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: 1351896
Sex: F
Age: 25
State:

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 05/26/2021
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: Penicillin, Latex, peanuts

Symptom List: Dysphagia, Epiglottitis

Symptoms: Tachycardia, persisting for 4 days, rates up to 160 bpm, abnormal ekg : sinus tach with flipped T waves in inferior leads suggesting ischemia.

Other Meds:

Current Illness:

ID: 1351897
Sex: F
Age: 68
State: CA

Vax Date: 02/24/2021
Onset Date: 04/01/2021
Rec V Date: 05/26/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Tinnitis In left ear, Virtually constant.

Other Meds: Simvastatin 5mg, Multivitamin

Current Illness: None

ID: 1351899
Sex: M
Age: 34
State: CA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Muscle aches, ocular pressure behind the eyes, chills, fever, soreness, gas and bloating, frequent urination, dizziness, faintness, difficulty moving, head ache, subocciptal pressure / muscle tightness, nausea.

Other Meds: None

Current Illness: None

ID: 1351900
Sex: F
Age: 15
State: OR

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient received c19 vaccine Pfizer - lot EW0178 at 1437 on 5/26/021 At 1443, patient was given 0.15mg Epi in left thigh due to reaction. BP 104/68 P: 63 O2: 97% RA (laying) BP 101/70 P: 88 O2: 98% RA (laying) Patient was seen with her head back in her chair, then sliding down the chair with her eyes rolled and unable to breath. RN assisted Patient mother at side Lab Mgr present Patient was kept on the floor until 911 arrived for EMS transport to Hospital.

Other Meds: Concerta 36mg

Current Illness: None

ID: 1351901
Sex: F
Age: 36
State: TX

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Patient received exact amount of vaccine in her left deltoid through injection site bandage. She was in observation tent when she notice a drop of liquid that is not red rolling down from her bandage for about 2 inches. She videotaped it and came back to pharmacy and show staff. Moderna was called and case # assigned with safety team to follow up from Moderna. We spoke with patient before she left and 2 hours later on the phone and told her that Moderna will follow up.

Other Meds: na

Current Illness: unknown

ID: 1351902
Sex: M
Age: 46
State: OH

Vax Date: 03/18/2021
Onset Date: 03/28/2021
Rec V Date: 05/26/2021
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: Loss of hearing in my right ear - Sudden Sensorineural Hearing Loss and now constant Tinnitus 10 days after 1st Phizer Covid vaccine I woke up with a plugged ear. A week later I went to an Urgent Care to have my ear checked out. I was put on antibiotics. After that not clearing up my ear, I visited an ENT doctor who diagnosed me with Sudden Sensorineural Hearing Loss. I also now have constant Tinnitus in my right ear. Dr did 2 injections into my eardrum with steroids and I was also put on Prednisone pills for 2 weeks. After these course of treatments I had no improvement in the hearing loss.

Other Meds: No

Current Illness: NO

ID: 1351903
Sex: F
Age: 36
State: IL

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
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: Ibuprofen , Baby Oil

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: PATIENT RECEIVED JANSSEN VACCINE ON 5/19/21. PATIENT COMPLAINED NEXT DAY, THAT SHE DEVELOPED A BRUISE ABOUT THE 1/4 INCH X 1/4 INCH ON THE INSIDE OF ARM WHERE YOU GET BLOOD DRAWN ON VEIN. The upper arm was , was clear and no problem. Patient says that bruise went away, but her arm gets nump and falls asleep. On May 26, 2021 patient called and complained got outer left leg thigh bruise blue in color, the spot is 2 inch x 2 inch in diameter and is hard and hurts. The pain radiates out about the size of palm of her hand and is warm to touch. Patient says she did not bump herself , and attributes to her Janssen vaccine. Patient feels the pressure, in the area of the bruise when she stands at work. Patient has put call in to doctor. Patient was counseled to go to hospital.

Other Meds: LOSARTAN VENLAFAXINE, CHILDRENS VITAMINS, B12, HYDROCHLOROTHIAZIDE

Current Illness: Patient HAD PANIC ATTACK NIGHT BEFORE MOTHER'S DAY

ID: 1351904
Sex: M
Age: 54
State: IN

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: ALMOST EXACTLY 24 HOURS LATER, FEVER 101, COLD CHILLS, TIRED, SLEEPY. SLEPT 2 HOURS WHEN I GOT HOME FROM WORK . GOT UP FROM NAP AND WENT TO BED. ALL NORMAL IN THE MORNING.

Other Meds: none

Current Illness: none

ID: 1351905
Sex: M
Age: 18
State: IL

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt received the vaccine & was advised to sit near the pharmacy for 15 min but pt preferred to walk around the store instead. heard mom yelling to call 911 & went to the aisle. Pt fainted while walking in the cooler aisle. Per mom he hit his head against a shelf. He does not recall hitting his head but said his neck was hurting. Pt was alert. Per pt & per mom pt gets anxious w/shots. 911 was called, pt stayed laying on the floor until EMS came to evaluate pt. EMS did not advise pt to go to hospital.

Other Meds: n/a

Current Illness: n/a

ID: 1351906
Sex: F
Age: 70
State: TX

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 05/26/2021
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: Ace Inhibitors Aspirin Sulfonamides

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient received 2nd Moderna shot on 05/15/2021 and started feeling eye pain and believes her glaucoma to be worse now.

Other Meds:

Current Illness:

Date Died: 05/17/2021

ID: 1351907
Sex: F
Age: 55
State: KY

Vax Date: 04/01/2021
Onset Date: 05/16/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: My mother described feeling "off" from the moment after the second vaccination of COVID19 (Pfizer-BioNTech). She Continued to feel strange weeks after the vaccine. My mother passed away at age 55 completely healthy and had a check-up with her primary care physician prior to any vaccinations. My mother did not die of natural causes at the time of her age and health.

Other Meds: Meloxicam 15MG, Hydrochlorothiazide 25MG, Cyclobenzaprine 10MG

Current Illness: N/A

ID: 1351908
Sex: M
Age: 22
State:

Vax Date: 05/16/2021
Onset Date: 05/17/2021
Rec V Date: 05/26/2021
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: NKDA

Symptom List: Rash, Urticaria

Symptoms: 22y/o AD male c/o Chest Pain since 4am today, Mid-sternal radiates to back. PT states Shivers/chills and anxious. PT is in Quarantine right now recieved J&J vaccine last night at 2300.

Other Meds: UNK

Current Illness: N/A

ID: 1351909
Sex: F
Age: 68
State: CA

Vax Date: 03/12/2021
Onset Date: 03/14/2021
Rec V Date: 05/26/2021
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 that I know of.

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

Symptoms: Approximately 40 hours after 2nd Pfizer vaccine, I developed partial facial paralysis. It became so bad the following day, I went to Urgent Care near my home. I was afraid I was having a stroke, so did not attempt to drive to my regular doctor. The PA on staff at UC diagnosed Bell's Palsy, and prescribed 7 days of an anti-viral plus prednisone. I am now almost 11 weeks out from the initial diagnosis, and although I have some facial movement, full movement has not returned. I am a professional flutist, and am devastated that I cannot form my embouchure to play my flute.

Other Meds: Montelukast, Breo, AREDS2, Calcium, Magnesium, Advil

Current Illness:

ID: 1351910
Sex: M
Age: 33
State: AL

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
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: None

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

Symptoms: Patient got light headed and passed out sitting in his chair. His pupils were very dilated and he fell in and out of consciousness for about 2 minutes. EMTs arrived and cleared him to go home.

Other Meds:

Current Illness:

ID: 1351912
Sex: M
Age: 11
State: TX

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: No known drug, food, or other products allergy at the time of vaccination

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

Symptoms: Pfizer COVID-19 vaccine dose 1 administered to an 11-year-old patient (not approved for patients less than 12 years of age) on 5/24/21. Patient reports no abnormal symptoms or reactions from vaccine on 5/26/21.

Other Meds: No known medications at the time of vaccination

Current Illness: No known illnesses at the time of vaccination

ID: 1351913
Sex: U
Age: 20
State:

Vax Date: 05/21/2021
Onset Date: 05/23/2021
Rec V Date: 05/26/2021
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: NKDA

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

Symptoms: vaccine side effect. tingling in bil cheeks x 1 day, J&J vaccine received Friday; denies any fevers/chills.

Other Meds: UNK

Current Illness: N/A

ID: 1351915
Sex: F
Age: 16
State: CA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/26/2021
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: Penicillin allergy

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

Symptoms: Approximately 10 minutes after vaccination, patient's brother yelled out for help. The pharmacy cashier then observed the patient convulsing. Her body was leaned back on the bench, with head tilted back a bit. When I came out, patient appeared very pale. I immediately ran back into the pharmacy, instructed a fellow employee to reach out for assistance from front end management, and I called 911. While on the phone with 911, I walked out to check on the patient. At that point, she appeared to be coherent and said she was okay, and doesn't need any medical help. At that time, her brother explained that a reaction like this had occurred in the past when she got other vaccinations/injections so they were familiar with the symptoms. We continued to monitor patient for further reactions. After about 30 minutes, patient appeared to have no further reactions and left.

Other Meds: none known

Current Illness: none known

ID: 1351916
Sex: F
Age: 57
State: WV

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Injection site rash aprox 2x2 inches. It is red and swollen. Feels hot but does not have a fever.

Other Meds: loratadine, gabapentin, buspirone, Lantus, Novolog, glyburide/metformin

Current Illness: none

ID: 1351917
Sex: F
Age: 26
State:

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: c/o worsening hives on Moderna vaccine area since 1st dose on 12 May. denies fever, chest pain, BLE pain. last Zyrtec and Tylenol last night. take Zyrtec regular base for allergy.

Other Meds: UNK

Current Illness: anxiety

ID: 1351918
Sex: F
Age: 19
State: CA

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Client received 2nd COVID vaccine of Pfizer (Lot# EW0185 expiration date 06/24/2021). Client reported nausea and upset stomach at 1528. EMT and EMT responded to this event. RN was notified and responded at 1529. At 1529, vital signs are blood pressure 122/84, heart rate 88, oxygen saturation 97%. Client reports a history of anxiety and insomnia. Client reports current medication usage of Alprazolam, Ambien, Zoloft (sertraline) Sonata, and Zalephon. Client was offered supplemental nutrition and fluids. Client denied nutrition, but accepted fluids. RN educated Client about ED precautions and common adverse effects of the COVID vaccines. At 1540, vital signs are blood pressure 124/90, heart rate 84, oxygen saturation 99%. Client denies shortness of breath, no chest pain, no blurred vision, no headache, no lightheaded. Client reports "stomach feeling better" while drinking water. At 1550, vital signs are blood pressure 122/90, heart rate, 91, oxygen saturation 99%. Client reports "my stomach is improving", reports no nausea and continues to drink water. At 1600, vital signs are blood pressure 119/90, heart rate 86, oxygen saturation 98%. Client reports no new symptoms and that all past symptoms have resolved. At 1604, Client stood up with no complaints and states "I am ok to drive myself". Client walked out of facility with a steady gait.

Other Meds: Alprazolam Ambien Zoloft (sertraline) Sonata Zalephon.

Current Illness:

ID: 1351919
Sex: M
Age: 22
State:

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 05/26/2021
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: NKDA

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

Symptoms: PT presents with HA, fever and bodyaches x last night reports receiving JJ vaccine 1000 yesterday. denies taking medication. denies known sick contacts.

Other Meds: UNK

Current Illness: N/A

ID: 1351920
Sex: F
Age: 48
State: PA

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List: Unevaluable event

Symptoms: Initially was having some significantly elevated BP after the 1st Pfizer vaccine dose in January 2021. Was getting under control on Lisinopril 5mg medication. Had bloodwork all performed that was negative to rule out other underlying causes for HTN. Was getting ready to wean off the medication, when within 24 hours after the 2nd Pfizer vaccine dose on 2/22/21, my BP significantly elevated again. Continued to follow up with my PCP, trying increased medication dosage (Lisinopril 10mg). BP was not fully stabilizing, and started having significant headaches, which was then attributed potentially to Lisinopril. Changed to Metoprolol Succinate 25mg on 4/5/21, and my PCP performed another EKG, and then referred me for an echo cardio stress test, and to see a cardiologist, as BP had continued to be elevated, and was now also have PVCs.

Other Meds: Lisinopril 5mg (Had only started taking it after an incident after the first vaccine on 1/23/21, that was almost resolving, until this second dose of vaccine was now received). Prior to this, no prior history of HTN. Reported the first i

Current Illness: Started having significant HTN issues just 2 days after the first vaccine dose on 1/23/21, with no prior history. Had been at an annual gynecology check-up on 1/22/21, with no HTN issues. No other medical issues or illnesses prior to the first vaccine dose.

ID: 1351921
Sex: M
Age: 43
State: IN

Vax Date: 02/25/2021
Onset Date: 03/06/2021
Rec V Date: 05/26/2021
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: antihistimines some grasses, trees, plants, dust, fungus

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

Symptoms: "Moderna COVID-19 Vaccine. Vaccine on 2/25. Took him to an urgent care on 3-7 because of swollen ankle, foot and lower leg. Had xray but nothing was broken. thought he had sprained ankle. Given prednisone. Ankle continued to be swollen for following days so we followed up with family dr. on 3-22 who sent him for ultrasound which showed an extensive blood clot - DVT. Sent to emergency room. Put on blood thinner shots for a week and sent to doctor on 3-24. He did many blood tests. He started eliquis on 3-30. Saw doctor again on 4-13. His blood tests had shown he has Factor 5--Leiden. On May 11 we saw doctor again. Remain on Eliquis. Another ultrasound and more bloodtests show clot is chronic, but blood thinner is doing its job. No active clotting.

Other Meds: flonase and benefiber

Current Illness: none

ID: 1351922
Sex: F
Age: 48
State: CO

Vax Date: 01/02/2021
Onset Date: 01/11/2021
Rec V Date: 05/26/2021
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: Sulfa - rash

Symptom List: Injection site pain, Pain

Symptoms: developed sinus symptoms on 1/11/21, they progressed to coughing and wheezing. Treated with Prednisone and antibiotics, symptoms improved and returned 3 times over the next 4 months. Eosinophils raised to 1700 and IgE to 665. Previously diagnosed with Eosinophilic Esophagitis. No previous diagnosis of allergies or asthma. Developed asthma so severe requiring albuterol nebulizers, Flonase, singulair, Symbicort, and could not continue activities of daily living. Once off steroids symptoms progress approximately 7-10 days off with nasal congestion, coughing and wheezing.

Other Meds: Florastor, Omeprazole

Current Illness: none

ID: 1351923
Sex: F
Age: 23
State: OR

Vax Date: 05/22/2021
Onset Date: 05/23/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pain in abdomen and lung pressure when taking a deep breath. Symptoms started at about 4:00pm on Sunday 5/23/2021

Other Meds: Citalopram Thermotabs (OTC)

Current Illness: None

ID: 1351924
Sex: M
Age: 34
State:

Vax Date: 04/12/2021
Onset Date: 05/25/2021
Rec V Date: 05/26/2021
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: NKDA

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

Symptoms: covid reaction- SOB, rashes. HPI:35-year-old male with chief complaint of cough and shortness of breath. Symptoms have been present since the beginning of May. He reports this started after receiving his coronavirus vaccine. he reports he gets short of breath with walking short distances as well as he is unable to lay flat as he wakes up coughing and having difficulty breathing. He denies any heart history.

Other Meds: UNK

Current Illness: N/A

ID: 1351925
Sex: F
Age: 23
State: WI

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 05/26/2021
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 Sulfa Zithromax Peanuts Fruits and vegetables

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The day I got the vaccine I had been having health problems. I had been having withdrawal from one of my medications and I had lost weight. Right away after the shot I passed out and when I came to, I threw up a couple of times. I was taken to the ER and I had low potassium levels were low, but all other tests were normal. I had some aches pains and feverishness for a couple of days. Five days after the vaccine I had bad diarrhea several times a day. I was nauseous and feeling bad. I had an appointment with my GI doctor a week later but I had to go to the ER before that. They did not find anything in most tests. The next day I tested positive for CDIFF. I was prescribed antibiotics. I went back to the ER a third time because the Vancomycin prescription had caused severe nausea. I am still feeling bad after six weeks but it has gotten better.

Other Meds: Prilosec 20mg twice daily Zofran Gabapentin Mirtazapine Lorazepam Hydroxyzine

Current Illness:

ID: 1351926
Sex: M
Age: 12
State: NE

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
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: PFIZER COVID VACCINE ADMINISTERS APPROX 4PM, 4:03PM (APPROX.) PATIENT FAINTED IN CHAIR IN WAITING AREA. MOM & PHARMACIST GENTLY LAID PATIENT DOWN ON FLOOR, PATIENT REGAINED CONSCIOUSNESS WITHIN 1 MIN & WAS ALERT, KNEW HIS NAME, WHERE HE WAS, WHAT WAS HAPPENING. GAVE PATIENT OJ, WATER, GRANOLA BAR, TRIED TO HAVE HIM SIT IN CHAIR AFTER ABOUR 5-10 MIN, BUT PATIENT STATED FEELING LIKE GOING TO PASS OUT, HAD PATIENT LAY ON FLOOR WITH FEET UP ON CHAIR. APPROX 4:30PM PATIENT VITALS: BP 72/48, HR 81, O2 SAT 99%. PATIENT FEELING DIZZY, LAID ON FLOOR WITH FEET UP ON CHAIR, CONTINUED DRINKING WATER AND OJ. APPROX. 5PM PATIENT SITTING IN CHAIR, VITALS: BP 98/62, HR 95, O2 SAT 98%. PHARMACIST CONSULTED PEDIATRICIAN WHO ADVISED IF PATIENT FEELING OKAY AND NOT DIZZY/FEELING FAINT, OKAY TO LET GO HOME BUT TO REST TONIGHT AND TAKE IT EASY. ADVISED MOM TO TAKE TO ER IF ANY FURTHER FAINTING INTO THE EVENING. APPROX. 5:10PM PATIENT LEFT PHARMACY WITH MOM AND STATED FEELING FINE. MOM ACKNOWLEDGED SHE UNDERSTOOD PLAN FOR EVENING AND TO FOLLOW UP WITH PEDIATRICIAN REGARDING GUIDELINES/HOW TO HANDLD 2ND DOSE OF VACCINE.

Other Meds:

Current Illness:

ID: 1351928
Sex: M
Age: 31
State: CA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: I experienced a fever going to sleep at 05/25/21 at 2300h. My temperature reading was 97 F. I woke up on 05/26/21 at approximately 0120h feeling the need to urinate and was very sweaty, hot and thirsty. I sat down to urinate, and I felt dizzy standing back up. I was feeling very thirsty so proceeded to walk to get some water. I fainted after walking about 10 feet. I regained consciousness, and I drank water and ingested an Advil with the help of my wife. I felt a lot better after drinking the water, but still had a mild throbbing headache. I went back to sleep, and the fever symptoms came and went which affected my sleep quality. I drank more water any time I woke up. I took 2 more Advil as well at one time waking up. I woke up around 1300h on 05/26/21 feeling a lot better and a little more well rested. My fever symptoms are gone, but I am still a little sensitive to cold and feeling a little weak.

Other Meds: N/A

Current Illness: N/A

ID: 1351929
Sex: M
Age: 26
State:

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Nausea

Symptoms: patient reports fever, chills, diarrhea that started yesterday. states was vaccinated yesterday J&J vaccine. was called today by someone stating was in contact with someone that tested positive.

Other Meds: UNK

Current Illness: N/A

ID: 1351930
Sex: F
Age: 55
State: TX

Vax Date: 12/19/2020
Onset Date: 12/20/2020
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: Sulfur drugs

Symptom List: Injection site pain

Symptoms: Dose 1 - 12/19/20 - Exactly 12 hrs later, I started vomiting every 15 to 20 min, for 5 1/2 hours. Around 9 am, I had a fever of 102.4, a bad headache and body aches--flu like symptoms. I called the Occupational Health Doctor at my job and was told that I needed to get rehydrated. I took some Zofran that I had on hand and was then able to drink some Gatorade. I stopped vomiting, but was nauseous for the next 5 days. I didn't feel like myself until around 8 days later. Dose 2 - 1/9/21 - I took Phenergan and Tylenol about 4 hours after I received my vaccine. On the following Monday, I had a fever of 100.4, so I took more Tylenol. I was fine after that. Nothing like my experience with the first dose.

Other Meds: HCZT Losartan Delixant

Current Illness: No

ID: 1351931
Sex: M
Age: 52
State: AZ

Vax Date: 04/18/2021
Onset Date: 05/25/2021
Rec V Date: 05/26/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Sudden onset tinnitus in the right ear and decreased hearing Not sure if related, but if there is an increased incidence of these types of reactions, wanted to report.

Other Meds:

Current Illness:

ID: 1351932
Sex: F
Age: 73
State: TX

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Was awakene by a sharp, shooting pain in my head. These shooting pains continued sporadically, but did not stop throughout the next day. I did not time them but at least every five minutes they would come and jolt me. About halfway thru the day 5/25/21, I took a 5. xanax and a tramadol and they subsided, however the sharp searing, shooting pains started up again in the later evening, probably when the meds wore off. It is a sharp quick jolting pain almost electrical in the way they feel. Also had brain fog and sporadic fever of 99.2 and sweating. I usually run around 97. something. Today is Wednesday 5/26 and still have the sweating and slight brain fog and sporadic low grade fever that comes and goes. It is now 6:51 and the pains have seem to have subsided, thankfully.

Other Meds: Synthroid .1

Current Illness: none

ID: 1351933
Sex: M
Age: 29
State:

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Tremor

Symptoms: JJ Vaccine today reports with chills/HA bodyaches, requesting quarters

Other Meds: UNK

Current Illness: back pain

ID: 1351935
Sex: F
Age: 40
State: MD

Vax Date: 05/23/2021
Onset Date: 05/23/2021
Rec V Date: 05/26/2021
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: Allergic to levequin medication that?s all I?m aware of

Symptom List: Erythema, Pruritus

Symptoms: My first dose I got a reaction - bad joint and body pain. I wasn?t able to move for a couple hours but then it subsided less than 24 hours. It hurt but not so much where I didn?t want to move forward with 2nd dose. About 9 hours after my 2nd dose my joints in my body starting hurting and it was so painful I couldn?t move my body. It was a lot worse than my first dose. I started feeling high fever but I couldn?t get up to check temperature. It felt like someone threw me off a building and I couldn?t get up. That reaction lasted until morning and then that went away and then I got headaches. Headaches eventually went away the next day but it was a very painful experience I was scared. I don?t feel any of the symptoms anymore but wanted to report.

Other Meds: None

Current Illness: None

ID: 1351936
Sex: F
Age: 53
State: PR

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/26/2021
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: UNKNOWN

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

Symptoms: PT INDICATES THE NIGHT AFTER RECEIVING THE FIRST SHOT, SHE HAD HIVES IN THE BACK, AND THEY KEEP COMING IN HER WHOLE BODY. THEY ITCH AND FORM A CRUST.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1351937
Sex: M
Age: 12
State: VT

Vax Date: 05/14/2021
Onset Date: 05/16/2021
Rec V Date: 05/26/2021
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: Seasonal allergies to pollen and trees

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

Symptoms: Patient experienced unexplained episodes of petechiae (bleeding under his skin) for starting two days after the vaccine (and continuing since then).

Other Meds: None

Current Illness: None

ID: 1351938
Sex: F
Age: 43
State: WA

Vax Date: 05/08/2021
Onset Date: 05/10/2021
Rec V Date: 05/26/2021
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: nkda

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pt presented with angina, inital troponin normal, then rose to 5.2. Ck-MB and MB index also rose and fell consistent with MI. D-dimer was normal. EKG without clear evidence of ishcemia or pericarditis. Coronary angiogram with no culprit lesion identified (either spontaneous coronary artery dissection or thrombus). Echo did not show wall motion abnormalities or pericardial effusion. Differential for this hospitalization with NSTEMI includes myocarditis, coronary spasm, or subclinical dissection.

Other Meds: Lisinopril 10 mg, vitamin c, vitamin d

Current Illness: none

ID: 1351939
Sex: M
Age: 25
State: MO

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
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: None

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

Symptoms: Patient received vaccine and with in minutes, became very light headed, vomited and lost consciousness. Patient became alert but still had trouble hearing, seeing and speaking, and vomited several more times. Paramedics arrived and transported to hospital

Other Meds: None

Current Illness: None

ID: 1351940
Sex: F
Age: 57
State: NM

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/26/2021
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: Tetracycline, Celebrex, Lisnopril, Methyl Presdnisolone, Trazodone

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

Symptoms: My arm was hot and shooting pain in left arm, My migrames got more intense, I went into sneezing spells for a half a hour. I felt hot and my stomach was upset for several days. My head felt light headed and my eyes were blurrey. I recieved the Pfizer vaccine.

Other Meds: Altenolol 25mg, Zomig 2.5,

Current Illness: Suffer from Migrimes, Diabetic Type 2, High Blood Pressure, Gastritis, Rheumatoid arthritis (RA)

ID: 1351942
Sex: M
Age: 43
State: OK

Vax Date: 05/23/2021
Onset Date: 05/23/2021
Rec V Date: 05/26/2021
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, robaxin, skelaxin

Symptom List: Pain in extremity

Symptoms: 10 hours after receiving shot patient temperature spiked and at the ER the patient said it read 110

Other Meds: none

Current Illness: none

ID: 1351943
Sex: M
Age: 35
State: MN

Vax Date: 05/21/2021
Onset Date: 05/24/2021
Rec V Date: 05/26/2021
Hospital: Y

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: Awoke to chest pain on 5/24 @ 1AM. Waited 24hrs with pain fluctuations. Went into ED 5/25 @0630, with continued chest discomfort. Was given nitro, ibuprofen, colchicine. Was diagnosed with Myocarditis.

Other Meds:

Current Illness:

ID: 1351944
Sex: F
Age: 46
State: CA

Vax Date: 05/22/2021
Onset Date: 05/23/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: First two days after shot, extreme chest pressure/tightness, extreme shortness of breath, heart palpitations- began 12 -14 hours after 2nd dose of Pfizer vaccine. Improved a little over next two days but still chest pressure/tightness, palpitations, and shortness of breath. I get winded just talking. I have never had these problems before..Went to Urgent care on 5/26/21.

Other Meds: spironolactone 25mg/day, vitamin D, Magnesium, vitamin C

Current Illness: None

ID: 1351946
Sex: F
Age: 65
State: WV

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt states that she received the injection, her arms went numb and was lightheaded. She sat around for 30 minutes then went home. The next day she got sick for 1 week. The numbness is in both of her arms and radiates across to her back. This is still currently going on. Pt is going to make an appt with her doctor.

Other Meds:

Current Illness:

ID: 1351947
Sex: F
Age: 34
State: NC

Vax Date: 03/18/2021
Onset Date: 04/09/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Chills, nausea, and body aches the day after my 2nd shot lasted about 24 hours. About 1 week later I developed hives, sinus drainage, fatigue and general unwell feeling for about 5 days. I continue to have reoccurring hives in 1 particular spot on my right arm which comes and goes. I take a Claritin or Benadryl for it and it goes away.

Other Meds: None

Current Illness: None

ID: 1351948
Sex: F
Age: 52
State:

Vax Date: 05/05/2021
Onset Date: 05/07/2021
Rec V Date: 05/26/2021
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: patient stated that after receiving their vaccines and waiting their 15 minutes, they went to work. after being at work for 20 minutes they stated they felt a euphoric high feeling and left to go hone to sleep it off. the next day they felt terrible with normal symptoms (headache, fever, chills) but also said that they were suffering from severe pain at the bottoms of their feet. furthermore, the patient stated they went to the emergency department due to feeling so terrible and it was seen that her blood pressure was 90/60 and that she was given fluids at the hospital and monitored before being released. Although it has been a few weeks since immunization, the patient stated that they still are suffering from pain in their feet.

Other Meds:

Current Illness:

ID: 1351950
Sex: M
Age: 17
State: LA

Vax Date: 05/22/2021
Onset Date: 05/23/2021
Rec V Date: 05/26/2021
Hospital: Y

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: hives after taking penicillin 1x as a toddler; no other known

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

Symptoms: chest pain, nausea, sweating w/ alternate chills, and headaches onset at approximately 10-11 a.m. Sunday, 5/23/21. Because he was reporting for work to a camp, he reported to the camp nurse. After conferring with parents, he reported to Hospital for testing. EKG there was normal; minimal labwork performed - Troponin test requested by parent came back at 0.03. Advil taken earlier had resolved pain at that time, but pain was persistent the following day. Parent retrieved patient, and he reported to his pediatrician at the PCP Clinic and more labwork was performed at approximately 10 a.m. Troponin level had increased to 14, with other inflammatory markers elevated and abnormal EKG result. Pediatrician consulted with pediatric cardiologists, and parents were advised to proceed to the ER. Mother arrived with Hospital at approximately 5:30 p.m. Troponin results from 6:45 elevated to 16. Ped. Cardiologist performed echo-cardiogram, which showed no abnormal heart functioning. Ped. Cardiolgist diagnosed myocarditis and prescribed 15-hour IVIg infusion. As of Wednesday, 5/26, at noon, troponin level had decreased to 10.8 and other inflammatory markers were improving. Patient is currently still hospitalized in the ICU Step Down Unit at Hospital.

Other Meds: none

Current Illness: none

ID: 1351951
Sex: F
Age: 90
State: LA

Vax Date: 05/21/2021
Onset Date: 05/23/2021
Rec V Date: 05/26/2021
Hospital: Y

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: It started with swelling, redness, and heat at injection site pretty soon after the injection on Friday 5/21. By Sunday, 5/23, patient had instability when standing and walking; her dementia had gotten worse; there was edema in her whole right arm; and she started having tremors. She was brought to Hospital by ambulance that afternoon and has since had decreased appetite and thirst; continuing swelling at injection site and in her whole right arm; terrible tremors; very low oxygen levels; and is almost comatose. The doctors there have said her kidney function has dropped to unacceptable levels and they are also monitoring her heart. She has been put on hospice care as of this time, 5/26.

Other Meds: Centrum silver, Celexa

Current Illness: UTI (discovered 5/23)

ID: 1351952
Sex: F
Age: 15
State: FL

Vax Date: 05/24/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
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: Sudden onset severe excruciating upper body pain including back, abdomen, chest, throat, neck causing difficulty moving, difficulty breathing, difficulty speaking, nausea. Severe pain lasted 20-25 minutes then slowly diminishing over next hour. After severe pain diminished, ongoing symptoms included severe fatigue, lack of fine motor coordination, brain fog, weaknesses.

Other Meds: Multivitamin, calcium, vitamin D, zinc, Larix, magnesium

Current Illness: None

ID: 1351953
Sex: M
Age: 33
State: NJ

Vax Date: 04/26/2021
Onset Date: 05/03/2021
Rec V Date: 05/26/2021
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: Minocycline

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

Symptoms: About a week or so after my first dose I started having muscle tightness and cramping in my legs and some ?electric? type radiating shots down my left leg starting up in my thigh down to my ankle. I thought it was getting better but then a week or so after my second shot I began having worse leg problems (weakness, pains, pulsing, numbness, tingling). It?s just gotten worse and I?m having tests done and seeing a neurologist.

Other Meds: Ketoconazole cream

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm