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: 1245284
Sex: F
Age: 24
State: MO

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Lots of food allergies due to Acid Reflux and IBS

Symptom List: Dysphagia, Epiglottitis

Symptoms: In addition to the five main side effects (fever, chills, headache, nausea, and muscle pain), I also had severe lower body pain in my legs. I couldn?t walk. It felt like my limbs were cut off from the rest of my body. I had an intense sensation of knives stabbing me in different places all over my body. I couldn?t sleep the night of the shot due to the pain. Today marks 15 days since getting it, and I still have fatigue, radiating pain down my left arm and leg, and brain fog. I had a pretty bad migraine the other night. I have not received any treatment. I called my doctor who told me to go to the ER to get checked for a blood clot using a Doppler. I haven?t gone yet because it?s expensive and I?m still functioning. I?m considering going if I don?t get better.

Other Meds: Protonix, Lithium, Lamictal, Seroquel

Current Illness:

ID: 1245285
Sex: F
Age: 22
State: IN

Vax Date: 02/26/2021
Onset Date: 03/08/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Two months of Irregular menstruated bleeding occurring immediately after second dose of vaccine.

Other Meds: Birth control gianvi

Current Illness:

ID: 1245286
Sex: M
Age: 26
State: CA

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

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

Lab Data:

Allergies: None

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

Symptoms: Patient received the vaccine in the vaccination room and was instructed to wait 15 minutes to monitor for a reaction. The pharmacist returned to the pharmacy and shortly after was notified by another customer that someone had fallen down. The pharmacist arrived at the aisle to find the person laying on floor unconscious. The patient quickly regained consciousness and had no breathing or swelling. He was assisted to a chair and was responsive to questions. A few minutes later, he lost consciousness again and emergency services were contacted. He was taken to the hospital.

Other Meds: Unknown, not reported

Current Illness: Unknown, not reported

ID: 1245287
Sex: M
Age: 12
State: OK

Vax Date: 06/01/2017
Onset Date: 09/17/2017
Rec V Date: 04/23/2021
Hospital: Y

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: My son started not feeling well, losing weight and then started not remembering anything. He then went into DKA and we almost lost him. Now he has type one for the rest of his life. 3 months after the shot it started and then 5 months after vaccine the complete damage was done.

Other Meds: None

Current Illness: None! Very healthy until vaccines

ID: 1245288
Sex: F
Age:
State: NC

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: REDNESS IN THE AREAS OF THE HANDS; BLOOD LINE UNDER THE SKIN OF ALL OVER BOTH HANDS THAT LOOKS LIKE BROKEN BLOOD VESSELS; This spontaneous report received from a patient concerned a 51 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included hypertension, thyroid problems, anxiety, latex allergy, and sulfonamide allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1802070, expiry: UNKNOWN) dose was not reported, administered on 16-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-APR-2021, the subject experienced blood line under the skin of all over both hands that looks like broken blood vessels. On 16-APR-2021, the subject experienced redness in the areas of the hands. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from blood line under the skin of all over both hands that looks like broken blood vessels on 04-APR-2021, and was recovering from redness in the areas of the hands. This report was non-serious.

Other Meds:

Current Illness: Anxiety; Hypertension; Latex allergy; Sulfonamide allergy; Thyroid disorder

ID: 1245289
Sex: M
Age: 17
State: CA

Vax Date: 04/19/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: none known

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

Symptoms: Itchy rashy skin, bumps, hives

Other Meds: none

Current Illness: none

ID: 1245290
Sex: M
Age: 54
State: MA

Vax Date: 04/09/2021
Onset Date: 04/19/2021
Rec V Date: 04/23/2021
Hospital: Y

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

Lab Data:

Allergies: No known allergies

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Multiple pulmonary embolisms in bilateral lungs with lung infart, superficial blood clot in the right groin area, significant right abdominal pain, shortness of breath, low oxygen saturation levels admitted 3 days in the hospital. 36 hours of Lovanox injections followed by transition to Eliquis 10 mg twice per day, respiratory exercises, oxycodone given for pain Pain has diminished in lower right lung area, clotting appears to be under control

Other Meds: Lexapro 15mg per day, multi-vitamin, milk thistle, tumeric, colace, fiber capsules, elderberry

Current Illness: sleep apnea and depression

ID: 1245291
Sex: F
Age: 67
State: PA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, dust, mold, some pollens

Symptom List: Pharyngeal swelling

Symptoms: Sharp pain in my upper arm, wrapping around to my triceps, into my left trapezius and up into the left side of my neck. At about that same time, I developed pain in my left wrist and in the pinky and ring fingers of my left hand. Pain has continued for more than two months now despite regular stretching of the affected areas, use of a wrist brace, and applications of Icy Hot patches to my arm and upper back.

Other Meds: Omeprazole, duloxetine, victoza, metformin, flonase, atorvastatin, gabapentin, flaxseed oil, calcium, xanax

Current Illness:

ID: 1245292
Sex: M
Age: 52
State: TX

Vax Date: 03/26/2021
Onset Date: 04/09/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Constant ringing in left ear, tinnitus. So bad on one day it gave me nausea and severe headache, dizziness. Tried a round of steroids (Methylprednisolone) from doctor, did not improve.

Other Meds: Atorvastatin 20 mg, Loratidine 10 mg, Qunol Ultra CoQ10, Nature's Bounty Probiotic

Current Illness: None

ID: 1245293
Sex: M
Age: 55
State: CA

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Aspirin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 99.9 Fever, headache, fatigued for 17 hours. Then painful arthritis in all joints especially old injuries (ankles, knees, back, shoulders, wrists). This was quite pronounced for two weeks then abated gradually over the week 3. Normal after 22 days.

Other Meds: None

Current Illness: None

ID: 1245294
Sex: M
Age: 63
State: HI

Vax Date: 04/19/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital: Y

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: received the vaccine on Monday 4/19/21 into his left arm Tuesday 4/20/21 he went to work but after lunch became extremely fatigued and achy, went home to sleep it off Wednesday 4/21/21 he woke up with right UE/LE numbness and weakness which persisted until Thursday 4/22/21 so sought medical attention

Other Meds: amlodipine 5 mg QD allopurinol 300mg QD atorvastatin 10 mg QD

Current Illness: none

ID: 1245295
Sex: F
Age:
State: AR

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: TIREDNESS; This spontaneous report received from a consumer concerned a 61 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included thyroid disorder. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included alprazolam for sleep. On 07-APR-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tiredness on APR-2021. This report was non-serious.

Other Meds: XANAX

Current Illness: Thyroid disorder

ID: 1245296
Sex: F
Age: 41
State: CA

Vax Date: 04/15/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Red, swollen and itchy rash around injection known as covid arm started today - 1 week after injection

Other Meds: Lecapro

Current Illness:

ID: 1245297
Sex: F
Age: 49
State: TX

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Unknown

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

Symptoms: All this on the right side of the body. Injection site was on the right arm. Dizziness and weakness, swollen/painful lymph nodes (axillary, cervical, epitrochlear, under jawline and chin). Parotid gland swollen and painful. Entire right arm swollen with rash, Right check swelled. Right ear pain.

Other Meds: None

Current Illness: None

ID: 1245298
Sex: F
Age: 30
State: CA

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: Woken from sleep approx 11hrs after shot. Chills, mild fever, uncomfortable, joint pain including wrists and fingers, lymphnode in left armpit sore. As time went on alternated between chills and sweats. Symptoms continued for approx 36hrs. Lympnode soreness lasted approx 3days

Other Meds: No

Current Illness: No

Date Died: 04/15/2021

ID: 1245299
Sex: M
Age: 87
State: OR

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 04/23/2021
Hospital: Y

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: Patient developed swelling of his upper and lower lip on 4/11 and was given 25 mg benadryl at the care home. Swelling subsequently worsened and 911 was called, with EMS noting SpO2 at 88%. He was transported to the ER and found to have CHF/pulmonary edema and NSTEMI. Comfort care measures were implemented and he died 4/15.

Other Meds: acetaminophen allopurinol atorvastatin atropine cal-mag-zinc vitamin D3 clopidogrel hydrocodone-acetaminophen lorazepam memantine morphine multivitamin-minerals olanzapine oxybutynin quetiapine sennosides-docusate sodium trazodone

Current Illness: No recent acute illnesses

ID: 1245300
Sex: M
Age:
State: NJ

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: SUSPECTED COVID-19 INFECTION; This spontaneous report received from a parent concerned a male of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 05-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On APR-2021, the subject experienced covid-19 symptoms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from covid-19 symptoms. This report was non-serious. This parent/child case is linked to 20210438886.

Other Meds:

Current Illness:

ID: 1245301
Sex: M
Age: 29
State: NY

Vax Date: 04/12/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: No known food or drug allergy. Suspect food allergy as cause of urticaria

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Urticaria starting morning of April 22nd, 10 days post 1st Pfizer shot in left arm. Worse in left forearm, but also on right forearm, chest, back, and neck. Suspect new food allergy or possibly recent viral illness.

Other Meds: None

Current Illness: Mild URI for 2-3 days a couple weeks prior

ID: 1245302
Sex: M
Age: 35
State: CA

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

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

Lab Data:

Allergies: Denies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Client received 2nd dose COVID vaccine @ 12:00pm, complained of feeling burning sensation in chest and lower back, with pressure in head @ 12:02pm. Client placed in chair, vital signs stable. Burning sensation in chest and lower back resolved at 12:09pm, head pressure lessened. Client left for home @ 12:34pm, with headache, advised to follow up with primary care if symptoms not resolved at home or worsen.

Other Meds: Denies

Current Illness: Denies

ID: 1245303
Sex: F
Age: 63
State: WA

Vax Date: 03/01/2021
Onset Date: 04/09/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Methotrexate, Sulphas

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

Symptoms: 2nd shot was 03/05/2021. Left arm was sore almost immediately. Mild flu like symptoms next 3 days. Extreme fatigue. 04/09/2021 left side of neck - 3 swollen lymph nodes. Started as stiff sore neck. Made appointment with primary for the next Monday 04/12/2021. But in Friday my right side of neck swelled and hurt. Then the lymph nodes swelled. Sore throat. Became worse than left side which was still swollen. Also had sore develop inside mouth. Severe itching to lower face. Saturday I went to Urgent Care. Dr. believed it was allergic reaction to cleaner I was using. The itching probably was. But I have never had my lymph nodes swell like this before. Today is the 23rd and my lymph nodes are still slightly swollen.

Other Meds: Atorvistatin Adderall Calcium Fish oil Vitamin c Magnesium NAC 600 mg Baby aspirin Allergy pill

Current Illness: Seasonal allergies

ID: 1245304
Sex: M
Age: 59
State: HI

Vax Date: 01/18/2021
Onset Date: 02/17/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: One week after my second dose, I began developing random hives on different parts of my body that were and are extremely itchy. I also get red streaked areas that are itchy as well.

Other Meds: Zocor once per dah.

Current Illness: None

ID: 1245305
Sex: F
Age: 32
State: TX

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Bananas

Symptom List: Unevaluable event

Symptoms: Redness swelling and warmth at injection site Body aches treated with ibuprofen and aleve

Other Meds: Women's multi vitamin Celexa 20mg

Current Illness: None

ID: 1245306
Sex: M
Age: 68
State: NY

Vax Date: 02/13/2021
Onset Date: 03/10/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: I got a blood clot, venous, in my upper right leg. Started on or about March 3rd, 2021

Other Meds: Adreset, Alpha-Liopic Acid, Aspirin, Co Q10. Flomax, Grape Seed, Insulin, magnesium, Probiotic, Sertaline, Synthroid, Valtrex, Vit. D3,

Current Illness:

ID: 1245307
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 04/06/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: FEEL THE POINT OF INOCULATION; SORENESS OF ARM; This spontaneous report received from a patient concerned a 40 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included hypertension, diabetes type 2, and seasonal allergies, and other pre-existing medical conditions included no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 06-APR-2021, the subject experienced feel the point of inoculation. On 06-APR-2021, the subject experienced soreness of arm. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from soreness of arm, and feel the point of inoculation. This report was non-serious.

Other Meds:

Current Illness: Hypertension; Seasonal allergy; Type II diabetes mellitus

ID: 1245308
Sex: F
Age: 30
State: UT

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: I have a dime sized blister about 1.5 inches from the injection site. The blister is yellow and fluid filled. I noticed it today, but it could have appeared sooner.

Other Meds: Levothyroxine (137mcg) Liothyronine sod (5 mcg)

Current Illness: N/a

ID: 1245309
Sex: F
Age: 15
State:

Vax Date: 04/01/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient was vaccinated on 04/01/2021. Patient is 15 years old and was not supposed to be vaccinated on that day, she should have been refused. It is unknown as to what occurred on that day that patient was vaccinated even though she is 15 years old. It was not brought to the attention of the site lead or charge nurse on 04/01/21. Patient returned to the site on 04/22/2021 for second dose. Vaccinating nurse and scribe asked the patient and looked at her date of birth which states she is 15 years old. It was brought to the attention of the charge nurse and site lead that the patient had been incorrectly vaccinated 3 weeks ago. Patient was not given second dose and educated that she may not receive it until she is 16 years old. Patient and mother understood and left site without incident.

Other Meds:

Current Illness:

ID: 1245310
Sex: M
Age: 19
State: SC

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

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

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Heart and chest pain, started about 8-9 hours after injection. Going to sleep, so I cannot continue to monitor until morning.

Other Meds: Focalin, Intuniv

Current Illness: None

ID: 1245311
Sex: F
Age: 66
State: CA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Ringing in ears started and keeps getting louder

Other Meds: Synthroid daily Vitamin D Vitamin B

Current Illness: None

ID: 1245312
Sex: F
Age: 29
State: CA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Oranges, TB test, dust, hay, pollen, bees, insect stings and bites

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

Symptoms: Hives starting around 6pm on Thursday evening Saturday evening horrible headache and head started swelling Sunday morning back started swelling Monday morning neck and face started swelling Tuesday went to ER was prescribed Prednisone to start taking on Wednesday been taking for 2 of 4 days and swelling is still present, but starting to lessen.

Other Meds: Lexapro, Flonase, Benadryl

Current Illness: Just allergies

ID: 1245313
Sex: F
Age:
State: AZ

Vax Date:
Onset Date: 04/08/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: SEVERE HEADACHE; COULD NOT LIFT ARM; SORE ARM; This spontaneous report received from a patient. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808980, and expiry: UNKNOWN) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 08-APR-2021, the subject experienced sore arm. On 17-APR-2021, the subject experienced could not lift arm. On 19-APR-2021, Laboratory data included: X-ray (NR: not provided) X- ray Normal. On an unspecified date, the subject experienced severe headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the sore arm, could not lift arm and severe headache was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1245314
Sex: F
Age: 36
State: CA

Vax Date: 04/02/2021
Onset Date: 04/08/2021
Rec V Date: 04/23/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfa, lanolin, co-trimoxazole

Symptom List: Injection site pain

Symptoms: Acute non-ischemic myocardial injury, likely coronary vasospasm

Other Meds: one a day, vitamin c, theracurmin, DIM Detox, EGCG, B Complex, Magnesium citrate, vitamin D, loestrin

Current Illness: NA

ID: 1245315
Sex: F
Age: 45
State: UT

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: no

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

Symptoms: Vertigo, body aches, headache first 2-3 days. Then a few days later major fatigue set in, chest pain, mouth breaking out in canker sores randomly, broke out in hives, rashes on my legs and arms, skin hurts to touch, dizzy, loss of balance, difficulty sleeping, night sweats, blurred vision, double vision this is probably the worst of all the symptoms, I lost my taste for 5 weeks. I have taken anti-viral homeopathic drops because it really felt like I was getting the chickenpox or something...like a nerve pain burning. I have documentation how perfectly healthy I was before this and now I am not.

Other Meds:

Current Illness: no

ID: 1245316
Sex: F
Age: 64
State: CA

Vax Date: 03/13/2021
Onset Date: 04/01/2021
Rec V Date: 04/23/2021
Hospital: Y

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: Subarachnoid hemorrhage on 4/20/21. She began complaining of strong pain that caused vomiting, swelling, and hospital visits from about 3 weeks ago. We thought it was her blood pressure but it was consistently normal. She described it as the worst pain she has ever felt.

Other Meds: Blood pressure medication Thyroid medication Depression medication Sleep medication

Current Illness:

ID: 1245317
Sex: M
Age: 55
State: CA

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin Cipro Doxycycline Sulfa drugs Cats Rabbits

Symptom List: Tremor

Symptoms: Tinnitus Facial swelling Eye irritation Lip and mouth irritation Throat irritation Canchre sores Tounge sore Ongoing - some improvement w Benadryl and nose steroid spray

Other Meds: Benadryl

Current Illness: None

ID: 1245318
Sex: F
Age: 57
State: PA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: A soon the vaccine was giving High fevers start occurring with the chills went to the hospital because 10 days we high fevers and chills has gone bye the hospital diagnose was that the immune system was down And the blood count specially white cells were really low and infections like liver was occurring

Other Meds: Tynenol

Current Illness: Gallbladder stones

ID: 1245319
Sex: M
Age: 20
State: MA

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

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

Lab Data:

Allergies: Amoxicillin penicillin and sulfa

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

Symptoms: Chills so bad I had to put a mouthguard in to prevent me from grinding my teeth the whole time and body aches worse than when j hurt my back and had a discetomy

Other Meds:

Current Illness:

ID: 1245320
Sex: F
Age: 32
State: CO

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

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

Lab Data:

Allergies: None

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

Symptoms: Upon onset of other typical effects (sore/swollen arm, fever, fatigue) experience instantaneous and intense panic attack, which included tightness in the chest, feeling of fear and danger, sobbing, and paranoia. I had no anxiety surrounding the receiving of the vaccine nor anxiety about potential side effects. I was standing still and upright at the time of the attack and it lasted appx 30-40 min, subsiding to feelings of heightened anxiety through the remainder of the night. While anxiety and panic attacks have occurred in the past, it is not on a regular basis, nor has either occurred in over 6 months.

Other Meds: Yaz

Current Illness: None

ID: 1245321
Sex: F
Age: 61
State: MS

Vax Date: 02/03/2021
Onset Date: 02/24/2021
Rec V Date: 04/23/2021
Hospital: Y

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 known

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 02/24/2021 Guillain Barre' Syndrome 04/19/2021 Renal Failure with other complications

Other Meds:

Current Illness: Rheumatoid arthritis

ID: 1245322
Sex: M
Age:
State: MI

Vax Date:
Onset Date: 03/17/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: DIZZINESS; WEAKNESS; FEVER; HEADACHE; MUSCLE ACHE; This spontaneous report received from a patient concerned a 51 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included hepatitis b, non smoker, and no alcohol use, and other pre-existing medical conditions included the patient have no known drug allergies and no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 16-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 17-MAR-2021, the subject experienced dizziness. On 17-MAR-2021, the subject experienced weakness. On 17-MAR-2021, the subject experienced fever. On 17-MAR-2021, the subject experienced headache. On 17-MAR-2021, the subject experienced muscle ache. Treatment medications (dates unspecified) included: paracetamol, and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from dizziness, weakness, fever, headache, and muscle ache on 20-MAR-2021. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Hepatitis B; Non-smoker

ID: 1245323
Sex: M
Age:
State: WA

Vax Date: 04/22/1921
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Bee venom

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

Symptoms: Had swelling of that and numbness in lips and stomach started hurting and only took 10 mins after shot.Then the people admitted ephi into my leg..03mg.And then fire department got called and got 50 cc of liqard benadryl into me and iv and it was off to the hospital and got some prednisone and and was in hospital for 8 hrs

Other Meds: None

Current Illness: None

ID: 1245324
Sex: M
Age: 58
State: UT

Vax Date: 04/14/2021
Onset Date: 04/18/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Started developing morbiliform exanthem that spread to the whole body, sparing palms and soles of feet 4 days after Vaccination, Worsened into day 8 in spite of Prednisone 20mg Daily 2 doses. Also developed Temp up to 102 day 7-8.

Other Meds: Allopurinol, Lisinopril, Pravastatin

Current Illness: None reported

ID: 1245325
Sex: F
Age: 59
State: NJ

Vax Date: 04/07/2021
Onset Date: 04/18/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: only slight allergy if consume large quantity of sea food

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

Symptoms: I got the JNJ vaccine on Wed 4/7/21 (a wk before FDA paused that covid vaccine). Initial response was Extreme Fatigue, but starting 11:45 pm on 4/18/21, I suffered headache, chest pain, short of breath. I could not sleep at all till 4/19/21 PM after asking my kids to pray for me. In case it's just heartburn, I took TUMS at 8:15 pm on 4/19/21 . Headache, short of breath comes and goes, but the chest pain persists, and I develop a hot flash. I never took birth control pills, but my OB/GYN prescribed daily Estrogen (to prevent osteoporosis) and every 3 month, Progesterone for 10 days (to prevent breast cancer). Estrogen & Progesterone happen to be the birth control pills' composition. On 4/17/21, I finished my 10 days Progesterone regime. I discontinued the Estrogen supplement on 4/19/21 or 4/20/21, now (4/23/21 1:20 am) no more chest pain, but still feel fatigue, feverish with a hazy/foggy head (not really a headache). I have a suggestion for JNJ, FDA, CDC on JNJ vaccine warning label. If indeed those 6 women are all on birth control pills which are composed of synthetic estrogen and progesterone, then the warning label should also warn people who take these hormone supplements, instead of just an age range.

Other Meds: Estrogen, Progesterone, Lipitor 20 mg, Benadryl, Trazadone 50 mg, etc.

Current Illness:

ID: 1245326
Sex: F
Age: 39
State: CA

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Hives after a tetanus shot and after a Rhogam shot

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

Symptoms: Approx. 24 hours after 2nd shot, a very large swollen lump appeared at injection site. It is more than 3? in diameter, very hot to the touch, and very itchy. A rash has also appeared around the edges of the soles of my feet.

Other Meds: Zoloft, 50mg Prenatal vitamin Vitamin D Probiotic

Current Illness: None

ID: 1245327
Sex: M
Age:
State: MI

Vax Date:
Onset Date: 03/17/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: HEADACHE; This spontaneous report received from a patient concerned a 52 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included non alcohol user, and non smoker, and other pre-existing medical conditions included the patient had no known drug allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 16-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 17-MAR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache on 19-MAR-2021. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker

ID: 1245328
Sex: F
Age: 39
State: TX

Vax Date: 04/14/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: One week after vaccination my arm started to itch. When I looked at it it was pink, about an inch around. Also at the same time the lymph node under my arm, on the same side as the vaccine site, started hurting. Over the next 24 hours the spot on my arm grew to about four inches around and got brighter red. It alternated between itching and burning, much of the time feeling like a sunburn. One day after it started I did an online doctor visit. She said it was most likely "Covid arm" and after reading about it online I agree. Now almost 48 hours after symptoms started there is improvement, it has gone back to a dark pink. Lymph node still hurts but it has also improved.

Other Meds:

Current Illness:

ID: 1245329
Sex: F
Age: 47
State: CA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: NSAIDS, aspirin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Period came 8 days early on the day after the 2nd vaccine shot. This is rare for me.

Other Meds: Iron, multivitamin, fiber

Current Illness: none

ID: 1245330
Sex: F
Age: 59
State: VA

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Normally I take a Coreg CR 20 mg @9am, and another one @9pm; blood pressure (BP) was well controlled for the last 5 years. The day of the 2nd COVID dose I started feeling malaise/weakness around 7-8pm. My BP was 188/106 (3 measurements average). Took the 9pm Coreg at 8pm; didn't feel improvement, my BP increased to 220/118. I took a Labetalol 100mg; in about 2-3 hrs my PB came down to 170/105 and I fell asleep. I woke up several times feeling sick. The next day my BP was higher than usual around 170/112 (in the morning I felt a bit better; but started to feel very sick again in the afternoon; it continued in the evening & during the night). I felt as if my heart was giving up. The only reason I did not go to Emergency was the fear I can get the COVID in the hospital. THIS WAS A VERY SERIOUS, LIFE THREATENING EVENT; if I didn't have Labetalol in the house I believe I would be dead now. Note: I did not panic, my pulse was around 66 the first day. The second day it was around 72. There should be an investigation covering the side effects in people with a high BP history after the 2nd vaccine dose, to make sure their problems were not blamed on their health history. During the side effects/time frame I described, it seemed my BP medication did not have the effect it usually has on me. I found it unacceptable that the only site reporting the spikes in BP as a COVID vaccine side effect was a hospital in another country; if there were such side effects reported by the date of my vaccine, they were not readily available for the public. These heart problems could have been made much better if people like me knew of an increase in BP as adverse reaction to the vaccine's 2nd dose, so we could have been prepared, i.e. take the BP medication BEFORE the BP spikes up so much, so it doesn't reach critical values (especially in the conditions of malaise and general sickness given by the vaccine.)

Other Meds: Coreg CR 40mg/day; Atorvastatin 40mg/day

Current Illness: none

ID: 1245331
Sex: F
Age: 17
State: CO

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

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: EXTREME NAUSEA AND SEVERE FATIGUE AS WELL AS SHAKINESS

Other Meds: Citalopram, Wellbutrin, Vitamin C, Vitamin D, Zyrtec, Multivitamin & Probiotic

Current Illness:

ID: 1245332
Sex: F
Age: 35
State: WA

Vax Date: 04/15/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Flush and feverish (low grade), racing heart. Headache onset at say 6 and continuing.

Other Meds:

Current Illness:

ID: 1245333
Sex: F
Age: 56
State: CA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Bell's palsy symptoms within 4 hours of shot.

Other Meds:

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm