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: 1126032
Sex: F
Age: 44
State: IN

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: 12 hrs after vaccination, developed chills, total body muscle aches, fever/sweating, intense headache. Symptoms persisted throughout night, with no relief from multiple doses of acetaminophen. After taking 2 ibuprofen in morning, muscle aches and headache subsided.

Other Meds: Acyclovir 200mg Multivitamin

Current Illness: None

ID: 1126034
Sex: F
Age: 58
State: TX

Vax Date: 03/20/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
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: Erythromycin

Symptom List: Anxiety, Dyspnoea

Symptoms: After Injection pain, swelling (hardness) in arm; Sunday side effects joint pain; Monday fatigue , awaken in sweat, dizziness, nausea and vomiting for 10minutes; No fever; Tuesday fatigue, No fever 96.6; little dizziness and nausea.

Other Meds: Hydrochlorothiazide Triamterene 75-50MG, Amlophine 10mg;Metformin 500MG;Vitamine D3 5000;Black Seed Oil

Current Illness: None

ID: 1126035
Sex: F
Age: 68
State: AZ

Vax Date: 03/21/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
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: sulfa drugs, Libra; Peanuts

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

Symptoms: Had the injection 3/21/2021 at 2:30. On 3/22/2021, the next morning after the injection had nausea, flu-like symptoms, and slept all day. Took two advil and one tylenol at 6:30 am, 2:00 pm and again at 10 pm. On 3/23/2021, woke up 7 am in the morning and felt fine.

Other Meds: calcitriol; calcium, CoQ10,

Current Illness:

ID: 1126057
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/23/2021
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: Suspected vaccination failure; Shingles; This case was reported by a consumer and described the occurrence of suspected vaccination failure in a patient who received Herpes zoster (Shingles vaccine) for prophylaxis. Co-suspect products included Herpes zoster (Shingles vaccine) for prophylaxis. The patient's past medical history included shingles. On an unknown date, the patient received the 1st dose of Shingles vaccine and the 2nd dose of Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine and Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine and Shingles vaccine. Additional details were reported as follows: The age at vaccination was not reported. The patient had shingles after receiving the two shingles shots. This case was considered to be a suspected vaccination failure case, as the details regarding laboratory confirmation for shingles and exact time to onset were unknown.

Other Meds:

Current Illness:

ID: 1126059
Sex: F
Age: 80
State: PA

Vax Date: 02/05/2021
Onset Date: 03/09/2021
Rec V Date: 03/23/2021
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: Bilateral pulmonary emboli; A spontaneous report was received from a physician concerning an 80-year-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) experienced shortness of breath and oxygen level low. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. The patient received her first of two planned doses of mRNA-1273 (LOT: unknown) on 05-Feb-2021. On 05-Mar-2021, approximately 1 day prior to the onset of the symptoms, the patient received their second of two planned doses of mRNA-1273 (Batch number: 048A21A) intramuscularly for prophylaxis of COVID-19 infection. On 06-Mar-2021, the patient developed shortness of breath and her oxygen level was low. On 09-Mar-2021, she was diagnosed with bilateral pulmonary embolisms. No hospitalization was required. The reporter stated that the patient had no history of blood clots. Treatment for the event included apixaban. The patient received both scheduled doses of mRNA-1273 prior to the events; therefore, action taken with the drug in response to the events is not applicable. The outcome of the events was considered unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded

Other Meds:

Current Illness: No adverse event (No medical history reported.)

Date Died: 03/05/2021

ID: 1126060
Sex: M
Age: 61
State: ME

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/23/2021
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: death 2 and half hours after receiving the first Moderna vaccine; A Spontaneous report was received from a health care professional concerning a 61 year old male patient,who received Moderna's COVID-19 vaccine (mRNA-1273) and reported death. The patient's medical history as provided by the reporter included diabetes, history of shortness of breath, cardiac history. Concomitant medications included metoprolol, metformin and glipizide. On 05 Mar 2021, prior to the onset of events the patient received his first dose of their two planned doses of mRNA-1273 (Batch N0: 030a21a) intramuscularly for prophylaxis of covid 19 infection. On 05 Mar 2021,it was reported that the patient died 2 and half hours after receiving the first Moderna vaccine. The patient had no symptoms during observation 15 minutes after receiving fist Moderna vaccine.The patient's PCP ordered an autopsy. Treatment information not included. Action taken with mRNA-1273 in response to the events was not applicable. On 05 Mar 2021, it was reported that the patient died.; Reporter's Comments: This is a case of sudden death in a 61-year-old male subject with hx of diabetes, history of shortness of breath and cardiac history, who died 2 1/2 hours after receiving first dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: unknown cause of death

Other Meds: METOPROLOL; METFORMIN; GLIPIZIDE

Current Illness: Diabetes

ID: 1126061
Sex: F
Age: 89
State: OH

Vax Date: 01/21/2021
Onset Date: 02/08/2021
Rec V Date: 03/23/2021
Hospital: Y

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: Brain encephalopathy; This spontaneous report was received from a consumer (daughter) concerning an 89 year-old female patient who was administered Moderna's COVID-19 vaccine (mRNA-1273) and developed brain encephalopathy (encephalopathy). The patient's medical history included aortic aneurysm (untreated), esophageal hernia (repaired), rectal cancer and uterine cancer. Concomitant medications included lisinopril, furosemide, sertraline, levothyroxine and FDgard. On 21-Jan-2021, the patient received their first of two planned doses of mRNA-1273 (Lot/Batch number: 032L20A). On 17-Feb-2021, the patient received their second dose of mRNA-1273 (Batch/Lot # 006M20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 08-Feb-2021, 13 days after first vaccination, the family started to notice small balance changes, slight fine motor coordination changes (handwriting, etc.) and a little forgetfulness. They chalked it up to her being an 89 year-old. On 17-Feb-2021, the patient was administered her second dose of the vaccine. On an unknown date, the patient was unable to stand without assistance, leans backwards when trying to stand, has developed a spastic tremor bilaterally in her arms and her cognition is completely altered. She is experiencing hallucinations, memory loss, can follow some directions and her speech is clear, but inappropriate. Her hand writing was concise and clear prior to vaccine, but later became illegible; missing entries with no spatial awareness. On an unknown date, she was hospitalized. On 06-Mar-2021 and 07-Mar-2021 a CT (computed tomography) of brain, CT of neck, multiple urinalysis and multiple blood labs were performed. On 07-Mar-2021, the patient could not identify immediate family members in a photo. On 8-Mar-2021, short EEG (electroencephalogram), brain CTs with and without contrast, neurological consultation, speech consultation, psychological evaluation, lumbar puncture and MRI (magnetic resonance imaging) were performed. Results are pending. She has been diagnosed with brain encephalopathy, probably caused by molecular mimicry in response to the vaccine. She is being treated, but treatment information was not provided. The patient's daughter reports that prior to the vaccination, her mother was fully independent, living alone, mobile and with excellent cognitive function. Action taken with the drug in response to the event is not applicable. The outcome for the event, brain encephalopathy, was not resolved.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds: LISINOPRIL; FUROSEMIDE; SERTRALINE; LEVOTHYROXINE

Current Illness: Aortic aneurysm (Untreated)

ID: 1126062
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 03/23/2021
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: The patient fainted; A spontaneous report was received from a consumer concerning her friend, a female patient of unspecified age, who received Moderna (mRNA-1273) vaccine experienced fainting after getting the vaccine. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On an unspecified date, prior to the onset of the symptoms, the patient received her first dose of two planned doses of mRNA-1273 (Batch number not provided) for prophylaxis of COVID-19 infection. On an unspecified date, the patient fainted after getting the vaccine. Treatment information was not provided by the reporter. Action taken with mRNA-1273 in response to the event(s) was not provided. The outcome of the event fainting after getting the vaccine was unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1126063
Sex: M
Age:
State: IL

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/23/2021
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: Fever 106 F; Sweating; Vomiting; Chills; Fever; A spontaneous report was received from a consumer concerning a male patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced fever of 106 F, sweating, fever, vomiting and chills. The patient's medical history was not provided. Concomitant medications were not provided by reporter. On 08 Mar 2021, 2 or 3 hours prior to the onset of the events, the patient received first of the two of his planned doses of mRNA-1273 (Lot number: unknown) in the left arm for prophylaxis of COVID-19 infection. On 08 Mar 2021, After receiving vaccine,and within 2 or 3 hours patient showed symptoms of vomiting, fever, and chills. On 09 Mar 2021, patient woke up sweating and fever was 106 F. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the events fever of 106 F, sweating, fever, vomiting and chills were unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1126064
Sex: M
Age:
State: OK

Vax Date: 03/08/2021
Onset Date:
Rec V Date: 03/23/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: passed out completely for 15 minutes; fell backwards for about 15 minutes and was fine; sore arm; lethargic; little bit of chill every now and then; low grade fever; felt like he was about to see stars; felt chills up the back of his neck; A spontaneous report was received from a consumer concerning a 49-years-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events sore arm, lethargic, little bit of chill every now and then, low grade fever, felt like he was about to see stars, passed out completely for 15 minutes, felt chills up the back of his neck, fell backwards for about 15 minutes and was fine. The patient's medical history was not provided. Concomitant medications reported were Singulair, Zyrtec, Rhinocort nasal spray for drug use for unknown indication. On 8 Mar 2021, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot/batch: 003A21A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced the event sore arm, lethargic, little bit of chill every now and then, low grade fever, felt like he was about to see stars, passed out completely for 15 minutes, felt chills up the back of his neck, fell backwards for about 15 minutes and was fine. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event, sore arm, lethargic, little bit of chill every now and then, low grade fever, felt like he was about to see stars, passed out completely for 15 minutes, felt chills up the back of his neck, fell backwards for about 15 minutes and was fine was unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds: SINGULAIR; ZYRTEC ALLERGY; RHINOCORT ALLERGY

Current Illness:

ID: 1126065
Sex: F
Age:
State: MI

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 03/23/2021
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: Extreme headache; pain in both ears; fever; chills; nausea; This is a spontaneous report from a contactable consumer. A 53-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Lot number unknown), via an unspecified route of administration on 16Feb2021 at 16:00 (at the age of 53-years-old) as a single dose in the right arm for COVID-19 vaccination. Medical history included psoriasis. The patient's historical vaccinations included the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Lot number unknown) on 26Jan2021 at 16:00 in the right arm for COVID-19 vaccination. The patient was not pregnant at the time of vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included an unspecified low dose blood pressure medication. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 17Feb2021 at 07:00, the patient experienced extreme headache, pain in both ears, fever, chills and nausea. The patient did not receive any treatment for the events. The clinical outcomes of the events headache, pain in both ears, fever, chills and nausea were reported as recovering. It was also reported that since the vaccination, the patient had not been tested for COVID-19.

Other Meds:

Current Illness:

ID: 1126066
Sex: F
Age:
State: WI

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 03/23/2021
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: fever; Pressure in my head; dizziness; Headaches; sinus pressure; body aches in my upper back, arms and fingers; chills; This is a spontaneous report from a contactable a nurse, the patient. A 74-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration, in the right arm on 18Feb2021 at 09:00 AM (at the age of 74-years-old) (Batch/Lot Number: EN6200) as a single dose for COVID-19 immunisation. Medical history included migraine from an unknown date and unknown if ongoing, psoriasis from an unknown date and unknown if ongoing, and allergy to penicilin and sulfa drugs, from an unknown date and unknown if ongoing. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. The patient previously received the first dose of BNT162b2 on 29Jan2021 at 09:00 (Lot Number: EL3249) for COVID-19 immunisation. Concomitant medications included estradiol for an unspecified indication, start and stop date were not reported; levothyroxine for an unspecified indication, start and stop date were not reported. The patient had not received any other vaccines within 4 weeks prior to the COVID-19 vaccine. On 18Feb2021, at 09:30 AM, the patient experienced the events, fever, pressure in head, dizziness, Headaches, sinus pressure, body aches in upper back, arms and fingers, chills. The patient did not receive treatment for the events. The patient was recovering from the events, fever, pressure in head, dizziness, headaches, sinus pressure, body aches in upper back, arms and fingers, and chills.

Other Meds: ESTRADIOL; LEVOTHYROXINE

Current Illness:

ID: 1126067
Sex: F
Age:
State: NJ

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 03/23/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: diarrhea; nausea; tired; lower back pain as if she had back labor it's so sore; This is a spontaneous report from a contactable consumer (patient). A 36-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) (lot number: EL3302), via an unspecified route of administration on 05Feb2021 at 11:45 at single dose in the left arm for COVID-19 immunization. Medical history and concomitant medications were not reported. The patient was not diagnosed with COVID-19 prior to vaccination. The patient was not pregnant at the time of vaccination. On 05Feb2021 at 14:00, a few hours after getting the vaccine, the patient experienced diarrhea, nausea, tired, and lower back pain as if she had back labor it's so sore. The patient did not receive any treatment for the reported events. The patient underwent lab test which included saliva test with pending results on 19Feb2021. The outcome of the events was not recovered. The events were considered non-serious.

Other Meds:

Current Illness:

ID: 1126068
Sex: M
Age:
State: AZ

Vax Date: 02/05/2021
Onset Date: 02/19/2021
Rec V Date: 03/23/2021
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:

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

Symptoms: Left index finger suddenly developed considerable pain in the tip of the finger and a slight numbness there as well; Left index finger suddenly developed considerable pain in the tip of the finger and a slight numbness there as well; This is a spontaneous report from a contactable consumer (the patient). A 77-year-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN), via an unspecified route of administration in the left arm on 05Feb2021 at 13:00 (at the age of 76-year-old) as a single dose for COVID-19 immunization. Medical history included heart condition. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not have any allergies to medications, food, or other products. The patient's concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 19Feb2021, the patient experienced left index finger suddenly developed considerable pain in the tip of the finger and a slight numbness there as well. The patient did not receive any treatment for the events. The clinical outcome of the "left index finger suddenly developed considerable pain in the tip of the finger and a slight numbness there as well" was not resolved. The lot number for the vaccine, BNT162b2, was not provided and will be requested during follow-up.

Other Meds:

Current Illness:

ID: 1126069
Sex: F
Age:
State:

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 03/23/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Fatigue; Body aches; Fever; Chills; Nausea; vomiting; This is a spontaneous report from a non-contactable healthcare professional, the patient. A 29-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN), via an unspecified route of administration in the left arm on 20Feb2021 at 08:45 (at the age of 29-year-old) as a single dose for COVID-19 immunization. Medical history included constipation predominant irritable bowel syndrome (IBS-C). The patient did not have any allergies to medications, food, or other products. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. Concomitant medication included ethinylestradiol/ norgestimate (PREVIFEM). The patient previously received the first dose of BNT162b2 on 24Jan2021 at 14:30 (at the age of 29-years old) in the left arm for COVID-19 immunization. On 20Feb2021 20:30, the patient experienced fatigue, body aches, fever, chills, nausea and vomiting. No treatment was received for the adverse events. The clinical outcomes of the fatigue, body aches, fever, chills, nausea and vomiting were resolving. No follow-up attempts are possible; information about batch/lot number cannot be obtained.

Other Meds: PREVIFEM

Current Illness:

ID: 1126070
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/23/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: she was tired; This is a spontaneous report from a sponsored program received from a non-contactable consumer. A female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 1, via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as SINGLE DOSE for covid-19 immunisation. The patient's medical history was not reported. Concomitant medications included paracetamol (TYLENOL) taken for an unspecified indication, start and stop date were not reported; ibuprofen (IBUPROFEN) taken for an unspecified indication, start and stop date were not reported. The patient was tired on an unspecified date. The patient took paracetamol or ibuprofen two after receiving the covid vaccine. The patient later heard that you are not supposed to take pain medication after receiving the vaccine and wanted to know if it will change the effectiveness. Outcome of event was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds: TYLENOL; IBUPROFEN

Current Illness:

ID: 1126071
Sex: F
Age:
State: NH

Vax Date: 02/18/2021
Onset Date: 02/01/2021
Rec V Date: 03/23/2021
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:

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

Symptoms: Severe vomiting repeatedly the night/morning after injection; fever; body aches; This is a spontaneous report from a contactable consumer. A 69-years-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2, lot unknown as unable to locate, via an unspecified route of administration, administered in arm right on 18Feb2021 09:00 (Batch/Lot number was not reported) as SINGLE DOSE for covid-19 immunisation. Medical history included asthma from an unknown date and unknown if ongoing. Historical vaccine information included BNT162B2, brand Pfizer , dose 1, administered 28Jan2021 13:30 in the right arm. Concomitant medication included escitalopram oxalate (LEXAPRO) taken for an unspecified indication, start and stop date were not reported; acyclovir [aciclovir] (ACYCLOVIR [ACICLOVIR]) taken for an unspecified indication, start and stop date were not reported; levothyroxine taken for an unspecified indication, start and stop date were not reported; vitamin d3 (VITAMIN D3) taken for an unspecified indication, start and stop date were not reported; cyanocobalamin (B12 [CYANOCOBALAMIN]) taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccine within 4 weeks prior to the vaccine. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. On "19Feb2021 09:00 PM", the patient experienced severe vomiting repeatedly the night/morning after injection. Then 48hrs later (in Feb2021) developed fever and body aches again. No treatment was received. Outcome of the events was not recovered. It was also reported that since the vaccination, the patient had not been tested for COVID-19. Information on the lot/batch number has been requested.

Other Meds: LEXAPRO; ACYCLOVIR [ACICLOVIR]; LEVOTHYROXINE; VITAMIN D3; B12 [CYANOCOBALAMIN]

Current Illness:

ID: 1126072
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: left his hand and fingers swollen and red; left his hand and fingers swollen and red; This is a spontaneous report from a Pfizer-sponsored program. A non-contactable consumer reported for a male patient (reporter's husband). A male patient of an unspecified age, received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) (lot number/expiration date: not provided), via an unspecified route of administration, on an unknown date (reported as "Thursday morning") for COVID-19 IMMUNIZATION. Relevant medical history and concomitant medication were not provided. On an unknown date, the patient experienced left his hand and fingers swollen and red. The patient received treatment for the event. The patient decided to take two acetaminophen (TYLENOL) to see if the swelling would go down and stated if the medicine did not work that the patient will call his physician. The outcome of the events left his hand and fingers swollen and red was unknown. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1126073
Sex: M
Age: 32
State:

Vax Date: 03/04/2021
Onset Date: 03/05/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Moderna COVID-19 Vaccine EUA. Adverse side effects; lethargy, fever, chills, vomiting, blisters in throat/sore throat, fatigue.

Other Meds:

Current Illness:

ID: 1126074
Sex: F
Age: 71
State: MA

Vax Date: 03/11/2021
Onset Date: 03/13/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Voltaren

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

Symptoms: First dose was uneventful. After the second dose of vaccine I experienced neck and back of head pain. It's always there. Ibuprofen does not take the entire ache away. Hoping that this will subside. Trying massage, yoga, and home heat massage. It's like a tooth ache.

Other Meds: Atorvastatin Citalopram Flonase Vitamin b12 Calcium with vitamin d Vitafusion women's multivitamin

Current Illness: None

ID: 1126075
Sex: F
Age: 65
State: FL

Vax Date: 03/09/2021
Onset Date: 03/13/2021
Rec V Date: 03/23/2021
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: Thiomersal

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

Symptoms: Oral inflammation, burning, bumps on her tongue, canker soars. Still feels a little irritated but better. has taken benadryl and used ambesol and mouth wash.

Other Meds: Metroprolol ER Omeprazole

Current Illness:

ID: 1126076
Sex: F
Age: 26
State: CA

Vax Date: 03/15/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
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: Lymph node under the armpit is swollen

Other Meds:

Current Illness:

ID: 1126077
Sex: F
Age: 78
State: NJ

Vax Date: 01/29/2021
Onset Date: 03/08/2021
Rec V Date: 03/23/2021
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 reported

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

Symptoms: Patient received full vaccination with 2 doses of Pfizer Vaccine. First dose was on 1/29 and second on 2/19/2021. No significant reactions. We were informed that she then had PCR ++ Test for COVID-19 on 3/8/2021. No hospitalization reported after testing positive.

Other Meds: None reported

Current Illness: None reported

ID: 1126078
Sex: M
Age: 34
State: CA

Vax Date: 03/01/2021
Onset Date: 03/03/2021
Rec V Date: 03/23/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Blood in ejaculate

Other Meds: None

Current Illness: None

ID: 1126079
Sex: M
Age: 25
State: IL

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Injection site pain, Menorrhagia

Symptoms: headache warm

Other Meds: LITHIUM

Current Illness: NONE

ID: 1126080
Sex: M
Age: 57
State: MD

Vax Date: 02/22/2021
Onset Date: 02/24/2021
Rec V Date: 03/23/2021
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: I had extremely burning pain on my left hip and quadricep/thigh area that started without warning. Feeling like extreme leg cramps when standing or walking. I did seek medical attention with my orthopedic doctor and had hip xrays on my left hip. She saw mild to moderate arthritis in my hip joint. I was prescribed an anti inflammatory as well as taking tylenol to supplement. The symptoms have not subsided and I plan on following up with my medical doctor. I have had bad spasms in my hip and thigh area and swelling from the top of my thigh to my knee.

Other Meds: None

Current Illness: None

ID: 1126081
Sex: F
Age: 50
State: NY

Vax Date: 03/21/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
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: Sudden feeling of needing to burp but not being able to, building up pressure. No trouble breathing. Just this creepy pressure in the chest. Took tums and then drank herbal tea with honey and it seemed like that helped to get the burps to come through finally so I was able to sleep, but the burping is continuing this morning. Not sure if this is related to the vaccine, but I've never felt anything like this before. I also didn't eat anything outside my norm yesterday and didn't have any alcoholic drinks,

Other Meds: None

Current Illness: None

ID: 1126082
Sex: F
Age: 45
State: FL

Vax Date: 03/16/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Polen, ephedrine, grass, low peanut allergy.

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I had same reaction on days 1-3 then it disappeared, a week later I stared with the Sam symptoms again, The site where I got the vaccine is red, warm and hard. It is itchy as well.

Other Meds: Vitamin D3+k, aloe pill, water pill

Current Illness: Polen Allergy

ID: 1126083
Sex: F
Age: 23
State:

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
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: None stated.

Other Meds:

Current Illness:

ID: 1126084
Sex: F
Age: 60
State: IN

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: sulfa drugs

Symptom List: Nausea

Symptoms: DIzzyness and mild nausea

Other Meds: Gamma guard symbicort azelastine

Current Illness:

ID: 1126085
Sex: M
Age: 71
State: OH

Vax Date: 03/13/2021
Onset Date: 03/17/2021
Rec V Date: 03/23/2021
Hospital: Y

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: Came into ED 3.17.21 with chills, cough that caused chest discomfort, fever 103, chronic SOB with exersion, sats in the low 90s at rest. Was diagnosed COVID+ on 3.17.21 and admitted to the hospital. He had his second Moderna vaccine March 13 th.

Other Meds:

Current Illness:

ID: 1126086
Sex: F
Age: 62
State: MN

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies: Allergic to penicillin, arithromicin, ceclor.

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

Symptoms: About 7 hours after injection, I had a large flutter feeling in my chest that lasted about 3-5 seconds. It happened again about 10 minutes later, nothing after that.

Other Meds: Vitamins, D3, multi B

Current Illness: Second shingles shot on March 4

ID: 1126087
Sex: F
Age: 31
State: OR

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/23/2021
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: Severe shakes and chills with low grade fever (99.5). Extreme fatigue for 2 days following

Other Meds: IUD birth control

Current Illness: None

ID: 1126088
Sex: F
Age: 28
State: MO

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
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: anaphylaxis secondary to iron dextran and the seasoning, basil

Symptom List: Tremor

Symptoms: I went to the medical facility for a covid vaccine today. I received the Pfizer vaccine. I started to have a reaction to it and was instructed by the physician on site to use my epi pen. Symptoms resolved within 5-10 minutes of using my epi pen. The on site MD called EMS and I was transported to ED for obs. I was discharged shortly thereafter. I have a hx of anaphylaxis both idiopathic and to iron dextran and basil.

Other Meds:

Current Illness:

ID: 1126089
Sex: F
Age: 65
State: FL

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Started 10 min post vaccine, began to feel chills, nauseous with body aches. Next day, symptoms worse with vomiting. PCP prescribed zofran to use as needed. Denies fever. Symptoms resolved as of 3/21/2021, except for nausea. Follow up with PCP as needed.

Other Meds: pantoprazole pravastatin propranolol baby aspirin Claritin duloxetine hydroxychloroquine Chantix

Current Illness:

ID: 1126090
Sex: M
Age: 52
State: MI

Vax Date: 12/26/2020
Onset Date: 01/02/2021
Rec V Date: 03/23/2021
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: knda

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

Symptoms: Received Pfizer COVID-19 vaccine 12/26/2020. On 1/2/2021 developed congestion, tested positive for COVID.

Other Meds: allopurinol, lotrisone cream, colchicine, sildenafil

Current Illness: none

ID: 1126091
Sex: F
Age: 59
State: MI

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 03/23/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: ?Fainting, ?body chills, ?fever, ?loss of appetite, ?weakness, ?sleepiness, ?headaches

Other Meds: N/A

Current Illness: N/A

ID: 1126092
Sex: M
Age: 42
State: PA

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/23/2021
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: Mild Headache, Difficulty concentrating, Tiredness during day

Other Meds: Vitamin D 2000iu

Current Illness:

ID: 1126093
Sex: M
Age: 51
State: WA

Vax Date: 03/17/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
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: Had a swelling at the site of injection for tetanus shot

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

Symptoms: Fatigue, Dry throat and body aches

Other Meds: None

Current Illness: None

ID: 1126094
Sex: F
Age: 31
State:

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/23/2021
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: unknown

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

Symptoms: Face: numbess, burning, throbbing pain. Difficulty swallowing. Face symptoms started on left side but appear on both sides. Left arm is numb. dizziness, weakness, fatigue. Full body itching.

Other Meds: Ritalin 10mg Citalopram 5mg Clonex 0.5mg

Current Illness: None

ID: 1126095
Sex: M
Age: 24
State: NV

Vax Date: 03/13/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
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: Big rashes all over body. No other symptoms

Other Meds: None

Current Illness: None

ID: 1126096
Sex: F
Age: 82
State: AZ

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

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Chills 1 hour after injection, tightness and aching in upper arm just below injection site and radiating down arm to hand, sleepless night, took two oxycodone during night to alleviate pain

Other Meds: amlodipine, lisinopril, pregabalin, atorvastatin, pantoprazole, alprazolam, methimazole

Current Illness: Fibromyalgia, spinal stenosis, injection site pain second week after first Covid-19 shot until date of second shot

ID: 1126099
Sex: M
Age: 25
State:

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
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: Seen and released by EMS for "numbness to forehead" 02 saturation 99%. Pulse 60 Blood pressure 136/80

Other Meds:

Current Illness:

ID: 1126100
Sex: F
Age: 45
State: WI

Vax Date: 03/15/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
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: raised, red, itchy, sore rash on arm at vaccination site

Other Meds: celexa, multi vitamin

Current Illness: none

ID: 1126101
Sex: F
Age: 25
State: GA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Headache, head congestion

Other Meds: Hydrocortisone - 15 mg AM Fludrocortisone - .05 mg AM I've been taking these for 5+ years

Current Illness: Ear infection a few weeks prior

ID: 1126102
Sex: M
Age: 36
State: LA

Vax Date: 03/11/2021
Onset Date: 03/20/2021
Rec V Date: 03/23/2021
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: Latex, lactose, adhesives, bees, naproxen

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Redness, swelling, itching, tenderness, and heat around injection area.

Other Meds: Vyvance, Prozac, testosterone cyponaite

Current Illness:

ID: 1126103
Sex: M
Age: 75
State: FL

Vax Date: 02/26/2021
Onset Date: 03/03/2021
Rec V Date: 03/23/2021
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: NKDA

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

Symptoms: Heart block, pulse down to 36. Required a pacemaker to be placed.

Other Meds: Lisinopril, multivitamin

Current Illness: none

ID: 1126104
Sex: M
Age: 38
State: FL

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
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: N/a

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 26 hours of fever spiking to 101

Other Meds: Advil

Current Illness: Sinus infection day of

ID: 1126105
Sex: F
Age: 73
State:

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/23/2021
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:

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

Symptoms: Hospital Discharge Summary Note: Patient is a 73-year-old female with a past medical history significant for hypertension, hyperlipidemia, hypothyroidism, and breast cancer. She presented to the emergency department with reports of possible allergic reaction to Pfizer vaccine. Patient received her first dose of: Vaccine earlier today and approximately 5 minutes later developed a cough, diaphoresis, and lightheadedness. She was given 50 mg oral Benadryl in the ED. Patient then complained of tingling sensation throughout her body and was continuously coughing. She was brought to the emergency department for evaluation. Patient noted she felt jittery and "disconnected". In the ED her cough and dizziness significantly improved. Upon examination, patient was noted to have right lower extremity weakness. She denied any weakness. CT of the head was performed to rule out stroke. Neurology was consulted. CT head brain was negative however patient was still having right-sided weakness. Emergency department physician confirmed the patient was able to get up without difficulty after receiving her vaccine at 1415 immediately following her vaccine. It was determined she was within the window for TPA. Patient was transferred to the ICU for further management.

Other Meds:

Current Illness:

ID: 1126106
Sex: F
Age: 37
State: MN

Vax Date: 03/17/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
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:

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

Symptoms: vomitting continuously 10am -6pm sweating headache arm pain

Other Meds: levothyroxine 50mg

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm