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: 1243335
Sex: F
Age: 46
State: WA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: yes-Not anaphylaxis-unknown product

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt, was sitting in post observation post 1st dose of Pfizer vaccine. Pt has no hx of anaphylaxis. Pt began to feel numbness in left arm radiating up to left side of throat. Pt a bit lightheaded. Pt given juice and water and felt better. Numbness resolved after juice and water. Pt call. Pt finished appropriate monitoring time and ambulated out of facility with steady gait in no distress.

Other Meds: unknown

Current Illness: unknown

ID: 1243336
Sex: M
Age: 80
State: TX

Vax Date: 03/08/2021
Onset Date: 04/16/2021
Rec V Date: 04/22/2021
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: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: Presented to ER via private vehicle with complaints of general malaise, weakness, "not feeling good" beginning the morning before (04/16/2021), complaints not more specific. Associated symptoms included encephalopathy, lethargy, anorexia, progressively unsteady gait. Wife denied nausea, vomiting, diarrhea, fever, bloody stools, difficulty/painful urination. Diagnosed with thrombotic thrombocytopenic purpura with an initial hemoglobin of 4.8g/dL, hematocrit 14.2%, platelet count 6000uL, PT 12.2sec, INR 1.2, BUN 75mg/dL, creatinine 2.4 mg/dL, total bilirubin 3.3 mg/dL, direct bilirubin 0.60mg/dL, troponin 3.81ng/mL, and ADAMTS13 activity <2.0. He received 2 units PRBC, 2 units platelets, and plasmapheresis was initiated. As of today, he has had 5 consecutive days of plasmapheresis. Repeat laboratory evaluation this morning hemoglobin 8.8, hematocrit 28.4, platelet count 97000, BUN 35, creatinine 1.5, total bilirubin 1.3. Now awake, alert, and oriented. Eating and ambulating with physical therapy

Other Meds: Allopurinol 100mg po qd Amlodipine besylate/Benazepril 5-20mg po qd Finasteride 5mg po qhs Metformin 500mg po bid meal Omeprazole 40mg po qd Simvastain 20mg po qhs

Current Illness: None

ID: 1243337
Sex: F
Age: 64
State: NY

Vax Date: 03/27/2021
Onset Date: 03/29/2021
Rec V Date: 04/22/2021
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: none

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

Symptoms: 1st occurrence: After 1st vaccination on March 6th, 2021- intense pain in left leg, passed out, went to urgent care 2nd occurrence: After 2nd dose on March 27th, 2021 - on the 28th flu like symptoms- on the 29th intense leg pain, passed out, transported to hospital by ambulance, doppler revealed blood clot, blood work normal, placed on Eliquis I have since been to the hematologist and had a work up... blood tests are normal

Other Meds: Losartan 10mg Hydrochlorothiazide 12.5mg Nitorfurantoin 100 mg

Current Illness: none

ID: 1243338
Sex: M
Age: 64
State: CA

Vax Date: 04/06/2021
Onset Date: 04/16/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Swelling on left side of neck and shoulder has gotten worse over last 5-6 days.

Other Meds: Prostonic for prostate health

Current Illness: None

ID: 1243339
Sex: F
Age: 38
State: CO

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: strawberries, roses

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

Symptoms: nausea immediately after vaccine, continuing off on on for several hours before ceasing increased level of exhaustion developing within 24 hours and lasting for 72 hours metallic taste in mouth immediately after vaccine, diminishing over 72 hours

Other Meds: probiotic, multi-vitamin

Current Illness: N/A

ID: 1243340
Sex: F
Age: 20
State: MT

Vax Date: 03/26/2021
Onset Date: 04/13/2021
Rec V Date: 04/22/2021
Hospital: Y

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: none

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

Symptoms: started having hallucinations and delusions, thought someone was after her, thought someone broke into the house, seeing relatives who have passed, paranoia, refers to herself as her given name not legal name, refers to an awakening, quit her job, accused coworker of harassing her, talking loudly-normally very quiet and reserved started April 13, 2021. Symptoms escalated from 4/13 until she was involved in high speed chase on April 16, 2021, has no recollection of being involved in high speed chase.

Other Meds: none

Current Illness: none

ID: 1243341
Sex: F
Age: 35
State: MA

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: High fever over 103, nausea, dizziness, static and pressure in ears, arm soreness, exhaustion. High fever lasted around 24 hours, moderate 100 degree fever for next 24 hours

Other Meds: None

Current Illness: None

ID: 1243342
Sex: F
Age: 76
State: MI

Vax Date: 02/19/2021
Onset Date: 04/06/2021
Rec V Date: 04/22/2021
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: Pharyngeal swelling

Symptoms: Pt admitted with acute portal vein thrombosis and pancytopenia about 5 weeks after vaccination, did not have known pre-existing liver disease but did have ETOH chronic use and likely prior unrecognized liver disease

Other Meds: Levothyroxine, losartan-hydrochlorothiazide, hiprex

Current Illness: alcoholism

ID: 1243343
Sex: F
Age: 32
State: CA

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: hx of migraine rare in life recent headaches no photophobia, not severe, no n/v states light, not to point of taking tylenol but had similar with covid also states a/w with lightheadedness on standing that might have been associated with blood donation that has since improved also intermittent right arm "heaviness" denies paresthesias or true weakness or dyspraxia states these sx are exactly what she experienced with covid dz and had them again following covid vaccine over last 10 days. initially not concerned as had head others with similar and states drank wine over weekend so attributed to this. neuro exam fully normal so less likely more serious issues such as mass, myelitis, but discussed our understanding of this disease and the vaccine are still emerging and she is the second patient I have met with headache and dizziness beyond day after the vaccine who had the virus priorly engaged in shared decision making about getting second shot given that this has effected her life and functioning and given there is some evidence in those who had the virus that one mRNA vaccine dose may result in levels commensurate to two doses in those who are virus-naive. Pt to consider this. discussed to be in close touch if symptoms evolve especially if focal weakness or increasing severity of headache. Offered meds such as migraine ppx for headache and pt deferred given headache is not terribly severe, more so she is seeking explanation offered covid testing as pt requested given sx so similar and when she had virus no clear chain of infection. advised isolation until test result available

Other Meds: mirena IUD

Current Illness: pt had test proved COVID illness in January 2021 in Colorado per her (not in our system)

ID: 1243344
Sex: F
Age: 18
State: CO

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

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

Lab Data:

Allergies: Allergic to amoxicillin (hives; throat closed up)

Symptom List: Diarrhoea, Nasal congestion

Symptoms: There has not been an adverse event associated with this at this time. This was a vaccine administration error that happened and was reported to the Department of Health by the patient. The patient had her first dose as Moderna, told the clinic this on 4/21, and they administered the 2nd dose as Pfizer by mistake on 4/21, according to the patient who called the Dept of Health. According to the patient, the clinic is aware of the error.

Other Meds: None

Current Illness: None

ID: 1243345
Sex: F
Age: 65
State: MN

Vax Date: 03/25/2021
Onset Date: 04/20/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient tested positive for COVID-19 by PCR on 4/20/21, >2 wks after 2nd COVID vaccine. Patient was asymptomatic and was only tested due to upcoming planned procedure at our facility.

Other Meds:

Current Illness:

Date Died: 03/25/2021

ID: 1243346
Sex: M
Age: 90
State: MT

Vax Date: 03/17/2021
Onset Date: 03/21/2021
Rec V Date: 04/22/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Pt received vaccine on 03/17/2021. Pt's wife stated that pt never felt well after receiving the vaccine. Per hospital notes, pt lost his balance and fell at home approximately 12 hours prior to admission. By report, he laid on the floor for around 12 hours before emergency services were activated and he was brought to the ED. Primary diagnosis was a closed left hip fracture with other hospital problems of the fall at home, bradycardia, coronary artery disease, hypokalemia, protein calorie malnutrition, type 2 myocardial infarction and essential hypertension.

Other Meds: alfuzosin, amlodipine, atorvastatin, diphenoxylate-atropine, hydrocodone-acetaminophen, lisinopril, metoprolol succinate, potassium chloride

Current Illness:

ID: 1243347
Sex: M
Age: 16
State: ID

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Moderna COVID-19 vaccine given to a 16 year old. No adverse event.

Other Meds:

Current Illness:

ID: 1243348
Sex: F
Age: 63
State: PA

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

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

Lab Data:

Allergies: N/A

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

Symptoms: The patient received Moderna COVID vaccine on 3/25/2021 at a different facility, then she received Pfizer COVID vaccine from our facility on 4/21/2021. The patient is not experiencing any side effects and feels normal. Recommeneded that she not receive any further covid vaccines since it has been ~28 days from her first vaccine and she received another mRNA covid vaccine (Pfizer). CDC suggests that she not receive any other COVID vaccines or the 2nd dose of Moderna or Pfizer at this time.

Other Meds: N/A

Current Illness: N/A

ID: 1243349
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1243350
Sex: M
Age: 39
State: CO

Vax Date: 04/05/2021
Onset Date: 04/07/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Persistent dizziness started 2 days after vaccine and has not gone away since, it has been 3 weeks. The dizziness reminds me of getting motion sick or after you found the boat for a very long time but feeling when you get when you're off the boat at first. They have tried taking vitamin c and d they have not helped so far. The dizziness sometimes does get worse when doing certain motions

Other Meds: None

Current Illness: None

ID: 1243351
Sex: F
Age: 33
State: DE

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: none reported

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

Symptoms: fever 102F fatigue joint pain headache

Other Meds: none reported

Current Illness: none reported

ID: 1243352
Sex: F
Age: 51
State: AK

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Reports felt sharp pain at the time of the injection which radiated to her wrist /hand. 20 minutes later during her Physical Therapy session, while lying on the table during a massage she felt body wide pain, described as sharp pain and her muscles were rigid, she could not get up off the table. After 20 minutes of this; her Physical Therapist was able to assist her off the bed, to standing/walking, she felt very stiff, difficulty flexing her muscles. Also, had a headache that she described was very painful; that evening she had fever and fatigue. Symptoms lasted approximately 4-5 days. She did not seek medical attention, other than the PT at the onset of her symptoms . Three weeks later her toddler "head butted" and hit her right arm at the site wear vaccine was given. Reports very sharp and profound pain, "felt exactly as it did when I first got the injection" The pain took a couple days to resolve. Today 4 weeks later she reports still having some swelling/soft tissue lump at the injection site. Negative for redness, warmth. She did not seek medical care or call the clinic to report adverse events. She attempted to file a VAERS report but was unsuccessful as she did not have her vaccine lot number.

Other Meds:

Current Illness:

ID: 1243353
Sex: F
Age: 76
State: IA

Vax Date: 03/09/2021
Onset Date: 03/25/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: Demerol, Ranexa, Heparin, Statins

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Two weeks after receiving vaccine, experiencing severe pain in under left breast, radiating around to the back. Chest pain and some breathlessness. I took her to the ER , on March 27, 2021, thinking it might be her heart. She was admitted for observation. She broke out with a severe case of shingles the next day, 3/28/21. She had been fully vaccinated for Shingles two years before (Shingrix).

Other Meds: Isosorb Mono 60 mg., Clonazepam 0.5 mg, Clopidogrel 75 mg, Furosemide 40 mg, Glimepride 4 mg, Hydralazine 100 mg, Metropolol 50 mg, Nifedipine 60 mg, Pramipexole 0.25, Spironolactone 25 mg, Tramadol 50 mg. Loratadine 10 mg, , Biotin 5000

Current Illness: None

ID: 1243354
Sex: F
Age: 35
State: CA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: PT HAS A PHOBIA OF NEEDLES SHE WAS LAYED DOWN FOR VACCINE BUT SHE HAS SEIZURE DISORDER, SHE TOOK KEPPRA BEFORE SHOT AND DID NOT EAT. HER CC IS DIZZINESS. NO MED HX EXCEPT SEIZURES AND NO OTHER MEDS EXCEPT KEPPRA. CODE GREEN CALLED ALL VSS 109/74 O2 100% HR 89. MONITORED X30 MIN, WHEELCHAIRED TO CAR, REFUSED HOSPITAL.

Other Meds: KEPPRA

Current Illness:

ID: 1243355
Sex: F
Age: 57
State: WI

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: Cats

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

Symptoms: Extreme tiredness followed by inability to move all body parts and unable to swallow. Needed help to sit up in bed eventually unable to speak to say that I was nauseous. Fell asleep propped up with pillows and head turned. Woke at 7 am able to move body parts but very 'out of it' - dizzy, light headed, and hard to swallow. Full day later, I was good.

Other Meds: One a Day for Women

Current Illness: None

ID: 1243356
Sex: M
Age: 40
State: CA

Vax Date: 03/05/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: Sulfa Drugs

Symptom List: Unevaluable event

Symptoms: Ii got he vaccinator on 3/5 and went home. the first night around 9p, I started to feel chills, Had a really big temporal headache. I thought it was a reaction to vaccination, I took Tylenol PM, layer down and woke up in the middle of the night, in a full body sweat. I went strait into chills, changed my clothes. Layed back own and awoke the next morning, with chills and temp of 101. I had body ache but proceeded with my day. I continued to have chills, I went out to my elderly parents, took them food and had dinner. Upon arrival home, had high fever 103...no Tylenol. Awoke still w/ chills and high fever and this was Sunday. Stayed in Sunday then the afternoon, felt like I needed to seek help. I went to get a rapid test at Medical Center and it came back Neg. Went back home, I could now sense that my taste was altered. I then continued to have a high fever but they would only come at night. Body sweat, aches, chills cont'd on Sunday. Monday still had same s/s and Tuesday, I thought that I should seek more medical attention. I went to an Urgent Care 3/9/21. They then did a nose swab and felt that it would come back Neg. I went home and on Thursday 3/11/2021 I got a call that I was positive. Did isolate. But from 3/5 to 3/11 then I lost taste/smell. Came out of isolation 3/20 and on 3/21 my whole left side of fact, shoulder and leg went numb for approx 1hr. Then my wife said that I was talking a little slow in my response. Next morning my left shoulder was hurting and I had pain. The Urgent care provider wanted to r/o TIA so he sent me to ER for full work up and that doctor said he saw nothing. He didi say that it could be Covid related and/or possible TIA. "I am feeling good today" There is no residual but because of the left shoulder pain I did go back to Urgent Care. Got cortisone inject and MRI. My PCP then told me that I had a partial "tear" in my left shoulder but I do exercise every day and could have done it then.

Other Meds: None

Current Illness: I had a sty in my left eye for Wed/Thur and came for vaccine on friday 3/5/21. My face was hurting, cheek area and a sharp pain inervated my cheek and I had a headache. The sharp pain to cheek was a come and go feeling. Felt a temporal headache, the the ES Tylenol did give me relief. It did dissipate after that.

ID: 1243357
Sex: F
Age: 34
State: FL

Vax Date: 01/13/2021
Onset Date: 01/24/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: omeprazole; can't eat raw apples - they make me itchy in my mouth

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

Symptoms: I started with symptoms at 11 days post vaccine. It lasted three weeks. Intense itching that would wake me up at night. There would be no rash. I would wake up itching, put some hydrocortisone on and in the morning I would be fine, and this happened daily for three weeks. I saw Nurse Practitioner in my doctor's office - she recommended I stop my supplements and I was going in to the placebo week of my birth control and I stopped and within a couple of days I had no more itching. Since then I restarted my birth control on schedule and have slowly introduced each of my supplements (one at a time) and today was the last one to introduce and that was the fiber and I started that today. So far, I have had no symptoms that I had before.

Other Meds: Oral Contraceptive - Junel; Probiotic; Vit D3; Vit C; elderberry; fiber supplement

Current Illness: no

Date Died: 04/12/2021

ID: 1243358
Sex: M
Age: 82
State: MN

Vax Date: 03/09/2021
Onset Date: 04/07/2021
Rec V Date: 04/22/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Patient was hospitalized and died within 60 days of receiving a COVID vaccine

Other Meds:

Current Illness:

ID: 1243359
Sex: F
Age: 63
State: NY

Vax Date: 03/22/2021
Onset Date: 03/31/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: erythrmycin-- makes me sick to stomach certain latex bandages give me hives seasonal allergies

Symptom List: Injection site pain, Menorrhagia

Symptoms: After first dose on March 22, I was fine. However on March 31, I woke up very nauseous, headache, head felt foggy and cloudy, dizzy. Went to work. At 9am, i got so dizzy when I turned head that I blacked out, hit cheek on chair as I fell to floor. Saw Dr. at the Family Health Clinic, who did EKG, Epply test, blood pressure and recommended going to ER for further evaluation. Cat scan with contrast was done to check for anything unusual. On April 1, was prescribed Meclizine by Dr. to take for dizziness. On April 20- received 2nd dose of vaccine- started to feel headache, slight dizzy by 11:30 that evening. Next morning, felt slight nausea, light headed and dizzy. Started taking meclizine again for dizziness at recommendation of Dr. Spoke with Dr. from Family Health Center again on 4/22/21 to advise of stronger symptoms.

Other Meds: Atenelol (E50-25) Vitamin Apple cider vinegar capsules (2400 mg) Simvastatin (evening) Co Q 10 Evening

Current Illness: no other illnesses

Date Died: 03/27/2021

ID: 1243360
Sex: M
Age: 66
State: WI

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: unknown

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

Symptoms: Patient received first Moderna Vaccine on 02/26/2021 and second Moderna Vaccine on 03/26/2021. Health Department was notified of patients death on 03/27/2021, today 04/22/2021. Any further information is unknown by the health department for patients cause of death that occurred on 03/27/2021.

Other Meds: unknown

Current Illness: unknown

ID: 1243361
Sex: F
Age: 47
State: CA

Vax Date: 01/31/2021
Onset Date: 02/01/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: Compazine (dystonia), EnteraGam (GERD), ciprofloxacin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Started having significant twitching under both eyelids on the day after initial vaccination, soon thereafter followed by progressive fluctuating palpitations. Issues persisted through 3/2021.

Other Meds: None

Current Illness: None

ID: 1243362
Sex: F
Age: 52
State: NH

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: Cipro

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Sore arm shortly after administration. Soreness continued into evening and developed headache within a few hours. Sleeping was uncomfortable due to sore arm and restlessness. Next day very sore, headachy and tired. Stayed home from work and slept a lot. Headache and sore arm subsided within a 3-4 days. Next days following some minor headaches and tiredness.

Other Meds: Lisinipril, Pravostatin

Current Illness: None

ID: 1243363
Sex: M
Age: 19
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Sore at injection site

Other Meds:

Current Illness:

ID: 1243364
Sex: F
Age: 83
State: MT

Vax Date: 03/03/2021
Onset Date: 04/11/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: sulfa drugs

Symptom List: Nausea

Symptoms: After several days of pain in left shoulder, on the morning of 4/11/21 a harsh rash was noted on the back next to the shoulder blade as well as a similar bright red rash on the thorax front. A visit to a Now Care facility on that Sunday morning confirmed a diagnosis of shingles, and Valacyclovir was prescribed, 1 gm. tablet every 8 hours for 7 days. In the following 4 days, as the medication was taken, the rash gradually spread around the side of the thorax from front to back and under the left arm. The pain remains as of 4/22/21.

Other Meds: multivitamin, calcium, vitamin D, biotin, lutein,

Current Illness: none

ID: 1243365
Sex: F
Age: 50
State: FL

Vax Date: 04/15/2021
Onset Date: 04/21/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: I am post menopause and 6 days after 2nd shot I started bleeding. My period started.

Other Meds:

Current Illness:

ID: 1243366
Sex: M
Age: 66
State: IL

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: n/a

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

Symptoms: Flare up of periodontal infection, swelling of hard palate

Other Meds: nuvigil 250 mg daily

Current Illness: n/a

ID: 1243367
Sex: F
Age: 40
State:

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Patient (DOB 6/11/1980) received dose 1 of the Pfizer COVID vaccine (lot EW0162, expiration 7/2021) at 1050. At 1052, patient laid down on the ground with her feet propped up on her chair in the observation area. PHN and RN approached the patient to assess. Patient reported blurry vision and feeling as though she was going to faint before she laid down. Patient reported a fear of needles and fainting with previous injections. Vital signs: O2 98%, pulse 72, blood pressure 120/90, respirations 14. Patient reported eating breakfast then going on a run before coming to the vaccine POD. Patient denied allergies, medications, or medical conditions. At 1058, patient reported symptoms were improving. Vital signs: O2 97%, pulse 70, blood pressure 120/95, respirations 14. At 1102, the patient sat up, drank some water, stated she felt wobbly and laid back down. Vital signs at 1104: O2 98%, pulse 66, blood pressure 120/90, respirations 14. Patient sat up reporting decreased dizziness. At 1114, vital signs: respirations 16, O2 99%, pulse 72, blood pressure 120/98. At 1116, patient stood up momentarily while monitored closely by PHN and RN, then laid down again reporting feeling dizzy. Vital signs at 1118, O2 96%, pulse 69, respirations 16, blood pressure 120/90. Patient sat up, then laid down again reporting dizziness. PHN asked patient to contact a family member to drive her home. Patient reported she wanted to leave and wait for her husband in her car instead of the vaccination room. PHN encouraged patient to wait in the observation room so medical staff could monitor until symptoms resolved or called 911 per emergency protocol. At 1130 patient sat up. At 1138, patient stood up, denied dizziness. RN walked patient out to the parking lot. Patient left at 1140, walking with steady gait.

Other Meds: none

Current Illness:

ID: 1243368
Sex: F
Age: 73
State: MD

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

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

Lab Data:

Allergies: NONE

Symptom List: Tremor

Symptoms: CHILLS, SEVERE HEADAKE, UPSET STOMACH, ACHING ALL OVER, DIZINESS

Other Meds: PRAVASTATIN, SERTRALINE, LATAN0PROST, DOXYCYCLINE CALCIUM, D-3, FISH OIL.

Current Illness: NONE

ID: 1243369
Sex: F
Age: 40
State:

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Menstrual spotting following vaccine.

Other Meds: None

Current Illness: None

ID: 1243370
Sex: M
Age: 72
State: GA

Vax Date: 02/18/2021
Onset Date: 04/20/2021
Rec V Date: 04/22/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: Penicillin Iodinated Contrast

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

Symptoms: Patient received 2nd dose pfizer vaccine on 2/18/2021. On 4/20/2021 I was the CRNA for the patient. Before givining anesthesia, I placed him on monitors. The EKG showed Afib. Patient denied any history of afib and is regularly followed by a cardiologist. Patient case cancelled and sent to ER for workup. 12 lead EKG shower A flutter with RVR. Patient seen by cardiologist and given prescription for eliquis and told to followup.

Other Meds: Amlodipine Centrum men Finasteride KCL Valsartan-hydrochlorothiazide

Current Illness: unknown

ID: 1243371
Sex: M
Age: 79
State: OR

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

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

Lab Data:

Allergies:

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

Symptoms: Patient came for vaccination in the morning, then went out to breakfast. During breakfast, the patient slumped forward in his seat and was unresponsive for about a minute. There was no incontinence or seizure activity. On regaining consciousness, patient seemed to quickly get back to his usual level of mentation. He was diaphoretic and nauseous. He denies any preceding lightheadedness, nausea, visual changes, chest pain or palpitations. He presented to the emergency room, also had nosebleed and UTI. Was admitted for observation overnight and discharged the next day.

Other Meds:

Current Illness:

ID: 1243372
Sex: F
Age: 71
State: MT

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: nkda

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pt had already received both doses of Moderna. Pt was in to get a shingrix vaccine but the wrong medication was selected and administered. (she was given 0.3ml of pfizer covid vax) She has been checked up on and tolerated the vaccine with not adverse side effects

Other Meds: none

Current Illness: none

ID: 1243373
Sex: M
Age: 49
State: VA

Vax Date: 03/31/2021
Onset Date: 04/14/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: Soliqua 100/33

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

Symptoms: COVID vaccine 1st dose received by patient on 3/31/21; shingles onset began around 4/14/21

Other Meds: Taking omeprazole 20 mg delayed release capsule 1 cap(s) orally once a day (30 min prior to eating), Taking simvastatin 40 mg tablet 1 tab(s) orally once a day (at bedtime), Taking Wellbutrin SR 150 mg/12 hours tablet, extended release 1 ta

Current Illness: Diabetes, GERD

ID: 1243374
Sex: M
Age: 60
State: PA

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

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

Lab Data:

Allergies: Penecillin

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

Symptoms: Headache, severe chills, 100 degree F fever, extreme fatigue

Other Meds: Metformin HCL 1000mg. Jardiance 25 mg. Citalopram 40 mg. Omeprazole 20 mg. Atorvastatin 40 mg. Clopidogrel 75 mg. Asprin 80mg. Soliqua sub Q injection 42 units

Current Illness: None

ID: 1243375
Sex: F
Age: 16
State: MA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: 16 yo female received Moderna COVID 19 Vaccine 1st dose

Other Meds:

Current Illness:

ID: 1243376
Sex: F
Age: 64
State: MN

Vax Date: 01/25/2021
Onset Date: 04/19/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Developed Covid-19 on 4/19/21

Other Meds:

Current Illness:

ID: 1243377
Sex: F
Age: 59
State: CA

Vax Date: 04/10/2021
Onset Date: 04/20/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: 3 days after the first shot I felt achy lower back pain in the area of my kidneys. 10 days after, I felt feverish and woozy at the end of the day, and when I arrived home and took my temperature, it was 100.7. 20 minutes later, it was 101.6, which remains the highest recorded. By the time I went to bed about 3 hours later, it was back to 98.8. The next morning at 9:00 am, it was 99.9 and hovered between there and 99.3 for most of the day. By 6:00 that evening, it had returned to 97.7, which is in my normal range. I was tested for COVID during that day, and received a negative test result the next day.

Other Meds: Vitamin D, C, magnesium

Current Illness: None

ID: 1243378
Sex: F
Age: 62
State:

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Spiked fever 12 hours after injection. For the next 48 hours had chills and was achy.

Other Meds: MultiVitamin, Fish Oil, VitD, Calcium Citrate, Glucosamine Chondroitin

Current Illness: Covid April 1-12, 2021

ID: 1243379
Sex: F
Age: 56
State: MD

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: none reported

Symptom List: Vomiting

Symptoms: fever 102.3 F headache

Other Meds: none reported

Current Illness: none reported

ID: 1243380
Sex: F
Age: 59
State: TX

Vax Date: 04/18/2021
Onset Date: 04/19/2021
Rec V Date: 04/22/2021
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: sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Extreme swell of axillary lymph nodes at the inoculated arm and pain at the site. Other normal known side effects: fever, chills, body aches, headache.

Other Meds: Biotin, multivitamin

Current Illness: none

ID: 1243381
Sex: M
Age: 34
State: AZ

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Side effects started after 4 minutes of the shot. I started with nausea, followed by shortness of breathe as well as heart pacing at a faster rate. The feeling was uncomfortable, so I stood up to walk around. After 15 seconds, I felt very nauseous as weak. Hey went to sit back down, but felled while trying to sit. I was able to sit back up and started to shake/shiver and sweat heavily. This happen for over 15 minutes, than it felt as it was coming and going.(the side effects) for the next 40 minutes, I felt very weak and stiff in the left arm. After another 20 minutes, I started to feel better/normal. My arm started to feel less stiff. Waited another hour and half total before discharged from the clinic.

Other Meds: N/A

Current Illness: N/A

ID: 1243382
Sex: F
Age: 67
State: MD

Vax Date: 02/26/2021
Onset Date: 03/03/2021
Rec V Date: 04/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 5 Days after second Moderna shot, I developed intermittent stinging at the top of two toes on my left foot and at the same time stinging and itching on my face. Red, itches splotches/patches developed on the left side of my neck and traveled up the left side of my face, across the top of the face and eyelids, town the right side, and now have spread to the right side of my neck.

Other Meds: None

Current Illness: None

ID: 1243383
Sex: F
Age: 56
State: CA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Time 8:05 pt started to cough c/o of c/o of chest pain , lip numbness 911 called vital taken Dr. called to assess pt , after assessment pt stated she was feeling better Paramedics arrived and pt stated to c/o Nausea and started to vomit , pt taken transferred to ER via Paramedics

Other Meds: Unknown

Current Illness: none

ID: 1243384
Sex: F
Age: 34
State: TX

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt stated her arm hurt and she felt tingling, was confused and couldn't answer questions properly. The Pt became catatonic and unresponsive to questions. EMS called. She was evaluated and pt started to come around and started answering questions and stated behavior is normal for her due to her neurological condition.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm