VAERS 2021 Database www.vaers.hhs.gov

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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: 1466929
Sex: F
Age: 74
State: PA

Vax Date: 03/19/2021
Onset Date: 04/05/2021
Rec V Date: 07/13/2021
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: Sulfa; Aspirin; statins

Symptom List: Dysphagia, Epiglottitis

Symptoms: Approx. 2 weeks after first dose of Moderna, I experienced pain in my left calf. The pain became more intense over time radiating down into my ankle and top of my foot. The pain was rated 10 out of 10. I could not reposition myself in bed because I could not put any pressure on my left leg. Walking was very difficult requiring me to use a cane and then a walker. There was no injury or accident that would cause such pain. The only thing that occurred was the Moderna vaccination. It is nearly 4 months later and still use the cane and walker. I take both OTC and prescription pain meds to be functional.

Other Meds: Multi vitamin; Vit. D; Protonix : Gaviscon prn; LIsinopril;

Current Illness: gastric ulcer diagnosed early Feb.

ID: 1466930
Sex: F
Age: 38
State: FL

Vax Date: 07/02/2021
Onset Date: 07/04/2021
Rec V Date: 07/13/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Systemic: Fever-Medium, Systemic: Hypertension-Severe, Systemic: Tachycardia-Severe, Additional Details: Heart flutter, very high blood pressure and heart rate, 103 degree fever, skin pain, painful urination - patient went to ER

Other Meds:

Current Illness:

ID: 1466931
Sex: M
Age: 78
State: ME

Vax Date: 07/10/2021
Onset Date: 07/11/2021
Rec V Date: 07/13/2021
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:

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

Symptoms: Patient received the Pfizer vaccination on 07/10/21 at 10:45am, but the vial was reconstituted incorrectly using only 0.8ml of sodium chloride instead of the required 1.8ml. Patient received more than double the dose. I spoke with patient on Sunday at 6:30pm and explained what happened and that he may have a stronger immune response due to the higher dose. He stated he was feeling good and so far had not had any adverse effects. I asked him if I could check back in with his later this week and he said Thursday afternoon would be fine. I will call him Thursday afternoon to check in and determine whether he has had any adverse effects.

Other Meds:

Current Illness:

ID: 1466932
Sex: F
Age: 36
State: MI

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

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

Lab Data:

Allergies: Norco

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient calling for Acute COVID-19 Vaccine and NUMBNESS. Vaccine given Friday - Symptoms started Sunday. Symptoms include: Patient received her Covid vaccine on Friday in her right arm. Saturday morning, her right leg also felt sore. Sunday morning, she says that her right foot and the right side of lower leg, from about halfway down from her leg to her foot she started to experiencing numbness. She says it came on suddenly. She is still experiencing the numb feeling and says that it makes it difficult to walk. Per Patient Report: On Friday I received my first vaccine dose. On Sunday, Less than 48 hours later, I suddenly lost sensation/feeling in my right foot and half of my lower right leg. I still haven't gained feeling back so I called the nurse line yesterday. They recommended I call 911. I decided to drive myself to ER. They ran a bunch of blood work, did an EKG, an ultrasound of my leg and did CT scan. All findings were normal with no explanation of what could could've caused the sudden numbness. The ER doctor said I needed to follow up with primary. My discharge papers said unexplained paresthesia. Went to ED again on 7/12/21 for rash. History of Present Illness Patient is a 36-year-old female, who presents to the emergency department complaining of pruritus for the last few hours. Past medical history is significant for otherwise healthy female. Patient states that she thinks she is having an allergic reaction she has itching all over her body. Patient states she did try some Benadryl cream without any relief. She expresses that the primary itching area is her torso. She expresses that this began while she was at work earlier today. She denies any new detergents, soaps, lotions, or changes in oral intake. She denies any known exposures. She does express that she got her Covid vaccine over 5 days ago and she did have some described paresthesias of her right lower extremity. She expresses that she was evaluated for this and that it comes and goes. She denies any trauma or injuries. She denies any further systemic symptoms at this time including fevers, chills, cough, congestion, difficulty swallowing describing appropriate tolerance of her secretions, denies difficulty breathing, chest pain, abdominal pain, nausea, vomiting, change in bowel bladder habits, episodes of incontinence, or any other concerns. And Urgent Care visit 7.13.21 - HPI: This is a 36-year-old female who presents to urgent care for evaluation of itchy rash to her torso. Rash started yesterday. She believes this is an allergic reaction to the COVID-19 vaccine which she received on 07/02. She states that she has been having a myriad abnormal symptoms including right leg numbness, fatigue, and this itchy rash. This is the 3rd time she has been evaluated for this. She tells me she had a full work up on 7/6 and was told everything was normal and then was seen in ER yesterday when the rash started and started on benadryl, prednisone, and Pepcid. She has been taking the Benadryl without much relief, but hasn't yet taken her other medications. She denies any new or worsening numbness/tingling to her foot. She states she does get some pain in the foot when working and standing for long periods of time. She has an appointment to establish with primary care on Thursday. She denies any new exposures, lotions, soaps, or detergents.

Other Meds: acetaminophen (TYLENOL) 500 MG tablet compounded medication hydrocortisone (HYTONE) 1 % cream hydrOXYzine (VISTARIL) 25 MG capsule ibuprofen (MOTRIN) 600 MG tablet naproxen (NAPROSYN) 500 MG tablet predniSONE (DELTASONE) 10 MG tablet predni

Current Illness: NA

ID: 1466933
Sex: M
Age: 42
State: CA

Vax Date: 04/07/2021
Onset Date: 04/14/2021
Rec V Date: 07/13/2021
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 antibiotics.

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

Symptoms: In the beginning, my feet and hands had poor circulation and became discolored, cold, and painful (like Reynaud's syndrome). I was able to get the circulation going by exercising. This lasted for a couple of weeks. I had cold sweats and chest discomfort, which I thought were symptoms of WPW. I went to the cardiologist. An EKG was done and I was put on a 2-week halter monitor. Everything checked out as not being a heart issue. Blood tests were done, and the results were normal. After the cold hands symptom, I developed palmar erythema. I also developed a lot of abdominal pain. I became really gassy, and my bowel movements became a light yellow. I had frequent urination. My weight dropped from 191 to 180, and I lost my appetite completely; the appetite loss happened for a week and a half. I had to force myself to eat. My hunger is now back, and I currently weigh 187. The gassiness, yellow stools, abdominal pains, and the frequent have all largely subsided. The stools are now a normal color. The palmar erythema is still present, though.

Other Meds: Olly's men's multivitamins.

Current Illness: None.

ID: 1466934
Sex: F
Age: 47
State: NM

Vax Date: 04/29/2021
Onset Date: 05/01/2021
Rec V Date: 07/13/2021
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: N/A

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

Symptoms: I had one menstrual cycle after receiving my first vaccination shot but none since.

Other Meds: Prozac Zyrtec

Current Illness: N/A

ID: 1466935
Sex: M
Age: 61
State: NE

Vax Date: 05/22/2021
Onset Date: 05/23/2021
Rec V Date: 07/13/2021
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: Pyrexia, White blood cell count decreased

Symptoms: 5/23 chills,headache, sore throat, diarheah, vomiting, cough, low energy 5/24 Seen doctor given steriod and antibiotic injections, prescribed prednisone and antibiotics. Condition improved for a few days but never went away. Then condition started to worsen as energy and breathining became worse. condition continued to decline as breathing becomes more labored and energy level dropped more. had to stop working as condition worsend. couldnt walk 20 feet without having to stop and rest. i was out of breath and struggling. decided to see doctor again. 6/17 seen doctor and given steriod and antibiotic injections again. given new scripts for prednisone and antibiootics. condition did not improve. more to add

Other Meds: LOSARTAN, ATENOLOL,ATERVASTATIN, AMLODIPINE,BRILINTA...`

Current Illness: NONE

ID: 1466936
Sex: F
Age: 17
State: MA

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

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1466937
Sex: F
Age: 62
State: GA

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 07/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1466938
Sex: F
Age: 17
State: OH

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Off label use

Other Meds: N/A

Current Illness: N/A

ID: 1466939
Sex: M
Age: 11
State: KS

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 07/13/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Patient and Parent lied on pharmacy consent form about patient's age so he could receive the vaccine. First dose was administered to patient at age of 11 years old. This was discovered when Patient's other parent brought him in for dose two and Parent gave us actual birthdate.

Other Meds: N/A

Current Illness: N/A

ID: 1466940
Sex: F
Age: 13
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: PT STATED SHE FELT TIRED AFTER WAITING 15 MINS.

Other Meds:

Current Illness:

ID: 1466941
Sex: M
Age: 82
State: OH

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

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

Lab Data:

Allergies:

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

Symptoms: PATIENT PREVIOUSLY RECIEVED 1 DOSES OF PFIZER VACCINE AND THEN RECEIVED TWO DOSES OF MODERNA VACCINE.

Other Meds:

Current Illness:

ID: 1466942
Sex: M
Age: 77
State: MO

Vax Date: 03/20/2021
Onset Date: 07/11/2021
Rec V Date: 07/13/2021
Hospital: Y

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

Lab Data:

Allergies: unknown

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

Symptoms: Patient receiving remdesivir. Still currently hospitalized.

Other Meds: unknown

Current Illness: Right foot injury from fall, recent podiatry surgery.

ID: 1466943
Sex: F
Age: 27
State: GA

Vax Date: 07/09/2021
Onset Date: 07/09/2021
Rec V Date: 07/13/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1466944
Sex: F
Age: 52
State: CA

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 07/13/2021
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: Cephalosporins

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

Symptoms: When I received both the 1st and 2nd doses of the vaccine I was in good health. I was walking and jogging 6 miles a day. The minute I received the vaccines I got a metallic taste in my mouth, flush and then felt sick for an hour. That went away both times. However I have had muscle cramping and severe fatigue and aching since the 1st dose and have not been able to walk more than a few blocks or exercise since. It has now been 3.5 months of waiting for the flu-like symptoms to go away. My muscles go into cramps doing small things like stairs or an incline on the street or even just house cleaning getting up and down and I get out of breath. I have been to the doctor and cannot find the cause.

Other Meds: Omeprazole 40 mg 1 time per day

Current Illness:

ID: 1466945
Sex: F
Age: 61
State: MI

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 07/13/2021
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 received her 1st COVID Moderna dose on 3/10/21. She received a dose of the Pfizer vaccine on 3/12/21 at a different facility and her 2nd Pfizer dose on 4/2/21 at that same facility. She then returned to our clinic and received the 2nd dose of Moderna on 4/7/21. She received both doses of both COVID mRNA vaccines within a month.

Other Meds:

Current Illness:

ID: 1466946
Sex: F
Age: 19
State: PA

Vax Date: 05/29/2021
Onset Date: 07/05/2021
Rec V Date: 07/13/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: ASYMPTOMATIC Admission Discharged 7/5/2021 - 7/7/2021 (2 days) Last attending ? Treatment team 39 weeks gestation of pregnancy Principal problem Discharge Summary (Resident) ? ? Family Medicine Cosigned by: MD at 7/7/2021 10:24 PM Attestation signed at 7/7/2021 10:24 PM I was present on the 3rd floor and saw this patient prior to her discharge. I agree with the key elements of the discharge note as written by Dr. Routine anticipatory guidance given including need for follow-up, daily vitamin, and pelvic rest. Discussed birth control options, post-partum depression issues, and other issues that would warrant a call to the office. Obstetric Discharge Summary BRIEF OVERVIEW Admitting Provider: DO Discharge Provider: DO;Nic* Primary Care Physician at Discharge: N/A Admission Date: 7/5/2021 Discharge Date: 7/7/2021 Primary Discharge Diagnosis 1-Postpartum day #2 post vaginal delivery 39 weeks gestation of pregnancy 2-Postpartum hemorrhage Secondary Discharge Diagnosis 1-Iron deficiency anemia 2-Asymptomatic COVID-19 positive test Hospital Course PT is a 19-year-old G1P0 at 39w4d admitted on labor. Patient was GBS negative. Patient completed COVI-19 vaccine schedule and tested positive on admission to the unit. No evidence of respiratory symptoms during hospital stay. Following unit policy isolation measures were placed. Patient had spontaneous vaginal delivery of viable female infant. Labor course was uncomplicated. However, persistent bleeding was noted after delivery. Fundal tone was adequate following active management of the 3rd stage with oxytocin and then use of misoprostol 1000 mcg were given following delivery of the placenta. Due to the persistence of bleeding examination was remarkable for bilateral sulcal laceration with brisk bleeding that were controled with repair (suture). Total blood loss during delivery: 1400 ml. Postpartum course in the hospital was uncomplicated. Her hemoglobin at the time of discharge was 9.6 g/dL and she was discharged with ferrous sulfate 325 mg p.o. twice daily. Patient was stable for discharge to home with appropriate follow-up.

Other Meds:

Current Illness:

ID: 1466947
Sex: M
Age: 51
State:

Vax Date: 04/03/2021
Onset Date: 04/06/2021
Rec V Date: 07/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: PATIENT HAD PVC'S 3 DAYS POST VACCINATION. POSSIBLE MYOCARDITIS PER PATIENT.

Other Meds:

Current Illness:

ID: 1466948
Sex: M
Age: 93
State: WI

Vax Date: 03/10/2021
Onset Date: 07/12/2021
Rec V Date: 07/13/2021
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: Gabapentin

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

Symptoms: Pt received both doses of the Pfizer COVID-19 vaccine, on 2/18/2021 and 3/10/2021. On 7/12/2021, pt presented to our ED for "feeling crumy" with a decline in ADLs. Pt tested positive for COVID 19 via PCR. Chest Xray positive for pneumonia, suspected UTI also contributing. Pt admitted to inpatient due to weakness and suspected underlying infection.

Other Meds: brimonidine, dorzolamide, dutasteride, ferrous gluconate, insulin aspart, insulin glargine, latanoprost, levetiracetam, melatonin, montelukast, multivitamin, pregabalin, rosuvastatin, umeclidinium-vilanterol

Current Illness:

ID: 1466949
Sex: M
Age: 76
State: MI

Vax Date: 03/20/2021
Onset Date: 07/11/2021
Rec V Date: 07/13/2021
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: Morphine

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

Symptoms: Patient came in to the Hospital with blood in the urine since July 3. Patient had been on Kleffx, and then called his own pcp. Pcp adviced he get blood work done at the urgent care. Urgent care was only able to do urine test. Kleffix was discontined and patient was then given Bactrium also Zofran. Patient was complaining of eating very little , denied chest pain, denies SOB. Complained of chills and shaking. No other complaints, Patient did have a chest x-ray. Found on x-ray ground glassin the perfary of right lower lobe. Diagnosis was , acute weakneess, phemonia, hematuria.

Other Meds: Kleffix, bactrum, and zorfan

Current Illness:

ID: 1466950
Sex: F
Age: 45
State: CA

Vax Date: 03/29/2021
Onset Date: 06/14/2021
Rec V Date: 07/13/2021
Hospital:

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

Lab Data:

Allergies: Dust, pollen

Symptom List: Unevaluable event

Symptoms: Severe pain in left leg. Couldn't walk. Went to urgent care . Did blood work and x-ray. A week later, severe in right shoulder blade and upper back. Had to leave work. Took pain medication. The next day, woke up with severe pain in right calve, felt tingling in numbness in both legs. Went to ER. Given pain medication. Did Dopler untrasound on right leg to rule out blood clot. Still have severe pain in different locations. Still having numbness and tingling in arm and legs. Went to a neurologist. Feeling discomfort in throat. Feeling aniexty. Can't do activities like before.

Other Meds: Claritin, Indiryl

Current Illness: None

ID: 1466951
Sex: M
Age: 17
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 07/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1466952
Sex: F
Age: 47
State: NE

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 07/13/2021
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: NKA

Symptom List: Injection site pain, Pain

Symptoms: 12/24/2020 PT is a 47 y.o. female who arrived by Car presented to the emergency department for Stroke symptoms. Patient awoke at 6:15 this morning, some difficulty seeing out of the right eye and also was stumbling towards the left and to table. Concerned about things not being right so brought to the emergency department. Patient feels her speaking and swallowing are okay. She did drink a bit of coffee earlier. She denies headache or significant vision problems presently. Continues to not feel normal on her left side. No history of stroke and parents or siblings. She does give personal history of an occipital migraine many years ago at which time she did not have a headache but had some vision troubles. Patient's speech seems a bit slurred to me. Absence of ocular movements towards left noted as well as upward movements. Tongue is midline. Patient is unable to shrug the left shoulder or lift the left arm off the bed. Grip strength is 4 out of 5 on the left. Left leg strength is 3 out of 5. Extremity strength on right arm and leg is 5 out of 5. Pt transferred to another facility. PT is a 47 y.o. female with benign past medical history apart from tobacco use presents as a transfer to our facility from ER for further evaluation and treatment sudden onset bilateral blurred vision, difficulty with visual tracking as well as slurred speech, perioral paresthesias, with left hemiparesis. Patient was last known well last evening. She awoke today at approximately 6:15 AM with above described focal neurologic deficits. She does have a history of migraines (specifically citing an ocular migraine roughly 12 years ago which resulted in similar strokelike symptoms) but denied aura, headaches in the last 24 hours. No other physical complaints noted including chest pain, shortness of breath, GI upset, irritative urinary symptoms; no fevers, body aches or chills; no recent illnesses. She does work in the lab at Hospital and admits to possible Covid encounters but denies Covid symptoms. She was in fact vaccinated yesterday 12/23/2020. Pt has had extensive rehab and therapies. PT is a 47-year-old female with a history of PFO, CVA and tobacco abuse. On 12/24/2020 she awoke with vision changes and some issues with walking and depth perception. She was diagnosed with acute ischemic stroke. MRI showed a basal ganglia stroke, CT of the head and neck arteries were without significant carotid disease. She had an extended Holter monitor that did not suggest significant arrhythmias. Her hypercoagulable work-up was positive for MTHFR mutation. She is on single antiplatelet therapy with aspirin and high intensity statin. She presented to Hospital on 4/15/2021 with planned PFO closure procedure. 6/29/21 HPI patient is seen today to discuss going back to work. She feels like she is ready to go back to work and did have a work well functional capacity evaluation on 6/15/21. This did demonstrate that she is able to work at medium physical demand level VIII hours a day for 5 days a week. She continues to follow with neuro-ophthalmology for her left eye. She is currently wearing a frosted lens on the left and states that she was told that her eye is a 20% chance of improving on its own or 80% chance of having to proceed with surgery. She feels like her gait and balance are much improved. She has been doing household chores, shopping, gardening, even mowing the yard and has tolerated this well. Sometimes she gets more tired but does feel like her excessive fatigue is not quite as bad since she has been more active. She continues to sleep well at night. She does occasionally have to take a nap in the afternoon. She does have chronic neck and back pain which she uses tramadol occasionally for. She has been having more achiness in her hips, legs as well as arms but is wondering if this is due to lack of activity and she also blames weight gain since her stroke. She has not had any swelling in her lower extremities. She does have some varicose veins of lower extremities and has support hose but has not been wearing them. Plan: She will continue with her current medications. She states that her neurologist to decrease her Lipitor to 40 milligrams daily. She does not feel like this has necessarily caused increased myalgias or arthralgias. She does have varicosities of the lower extremities and encouraged her to use her support hose especially when she returns to work. She does feel like she is ready and capable to return to work and will gradually ease back into this. I think it is best to start with 4 hours a day 3 times a week the first week then increase to 4 times a week (or 16 hours a week) for 1?2 weeks and if tolerated increase this to 32 hours a week. Once she is able to tolerate 32 hours a week for 4 weeks then would try to resume her normal 40 hours a week. She is going to give us a phone report in 2 weeks however she is to call or return sooner if she cannot tolerate this.

Other Meds: Celexa and Nicoderm patch

Current Illness: N/A

ID: 1466953
Sex: M
Age: 11
State: LA

Vax Date: 05/30/2021
Onset Date: 05/30/2021
Rec V Date: 07/13/2021
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: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1466954
Sex: M
Age: 33
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Partial dose was given as the vaccine leaked from the syringe hub. It was estimated that less than a half dose was given so the patient was contacted to be given another dose.

Other Meds:

Current Illness:

ID: 1466955
Sex: F
Age: 68
State: KS

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 07/13/2021
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: continual ringing in ears

Other Meds: ezetimibe, vitamin d3, vitamin c, magnesium, calcium, collagen, turmeric

Current Illness: none

ID: 1466956
Sex: F
Age: 19
State: NJ

Vax Date: 07/11/2021
Onset Date: 07/11/2021
Rec V Date: 07/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Systemic: Chest Tightness / Heaviness / Pain-Medium

Other Meds:

Current Illness:

ID: 1466957
Sex: F
Age: 77
State: MO

Vax Date: 03/20/2021
Onset Date: 07/11/2021
Rec V Date: 07/13/2021
Hospital: Y

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

Lab Data:

Allergies: unknown

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

Symptoms: shortness of breath, O2 80%.

Other Meds: unknown

Current Illness: unknown

ID: 1466958
Sex: M
Age: 60
State: CA

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: None stated.

Other Meds: Lisinopril,Tutmeric/curcumin,b-complex,E, fish oil,triple action joint health,and Acetaminophen...

Current Illness: Liver

ID: 1466959
Sex: F
Age: 60
State: OH

Vax Date: 03/12/2021
Onset Date: 03/26/2021
Rec V Date: 07/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: 2 weeks after getting the vaccine I experienced a horrible headache that lasted 2 weeks. None of my migraine meds worked on this headache. It was constant, for 2 weeks. It then started letting up, but I woke up with half my face being numb. It starts at my lips and moves up my face to my lower eye lid. My upper teeth are also numb on that side. The left side, When that happened I went to the ER as advised by my doctor (4-12-21). My blood pressure was very high so they treated me for that and did a CAT scan of my head and found nothing. I was sent home. Saw my Neurologist the next day 4-13-21, She ordered an MRI which was done on 4-17-21. Nothing significant was found. I also saw my Primary care doctor that same week. He did bloodwork to rule out auto immune diseases. Bloodwork was good. I also went to see my dentist that week to rule out dental problems. He did an xray and did not think it was dental related. The numbness is still there. It has not gone away

Other Meds: Levothyroxine .88 mcg Losartan 100 mg. Carvedilol 25 mg. Omeprazole 20 mg. Trulicity 1.5 mg. 1 X week Fluoxetine 20 mg. Metformin ER 1000 mg. twice a day Fenofibrate 160 mg.

Current Illness: None

ID: 1466960
Sex: F
Age: 78
State: WI

Vax Date: 03/05/2021
Onset Date: 05/26/2021
Rec V Date: 07/13/2021
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: 5/28/2021 Patient started experiencing sharp pain in her left ear. In May patient had stroke symptoms for about 15 mins. Speech was slurred and she could not remember people. In June stabbing pain and left feverish and had a episode of loose stool.

Other Meds: Metaprolong Vitamin d3 Biotin Asprin

Current Illness:

ID: 1466961
Sex: F
Age: 52
State: UT

Vax Date: 07/13/2021
Onset Date: 07/13/2021
Rec V Date: 07/13/2021
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: Pcn, morphine, seasonal allergies

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

Symptoms: Began itching around the nose and the mouth after about 8 to 10 minutes and the skin around nose and mouth began turning red. Continued getting worse she took a Benadryl tablet. She began mildly panicking. Then she felt goose bumps on her arms began getting hives, throat began itching and closing, increased panic, trying to clear throat. Felt throat swelling. nurse administered epinephrine 0.5mg called ambulance.

Other Meds:

Current Illness: None

ID: 1466962
Sex: M
Age: 26
State: MO

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

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Systemic: Fainting / Unresponsive-Severe, Systemic: Seizure-Severe, Systemic: Vomiting-Mild, Additional Details: shortly after receiving vaccination, the patient became unconscious, fell out of his chair and to the floor, and began to seize. Body shaking lasted around 15-20 seconds. Patient then immediately became alert and concscious. Stated after this episode that he has a history of fainting and having seizures after he receives vaccinations. Patient vomited ~15-20 minutes after this episode.

Other Meds:

Current Illness:

ID: 1466964
Sex: M
Age: 66
State: NY

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/13/2021
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: Erythema, Pruritus

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1466965
Sex: F
Age: 29
State: GA

Vax Date: 06/07/2021
Onset Date: 06/16/2021
Rec V Date: 07/13/2021
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: Penicillin, Amoxicillin and Sulfa Drugs

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

Symptoms: Heavy rash taking over my skin on my right arm bringing discoloration to my skin and it?s spreading

Other Meds: Vacyclovir

Current Illness:

ID: 1466966
Sex: F
Age: 28
State: OK

Vax Date: 07/09/2021
Onset Date: 07/10/2021
Rec V Date: 07/13/2021
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: Mild Guillain-Barre syndrome in arms and hands, resolved with no additional treatment within 8 hours

Other Meds: Estarylla 0.25mg/0.035mg

Current Illness:

ID: 1466967
Sex: M
Age: 54
State: GA

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 07/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1466968
Sex: F
Age: 16
State: TX

Vax Date: 07/13/2021
Onset Date: 07/13/2021
Rec V Date: 07/13/2021
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: None

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

Symptoms: Complains of heart palpitations , pulse 120 when checked. Please went down to 105.

Other Meds: None

Current Illness: None

ID: 1466969
Sex: M
Age: 16
State: WA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 07/13/2021
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 did not have an adverse reaction, but was administered the vaccine while they were not of age.

Other Meds: n/a

Current Illness: n/a

ID: 1466970
Sex: M
Age: 53
State: NY

Vax Date: 03/28/2021
Onset Date: 05/01/2021
Rec V Date: 07/13/2021
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: Gradual increase of ringing in the ears while at the same time experiencing hearing loss. Within a few weeks the ringing increased to almost permanent, especially in one ear. The tinnitus is as a high pitched noise and occasionally sounding like crickets. There has also been an adverse reaction to caffeine that causes the tinnitus to increase.

Other Meds: none

Current Illness: none

Date Died: 07/05/2021

ID: 1466971
Sex: M
Age: 81
State: KY

Vax Date: 02/25/2021
Onset Date: 06/16/2021
Rec V Date: 07/13/2021
Hospital: Y

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: shortness of breath, endotracheal intubation, ventilator, death

Other Meds: amlodipine 5 mg tablet once a day with benazepril; omeprazole 20 mg tablet once a day in the morning; Synthroid 75 ?g tab, 1 every day; atorvastatin 40 mg tablet, 1 every evening; doxazosin 2 mg tablets 1 every day; clopidogrel 75 mg tablet

Current Illness:

ID: 1466972
Sex: F
Age: 56
State: NY

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

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1466973
Sex: M
Age: 57
State: AZ

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

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

Symptoms: Pt came into the clinic requesting dose #1 . He was acting nervous & claustraphic (not wanting to be inside). I did not check the state system to see whether or not he had received prior doses before administering the vaccine today. It wasn't until afterwards that it was determined that he had received Phizer on 2/8/21 & 3/1/21. He received the 3 rd dose today. He was feeling fine when he left the clinic after observation.

Other Meds:

Current Illness:

ID: 1466974
Sex: F
Age: 74
State: FL

Vax Date: 02/07/2021
Onset Date: 02/21/2021
Rec V Date: 07/13/2021
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: I have lo level allergies to various foods (blueberries, egg whites, raspberries, cashews, etc.) and high levels to cats, roaches and dust mites. Allergy to latex, problems with some antibiotics (diaherrea).

Symptom List: Vomiting

Symptoms: The second Moderna shot was given on Feb. 2, 2021 (16:26) (Lot number 028220A), upper right arm, and was followed by a slight fever and tiredness the next day. Exactly two weeks later, Feb. 21 I experienced a severe bout of vertigo, which left me unable to stand, with continued vomiting and severe tinnitus. I have never had anything near this extreme in my history with Meniere?s. It lasted about an hour. The tinnitus remained at a reduced level but the vertigo was down to occasional dizziness. A week later I had another episode of severe vertigo which lasted about 4 hours and was accompanied by severe tinnitus. I got in to see my PCP?s nurse practitioner, March 1. He prescribed Odansetron, 4 mg, to be taken as needed and Meclizine 25mg as needed. I took these two pills on some days twice a day. For the next 4-5 weeks I had the following cycle: one bad day (severe tinnitus, some vertigo) followed by a good day (tinnitus down, no vertigo) followed by increasing symptoms until day 5 or 6 of the cycle then another bad day. This cycle continued until I found an ENT who had experience with Meniere?s. This visit was April 13, 2021. He prescribed Diamox (Acetazolamide), 125 mg twice a day to reduce the pressure in my middle and inner ear. The cycles stopped and I have had varying levels of relief of symptoms since then (very little dizziness, some to moderate tinnitus. I have had about a 75% hearing loss in my left ear. Symptoms persist to some degree and when I attempt to stop the Diamox they recur at varying levels.

Other Meds: 20 mg Pravastatin, 2.5 mg Letrozole, 800 IU Vit. D, 60 mcg K2, Calcium citrate 500 mg, and 250 mg Magnesium.

Current Illness: None

ID: 1466975
Sex: F
Age: 59
State: AR

Vax Date: 04/28/2021
Onset Date: 05/05/2021
Rec V Date: 07/13/2021
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: Penicillin; cephalexin; Nitro Furanone Micro Crystal; Cyclosporine; Ciphertext

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Large joint pain. My wrist and hand was painful. It got so bad that I could not lay on my sides. I had to get steroid shots for the pain. I had headaches as well. They ran X-ray on my joints, that came back with fluid on my joints. They diagnosed me with arthritis.

Other Meds: Acyclovir; Autologous Sturm Tears; Bactrim DS; Drisdol; Peptized; Fluconazole; Lantus insulin; Levothyroxine; Potassium; Prava statin; Siri Linus; Xiidra

Current Illness: Grasp Host disease secondary MDS

ID: 1466976
Sex: F
Age: 58
State: WV

Vax Date: 07/13/2021
Onset Date: 07/13/2021
Rec V Date: 07/13/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Pt did not dilute Pfizer vaccine before administration. According to two Ladies she received 0.3mL of undiluted Pfizer vaccine.

Other Meds:

Current Illness:

ID: 1466977
Sex: M
Age: 31
State: IN

Vax Date: 07/08/2021
Onset Date: 07/10/2021
Rec V Date: 07/13/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Nausea. No appetite. Current medication now feels ineffective.

Other Meds: Glycopyrrolate

Current Illness: None

ID: 1466978
Sex: M
Age: 23
State: TX

Vax Date: 07/11/2021
Onset Date: 07/11/2021
Rec V Date: 07/13/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: I was laying in bed and felt a pins and needles pain in my legs it was worst in my left leg so I stood up to go to the bathroom and my legs wouldn?t move I ended up falling over and hit my head and sprained my foot

Other Meds: N/A

Current Illness: N/A

ID: 1466979
Sex: M
Age: 71
State: NY

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

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm