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: 1450277
Sex: M
Age: 16
State: KY

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: EKG - 2 UltraSound of heart blood work X-ray

Allergies: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: My son began experiencing chest discomfort a few hours after he had received his 2nd dose. The discomfort only increased with his anxiety and having difficulty breathing. He also experienced his heart racing. I took him to the facility the following afternoon - approximately 31 hours after the 2nd dose and the facility completed blood work, x-ray and EKG; I was to follow-up with a cardiologist and that was also completed with Dr. and another EKG was performed, followed by an ultrasound of his heart. I have not received the result of the ultrasound as it was just performed on 06/30/2021.

Other Meds: N/A

Current Illness: N/A

ID: 1450278
Sex: M
Age: 62
State: FL

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: None

Allergies: Penicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: Nausea, vomiting, pasted out twice at the pharmacy, Dizziness, Muscle Weakness, Shortness of breath, chest pain and tightness.

Other Meds: Carvedol, Entresto, Rosuvastatin, 325 aspirin, vitamin C, D, one day multi vitamin, chondrotin, Glucosamine, l- Lysine

Current Illness: Heart failure

ID: 1450279
Sex: F
Age: 52
State: CA

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/06/2021
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: Clindamycin ICG contrast dye Penicillin Sulfa MMR (adverse reaction) Preparation H

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

Symptoms: Itching over entire body, raised rash on back and belly

Other Meds: Levothyroxine and daily vitamins

Current Illness: None

ID: 1450280
Sex: F
Age: 33
State: NC

Vax Date: 04/01/2021
Onset Date: 06/01/2021
Rec V Date: 07/06/2021
Hospital: Y

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

Lab Data: ER visit at Wake Med Hospitalization from 6/2/2021 - 6/4/2021 (2 days) HOSPITAL patient received IVIG/dex and prednisone

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: patient developed severe thrombocytopenia (platelet count =10K)

Other Meds: adapalene-benzoyl peroxide (EPIDUO) 0.1-2.5 % GlwP Apply 1 Pump topically nightly 45 g 11 ? albuterol (PROAIR HFA) 90 mcg/actuation inhaler Inhale 2 inhalations into the lungs every 4 (four) hours as needed for Wheezing or Shortness of Bre

Current Illness: none

Date Died: 05/19/2021

ID: 1450281
Sex: F
Age: 86
State: NJ

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 07/06/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Daughter stated that patient got very weak about a week after the 2nd dose of pfizer vaccine. Daughter also stated that patient was taken to ER bc she was unresponsive and her blood pressure was dropping, patient passed at ER on 05/19/2021

Other Meds: High blood pressure meds

Current Illness:

ID: 1450282
Sex: F
Age: 7
State: CT

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/06/2021
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: None

Allergies: none

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

Symptoms: Informed by staff that patient experienced urticaria and pruritus with slight burning sensation immediately post vaccination localized to MMRV vaccination site. RN at bedside. No SOB, EWOB. Patient not in distress. RN sought guidance from pediatrician. Pediatrician ordered 5mL of Benadryl PO. Medication given as ordered. Patient transferred to pediatrics for further monitoring. Released home without incident.

Other Meds: none; Sterile Diluent for MMRV

Current Illness: unknown

ID: 1450283
Sex: F
Age: 67
State: KY

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/06/2021
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: NA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient reported to PCP that she received Moderna Covid19 vaccine (lot 006C21A) at another facility on 5/20/21 and then received one dose of Pfizer vaccine as documented here on 7/1/21. Patient denied adverse reaction to either, simply concerned whether further doses would be required. No further doses administered of either product.

Other Meds: NA

Current Illness: NA

ID: 1450284
Sex: F
Age: 73
State: VT

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: none

Allergies: - Asmanex (30 Metered Doses) Moderate Respiratory Distress - Azithromycin Moderate Respiratory Distress - Clarithromycin Moderate - Ethambutol HCl Moderate Respiratory Distress - Influenza Vaccines Moderate - Rifampin Moderate Respiratory Distress - Soybean Oil Moderate - Sulfa Drugs Moderate Respiratory Distress - Penicillins Mild Hives - Eggs Moderate - Gluten Moderate Bloating/gas - Shellfish Moderate - Cat dander Moderate Respiratory Distress - Dog dander Moderate - House dust Moderate Hives - Mold (Inhaled) Mild Respiratory Distress

Symptom List: Pharyngeal swelling

Symptoms: Vaccine was taken was taken from a vial that had been opened and prepared 8 days prior on 6/21/2021. So the vaccine viability had already past.

Other Meds: Levalbuterol Tartrate, Multivitamin, Pravastatin, Aspirin, Vitamin D, Clopidogrel Bisulfate, CoQ10, Nasalcrom, Fexofenadine

Current Illness: none

ID: 1450285
Sex: M
Age: 26
State: CA

Vax Date: 07/01/2021
Onset Date: 07/04/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: N/A

Allergies: N/A

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Severe back pain in lower back muscle next to spine. Difficulty to get out of bed and move. 24 hours of pain severe back pain, 24 hours of more manageable back pain and now the back pain is subsiding.

Other Meds: N/A

Current Illness: N/A

ID: 1450286
Sex: F
Age: 46
State: NY

Vax Date: 04/04/2021
Onset Date: 04/13/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: Only the ones done at the ER.

Allergies: Penicillin, Entex, Erythromycin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 2 days after the 1st shot, I got extreme hives all over my face and chest. Internal medicine Dr prescribed a steroid to take an hour before I took the 2nd shot - as a precaution. On the 9th day after the 1st shot, I felt like I had food poisoning. Abdominal cramps. Vomitting. diarrhea. Started getting really cold in my extremities and nose, but didn't really think much of it. Had to take 2 days off from work to recover. Took the steroid, got my 2nd shot. Ended up having hives 2 days later, but not as bad. 9 days later, I ended up having extreme abdominal cramps, Vomitting, diarrhea, and I nearly passed out at work. EMTs called. BP extremely low. BPM were in the upper 30's. Taken to ER. Given 2 bags of fluids. BP came back up to a low level. BPM never came out of the 40s. Since then, I've been monitoring my BPM. My extremities get really cold to the touch, including my nose, and it is common for my BPM to go into the mid 30s to 40s. Getting the BPM to get into the 60s takes excessive moving / working out. Nose is nearly always cold. Fatigued easily.

Other Meds: None

Current Illness: None

ID: 1450287
Sex: F
Age: 36
State: TX

Vax Date: 04/07/2021
Onset Date: 04/25/2021
Rec V Date: 07/06/2021
Hospital: Y

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

Lab Data: CT scan and blood work to rule out clots/brain bleeding. All tests were clean.

Allergies: Topiramate - determined after taking for several days to treat migraine.

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

Symptoms: After 2nd dose of the Moderna shot, my wife had body aches, lethargy/fatigue, chills and a headache that would come for about 6-10 hours and then leave for 2.5 weeks straight. There were some days where only some of those symptoms would show (e.g. fatigue and chills) but not the others - all symptoms were coming and going in waves (all these symptoms, except the headache/migraine, which has now lasted continuously day/night without stopping for 72 days straight, would actually last for a full 5 weeks). On April 25, she woke up with a strong headache, which has now lasted continuously for 72 days straight in varying degrees. When the migraine pain was at its' peak, her thinking was very foggy, she has trouble speaking and she started losing motor control. She could not get out of bed for days and needed full time care. After a few weeks of intense pain, during which she was hospitalized for 3 days/2 nights, the pain lessened and she was able to get out of bed and take care of her personal needs. She has had light sensitivity and noise sensitivity since this migraine began. During these 72 days, the pain went down to a 2 on a 1-10 scale for 10 days and we thought we were making progress only to see it spike again and again. It seems to go down for 8-10 days then spike for 7 days or so - but it never goes away.

Other Meds: None.

Current Illness: None.

ID: 1450288
Sex: F
Age: 39
State: NC

Vax Date: 04/01/2021
Onset Date: 06/21/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Nasal Congestion Cough Weakness Dizziness Sore throat (1st day only)

Other Meds:

Current Illness:

ID: 1450289
Sex: M
Age: 68
State: FL

Vax Date: 01/21/2021
Onset Date: 01/24/2021
Rec V Date: 07/06/2021
Hospital: Y

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

Lab Data: EKG, Chest X-Rays

Allergies: None

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

Symptoms: The following Tuesday i started with a low grade fever. As the week went on the fever started to rise. I contacted my doctor and he put me on prednisone. I was tested for COVID-19 and the results came back that positive. The following week my temp continued rise to over 105 and I realized things were getting out of hand and call the emergency response. i bled out, had hematoma, I had heart failure, and lost my ability to walk. Was admitted to for 12 days. I was then transferred to Select Speciality for recovery.

Other Meds: Blood pressure medicine, Oxycodone

Current Illness: None

ID: 1450290
Sex: M
Age: 67
State: MA

Vax Date: 03/30/2021
Onset Date: 05/30/2021
Rec V Date: 07/06/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Blood clot left leg

Other Meds: Metoprolol, Simvastatin, Aspirin

Current Illness: none

ID: 1450291
Sex: F
Age: 26
State: CA

Vax Date: 06/22/2021
Onset Date: 06/24/2021
Rec V Date: 07/06/2021
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: By June 25th I had two pimples on my tongue, I had them for three days and also every night for those three days my left arm hurt really bad. By June 28th, in the morning the pimples disappeared and by 2:00 pm half of my tounge was tasting salty and the other half sweet. June 29, my left eye was red, inflamed, and wasn't responding. June 30th my left side of the mouth was not responding either.

Other Meds: No

Current Illness: No

ID: 1450292
Sex: F
Age: 45
State: PA

Vax Date: 02/01/2021
Onset Date: 03/01/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: 2 CT scans, 1 MRI, 4 Prescriptions, neurologist consultation

Allergies: Ibuprofen

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

Symptoms: Headache for months

Other Meds:

Current Illness: N/A

Date Died: 04/01/2021

ID: 1450294
Sex: F
Age: 67
State: MO

Vax Date: 04/13/2021
Onset Date: 04/15/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: Autopsy

Allergies:

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

Symptoms: Found dead. Evidence of diffuse alveolar pulmonary damage (ARDS, DAD).

Other Meds:

Current Illness:

ID: 1450295
Sex: M
Age: 51
State: NC

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient indicated debilitating fever, aches, and fatigue that lasted approximately 10 days. Patient reported having hallucinations and having trouble getting out of bed.

Other Meds:

Current Illness:

ID: 1450296
Sex: M
Age: 49
State: TX

Vax Date: 04/04/2021
Onset Date: 04/16/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: BNP WAS HIGH. ECHO WAS DONE ALSO

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: AFTER 2-3 WEEKS AFTER THE SECOND DOSE, STARTED FATIGUE, SOB, COUGHING CAME TO SEE ME, HAD CHF , REFERRED TO A CARDIOLOGIST DR, MD, WHERE HE HAD ECHO DONE WITH NML CHF AND SEVERE LVH. HE HAD A COVID TEST NEGATIVE.

Other Meds: Metformin. glipizide.januvia/zocor

Current Illness: none

ID: 1450297
Sex: M
Age: 54
State: MI

Vax Date: 06/03/2021
Onset Date:
Rec V Date: 07/06/2021
Hospital:

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

Lab Data:

Allergies: Unknown

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

Symptoms: None stated.

Other Meds: Unknown

Current Illness: No

Date Died: 02/17/2021

ID: 1450298
Sex: M
Age: 82
State: FL

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 07/06/2021
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: None - Funeral home refused to do testing. All doctors related to the patient refused to do testing. We were faced with hiring a private autopsy to get any results.

Allergies: None

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

Symptoms: Pfizer Dose #1 - Jan 22, 2021 - Symptom: arm pain, fatigue Pfizer Dose #2 - Feb 16, 2021 (11:57am) - Death approximately 12 hours later before 1am 02/17/2021.

Other Meds:

Current Illness: Recovering from heart surgery.

ID: 1450299
Sex: F
Age: 63
State: UT

Vax Date: 01/30/2021
Onset Date: 02/02/2021
Rec V Date: 07/06/2021
Hospital: Y

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

Lab Data: Blood test, MRI. ECHO with contrast, CT Scan, ultrasound of the legs and heart at the Hospital

Allergies: Aspirin and Celebrex

Symptom List: Unevaluable event

Symptoms: On February 2nd woke around 07:50 that morning wasn't feeling well but her eye was foggy and she thought something was in her eye but when she looked out her left eye everything went blank. Went to the hospital the same day went to the Eye Center at the hospital and then got admitted into the hospital. Did a full stroke work up and examination of the heart. Was on a heart monitor for a month only thing they found was that her high blood pressure was really high. Patient is now blind in her left eye.

Other Meds: multi vitamin, vitamin d, fish oil, vastardane, amlodipine, and high blood pressure meds

Current Illness: none

ID: 1450300
Sex: F
Age: 72
State: NY

Vax Date: 03/05/2021
Onset Date: 04/13/2021
Rec V Date: 07/06/2021
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: 4 x-rays done MRI Physical therapy

Allergies: Codeine Ativan IVP dye

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

Symptoms: Soreness at sight, extreme pain in arm from bicep to shoulder, unable to raise arm

Other Meds: Atenolol 25mg daily Synthroid 75mcg daily

Current Illness: none

ID: 1450301
Sex: M
Age: 73
State: NV

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: No

Allergies: No

Symptom List: Injection site pain, Pain

Symptoms: I started feeling dizzy within the first day of receiving the 2nd shot. By April 2nd, I noticed I was getting really dizzy and had headaches. By April 7th the dizziness was even more concerning, I checked my blood pressure and it was a little high so I limited my caffeine aspirin etc. I was having brain fog, fatigue, dizziness and blurred vision. On April 29 I went to the doctor. I was examined and was prescribed meclizine. It did not seem to help at all. The headaches and all persisted about 2 months before the dizziness was not so bad. I still have the blurred vision and headache problems. My eyes seem like they cannot focus. I have been dealing with this for 3 months now.

Other Meds: Hydrochlorothiazide

Current Illness: No

ID: 1450302
Sex: F
Age: 23
State: IL

Vax Date: 03/27/2021
Onset Date: 06/14/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: Covid 19 rapid and culture-Negative Strep rapid and culture-Negative Influenza -Negative Blood Test for walking Pneumonia- Negative

Allergies: Sulfa Penicillin Clarithromycin

Symptom List: Injection site pain, Menorrhagia

Symptoms: 2 months post vaccine, I developed a severe chest cold. I had a productive cough I would get lightheaded from the cough with a slight fever, I couldn't taste or smell my ears were really sore I was out of work and normal activities for 5 days or so. I tested negative for Covid and strep throat and both strains of influenza the doctor ruled it out as viral and stated it would run its course. I had 2 separate office visits. The first was with at and followed up with my PCP at .

Other Meds: Zofran 4mg as needed Nexium 20mg 2xdaily Famotidine 20mg 1xdaily Tums 1000mg as needed Methylphenidate 18mg 1xdaily

Current Illness: none

ID: 1450303
Sex: F
Age: 33
State: PA

Vax Date: 04/22/2021
Onset Date: 04/24/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: None yet besides monitoring from physician for worsening symptoms.

Allergies: N/A

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

Symptoms: 1st Moderna shot received 4/22/21. Swollen lymph appeared on left side of neck 2 days later on 4/24/21. I had neck pain and the size of the lymph node did not go down in size. It was golf ball sized. I had a body massage on 5/8/21 where the massage therapist tried to do a lymphatic massage to promote circulation and drainage. This helped the lymph node reduce in size within 24 hours. It went from a golf ball size to kidney bean size. The lymph node has stayed the same kidney bean size since 5/9/21 and has not gone down in size. I had another massage on 6/5/21 in hopes that that it would help, but it has not. I had a doctor's visit on 5/14/21 because I had concerns about getting my 2nd Moderna shot. Ultimately, I did get my second vaccine but was advised by my doctor to revisit in July or August if my lymph node doesn't go away. Since it is still here, I will have to schedule that visit. The lymph node is kidney bean size, and does feel like it causes tension pain in my neck at times.

Other Meds: Centrum multi-vitamin gummies

Current Illness: N/A

ID: 1450304
Sex: F
Age: 72
State: TN

Vax Date: 12/28/2020
Onset Date: 05/03/2021
Rec V Date: 07/06/2021
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: Blood test were given

Allergies: Penicillin, sulfa

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Around two months after receiving my 2nd dose I became very hypothyroid. I have been stable for 15 years with my thyroid condition and it seems to have increased after receiving the vaccine. Dr. did blood test on me to determine that I was experiencing hypothyroid.

Other Meds: Lisinopril 10mg 1x day, Prilosec 20mg 1x day, Synthroid 112 micrograms 1x day, Crestor 10mg 1x day, Vitamin D 1xday,

Current Illness:

ID: 1450305
Sex: F
Age: 63
State: NY

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 07/06/2021
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 - do not recall date or results

Allergies: Morphine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Okay I have been having joint aches, especially in my knees. The big problem I got is that my legs swell up, I have never had that happen before. I also experience lower back pain. This began maybe 3-4 weeks after the vaccine, and I did not relate it to the vaccine although it is unknown. I contacted my DR about a month post vaccination. My DR tried treating me, I also get pretty bad cramping for my hands. She got me on a medication to relax muscles - cyclobenzaprine 10MG 3x a day. DR also gave me meloxicam 15MG 1x daily. I also see a vascular DR this Friday, July 9th 2021, about the swelling in my legs.

Other Meds: Gabapentin 600MG 4x daily, Trazadone 100MG 3x nightly, Atorvastatin 40MG, Loratadine 40MG, Escitalopram oxalate 20MG

Current Illness: N/a

ID: 1450308
Sex: F
Age: 51
State: ID

Vax Date: 03/28/2021
Onset Date: 06/20/2021
Rec V Date: 07/06/2021
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: COVID test. Strep test.

Allergies: Codeine.

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

Symptoms: I started with a really bad sore throat that lasted 7 days. I had to live off ice chips for those 7 days. I also had were my lip had tiny white bumps on it. I had no other symptoms. I went to the urgent care clinic. They did a rapid a cultured strep test they were negative. They also did a COVID test that were negative. I had a shingles vaccine about 6 weeks after the second dose of the COVID vaccine. I did also travel right before my symptoms started. My lip is still a little numb.

Other Meds:

Current Illness:

ID: 1450309
Sex: M
Age: 40
State: CA

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

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

Lab Data:

Allergies: NA

Symptom List: Nausea

Symptoms: Itchy throat, headache,flu like symptoms, pain and weakness on vaccination site(RightArm)

Other Meds: NA

Current Illness: NA

ID: 1450310
Sex: F
Age: 32
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Patient came to lab for a COVID-19 J&J vaccination on June 30, 2021. She was sent by employee health at to our vaccination clinic and filled out the paperwork prior to the vaccine. She checked "NO" for the question asking if you have received any covid-19 vaccination before. She did not ask us any questions. The J&J vaccine was given. The vaccines were logged in later that day (June 30 2021) and it showed that patient had actually received the Pfizer Covid-19 vaccine on May 20 2021 and June 17 2021 at clinic. A staff member called the patient and the patient verified that she did receive vaccines in May and June. The patient stated she must have misunderstood about getting the covid-19 vaccine today, but did not ask any questions. I personally called the patient on July 6th 2021 at 930am (verified name and DOB) and the patient reports no side effects that she is experiencing. No doctors visits. No illness. no hospitalizations. She is a little tired (some fatigue) but no other symptoms.

Other Meds: unknown

Current Illness: unknown

ID: 1450311
Sex: F
Age: 42
State: GA

Vax Date: 07/01/2021
Onset Date: 07/06/2021
Rec V Date: 07/06/2021
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: The patient did not have an adverse event. The patient lied to us stating that she had not received the vaccine even though she had already received dose 1 and 2 in March and April of 2021. She was informed to lie to us in order to get the vaccines again as she was told she did not have any antibodies. As of today she has received a total of 3 doses of Moderna. Per company policy it is required for us to report this to VAERS.

Other Meds:

Current Illness:

ID: 1450312
Sex: F
Age: 35
State: IL

Vax Date: 03/03/2021
Onset Date: 03/23/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: papsmear

Allergies: none

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

Symptoms: i started bleeding for three weeks straight. I had body aches and my arm was sore

Other Meds: none

Current Illness: none

ID: 1450313
Sex: M
Age: 71
State: OK

Vax Date: 01/22/2021
Onset Date: 07/02/2021
Rec V Date: 07/06/2021
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: 6/25 - COVID-19 positive

Allergies: Sulfa

Symptom List: Tremor

Symptoms: Patient presented 7/2 with SOB, fever, muscle aches, generalized weakness, and dry cough. Diagnosed with COVID-19. Reportedly started on ivermectin, dexamethasone, azithromycin, and an inhaled steroid by PCP with initial improvement, and then significant worsening warranting admission. Was admitted to ICU, and emergently intubated on 7/2. As of 7/6, patient remains intubated on mechanical ventilation in the ICU.

Other Meds: Unknown

Current Illness: Unknown

ID: 1450314
Sex: F
Age: 34
State: TX

Vax Date: 06/29/2021
Onset Date: 06/30/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: I received the shot on 6/29/21. Wednesday my stomach started cramping. Thursday night my stomach started to hurt a lot more. I had dirrhea almost constantly Friday morning 1 am - 2 pm Friday afternoon.

Other Meds: None

Current Illness: None

ID: 1450315
Sex: F
Age: 78
State: FL

Vax Date: 01/21/2021
Onset Date: 01/30/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: None

Allergies: Wheat Dairy Ceclor

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

Symptoms: I had the itchy the arm on the 9th day and then 13 days later i broke out in hives. I was then put on predinisone. He told me once the hives started to disappear i could stop taking them.

Other Meds: Provala

Current Illness: None

ID: 1450316
Sex: M
Age: 25
State: PA

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

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

Lab Data: N/A

Allergies: NKDA

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

Symptoms: Individual presented for vaccination for Covid-19. Right after the vaccinator administered the Janssen vaccine without issue the data collector realized he had completed a series of vaccination with the Moderna product on 3/27/2021. He was observed for about 30 minutes post-vaccination without issue. He was informed that he had received a dose of Janssen but was already vaccinated with the Moderna series and should not seek further vaccination.

Other Meds: N/A

Current Illness: Unknown

ID: 1450317
Sex: F
Age: 57
State: MO

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: 04/16/2021 SPECTRALISE TRACKING LASER TOMOGRAPHY AND OTHER EYE EXAMINATIONS

Allergies: SULFA DRUGS, CLINDAMYCIN, CODEINE STRAWBERRIES

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: EYE FLOATER AND FLASHES OF LIGHT IN RIGHT EYE

Other Meds: ESTRADIOL PATCH .025 TWICE A WEEK 1.5 GRAINS ARMOUR THYROID DAILY 10 MG HYDROCORTISONE DAILY LORATADINE 10 MG DAILY 750 MG POTASSIUM DAILY

Current Illness: NONE

ID: 1450318
Sex: M
Age: 44
State: IN

Vax Date: 07/02/2021
Onset Date: 07/03/2021
Rec V Date: 07/06/2021
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: Cold chills, cough, muscle aches, swelling at injection site, dizziness, body aches, headache, fatigue

Other Meds: Amlodiopine, Low Dose Aspirin

Current Illness:

ID: 1450319
Sex: F
Age: 0
State: MA

Vax Date: 07/06/2021
Onset Date: 07/06/2021
Rec V Date: 07/06/2021
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: NO ALLERGIES

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

Symptoms: vaccine vial punctured and administered and left in fridge overnight. next morning same vial was used to administer vaccine. rph phoned patient who said she was fine. rph phoned md who said they made note and will call if they have further questions.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1450320
Sex: F
Age: 62
State: NY

Vax Date: 03/10/2021
Onset Date: 03/13/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: MRI March 16, 2021 - everything stable, normal

Allergies: Lisinopril, Penicillin, Ampicillin

Symptom List: Pain in extremity

Symptoms: I started getting a migraine on March 12, 2021 and on March 13, 2021 flashes replaced the aura of the migraine, which was especially noticeable at night when I was driving. I went in on Monday March 15th 2021 to the DR. They did an MRI and everything was stable, nothing going on with that. They said it was a detached vitriol gel. They gave me refresh tears. I then started having pain in my eyes later that month. I went in and they realized that I had ocular rosacea. I'm on Azithromycin until December when I go back to my DR, that is to treat the ocular rosacea.

Other Meds: Bystolic 10mg, Simvastatin 40mg, Water Pill unknown mg, Vitamin D, Baby Aspirin 2x daily

Current Illness: N/A

ID: 1450321
Sex: F
Age: 67
State: AZ

Vax Date: 05/01/2021
Onset Date: 05/12/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: EKG, CAT scan, COVID and Flu test. Urine test. Blood test. 6-25-2021. Only thing shown was low Potassium level.

Allergies: Morphine

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

Symptoms: My wife became delusional for a short while, then lost her short term memory. She still does not have it back.

Other Meds: Keppra (1500mg morning / 2000mg night)

Current Illness: None

ID: 1450322
Sex: M
Age: 63
State: ID

Vax Date: 06/12/2021
Onset Date: 06/14/2021
Rec V Date: 07/06/2021
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: Desorientation while working at design work in computer Sudden weight loss -muscle mass Tiredness Extremely often urination Demotivation

Other Meds: None

Current Illness: None

ID: 1450323
Sex: M
Age: 57
State: TN

Vax Date: 05/14/2021
Onset Date: 05/20/2021
Rec V Date: 07/06/2021
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: Sulfur

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

Symptoms: I started waking up after 2-3 hours of sleep and I would be wide awake. When I would try to go back to sleep I would hear like someone was walking through the house. I would usually have a pretty good night of sleep the next night and then I would go back to a night of hardly any sleep. This week I went 3 days with out sleep. During the day I have troubled staying focused and I am unable to function as well. I am unsure if it is because I am not getting enough sleep. I am also having trouble remembering things. My doctor advised me to take over the counter melatonin . I feel like that it is not making a difference.

Other Meds: Vitamin C Multivitamin

Current Illness:

ID: 1450324
Sex: F
Age: 78
State: FL

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: None

Allergies: Wheat Dairy Celcor

Symptom List: Vomiting

Symptoms: Muscle joint aches, terrible headache, 106 fever and slept for 36 hours. I had hives spots again and i grabbed the leftover predinione and took them. I went to the doctor and she gave me another prescription of predinisone.

Other Meds: Provol

Current Illness: None

ID: 1450325
Sex: F
Age: 63
State: NJ

Vax Date: 03/13/2021
Onset Date: 04/01/2021
Rec V Date: 07/06/2021
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: gastric intolerance to erythromycin, migratory arthralgia and swollen numb hands after rubella vaccine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Approximately a month after receiving my second Covid vaccine, I noticed that I had severe right sided back, right hip and right buttock pain on a daily basis, preventing me from sleeping or performing my usual activities of daily living. I have had some mild pain in my right knee. I also had severe right ear pain which I saw a doctor for and he said I had TMJ. In June, when I had the ear pain, I also had a lump on the right side of my tongue which I showed the doctor. That has disappeared. I have diarrhea most days. I have an old history of Crohn's, but ,my last colonoscopy showed no evidence of Crohn's. I was asymptomatic for about 30 years. I have developed 2 small tender nodules over the DIP joint of my right index finger. I noticed that today. Everything is on the right side, which is the side where I received my second Covid vaccine. I have also noticed a decrease in the stream when I urinate. My husband and 22 year old (athlete) daughter are also experiencing severe back and hip pain, so that is why I think this is all related to the Covid vaccines we received .

Other Meds: losartan/hctz, bystolic

Current Illness:

ID: 1450326
Sex: M
Age: 39
State: TX

Vax Date: 03/31/2021
Onset Date: 06/04/2021
Rec V Date: 07/06/2021
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: I had an MRI of my leg and my lungs. I had an ultrasound of my heart.

Allergies: I am allergic to Bactrim and all sulfur drugs.

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

Symptoms: I had a BVT in my leg and a PE in my lungs and I was treated with a clot blocker. I was sent home and was told that I would be on blood thinners the rest of my life.

Other Meds: I take Novolog, Levemir, lithium, vraylof and cosentyx.

Current Illness: No illnesses at the time of vaccination.

ID: 1450327
Sex: M
Age: 13
State: TX

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 07/06/2021
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: Milk

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Severe headache, 10 days after vaccination he started having a rash at the injection site. Soreness in the arm, chills, fever, fatigue.Took tylenol.

Other Meds: None.

Current Illness:

ID: 1450328
Sex: M
Age: 14
State: VA

Vax Date: 06/12/2021
Onset Date: 06/22/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: Lyme blood test - negative

Allergies: Augmentin

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

Symptoms: Received COVID #2 on 6/12 and developed cold symptoms with ear pain and loss of taste. On 6/22/2021, developed right facial droop and was seen in the ER - diag with Bell's palsy and placed on Abx, Prednisone, and acyclovir. Lyme came back negative. Was seen in f/u 6/25 in clinic with improved but still apparent right facial droop. Abx discontinued at that point. He is doing much better now (7/6) with some residual facial droop.

Other Meds: None

Current Illness: None

ID: 1450329
Sex: F
Age: 73
State: TN

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 07/06/2021
Hospital:

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

Lab Data: Antibody test (6/21/2021)

Allergies: Singular, Venlapaxine, Lipator, Lycenapril, Benezone, Phistolic

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

Symptoms: Chills, really bad headache, nausea, rash on face (lasted 3 days). Antibody test came back negative (no coverage listed).

Other Meds: Advair, Albuterol, Lodapene, Eliquist, Maltac

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am