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: 1455106
Sex: F
Age: 57
State: TN

Vax Date: 04/24/2021
Onset Date: 04/29/2021
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:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Less than one week after injection I began having severe diarrhea, nausea. My abdominal area began to swell. Pain in the mid section. Lots of exhaustion bouts. This has gone on since it began and we are now at July 7, 2021 and am still having diarrhea and dealing with bouts of fatigue. I have been to gastroenterologist and my regular physician. Nothing has been found as what is causing it. I am scheduled for a colonoscopy in August. I don't know what to do.

Other Meds: zoloft / thyroid meds / singulair / zanex / trazodone

Current Illness: no

ID: 1455107
Sex: M
Age: 27
State: SD

Vax Date: 04/07/2021
Onset Date: 06/27/2021
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:

Allergies: Cat dander

Symptom List: Anxiety, Dyspnoea

Symptoms: Muscle pain for several days after then stomach problems(not diagnosed gas problem) since culminating in my trip to the ER and immediate surgery to remove my gallbladder on June 29. Stomach problems are not fully resolved as of yet.

Other Meds: Centrum multivitamin

Current Illness: None

ID: 1455108
Sex: F
Age: 35
State: TX

Vax Date: 06/17/2021
Onset Date: 06/28/2021
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: Peaches, Lisinopril, and codeine

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

Symptoms: Below is the email sent to my PCP via messaging system. Sent:6/28/2021 5:24 AM CDT To: MD Subject:Question About Non-Urgent Medical Matter Good morning Dr., I wanted to inquire if it is still normal that I am experiencing pain at the injection site since receiving the pneumococcal vaccine on 6/17/2021. The pain can be described as a shooting pain that radiates to the rotator cuff. It's also painful to lie on my arm or to put my arm directly straight out. I am relatively active, especially being outside and since receiving the vaccine I feel that my range of motion is hindered. I have not felt this on my left arm where I received the tetanus, only the right one. Thank you Ma'am and I look forward to hearing from you. Progress Notes from, FNP at 7/2/2021 11:01 AM: Arm pain 6/7/2021 received 2 vaccines. Tdap Lt arm PCV on Rt . Rt arm is still painful. Pain is positional- with movement up or backward. Pain radiates from injection site which Is upper deltoid as per pt into mid upper arm. Initial redness and pain resolved after a few days but positional, shooting pain continues. Taking Motrin 800mg about daily and using heat with sub optimal relief. Musculoskeletal: Comments: Rt upper arm. No visible site of injection. Pt can pinpoint site as source of pain in upper deltoid below humeral head. No redness, swelling Exquisite tenderness to light touch. In area of about 6 cm around injection site. FROM of RUE with pain on full abduction.

Other Meds: fluticasone 50 MCG/ACT nasal spray, losartan 25 MG tablet, montelukast 10 MG tablet, topiramate 50 MG tablet, hydrOXYzine 50 MG capsule, buPROPion 100 MG extended release tab 12 hour, escitalopram 5 MG tablet, sumatriptan 50 MG tablet, albu

Current Illness:

ID: 1455109
Sex: F
Age: 35
State: CO

Vax Date: 05/20/2021
Onset Date: 05/24/2021
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:

Allergies: NONE

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I have not had a period since April of 2021. I was supposed to get my period two days after receiving the vaccine in May and never got it. It has been 4 months of no period. I am bloated and feel fatigued like I should be starting my period, but I never do.

Other Meds: NONE

Current Illness: NONE

ID: 1455110
Sex: M
Age: 26
State: FL

Vax Date: 06/26/2021
Onset Date: 06/28/2021
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: None

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

Symptoms: Myocarditis and pericarditis

Other Meds: None

Current Illness: None

ID: 1455111
Sex: M
Age: 43
State: CA

Vax Date: 05/12/2021
Onset Date: 05/12/2021
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:

Allergies: None.

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

Symptoms: 35 minutes after receiving the shot, I went into a cluster headache. My last cluster headache was 7 years ago and I learned to treat it with oxygen therapy. I have now had about 10 cluster headaches since the injection. Because I have a tank of oxygen, I shut them down for about 2 weeks at a time. When I ran out of oxygen and had to wait for the tank to get refilled, I got headaches 4 nights in a row for about 30-45 minutes each. On the 4th night (this week), I had oxygen again and was able to shut down the headache as it started to happen and haven't had one again since.

Other Meds: None.

Current Illness: First vaccination made my face swell up and I was prescribed steroids to reduce the swelling.

ID: 1455112
Sex: F
Age: 47
State: NE

Vax Date: 01/21/2021
Onset Date: 03/12/2021
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: none that I was taking. Bactrim that I was not taking at the time.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Extreme vertigo. Loss of balance. Loss of memory. Had to be taken to be laid down to sleep. When woke up 4 hours later there were no symptoms. It happened again a few days later. Then a few days later. It has happened a total of 8 times - the most recent were 7/4/21 and 7/6/21. Extreme vertigo and loss of balance without loss of memory during the last 6 of the 8 episodes. Never had episodes anything like this in the prior 47 years before the vaccine.

Other Meds: progesterone, NT Thyroid

Current Illness: none

ID: 1455113
Sex: M
Age: 12
State: CA

Vax Date: 07/07/2021
Onset Date: 07/07/2021
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: Pollen

Symptom List: Pharyngeal swelling

Symptoms: Itchy, rash near injection site, rash is warm to touch

Other Meds: None

Current Illness: None

ID: 1455114
Sex: F
Age: 45
State: TX

Vax Date: 05/12/2021
Onset Date: 05/20/2021
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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: The main reaction I am experiencing is vaginal bleeding started May 20th 2021 and has not stopped it is now July 7th 20th 21 there have been days where it was spotty others were just normal type. Days. In the beginning I was 10 days early for my typical menstrual cycle and the blood seemed to be old. It was dark in color and not like a fresh shedding of the uterine wall. And then we're my normal period cycle came up it turned to what appeared to be my typical bleeding I continued to spot. And today on July 7th I started having clots large blood clots fresh in color but a lot of bleeding I have had two periods since it's began and July 7th would be a week after what would have been my typical cycle. Another side effect of experiencing is painful cramping of my hands and feet and occasionally my calves. It's to the point where pressing on the gas pedal can make my toes cramp when driving holding grocery bags with my hand cramp. Any kind of body stretch will make any of my muscles cramp I never know which one. I've had multiple side effects starting with a raised bumpy rash on both sides of my face. They were not pimples they never came to a head a few of the bumps ended with small scab on them I'm not sure if that's from me scratching at times it was itchy they started May 20th and I have just a scattering of the bumps at this point July 7th 2021.

Other Meds: None

Current Illness: None

ID: 1455115
Sex: M
Age: 18
State: FL

Vax Date: 07/01/2021
Onset Date: 07/07/2021
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: N/A

Symptom List: Diarrhoea, Nasal congestion

Symptoms: PT SAID HE LOST VISON AND GOT DIZZY AND HAD SYNCOPE. SKIN WAS EXTEMELY PALE AND THEN HE VOMITTED

Other Meds: N/A

Current Illness: N/A

ID: 1455116
Sex: M
Age: 21
State: PA

Vax Date: 06/23/2021
Onset Date: 06/23/2021
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: Sensitivity to Augmentin

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

Symptoms: Day of vaccination, patient experienced uncontrollable tremors in both arms. In response, patient took a dose of ibuprofen, performed stretches and took a nap; symptoms subsided. On June 28th, 2021, patient experienced another bout of tremors in both extremities at around 10am, which persisted for approximately 12 hours. After a televisit with CRNP, patient was referred to Emergency room. Patent reported to Hospital with continuing tremors. Doctors examined the patient's blood, as they head suspected rhabdomyolysis after ruling out any neurological causes for the symptoms. All bloodwork came back negative. Doctors intravenously injected 1.5 liters of saline fluid, after which the tremors subsided. Patient was thus discharged from ER. On July 2, 2021, at around 6pm, patient experienced sporadic tremors in right arm, which subsided after approximately 30 minutes. On July 4th, 2021, patient experienced frequent and sporadic tremors in both arms during the course of the day. Symptoms only subsided with sleep. On July 5th, 2021, patient experienced tremors in all four extremities during the course of the day. Consumed electrolyte water, remembering that the saline IV fluids had previously treated the tremors. Frequency and intensity of tremors decreased after patient consumed 48 fl oz of electrolyte water. Tremors fully subsided in sleep. On July 7th, 2021, patient was admitted to Family Practice and referred for a CT scan while still experiencing tremors. Scan showed no hemorrhages or growths in brain. Patient continues to experience sporadic and frequent tremors in all four extremities, varying in length and intensity.

Other Meds: Singular, Ventolin HFA, Flovent, Benadryl

Current Illness: None

ID: 1455117
Sex: F
Age: 50
State: CA

Vax Date: 03/04/2021
Onset Date: 03/11/2021
Rec V Date: 07/07/2021
Hospital:

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

Lab Data:

Allergies: Hydrocodone Opoids Any pain meds

Symptom List: Rash, Urticaria

Symptoms: After the first Vaccine Patient started having Migraines. Migraines lasted for about 2 months. Patient stated that a few days after receiving the vaccine she lost her vision. she was disoriented and weak.

Other Meds:

Current Illness:

ID: 1455118
Sex: M
Age: 25
State: NJ

Vax Date: 07/07/2021
Onset Date: 07/07/2021
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: Pollen

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

Symptoms: Syncope. Patient experienced Nausea, sweating, pain, and dizziness. Patient was told to sit down, given and ice pack, and water

Other Meds: N/A

Current Illness: N/A

ID: 1455119
Sex: F
Age: 31
State: KY

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

Allergies: Tamiflu

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

Symptoms: Extremely painful menstrual cramps.

Other Meds:

Current Illness:

Date Died: 04/29/2021

ID: 1455120
Sex: M
Age: 81
State: OR

Vax Date: 03/23/2021
Onset Date: 03/24/2021
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: None

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

Symptoms: All events took place: Following first dose, minor rash on left arm; following second dose, first developed severe rash on arm and belly, extreme fatigue, severe hiccups and inability to swallow without choking; ultimately developed liver and kidney failure, was diagnosed with DRESS syndrome resulting from reaction to vaccine, was administered high-dose corticosteroids and antibiotics but continued to decline, developed hemorrhage in lungs and died due to multi-organ failure. PDF Continuation field did not permit entering text, see attached Continuation Page.

Other Meds: Co-Diovan, Vitamin D3, Ginkgo Biloba, Collagen, Melatonin

Current Illness: None

ID: 1455121
Sex: F
Age: 57
State: AZ

Vax Date: 07/07/2021
Onset Date: 07/07/2021
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 first dose Moderna on 3/20/21 from spectrum health. Patient then came to get second dose Moderna on 7/7/21 and is outside the recommended 2nd dose vaccination window.

Other Meds:

Current Illness:

ID: 1455122
Sex: F
Age: 39
State: CA

Vax Date: 05/19/2021
Onset Date: 05/21/2021
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:

Allergies:

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

Symptoms: "Pt stated pt got 1st covid vaccine Pfizer 5/19/2021 at vaccine site and pt feels lethargic and dizziness that pt said pt almost feels ""pass out"", fatigue after covid vaccination. Noted pt has runny nose after covid vaccination. Noted no known allergies. Pt shown 2 s/sx of covid vaccine side effect after evaluations. recommended pt to call 911 or go to ED d/t evaluations of screening. Pt is educated covid vaccine side effects. Pt agreed and verbalized understanding. Pt said pt will go to nearest ED

Other Meds:

Current Illness:

ID: 1455123
Sex: F
Age: 60
State: IN

Vax Date: 06/28/2021
Onset Date: 07/05/2021
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: Latex Norvasc

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Allergic Inflammatory Response Distal to the injection site. Redness, swelling, tenderness, itching, and warmth.

Other Meds: Vitamin D Lisinopril Metformin

Current Illness: None

ID: 1455124
Sex: F
Age: 25
State: CA

Vax Date: 04/04/2021
Onset Date: 04/05/2021
Rec V Date: 07/07/2021
Hospital: Y

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

Lab Data:

Allergies: no

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Chills, fever and headache starting about midnight at the end of Sunday night and I went to work and had to leave within an hour. I took Tylenol about 10:00 or 11:00 that day. I felt sore and feverish until about noon on the 6th. On the 12th of June, I had acute pain in my lower right side. I started noticing them at about 08:00 am that morning. I originally went to Urgent Care and then they sent me to hospital around 07:00 pm and I had the appendix out around 04:00 am on the 13th. They gave me antibiotics in ER until they took it out on 13th. I was given three pain meds - Tramadol; extra Strength Tylenol; Extra Strength Ibuprofen. I had complications on Monday the 14th - ended up back in ER - I had nausea and couldn't stop throwing up. I was given Zofran. I took that the next two days after which nausea and constipation had passed. I'm in the process of recovering. I'm getting better every day. It will be six weeks before I won't have limitations.

Other Meds: Lutera - Birth control

Current Illness: no

ID: 1455125
Sex: F
Age: 62
State: TX

Vax Date: 07/01/2021
Onset Date: 07/04/2021
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: None

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

Symptoms: Nothing reported at time of event. Patient called 7/6/21 and reported Sunday ? swollen at injection site and hot to the touch. Patient unable to lift arm or sleep on left side.

Other Meds: Tylenol ? 500 mg/day starting 6/30

Current Illness: None

ID: 1455126
Sex: M
Age: 60
State: PA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
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: Amoxicillin

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

Symptoms: Reoccurring cluster migraine headaches. No medical diagnosis due to history of adverse event. Headaches occur generally around the same time each day, 9:30 PM. Headaches last around 1 1/2 hours. This headache cycle lasted until 4/29/2021 (day after 2nd vaccination shot).

Other Meds: Finasteride, Omeprazole

Current Illness: None

ID: 1455127
Sex: F
Age: 62
State: WA

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

Lab Data:

Allergies: None.

Symptom List: Unevaluable event

Symptoms: On April 3, the day after the vaccine, I got out of the shower and I noticed a rash under both of my breasts but I didn't think much of it. As the day went on, the rash spread throughout my body. I did not feel sick and I did not have a rash on my left arm. I didn't hurt or itch. I talked to a friend and her mother had the same issue. She said to contact the doctor and I would possibly get prednisone. I had bumps on my eyelids. I saw another doctor where I said that I am coming in due to this spreading rash. The treatment was going to be triamcinolone 1% cream and doxycycline. I got my steroids but I could not get the cream on my face so she referred me to an allergist and dermatologist. The allergist was first and 14 days had passed and the rash was so horrific. The rash was horrible and everywhere. He did nothing. I left and went to the dermatologist. She was the only person who seemed to care and punctured two holes in a biopsy. To rule out everything, she referred me to a cancer hematologist on June 22. I don't have cancer. I have never had a rash in my entire life and it all happened after the Moderna vaccine. One of the conclusions is from this vaccine.

Other Meds: Fish oil; Vitamin D; Acyclovir; Cymbalta; Topiramate; Triamterene; Diclofenac sodium; Cyclobenzaprine; Hydrocodone.

Current Illness: None.

ID: 1455128
Sex: M
Age: 55
State: MT

Vax Date: 06/23/2021
Onset Date: 06/23/2021
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: Morphine, Topamax, SSRI's Aspirin, NSAID's, MSG

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

Symptoms: beginning in the evening after the shot I noticed a red area starting to appear around the injection site. Early in the morning of June 24, approx 1:30 AM I awoke with severe joint and muscle pain over my entire body with a pain level of 10. I had tears uncontrollably running from my eyes due to the pain. Friday June 25, the muscle and joint pain had dropped to a level of 6 to 7. and I was able to realize that I also was having a severe migraine unlike any I have ever had before. I also notice that I had been having swelling in my hands and feet, dizziness and some cognitive issues. My hands hurt enough that I was unable to make a fist. The migraine after 4 days dropped down to a bad headache and that lasted 11 days. I still have been having off and on headaches with them intensifying to migraines and since the shot have had a total of 12 migraine days. My hands are still swelling and varies from day to day. It has also affected the migraines that I have suffered from and intensified them and changed the location of where I feel the pain. The Chronic Pain that I have been suffering prior to the shot that was 80% under control is now down to 40% controlled and I am having difficulty walking and being able to hold things in my hands. I am afraid that the vaccine has perinatally changed and intensified the migraines and pain issue and regret ever being pushed into receiving it.

Other Meds: Belbucca, Proprananola ER, Prevacid, Colestipal, Cyclobenzaprine, Flonase, Relpax,

Current Illness:

ID: 1455129
Sex: F
Age: 35
State: CA

Vax Date: 04/12/2021
Onset Date: 06/17/2021
Rec V Date: 07/07/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfa, Azithromycin, Morphine

Symptom List: Injection site pain, Pain

Symptoms: Severe sharp pain in abdomen, diarrhea, nausea; lasted 48 hours before being transported to hospital via ambulance due to severity of pain

Other Meds: Imitrex 100mg Lisiniprol 12.5-20mg

Current Illness:

ID: 1455130
Sex: F
Age: 64
State: CA

Vax Date: 04/28/2021
Onset Date: 05/19/2021
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: Pt called hospital advice call center. noted no emergency s/sx. Pt stated pt got 1st covid vaccine Pfizer 4/28/2021 at facility and pt got facial redness, rashes, facial swelling, tearing after covid vaccination and those symptoms last for 3 weeks. The symptoms got better 90 % but still pt has facial rash on temporal area. Pt said pt got redness beginning from around eye area to facial, collar bone area in a few days after covid vaccination. Pt took benadryl facial cream. Noted no allergies except pollen. Pt said pollen allergy used to be gone after 4-5 days but redness, rash on face at this time last 3 weeks and still pt has 10 % of redness, rash on face. Pt said pt had pain on left arm pit and it last 2-3 days and then pain went away. Noted pt got vaccinated on left arm. recommended pt to discuss with MD prior to covid vaccination. Pt agreed. Pt scheduled visit with urgent care MD 5/20/2021 for consultations. Pt is educated covid vaccine side effects. Pt verbalized understanding. All questions answered.

Other Meds:

Current Illness:

ID: 1455131
Sex: F
Age: 58
State: MI

Vax Date: 04/20/2021
Onset Date: 04/23/2021
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: Codine causes me itchiness

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

Symptoms: Red, round itchy spots, bumps/rash on under arms, abdomen, lower abdomen, upper thighs, and lower legs. Very itchy, very inflamed. Lasted over two months, until treated with steroid injection, oral steroids, and topical steroids (on 6/25/21). A few areas left slight scarring. Also had some issues urinating. Had kidney scan on 6/22/21 and blood work on 6/7/21. Still investigating that issue. Apeear to have recoved fully from rash but treatment was completed recently (6/30/21).

Other Meds: None

Current Illness: None

ID: 1455133
Sex: F
Age: 11
State: KY

Vax Date: 07/02/2021
Onset Date: 07/02/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: information given by pt stated that she was 12yr old to receive vaccine however she was 11. the 1st dose had already been administered at a previous date. Second vaccine was given.

Other Meds:

Current Illness:

ID: 1455134
Sex: M
Age: 50
State: MA

Vax Date: 06/14/2021
Onset Date: 06/16/2021
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: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Chest pain, irregular blood pressure, mostly high.

Other Meds: none

Current Illness: none

ID: 1455135
Sex: F
Age: 45
State: CA

Vax Date: 07/06/2021
Onset Date: 07/06/2021
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:

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

Symptoms: Patient given expired Moderna vaccine from 7/4/2021 at 10am. No adverse reaction reported.

Other Meds:

Current Illness:

ID: 1455136
Sex: F
Age: 56
State: CA

Vax Date: 04/29/2021
Onset Date: 05/20/2021
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:

Allergies:

Symptom List: Nausea

Symptoms: Pt stated pt got 1st covid vaccine Pfizer 4/29/2021 and pt got hives on left arm, rapid heartbeat after 6 hours from covid vaccine 4/29/2021. Pt also said tiredness, headache, chills after covid vaccine but pt didn't take any medications. Pt said hives and rapid heartbeat went away in couple of days without taking benadryl nor any medication, treatments. Noted pt is allergic to malaria medication with hallucination, dental anesthesia mediation with hives, bad fish allergy. Pt already made appt with her PCP(outside) and MD recommended pt to get tested for allergy lab with allergy specialist MD. recommended pt to f/u with PCP/Allergy specialist MD prior to 2nd covid vaccine.

Other Meds:

Current Illness:

ID: 1455137
Sex: F
Age: 63
State: GA

Vax Date: 03/19/2021
Onset Date: 04/01/2021
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: Trintellix Imetrex

Symptom List: Injection site pain

Symptoms: Change in medications. Increased doseages. Ozempic shots for diabetics in addition to increased level of oral meds. TSH elevated. Increased medication dose. Uncontrolled blood pressure. Increased meds and addition of second medications.

Other Meds: Levothyroxine Junevia Losartan Omeprazole Atorvastatin

Current Illness: Diabetic High BP High Cholesterol

ID: 1455138
Sex: M
Age: 25
State: CA

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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient given expired Moderna vaccine from 7/4/2021 at 10am. No adverse reaction reported.

Other Meds:

Current Illness:

ID: 1455139
Sex: F
Age: 29
State: OR

Vax Date: 04/25/2021
Onset Date: 05/27/2021
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:

Allergies: sulfa or sulfa based medication; adhesive tape

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

Symptoms: Dizziness on Thursday before Memorial day weekend. I talked to my doctor. I have never had issues with dizziness before this. It happens throughout the day. It lasts about 5 seconds and then dissipates and happens several times per day (dizziness spells). Dr wants to do a test for Vertigo to see about my inner ear. Haven't had that test yet. I haven't been able to pinpoint anything that triggers the dizziness. It's really bad for a few seconds and then goes away.

Other Meds: birth control: Hormonal Implant

Current Illness: no

ID: 1455140
Sex: F
Age: 34
State: KY

Vax Date: 06/09/2021
Onset Date: 06/09/2021
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: UNKNOWN

Symptom List: Tremor

Symptoms: PATIENT STARTED HAVING HORRIBLE HEADACHE ABOUT 12 HOURS AFTER MODERNA VACCINE. NOTHING OTC WOULD HELP ALLEVIATE THE HEADACHE PAIN FOR ABOUT 10 DAYS. SHE STIL HAS SOME LINGERING HEADACHE. HER DR. ADVISED HER NOT TO GET THE 2ND DOSE.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1455141
Sex: F
Age: 55
State: OR

Vax Date: 02/24/2021
Onset Date: 05/09/2021
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: Zephran

Symptom List: Erythema, Pruritus

Symptoms: 05/09/21 - start of Uterine Hemorrhaging after six months of no menstrual cycle; bleeding lasted 10 days followed by 2 days of spotting. Severe lower back pain and extreme fatigue included in symptoms. 05/20/21 - start of chest pains, upper back pain, and difficulty breathing 05/24/21 - visit to doctor, concern of possible extreme anemia from hemorrhaging, lab work done 05/25/21 - doctor visit to address lab results, chest pain, back pain, difficulty breathing, light headedness, and sweatiness condition at extreme level. EKG in doctor office shows problem. Doctor staff takes me to ER. EKG in ER points to heart attack (also labs, xray, and other tests). ER sends me by air lift to a hospital with a cath lab. 05/25/21 continued....cath lab does angiogram, blood tests, etc... Cardiologist cannot find cause of heart arrhythmia, no blockage found, "wandering" EKG settles back to normal. Cardiologist verbally mentions Paricarditis as a possible diagnosis but does not include that in his written report/medical record. Discharged. Since 5/25/21 doctor's have continued with diagnostic tests to explain "heart" event. As of 07/07/21 no definitive diagnosis, continuing tests.

Other Meds: See List on Page 2 Glucosamine Chondroitin Complex/MSM - 2 capsules per day Vitamin D3 25mcg (1000ut) - 1 capsule, once per day Cetirizine HCI 10mg - 2 capsules per day Metformin HCI ER 500mg - 4 capsules per day Lisinopril-Hydrochlorothia

Current Illness: Sinus Infection

ID: 1455142
Sex: M
Age: 41
State: WI

Vax Date: 02/08/2021
Onset Date: 02/10/2021
Rec V Date: 07/07/2021
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: patient diagnosed with Parsonage-Turner syndrome. Symptoms of weakness and pain started on 2-10-2021; returned approximately 2 months later with significant atrophy and continued weakness and pain

Other Meds:

Current Illness:

ID: 1455143
Sex: M
Age: 20
State: CA

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: 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: Patient given expired Moderna vaccine from 7/4/2021 at 10am. No adverse reaction reported.

Other Meds:

Current Illness:

ID: 1455144
Sex: F
Age: 51
State: WI

Vax Date: 06/02/2021
Onset Date: 06/03/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Massive swelling at injection site red hot to the touch body aching headaches fatigue

Other Meds: None

Current Illness: None

ID: 1455145
Sex: F
Age: 42
State: CA

Vax Date: 04/26/2021
Onset Date: 05/21/2021
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:

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

Symptoms: "Pt stated pt got 1st covid vaccine Pfizer 4/26/2021. Pt said pt has tiredness, headache,chills, night sweats, cough, sore throat, sleeping pattern change after covid vaccine. Pt already contacted with PCP(outside) and prescribed melatonin for sleeping pattern change. Noted pt is allergic to Iodine, Acne cream. Pt concerned that daily activities are still affected by the symptoms of covid vaccine side effects. Pt intends to make appt with MD before 2nd covid vaccine. Pt scheduled urgent care provider 5/21/2021 for consultations d/t pt said pt is not able to communicate with PCP during the weekends. Pt made aware. Pt is educated covid vaccine side effects. Pt agreed and verbalized understanding.

Other Meds:

Current Illness:

ID: 1455146
Sex: M
Age: 70
State: NC

Vax Date: 06/09/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: Patient explained that he developed heart palpitations, shortness of breath and difficulty breathing, gas pain and insomnia.

Other Meds: N/A

Current Illness: N/A

ID: 1455338
Sex: M
Age: 34
State: CA

Vax Date: 05/27/2021
Onset Date: 05/29/2021
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: None

Symptom List: Pain in extremity

Symptoms: I have been having diarrhea every day since 05/29/2021. Went to the clinic & so far nothing in terms of results of what is wrong. Second dose was 06/19/2021 & symptoms are constant, if not slightly worse.

Other Meds: None

Current Illness: None

ID: 1455339
Sex: F
Age: 52
State: MD

Vax Date: 04/14/2021
Onset Date: 04/17/2021
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:

Allergies: None

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

Symptoms: A rash developed on the inside of upper left arm a few days after first shot. Within a few weeks it had spread to lower arm. It began to clear up slightly prior to second shot. After second shot it spread to right arm, back, buttocks, legs, stomach, and chest over a month's time. Was prescribed Fluocinonide 0.05% ointment, Mycophenolate 500MG tablet, and Hydroxyzine HCL 25MG tablet

Other Meds: None

Current Illness: None

ID: 1455341
Sex: F
Age: 74
State: TX

Vax Date: 03/30/2021
Onset Date:
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: Acyclovir Penicillin Motrin Codeine IVP iodine Seashell

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

Symptoms: I experienced pain in the arm and some fatigue the next day after receiving the second shot. However, I went to the doctor on April 19th to get a mammogram and then it was discovered that I had enlarged lymph nodes. On May 27th, I took an ultrasound and I was told that the lymph nodes were no longer enlarged.

Other Meds: Blood pressure medication Breathing medication/steroid inhaler Vitamin E Baby Aspirin Eye drops for Glaucoma

Current Illness: Shortness of breath Coughing

ID: 1455342
Sex: F
Age: 23
State: ND

Vax Date: 12/20/2020
Onset Date: 06/14/2021
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:

Allergies: POLLEN EXTRACT-TREE EXTRACT METALS NICKEL

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

Symptoms: Case was hospitalized. 2nd vaccine given 1/10/2021

Other Meds: unknown

Current Illness: unknown

ID: 1455345
Sex: F
Age: 70
State: CA

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

Symptom List: Vomiting

Symptoms: Patient arrived to vaccine clinic accompanied by her husband. Patient received her first dose of the Pfizer vaccine in left deltioid at 1517 and then waited the suggested 15 min in the waiting are post vaccine administration. More than an hour later, staff made RN aware that patient and husband returned and is sitting in vehicle. Upon opening patients door to her vehicle, large amount of vomit was visibly noted inside of vehicle. Patient answering some questions appropriately but then does not answer others. Patient's husband mentioned patient does have mild dementia. No shortness of breath noted nor difficulty breathing. Patient was then transferred via wheelchair into clinic. Vital signs taken. Patient continues to vomit at this time. Ice pack provided. 911 called. Paramedics and Fire department arrived at approximately 1700. Medication administered via paramedics. Patient was then transferred out of clinic via stretcher accompanied by patients husband.

Other Meds:

Current Illness:

ID: 1455346
Sex: F
Age: 52
State: CA

Vax Date: 06/05/2021
Onset Date: 06/06/2021
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:

Allergies: Allergic to Sulfa and Walnut

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: No Fever Sweats Body Ache Fatigue Nausea Blur vision headache Loss of apetite

Other Meds: N/A

Current Illness: N/A

ID: 1455347
Sex: F
Age: 21
State: CA

Vax Date: 06/14/2021
Onset Date: 06/15/2021
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: Eggs

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

Symptoms: Client reported an onset of chest pain the morning after receiving the 1st COVID vaccine Pfizer. The client described the chest pain as dull and intermittent. The client stated the chest pain resolved after about 1 hour. The client stated she has previously experienced similar "chest pain when I gets sick." The client did not take any medications for the chest pain and did not seek any medical care regarding the chest pain. The client denied any s/s of anaphylaxis following the 1st COVID vaccine Pfizer. The client has no chronic conditions. She currently takes oral contraceptive Drospirenona. The client has a history of anaphylactic reactions to eggs. Vitals obtained at 2:47 PM were as follows: HR 80, BP 128/80, and O2 99%. RN submitted a medical consult via text message. Approval to proceed with the 2nd COVID vaccine Pfizer was obtained by Vaccine Operations. RN educated the client on s/s of anaphylaxis, pericarditis, and myocarditis. The client voiced understanding of this. RN also educated the client on when to seek EMS services and when to follow up with a primary care doctor, v-safe, and recommended a 30 minute waiting period. The client voiced understanding of this. The client received the 2nd COVID vaccine Pfizer at 3:26 PM. The client tolerated the vaccine well and did not report any symptoms to the EMT's during the observation period.

Other Meds: Drospirenona.

Current Illness:

ID: 1455348
Sex: F
Age: 64
State: MN

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 5/11/21 developed chest pain, had initial improvement, then worsening on approx 5/26/21. on 6/4, she was diagnosed with pericarditis and acute CHF, afib with RVR. Pericarditis has been treated with indomethacin, colchicine, and she is improving with CRP normalized. Afib treated successfully with cardioversion. she was treated with diuretics for her CHF.

Other Meds: rivaroxaban 10 mg po daily rosuvastatin 10 mg po daily losartan 25 mg po daily metoprolol succinate 50 mg po daily loratidine 10 mg po daily fluticasone 2 sprays each nostril daily olopatadine 0.2% 1 drop both eyes daily cholecalciferol 1

Current Illness:

ID: 1455349
Sex: F
Age: 28
State:

Vax Date: 07/07/2021
Onset Date: 07/07/2021
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:

Allergies:

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

Symptoms: 11:24 when asked, voiced dizzyness and nausea, ambulated without assistance or event to cot and reclined. Vital signs taken were stable, Monitored longer and during periods she attempted to sit and stand under observation, Wheelchaired to vehicle under parental supervision at 12:14. No other complaints.

Other Meds:

Current Illness:

ID: 1455350
Sex: F
Age: 60
State: OR

Vax Date: 06/06/2021
Onset Date: 06/07/2021
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: yes, strawberries, chocolate, cigarette smoke, dust, garlic, onions.

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

Symptoms: The day after my second dose of the covid19 vaccine, I developed itchiness all over my body. It itches everywhere, every day, all the time. Feels like I have ants crawling on me all the time, it is so intense it sometimes wakes me up at night. There is no rash, no welts, no redness, just intense itching that moves around my body. Chest, back, thighs, legs, feet, arms, shoulders, scalp, face. antihistamines have no effect (Benadryl, Zyrtech, diphenhydramine), OTC itch cream and Calamine lotion do not work. Cool showers work briefly. I have never before experienced anything like this.

Other Meds: MultiVitamin, occasional Zolpidem and Quetiapine for sleep, daily Metformin for high Ha1c.

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm