VAERS 2021 Database www.vaers.hhs.gov

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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: 1337265
Sex: F
Age: 13
State: NC

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
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: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Additional Details: Pt had dentist appointment the morning of vaccine. After pt got vaccine and was seated in observation area pt got dizzy and passed out and hit head. BP was taken and was 84/54. 911 was called and pt went to ER due to continuous low blood pressure.

Other Meds:

Current Illness:

ID: 1337266
Sex: M
Age: 33
State: MI

Vax Date: 04/26/2021
Onset Date: 05/09/2021
Rec V Date: 05/21/2021
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: 13 Days after second dose of Pfizer covid vaccine developed severe tinnitus in right ear. Continuous ringing of varying intensity from mild to severe. Prescribed 5 day course of azithromycin and prednisone. No change.

Other Meds:

Current Illness:

ID: 1337267
Sex: F
Age: 73
State: WI

Vax Date: 03/03/2021
Onset Date: 03/08/2021
Rec V Date: 05/21/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient presented to the ED and was subsequently hospitalized on 3/8/21. She presented to the ED on 3/13/21. Patient presented to the ED and was subsequently hospitalized on 4/6/21.

Other Meds:

Current Illness:

ID: 1337268
Sex: F
Age: 44
State: IL

Vax Date: 04/17/2021
Onset Date: 05/13/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: On May 13, 2021, approximately 4 weeks after second dose of the vaccine, I developed a very severe stabbing ice pick headache on the left side of my head behind my eye. By May 17, 2021, the pain was so severe that I went to the emergency room but did not receive a clear diagnosis. On May 18, 2021, I began to notice a prickly sensation on my forehead and rash forming. Urgent care confirmed diagnosis of shingles on evening of May 18, I was prescribed Valtrex, Gabapentin, and an oral steroid. As of today (May 21), the shingles rash is blistering on my left forehead, eyelid, and scalp and is mildly painful, and I have a few swollen lymph nodes, but the shooting nerve headache comes back intermittently and is still very uncomfortable. I feel that this should be reported because if people could be more susceptible to shingles after the vaccine, there should be public information about this. My case was very scary with the terrible shooting nerve pain in my head and I have learned that it is very important to get treatment for shingles started as early as possible to prevent long term effects, so I think this is something people should be made aware of.

Other Meds: Escitaloprolam 20 MG

Current Illness: None

ID: 1337269
Sex: M
Age: 15
State: MA

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/21/2021
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: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1337270
Sex: M
Age: 40
State: OH

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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 known allergies

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

Symptoms: Patient received their first dose of the covid vaccine at another site and received the moderna vaccine. Patient scheduled an appointment at a first dose clinic at Hospital. A trainee vaccinator was in the room administering the dose and the individual documenting and asking the screening questions missed the answer to the vaccine question. Medical Lead, Dr. examined and disclosed the error to the patient. We observed the patient for 30 minutes with no adverse events.

Other Meds: unknown

Current Illness: unknown

ID: 1337271
Sex: F
Age: 34
State:

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 05/21/2021
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: Pfizer-BioNTech COVID-19 Vaccine EUA - tech hit a blood vessel when administering the first vaccine. This resulted in a large bruise. The bruise eventually went away, but it left a skin discoloration in the size/shape of the bruise. I haven't experienced this before with bruises and thought it may have been caused by a combination of the vaccine + hitting a blood vessel.

Other Meds: Levothyroxine Sertraline Spironolactone Bupropion Vitamin D Omega 3

Current Illness:

ID: 1337272
Sex: M
Age: 60
State: PA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Systemic: Chills-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Seizure-Severe, Systemic: Shakiness-Severe, Additional Details: At this point in time, patient was taken by paramedics and they took him to the local hospital. Additional symptoms,issues, or outcome unknown.

Other Meds:

Current Illness:

ID: 1337273
Sex: F
Age: 25
State: MN

Vax Date: 05/19/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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, Grasses, Trees

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: injection site became red, swollen, itchy, painful and hard lump under the skin within 24 hours of injection. Appears that injection was not given in the muscle but below.

Other Meds: Norethindrone

Current Illness: none

ID: 1337274
Sex: F
Age: 78
State: TX

Vax Date: 01/03/2021
Onset Date: 01/15/2021
Rec V Date: 05/21/2021
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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: loud ringing in the ears......consistent 24/7

Other Meds: Xarelto, Levothyroxine Metopropol, myrbetriq, atorvastine, potassium, furosemide, pro-biotic, flecanide, Vit C and D,

Current Illness: None

ID: 1337275
Sex: M
Age: 62
State: MI

Vax Date: 04/21/2021
Onset Date: 05/10/2021
Rec V Date: 05/21/2021
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: KNA

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

Symptoms: past history of diabetes, hypertension, hyperlipidemia and recent diagnosis of COVID-19. Apparently the patient received his initial dose of COVID vaccine on 03/31/2021 and subsequently developed loss of taste and smell. He was tested for COVID-19 at local Pharmacy and received notification that his result was positive. He subsequently had improvement in his symptoms and was retested 2 weeks subsequent with negative results. On for 01/20/2021 he received his 2nd COVID 19 vaccination and subsequently developed recurrence of feeling ill 2 days afterwards. He progressively had feeling of shortness of breath along with nonproductive cough. The patient then developed complaints of chest pain and rib discomfort. He presented to the emergency department where he was found to be hypoxic along with abnormal labs including a creatinine of 1.84 BNP of 12,699, elevated transaminase levels, hemoglobin of 8.9. Chest x-ray showed patchy airspace disease to the right lung consistent with COVID-19 pneumonia. At time of admission he was given IV Lasix and started on Rocephin and Azithromycin. The use of steroids as well as any antiviral treatment was withheld because of presumptive symptoms related to bacterial pneumonia (secondary to COVID 19.) He also did not require oxygen supplementation during his stay.

Other Meds: lisinopril Zocor Hytrin Clonidine

Current Illness: None known

ID: 1337276
Sex: M
Age: 21
State: WA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Fever, chills, headache, anger.

Other Meds:

Current Illness:

ID: 1337277
Sex: F
Age: 17
State: HI

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: patient thought she received 1st dose of moderna vaccine and was confirmed during patient discussion prior to administration. Pt received 2nd dose of Moderna vaccine on 5/21/21 to right deltoid. After administration, it was found that patient received 1st dose of pfizer and should have received pfizer as second dose. Pt did not report any adverse reactions upon vaccine administration of second dose.

Other Meds: none

Current Illness: none

ID: 1337278
Sex: M
Age: 44
State:

Vax Date: 05/14/2021
Onset Date: 05/23/2021
Rec V Date: 05/21/2021
Hospital: Y

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: None

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

Symptoms: Patient reports sudden onset of auditory hallucinations , which he never had before. He also had episodes of mania, where he will stay up all night and got no sleep followed by episodes of depression and sleeps for few days. Patient appears confused.

Other Meds: None

Current Illness: None

ID: 1337279
Sex: M
Age: 30
State:

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient stated " I don't feel ok' EMS came by patient side. Lead staff been aware of it. Patient vitals took by EMS BP 118/86, HR 61, O2 96. After 10 minutes lay flat and vitals taken. Patient Stated I feel good. Patient refused to go to the hospital.

Other Meds:

Current Illness:

ID: 1337280
Sex: M
Age: 63
State: PA

Vax Date: 04/28/2021
Onset Date: 05/04/2021
Rec V Date: 05/21/2021
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: NKA

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

Symptoms: Office Visit 5/5/2021 Dx Fever ? Generalized Body Aches ? Fatigue Reason for Visit Progress Notes PA Encounter Date: 5/5/2021 Signed Cosigned by: MD at 5/12/2021 8:00 PM Assessment/Plan PT was seen today for fever, generalized body aches and fatigue. Diagnoses and all orders for this visit: Viral illness - COVID-19 PCR; Future History Chief Complaint Patient presents with ? Fever Started yesterday ? Generalized Body Aches ? Fatigue had cvoid vaccine last wednesday HPI Patient is a 63-year-old male presenting today for evaluation of fever and body aches that started last night. He states that he received his first Pfizer Covid vaccination 1 week ago, no significant reaction or side effects. He reports now having fever up to 101, body aches and muscle pains, fatigue. No congestoin, rhinorrhea, cough, V/D. He has taken some Tylenol 500 mg, LD was this morning. No sick contacts. No hx of asthma. No rashes. Nonsmoker. ED to Hosp-Admission Discharged 5/18/2021 - 5/19/2021 (24 hours) Hospital DO Last attending Treatment team Chest pain Principal problem Discharge Summary (Physician) Internal Medicine Inpatient Discharge Summary Brief Overview Admitting Provider: MD Discharge Provider: DO Primary Care Physician at Discharge: MD Admission Date: 5/18/2021 Discharge Date: 5/19/2021 Presenting Problem/History of Present Illness/Reason for Admission Chest pain [R07.9] Acute chest pain [R07.9] History of coronary artery disease [Z86.79] Hospital Course HPI: PT is a 63 YO M admitted with chest discomfort in the setting of asymptomatic COVID 19 infection. His chest pain was associated with troponin elevation prompting admission and cardiac stress testing. His troponins peaked at 0.09. His PET stress test was negative. Therefore he was discharged to home without medication changes.

Other Meds: acetaminophen (TYLENOL) 500 mg tablet calcium carbonate (TUMS) 500 mg (200 mg calcium) chewable tablet cholecalciferol, vitamin D3, 10 mcg (400 unit) oral capsule coenzyme Q10 (CO Q10) 100 mg capsule famotidine (PEPCID AC ORAL) metoprolol s

Current Illness:

ID: 1337281
Sex: F
Age: 58
State: WA

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/21/2021
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: Sulfa

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

Symptoms: Arm Swelling at shot site, slight fever, chills, slight headache.

Other Meds: Metformin, Synthroid, Losartin, Januvia, Bayer Low Dose, Omega-3 Krill, Multi Vitamin.

Current Illness: Same side effects 04/01/2021 Moderna vaccine MODERNA008B21A. Side effects for both vaccinations included slight fever, arm swelling at point of shot, chills, slight headache.

ID: 1337282
Sex: M
Age: 60
State: OR

Vax Date: 04/12/2021
Onset Date: 04/14/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Amoxicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: This was for the first COVID shot, A few days afterwards, I got a significant rash on my lower legs and ankles. Rash continued until my second vaccine on 05/03/2021. After I took the second vaccine, the rash subsided on my legs but came back strong on my upper arms, back and neck. I have been taking Benadryl and applying hydrocortisone to treat the itching.

Other Meds: Citalopram, Propranolol, Lisinopril, Lipitor, Adderall, Ambien

Current Illness: None

ID: 1337283
Sex: F
Age: 24
State: IN

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Muscle pain, fatigue, loss of appetite, nausea; between 11am-5pm Treated with Acetaminophen, 1000 mg

Other Meds: Bupropion Acyclovir Duloxetine Spironolactone

Current Illness: None

ID: 1337284
Sex: M
Age: 26
State: MI

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: sulfa

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

Symptoms: Patient stated he became ill and suffered syncope a day after receiving the vaccine. He experienced what he described as palpitations. He went to the ER and given an EKG and "tests". The findings did not indicate any type of dysrhythmia. He was referred to a cardiologist appointment for next week as a follow-up and precaution.

Other Meds: unknown

Current Illness: none noted on consent form.

ID: 1337285
Sex: M
Age: 34
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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:

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

Symptoms: Patient received the Janssen COVID vaccine then shortly after administration patient stated that their vision started to go blurry and the next thing their sight went dark, patient was seen falling out of chair head first after passing out.

Other Meds:

Current Illness:

ID: 1337286
Sex: M
Age: 62
State: NC

Vax Date: 05/01/2021
Onset Date: 05/16/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: joint pain, muscle pain, tiredness

Symptom List: Unevaluable event

Symptoms: I have joint pain all over, muscle ache and tiredness

Other Meds: Alive

Current Illness: None

ID: 1337287
Sex: F
Age: 26
State: TX

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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, mushrooms

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

Symptoms: Lightheadedness, Chest pain, feeling heavy O2: 99% Pulse: 95 BP: 140/90

Other Meds: None

Current Illness:

ID: 1337288
Sex: M
Age: 15
State: NY

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: Patient experienced as 15- 20 second syncopy spell when he sat up frpm a sitting position after receiving the covid vaccine initial vitals 102/60 pulse 40 after regaining conciousness BP was 111/60 pulse at 60 patient prior to fainting appeared diapharatic, pale and cool to the touch there were no signs of llegeric reaction including flushing of the face lack of hives or angiodema no wheezibg, no strider or labored breathing patient complained of dizzness upopn standind equal to 30 mins.. EMS was notrified when arrived patient was up and alert without dicculties EMS recommended patient be released to his gaurdian BP at release 112/57 pulse 62 father advised to call physician if any concerns arise or go to nearest hospital in an emergent situation

Other Meds:

Current Illness:

ID: 1337289
Sex: F
Age: 59
State: CO

Vax Date: 04/11/2021
Onset Date: 04/28/2021
Rec V Date: 05/21/2021
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: Patient got the Shingles. This is the second time for this patient, the first occurrence of the Shingles was in March of 2020

Other Meds: None

Current Illness: None

ID: 1337290
Sex: F
Age: 13
State: WA

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: Sensitivity to tomato products, scented soaps and shampoos; allergic to guinea pigs; allergic to Spring

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

Symptoms: Immediately began bleeding, which ran down arm from injection site. Approximately 4 minutes later, back of entire arm that received injection was numb from underarm to pinky and ring finger; warm hives on front of both arms down to wrists; warm, rosy cheeks and cold hands/fingers; tickle in back of throat. Benadryl given at clinic. 2.5 hours later, numbness in arm reduced to upper arm only; hives on arms have reduced; tickle in throat gone. Continues to have pain at site of injection.

Other Meds: None

Current Illness: None

ID: 1337291
Sex: M
Age: 34
State: PA

Vax Date: 04/29/2021
Onset Date: 05/04/2021
Rec V Date: 05/21/2021
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: NKA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: ED Discharged 5/4/2021 (26 minutes) Last attending ? Treatment team Viral illness Clinical impression Covid-19 Screening Chief complaint

Other Meds: ALBUTEROL SULFATE (VENTOLIN HFA INHL) amphetamine-dextroamphetamine XR (ADDERALL XR) 20 mg 24 hr capsule buPROPion SR (WELLBUTRIN SR) 200 mg 12 hr tablet buPROPion XL (WELLBUTRIN XL) 150 mg 24 hr tablet cetirizine (ZyrTEC) 10 mg tablet cita

Current Illness:

ID: 1337292
Sex: M
Age: 28
State: CA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient received 2nd dose of Moderna 7 days earlier than recommended. After administration of vaccine and monitoring, patient did not report any signs and symptoms from vaccine administration.

Other Meds:

Current Illness:

ID: 1337293
Sex: M
Age: 35
State:

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: No

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

Symptoms: Swollen lymph node above left collar bone, fatigue, headaches, nausea.

Other Meds: Adderall

Current Illness: N/a

ID: 1337294
Sex: F
Age: 26
State: AZ

Vax Date: 05/05/2021
Onset Date: 05/07/2021
Rec V Date: 05/21/2021
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: Nausea

Symptoms: For 2 weeks have been feeling dizzy all day gets even worse at night to the point where I can?t sleep . Also get really bad dry mouth . Hasn?t gone away so just concerned

Other Meds: None

Current Illness: None

ID: 1337296
Sex: F
Age: 65
State: IL

Vax Date: 08/29/2019
Onset Date: 08/29/2019
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Cipro Erithromiacin

Symptom List: Injection site pain

Symptoms: On August 29th, 2019 I went to Dr. office for my two year physical for work. The Doctor completed his examination and then told me that I was due for a pneumonia injection. I hesitated and reminded him that I had a serious reaction to the flu shot in 2011 and that was added to my allergy list. He said that the pneumonia vaccine was completely different and I probably would not have a reaction from it. As soon as I got home from work that night my right upper arm was swollen twice it?s size, very hot to the touch and red in color. I also had a temperature starting which was a little over 100?. I was feeling very ill and went straight to bed. I was sick and very uncomfortable all through the night. When I awoke the next morning on August 30th I called off work because I was so sick I couldn?t get out of bed. My fever had gone up to 102? and I lost use of my right arm. I had to put it in a sling in order to get any comfort. I had no feeling from my elbow up. As soon as the doctors office opened at 8:00 AM that morning, I called Dr. office and talked to a nurse and told her what my symptoms were. She said that this is quite common for some elderly people to have reactions from certain vaccines and told me to take some ibuprofen and put ice on my upper arm. That was on a Friday and the doctors office was closed over the weekend because it was Labor Day weekend. I suffered all weekend not able to use my right arm and I am right handed. I called the doctors office once again on Tuesday morning, September 3rd. I had an in-service training day on that day but I couldn?t go in because I could not set up or conduct the training at all. I still could not use my right arm. I talked to a nurse at the doctors office once again that day when they opened at 8 o?clock in the morning and told her that I was still having a very bad reaction. She reminded me to keep taking the ibuprofen and that Dr. did not have any openings until the end of the month but if I continued to react and it caused breathing problems to go to the emergency room. I did not have breathing problems but my arm continued to hurt and is still hurting to this day. I still cannot lift my right arm above my shoulder without pain. My right shoulder hurts so bad and has been hurting for almost 2 years since the pneumonia injection. I want to scream at times when I have to take my tops or dresses off when I have to pull them off over my head. Sometimes if the neck opening is large enough I pull them down over my body. Many times I?m in tears getting dressed and undressed. I had to adjust my duties at work because I cannot lift children anymore onto the diaper changing station. I was a director at a childcare center and needed to work in different aged classrooms at times. It has interfered with my personal life at home. I can?t reach up to put my dishes away without having a lot of pain. I live on the second floor in my apartment building and carrying up groceries is so painful. I have never had any problems with my arms or shoulders until this pneumonia injection was given to me on August 29th, 2019. Doctor ordered the MRI on my shoulder. He told me it was possible that I could have inflammation still from receiving that vaccination. I had the MRI on January 23rd, 2020. The reason I was so late getting the MRI was they didn?t have any appointments available until that date. Because of my position at school, I was covering other classrooms which included very young children. I actually injured my knee twisting it while trying to place a baby down on the rug because I was losing grip with my right arm. So now I have a tear in my lateral meniscus and it has caused fluid to build up behind my kneecap with a cyst. That injury has caused me to be out of work permanently and it is still not better. If my right arm wouldn?t have been injured, I am sure I wouldn?t have lost grip of that child and my knee injury would not have happened. After Dr. read the MRI results he suggested that I see an Orthopedic doctor ASAP, which I immediately made an appointment. I saw the Orthopedic doctor on Wednesday, January 29th who?s name is Dr. and he told me that it was possible that the pneumonia injection could have caused the injury to my right shoulder. I actually saw Dr. on January 15 before the MRI. He recommended physical therapy for twice a week which I scheduled at that time. Unfortunately my torn meniscus on my knee turned into a major situation causing blood clots and I have been in the hospital three times in the last 13 months. I had to stop my therapy for my shoulder and take care of my knee. Dr. did give me a Cortisone injection but it did not help it only lasted about three days and then it went back to hurting again. I have finally started back in March with Physical Therapy and it is improving somewhat if I am consistent. I have seen an orthopedic surgeon Dr., But they cannot do anything more for me because they cannot do surgery. I am on too much blood thinner I am taking Xarelto and Plavix for my lifetime. I do not want any more injections going into that arm. I had to take the Covid injection but they put it in my left arm.

Other Meds: Methiphenidate 1, 20 mg ER daily Tramadol 50 mg as needed

Current Illness: None

ID: 1337297
Sex: F
Age: 40
State: CA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 05/21/2021
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: dizziness, ear fullness in both ears, headaches. Still experiencing these same symptoms at 6 weeks post shot

Other Meds: omega 3s, align probiotic

Current Illness: no

ID: 1337298
Sex: F
Age: 45
State: MI

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

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

Symptoms: Insomnia the night after receiving vaccine; felt "wired," could not sleep. Only lasted the first night. Also, broke out in hives the day after receiving the shot. Large splotches on face, neck, left wrist, and right inner elbow. Over the course of ten days after receiving the shot, I continued to break out in small bumps here and there (hands, torso). The large splotches receded after about a week. I occasionally treated the hives with hydrocortisone cream. The hives eventually receded. I was drinking a lot of almond milk for the first time around the time of the second vaccination. The almond milk may also have been a cause of the hives.

Other Meds: Levothyroxin Citalopram

Current Illness:

ID: 1337299
Sex: F
Age: 38
State: NJ

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/21/2021
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: Shellfish

Symptom List: Tremor

Symptoms: Miscarriages at 5/6 weeks Started cramping night of first dose. Started bleeding the day after first dose. Numbers started dropping. Miscarriage completed a week after first dose.

Other Meds: Prenatal

Current Illness:

ID: 1337300
Sex: F
Age: 28
State: PA

Vax Date: 04/12/2021
Onset Date: 04/20/2021
Rec V Date: 05/21/2021
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: No known allergies

Symptom List: Erythema, Pruritus

Symptoms: Episcleritis, unilateral, right eye. Woke up with a reddish eye, came to school and got it checked by a couple professors at the slit lamp. They confirmed it was episcleritis (they saw maybe 1-2 white blood cells swimming around in the anterior chamber - not a lot). I had never had this before. My symptoms were minimal; mild ache, nothing else really. They debated putting me on a steroid eyedrop, but we decided to monitor for a few days, and it started to slowly go away. The obvious redness was gone in about three days, and the leftover signs disappeared after around Day 10-11.

Other Meds: Birth control - Tri-Previfem (QD) Concerta - 36mg QD

Current Illness: None

ID: 1337301
Sex: F
Age: 41
State: AR

Vax Date: 03/17/2021
Onset Date: 03/22/2021
Rec V Date: 05/21/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient presented to the ER with a chief complaint fever and myalgias, found to have severe neutropenia and neutropenic fever. She was started on doxycycline for concern for tick-borne illness, but serologies have returned negative. Her counts recovered spontaneously and her fevers resolved.

Other Meds:

Current Illness:

ID: 1337302
Sex: F
Age: 63
State: GA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 05/21/2021
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: Penicillin

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

Symptoms: Less than 15 minutes after vaccine I experienced frontal sensations in my brain. I also felt very dizzy and have ringing in left ear. A day after I experienced a dull headache for almost a month.

Other Meds: The only medications I take are compound hormones.

Current Illness: No other illness at the time of vaccination.

ID: 1337303
Sex: F
Age: 50
State: NY

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 05/21/2021
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: Suspected allergy to Penicillin (was infant)

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Starting at 10pm April 24, Severe headache, migraine level, both eyes watering, ears ringing, could not look at light. Fever just under 101, rash on scalp starting around 12 midnight. Aches, exhaustion, slight stomach upset. Took Tylenol. Headache did not go away, felt likeTylenol did nothing. Fever and severe headache lasted 4 days. Aches lasted 5 days. On DAY 2 after vaccine, 2 hard, golf-ball sized lumps under left arm appeared, and some others slightly smaller (lymph nodes). Lumps were too painful to sleep on that side or do any normal physical activity. Fever and most aches resolved after Day 4, but Lymph nodes stayed golf ball size and painful for 3 weeks. At time of this report, it has been 4 weeks, postponed 2nd shot one extra week hoping nodes would improve, they have reduced in size but are still very swollen and sore. Also ache at sternum (??) has not resolved at all.

Other Meds:

Current Illness: None

ID: 1337304
Sex: F
Age: 36
State:

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
Hospital: Y

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: the patient complained of dry mouth with no other signs of swelling or trouble breathing hours after her 15 minute observation time. I advised her to take diphenhydramine and seek medical attention if the condition did not improve. She ended up going to the hospital. Since then division 1 has been checking in with her

Other Meds:

Current Illness:

ID: 1337305
Sex: F
Age: 19
State: TX

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: Unknown

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

Symptoms: After receiving covid vaccine, and receiving patient education of Pfizer COVID vaccine pt states "I can't see." Nurse placed pt in supine position and provider was called to the exam room. Pt denies history of passing out with previous vaccines, denies LOC, loss of bowel/bladder and reports "I feel hot" and "I can't feel my hands and feet." Pt also reports she has not had anything to eat or drink prior to arrival to clinic. 1411 Vital signs: BP 107/69; HR 70; RR 20; pulse ox 99%. Upon provider exam mild pallor/diaphoresis noted, pt is awake alert and oriented to person/place/time/situation; No stridor, wheezing, sensation intact in all 4 extremities; pt has wrists and elbows in flexed position but able to straighten all upon request to place pulse ox and blood pressure cuff; 1415 BP 99/69; HR 102; RR 22; pulse ox 98%; Pt is continuing to report numbness bilat hands/feet and began to complain of nausea. EMS contacted. No hives, wheezing, stridor noted by provider, no emesis. Per provider sensations continue to be intact. 1423 VS BP 102/62 HR 67 pulse ox 99% pt remains awake alert and oriented x4; pt asked mom to contact her employer and call off work today. EMS arrives at 1430 and evaluates pt. After EMS evaluation, pt declined EMS transport states she feels better and just wants to go eat something. Pt reports symptoms resolved.

Other Meds: Unknown

Current Illness:

ID: 1337306
Sex: F
Age: 63
State: VT

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Pain in extremity

Symptoms: in addition to the painful arm, an hour after my nose started running, burning watery eyes, followed by headache, fever, chills, nausea, fatigue, This lasted for four days. Wednesday 5/19 the arm that was injected blew up to a large hard bump with an itchy rash. The large swollen hard itchy rash bump is still there on Friday 5/21.

Other Meds: low dose aspirin, vitamin D and melatonin

Current Illness: N/A

ID: 1337307
Sex: F
Age: 0
State: GA

Vax Date: 05/29/2021
Onset Date: 05/08/2021
Rec V Date: 05/21/2021
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: Nails have white blotches and are brittle and breaking and have a upside down reddish moon. Tips are very white and lines/ ridges.

Other Meds:

Current Illness:

ID: 1337309
Sex: M
Age: 59
State:

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 05/21/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: "Extreme, almost out of body experience. Had to call someone to have them stay on the phone with me in case I passed out"

Other Meds:

Current Illness:

ID: 1337310
Sex: F
Age: 53
State: CA

Vax Date: 04/05/2021
Onset Date: 04/12/2021
Rec V Date: 05/21/2021
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 reported

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

Symptoms: On 04-12-2021, I experienced itchiness at the injection site and both of my arms had rashes and large bumps that lasted two weeks. I had these same symptoms four times in the two weeks span. I spoke with a doctor through a telehealth consult and was prescribed Loratadina medicine. I can say today I have recovered from the rashes and large bumps on my arms and do not have any symptoms today.

Other Meds: None reported

Current Illness: None reported

ID: 1337311
Sex: F
Age: 45
State: TX

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 05/21/2021
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: Ritalin, morphine, flexiril, preservatives, Humira, cimzia, corn / cornstarch (anaphylaxis)

Symptom List: Vomiting

Symptoms: 3/13 vaccination. 3-4 hours later, I started having symptoms to include tickle in throat, post nasal drip. By 11:40 I had a HA, I was very tired, quite a bit of secretion. I continued taking Benadryl every 3 hours. At 2 :30 PM, heart palpitations and angina. My BP was 98/69. I took more Benadryl, drank some fluids. By 4:15, I was getting drowsy and tired, having pain in multiple joints through my body; 8/10 scale, especially in my hands in feet. I took something for pain. My arm was very sore. I had mild to moderate slight cough. By 7:40 PM I took my regular medication. I was having a sudden intense HA and pain in joints was 9/10. I was having stiffness, chest congestion, feeling 'flu like' symptoms, brain fog, and weird pains / electro shock pains on extremities. By 830, my symptoms increased to almost a really bad allergic reaction. I couldn't think well, dizzy, cough, chest congestion and my lungs started to hurt. By 10:30pm, I started to have a low grade fever, pain 9/10, I took Ibuprofen and Benadryl every 3 hours. 3/14 Ibuprofen, slight fever, slight HA, joints were swollen and stiff; 8/10 on pain and stiffness. I had muscle pain and brain fog, could not say words. Dull pain back of head. My kidney area, I felt like it hurt, severe anaphylactic reaction it felt like. I still had photophobia. It continued into the evening. I continued taking the Benadryl and ibuprofen. Around 6pm, I had 101.5 temperature, nauseated, crying, chest congestion. By 10:45, my temp was going up again. Monday I had low grade fever, continued medication. Symptoms continued for a few more days with palpitations, brain fog, pain in lungs and kidneys. I couldn't do anything. By the end of the week, I started to recover. *My PCM knew before I got the vaccine they were on board and knew what was going to happen in regards to my reaction, EKG, I had epi pen, didn't pass out, I decided I was going to stay home. *It took me a good couple weeks to recover to my baseline. But it was pretty tough.

Other Meds: Antihistamines, xyzal, singular, famotidine, aspirin, quercetin, diazepam, Benadryl

Current Illness: Mast activation syndrome

ID: 1337312
Sex: M
Age: 55
State: OR

Vax Date: 05/05/2021
Onset Date: 05/09/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: sulfa antibiotics

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Shingles- still active

Other Meds: plaquenil

Current Illness:

ID: 1337313
Sex: F
Age: 89
State: MA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: NSAIDS, SPECIFICALLY IBUPROFEN

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

Symptoms: S/P VACCINE, STARTED WITH FEVER OF 101.2, CHILLS, RESPIRATORY WHEEZING, AND BODY ACHES AT 2100. PRN TYLENOL GIVEN AT 2116, TEMP DECREASED TO 100.1. NURSE PRACTIONER MADE AWARE WITH NEW ORDER FOR DUONEBS. TODAY ON 5/21 SHE STATES SHE STILL FEELS ACHES, HAS NOT HAD ANY TYLENOL TODAY- MORNING TEMP WAS 99.1 AND CURRENTLY IT IS 98.4.

Other Meds: PROBIOTIC, ALBUTEROL VIA NEBULIZER, ALLOPURIONAL, AMIODARONE, NORVASC, LIPITOR, COLACE, DORZOLAMIDE EYE DROPS, ELIQUIS, FERREX, LASIX, GABAPENTIN, HUMALOG, LANTUS, MUCINEX, NITROGLYCERIN PATCH, PROTONIX, MIRALAX, SENNA-S, SPIRIVA INHALER, S

Current Illness: ADMITTED TO CATHOLIC MEMORIAL ON 5/1 FROM HOSPITAL S/P NEW ONSET OF PNEUMONIA AND ATRIAL FIBRILLATION.

ID: 1337314
Sex: M
Age: 17
State: OH

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: Within a few minutes of receiving the vaccine, the patient turned pale and clammy. He became confused and lost consciousness for several seconds, his head fell back and he made gurgling noises. When he regained consciousness, he couldn't remember our conversation. He said he was hot and his head hurt for a few minutes, he remained pale and sweaty for several minutes. After 10-15 minutes he said he felt fine.

Other Meds:

Current Illness:

ID: 1337315
Sex: M
Age: 30
State:

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/21/2021
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: Had a seizure.

Other Meds:

Current Illness:

ID: 1337316
Sex: F
Age: 32
State: DE

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 05/21/2021
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: No

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

Symptoms: Nausea and tiredness that evening. Those lasted about a day. My arm at the injection spot was a little sore. Two weeks later I saw a video that made me cry and it shouldn't have made me cry. I took a pregnancy test and it was positive. Conception date would have been the 15th. I had been trying without success to get pregnant. I had been trying for a year and a half. I think the vaccine helped. Pregnancy history 2nd pregnancy 1st one ended in early miscarriage. Estimated of date of delivery 11/10/2021.

Other Meds: Fish oil; Vitamin E

Current Illness: No

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm