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From the 7/23/2021 release of VAERS data:

Found 506,830 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

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VAERS ID: 1484014 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Blood pressure increased, Headache, Immediate post-injection reaction, Injection site hypoaesthesia, Injection site pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client reported "burning" in his arm around the vaccination site immediately after receiving the COVID vaccine. The client reported "numbness" around the deltoid where he received the COVID vaccine. No noted redness or swelling around the site. At 1:35PM the client reported a headache, stomachache, and left arm pain from his elbow to shoulder. The client described the arm pain similar to sore muscle pain. The client denied any s/s of anaphylaxis. The client stated "I feel the food in my stomach." Vitals obtained at 1:38 PM were as follows BP 141/84, HR 95, and O2 98%. The client stated he went to bed at 2:00AM last night and did drink water this morning. At 1:40PM the client requested, was provided, and began consuming a snack and juice. At 1:48PM the client said, "I feel good." Vitals obtained at 1:49PM were as follows: automatic BP 172/73, HR 95, and O2 98%. Noted the automatic BP cuff was placed incorrectly. Repeat automatic BP obtained at 1:532PM was 151/82. At 2:03 the client reported that his arm was still sore but his headache was improving. The client denied any dizziness, nausea, or chest pressure. Vitals obtained at 2:03PM were as follows: automatic BP 162/83, HR 90, O2 97%. At 2:07PM education was provided to client and his mother regarding elevated BP, s/s of anaphylaxis, when to seek EMS. The client and his mother voiced understanding of this. The client stated that he felt nervous. Recommended the client and his mother follow up with PCP regarding elevated BP. Client''s mother voiced understanding of this education. Assessed upper extremity strength, which was equal bilaterally. Assessed facial nerve function which was equal bilaterally. The client denied any shortness of breath, dizziness, or itching. Examined the vaccination site, and noted no redness or swelling. Manual BP obtained at 2:09PM was 150/86. Vitals obtained at 2:24PM were as follows: manual BP: 150/78, HR 86, and O2 96%. Offered to call EMS to evaluate the client. The client''s mother declined EMS at 2:29PM.


VAERS ID: 1484024 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Feeling hot, Hypoaesthesia, Hypoaesthesia oral, Palpitations, Tremor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient takes blood pressure medication and took Ibuprofen 07/18/21.
Current Illness: No known illnesses.
Preexisting Conditions: Patient has history of hypertension.
Allergies: No known allergies.
Diagnostic Lab Data: Unknown.
CDC Split Type:

Write-up: After 15 minutes of observation after receiving the Pfizer vaccine, the patient complained of shortness of breath, palpitations, and feeling warm. Vital signs were initiated at 4:45PM: BP 162/78, RR 22, SpO2 98%, HR 77, Temp 98.1 F. 3 8oz bottles of water was offered and consumed. Client almost fainted, was shaky, and complained of numbness of left side of face and lips. Patient was placed on the floor in supine position. Vitals were reassessed at 4:52PM BP 160/94, RR 20, SpO2 98%, HR 80. EMS was called at 4:51PM and arrived around 5:10pm. Vitals were reassessed at 5:03PM: BP 162/88, RR 21, SpO2 99%, HR 74. When patient left the facility, she was alert, verbally responsive and in stable condition. Patient left the facility at 5:15PM and brought to the nearby hospital.


VAERS ID: 1484045 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dyspnoea, Lymphadenopathy, Muscular weakness, Nausea, Pain, Pain in extremity, Pharyngeal swelling, Pyrexia, Vaccination site rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: keflex
Diagnostic Lab Data:
CDC Split Type:

Write-up: The day of the vaccine: late afternoon and evening 5:30 p.m. - 1:30 a.m. - Swelling in my throat and lymph nodes, trouble breathing, fever, chills, nausea, rash at the vaccine site on my arm. The next day upon waking up : Extreme pain and weakness in my entire body (including my arm)


VAERS ID: 1484059 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-11
Onset:2021-07-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain, Injection site pruritus, Injection site swelling, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 25mg
Current Illness:
Preexisting Conditions: Depression
Allergies: Mild allergies to some types of fruit. Mild seasonal allergies. Allergies to some pets.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchiness at the injection site, then swelling and pain. The swelling is getting bigger and so is the pain. It hurts to lift my arm up. This started a week after the injection....


VAERS ID: 1484089 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-16
Onset:2021-07-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Injection site swelling, Lip swelling, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Severely sore arm
Other Medications: Zoloft, triamerterine, adderral,
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen arm at location site, aches, fever, chills and swollen bottom lip


VAERS ID: 1484097 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-16
Onset:2021-07-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site rash, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol inhaler
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red, raised rash under injection site on left arm. Very warm and sore to the touch. Noticed 7/18 (2 days after 2nd covid vaccine). Applied cool compress.


VAERS ID: 1484102 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Body temperature abnormal, Chills, Feeling abnormal, Hyperaesthesia, Pyrexia, Sensitive skin
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within about 5 hours of the vaccine, started to feel skin sensitivity all over my body. It felt like every pore on my body was open and hyper sensitive to touch. My scalp was very sensitive to touch and there was a strange sensation when my clothes touched my body- I''ve never been hyper sensitive like this before. Within about 12 hours, developed a fever, chills and inability to get warm. Symptoms persisted for about 36 hours.


VAERS ID: 1484104 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate increased, Palpitations, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Pineapples
Diagnostic Lab Data:
CDC Split Type:

Write-up: Around 4pm, the same day I got my vaccine, I got horrible heart palpitations, and my heart rate went up very high. I also started to get very shaky (not related to the chills). This lasted for hours at first, but now it is on & off.


VAERS ID: 1484269 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dizziness, Dyspnoea, Hyperventilation, Injection site pain, Nervousness
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Mild, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Pt was experiencing a severe anixety attack-Mild, Systemic: Hyperventilation-Mild, Additional Details: Pt was apprehesive about the shot upon arrival to pharmacy. Very nervous. Administer the vaccine and within a few minutes patient begin to complain of lightheadness/breathing issues. I called 911 upon patient request and emts arrived within a matter of minutes. They walked patient to ambulance to check her out. Patient returned to the pharmacy after about 30 minutes to check in with us. She was feeling a little bit better and EMTs believe she had severe anxiety attack.


VAERS ID: 1484274 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hypotension, Syncope, Unresponsive to stimuli, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Medium, Systemic: Hypotension-Mild, Systemic: Visual Changes/Disturbances-Mild


VAERS ID: 1484275 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Condition aggravated, Rash, Seizure, Syncope, Tachycardia, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Allergic: Anaphylaxis-Severe, Systemic: Allergic: Rash Generalized-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Seizure-Severe, Systemic: Tachycardia-Medium, Additional Details: pt history of seizure disorder, did not mention her last seizure was 2 days before vaccination. went unresponsive and had epipen given, then had several seizures and was taken by EMS


VAERS ID: 1484282 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0382C1A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Nausea-Mild


VAERS ID: 1484284 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Fatigue, Flushing, Gait inability, Hyperhidrosis, Hypoacusis, Impaired driving ability, Lethargy, Paraesthesia, Visual impairment
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Systemic: Visual Changes/Disturbances-Medium, Systemic: Weakness-Medium, Additional Details: Within 5 minutes of receiving vaccine, patient alerted store personnel that he was "seeing stars" and have impaired hearing (sounds like underwater). Within 10 minutes, he started feeling chills and sweating; he reported feeling weak, unable to walk or drive and had tingling on his forearms. He was offered acetaminophen and Benadryl. He refused Benadryl but took on tablet of acetaminophen 500mg. At about 25 minutes post-injection, he reported feeling better and refused paramedics.


VAERS ID: 1484287 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1484428 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Heart rate increased, Painful respiration
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chest pain, feel like blockage to chest area, worsening on deep breathing and laying down, get some relief once sit up or stand up. Had short period of fast heart beats on Sunday night, but went away after a few hours.


VAERS ID: 1484436 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil
Current Illness:
Preexisting Conditions: Asthma
Allergies: Pit fruit, pollen, dust
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart pounding and chest pain, shortness of birth


VAERS ID: 1484441 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: BP 92/41, P: 55, BP 119/72, P: 71 BP 128/81, P:62
CDC Split Type:

Write-up: Patient complains of diaphoresis and lightheadedness. EMS called. Patient symptoms subsided after lying back and following breathing techniques. Patient left.


VAERS ID: 1484454 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-05
Onset:2021-07-18
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed shingles on left side of face on July 18, 2021.


VAERS ID: 1484459 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-12
Onset:2021-07-18
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Malaise, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 50 mcg
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: NKA
Diagnostic Lab Data: PCR COVID-19 test positive on 07/18/2021.
CDC Split Type:

Write-up: Patient has symptoms of COVID-19 which developed on 07/18/2021.


VAERS ID: 1484480 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Loss of consciousness, Malaise, Nausea, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Complained of not feeling well, collapse to the floor while walking, rapid sweating, pale skin, dizziness and nausea, loss consciousness for about 10 seconds


VAERS ID: 1484484 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-12
Onset:2021-07-18
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient tested positive for COVID 7/18/21. He is fully vaccinated.


VAERS ID: 1484563 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Dyspnoea, Electrocardiogram, Full blood count, Heart rate increased, Hot flush, Hyperhidrosis, Hypopnoea, Metabolic function test, Troponin I
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multi-Vitamin only.
Current Illness: No illnesses.
Preexisting Conditions: No chronic or long-standing health conditions.
Allergies: None.
Diagnostic Lab Data: DG Chest 2 View, EKG 12-Lead, Basic Metabolic Panel, CBC and Troponin I (High Sensitivity) performed 2 times.
CDC Split Type:

Write-up: The time of the schedule appointment was for 3:00pm at the local Pharmacy). Once the vaccine was injected into my left arm, I was placed into a different seating placement, to be observe for any signs of side-effects that may occur form the injection. This seating area also displayed a digital clock to notify how long each patient must be stationed for (each station is registered for each patient to wait approximately 15 minutes after injection). Once placed in the seating area and the clock was started to examine my treatment, within the six minutes of observation, the following signs occurred: Rapid-Heart Rate, Short and Shallow Breathing, Sweaty Palms including Hot Flashes (lasting 4 seconds).


VAERS ID: 1484586 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Influenza, Pneumonitis, Respiratory tract irritation
SMQs:, Interstitial lung disease (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Caffeine (coffee addiction) and theobromine to regulate hormones (Fine balance of diet is needed -- slight changes in caffeine intake affect hormones and headaches/cardiovascular reactions.
Current Illness:
Preexisting Conditions: Undiagnosed (all listed): (Emergent protocol in play: 105 -- unable to seek diagnosis) Emphysema (mild or moderate/depending on diet and time of day; fluctuating) Arthritis Multiple Sclerosis (not on record; CT scan sole evidence/indicative Lupus probable. Rare flu events, only mild/resolving after one week -- undiagnosed lupus probable (May have COVID19/asymptomatic)
Allergies: fluxuating allergies. Consistent allergy to "crimson lake" red food dye (made from cochneal bug shells)
Diagnostic Lab Data: none possible (except via "new patient record") Protocol 102.
CDC Split Type: do not report ''antero''/re

Write-up: typical flu (moderate weakness) inflammation of lungs/irritation (suspect COVID19 infection already present prior to vaccination date//contact via email)


VAERS ID: 1484626 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient said he blacked out at night the night of the vaccine


VAERS ID: 1484654 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-16
Onset:2021-07-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Adnexa uteri pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Less than 48 hours after her second dose, she felt severe ovary pain on both sides and fainted.


VAERS ID: 1484667 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-09
Onset:2021-07-18
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, Echocardiogram abnormal, Ejection fraction normal, Electrocardiogram ST segment elevation, Myocarditis, Systolic dysfunction, Troponin increased
SMQs:, Cardiac failure (broad), Myocardial infarction (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Troponins: 24.86 (7/18 13:00), 33.07 (7/18 @ 20:31), 21.34 (7/19 @ 04:35) B-NP: 178 (7/19 @ 05:55) ECHO: systolic dysfunction, LF ejection fraction 56% (7/18 @ 14:22) EKG: ST elevation (7/18 @ 10:25)
CDC Split Type:

Write-up: Myocarditis starting 7/18/21. Treated with oral colchicine and IV ketorolac (NSAIDs). Today is day 2 of hospitalization and patient''s troponins are improving.


VAERS ID: 1484707 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 08/17/2021 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Intern administered vaccine that had been open 17 hours ago on 7/18, Vaccine expired 5 pm on 7/17. Unable to contact patient.


VAERS ID: 1484719 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: none
Allergies: nkda
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Redness and swelling at injection site


VAERS ID: 1484731 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-01-28
Onset:2021-07-18
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Influenza A virus test negative, Influenza B virus test, Nasal congestion, Pyrexia, Respiratory syncytial virus test negative, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast, Albuterol inhalor, candesartan, Omega-3 fish oil, triamcinolone cream, Glyburide/metformin, Atorvastatin, Asprin, Lorantadine,
Current Illness: None
Preexisting Conditions: HTN, DM type 2, Hyperlipidemia, Obesity, Seasonal Allergy, Asthma,
Allergies: Penicillin
Diagnostic Lab Data: Jul 18, 2021@14:23:46 FLU A (CEPHEID) NEGATIVE , FLU B (CEPHEID) NEGATIVE , RSV (CEPHEID) NEGATIVE COVID-19 (CEPHEID) POSITIVEA*
CDC Split Type:

Write-up: complaining of headache, congestion, fever and cough x 1 day.


VAERS ID: 1484734 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Headache, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan
Current Illness: High bp, valve disease, liver disease, acid reflux
Preexisting Conditions: High bp, valve disease, liver disease, acid reflux
Allergies: Sulfa, amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headaches, joint pain, burning in throat, chest tightness


VAERS ID: 1484751 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267100002 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Mild


VAERS ID: 1484759 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-16
Onset:2021-07-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Diarrhoea, Dry mouth, Fatigue, Headache, Malaise, Pain
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Migraines
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Body ache, chills, diarrhea, dry mouth, not appetite, headache, just not feeling well, soreness and body aches, tiredness.


VAERS ID: 1484821 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-26
Onset:2021-07-18
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Dyspnoea, Electrocardiogram, Full blood count, Headache, International normalised ratio, Metabolic function test, Prothrombin time
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: chest xray, EKG, PT/INR, CBC, BMP
CDC Split Type:

Write-up: chest pain, SOB, headaches


VAERS ID: 1484841 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-23
Onset:2021-07-18
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK UN / -

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray abnormal, Condition aggravated, Confusional state, Cough, Infusion, Lung consolidation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: histroy artery disease, Diabetes type 2, gerd, chronic back pain,and confusion
Allergies: Pollen
Diagnostic Lab Data:
CDC Split Type:

Write-up: DId not know body site of injection Worsening confusion, exposed at a birthday party daughter wanted patient to come in / patient was very cofused per daughter patient is poor historian dry cough at exam considelation on right lower love on chest x-ray patient did an infusion on 7/12 casirivimab-imdevimab patient was admited on 7/18/2021 to hospital.


VAERS ID: 1484907 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-05
Onset:2021-07-18
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / UNK LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown.
Current Illness: unknown
Preexisting Conditions: Gastroesophageal reflux disease; H/O: depression; Hypertensive disorder;
Allergies: Sulfa, Penicillin
Diagnostic Lab Data: COVID positive via PCR test 7/18/21
CDC Split Type:

Write-up: Patient admitted to hospital on 7/18/21 with Dx of lab confirmed COVID 19


VAERS ID: 1484944 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site pruritus, Injection site rash
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: oral iron
Current Illness: none, prior site reaction to Moderna vaccination
Preexisting Conditions: PE, DVT, Anemia
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received her second Moderna vaccination, after having a localized reaction (likely COVID arm) with the first vaccination. The same day she received her second vaccination she developed a rash all around the injection site and extending down to her elbow. Itchy


VAERS ID: 1484967 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chills, Myalgia, Nausea, Pain in extremity, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Annually, last at age 25, flu vaccine, similar symptoms
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approx 8 hours after shot, developed fever, chills, myalgias, nausea, vomiting and abdominal pain, severe. Symptoms lasted over 12 hours. By 24 hours, fever and arm soreness persisted.


VAERS ID: 1484987 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-01
Onset:2021-07-18
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Infection, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine 20mg QD
Current Illness: None known
Preexisting Conditions: None known
Allergies: None known
Diagnostic Lab Data: Positive - Now rapid test
CDC Split Type:

Write-up: Breakthrough CoVID infection


VAERS ID: 1485020 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Lethargy, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient complained of upset stomach, nausea, vomiting and lethargic, weakness.


VAERS ID: 1485085 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hot flush
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hot Flashes


VAERS ID: 1485153 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Vision blurred, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blurred Vision /Blind Spot in Right Eye in July 18th 2021 11:00PM Headache on right side of head


VAERS ID: 1485439 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-16
Onset:2021-07-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Groin pain, Laboratory test, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin C and E mulit Vitamin garlic pill calcium omega 3
Current Illness: no
Preexisting Conditions: swelling on right side
Allergies: no
Diagnostic Lab Data: physical and blood work
CDC Split Type:

Write-up: sharp pain in groan area . lump appeared in left clavicle


VAERS ID: 1485641 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Bone pain
SMQs:, Osteonecrosis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Heart burn
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain in left shoulder collarbone


VAERS ID: 1485648 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Erythema multiforme, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None Known
Current Illness: None Known
Preexisting Conditions: None Known
Allergies: None Known
Diagnostic Lab Data: Dr diagnosed patient with Nonbullous Erythema Multiforme (695.10, L51.0) Uncomplicated
CDC Split Type:

Write-up: Patient reported feeling dizzy and short of breath. Went to walk-in clinic next morning after developing rash and no improvement in previous symptoms.


VAERS ID: 1485651 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 RA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Fatigue, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan/Hydrochlorothiazide Tabs 100/25, Womens Multi Vitamin, Fish Oil, Vitamin D, Zinc, Calcium
Current Illness: Cold, Fever week before
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever 101.5, Muscle pain, Nasuea, Very Tires


VAERS ID: 1485656 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Painful respiration, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Only acetaminophen after vaccination.
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Severe chest pain (he said it hurt to breath) Fever for 2 days. He had acetaminophen every 4 hours.


VAERS ID: 1486067 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-16
Onset:2021-07-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute myocardial infarction, Catheterisation cardiac normal, Chest pain, Echocardiogram, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pain with NSTEMI - troponin elevated to 6, downtrended. No EKG changes. TTE without reduced EF or wall motion abnormalities. Left heart cath did not show any significant CAD. Therefore, we believe this was a case of mRNA myocarditis from the 2ns Moderna dose 48 hours prior


VAERS ID: 1486396 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 2 LA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Pain, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart racing Fever Chills Body aches


VAERS ID: 1486581 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-09
Onset:2021-07-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Erythema, Peripheral swelling, Rash, Rash erythematous, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known of
Preexisting Conditions: None
Allergies: None known of
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Red rash on arm , started 9 days after injection . Started smaller , became larger . This is day 3 , arm is slightly swollen warm to the touch and red .


VAERS ID: 1486822 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-16
Onset:2021-07-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Gait inability, Hypersensitivity, Loss of personal independence in daily activities, No reaction on previous exposure to drug, Peripheral swelling, Pyrexia, Rash, Urticaria, Vaccination complication
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: None done.
CDC Split Type:

Write-up: The vaccination went as expected the day after with fever and chills. But the second day after the vaccine I woke up with welts on my arms and legs the grew until they encompassed my legs fully and inner arms full. It spread to my entire body in big parts. The third day is spread to everywhere it hadnt the first (chest, stomach, outer arms, feet and hands). But it swelled my hands to the point that I can''t make a fist. The fourth day the welts and rash cleared up everywhere else but I woke up with it on my feet and they swelled to the point where I can''t walk today. So day 3 it swelled my hands and day 4 is swelled my feet but its going away within a 24 hrs period. I am currently unable to use pens and small objects in my hands to hold due to the swelling. I am also unable to walk. The ER says to wait it out because its an allergic reaction and I intend to. But even the pharmacy said that out of their 9000 patients done i have been the only one thst has had a worse adverse effect on the second dose. Nothing occurred on the first dose, just the second. I hsvebeen taking benadryl and tylonol but they don''t seem to do much ut just is taking time, but there has been no improvement on my hands or feet.


VAERS ID: 1486899 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Rash erythematous, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Tylenol
Current Illness: n/a
Preexisting Conditions: DM
Allergies: Strawberries
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Red itchy hives on multiple areas of body to include face, arms, legs, and abdomen. Began approximately 4 hours after injection on legs: after overnight red bumps/hives appeared on other areas as above.


VAERS ID: 1486997 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood test, Computerised tomogram, Dizziness, Eye movement disorder, Face injury, Fall, Glassy eyes, Haemorrhage, Heart rate increased, Hypotension, Loss of consciousness, Pyrexia, Raynaud's phenomenon, Respiratory arrest, Seizure, Tremor, Urinary incontinence
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I began feeling weak and fluey around 8:30 or 9:00 pm. I decided to go to sleep around 10, noticed my fingers had turned yellow and lost all circulation. I went downstairs to ask my dad what to do, and immediately felt like I was going to faint. Sat down on a chair and put my head between my legs, but passed out as I was doing so, and fell on the floor. According to onlookers (brother and sister, who is an EMT) I was convulsing and stopped breathing for about thirty seconds, and my eyes were glassy and rolling. I woke up to my sister telling me to breathe. There was blood on the floor (I had hit my face on the way down) and I was trembling uncontrollably and had wet myself. I was awake and aware of my surroundings, and remembered everything up to and including sitting sitting on the chair before I passed out. My brother had called 911 while I was out and an ambulance came within five minutes. The paramedics put me in the ambulance and took me to the hospital (they would have taken me to local except there was risk that it was a seizure, which I guess local isn''t equipped to handle). They measured my vital signs, made IV ports in my arms and drew some blood. My blood pressure was super low and my heart rate was super high, and I had a temperature of 102. When I got to the hospital they put two liters of saline drip into me to rehydrate me, did a CAT scan, and some bloodwork. They discharged me around 3:30 AM on Monday morning, told me to stay hydrated and get a lot of rest. I slept all day yesterday (Monday) and was feverish and weak. By today (Tuesday) I think I have mostly recovered.


VAERS ID: 1487172 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046821A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fear of injection, Hypotension, Injection site pain, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Hypotension-Medium, Additional Details: Patient passed out approximately 3 min after given the dose. While getting ready to conduct CPR, the patient started responding. Patient was able to be seated. Called 911 and the paramedics arrived. After examining the patient, paramedics told me that patient told them that she was only afraid of needles and they think the reaction is Psycho-Somatic. Patient blood pressure was low for a little while.


VAERS ID: 1487196 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-04-06
Onset:2021-07-18
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Hypersensitivity, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: No food or drug allergies. Allergies to pollen / rag weed
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Allergic reaction which came on without a known specific reason. face swelling and elevated blood pressure,


VAERS ID: 1487264 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pericarditis- chest pain


VAERS ID: 1487324 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 88
Current Illness: None
Preexisting Conditions: Thyroid
Allergies: Penicillin, sulfates
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nausea, headache, fever, diarrhea - symptoms went away on their own after three days


VAERS ID: 1487378 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN J820095 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Dehydration, Injection site pain, Nausea, Pain, Paraesthesia, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Same day of receiving the vaccination woke up with chills, fever, nauseous, tingling feeling in the index finger. Next day body was in pain, no appetite, dehydration, soreness at injection site.


VAERS ID: 1487393 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-09
Onset:2021-07-18
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031M20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Fatigue, Malaise, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: SARS CORONAVIRUS-2 RNA, V: Detected
CDC Split Type:

Write-up: Symptomatic, started on 7/18 with fever & fatigue.


VAERS ID: 1487401 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-09
Onset:2021-07-18
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Coronavirus infection, Fatigue, Pyrexia, SARS-CoV-2 RNA increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: SARS CORONAVIRUS-2 RNA, V; Detected
CDC Split Type:

Write-up: Symptomatic, started on 7/18 with fever & fatigue


VAERS ID: 1487455 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Fatigue, Headache, Heart rate increased, Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: losartan 50 mg
Current Illness: no
Preexisting Conditions: high blood pressure
Allergies: unknown
Diagnostic Lab Data: no
CDC Split Type:

Write-up: rapid heart beat, high blood pressure, headaches, dizziness, tiredness


VAERS ID: 1487506 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-10
Onset:2021-07-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011021A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanus injection and boosters - last received Jan 2012- local swelling and fever/malaise
Other Medications: Gabapentin Alleve Antihistamine CBD Acidophilus Vitamin d
Current Illness:
Preexisting Conditions: Rosacea Nerve pain from pars defect - 1 year
Allergies: Sulfa drugs- cechlor, Sentra Penicillin Gluten sensitivity
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy bump similar to mosquito bite appeared during evening walk on 07/18. Visible but not itchy rash appeared 4pm 07/20 (1 by 2 inches).


VAERS ID: 1487512 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Chills, Decreased appetite, Diarrhoea, Facial pain, Fatigue, Feeling cold, Feeling hot, Joint range of motion decreased, Lymphadenopathy, Nausea, Pain, Pyrexia, Sleep disorder, Swelling, Toothache
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loratadine 10mg, Singulair 10mg, 2 doses of Emergen-C
Current Illness: I had a common cold one month prior
Preexisting Conditions: Asthma and environmental allergies
Allergies: Asprin
Diagnostic Lab Data:
CDC Split Type:

Write-up: I woke at 2:30 AM the day after my shot (so 7/18/21) with chills, a fever of 101.3, and body aches in my joints, teeth, and face. I was unable to sleep through it. Around 10AM, I took 400mg of ibuprofen and was able to sleep for a bit. I woke around noon feeling hot. I basically bounced from being too hot to being too cold all day, in and out of sleep, from here. At 8 PM, the left side of my upper chest started to hurt and I discovered a lump between my armpit and left breast. I determined this to be enlarged lymph nodes. It was very difficult to sleep that night due to this soreness (I can best describe that it felt like a bruised rib). The next morning, (so 7/19/21),


VAERS ID: 1487552 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis, Erythema, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Chronic hypertension
Allergies: None
Diagnostic Lab Data: None available
CDC Split Type:

Write-up: Fever from time woke up on the 18th until went to sleep on the 19th. Shoulder is red and inflamed with goosebumps on it started at same time as fever and is growing larger still swollen on the 20th at 7pm


VAERS ID: 1487752 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Chest discomfort
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Tachyarrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports that the day following the vaccine she experienced chest discomfort that lasted for 1 day. She felt like something was on her chest, felt fluttering in her chest, and felt like she was having a heart attack.


VAERS ID: 1487975 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Penicillin, codeine, latex, anesthesia
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site arm is red, swollen, and hot - started 1 day after administration. 2 days after administration red rash was at its worst.


VAERS ID: 1488214 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Ear pruritus, Periorbital oedema, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA non-severe allergic reactions- facial rash (7/20/21), right auricular pruritus (7/20/21), right periorbital edema (7/19/21), abdominal pain (7/18/21)


VAERS ID: 1490060 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-18
Onset:2021-07-18
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLUoxetine (PROzac) 20 mg capsule gabapentin (NEURONTIN) 300 mg capsule meloxicam (MOBIC) 15 mg tablet(Expired) traZODone (DESYREL) 100 mg tablet
Current Illness: Abnormal mammogram - invasive ductal carcinoma
Preexisting Conditions: Nervous Headache(784.0) Brachial neuritis Lumbar radiculopathy Sciatica Respiratory Enlarged tonsils Digestive Obesity Genitourinary Hot flashes, menopausal Musculoskeletal Foreign body of left hand, initial encounter Acquired spondylolisthesis Cervical spondylosis without myelopathy Cervical disc disorder Plantar fascial fibromatosis Sprain of medial collateral ligament of knee Synovitis and tenosynovitis Immune Exercise anaphylaxis Other Depression Encounter for gynecological examination without abnormal finding Encounter for mammogram to establish baseline mammogram Long term use of drug Screen for colon cancer Screening for breast cancer Screening for lipid disorders Screening mammogram, encounter for Need for hepatitis C screening test Screening for HIV (human immunodeficiency virus) Insomnia, unspecified type Disorder of soft tissue Encounter for removal of sutures Spinal stenosis of lumbar region Infiltrating ductal carcinoma of left breast
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 (SARS CoV-2,RNA Molecular Amplification)
CDC Split Type:

Write-up: Patient tested positive for COVID-19 but is asymptomatic


VAERS ID: 1490271 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: HE FAINTED EVERY TIME GETS VACINATION


VAERS ID: 1490272 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-16
Onset:2021-07-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Echocardiogram normal, Electrocardiogram ST segment elevation, Inflammation, Myocarditis, Pain, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: 1 week of cough, congestion, loss of smell/taste about 2-3 weeks prior to presentation to hospital with chest pain after vaccine.
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG: NSR, diffuse ST elevation Echo: normal biventricular function Troponins: highest ~ 15, down-trending by day two of admission.
CDC Split Type:

Write-up: Presented with pressure-like chest pain, elevated troponins and diffuse ST elevations on EKG consistent with perimyocarditis. Troponins continue to up-trend during first day of admission (highest ~15). Started on scheduled ibuprofen for pain and inflammation. Pain resolved by day 2 of admission and troponins were down-trending. Echo with normal biventricular function. Discharged home on ibuprofen PRN and cardiology follow-up.


VAERS ID: 1490385 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Joint range of motion decreased, Pain
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ER visit 07/18/21
CDC Split Type:

Write-up: patient experiencing increasing pain in shoulder ultimately reducing range in motion and pain upon movement.


VAERS ID: 1490435 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Chills, Cold sweat, Dizziness, Fatigue, Hot flush, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: - Chills: started same day as second dose, after 10-11 hours of receiving the shot. Lasted for 24 hours intermittently - Nausea, dizziness, tiredness , hot flashes, muscle pain: started the day after receiving the second dose, around 19 hours of receiving the shot. Lasted for 14 hours approx. - Sudden blood pressure drop, cold sweats: started 3 days after second dose (today). Blood pressure in 9/6. Recovered after laying down for a while.


VAERS ID: 1490516 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-01-27
Onset:2021-07-18
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Diarrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccinated with Pfizer on 1/27/21 and 2/17/21. Symptom onset 7/18/21 with cough and diarrhea. Tested positive for covid-19 on 7/20/21.


VAERS ID: 1490521 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-17
Onset:2021-07-18
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Diarrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccinated with Pfizer on 1/27/21 and 2/17/21. Symptom onset 7/18/21 with cough and diarrhea. Tested positive for covid-19 on 7/20/21.


VAERS ID: 1490527 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Condition aggravated, Diarrhoea, Headache, Influenza like illness, Injection site mass, Injection site pain, Nausea, Oropharyngeal pain, Pain
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pneumonia Vaccine: Soreness around injection site.
Other Medications: None Took meds after vaccinated.
Current Illness: Breathing issues Gets nauseated at times
Preexisting Conditions: Asthma Arthritis Bursitis Allergies IBS
Allergies: Sulfur
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Flu like symptoms, sore throat, headache, aches, pains through body, nauseated, stomach ache, diarrhea, area around injection was sore with a lump on it, chills


VAERS ID: 1490565 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Hyperhidrosis, Limb discomfort, Lymphadenopathy, Nausea, Urticaria
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 14 years ago reaction to the flu shot. Hives
Other Medications: Zyrtec Symbicort
Current Illness: no
Preexisting Conditions: asthma
Allergies: seasonal allergies , tree nuts ,flu shot
Diagnostic Lab Data: no
CDC Split Type:

Write-up: At 4:42 shortness breath also became dizzy and nausea Sweating profusely that lasted about 20min. On the 19th had chest tightestness that radiated to arm. Hive and swollen lymph nodes swollen and visible.


VAERS ID: 1490569 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient c/o itchiness to palms and scalp. Patient given Benadryl 25mg po as ordered per standing orders for itchiness. Patient''s symptoms resolved prior to discharge.


VAERS ID: 1490585 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-13
Onset:2021-07-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Chest pain, Computerised tomogram thorax abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: sertraline, flovent discus 100 mg bid, desogestrel-ethinyl Estradiol, methocarbamol, gabapentin
Current Illness: Unknown couth has been going on for months- being evaluated for allergies. Fh of lupus, she having muscle aches is seeing a rheumatologist getting bloodwork. All previous testing negative
Preexisting Conditions: fibromyalgia bipolardisorder/major depressive disorder
Allergies: Bee stings
Diagnostic Lab Data: CT Chest 7/19/2021 +PE
CDC Split Type:

Write-up: Had Chest pain 7/19/2021 went to er and was diagnosed with pulmonary embolism. Started on rivaroxaban/ xarelto. Was discharged from ER same day. Stable. Would not say she is "recovered" as we are early out from PE. Stopped combination oral contraception.


VAERS ID: 1490640 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-16
Onset:2021-07-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Nodule
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: She woke uo with a knot on a the left side and I gave her advil and heating pad.


VAERS ID: 1490651 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: keflex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received improperly stored vaccine. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, the patient will need revaccination


VAERS ID: 1490660 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-12
Onset:2021-07-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvastatin, omeperzol, wellbutrin, birth control
Current Illness: None
Preexisting Conditions: High white blood count
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm is swollen, red and itchy a week after injection


VAERS ID: 1490685 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received improperly stored vaccine. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, the patient will need revaccination


VAERS ID: 1490704 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-24
Onset:2021-07-18
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Nasal congestion, Oropharyngeal pain, Pain, Respiratory tract congestion, Rhinorrhoea
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: phenobarbitol, carbamezapine,amlodipine,irbesertan, centrum multi
Current Illness: none
Preexisting Conditions: avm
Allergies: none
Diagnostic Lab Data: rapid test - covid- 7/21/21
CDC Split Type:

Write-up: sore throat, nasal congestion and runny, chest congestion, tired and body aches


VAERS ID: 1490747 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Describe the adverse events, treatment, and outcomes?: enter: ?Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.?


VAERS ID: 1490819 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Kelfex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Describe the adverse events, treatment, and outcomes?: enter: ?Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.?


VAERS ID: 1490826 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-09
Onset:2021-07-18
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, Nexium, Metoprolol, Glucosamine, Mobic, Fosamax
Current Illness:
Preexisting Conditions: GERD, HTN, Osteoporosis
Allergies: Augmentin
Diagnostic Lab Data: COVID-19 Rapid Antigen Test
CDC Split Type:

Write-up: Breakthrough COVID19 infection


VAERS ID: 1490923 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490939 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 06/17/2021. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490948 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 06/17/2021. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490954 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490958 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immunisation, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: ?Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490959 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site reaction, Injection site warmth, Pyrexia, Rash erythematous, Rash papular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID DIAGNOSIS DECEMBER 2020
CDC Split Type:

Write-up: RASH AT INJECTION SITE WARM TO THE TOUCH, RAISED AND RED, NOT ITCHY. LOW FEVER APPROX 99.3,


VAERS ID: 1490962 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-07-16
Onset:2021-07-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Hot flush
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Natures Way Vitamin C, Natural Factors Vitamin D3, Flonase sensimist, Norethindrone Acetate and Ethinyl Estradiol Tablets 1mg/.02mg (Birth control)
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillian
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Ongoing sudden flashes of hot sensations that move down my legs and occasionally my arms. They''re more dominantly on my left side but have felt them on my right leg on occasion since Sunday following my injection. These are reoccurring sensations all day/night. I have not had it checked out by a doctor. I started a new job and cannot afford the time off or a dr visit.


VAERS ID: 1491423 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dry throat, Eye pain, Headache, Insomnia, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Sulfa, Biaxin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sleeplessness, headache, eye pain, severe sore throat, throat dryness


VAERS ID: 1491872 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-15
Onset:2021-07-18
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test abnormal, Cardiac stress test, Dizziness, Migraine, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: klonopin
Current Illness: none
Preexisting Conditions: epilepsy traumatic brain injury
Allergies: pollen flouresce eye drops used at the eye doctor to contrast the eye gel deoderant
Diagnostic Lab Data: heart stress hormone blood test was elevated
CDC Split Type:

Write-up: extreme heart palpitations, dizziness, severe migraine


VAERS ID: 1492075 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Injection site pain, Injection site pruritus, Injection site reaction, Injection site swelling, Injection site warmth, Lethargy, Pain, Pyrexia, Skin reaction
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: MMR booster at age 25, pain and swelling for several daya
Other Medications: Generic Nexium, Wellbutrin, Lexapro
Current Illness: N/a
Preexisting Conditions: Obesity, depression
Allergies: Possible tree nuts
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Chills, fever of 102, lethargy, headache, body pain, subsequent ?COVID arm? at injection site 1-3 days later with itching, soreness, swelling, heat.


VAERS ID: 1492870 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-18
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Ear congestion, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Exposure to COVID-19 (She had been exposed to husband)
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210741495

Write-up: LEFT EAR IS BOTHERING; NAUSEA; HEADACHE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included exposure to covid. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 06-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 18-JUL-2021, the subject experienced nausea. On 18-JUL-2021, the subject experienced headache. On an unspecified date, the subject experienced left ear is bothering. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from nausea, and headache, and the outcome of left ear is bothering was not reported. This report was non-serious. This case, from the same reporter is linked to 20210742023.


VAERS ID: 1492899 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-07-17
Onset:2021-07-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: collapsed after second dose; got really dizzy; since then really foggy & out of it; then vomitted; This spontaneous case was reported by a consumer and describes the occurrence of SYNCOPE (collapsed after second dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 17-Jul-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Jul-2021, the patient experienced SYNCOPE (collapsed after second dose) (seriousness criterion medically significant), DIZZINESS (got really dizzy), FEELING ABNORMAL (since then really foggy & out of it) and VOMITING (then vomitted). At the time of the report, SYNCOPE (collapsed after second dose), DIZZINESS (got really dizzy), FEELING ABNORMAL (since then really foggy & out of it) and VOMITING (then vomitted) outcome was unknown. No concomitant medications were reported. Treatment information was not provided. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1493715 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart pain and trouble breathing.


VAERS ID: 1493840 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-18
Onset:2021-07-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, Incomplete course of vaccination
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Keflex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the pt will need to be re-vaccinated.


VAERS ID: 1493987 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-11
Onset:2021-07-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: redness, swelling that started 7 days after vaccination and is now still spreading


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