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: 1247461
Sex: M
Age: 53
State: VA

Vax Date: 04/02/2021
Onset Date: 04/08/2021
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: Flo Nasal

Symptom List: Dysphagia, Epiglottitis

Symptoms: Moderna COVID-19 Vaccine EUA Around five days after receiving my first shot I started feeling aching and throbbing on my left side in my neck, shoulder blade, shoulder, bicep area down to my elbow, and a swollen lymph node in my left arm pit. My neck, bicep area, and shoulder is still producing a throbbing type pain. On April 18, 2021 I awoke to the tip of my left thumb being numb. It is still numb as of today, April 23, 2021..

Other Meds: None

Current Illness: Rhinitis

ID: 1247462
Sex: F
Age: 67
State:

Vax Date: 04/16/2021
Onset Date: 04/16/2021
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: Swelling in given area and in left leg for five (5) days starting on day one.

Other Meds:

Current Illness:

ID: 1247463
Sex: F
Age: 29
State:

Vax Date: 04/21/2021
Onset Date: 04/21/2021
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:

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

Symptoms: Nausea, vitals wnl. Crackers and water provided.

Other Meds:

Current Illness:

ID: 1247464
Sex: F
Age: 52
State: FL

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

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

Lab Data:

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Six hours after receiving my second dose of Moderna my body started shaking so badly that I was unable to sit up or swallow. I had violent tremors for over 30 minutes and then my temperature spiked to 102.3 for 2 days and on the 3rd day my temperature was around 99.9. This lasted all weekend even with the therapy of ibuprofen and Tylenol .

Other Meds: Enbrel and Synthroid

Current Illness: Auto immune disease

Date Died: 04/22/2021

ID: 1247465
Sex: M
Age: 84
State: ND

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: Biguanides Sulfa Metformin and related

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

Symptoms: Patient received vaccine on 4/15/21 2nd dose of 2 dose series. He woke up the morning of 4/22/21 at 6:15am with vomiting. His temperature spiked to 104.2 and his O2 sat dropped to 98%. He developed shaking chills, and a loose wet sounding cough. He had chest xray and labs. Started on treatment for pneumonia with rocephin, zithromax and solumedrol. Declined throughout the day and had increasing requirements for O2 and patient passed away at 1355 on 4/22/21.

Other Meds: TYLENOL(ACETAMINOPHEN [325 MG] TABLET) 325 MG Tablet 325 mg Oral as needed every 6 hours 03/08/2021 07:00 VITAMIN C(ASCORBIC ACID [500 MG] TABLET) 500 MG Tablet 500 mg Oral EVERY MORNING 03/08/2021 07:00 03/04/2021 08:00 ECOTRI

Current Illness: Foot/heel ulcer

ID: 1247466
Sex: F
Age: 77
State: MN

Vax Date: 03/12/2021
Onset Date: 04/02/2021
Rec V Date: 04/23/2021
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:

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

Symptoms: Patient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1247467
Sex: F
Age: 48
State: WA

Vax Date: 04/07/2021
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: Sulfur

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 4/17 Itchy abdomen 4/18 Nausea feeling 4/19 Abdominal pain with more severe abdominal pain on the right side followed by itchy rash & blisters on the abdomen & back. 4/20 Severe rash in abdomen & back with severe abdominal pain & cramps. 4/22 Diagnosed with Shingles.

Other Meds:

Current Illness:

ID: 1247468
Sex: F
Age: 98
State: WV

Vax Date: 04/23/2021
Onset Date: 04/23/2021
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: aspirin

Symptom List: Pharyngeal swelling

Symptoms: facility thought this would be her 2 nd dose but upon getting back to bill the shot and checking the registry the patient received this dose as her 3rd shot. no ill effects so far.

Other Meds: not known

Current Illness: not known

ID: 1247469
Sex: F
Age: 52
State: NJ

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Severe, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Medium, Systemic: Flushed / Sweating-Medium, Additional Details: Symptoms began 30min after dose. pt was on way home from vaccine then went to ER for treatment. was given benadryl at hospital then released.

Other Meds:

Current Illness:

ID: 1247470
Sex: F
Age: 55
State: AZ

Vax Date: 04/05/2021
Onset Date: 04/06/2021
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: None up to the Janssen vaccine

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 4/5/2021--Received Janssen vaccine. Felt very hot during the day. 4/6/2021--Woke up with very bad headache and rash on the injected arm plus on my stomach. Went for a walk and felt pain in my left calf and achilles tendon. Went to work. 4/7/2021--Started my work day as a Personal Trainer/Fitness Instructor at 6am as usual. Taught cycling classes and trained a few clients. Went for walk. Still had a headache. When I got in my car to head home, my vision was super blurry and I felt very dizzy. I ate an orange and peanuts and hydrated more. I was not even sure I could drive home. I got home told my family how I was feeling. My husband noticed my eyes were very red and swollen. I took a shower, drank a smoothie and ate a salad. Used my aunt's BP cuff to check my BP and it was 148/99. I have NEVER had HBP. 4/8/21--Woke up feeling disoriented as if the left side of my face, body were off--neurological stuff. I went to reach for grapes in the refrigerator and could not grab them. I felt like I have never felt before and ask my husband to drive me to the ER. While at the waiting room at the ER, I felt chest tightness and pain and nauseous. My BP was 153/111. Again, I have never been diagnosed or been treated for hypertension. They did EKG, lab tests, chest X-ray. Once my BP came down, they sent me home. This is before all the JJ Janssen vaccine "news" came out and the reasons it was paused. I developed a very bad cough about two hours after I got home from the ER. 4/9/11--Made appointment with a brand new primary care doctor. Saw her on Monday 4/12/2021 as recommended by ER. I had never met her before. She prescribed a very low dose of BP medication, which I did not take because the number one side-effect is dry-cough. I was already coughing a lot, later on with blood. 4/11/2021--Still feeling pretty bad, I woke up to the news of the Janssen vaccine being paused. Frankly, I felt relieved that I was not going crazy. This truly has been one of the hardest things I have ever gone (and still am) going through. I became concerned about the pain in the left calf and heel could be a clot. Called primary care doctor. Had ultrasound of legs and chest x-ray the following day 4/12/2021--Had persistent cough with blood. Went to ER at 9pm. Had EKG, blood work, CT without contrast of chest, covid test--negative. Got home around 2am. 4/19/21--Followed up with primary care doctor who after explaining to her I am extremely fatigued, still blurry vision, dizzy, cough better but not gone, chest discomfort on the left side, she referred me to an ophtamologist and cardiologist. My insurance and this poorly established referral system is very difficult to navigate. Up to now I am still waiting for the referral and pre-aurhtorization to the opthtamologist. (4/23/2021). I want to say, I am pretty healthy. I have worked in fitness and wellness for over 30 years. I have never drank alcohol, smoked or done any drugs. Prior to this no physician has told me I have HBP or any issues for which I have to be medicated. I take zero medications. Even when I had the bad headache from the vaccine I took nothing. I have not worked in two weeks and had not driven until last saturday. If I don't work, I don't get paid. I pay for almost $600/month for my insurance in the marketplace. This has been another stressor of this storm. Getting providers to really listen and insurance companies to take situations like this seriously. I could not drive at night. This has been rough and I look forward to being myself soon. This reaction felt like a heart attack/stroke with extreme fatigue, acid reflux, cough with some blood, muscular pain. The rash and headaches were the least of my concerns. I am not yet recovered from all of this. I sure hope there is no permanent damage and that this too shall pass. It is important to note that I have tried reporting this event several times to the VAERS website online. I completed the 4-5 pages multiple times and it would not let me submit. I also called the VAERS 1-800 number to report and they told me to go back to the online form. I left several messages when I could not get it done online and to this date no one has called me back. I called to report my adverse reaction and they told me they do not take that info. I also called the health dept. After several phone calls to them a nurse called me back but did not take a formal report. When someone is feeling pretty sick, this is a lot to ask of. I persisted because I feel this is important to be reported.

Other Meds: None

Current Illness: None

ID: 1247471
Sex: F
Age: 27
State: MN

Vax Date: 04/23/2021
Onset Date: 04/23/2021
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:

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

Symptoms: Fever, muscle aches , weakness ( couldnt walk!) chills

Other Meds:

Current Illness:

ID: 1247472
Sex: F
Age: 44
State: TX

Vax Date: 02/25/2021
Onset Date: 03/10/2021
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: unknown

Symptom List: Rash, Urticaria

Symptoms: red area to arm about 7in in diameter

Other Meds: unknown

Current Illness: unknown

ID: 1247473
Sex: F
Age: 21
State: FL

Vax Date: 04/09/2021
Onset Date: 04/17/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: 4/17 Chest pain when she takes deep breath that spreads to her left arm 4/20-Follow up call second attempt - Voicemail not set up yet; unable to leave a message.

Other Meds: none

Current Illness:

ID: 1247475
Sex: F
Age: 33
State: CA

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: ALLERGIES/SENSITIVITIES: Dairy {Severe Intolerance} Spandex (severe itching) Gluten {Severe Intolerance} Cipro Sloxacin (Rash) Flagyl (Vomit) Spironolactone (Diarrhea, constipation weight gain,) Sensitive to Steroids. Azithromycine (makes me nauseous) {If medically necessary- can take Prednisone (Severe itching) Azithromycine or Prednisone) Lyrica (skin irritation, swelling, severe itching) ALL Narcotics (skin irritation, severe itching) Gabapentin (skin irritation, swelling, severe itching)

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

Symptoms: After my first shot I had a swollen arm at the injection site, and extreme fatigue. Arm Soreness happened 3-4 hours after injection My SECOND SHOT is where I had the Severe reaction: I decided to treat at home because I had my tens units, leg massager, and pain relievers. Symptoms: extreme fatigue, sore muscles (aching) and some hardness at injection site, muscle weakness, joint pain, diarrhea, dizziness, fever, one case of the sweats (due to fever), headache, increased heart beat, sore throat (from dripping nose and yet it was also stopped up making the headache happen), and (some short breathing-but I have an inhaler for that, so I was fine). I began feeling them in the evening about 8-9 hours after the shot. I didn?t sleep well that night, and spent most of it in pure agony and searing pain. I have fibromyalgia and the shot clearly aggravated that condition so I felt like my veins were on fire. -and still do. Third day after symptoms have lessened, but still persist. Doing all I can to rest and get better. HOW I TREATED: -Took Tylenol -Took an episome salt bath ?? first. Soaped and rinsed after. -Used a Cain or a family member help me walk to and from the bathroom so I didn?t fall over due to dizziness. -Called my Dr. And asked for a limited dose of Tramadol-pain meds (I?m allergic to narcotics and opiate pain treatments) -I used 2 at home tens units and had them all over my body. (That I got originally for my back pain and fibromyalgia) -I used my top of the line leg massager (that I got originally for my fibromyalgia) -My family made chicken soup -I drank water, Pedialite with juice, and mint tea. -Took my temperature regularly to keep up with Tylenol -Eventually used over the counter lidocaine and Aspercream all over my body. -Had a pressure cuff at home to monitor vitals

Other Meds: Dexadrine Spansule 15mg (once daily) Lexapro 30mg (once daily) Trazodone 50mg (1/4, ?, or 1 whole once nightly) Fibromylgia and CRPS Lo Lo Estrin Fe (once daily) Montelukast sodium 10mg (once daily)

Current Illness: none.

ID: 1247476
Sex: F
Age: 64
State: MD

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: NKDA

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

Symptoms: Pt. was administered incorrect dosage of Pfizer (0.1) : Vaccinator notified site leader in regards to the above. Site leader contacted Pt. and advised Pt. to return to receive the remaining dosage of 0.2. 0.2 was was administered and Pt. was fully vaccinated with the correct dosage of 0.3

Other Meds: none

Current Illness: none

ID: 1247477
Sex: F
Age: 50
State:

Vax Date: 01/26/2021
Onset Date: 01/27/2021
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: Mefloquine - low blood pressure Percocet - itching

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

Symptoms: Patient called occupational medicine to report adverse reaction post 2nd dose Moderna Vaccine Admin 1/26 Chills, and body aches 1/27 with severe SOB this morning, heard over the phone. Was advised to head to ED for evaluation and 02 sat check. NP team advised. Patient did not report to ED for evaluation.

Other Meds: Vitamin C 1000 PO daily Lipitor 10mg PO qHS Vitamin D3 2000 units PO daily Synthroid 75mcg PO daily before breakfast magnesium 400mg PO daily MVI PO daily

Current Illness: No known

ID: 1247478
Sex: M
Age: 53
State: WA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
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: none reported

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

Symptoms: This patient received his first shot of covid-19 vaccine and was asked to wait in the pharmacy observation area for 15 minutes. others in the observation area witnessed the patient appear to have some form of seizure while seated in his chair. the patient slipped from his seat and apparently hit his head on the floor. medics were called and patient was transported to an unknown local hospital.

Other Meds: none reported

Current Illness: none reported

ID: 1247479
Sex: F
Age: 51
State: GA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Site: Pain at Injection Site-Medium, Systemic: Joint Pain-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium, Additional Details: Pain Numbness of arm right after injection and afterwards, arm and collarbone neck back area

Other Meds:

Current Illness:

ID: 1247480
Sex: F
Age: 41
State: GA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: My fingers started tingling about an hour after the vaccine then my feet started tingling. It subsided about 18 hours after. Now my fingers are tingling intermittently and my toes and feet are now pretty constantly tingling/pins and needles and are going numb often.

Other Meds: None

Current Illness: None

ID: 1247481
Sex: M
Age: 26
State: CA

Vax Date: 04/03/2021
Onset Date: 04/05/2021
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: N/A

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

Symptoms: I developed stomach cramps and discomfort, paired with some diarrhea. I also developed the worst heartburn/acid reflux I have ever experienced. Normally if I get heartburn it?s after a meal, but this was constant throughout the day and night. I am still feeling the heartburn, although it seems it?s not as bad as before. I also developed the worst depression and anxiety of my life. It hit me Friday, April 9 like a bag of bricks. I started crying out of nowhere. I have had intense depression since. The anxiety has been worse than the depression. Pretty much unbearable worry and panic. I have been waking up in the middle of the night around 4 am every night worried. Also when I wake up in the morning I wake up in a panic. The feeling has been terrible and also consistently present.

Other Meds: Flonase, Zyrtec, Vitamin C, Vitamin D

Current Illness: N/A

ID: 1247483
Sex: M
Age: 78
State: IN

Vax Date: 04/20/2021
Onset Date: 04/21/2021
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: Sulfa Drugs, Norco, Codiene, Cephtriaxone, Phenergan, Xeralto

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

Symptoms: Fatigue, Body aches, Headache, fever 1- 2 degrees Lasted 24 Hours. Took Tylenol but did not help much.

Other Meds: Uribel, Lisinopril, Simvastatin, Baby aspirin, Vitamin D3, Sinus Spray

Current Illness: Sinus Allergy

ID: 1247484
Sex: F
Age: 17
State: WI

Vax Date: 04/20/2021
Onset Date: 04/20/2021
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: Unevaluable event

Symptoms: Patient was registered under a parent's DOB and was administered the moderna vaccine LOT Number 046A21A by a volunteer physician. The patients of this vaccination clinic were scheduled by partner organization. The date of birth was not checked by the vaccinator, prior to vaccination, as it was not routine, and was only discovered while entering the patient's information into immunization registry. The clinic was notified by immunization registry and the clinical guidance provided was to proceed with the second dose of moderna to complete the series. The second dose of moderna LOT Number 039A21A was administered on 04/20/21, as scheduled, again at the same site. The patient was contacted and reported no reactions to the 1st dose, Moderna Lot 46A21A. The patient also confirmed that she did not experience any reactions to the 1st dose at the time of the 2nd dose on 04/20/21. The patient was accompanied by a parent during both vaccinations.

Other Meds:

Current Illness:

ID: 1247485
Sex: F
Age: 63
State: NY

Vax Date: 04/19/2021
Onset Date: 04/19/2021
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: Sulfa, (antibiotic ?).

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

Symptoms: She got the vaccine, and had a sore throat initially. She felt in her mouth that it was swollen the first night. Had a slight headache and a slight tiredness. On Tuesday, the next day she felt unwell, but nothing abnormal about that. That evening she had a fever, surprising to her as it was already the 2nd day. The next day from there Wednesday, was weak, a little dizzy. Then on Thursday she started feeling very very dizzy, she felt it coming on and about 10 minutes after she felt that she felt as is she was going to faint, very dizzy feeling. She said it out loud so that somebody could recognize she was having problems. She slumped into the chair with dizziness and not feeling well, a lot of weakness. Since yesterday the sore throat has continued, and has had a cough since the beginning also. She also had on Tuesday some diarrhea, but nothing too serious Since yesterday she is still dizzy, has a canker sore, lips feel a little more puffy, still has headache. She does not feel that she needs to go to the hospital, but still feeling unwell. She also did have the arm pain at the injection site, and felt that she was getting better as her reaction didn't seem so severe and went away quickly. She did not take anything for her symptoms. She also did have burning on urination. She also had chest discomfort/burniness.

Other Meds: 81 mg aspirin, Crestor, Zetia. Vitamin D, Vitamin C and Zinc, Vitamin B.

Current Illness: None.

ID: 1247486
Sex: M
Age: 25
State: KS

Vax Date: 04/23/2021
Onset Date: 04/23/2021
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: no

Symptom List: Injection site pain, Pain

Symptoms: Patient reports that 5 hours after injection he began to have some mild swelling on right side of face and lip- no treatment needed and symptoms resolved spontaneously

Other Meds: no

Current Illness: no

ID: 1247487
Sex: F
Age: 66
State: WA

Vax Date: 03/29/2021
Onset Date: 03/30/2021
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: antibiotics

Symptom List: Injection site pain, Menorrhagia

Symptoms: Rash on chest started within 18 hours of having the 2nd Pfizer shot on 3/29/21, continuing through today 4/23/21 Extreme eye swelling, Face swelling, Neck swelling worsening each day Saw emergency doctor via Zoom on 4/21/21, prescribed Prednisone Started Prednisone 4/21/21 in combination with Benedryl Symptoms improved slightly 4/22/21 Symptoms worsening 4/23/21

Other Meds: Only one OTC herbal medication: Remifemin (for menopause)

Current Illness: None

ID: 1247488
Sex: F
Age: 58
State: NJ

Vax Date: 04/06/2021
Onset Date: 04/08/2021
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: NO

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

Symptoms: HEADACHE & EXHAUSTION. EXHAUSTION HAS CONTINUED FOR 3 WEEKS

Other Meds: LEVOTHYROXIN, NEXIUM, SULINDAC, ROSUVASTATIN CALCIUM

Current Illness: NO

ID: 1247489
Sex: F
Age: 65
State: IA

Vax Date: 04/13/2021
Onset Date: 04/19/2021
Rec V Date: 04/23/2021
Hospital: Y

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: Oxycodone, Codeine, Adhesives

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Admitted with aeseptic meningoencephalitis without any other known cause. Had some low grade fever for 24 hours s/p 2nd vax. Found by husband aphasic/lethargic/unwell 6 days later, brought to ER. LP was mildly abnormal; had MRI which showed an incidental anterior cerebral artery aneurysm but nothing else of note. No high fevers. She did receive <24 hours of IV acyclovir but really improved rapidly, however still has significant altered mental status; HSV PCR neg, enterovirus PCR neg, cultures neg; Lyme serology neg. She does in home child care and a couple of children had HFMD/coxsackie virus.

Other Meds: Lipitor 10mg Daily, Tylenol PRN

Current Illness: None

ID: 1247490
Sex: F
Age: 43
State: WA

Vax Date: 04/01/2021
Onset Date: 04/15/2021
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: Amoxicillian, Penicillian, Augementin, Lyrica, Gabapentin, Sulfa, MRI contrast

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: On 4/15/2021 I saw on my leg blisters, went to my local urgent care and was diagnosed with Shingles at the age of 43 and 2 weeks to the date after my 2nd dose of Pfizer Covid 19. I was put on a anti viral famiciclovir and antibiotic doxycycline, as well as tramadol for pain. Over the past week since my diagnosis, the lesions are large and in a straight line down my leg and then turn to the right. I have a patch that covers a varicous vein that looks like it might be infected. I am on a immuno suppressant medication for my Multiple Sclerosis. I am still being treated and recovering from shingles to this date.

Other Meds: Gileyna Topomax Venoflexine

Current Illness: Multiple Sclerosis Fibromyalgia

ID: 1247491
Sex: M
Age: 30
State: VA

Vax Date: 04/11/2021
Onset Date: 04/11/2021
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: Sulfa

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

Symptoms: Client was leaving the parking lot post vaccination waiting period when he felt lightheaded. Wife indicates that client passed out twice in the car. Client reports feeling dizzy and hot and he looks pale and sweaty. His BP is 60/40. Client does not have any other medical history and is not taking any medications currently. He is allergic to sulfa. EMS on site evaluated client and was determined that 911 needed to be called. EMS responded and client was transported to the hospital.

Other Meds: None

Current Illness: None

ID: 1247492
Sex: M
Age: 30
State: TX

Vax Date: 04/23/2021
Onset Date: 04/23/2021
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: Systemic: Seizure-Severe, Additional Details: Pt with history of seizure passed out while sitting down hit head then started seizing. Pt was placed on side till seizing stopped and until ambulance got to store. Pt was dazed and out of it while ambulance took him away.

Other Meds:

Current Illness:

ID: 1247493
Sex: M
Age: 32
State: CA

Vax Date: 04/08/2021
Onset Date: 04/16/2021
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: none

Symptom List: Injection site pain

Symptoms: Covid-19 vaccine JJ: 32 y.o. male w/ no PMH presenting 2 weeks after receiving his Johnson & Johnson COVID vaccine after having severe L calf pain found to have thrombocytopenia. From H&P on 4/21, Patient reports that he had both fevers and aches after his vaccine (4/8/2021). Several days later developed low back pain radiating into his left leg which he initially attributed to sciatica. However, several days later, he went for a 6 mile hike, and felt that his left leg was hurting more. He went to PCP, where he received a blood test and was found to have a platelet count in the low 60s. This was initially thought to be a lab error, but he noticed that his left leg was swollen, somewhat red, and appeared that his blood vessels were swollen. This swelling resolves when he is lying down, and is worsened when he is standing. He received an US to r/o DVT, which was negative. However, after his repeat platelet count demonstrated thrombocytopenia, he was sent to the ED. He denies any recent leg trauma, though he has broken his leg before nearly 15 years ago. He denies weakness or issues going to the bathroom. Denies chest pain or shortness of breath. Denies chills, fevers, but did wake up last 2 nights drenched in sweat. He also reports a petechial rash on his legs. As of 4/22, medical team suspects Vaccine-induced thrombocytopenic purpura (VITT). VITT requires 1) thrombocytopenia, 2) documented clot, 3) positive PF4 Ab, and 4) recent AstraZeneca or J&J vaccine. He meets criteria 1, 3, and 4. He has clinical signs of DVT but does not have a documented clot. Patient has L calf tenderness and prominent pooling of blood and vein engorgement of the L leg when he stands up. Possible that he had a DVT or multiple that cleared and now he has post-thrombotic syndrome. This is consistent with the pooling of blood with gravity and relief of symptoms with elevation. As he has had 2 negative US for DVT, unlikely that he has an unresolved DVT. abdominal and head CT are neg for thrombosis.

Other Meds: none

Current Illness: none, otherwise healthy

ID: 1247494
Sex: F
Age: 56
State: TX

Vax Date: 03/30/2021
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: Penicillin

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

Symptoms: Chills, fever, coughing, throwing up, dry heaving, very sick. Lasted 3 weeks

Other Meds:

Current Illness:

ID: 1247495
Sex: F
Age: 20
State:

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Nausea, cold hands, vomited x 2. BPs 90/70 (pulse 68), 106/66 (pulse 92).

Other Meds:

Current Illness:

ID: 1247496
Sex: M
Age: 41
State: NE

Vax Date: 04/14/2021
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:

Symptom List: Tremor

Symptoms: RN witnessed Patient syncope - fell face down out of chair, landed on forehead/nose area, very brief tonic/clonic activity. Bloody nose, bleeding from cut on bridge of nose, abrasion above R eyebrow. Swelling on bridge of nose, appears that it may be broken. Patient conscious soon after syncopal episode and able to speak to RN and Medic. Patient notes history of syncopal episodes related to needles. Volunteer Medic applies pressure to cut and nose to stop bleeding. EMS called due to concern of patient hitting head during fall, possible broken nose. Patient hypotensive (90s/60s), blood sugar 76 - pt stated only black coffee to eat/drink today, slow to recover, dizzy, unable to sit up. EMS transferred to ED for assessment at ~1000.

Other Meds:

Current Illness:

ID: 1247497
Sex: U
Age:
State: MN

Vax Date:
Onset Date:
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: Erythema, Pruritus

Symptoms: Patient got pale, diaphoretic and pasted out for approx. 15 sec., after 5 min after getting the injection. Patient aroused. She reports that she had not eaten anything today. Given graham crackers and water for oral intake. Shortly after eating the crackers and drinking the water, patient vomited. She reports that she felt better after the emesis. Patient able left per ambulatory status, after 30 min of monitoring patient.

Other Meds:

Current Illness:

ID: 1247498
Sex: F
Age: 31
State: MN

Vax Date: 01/27/2021
Onset Date: 03/25/2021
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:

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

Symptoms: Received Pfizer vaccines on 1/6/21 and 1/27/21. Tested positive for COVID by PCR on 3/25/21. Symptoms of H/A, rhinorrhea/congestion beginning 3/23/21.

Other Meds:

Current Illness:

ID: 1247499
Sex: M
Age: 52
State: CA

Vax Date: 04/16/2021
Onset Date: 04/18/2021
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: NKDA

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

Symptoms: SIRVA. Patient developed severe left shoulder/arm pain and weakness 48 hours after receiving Pfizer vaccine.

Other Meds: metoprolol ER 100mg

Current Illness: N/A

ID: 1247500
Sex: M
Age: 35
State:

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

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient had ED visit / hospitalization within 6 weeks of receiving COVID vaccine

Other Meds:

Current Illness:

ID: 1247501
Sex: F
Age: 51
State: CT

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: Site: Pain at Injection Site-Medium, Systemic: Joint Pain-Mild, Additional Details: Sore arm and radiating pain that extends down the arm from where the shot was administered, and extends to the shoulder blade in the patient's back.

Other Meds:

Current Illness:

ID: 1247502
Sex: F
Age: 28
State: CA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
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:

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

Symptoms: 13:10 After 2nd covid vaccine, pt reported feeling "very dizzy and weak" and that her legs from thighs to calves felt numb bilaterally. Reported SOB intermittently. Lungs clear to auscultation. VSS BP 140/72, HR 116, R 20, O2 sat. 76-87%. 13:20 25 mg IM benadryl to right deltoid. Pulse ox replaced to r. finger = 90-94%. This RN consulted with RN director of vaccine clinic, RN who recommends pt follow up at urgent care. 13:40: Pulse ox continues 90-94%. Pt reports legs continue to feel numb. Pt advised to f/u at urgent care. Pt agrees with plan and will be driven there by her sister. 1344: Urgent care called and notified of pt imminent arrival and report given to RN. Care relinquished.

Other Meds:

Current Illness:

ID: 1247503
Sex: F
Age: 20
State:

Vax Date: 04/23/2021
Onset Date: 04/24/2021
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: Pain in extremity

Symptoms: Fever. Low back pain. Headaches.

Other Meds:

Current Illness:

ID: 1247504
Sex: M
Age: 24
State: MD

Vax Date: 04/23/2021
Onset Date: 04/23/2021
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:

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

Symptoms: Lightheaded. Nausea Seen by on site EMT BP=116/57 P= 50 02=100

Other Meds:

Current Illness:

ID: 1247505
Sex: M
Age: 70
State: NC

Vax Date: 04/07/2021
Onset Date: 04/08/2021
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: lisinopril, cocunut

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

Symptoms: DVT within 24 hours of vaccine

Other Meds: tylenol, coreg, b12, garlic, levothyroxine, lovastatin, miralax, potassium, cialis, tamsulosin,

Current Illness: no

ID: 1247506
Sex: M
Age: 55
State: OK

Vax Date: 03/31/2021
Onset Date: 03/31/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: fever, fatigue, difficulty breathing, cough, nausea,

Other Meds: none

Current Illness: none

ID: 1247507
Sex: F
Age: 58
State: VA

Vax Date: 03/29/2021
Onset Date: 03/29/2021
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: Erythromycin sensitivity, adhesive allergy. Food intolerances - grains, dairy, nightshades.

Symptom List: Vomiting

Symptoms: Patient had extreme pain, fatigue, chills, fever. Patient developed lump in arm pit, approx 1 cm that is still there currently. Patient could not get out of bed for over 24hrs post 2nd dose. Reporting kidney pain and full body pain.

Other Meds: Amorthyroid, metoprolol. Milk thistle.

Current Illness: No

ID: 1247508
Sex: F
Age: 44
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Sunflower seeds (not oil), epinephrine (strong reaction, shaking and fear)

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Tired the same evening, went to bed early. Next morning woke up tired but motivated taking shower and getting ready to work but by 8am was noticing decreased energy and buttocks and backs of legs aching in addition to sore vaccination site. It quickly proceeded to get worse with severe headache, neck pain, arms and legs aching. Throughout the day temperature went up and down and varied from 96 to 102. The highest temperature was the day after vaccination around 6pm about 24-27 hours after. Two days after in the morning, still fatigued and temperature at 97-100 .

Other Meds: Zyrtec, turmeric, Odactra, vitamins c and d3

Current Illness: Back and head aches mild arthritis, dental surgery 1 1/2 weeks prior

ID: 1247509
Sex: F
Age: 53
State: CA

Vax Date: 04/21/2021
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: RA

Lab Data:

Allergies: gluten, wheat, down feathers, bananas, strawberries

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

Symptoms: April 22, I started out the day with fatigue I noticed around 9am (the day after my 2nd shot). That quickly progressed into chills. Then throughout the day progressed into constant extreme chills, body aches, swimmy head, dizziness, extreme weakness, headache and fever (100 degrees). Slight nausea toward the evening. I didn't take any medication for the symptoms. Went to sleep around 8:30pm and woke up around 7am April 23) feeling much better. Still slightly weak and tired but no other symptoms.

Other Meds: D-3, B-12, multivitamin, zinc, Liver Refresh(tm), vegan Omega-3 supplement, Bilberry (for eyes)

Current Illness: None

ID: 1247510
Sex: F
Age: 90
State: FL

Vax Date: 04/16/2021
Onset Date: 04/16/2021
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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Fever, nausea, and fatigue

Other Meds: Vitamins Carvedilol

Current Illness:

ID: 1247512
Sex: F
Age: 46
State: FL

Vax Date: 03/22/2021
Onset Date: 03/24/2021
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: none

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

Symptoms: Received the shot just before 11am. 14 hours later, at 1am, I woke up with horrific projectile vomiting, the kind that splashes back out of the toilet onto myself and the bathroom. This lasted for approximately 4 hours all while shivering/shaking/freezing and had a fever. I would throw up, shiver for about 10 minutes and then do it all over again non-stop for 4 hours. Finally fell asleep and woke up with a fever over 101 that lasted all day with body aches.

Other Meds: none

Current Illness: none

ID: 1247514
Sex: M
Age: 35
State: MA

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Weakness-Medium, Additional Details: FOLLOWED UP WITH PATIENT 12 HOURS POST EVENT- REPORTS FEELING NORMAL,WITHOUT ANY/NEW SYMPTOMS

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm