VAERS 2021 Database www.vaers.hhs.gov

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

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

COVID19 Lot Number

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

Incidents per State

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

ID: 1444155
Sex: F
Age: 39
State: MA

Vax Date: 03/01/2021
Onset Date: 05/03/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: Seen in urgent care clinic

Allergies: Cipro

Symptom List: Dysphagia, Epiglottitis

Symptoms: Triggered Chron?s symptoms for 2 weeks - stomach aches and diarrhea abs then I got shingles in May

Other Meds: Prozac 5mg Zyrtec 10mg

Current Illness: None

ID: 1444156
Sex: F
Age: 71
State: DE

Vax Date: 03/24/2021
Onset Date: 05/24/2021
Rec V Date: 07/02/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Lyme's disease test was negative. Blood wor and blood chemistry normal. Tests came back positive for both EBV early antigen and EBV nuclear Antigen. Diagnosis was Mononucleosis. Date of lab work was June 2, 2021

Allergies: vancomycin

Symptom List: Anxiety, Dyspnoea

Symptoms: Headache would come and go, sore throat would come and go, achy shoulders would come and go, tired. On June 1, I went to the doctor's office and she prescribed labwork.

Other Meds: Paroxetine, Trazodone, Simvastatin, VitD +VitD2 50,000 q3weeks, calcium

Current Illness: none

ID: 1444157
Sex: M
Age: 49
State: PA

Vax Date: 06/11/2021
Onset Date: 06/27/2021
Rec V Date: 07/02/2021
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: N/A

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

Symptoms: When the pt went to get his 2nd shot he stated that approx 5 days prior his L arm was red, swollen, and bruised

Other Meds: N/A

Current Illness: None

Date Died: 05/26/2021

ID: 1444158
Sex: M
Age: 58
State: FL

Vax Date: 05/22/2021
Onset Date: 05/23/2021
Rec V Date: 07/02/2021
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: Death... left ventricle rupture of the heart 4 days after the vaccine

Other Meds: None

Current Illness: None

ID: 1444159
Sex: F
Age: 63
State:

Vax Date: 06/29/2021
Onset Date: 07/01/2021
Rec V Date: 07/02/2021
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: redness at site of injection

Other Meds:

Current Illness:

ID: 1444160
Sex: F
Age: 46
State: FL

Vax Date: 04/25/2021
Onset Date: 05/12/2021
Rec V Date: 07/02/2021
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: Had annual ob/gyn exams on June 22. Communicated with doctor of missed cycles. He said to continue to monitor and if it continues for additional 2 months to follow up.

Allergies: None

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

Symptoms: Menstrual cycle was to begin on May 12. Did not have cycle again until July 1.

Other Meds: None

Current Illness: None

ID: 1444161
Sex: M
Age: 37
State: LA

Vax Date: 05/26/2021
Onset Date: 07/01/2021
Rec V Date: 07/02/2021
Hospital: Y

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

Lab Data: EKG, cardiac enzymed, cardiac cath

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 1 July (35 days post immunization) developed chest pain, Troponin elevated, sent to cath lab who removed thrombus in LAD without plaque formation. Possible that clot related to vaccine.

Other Meds: None

Current Illness: None

ID: 1444162
Sex: M
Age: 52
State: VA

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: Unknown

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Customer did not feel right within 7-10 mins after receving the Janssen vaccine. He complained of vision changes, "seeing dots". When he tried to walk, his legs buckled, but customer was slowly assisted to the floor. While on the floor, my technician heard grunting noises coming from him and his left arm was rigid and bent at the elbow. But within 5-10 seconds, he slowly sat up and said that he "doesn't remember being on the fall" and complained of being sweaty and "seeing dots". Paramedics were contacted and took him the hospital. Contacted the customer later in the evening and was informed that he was resting at home after spending half of the day in the hospital. He mentioned that the paramedics treated him with Epipen and bendadryl and then he felt better. He was treated "other things" but don't recall.

Other Meds: None

Current Illness: None

ID: 1444163
Sex: F
Age: 58
State: CA

Vax Date: 03/26/2021
Onset Date: 03/28/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: Xrays R shoulder performed 4/1/21 MRI R shoulder performed 6/9/21

Allergies: Sulfa

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Subacromial bursitis of the right shoulder that is resolving with time and therapeutic exercise program.

Other Meds: albuterol nebulizer, estradiol, Breo-Ellipta, Singulair, pravastatin, progesterone

Current Illness: none

ID: 1444164
Sex: F
Age: 51
State: NE

Vax Date: 06/01/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: NONE

Allergies: Zulfa

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Approximately five and a half hours after the moderna vaccine number two, taken on July 2nd 2021, this patient (self) experience a red, swollen rash on the left arm below the injection site north of hand. Dizziness, joint pain, extreme fatigue.

Other Meds: Over the counter antihistamine generic Zyrtec

Current Illness: NA

ID: 1444165
Sex: F
Age: 63
State: FL

Vax Date: 06/03/2021
Onset Date: 06/29/2021
Rec V Date: 07/02/2021
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 and tetracycline

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

Symptoms: Floaters in eyes

Other Meds: Armour Thyroid,bio natural hormones, vitamins

Current Illness:

ID: 1444166
Sex: F
Age: 41
State:

Vax Date: 06/25/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Itchy arm with red circular rash around injection site, about 1-inch in diameter.

Other Meds: Zyrtec (apx 12 hours before); Complex B supplement, probiotic, Vitamin D supplement (all OTC), and Arnica montana "pellets" taken apx 1 hour before vaccination.

Current Illness: None

ID: 1444167
Sex: F
Age: 50
State: CA

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: TDAP 06/14/21

Allergies: Shrimp, Peanuts

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

Symptoms: Pt states immediately post vaccine "throat began to feel tighter" & states dizziness p/t arrival & @ time of arrival, & informed RN of experiencing dizziness p/t & at time of vaccination & received TDAP 6/14/21. Pt states only dizziness & tightened throat at this time 1635. Pt vitals: 122/62 HR 78, 98% RA, RR 16, No swelling, inflammation, redness to throat & inside mouth, appeared WNL. No dysphagia, no dysphasia. Pt & family informed medical professional of vaccine & what to expect over post vaccine & when to call DR, EMS, & go to ER. Pt & family verbalized understanding & states no needs at time at 1720 &

Other Meds: denies

Current Illness: Pt states informed RN felt dizzy upon entering clinic & prior to vaccine. Also states informed RN received TDAP vaccine on 6/14/21.

ID: 1444168
Sex: F
Age: 39
State: TX

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 07/02/2021
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: none.

Allergies: NKDA

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

Symptoms: patient reports developing "whole body hives" after 1st dose of pfizer covid vaccine. no sensation of throat closing in.

Other Meds: lexapro, adderall, flonase

Current Illness: none known

ID: 1444169
Sex: F
Age: 20
State: TX

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
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

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

Symptoms: Before pt got her 2nd Covid injection, she did warn me that she might faint. She said that she is afraid of needles. I advised to stay seated after the vaccine was given. After the injection, less than a few minutes, patient did have an episode of syncope. Mom and brother were there. I immediately got the EpiPen and told my technician to call 911. When I got to her, it looked as if she was seizuring for a few seconds, then she came out of it. I told her that I would give her the epinephrine injection and put she pushed it away and said that she was fine and not needing it. I asked mom on what they wanted me to do. She said that she wasn't quite sure. Patient then slowly became more conscious and was able to talk to me. I asked her whether she had any difficulty breathing but she said no. She said that she was just really dizzy. She was sweating a bit. She didn't eat or drink anything before coming to the pharmacy. The injection was given around 12:48pm. I kept on talking to her to make sure that she was still conscious and not passing out. Then the EMT came. They took her blood pressure. First, it was 90s/60s, then 105/70s (if I am not mistaken). Per patient, she almost passed out before at Dr. office but ever did. She didn't with her first Covid vaccine. Eventually, patient agreed to go to the ER. I called my coordinator, and informed her of what happened. I did ask mom whether I could call her to check on her and mom was okay. However, when I called around 7:20p, and I couldn't reach her. I left a VM and told them that I will checked back with her on Monday.

Other Meds:

Current Illness: NO

ID: 1444170
Sex: M
Age: 24
State: IA

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt received an unnecessary dose of Pfizer Covid19 vaccine due to his apparently not knowing or remembering that he had previously received the Janssen Covid19 vaccine several months ago. He presented requesting a first dose of the Covid19 vaccine and pharmacy was initially unable to look up his vaccine history. After double-checking with the patient that he had not received a previous Covid19 vaccine, vaccine was administered. Afterward, when we located the patient's vaccine history, we noticed that he had previously received the Janssen Covid19 vaccine in March. After questioning the patient about this discrepancy, he maintained that he did not remember ever getting the Covid19 vaccine, but stated that his English was not very good, so he may have gotten it without realizing it. Patient was not given an additional immunization record card, and 2nd dose appointment was cancelled. No adverse effects occurred during the 15 minute waiting period in the pharmacy.

Other Meds:

Current Illness:

ID: 1444171
Sex: F
Age: 44
State:

Vax Date: 06/24/2021
Onset Date: 06/27/2021
Rec V Date: 07/02/2021
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: sulpur

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

Symptoms: Tingling in my hands. Feels like carpel tunnel and fingers feel hot inside .Adrenaline throughout my body that i can cant sleep.

Other Meds: Iron Tablet, multi vitamin tablet daily

Current Illness:

ID: 1444172
Sex: M
Age: 41
State: UT

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: Phone consult conducted with photos

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Dx: Angioedema, pruritus Tx: Prednizone, Clairitin, ice Results: Swelling not going down with treatment, itching is now gone.

Other Meds: None

Current Illness: None

ID: 1444173
Sex: F
Age: 19
State: PA

Vax Date: 06/23/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: When I use my arm muscles of the arm where I got the vaccine, I get really weird nerve like(?) pain all along my arm. It hurts more so when I pull my arm to the back and when I flex my muscles/grab something tight. It goes away in a few minutes but comes back when I flex my muscles again.

Other Meds: Tylenol, Hair/skin/nail vitamins and Women?s Multivitamins

Current Illness:

ID: 1444174
Sex: F
Age: 41
State: IL

Vax Date: 05/13/2021
Onset Date: 06/06/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: Bloodwork is showing Rheumatoid Factors as 168.4 (6/24/2021)

Allergies:

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

Symptoms: I've had joint pain and swelling everyday starting the third week after my second dose. This has never happened before.

Other Meds:

Current Illness:

ID: 1444175
Sex: F
Age: 24
State: TX

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 07/02/2021
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: Nothing. She does not have insurance. I am a student and so I can't afford the insurance premium for her.

Allergies: Eggplant, dust

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

Symptoms: My wife is having headaches on a continuous basis. The mild headaches are not in one particular area of the head. It moves all over the head. Before it was not frequent. But for the last 2 to 3 weeks, she is having this mild headache almost every day for the whole day from the last week. If she takes Ibuprofen, she feels a little better but the headache does not completely go away.

Other Meds: Ibuprofen

Current Illness: No

ID: 1444176
Sex: F
Age: 45
State: WI

Vax Date: 06/21/2021
Onset Date: 06/22/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: NONE YET

Allergies: SULFA, AMOXICILLIN ,PENICILLIN.

Symptom List: Unevaluable event

Symptoms: PATIENT REPORTED NAUSEA, PAIN ON LEFT THIGH AND HEADACHE. PATIENT SAID THAT SHE HAS AN APPOINTMENT COMING UP ON 7/15/21 BUT HAS NOT RECEIVED ANY TREATMENT YET.

Other Meds: RIZATRIPTAN, TRAMADOL ER, OXYCODONE, BENADRYL, MULTIVITAMIN

Current Illness: NAUSEA (FIRST VACCINATION), MIGRAINE, ENDOMETRIOSIS, LEG PAIN (FIRST VACCINATION) , NUMBNESS (FIRST VACCINATION),

ID: 1444177
Sex: M
Age: 36
State:

Vax Date: 06/22/2021
Onset Date: 06/25/2021
Rec V Date: 07/02/2021
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: CC: Chest pain Troponin: 0.06 Repeat Troponin: 0.03 after receiving SoluMedrol 125mg and Ketorolac 30mg ECHO ok EF 61% Cleared by Cardiology to discharge home

Allergies: NKA

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

Symptoms: 6/22/21 first dose of Pfizer Vaccine 6/25/21 Chest Pain 7/2/21 Seek medical attention at ER/Urgent

Other Meds:

Current Illness:

ID: 1444178
Sex: M
Age: 21
State: MN

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 07/02/2021
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: I was and had order to be given tdap and instead was given TD vaccine instead

Other Meds: vyvanse, sertaline, qysmia, melatonin

Current Illness:

ID: 1444179
Sex: F
Age: 40
State: NJ

Vax Date: 04/01/2021
Onset Date: 04/19/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data:

Allergies: Na

Symptom List: Injection site pain, Menorrhagia

Symptoms: 3 periods in 2 months. Abnormal menstruation. Then no period for 40 days.

Other Meds: Na

Current Illness:

ID: 1444368
Sex: F
Age: 33
State: RI

Vax Date: 02/26/2021
Onset Date: 02/28/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: Increased atenolol to 75mg daily, some improvement but sxs return as soon as does wears off

Allergies: Chili peppers, lyrica, mirtazapine

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

Symptoms: My POTS went from well controlled to debilitating. Chest pressure, out of breath, shaky, brain fog, severe fatigue, nausea, headache. Resting heart rate went from 55-65 to 75-90. Unable to work

Other Meds: Welbutrin 300MG Daily Atenolol 50MG Daily Naltrexone 4.5MG Daily Pyridostigmine (Mestinon) 30MG 2xDaily Cromolyn Sodium 10mL 4xDaily Famotidine Allegra Vitamin D Fish oil

Current Illness: N/a

ID: 1444369
Sex: M
Age: 50
State: LA

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 07/02/2021
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: Numerous: ? 7+ ER visits. ? Carotid artery scan ? Min 3 lung cat scans related to events ? MRI brain ? EGD with Bravo ? Insomnia ? Heat-induced asthma symptoms ? Fungal infection tests (negative) ? Visits to Neurologist, Cardiologist, ENT (did scope), Pulmonologist (lung tests), Asthama Doctor, GP, Gastrointerologist, etc. ? Tests for rare blood diseases (Lyme, Rocky Mountain Spotted Fever, etc) ? Numerous CBC panels

Allergies: Fire ants, Plavix

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 05:02 through 06.30: ? Shortness of breath ? Fluctuating blood pressure. ? Severe chest pain. ? Pain in joints. ? Muscle pain. ? Petechiae ? Purpura ? Diziness ? Headaches ? Asthamtic-like phlegm ? Nerve pain in hands ? Numbness in hands

Other Meds: Steroidal cream, lidocaine (hemorrhoids), statin

Current Illness: Hemorrhoids

ID: 1444370
Sex: M
Age: 41
State: WA

Vax Date: 04/02/2021
Onset Date: 04/04/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: Blood work drawn. waiting on results Allergy test prescribed. Unable to be tested due to hives and antihistamines, need to wait for "body to calm down" first.

Allergies: Penicillin Shrimp Mango pollen

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: After shot there was a soreness in the left arm that slowly radiated out to the rest of the body. Morning of 4/4/2021 body was covered with an itchy rash, Dr. tried OTC antihistamines. 4/7/2021 Dr. prescribed steroids and stronger antihistamines. 4/20/2021 ER visit had more steroids and antihistamines prescribed. 4/292021 Dr. prescribed steroids and stronger antihistamines. 5/10/2021 Dr. stopped steroids and tried new cocktail of antihistamines. 6/1/2021 Dr. prescribed visiting allergy clinic and had blood test run. 6/9/2021 Allergy clinic Dr. could not run test as i am on a coattail of antihistamines, have to wait until i can go 5 days without antihistamine and hives before testing can start.

Other Meds: Vitamin D3 Trazodone Omeprazole Loratadine

Current Illness: none

ID: 1444371
Sex: M
Age: 30
State: CA

Vax Date: 06/25/2021
Onset Date: 06/28/2021
Rec V Date: 07/02/2021
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: Elevated heart rate for a week

Other Meds: Finasteride 1mg

Current Illness: None

ID: 1444372
Sex: M
Age: 69
State: MA

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 07/02/2021
Hospital: Y

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

Lab Data: admitted to hosp 04/18/2021

Allergies: none

Symptom List: Nausea

Symptoms: Transient ischemic attack 24 hours after 2nd dose

Other Meds: n/a

Current Illness: n/a

ID: 1444373
Sex: F
Age: 51
State: VA

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 07/02/2021
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: Injection site pain

Symptoms: Elevated resting heart rate 100-125 when typical rate is 76.

Other Meds: None

Current Illness: None

ID: 1444374
Sex: F
Age: 61
State: NY

Vax Date: 03/30/2021
Onset Date: 04/08/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: Sonogram; 5/13/21; enlarged lymph nodes MRI; 5/25/21; enlarged lymph nodes Ultrasound; 6/15/21; compared to 5/13/21 ultrasound -- still shows enlarged lymph nodes

Allergies: Sulfa-based drugs, morphine, Clindamycin

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

Symptoms: Enlarged lymph nodes

Other Meds: Biotin, calcium citrate

Current Illness: None

ID: 1444375
Sex: F
Age: 18
State: AL

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: Urinalysis clean

Allergies: Omnicef

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

Symptoms: Since having my second shot I have felt severally nauseated constantly and cannot function due to debilitating nausea the nausea started the day after I got my second shot on April 13, 2021 taking Zofran has helped however it comes back as soon as the zofran wears off

Other Meds: None

Current Illness: None

ID: 1444376
Sex: M
Age: 30
State: MA

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: None

Allergies: Amoxicillin and Hazelnuts

Symptom List: Tremor

Symptoms: The event that I would consider abnormal (couldn't find info about it) was tachycardia. My resting heart beat when I'm falling asleep is pretty low, 50s and 60s, and my heart was pounding. I have a fitbit and checked it, wondering why it felt like I had just drank a pot of coffee, and my heartbeat reached 108 at several points, including while lying in bed trying to sleep. This happened several times that day and I recall calling my doctor's office for advice. I think I was advised to come in if I felt worse or if new symptoms arose. I also experienced: fever (99.2), aches, chills, headache, poor sleep (awake early), fatigue, arm pain and diarrhea. I took Tylenol extra strength and had to go to work as we were shortstaffed and I wasn't given much of a choice. I took some Benadryl to help me sleep and by the 30th, I was a bit tired, but my fever and the other symptoms were gone. I had some arm pain but it wasn't nearly as painful as it was on the 29th. By the 31st I believe all symptoms had resolved

Other Meds: CBD oil, melatonin, 5HTP, B complex, Vitamin D3, Magnesium complex Finasteride, Testosterone, Metformin, Tirosint, Liothyronine

Current Illness: None

ID: 1444377
Sex: M
Age: 77
State: AL

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Night of first injection my dad said he missed his bed and fell on the floor and laid in the floor and couldn?t move for an hour. The day after second injection he almost passed out and we went to the ER. He was sent back home. Now he has been diagnosed with Parkinson?s disease. He has low Vitamin D. He is anemic and his iron is so low he is receiving 2 iron infusions. He has blood that has showed up in his stool and is having a colonoscopy on July 15th. He stays very dizzy and weak. He also has problems now with his eyesight.

Other Meds:

Current Illness: Had open heart surgery October 7, 2020 to repair an aortic aneurysm. No illnesses.

ID: 1444378
Sex: F
Age: 63
State: NC

Vax Date: 03/21/2021
Onset Date: 03/28/2021
Rec V Date: 07/02/2021
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: CT brain showed a left basal ganglia lancunar infarct. Platelets were 51. Previous levels were 63 in Nov-2020. She received IG injection on sat for hypocomplementemia.

Allergies: Metformin, penicillin, Septra, Ciprofloxacin, oxycontin,

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

Symptoms: She presented with right sided weakness, altered gait, slurred speech, facial droop on March 28, 2021 in the afternoon. She contacted her PCP on March 30,2021 who advised her to go to the ER. Her symptoms were improving when she arrived at the ER. CT brain showed a left basal ganglia lacunar infarct

Other Meds:

Current Illness:

ID: 1444379
Sex: F
Age: 37
State: IN

Vax Date: 06/28/2021
Onset Date: 06/29/2021
Rec V Date: 07/02/2021
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: Sulfa (Bextra); latex sensitivity

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

Symptoms: Abdominal pain 4 days and continuing; chest heaviness/pains 3 days; diarrhea 3 days; vaginal cramping and bleeding outside of menstrual cycle 1 day and continuing; increased palpitations and skipped heart beats 4 days and continuing; fatigue 4 days and continuing; arm tenderness at injection site 4 days; redness at injection site 3 days; itching at injection site 3 days; lymph node tenderness in right arm 3 days; chills 4 days and continuing; night sweats 4 days and continuing; vomiting 1 day; body aches 4 days and continuing; leg pain/ cramping 2 days and continuing; joint pain 2 days; anxiety 3 days; insomnia 2 days

Other Meds:

Current Illness:

ID: 1444380
Sex: M
Age: 43
State: CA

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sharp pain behind knee cap lasting 24 hours

Other Meds: None

Current Illness: None

ID: 1444381
Sex: M
Age: 48
State: FL

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: Hearing test.

Allergies: None

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

Symptoms: The day of the first dose of the COVID 19 Moderna vaccine I experienced tinnitus in my right ear for about 2 hours. Thereafter, I started feeling my heartbeat in my ear every time I laid down and intermittent tinnitus . In early June, I started feeling pain in the same affected ear. At that time I went to my primary care physician who prescribed me antibiotics(Amoxilin) infection. After completing the five day treatment of antibiotics symptoms did not improve so I made an appointment with an ENT and went to an urgent care clinic where they prescribed me an antibiotic and steroid drop but that medication did not improve my symptoms. At the appointment with the ENT on June 9th I was diagnosed with a bulging ear drum and ear infection. More oral antibiotics were prescribed with a steroid to reduce swelling. Pain in the ear seemed to subside but I still had ear fullness and redness. At the follow up appointment on 6/30 a hearing test was done where it was discovered that I lost about 50 percent of my hearing on right ear. I still have tinnitus and hearing loss today.

Other Meds: None

Current Illness: None

ID: 1444576
Sex: M
Age: 44
State: TN

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 07/02/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: experience chest pain and tightness. He had some dyspnea. This occurred for the next week or so with the patient. He suspected it may be a myocarditis event. The pain is no longer present in

Other Meds:

Current Illness:

Date Died: 05/06/2021

ID: 1444577
Sex: M
Age: 68
State: MS

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: He visited Medical Center 04/18/2021. He visited PCP on 04/28/2021. He visited Dr. on 04/30/2021. DOD: 05/06/2021.

Allergies: N/A

Symptom List: Pain in extremity

Symptoms: My father became ill after the 2nd does and did not recover. His legs began to hurt. He found it hard to walk. He didn?t want to go to the doctor from fear of COVID. But his legs began to swell and he couldn?t walk, so he went to ER on 4/18/2021 and released on 04/20/2021. He then went to his PCP on 04/28/2021. He went to see a cardiologist who said his heart was good on 04/30/2021. He passed away on 05/06/2021 in his sleep. Please help.

Other Meds: Oxygen

Current Illness: Emphysema/COPD

ID: 1444578
Sex: M
Age: 12
State: OH

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: Checked by paramedics vital signs and cognitive signs.

Allergies: NKA

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

Symptoms: Patient became light headed and fainted from a seated position and fell on floor within one minute of receiving vaccination. Patient checked by pharmacist on site as well as Nurse practitioner and paramedics and was deemed well and fit to go home. There was a facial injury from the fall.

Other Meds: None Known

Current Illness: not known

ID: 1444579
Sex: M
Age: 15
State: OR

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Patient Vomited about 10 minutes after the Pfizer COVID-19 vaccine. We gave the mother a water bottle, asked how he was and he said he felt better. About 10 minutes later they left without checking back in with the staff. The RPh on duty was watching him for other reactions and he seemed fine.

Other Meds: COVID-19 Pfizer vaccine

Current Illness: unknown

ID: 1444580
Sex: F
Age: 40
State: CA

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: n/a

Allergies: none

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

Symptoms: C/o throat closing up, dizziness, headache soon after 2nd dose Moderna. Pt took a puff of her inhalant & felt relieve. All vitals wnl.

Other Meds: Albuterol inhalant PRN

Current Illness: Asthma

ID: 1444581
Sex: F
Age: 28
State: NC

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: NA

Allergies: NKA

Symptom List: Vomiting

Symptoms: On 7/2/2021, 28y.o. female patient presented to the pharmacy with her husband to receive their COVID-19 vaccines. Patient was checked in, screened and requested Janssen vaccine. RPh stepped outside to speak with patient about the potential side effect risks with Janssen due to her age group but told patient ultimate decision of which vaccine to receive was her choice. Patient stated she wanted to stick with Janssen and RPh then proceeded to review the questionnaire with patient that she had filled out online. Patient answered no to all questions including the question about ever having a reaction, fainting or feeling dizzy after a vaccine. She was counseled by the pharmacist of potential side effects and how to treat at home or seek medical attention , v-safe program reporting, vaccine card, waiting 15 mins in pharmacy area to be monitored, etc. Her vaccine was administered at approximately 10:12 by rx tech and a wait time of 10:27 given to pt. Work continued in the pharmacy and the patient and her husband were in the waiting area chairs in front of the pharmacy talking (per him, they were joking about side effects when she started to slump over and he thought she was playing around until she started falling backwards and he tried to catch her by her shirt). At approximately, 10:19, the pharmacist and techs heard a loud noise as patient experienced syncope falling backwards hitting the back of her head on the cement floor and the chair fell out from under her and crashing against the floor. Husband was by her side as RPh ran out to assist asking techs to close the pharmacy down for the medical emergency and to call 911 ASAP, call in around 10:19. Code white was called as well. Assessment following Adv Events protocol: Patient was breathing and awake with dazed/glazed eyes as pharmacist started trying to ask questions to assess her conscious level. After about 30-45 seconds pt came back around and answered name and DOB for pharmacist who was talking back and forth with 911 operator. Patient answered that she felt hot, dizzy and anxious to rph who immediately had cold compresses (cool, wet paper towels) for patient's face and neck. Patient also stated that she had not had anything to eat since 7/1 PM as they had planned to grab breakfast after their vaccines. Store managers arrived as well. Local firefighters from the station just down the street were in the store doing their daily meal shopping and heard the call come across to EMS so they came back to the pharmacy to help. They already had equipment in hand and recorded vitals while RPh was still attending to pt and 911 operator. at 10:24; bp:124/92, pulse 70, O2 sat: 98. Patient stated she felt well enough to try to sit up in the chair again and get off the hard floor and was assisted up by firemen and husband. One of the firemen and RPh assessed the back of the patient's head and no blood or knot was located, patient able to ambulate head and neck and no blood was found on the floor. Patient still able to answer questions, knew where she was, what she had done except in the moment of fainting and knew who her husband was. Patient refused to be transported to the hospital and EMS was cancelled by firemen to 911. Firemen left scene. Rph, rx tech and Assest Protection completed initial questioning for VAERS/SCRT, Incident and EOC contacted while patient and husband still present. Patient asked for some water and was provided her wishes. Rph continued to ask patient questions about how she was feeling as reports were being gathered. Patient stated she thought not eating and her anxiety got to her causing her to faint and still reported no previous issues with receiving vaccines. Also counseled on signs/symptoms of a concussion, soreness to be expected over the next few days and to seek help immediately if any conditions worsened. Patient was given RPh's card and told that she would be followed up with Friday PM at COB and Monday, but if anything changed between then to call RPh at the number on the business card. Upon finishing reporting and standing, patient stated back of right knee was hurting from tangle with chair upon fall; otherwise felt fine just a little tired and laughing. A wheelchair or electric cart was offered to patient upon leaving but she asked to walk out assisted by husband and was released. Reporting: Pt meds tri-sprintec and lexapro 20mg, no allergies, only medical condition is anxiety, no PCP

Other Meds: Lexapro 20mg, Tri-Sprintec

Current Illness: NA

ID: 1444582
Sex: M
Age: 51
State: WA

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
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 BROUGHT IN COVID VACCINATION CARD WITH A FIRST DOSE OF MODERNA FROM 6/4/21 RECEIVED FROM ANOTHER SITE. I GAVE THE PATIENT HIS SECOND DOSE OF MODERNA AND WHEN I WENT TO PROCESS THE VACCINE OUR SYSTEM ALERTED ME THAT HE HAD ALREADY RECIEVED 2 DOSES OF PFIZER FROM ANOTHER PHARMACY. UPON FURTHER INVESTIGATION IN THE IMMUNIZATION REGISTRY, I SAW HE HAS RECIEVED BOTH PFIZER DOSES AND NOW BOTH MODERNA DOSES. PATIENT DID NOT DISCLOSE THIS INFORMATION AT TIME OF VACCINATION.

Other Meds:

Current Illness:

ID: 1444583
Sex: M
Age: 66
State: OH

Vax Date: 06/02/2021
Onset Date: 06/14/2021
Rec V Date: 07/02/2021
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: He was in hospital for 4 days, checking in day after event. They did various tests, some cancelled. MRI, sonograms. etc.

Allergies: none

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

Symptoms: Stroke 3 weeks later. Ringing in right ear, blurred vision, numbness on right side.

Other Meds: Vicodin, tylenol

Current Illness: rheumatoid arthritis.

ID: 1444584
Sex: F
Age: 51
State: GA

Vax Date: 06/01/2021
Onset Date: 07/02/2021
Rec V Date: 07/02/2021
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: After 2nd shot- Covid arm- large red spot by injection spot. Hot to touch. A little itchy. Appeared 3 days after injection. First day after injection felt drunk- woozy- foggy. Today is first day of Covid arm. No treatment yet. After first shot - felt dizzy and waves of nausea off and on for 4 days.

Other Meds: None

Current Illness:

ID: 1444585
Sex: F
Age: 47
State: ID

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: None.

Allergies: None

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

Symptoms: Approximately 5 minutes after the 15-minute waiting period after the shot, the left side of my entire body had intense tingling - from my head to my feet. My throat began to constrict making my breathing sound like a snore. This lasted for approximately 30 minutes, then completely subsided.

Other Meds: None

Current Illness: None

ID: 1444586
Sex: F
Age: 47
State: CA

Vax Date: 05/15/2021
Onset Date: 06/01/2021
Rec V Date: 07/02/2021
Hospital:

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

Lab Data: MRI/MRA on 6/29/21 at Medical Center Blood tests on 6/28/21 at Medical Center I was on steroid pack medicine twice; 6/12/21 and 6/25/21 (MethylPrednisolone)

Allergies: Sulfa group

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

Symptoms: severe burnt sensation on ceiling of mouth, indescribable entire jaws/teeth pain, itchiness, the most severe migraine pain reaching level 100, intense severe tight neck, stiff neck, brain pressure, back of the head tightness, uncontrollable fatigue, lethargy, temple headache, ear clogging, severe inflammation type of swelling on right neck from 6/1/21 to present and ongoing, still sick as of 7/2/21.

Other Meds: Acyclovir 400mg daily

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am