VAERS 2021 Database www.vaers.hhs.gov

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

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

Incidents per State

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

ID: 1423859
Sex: M
Age: 80
State: VT

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient describes full-body itch that developed after the vaccine within a day. Slightly better at the present time than when it began.

Other Meds: Multivitamin

Current Illness: None

ID: 1423860
Sex: F
Age: 37
State: FL

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: No Known Allergies

Symptom List: Anxiety, Dyspnoea

Symptoms: Allergic reaction w/ lightheadedness, near syncope

Other Meds: Acyclovir 800mg tablet, twice daily as needed by mouth. Multivitamin Once daily.

Current Illness: None

ID: 1423861
Sex: F
Age: 36
State:

Vax Date: 06/14/2021
Onset Date: 06/21/2021
Rec V Date: 06/24/2021
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: Seasonal allergies

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

Symptoms: Pleurisy - Severe pain around left lung for about 4 days. I've had it diagnosed before. Did not see doctor this time. Treated at home. It is almost resolved now.

Other Meds: Loratadine, Citalopram

Current Illness: None at all.

ID: 1423862
Sex: M
Age: 25
State: KY

Vax Date: 06/23/2021
Onset Date: 06/23/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Client received Pfizer vaccine at 1502 without any complications/client anxiety. Client was lead to lobby for CDC recommended 15 minutes of observation. At 1508, the client fell sideways in his chair but caught himself. Client reported having hazy vision for a second. Client's skin was pale and highly diaphoretic. Client then passed out for 20 seconds. Clinic RN grabbed under his armpits to hold him in chair to prevent him from falling over. Once client regained consciousness, (1510: BP 100/85, HR 60) Client was moved to the vaccination room to lie down on the floor with his feet elevated above his heart with a chair. BP taken at 1512, 110/80. Client given 4 cups cold water to drink and 3 fun sized candy bars to eat. At 1520 BP was 110/70, HR 70. Client monitored and assisted to chair. Ten minutes in chair he was allowed to try standing. Client was able to ambulate on own without assistance. Client was monitored for 45 minutes post vaccination, no obvious signs of distress, pruritus, apnea, hives/rashes, heart palpitations. Instructed to place family member on speaker phone while driving home/ leaving clinic.

Other Meds: None

Current Illness: None

ID: 1423863
Sex: F
Age: 90
State: MA

Vax Date: 03/13/2021
Onset Date: 03/01/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Patient described onset shoulder pain approximately 1 week after 2nd covid vaccine injection. Patient presented to PCP office on 4/5/21 for initial evaluation following pain with no resolve after trying exercises etc. At this time during evaluation PCP discussed possibility of vaccine related injury. Since this time, patient has undergone oral pain medications, PT exercises, and steroid injection, TENS treatment. Seen today 6/24/21 for continued evaluation. Major ongoing symptom is near constant pain. Bothers even at night, making it hard to sleep. Does not use arm because of the pain. Painful if tries to reach behind herself. Does not feel she is improving. PCP diagnosed as SIRVA, and next plan is MRI of shoulder.

Other Meds: Aspirin 81mg Cholecalciferol 25mcg Levothyroxine 125mcg Lisonopril/Hydrochlorothiazide 20-12.5mg Tramadol 50mg

Current Illness: N/A

ID: 1423864
Sex: F
Age: 70
State: NJ

Vax Date: 05/24/2021
Onset Date: 05/28/2021
Rec V Date: 06/24/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Cholestatin

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

Symptoms: Hospital HPI Patient is a 70 y.o. female with a PMH significant for bipolar disorder , anxiety/depression , fibromyalgia, osteoarthritis, aortic stenosis status post TAVR x2 in 2001 and 2019, CAD, AFib on Eliquis, hx of CVA on ASA/plavix, HTN, DVT s/p IVC filter, chronic diastolic heart failure who initially presented to the hospital on 5/28 to SLW as a stroke alert with aphasia, confusion, repetitive speech. Not a tPA candidate given she is on systemic anticoagulation with Eliquis for Afib. Imaging negative for hemorrhage, ischemia, and large vessel occlusion. Patient was admitted to the ICU, she remained confused, but alert. The next morning, the patient was found to be unresponsive and have twitching to bilateral sides of the face and left gaze for preference. Seizure was suspected. Patient was given Depakote and Ativan. Neurology was consulted. Patient was started on Vimpat. No significant improvement in her exam. Patient was intubated for airway protection, and transferred to hospital for continuous video EEG monitoring. Upon arrival to the ICU, the patient was intubated and sedated on propofol at 40. Sedation was held the patient became agitated. Would not open eyes spontaneously, but was moving all 4 extremities equally and pulling at restraints. Patient purposeful, but not following commands. Attempting to sit up in bed. Patient was initiated on video EEG monitoring to rule out intermittent seizure activity and postictal state. Repeat labs drawn and electrolytes repleted. Patient hemodynamically stable. Patient started on Precedex for sedation. Patient's daughter was updated via the telephone. Patient's daughter reports that she was recently started on baclofen for her hip pain. Patient was given a prescription which she filled on 5/26 for 20 tabs of 20mg each. Patient's daughter reports that it is possible she could have taken more than the prescribed dose in order to make her pain better faster. Daughter states she does not think she took the whole bottle, but is unsure of how many she took. Patient's daughter also reports that she drinks alcohol daily, 10 oz glasses of gin and vodka." Hospital Course Brief ICU course: Patient intubated for airway protection and transferred about plan for continuous video EEG monitoring. EEG was negative for any seizure activity and patient's antiepileptics were stopped. LP and MRI were negative for any etiology of encephalopathy and neurology signed off. Patient's mental status was eventually improving and encephalopathy was thought to be secondary to polypharmacy. Throughout course she had multiple extubations a re-intubation but finally has been extubated since 6/10 and on room air. Course was also complicated by acute blood loss anemia secondary to left flank/abdominal wall hematoma status post empiric embolization of T8 and T9 intercostal arteries. Initial planning to transfer out to floor on 06/11 however prior to leaving ICU patient had episode of SVT and was kept for further monitoring. During this event her Coreg was uptitrated and her home metoprolol was added without any more recurrent tachyarrhythmias. Transfer to the floors with SLFM team on 06/14. Patient's mental status had returned back to baseline. Unfortunately on morning of 6/15 patient had an episode of burning chest pain and tachycardic to 150. Alerted and evaluated at bedside. EKG at that time showed AFib with RVR in the 130s. Troponins were obtained which were 0.04 then trended down to 0.03. Cardiology was consulted. Patient's heart rate eventually returned to normal on own and chest pain gradually resolved. Patient should not be on 2 beta-blockers, per Cardiology Coreg was stopped and her metoprolol dose was increased. Patient was continued on IV Lasix for 1 more dose on 06/16 then transition to p.o. Home dose 40 mg daily. Patient remain observed on tele and arrhythmia free, stable, mental status at baseline. On day of discharge, patient remains stable and looked well, wanting to go home. Cardiology cleared patient for home. PT/OT recommended home with PT services. Case management involved for services at home. Plan to discharge with PCP and cardiology follow-up. Advised that her abdominal wall hematoma will slowly shrink and pain will improve appropriately. ---When calling patient to follow up, she stated her symptoms started 4 days after vaccination with COVID vaccine. Symptoms also started day after she reportedly by daughter and patient only taking 2 doses of Baclofen to me today 6/24/21. She presented to ED on 5/28, received COVID vaccine 5/24, and took two doses of Baclofen 5/27.

Other Meds: Patient was started on Baclofen 20mg and took two doses on 5/27/2021 prior to symptom onset.

Current Illness: GERD COPD Coronary Artery Disease Essential HTN Aortic Stenosis Paroxysmal AFIB Pulmonary HTN Bipolar 1 History of CVA

ID: 1423865
Sex: F
Age: 71
State: NC

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 06/24/2021
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: Contrast xray dye

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Approx 32 hours after vaccine I got a tightness and heaviness in chest, hard to get a deep breath (like one would experience in a high altitude}. and immed went hoarse. The hoarseness was gone in 4 days. The breathing and heavy chest feeling lasted for 4 or 5 days, then would get better for a few days and then occurr again. This continued until I went to a Urgent Care May 4th. There, they did a chest xray and EKG and sent me to an Emergency Hospital. I went to Emergency Department where they did another EKG and blood tests. All finding were okay and I was told to see a Cardiologist and sent home. I saw cardiologist May 6th and he ordered an Echocardiogram and Stress Fitness tests. These were completed June 3rd and results were good.

Other Meds: Prescriptions -- Livalo 2mg, Ezetimibe 10mg, Armour Throid 60mg, Premarin Vaginal cream BetamethasoneDip 0.05% Cream for skin allergy, Supplements - Ginger capsule by Jarrow Formulas, Astaxathin 4mg by Jarrow Formulas, EyeProtect Basics by

Current Illness: none

ID: 1423866
Sex: F
Age: 68
State: NV

Vax Date: 04/23/2021
Onset Date: 04/30/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: Morphine, Aspirin, Sulfa, oral steroids, citric acid (oranges)

Symptom List: Pharyngeal swelling

Symptoms: Pink left eye with severe pain never resolved to date!

Other Meds: Lisinopril

Current Illness: None

ID: 1423867
Sex: M
Age: 29
State: OR

Vax Date: 06/21/2021
Onset Date: 06/23/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 6/21 - Had a fever and tremors that started roughly 12 hours after injection that went away overnight 6/22 - Felt tired and achey all over, little appetite. Went away after this day 6/23 - Felt fine until roughly 10pm, began to experience chest pain in hand sized area centered on sternum 6/24 - Chest pain continues and any significant activity causes slight shortness of breath

Other Meds: ibuprofen, calcium/zinc/magnesium combo supplement, lecithin

Current Illness: none

Date Died: 03/18/2021

ID: 1423868
Sex: F
Age: 85
State: IN

Vax Date: 02/03/2021
Onset Date: 03/18/2021
Rec V Date: 06/24/2021
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: Death 3/18/2021 Causes of death listed on patient's death certificate: 1) Acute cessation of cardiac function Other: Severe symptomatic aortic stenosis, coronary artery disease status post percutaneous coronary intervention

Other Meds:

Current Illness:

ID: 1423869
Sex: M
Age: 36
State: MA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

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

Symptoms: Heart palpitations, intermittent, extending to at least today (several weeks later) -- fluttering sensation in chest, several seconds apart, in groups of a few minutes at a time; these groups might happen once or twice a day or not at all. No shortness of breath or other discomfort.

Other Meds: Venlafaxine HCL ER 37.5 1/day Vitamin D3 50 ?g 3/week Calcium 500 mg 1/week

Current Illness:

ID: 1423870
Sex: F
Age: 17
State: CA

Vax Date: 05/28/2021
Onset Date: 05/29/2021
Rec V Date: 06/24/2021
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: Raw eggs, dust

Symptom List: Rash, Urticaria

Symptoms: Chest pain, sinking feeling, shortness of breath,. It lasted for 1/2 a day

Other Meds: None

Current Illness: None

ID: 1423871
Sex: F
Age: 55
State: OR

Vax Date: 05/06/2021
Onset Date: 05/12/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to Codeine.

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

Symptoms: I woke up early on a Saturday morning with heavy nausea and feeling achy with the flu but no fever; however, my temperature was 96.2 the duration of my symptoms. I was really cold and my stomach was growling and it was very much like the symptoms of the flu. I was exhausted and could not walk to the restroom. I slept 8 hours straight that Saturday which is very unusual for me. I called my doctor via a tele-health call three days later once I was better and he suggested that I get a COVID test and I took the test and it came back negative. The next day I felt better and was able to get up, get something to eat, and run some errands. I took Ibuprofen for a migraine that I experienced but it did not do anything. I was very pale because my blood pressure was so low (was not tested or checked). I had loose stools for three days (was sick for approximately 4 days). I have never had such progression of symptoms where each day was very odd. I also experienced a runny nose.

Other Meds: No

Current Illness: No

ID: 1423872
Sex: F
Age: 47
State: AL

Vax Date: 02/14/2021
Onset Date: 06/07/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: Allergic to Ace Inhibitors

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

Symptoms: Coughing up blood

Other Meds: Prednisone 5mg/day Amlodopine 10mg/day Olmesartan Medoxomil and Hydrochlorothiazide 21mg/12.5mg daily Hydroxychloroquine 200mg 2X/day Sildenafil Citrate 20mg 3X/day Klor-Con M20 daily Pravastatin Sodium 20mg/day Clonodine Patch 0.3mg weekly

Current Illness:

ID: 1423873
Sex: M
Age: 76
State: PA

Vax Date: 02/17/2021
Onset Date: 05/24/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Upper respiratory congestion with cough and excess mucous. Treated with Z-pak of antibiotics and antihistamine. Lasted about 1 week

Other Meds: Lisinopril 40 mg Hydrochlorothiazide 12.5 mg Glucosamine chondroitin Coenzyme q 10 200 mg Simvastatin 40 mg

Current Illness: none

ID: 1423874
Sex: M
Age: 12
State: TX

Vax Date: 06/23/2021
Onset Date: 06/23/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Vaccine given, possibly 8 minutes post expiration Done while vaccines and pharmacy under the supervision

Other Meds: none listed

Current Illness: none listed

ID: 1423875
Sex: F
Age: 28
State: CO

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient came in for 2nd dose of Pfizer. She instantly had an increase in heartrate. We had her recline back in the chair in our observation room, checked her BP, Pulse ox, both of which were in normal range.. I gave her a bottle of water and had her try and relax. We covered her with a blanket. After 30 minutes she said she was still not 100% and we had her call a friend to drive her home. The friend could not come, so I had her rest for another 30 minutes. She felt better after staying with us for an hour and a half and she left. She was steady on her feet and reported that she was not dizzy and felt fine.

Other Meds:

Current Illness:

ID: 1423876
Sex: F
Age: 49
State: NC

Vax Date: 05/26/2021
Onset Date: 06/01/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: Tetanus, Grapefruit and Amoxicillan

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Dizziness, vomiting, diarrhea, headache on the left side, stiff eyes, ear ache left ear, heart racing, tired easily, left shoulder stiff, muscles on left side of upper back very tense, left wrist sore, left nostril swollen and sore inside and swelling of the face mostly on the left side. Doctor visit, prescribed promethazine and told to take acetaminophen. Labs were ordered.

Other Meds: Prograf, Cellcept, Prednisone, Aspirin, Cod Liver Oil and VitaminD

Current Illness:

ID: 1423877
Sex: M
Age: 60
State: MA

Vax Date: 03/12/2021
Onset Date: 04/29/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: dust

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: ON 04/29/2021 HEAVY INDEGESTION, CHEST PAINS ACROSS FULL CHEST, CHILLS, FEVER 98-100 DEGREE RANGE SPENT 36 HRS IN HOSPITAL DID CARDIAC STRESS TEST AND LUNG IMAGING, DISCOVERED SWELLING IN NOGILES REALEASED ON THE 31st.

Other Meds: otorvastatan asprin vitamin b12 hrodraclorathyozide lacenapril clepodogril omeprizol vitamin d

Current Illness: none

ID: 1423878
Sex: M
Age: 29
State: NJ

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

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

Lab Data:

Allergies: none

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

Symptoms: Patient had a left sided segmental and subsegmental pulmonary embolism, severe back pain, dyspnea, tachycardia and tachypnea, started on 6/24.

Other Meds: prednisone

Current Illness: none

ID: 1423879
Sex: F
Age: 37
State: MI

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 06/24/2021
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: No

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

Symptoms: After the shot I got a severely red patch on my arm. It was hot and sore

Other Meds: Zyrtec

Current Illness: No

ID: 1423880
Sex: F
Age: 54
State: ID

Vax Date: 04/02/2021
Onset Date: 04/12/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List: Unevaluable event

Symptoms: My palette has radically changed. Food and drink don't taste good. My body smells like sulfur or vinegar, in a bad way. My urine and poop smells weird, also like acidic.

Other Meds: lisinopril

Current Illness:

ID: 1423881
Sex: F
Age: 33
State: WI

Vax Date: 05/06/2021
Onset Date: 06/09/2021
Rec V Date: 06/24/2021
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: Morphine

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

Symptoms: Heavy breathing , felt like something heavy was on my Chest , coughing so much . Diagnosed with bronchitis, given a steroid , and an inhaler

Other Meds: None

Current Illness:

Date Died: 04/01/2021

ID: 1423882
Sex: F
Age: 74
State: IN

Vax Date: 02/08/2021
Onset Date: 03/21/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Death 4/1/2021 Causes of death listed on patient's death certificate: 1) Acute on chronic respiratory failure 2) Metastatic spindle cell malignancy Other: COVID-19, pneumonia

Other Meds:

Current Illness: Metastatic spindle cell malignancy Other: COVID-19, pneumonia

ID: 1423883
Sex: F
Age: 47
State:

Vax Date: 06/09/2021
Onset Date: 06/16/2021
Rec V Date: 06/24/2021
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 presented to ED 6/16 with chest pain. Patient got her second Covid vaccination a week ago today. That night she said she had some numbness on her face from mid lip and chin to the left side of her face. When she went to bed that night she slept when she woke up that numbness was gone and has not had any since. She is having body aches now she said the next day she had a lot of bilateral hip pain that seemed to improve some but now it is pain mainly in her back both upper and lower in her ribs. She also has some anterior chest pain feels short of breath hurts to take a deep breath. No other complaints she says she is had some low-grade temperatures in the low 100 200.2 may be 100.5 periodically and some chills. Patient was in fair amount of discomfort very pleuritic breathing. Given 50 mcg of fentanyl 4 mg Zofran IV. She actually doing better. Reviewing her records her platelets run about 240,000. This is cut in half. She did not have a significant headache and not concerned about an venous thrombosis in the brain however I am concerned about a pulmonary embolism. CT scan obtained and reviewed as below negative for PE or acute abnormality. Repeat troponin negative, doubt ACS. Possible Covid reaction. No other significant findings on ED work-up today. Patient given IV Decadron and repeat dose of fentanyl. She is comfortable with plan discharge home with close outpatient follow-up. Presented again to ED 6/20 with 12 hours of progressive now constant severe low back pain radiating diffusely about the low back into both hips down the back of both legs. Told to F/U with PCP. F/U with PCP on 6/21 and 6/23. One possibility is new onset ITP or immune thrombocytopenia. Plan to Prednisone taper over 3 weeks, also H2 blocker prescribed. CBC twice weekly; follow up CMP with next draw . CTA abdomen rule out portal/mesenteric vein thrombosis or consumptive thrombocytopenia. Tramadol prn pain.

Other Meds:

Current Illness:

ID: 1423884
Sex: M
Age: 14
State: CA

Vax Date: 06/11/2021
Onset Date: 06/16/2021
Rec V Date: 06/24/2021
Hospital: Y

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

Lab Data:

Allergies: nkda

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

Symptoms: 14yo M initially presented to the ED with headache, fever, myalgia, abdominal pain, NBNB emesis, unsteady gait and soft/garbled speech, 6 days after returning from a recent trip to Mexico and 4 days after receiving 2nd dose of Covid-19 vaccine. In the ED patient had multiple tonic clonic seizures, total episode lasting about 5 minutes requiring ativan and keppra. Pt was admitted to PICU for management, found to have continued seizures on EEG resolved with fosphenytoin

Other Meds: Olopatadine 0.1% Opht Drop

Current Illness: None

ID: 1423885
Sex: F
Age: 66
State: RI

Vax Date: 03/15/2021
Onset Date: 04/23/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Erratic heartbeat even skipping a beat at times, Alive Cardia EKG, scheduled for July 1, 2021 for ECG

Other Meds: Metoprolol, Lisinopril, Anastrozole, D3

Current Illness:

ID: 1423886
Sex: F
Age: 93
State:

Vax Date: 02/11/2021
Onset Date: 02/19/2021
Rec V Date: 06/24/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient presented to the ED on 2/19/2021 for gout of left ankle. Patient presented to the ED on 3/7/2021 and was subsequently hospitalized for fracture of right femur. These visits are within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1423887
Sex: F
Age: 40
State: ID

Vax Date: 01/12/2021
Onset Date: 06/10/2021
Rec V Date: 06/24/2021
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:

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

Symptoms: Patient ended up getting COVID-19 even after she got vaccinated 5 months beforehand. Symptoms were cough, headache, loss of taste and smell, congestion.

Other Meds:

Current Illness:

ID: 1424008
Sex: F
Age: 76
State: NC

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Breakout rash around neck, shoulders, chest, arms and tops of legs. None under arms or breasts. Has had rash since 6/7/21. Some raised bumps within rash as well, resembled insect bites. Some of the rash looked like insect bites, other areas skin broken, looks like skin scraped. Skin has peeled off on those areas. Had got bladder infection since then as well. Had blood in urine and received antibiotic (6/9/2021). Since then bladder infection has cleared. But patient has had a cough since then (about 5 days into breaking out). Has also had a slight headache.

Other Meds:

Current Illness:

ID: 1424009
Sex: F
Age: 44
State: WA

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

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

Lab Data:

Allergies: Codeine, fentanyl, morphine

Symptom List: Injection site pain

Symptoms: Approximately 5 minutes after receiving vaccine, patient developed numbness and tingling around her mouth, inside her mouth and in her throat. She did feel like it was difficult to swallow due to not being able to feel the inside of her mouth, but denied any swelling. BP was elevated initially to the 170s/90s, SpO2 remained >92 throughout. Lungs were clear on exam, there was no asymmetry to her face and no visible swelling. She was given 50mg IM Benadryl and symptoms improved within 20 min. She was advised to take another 50mg of Benadryl at home and go to ED if symptoms returned. Symptoms did not return, but one day after vaccine did develop mild diarrhea.

Other Meds: Azathioprine 50mg, cetirizine 10mg, gabapentin 300mg TID, hydroxychloroquine 200mg BID, Imuran 50mg BID, ipratropium nasal spray 0.03% 2 sprays BID, lactulose, linzess 145mcg 1-2 tabs/day, naltrexone 17g BID, omeprazole 20mg BID, albuterol

Current Illness: None

ID: 1424010
Sex: F
Age: 45
State: IL

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: Wellbutrin and Tramadol

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

Symptoms: After the vaccine my arm was sore for about a day or two. A couple weeks later I was told I had bronchitis and developed into walking pneumonia.

Other Meds: Sertraline and over the counter allergy medicine

Current Illness: None

ID: 1424011
Sex: F
Age: 29
State: GA

Vax Date: 05/01/2021
Onset Date: 05/05/2021
Rec V Date: 06/24/2021
Hospital: Y

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

Lab Data:

Allergies: benadryl (likely the red dye), aloe vera

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

Symptoms: Patient experienced a thunderclap headache during a workout at about 6:00pm on 05/05/2021. She also had nausea, light sensitivity, and neck stiffness. She went to urgent care around 8:00pm and received a shot of toradol for suspected migraine. When the headache didn't resolve completely, she went to the emergency room around 11pm. On 05/06 around 5:30am, a CT scan revealed a subarachnoid hemorrhage over the right sylvian fissure. A CTA of the head and neck immediately following showed no aneurysm or AVM. The patient was admitted, and underwent a catheter angiogram later that afternoon, which also showed no aneurysm or AVM. She was admitted to the NeuroICU for one week, took nimodipine and keppra as prescribed, underwent transcranial dopplers daily to check for vasospasm, and did not develop any major complications. Patient developed worsening pain near the tailbone while hospitalized, which was attributed to nerve pain from blood in the subarachnoid space. On 05/12/2021, the patient underwent a second catheter angiogram, which also showed no aneurysm, AVM, or abnormality. The patient was discharged home on 05/13/2021, with followup with neurosurgeon for a likely third cerebral catheter angiogram.

Other Meds: cabergoline .25mg once weekly, metamucil

Current Illness:

ID: 1424012
Sex: F
Age: 46
State: FL

Vax Date: 02/15/2021
Onset Date: 06/03/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Tremor

Symptoms: Pt had second Moderna vaccine in 02/2021. Pt tested positive for Covid 19 on 06/03/2021.

Other Meds:

Current Illness:

ID: 1424013
Sex: F
Age: 40
State: OR

Vax Date: 06/10/2021
Onset Date: 06/23/2021
Rec V Date: 06/24/2021
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: Meloxicam, Lidocaine, Lidocaine with Epinephrine

Symptom List: Erythema, Pruritus

Symptoms: After initial vaccination a lump with redness and itchy skin appeared. It went away after a 4 days except for the lump. Almost exactly two weeks after the vaccination, the lump still exists but an itchy rash has a appeared approximately 2 inches in diameter. I have applied a corticosteroid and am beginning to take Benadryl to hopefully help.

Other Meds: None

Current Illness: None

Date Died: 04/18/2021

ID: 1424014
Sex: F
Age: 81
State: IN

Vax Date: 03/04/2021
Onset Date: 03/22/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Death 4/18/2021 Causes of death listed on patient's death certificate: 1) Sequelae of SARS-Coronavirus 2019 Other: Rheumatoid Arthritis, Insulin Dependent Diabetes, Chronic Hypoxic Respiratory Failure, Morbid Obesity

Other Meds:

Current Illness:

ID: 1424015
Sex: F
Age: 13
State: MN

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

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

Lab Data:

Allergies: NO KNOWN DRUG ALLERGIES

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

Symptoms: Within minutes of receiving vaccine, pt verbalized feeling dizzy with a headache. Pt became pale and diaphoretic. Pt's lower extremities were elevated, ice pack applied to back of the neck and vital signs obtained. Juice and crackers were given. Within several minutes, Pt verbalized symptoms resolved and was ready to go home. Pt will lie down to receive second dose of Pfizer vaccine.

Other Meds: IBUPROFEN

Current Illness: NONE

ID: 1424016
Sex: F
Age: 52
State: NJ

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 06/24/2021
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: Honey

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 12/21/2021, day of first dose I experienced chills, aches and general discomfort. I developed covid shortly after first dose and I developed ulcers. Second dose was on 03/14/2021 and it wasn't until 04/07/2021 that my ulcers began worsening into mouth, throat, nose. Worsening of arthritis that I did not have before the vaccine. I started having a tingling sensation as well as exhaustion and depression, all of these symptoms are worsening. I am very dizzy and falling all the time.

Other Meds: Toprol xl Pepcid Motrin Oral rinses

Current Illness: Covid 01/13/2021

ID: 1424017
Sex: M
Age: 62
State: MN

Vax Date: 03/06/2021
Onset Date: 03/10/2021
Rec V Date: 06/24/2021
Hospital: Y

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

Lab Data:

Allergies: None.

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

Symptoms: I had the injection on 03/04/2021 I had the first dose on the vaccine on 03/06/2021 four days after that I had lower pain in my back, right glute and right leg. Three more days after that on 03/13/2021 I could not get up from the couch and my right food could not raise up. I was hospitalized at the emergency department. I got there at 8 or 9 o clock at night and was hospitalized until the next day. I was there for around 5 days. It ended up being diagnosed as a infectious disease. I was on Vancomycin IV. I was then put on vancomycin home infusion for six more weeks that along with opiates for the pain.

Other Meds: Xarelto, Atorvastatin, Metformin, Celebrex, Vitamin D3, Vitamin K, Co Q 10, Fish Oil, Curcumin , Magnesium, Evening Primrose oil, VHEA.

Current Illness: 2 days prior 03/04/2021 Platelet rich plasma injection done

ID: 1424018
Sex: F
Age: 60
State: CA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 06/24/2021
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: penicilin, prednisone, methotrexate, infliximab

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

Symptoms: Joint pain, difficulty breathing, fatigue, extreme thirt, headaches, acid reflex.

Other Meds: ACTEMRA every 28 days

Current Illness: none

ID: 1424019
Sex: M
Age: 54
State: IA

Vax Date: 04/01/2021
Onset Date: 06/10/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List: Pain in extremity

Symptoms: I had a lot of pain and aches after the second vaccination. I rested in bed for the whole afternoon and night, and I felt better the next day

Other Meds: Multi Vitamins, aspirin, Melatonin 10mg, Vitamin C, Iron 65mg, Zinc 50, Calcium 1200mg

Current Illness: NO

ID: 1424020
Sex: F
Age: 55
State: MI

Vax Date: 02/12/2021
Onset Date: 03/01/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: Bactrim

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

Symptoms: I am questioning new onset of generalized edema, no history of this prior to vaccine; I am uncertain if this could be related as no known cause yet identified. Is there any other reports of this?

Other Meds: ASA Vit C Zinc Apple Cider Vinegar Fish Oil Probiotic Vit D-3 Glucosamine Chondroitin Acyclovir Adderall Fiber Choice Magnesium

Current Illness: None

Date Died: 05/30/2021

ID: 1424021
Sex: M
Age: 47
State: TX

Vax Date: 03/24/2021
Onset Date: 04/15/2021
Rec V Date: 06/24/2021
Hospital: Y

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

Lab Data:

Allergies: unknown

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

Symptoms: Patient had an acute MI died after within 8 weeks of last vaccine patient had been complaining of dizziness and feeling different since second vaccine

Other Meds: furesomide carvedilol spironolactone

Current Illness: chf

ID: 1424022
Sex: F
Age: 72
State: CA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 06/24/2021
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: Anaphylactic reaction CIPRO; I develop a bright red rash from Bactrim; Eye ointment -related to Bactrim; Erythromycin - Purple rash; Codeine - high dose made me so depressed Shellfish; Anaphylactic reaction to bite of fire ant

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

Symptoms: Numbing and tingling sensation in my hands right after the shot. I have moderate carpal tunnel in both wrists so first thought I had was that it was affecting my nerves. Those symptoms resolved after two days. I was still able to perform tasks. A bit after that, I also noticed my right eye lid drooping and my left eyelid was open and staring - like it was fixed. In next week and 1/2, I noticed symptoms consistent with my auto-immune ( M. Gravis) disease my neck was getting stiff and range of motion in neck was constrained. I noticed stiffness in my shoulders. Those are areas where my disease has targeted before in the past. Those symptoms lasted a few days. I did report these symptoms to my neurologist . 8th of May, I walk with a cane and I walked and afterward, I noticed pain in my left leg. The pain didn't stop and it got worse - it got so that every step I took hurt. I tried to deal with it for seven days. I thought at first that maybe I just had twisted something. On the 14th of May, I explained my symptoms to advice nurse. I received an appt on Monday and I went to see Dr. Bearing full weight on my left leg was excruciating and also on the left leg , I have had one old varicose vein for 15 years ( and no others on my body) but between the time of talking to the advice nurse and going to the doctor - 8 or 9 varicose veins popped up within 48 hours- all were on the left leg except one. And they were all over from bottom of leg to hip. At the appt, she ordered an ultrasound. I've started to use the seated walker instead of cane and I'm walking shorter distances and trying to rest my leg and it is resolving. They have referred my to physical therapy to help with the compressed vertebrae. I don't use the analgesic they prescribed because it doesn't work- I mostly just rest it and use Tylenol when need.

Other Meds: Tyridoltigmine Bromide - 60 mg - 3 times a day (Mestinon - generic of it); Levothyroxine - 1 tablet once a day in the morning; Attenolol - 25 mg tablet (one per day); Inhaler - Alvesco - 80 mcg - twice a day - 1 puff in am; 1 puff in eveni

Current Illness: no

ID: 1424023
Sex: F
Age: 64
State: MI

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: benadryl, cymbalta, compazine, shellfish

Symptom List: Vomiting

Symptoms: Numbness on left side of face

Other Meds: lisinpril 2.5, multi vitiman, baby aspirin

Current Illness: None

ID: 1424024
Sex: F
Age: 12
State: CO

Vax Date: 06/02/2021
Onset Date: 06/05/2021
Rec V Date: 06/24/2021
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: No

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient reports she developed severe headache, chest pain and shortness of breath 3 days after receiving the vaccination. Her symptoms lasted for 2 days. She did not need to seek medical care.

Other Meds: Zyrtec prn

Current Illness: None

ID: 1424025
Sex: F
Age: 40
State: OR

Vax Date: 06/15/2021
Onset Date: 06/23/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Severe soreness and swelling in arm returned 8 days after initial soreness from shot. Soreness is traveling up my arm, into my neck and down my back muscle. Feeling very tired today (6-24-21) .

Other Meds: Clairton

Current Illness: None

ID: 1424026
Sex: M
Age: 70
State: NE

Vax Date: 03/17/2021
Onset Date: 03/29/2021
Rec V Date: 06/24/2021
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: NSAIDS

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Approximately 10 to 12 days after 2nd vaccination, strong joint pain began, first left arm, then abated after 3-4 days; next right wrist then abated after 3-4 days; next right arm abating after 3-4 days; next left wrist abating after 3-4 days. Made appointment with my doctor who said he found I had a high degree of inflammation. Referred me to a specialist who performed blood tests. She found abnormal results and concluded that I was experiencing rheumatiod arthritis. Currently taking methotrexate by injection and prednisone orally to relieve symptoms.

Other Meds: amlodipine besylate, benazepril hcl, rosuvastatin, arnuity ellipta, daily vitamin, fish oil

Current Illness: None

ID: 1424027
Sex: F
Age: 80
State: AL

Vax Date: 06/03/2021
Onset Date: 06/08/2021
Rec V Date: 06/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pain in both arms following shot that has persisted and has spread into her back

Other Meds:

Current Illness:

ID: 1424028
Sex: F
Age: 46
State: WA

Vax Date: 06/07/2021
Onset Date: 06/08/2021
Rec V Date: 06/24/2021
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: Gluten and latex

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

Symptoms: Triggered autoimmune disease symptoms which were sore joints, fatigue, constipation, bloating, severe abdominal pain, nausea, and vomiting.

Other Meds: None

Current Illness: Celiac Disease

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm