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: 1122218
Sex: F
Age: 65
State: IN

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/22/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Swollen, painful, itchy rash at injection site. Also felt very warm to the touch. Still red and slightly sore with some itchiness ongoing a week later.

Other Meds:

Current Illness:

ID: 1122219
Sex: F
Age: 79
State: PA

Vax Date: 03/03/2021
Onset Date: 03/11/2021
Rec V Date: 03/22/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: 8 days after vaccine, patient presented with headache, severe body aches, fever, chills, and fatigue. Patient had a patchy right upper lobe infiltrate, pulmonary infarction was ruled out.

Other Meds:

Current Illness:

ID: 1122220
Sex: F
Age: 68
State: PA

Vax Date: 03/06/2021
Onset Date: 03/08/2021
Rec V Date: 03/22/2021
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: Patient had a small, itchy rash that started 2 days after the shot. It lasted for 2-3 days then cleared.

Other Meds:

Current Illness:

ID: 1122221
Sex: F
Age: 60
State: MI

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs, menthol/mint oil, hair and food dye, bee stings, hydrocortisone, fragrances, formaldehyde and derivatives thereof, urea, nickel, colophony, tixocortol-21-pivalate,

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Chills, musculoskeletal pain, headache, sinus pain, nausea, tooth sensitivity

Other Meds: Levothyroxine Calcium plus D3 Vitamin C Vitamin B12 Magnesium

Current Illness: None

ID: 1122222
Sex: F
Age: 26
State: WI

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
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 Known Allergies

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

Symptoms: Client received Moderna vaccine at 1817 and at 1825 client intentionally laid down and reported feeling lightheaded, dizzy, and nauseous after receiving injection. Client's skin color appeared pale. Client reports that "this happens every time" she gets vaccines. Client's vital signs were stable: BP 108/72, P 66, O2 99% on room air, and R 16. Client was assisted to sitting position and given some water. After waiting an additional 15 minutes, client reported that her nausea and dizziness had resolved. Client's color improved.

Other Meds: unknown

Current Illness: unknown

ID: 1122223
Sex: F
Age: 36
State: NY

Vax Date: 03/04/2021
Onset Date: 03/09/2021
Rec V Date: 03/22/2021
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:

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

Symptoms: Issues breathing- short of breath, pressure on chest

Other Meds: Synthroid, Crestor

Current Illness:

ID: 1122224
Sex: F
Age: 29
State: AL

Vax Date: 03/20/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Swollen, itchy and red at injection site. Flu like symptoms with fever for 24 hours after injection.

Other Meds: N/A

Current Illness: Cold symptoms

ID: 1122226
Sex: F
Age: 52
State: IN

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/22/2021
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: This was my second dose btw. Arm pain after first dose. No other noticeable symptoms. Second dose: Headache almost immediately after being given the vaccine. Followed by arm pain/ache in BOTH arms, fatigue, lung pain, hip pain, general feeling of being unwell or having the flu. Went to work the next day. Still not feeling well. Felt even worse as the day progressed (with symptoms listed), went home early. Slept for twelve hours. Same symptoms the next day. Oddly, my symptoms seemed to relax a little after I ate lunch. Then returned a few hours later. Tomorrow will be 7 days after dose. I still have arm pain in both arms and extreme fatigue.

Other Meds:

Current Illness: None

ID: 1122227
Sex: F
Age: 68
State: CT

Vax Date: 01/25/2021
Onset Date: 03/15/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Diflucan

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Given Moderna on 12/28/2020 second dose Moderna 1/25/2021 But Dx covid 19 on 3/19/2021

Other Meds: Estrace cream Restasis eye drops Aspirin

Current Illness: None

ID: 1122228
Sex: M
Age: 60
State: OH

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
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: Allopurinol Milk Shrimp

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Shortness of breath Flushing

Other Meds: Glimiperide Losartan Vitamin E

Current Illness: None

ID: 1122229
Sex: F
Age: 47
State: TX

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/22/2021
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 and antibiotic (unknown name)

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

Symptoms: Pt reported "flushing and crawling" feeling on body. Redness observed on bilateral lower extremities, no tenderness or pain reported. Pt was alert and oriented; Liquid benadryl given per standing order. Pt denies other symptoms but reports feeling "anxious or nervous." Oxygen saturation was 96%. Pt states a similar episode happened when she received her 1st dose and reported it subsided after taking benadryl at home. States she never reported the 1st effects to anyone.

Other Meds: Takes Wellbutrin daily (states she did not take that morning of 03/05/21)

Current Illness:

ID: 1122230
Sex: F
Age: 52
State: TN

Vax Date: 03/15/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
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: Penicillin

Symptom List: Rash, Urticaria

Symptoms: Pain, redness, swelling, warmth at injection site began 1 week after receiving vaccine

Other Meds: Buproprion, levothyroxine, amlodipine, myrbetriq, junel

Current Illness: none

ID: 1122231
Sex: F
Age: 63
State: TN

Vax Date: 03/13/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
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, sulfa-based drugs, shellfish.

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

Symptoms: 8 Days after the shot, acquired a red, round, itchy rash patch on same arm, near shot site. Treating with Benadryl cream on the site, will add a Benadryl pill if needed.

Other Meds: 1 low dose Asprin per day.

Current Illness: None.

ID: 1122232
Sex: M
Age: 36
State: MI

Vax Date: 01/09/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
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: none

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

Symptoms: Patient received 2nd dose of Pfizer COVID-19 vaccine on 1/9/2021. On 3/18/2021 patient developed cough, headache, nasal congestion. Tested positive for COVID.

Other Meds: none

Current Illness: none

ID: 1122233
Sex: F
Age: 40
State: IL

Vax Date: 03/04/2021
Onset Date: 03/07/2021
Rec V Date: 03/22/2021
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: Shellfish

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

Symptoms: Two days after the vaccine, my right foot started to feel weird - felt wet sometimes or felt tingly. My foot was not swollen. I still have those weird sensations 18 days after getting the vaccine. Also, I had many small blood clots during my first menstruation after the vaccine (13 days after vaccine), which is not normal for me.

Other Meds: None

Current Illness: None

ID: 1122234
Sex: F
Age: 63
State: MN

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: codeine gives headache

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

Symptoms: one to two days after Moderna vaccine developed numbness and tingling of hands and feet which persists though mild; four days after vaccine developed new left lateral leg pain in IT band distribution. She had transverse myelitis in 1992, unknown cause, had numbness below the waist, it resolved ; she is generally healthy and active, normal physical exam in office Feb 18, 2022

Other Meds: one multiple vitamin daily

Current Illness: none

ID: 1122235
Sex: F
Age: 45
State: IN

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
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: Latex, banana, Kiwi

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

Symptoms: Itching starting 10 minutes after vaccine to next day Severe headache on the 19th and 20th Severe fatigue on 19th

Other Meds: Benadryl an hour after vaccination

Current Illness: None

ID: 1122236
Sex: M
Age: 74
State: MI

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: sulfa drugs

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Severe shoulder pain still persisting, after 24 hrs. Limits use of right arm shoulder movement. Pt went to urgent care for assessment/treatment of possible SIRVA on 3/19/2021. Diagnosis was acute pain of right shoulder. Reports s/s slightly improved after 4 days. Still reported some limited ROM

Other Meds: asa 81 mg, norvasc 5 mg daily, lipitor 40 mg daily, MVI daily, benicar 20 mg daily, saw palmetto daily

Current Illness: none

ID: 1122237
Sex: F
Age: 58
State: IN

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: About 9 hours after injection, the site started to ooze clear liquid. A perfect small circle of skin appeared to be burned off. I cleaned it. Next morning still oozing. Now it is scabbing over day on day 3 Armpit feels like I have a golfball in it.

Other Meds: Vitamins: multi, B12, C, D Caltrate, escitalopram, losartin, simvastatin, fenofibrate, low dose aspirin, necium, probiotic, levothyroxine, turmeric Dietary: forskolin and keyo weight loss supplement Cranberry

Current Illness: None

ID: 1122238
Sex: F
Age: 53
State: IN

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: penicillin, sulfa, contrast dye

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

Symptoms: 1/9 vaccination 2.5 hours later, my arm was swollen, itchy, raised, heated, increased HR, chills, weakness. Symptoms lasted for 2 days. Fatigue lasted for 4-5 weeks after; 'washed out' 1/13 days later, I could barely walk due to the swelling. I thought my foot was going to collapse due to the crackling sound. Sent to urgent care for xray, swelling and inflation, no breaks. 1/21 I had to go to a foot and ankle specialist 1/25 I was referred to have a doplar to make sure I didn't have a clot. I had to get fitted for a special foot brace, had to get a second one. My retina, on my L side, started to see flashes of light. Dr. stated it was prob going to tear. The specialist said could be a autoimmune; fighting off the vaccine. 1/28 urgent care. Foot was infected. Prescribed 500 mg x3 Cycler x 7 day; probiotic, as well. I removed my name for 2nd vaccine. Swelling lasted till March 13. Told body was fighting off vaccine.

Other Meds: n/a

Current Illness: n/a

ID: 1122239
Sex: F
Age: 46
State: CO

Vax Date: 02/27/2021
Onset Date: 03/01/2021
Rec V Date: 03/22/2021
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: adverse reaction to Phenoprop

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

Symptoms: Swollen, reddened left preauicular lymph node. Continued swelling without pain. Swelling duration continued including today. Has not fully resolved, however swelling has diminished, although not fully resolved - can both see and feel swelling still.

Other Meds: none

Current Illness: none

ID: 1122240
Sex: F
Age: 79
State: MI

Vax Date: 03/20/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Unevaluable event

Symptoms: Patient became short of breath and felt flushed within 5 minutes after dose administration. Pulse ox recorded at 92 and pulse of 99. Blood pressure 160/110. EMS was called and vitals had stabilized to pulse ox of 98-99 and systolic BP of 140s. Patient remained short of breath, has a cardiac history but as baseline status was unknown and husband was a poor historian we sent her to the ER for workup. Did not endorse symptoms of anaphylaxis. Unknown h/o COPD or other chronic lung conditions.

Other Meds: Multiple comorbidities, h/o cardiovascular disease, chronic kidney, diabetes, hypertension. Patient did not have a list but did take nitroglycerin at the site.

Current Illness: Unknown

ID: 1122241
Sex: F
Age: 83
State: MI

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
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:

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

Symptoms: Sore arm for two days. Very painful joints for 3 days, especially hip joints, stiff neck

Other Meds:

Current Illness:

ID: 1122242
Sex: F
Age: 62
State: TN

Vax Date: 03/12/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
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: Have allergies to lots of medicines, including antibiotics, flagyl and several pain relievers. Have several food sensitivies.

Symptom List: Injection site pain, Pain

Symptoms: I had itching on injection site immediately after shot. It wasn't terrible itching. But it was itching. I stayed at the pharmacy for 30 minutes before leaving. My main side effect was itching at injection site on arm. I continued to have itching on and off. I didn't scratch it. I put Hydrocortisone cream on it, and tried also antibiotic cream, and Benadryl gel. I haven't had a lot of swelling. Just noticeable itching. Arm isn't swollen really. I didn't have a very sore arm either. It was mildly sore. Itching comes and goes still.

Other Meds: Propanolol, Protontic, Prozac, Elevil, a few vitamins

Current Illness: Had one of my implant teeth bothering me and had taken an antibiotic a couple of weeks ago.

ID: 1122243
Sex: F
Age: 70
State: MD

Vax Date: 02/21/2021
Onset Date: 03/04/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

Symptom List: Injection site pain, Menorrhagia

Symptoms: The day following the vaccine, I experienced a sore left arm. Ten days following the vaccine, I began having extreme fatigue and muscle aches throughout my entire body. I felt inflamed. The fatigue impaired my ability to walk and do normal activities. I mostly wanted to sleep. At first I did not associate the symptoms with the vaccine, but then realized it was probably associated. The fatigue and muscle aches lasted about 7 or 10 days.

Other Meds: Synthroid 88 mcg; gabapentin 200 mg; Lexapro 5 mg; Vitamin D 5000 IU

Current Illness: none

ID: 1122244
Sex: M
Age: 37
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/16/2021
Rec V Date: 03/22/2021
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: None.

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

Symptoms: iT seemed on Tuesday the following week I had hive throughout my entire body. I went to the Doctor on 2/18/2021 and recieved a Steroid Shot, Steroid Pills, and also presciption benadryl.

Other Meds: Nortriptylin -25mg once a day at bed Buspirone - 15mg once a day at bed Viberzi - 100mg once a day upon waking

Current Illness: None.

ID: 1122245
Sex: F
Age: 89
State: VA

Vax Date: 03/08/2021
Onset Date: 03/11/2021
Rec V Date: 03/22/2021
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 Known

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Three days after receiving the Pfizer COVID 19 vaccination patient report waking up with chills, and heart racing . She did not take her temperature or pulse at the time. The chills and heart racing lasted about 15 minutes total while the patient was lying in bed. She has never had these symptoms before. She had no other associated symptoms at the time including, nausea, vomiting, sweating, dizziness, shortness of breath, chest pain, abdominal pain. Once the episode passed she got up and performed her usual routine. She noted her blood pressure was a little higher than normal at 140-145 systolic. Pulse was normal at that time on her machine. She continued to feel "wobbly in her legs" throughout the rest of the day and was back to her usual state of health by the next morning.

Other Meds: Hydrochlorothiazide, amlodipine, metoprolol, simvastatin, acetaminophen, Centrum Silver Multivitamin

Current Illness: None known

ID: 1122246
Sex: F
Age: 39
State: KY

Vax Date: 03/20/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Dilaudid [hydromorphone] Not Specified Swelling Zosyn [piperacillin Sod-tazobactam So] Not Specified Swelling Solu-medrol [methylprednisolone

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt waiting after vaccination. At about 30 minute mark pt reported throat itching. nurse monitored pt. Symptoms progressed to throat clearing/cough. Epinephrine administered. Benadryl administered IM. Ambulance called. While waiting for ambulance pt reported feeling tongue thickness. @nd dose of epinephrine given while awaiting ambulance. Paramedics evaluated pt and advised ER. pt refused. Advised pt to seek medical attention for any new/worsening symptoms. Advised pt not to drive home but have someone else take her home and to not be alone. pt daughter came to clinic and nurse witnessed pt enter vehicle.

Other Meds: N/A

Current Illness: N/A

ID: 1122247
Sex: M
Age: 87
State: TN

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/22/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: 2 vaccine doses given back to back. Total dose administered estimated at 0.45 mL. Watched for 30 minutes without any reaction noted. Called on 3/13/2021 as still no signs of reaction.

Other Meds:

Current Illness:

ID: 1122248
Sex: M
Age: 66
State: OH

Vax Date: 02/23/2021
Onset Date: 02/27/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

Symptom List: Nausea

Symptoms: 2/27 Patient presented to a Clinic with ~4 days of nausea, chills, muscle aches and fatigue. He was diagnosed with COVID-19. He continued to feel poorly and 3/1 was started on doxycycline as an outpt. 3/3 was started as outpt on dexamethasone. 3/6 Presented to ED w/ worsening symptoms including SOB. RA pulse ox was 88%. He was admitted for COVID/COPD exacerbation and was changed to IV azithromycin/rocephin and dexamethasone. He was maintained on oxygen. He was unable to be weaned off oxygen and was discharged to home on 3/9 on oxygen.

Other Meds: amlodipine 10mg daily dexilant 60mg daily advair 250/50 inhalation BID gemfibrozil 600mg BID indapamide 1.25mg daily losartan 100mg daily reglan 5mg daily zofran 8mg TID prn nausea rosuvastatin 40mg daily terazosin 1mg QHS trazodone 150mg t

Current Illness: none

ID: 1122249
Sex: F
Age: 52
State: IL

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
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: I could not use the arm where vaccine was administered. It felt heavy and just hung. Ended up making a sling for it. Swollen glands in right side of neck, headache, fever, chills, nausea(vomiting), and fatigue.

Other Meds: Jolessa

Current Illness: None

ID: 1122250
Sex: F
Age: 19
State: MA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Augmentin, Nitrofurantoin

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

Symptoms: Developed itching and rash on bilat arms and neck immediately after vaccination

Other Meds: unknown

Current Illness: unknown

ID: 1122251
Sex: F
Age: 31
State: SC

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
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: None

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

Symptoms: Nose Bleeding Every day since Vaccine. 4 days in a row.

Other Meds: None

Current Illness: PCOS

ID: 1122252
Sex: F
Age: 60
State: NC

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/22/2021
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: codeine aspirin coconut feta shell fish

Symptom List: Tremor

Symptoms: chills tired fever headache

Other Meds:

Current Illness:

ID: 1122253
Sex: F
Age: 28
State: TX

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/22/2021
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: Erythema, Pruritus

Symptoms: Stroke (blood clot in vein in left side of brain), occurred Wednesday March 17 at 5:15 pm. Immediately admitted to emergency room/stroke unit and given blood thinner IV and anti-seizure medicine

Other Meds: Multivitamin Microgestin

Current Illness:

ID: 1122254
Sex: F
Age: 23
State: NY

Vax Date: 03/14/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
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: Itchy, warm hives that appeared last night and have since grown to become one large red mound

Other Meds: Zoloft, Maxalt

Current Illness:

ID: 1122255
Sex: F
Age: 39
State: KS

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/22/2021
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: patient states that she has multiple allergies

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

Symptoms: On Thu, Mar 11, 2021, 6:18 PM patient wrote: I have had an allergic reaction to this vaccine. I felt like crap afterwards and stayed the full 30 minutes too. I had thought maybe it was anxiety, but I've broken out all over in hives and I can barely talk now due to how hoarse my throat is. I felt off very quickly post vax and like I was drunk or something after my injection. I have had a high pulse, palpitations, bad headache, jitters, lightheaded/ dizziness, nausea, vomiting, feeling like I have to constantly swallow (and do), and other post vax issues. I have felt very out of it and overall very cruddy. I hope you'll respond to this email so that I know it gets reported. I have taken a lot benadryl and have an EpiPen handy if I ended up needing it. My mouth has been fine, but not my throat.. but it isn't closing up so I think it's okay for it to just be swollen. I have had so much going on post vax that I've literally just been laying in bed hoping I'll feel better. 03/12/2021 The hives have come back and the itching hasn't ever stopped, my tongue is still super swollen and sore from me constantly accidentally biting it, my throat is still red, swollen, and sore, and I generally feel like crap. I'm taking a ton of antihistamines to combat this and they're not touching it. I am probably going to need more steroids and a visit to urgent care tomorrow. :( 03/13/2021 The email is too large with the new pics and it got kicked back...trying again minus the body hive pics. The hives just keep spreading :( . I know you can't see them all because the lighting isn't great, but you can make out the outlines of the welts like on my forehead. I have hives all over my face, throat, neck, chest, arms, and more every day. My whole body is very itchy even in areas without hives. I am still dealing with: hives/ itchiness, stomach issues, tongue, throat, headache, etc. I am taking zyrtec twice a day, 50 mg benadryl every 8 hours, a prednisone pack, and a pepcid twice a day. I have my h1, h2, and h3 categories covered along with steroids onboard which is my allergic reaction regimen protocol from my allergist. I also have my asthma meds which helps with allergies. Unfortunately it isn't working to keep it from spreading/ continuing or to even keep it at bay. I am trying to hang out until Monday morning for my allergist's office to open and see if I can get an appt or help via meds called in. I've never had this before in my life! One big bad reaction and then it goes away, not this long dragged out big reaction. This is crazy! I figure you probably need this info for the CDC VAERS report, I'm sorry if you didn't! Show quoted text 03/14/2021 The hives are even on my feet now ( my whole body either has hives or is itchy). I feel like absolute hell and I am completely regretting this.???? Here I thought the moderna would of been safe for allergic people. I have all of these allergy meds too and nothing is helping, but I'm going to call my doctors first thing when they open and try to get seen tomorrow or at least Tuesday with my allergist. This is all just so crazy to me! I have had all of my vaccines with no problems too, last one was my tetanus shot and that was within the last 2 years... not one single problem with the exception of injection site soreness for a day. 03/15/2021 I am still going strong with the hives and now I have pneumonia, which I have never had before in my life. :( The doctor gave me a Z pack, but I can't take it until after I see the allergist tomorrow and that's if he says it is safe for me to do so. She is worried it would cause another anaphylactic reaction. We are also worried about the 1 week delayed allergic reaction that people are having now and what that will mean for me when I'm already bad off. Allergist appt is tomorrow at 245pm. 03/17/2021 I'm sorry I didn't update. I'm still dealing with hives, but they're getting better. I am still dealing with the heart arrhythmias pretty hard. They are not pleasant to say the least and I am still feeling really wiped out. I am dealing with PVCs for the most part today and some others that I'm not sure what they're called (like I don't know if it's a PAC, PVT, but I do know I've had V-tach and PVCs going on). Hopefully it will get better soon, I'm so over all of this and have things I need to get done LOL! 03/20/21 I am on a 2 week heart monitor now due to the heart issues I've been having post vax. I just saw a fb post from a friend and she's having the same problems after hers. I never posted about the heart issues with mine either and correlation doesnt equal causation of course, but this is interesting and may be of concern so I'm passing it along. The hives are finally gone minus the "moderna arm." 03/21/20 Dude... this rash started up a tiny bit friday, a little more then went away Saturday, and now it's coming back in full force! I'm still taking allergy meds too! This is just crazy!

Other Meds:

Current Illness: None

ID: 1122256
Sex: M
Age: 39
State: PA

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Received vaccine at 7PM, and by 1:30AM had severe chills/shivering; Fever reached 103, and continued throughout the day. Finally dropped to 99 by 3PM the next day. Continued throughout day to have body aches, head ache, chills. Around 3PM had hives on both sides

Other Meds: None

Current Illness: None

ID: 1122257
Sex: F
Age: 66
State:

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient was sitting s/p vaccination waiting 15 min. She became diaphoretic, nauseous, and pale. She vomited twice. She stated that she thought she had a panic attack. Her vital signs were normal at all times. Last set of vitals 97.6 po, 126/84, 77, 98%

Other Meds:

Current Illness:

ID: 1122258
Sex: F
Age: 56
State: UT

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/22/2021
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: allergy to narcotic pain killers

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

Symptoms: Sore arm within 15 mins. Approx 12 hours later got migraine-level headache and experienced swelling and purplish bruising approx 10" around injection site. Had intense pain from neck all the way to fingertips for 1.5 days. Only slept about 45 mins the first night because every tiny moment of my left arm resulted in unbearable pain. I couldn't get dressed or use my left arm for 1.5 days. Over the counter pain med did nothing to reduce the pain level. Didn't feel better for more than 2 days. Worst I've felt in over a decade.

Other Meds: regular daily vitamins

Current Illness: None. Haven't been sick for about 10 yrs.

ID: 1122259
Sex: F
Age: 50
State: MI

Vax Date: 02/25/2021
Onset Date: 03/10/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies: Clonidine ("BP drops"), demeraol (shortness of breath), metronidazole (nausea/vomiting), morphine (shortness of breath), tramadol (hypertension)

Symptom List: Pain in extremity

Symptoms: Presented to ED on 3/10/21 for migraine and discharged home. Reported only sore arm following vaccination. Presented to ED on 3/7/21 with back pain, no COVID symptoms reported and was discharged home. Presented to ED on 3/10/21 with generalized body aches, nausea, vomiting, and headache for 2 days. Noted mild cough and sinus congestion and was admitted to hospital for 5 days until 3/14/21. Returned to ED on 3/15/21 with worsening shortness of breath and was admitted to hospital for another 5 days until 3/19/21.

Other Meds: Tylenol, amlodipine, calcium carbonate, lactulose, metoprolol succinate, mycopehnolate, ondanestron, miralax, senna, sodium bicarbonate, tacrolimus, vitamin D, warfarin, zinc

Current Illness: None known

ID: 1122261
Sex: F
Age: 37
State: FL

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
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: 9':55 c/o heart racing, Blood sugar 131 prior getting vaccination. Apical 108 162/82, 98.5, 98%. Transported to EMS truck due to rain. Vital signs 10:05 HR 99, BS 184, B/P 150/88. 10:13 States feeling bette 10:15. Asst. to car, stated felt much better. Stated she ate breakfast from fast food vendor (Bagel) prior receiving vaccination. Blood glucose monitor implant.

Other Meds: anti diabetic medications

Current Illness: none

ID: 1122262
Sex: F
Age: 93
State: PA

Vax Date: 02/19/2021
Onset Date: 03/01/2021
Rec V Date: 03/22/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Severe attack of Trigeminal Neuralgia requiring being transported to ER via ambulance. Began having attack during the early hours of the morning, 10 days after the 2nd vaccine. She had her first episode of Trigeminal Neuralgia on 1/8/21 and was doing well being treated with Homeopathic remedy Magnesia Phosphorica. Because Bells Palsy has been connected to the vaccine we are concerned that the 2nd vaccine could have exasperated her underlying problem of Trigeminal Neuralgia. Because her attack required treatment to the ER and caused her to require being treated with Carbamazepine we felt it was important to report this incident to you.

Other Meds: Losartan, Synthroid, Carvedilol, Alprazolam, Ciopidogrel Amlodipine Besylate

Current Illness: She had an attack of Trigeminal Neuralgia on January 8, 2021. She was doing well using a Homeopahtic treatment of Magensia Phosphorica. 10 days after her 2nd vaccination (2/19/21) she suffered a severe attack of Trigeminal Neuralgia requiring ambulance transportation to the ER on the morning of 3/2/21. This attack was to such extent that Carbamazepine has been prescribed for this 94 year old. Because Bells Palsy has been connected to the vaccine we are concerned that the vaccine exasperated the Trigeminal Neuralgia in this 94 year old female. Please consider this as a serious possible interaction with the vaccine.

ID: 1122263
Sex: F
Age: 77
State: WI

Vax Date: 02/18/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: CODEINE, SULFA, CIPRO

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

Symptoms: 2/28/2021 DAY OF INJECTION #1 - HEAVY SENSATION IN UPPER LEFT ARM, LASTED LESS THAN 24 HOURS 2/18/2021 DAY OF INJECTION #2 - MILD SORE UPPER LEFT ARM RADIATED TO LEFT SHOULDER BLADE, USED TOPICAL ARNICARE FOR THE SORENESS WHICH LASTED ABOUT 24 HOURS 3/21/2021 VERY SORE UPPER LEFT ARM, SUDDEN "CHARLIE HORSE" RADIATED FROM THE INJECTION SITE TO THE LEFT SHOULDER BLADE, LUMP/KNOT UNDER THE INJECTION SITE ABOUT THE SIZE OF A WALNUT, USED ARNICARE AND MASSAGE, NO RASH OR VISIBLE BRUISING, SORENESS LASTED SEVERAL DAYS

Other Meds: SYNTHROID, METHENAMINE HIPPURATE, FAMIDODINE, MOTRIN, ECHINACEA, VITAMIN C, VITAMIN B1 & B12, VITAMIN D3, .SENNA, CALCIUM CITRATE, GLUCOSAMINE CHONDROITIN

Current Illness: NONE

ID: 1122264
Sex: M
Age: 39
State: LA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
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: n/a

Symptom List: Vomiting

Symptoms: aches in the lower back, followed by cold extremities shortly after in the early evening. By midnight I had a fever over 102* and bad chills throughout the night with very little sleep. the next day (Friday) I had a fever of 100* all day while on Tylenol and ibeprophin alternately. I stayed home from work to try to rest, but was fatigued all day. By Friday evening I started regaining strength, aches subsided and temperature was back to normal.

Other Meds: n/a

Current Illness: n/a

ID: 1122265
Sex: F
Age: 1
State: MN

Vax Date: 04/20/2020
Onset Date: 04/25/2020
Rec V Date: 03/22/2021
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: Rash to amoxycillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Symmetrical and sever lesions to the basal ganglia, anti NMDA receptor encephalitis. Symptoms began with a gait (walking) abnormality April 25th, 2020. Her symptoms worsened including dystonia, losing ability to walk, crawl, and talk. Went to the hospital May 27, 2020 where symptoms were severe. She screamed and cried constantly, was severely agitated, lost ability to eat orally, and dystonia worsened. MRI showed continued worsening of basal ganglia lesions. CSF showed positive anti NMDA receptor encephalitis. Seizures started August 2020. As of today, March 12, 2021 she is non mobile (cannot hold her head up or move any of her body voluntarily) and nonverbal.

Other Meds: None

Current Illness: None

ID: 1122266
Sex: F
Age: 52
State: DC

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
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: Latex, paprika, peanuts

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

Symptoms: Body aches, pain and swelling at injection site, headache, fever, chills, nausea, and hives on left leg; symptoms began just over 3 hours after vaccination

Other Meds: Lamotrigine taken at 8pm the night before the vaccination

Current Illness: None

ID: 1122267
Sex: F
Age: 53
State: MI

Vax Date: 01/14/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Received dose #2 of Pfizer vaccine on 1/14/2021. On 3/18/2021 developed nasal congestion and cough. Tested positive for COVID.

Other Meds: amlactin cream, diprosone ointment, fexofenadine

Current Illness: none

ID: 1122268
Sex: F
Age: 52
State: CA

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Sulfa

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

Symptoms: Fever of 100.5 treated with acetaminophen for 1 full day. Loss of appetite. Muscle pain.

Other Meds: Levoxxyl Hydrocodone Chlorthalidone Supplemental Potassium

Current Illness: Detox from Effexor x2days

ID: 1122269
Sex: F
Age: 30
State:

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
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: Dust, cats, Isoeugenol, certain type of pine trees, hay-fever Significant side effects with Minocycline but not allergic reaction.

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

Symptoms: 3 h - start of arm pain 5 h - upper arm non functional from severe pain. could not be moved in any direction 6h - start of nausea, mild chills and tiredness 8h - temp of 99.3 (usually at or below 98.6), chills, headache. Pain from arm made sleeping almost impossible. 13h - temp and chills ended. arm still very painful 40h - arm pain started to subside. 18-56h - on and off nausea, dizziness and evening tiredness 48h - slight nose bleed, on and off. 64h - arm fully functional with slight lingering discomfort ongoing - slight nose bleed, slight nausea, dizziness

Other Meds: 10 mg Citalopram daily, 25 ,g Iron daily, 5000 units Vitamin D every other day, Align probiotic daily, B12 with folic acid supplement once a week.

Current Illness: Skin infection on cheek and use of 30 days of Bactrim. Finished 10 days before vaccine.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm