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: 1227278
Sex: F
Age:
State: NJ

Vax Date: 01/24/2021
Onset Date: 02/01/2021
Rec V Date: 04/18/2021
Hospital: Y

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: heart attack; stroke; This is a spontaneous report from a contactable consumer. A 67-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), dose 1 via an unspecified route of administration on 24Jan2021 13:00 (at the age of 67-years-old) (Batch/Lot number was not reported) as SINGLE DOSE for covid-19 immunisation. Medical history included hypothyroid, sleep apnea, known allergies: Shellfish, Sulfa, Possible Tree Nut allergy. Concomitant medications included levothyroxine sodium (SYNTHROID); ascorbic acid, ergocalciferol, nicotinamide, retinol, riboflavin, thiamine hydrochloride (VITAMINS [ASCORBIC ACID;ERGOCALCIFEROL;NICOTINAMIDE;RETINOL;RIBOFLAVIN;THIAMINE HYDROCHLORIDE]); clarithromycin (CLARITIN [CLARITHROMYCIN]). In Feb2021, Exactly 3 weeks after the first dose, the patient had a heart attack and stroke. The events were assessed as serious (hospitalized, life-threatening, disability). The event resulted in emergency room and physician visit.The patient was hospitalized for 10 days. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on an unspecified date. The outcome of the events was unknown. Information about lot/batch number has been requested.

Other Meds: SYNTHROID; VITAMINS [ASCORBIC ACID;ERGOCALCIFEROL;NICOTINAMIDE;RETINOL;RIBOFLAVIN;THIAMINE HYDROCHLORIDE]; CLARITIN [CLARITHROMYCIN]

Current Illness:

Date Died: 04/04/2021

ID: 1227279
Sex: F
Age:
State: NJ

Vax Date: 03/14/2021
Onset Date: 04/04/2021
Rec V Date: 04/18/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: heart attack; stopped breathing; This is a spontaneous report from a contactable consumer. A 67-year-old female patient (mother) received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number and expiry date: unknown), via an unspecified route of administration on 14Mar2021 (67-year-old) as single dose for COVID-19 immunization. Medical history included Hypothyroid, Sleep Apnea, Known allergies: Shellfish, Sulfa, Possible Tree Nut allergy. Patient is not pregnant. Concomitant medications included levothyroxine sodium (SYNTHROID); apixaban (ELIQUIS); senna [senna alexandrina]; valsartan; clopidogrel; metoprolol; atorvastatin; macrogol 3350 (MIRALAX). The patient previously took vitamins, Claritin , first dose of bnt162b2 on 24Jan2021 01:00 PM (67-year-old) for COVID-19 immunization and exactly 3 weeks after the first dose, the patient had a heart attack and stroke. Exactly 3 weeks after the second dose (04Apr2021), the patient stopped breathing and died. It was reported that death cause was unknown but also likely heart attack (unspecified date). Ae resulted in: [Emergency room/department or urgent care, Hospitalization, Life threatening illness (immediate risk of death from the event), Disability or permanent damage, Patient died]. Number of days hospitalization is 10. Patient had no covid prior vaccination. The patient was covid tested post vaccination. The patient underwent lab tests and procedures which included covid test (Nasal Swab): negative on an unspecified date. The patient died on 04Apr2021. An autopsy was not performed. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: stopped breathing; death cause: likely heart attack

Other Meds: SYNTHROID; ELIQUIS; SENNA [SENNA ALEXANDRINA]; VALSARTAN; CLOPIDOGREL; METOPROLOL; ATORVASTATIN; MIRALAX

Current Illness:

ID: 1227281
Sex: M
Age:
State: MD

Vax Date: 04/02/2021
Onset Date: 04/11/2021
Rec V Date: 04/18/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: stroke; This is a spontaneous report from a non-contactable pharmacist. A 71-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) intramuscularly at the age of 71-years, at single dose in right arm on 02Apr2021 09:00 (Lot number: EP7533) for COVID-19 immunisation. The patient medical history was not reported and there were no known allergies. Concomitant medications included rivaroxaban (XARELTO); empagliflozin (JARDIANCE); lisinopril all taken for an unspecified indication. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) intramuscularly at the age of 71-years, at single dose in right arm on 05Mar2021 09:00 (Lot number: EN6199) for COVID-19 immunisation. The patient experienced stroke on 11Apr2021 (Stroke 7 days after injection (as reported)), it resulted in "Emergency room/department or urgent care, Hospitalization, Life threatening illness (immediate risk of death from the event) and Disability or permanent damage". The patient was hospitalized for stroke for 2 days. The patient was not diagnosed with COVID prior to vaccination and he had not been tested for COVID since the vaccination. Event outcome was not recovered. No follow up attempts are possible. No further information is expected.; Sender's Comments: The reported stroke is likely due to an underlying medical condition and unrelated to BNT162B2. Although temporally related, there is no sufficient evidence that the reported stroke is related to BNT162B2. Note that the patient's medical history was not reported, however, patient is taking rivaroxaban and lisinopril for unspecified indication. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.

Other Meds: XARELTO; JARDIANCE; LISINOPRIL

Current Illness:

Date Died:

ID: 1227282
Sex: U
Age:
State: GA

Vax Date:
Onset Date:
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I know a physician in died afterwards; This is a spontaneous report from a Pfizer-sponsored programs from a contactable consumer. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date (Lot number was not reported) as single dose for COVID-19 immunisation. The patient's medical history and concomitant medications were not reported. The patient knows a physician and died afterwards on an unspecified date. It was unknown if an autopsy was performed. Information about lot/batch number has been requested.; Reported Cause(s) of Death: I know a physician in (name) died afterwards

Other Meds:

Current Illness:

ID: 1227284
Sex: F
Age:
State: WA

Vax Date: 03/30/2021
Onset Date: 04/06/2021
Rec V Date: 04/18/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: She almost died from pulmonary edema; Lungs have blood clots in them; This is a spontaneous report from a contactable consumer (patient's husband). 74-year-old female patient received BNT162B2 (Pfizer-BioNTech COVID-19 mRNA vaccine), dose 2 intramuscular, administered in left upper arm muscle at age 74 years on 30Mar2021 (Batch/Lot Number: EP6955) as single dose, for COVID-19 immunisation. The patient medical history was reported as no. There were no concomitant medications. The patient historically took the first shot of BNT162B2 on an unspecified date for COVID-19 immunisation. It was reported that the patient took the shot of second dose of Pfizer BioNTech COVID Vaccine (Lot number: EP6955) shot on 30Mar2021 in her left upper arm muscle. Patient was in the hospital at the time of reporting hanging on to life. Patient got pulmonary edema and she almost died, her lungs are, have blood clots in them from 06Apr2021 then she went to the hospital on 07Apr2021, has to stay in the hospital for 4 days. Patient was not experiencing symptoms anymore, she has had blood thinners they administered blood thinners (treatment), she was improving. She has to stay 2 more days in the hospital taking the blood thinners. Laboratory test was done on 08Apr2021 which is in the hospital where she almost died. Vaccine was administered at a hospital. Patient was recovering at the time of report.

Other Meds:

Current Illness:

ID: 1227285
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Maternal exposure during pregnancy; The newborn is in the NICU; This is a spontaneous report from a contactable consumer (parent) via a Pfizer sales representative. This consumer reported information for both mother and fetus/baby. Thi is the fetus/baby rpeort. Only this case is serious. A fetus of an unspecified gender received both doses of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via transplacental route of administration on unspecified dates as single dose for COVID-19 immunisation. The patient experienced maternal exposure during pregnancy and premaure birht at 25 weeks (the newborn is in the NICU) on an unspecified date. The events were considered serious as life-threatening. Birthweight was 1.96 pounds. The outcome of the events was unknown. No follow-up attempts are possible; Information about lot/batch number cannot be obtained.; Sender's Comments: Linked Report(s) : US-PFIZER INC-2020513513 Same reporter/ drug, different patients/ events;US-PFIZER INC-2021412709 Same reporter/ drug, different patients/ events

Other Meds:

Current Illness:

Date Died:

ID: 1227286
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: within two weeks of receiving the vaccine the patient died; This is a spontaneous report based on information received by Pfizer from Merck & Co., Inc. A contactable Consumer reported for a male patient of an unspecified age that received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on an unspecified date as single dose for covid-19 immunisation. The patient medical history and the patient's concomitant medications were not reported. The patient died within two weeks of receiving the vaccine on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible, information about lot/batch number cannot been obtained.; Reported Cause(s) of Death: within two weeks of receiving the vaccine both family members died

Other Meds:

Current Illness:

Date Died:

ID: 1227287
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: within two weeks of receiving the vaccine both family members died; This is a spontaneous report based on information received by Pfizer (Case Number: 01903495). A contactable Consumer reported for two family members. A male patient of an unspecified age received bnt162b2 (BNT162B2), 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 medical history and concomitant medications were not reported. The patient died on an unspecified date within two weeks of receiving the vaccine . It was not reported if an autopsy was performed. No follow-up attempts are possible, information about lot/batch number cannot been obtained.; Reported Cause(s) of Death: Unknown cause of death

Other Meds:

Current Illness:

ID: 1227290
Sex: F
Age: 47
State: PR

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Shrimp

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: About an hour after vaccine (1st dose) my left cheek and lips were numb, had headaches. Numbness were on and off and lasted for 2 days. At exactly 72 hours I felt like myself again. Not sure if I should get 2nd dose.

Other Meds:

Current Illness:

ID: 1227291
Sex: M
Age: 41
State: NY

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Overnight the night of the vaccine: severe chills, body aches, next day severe headache/migrane, mild nausea, weakness, winded, fatigue

Other Meds: Oxcarbazepine, Lamotrgine

Current Illness:

ID: 1227292
Sex: M
Age: 59
State: VA

Vax Date: 04/10/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Pfizer-BioNTech Covid 19 Vaccine EUA: One week post-injection I experienced extreme fatigue, body aches, chills, shivering, hot and cold flashes. At this time the symptoms have persisted for 30 hours, although the shivering subsided after sleeping through the night. The heavy fatigue and body aches continue however.

Other Meds: Singular, Symbicort Inhaler, Daily multivitamin, Daily probiotic

Current Illness: None

ID: 1227293
Sex: F
Age: 39
State: WA

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Cipro and opiate pain killers

Symptom List: Rash, Urticaria

Symptoms: Between 20-60 minutes of receiving the vaccine in my left arm, my lips and face started tingling and going numb, a sensation very similar to receiving novocaine when visiting the dentist. The sensation was primarily felt on the left side of my face, and had also affected my left arm, chest and leg by the time I was seen at the urgent care clinic. A MRI was conducted to rule out any kind of stroke event.

Other Meds: Spironolactone amd metformin

Current Illness: Seasonal allergies

ID: 1227294
Sex: F
Age: 30
State: AZ

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Capsaicin, pine nuts, NSAIDS

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

Symptoms: Being observed for 30 min due to allergy history. Pt stated she felt like her throat was tight and closing., right at her 30 min time. EMS responded and took control of scene. No wheezing, moving good air, o2 was 96% on room air. Other VS stable. Kept an additional 10min, VS remained the same and pt calmed down and stated she felt better.

Other Meds:

Current Illness: Unk

ID: 1227296
Sex: F
Age: 38
State: CA

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Leviquin and Macrobis

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

Symptoms: I woke up with a red hot face rash on my cheeks and chin. It is itchy and burning. Very red.

Other Meds: Synthroid, Claritin, Zoloft, probiotics

Current Illness: No

ID: 1227297
Sex: M
Age: 35
State: NE

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 04/18/2021
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: NONE

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

Symptoms: MARCH 9: BODY ACHES AND HEADACHE, SLEEPLESSNESS. CONTINUED OFF AND ON OVER FOLLOWING DAYS. MARCH 18: BLOOD PRESSURE AND PULSE WERE TOO HIGH TO DONATE PLASMA MARCH 21: DIDN'T FEEL NORMAL, GASTROINTESTINAL ISSUES, FATIGUE, SLEEPLESSNESS, ABDOMINAL PAIN, RAPID WEIGHT LOSS, LOSS OF APPETITE MARCH 26: URINE STARTED DARKENING TO ORANGE COLOR DESPITE STAYING HYDRATED, FEVER, MALAISE. APRIL 1: WENT TO DONATE PLASMA AT BIOTEST PLASMA CENTER AND NOTICED BLOOD PLASMA WAS AN ODD COLOR. APRIL 4: EMERGENCY ROOM PRESENTED WITH ABDOMINAL PAIN, JAUNDICE, WHITE/LIGHT COLORED STOOL. BLOODWORK, ULTRASOUNDS, CT'S WERE DONE AND SHOWED INFLAMMATION IN LIVER/GALLBLADDER/GI TRACT. HIGH BILIRUBIN. APRIL 5: COLONOSCOPY PERFORMED. DIAGNOSIS: ULCERATIVE COLITIS. ERCP PERFORMED WITH LIVER BIOPSIES. DIAGNOSIS: COMMON BILE DUCT BLOCKAGE WITH CHOLECYSTITIS AND HEPATITIS. STENT WAS PLACED. POSSIBLE PRIMARY SCLEROSING CHOLANGITIS- DEPENDING ON BIOPSY RESULTS. APRIL 6: CHOLECYSTECTOMY, MORE LIVER BIOPSIES TAKEN. APRIL 7: LIVER BIOPSY RESULTS/DIAGNOSES: OVERLAP SYNDROME OF AUTOIMMUNE HEPATITIS & PRIMARY SCLEROSING CHOLANGITIS. PLACED ON PREDNISONE. AWAITING APPROVAL FOR REMICADE INFUSIONS WITH POSSIBLE NEED FOR LIVER TRANSPLANT IN THE FUTURE AS PSC PROGRESSES. AS OF APRIL 18: JAUNDICE STILL PRESENT, BILIRUBIN NOT DECREASING. BEING REFERRED TO MEDICAL CENTER FOR FURTHER OBSERVATION AND TREATMENT.

Other Meds: LEVOTHYROXINE

Current Illness: NONE

ID: 1227299
Sex: F
Age: 78
State: CO

Vax Date: 03/16/2021
Onset Date: 03/18/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: PCN, keflex, Cipro, levaquin, dilaudid, aldendronate

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

Symptoms: Extreme joint and muscle pain, extreme fatigue I took tyleno, tramadol and advil at the appropriate time periods, Very sore injection site; became very, very red swollen and went down my arm almost to my elbow, around to underside of my arm. The pain and fatigue lasted 1 week and I stayed in be most of the time as I felt terrible. The arm lasted approx 3 weeks, I used benadryl and over the counter cortisone cream.

Other Meds: Tylenol prn, adderall 10 mg 1 tab qd, Vit D3 qd, folicacid 800mg qd, krill oil 500mg 1qd, levothyroxine 125 mcg 1 qd, lorazepam 1mg for sleep, losartan 50mg 1 qd, multi and mineral vitamin, probiotic, tramadol 50 mg prn, venlafaxine XR 75mg

Current Illness: none The reaction severe was after my second shot....first shot was on 2/22/21 ( only had mild aches, sore arm, fatigue

ID: 1227300
Sex: F
Age: 52
State: WA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
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: Baclofen, erythromycin based, sulfa, tape, valacyclovir HCl, alcohol, citalopram hydrobromide, dexbrompheniramine maleate, ethyl alcohol

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

Symptoms: Patient received Pfizer vaccine at approximately 1815 and after about 15 minutes the observer on shift noticed that she was clearing her throat. This patient also reported feeling heated and flushed and itchy. Stated history of allergic relation to Baclofen, which caused lightheadedness and syncope. Her chart lists several more allergies. This patient was transported to the ER by one of the vaccinators on shift. This vaccinator reported that by the time they got down to the ER her voice sounded constricted and her breathing difficulty had increased.

Other Meds:

Current Illness:

ID: 1227302
Sex: M
Age: 42
State: AR

Vax Date: 04/10/2021
Onset Date: 04/13/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: sulfur

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 1st Adverse Event 4/13/2021, Left posterior lower leg(calve) pain, lasted 2 days, no treatment 2nd Adverse Event 4/16/2021 Left posterior knee pain, pain is still present but pain level has decreased, no treatment 3rd Adverse Event 4/16/2021 Left supraclavicular tender and enlarged lymph node for 2 days, no longer tender but lymph node is currently slightly enlarged, no treatment.

Other Meds: None

Current Illness: None

ID: 1227303
Sex: F
Age: 32
State: VA

Vax Date: 04/12/2021
Onset Date: 04/16/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Intolerant to gluten and dairy

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Received dose on Monday 4/12 at 7:15am. Low grade fever, neck ache and chills developed that evening and went away by next morning. On 4/16, woke up with almost no ability to hear out of my left ear and there was a very loud ringing sound in my ear. Happened off and on throughout the day but by evening, I only heard a ringing noise. I went to the urgent care and they said my ear had no sign of ear infection or allergies. Next morning, I couldn?t hear almost anything out of my ear with a very loud ringing noise. Was consistent through 4:30pm that day. Went back to the urgent care and a different nurse practicing confirmed my ear looked completely normal. I?ve never experienced deafness or ringing in my ear before. Since this morning (4/18) I have had a low ringing sound in my left ear, but no more deafness.

Other Meds: N/a

Current Illness: None

ID: 1227304
Sex: F
Age: 34
State: OR

Vax Date: 04/11/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: penicillin, ragweed, cats and dogs

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

Symptoms: My skin is sensitive to the touch, I am achy and my joints feel inflamed. I started this reporting because I noticed that my supraclavicular lymph nodes were swollen (bilaterally) and painful to the touch (also bilaterally). My joints didn't hurt as bad yesterday, and my skin didn't feel the way it does today.

Other Meds: metformin, klonopin, Pristiq, Wellbutrin, ketamine, multivitamin, gabapentin, prazosin

Current Illness: possibly a sinus infection

ID: 1227305
Sex: F
Age: 51
State: OR

Vax Date: 04/14/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Clindamycin

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

Symptoms: Tinnitus starting less 4 days after first dose.

Other Meds: Atenolol

Current Illness: None

ID: 1227306
Sex: M
Age: 38
State: CA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Septra

Symptom List: Unevaluable event

Symptoms: 04/16/2021 PM: Light fatigue as well as light soreness in shoulder around injection point 04/17/2021 AM: Moderate soreness in upper body and back as well as moderate fatigue 04/18/2021 AM: Heavier fatigue and moderate soreness 04/18)2021 PM: Mild fever, moderate fatigue

Other Meds: Adderall, acyclovir, trileptal, clonazepam

Current Illness:

ID: 1227307
Sex: M
Age: 42
State: IN

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Low Grade Fever, Severe aching, violent shivering for hours on end, Lethargic body and cloudy head. Cranial pressure that felt around entire circumference of head. Lasting over 36 hours each time that forced bed-ridden behavior, forced time off of work, and loss of appetite. Spiked heart rate on numerous occasion throughout the following 36+ hours with heart rates spiking as great as 136 bpm. I should of reported it and visited my physician, but there was nothing more they could do besides for me to hydrate, suppress with Tylenol, & ride it out. Anyone with previous decent COVID cases should be advised against receiving the vaccine. But entities are still forcing us to have it for our jobs. I couldn?t endure a third round. It was a violent illness following the vaccine, which was equivalent to one of my first ?bad? days of actual COVID.

Other Meds: Propafenone HCL 150MG (3x/day), Metoprolol SUCC ER 25 MG (1X/day), Eliquis 5 MG (1X/day), Losartan Potassium 25 MG (1X/day), Allopurinol 300 MG (1X/Day), Zyrtec 10 MG (1X/Day)

Current Illness: None other than severe reaction from first dose given on 3/18/21

ID: 1227308
Sex: M
Age:
State: MD

Vax Date: 04/01/2021
Onset Date: 04/08/2021
Rec V Date: 04/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None. Also have taken flu shot every Fall for past 30 years- never had any negative reactions. In Fall of 2020 took Flu, Tetanus and 1st dose of Shingrix - Shingles vaccine. Took 2nd dose of Shingles on January 27, 2021. No negative reactions. Shingles was over 14 days - actually 60 days before Moderna vaccination on April 1. Again no known allergies and never a negative reaction to a vaccination.

Symptom List: Injection site pain, Pain

Symptoms: About 8 days after vaccination noticed rash on underside of right forearm and rash on left side of body. Rash does not cross midline of stomach. Also smaller rash above right eye. Rash also under left eye near midpoint of nose. Applied Cali nine and hydrocortisone ointments. Took over the counter Benadryl but rash has not healed. Concerned as I may be scheduled for 2nd shot between Wed. April 21 and April 29th according to vaccine appointment card.

Other Meds: None

Current Illness: None

ID: 1227309
Sex: F
Age: 73
State: IN

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: All caines, soy, Fenton,

Symptom List: Injection site pain, Menorrhagia

Symptoms: Aching, pain, redness and warmth at shot site. Chills. Fever. Brain fog. Dry heaves. VERY tired. Dizzy

Other Meds: High blood pressure, asthma, cholesterol, anxiety and allergy

Current Illness: None

ID: 1227310
Sex: F
Age: 50
State: OH

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: N/a

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

Symptoms: Tingling in left foot, numbness in left foot, (5 days after vaccine), dizziness, headache, fatigue more than 5 days after vaccine, heaviness in head (brain fog).

Other Meds: Synthroid, prozac

Current Illness: None

ID: 1227311
Sex: F
Age: 45
State: LA

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I'm on my 3rd Mirena IUD and haven?t had a period or spotting in over 11 years, but started spotting about 24 hours after my first vaccine. The spotting lasted three days.

Other Meds: Topamax 100mg QD Zyrtec-D

Current Illness:

ID: 1227312
Sex: M
Age: 42
State: OH

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Chills, fever, body aches, headache, pain at site of injection. Symptoms managed by using NSAID (Advil)

Other Meds: None

Current Illness: None

ID: 1227313
Sex: F
Age: 34
State: TX

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Heavy irregular menstral bleeding started 1 day after 2nd dose

Other Meds:

Current Illness:

ID: 1227314
Sex: F
Age: 44
State: MI

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Nausea

Symptoms: Armpit swollen up

Other Meds: Hydrochloride

Current Illness: n/a

ID: 1227315
Sex: F
Age: 38
State: CO

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: About 5:30pm on Thursday same day as vaccine started having is tense cramping in abdominal area, similar to a period cramp. Since I have PCOS I felt it was weird but thought maybe it was a muscle reaction to vaccine. Got worse throughout the night but was bearable. Then came what felt like UTI like symptoms which was very bizarre since I had nothing that could have caused that. Decided to wait it out and see if it would go away. By Sunday (3 days later) pain was still uncomfortable but I could manage as I have 3 kids. Around 3:30pm Sunday 4/18 the pain was in my right abdominal and lower back it took. My breath away. Finally decided I needed medical help and learned I was passing a kidney stone which has never happened before. I drink 80-90 floz of water a day, exercise regularly, and eat a very healthy diet of veggies, protein, and minimal carbs. Nothing I was experiencing made sense and all I could be told was, ?Guess your unlucky.?

Other Meds: Imatrex when needed Sumatriptiphan 2x a day Lexapro 10mg 1x a day B12 Magnesium Zinc Vitamin D Coqu 10

Current Illness: None, just had seen my doctor for a wellness exam on 4/7 and was doing great!

ID: 1227316
Sex: F
Age: 44
State: PA

Vax Date: 04/14/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Spotting between periods in the form of clots. Day 16 of cycle. Cramps.

Other Meds: Daily women?s vitamin, vitamin c, fish oil, tylenol

Current Illness: None

ID: 1227317
Sex: F
Age: 24
State: CA

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Amoxicillin

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

Symptoms: April 17th started having headaches and nausea that quickly morphed into all over body aches and high grade fever. Feeling of pressure on chest was present. Started around 6 pm lasted until I went to sleep at 6 am by the time I woke up at 1:45 pm Sunday April 18th I felt significantly better. Still have aches in torso, and occasional pangs in chest. No medicine has been taken.

Other Meds: Testosterone

Current Illness:

ID: 1227318
Sex: M
Age: 47
State: MI

Vax Date: 03/26/2021
Onset Date: 04/01/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Tendons in both feet are quite painful and very sensitive to stretching or pressure. No prior issues with this.

Other Meds: Propranalol, Lisinopril, Metformin, Magnesium, Saw Palmetto, Glimeperide

Current Illness: None

ID: 1227319
Sex: F
Age: 52
State: NY

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: NyQuil, Benadryl, shrimp, bug bites, bee stings

Symptom List: Erythema, Pruritus

Symptoms: hives and rash throughout body and face, labored breathing, fatigued, pressure in head and upper jawline on right side of head/behind ear.

Other Meds: Hair, skin and nails

Current Illness: varicose veins treatment using policodanol

Date Died: 02/06/2021

ID: 1227320
Sex: M
Age: 71
State: CA

Vax Date: 01/16/2021
Onset Date: 01/18/2021
Rec V Date: 04/18/2021
Hospital: Y

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: about 2 days after the 1st dose of the moderna vaccine, felt very tired and unwell for several days. He felt okay for about 2 weeks then on January 29, 2021 he felt intense chest pain. Concerned it was a heart attack, he was brought to the hospital. He stayed one night and the hospital ran several tests like EKG, stress test and others. Found his results to be normal and was released on January 20, 2021. Even the moment he was released, he felt very dizzy but hospital was not concerned and thought maybe side effect of medication. He continued to feel dizzy, fuzzy brain and hard time staying awake during the day and sleeping through the night for the rest of the week. He passed sometime in the early hours of February 6, 2021. Doctor's suspicion is a blood clot. He has no history of blood clots, heart problems or any health issues.

Other Meds: Losartan Potassium 25mg, Azithromycin and Amlodipine Besylate

Current Illness: Had severe Covid in June 2020 but cleared after one month.

ID: 1227321
Sex: F
Age: 42
State: GA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, Ceclor, furadanron, clindamycin, clarithromycin

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

Symptoms: Day 1 - joint pain in hands, some lymph pain in legs, lower back and kidney pain, fatigue Day 2 - lymph pain/swelling in injection site arm pit, fatigue, swelling has not subsided in 24 hours

Other Meds: Levothyroxine, armor thyroid, bupropion, phentermine

Current Illness:

ID: 1227322
Sex: F
Age: 34
State: ID

Vax Date: 01/20/2021
Onset Date: 04/14/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I never had COVID 19. Tested 5x negative. Experiencing pots symptoms ambulanced to hospital now wearing a heart monitor. Pulse goes to 135 used to only be in 50s. I experienced symptoms after first shot that went away and is now back

Other Meds: None

Current Illness: None

ID: 1227323
Sex: F
Age: 61
State:

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Developed chest pain, fever, chills, dyspnea, and diarrhea beginning a most immediately after the vaccination

Other Meds: Glyburide, metformin, losartan, venlafaxine XR, lorazepam, trazodone

Current Illness:

ID: 1227325
Sex: M
Age: 53
State: MN

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Mild seasonal allergies

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

Symptoms: I felt weak/drained within about an hour of vaccination on April 16. On April 17 I felt pain across my body at the level of the skin, including on my scalp. I was extremely cold without a fever, but later developed a fever with e a temperature of 100.7. The symptoms subsided at approximately 5:30 PM on the same day.

Other Meds: Lisinopril 10mg, Vitamin D Supplmement - 4000IU

Current Illness: None known

ID: 1227326
Sex: M
Age: 49
State: WA

Vax Date: 04/15/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Shingles

Other Meds: Aspirin

Current Illness: Possible rheumatoid arthritis in right hand and arm. Hand pain since possibly mid 20?s.

ID: 1227327
Sex: M
Age: 58
State: OH

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Relatively Severe Fatigue, Fever, Chills, Body Aches, and Headache for approximately 72 hours

Other Meds:

Current Illness:

ID: 1227328
Sex: M
Age: 44
State: AZ

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Tetanus, aspirin, allopurinol, lisinopril

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

Symptoms: As soon as pt received vaccination, he said he felt tightness in his chest, heart racing, irregular heart rate, SOB, nurse noted he was ?swallowing hard?. EMS called ASAP, BP 172p (pt obese) hr 108 sao2 98%. He was soon able to get out of the drivers seat to allow is mother to drive, moved for further obs. Stated chest felt intermittently tight and burning. No rash, swelling of tongue lips or airway noted, pt admitted to h/o anxiety, next vitals similar, pt released after 30 min by EMS into the care of his,other

Other Meds:

Current Illness:

ID: 1227329
Sex: F
Age: 34
State: MT

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

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

Symptoms: Started feeling light headed and achy around 4 pm following 7 am vaccination. ?Pfizer-BioNTech COVID-19 Vaccine EUA. By 5:45 pm I had a fever (based on how I felt). I was away from home and got back around 7:15 pm and measured fever at 100.4 F. Took 2 liquid gel ibuprofen (regular over the counter dose) at 7:15 pm. Had chills, very achy, headache, joints popping in a way that is not normal for me. 8:44 pm now, still feel very hot. Able to eat and have been drinking lots of water. Realize now that malaise after first dose was a reaction. I feel as though I'll soon be feeling better but it's the sickest I've been in 2 years.

Other Meds: Vitamin D liquid drops, first Pfizer dose 3/28/2021

Current Illness: No

ID: 1227330
Sex: F
Age: 47
State: WA

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Mangos Miconazole Intrate Clotrimazole Terbinafine Lamisil Diflucan-Fluconazole

Symptom List: Vomiting

Symptoms: April 17th 10:28 Took Vaccine 10:45 Reaction started with tightening of my throat and drank some water 11:00 ish gums started swelling and lips tingling My hands and tongue started swelling and my face was warm 11:15 ish-took 25 mg Benadryl via shot 12:27-arrived at ER for monitoring 2:22-took Pepsid and steroid ( dexamethasone) orally 4:00-50 mg of Benadryl orally 10:00 pm- 25 mg Benadryl and Pepsid tablet April 18th Symptoms: ? Face flushed and stretched ? Face and neck itchy / small hives ? Mentally scattered ? Auras Headache 4:00 am - 50 mg of Benadryl oral 10:00 am - 25 mg of Benadryl oral 10:00 Pepsid 11:00 Tylenol 4:00 Tylenol 6:00 Benadryl 7:25 Imetrex

Other Meds: Lamectal Imitrex Folic Acid Zyrtec B Complex Multi Vitamin Calcium Fiber Biotin

Current Illness: Migraine Seizures Seasonal Allergies ABI

ID: 1227331
Sex: F
Age: 40
State: CO

Vax Date: 03/19/2021
Onset Date: 03/21/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: shrimp allergy

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Broke out in an itchy rash all over her body (legs, arms, torso). Had dry skin and discoloration on her legs. Took OTC allergy medicine and it helped with the itching. This lasted 3 weeks. She did not seek care, it ended up resolving on its own.

Other Meds: none

Current Illness: none

ID: 1227332
Sex: F
Age: 31
State: NY

Vax Date: 04/11/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Casein, lactose

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

Symptoms: Extreme sensitivity to sound. Almost every sound feels like nails on a chalkboard. This happened before, in 2007, when I got vestibular neuronitis from a mono infection.

Other Meds: Estradiol, progesterone, dutasteride, Vyvanse, rexulti, magnesium oil spray, vitamin D-3, vitamin B-12

Current Illness:

ID: 1227333
Sex: M
Age: 26
State:

Vax Date: 03/28/2021
Onset Date: 03/30/2021
Rec V Date: 04/18/2021
Hospital: Y

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: NKA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 3/31/21 26YM admit with Acute issue: myocarditis, chest pain, extreme fatigue, body aches, SOB; Moderna (first dose on 3/28). No known prior COVID. Patient admits that approximately a month and a half ago, he was drinking a significant amount of alcohol with a 24-pack of beer daily and 5 drinks at night. He quit this approximately 2 weeks ago when he got back together with his girlfriend. He has had stress in his life with the death of a cousin approximately 2 weeks ago. The patient had been feeling well over the last week or so and received the Moderna COVID-19 vaccine on 3/28 Sunday. This was his first dose. Approximately an hour and a half after receiving the vaccine, he had symptoms of feeling dizzy with position change. He went home from work. He developed fevers, chills, rigors, diaphoresis, and headaches. He slept a lot due to these symptoms. On 3/30 Tuesday, he woke with mild chest discomfort that he described as a pressure sensation in his anterior chest. He states that it was bothersome, but not too significant. He woke up 3/31 at approximately 0200 hours with a stabbing left anterior chest discomfort. He notes that it felt like a hot knife stabbing him. He admits that over the last couple of days, he had a cough when he would lay back in bed. He admits to feeling more short of breath when flat and feeling like he had to put pillows behind his head. He came to the emergency department due to these symptoms. He was given a dose of acetaminophen and promptly had nausea and vomiting. He received a dose of aspirin 325 mg and states that his symptoms resolved shortly after that. 3/31 He now feels well and denies any further chest discomfort. He denies any dyspnea.

Other Meds:

Current Illness:

ID: 1227334
Sex: F
Age: 36
State: NJ

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: With a few seconds of the first dose, i felt a little dizziness. The dizziness did not last long. After afew hours i started feeling tired and back pain

Other Meds: Pre natals

Current Illness: Bo

ID: 1227335
Sex: F
Age: 81
State: VA

Vax Date: 02/26/2021
Onset Date: 04/11/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: 98% Hearing Loss

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm