VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1348055
Sex: M
Age: 83
State: GA

Vax Date: 05/16/2021
Onset Date: 05/16/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient's wife states patient having problem with his knees

Other Meds:

Current Illness:

ID: 1348056
Sex: F
Age: 19
State:

Vax Date: 04/16/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
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: Mold, pollen

Symptom List: Anxiety, Dyspnoea

Symptoms: I have not had a period in 2 months (April and May). Last period was on 3/10

Other Meds: No

Current Illness: No

ID: 1348057
Sex: F
Age: 68
State: WA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
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: Blood glucose:105

Allergies: Unknown

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

Symptoms: Pt reported feeling new onset dizziness 10 minutes following administration of second dose of the Pfizer vaccine. Clinical staff requested assistance from on site EMS. VS taken and were reported WNL. Pt condition improved with administration of H2O, candy and rest. Patient able to leave independently following period of observation.

Other Meds: Unknown

Current Illness: Unknown

ID: 1348058
Sex: M
Age: 62
State: MI

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data:

Allergies: macrolides and NSAIDS

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient came into the pharmacy today debating on getting the 2nd dose in the series. He was due 4/13/21 He tells me he has limited range of motion and some remaining pain in his arm where the vaccine was administered . He has not seen his physician at this point. I strongly encouraged him to do so and told him I would file this report

Other Meds: atenolol 50mg once daily, atorvastatin 10mg once daily, benazapril 20mg once daily

Current Illness:

ID: 1348059
Sex: F
Age: 53
State: VA

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: I had an evaluation of my arm by the Nurse Practitioner on 5/25/2021

Allergies: No medications that I know of. Severe allergies to all types of sea food; sensitive to mushrooms, pineapples , and dairy products

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

Symptoms: Immediately after the injection, I noticed it was administered very high - near my shoulder - which worried me. The dose was given around 2:30pm on 4/28 and around 2:00am, I had an unusual headache and a sore arm. Shortly after 5am on 4/29, I had the worst migraine I have ever had in my life. Migraine, nauseas, slightly dizzy and a dull, limp arm. The pain of the migraine was about a 9. I had taken an Ibuprofen and tried to sleep the remainder of the day away. By 6am on 4/30, the migraine was at a 6. I got up to walk around a bit, eat and drink about 2 16oz bottles of water. I felt dehydrated so I drank approximately 10 bottles that day and ate salads and fruit only. I still felt nauseas. By 5/1, I just had a lingering, dull headache but no appetite. I was back to 'normal' by 5/3. The injection was administered to my left arm, fairly high, and that did not bother me until late day on 4/29. My arm felt very heavy and dead. I used my right hand to lift my left arm. It was difficult to get my shirts on and off. There was a constant pain but not intense; dull. Over time, I massaged my arm, used a massage gun, used Salon Paas pads and cream, used ice and heat packs. My arm is about 50% better but it is still giving my problems. Sporadic, dull pain and I am not able to move it all of the way around or back. I have a time sleeping on it at night so I don't.

Other Meds: Chlorthalidone 25mg, Rosuvastatin Calcium 10mg

Current Illness: Severe seasonal allergies, mild asthma attack

Date Died: 05/15/2021

ID: 1348060
Sex: M
Age: 57
State: WA

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/25/2021
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: No

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

Symptoms: My father in law suffered a heart attacked on the day he received his second shot. at the time of this he was staying in our house where he wasn't found until two days later when we received a call from his work saying he never showed up or called in to work. The medical examiner told us that prior to the second vaccine in the last few weeks he had suffered some sort of heart issue that damaged his heart, but wasn't big enough for him to notice or think anything of it. The timeline the medical examiner gave us would have been after receiving the first vaccine. He then received his second Vaccine on a Thursday which was the last time anyone heard from him and he didn't show up to work Friday and was found Saturday after we were notified he didn't show up to work and we called 911. The medical examiner said he suffered a heart attack. The medical examiner said they had to write the death date on Saturday because that was when he was found, but the last anyone heard of him was prior to getting the vaccine and then he missed work the very next day(which was Friday).

Other Meds: No

Current Illness: No, but the medical examiner said sometime after the first Vaccine on 4/13/2021 he had a minor heart attack or some sort of heart issue that wasn't big enough for him to realize to go to doctors. On second Vaccine is when he had Heart attack.

ID: 1348061
Sex: F
Age: 26
State: WA

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient has been contacted, no existing reactions were mentioned from patient herself. She was informed that the vaccine that was administered was past it's expiration date, 4-27-2021. Gardisil was given 15 days past the expiration date.

Other Meds:

Current Illness:

ID: 1348062
Sex: M
Age: 60
State: AZ

Vax Date: 03/30/2021
Onset Date: 04/19/2021
Rec V Date: 05/25/2021
Hospital: Y

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

Lab Data: While hospital the did a battery of blood tests to determine clotting, along with an EKG and ECHO. The EKG as was the ECHO. The doctors consulted and determined i wasn't a candidate for thrombectomy. I was put on a Heprin drip. After consulting with the physicians they determined there wasn't much more they could do. They gave me a prescription of Eloquis an sent me home. I was in the hospital for only one night.

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: On or around April 15th I developed a pain in my left calf. As a senior citizen and avid golfer I chalked this up to age and activity. But the problem didn't go away and on some days would be more painful than others. Additionally, the point where my calf hurt seem to move around and sometimes be higher on my calf behind my knee. Some days the pain was gone altogether only to return the later that same day or the next. At the beginning of May I started to develop a cough. I had no fever or other symptoms so I thought it might be seasonal allergies. The cough continued to get worse so I made an appointment with my doctor on 5/26/21 and was seen that day. I was given a COVID test even though I had taken the vaccine and scheduled for an ultrasound on Friday 5/28/21. During the ultrasound they discovered a DVT in my left calf that extended from my ankle to behind my knee. Since I was also coughing they scheduled me for a CT scan that same day. The CT scan showed multiple PE's in both lungs. They sent me to the hospital.

Other Meds: Duloxotine, mult-vitamin, vitamin d.

Current Illness: None

ID: 1348063
Sex: M
Age: 20
State: GA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: PT CAME TO PHARMACY ON EMPTY STOMACH FOR GETTING VACCINE. HE WAS NERVOUS TO GET VACCINE. WHILE HE FEEL COMFORTABLE HE RECEIVED THE VACCINE. BUT AFTER 5 MINUTES FELL DOWN FROM CHAIR HE WAS SEATING AND FAINTED FOR 30 SECONDS. ONCE HE CAME BACK, WE EXPLAINE HIM WHAT HAPPENED AND HE SAID WAS GETTING NERVOUS FROM THE SORROUNDING ENVIREMENT SINCE HE DID NOT RECEIVED ANY VACCINE SINCE SO MANY YEAR. HE FEEL NORMAL AND DID NOT WANTED US TO CALL FOR 911 HELP. FAMILY MEMBER/ FRIND CAME TO PICK HIM UP. HE APPRECIATED THE HELP WHILE HE FAINTED.

Allergies: NKDA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: None stated.

Other Meds: Pt does not take any medications

Current Illness: No history of illnesses

ID: 1348065
Sex: F
Age: 36
State: OH

Vax Date: 05/14/2021
Onset Date: 05/22/2021
Rec V Date: 05/25/2021
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: Bactrim

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Arm still warm to touch, itching and red. Was 15 weeks pregnant.

Other Meds: Cimzia 200mg/ml injection Prenatal vitamins

Current Illness: None

ID: 1348066
Sex: M
Age: 51
State: MI

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
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 received Pfizer as their 2nd dose and they were supposed to get Moderna

Other Meds:

Current Illness:

ID: 1348067
Sex: F
Age: 50
State: NY

Vax Date: 05/02/2021
Onset Date: 05/05/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: None

Allergies: Celiac - allergy to gluten Histamine - MCAS

Symptom List: Rash, Urticaria

Symptoms: A MCAS flare that was manageable for the first 5 days and then unbareable for the next 10 days. Ear ache. Low grade fever. Exhaustion. Nasal drip. Sore throat. Respiratory steaming. Elevated heart rate. Diaphragm pain. Brain fog.

Other Meds: Life Essence Multivitamins Omega 3 Phospholipids Antihistamine Sacchromyces Bouladii Zeobent binder Interfase biofilm disruptor Chlorella

Current Illness: Mycotoxins MCAS

ID: 1348068
Sex: M
Age: 29
State:

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/25/2021
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: Pain in arm, headache, temporary backpain

Other Meds: None

Current Illness: Stomach pain

ID: 1348069
Sex: M
Age: 68
State: PA

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 05/25/2021
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: lab, stress test

Allergies:

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

Symptoms: burning at injection sit, 12 hours later 3am total body aches, trouble walking, breathing, chest pains, tingling in hands and feet

Other Meds: hydrochlorothiazide, Lipitor

Current Illness:

ID: 1348070
Sex: M
Age: 17
State: CA

Vax Date: 05/07/2021
Onset Date: 05/13/2021
Rec V Date: 05/25/2021
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: On admission 5/20/21 patient was febrile to 39 C, hypotensive and tachycardia with systolic blood pressures 90-100 and heart rates in the 120-130s. Labs included thrombocytopenia, bandemia, hyperbilirubinemia and transaminases, elevated lipase, elevated ESR, CRP, D-dimer, LDH, ferritin, and prolonged PT. COVID IgG antibodies were positive as expected given vaccination. The family had no known Covid exposure otherwise. Repeat echocardiogram (5/24/21) showed small fusiform aneurysm in the right coronary artery (Z score 3.0) that was not present on initial echo on admission. Additionally, abdominal ultrasound (5/23/21) showed hepatosplenomegaly and hepatic steatosis, echogenic pancreatic head, and small volume pelvic ascites. On admission 5/20/21: Platelets 106 Bands 60.5% Tbili 1.88 AST 235 ALT 306 Lipase 634 ESR 24 CRP 6.2 D-dimer 13,734 LDH 2,590 Ferritin 1,320 PT 14.3

Allergies: None

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

Symptoms: Patient received his first dose of the Pfizer vaccine on 5/7/21. On 5/13/21 he began to feel feverish (unsure Tmax, never took temperature) and was intermittently febrile until hospital admission on 5/20/21. On 5/18/21 he was seen in the ED for fever and tested positive for strep throat and started on amoxicillin. His inflammatory labs were elevated at this time and did not notice improvement on amoxicillin. He returned to the ED on 5/20/21 at which time patient reported headaches on the right side, sharp 7/10 pain which come and go with the fevers as well as fatigue, muscle/body aches, and sweats in addition to persistent fever. He also noticed maculopapular rash on palms and soles and on distal extremities which was not pruritic or painful on day of hospital admission. All infectious workup was negative and patient did not improve on broad spectrum antibiotics. Given his persistent fever, hypotension, and inflammatory labs without other cause, patient was empirically treated for MIS-C and was given IVIG and methylprednisolone as well as being started on prophylactic dose enoxaparin for his elevated D-dimer. Repeat echocardiogram identified a new coronary aneurysm, supporting the diagnosis of MIS-C. Following IVIG and steroids patient remained afebrile and inflammatory markers down trended, however liver enzymes remained elevated at time of discharge. He improved and was discharged to finish steroid course at home with close follow up.

Other Meds: None

Current Illness: None

ID: 1348071
Sex: F
Age: 13
State: OH

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Almost 15 min after pt received her first dose of Pfizer vaccine, she felt light-headed. Mom who was at side held pt up and called for provider. Provider came over and pt said she had blurred vision and muffled hearing, pupils were dilated. A few seconds later, pt felt better and was able to drink water. Had pt and mother stay a few extra minutes past 15 min for observation time and patient able to slowly stand up and walk out clinic with mom. She did report not drinking water since this morning.

Other Meds:

Current Illness:

ID: 1348072
Sex: F
Age: 38
State: TX

Vax Date: 04/03/2021
Onset Date: 04/04/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: 5/20/2021 Lab test

Allergies: None

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

Symptoms: Lymph Nodes swelling, fever, body aches, nausea, UTI, heavy menstruation, missing skipped menstrual cycle in month of May.

Other Meds: None

Current Illness: None

ID: 1348073
Sex: F
Age: 0
State: WA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
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: No Adverse reaction. Administered Modena to 17 years old by mistake.

Other Meds:

Current Illness:

ID: 1348074
Sex: F
Age: 68
State: FL

Vax Date: 05/16/2021
Onset Date: 05/16/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data:

Allergies: Pt reported that she wanted to try the J&J vaccine because it contained Polysorbate instead of PEG

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pt reported bloating that kept her up the night of the vaccination. The bloating had not resolved 9 days post vaccination. She has experienced this type of bloating in the past but not to this extent. She is seeking further information from the hospital to determine if they believe the polysorbate from the vaccination is the cause or an alternate cause.

Other Meds:

Current Illness:

ID: 1348075
Sex: F
Age: 27
State: MO

Vax Date: 03/08/2021
Onset Date: 04/16/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: Tests were done for strep and mono; both were negative.

Allergies: None

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

Symptoms: I first noticed a sore throat on 4/16 that I attributed to the start of allergy symptoms. On Saturday, I began to get a headache and felt very lethargic. On Sunday, I was extremely lethargic and unable to leave my bed. I had no appetite, a headache, a sore throat, and a dry cough. My fever reached 101 degrees F. Monday morning I went to urgent care; I no longer had a fever but was still tired with a sore throat. As the week went on, my symptoms dissipated

Other Meds: Metformin, topiramate, duloxetine, bupropion, hormonal birth control, famotidine, vitamin d, vitamin b12

Current Illness: Common cold prior to vaccination

ID: 1348076
Sex: F
Age: 68
State: CA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 05/25/2021
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: Sulfates

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

Symptoms: Fatigue - chills-sweating - joint pain Severe for 3 days. Back to normal day 7

Other Meds: Creator - xeljanz- levothyroxine- Leflunomide Vit. D and multivitamin

Current Illness:

ID: 1348077
Sex: M
Age: 26
State: WA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: NONE.

Allergies: CONTRAST IODINE

Symptom List: Unevaluable event

Symptoms: 2:01P PT RECEIVED VACCINE. 2:02P PT MOVED TO LOBBY AND SAT AT BP MACHINE. STATED HE FELT DIZZY AND LOST CONSCIOUSNESS AND FELL TO THE FLOOR. REGAINED CONSCIOUSNESS BY 2:04P ASKING WHAT HAPPENED, STATED HIS WRIST HURTS. ACKNOWLEDGED HE ALWAYS FAINTS WITH VACCINES/NEEDLES. BY 2:08PM PT REPORTED FEELING BACK TO BASELINE BESIDES HIS WRIST. EMS ARRIVED BY 2:18PM. WHEN GETTING HIM TO SIT UP HE FELT DIZZY AGAIN AND LIED BACK DOWN. WAS ABLE TO SIT THEN STAND BY 2:25PM. DUE TO THE DIZZINESS AND FAINT FEELING LASTING GREATER THAN 10 MINS, EMS RECOMMENDED AMBULENCE TRANSPORT TO HOSPITAL. PATIENT REFUSED STATING HE FELT EXACTLY AS HE HAD IN THE PAST WHEN HE HAD FAINTED PREVIOUSLY FROM VACCINES. NO REDNESS/ITCHING/SWELLING/PAIN AT SITE OF INJECTION. DECLINED TRANSPORTATION TO HOSPITAL. ONLY COMPLAINT WAS WRIST PAIN WHICH WAS A RESULT OF FALLING.

Other Meds: ALLERGY MEDICATION (ZYRTEC MAYBE)

Current Illness: NONE REPORTED

ID: 1348078
Sex: M
Age: 25
State: OR

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 05/25/2021
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: N/A

Allergies: N/A

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

Symptoms: Shot was inserted into right arm just slightly below the shoulder and I still have long lasting pain in my arm that comes and goes.

Other Meds: N/A

Current Illness: N/A

ID: 1348079
Sex: F
Age: 65
State: CT

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: patient had fainted about 5 mins after the vaccine but then she woke up in about 2 mins . Her husband had laid her flat on the ground. She seem to feel better as she was laying on the ground. at that time the ambulance was en route . i had checked on her pulse/bp . the ambulance had arrived but she refuse to go to the hospital . she had felt better . she did walk out of the pharmacy on her own.

Other Meds: n/a

Current Illness: none

ID: 1348080
Sex: M
Age: 25
State: NY

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: N/A

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Administered about 3:30pm and sent to observation area. At roughly 4:40pm client started getting dizzy and closing eyes, color gone from skin with lips getting grayish-purple. At 4:45pm client was going in getting "clamy" skin, sweating some. I had him recline in a chair and administered 1 dose (0.3mg) epinephrine using an auto-injector pen and called for emergency services. At 4:50pm blood pressure was 125/80. Client still coherent. Had mentioned that he had not eaten that day so gave him some saltine crackers and juice. Color started to return and emergency services arrived to take over.

Other Meds: None

Current Illness: None

ID: 1348081
Sex: M
Age: 37
State: CA

Vax Date: 05/14/2021
Onset Date: 05/20/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: on 5/20/21, I felt itchy on my back and started seeing rash near mid, left side of my back. The rash area grew larger over the time and I started feeling the pain the following day. I went to the urgent care on Monday morning and the doctor confirmed that I got shingles. I started antiviral (Valacyclovir) medicine now.

Other Meds: N/A

Current Illness: N/A

ID: 1348082
Sex: F
Age: 75
State: VA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/25/2021
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: None

Allergies: Morphin Unysen Pineapple

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA

Other Meds: Carvedilol Hydrochlorothiazide Losartan Potassium Simvastatin Levothyroxine Omeprazole Miralax Centrum Silver Vitamin D

Current Illness: None

ID: 1348083
Sex: F
Age: 47
State: IN

Vax Date: 05/22/2021
Onset Date: 05/23/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: Didn't go to dr just took extra strength Tylenol and my oxycodone pain killers

Allergies: Penicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Injection site very swollen, very bad headaches for 2 days couldn't get out of bed very bad

Other Meds: Effexor,eliquist,Effector,calcium,iron ,mutivitamin,b1,vitaminD,prazosin, latuda and valacyclovir

Current Illness: Anemia,blood clot had total hip replacement

ID: 1348085
Sex: F
Age: 36
State: MI

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
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: patient received a 2nd COVID vaccine and it was supposed to be moderna but the patient received Pfizer

Other Meds:

Current Illness:

ID: 1348086
Sex: M
Age: 49
State: NV

Vax Date: 05/24/2021
Onset Date: 05/01/2021
Rec V Date: 05/25/2021
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: 1st dose 03/16/21, 2nd dose 05/24/21

Other Meds: reporting covid-19 vaccine pfizer 1st dose 03/6/2021. 2nd dose on 05/24/21. (more than 42 days )

Current Illness:

ID: 1348087
Sex: F
Age: 73
State: OR

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data:

Allergies: NSAIDS, Penicillins, Dipyrimidole, Imidazole anitfungals

Symptom List: Injection site pain

Symptoms: After about 20 minutes of observation she started to dry heave/spit up white bubbles. She said her mouth felt "spicy" and her eyes felt "weird" Checked blood pressure it was over 180/90 on the first read, 153/109 on the second and 176/98 on the third. Pulse was normal, strong and steady. No classic symptoms of allergy. Called 911 to be taken in, no treatment given in facility.

Other Meds: Unknown

Current Illness: Unknown

ID: 1348088
Sex: F
Age: 54
State: CA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: none

Allergies: stated allergic to the flu vaccine

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

Symptoms: While sitting in observation post vax, at 4:15 PM, pt states that she felt anxious and took her own personal dose of ativan 1 mg. Pt had visual shakes and slight diaphoreses. Assessing RN gave 1 bottle of water. HR 119, 02 sat on RA 99 %. Pt remained anxious, husband at side. After a period of 15 min, pt requested RN to call 911. Charge Nurse notifiedn911 w/ current BP of 190/100 at 4:28 PM. Pt remained alert until arrival of EMS for transport to Medical Center. Husband remained w/ client for transport. Gave care to EMS at 4:45.

Other Meds: ATIVAN 1mg taken at 4:15 pm

Current Illness: none

ID: 1348089
Sex: F
Age: 69
State: CA

Vax Date: 05/23/2021
Onset Date: 05/23/2021
Rec V Date: 05/25/2021
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: wheat

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

Symptoms: After both shots, experienced body aches, chills, mild fever, intense tiredness, "covid arm" - red, feverish, slightly swollen about 4 inches in diameter around injection site. After first shot also experienced nausea and intense headache.

Other Meds: pravastatin tamoxifin levothyroxin metopotol magnesium D baby aspirin condriton

Current Illness:

ID: 1348090
Sex: M
Age:
State: WA

Vax Date: 04/13/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
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: No adverse events, 17 years old received Moderna vaccine by mistake

Other Meds:

Current Illness:

ID: 1348091
Sex: F
Age: 49
State: GA

Vax Date: 04/08/2021
Onset Date: 04/11/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: 3 days receiving the 1st shot, I began experiencing dizziness. For the next few days, it progressively got worse and eventually led to me not being able to drive. After over 7 weeks, although it's gotten the better, the dizziness still persists as spasm like episodes throughout the day.

Other Meds: None

Current Illness: None

ID: 1348092
Sex: F
Age: 65
State: WV

Vax Date: 05/14/2021
Onset Date: 05/20/2021
Rec V Date: 05/25/2021
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: None at this time

Allergies: Sulfa / PenVk

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

Symptoms: Starting approx 5 days ago pt states that she has a constant ammonia smell that nobody else can smell. Does not smell if holds nose or breaths through mouth.

Other Meds: Omeprazole

Current Illness: None

ID: 1348093
Sex: F
Age: 32
State: KY

Vax Date: 12/29/2020
Onset Date: 04/14/2021
Rec V Date: 05/25/2021
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: Vaccine series in Dec/Jan. LMP Feb 11. Breast lump noticed March 2. Positive pregnancy test March 14. Bleeding April 10, miscarriage April 14. D/C April 16

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1348094
Sex: M
Age: 19
State: OH

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pt was sitting in chair after vaccination and passed out

Other Meds: Unknown

Current Illness: Pt states being stressed

ID: 1348095
Sex: F
Age: 46
State:

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: no

Allergies: none

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

Symptoms: Patient received Moderna for first dose. Today Pizer was given for second dose (error). Patient had no adverse or allergic reaction. Patient was in observation for an hour from 1230 to 130pm. Monitoring vitals and SP02%. Patient decline any symptoms and stated she felt fine at the time of discharge at 130pm.

Other Meds: none

Current Illness: none

ID: 1348096
Sex: M
Age: 39
State: CA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/25/2021
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: none

Allergies: NKDA

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

Symptoms: The patient is a 30 year old male who presented to the vaccine clinic. for the COVID vaccine. The patient was scheduled to receive his first Moderna dose. At registration, the patient did not have his COVID vaccine card. The vaccine survey from 05/06/2021 was missed by the person registering the client, so he received a second Moderna vaccine within 12 days of the first dose he received on 05/06/2021. The patient had neither allergic or adverse reactions from the first or second doses given within the 12 day timeframe. Follow up completed at the facility on 05/24/2021. The patient was no longer at the facillity but the nurse reports the patient reported fatigue but had no adverse events when he left the facility on 05/21/2021.

Other Meds: patient denied medication use

Current Illness: patient denied other illnesses

ID: 1348097
Sex: M
Age: 0
State: CO

Vax Date: 04/27/2005
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
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: Patient stated his age is (21 y) for first dose. When he came back for 2nd dose due to insurance we found his birth date to be only (16y and one month). After consulting with CDC guide line and ok from his legal guardian he will get 2nd dose soon.

Other Meds:

Current Illness:

ID: 1348098
Sex: M
Age: 62
State: NV

Vax Date: 02/06/2021
Onset Date: 05/11/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: Ultra sound 5-25-21

Allergies: Sulpha

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

Symptoms: Extensive multiple DVT's

Other Meds: None

Current Illness: None

ID: 1348099
Sex: M
Age: 23
State: NY

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data:

Allergies: No allergies reported on consent form

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

Symptoms: Adverse event included loss of color in face (patient turned pale) including lips, eye rolled upward staring at ceiling, patient slouching on bench until flat on back on bench (head in mother's arms); patient remained like this for at least a couple minutes while mother was yelling for help; patient eventually regained focus and comforted mother in return; patient reported could not see well and experienced dizziness and still had complete loss of color in face; epinephrine pen was not used on patient--only cold wet compress (paper towel) and some air from fan; 911 was called during the incident and paramedics took 10-15 minutes to arrive on scene; mother hysterically crying while pharmacist and manager remained with patient until paramedics brought patient on stretcher to a local hospital

Other Meds: Unknown

Current Illness: unknown

ID: 1348100
Sex: M
Age: 31
State: NY

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 05/25/2021
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: Gluten intolerance Mild allergy to corn and soy

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

Symptoms: Starting approximately 12 hours after injection and lasting 12 hours: Headache Stuffy nose Aching muscles and joints (especially strong in old injuries from over year ago: broken leg and sprained wrist) Cold chills Fever and sweats Nausea Feeling faint Insomnia Fatigue (lasting from April 11th to present May 25)

Other Meds: Vitamin D, 5000 IU Fish oil, 2g Desiccated Beef organs, 3g N-acetyl L-Tyrosine 300mg twice daily

Current Illness: No

ID: 1348101
Sex: M
Age: 12
State: NM

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data: CMP, CBC, and TSH

Allergies: None

Symptom List: Vomiting

Symptoms: Approximately five minutes post vaccine administration patient complained of chest tightness/pain. Patient verbalized that he pain was a 2/10. Patient's vital signs were within normal ranges. Patient denied shortness of breathe or swelling of the tounge/throat. Doctor evaluated patient and took patient to urgent care for further observation. Patient was discharged from urgent care with instructions to report to ER if symptoms come back or worsen.

Other Meds: Albuterol inhaler

Current Illness: None

ID: 1348102
Sex: F
Age: 17
State: WA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 05/25/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: No adverse event, gave Moderna to 17 years old my mistake.

Other Meds:

Current Illness:

ID: 1348276
Sex: F
Age: 19
State: IL

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Client 2-5 minutes after vaccine fell out of her chair and hit her head on the ground. Client attended to immediately, when she was rolled over she was unconscious. Epi 0.3 mg im given, feet elevated as she laid on the ground. Client awoke. 911 called and client sent to ED.

Other Meds:

Current Illness:

ID: 1348277
Sex: F
Age: 49
State: NJ

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/25/2021
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: None

Allergies: Unknown

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Extreme body temperature fluctuating; severe dizziness; passed out for 5 seconds (as a result fell to the floor and caused severe bruising - possible concussion sustained)

Other Meds: None

Current Illness: None

ID: 1348278
Sex: M
Age: 57
State: FL

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/25/2021
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: patient felt Tingley at 15 minutes wait 10 more minutes the stated he felt fine

Other Meds:

Current Illness:

ID: 1348279
Sex: M
Age: 17
State: WA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 05/25/2021
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: No adverse event, gave 17 yeas old Moderna vaccine by mistake.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am