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: 1454122
Sex: F
Age: 78
State: IA

Vax Date: 03/18/2021
Onset Date: 06/23/2021
Rec V Date: 07/07/2021
Hospital:

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

Lab Data: see above

Allergies: ezetimibe - unknown

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pfizer COVID 19 Vaccine EUA Pfizer Dose 1 2/26/21 (EN6198) Pfizer Dose 2 3/18/21 (EP7534) COVID Positive 7/6/21 7/6/21: The patient presents to ED with diarrhea and Pt is 78 y/o female who presents to the ED complaining of chronic diarrhea onset since March that worsened over the last two weeks. Pt has had a cough as well. Pt has had a previous colonoscopy, but was told by GI that it was "too soon to have another." Pt denies any recent antibiotics, recent sick contacts, or recent travel. Pt states she is diabetic and her sugars have been 112 in the morning and 150 in the evening. Pt denies any abdominal surgery. Pt admits to cough, nausea and back pain, but denies vomiting, bloody stools, fevers, chest pain, shortness of breath, and abdominal pain aside from a pain that occasionally radiates down to her pelvic which she does not have currently. Pt denies a bowel movement today. Pt admits to both Covid-19 vaccine doses in March. Pt received the Pfizer vaccine.. The onset was chronic. The course/duration of symptoms is worsening. The character is not bloody. Risk factors consist of not recent antibiotic use, not infectious exposure and no recent travel. Associated symptoms: abdominal pain, nausea, cough, denies vomiting, denies fever, denies chest pain and denies shortness of breath. Patient seen examined emergency department for chief complaint of diarrhea that has been present for several weeks. Patient has seen her GI doctor. She states that stool cultures were obtained. Stool cultures reviewed, which demonstrated all negative stool cultures. Due to patient's persistent diarrhea, workup was obtained to rule out acute dehydration verses AKI verses electrolyte abnormality. Workup obtained demonstrates no acute findings. Patient was updated results. On reexamination, patient states he has had no episodes of diarrhea in the ED. This juncture, I believe patient is stable for discharge home with close follow-up with GI. Patient is agreeable. Return precautions are discussed, including change in mental status, decreased urinary output, or any other concerns..

Other Meds: acetaminophen 325 mg PO QD amlodipine 10 mg PO QD aspirin 81 mg PO QD atenolol 50 mg BID atorvastatin 40 mg PO QD insulin glargine 20 units SQ QD irbesartan 150 mg PO QD melatonin 3 mg PO HS metformin 500 mg PO QD multivitamin 1 tab PO QD n

Current Illness: CAD CKD III DM Type II diabetic retinopathy GERD HLD HTN urinary urgency-frequency syndrome

ID: 1454123
Sex: F
Age: 15
State: NJ

Vax Date: 06/16/2021
Onset Date: 06/21/2021
Rec V Date: 07/07/2021
Hospital: Y

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

Lab Data: Blood work done on 06/21/2021 came back with Platelet level @9. Blood repeated 2-3 times on 06/22/2021 and platelet level came back being at 6 -8. Dr. advised to give IViG INFUSION with Steroid to avoid immediate risk of Internal bleeding. Patient was showing signs of Petechiae on her lower legs when at the hospital.

Allergies: not known

Symptom List: Anxiety, Dyspnoea

Symptoms: Blood work done on 06/21/2021 came back with Platelet level @9. Blood repeated 2-3 times on 06/22/2021 and platelet level came back being at 6 -8. Dr. advised to give IViG INFUSION with Steroid to avoid immediate risk of Internal bleeding. Patient was showing signs of Petechiae on her lower legs when at the hospital. Subsequent blood work on 06/25/2021 after IViG showed a boost in platelet to 138. Weekly blood work has been ordered to check platelet levels and impact activities have been restricted.

Other Meds: none

Current Illness: none

ID: 1454124
Sex: M
Age: 12
State:

Vax Date: 06/29/2021
Onset Date: 06/30/2021
Rec V Date: 07/07/2021
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: No

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

Symptoms: Chest tightness in the morning after with shortness of breath. Mild cough and neck spasms. Patient received prednisolone

Other Meds: FLOVENT HFA 44 mcg/act inhaler

Current Illness: No

ID: 1454125
Sex: F
Age: 48
State: NJ

Vax Date: 06/26/2021
Onset Date: 06/27/2021
Rec V Date: 07/07/2021
Hospital:

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

Lab Data: No

Allergies: No

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: About 24 hours I started feeling nauseated, joint pain in left hand, arm pain at injection site, acid reflux.

Other Meds: No

Current Illness: No

ID: 1454126
Sex: M
Age: 59
State: CO

Vax Date: 03/05/2021
Onset Date: 06/16/2021
Rec V Date: 07/07/2021
Hospital: Y

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

Lab Data: 6/20: Covid-19 RNA positive (Cepheid SARS CoV-2 EUA)

Allergies: Betadine, Contrast, Iodine, ondansetron - nausea, simvastatin - myalgia

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

Symptoms: 60 year old, immunosuppressed man, who developed Covid-19 pneumonia approximately 3 months after receiving the Johnson & Johnson vaccine.

Other Meds: acetaminophen, albuterol, amlodipine, aspirin, atorvastatin, azathioprine 100 mg at bedtime, carvedilol 25 mg BID, doxycycline 100 mg po BID (prescribed 6/18-6/25), insulin NPH 50 units BID, regular insulin correction scale, oxycodone 30 mg

Current Illness: None

ID: 1454127
Sex: F
Age: 51
State: LA

Vax Date: 04/22/2021
Onset Date: 05/05/2021
Rec V Date: 07/07/2021
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: Chiropractor, Ultrasound on neck, Body Adjusted

Allergies: Penicillin

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

Symptoms: Taking tylonla 1000mg, Trazodone 50mg, Tizanidine 1mg, Celecoxid 400mg, Venlafaxine-er 37.5mg. Has had to go to a chiropractor to try to numb arm, and got body adjusted. After getting the shot 2 weeks later her left side of her arm and neck has had pins and needles sharp pains going down arm and around the left side.

Other Meds: N/A

Current Illness:

ID: 1454128
Sex: U
Age: 30
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1454130
Sex: F
Age: 65
State: NY

Vax Date: 04/02/2021
Onset Date: 06/22/2021
Rec V Date: 07/07/2021
Hospital:

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

Lab Data: covid test

Allergies: penicillin Vacoymimcin

Symptom List: Pharyngeal swelling

Symptoms: I had a headache and pain in my arm.

Other Meds: Lasartin Asprin Vitamin C

Current Illness: None

ID: 1454131
Sex: M
Age: 47
State:

Vax Date: 07/05/2021
Onset Date: 07/06/2021
Rec V Date: 07/07/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt reported a low grade fever, aches, and diarrhea that lasted a couple days to the pharmacy

Other Meds:

Current Illness:

ID: 1454132
Sex: F
Age: 66
State: DC

Vax Date: 04/11/2021
Onset Date: 06/27/2021
Rec V Date: 07/07/2021
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: -

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Acute Ischemic stroke caused by blood clot.

Other Meds: -

Current Illness: -

ID: 1454133
Sex: F
Age: 62
State: NY

Vax Date: 05/07/2021
Onset Date: 06/14/2021
Rec V Date: 07/07/2021
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: Fatigue, malaise, elevated heart rate, difficulty taking deep breaths, feel like I'm fighting the flu. Crashed in bed a few weeks after receiving the booster.

Other Meds: Amlodipine

Current Illness: None

ID: 1454134
Sex: M
Age: 88
State: IL

Vax Date: 03/12/2021
Onset Date: 05/08/2021
Rec V Date: 07/07/2021
Hospital: Y

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

Lab Data: see above

Allergies: NDKA

Symptom List: Rash, Urticaria

Symptoms: Pfizer COVID 19 Vaccine EUA Pfizer Dose 1 2/18/21 (EN6200) Pfizer Dose 2 3/12/21 (EN6208) COVID Positive 5/13/21 5/20/21: The patient presents with fever and stats that he started couging 12 days ago. He was seen in the ER on 05/13 for fever and cough. He was was found to have covid. Blood test were unremarkable and the chest X ray was negative. He was enrolled to the Covid out patient risk assessment. He states that he continue to have fever with eakness. He was seen 2 days ago at the clinic. He was sent home but he continue to have fevr, cough and weakness. No shortness of breath. No chest and no abdominal pain. No nausea nor vomiting.. The onset was 12 days ago. The course/duration of symptoms is constant. Associated symptoms: cough, decreased oral intake, denies chest pain, denies shortness of breath, denies rhinorrhea, denies sore throat, denies nausea, denies vomiting, denies abdominal pain and denies rash. Temperature is 102 Fahrenheit. 6/2/21: Patient continues to feel well; nurse reports he is cleaning is dinner plate thoroughly; he has questions about discharge; physical therapy was unable to assess him yesterday, they will see him this morning at 9:00 a.m.; if they recommend physical therapy we will proceed in that direction; if they state that he is at his baseline and not in need of their services, we will discharge him with monitoring. 6/3/21: Discharged home.

Other Meds: levothyroxine 25 mcg PO QD metoprolol 25 mg ER PO QD multivitamin 1 tab PO QD omeprazole 1 tab PO QD

Current Illness: HTN CKD Hypothyroidism GERD

ID: 1454135
Sex: U
Age: 42
State: TX

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 07/07/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1454136
Sex: F
Age: 43
State:

Vax Date: 06/16/2021
Onset Date: 06/29/2021
Rec V Date: 07/07/2021
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: the heart

Allergies: No

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

Symptoms: Indigestion, palpitations, feeling of needing to burp.

Other Meds: Euthyrox 25

Current Illness: Hypothyroidism

ID: 1454137
Sex: F
Age: 42
State: CT

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

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

Lab Data: EKG - normal - 7/25/2021 Lung X-rays - no pneumonia or anything - 7/28/2021 Blood work - 4/7/2021

Allergies: N/a

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

Symptoms: So right after the second vaccine, I had problems, my kidneys were hurting and I had difficulty breathing. I had scheduled to get bloodwork done and after that work it showed that my kidneys were not functioning like they were supposed to. I told my DR that I felt like I had mono. My DR said tests results show that the results are similar to mono. I also lost like 8 pounds and had basically no strength. I was so tired and had to continue working, wearing two face masks and a shield because I work at a school. I was also dizzy and fatigued and would just sit down on the floor because I was getting so dizzy. I am also sleeping a lot. When school ended I was able to really just sleep a lot. Usually I would wake up on my own before 5AM but now I sleep in several hours past then. After medical tests the DR put me on two allergy medications and an antibiotic. The antibiotic was Azithromycin 500MG for five days 1x daily. The medications I am still having problems with my lungs/breathing and the tiredness. I also had a cough which seems to be getting better but I am still not recovered. I did not take the inhaler from the DR because I didn't want to take the antibiotic at the same time due to a worry about thrush.

Other Meds: Micronutrient daily vitamin, Fluoxetine HCI, Tumeric, CBD

Current Illness: Wasn't feeling well post vaccination for first dose, but felt worst after 2nd dose and saw a DR after 2nd dose. Extreme fatigue and soreness after 1st dose, flu-like symptoms.

ID: 1454138
Sex: M
Age: 14
State: NE

Vax Date: 07/06/2021
Onset Date: 07/06/2021
Rec V Date: 07/07/2021
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: Patient was given second dose of COVID-19 Pfizer vaccine 14 days after first dose instead of 21 days. No signs/symptoms observed/reported at this time. Patient has been informed and will be monitored for adverse events.

Other Meds:

Current Illness:

ID: 1454139
Sex: F
Age: 52
State: MN

Vax Date: 03/24/2021
Onset Date: 04/14/2021
Rec V Date: 07/07/2021
Hospital:

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

Lab Data: NA - Consulted with Nurse who administrated the clinic.

Allergies: Wasps, adhesive tape

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

Symptoms: Shooting pain upon raising my left arm about 3 weeks after the 2nd dose. The pain has moved up the left arm into the shoulder region and causes shooting pain when arm is raised and muscles engaged. Tendonitis?

Other Meds: Periodic use of Alieve for arthritis.

Current Illness: NA

ID: 1454141
Sex: U
Age: 16
State: TX

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 07/07/2021
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: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1454142
Sex: M
Age: 62
State: MT

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

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

Lab Data: None

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: About a month after getting the second moderna dose, I began having hives, which was new to my health. Hives were never an issue previously. They are almost 24/7 now. Break outs have occurred almost everywhere on body.

Other Meds: Levothyroxine and simvastatin

Current Illness: None

ID: 1454143
Sex: M
Age: 17
State: NE

Vax Date: 07/06/2021
Onset Date: 07/06/2021
Rec V Date: 07/07/2021
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: Patient was given second dose of COVID-19 Pfizer vaccine 14 days after first dose instead of 21 days. No signs/symptoms observed/reported at this time. Patient has been informed and will be monitored for adverse events.

Other Meds:

Current Illness:

ID: 1454144
Sex: F
Age: 21
State: WI

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Received SARS Coronavirus 2 RNA-SARS-CoV-2, NAA test at Pharmacy on 07/05/2021 at 12:15. Case investigation interview has not been completed for this individual at time of writing this note.

Other Meds:

Current Illness:

ID: 1454145
Sex: M
Age: 61
State: CA

Vax Date: 06/23/2021
Onset Date: 06/28/2021
Rec V Date: 07/07/2021
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: N/A

Symptom List: Unevaluable event

Symptoms: Chest pains, almost passing out. profuse sweating,throwing up, EMT ride to Hospital, full series of heart and arty tests. Cat scan EKG,ultra sound, blood tests, All came back negative no known cause for episode. Only thing different in life style was the vaccine

Other Meds: N/A

Current Illness: N/A

ID: 1454146
Sex: U
Age: 14
State: TX

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

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

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1454147
Sex: F
Age: 72
State:

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 07/07/2021
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: Simvastatin

Symptom List: Injection site pain, Pain

Symptoms: Left arm bruising. Patient had hives prior to ED admission that resolved at home. Received Benadryl and Tylenol.

Other Meds:

Current Illness: No

ID: 1454148
Sex: F
Age: 39
State: NE

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient was given second dose of COVID-19 Pfizer vaccine 14 days after first dose instead of 21 days. No signs/symptoms observed/reported at this time. Patient has been informed and will be monitored for adverse events.

Other Meds:

Current Illness:

ID: 1454149
Sex: U
Age: 44
State: TX

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 07/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1454150
Sex: M
Age: 67
State: MN

Vax Date: 03/26/2021
Onset Date: 05/26/2021
Rec V Date: 07/07/2021
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: No

Allergies: Seasonal allergies

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I had surgery on my back in July 2020. After receiving the vaccine in March of 2021, my scar started itching about 2 months after . Eventually the itchiness spread to my arms, back, legs, belly and especially my back. A bubble appeared in the palms of my hands. If it was touched, it was itchy. It then spread to my fingers. The more I rubbed them together to receive the itching, the worse it got. I went to the doctor who at first thought it was psoriasis. She then determined it might be eczema. I went home and then it got worse. I went back and the doctor prescribed triamcinolone 0.5%. I put this on the bubbles on my hands and fingers. It relieved the itching but it has dried my skin and it is now peeling. It is like when your hand is in water for a long time. Even though the itching was relieved, there is still itching present. The doctor told me to use the triamcinolone for 10 days and after the 10 days, just use as needed. The triamcinolone has overall helped. Heat makes the itching worse.

Other Meds: Cordyceps- vegetable capsule (very rarely)

Current Illness: No

ID: 1454151
Sex: M
Age: 59
State: OH

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

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

Lab Data:

Allergies: n/a

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: VERY PAINFULL ABDOMONAL CRAMPING, STARTING 11:00 PM AND LASTING FOR ABOUT 1 MIN. THIS REPEATED 4 TIMES, FOLLOWED BY DIARRHEA FOR A COUPLE HOURS (AFTER THE 2ND DOSE)

Other Meds: 40 mg statin pepcid ac

Current Illness: n/a

Date Died: 06/03/2021

ID: 1454152
Sex: M
Age: 73
State: CO

Vax Date: 05/31/2021
Onset Date: 06/03/2021
Rec V Date: 07/07/2021
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: Cefazolin - anaphylaxis

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

Symptoms: 73 year old male, vaccinated with the Janssen Covid-19 vaccine at the time of hospital admission (5/31/21) for a type 3 odontoid fracture; C2 vertebral body fracture extending into bilateral transverse foramina and nasal bone fracture from a fall from standing. Admitted to the trauma service for pain control. Noted to be somnolent throughout admission. On 6/2, developed AKI, likely related to dehydration vs. contrast nephropathy. On the early morning of 6/3, found unresponsive. Given naloxone 0.02 mg x 3 with no documented response. Transferred to the ICU, intubated and had PEA arrest on induction for intubation. CPR was initiated and he received epi x 1 with ROSC within 3 minutes. Remained intubated and sedated in the ICU with labile pressures on 2 pressors throughout the day on 6/3. The patient expired following compassionate extubation 6/3 2211.

Other Meds: amlodipine, duloxetine, nitroglycerin SL tablets prn, rosuvastatin 5 mg daily, tamsulosin

Current Illness: None

ID: 1454153
Sex: F
Age: 53
State: WI

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 07/07/2021
Hospital:

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

Lab Data: Symptom tracking w/ possible MRI of the Brain; pt is currently trying migraine medication

Allergies:

Symptom List: Nausea

Symptoms: increased headaches, brain fog, memory problems

Other Meds:

Current Illness:

ID: 1454154
Sex: F
Age: 11
State: OR

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 07/07/2021
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 with mom for COVID 19 vaccination. Mom and daughter both gave patient's age, patient reported age as 12., but actual making her eleven years old at age of vaccination. This was discovered through audit of medical records.

Other Meds:

Current Illness:

ID: 1454156
Sex: M
Age: 89
State: IL

Vax Date: 03/11/2021
Onset Date: 05/24/2021
Rec V Date: 07/07/2021
Hospital: Y

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

Lab Data: see above

Allergies: metoprolol - confusion

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

Symptoms: Pfizer COVID vaccine EUA Pfizer Dose 1 2/17/21 (EN6200) Pfizer Dose 2 3/11/21 (EN6208) COVID Positive 5/30/21 5/30/21: 89-year-old male with history of coronary artery disease status post stenting, most recently on 4/13/2021, hypertension, aortic stenosis, hyperlipidemia, neuropathy, peripheral vascular disease, GERD, pulmonary nodule, hard of hearing and glaucoma has presented to the emergency room at hospital with complaints of chest pain. Patient reports that his whole lower chest was hurting on and off which was sharp pain which would come and go at rest. Patient initially reported that he had the pain when he woke up today but also reported for a week he was having some pains which was not as bad as today. Patient denies having any radiation of pain other than the lower chest across. He did not have any nausea or emesis or sweating associated with it. No aggravating or alleviating factors. In the emergency room patient's initial workup with troponin and EKG were not showing any elevation in troponin and no acute ST-T changes suggesting acute ischemia. Patient's chest x-ray did show possible left lower lobe pneumonia. Patient did not have any fever or chills or cough. Patient has some baseline shortness of breath. He denied any headache, nausea or vomiting or abdominal pain or diarrhea. He had no other acute health concerns. 6/3/21: Chest pain, resolved, ACS ruled out. Patient is chest pain-free, troponins x3 normal, ACS ruled out. The chest discomfort is likely related to the pneumonia. Community-acquired pneumonia - clinically improved, on CTX Rocephin and Azithromycin. Also received vancomycin as cultures as noted below. On room air not working hard to breathe Acute episode has resolved. GPC in chains 2/2 and GPC in clusters 1/2-likely contaminant - true bacteremia vs contamination, vancomycin was initiated. Has old systolic murmur due moderate AS & AR. Low probability of IE by Modified Duke's criteria. ID was consulted Considering 2 different blood cultures Gram-positive cocci in chains and Gram-positive cocci in clusters based on ID recommendations this represented contamination rather than true infection. Follow-up blood cultures are also negative after 72 hours. Per Infectious Disease no further treatment/intervention was required. Severe AS & moderate AR: stable, plan to f/u as an out patient for evaluation of TAVR. HFmrEF 45%: stable, not in decompensation, continue GDMT. CAD s/p DES : Continue on aspirin 81 mg daily, Plavix 75 mg daily, Coreg 3.125 mg twice a day and rosuvastatin. Peripheral arterial disease : He underwent left common femoral and superficial femoral artery intervention in 2015 per records, on dual antiplatelet therapy and statin. Positive COVID 19 test- initial with PCR negative. Patient has been vaccinated. Pulmonary nodules: Patient undergoing evaluation for pulmonary nodules as an out patient.

Other Meds: ASA 81 mg PO QD bisacodyl 10 mg PO QD PRN carvedilol 3.125 mg PO BID clopidogrel 75 mg PO QD cyclobenzaprine 10 mg PO TID PRN furosemide 20 mg PO QD gabapentin 300 mg PO BID latanoprost 1 drop left eye bedtime meclizine 25 mg PO TID nitrogl

Current Illness: CAD s/p stenting HLD Aortic stenosis HLD Neuropathy PVD GERD Pulmonary nodule Hard of hearing Glaucoma

ID: 1454157
Sex: M
Age: 54
State: FL

Vax Date: 04/29/2021
Onset Date: 04/01/2021
Rec V Date: 07/07/2021
Hospital:

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

Lab Data: I had a CT scan and the results came back normal, I can not remember the date but it was sometime in May of 2021.

Allergies: none.

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

Symptoms: So in mid May 2021 you started feel dizzy. I think May 14, 2021 but this is probably not the exact. I got a referral from Dr. to get a CT scan at Imagining center, I can't remember the date. The CT scan came back normal. Then I made an appointment with the Ears, Noses, and Throat doctor mid May first week of June. The did basic hearing test with the tones. My hearing was normal except for one frequency that was high in both ears. I don't have the ENT doctor's name. They prescribe me prednisone for 1 week. I went back two weeks later to check if the prednisone helped and it didn't and after the appointment they said that I didn't need to see me anymore and gave me paper work stating that the visits were for tinnitus .

Other Meds: Sumatriptan 100mg for migraine headaches and Valacyclovir.

Current Illness: none.

ID: 1454158
Sex: F
Age: 30
State: CO

Vax Date: 06/28/2021
Onset Date: 07/06/2021
Rec V Date: 07/07/2021
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: Tremor

Symptoms: Swollen and painful lymph nodes - left axilla . Painful bruising - site of injection .

Other Meds: Multivitamins

Current Illness:

ID: 1454159
Sex: M
Age: 13
State: OK

Vax Date: 07/06/2021
Onset Date: 07/06/2021
Rec V Date: 07/07/2021
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: NKDA

Symptom List: Erythema, Pruritus

Symptoms: Given at 14 days after first dose

Other Meds: UNK

Current Illness: none

ID: 1454160
Sex: F
Age: 77
State: IA

Vax Date: 03/06/2021
Onset Date: 05/18/2021
Rec V Date: 07/07/2021
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: see above

Allergies: narcotics - nausea, confusion propoxyphene - nausea

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

Symptoms: Pfizer COVID Vaccine EUA Pfizer Dose 1 2/6/21 (lot # not listed) Pfizer Dose 2 3/6/21 (lot # not listed) COVID Positive 5/25/21 at PCP office (but negative upon repeat testing 5/25/21) 5/25/21: The patient is a 78-year-old female presents emergency department today after testing positive for COVID-19 at her PCP office, they recommended she present to ED to rule out pulmonary embolism. Patient has a past medical history significant for ESRD on HD Monday Wednesday Friday, hypertension, diabetes mellitus type 2, anemia of CKD, and osteoarthritis. Of note, the patient had her COVID-19 Pfizer vaccination series completed in February of this year. On arrival to the ED, the patient's temperature is 98.4? F, heart rate 68, respiratory rate 26, saturating 90% on room air with blood pressure 163/63. The patient did desaturate to 87% on room air when ambulating in the room. The patient's laboratory studies were significant for HGB 11.3, ESR 44, CRP 1.7, BUN 17, CR 4.80, UA: Proteinuria, trace hematuria, small leukoesterase, many bacteria, 11-30 pyuria, 1-3 RBCs and moderate squamous epithelial cells sent for culture. Blood cultures x2 obtained. Chest x-ray shows no acute cardiopulmonary findings. V/Q scan showed normal exam. EKG showed normal sinus rhythm. The patient was seen emergency department laying in bed. She reports worsening shortness of breath over the weekend and COVID like symptoms for the past week. She reports some dyspnea on exertion. She states she has been weak, fatigued, had some chills, and was seen by her PCP, who tested her for COVID-19 and she tested positive. This COVID-19 test is not and are records. The patient has had some desaturations less than 90% when she falls asleep. She wishes to be a full code. 6/1/21: She is admitted to the hospital, as mentioned above 0 repeat COVID test is negative. V/Q scan is reported as normal. She is started on dexamethasone 6 mg IV daily, along with IV antibiotics ceftriaxone Zithromax and Acapella. Pulse ox is monitored, oxygen is weaned off patient has been stable on room air and has been afebrile. Nephrology consult is requested, patient had hemodialysis as per Nephrology recommendations on Monday, Wednesday and Friday. Her blood pressures were uncontrolled, her home medications Coreg dose was increased to 37.5 mg p.o. b.i.d. and Procardia XL increased to 60 mg p.o. daily and blood pressures have been stable now. Patient did complain of weakness to ambulate, had physical therapy and occupational therapy evaluation. She is being discharged home today in stable condition for skilled nursing. She is off steroids now. Discharge plan is discussed with the patient.

Other Meds: APAP 650 mg PO Q4h PRN carveidlol 37.5 mg PO BID docusate 100 mg PO BID PRN lactobacillus rhamnosus 1 cap PO BID nifedipine 60 mg ER PO QD sevelamer 1600 mg PO TID

Current Illness: ESRD on HD MWF HTN DM Type 2 Anemia of CKD OA

ID: 1454161
Sex: F
Age: 13
State: TX

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 07/07/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1454162
Sex: F
Age: 75
State: DE

Vax Date: 02/22/2021
Onset Date: 04/05/2021
Rec V Date: 07/07/2021
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: sensitive to some meds

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Broke out with blisters on left leg and heal which scabbed and seeped. major area around blisters sorrounded by large rash. Also broke out on leg and thigh on left and right leg. On the first day of breakout my blood presure (taken at home) was 180/90. It in the 140's for the next three weeks. During third week of issue had a very hard time with emotions; anxiety, could cry at any time, thoughts of death, not suicide but what it was like to die. Never in my 75 years of life have I experienced anything like this. I am energetic and very positive. Emotional issue lasted 1 week. Entire reaction lasted 4 weeks. I was seen by a walk in clinic and was diagnosed with poison ivy in the beginning. I sought a second opinion from my family physician who agreed. I disagreed with both as I had not been any where near plant life. I then saw my cardiologist who felt there was a possible reaction to a new BP med he had put me on a month before. At this time I thought it might have been a reaction to the moderna 2nd shot, but did not pursue this until I recently have become aware of possible reactions with blisters and emotions. I do have pictures of the reaction

Other Meds: moderna 2nd shot

Current Illness: none

ID: 1454163
Sex: M
Age: 15
State:

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 07/07/2021
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: No

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

Symptoms: Syncope episode. Patient received 1,000 ml NS bolus

Other Meds: No

Current Illness: No

ID: 1454164
Sex: F
Age: 33
State: MD

Vax Date: 06/04/2021
Onset Date: 06/07/2021
Rec V Date: 07/07/2021
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: none

Allergies: no

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

Symptoms: Had a fever, fatigue, headaches after receiving vaccine for several days. After fever broke I got a really weird rash inflamed, blotchy, hot to touch, had different sized shapes, spread from injection site down arm and to armpit. Lymph nodes felt swollen and were sore. Lasted for several days. Took Zyrtec but did not help. Sought care from pharmacist.

Other Meds: Welbutrin 150MG daily , perthenezine 8mg daily , clonazepam 1mg 3x daily, ritalin 20mg 2x daily, fish oil 1000mg 3x daily. Marijuana. Ibuprofen prn

Current Illness: no

ID: 1454165
Sex: F
Age: 45
State: TX

Vax Date: 02/24/2021
Onset Date: 05/17/2021
Rec V Date: 07/07/2021
Hospital: Y

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

Lab Data: Cardiac Echocardiogram on 5/17/2021

Allergies: Levaquine, Sulfa Drugs, Nuts, Gluten

Symptom List: Pain in extremity

Symptoms: Severely depressed left ventricular systolic function with LVEF 25-30% Mildly dilated left ventricle Mitral valve is moderately thickened with stenosis

Other Meds: Ibrance, Anastrozole, Oxybutynin, Montelukast, Advair Diskus, Venlafexine, Vitamin D, Calcium, Allegra

Current Illness: None. May have had wide QRS complex since October 2020.

ID: 1454166
Sex: F
Age: 58
State: MO

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

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

Lab Data: N/A

Allergies: Latex, Crab Meat

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

Symptoms: Pt. states received Phizer 07/07/2021, at 7:00pm experienced extreme dizziness lasting until 11:00pm while entering bed. No other symptoms reported.

Other Meds: N/A

Current Illness: N/A

ID: 1454167
Sex: F
Age: 64
State: CA

Vax Date: 03/19/2021
Onset Date: 03/21/2021
Rec V Date: 07/07/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Stabbing deep pain that continues even today

Other Meds: Hydrochlorizide Lipitor Lisinaprol Metforim

Current Illness:

ID: 1454168
Sex: M
Age: 78
State: IA

Vax Date: 03/13/2021
Onset Date: 05/12/2021
Rec V Date: 07/07/2021
Hospital: Y

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

Lab Data: see above

Allergies: hydromorphone - unknown gabapentin - unknown morphine - unknown tramadol - hallucinations

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

Symptoms: Pfizer COVID vaccine EUA Pfizer Dose 1 2/13/21 (EN6201) Pfizer Dose 2 3/13/21 (EN6204) COVID Positive 5/24/21 5/24/21: 78-year-old man brought to the emergency department for further evaluation of worsening shortness of breath and cough. He was in his usual state of health until approximately 11 days ago when he started to have upper respiratory symptoms characterized by congestion, rhinorrhea, sneezing episodes. Symptoms gradually worsened until 5 days ago when he started to have for productive cough accompanied by shortness of breath. He denies accompanying fever, chills, nausea or vomiting. His sister who accompanied him has been checking on him daily and has noted worsening bouts of coughing as well as shortness of breath, unable to keep up with ADLs. Upon checking on him today she noted that his lips were blue, brought in to the emergency department by private passenger car and in trial urge his oxygen saturation was noted to be 64% on room air. He was immediately started on supplemental oxygen via OxyMask, nebulizer therapy. COVID-19 rapid antigen test was subsequently positive, CT pulmonary angiogram was done which is negative for PE but also did not demonstrate any evidence of pneumonia. He is fully vaccinated against COVID-19 since March, denies any known contacts being treated for or with symptoms suggestive of COVID-19 infection. While in the ED continued to deteriorate requiring increasing amounts of oxygen via OxyMask, desaturating to 82-85% on 15 L OxyMask. Has been started on NIPV and will be admitted to the ICU for further treatment and evaluation. Of note, he reports that he and 5+ of his family members were all fully vaccinated and all tested positive to COVID around the same time. 6/14/21: The patient presented to the hospital on May 24 with cough and shortness of breath, COVID-19 test positive, initially he was hypoxic requiring 6 L of oxygen then his oxygen demand increased until he require to be on BiPAP and high-flow nasal cannula, then on May 29th require endotracheal intubation the ICU and started on Remdesivir, Decadron, but he was not candidate for Acterna, on June 3rd the patient had a fall with dislodged endotracheal tube require immediate re-intubation and his CT show simple nondisplaced skull fracture and subgaleal small hematoma without intracranial hemorrhage. Patient extubated on June 6 to BiPAP then the oxygen requirement taper down. The patient post extubation kept having shortness of breath and cough, sputum culture grow Klebsiella pneumonia and he was on Zosyn which cover it and will complete the antibiotic on June 15th. The patient is hypercoagulable with elevated D-dimer 2 to COVID-19 infection and will continue Lovenox b.i.d. with his aspirin and Plavix for CAD with pantoprazole. Will continue his chronic steroid. The pulmonologist recommend to keep the patient in isolation due to prolonged virus shedding. On per oral Vanco for C diff prophylaxis due to history of recurrent C diff infection and he is currently on antibiotic. Echocardiogram showed normal EF without significant valvular disease. Patient had episodes of dysphagia and swallow studies show some aspiration and he placed on pureed diet/dysphagia level 1. Sign-out given to SELECT LTAC team, they will follow on management.

Other Meds: acetaminophen 325 mg PO QD amitryptiline 25 mg PO HS amlodpine 10 mg PO QD aspirin 81 mg PO HS clacium-vitamin D 1 tab PO BID clopidogrle 75 mg PO QD finasteride 5 mg PO QD folic acid 1 mg PO QD hydroxychloroquine 200 mg PO QD lisinopril 20

Current Illness: OSA rheumatoid arthritis HTN Obesity

Date Died: 07/04/2021

ID: 1454169
Sex: F
Age: 75
State: NJ

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

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

Lab Data: Contact Hospital

Allergies: None

Symptom List: Vomiting

Symptoms: Death

Other Meds: None

Current Illness: Heart Surgery May 18th

ID: 1454171
Sex: F
Age: 12
State: SC

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

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

Lab Data: Unknown at this time

Allergies: Pine trees, grass

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fever, fatigue, headache, sleepiness, chest pain, and. pain during days 1-4 , after that she was not herself. She had taken 9 tylenol and did not want to live anymore. She is admitted to hospital at this time.

Other Meds: Tylenol

Current Illness:

ID: 1454172
Sex: M
Age: 73
State: OH

Vax Date: 03/31/2021
Onset Date: 05/26/2021
Rec V Date: 07/07/2021
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: MRA Head without Contrast: MRI Brain without Contrast 5/26/2021 05/26/21 10:02 Facility: INDICATION: Right sided weakness. Stroke protocol STUDY: MRI BRAIN WO; MRA HEAD W/O C; MRA NECK WO.C; 5/26/2021 9:44 am IMPRESSION: MRI Brain: 1. Small focus of acute to early subacute ischemic injury in the left centrum semiovale. 2. Nonspecific white matter changes may represent small-vessel ischemic disease in a patient of this age. Several areas of remote ischemic injury are suspected within the cerebellum, right greater than left. MRA: 1. Developmental variants on MRA of the head is described. There is narrowing of the distal intra-cranial vertebral arteries extending to the vertebrobasilar junction. There is also irregularity and narrowing of the P2 segment of the left PCA. No proximal large branch vessel cutoff is identified. 2. No measurable stenosis on MRA of the neck. Corona-virus 2019 by PCR 3 tests including fluid source Corona-virus 2019 PCR, Date of Symptoms Normal 5/26/2021 Complete Blood Count 5/26/2021 8 items Lipid Panel 5/26/2021 6 items Hemoglobin 5/26/2021 A1C 2 items A1C 6 Normal Estimated Average Glucose Normal 126 Mg/Dl Glucose POCT 5/26/2021 2 items Glucose POCT 95 mg/dl & 93 mg/dl Both show normal glucose Basic Metabolic Panel 5/26/2021 11 items LUMIRADX SARS-COV-2 AG TEST Results Normal Status: Final result (Collected: 5/17/2021 5:59 PM & 5/25/2021) You have a NEGATIVE Covid-19 Test Result.

Allergies: Ciprofloxacin, Relafen

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

Symptoms: CVA, Stroke Onset 5/26/2021, Numbness right side and fall due to weakness of same side. Treated at ER and transported to Hospital. CAT Scan at ER and low dose aspirin prior to transport. hospital performed the following tests

Other Meds: Aspirin, Multi-Vitamin, Resveratrol, Turmeric Extract, CoQ10

Current Illness: Arthritis of spine

ID: 1454173
Sex: F
Age: 13
State: OK

Vax Date: 07/06/2021
Onset Date: 07/06/2021
Rec V Date: 07/07/2021
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: none

Allergies: NKDC

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Gave second dose 14 days after the first dose. No need to repeat dose per CDC guidelines.

Other Meds: none

Current Illness: none

ID: 1454174
Sex: F
Age: 24
State: WI

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

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

Lab Data: TSH, Free T3, Free T4, Thyroid US and FNA of Thyroid Lump was ordered by our clinic. Healthcare facility has ordered other studies

Allergies: NKDA

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

Symptoms: Pt was in for her physical on 8/5/2020 w/ no noted abnormality of her neck/thyroid. She was then in on 2/15 after receiving her 1st and 2nd dose (2/3/21) of Moderna. She presented w/ concerns of a lump on her neck. Upon exam she stated to the provider that she and noticed tingling in her neck after the first injection. She then had labs done that day w/ our clinic, this was followed by a biopsy of the lump. She was then referred over to a healthcare facility for treatment/surgical intervention. To our knowledge she had a thyroidectomy done and is now following with the healthcare facility.

Other Meds: Benadryl prn, OCP daily; Ibuprofen prn; Ketotifen bid; loratadine prn

Current Illness: n/a

ID: 1454175
Sex: U
Age: 12
State: TX

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

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

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am