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: 1109331
Sex: F
Age: 47
State: PA

Vax Date: 01/06/2021
Onset Date: 01/17/2021
Rec V Date: 03/17/2021
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: No known allergies to medications. Significant food, chemical, preservatives, and environmental allergies.

Symptom List: Dysphagia, Epiglottitis

Symptoms: This is a follow up report starting from day after that first report was made -Report # 244159 - Starting with the 17th of January - I was still having facial numbness/tingling/pressure in my head/feeling like head was going to swell; arms were so heavy - couldn't lift my arms - like a heavy pressure on my chest; breathing was a problem; Swelling in my head caused eye issues. 18th - tingling started on back of neck; affecting my hearing and eyes (swelling in head); a lot of cognitive challenges. 1-20-2021 - heart racing; itchy all over; blood pressure spikes. Heart can feel like it's too fast and then going too slow. 1-21-2021 - legs burning from waist to hip; chest pain; heart racing; struggling to breath. 1/22 - chest pain and discomfort - pain shooting through arms; didn't sleep well. Arms wanted to pull into my chest. Stomach cramping on 1/23 - stabbing pain in wrists and hands; left side on heart pain. Pain was like having a beating. Left knee pain - January 24 - up all night with shooting pain in arm; fine motor pain skills shot - can't do what I need to do. January 25 - Elevated heart rate; elevated blood pressure. 1/26 - vision challenges; fuzzy. Heart racing; feet swollen; face feels puffy doesn't look puffy - pressure/tingly feeling in left cheek. Ongoing and Changing symptoms every day/week - with no let up. 3/11/ - buckling of legs started. Big thing now is my legs are buckling (happening from the hips) - when I try to get up or walk. I haven't fallen yet but I know it's coming. 3/12/2021 - heavy weight back in the arms. I still don't have the fine motor skills. I still can't drive and don't have control over my body and reflexes enough. Still having Pressure in chest and the face and head swelling - is unbearable and affecting my vision. I will see a neurologist next month. Dr is not sure what to do. Jan 12 - first ER visit. I have specific notes/log on all of my symptoms each day. If anyone wants to call - please call on Mondays or Wednesdays only( or Saturday or Sunday.) Also, Menstrual cycle is wonky. I had a normal period before the vaccine - 12/28-12/31/2020 - but didn't have one in January and I had one in February 10th - but just one day; 3/11/2021 - I had my next one and it was four days long and fourth day was very heavy then all the rest of the days.

Other Meds: Taken Daily (all OTC): Esomeprazole Magnesium 20 mg (delayed-release capsules USP) Cetirizine Hydrochloride 10 mg (antihistamine) Ginger Root 550 mg Panax Ginseng 100 mg Ginkgo Biloba 60 mg Zinc 50 mg Omega-3 500 mg (from fish oil) Vitamin

Current Illness: no

ID: 1109332
Sex: F
Age: 36
State: NE

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/17/2021
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: Prednisone, wheat, corn

Symptom List: Anxiety, Dyspnoea

Symptoms: When I first got the shot, I was dizzy. I felt drunk for about 4 hours and then wanted to eat a lot and craving. A little over a day later, my right arm, the opposite arm of the injection, started to twitch. it twitches on the upper forearm and lower bicep. This has been going on since the day after. About three days after, above my left knee started to twitch as well. I did not have any impacts or anything out of the ordinary that would cause this outside of the vaccine.

Other Meds: Estradiol, prenatal vitamins, Pedialyte

Current Illness: None

ID: 1109333
Sex: F
Age: 30
State: GA

Vax Date: 03/08/2021
Onset Date: 03/16/2021
Rec V Date: 03/17/2021
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: Macrobid

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

Symptoms: Sudden onset of chills, vomiting, diarrhea, and vertigo

Other Meds: Lorazepam Kyleena

Current Illness:

ID: 1109334
Sex: F
Age: 43
State: MD

Vax Date: 01/14/2021
Onset Date: 01/18/2021
Rec V Date: 03/17/2021
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: For the first three days normal symptoms. On day four I had debilitating Vertigo when I got up in the morning. If I moved I would vomit from Vertigo. It lasted about 8 hours during which I needed to stay in bed. My doctor advised that if it did not improve I should come in but it got better. For a couple of weeks afterward I had brief incidences of feeling dizzy. I got dose two and no symptoms after that dose.

Other Meds: Lexapro 10mg Multivitamin Vitamin D Iron

Current Illness:

ID: 1109335
Sex: F
Age: 78
State: CA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/17/2021
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: Felt like she had a few drinks, given water and felt better. BP 141/57, pulse 80, O2 sat 96%.

Other Meds:

Current Illness:

ID: 1109336
Sex: F
Age: 48
State: MD

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 03/17/2021
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: Keflex- Rash

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

Symptoms: Within the first few minutes experienced palpatations, increased heart rate, and dizziness. Palpations were frequent. This continued for several days. I have a history of SVT's - but after vaccine the palpations felt with SVT's increased in frequency and lengthy. Heart rate was in the 90's- 110's at rest most of the time. Had chest discomfort by day 3 post vaccine. On Feb 8th- late night began to have left chest pain, left arm/jam tingeling, and shortness of breath. In addition to this had weakness, fatigue, muscle aches, pain at injection site, headache- started on January 30th 2021 and worsened over the next several days. ** Immediate symtoms not reported at the vaccine site as I thought they would go away on own.

Other Meds: None

Current Illness: None

ID: 1109337
Sex: F
Age: 70
State:

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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: a few minutes after receiving her vaccine the patient complained of feeling flushed, lightheaded, mild headache. she had no rashes or shortness of breath. It was a few minutes before the patient reported to the observation nurse that she was having these symptoms. By the time I was called over, the patient stated she was already feeling better. Her vital signs were recorded and her case was discussed with the doctor on duty. The patient was kept for an additional 10 minutes of observation. Her symptoms completely resolved and she was discharged to home after the doctor saw her per the doctor's instructions. The patient left the clinic ambulatory with out any further complaints.

Other Meds:

Current Illness:

ID: 1109338
Sex: F
Age: 42
State: OK

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Sore arm, joint pain, nausea, fever. But later that afternoon EXTREME fatigue set in. I have slept for the majority of the last 3 days. I wake up foggy and disoriented. Takes a while to focus and become alert. I use the restroom and maybe I'm able to be active for 15- 20 minutes then I'm back asleep, or too tired to keep my eyes open. Today is the first day I have been able to stay awake more than an hour. I had energy for about an hour and then felt like I was unplugged I'm just too tired to function. All I can do is go back to bed.

Other Meds: Calcium Vitamin d Daily Vitamin Folic acid Potassium L lysiene Aimovig Rinvoq (last taken day before vaccine- will hold 1 week)

Current Illness: Rheumatoid Arthritis Non active Shingles

ID: 1109339
Sex: F
Age: 68
State: WI

Vax Date: 02/17/2021
Onset Date: 02/24/2021
Rec V Date: 03/17/2021
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: 1 week following 1st Moderna COVID vaccine, developed a red itchy rash at injection site. Rash included red, hard, raised area around injection site. Lasted approx 1 week, intermittently. No medications taken to alleviate symptoms. Patient consulted nurse line at clinic, was not seen by medical professional, did not seek additional medical attention.

Other Meds:

Current Illness:

ID: 1109340
Sex: M
Age: 43
State: CA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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: Client received second dose of Pfizer Lot EP7534 COVID vaccine prior to 21 day window

Other Meds: None

Current Illness: None

ID: 1109341
Sex: F
Age: 70
State: MO

Vax Date: 01/29/2021
Onset Date: 02/19/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: allergic to morphine, codeine, tardol, tramadol, msg in food

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

Symptoms: Since my second shot on February 19, I have started sleeping more and more. I am sleeping from 14 to 18 hours a day and could sleep more if I didn't force myself to get up. No other symptoms just extreme fatigue

Other Meds:

Current Illness: none

ID: 1109342
Sex: M
Age: 34
State: TX

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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: Reports dizziness, fainted for few minutes. history of same symptom with venipuncture. BP: 71/42; Repeat: 110/69 HR: 57 Sp02: 97% Refused to be transported to ER, refusal form signed. Seen and cleared by EMS

Other Meds: NONE

Current Illness:

ID: 1109343
Sex: F
Age: 66
State: NE

Vax Date: 03/09/2021
Onset Date: 03/11/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: Formaldihyde and amlodapine

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

Symptoms: Started getting little tiny bumps in random places on my body that would itch extremely and then look like a hive but it went away in about 20 minutes. Then it might be on my foot or back and do the same thing. Had a low grade fever and started getting fever sores on my lip and took Valtrex.

Other Meds: Synthroid, Lorsartan, Carvediol, Vitamin D supplement

Current Illness: none

ID: 1109344
Sex: F
Age: 72
State: AZ

Vax Date: 03/09/2021
Onset Date: 03/16/2021
Rec V Date: 03/17/2021
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: Pennecilin, pneumonia vaccine, ant bites.

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

Symptoms: No symptoms for 6 days. On 7th day arm discomfort and a large red area on upper left arm

Other Meds: Lisinopril 20mg, metoprolol succer 25mg.

Current Illness:

ID: 1109345
Sex: F
Age: 60
State: FL

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/17/2021
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: Penacillin

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

Symptoms: High blood sugar Irregular heart beat

Other Meds: Metfotmin Bydureon Pradaxa Bystolic Fleccanide

Current Illness:

Date Died: 02/23/2021

ID: 1109346
Sex: F
Age: 86
State: OR

Vax Date: 02/17/2021
Onset Date: 02/23/2021
Rec V Date: 03/17/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: When patient didn't show up for her second COVID-19 vaccine today 3/17/21, we couldn't reach her so we contacted her Dr. office. They informed us that patient visited the emergency department on 2/22/21 and passed away while in the hospital on 2/23/21.

Other Meds:

Current Illness:

ID: 1109347
Sex: F
Age: 55
State: AZ

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/17/2021
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: yellow cherries, beef heart

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

Symptoms: Day #1, face tingling began at 3:00pm-10:00pm, localized redness and pain at injection site on right arm. Day# 2,generalized body aches, headache, fever (101), face tingling all day, pain and redness at injection site. Day #3, tiredness, face tingling at 12:00PM-10:00PM, pain/swelling and redness at injection site. Day#4, slight cough with phlegm, and slight wheezing in morning and bedtime . pain/swelling/redness at injection site. Day #5, Slight wheezing in AM, Pain, redness and edema at injection site and on the whole upper Right upper arm.

Other Meds: flonase, allergy eye drops, ear drops, allergy pill, multivitamin, lysine.

Current Illness: Sinus Infection, Right Ear Infection, Right eye irritation due to seasonal allergy

ID: 1109348
Sex: M
Age: 65
State: WA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/17/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: propoxyphene

Symptom List: Ear pain, Hypoaesthesia

Symptoms: swelling at injection site, tenderness, low fever, chills, headache, muscle pain

Other Meds: sinent cr 50/200mg, lisinopril 20mg,

Current Illness:

ID: 1109349
Sex: M
Age: 25
State: PA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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: About 5 minutes after getting the vaccine, patient started to have tunnel vision, loss of hearing, change in LOC unable to answer where he was, he was pale, diaphoretic and unable to respond to signals patient stated he was going to pass out he was removed from the chair and placed on the floor with his legs in the air, his pulse via palpation was slow, he stated that he does not like needles and he had a similar reaction to the H1n1 vaccine . He was placed on a back board and lifted to a litter and taken to the medical obs, vital signs on arrival were 134/75, pulse72 and oxygen 100 in the right arm, @ 1830 , and at 1834 vital 148/88 HR 75 pulse ox 99 on room air. patients skin was now warm and dry, he reported that he was feeling better, at 6:35 bp 133/81, patient was then placed in a sitting position and blood pressure with position change was :143/92, pulse 68 and 99% on room air, standing after 1 minute patient was 145/87 and heart rate 78 and pulse ox 99%. Patient reported feeling better. His color had returned, he was given water and monitored for another 5 minutes.

Other Meds:

Current Illness: none

Date Died: 03/15/2021

ID: 1109350
Sex: F
Age: 67
State: MO

Vax Date: 03/11/2021
Onset Date: 03/15/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: adhesive, aluminum-magnesium hydroxide, dicloxacillin, ketorolac, lidocaine, penicillin, povidone-iodine

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

Symptoms: unexplained death on 3/15/21

Other Meds: codeine-guafenesin, omeprazole, tizanidine, duloxetine, doxepin, ondansetron, amlodipine, fluticasone-salmeterol, monteleukast, ropinirole, simvastatin, cetirzine, bupropion, buspirone, methotrexate, oxycodone, loperamide, ergocalciferol

Current Illness: admission 2/28-3/1 for chronic cough, recent sob, chest pain. evaluation at that time including CTA chest, cardiac stress test unremarkable. further outpatient evaluation for the cough was pending.

ID: 1109351
Sex: F
Age: 65
State: CA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/17/2021
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: Vicodin

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

Symptoms: Pt was in COVID-19 Observation area pt complained of Headache , shakyness, and Nausea. B/P @ 128/53 P-82. Doctor available in Observation area to evaluate pt and pt taken to Clinic via W/C by R.N..

Other Meds: None

Current Illness: None

ID: 1109352
Sex: M
Age: 61
State: VA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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: Unevaluable event

Symptoms: diarrhea.

Other Meds:

Current Illness:

ID: 1109353
Sex: M
Age: 58
State: CA

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/17/2021
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: Penicillin

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

Symptoms: headache, malaise, myalgia, poor appetite x 24 hours - I was flat on my back on 3/6/21, but fully recovered on 3/7/21

Other Meds: Lisinopril for hypertension

Current Illness: none

ID: 1109354
Sex: F
Age: 0
State: NE

Vax Date: 03/17/2021
Onset Date:
Rec V Date: 03/17/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: During the 15 min. observation period post vaccination this individual reported tingling in the back of her tongue and feeling hot. Reported no difficulty swallowing, and no difficulty breathing. Observed for 30 minutes and released following report if decreased symptoms.

Other Meds:

Current Illness:

ID: 1109355
Sex: F
Age: 71
State: WA

Vax Date: 02/26/2021
Onset Date: 03/04/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List: Injection site pain, Menorrhagia

Symptoms: About 18 months ago, I was bitten by swarms of black flies and had a strong reaction to numerous bites on both arms. Inflamed, itchy, painful. They went away after 2 months. Within a week of the second dose of the vaccine 02/26/2021, the exact pattern of bites showed up again on both arms. Very itchy, inflamed, and looking like bites again. Could this possibly be related?

Other Meds: Vitamin B, D, cinnamon

Current Illness: none

ID: 1109356
Sex: F
Age: 66
State: IL

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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: PCN- hives

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

Symptoms: Patient was being observed for 30 minutes, did not complain of any symptoms during this time. When observation nurse was checking on patient to allow the to leave, resident complained of light headed. Patient brought to triage for evaluation. Patient reported they had a Vasovagal response 6 years ago. Vital signs were taken, all within normal limits. Ice pack was applied to back of neck, as patient felt flushed and juice was given. Patient said she did not eat breakfast when asked. Patient was observed being very restless and rubbing/scratching her arms, scalp and upper back. Rash was noted on upper back left side, NO hives. Benedryl 50 mg IM was given. Called patients friend, patient did not want emergency contact called for pickup. Patient's friend was willing to come and pick her up. Patient observed with diminished restlessness and itching. Patient reported a "tightness" in her neck muscles, almost like she had swollen glands. Patient was able to talk well, no c/o of SOB or difficulty breathing or itchiness of her throat. Patients friends arrived, informed of the incident. Patient was sleepy, rash was gone, patient denied any more itching, patient appeared more peaceful. Advised if she had any worsening symptoms or signs of a severe allergic reaction to call 911. Patient stayed in total for 90 minutes. Patient was assisted by nurse to her friends car.

Other Meds: unknown

Current Illness: None

ID: 1109357
Sex: M
Age: 29
State: CA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/17/2021
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: Fever of 100 degrees accompanied by chills started approximately 7.5 hours after administration and persisted until through going to bed. Cleared up by the morning

Other Meds: None

Current Illness: None

ID: 1109358
Sex: F
Age: 67
State: PA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient exhibited a forceful cough for a few minutes after receiving vaccine. RN talked with patient through care giver as patient does not speak English, as well as an on site interpreter. Patient described feeling "dizzy" and "sleepy" . patient's care giver described the patients' history of absent seizures brought on by panic attacks. In this anxious state, patient was tachycardia, hypotensive, and tachypneic. RN monitored patient as she lost consciousness for about 7 minutes. in this state, patient was unresponsive with normalized heart rate and respiratory rate. Blood pressure was measured when patient was out of consciousness and was hypotensive. Patient began to regain consciousness after about 7 minutes and was oriented to person, but not place or time. Care giver insisted on not calling for an ambulance and he would take her home. Patient was given 16 ounces of water and vitals monitored for about 20 more minutes until patient was normotensive and orientedx3 and was discharged to home with care giver.

Other Meds: Gabapentin Lexapro vitamin B12 levothyroxine

Current Illness:

ID: 1109359
Sex: F
Age: 62
State: TX

Vax Date: 03/05/2021
Onset Date: 03/15/2021
Rec V Date: 03/17/2021
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: Sumycin, Thimerasol

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

Symptoms: On May 15, 2021, I developed an extremely itchy rash at the site of vaccine injection. The rash moved down my arm and then on my other arm (on both arms all the way to the wrist) and also on both legs, and groin area.

Other Meds: Metformin, Pantaprazole, Cetirzine, Fluoxetine, Colestipol, Pravastatin, Amlodipine, Vitamin D3, Milk Thistle

Current Illness: None

ID: 1109361
Sex: F
Age: 36
State: TX

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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: hand tremors tingling in the throat Denies SOB, chest pain BP: 146/108 HR 70 Sp02: 97% Refused hospital transport, signed refusal form, seen and cleared by EMS

Other Meds: none

Current Illness:

ID: 1109362
Sex: F
Age: 53
State: IN

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: As soon as I got to my car in the parking garage my left knee started hurting, like aching. Went to the store when I got home my left ankle and the top of my left foot started to hurt. Fell asleep took a nap and woke up and my whole body hurt left arm was really hurting. Woke up Sunday morning and whole body hurt X10! Back, knees, hands, wrists, fingers, shoulders, shoulder blades, neck, left arm. Woke up Monday and could hardly move right arm and this is Wednesday and it still hurts, hands and wrists still ache, not as bad but still do. It seems like it really got to my joints, which I already have issues with but since the shot the issues have increased X10.

Other Meds: Vitamin D3/5000 IU/day Curcumin/750mg/day Simplinano/900mg/full spectrum us grown hemp with glutathione

Current Illness: none

ID: 1109363
Sex: F
Age: 65
State: OH

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Yeast Molds Sensitive to dairy and gluten

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

Symptoms: I went back to work, but started feeling a little sluggish around 2pm. By 5:30pm, I had a fever. It went up to 101 and I had chills throughout the night. I was extremely nauseous and then started vomiting. Afterwards, I went back to bed. I continued to monitor my temperature and drinking fluids. I felt depleted and I was extremely achy. I had a headache, but not a migraine like the first time. It lasted for about 48 hours just like the first time. By Sunday evening, my symptoms started to go away. I didn't eat much, though. I was able to go to work the next day. Did not seek treatment this time.

Other Meds: Enalapril Maleate HCTZ -1025mg - 1x a day morning Guanfacine Hydrochloride -2mg - 1x a day morning Levothyroxine - 88mcg - 1x a day morning Atorvastatin - 20mg - 1x a day before bedtime Famotidine - 20mg - 1x a day morning Cyclobenzaprine

Current Illness:

ID: 1109364
Sex: F
Age: 65
State: IL

Vax Date: 03/05/2021
Onset Date: 03/10/2021
Rec V Date: 03/17/2021
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: I was diagnosed with bells palsy in 2005. Full recovery with small amount of paralysis remaining on left side of face (left corner upper lip). About 5 days after vaccine noted chewing differently. Eight day after vaccine new paralysis on left side of face now extending to entire jaw area and upper and lower lip. New paralysis on right side of face. Eye won't blink, eye brows won't raise, unable to puff jaw and area next to noise won't move. Twelve days after vaccine minimal improvementlater

Other Meds: amlodipine 10mg; levothyroxine 50mcg; aspirin 81 mg; multivitamin; glucosamine

Current Illness: hypertension; hypoactive thyroid

ID: 1109365
Sex: F
Age: 47
State: OH

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/17/2021
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: Topamax

Symptom List: Tremor

Symptoms: Seizure. Convulsions, lost consciousness, amnesia, high blood pressure, confusion. Numbness of lower lip, tingling in hands and feet, consistent headache, fatigue, memory problems, and filling out of my body are all still occurring five days later.

Other Meds: Synthroid, cytomel, lunesta, amitryptaline, tramadol, methotrexate, prednisone, sumitryptan

Current Illness: Covid and pneumonia

ID: 1109366
Sex: F
Age: 48
State:

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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: codine

Symptom List: Erythema, Pruritus

Symptoms: Patient reports tingling to left arm where she received her vaccination and numbness. No lightheadedness or dizziness. Cleared by EMS

Other Meds:

Current Illness:

ID: 1109367
Sex: M
Age: 69
State: UT

Vax Date: 03/03/2021
Onset Date: 03/14/2021
Rec V Date: 03/17/2021
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: None

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

Symptoms: Patient had minimal reaction to the first Moderna vaccination--nothing more than a sore arm. Ten days later he awoke feeling dehydrated and drank some water which he immediately vomited back up. No food had been consumed. He then developed a cutting sore throat (as in the feeling of strep throat) and developed a fever of 101+ along with general joint aches. In about four hours the fever dropped abruptly along with the sore throat. Patient felt tired the rest of the day then awoke the next day feeling fine.

Other Meds: None

Current Illness: None

ID: 1109368
Sex: F
Age: 36
State: MI

Vax Date: 03/01/2021
Onset Date: 03/11/2021
Rec V Date: 03/17/2021
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: Benadryl, lyrica, asprin, Zithromax

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

Symptoms: Shortness of breath, fainting with fall loss of consciousness, Racing heart 160s for prolonged period of time, feeling of squeezing of chest/lungs, dizziness, severe nausea, muscle pain, severe back pain.

Other Meds: Amitriptylene Effexor

Current Illness: Pelvic floor dysfunction, fecal incontinence

ID: 1109369
Sex: F
Age: 27
State: NY

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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: Tylenol allergy on pharmacy file, but patient marked "No allergies" on Vaccine Administration Record.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: First: Extreme lightheadedness, difficulty seeing, fingers very red. Patient was given water while she sat. Second (minutes later): Tightness of the throat and difficulty speaking. Epinephrine 0.3mg and diphenhydramine 25 mg given. Over the next 30 minutes the patient's symptoms resolved.

Other Meds:

Current Illness:

ID: 1109370
Sex: F
Age: 35
State: AZ

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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 documented in electronic health system

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

Symptoms: Vaccine given 3/17 @ 1150am. Started itching on hands and feeling SOB and CP 3/17 @ 1220. Brought to ER by EMS 3/17 @ 1255. ER did not note a rash but patient was scratching when arrived and examed no angioedema/wheezing/or strider. Was given po diphenhydramine 25mg x 1 and famotidine 20mg po x 1. Sx resolved.

Other Meds: unknown

Current Illness: no

ID: 1109371
Sex: F
Age: 68
State: ME

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/17/2021
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: penicillin

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

Symptoms: Moderna Covid-19Vaccine With-in 3 hours of my second shot, I could not lift my arm which lasted for two days. Although my range has improved, it has been almost 2 weeks and my left arm/shoulder hurts, aches, and is still painful. It interrupts my sleep. (This was a different experience from the 1st Moderna shot.) Treatment includes ice/heat, advil, and a massage.

Other Meds:

Current Illness: none

ID: 1109372
Sex: M
Age: 40
State: MI

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: medications: none allergies / sensitivities to foods (not necessarily a true IgE): constantly changing, but lately has included eggs, dairy, shellfish, peanuts, other roasted nuts, some sugars, molds and fungi * on 3/8/21 I began 5 days of non-traditional allergy and sensitivity testing using AAT. Among other things it showed I was having both a true IgE response and other sensitivities to vaccine components. These changed from day-to-day throughout the week.

Symptom List: Pain in extremity

Symptoms: It has been 6 weeks since my 2nd dose of the Moderna vaccine for Covid-19. For the first 3-4 days I had the usual moderate flu-like symptoms: dizziness, headaches, fatigue, chills, soreness at vaccine siteetc. Days 5-7 I seemed to gradually improve. On day 8 all of the symptoms returned with greater severity: this time I had a fever, the chills were much more intense, the headaches were excruciating, body and joint aches all over the place--I couldn't sleep or focus on anything cognitively taxing. Interestingly, my brother, who was vaccinated just after me, also had more severe side effects beginning on day 8 post 2nd dose. He improved after 3-4 days, but my recovery has been much much lengthier. By day 14 I was still feeling very ill, though the fever did subside. Sometime in the third week the pain in my arm at the vaccination site returned, then became intermittent, and still bothers me from time to time. I also started getting muscle spasms in the same exact locations that sent me to the ER after my probably bout with Covid in the spring of 2020. Thankfully these lasted only a week or so, though I began feeling muscle soreness in different parts of my body, ever changing. By the 4th week I was slightly better and down to 4 main symptoms: chills (by far the worst of the symptoms--to the point at which my skin would feel like it was being frostbitten by dry ice every time I changed sweaty clothes), occasional splitting headaches, and muscle soreness that included both the injection site on my arm and other areas. I had other symptoms as well, fatigue and brain fog, etc, but these were present before the vaccination, though not as severe.

Other Meds: Day of vaccination: Modafinil, Dufloxetine, Malate, D-Ribose, Bovine Derived Serum IgG, Probiotic, Licorice root extract, Vitamin D Day before vaccination: I may have taken a Zyrtec, Melatonin, and low dose of THC/CBD oil.

Current Illness: After my first Moderna dose on 1/10/21 I had much milder and short-lived flu-like symptoms, but other than those I had no illnesses (besides my chronic conditions) within one month prior.

ID: 1109373
Sex: F
Age: 63
State: OK

Vax Date: 03/08/2021
Onset Date: 03/15/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs - rash all over

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

Symptoms: Received Moderna 1st dose on 3/8. On March 14th the injection site itched like crazy, then the area swelled, becoming red, hard, and hot. Her symptoms have not resolved at this time.

Other Meds: Multi vitamin daily

Current Illness: None

ID: 1109374
Sex: M
Age: 55
State: WA

Vax Date: 03/01/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Headache, dizziness, nausea, feel like I have a fever.

Other Meds: Imipramine Fluoxentine Lisinopril Metformin CoQ10 Low dose aspirin

Current Illness: Following the second Moderna vaccine, the next day I got really sick. Fever, nausea, dizziness, aches in muscles, headache. The second day after, I was fine until this afternoon. Tylenol is not helping as much as it did when I experienced the side effects the day after the second Moderna vaccine. But maybe this is normal. I do not know. I hate to think I ha e had the shots but I am now sick 2.5 weeks later. And I am a very diligent mask wearer and I follow all the guidelines. I hope this is nothing, but I am sorry for wasting your time if it is. Best regards,

ID: 1109376
Sex: F
Age: 65
State: LA

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

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

Lab Data:

Allergies: None

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

Symptoms: Severe vomiting within 45 minutes of receiving vaccine. I had 4 distinct vomiting episodes, vomiting 3 or 4 times during each episode. I took a single dose of Zofran at about 2 pm and had last vomiting episode around 4 pm. Vomiting episodes lasted a total of about 6 hours. I had chills for about an hour right after 1st vomiting episode. I had significant left arm pain that prevented use of arm for 2 days. I also had extreme weakness the 1st day, I couldn?t get out of bed except to vomit. I got the vaccine on Wednesday and didn?t feel fully recovered until Sunday.

Other Meds: None

Current Illness: None

ID: 1109377
Sex: M
Age: 22
State: TX

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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: nuts

Symptom List: Vomiting

Symptoms: ringing in the ears, nausea, numbness in extremities BP: 124/62 HR: 70 Sp02: 98% Seen and cleared by EMS

Other Meds: none

Current Illness:

ID: 1109378
Sex: F
Age: 59
State: MD

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 03/17/2021
Hospital: Y

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

Lab Data:

Allergies: Gluten and lactaid

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I tested positive for Covid on November 11th 2020,and was asymptomatic. Within 48 hrs of getting the vaccine both my right hand and right leg started tingling and I had pins and needles sensation. I also woke up in the middle of the night with immense night sweating. My arm started becoming numb and cold. I talked to a doctor and she suggested I go to the ER right away as this could be indicative of a minor stroke. I was admitted in the hospital as they needed to run several tests. I spoke with other doctors who suggested not taking the 2nd shot as it could make matters worse. So I opted out of taking the 2nd jab. I wonder if there is any study about adverse reaction for former Covid positive people and if they are better of only taking the 1st jab. Another Covid positive friend also had a similar reaction after the 1st jab. His right side of face became numb. I am worried about lasting damage if any. Could somebody please get back with me on this.

Other Meds: Vitamins

Current Illness: slightly elevated blood pressure

ID: 1109379
Sex: F
Age: 62
State: PA

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/17/2021
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:

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

Symptoms: tiredness; achiness; headache; soreness of arm; redness from injection site to just above elbow; chills; weakness; vomiting; Symptoms started slightly in the morning and progressing throughout the day. I did not feel like eating at dinnertime (5:30) but only ate a little with my medication. Was very tired but stayed awake until about 8:45. I was so weak I could not stand up to get out of the bathtub (my husband picked me up from behind). I vomited and felt warm. I went to bed and had a headache in the night that lasted most of the next day (Friday). I took 2 tylenol in the morning on Friday and then 2 more about 4:00 in the afternoon because i still had the headache. The redness on my arm lasted until today, Wednesday, Mach 17. There was also soreness, warmth and itchiness in this area.

Other Meds: metformin; atorvastatin; 81mg aspirin; calcium; black elderberry supplement; multi-vitamin; vitamin B12

Current Illness:

ID: 1109380
Sex: F
Age: 31
State: CA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/17/2021
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: 1401- cold, clammy, diaphoretic, hypoxic (vital signs: b/p 90/70, 87% on Room Air, 20 respirations, 68 HR) 1404- RRT called 1404- 2-3 seconds of shaking, no medical history, per pt 10 weeks pregnant 1409- 101/69 99% 02 2L n/c, 69 HR, 20 RR 1420- 113/70 99% 02 2l n/c, 68 HR, 20 RR (pt transferred to ER)

Other Meds:

Current Illness:

ID: 1109381
Sex: M
Age: 17
State: NJ

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 03/17/2021
Hospital:

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

Lab Data:

Allergies: no known allergy

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

Symptoms: Patient was only 17 years old and 10 months, and moderna covid 19 vaccine was indicated for 18 years old . Neither patient nor parents reported any adverse events and no treatments were reported.

Other Meds: none

Current Illness: Seizure

ID: 1109382
Sex: M
Age: 42
State: NY

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/17/2021
Hospital: Y

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: Acute cholecystitis

Other Meds: 5 mg escitalopram

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm