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: 1478283
Sex: F
Age: 66
State: MD

Vax Date: 04/05/2021
Onset Date: 05/15/2021
Rec V Date: 07/16/2021
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: Oxycodone (hives), erythromycin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Uveitis and retinal vasculitis symptoms that began on 05/14/2021. Currently under treatment with oral prednisone, has not resolved.

Other Meds: Align, turmeric, vitamin D, vitamin C, Zyrtec

Current Illness: None

ID: 1478284
Sex: M
Age:
State: NC

Vax Date: 06/24/2021
Onset Date: 07/04/2021
Rec V Date: 07/16/2021
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: No

Symptom List: Anxiety, Dyspnoea

Symptoms: I ended up having a stroke after having blood clots Dr could not find cause of blood clots and this is only thing different I introduced into my body

Other Meds: Venlafaxine

Current Illness: No

ID: 1478285
Sex: M
Age: 27
State: VA

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 07/16/2021
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: nkda

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

Symptoms: No more than 60 seconds or so after vaccine was administered, patient stopped responding verbally then his head tilted backwards (seemed to be vasovagal response). Held patient's head upright so that he did not hit his head on wall and applied ice pack to the back of his neck. Patient twitched, sneezed, then muscles tensed and then relaxed. He came to not 45 seconds after initially losing consciousness. Patient was very pale and sweaty. He asked for water and sat for 5 minutes or so. Patient said he was then feeling a bit lightheaded so we gave some orange juice. 5 more minutes passed and he said he was feeling much better. Patient described feeling very dizzy and not being able to hear clearly before losing consciousness

Other Meds: none

Current Illness: none

ID: 1478286
Sex: F
Age: 68
State: NJ

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Tramadol, Percocet, Toradol, Dilaudid

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Redness, swelling at and near the injection site, patient reports itching, pain & pain radiating down the arm to forearms. Fever was also initially reported but has subsided, body aches were also reported. At this time, patient has redness & swelling & pain....patient was instructed to do soft compresses around the site & take anti-inflammatory as directed by MD

Other Meds: Gabapentin, Zolpidem, Levothyroxine, Multivitamins OTC

Current Illness: none

ID: 1478287
Sex: F
Age: 44
State: VA

Vax Date: 07/07/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Na

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

Symptoms: Had immediate tingling in left arm, fast heart beat. Lymph nodes swelled very large in neck. Exactly 1 wk later right knee swelled & was unable to bend. By next morning couldn?t feel leg was numb & tingling. Next day broke out in rash all around trunk area.

Other Meds: Birth control pills

Current Illness: Na

ID: 1478288
Sex: M
Age: 21
State: PA

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 07/16/2021
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: NKA

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

Symptoms: PATIENT FELT WARM AND WAS FLUSH-MENTIONED PAIN BEGINNING IN THROAT

Other Meds: ASPIRIN-DIPYRIDAM, METFORMIN, BUSPIRONE, CITALOPRAM, CLONAZEPAM, HYDROXYZINE, VYVANSE ALBUTEROL

Current Illness: NONE KNOWN

ID: 1478289
Sex: M
Age: 64
State: MI

Vax Date: 03/17/2021
Onset Date: 06/28/2021
Rec V Date: 07/16/2021
Hospital: Y

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

Lab Data:

Allergies: Codeine

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fully vaccinated patient admitted through ED with COVID positive test upon admission. Admitted 06/28/21 for weakness, confusion, difficulty urinating, and decreased oral intake. Found to have MSSA bacteremia. No s/s of COVID throughout stay.

Other Meds: Aspirin, vitamin D3, valium, voltaren gel, nexium, ferrous sulfate, lasix, lopressor, multivitamin, maxitrol opthalmic ointment, miralax, thiamine mononitrate

Current Illness: N/A

ID: 1478290
Sex: F
Age: 43
State: TX

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: I had the dose on 04/09/2021 and on 04/12/2021 I started having some symptoms and on Tuesday I started having a lot of anxiety and panic and chest pain. I could not breathe. I ran outside and my husband behind me. I told him I was not feeling well. We called an ambulance and they checked me at home. They told me my vitals were ok but they said if I wanted to go to the hospital I could but I did not. I have felt changes in me. I always have headaches and anxiety. Sometimes I do not do my house chores because I get tired. I still have the chest pain. Sometimes I cannot take care of my kids because the symptoms do not let me. I have not taken any medication. My doctor did some blood work and it was normal.

Other Meds: None

Current Illness: None

ID: 1478291
Sex: F
Age: 17
State: VA

Vax Date: 07/15/2021
Onset Date: 07/16/2021
Rec V Date: 07/16/2021
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: Polydipsia and subsequent polyuria

Other Meds:

Current Illness:

ID: 1478292
Sex: M
Age: 12
State: AZ

Vax Date: 07/15/2021
Onset Date: 07/16/2021
Rec V Date: 07/16/2021
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: NONE

Symptom List: Diarrhoea, Nasal congestion

Symptoms: NO adverse event at the time of this report filing. Patient got 1/6th dose of the Varicella (Varivax)

Other Meds: Multivitamin and Melatonin 2.5mg to sleep, Ibuprofen PRN

Current Illness: None

ID: 1478293
Sex: F
Age: 35
State: CA

Vax Date: 06/18/2021
Onset Date: 06/19/2021
Rec V Date: 07/16/2021
Hospital: Y

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

Lab Data:

Allergies: Allergic to Sulfa

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

Symptoms: Hard headaches Tiredness Numbness up to this moment 76% Blood clots Short breath up to this moment Chest pain comes and go up to this moment Hard coughing up to this moment Sweating while sleeping at night up to this moment. High blood pressure at the time I visited the ER. Made my Anxiety worse since I took the vaccine.

Other Meds: Tylenol

Current Illness: No

ID: 1478294
Sex: M
Age: 83
State: MI

Vax Date: 05/12/2021
Onset Date: 07/16/2021
Rec V Date: 07/16/2021
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: nkda

Symptom List: Rash, Urticaria

Symptoms: 7/16/2021 He came to ER. For weakness diarreah and incont issues. C-19 pos test upon admission. However he also tested C-19 pos in 5-03-2021

Other Meds:

Current Illness:

ID: 1478295
Sex: M
Age: 30
State: IA

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
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: The patient was administered an un-diluted vial of Pfizer COVID-19 vaccine (approximately 6 doses). Once the error was discovered, the patient was contacted and educated on adverse effects to monitor for. The patient had no questions at the time, and stated he would contact us if he did (and also would report any adverse effects to us, he was not experiencing any at the time of contact).

Other Meds:

Current Illness:

ID: 1478296
Sex: M
Age: 62
State: TX

Vax Date: 03/12/2021
Onset Date: 03/24/2021
Rec V Date: 07/16/2021
Hospital: Y

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

Lab Data:

Allergies: none

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

Symptoms: On March 24 I began experiencing severe pain in my right arm. The er thought it might have been a pinched nerve or something along those line. March 28, noticed a lack of muscle control on the right side of my lips while drinking from a straw. This time I was admitted as a possible stroke. Two different MRI sessions revealed no stroke. They performed a lumbar puncture and discovered that I had extremely high protein levels. After having been admitted, for the next couple of days my face slowly lost the ability to close my eyes fully and a complete lack of control of my lips (total paralysis on my face). I also began to experience bouts of stabbing pain throughout my body and weakness in my limbs. After the after th

Other Meds: Metformin, Glipizide, Atorvastatin, Lisinopril

Current Illness: none

ID: 1478297
Sex: M
Age: 13
State: CA

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
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: Unknown

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

Symptoms: On 07-15-21 we had a nurse vaccinating for Pfizer at one table and a nurse vaccinating for Janssen at another table. Each table keeps their vaccines in color coordinated boxes that is assigned for each vaccine being administered. At approximately 12:20PM the nurse who was vaccinating Janssen closed her pink box labeled J&J and stepped away 6 feet from her table to speak to the service representative that was checking in our patients. Unbeknownst to us, the nurse vaccinating Pfizer walked to the other table and grabbed vaccines from the pink box labeled J&J and took them back to her station and put them into her clear box. There were a total of 2 vaccines taken from the Janssen box. At approximately 12:45PM the nurse vaccinating Janssen returned to her table and noticed that two vaccines were missing from her box. The other nurse then proceed to give her one back. The nurse vaccinating Janssen immediately brought the syringes to a supervisor for disposal. Based on the timeline we have compiled a list of patients that were vaccinated by the nurse who took the Janssen vaccines. Patient was to receive his second dose of Pfizer but now based on the above instance we are unsure if he was given Janssen. Administration has been made aware of the instance and one of our MDs notified the patient.

Other Meds: Uknown

Current Illness: Unknown

ID: 1478298
Sex: F
Age: 77
State: MI

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 07/16/2021
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: atropine, sulfa, PCN, latex

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

Symptoms: She has symptoms of bilateral adhesive capsulitis. She is using NSAIDs, intraarticular shoulder injections, and physical therapy.

Other Meds: none

Current Illness: No known

ID: 1478299
Sex: F
Age: 37
State: WI

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 07/16/2021
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 BECAME LIGHTHEADED, DIZZY, SWEATY, AND SLIGHTLY NAUSEATED WITHIN 1 MINUTE OF RECEIVING COVID PFIZER VACCINE. VITALS TAKEN: BP = 98/62, PULSE = 92, O2 SAT = 100%. PATIENT WAS LAID DOWN ON BENCH WITH FEET ELEVATED AND DRANK GLASS OF APPLE JUICE AND WATER. PATIENT REPORTED RELIEF OF SYMPTOMS AFTER 5-10 MINUTES OF LYING DOWN. PATIENT SAT UP IN CHAIR FOR 5 MINUTES BEFORE ALLOWED TO STAND UP AND WALK ABOUT. PATIENT APPEARRED AND REPORTED STABLE ENOUGH TO RIDE IN CAR BACK HOME.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1478300
Sex: F
Age: 40
State: IL

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I fainted the following day. I had facial droop from the fall and ended up getting an MRI where a 1.5 cm brain lesion was found. I have undergone numerous test to find the source of the lesion and there is no apparent cause. I have been referred to a university hospital to meet with a specialist to see if the lesion could have been triggered from the vaccine.

Other Meds: Lexapro 10mg

Current Illness: none

ID: 1478301
Sex: F
Age: 20
State: NC

Vax Date: 06/11/2021
Onset Date: 06/14/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin *PENICILLINS* Hives as infant

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 3 days after second Covid 19 vaccine, June 11, had one nose bleed that bled "a lot"- was bleeding out the front of the nose and just stopped on its own without any treatment. Started back up a week later with usually 2-3 times per day average time it lasts 10-15 minutes. After about 3 days she stopped her Zyrtec and Flonase to see if it would help, it didn't seem to help. She blows her nose, and will get out a larger clot- now the bleeds just fill up the nostril- has a big scab there. She does have a large scab in the nose. Right nostril only. Remote history of nose bleeds- however only 2 times previously- around 7/8 years old related to trauma/dry nostrils-

Other Meds: Fluticasone Propionate (50MCG/ACT Suspension, 2 (two) sprays Nasal each nostril daily, Taken starting 03/24/2020) Active. ZyrTEC Allergy (10MG Tablet, 1 (one) Tablet Oral daily, Taken starting 05/30/2019) Active. Tri-Linyah (0.18/0.215/0

Current Illness: None

ID: 1478302
Sex: F
Age: 46
State: IN

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Rapid HR, chest tightness, sob, for about 2 minutes. Has happened 4 times over an 48 hr period.

Other Meds:

Current Illness:

ID: 1478303
Sex: F
Age: 62
State: CA

Vax Date: 06/22/2021
Onset Date: 06/23/2021
Rec V Date: 07/16/2021
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: Bee stings

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

Symptoms: Devloped Parsonage Turner Syndrome on 6/23/21 of right arm and hand. Have limited right hand usage. Had a Varaciella titer on 6/10/21 for pre-employment showing titer greater than 4000. Questioned pharmacy about relationship with titer and first shingle shot and she could not answer. I believe my husband had the same thing the year before, however he died of a complication. I believe he was not duangmnosed correctly. Per Dr. Parsonage Turner Syndrome is mistaken for cervical disc issues. I believe he had his second shingle shot just before starting with right shoulder and arm pain too.

Other Meds: N/A

Current Illness: N/A

ID: 1478304
Sex: F
Age: 29
State: CT

Vax Date: 04/11/2021
Onset Date: 04/12/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin; Dust; Pollen; Cats

Symptom List: Unevaluable event

Symptoms: For 24 hours after getting the shot, I developed a fever, aches, chills, and arm soreness. I took Tylenol three or four times the following day. I also developed a rash on my face, neck, chest, forearms, and back of my hand that lasted for a week. The dermatologist prescribed me with Triamcinolone .1%, which helped a lot with the itching. I developed this around June 27th 2021. I will be seeing an allergist on July 17, 2021 regarding these symptoms.

Other Meds: Zyrtec; Fluticasone; Multivitamin

Current Illness:

ID: 1478305
Sex: F
Age: 51
State:

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 07/16/2021
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: Pt w/ hx of allergy to oxazepam (numbness & HTN) and an unknown food allergen.

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

Symptoms: "Pt w/ hx of allergy to oxazepam (numbness & HTN) and an unknown food allergen. S/p kidney removal @ 2yrs of age. Possible Hx of GERD vs. Anxiety. Pt had an allergic rxn to Chinese food w/ in 1 month of Covid Vaccine. Treated w/ steroids. Pt developed redness of the skin and dizziness starting 30mins post vaccination. Itchy rash developed within 4hrs on the temple, ears, chest that mostly resolved the same day. Pt continued to have dizziness and developed foot cramps, intermittent sharp pains in right ear, intermittent chills for the next 2 days. June 6, pt had severe stomach pain and diarrhea x2. June 7 pt had throbbing pain on the side of the head. Pressure on the front of the head and foot numbness persisted until June 21. Pt developed SOB and palpitations June 23 and went to ED (likely unrelated GERD vs. Anxiety)."

Other Meds: N/A

Current Illness: Pt had an allergic rxn to Chinese food w/ in 1 month of Covid Vaccine. Treated w/ steroids.

ID: 1478306
Sex: M
Age: 67
State: NH

Vax Date: 04/07/2021
Onset Date: 04/15/2021
Rec V Date: 07/16/2021
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: none

Symptom List: Injection site pain, Pain

Symptoms: tingling sensation on right side of neck and jaw, all day , every day.

Other Meds: none

Current Illness: slight vertigo at times

ID: 1478307
Sex: F
Age: 50
State: CA

Vax Date: 03/23/2021
Onset Date: 04/09/2021
Rec V Date: 07/16/2021
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: was diagnosed with heart arrythmia (PVCs) 2 weeks later. It may be coincidence but I had no sign of it during a procedure with anesthesia 2 weeks prior to the vaccine. Now on daily medications to try to resolve arrythmia.

Other Meds:

Current Illness:

ID: 1478308
Sex: M
Age: 63
State: CO

Vax Date: 04/08/2021
Onset Date: 06/11/2021
Rec V Date: 07/16/2021
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: None Known

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

Symptoms: I had severe pain at injection site when initially given but it went away after a few days. I had emergency Gall Bladder surgery on Jun 9, 2021 and a afterwards, my arm where the initial COVID shot was given, had the same pain develop at the injection site along with a slight amount of swelling

Other Meds: Allegra Atorvastatin 40mg Valsartan/HCTZ 160mg/12.5mg Vitamin D

Current Illness: None

ID: 1478309
Sex: F
Age: 31
State: MO

Vax Date: 03/06/2021
Onset Date: 05/12/2021
Rec V Date: 07/16/2021
Hospital: Y

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: No known allergies

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Previous healthy pregnancy with healthy live childbirth Jan 22nd, 2019. Healthy pregnancy, no complications, due May 23rd, 2021. 38 week check-up with OB on Mon May 10th, 2021 - normal, healthy, heard heartbeat ER visit on Wed May 12th, 2021 due to reduced fetal movement detected and ER OB confirmed no fetal heartbeat Stillborn baby girl delivered via induction on Fri May 14th, 2021 Autopsy and Genetic Testing performed and revealed no known cause for fetal demise

Other Meds: Prenatal Vitamin

Current Illness: No illnesses prior to vaccination

ID: 1478310
Sex: F
Age: 84
State: AK

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: While conducting a door to door vaccination and covid testing campaign on 7/1/21 I administered a third dose of the Pfizer vaccination to a Elder. She had received her first two doses 4/21 and 5/11/21. The family reported to us that she was due for her second dose. The patient is HOH and we were using the family as interpreter as well. We do not have access to patient records while doing these kinds of public health operations in the community.

Other Meds: a third dose was administered during community outreach vaccination in an village.

Current Illness: frail 83 year old female with several comorbidities.

ID: 1478311
Sex: F
Age: 39
State: CA

Vax Date: 02/12/2021
Onset Date: 03/01/2021
Rec V Date: 07/16/2021
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: Soy Sesame

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

Symptoms: Excessive, heavy menstrual bleeding from March to June without stop (bled daily for the better part of 4 months). Presence of clots discharging from my body when I used toilet or showered. Heavy cramping and pain. Stopped my period mid June and then started around July 4 with heavy cramps, bleeding and clots which then lasted 5 days and stopped. Prior to this, I did not hardly have a period because I have an IUD with hormones. (Morena)

Other Meds: Concerta 36mg

Current Illness: None

ID: 1478312
Sex: F
Age: 21
State: NY

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

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

Lab Data:

Allergies: No known

Symptom List: Nausea

Symptoms: Patient was sitting in chair and head tilted back with eyes rolling back in head. Head started to tilt forward and shaking of arms and legs happened. Shaking lasted for around 3 seconds and stopped. Once done shaking, the patient became highly alert with wide eyes )as if she was unconscious). Lost color in face and lips. Took pulse of patient and was slightly elevated around 70bpm (however, could be normal for her). Placed cold pack on back of neck. Patient was able to talk and was responsive. I had water available for her if she needed.

Other Meds: Sumatriptan Sertraline Gianvi

Current Illness: None known

ID: 1478313
Sex: F
Age: 88
State: MI

Vax Date: 03/02/2021
Onset Date: 07/01/2021
Rec V Date: 07/16/2021
Hospital: Y

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

Lab Data:

Allergies: Dust

Symptom List: Injection site pain

Symptoms: Fully vaccinated patient tested positive for COVID upon admission to hospital. Patient admitted through ED on 07/01/21 after fall resulting in hip fracture. Patient tested for COVID with routine admission testing and tested positive. Patient asymptomatic at time of admission for s/s of COVID.

Other Meds: Eliquid, tylenol, plavix, culturelle, colace, synthroid, ativan, namenda, nystatin, seroquel, senna

Current Illness: N/A

ID: 1478314
Sex: F
Age: 14
State: CA

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Nkda

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

Symptoms: On 07-15-21 we had a nurse vaccinating for Pfizer at one table and a nurse vaccinating for Janssen at another table. Each table keeps their vaccines in color coordinated boxes that is assigned for each vaccine being administered. At approximately 12:20PM the nurse who was vaccinating Janssen closed her pink box labeled J&J and stepped away 6 feet from her table to speak to the service representative that was checking in our patients. Unbeknownst to us, the nurse vaccinating Pfizer walked to the other table and grabbed vaccines from the pink box labeled J&J and took them back to her station and put them into her clear box. There were a total of 2 vaccines taken from the Janssen box. At approximately 12:45PM the nurse vaccinating Janssen returned to her table and noticed that two vaccines were missing from her box. The other nurse then proceed to give her one back. The nurse vaccinating Janssen immediately brought the syringes to a supervisor for disposal. Based on the timeline we have compiled a list of patients that were vaccinated by the nurse who took the Janssen vaccines. Patient was to receive her first dose of Pfizer but now based on the above instance we are unsure if she was given Janssen. Administration was informed of the instance and one of our MDs has called and notified the patient.

Other Meds: Medication list includes: Fluticasone 44 mcg/actuation Inhl HFAA Albuterol 90 mcg/actuation Inhl HFAA Montelukast 5mg Oral Chew Tab Unknown if patient took any medication prior to vaccination

Current Illness: Unknown

ID: 1478315
Sex: M
Age: 36
State: NC

Vax Date: 06/14/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
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: n/a

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

Symptoms: Bell's Palsy on the left side of my face. Started with my upper lip on the left side, spread to the left side of my mouth the next day, and several hours later I am having trouble trying to close my left eye.

Other Meds: Bupropion XL 450mg Atorvastatin 40mg Venlafaxine 50mg Bayer's Men's One-A-Day Biotin 5000 mcg

Current Illness: n/a

ID: 1478316
Sex: F
Age: 66
State: CA

Vax Date: 04/01/2021
Onset Date: 04/04/2021
Rec V Date: 07/16/2021
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: Quinolone antibiotics. Sulfa. Epineprhine. Cats.

Symptom List: Tremor

Symptoms: Immediate symptoms were extreme hunger (eating everything in sight despite being on Weight Watchers and having been perfect for a year and losing 28 lbs) and then the normal reactions (slight fever, mild body aches, etc) for a day or two. Got all better from that. Then on day 4 after the 2nd shot, out of the blue, I got very moody and irritable for no reason. And I have been experiencing what feels like a biologically-based (rather than reaction-to-life-events-based) feeling of depression ever since. Along with that I have experienced: mild nausea wierd food cravings (for intensely spicy,sour, salty foods.. not usual for me) (Continued on continuation page, please read) Fatigue (had to start drinking coffee again to wake up in the morning, after not drinking or needing coffee for the past 10 years. The main effect I've experienced is depression, which is NOT normal for me. I've always been a very upbeat person... even in the face of difficult or even tragic life events. My normal personality has always been set to "upbeat and cheerful". The shot seems to have reset this to "downbeat and apathetic" which is not usual for me and not helpful at all. I need my normal can-do personality to function in my life and work. The depression started suddenly and for no apparent (life-based) reason, four days after my 2nd shot. Have consulted my therapist on this and also my medical doctor. I reported it to V-safe and they told me to report it to you. All of my symptoms would make perfect sense if I were... pregnant. But considering I'm 67 years old, 10 years past menopause, and haven't had a man in my life in many years, there's no way short of a Biblical event that that could possibly be the case. I continually feel hungry and like I can't get enough to eat. I am trying to continue my weight loss journey so that is especially hard. I'm slowly getting better from the depression, but it's been a long process. It doesn't seem like a therapy-based solution is the answer, more physiological. I've been using the mushroom elixir coffees and supplements: This has been the most helpful thing for me I am very sensitive to medications and I don't take any Rx other than my three blood pressure medications. Have never taken (nor, till now, needed or considered) anything for depression. I didn't have wierd food cravings when I was ACTUALLY pregnant. But now it's like I HAVE to have sour lemon juice with pickle juice and hot sauce. I am not making this up.

Other Meds: Metoprolol Tartrate 50mg . Cozaar 100 mg. Amlodipine 5 mg.

Current Illness: None

ID: 1478317
Sex: M
Age: 14
State: CO

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
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: Shrimp

Symptom List: Erythema, Pruritus

Symptoms: Prior to administration of the vaccine, I discussed with mom and patient about previous immunizations and the YES response to previously fainting or felt dizzy post immunization. Mom proceeded to state that he has a strong vaso-vagal response to needles/immunizations and he has fainted multiple times during and after immunizations. The patient appeared calm, so I did some breathing exercises with him and when I determined that he was calm, I administered the vaccine. Patient was still sitting upright, I asked him to continue to breathe slowly and deeply. I asked if he would like a water, and so I went to grab it from the pharmacy lab. Patient then stated he was dizzy and was going to pass out. He did not pass out, and I asked him if he would like to lay down. I put down a towel for him and then he started to throw up. I got a cold washcloth for his neck. He started sweating profusely (essentially a marked cholinergic response). I got him to lay down after some more vomiting . He stated that his vision was blurry, but he was laying down calmly. after 25 minutes of reclining, he stated he was starting to feel a bit better. I offered a 25mg diphenhydramine tablet to help with residual nausea. He stated he was better and go shop with his family. They did not return to the pharmacy, so as of my last interaction, he was fully recovered from the event.

Other Meds: Unknown

Current Illness: Unknown

ID: 1478318
Sex: M
Age: 65
State: MI

Vax Date: 02/22/2021
Onset Date: 07/15/2021
Rec V Date: 07/16/2021
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: URI symptoms

Other Meds:

Current Illness:

ID: 1478319
Sex: F
Age: 71
State: WA

Vax Date: 03/19/2021
Onset Date: 05/01/2021
Rec V Date: 07/16/2021
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 allergies

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

Symptoms: Pt reports that on 5/1/21 she had marked swelling of her right ankle only. Weight wise it seemed to be 4 pounds of water weight. Swelling has persisted until today's date. Pt physician thinks it may be a side effect of amlodipine but patient insists I report.

Other Meds: amlodipine, losartan, percocet, desoximetasone cream

Current Illness:

ID: 1478320
Sex: M
Age: 12
State: AZ

Vax Date: 07/15/2021
Onset Date: 07/16/2021
Rec V Date: 07/16/2021
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: No adverse event. How this happened: I removed the smaller vial from the Covid-19 basket in refrigerator (not freezer) that has one Pfizer Covid-19 Vaccine and one Moderna Covid-19 vaccine and proceeded to dilute it with 1.8ml 0.9% sodium chloride, removed 0.3ml from the vial and attached expiration sticker to said vial. around 5:50PM I retrieved the vial from the refrigerator to waste it and discovered that I have used a vial of viravax. I called the mother and she stated that is doing OK. I will call PCP on Friday and inform them of the error.on 7-16-2021 I called PCP and Mother, She stated that is doing OK had few questions that I answered. Informed mother to contact us if has any adverse reactions.

Other Meds: Multivitamin, Melatonin 2.5mg for sleep, Ibuprofen PRN

Current Illness: None

ID: 1478321
Sex: F
Age: 38
State: GA

Vax Date: 07/08/2021
Onset Date: 07/09/2021
Rec V Date: 07/16/2021
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: Norco

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

Symptoms: Okay so after I got the vaccine, around 12:00AM I had a low grade temperature and was feeling chills. Knowing that, I went ahead and took Tylenol to see if I could get the fever to go down. Around 1:00 AM I texted my midwife and let her know. At 2:00 AM I took another dose of Tylenol and my fever was about 104F. I had a mild headache at that point. I waited another 4 hours and at that point it was about 102, so the Tylenol was helping but it was the maximum dose so I went into the birth center to see if they could get the fever down. I got fluid IV and the temperature went down to 99.8. I continued to have chills and body aches after I went sent home after that though. I was in a lot of pain too, had no appetite and also experienced abdominal pain. I had a fever again 100.9 and I continued to rest and drink fluids. By that evening, the fever went down to 99 and the next day, on the 10th I was OK.

Other Meds: Prenatal vitamin; Probiotic; Vitamin D; Aspirin; Fish oil; Omega 3; Tylenol

Current Illness: N/A

ID: 1478322
Sex: F
Age: 36
State: TX

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 07/16/2021
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: Peanuts (not life-threatening)

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

Symptoms: I started having chills, fever, fatigue, and body aches 8-9 hours after receiving my 2nd dose. My fever went up to 102 degrees, and my blood glucose levels (I?m a type 1 diabetic) were slightly elevated for about 36 hours. I took 2 aspirin, and chills resolved and fever went down to 100.6 about 2 hours after. Fever was down to the 99-100 range the day after (Thursday), and was back to normal by Friday morning. I have some lingering fatigue, but otherwise feeling normal now (2 days later).

Other Meds: Humalog (insulin), iron supplement, multi-vitamin. Took Benadryl in the evening

Current Illness: None

ID: 1478323
Sex: F
Age: 34
State:

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 07/16/2021
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: Pain in extremity

Symptoms: hives, which spread to entire body except face/ scalp approx. 48 hours after second vaccine. treated with steroids and Benadryl.

Other Meds: plaquinil, acyclovir

Current Illness:

ID: 1478324
Sex: F
Age: 14
State:

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

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

Lab Data:

Allergies: Patient w/history of past allergy to egg, peanuts and strawberries.

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

Symptoms: Patient w/history of past allergy to egg, peanuts and strawberries. PMH significant for asthma. Tympanostomy tube placement in 2009. The mother called regarding advice regarding second dose on 7/12. The mother reports that about 1 hour after receiving her first dose of Pfizer vaccine she developed a rash consistent with hives all over her body. She did not have associated shortness of breath, vomiting or diarrhea. Unknown time course for resolution.

Other Meds:

Current Illness:

ID: 1478325
Sex: F
Age: 78
State:

Vax Date: 07/13/2021
Onset Date: 07/14/2021
Rec V Date: 07/16/2021
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: swollen from behind left ear to tip of fingers.

Other Meds:

Current Illness:

ID: 1478326
Sex: F
Age: 77
State: MI

Vax Date: 03/17/2021
Onset Date: 07/01/2021
Rec V Date: 07/16/2021
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: ciprofloxacin, bee pollen, PCN, sulfa's

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

Symptoms: Fully vaccinated patient tested positive for COVID upon admission to hospital for unrelated event. Patient admitted through ED on 07/01/21 for orthopedic needs after a fall. No s/s COVID throughout stay. Patient also with positive COVID test in 04/2021.

Other Meds: Eliquis, cardizem, flonase, lasix, avapro, xopenex, melatonin, lopressor, senna, zanaflex

Current Illness: N/A

Date Died: 07/04/2021

ID: 1478327
Sex: M
Age: 41
State: OH

Vax Date: 05/27/2021
Onset Date: 06/11/2021
Rec V Date: 07/16/2021
Hospital: Y

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

Lab Data:

Allergies: morphine

Symptom List: Vomiting

Symptoms: PE diagnosed 6/11/21 death 7/4/21

Other Meds: colace and famotidine

Current Illness:

ID: 1478328
Sex: F
Age: 74
State: WI

Vax Date: 07/07/2021
Onset Date: 07/07/2021
Rec V Date: 07/16/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: J&J COVID 19 vaccine given 15 minutes after expiration.

Other Meds:

Current Illness:

Date Died: 07/13/2021

ID: 1478329
Sex: M
Age: 56
State: PA

Vax Date: 07/12/2021
Onset Date: 07/13/2021
Rec V Date: 07/16/2021
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 Known

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

Symptoms: Approx 1 day after receiving vaccine, patient died while working in the yard. He had complained earlier at work of soreness in knees. He was mowing after work in his yard. He was found in the front of his house where it appears he fell and hit his head. It is not clear what made him fall. The mower was left in the yard and the mowing was only partially completed.

Other Meds: Daily Vitamins, One puff from a Breo Inhaler Daily

Current Illness: In very good health

ID: 1478330
Sex: F
Age: 55
State: NV

Vax Date: 04/02/2021
Onset Date: 04/22/2021
Rec V Date: 07/16/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I got mild and moderate in pain in my chest. I never had it at night, but I had it during the day. It happened at the end of April until the end of June. I also had shortness of breath. I feel like I can't do my full inhale of air. I had pain when I did inhale. I had an appointment with my PCP, but I did not have an appointment with my PCP three weeks. I told myself that if it got worse, I would go to urgent care.

Other Meds:

Current Illness:

ID: 1478331
Sex: F
Age: 52
State: PA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 07/16/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Migraine

Other Meds: None listed

Current Illness: None listed

ID: 1478332
Sex: M
Age: 40
State: MI

Vax Date: 07/09/2021
Onset Date: 07/10/2021
Rec V Date: 07/16/2021
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: None

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

Symptoms: Patient came into pharmacy on 7/ 14/21 and described the following: Severe body pain in areas where he has "recent" injuries (vasectomy, back issues). No control over bowel movements. Disoriented/ motor skills severely lacking; couldn't walk down steps or down the hallway. had to call for help to family to do normal tasks. mild hallucinations. mental anguish; things were true in his head but not true in reality; mental dysphoria. Thinking this was the end; was able to recognize it but also very concerning. 3:30 am saturday this started; not all gone yet (7/14). Tension headaches (not prior). Extremely cold, clammy, sweaty; had to change clothes based on the amount of sweat. Not drug user, not alcohol, active military, not 48 hrs prior till recent. no pre workout. no medications. ibuprofen later saturday morning. First vaccine he just had local pain at shot site, some pain to the older issue sites and tiredness but nothing more than 24 hours. No mental illness dx at this time; possible ptsd but never diagnosed, not something he suffers from on a daily basis.

Other Meds: Tylenol/ Ibuprofen taken after symptoms had already started

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm