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: Red and swollen rash on left upper arm at injection site; with hard bump/bumps 3"x3" diameter. Itchy and bruised feeling.

Other Meds:

Current Illness:

ID: 1104600
Sex: F
Age: 62
State: NY

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Reported chest pain, shortness and of breath, and headache. Transferred to the ED. Symptoms resolved. Followed up with PCP.

Other Meds:

Current Illness:

ID: 1104601
Sex: F
Age: 54
State: CA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pt had feeling of nausea. Was given apple juice and zyrtec

Other Meds: Nortryptaline

Current Illness: none

ID: 1104602
Sex: F
Age: 58
State: CT

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
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 described by patient

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

Symptoms: patient felt like her throat was closing. a few minutes after dose administered. she was given epi injection, ems was called and she was transferred top the hospital

Other Meds: unknown

Current Illness: denied any illness

ID: 1104603
Sex: F
Age: 85
State: MN

Vax Date: 02/12/2021
Onset Date: 02/19/2021
Rec V Date: 03/16/2021
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: Massive hair loss. Fever, temperature, chills, headache.

Other Meds: blood pressure medication- Amlodium Zoloft Calcium

Current Illness: none

ID: 1104604
Sex: F
Age: 61
State: NM

Vax Date: 03/03/2021
Onset Date: 03/11/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: possible shellfish sensitivity/allergy possible epinephrine (sudafed)sensitivity/allergy possible codiene sensitivity/allergy

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

Symptoms: on the day of the shot ,i felt fine until the evening.in pm i started execising my right arm more vigorously than i had during the day-then i started to feel light headed and my arm started to hurt quite a bit.it was still sore the next day,but gradually the pain subsided over the next 2 days.suddenly on appx thursday,march 11,i noticed a large red lump on my arm (about the size of 1/2 an egg) at the injection site-it was painful again(although not as bad as the first time),and also itchy.this lasted another day or 2,,and now it is just mildly itchy

Other Meds: chlorophyll,omega 3, wellness formula,leutin,ps,garlic

Current Illness:

ID: 1104605
Sex: M
Age: 73
State: FL

Vax Date: 02/24/2021
Onset Date: 03/01/2021
Rec V Date: 03/16/2021
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: NKDA

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

Symptoms: Pt had reported red and swollen arm

Other Meds: Unsure

Current Illness: Unsure

ID: 1104606
Sex: F
Age: 60
State: MO

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
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: Can't eat anything with gluten, Penicillin, Codeine, Bactrim, Naproxen, Sulfa, ? to Humira.

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

Symptoms: Got her vaccine with no problem, got her vaccine and felt dazed as she was going to the waiting area. She was anxious and then started feeling heaviness in her chest. She felt dazed, nothing registered and was not focused on anything, and sat for 25 minutes. She then got up and walked to the car, felt like she was in the clouds and her right lung was really, really bothering her by the time she got home and tired. Her heart rate was 140 and very fast. She didn't feel as if she was anxious but just blaise. She was really winded and exhausted by the time she got home. She had not eaten before she got the vaccine, made herself a sandwich and fell asleep and slept for about 3 hours. When she woke up she had a very, very sore arm. Then on Saturday, she woke up around 3:00 AM, and could not go back to sleep as she was wide awake. Then every task that she did just exhausted her and still felt heaviness in her chest and back and the right lung was really bothering her like she had worked like an animal for a period of time. She has a small apartment and it doesn't take any energy to walk to the kitchen. Saturday she felt fine, was cleaning and felt good. Sunday she slept all day and her right lung was still hurting her. Yesterday was still exhausted and winded feeling. Today, 3/16/21 she is still feeling the same way and exhausted doing simple tasks. She has a nodule in her right lung and several spots in her left lung but nothing is being done for them. The vaccine seems to have exacerbated the symptoms and made them worse. The injection site is a little sore but nothing out of the ordinary for a vaccine. She took two Advil for her symptoms which did help as she had pain in her head with this which will last for 5-10 minutes and then goes away. She has notified her doctor and she has an appointment on Friday at 11:00 AM.

Other Meds: Levothyroxine, Vitamin D3, Alendronate.

Current Illness: None.

ID: 1104607
Sex: M
Age: 74
State: NJ

Vax Date: 02/08/2021
Onset Date: 02/11/2021
Rec V Date: 03/16/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

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

Symptoms: Stroke on 2/11/2021 caused by a blot clot

Other Meds: Xarelto, Diltiazem, vitamin D3

Current Illness: A fib/A Flutter

ID: 1104608
Sex: F
Age: 76
State: NH

Vax Date: 03/13/2021
Onset Date: 03/01/2021
Rec V Date: 03/16/2021
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: No

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

Symptoms: Day 2 site hard and inflamed Day2 and 3 headache

Other Meds: Prozac, metoprolol, creator, probiotics, olmasartan, amlodipine

Current Illness:

ID: 1104609
Sex: F
Age: 47
State: AL

Vax Date: 02/11/2021
Onset Date: 02/15/2021
Rec V Date: 03/16/2021
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: My doctor think I have Pleurisy. . I have shortness of breath, hard to couch or take a deep breath. Spasms in my right side,

Other Meds: Pravastatin 40 mg, Pantoprazole Sodium 40 mg, Amlodiine Besylate 5 mg, Vitamin D2 1.25, Atenolol 50 mg, Vitamin C, Multi- Vitamin, Biotin, B12,

Current Illness: none

ID: 1104610
Sex: F
Age: 74
State: NC

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Penicillins, Sulfa Drugs, Cefdinir, Clarithromycin, Latex,

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Next day, muscle swelling at site of injection; 4-5 inch rash around injection site (6 days); severe headache starting next day after injection lasting 2 days. Pain in muscles in neck. Tenderness around injection area continues to be tender 3 weeks following injection.

Other Meds: Toviaz, Esomeprazole, Atorvastatin

Current Illness:

ID: 1104611
Sex: F
Age: 61
State: FL

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Fatigue, tired, dizziness, palpitations, shallow breathing, lack of energy, diarrhea on 5th day after the vaccine shot

Other Meds: None

Current Illness: None

ID: 1104612
Sex: F
Age: 30
State: MO

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
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: Na

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

Symptoms: Fever started around 8pm. Increased to 102.5 at 2am.

Other Meds: Sprintec

Current Illness: Na

ID: 1104613
Sex: F
Age: 76
State: OH

Vax Date: 03/10/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List: Unevaluable event

Symptoms: Redness, sharp pain, shot area lump, redness swollen arm lump which went down to the elbow on left side. Doctors appointment who prescribed clindamycin. To take for 7 days 3 daily.. started 3/16/21.

Other Meds: Levothyroxine, atenolol, allergy relief, valsartan-HCTZ, januvia, pravastatin, vitamin D3, citrucel, centrum, metformin, IComega-3 ethyl esters, Bayer aspirin

Current Illness: No

ID: 1104614
Sex: F
Age: 33
State: KY

Vax Date: 02/11/2021
Onset Date: 02/14/2021
Rec V Date: 03/16/2021
Hospital: Y

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: NKDA

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

Symptoms: Patient developed lip and tongue swelling and came to the Emergency Department on 2/14/21. She was admitted for observation. Also gave a history that on 2/13 too her lisinopril, had a seafood dinner with some wine. She awoke on 2/14 with swelling, took some Benadryl, went to the Urgent treatment Center and received a Decadron prior to trip into the Emergency Department where she was admitted, observed and discharged on 2/15/21.

Other Meds: Lisinopril Prozac Vit D2

Current Illness: None given

ID: 1104615
Sex: F
Age: 68
State: OH

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
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; shell fish (throwing up/diarrhea); latex (itching)

Symptom List: Injection site pain, Pain

Symptoms: Upper arm swelling with rash and itching at site of injection. Swelling is approximately 2 inches wide and 3 inches long. Rash is slightly red with about 3 groups of minute red scabs which may be due to scratching. Symptoms are minor, but I have not had reactions to other vaccines before - except for the first Shingrix shot received on 12/16/2020. Waiting for second Shingrix shot until 14 days after this second Moderna COVID-19 shot.

Other Meds: Daily for last 6 years: Lisinopril 10MG tablet; hydroCHLOROthiazide 12.5MG; Fish oil 1000mg/300mg of Omega-3; Flaxseed Oil 1200 mg/540mg Omega-3;Coenzyme Q-10 200mg. Every other day: Complete Women 50+ Multivitamin/Multimineral Supplemen

Current Illness: None to report

ID: 1104616
Sex: F
Age: 63
State: NM

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: penicillin, clindamycin, codeine

Symptom List: Injection site pain, Menorrhagia

Symptoms: Throat hoarseness severe unable to speak and beginning of closure, hives.

Other Meds: symbicort, spiriva respimat, pioglitazone, jardiance, quetiapine, clonazepam, gabapentin, hydrocodone/acetaminophen 5.5, simvastatin, finasteride, zinc, vitamin b's, vitamin e, biotin, humalog injection as needed, lantus as needed 10 - 15

Current Illness:

ID: 1104617
Sex: F
Age: 58
State: IN

Vax Date: 03/08/2021
Onset Date: 03/10/2021
Rec V Date: 03/16/2021
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: No

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

Symptoms: I had a headache on 3/10 throwing up 3/11 muscle pain, chills, joint pain, fever, trouble breathing, weakness, sore throat, runny nose, left side of throat felt swollen. on 3/12 I felt like the inside of my body arms legs etc all hurt. Tylenol and Hydrocodone didn't help and i was drinking lots of water but vomiting and not peeing a lot. I took meds for my nose and throat but it didn't help. I have weakness still and chills come and go.

Other Meds: trantelix, singulair, levothyroxine, cholesterol medication, atorvastatin, vitamin D

Current Illness: No

ID: 1104618
Sex: F
Age: 53
State: VT

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/16/2021
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: Throat constriction, ears tingling and warm. HR regular, color pink, no difficulty swallowing, no history of allergies to food or medications. Monitored for 30 minutes with resolution of symptoms. Instructed to go to the ER if symptoms worsen.

Other Meds:

Current Illness:

ID: 1104619
Sex: F
Age: 17
State:

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient began vomiting 3 minutes after injection. BP 110/72, HR 82, O2 98%.

Other Meds:

Current Illness:

ID: 1104620
Sex: F
Age: 58
State: NY

Vax Date: 03/04/2021
Onset Date: 03/06/2021
Rec V Date: 03/16/2021
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: Cefton, Levaquin

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

Symptoms: Severe stomach cramping, sweating, chills, diarrhea, tiredness lasting over the course of 2-3 days

Other Meds: Letrozol, Fluticasone Propionate 50 MCG/ACT , Zyrtec D, Quinapril-Hydrochlorothiazide 20-12.5 MG, Famotidine 40 MG, Rosuvastatin Calcium 20 MG, Synthroid 25 MCG, Crestor 20 MG

Current Illness: None

ID: 1104621
Sex: F
Age: 22
State:

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: 10 minutes after receiving the first dose of Pfizer, the patient began feeling dizzy and had a syncope event. BP 105/59. HR 59. 100% saturation on room air. Repeat vitals 10 minutes later: BP 95/39, HR 66, 100% sat on room air. Blood glucose 109. Patient noted she came from the gym and had not eaten a full meal. Patient reports passing out after donating blood, and felt similar to that experience. No history of syncope events related to vaccines.

Other Meds:

Current Illness:

ID: 1104622
Sex: F
Age: 48
State: CA

Vax Date: 03/09/2021
Onset Date: 03/13/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain

Symptoms: 48 year old female with left shoulder pain x 2 days after getting 1st Moderna COVID vaccine 1 week ago in left deltoid. Pain is from deltoid to trapezius with significantly reduced active ROM. She felt really poorly about 6 hours after vaccine and missed work x 2 days. She felt better and resumed normal activities. On day 6 shoulder got really painful and unable to move normally. She denies redness or itching. No palpable lymphadenopathy but didn't go looking. No axillary pain.

Other Meds: albuterol sulfate inhalation 90 mcg/actuation HFA aerosol inhalers, inhale 1 to 2 puffs by mouth and INTO THE LUNGS every 4 to 6 hours if needed for shortness of breath or wheezing BreatheRite MDI Spacer spacers, Any spacer will do. clobeta

Current Illness: none

ID: 1104623
Sex: M
Age: 66
State: CA

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Increasing arm soreness, fever of 102, chills, headache, starting in the morning, lasting until that evening. After 11.5 hours of sleep, symptoms resolved the next morning (around 9 a.m.) other than some lingering arm soreness and tiredness.

Other Meds: Atorvastatin, Losartan, Fluticason propionate, low-dose aspirin, Loratadine, multi-vitamin

Current Illness: None

ID: 1104624
Sex: F
Age: 35
State: WI

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/16/2021
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: penicillin, cats, and dogs

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

Symptoms: The day after my vaccine (and still now), I have had pain in my right neck and shoulder area, the same side as the vaccine. It feels like a really stiff neck. Starting 4 days after my vaccine, I began having pain in my right armpit. I think my lymph nodes in my armpit are swollen; it is uncomfortable and painful.

Other Meds: fluticasone propionate 50 mcg/actuation nasal spray; hydroCHLOROthiazide 25 mg tablet; omeprazole 40 mg DR capsule; Aurovela Fe 1-20 (28) 1 mg-20 mcg (21)/75 mg (7) per tablet; ibuprofen as needed; ashwaganda gummies

Current Illness:

ID: 1104625
Sex: F
Age: 45
State: VA

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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-containing compounds, lactose intolerance

Symptom List: Tremor

Symptoms: Soreness in upper right arm where vaccine administered; nausea and diarrhea starting around ~2am in the morning on Tuesday 3/16 immediately following the shot at ~6pm on Monday 3/15

Other Meds: Nuvaring, women's daily vitamin, vitamin D, allergy medication (diphenhydramine HCI 25 mg)

Current Illness: Allergies, PCOS

ID: 1104626
Sex: F
Age: 43
State: WA

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/16/2021
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: 43 YO F C/O NUMB SENSATION IN HER FACE SOME UNUSUAL SENSATION IN HER TONGUE FOLLOWING COVID SHOT. DENIES OTHER C/O TO INCLUDE DIFFICULTYBREATHING, SWALLOWING, SPEAKING, DENIES SWELLING IN OR AROUND FACE/MOUTH, NAUSEA, OR OTHER C/O. PT INITIALLY WAS WILLING TO GO TO ER BUT HER SXSUBSIDED WHILE WAITING FOR AMBULANCE AND SHE DECIDED TO AMA AND FOLLOW UP ON HER OWN. FOUND ABOVE PT A/O X4, NO OBV DISTRESS, NO OBVIOUS ANGIOEDEMA, SPEAKS IN FULL SENTENCES, CLEAR LS BILAT ALL, SOME HIVE LIKE RASH ON ANTERIOR CHESTBELOW THE CLAVICLES, EXTREM - PWD, GOOD PMS X4, MOVES ALL WITH PURPOSE

Other Meds:

Current Illness:

ID: 1104627
Sex: F
Age: 56
State: CO

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/16/2021
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: Bee sting (swelling, diff breathing), codeine-guaifenesin (hives), fexofenadine (rapid HR), diphenhydramine (diff breathing), pseudoephedrine (diff breathing), zinc acetate (diff breathing) providone-iodine (rash)

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

Symptoms: Moderna administered at 17:22. 1740: Patient states that she is itching. Patient states that she has had panic attacks in the past and "this feels like a panic attack." She has "felt like this before" when she had another medication, but she can not remember what medication it was. "When this happens, then I go to the ER." She can not take benedryl due to increasing her HR and causes difficulty breathing. She currently has redness on her back and is itching on her arms and legs. No audible wheezing. 17:40: 140/58 BP 94% SPO2 88 HR Lungs clear to ascultation. Denies difficulty breathing. Denies throat itching or throat swelling. Patient is able to speak in full sentences and is AOx4. Patient states that her lips and nose are itching. Back has redness. She is itching and scratching on her arms, legs, back, chest. I offered cool towels. Unable to administer PO benedryl due to patient stating that she "can not take benedryl, Claritin, or zyrtec." I asked if I could call her husband in, and she agreed. Another staff member went out to get husband. 17:52pm: Patient is states that her "throat feels funny" and she starts to vomit clear emesis/sputum. She is still itching. Patient is not able to speak in full sentences due to coughing and stating that she is having more difficulty breathing. No wheals or bumps on skin. Face and back with redness. EMS called. 2L NC put on for comfort: 1752 HR 104 156/67 99% on 2L NC. 1800: EMS arrived. Report and handoff given. Face sheet given to EMS. Pt received steroids in ER. PCP visit on 3/12/21 PCP visit, still had rash.

Other Meds: Lasix, coreg, Prilosec, voltaren, astelin, lipidor, Advair diskus, vitam D, albuterol, pepsid, lovaza, lisinopril

Current Illness:

ID: 1104629
Sex: F
Age: 29
State: WI

Vax Date: 02/09/2021
Onset Date: 03/08/2021
Rec V Date: 03/16/2021
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: TRAMADOL, AMOXICILLIN

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

Symptoms: noticed difficulty breathing and extreme pain on inhalation. went to the emergency room and was diagnosed with pleurisy

Other Meds: VENLAFAXINE ER 150MG, EMGALITY 120MG

Current Illness: NONE

ID: 1104630
Sex: F
Age: 57
State: IL

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
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: lisinopril,

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: pt states that she developed the chills and then the hives on her legs which went away. She developed chills again and then they went away. She woke up the next day her left arm was very sore. The only symptom she has left is a fever. Her temp is 100.1. Pt is not taking any medicine but plenty drinking fluids.

Other Meds: none

Current Illness: no

ID: 1104631
Sex: M
Age: 47
State: UT

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: None that are known

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

Symptoms: Day 1: Saturday morning March 6 at 5:00am I was shaken out of my sleep with a nasty migraine, sour stomach, intense body aches, stuffy nose, fever (102f). Classic flu like symptoms. I was extremely sick all day Saturday (level of sick: 8/10). Day 2: Sunday morning March 7 I awoke again extremely sick, just as sick as Saturday. All same symptoms (level of sick: 7/10). Sunday night I was incredibly miserable, all flu symptoms, I did not sleep Sunday night, up all night and up all day the next day Monday. Day 3: Monday I continued to be sick, all same symptoms, all day long. This time the blood shot eyes & bloody nose came on, fever was steady at 101f (level of sick: 6/10). Day 4: Tuesday woke up still stick, same flu like symptoms. I feel the headache has gotten worse, in fact way worse. Fever steady at 101f all day. Overall I'm not as sick except the headache and fever (level of sick: 6/10). Day 5: Wednesday I was really hoping I'd make a full recovery but still still sick, fever dropped for a few hours then came back, fever peaks and bounces around at 101f. Headache is absolutely nasty, I feel intense pain in the back of my neck and head, hard to sleep or lay down. (level of sick: 5/10). Day 6: Thursday I feel like I'm just about kick this sickness, feeling way better. I dont have a fever today but I still have an incredibly nasty headache, really intense, my eyes hurt, back of my neck hurts. (level of sick: 3/10). Day 7: Friday, no flu symptoms, finally!! But the headache continues, really bad. It sort of disables my ability to function with the headache. Back of my neck and back of head hurts, inside my brain hurts. Ugh! Day 8: Saturday, no flu, no fever, although still bad headache. I've been taking Advil all week to help reduce the headache. It helps, but after about 6 hours later the headache returns. Late in the evening Saturday my head was pounding. Day 9: Sunday headache not that bad, mild headache lingered throughout the day, tolerable. Day 10: Monday no headache!! Today was the first full day of full happiness!! *NOTE*: In July 2020 I got COVID extremely bad, spent 4 days in the ICU, couldnt breathe!! I had a fever of 103 for 6 days straight before calling 911 to come and get me. I was in bad shape, lost 30 lbs, had respiratory breathing issue for about 2 months after hospital stay. Most sick I've ever been, total game changer, I will never be the same. To this day I feel my respiratory is at 90%, fatigue still comes around every so often. --- Thank you ---

Other Meds: Atorvastatin 40mg daily, Losartan 100mg daily, Hydrochloro 25m

Current Illness: None

ID: 1104632
Sex: F
Age: 41
State: WA

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
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: PCN

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

Symptoms: Patient reported uticaria and itching to medics while waiting in the 30 minute observation lane of mass vaccination site. Patient reported the same symptoms had occurred when taking PCN for a prior infection and she was treated with epinephrine and steroids at that time after swelling of her face and neck had progressed. No progression to swelling of the face and neck noted at the time of this evaluation. Patient denied any shortness of breath. Requested transport to hospital. Transfered care after patient walked to the medic unit on site of mass vaccination clinic. Lead Fire Fighter/ Paramedic on site called patient later that afternoon to check on her status. Patient had fully recovered and

Other Meds: NA

Current Illness: NA

ID: 1104633
Sex: F
Age: 28
State: OH

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Lightheadedness, nausea (no vomiting), anxious. She has a history of anxiety with needle injections. She laid down on the floor (voluntary, no syncope, no mental status changes), when taken to private section of the Center via EMS stretcher. Symptoms lasted 20 minutes, then resolved on their own.

Other Meds: Prozac, Lamictal, Omeprazole, Wellbutrin XL, Vit B12 supplement

Current Illness: None

ID: 1104634
Sex: F
Age: 61
State: AZ

Vax Date: 03/08/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
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: Sore arm for about 1 day after injection, then raised and itchy rash appeared below injection site about 1 week after vaccination (COVID arm?)

Other Meds: None

Current Illness: None

ID: 1104635
Sex: F
Age: 48
State: OR

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
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: penicillan

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

Symptoms: I received the 2nd dose of the Covid 19 vaccine on March 11th. The first dose, I only had a sore injection area, so there were no other side effects for the first dose. The second dose, proved other. I got the 2nd dose at approximately 10 am, and did not have any effects until that evening. At 1230 am, I awoke with extreme chills, a low fever, 101, and severe body pain. I was able to crawl on the floor and sit next to a heater vent and get warmed up. I made a cup of tea and took 2 ibuprofen and was unable to get back to sleep for about 4 hours. Palms of both my hands were extremely hot, every joint hurt and especially the arthritis within my right shoulder. 5 days later, my right side organs feel uncomfortable

Other Meds: n/a

Current Illness: n/a

ID: 1104636
Sex: F
Age: 72
State: IL

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
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: grapes

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

Symptoms: Patient began to feel trinity to lower lip. Similar reaction to when she eats grapes which she is allergic too

Other Meds: HTN medications, arthritis medications, A-fib medication

Current Illness: none

ID: 1104637
Sex: M
Age: 27
State: CA

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/16/2021
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:

Symptom List: Vomiting

Symptoms: Patient noted to have unsteady gait - experienced syncopal episode. Placed in supine position, with BP 82/40 (pulse 46). Blood glucose 112. Given 500 mL normal saline. Sent to Medical center.

Other Meds:

Current Illness:

ID: 1104638
Sex: F
Age: 65
State: MI

Vax Date: 03/09/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
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

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: patient developed COVID

Other Meds: albuterol, calcium, lasix, cozaar, potassium, multiple vitamin, kenalong cream, xarelto

Current Illness: husband has COVID,

ID: 1104639
Sex: F
Age: 69
State: CA

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
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: Lactose intolerant

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

Symptoms: No symptoms noted with my 1st dose. The 2nd dose injection was approximately on Thurs afternoon at 1:30 pm. Arm and slight body ache noticed around 3:30 am the following Friday. Severe chills and body aches began around 11:45 am Friday morning followed with a 101.7 fever around 12:30 pm. Took 1 aspirin and by around 3:30 or so chills subsided and the fever broke. Soreness and redness began taking place the next day, Saturday, early morning. Rash-like itching and swelling began the following Sunday morning around 6 am. I rubbed my arm periodically with ice. Redness and itching continued Monday, used more ice. I took 2 Benadryl tablets around 9 am Monday. Redness and swelling are down but slight itching remains this morning and I've just taken 1 Benadryl tablet.

Other Meds: Valsartan-HCTZ160-25 mg tab, Hydralazine 10 mg tab 1 daily, Lovastatin 40 mg tab, Estrogen-Methyltestos HS tab, Vitamin B-12, Vitamin D, and Milk Thistle

Current Illness: None

ID: 1104640
Sex: F
Age: 71
State: MO

Vax Date: 02/15/2021
Onset Date: 02/17/2021
Rec V Date: 03/16/2021
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: Keflex

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Severe rash started on my hips and became beet red, burning and itching intensely. Over the next 2 days the rash spread up my back, and to the top of my thighs. The second day it spread down my legs to my feet (but not as severe) and on my arms down to my hands. My head also began itching. This lasted for about 10 days and has now cleared up. I experienced extreme exhaustion and dry mouth. I still feel tired and have a dry mouth when arising.

Other Meds: Daily: Venlafaxine - 100 mg (only prescription); Centrum Silver multi-vitamin- 1 tab; Ginko Biloba- 120 mg; Biotin- 20,000 mcg; D3 - 1000 iu; Apple Cider Vinegar capsule-420 mg; Calcium- 1200 mg+ 40mcg D3; Super B Complex with ascorbic aci

Current Illness: None

ID: 1104641
Sex: F
Age: 32
State: MA

Vax Date: 03/14/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Sulfa based medications

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

Symptoms: Cellulitis at injection site (spreading, red, rash, hot to touch and very tender)

Other Meds: Lexapro

Current Illness: None

ID: 1104642
Sex: F
Age: 65
State: VA

Vax Date: 03/14/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
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: fever, chills and sweats, muscle ache, head ache, fatigue, loss of appetite, brief nausea. All resolved within 36 hours. Fever and aches mitigated with Tylenol

Other Meds: Multi-Vitamin; Calcium

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm