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: 1220045
Sex: M
Age: 20
State: WI

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

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Janssen Covid 19 vaccine given at onsite employer vaccine clinic As documented on: 1025 client c/o bilateral itching upper arm and slight headache 5/10. Itchy and HA began after 15 min observation period. Denies SOB, no wheezing noted. no hives or rash noted. 1027 50mg of Benadryl administered for itching. BP 122/70 , HR 88 @ 1045 1058 142/72 RUA, HR 82. Continued to c/o itching, no hives or rash visible. Reports slight improvement in HA, rating 5/10 pain level. Reports slight drowsiness, A&Ox3. 1110 Continued intermittent itching. Reporting worsening HA 7/10 frontal area. states he is unsure if HA has worsened because he is thinking about not itching. Mild nausea reported. 1124 BP148/82 HR 86, Reports continued mild nausea, upper extremity itching. Patient went home at 1128am.

Other Meds:

Current Illness:

ID: 1220046
Sex: F
Age: 31
State: NC

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: Penicillin - Hives Azithromycin - Shortness of Breath, Rapid Heart Rate

Symptom List: Anxiety, Dyspnoea

Symptoms: Almost immediately began to experience lightheadedness, racing heart, and throat tightening. Informed nurse. Was told to sit on ground and was given liquid Benedryl. Was told to lie down with legs propped up on chair while ice pack was put under my neck. Throat continued to tighten. Gave permission for epi pen, which was administered. Laid back down for a few minutes and tightening did not seem to worsen. After a few minutes I sat back up and was told to sip a few sips of water. After the third sip, my throat began to tighten, laid back down which did not help. Technicians called an ambulance and administered a second epi pen with my permission. EMTs arrived and took me to their rig. My vitals were fairly steady but my lips and tongue had started to tingle and my throat was still tight. EMTs took me to Emergency Room. Was given steroids, pepcid, and benedryl. While throat was still tighter than normal, my stats were good, so I was discharged between 5-6, with perscriptions for prednesone, benedryl, pepcid, and 2 epi pens. At approximately midnight, began to feel throat tighten up again, took benedryl at 1:00, when condition did not improve, went back to ER approx, 2:20 am. Around 7-8 am was given steroids and benedryl, however my body began to react to the steroids with full body sensation of tingling/feeling as though it was going to sleep. Was given an ativan which calmed system down and allowed me to sleep. Eventually discharged around 11 am, told not to use steroids but to continue benedryl as needed.

Other Meds: Women's One a Day Vitamin Gummies, Vitamin D, Claritin, Albuterol inhaler as needed, elderberry gummies, fiber plus gummies

Current Illness: none

ID: 1220047
Sex: F
Age: 68
State: NY

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
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: No allergies reported by the patilent

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

Symptoms: Patient reported level 5 chest pain 5 minuted after receiving 2nd dose of covid 19 vaccination. Patient denied LOC, resp. diff. or other symptoms.

Other Meds: No medication list available .

Current Illness: None reported by patient

ID: 1220048
Sex: F
Age: 43
State: MI

Vax Date: 04/06/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Red itchy rash and tenderness at vaccine site.

Other Meds: Zyrtec D, Larissa birth control, vitamin D, Lamotrine

Current Illness: None

ID: 1220049
Sex: M
Age: 38
State: MT

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Patient experienced near syncope immediately following first dose of vaccine. Patient reports that this is a common occurrence following any procedure involving needles. Patient recovered quickly and refused any further treatment prior to leaving the vaccine POD.

Other Meds: None

Current Illness: None

ID: 1220050
Sex: F
Age: 45
State: WI

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
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: Allergies ClindamycinRASH, DIARRHEA, Other (See Comments) AmoxicillinHIVES CiprofloxacinHIVES Darvocet [Propoxyphene N-apap]HIVES Guaifenex Dm [Dextromethorphan-guaifenesin]HIVES, NAUSEA LamictalINSOMNIA, Other (See Comments) Metal Topical (Environmental)HIVES Metoprolol NickelHIVES Tape [Adhesive (Environmental)]RASH Ultram [Tramadol Hcl]HIVES

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

Symptoms: nausea diarrhea headaches fatigue

Other Meds: cloNIDine (CATAPRES) 0.1 MG tablet FLUoxetine (PROzac) 10 MG capsule FLUoxetine (PROzac) 20 MG capsule irbesartan (AVAPRO) 300 MG tablet dilTIAZem (CARDIZEM CD) 240 MG 24 hr capsule nortriptyline (PAMELOR) 10 MG capsule metFORMIN (GLUCOPHAG

Current Illness: none

ID: 1220051
Sex: F
Age: 65
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Chest pains,light headed Difficulty breathing

Other Meds:

Current Illness:

ID: 1220052
Sex: M
Age: 56
State: WA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: dexamethasone

Symptom List: Pharyngeal swelling

Symptoms: dizziness within 5 minutes, pt moved to chair with arms against wall for support. blood pressure continued to drop and and dizziness increased until pt lost consciousness. Epinephrine administered which resulted in pt becoming alert, once alert pt was given 15ml of hydroxyzine 10mg/5ml and pt then stabilized. pt left with paramedics about 15 minutes later

Other Meds: tadalafil, rapaflo, finasteride

Current Illness: unknown

ID: 1220053
Sex: F
Age: 49
State: MA

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 04/16/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Typical symptoms began the evening of the day I got the shot (March 21st): sore arm, achy, headache, dizziness, and just generally beginning to feel ?off?. Took Aleve. Symptoms worsened the next day and I was extremely fatigue and that carried into Tuesday. Taking Advil as needed. Started vertigo exercises ?just in case? to help with the dizziness. By the end of day on Tuesday, all symptoms had cleared except headache, dizziness and fatigue. However, I was beginning to feel a sense of ?brain fog?? I was starting to have a really hard time writing a simple email without it being littered with typos or inconsistent thoughts. By Thursday I was in my doctor?s office/prescribed meclizine and by Friday he sent me to the ER: EKG, CAT scan and blood work all checked out. No ?real? explanation for my symptoms except a weird reaction to the second shot. Over the course of the following three weeks, the headache has subsided but flares up from time to time however the ?dizziness?, disorientation, brain fog has continued. Sometimes it feels like I have a focus problem too? like it takes me a while to register what it is I am looking at. Then the more I try to live a ?normal? day, the more I seem to experience something that I refer to as a ?neurological meltdown? starting mid-afternoon and by dinnertime I can barely think my way through dinner preparation. ANY stimulation like children singing, TV noise, dog barking, etc. feels intolerable. It is all I can do to keep myself upright and engaged in the evening routine and then I am passed out on the couch. The other way to describe this is that I feel ?concussive?? like I have a concussion. I have to wear sunglasses now. I can?t listen to music through my headphones anymore? it is just too much for my brain. It is like by the end of the day my ?brain battery? is drained and if I doesn?t recharge overnight, I wake up off and dizzy and just can?t think clearly or remember much of anything. I saw an ENT on April 12th and am scheduled to see a neurologist on May 3rd. I have NO idea what has happened to me but I was a high energy, multi-tasker, never sit down kind of person who exercised daily until the second shot. NOTE: Prior to the second shot, I was running 6 miles three times a week and swimming 1 ? miles three times a week.

Other Meds: only vitamins

Current Illness: none

ID: 1220054
Sex: F
Age: 45
State: NY

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/16/2021
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: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Received Johnson and Johnson COVID19 vaccine on 4/11. Felt fatigued 3 hours after. 2 days after that started developing generalized arthralgias and at this time more her b/l knees and hips and lower ext. pain. Pain scale of 7/10. No overt swelling or change in color noted. No shortness of breath. Slightly better today but pain still present now 3/10. No abd. pain at this time. No fevers/chills. NO cough or sputum production.

Other Meds: Estradiol 0.1/24 hour transdermal patch omeprazole 20 fluoxetine 40 propranolol 20 sumatriptan 50 as needed

Current Illness:

ID: 1220055
Sex: F
Age: 30
State: NY

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Na

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

Symptoms: Headache onset 2 hours after shot. Roughly 9 hours after shot developed joint pain/tickling/shaking chills in my legs (mostly in the thighs) and nausea. Temperature rose to 102 degrees over the next 3 hours (I usually run around 97.5) along with the above pain. Around midnight/1 am I was able to get the fever down using Tylenol and a cold bath and the sensation in my legs lessened. The following day I was still a bit nauseous with a headache and low grade fever. The same leg sensation (but to a much lower degree) persisted for 2 days.

Other Meds: Lamictal

Current Illness: Na

ID: 1220056
Sex: F
Age: 55
State: IL

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
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: No

Symptom List: Rash, Urticaria

Symptoms: Had flu like symptoms day of vaccine next morning Got Sick at stomach was leaning against bed passes out fell between bed and bed table. Was out for 1 /2 minutes came to and felt ok the rest of day

Other Meds: Duloxetine DR 60mg daily Vitamins Calcium, B-100 , Biotin, super primrose

Current Illness: None

ID: 1220057
Sex: M
Age: 91
State: IN

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: Patient received first dose of Pfizer vaccine but had already been vaccinated with Moderna's vaccine on 3/21/21 at "HS", assumed to be the high school where the patient lives. The patient did not have any immediate adverse events due to the pfizer vaccination. This record is to report vaccine administration error in which the patient received Pfizer 4/16/2021 instead of Moderna. A root cause analysis will be performed for this medication error.

Other Meds:

Current Illness:

ID: 1220058
Sex: F
Age: 26
State: RI

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Chest pain Left Side pain Shortness of breath

Other Meds: Multi vitamin Probiotics

Current Illness: None

ID: 1220059
Sex: F
Age: 53
State:

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 04/16/2021
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: Missed 2 days of work due to fever, chills and myalgias.

Other Meds:

Current Illness:

ID: 1220060
Sex: F
Age: 48
State: IN

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 04/16/2021
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: Allergic to penicillin and sulfa /sulphur medicines

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

Symptoms: Headaches for 2 1/2 days and needed to be out of work

Other Meds: Thyroid medicine, lisinopril, paroxten, MetForman

Current Illness: No

ID: 1220061
Sex: F
Age: 44
State: FL

Vax Date: 02/16/2021
Onset Date: 03/16/2021
Rec V Date: 04/16/2021
Hospital: Y

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

Lab Data:

Allergies: demerol

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

Symptoms: Profound weakness, shortness of breath, saddle pulmonary embolism diagnosed by CT angiogram at healthcare facility on 4/.5/2021.

Other Meds: atorvastatin, glipizide, farxiga, metformin,

Current Illness:

ID: 1220062
Sex: F
Age: 25
State: DE

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: nka

Symptom List: Ear pain, Hypoaesthesia

Symptoms: About an hour after her vaccine, patient called and said that she was nauseous, vomiting, had passed out twice, a rash from the injection site up to her throat, and her arm was swollen from the elbow up. I told her to take Benadryl and to go to the ER or to the immediate care. I followed up with her the next day and she went to the ER, she said the Benadryl helped her out significantly and that she was feeling much better that day. She was still inquiring about the second shot but, she was following up with her MD on Wednesday.

Other Meds: nka

Current Illness: Sjogrens syndrome and Rheumatoid arthritis

ID: 1220063
Sex: F
Age: 46
State: IL

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Tizanidine, Cats, Hayfever

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: All these occurred the day after the vaccine: Sore, itchy arm-no treatment-resolved after a week. Bone-crushing pain throughout whole body-slept and took Extra Strength Tylenol-resolved after 1 day. Chills-slept, and wrapped myself in two blankets-resolved after 1 day. 101 degree fever-took Extra Strength Tylenol-resolved after 1 day.

Other Meds: Gabapentin, Celebrex, Bupropion, Norethindrone, Lansoprazole, Amlodipine, Fluticasone, Probiotic, Iron, Vitamin D, Omega 3

Current Illness:

ID: 1220064
Sex: F
Age: 55
State: VA

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

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Patent was given vaccine and started to feel dizzy, light headed, itchy. After resting and fluids for 20 min patient began to feel as if her throat was getting tight. Patient began to cough intermittently and felt as "if I just cant breath and my throat is so tight". Nurse from clinic provided first aid, vital signs showed decrease in o2 sats from 95% to 92% with increase of coughing. Pt was placed in semi fowlers position and given IM EPI pen in left thigh (10:20) (VS 142/80 HR 74, rr 18) and 1cc IM Benedryl, EMS services were called. At 10:25 (VS 132/82, HR 88, rr 22) pt began shaking, coughing and feeling more "like I cant breath. Repeat IM EPI pen given in rt thigh at 10:39. EMS arrived, report given to EMS staff by physician and nurse. Patient spouse arrived on scene and patient was transferred into ambulance and taken to Health Care center. Followup-04:30 PM call with spouse and patient. Patient was discharged to home. Given one more treatment of IM Benadryl in ER and discharged to home. Patient is feeling much better. Only given Allegra for home use.

Other Meds: Omeprazone

Current Illness: none

ID: 1220065
Sex: F
Age: 37
State: DC

Vax Date: 04/12/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: None

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

Symptoms: About 3.5 days after my second pfizer dose (dose was given April 12, this happened around 1:30 am April 16) I awoke with extreme vertigo. It felt as if the room was violently shaking. This also caused me to break into a cold sweat and become very nauseous. The extreme shaking subsided after about 1 minute but I continued to feel dizzy and unable to stand for another few minutes. After about 20 minutes the dizziness and nausea had subsided enough that I was finally able to fall back to sleep and woke up hours later with a headache and feeling a little shaky, but no longer dizzy. For what it's worth I have had this reaction one other time in my life--15 years ago when I took mefloquin for malaria, it triggered vertigo. I switched to a different malarial prophylaxis and have never experienced vertigo again until this week following the second pfizer dose.

Other Meds: Birth control

Current Illness: None

ID: 1220066
Sex: F
Age: 26
State: TX

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: vaccine administered at 3:07 pm, other complains of feeling sweaty tunnel vision, bilateral ringing of ears 1 minute after receiving vaccine, R 18, HR 49, BP 72/45, o2 99%, Temp 96.8 ... secondary vitals 3:20 pm. R 18, HR 62, BP 116/62, O2 99%, Temp 96.0. 3:34 pm lead nurse made aware. 3:38 pm Md on call made aware. Pt states feels much better. Instructed pt to call 911 if symptoms worsen and put will be driven home by significant other, pt under no distress 3rd vitals 3:35pm o2 99%, Hr 67, BP 110/68, Temp 97.4, R 18. 3:43 MD on call states pt is okay to go home. Pt left in no distress.

Other Meds:

Current Illness:

ID: 1220067
Sex: F
Age: 68
State: TX

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 04/16/2021
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: rice, beef, foods high in natural histamines, fish, shellfish, laytex

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

Symptoms: I have experience moderate fatigue (needing to sleep 15 hours each day to feel rested when I used to sleep 8-9) and diarrhea (moderately interrupting daily schedule) for four (4) weeks now. I have had to take time off from work to get extra sleep every week and sleep away most weekends. The diarrhea would not be manageable if I were at my workplace and not working from home, with 2-3 daily loose stools. I also feel chills. Oddly, I have lost no weight, just my bad luck. I figure if I start to lose weight, I will see my doctor.

Other Meds: 22 prescriptions for diabetes hypertension, hypothyroidism, hypocholesterolemia etc

Current Illness: none

ID: 1220068
Sex: F
Age: 36
State: MT

Vax Date: 04/06/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: NKA

Symptom List: Injection site pain, Pain

Symptoms: Pt had right sided chest pain x3 days starting 4/12/21, had a week of cough, fever, "general not feeling well" prior to ER admission 4/15/21. Had CT scan in ER on 4/15/21 - per radiology report a clot and pneumonia noted in RUL of lung. WBC count >22, elevated D Dimer, T Max in ER was 102.2. Was given PO Tylenol, 100mg Lovenox Subq, and IV antibiotics and flown to hospital.

Other Meds: received Vaccine at

Current Illness: I do not have access to the vaccine form

ID: 1220069
Sex: F
Age: 63
State: AR

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: Injection site pain, Menorrhagia

Symptoms: Pt called the day after receiving the moderna vaccine and said that her right big toe was numb and the toe next to it was partially numb

Other Meds:

Current Illness:

ID: 1220070
Sex: M
Age: 52
State: CA

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: I've already sent THIS to Moderna Covid vaccine company, oh I have my way's as a techie when I need to bring something to another's doorstep. Nevertheless, date and time would be around THAT as shown (below). Hello, Today's date: Friday, 4/16,/2021, time: 1:00pm. nurse and support staff you can reach someone there 24/7, 7 days a week. I have no cell / mobile phone nor want one < not all do, me NOT a mobile guy but a desktop / laptop web techie guy. I can be reached by email and limited social media. There is a local nurse onsite & staff per Services Authority I'm a techie nevertheless as I know however to network with various when it comes to a cause, misc, you know. I'll copy and paste the (above) text wordage into a Word Pad document and save it on my desktop LAPTOP pc / computer to archive until I deem I don't further need to share with you, CDC and ? misc related. I provided contact info (above). But here's the thing, I got / received the first Covid shot yesterday afternoon around sort of 12 noon or so, give or take (you can further ask the ONSITE staff whom would have contact info to the actual medical personnel who showed up yesterday, set up a tent in the parking lot & administered the actual shot'

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

Symptoms: I've already sent THIS to Moderna Covid vaccine company, oh I have my way's as a techie when I need to bring something to another's doorstep. Nevertheless, date and time would be around THAT as shown (below). Hello, Today's date: Friday, 4/16,/2021, time: 1:00pm. nurse and support staff you can reach someone there 24/7, 7 days a week. I have no cell / mobile phone nor want one < not all do, me NOT a mobile guy but a desktop / laptop web techie guy. I can be reached by email and limited social media. There is a local nurse onsite & staff per Services Authority I'm a techie nevertheless as I know however to network with various when it comes to a cause, misc, you know. I'll copy and paste the (above) text wordage into a Word Pad document and save it on my desktop LAPTOP pc / computer to archive until I deem I don't further need to share with you, CDC and ? misc related. I provided contact info (above). But here's the thing, I got / received the first Covid shot yesterday afternoon around sort of 12 noon or so, give or take (you can further ask the ONSITE staff whom would have contact info to the actual medical personnel who showed up yesterday, set up a tent in the parking lot & administered the actual shot's. But TODAY as of the (above) date & time) I'm noticing a sense of soft null or tone down pain in my right arm below the actual shoulder. Kindly directly THIS to your medical team - personnel for review and decision on course of action, just saying, sorry, not trying to step on any toes, God bless in Jesus, stay safe, I mean that sincerely. BUT I just wanted to let you know, as I have called downstairs and informed the onsite nurse. I feel fine more less, just that my right arm where I got the shot feels pain when lightly touching the shot area.

Other Meds: I've already sent THIS to Moderna Covid vaccine company, oh I have my way's as a techie when I need to bring something to another's doorstep. Nevertheless, date and time would be around THAT as shown (below). Hello, Today's date: Frida

Current Illness: I've already sent THIS to Moderna Covid vaccine company, oh I have my way's as a techie when I need to bring something to another's doorstep. Nevertheless, date and time would be around THAT as shown (below). Hello, Today's date: Friday, 4/16,/2021, time: 1:00pm. nurse and support staff you can reach someone there 24/7, 7 days a week. I have no cell / mobile phone nor want one < not all do, me NOT a mobile guy but a desktop / laptop web techie guy. I can be reached by email and limited social media. There is a local nurse onsite & staff per Services Authority I'm a techie nevertheless as I know however to network with various when it comes to a cause, misc, you know. I'll copy and paste the (above) text wordage into a Word Pad document and save it on my desktop LAPTOP pc / computer to archive until I deem I don't further need to share with you, CDC and ? misc related. I provided contact info (above). But here's the thing, I got / received the first Covid shot yesterday afternoon around sort of 12 noon or so, give or take (you can further ask the ONSITE staff whom would have contact info to the actual medical personnel who showed up yesterday, set up a tent in the parking lot & administered the actual shot's. But TODAY as of the (above) date & time) I'm noticing a sense of soft null or tone down pain in my right arm below the actual shoulder. Kindly directly THIS to your medical team - personnel for review and decision on course of action, just saying, sorry, not trying to step on any toes, God bless in Jesus, stay safe, I

ID: 1220071
Sex: F
Age: 39
State: WA

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: NKA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pt reports beginning of day 1 post COVID vaccine dose 2, she had h/a and neck pain and by the 24-hour mark everything started to occur. Pt presents with red blotchy skin on the face and torso, swollen lips (upper and lower), oral temperature of 100.5, sore arm with pain rating 10/10.

Other Meds: no medications or OTC at this time

Current Illness: no illnesses at this time

ID: 1220072
Sex: F
Age: 66
State: PA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin, Ampicillin, Sulpha Drugs

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: The night of the 1st injection, when it was quiet, I realized that I had tinnitus. I did not have this before that day/night. I checked online for that as being a side effect and found that it was not common but some people had developed it after getting the Moderna vaccine. I was a little concerned about getting the 2nd Moderna shot but did not feel that I could change to a different one. I got my 2nd shot yesterday and it seems to be a bit worse than it was before. It is not intolerable but annoying when I am trying to get to sleep.

Other Meds: Gabapentin, Cymbalta, Keppra, Atorvastatin, low dose aspirin, Vitamin D3, Vitamin B-Complex with B-12, Diphenhydramine HCl, Melatonin, CBD oil

Current Illness: None

ID: 1220073
Sex: M
Age: 16
State: MN

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/16/2021
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: N/A

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

Symptoms: No Adverse event- patient was under age 18.

Other Meds: N/A

Current Illness: N/A

ID: 1220074
Sex: F
Age: 51
State: TX

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: PCN, Sulfa, Minocin and duck

Symptom List: Nausea

Symptoms: Approximately 10-11 hours after receiving the vaccine, my eyes, lips, throat and tongue began to swell. I immediately took Bendryl 50 mg. I had some labored breathing for about 3 hours after taking the Benadryl, and the swelling completely went away about 6 hours later.

Other Meds: Adderall XR 20 mg, Ambien 5 mg, Remeron 15 mg, hormone replacement therapy

Current Illness: none

ID: 1220075
Sex: F
Age: 71
State: MA

Vax Date: 03/29/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
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: None

Symptom List: Injection site pain

Symptoms: I had been hospitalized 3-4 times between 2007 and 2009 for cellulitis on my face originating from my outer ears. No particular cause was found at those times. I was just hospitalized for the same problem (first time since those previous episodes) on April 14, 2021. Condition has been diagnosed as Relapsing Polychondritis, a rare autoimmune disease affecting the cartilage of the body. Now, the question is: Is it just coincidence this flare occurred after getting the COVID vaccines, or did the vaccine somehow stir up my immune system causing it to bring on this latest episode?

Other Meds: Singulair Crestor Senna Plus Effexor XR Tradjenta Protonix Estradiol Progesterone SR Synthroid Vitamin D3 Flonase Calcium + Mg 50+ Women's Multi Vitamin Nystatin Ointment Albuterol

Current Illness: None

ID: 1220076
Sex: F
Age: 41
State: GA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/16/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: woke up overnight feeling extremely nauseated. She was on the toilet holding the trash can and gagging and thinks she remembers putting the trashcan down but then passed out. Her husband found her on the bathroom floor with her jaw clenched. She says the nausea was so intense it felt like alcohol poisoning when she was younger. She did not go to ER. She felt weak and tired for the next several days.

Other Meds:

Current Illness:

ID: 1220077
Sex: F
Age: 52
State: FL

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 04/16/2021
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:

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

Symptoms: heart felt it was beating fast, feel anxious

Other Meds:

Current Illness:

ID: 1220078
Sex: F
Age: 59
State:

Vax Date: 04/03/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: Tremor

Symptoms: Small, itchy, raised bumps appeared in an irregular patter around the injection site after 12 days. The injection site is warm and hard to the touch.

Other Meds:

Current Illness:

ID: 1220079
Sex: M
Age: 61
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/16/2021
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 REPORTED

Symptom List: Erythema, Pruritus

Symptoms: PT RECEIVED HIS COVID-19 VACCINE AND WAS WAITING IN THE OBSERVATION AREA. AFTER ABOUT 10 MIN MY TECHNICIAN NOTICED HIM SIT ON THE FLOOR FROM HIS CHAIR AND SHE CAME TO GET ME. AS I APPROACED HIM HE LOOKED DAZED AND SUDDENLY BLACKED OUT. IN ABOUT 15-20 SECONDS HE AWOKE AND ABOUT 1 MINUTE LATER HE WAS SPEAKING. ROUGHLY 5 MINUTES LATER, EMS ARRIVED AND CHECKED HIS VITALS, BLOOD SUGAR AND EKG. ALL WERE WITHIN NORMAL LIMITS. WHILE TALKING TO PATIENT AND THE TWO LADIES WITH HIM, WE FOUND OUT HE HAD DRIVEN 3 HOURS FROM HIS HOME TO COME TO OUR PHARMACY FOR THEM TO GET VACCINATED. AND THEY PLANNED TO GET ON THE ROAD AND RETURN. EMS SUGGESTED HE GO TO THE HOSPITAL, BUT AFTER 20 MINUTES HE WAS WALING AND TALKING AND DRINKING WATER. HE AND HIS FRIENDS DECIDED THEY WOULD NOT GO TO THE HOSPITAL. I FOLLOWED UP WITH HIM 2 DAYS LATER ON 4/9 AND HE FELT FINE EXCEPT FOR SORENESS AT THE SITE OF INJECTION. HE ALSO RECALLED A TIME WHEN HE HAD PASSED OUT FROM AN INJECTION WHEN HE WAS A TEENAGER

Other Meds: PT TOLD EMS HE TAKES A BETA-BLOCKER (HE THOUGHT METOPROLOL)

Current Illness: SLIGHT HIGH BLOOD PRESSURE

ID: 1220080
Sex: F
Age: 72
State: NY

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/16/2021
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: sulphur

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

Symptoms: rectal and vaginal bleeding for 1 day

Other Meds:

Current Illness: hypertension

ID: 1220081
Sex: F
Age: 21
State: OH

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: @ 1317 c/o anxiety, encouraged to drinking water, eat gyms. VS 122/p, OxSat 100%, HR 98, RR 12. Pt reports not eating today and fear of medical situation. Called leader, F/U information offered and accepted. PT feeling better and discharged thereafter.

Other Meds: None

Current Illness:

ID: 1220082
Sex: F
Age: 28
State: AZ

Vax Date: 04/07/2021
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
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: penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: rash on stomach and back

Other Meds: vitamin D3, B12, fluoxitine

Current Illness:

ID: 1220083
Sex: F
Age: 17
State:

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 04/16/2021
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: No adverse event, patient was underage for vaccine administration recommendations.

Other Meds:

Current Illness:

ID: 1220084
Sex: F
Age: 24
State: RI

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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 began to feel nauseated at 1555, while sitting in observation approximately 5-10 minutes after receiving the Pfizer COVID-19 vaccine IM. Patient was brought to the EMS room at the vaccination clinic. Patients vital signs: BP 148/100; PR 125; RR 24; SpO2 100% r/a. Patient was treated with IV in right a/c. Patient began to have full uncontrollable body shaking, remained conscious, alert, and oriented throughout event. Patient did not complain of difficulty breathing or other anaphylaxis symptoms. Patient was transported to Hospital.

Other Meds: None

Current Illness: None

ID: 1220085
Sex: M
Age: 62
State: AZ

Vax Date: 04/15/2021
Onset Date: 04/01/2021
Rec V Date: 04/16/2021
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: Headaches, fevers, chills, body aches

Other Meds: None

Current Illness: None

ID: 1220086
Sex: F
Age: 68
State: CA

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Hytrin Teramyacin

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

Symptoms: Symptoms started the next morning, Severe fatigue, Flu symptoms ie: aching joints, aching muscles, low grade fever, really bad headache, nausea, These symptoms lasted 10 days. On day 10 breathing was difficult.

Other Meds: Lexapro, Cymbalta, Gabapentin, Baclofin, Norco, Hydroxizine, Provigil, Trazadone, Nudexta.

Current Illness: None

ID: 1220087
Sex: F
Age: 38
State: NY

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: No

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

Symptoms: Sore throat

Other Meds: Lortadine, multi vitamin, vitamin d

Current Illness: Ear ache

ID: 1220088
Sex: F
Age: 59
State: PA

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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, strawberries

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

Symptoms: injection site pain, injection arm was very sore, headache, muscle aches - opposite side of arm that was site of injection, legs, neck & shoulders, lower back (aches kind of came and went), mild nausea, mild diarrhea, fatigue, temporary loss of appetite. No treatment was necessary, all symptoms are mild to medium and flu-like.

Other Meds: Levothyroxine 112 MG, daily Emergen-C packet

Current Illness: possible long covid / residual covid symptoms

ID: 1220089
Sex: M
Age: 53
State: NJ

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: Within 5 minutes of vaccine being administered I experienced Dizziness and Headache. Additional symptoms experienced later in the day/overnight included muscle pain, fatigue, headache, chills, nausea, slight fever and slight swelling around /under my eyes

Other Meds:

Current Illness:

ID: 1220090
Sex: F
Age: 65
State: WI

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/16/2021
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: NONE

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient reported that she had not received any COVID vaccines in the past. She requested a COVID-19 vaccine at the time of visit on 4/8/21. The Pfizer covid vaccine was administered after patient signed the consent, however when Database was update, it indicated that the patient had already completed the 2 dose series of Pfizer covid-19 vaccine. Provider; FNP, MD on site, Manager, and patient was made aware. Patient was supervised in the clinic for greater than 60 mins. No reaction noted. Education to the staff to follow our normal protocol, which is to check the Database system prior to injection was reiterated and stressed.

Other Meds: NONE

Current Illness: N/A

ID: 1220091
Sex: M
Age: 71
State: CA

Vax Date: 03/08/2021
Onset Date: 03/10/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Gum and tooth pain

Other Meds: Atorvastatin, Finasteride, Tadalafil, Omeprazole, vitamins C, D, fish oil

Current Illness:

ID: 1220092
Sex: F
Age: 40
State: OR

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: Unknown

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Swelling and rigidity at injection site (immediate), shortness of breath (1:20pm) dizziness (1:20pm), nausea (1:20pm)

Other Meds: Eliquis

Current Illness: P.E's, Factor 5

ID: 1220093
Sex: F
Age: 51
State: TX

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Within 13 hours of receiving the second dose, I developed severe chills, migraine, fever and extreme nausea. I proceeded to vomit for the next 16 hours until I was able to reach my physcian who prescribed Zofran. I was advised to take Tylenol but could not keep anything in my stomach. At hour 18 I finally stopped vomiting and was able to take Excedrin Migraine, which dulled the headached but did not stop it. The first 24 hours after the injection, I was able to sleep off and on. The second 24 hours after the injection up until today, I have not be able to sleep more than a couple of hours at a time and continue to have stomach cramps.

Other Meds: Estrodiol, Progesterone

Current Illness: None

ID: 1220094
Sex: M
Age: 28
State: NC

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: None

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

Symptoms: patient sitting in post-vaccination area has a witnessed seizure at 1525, patient had twitching, LOC and eye rolling. EMT and RN were there and observed. Patient returned to consciousness, and moved behind curtin. Patient had another witnessed seizure @ 1532 lasting 10 seconds, with LOC, twitching, eyerolling and vomiting. Patient came to and placed on floor, alert and awake, able to answer questions but feeling foggy. EMS was called during 1st seizure. EMS arrived and took patient to hospital @ 1558.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm