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: 1112068
Sex: F
Age: 66
State: UT

Vax Date: 03/02/2021
Onset Date: 03/13/2021
Rec V Date: 03/18/2021
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: adhesive, cefaclor, clindamycin, codeine, penicillins, sulfacetamide, and trazodone

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient developed itchy rash at injection site 1.5 weeks later.

Other Meds: Premarin cream, methotrexate, folic acid, atorvastatin, claritin, hydrochlorothiazide

Current Illness: none

ID: 1112069
Sex: M
Age: 31
State: GA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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: Unknown

Symptom List: Anxiety, Dyspnoea

Symptoms: Dizziness; Vital signs: 12:29pm 112/78 67 18 O2 96%; 12:39pm 116/80 67 18 O2 96%; Patient stated he was no longer feeling dizzy after eating a snack and drinking water. DISPOSITION: Stable no longer feeling dizzy.

Other Meds: Unknown

Current Illness: Unknown

ID: 1112070
Sex: M
Age: 60
State:

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 03/18/2021
Hospital: Y

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: WEAKNESS - GENERALIZED GENERALIZED BODY ACHES SORE THROAT ALLERGIC REACTION

Other Meds:

Current Illness:

ID: 1112071
Sex: F
Age: 22
State: VA

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
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: Red mark at injection site and headache

Other Meds:

Current Illness:

ID: 1112072
Sex: F
Age: 61
State:

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, augmentin

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

Symptoms: Pt states that 5min after vaccination she developed a headache, her nose was tingling about an hour later, she took tylenol and currently 4-5h later her lip is tingling.

Other Meds: per chart abilify, hydrodiuril, ativan, prilosec, zoloft, trazodone

Current Illness: unknown

ID: 1112073
Sex: M
Age: 71
State: CA

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: No

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

Symptoms: The next day I had muscle soreness in both my buttocks. this lasted 3 days,

Other Meds: No

Current Illness: No

ID: 1112074
Sex: F
Age: 72
State: GA

Vax Date: 02/16/2021
Onset Date: 02/22/2021
Rec V Date: 03/18/2021
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: Avalox, ACE Inhibitors, Mobic, Celebrex, Tetracycline, Sulfa, Ulltram, Toprol XL, Codeine, Ethacrynic Acid, Seafood

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: atient called Re: symptoms she is having after she received her 2nd COVID vaccine. Patient received 2nd shot of Moderna vaccine 02/16/2021. Patient could not give a specific time frame for when symptoms started but states that "she knows it was after her 2nd COVID vaccine." Patient c/o pain across the back of her shoulder blades, hair loss and numbness in left thigh, swollen left ankle and calf. Patient states that she "has had left ankle swelling in the past but not to this extent." Patient states that she has appt with dermatologist on 03/24/2021 and that she has appt with her primary care doctor in May but that she is going to call and get appt moved to a sooner time. Advised patient that I would complete a VAERS report. Encouraged patient to F/U up with doctors as scheduled.

Other Meds: Unknown

Current Illness: Unknown

ID: 1112075
Sex: M
Age: 47
State: VA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
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: He received his Moderna vaccine and was sitting in waiting area with his spouse for his 15 minute post vaccine wait. RN was alerted that he did not feel well. RN #1 assessed him and gave him 10ml of Benadryl liquid due to his complaints of itchy/scratchy throat and difficulty breathing. Heart rate was 80 and respirations were 20. He reported he last ate at 8pm the night before and was too nervous to eat breakfast. RN #2 provided him with fruit juice and sliced apples. He reported feeling better and then two minutes later complained of feeling hot and cold and foggy headed and not right with some anxiety. RN #1 called local EMS/Fire Rescue and they arrived to assess him. Vital signs were within normal limits. He was transported to Hospital for further evaluation. He was alert and oriented and able to ambulate to EMS/Fire Rescue vehicle.

Other Meds:

Current Illness:

ID: 1112076
Sex: F
Age: 36
State: TX

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 102 fever for 2 days Nausea Fatigue Body aches Chills Chest tightness Sore throat

Other Meds: Tirosint, iron supplement, Vitamin D, albuterol as needed

Current Illness: Hashimotos, hypothyroidism, asthma

ID: 1112077
Sex: F
Age: 40
State: IL

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/18/2021
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: Penicillin, Cipro, Levaquin, Vicodin, Coconut

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Medal taste in mouth within 10 minutes. Next day cold sore/fever blister in crease of lips left side. Day 3 cold sore/fever blister in crease of lips right side. 10 days later lips full of fever blisters. See by APN, prescribed VALACYCLOVIR HCL 1 GRAM TABLET, 2 tablets every 12 hours for 24 hours. Prescribed same medication again on 2/23, not staying gone. On 2/25 started ACYCLOVIR 400 MG TABLET 1 tablet bid.

Other Meds: Sertaline 200mg qd

Current Illness: Anxiety

ID: 1112078
Sex: F
Age: 53
State: MS

Vax Date: 03/15/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: TENDERNESS IN LEFT ARM , NEAR BREAST AND LYMOH NODE AREA

Other Meds:

Current Illness:

ID: 1112079
Sex: F
Age: 34
State: KS

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Progress Notes APRN (Nurse Practitioner) ? ? Family Medicine Cosigned by: MD at 3/18/2021 2:52 PM Expand AllCollapse All COVID VACCINE CLINIC 3/17/2021 Date: 3/17/2021 Subjective Patient is a 34 y.o. female who was seen at COVID Vaccine Clinic today for her second dose of the COVID 19 vaccination. She was given the Pfizer vaccination in the left deltoid muscle. During her 30 minute waiting period after the injection, the patient began to experience itching. She denied rash, hives, welts, difficulty breathing, difficulty swallowing, wheezing, throat tightness, hoarseness, dizziness, facial swelling, lip swelling and tongue swelling. This provider was notified of patient reaction and she was then assessed in the emergency bay area. Monitored patient for severe reaction symptoms, including but not limited to blood pressure abnormality , rapid progression of symptoms, respiratory distress, skin changes and tongue swelling. Medical hx insignificant ALLERGY REVIEW OF SYSTEMS: Patient complains of itching of skin Patient denies chills, fever, malaise/fatigue, facial swelling, sore throat, frequent throat clearing, eyes watering, eyes itching, cough, chest tightness, shortness of breath, wheezing, rash, hives, vomiting, abdominal pain, muscle aches, joint pain, dizziness and headaches Previous Reactions: same itching with 1st vaccine of Pfizer. Objective Vitals Vitals: 03/17/21 1625 03/17/21 1640 BP: 128/74 124/79 Pulse: 71 SpO2: 100% Physical Exam Constitutional: General: She is not in acute distress. Appearance: Normal appearance. She is well-developed. She is not diaphoretic. HENT: Mouth/Throat: Mouth: Mucous membranes are moist. Pharynx: Oropharynx is clear. Eyes: Extraocular Movements: Extraocular movements intact. Conjunctiva/sclera: Conjunctivae normal. Pupils: Pupils are equal, round, and reactive to light. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Pulses: Normal pulses. Heart sounds: Normal heart sounds. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No wheezing. Skin: General: Skin is warm and dry. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Gait: Gait normal. Psychiatric: Mood and Affect: Mood normal. Behavior: Behavior normal. Thought Content: Thought content normal. Judgment: Judgment normal. Assessment/Plan Treatment included: antihistamines benadryl and pepcid Follow up response to treatment: fair. Patient discharge: Stable to go home and follow up with PCP. Differential Diagnosis: Systemic reaction (hypoglycemia, hypotension, generalized rash) All over itching. Similar to last time. Pt given benadryl 50 mg and pepcid 20 mg. Pt not drowsy at time of discharge. States she does fine with benadryl. She feels comfortable going home and managing it on her own. States she will seek emergent care if new symptoms arise. Pt wishes to be discharged. Discussed symptoms to monitor for. No progression of symptoms while observed in the bay. APRN Electronically Signed 3/17/2021 5:00 PM

Other Meds:

Current Illness:

ID: 1112080
Sex: F
Age: 32
State: CA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: salmon

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

Symptoms: About midnight, I woke up feeling really bad chills and I checked my temperature and I had fever of 101. I took Tylenol. No amount of blankets could make me feel like I wasn't freezing. After a few hours, I went back to sleep and had off and on fever and chills and whole body aches - especially stomach - for next four days. I rotated Tylenol and Motrin every 4-6 days. After fourth day, stomach pain got worse where it hurt to breathe. The chills had gone away. I thought I had constipation because of the pain meds and I tried to take a laxative but that didn't help it all and it made the pain worse. I went to URGENT CARE January 18- gave me Flagel and Cipro and they ordered Ultrasound which I had on the 19th. - Covid test - negative. Put me on Vancomycin - after the Flagel - I took that for 10 days. That helped with symptoms.

Other Meds: IUD - Zololeta

Current Illness: none

ID: 1112081
Sex: F
Age: 59
State: OH

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/18/2021
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: No medication or food allergies. I do have medication and food sensitivities and thus try to avoid these things. Seasonal allergies; esp. spring and fall (grass, molds, pollens) typically controlled with Clariton D or Zyrtec D and Flonase during peak times.

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

Symptoms: Woke on the morning after the shot 2/27/21 with a low grade fever (100), fatigue, headache, joint and muscle pain and slightly swollen lymph nodes in my neck. Within a few hours, my body was completely covered in large hives from head to toe. I rested or slept most of the day and by the afternoon, the fever had subsided. By the next day headache, joint/muscle pain and swollen lymph nodes diminished. I still felt fatigue and the hives were awful. Began taking Benadryl with no relief. Called my primary care doctor to report; increased Benadryl dosage to 2 every 4 hours. There was some relief during the day, but the large doses of benadryl were making me anxious/nervous, racing heart, shakes. Decreased following another call to Doctor and began taking Antronex; decreaed side effects, but little affect on the hives during the evening/overnight hours. At times I would be completely covered in them, other times they were localized (bottoms of my feet, face, neck, eyes). Returned call to Doctor, again suggested Prednisone. (I typically have strong reactions to steriods and wanted to avoid if at all possible) Began first dose 3/18/2021. Experiencing some relief already.

Other Meds: Prescriptions: Levothyroxine Suppliments: Cataplex C, Vitamin D/K2, Zinc, Magnesium, Clariton D

Current Illness: No illnesses to report

ID: 1112082
Sex: F
Age: 85
State: WI

Vax Date: 03/12/2021
Onset Date: 03/14/2021
Rec V Date: 03/18/2021
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: Adhesive, bee sting, food extracts, nortriptyline, PCN, pravastatin, prednisone, shell fish, sulfa

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

Symptoms: Patient developed rash cheek, wrist, back of neck 3/14/21. Had received 1st dose of Moderna Covid-19 3/12 but also took her 1st dose of Aricept this same day.

Other Meds: Tylenol, vit c, ASA, debrox otic, Aricept, neurotin, metoprolol, MVI, nitro SL

Current Illness: Unknown

ID: 1112083
Sex: M
Age: 63
State: VA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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: levaquin codeine

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

Symptoms: numbness and tingling in left hand diarrhea , fever chills nausea vertigo malaise increased heart rate decreased 02 stat

Other Meds: voltaren 75 mg lisinopril 20 mg asa 81 mg silver mens multivitamin

Current Illness:

ID: 1112084
Sex: F
Age: 72
State: NC

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/18/2021
Hospital: Y

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: Patient reports feeling symptoms later the same evening the day of receiving her 2nd dose of Moderna. Her twin sister, also reported similar symptoms after receiving her 2nd dose of Moderna the same day (3/5/21). Patient reported feeling nausea and having "extreme" chills that evening. The next morning at 8 a.m. Patient called her sister, at 8 a.m. When she arrived at her sister's house she found patient unresponsive. She was taken to the hospital and remained there for 5 hours. Patient reports passing out, losing control of her bodily functions and hitting her head on a heavy resin figure. "Blood was all over the place." She reports that 2 spots on her scalp were bleeding and subsequently treated at the hospital. Patient currently is still experiencing extreme fatigue following the vaccination.

Other Meds:

Current Illness:

ID: 1112085
Sex: M
Age: 65
State: CO

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Ear pain, Hypoaesthesia

Symptoms: When MA was administering vaccine, needle was in patients arm and hub where needle is attached to syringe was loose. Contents of syringe leaked out around needle. Unsure how much vaccine was actually administered into patients arm. Question: Do we need to revaccinate patient's second dose? If so, how long before we have the patient return for that dose? Thank you.

Other Meds: Crestor, Lisinopril, Metronidazole, Meformin

Current Illness:

ID: 1112086
Sex: M
Age: 28
State: MN

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/18/2021
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: Client vaccinated with First Dose Moderna at 3:20 pm. 10 minutes later reported feeling light headed and faint. BP 130/100; P 85, 02 sat 99%. Laid client down for 20 minutes and sated felt better and sat up. Provided crackers and juice. No itching or welling. BP taken every 5 minutes until 4:05 when it was BP 122/80; P 74 and 02 sat 100%. Suggested client get someone to pick him up but he declined and left at 4:15.

Other Meds: Unknown

Current Illness: Unknown

ID: 1112087
Sex: F
Age: 53
State: OH

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: PT CALLED INTO THE OFFICE REPORTING THAT HER ARM IS RED, HOT, RAISED, FIFTY CENT PIECE IN SIZE, DENIES RED STREAKS OR FEVER, ADVISED TO TREAT WITH OTC MEDICATIONS , IF S/S CONTINUE TO SEE MEDICAL ATTENTION WITH HER PCP, AWARE, VERBALIZED UNDERSTANDING

Other Meds:

Current Illness:

ID: 1112088
Sex: F
Age: 48
State: PA

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/18/2021
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: Sudafed - makes my heart race

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

Symptoms: Continuous and uncontrollable body shaking Low grade fever Fatigue Dry mouth Nausea

Other Meds: Estradiol

Current Illness: None known

ID: 1112089
Sex: F
Age: 37
State:

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 03/18/2021
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: allergic reaction

Other Meds:

Current Illness:

ID: 1112090
Sex: F
Age: 83
State: IL

Vax Date: 03/04/2021
Onset Date: 03/11/2021
Rec V Date: 03/18/2021
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: Lilacs, strawberries.

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

Symptoms: Awoke at 8 a.m. on Thursday. 0311/2021, to find a lot of blood on gown, bedding, and face, coming from left nostril constantly. I don't know how long it had been going on. Kept pressing nostril for about 30 minutes, bleeding didn't stop. I got an ice pack and pressed against nose for 20 minutes, did this off and on 3 times and bleeding finally slowed down and stopped at about 11:00 a.m. There have been no problems since. I have had very few nosebleeds due to dry air and they have been short and light. I have never had one like this. I don't know when it started during the night but ended about 11 a.m. There was a already a lot of blood by 8 a.m. My daughter thought such a rare event might be connected to the vaccine and that I should report it.

Other Meds: Metformin, Benazepril, Simvastatin, Venlafaxine, Escitalopram, Vitamins D3, and B12, Cherry Extract, Milk Thistle, Cinnamon.

Current Illness: None

ID: 1112091
Sex: F
Age: 60
State: NY

Vax Date: 03/14/2021
Onset Date: 03/16/2021
Rec V Date: 03/18/2021
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: some antibiotics

Symptom List: Injection site pain, Pain

Symptoms: Fever 101.7

Other Meds: none

Current Illness: none

ID: 1112092
Sex: F
Age: 69
State: CA

Vax Date: 03/12/2021
Onset Date: 03/16/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Injection site pain, Menorrhagia

Symptoms: On 3/16/2021 at 7:30pm, 4.5 days after vaccine, injection site began to itch, and a red, slightly bumpy patch appeared - approximately 2.5 x 3 inches in diameter. Patient self-treated area with "Sting Stop" gel [Active ingredients (HPUS): Echinacea augustifolia 1X 10%, Ledum palustre 1X 10%, Urtica dioica 1X 10%. Inactive ingredients include Citronella oil & Eucalyptus oil in a water gel base.] Wheal itched intensely and was very slightly burning and tender for 24 hours. There was no fever nor other symptoms. By 7:00 am on 3/18/2021, the itching and rash were greatly diminished.

Other Meds: Amantadine, Low Dose Naltrexone, Cal/Magnesium, Vit D3/K2, B12

Current Illness: none

ID: 1112093
Sex: F
Age: 65
State: MD

Vax Date: 03/04/2021
Onset Date: 03/06/2021
Rec V Date: 03/18/2021
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; phenothiazines and chemically related; MSO4 inj.; NSAIDS except ASA; iodine; adhesive; mold and dust in past

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

Symptoms: Within 2 days of vaccination, I began to experience moderate constitutional symptoms: headache, low grade fever of 99, and mild chills. Sunday AM I noted the onset of intense vaginal itching and burning. By the evening, I was clearly having an HSV2 outbreak. While it was similar in ?scope? to past outbreaks (none for more than 2 yrs.), it was more intense. Lasted slightly longer at 6 days rather than 4. No MD contact made as 1) I cannot take antivirals as they precipitate arrhythmia; and 2) taking antivirals at this time would clearly seem antithetical given the circumstances. This was shot #1.

Other Meds: Estradiol; coQ10; UC-II; vitamin D; digestive enzymes

Current Illness: None

ID: 1112094
Sex: F
Age: 65
State: GA

Vax Date: 03/16/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
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: Decline: causes rash.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Chill on day 2 and woke up day 3 with facial,lip and tongue swelling. I went to hospital and was diagnosed with angioedema.

Other Meds: None

Current Illness: None

ID: 1112095
Sex: F
Age: 34
State: VT

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Lactose intolerant. I'm allergic to something else but I don't know what. I haven't found a doctor that will agree to allergy tests.

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: A few inches below the shot my arm turned red, swelled up, and was hard. It was like that for 8 days. The muscle in my arm has been sore since.

Other Meds: D3, B12, calcium, biotin, birth control

Current Illness: None

ID: 1112096
Sex: M
Age: 65
State: NC

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
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: na

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

Symptoms: na

Other Meds: na

Current Illness: na

ID: 1112097
Sex: F
Age: 40
State: TX

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: shellfish and penicillin cause a rash

Symptom List: Nausea

Symptoms: 3/17/21 around 09:17 face felt hot, had hives on neck and chest , heart felt like it was racing, elevated heart rate B/P 145/117, Benadryl given and transported to emergency department at facility.

Other Meds: unknown

Current Illness: unknown

ID: 1112098
Sex: F
Age: 60
State: OH

Vax Date: 03/16/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: PT CALLED INTO THE OFFICE REPORTING THAT HER ARM IS RED, HOT, RAISED, FIFTY CENT PIECE IN SIZE, DENIES RED STREAKS OR FEVER, ADVISED TO TREAT WITH OTC MEDICATIONS , IF S/S CONTINUE TO SEE MEDICAL ATTENTION WITH HER PCP, AWARE, VERBALIZED UNDERSTANDING, VARES REPORT FILED WITH THE CDC

Other Meds:

Current Illness:

ID: 1112099
Sex: F
Age: 66
State: WA

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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, bell peppers, nitrile products.

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

Symptoms: My first Covid shot on 16 Feb 21 (previously submitted to VAERS) developed a rash on my left arm. It showed up 9 days after the first vaccination. It itched and was about 2.5" by 2.5" inches and 2.5" below the injection site. It lingered for about 3 days and I had no other reactions. My second Covid shot ( 11:30 hours on 16 Mar 21) developed a rash less than 24 hours later. The rash was present on my arm at 0530 hrs on 17 Mar 21. It didn't itch as much but was much larger than the first rash. It is about 3 inches by 3 inches and is in the same spot (about 2 to 3 inches below the injection site). In addition, after the second shot I had a headache and general malaise and fatigue the next day, but that wore off late on the 17th.

Other Meds: Pepcid, Miralax, Urea cream 40%

Current Illness: None

ID: 1112100
Sex: F
Age: 75
State: SC

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/18/2021
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: dairy, latex, pennicillin

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

Symptoms: After the 2nd Vaccine Shot I was very tired, chills and high fevers up to 103 degrees. My husband called doctor office , we were told to take Tylenol and the fever broke the next day, still weak. I had a sinus infection and was on a 5 day antibiotic the week I took the shot. On the last day I had the Covid -19 Vaccine 2nd dose and later came home and took the last antibiotic. Did the anitbiotic interfere with the 2nd Covid-19 Vaccine?

Other Meds: Prescription by doctor for Z pack Antibiotic for 5 days for Sinus Infection.

Current Illness: NONE

ID: 1112101
Sex: M
Age: 27
State: KS

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
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: Unknown

Symptom List: Tremor

Symptoms: 1242: Vaccine administered. 1255: RN called to assist with patient. Caregiver stated that the patient reported that he "felt funny" and "feel like I can't breathe." Caregiver stated that the patient was no longer responding to questions being asked. Caregiver reported not being able to arouse the patient after shaking his leg twice an no response. Caregiver stated that excess secretions from mouth is normal. 1255: Patient responding to questions being asked. Heart rate 123 beats per minute and oxygen saturation level 99% on room air via pulse oximeter. Lungs clear to ausculation. Patient sitting power chair. 1257: Apical heart, regular with a rate 100 beats per minute. 1258: Unalbe to obtain blood pressure in left arm due to tone. 1259: Blood pressure in right arm 168/92. 1303: Blood pressure in right arm 158/98. 1309: Patient reports feeling better at this time. Patient with caregiver. Caregiver verbalized appreciation.

Other Meds: Unknown

Current Illness: none

ID: 1112102
Sex: F
Age: 34
State: IN

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Pain in left armpit (swollen lymph node?), headache, body aches

Other Meds: Bupropion

Current Illness: None

ID: 1112103
Sex: M
Age: 90
State:

Vax Date: 01/26/2021
Onset Date: 02/02/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: ALLERGIC REACTION

Other Meds:

Current Illness:

Date Died: 03/09/2021

ID: 1112104
Sex: F
Age: 90
State:

Vax Date: 02/26/2021
Onset Date: 03/09/2021
Rec V Date: 03/18/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Patient passed away within 60 days of receiving a COVID vaccine

Other Meds:

Current Illness:

ID: 1112105
Sex: M
Age: 41
State: PR

Vax Date: 01/07/2021
Onset Date: 01/13/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: After my first dose vaccine, I developed two large lymph nodes in the sub clavicular aspect of my clavicle, left side. I went to see my surgeon who palpated them and said that they would go down in one or two weeks. These lymph nodes are still present today and I am concerned because I do not know when they will go away.

Other Meds: Synthroid

Current Illness:

ID: 1112106
Sex: M
Age: 50
State: MA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 03/18/2021
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: NKA

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

Symptoms: patient has developed pain, weakness and numbness in left arm

Other Meds: lantus insulin, humalog insulin ,atorvastatin

Current Illness: Deaf IDDM

ID: 1112107
Sex: F
Age: 84
State: PA

Vax Date: 03/13/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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: Sulfa, hydrochlorthiazide, Possible iodine and merthiolate

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

Symptoms: Itching and redness covering an 8"x6" area from the injection site down along the mid to inner aspect of the arm. Definite outline of the patch and the needle entry. This occurred 4 1/2 days following injection. At the time of this report redness and itch present but less after applying Benadryl topically this morning.

Other Meds: Multaq, prilosec, pravastatin, levothyroxine, coumadin, iron, vit d,

Current Illness: n/a

ID: 1112108
Sex: F
Age: 43
State: TX

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/18/2021
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: At 10:50 am a 43 years, female complain of a Metallic taste and ear pain after receiving the vaccination Moderna. Patient has a history of Chronic Nerve pain. No known allergies noted. V/S BP 118/79, HR 77, RR 16, O2 100%. 11:15 am BP 123/88, HR 77, RR 16, O2 100%. Patient was observed for 30 minutes. Patient stated that the ear pain was a 2 out of 10, 10 being the worst pain. Metallic taste had went away. Patient was discharged with family.

Other Meds: None

Current Illness: None

ID: 1112109
Sex: F
Age: 63
State: CA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: @1247 once client?s 15 minutes of observation was completed, she stood up to leave and felt dizzy. LPN assisted client to sit down and notified site managers. Client than reported feeling nauseated and dry heaved. RN and Site Supervisor and EMT arrived to client area. @1248 vital signs: 174/100, 82, 97% RA. Client AAOX4. NAD. Skin WNL. HA. EMT called 911 @1250. Fire Department Engine #1 arrived @1258. EMS repeat vitals @1300: 98.2, 187/102, 73, 20, 99% RA. EMS assessed BP/HR while standing, 218/123, 77. Stroke assessment negative. LAC 20g PIV inserted by Fire Department. BGL 170. County Rescue# 425 arrived @1307. Client showed no signs of improvement and no changes from prior assessment. Client transported to ER via ambulance @1310 in stable condition.

Other Meds: ASA, Norvasc, Losartan, Metoprolol

Current Illness: Denies

ID: 1112110
Sex: F
Age: 38
State: OH

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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: Clams( seafood) , Levaquin , hydrocodone , oxycodone , morphine ( iv only not pills ) - Medication

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

Symptoms: Injection Site Pain , Tiredness, Headache , Joint Pain , Sweating right after receiving the shot about 45 minutes later when it started and ended around 8 am this morning .

Other Meds: None

Current Illness: None

ID: 1112111
Sex: M
Age: 62
State:

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Patient reports feeling a little dizzy, pressure on his head, ringing in his right ear. Felt better after a few minutes. Cleared by EMS

Other Meds:

Current Illness:

ID: 1112112
Sex: F
Age: 68
State: IL

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
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: Patient reports history of 'throat swelling' with iodine.

Symptom List: Vomiting

Symptoms: Patient stated felt like she had sore throat. Felt it was slightly difficult to swallow saliva.

Other Meds: Unknown

Current Illness: Unknown

ID: 1112113
Sex: F
Age: 54
State: NC

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
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: na

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: na

Other Meds: na

Current Illness: na

ID: 1112114
Sex: M
Age: 69
State: IN

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

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

Symptoms: Chills, night sweats, colon discomfort all occurred during the next night. Colon discomfort continues today (3-18-2021).

Other Meds: 1md probiotic, Centrum Silver, lisinopril-HCT 10mg.

Current Illness: diverticular disease

ID: 1112115
Sex: F
Age: 47
State: WI

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
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: penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Achiness 4 hours after injection, fatigue 16 hours after injection. All seemed normal and expected from the vaccine. But then, Digestive tract unsettled around 12:45pm, abdominal discomfort and gas 12:45pm - 1:30pm, multiple bowel movements 1:30 - 2:15pm, diarrhea 2:30 - 2:45pm.

Other Meds: none

Current Illness: none

ID: 1112116
Sex: F
Age: 44
State:

Vax Date: 03/11/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient felt dizzy, light headed, and her limbs felt heavy and spongy (how she described it)

Other Meds:

Current Illness:

Date Died: 03/12/2021

ID: 1112117
Sex: M
Age: 88
State: UT

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/18/2021
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: no known allergies

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

Symptoms: Patient was a patient on hospice, had terminal dx of frontal lobe dementia. NP visited with patient on 03/10/2021, notable decline/flank pain, fever 101. Patient passed away on 03/12/21, Medical Director wanted this reported to VAERS d/t the vaccination was within 72hrs of the pts death.

Other Meds: Multivitamin, Allergy Med, Vit C, Ativan, B-12, Celexa, Chelated Zinc, cholecalcifefol - Vit D3, Crestor, Furosemide, Haloperidol lactate, Keflex, losartan, mangnesium oxide, morphine concentrate, potassium chloride ER, Promethazine, Seleni

Current Illness: Frontal Lobe Dementia, Muscle Weakness, Edema, weight loss

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm