VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1352378
Sex: F
Age: 50
State: OH

Vax Date: 05/16/2021
Onset Date: 05/18/2021
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: PCN Lisinopril

Symptom List: Dysphagia, Epiglottitis

Symptoms: It seems that soon after vaccine my daughter who has Dementia got very weak. Legs and arms shaky. I am personally doing exercises with her to try to help with weakness. and build strength

Other Meds: Donepezil Hydrochlorothiazide Memantine Vitamin D Mirtazapine

Current Illness: Dementia High BP

ID: 1352380
Sex: F
Age: 25
State:

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Heart pain, chest tightness, irregular heartbeat. Started on May 23, 2021 and is still present on May 26, 2021 although not as intense.

Other Meds:

Current Illness:

ID: 1352381
Sex: F
Age: 55
State: CA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
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:

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

Symptoms: Client received the 1st dose of Pfizer COVID vaccine (lot # EW0182 and expiration date 5/15/21) at 2:47pm. Client walked over to EMT to report that she was having pain on the opposite arm where vaccine was given and that she would like her blood pressure taken (vaccine given in left arm, pain in right arm). PHN finds patient alert and oriented x 4 sitting in a chair. Client reports she had been waiting 20 minutes in observation. Client reports a history of hypertension. Per client, she was not sure about taking her nifedipine, so she did not take her medication at the regular time. Client states she takes Losartan and took it this morning. Client denies any chest pain, headache, blurred vision, dizziness, or shortness of breath. At 3:14pm vitals: blood pressure:173/103, pulse:60, and oxygen: 98%. At 3:20pm vitals: blood pressure:161/106, pulse:60, and oxygen:99%. Client reports no symptoms. PHN came to speak to client and patient reports she has her medication with her and took it out of her purse. Client thought she should not take medication because she was getting the vaccine. Client also stated when she does not take her medication 160-180 systolic is her regular blood pressure at home. PHN let client know that she should take medication as prescribed. Client took 2nd dose of hypertension medication (Nifedipine) at 3:24pm. PHN recommended client to stay for further observation as blood pressure is high. At 3:25pm vitals: blood pressure:155/94, pulse:63, and oxygen:99%. Client reports no more arm pain on right arm and that "she was a little nervous about the vaccine and that her blood pressure goes up easily.". At 3:30pm vitals: blood pressure:160/99, pulse:66, and oxygen:98%. Client reports she is feeling better and was provided with ER precautions and to notify her provider about her blood pressure readings. Also recommended client eating and taking medication prior to dose #2. Client reports no shortness of breath, no headache, no arm pain, no chest pain, no blurred vision. At 3:38pm, vitals are: blood pressure: 152/99, oxygen:99, and pulse:60. Client reports no symptoms. At 3:44pm vitals: blood pressure: 148/99, pulse: 60 and oxygen: 98%. Client walked out with a steady gait at 3:46PM.

Other Meds: Nifedipine and Losartan

Current Illness:

ID: 1352382
Sex: F
Age: 35
State: CO

Vax Date: 05/20/2021
Onset Date: 05/24/2021
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: NONE

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: This is an additional report of events to the original report. I have begun suffering stomach aches daily. I missed my period. I am now late by a week. I am not pregnant. I will visit a doctor soon if the symptoms persist.

Other Meds: NONE

Current Illness: NONE

ID: 1352383
Sex: M
Age: 45
State: MA

Vax Date: 04/28/2021
Onset Date: 05/01/2021
Rec V Date: 05/26/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin, allergy type not specified

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

Symptoms: From hospital discharge summary: "45 y.o. right-hand-dominant male who presents with few hours of improving left arm heaviness/left hand cramping in the setting of getting his second Pfizer COVID-19 vaccination in his right arm 3 days ago and 3 weeks of mildly increased exercise/intermittent fasting. The patient reports getting his first Pfizer COVID-19 vaccination on April 7, 2021. Reports some mild symptoms afterwards. Around that same time, the patient reports having a checkup with his primary care doctor that was notable for a cholesterol elevation to 200. This prompted him to try and lose weight including intermittent fasting and increase in exercise, especially for exercises and cardio. The patient reports approximately 20 pound weight loss over the past 3 weeks. 3 days ago, the patient reports getting his second Pfizer COVID-19 vaccination in his right arm. Reports fever (maximum 103 Fahrenheit) and mild headache the subsequent 2 days after the vaccine. Last night, the patient went to sleep on his left side at around 8 PM. He woke up at 4 AM with significant left arm heaviness and left hand cramping. He tried to massage his hand with some slight improvement of the symptoms but otherwise the symptoms persisted. Hence, this morning, he called his PCP, who told him to come into the ER for further evaluation. Here, the patient reports improving left arm heaviness/left hand cramping. He also does report family history of heart attack and an uncle at a similar age and massive heart attack of his grandfather in their 60s. He denies fever, anorexia, unexpected weight change, headache, blurry vision, sinus pressure, cough, hemoptysis, orthopnea, PND, SOB, DOE, chest pain, pleurisy, changes in taste/smell, N/V/D, abdominal pain, flank pain, urinary sxs, genital sxs, black stools, incontinence, absence of flatus, calf pain, leg swelling, numbness/tingling, streaking redness/rash/skin changes, easy bruising. Also, deny history of HTN, DM, smoking, prior MI, prior PCI, prior CABG, prior TIA/CVA, or history of PAD. Further, denies recent trauma/fall, history of cancer, blood thinner use, recent drug use, recent travel, sick contacts, family history of connective tissue disease/congenital aortic anomaly, or family history of similar sxs. --- Hospital Course by Problem # Troponinemia (Likely myopericarditis) The patient has a family history notable for MI and CABG in relatives aged 50-70 on his mother's side. The patient notes that most of these family members were heavy smokers and drinkers, which he is not (never-smoker, rare EtOH, never illicit drugs). His symptoms are notable for L arm heaviness/cramping that began around 8pm on 4/30/21 at 9/10 severity and subsequently was 3-4/10 severity on presentation to ED and is 0-1/10 severity at time of admission to the floor; he has no associated numbness, weakness, coolness, or pallor. His symptoms are non-exertional. He denies CP, SOB, lightheadedness, nausea, jaw pain, abdominal pain, fatigue. He noes that he recently got the second COVID shot in the R arm, and had a post-vaccine course notable for Tmax 103 ~3d ago and 101 as recently as yesterday. His EKG was notable for ST-elevation in II/III/aVF and his troponins were elevated 305 -- > 298 -- > 328. Of note, his CRP was elevated at 69. The patients symptoms and findings could certainly be compatible with atypical ACS and, given the low risk of bleeding associated with heparin, he was treated conservatively upon admission with heparin infusion, metoprolol tartrate 6.25mg q6h, atorvastatin 80mg (he received ASA 325mg in the ED). However, given his recent covid vaccination and elevated CRP and reported fevers, this could also be compatible with myocarditis or other inflammatory etiology. TTE on 5/3 demonstrated preserved EF 55% with no WMA. Given reassuring TTE, a cMRI was ordered to assess for myocarditis vs scar tissue from recent ischemic event. Cardiac MRI on 5/5 was notable for finding consistent with myopericarditis (see below). Aspirin and atorvastatin was stopped on discharge. Patient was discharged with metoprolol 25 mg daily."

Other Meds: Omeprazole PO, 20 QD

Current Illness: GERD

ID: 1352384
Sex: F
Age: 32
State:

Vax Date: 05/24/2021
Onset Date: 05/26/2021
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: None

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

Symptoms: Spontaneous vaginal bleeding started 48 hours after first dose of vaccine. Last menstrual period finished on May 20th 2021, prior to the first Covid Vaccine dose on May 24th 2021.

Other Meds: None

Current Illness: None

ID: 1352386
Sex: F
Age: 46
State: ME

Vax Date: 04/30/2021
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: LA

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Extremely heavy bleeding and clots in period

Other Meds: None

Current Illness: None

ID: 1352387
Sex: M
Age: 32
State: TX

Vax Date: 04/01/2021
Onset Date: 04/15/2021
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: Heart issues, weakness and dizziness. I went to a family doctor and after blood test, I need to see a cardiologist urgently because my blood test found my CK in 742H where the scale is between 31-336. I?m young and athletic and never had a condition in my life, but all these started two weeks after the vaccination.

Other Meds: None

Current Illness: None

ID: 1352388
Sex: M
Age: 83
State: MI

Vax Date: 05/08/2021
Onset Date: 05/15/2021
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

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pain in left arm between elbow and shoulder. Painful in the morning, then subsides. One week after injection pain was severe for three days. Now not severe but still painful in morning and evening. Usually pain-free during the day.

Other Meds: Armour thyroid, Fish oil, V K2, V B12, V D3, Niacin, Alendronate, Tamsulosin

Current Illness:

ID: 1352389
Sex: F
Age: 47
State: SC

Vax Date: 02/25/2021
Onset Date: 03/03/2021
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: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Heart palpitations, chest pain

Other Meds: none

Current Illness: none

ID: 1352390
Sex: F
Age: 14
State: CA

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: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Her father let me know that patient felt nauseated a few mjnutes after vaccine.we had her remained seated with head down and she vomited a little

Other Meds: unknown

Current Illness: blood disorder

ID: 1352391
Sex: F
Age: 16
State:

Vax Date: 05/02/2021
Onset Date: 05/03/2021
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: none

Symptom List: Rash, Urticaria

Symptoms: Sharp, stabbing unilateral headaches lasting 1-3 seconds, initially 2/day, now 15/day. Different from baseline headache type. Started day after second dose.

Other Meds: flonase, vitamin D, multivitamin

Current Illness: none

ID: 1352393
Sex: M
Age: 34
State: MD

Vax Date: 04/29/2021
Onset Date: 04/30/2021
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: NO

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

Symptoms: AFTER MY FIRST DOSE OF THE PFIZER COVID-19 VACCINE,MY LEFT ARM HURTED FOR A LIL BIT THE NEXT DAY AROUND THE MORING TIME.BUT AROUND 12PM AFTERNOON 4/30/2021 MY LEFT SIDE OF MY FACE STARTED TO GET A NUMB FEELING.IT HAS BEEN FEELING LIKE THIS ALMOST A FULL MONTH NOW,AFTER TAKING MY SECOND DOSE OF THE PFIZER COVID-19 VACCINE,NOTHING HAS CHANGED.IT STILL FEELS THE SAME,I HAVE TO KEEP RUBING MY FACE BECAUSE IF I DONT IT WILL START TO GET NUMB EVERY TIME.I DONT LIKE THIS FEELING AT ALL,I GOT THE SHOTS BECAUSE I WANTED TO FEEL SAFE,AND MAKE SURE THE PEOPLE AROUND ME WAS ALSO SAFE.SO I NEED HELP NOW,I NEED SOMETHING TO HELP ME BEFORE IT GETS WORSE.

Other Meds: NO

Current Illness: NO

ID: 1352394
Sex: F
Age: 19
State: IL

Vax Date: 05/05/2021
Onset Date: 05/23/2021
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: Peanuts, tree nuts, legumes

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

Symptoms: itchy bump on injection site no treatment unresolved at time of report

Other Meds: Junel, Zyrtec

Current Illness: none

ID: 1352395
Sex: F
Age: 61
State: CA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
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:

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

Symptoms: Client (DOB:10/11/1959) received the 2nd dose of Moderna COVID vaccine lot # 021C21A and expiration date 5/26/21 at 2:45pm. Client reports to patient having an asthma attack at 3pm and using her albuterol inhaler. At 3:05pm healthcare provider arrives and sees client sitting in wheelchair, alert and oriented. Client reports she is feeling better but that "mask makes breathing harder". Client reports no symptoms at this time. Vitals at 3:05pm: blood pressure:140/90, pulse:80 and oxygen:97%. Client reports that after she was intubated she now has some issues with her breathing. Client reports she will be getting dialysis tomorrow. At 3:10pm client reports she feels "fine" and that she is "sure this is not from the vaccine and that this has happened before." At 3:15pm vitals: blood pressure:140/90, pulse:78, and oxygen:98%. Healthcare provider recommends client stay until 3:30pm but since client has already been waiting 30 minutes, client reports she is ready to leave. Healthcare provider reviewed ER precautions. Client was wheeled out at 3:17PM by healthcare provider. Client is being driven home by daughter.

Other Meds: albuterol

Current Illness:

ID: 1352396
Sex: F
Age: 71
State: AR

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa drugs, iodinated contrast media

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

Symptoms: Swelling, pain, redness that resembles cellulitis measuring 11cm x 23 cm.

Other Meds: Cyclobenzaprine

Current Illness: none

ID: 1352397
Sex: M
Age: 45
State: WA

Vax Date: 05/26/2021
Onset Date: 05/26/2021
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:

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

Symptoms: When injecting the vaccine into the patient's right arm, the needle and syringe disconnected, leading to a good amount of the vaccine splashing outside. Because of this and deciding that lower-than-authorized dose was administered (and most likely less than half of the dose), the vaccine was given again on the left arm of the patient.

Other Meds:

Current Illness:

ID: 1352398
Sex: F
Age: 15
State: MN

Vax Date: 05/26/2021
Onset Date: 05/26/2021
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: none reported

Symptom List: Ear pain, Hypoaesthesia

Symptoms: About 5 minutes after receiving her vaccine, patient described feeling light headed, had hearing and visual disturbances, felt like she might pass out. after several minutes of sitting with head between her leg, those symptoms went away but she said she had developed a headache. At time she left pharmacy she said she felt ok other than her headache.

Other Meds: none reported

Current Illness: none

ID: 1352399
Sex: F
Age: 40
State: VA

Vax Date: 05/14/2021
Onset Date: 05/15/2021
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: PCN and Ceclor

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Spotting has occured daily since the day after vaccine was administered on 5/14/21. Menstrual cycle typically regular and was expected to begin on 5/29/21.

Other Meds: Taken morning of; around 8:30/9:00am Vegan digestive enzymes (Veganzyme). Water with Vitamin C powder (1000mg)

Current Illness: N/A

ID: 1352514
Sex: F
Age: 57
State: AZ

Vax Date: 05/21/2021
Onset Date: 05/24/2021
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: Left arm red- nauseated- headache

Other Meds: migraine medications- B/p medications

Current Illness:

ID: 1352515
Sex: F
Age: 46
State: MN

Vax Date: 04/12/2021
Onset Date: 04/14/2021
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: Pineapple

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

Symptoms: Started with a mild headache which hasn't gone away despite otc pain meds. Then progressed to fatigue, swollen legs and ankles, shortness of breath, mild chest pain and several instances of abnormal heart rhythm (flutter in chest). Still having these issues

Other Meds: None

Current Illness: None

ID: 1352516
Sex: M
Age: 65
State: CA

Vax Date: 02/27/2021
Onset Date: 02/27/2021
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

Symptom List: Unevaluable event

Symptoms: A few hours after my second shot I got a mild headache, tired, and a bit blurry vision. The next day things got worse with high fever, bad headache, and very tired. The bad side effects went away after 4 days but since then I often feel tired with a mild headache and a little chest pain now and then. Before my vaccination, I played tennis 3 times a week, each time I played about 2 to 3 hours continuously without feeling tired. But after the vaccination, it takes only 15 to 30 minutes for me to run out of breath so I have to slow down to catch my breaths. My stamina is adversely effected after my vaccination . I'm afraid that I have a case of Myocarditis, a condition similar to Pericarditis, which is an inflammation of tissue surrounding the heart, that caused by the vaccine.

Other Meds: Vitamin-D Atenolol Lovastatin

Current Illness: None

ID: 1352517
Sex: M
Age: 25
State: OH

Vax Date: 04/13/2021
Onset Date: 04/17/2021
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: None

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

Symptoms: 4/13: vaccine - Pfizer 4/14-4/15: arm sore 4/17: wake up in morning with calf twitching for prolonged period, went back to sleep 4/17-4/19: muscles in my body continue to twitch, mainly legs and arms 4/19: right eye begins to twitch 4/22: stopped drinking coffee and alcohol, began drinking much more water than normal to hydrate 4/27: drank alcohol for first time since I stopped Twitching has not subsided or become better or worse in this previous timeframes 4/28: right eye didnt twitch that much during the day 4/28: playing video games and getting frustrated caused the my eye and hand to twitch 4/29: had coffee for first time, eye twitch was worse than normal In the late afternoon (last time drinking coffee until today 5/26) 4/29: abs twitched for first time 5/1: left eye begins twitching 4/30-5/1: tingling in right hand pinky finger like hand is falling asleep 5/1-5/2: went to bar 5/3: sneezed and both eyes began twitching (I had sneezed before and this has happened, this is the first note I had written) 5/4: I went to my primary care doctor and shared these notes. Stopped taking notes since. Doctor had me take a blood test (see below) as well as referred to a neurologist for an EMG. 5/4-5/26: I've since been on some extra vitamins (b12 and d, as my b12 was on the low side but not outside the recommended range and d was also low) and have not seen any decrease or increase in symptoms. Some days are better than others. My right eye has stopped twitching, but I continue to have it throughout my body in my arms, back, legs, feet, left eye. I've been on an average diet since the beginning of march.

Other Meds: None

Current Illness: None

Date Died: 05/13/2021

ID: 1352518
Sex: M
Age: 73
State: NM

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 05/26/2021
Hospital: Y

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: My father had a reaction soon after the first dose in which he vomited violently. The vomiting continued over the next several months but less frequent along with dizziness and fatigue. On April 10 he was admitted to the emergency room with low hemoglobin numbers. Things quickly escalated from there. He was admitted to the ICU and diagnosed with autoimmune hemolytic anemia. After a month in the ICU, over 60 blood transfusions, 20 dialysis, multiple pharmaceutical treatments and a splenectomy, my father died on May 13.

Other Meds:

Current Illness:

ID: 1352519
Sex: F
Age: 16
State: MN

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: SYR
Vax Site: LA

Lab Data:

Allergies: NONE REPORTED

Symptom List: Injection site pain, Menorrhagia

Symptoms: Immediately after receiving vaccine patient stated she felt light headed and nauseous and laid down. mom then stated that it was because she was sick when she came in and was probably from that. We let her lie down for the post observation time, and then we had her sit up for several minutes. after the post observation time was up she was able to get up and leave.

Other Meds: NONE REPORTED

Current Illness: At check in and on VAR patient stated wasn't ill, but when started feeling ill after vaccine, parent stated that she hadn't been feeling well before hand.

ID: 1352520
Sex: F
Age: 33
State: MN

Vax Date: 05/06/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: 14 weeks pregnant at town of vaccine. Due date 11/4/2021. Found out 5/26/2021 at 16 weeks 6 days that there was fetal demise. No heartbeat found on ultrasound. No other symptoms noted. No bleeding, spotting, or cramping. Fetus measured 16+ weeks on ultrasound. Last fetal heart tones heard on at home doppler on Monday 5/17 at 15 weeks 4 days.

Other Meds: Prenatal vitamin, baby aspirin, Claritin, Tylenol

Current Illness: None

ID: 1352521
Sex: F
Age: 44
State: CA

Vax Date: 04/23/2021
Onset Date: 05/01/2021
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: none know to meds

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Burning sensation on palm of hands and wrists for approximately 10 days

Other Meds: none

Current Illness: none

ID: 1352522
Sex: F
Age: 42
State: NJ

Vax Date: 05/01/2021
Onset Date: 05/05/2021
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: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Second day had fever and extreme lethargy. A few days later broke out in body rash that is still here a few weeks later. Went to doctor and she said it looks like P. Rosea. Rash covers full back, chest, stomache, partial neck and legs. No history of this.

Other Meds: Over counter vitamins

Current Illness: None

ID: 1352523
Sex: M
Age: 13
State: WA

Vax Date: 05/20/2021
Onset Date: 05/24/2021
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: None

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

Symptoms: Raised, itchy hives on right arm at injection site,

Other Meds: None

Current Illness: None

ID: 1352524
Sex: F
Age: 56
State: IL

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: IM
Vax Site: RA

Lab Data:

Allergies: Latex

Symptom List: Nausea

Symptoms: Arm pain, large, red, itchy rash in area of the vaccination. Swollen supraclavicular lymph node on right side.

Other Meds: Flonase daily and famotidine as needed.

Current Illness: Seasonal allergy. I had surgery in March and has an allergic reaction to the adhesive tape used to cover an incision that was taking longer to heal in April but was over it before my first shot. But I did have Prednisone shortly before my first vaccine as treatment for the rash from the aggressive tape. I was cleared by my doctor to get the first shot on May 1, 2921.

ID: 1352525
Sex: F
Age: 43
State:

Vax Date: 04/17/2021
Onset Date: 04/17/2021
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: iodine, pet hair, some seafood, latex

Symptom List: Injection site pain

Symptoms: Ringing in ears, very loud for the first two weeks after, subsided a lot after 3 weeks but is still present at 5.5 weeks after

Other Meds: none

Current Illness: none

ID: 1352526
Sex: F
Age: 16
State: CA

Vax Date: 04/23/2021
Onset Date: 04/03/2021
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: 16yo F patient came to our Moderna clinic on 4/23/21, inadvertently received COVID-19 vaccine Moderna lot 007C21A ext. 10/12/21. FDA EUA for Moderna is for age over 18. Patient was notified on the incident. Our ID physician was notified and consulted for feedback. Patient reported no side effects after 1st dose. Clinic leadership immediately convened meetings for process improvement with on-going audit to prevent future incident. The case was discussed with physician over her vaccination. Their recommendation was to offer Pfizer vaccine. Legal guardian consented to 2nd dose Pfizer, lot EW0167, which was given on 5/25/21. Patient reported no side effect after the dose.

Other Meds:

Current Illness:

ID: 1352527
Sex: M
Age: 68
State: CA

Vax Date: 02/18/2021
Onset Date: 02/23/2021
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: I started experiencing heart palpitations after the first dose. Then they started to get worse after the second dose. On March 5th, my blood sugar was higher than normal, about 130. It then went to about 160. I was getting worried about 6pm, my resting heart rate was about 80 bpm, if felt pressure on my chest and the palpitations felt strong. Then, my teeth on the left side of my mouth really started hurting, like someone was trying to pull them out. That is when I went to ER

Other Meds: Vitamin D and sometimes Diclofenac

Current Illness: none

ID: 1352528
Sex: F
Age: 13
State: CO

Vax Date: 05/01/2021
Onset Date: 05/22/2021
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: Tremor

Symptoms: Patient fainted immediately after receiving the Pfizer vaccine. She regained consciousness immediately as soon as patient was placed on her back on the floor with feet elevated. Her blood pressure was normal and she was kept under watch for 20-25 mins after receiving the vaccine and she left the clinic after we observed her for 20-25 mins and she was doing absolutely fine. Followed up with the parent on Wednesday 5/26/21 at around 7:45pm. Mother reported patient is doing absolutely fine. I told patient's mom, fainting can be caused due to nervousness and drop in oxygen levels to the brain. However, this adverse effect will be reported to patients doctor and also to the VAERS for Pfizer covid-19 vaccine.

Other Meds: NONE

Current Illness: NONE

ID: 1352529
Sex: F
Age: 60
State: OR

Vax Date: 05/03/2021
Onset Date: 05/15/2021
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: Sulfa

Symptom List: Erythema, Pruritus

Symptoms: Patient states that about 1.5 to 2 weeks after receiving the vaccine she broke out in itchy hives over body. Most severe upper thighs and back,

Other Meds: lisinopril, clopidogrel

Current Illness: N/A

ID: 1352530
Sex: F
Age: 24
State: GA

Vax Date: 04/25/2021
Onset Date: 05/25/2021
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: Capers

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

Symptoms: Mild fever, full body itching, irritability

Other Meds: Alieve

Current Illness: None

ID: 1352531
Sex: F
Age: 35
State: CO

Vax Date: 05/10/2021
Onset Date: 05/10/2021
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: None

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

Symptoms: Blurred, dimmed vision in left eye and tremors in left hand. Tremors began one week after injection so may be unrelated. The blurred and dimmed vision began almost immediately after injection and was significantly worse the following morning.

Other Meds: Gabbapentin, Albuteral Inhalor, Vitamin D, Tumeric

Current Illness: None

ID: 1352532
Sex: F
Age: 51
State: CA

Vax Date: 05/09/2021
Onset Date: 05/10/2021
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: Gluten intolerant, peanut intolerant, corn intolerant

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I had the "normal" aches and tiredness starting many hours after 2nd shot (1st shot only had the very sore arm/unable to lift left arm straight up on the second and third day). Went to bed around 10pm. Slept hard and woke up at 12:05am the next morning with EXTREME convulsing chills and clearly had a very high fever. I didn't have a thermometer to check, but had the old fashioned second person feel my forehead and cheeks. Teeth were chattering, literally. Every joint in my body and muscles ached and i felt extremely arthritic. Woke up in a pool of sweat maybe 24 hrs after 2nd shot. Slept on-and-off all day. Second morning after still had the chills/sweating. Still had arthritic-feeling joints on day 2. What is scaring me is that it has been 16/17 days later and I still have a constant dull ache in my left shoulder with a dull ache/weekness in my left hand.

Other Meds: None

Current Illness:

ID: 1352533
Sex: M
Age: 16
State: CA

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

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

Symptoms: 16yoF patient came to our Moderna Vax clinic on 4/23/21, inadvertently received COVID-19 vaccine Moderna lot 007C21A ext 10/12/21. FDA for moderna is for age over 18. Patient was notified on the incident. Our physician was notified and consulted for feedback. Patient reported no side effects after 1st dose. Clinic leadership immediately convened meetings for process improvement with on-going audit to prevent future incident. The case was discussed with physician and another physician over her vaccination. Their recommendation was to offer Pfizer vaccine. Legal guardian consented to 2nd dose Pfizer, lot EW0167, which was given on 5/25/21. Patient reported no side effect after the dose.

Other Meds:

Current Illness:

ID: 1352534
Sex: F
Age: 50
State: LA

Vax Date: 04/12/2021
Onset Date: 04/13/2021
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: N/a

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

Symptoms: Extremely heavy week long period, two years post menopause

Other Meds: Crestor, Vyvanse, omeprazole, vitamin B, C, D, K

Current Illness: N/a

ID: 1352535
Sex: F
Age: 54
State: CA

Vax Date: 05/07/2021
Onset Date: 05/08/2021
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 and Zithromax

Symptom List: Pain in extremity

Symptoms: 102 fever, body aches, headaches, lethargic. Lasted 3 days

Other Meds: Metoprolol, nexium, zoloft Estradiol patch, progesterone

Current Illness: None

ID: 1352536
Sex: M
Age: 24
State: WA

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

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

Lab Data:

Allergies: None Known

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

Symptoms: Patient with known Syncope reactions to needles answered no on intake form. Patient administered vaccine and immidiately passed out. Patient was transitioned to floor. feet elevated and blood pressure returned. rested for 25 min. tried to resume sitting position and passed out again. transitioned again and ok. Hydrated and gave sugar. checked pulse and BP and was normal. took an exaggerated rest period. patient left on own power once fully recovered. Then it was mentioned by the patient that we have a needle phobia and pass out.

Other Meds: None Known

Current Illness: None Known

ID: 1352537
Sex: M
Age: 34
State: IN

Vax Date: 05/18/2021
Onset Date: 05/24/2021
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:

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

Symptoms: After first shot, knee joint slight fluid retention and moderate pain. When driving extended period of time knee pain shot to hip and was more than moderate. No history of joint pain. Second shot, still had knee pain then right shoulder pain when lifting arm. The joint pains have started to subside some and are only mild now. Starting about 6 days after second shot, occasional heart flutter and some fatigue throughout the day. This has been going on for 2-3 days now.

Other Meds:

Current Illness:

ID: 1352538
Sex: M
Age: 30
State: NV

Vax Date: 05/21/2021
Onset Date: 05/22/2021
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: N/A

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

Symptoms: Significant chest pain, shortness of breath, and extreme fatigue after little to no activity whatsoever. I am still experiencing these symptoms five (5) days after receiving my second dose of the Pfizer vaccine. Additionally, I can assure anyone reviewing this report that I absolutely did not exhibit these symptoms (or anything similar) prior to Saturday, 22 May 2021.

Other Meds:

Current Illness: N/A

ID: 1352539
Sex: M
Age: 43
State: MO

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: NKDA

Symptom List: Vomiting

Symptoms: Pt. Had glucose level drops. Down into 60's with no previous issue with hypoglycemia, pale skin in face. Severe fatigue, low blood pressure readings of 112/60 and 110/90. Hot flashes and nausea. Non-coherent with glassy eyes with no awareness. Fluctuations in symptoms and slept for Three days in and out. Pt. Took approx. Three days to feel back to himself.

Other Meds: Metoprolol 50mg daily Clonazepam 1mg daily Omeprazole 40mg BID Multivitamin daily

Current Illness: None

ID: 1352540
Sex: F
Age: 49
State: AL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I had raised red whelps over large areas of my body and a itch that was almost unbearable. I took 3 Benadryl to get relief. I had covid arm. That is not the biggest issue as it resolved after the Benadryl. However now anytime my skin comes in contact with hot water (shower washing dishes etc) the same redness and intense itching is where the water touch. I do not mean scalding hot just the typical bath or dish washing temp of water. I have pictures of the red whelped areas and the site of injection as it looked the same as what my body does now once any hot water touches it.

Other Meds: Lexapro 20

Current Illness: None

ID: 1352541
Sex: F
Age: 46
State: NC

Vax Date: 05/18/2021
Onset Date: 05/19/2021
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: Penicillin

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

Symptoms: Beginning the next day, I started to experience an achy feeling in my upper arm, it traveled down to my lower arm, then by the net day i felt the aching feeling in my wrist. It then went into my other right arm by 3 days post shot. Now all of my joints ache and are uncomfortable all the time (legs and arms). I am having issues picking up heavy items without pain. I feel like I am swollen in all of my joints. I otherwise feel great

Other Meds: Pravastatin, Lisinopril, Januvia, Meloxicam, Loratadine, RePHresh Probiotic, Shaklee Stress Relief Complex, Shaklee Mindworks and Shaklee Vitalizer Vitamin Strip

Current Illness: None

ID: 1352542
Sex: M
Age: 35
State: OR

Vax Date: 05/20/2021
Onset Date: 05/20/2021
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: cefaclor

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt initally had heache dizzines, n/v . ON 5/26 admited with intracranial hemorrhage.

Other Meds: citriizine

Current Illness: none

ID: 1352543
Sex: F
Age: 26
State: WA

Vax Date: 05/25/2021
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: Mild reaction to latex

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

Symptoms: Syncope (lost consciousness) in the morning after the vaccine. Accompanied by fever, chills, dizziness/presyncope, nausea, headache, body ache, stiff neck on same side as vaccinated arm, sore throat and excessive saliva production

Other Meds: Benadryl for allergies taken on the night of vaccination only

Current Illness:

ID: 1352544
Sex: F
Age: 56
State: CA

Vax Date: 04/29/2021
Onset Date: 04/30/2021
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: none

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

Symptoms: rash, sore, irritating , itch under right breast and right stomach

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm