VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
PLEASE CHECK BACK SOON
Download the files above while you wait.






Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1197310
Sex: F
Age: 65
State: AR

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/12/2021
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: nka

Symptom List: Dysphagia, Epiglottitis

Symptoms: pt says that she woke up that night w/ chills. She got up next morning w/ 101.5 fever, chills, fatigued, and body aches. These symptoms lasted 2 days.

Other Meds: paroxetine 20mg qd, Flonase qd, Multivitamins, Citrucel qds

Current Illness: no

ID: 1197311
Sex: F
Age: 65
State: OR

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/12/2021
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: Shellfish and dust mites.

Symptom List: Anxiety, Dyspnoea

Symptoms: Within an hour after the injection my throat was scratching, eyes were itchy. At 7-8 pm, the symptoms of a usual shellfish allergic reaction started. My face was swollen, burning sensation, red, itchy. Hives appeared on my face, chest. I was dizzy and had a fast heartbeat. I took an antihistamine and within an hour or so I was better. I did not have an anaphylactic reaction as I normally would have if I ate any shellfish. 4/11/21 at 6:30 pm my face started to itch again, and have a burning sensation, eyelids itchy. I took my daily antihistamine and there was some improvement. I have some of the itch and burning sensation today 4/12 at 10:30 am. But not as bad as before.

Other Meds: Daily take Allergra 180 mg.

Current Illness:

ID: 1197312
Sex: F
Age: 35
State: PA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
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: tramadol, morphine

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

Symptoms: Light headed with in an hour from taking, muscle pain at injection site, same as dose #1. Around 5:50pm a "pull" in the chest area, went up stairs climbed 1 flight of stairs felt, out of breath (I workout 5-7 days a week, intense cardio and strength training, out of breath at top of stairs is not the norm) as I was taking deep breath audible wheeze, attempted to call hotline not open, attempted to call hospital to inquire about symptoms they also were unavailable. Logged in to teladoc, scheudled visit spoke with doctor via video explained symptoms, having hard time with deep breathing and continued wheeze, he stated to go to ER as I was having a "delayed allergic reaction" My husband took me to the ER, they triaged me right away with in the next 1-1.5 hr from when symptoms began, my HR increased, my blood pressure increased, difficulty with nasal breathing, continued with shallow breathing. throat began to feel itchy and coughing began with irritation, my voice became hoarse, could barely speak The ER doctor listened to my breathing and doctor stated by airway was "tight and constricted", IV fluids were ordered, benadryl was given via IV and breathing treatment to help reduce inflammation and open airway. Responded to treatment and was discharge by 10pm

Other Meds: none

Current Illness: none

ID: 1197313
Sex: F
Age: 59
State: AZ

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: Zoloft, bees, flu vaccine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Approximately 29 hours after injection I began feeling fatigue, muscle aches, headache and fever of 100.6

Other Meds: Lasix, spironolactone, pantoprazole, potassium chloride, phentermine, synthroid

Current Illness: None

ID: 1197314
Sex: M
Age: 45
State:

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Vasovagel

Other Meds: none

Current Illness: none

ID: 1197315
Sex: M
Age: 48
State: MT

Vax Date: 02/26/2021
Onset Date: 03/08/2021
Rec V Date: 04/12/2021
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: Penicillin, dust, hay

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

Symptoms: Headaches, nausea, vomiting, diarrhea, cold sweats, tinnitus, nasal pressure, congested ear, fatigue, short of breath

Other Meds: Lorazepam, loratidin, metformin, zinc, vitamin C, vitamin D3, losartan, levothyroxine, allopurinol, multivitamin, etodolac, folic acid, citalopram.

Current Illness: None known

ID: 1197316
Sex: F
Age: 17
State: IL

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient was 17 at the time of administration, recommended is 18 years of age. Her father states she has had no adverse reactions or symptoms.

Other Meds: None

Current Illness: None

ID: 1197317
Sex: M
Age: 82
State: NV

Vax Date: 03/15/2021
Onset Date: 03/28/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: Sagebrush

Symptom List: Pharyngeal swelling

Symptoms: Client reports feeling fatigues day after vaccine. however, on 3/28 he reports his face bilateral near the nose is firm swollen and red. he reports no relief with gels or antihistamine. He sought dermatology assistance and is seeking allergy evaluation and is contacting his primary MD.

Other Meds: Lovastatin, doxysosin PSA, vitamins

Current Illness: Client denies

ID: 1197318
Sex: F
Age: 64
State: MI

Vax Date: 03/17/2021
Onset Date: 03/19/2021
Rec V Date: 04/12/2021
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: mold, penicillin, eggplant

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Moderate migraine headache and chills

Other Meds: Omneprazole 20mg OTC, vitamin D

Current Illness: None

ID: 1197319
Sex: F
Age: 61
State: OH

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/12/2021
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: No known allergies.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I had a terrible headache and fever from 6:00am on 4/8 until 4:00am on 4/9. 101.4 with Tylenol and Advil alternating every 2 hours. Severe body aches, severe fatigue. It was incredible how terrible I felt. At 4:00am on 4/9 I miraculously felt fine! With the 1st injection I had a severe headache for 3 days. I do not get headaches any more since I made lifestyle changes. (I used to get migraines) I have been an RN for over 40 yrs. I am glad I got the vaccine but BOY was the second one tough!

Other Meds: Mobic

Current Illness:

ID: 1197320
Sex: M
Age: 43
State: NY

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/12/2021
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: Patient received dose at 1:19pm walked to OBs area, sat in chair. Started texting, noted weakness, c/o sweaty feeling, alerted staff. Placed in WC, back to Med Eval tent where he was diaphoretic, pale. Did not lose consciousness. Patient admits to not eating or drinking today at all, very stressed about vaccine. Drank a bottle of water, and gatorade, fan for air circulation. Patient recovered well on cot in supine position, walked out without incident. Likely vasovagal response without syncope. NP

Other Meds:

Current Illness:

ID: 1197321
Sex: M
Age: 66
State: PA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/12/2021
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: NKA

Symptom List: Rash, Urticaria

Symptoms: itchy maculopapular rash

Other Meds: Atorvastatin Ibuprofen Lisinopril/HCTZ Omeprazole

Current Illness: Adenocardinoma of Cecum

ID: 1197322
Sex: F
Age: 56
State: PA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Woke up around 1:30 am next morning with chills and fever of 100.5. Took 2 Tylenol, drank some warm tea, and water. Fever decreased to 99.9 within an hour after taking Tylenol. The chills also went away. It was around 7 am before fever was gone. Felt very achey and tired rest of the day. Took Tylenol every 6 hours for 3 more times. Felt dehydrated., pushed lots of fluid including pedialyte. Woke up next day feeling fine but still a little tired. still pushing fluids

Other Meds: None

Current Illness: none

ID: 1197323
Sex: F
Age: 44
State: MS

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 04/12/2021
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: Patient received Janssen covid 19 vaccine. She did not disclose that she had already received one dose of Moderna. She also did not present her vaccine card. When we were discussing her immunization form, she did not mention that she had previously taken the Moderna vaccine.

Other Meds:

Current Illness:

ID: 1197324
Sex: F
Age: 47
State: NJ

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/12/2021
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: Compazine, Steroids

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

Symptoms: Tachycardia, shortness of breath. Occurred while sleeping for about 30-45 minutes. Was transported by ambulance to hospital.

Other Meds: Cymbalta 30mg, Lorazepam .5mg

Current Illness:

ID: 1197325
Sex: F
Age: 21
State: MN

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/12/2021
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: Penicillin

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

Symptoms: Patient reported a history of nervousness around needles and had passed out after an immunization in the past. I walked her through the immunization process and after administering her vaccine, I asked her if she was feeling ok before allowing her to leave the clinical room. She stated she was feeling ok so I instructed her to have a seat in the post-vaccination waiting area just outside the pharmacy for 30 minutes so we could observe her as a safety precaution. Shortly after sitting down, the patient fell off her chair. I ran out to check on her and found her unconscious and lying face down on the floor. As soon as I touched her shoulders she began to wake up and tried to get up. I asked her to remain laying down and offered to help her roll over onto her back. I asked her if she could tell me her name - she responded correctly. I asked if she knew where she was and she correctly stated she was at store. I had her take some deep breaths until her color came back and when she asked if she could please sit up, I assisted her into her chair and asked a technician to get a bottle of water for her. She felt a little shaky so I continued to hold onto her shoulders until she felt completely stable. She was able to take a few sips of water which helped her feel more steady. EMS arrived and checked her blood pressure and blood glucose levels. She was cleared by EMS and chose not to go to the hospital for further care. I had her call a friend to drive her home and stay with her for a while to make sure she was ok.

Other Meds:

Current Illness:

ID: 1197326
Sex: F
Age: 18
State: FL

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/12/2021
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: Per the NP: 1:20pm: While in observation, patient had an episode of syncope/ hypotension. It was unclear at the time if this was a reaction to the vaccination or not. Was treated immediately by NP and EMT/Paramedic staff. 911 was called and pt was transferred to the ER via monitored stretcher for further evaluation. Prior to leaving, and as pt was being transferred from one stretcher to the transport stretcher, pt experienced another syncopal episode. No arrhythmia noted on monitor, BP running 70's/50's. Awake, sluggish but oriented to person and place upon leaving. Transported via monitored stretcher to the ER.

Other Meds:

Current Illness:

ID: 1197327
Sex: M
Age: 57
State: MI

Vax Date: 03/16/2021
Onset Date: 03/25/2021
Rec V Date: 04/12/2021
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, lisinopril

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Around 8 days post-first-injection, swelling and redness around injection site, muscle pain, warm skin. Irritated area grew from about 6cm x 2cm to about 10cm x 10cm over the course of a few days. Pain and redness persisted for about four or five days, then began to subside, though skin in that area remained warm. After about a week or so redness faded, and pain was replaced by itching. Warm skin persisted. After about two weeks, patch fully disappeared, skin returned to normal temp, and itching largely subsided.

Other Meds: losartan 100mg, hydroCHLOROthiazide 25mg, atorvastatin 80mg, clopidogrel 75mg, metroprolol 25mg, multivitamin, aspirin 81mg, glucosamine sulfate

Current Illness: none

ID: 1197328
Sex: M
Age: 54
State: TX

Vax Date: 03/31/2021
Onset Date: 04/07/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Received the second COVID vaccination on March 31, 2021. Developed a rash under the arms the morning of April 7, 2021. The rash had spread from shoulders to feet by the morning of April 8, 2021. Armpits, ankles/feet and wrists/hands were very itchy, but little or no itching on the back, stomach, thighs, calves or shoulders. Treated topically with hydrocortizone 1% during the day and diphenhydramine HCI 25mg at night. Rash cleared up almost completely by the evening of April 9, 2021.

Other Meds: Aspirin, 81mg daily

Current Illness: None

ID: 1197329
Sex: F
Age: 0
State: FL

Vax Date: 11/03/2011
Onset Date: 11/03/2011
Rec V Date: 04/12/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient was born a healthy 7 lb baby full term via a natural, vaginal birth. She was perfectly fine, very alert, held her head up, was tracking individuals with her eyes, latched onto the breast... until the Hep B vaccine. She went completely lethargic within hours and eventually had to be given a bottle because she was too tired to latch or do anything but sleep. She was hospitalized at 2 days old. Facility is only a birthing center so she had to be admitted into Hospital and was kept overnight. 6 individuals attempted to wake her up.

Other Meds:

Current Illness:

ID: 1197330
Sex: F
Age: 47
State: NY

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/12/2021
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: Allergies: Sulphur, Penicillin, Tetracycline and Erythromycin

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

Symptoms: Starting on Saturday early morning, had severe chills and was very tired. Had a fever of 101 and slept off an on all day. Could not keep my eyes open and went to bed very early. I woke up the next morning (Sunday) feeling soso even though the day before I drank a bottle of gatorade, a bottle of water and 1/2 of a jug of a 3 gallon water. My legs were sore, like a feeling of being dehydrated, not flu like and my arm swelled up like a balloon, my eyes were very swollen, hands and feet as well. The swelling lasted until this past Saturday, April 10 and had a bunch of water weight on my body (4 extra pounds, which I have shed 2 of). I have a lot of memory loss as well as I ended up with my period, which I have not had in approximately 9 years. I had a headache for the first four days.

Other Meds: Vitamin C and Vitamin D

Current Illness: None

ID: 1197331
Sex: F
Age: 67
State: OH

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to Sulpha, Penicillin and Biaxin.

Symptom List: Unevaluable event

Symptoms: After about 5 hrs, I was very fatigued, had nausea, arm swelling and a red spot on my arm that was raised and hot. Later that night, I had a low grade fever, body aches. After sleeping for 12 hrs, all of the symptoms were gone accept for being fatigued and my arm swelling which lasted for about 10 days.

Other Meds: I take Calcium , Vitamin D, Melatonin, Flonase and I use an inhaler.

Current Illness: No other illinesses at the time of vaccination or up to one month prior.

ID: 1197332
Sex: F
Age: 68
State: TX

Vax Date: 02/05/2021
Onset Date: 02/08/2021
Rec V Date: 04/12/2021
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: Demerol

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

Symptoms: 24 hours post shot fever chills aches/pains treated with Tylenol, resolved after 24 hours. 48 hours post-shot, developed heart arrhythmia that has been sporadic since onset.

Other Meds: Vitamin D, C, and Zinc

Current Illness: Fever chills aches/pains post vaccine

ID: 1197333
Sex: F
Age: 57
State: KY

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 04/12/2021
Hospital: Y

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: PATIENT WAS IN GOOD HEALTH WHEN VACCINATED ON 2-27-21. BY 3-3-21, PATIENT REPORTED TO ER WITH SHORTNESS OF BREATH AND SEVERE FATIGUE. PATIENT WAS ADMITTED TO HOSPITAL WITH DEHYDRATION AND POSSIBLE PNEUMONIA. ONCE ADMITTED, SEVERAL BLOOD CLOTS WERE FOUND IN PATIENT'S LUNG. PATIENT SPENT 4 DAYS IN HOSPITAL AND WAS THEN DISCHARGED. SHE IS SINCE IN GOOD HEALTH.

Other Meds:

Current Illness: NONE OTHER THAN CHRONIC CONDITIONS FOLLOWING IN NEXT BOX

ID: 1197334
Sex: F
Age: 24
State: MS

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: Kiwi, grapes

Symptom List: Injection site pain, Menorrhagia

Symptoms: 3 hours following vaccine, my face started itching and swelling. My eyes swelled shut and when my lips began to itch I took a Benadryl. Eyes remained swollen for one day after. Slept for 15 hours straight

Other Meds: Lexapro 20mg Yaz Trazodone 50mg

Current Illness: None

ID: 1197335
Sex: F
Age: 75
State: WA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
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: Sensitivity to several meds but no allergies. Allergic to Trees, pollens, grass, Dog hair, etc.

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

Symptoms: Currently experiencing reddened area from injection site about one-half way to elbow and both to the anterior and posterior of the arm with itching. It is gradually improving and the itching is less today.

Other Meds: Advair Diskus, Montelukast, Atorvastatin, Bystolic, Losartan, COQ10, Vitamin D3, Multivitamins, Ibuprofen, Tylenol Tums, Aleve.

Current Illness: None

ID: 1197336
Sex: F
Age: 50
State: GA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Fever 100.8, Pouring sweat all night long--range April 11, 2021 approx 10pm through April12 through 10 am. Fever 99.8, Tingling Zaps electrial impulses between temples of forehead from 3 am on 4/12/2021 continues still at 2:01 pm. Headache Contines from 4/10/2021 to present time. Nausea, all day 04/11/2021 all day long Heart Palpitations, 04/11/2021--3 pm to 5 pm & again 9 pm to 11 pm and continued again 04/12/2021 7 am to 11 am

Other Meds: Toprol, Nexium, Tamoxifen, Effexor, Ozempic, Advil, Tylenol

Current Illness: None

ID: 1197337
Sex: M
Age: 64
State: CA

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt. c/o feeling light head and dizzy. Patient states feels better return to sitting position was release by Doctor on site.

Other Meds: 1) Lexapro 2) Effexor

Current Illness: None

ID: 1197338
Sex: F
Age: 52
State: PA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 04/12/2021
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: Doxycycline; Levofloxin; codeine; meloxicam; diflucan; contrast dye; succinyl choline; mivacurium

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

Symptoms: 3/17pm face/neck/chest flushed, worsened over 3 days. 3/20 to UrgentCare w/full body redness/itching /painful puffy lips/sore throat. Started on 5d of prednisone 20mg; w/o relief by D#3. PMD increased prednisone to 60mg/d + 12 d taper + Pepcid + Zyrtec. 4/5 (day after taper ended) red face/neck/chest intensified, never fully resolved. By 11pm swollen glands--throat/neck + sore; body aches; fever; migraine (L-side, not usual central & no relief w/Maxalt Rx). Small relief w/Benadryl + Tylenol. 4/7 fever/swollen glands/neck/throat resolved, but red face/neck/chest + migraine remain and no relief w/15mg oxycodone + Maxalt so went to ER. Given IV fluid bolus + metoCLOPramide +diphenhydrAMINE + dexAMETHasone w/90% relief. Redness persists and migraine has returned with limited response to her current meds.

Other Meds: Maxalt; Zyrtec; Prilosec; Nortriptyline; Vitamin-D; baby-Aspirin; Crestor

Current Illness: None

ID: 1197339
Sex: M
Age: 54
State: WA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Localized pain in left arm approximately 30 minutes after injection and persisted for 3 days but diminished significantly by the third day. Felt body aches the first night and joint and muscle pains increased and plateaued on day 3 and has persisted. Headache began on first night and persisted since. Tylenol was ineffective but some relief from Ibuprofen. Dizziness throughout, especially when bending over. Loss of appetite. Weakness and malaise throughout. Mild hand tremors.

Other Meds: Metformin 1000mg twice daily, Allipurinol 300mg, magnesium, D3, CoQ10

Current Illness: Diabetes, Myalgic Encephalomyelitis, campylobacter jejuni infection treated with Azithromyecin.

ID: 1197340
Sex: F
Age: 32
State: CA

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain

Symptoms: Period came early - my last period finished up 2 weeks before my shot (April 1) and my period started up again on April 11 which is much earlier than usual.

Other Meds: N/A

Current Illness: N/A

ID: 1197341
Sex: F
Age: 28
State: CA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: Pennicillin

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

Symptoms: Horrible stomach cramps, indigestion, back pain radiates around my stomach

Other Meds: Tyneol

Current Illness: None

ID: 1197342
Sex: F
Age: 47
State: CA

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 04/12/2021
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: Sulfa, ginger

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

Symptoms: 8 1/2 hours after second dose, Fever 102.8, body aches, swollen lymph nodes in neck and arm pit, headache, chills, sweating, sore arm at injection site, swollen at injection site, itchy and swollen. all but the swollen arm and lymph nodes went away after 24 hours. Arm got better after 1 week. Lymph nodes were better after 6 days. 13 days later I now have hearing lose in my left ear.

Other Meds: Bupropion. Gabapentin, Omeprazole, Xyxal

Current Illness: none

ID: 1197343
Sex: F
Age: 40
State: FL

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/12/2021
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: Allergy to NSAIDs, aleve, advil, asprin

Symptom List: Tremor

Symptoms: Symptoms lasted approximately 36 hours. Felt extremely sleepy/tired 15 minutes after injection. A few hours later I developed a headache and minor body ache. The next morning, the body aches were worse and I had chills & a fever of 101.6.

Other Meds:

Current Illness: None

ID: 1197344
Sex: F
Age: 48
State: VA

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Extreme flu-like symptoms. Severe and debilitating headache and body aches.

Other Meds: Venlafaxine

Current Illness: None

ID: 1197345
Sex: F
Age: 74
State: GA

Vax Date: 03/26/2021
Onset Date: 04/05/2021
Rec V Date: 04/12/2021
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: 10 days after shot patient developed a rash that itched and swelled. It was red.

Other Meds:

Current Illness:

ID: 1197346
Sex: M
Age: 50
State: MD

Vax Date: 04/02/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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: Ciprofloxacin caused anaphylaxis

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

Symptoms: Hives starting 11 April; resolved temporarily with a single dose of benadryl; then recurred the following day.

Other Meds: Multivitamin, Milk Thistle, Benadryl as needed

Current Illness: None

ID: 1197347
Sex: F
Age: 33
State: NE

Vax Date: 03/28/2021
Onset Date: 04/06/2021
Rec V Date: 04/12/2021
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: Minocyclin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: After shot #1 within ten minutes I felt a wave of nausea, light-headedness, and dizziness pass through my body that lasted about a minute or two. I reported this to the pharmacist and she explained nausea was a symptom of the vaccine and let me go home. That night I had several waves of nausea/dizziness that lasted for a few minutes. I was mostly fine after that. Before shot #2 I relayed symptoms again to the pharmacist and she said to expect something similar for my second shot. After shot #2 I felt nothing except a sore arm until nine days later when I was hit with extreme dizziness, light-headedness, and nausea while driving. The symptoms persisted for several days and I went to my doctor to see if it could be a reaction to the vaccine. The doctor said no because it was too far out from my shot date and believes it's "motion sickness/vertigo" due to my age/gender and prescribed me Dramamine to get by. I'm still experiencing symptoms 13 days out from the date of my second shot.

Other Meds: n/a drank some gatorade after receiving it

Current Illness: n/a

ID: 1197348
Sex: M
Age: 31
State: FL

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/12/2021
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 FELT DIZZY, LIGHT HEADED AND VOMITING AFTER SHOT

Other Meds:

Current Illness:

ID: 1197349
Sex: M
Age: 39
State: MN

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/12/2021
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: None

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

Symptoms: Patient felt dizzy, light-headed, nauseous, and was diaphoretic about 5 minutes after vaccine given. Patient was assisted to the ground and legs were elevated. It took patient about an hour until he was able to sit up without dizziness. Juice and snacks given and VS were monitored. Patient was evaluated by Dr. onsite and instructed not to drive. Patient was picked up by his in-laws and instructed by Dr. to be checked out further at either Urgent Care or the ER due to prolonged dizziness after vaccination. Pulse was 86 sitting to 99 standing. BP stayed the same from sitting to standing. Blood pressures with manual cuff were 160/80. BP rechecked 30 minutes later and was 140/80. Patient was assisted by staff to the car when in-laws arrived to pick him up.

Other Meds: None

Current Illness: None

ID: 1197350
Sex: F
Age: 36
State: ND

Vax Date: 03/30/2021
Onset Date: 04/02/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Pain in extremity

Symptoms: Day 2-3 (Friday - Saturday) - [ ] Random twitching throughout body in muscles? (arm, legs, head once) (feels like something is crawling under my skin) - [ ] Fatigue - [ ] Tight muscles Day 4 (scary night time episode) - [ ] Moderate to severe Muscle spasm with no pain in legs worse in left leg - [ ] Sweating - [ ] Heart fluttering - [ ] Chills with moderate shaking - [ ] High pulse - [ ] Tight muscles - [ ] Continuous twitching through body in muscles? (arm, legs, back, chest, butt, chest) Day 5 (Monday) visited Urgent Care - [ ] Moderate Muscle spasm with no pain in legs worse in left leg - [ ] Tight muscles - [ ] Super weak legs - [ ] Heart fluttering - [ ] Fatigue - [ ] Continuous twitching through body (in muscles? arm, legs, back, chest, butt, chest) Day 6 - [ ] Tight and sore muscles - [ ] random to continuous twitching throughout body Day 7 Wednesday - [ ] random to continuous twitching throughout body (feels like a fast pulse on and off) - [ ] A few Eye and face twitches - [ ] Tight and sore muscles - [ ] Heart fluttering Day 8 -11 - [ ] random to continuous twitching throughout body (feels like a fast pulse on and off) - [ ] Eye and face twitches - [ ] Heart fluttering

Other Meds: Zyrtec 10 mg, Multivitamin, Ashwagandha, Magnesium Oxide 330 mg

Current Illness: N/A

ID: 1197351
Sex: M
Age: 49
State: MD

Vax Date: 03/20/2021
Onset Date: 03/22/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: Nothing

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

Symptoms: 42 hours after started notice noise is heard in the left ear. Not sure about right ear. Still the ringing noise on the left ear after 23 days. Checked with in ENT specialist and reported hear loss in the high frequency sound. It is TENNITUS. 22nd day I had a dizziness.

Other Meds: Nothing

Current Illness: Nothing

ID: 1197352
Sex: F
Age: 17
State: MA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/12/2021
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: Bactrim: rash, hives Penicillin: rash Vancomycin: rash, Redman syndrome Cats, cockroaches, dust mites, grass, mice, ragweed, shellfish

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

Symptoms: Reportedly had some redness and blotchiness at the time but currently no signs of anaphylaxis with no urticaria, no respiratory involvement, no intraoral swelling or voice changes, no GI symptoms. He is warm and well-perfused although is slightly tachycardic but appears anxious. His reported inability to move her arms and legs does not seem consistent with a neurologic etiology of this complaint and more likely consistent with anxiety/conversion reaction in the setting of a vasovagal episode. Will give zyrtec at mother and patient's request, PO challenge and reassess.

Other Meds: Acetaminophen, Albuterol MDI, EpiPen, Hydroxyzine, Aygestin

Current Illness: None reported

ID: 1197353
Sex: F
Age: 60
State: MS

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 04/12/2021
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: NKA

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

Symptoms: 3/23/2021 @ Vaccination drive through- pt received 1st dose Moderna vaccine in L deltoid. Approx. 5 minutes after vaccination @ 11:00 am, pt reported R side chest pain increasing suddenly on pain scale 5-10. EMS personnel onsite Assessed pt VS 153/90 HR 66. R-16 in AM pt's pain subsided. Refused to be transported to hospital. Pt continued to be observed during the next hour. No c/o chest pain upon leaving vaccination site

Other Meds: unknown

Current Illness: none

ID: 1197354
Sex: M
Age: 56
State: TX

Vax Date: 02/12/2021
Onset Date: 02/22/2021
Rec V Date: 04/12/2021
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: Severe swelling in hands and feet plus joint pain

Other Meds: Tylenol with Codeine for pain, Radiation for cancer treatment

Current Illness: SCC caused by HPV virus

ID: 1197355
Sex: M
Age: 29
State: GA

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/12/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient fainted in store after receiving first dose of Pfizer Covid vaccine. Patient regained consciousness within a minute and reported no other injuries. Patient was guided by pharmacist on duty to lie down with feet propped up. Patient remained in room for approximately 30 minutes after which patient confirmed that he was feeling fine. Patient will call pharmacy if any new symptoms develop

Other Meds:

Current Illness:

ID: 1197356
Sex: M
Age: 18
State: OH

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: none.

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

Symptoms: I gave an expired vaccination on 04/12/2021. The vaccination expired on 04/11/2021. The patient was notified and there was no adverse reactions to this vaccination.

Other Meds: Adderall XR 30 mg once daily, Lamictal 150 mg.

Current Illness: none.

ID: 1197357
Sex: F
Age: 30
State: IN

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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: Hot flashes without fever, tiredness, redness and welting at injection site, abdominal cramping, vaginal spotting, menstrual cramping

Other Meds: None

Current Illness: None

ID: 1197358
Sex: F
Age: 41
State: MI

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: CefaclorHives Cefaclor Morphine Hcl Tetanus And Diphtheria Toxoids, Adsorbed, Adult Tetanus Vaccines And ToxoidSwelling

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

Symptoms: Patient states after the vaccine, she developed wheezing, shortness of breath, headache, cough, and hot flashes. She states her chest feels tight, but denies any irritation or swelling in her throat.

Other Meds: albuterol (ACCUNEB) 1.25 mg/3 mL nebulizer solution albuterol (VENTOLIN HFA) 90 mcg/actuation inhaler amoxicillin-clavulanate (AUGMENTIN) 875-125 mg per tablet cetirizine (ZYRTEC) 10 MG tablet diphenhydrAMINE (BENADRYL) 25 mg capsule EPINEP

Current Illness: n/a

ID: 1197359
Sex: F
Age: 21
State: PA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/12/2021
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: Anaphylaxis - Tree nuts (walnuts) Vomiting - eggs, milk SOB - Peanuts, Fish oil, sesame oil, macadamia nut oil, Shellfish and shellfish containing products

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

Symptoms: Pt developed SOB 20 minutes after vaccine injection. On site paramedics administered benadryl. Pt minimally improved, was treated with epipen, IV steroids, nausea medication and transported to Hospital ED. She was treated in the ED, observed for 4 hours, then discharged with Medrol Dose pack.

Other Meds: Zyrtec, BreoEllipta, verapamil CR, albuterol, Junel FE

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm