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From the 10/15/2021 release of VAERS data:

Found 800,916 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 100 out of 8,010

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VAERS ID: 1735989 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (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: Administration error mixed series mRNA vaccine Pfizer and Moderna.


VAERS ID: 1735991 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (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: Administration error mixed series mRNA vaccine Pfizer and Moderna.


VAERS ID: 1735992 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (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: Administration error mixed series mRNA vaccine Pfizer and Moderna.


VAERS ID: 1735994 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (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: Administration error mixed series mRNA vaccine Pfizer and Moderna


VAERS ID: 1735995 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (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: Administration error mixed series mRNA vaccine Pfizer and Moderna.


VAERS ID: 1736001 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (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: Administration error mixed series mRNA vaccine Pfizer and Moderna


VAERS ID: 1736013 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Affective disorder, Change in sustained attention, Condition aggravated, Feeling abnormal, Hot flush, Hypomania, Irritability, Myalgia, Psychomotor hyperactivity, Sleep disorder, Tearfulness, Tic
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Propranolol; acyclovir (both regularly taken)
Current Illness: None
Preexisting Conditions: Mood disorder, possible bipolar Anxiety, social Minor tics that come and go, related to mood state Recurrent weekly to bimonthly outbreaks of herpes 1 virus cold sores on lips if not on acyclovir; possible immune dysfunction? Episodes of telogen effluvium; cause unknown
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hot flashes within 30 minutes which lasted for approximately 12 hours. Within approximately 4 hours, felt a surge of mental clarity and began hyperfocusing on a subject for approximately 7 hours, which is unusual for me unless I am experiencing a mood episode. I have experienced hypomanic episodes, around 1/year, and I started noticing the signs shortly after the dose which hadn?t been present in the days leading up to the day of the vaccine. I was awake all night and could not sleep. Finally slept for a few hours and woke up feeling okay. I noticed extreme irritability during the whole day and heightened psychomotor agitation (not caused by stimulant use or any other drug) including motor tics which I perform when I?m having a mood episode of hypomania. They don?t occur when I?m in a normal mood. I?m wondering if the immune response caused by the vaccine triggered a hypomanic episode. Also experiencing teariness at minor frustrations and slight muscle pain and fogginess like I cannot focus my energy but at the same time have an excess of it. None of this had started until a few hours after the vaccine dose


VAERS ID: 1736045 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-23
Onset:2021-09-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood magnesium normal, Differential white blood cell count normal, Electrocardiogram abnormal, Fibrin D dimer normal, Full blood count normal, Palpitations, Sinus rhythm, Troponin normal, Ventricular extrasystoles
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Hypokalaemia (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: None
Current Illness: None
Preexisting Conditions: Exercise-induced asthma
Allergies: Amoxicillin (reaction: rash)
Diagnostic Lab Data: EKG demonstrated sinus rhythm with occasional PVCs. CBC with diff, BMP, magnesium level, HS troponin, and ddimer were within normal limits.
CDC Split Type:

Write-up: Healthy, active, and young female developed palpitations 43 hrs after receiving 1st dose of Pfizer-BioNTech vaccine and noted frequent PVCs on her watch and later confirmed with 12-lead EKG at the ER. These symptoms have improved but continue to persist. No history of palpitations or heart problems.


VAERS ID: 1736063 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Chills, Fatigue, Headache, Injection site pain, Lymphadenopathy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (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: Swollen injection site and 104 degree fever
Other Medications:
Current Illness:
Preexisting Conditions: Truncus Arteriousis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site pain, headache, chills, joint and muscle pain, fatigue, sore armpit/swollen lymph nodes.


VAERS ID: 1736064 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Fatigue, Pain, Pyrexia, Skin mass
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (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: Enskyce (Birth Control) Levothyroxine Rabeprozol
Current Illness: Tested positive for COVID late August.
Preexisting Conditions: Hypothyroidism Tachycardia Hypertension Anemia Asthma
Allergies: Peanuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Subcutaneous Nodule. Appeared about 24 hours after vaccination. Still present 52 hours after vaccination. Appears to be growing in size instead of getting decreasing. Still painful lifting arm above chest. Slightly feverish. Body aches and Joint pain continues now since day after vaccination. Am normally fatigued due to Anemia and Hypothyroidism but am more fatigued than normal.


VAERS ID: 1736155 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Disturbance in attention, Fatigue, Feeling abnormal, Headache, Hypoaesthesia, Malaise, Pain
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad), Sexual dysfunction (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: Within 4 hours I developed severe fatigue and debilitating brain fog. I could not concentrate or even remember what I just thought. Also, body aches, chest pressure, headaches, and just an extreme unwell feeling. My arms also felt numb off and on.


VAERS ID: 1736164 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Lymph node pain, Lymphadenopathy, Pain in extremity
SMQs:, 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen and tender armpit (lymph nodes) Headaches tender arm


VAERS ID: 1736470 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Chest discomfort, Chest pain, Dizziness, Feeling hot, Flushing, Heart rate increased, Hyperhidrosis, Tachycardia, Tremor
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Allergic: Anaphylaxis-Mild, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Shakiness-Medium, Systemic: Tachycardia-Medium, Additional Details: 5 min post vaccine pt stated she felt hot all over. Gave her a cold bottle of water. 10 min post vaccine pt stated she felt like her heart was beating rapidly. Gave her Benadryl and told her she would have to wait 30 minutes. 20 min post vaccine pt said she felt her chest was getting tight. I called EMS and was about to administer Epiephrine but they arrived before I gave it. They examined her and ask if she wanted to go to the hospital to be seen by doctor. Pt ok today 9/26/21


VAERS ID: 1736471 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: SARS-CoV-2 test negative, Streptococcus test negative, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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: Nutropen (growth hormone) Minocycline (acne) Adderrall (did not take on day of vaccine)
Current Illness: none
Preexisting Conditions: ADHD
Allergies: none
Diagnostic Lab Data: COVID and Strep negative
CDC Split Type:

Write-up: hives started on elbows saturday afternoon. When he woke up Sunday his feet, elbows, knees and hands were covered with hives. Started taking Benadryl Q6hr, seen by pediatrian. Had Covid and strep test both negative. Sunday afternoon hives on ears, neck and face.


VAERS ID: 1736476 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (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: Numbness (specify: facial area, extremities)-Medium, Additional Details: numbness in middle and ring finger on left arm


VAERS ID: 1736485 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Fatigue, Flatulence
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Jan 2021, age 66
Other Medications: Allopurinal, diprydimal, statin, sodium bicarbonate,thyroid med,
Current Illness: Allergies
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme fatigue, digestive -stomach upset, chills, gas


VAERS ID: 1736655 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-17
Onset:2021-09-25
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: hospitalization (non-ICU)


VAERS ID: 1736657 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Headache, Injection site erythema, Injection site swelling, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Multivitamin
Current Illness: Cold about 3 weeks prior.
Preexisting Conditions: Hypertension, obesity, hypothyroidism, kidney stones, high cholesterol
Allergies: Doxycycline and simvastatin
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Red, warm, swollen vaccine site day after vaccine. Fever/chills/headache developed 2 days after vaccine.


VAERS ID: 1736673 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-17
Onset:2021-09-25
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030M20A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Bone cancer, Lung neoplasm malignant
SMQs:, Guillain-Barre syndrome (broad), Non-haematological malignant tumours (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Weakness. Lung and Bone Cancer. Admitted 9/25/21


VAERS ID: 1736689 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Axillary pain, Chills, Fatigue, Headache, Injection site pain, Lymph node pain, Lymphadenopathy, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: No
Preexisting Conditions: No
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 24Sept2021: I received my first dose of Pfizer COVID 19 vaccine at 1:00 pm in my left arm intramuscular. Later that night, I experienced chills and slight headache. On 25Sept2021: I was very fatigued, chills, injection site soreness, headache and nausea that resulted to one episode of vomiting. I took ibuprofen and aleve to help with injection site soreness and headache. On26Sept2021: Headache, nausea (with no vomiting), and lymph node swelling and pain under left armpit. The swelling is tennis size and very sore to touch. 27Sept2021: I reported my AEs but still have nausea and lymph node swelling and pain under left armpit.


VAERS ID: 1736693 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Back pain, Fatigue, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Back ache, fatigue, fever, nausea


VAERS ID: 1736700 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Immunodeficiency, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: 2nd dose COVID: Arm pain at injection site worse than first dose. Fever had started about 12 hours after second dose and lasted
Other Medications: Topical clindamycin and topical tretinoin (both on face for acne)
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: 3rd dose: Swollen underarm started about 24 hours after vaccine given, worsened at 48 hours, and still lasting on 9/27 (likely swollen lympth nodes; Ibuprofen does help the pain)--Unsure how long this will last. Noticed fever at about 24 hours after vaccine given and lasted <24 hours after 3rd shot (booster given ~7 months after 2nd dose). No Nausea.


VAERS ID: 1736705 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-09
Onset:2021-09-25
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen on 3/9. Positive on 9/23


VAERS ID: 1736721 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Erythema, Fatigue, Full blood count, Hyperhidrosis, Oedema peripheral, Paraesthesia, Peripheral swelling, Pyrexia, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (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), 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: Omperazole Lisinopril
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CBC
CDC Split Type:

Write-up: Severely swollen arm All around Armpit swollen tingling in fingers Fever 101.5 Chills Sweats Swelling increasing down arm over three days Extremely red Fatigue Arm is hot to touch


VAERS ID: 1736725 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-22
Onset:2021-09-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH D226SF1 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Rash erythematous
SMQs:, Anaphylactic reaction (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Big red rashes all over body.


VAERS ID: 1736756 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-23
Onset:2021-09-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C821A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Aspergillus
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sore for the first two days, woke up the third day and vomited, has a fever of 101.3 , headaches, body aches, chills and sweating.


VAERS ID: 1736779 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / UNK - / 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: pt has signed attestation form to be immunocompromised.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was hospitalized a day after dose was given. Not sure on exact condition. Patient came to pharmacy to get extra dose due to immunocompromised health status. Pfizer was the original shot she received, but was not available at the pharmacy so she was given moderna per cdc guideline


VAERS ID: 1736781 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-17
Onset:2021-09-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Unknown       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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID-19 positive.


VAERS ID: 1736800 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Chest discomfort, Computerised tomogram thorax normal, Dizziness, Echocardiogram normal, Electrocardiogram T wave abnormal, Electrocardiogram abnormal, Laboratory test normal, Loss of consciousness, Palpitations, Tachycardia, Troponin increased
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Stelera, birth control pill, anti-depressant citalopram, fish oil, multivitamin, iron, probiotic
Current Illness: None
Preexisting Conditions: Crohns
Allergies: Advil, augmentin
Diagnostic Lab Data: 09/25/2021: ECHO (normal), CT chest (normal), Troponin (elevated at 0.18, then 0.16), EKG abnormal with elevated T waves, tachycardia, elevated blood pressure
CDC Split Type:

Write-up: Received second Covid vaccine at 0800, at 0807 I started to feel faint, lightheaded, palpitations. I loss consciousness and then was awakened by medical emergency team from hospital. My heart rate was 145 and BP was elevated around 180/90?s. They took me to the ER where they ran lab work, all unremarkable except Troponin elevated 0.18. They did ECHO which was normal, they did chest CT which was normal. They admitted me to watch Troponin levels in which they ran a second and it was 0.16. They never ran another and they discharged me same day. I currently still have chest tightness.


VAERS ID: 1736820 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-06
Onset:2021-09-25
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Unevaluable event
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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: hospitalization (non-ICU)


VAERS ID: 1736864 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Neck mass, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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: previously filed a report on her 1st Moderna Vaccine
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: the following day after taking the vaccine she notice that evening a swelling on left side of her neck with a lump


VAERS ID: 1736877 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-29
Onset:2021-09-25
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19
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:
Current Illness:
Preexisting Conditions:
Allergies: Influenza Virus Vaccine, Ibuprofen, Keflex, Lomotil, Morphine, Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admission to with COVID-19 diagnosis on admission


VAERS ID: 1736878 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-03
Onset:2021-09-25
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest pain, Computerised tomogram thorax normal, Fibrin D dimer increased, Leukocytosis, Lipase increased, Liver function test increased, Lung opacity, Nausea, SARS-CoV-2 test positive, Tachycardia, Tremor, Vomiting, White blood cell count increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 36-year-old female with significant past medical history of alcohol abuse and hypertension who presented to the emergency department with a chief complaint of chest pain, associated nausea and vomiting, initial evaluation in the emergency room showed mild leukocytosis and elevated D-dimer, CT of the chest was negative for pulmonary embolism but showed ground-glass opacity bilateral COVID-19 PCR was ordered and was positive, LFTs was also elevated as well as lipase. VS stable, patient saturating above 95% on RA.
CDC Split Type:

Write-up: Patient is a 36-year-old female with significant past medical history of alcohol abuse (4-6 years) and hypertension (untreated) who presented to the emergency department with a chief complaint of chest pain. Patient states associated nausea and vomiting. Patient admits to heavy alcohol use over the past 4-6 years following her divorce, she reports that she drinks every day (vodka and red wine), last alcohol intake was yesterday evening. Degree at onset was moderate degree of present is moderate. She denies any alleviating or exacerbating factors. Patient was seen examined in the emergency department, she appears somewhat uncomfortable with upper extremity tremors and tachycardia noted. Lab work revealed mild leukocytosis with white count 11.8, D-dimer was elevated at 1.83 however CT scan of the chest was negative for pulmonary embolism however did suggest ground-glass opacities and therefore COVID-19 has been ordered, LFTs were elevated as well as elevated lipase at 324.


VAERS ID: 1736947 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-25
Onset:2021-09-25
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Blood pressure systolic abnormal, Flushing, SARS-CoV-2 antibody test, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: diltiazem 180 mg po daily Prednisone, tapering doses x 2 days Lisinopril 20 mg po daily pravastatin 40 mg po daily clopidogrel 75 mg po daily methotrexate 2.5 mg po weekly
Current Illness:
Preexisting Conditions: Rheumatoid arthritis; Non-Hodgkins Lymphoma;HLD, HTN, Fracture Left Shoulder, Macular Degeneration. Carotid surgery.
Allergies: Relafen, Cefzil
Diagnostic Lab Data: SARS-CoV-2 Antigen (+) on 9/25/21 SARS-CoV-2 IgM 46.18; IgG 0.00 done on 9/27/2021
CDC Split Type:

Write-up: The patient is a 87 year old female with PMH including non-hodgkins lymphoma, RA, HTN, and HLD. Today, she felt flushed which is similiar to the same feeling she gets when her blood pressure is high.Her caretaker took her blood pressure multiple times and when the SBP was consistently around 200 even after taking her usual cardizem dose, she came to the ED. In the ED, she was given vasotec IV without any improvement in her BP. She was started on a cardene gtt. Incidentally, her rapid SARS test came back positive. She has no c/o SOB, cough, sore throat, headaches, or body aches. She has had her Covid vaccines and a booster 2 weeks ago.


VAERS ID: 1736956 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-01-28
Onset:2021-09-25
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Cough, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Resident travels frequently, complained of coughing/sneezing, went to an Urgent Care and tested positive for Covid


VAERS ID: 1736963 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-07
Onset:2021-09-25
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, COVID-19, Fatigue, Fibrin D dimer increased, Haemoglobin decreased, Lung infiltration, Oxygen saturation decreased, SARS-CoV-2 antibody test, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Somnolence, Ultrasound scan normal
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine 10 mg Tablet Directions: 1 tablet oral daily (Active) aspirin 81 mg tablet,delayed release (DR/EC) Directions: 1 tablet oral daily at bedtime (Active) atorvastatin 20 mg Tablet Directions: 1 tablet oral daily at bedtime (Ac
Current Illness:
Preexisting Conditions: CVA, Dyslipidemia, HTN, Obesity; Fibromyalgia, Irritable bowel syndrome, Anxiety, Osteoarthritis ,Bilateral lower extremity lymphedema. Bilateral Achilles tendon surgery, Right total knee replacement x2 2009. Smoking Status Never Smoker.
Allergies: NKDA
Diagnostic Lab Data: SARS-CoV-2 Antigen (-) on 9/25/21; SARS-CoV-2 PCR (+) on 9/26/2021 SARS-CoV-2 IgM 0.09; IgG 0.02 on 9/26/21 SARS-CoV-2 IgG2 QT-SPIKE Antibodies 78.4 on 9/26/21
CDC Split Type:

Write-up: The patient is a 85 year old female with PMH as below. She has been tired and sleepy for the last several days. Her facility sent her to the ED. In the ED, her Hg was 10.3. She had a CTA Chest done which showed no PE but it did show a right base infiltrate. Her SPO2 was 90% on room air and improved to 99% on 2L. LE U/S showed no DVT. D-dimer was elevated.


VAERS ID: 1736973 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-18
Onset:2021-09-25
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: AST/ALT ratio abnormal, COVID-19, Chest X-ray abnormal, Computerised tomogram head normal, Coordination abnormal, Dyspnoea, Gait disturbance, Hypoaesthesia, Hypoaesthesia oral, Lung infiltration, Neurological symptom, Platelet count increased, SARS-CoV-2 test negative, SARS-CoV-2 test positive
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Interstitial lung disease (narrow), Anticholinergic syndrome (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 encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow), Sexual dysfunction (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine 10 mg Tablet Directions: 1 tablet oral daily (Active) cholecalciferol (vitamin D3) 50 mcg (2,000 unit) Tablet Directions: 1 tablet oral daily (Active) coenzyme Q10 100 mg Capsule Directions: 1 capsule oral twice a day (Acti
Current Illness:
Preexisting Conditions: Dyslipidemia, HTN. Appendectomy, L TKA, R TKA;Shoulder arthroplasty. Smoking Status Former Smoker.
Allergies: NKDA
Diagnostic Lab Data: SARS-CoV-2 Antigen (-), and PCR (+) on 9/25/2021 SARS-COV-2 IgM 0.05; IgG 5/14 on 9/26/21 SARS-CoV-2 IgG2 QT-SPIKE Antibodies $g50000 on 9/26
CDC Split Type:

Write-up: 60 yr old female w comes to ER today with complaints of SOB worsening and reports of neurological symptoms which stated yesterday but have since resolved. The pt states she tested positive for covid 19 on 9/18 and has been fine until yesterday when she developed tongue numbness, left arm and leg numbness yesterday and then difficulty ambulating and poor coordination earlier today. The pt also states amongst all of this she had increased sob. She informed her PMD of this he sent her for a cxr yesterday which resulted bilateral pulm infiltrates. In the ER a head ct is Negative for acute issues. labs show elevated ast/alt level, elevated platelets. Rapid Covid is negative and PCR is pending. The pt does have notable sob with conversation but o2 sats are 94% on room air. The pt was initlaly to be observation but given recent covid infection and symtpoms may required additional treatments lasting more than 24 hours and possibly could benefit from covid treatments.


VAERS ID: 1736980 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-05
Onset:2021-09-25
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COUGH, SOB


VAERS ID: 1736983 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-14
Onset:2021-09-25
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Computerised tomogram thorax abnormal, Cough, Dyspnoea, Exposure to SARS-CoV-2, Pneumonia, Respiratory symptom, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), 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: aspirin (Adult Aspirin Regimen) 81 mg tablet,delayed release (DR/EC) Directions: 1 tablet oral daily (Active) metoprolol succinate 25 mg Tablet Extended Release 24 hr Directions: 0.5 tablet oral twice a day (Active) pravastatin 40 mg T
Current Illness:
Preexisting Conditions: CAD, Dyslipidemia, HTN; Bladder cancer in 2011, Polio. Achilles heel repair, 5 cardiac stents
Allergies: NKDA
Diagnostic Lab Data: SARS-CoV-2 Antigen (+) 9/25/21
CDC Split Type:

Write-up: 75-year-old white male with a past medical history of childhood polio, bladder cancer in 2011, hypertension hyperlipidemia coronary artery disease status post stents According to the patient almost a week back he started developing cough upper respiratory tract symptoms. His family members including his daughter granddaughter and wife all came out positive for corona virus infection. His symptoms were getting progressively worse and he was also developing some shortness of breath hence he came to the ER for evaluation where he was found to be having bilateral pneumonia CT scan hence patient was admitted for further treatment to medical floor.


VAERS ID: 1737015 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-15
Onset:2021-09-25
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling, Pruritus, 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 (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: Flonase
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: On the 25th of September arm was swollen warm to touch and itching . it seems to be spreading .


VAERS ID: 1737033 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3055BA / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient received a dose of Pfizer Covid vaccine after receiving 2 doses of Moderna for her initial series


VAERS ID: 1737045 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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: Pfizer 1/16/21; 2/9/21
Other Medications: birth control (Lo Loestrin Fe)
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA; diary intolerance
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: At 2 am on Saturday early morning, I awoke with chills. By 4 am, I had a fever accompanying the chills. I had body aches, fever and chills for most of the day Saturday until the fever broke that night at about 7 pm. Chills persisted for another hour or two. Body aches and severe headache lasted all day Saturday and all day Sunday into today which is Monday. I have a headache and back aches and it is currently 10 am.


VAERS ID: 1737046 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-09-23
Onset:2021-09-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Lymphadenopathy
SMQs:, 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: Vyvanse 50mg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Phenegren
Diagnostic Lab Data:
CDC Split Type:

Write-up: Underarm left lymph swollen and hurt


VAERS ID: 1737095 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Administration site erythema, Administration site reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (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: Losartan, Amlodipine
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Raised 3 inch circular red welt at administration site.


VAERS ID: 1737096 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-02
Onset:2021-09-25
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 treatment, 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series


VAERS ID: 1737107 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-19
Onset:2021-09-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series


VAERS ID: 1737144 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-06-27
Onset:2021-09-25
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       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? 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: Tested Positive for Covid


VAERS ID: 1737172 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Myocarditis
SMQs:, 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:
Current Illness:
Preexisting Conditions: none
Allergies: augmentin, ceclor
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt called monday 9/27/21 stating he was admitted to the hospital over the weekend and diagnosed with myocarditis and stayed for 2 nights.


VAERS ID: 1737175 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-01
Onset:2021-09-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2
SMQs:, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid positive school


VAERS ID: 1737176 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Pain in extremity, Paraesthesia, Tremor, Vascular pain
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Tendinopathies and ligament 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? Yes
Hospitalized? No
Previous Vaccinations: Flu Vaccine
Other Medications: None
Current Illness: Mild Sore Throat
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None (yet).
CDC Split Type:

Write-up: 1. Uncontrollable shaking right hand and leg (on and off/mostly when being still). 2. Pain in veins (especially the wrist) on the right side (from shoulder to the palm of my hand). 3. Burning/tingling sensation in soles of feet and palms of both hands.


VAERS ID: 1737186 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Dizziness, Dyspnoea, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: DULOXETINE 30 MG ELIQUIS 5 MG SPIRONOLAETONE 50MG SYNTHOID .150MG ISINOPRIL 10MG METOPROLOL 50MG OMERPRAOLE 40MG VIT D CACIUM 600 W/D-3 TYMALOS INJ NIGHTLY
Current Illness: A-FIB
Preexisting Conditions: A-FIB ; RA; GERD; DEPRESSION ; EDEMA; HYPOTHROIDISM; HIGH BLOOD PRESSURE
Allergies: CODEINE ; KEFLEX; vancomycin; minocycline
Diagnostic Lab Data: LOTS OF BLOOD TEST; OXYGEN; IV MEDS; ORAL MEDS
CDC Split Type:

Write-up: AMBULANCE RIDE TO HOSPITAL COULD NOT BREATH HARD CHEST PAINS; FAINT; DIZZY; NAUSEA STARTED ABOUT 2PM HOSPITAL ADMINISTERED SEVERAL TREATMENTS HEART RATE WAS OVER 200 STAYED AT 134 TILL ABOUT 1:40 AM SUNDAY MORNING


VAERS ID: 1737197 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Periorbital swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions:
Allergies: cipro, statins, amitiza
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling around R eye and cheek


VAERS ID: 1737199 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-22
Onset:2021-09-25
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PT presented with cough and shortness of breath for over a week; Inpatient; PT is on Remdesvir, Aspirin, Medrol, vitamin C and D


VAERS ID: 1737229 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-20
Onset:2021-09-25
   Days after vaccination:248
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 RA / IM

Administered by: Work       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: 9/26/21 SARS/COV2, NAAT, positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1737234 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-30
Onset:2021-09-25
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anticoagulant therapy, Chest pain, Cough, Painful respiration
SMQs:, Anaphylactic reaction (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented with chronic onset chest pain, worsened by breathing and coughing, gave Lipitor, Famocidine, Aspirin, Tylenol, and Discharged.


VAERS ID: 1737244 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head normal, Computerised tomogram normal, Dizziness, Electrocardiogram normal, Fall, Feeling of body temperature change, Full blood count normal, Head injury, Heart rate decreased, Hyperhidrosis, Injection site pain, Loss of consciousness, Metabolic function test, Mobility decreased, Muscle spasms, Nausea, Troponin normal, Vertigo
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), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament 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: #1 similar to #3 minus fainting and sweating lasted maybe 4 hours not 6-7, #2 all the same symptoms but milder
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: latex, adhesive, narcotics
Diagnostic Lab Data: Sunday 26 Sept. - EKG 13:25. They sent me to Hospital Emergency for Labs; CBCD, Basic Metabolic Panel, Troponin, CT Scan (maxillofacial) no contrast, cervical spine w/o congtrast. head w/o contrast, EKG 12 lead. All tests were normal. Dr. monitored my low heart rate (50-60) and low blood pressure (122/70 for a few hours before releasing me.
CDC Split Type:

Write-up: Saturday 6:00 a.m. - tender arm at injection site. 12:00 p.m. felt dizzy for less than a minute and then passed out in the driveway attempting to get into the house. I hit my face on both the foundation and a retaining wall (corner). When conscious I got into the house, laid on the couch and couln''t move for 7-8 hours. I was nauseous, cramps in my rib cage and sweating profusely. My clothes were soaked and the fan was blowing on me. I was freezing and sweating but unable to move. I couldn''t get the phone on the table 12 inches away. I was very dizzy and if I moved my eyes everything was spinning.


VAERS ID: 1737313 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-05
Onset:2021-09-25
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Adverse event, 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series


VAERS ID: 1737362 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Insomnia, Pain
SMQs:, Neuroleptic malignant syndrome (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: Gabapentin, tramadol, ambien, crestor, doxyzosin, multi vitamins, calcuim supplement and probiotic supplement
Current Illness: vertigo
Preexisting Conditions: ckd stage 3, high blood pressure; small fiber neuropathy
Allergies: sulfa drugs, cipro, prednisone
Diagnostic Lab Data: didn''t go to doctor
CDC Split Type:

Write-up: 104.0 body temp with chills. Symptom started at 8 pm with chills. By 9 pm I went to bed with chills. Was awake all night with chills. At 5 a.m. I took my temp and it was 104.0. After struggling in bed for several more hours, I got up and took my temp and it was 103.5. I then took tylenol at 11 a.m. By 4 pm my temp was normal. It started going up again by 6 pm, up to 101, so I took tylenol again at that time. Temp has been hovering around 99.5 since then with moderate, and I would say expected, body aches.


VAERS ID: 1737370 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-29
Onset:2021-09-25
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series
CDC Split Type:

Write-up: None stated.


VAERS ID: 1737393 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-23
Onset:2021-09-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chills, Cough, Dizziness, Dizziness postural, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram ST segment elevation, Hypokinesia, Myocardial strain imaging, Myocarditis, Nausea, Pain, Pericarditis, Sinus tachycardia, Troponin increased, Vomiting, White blood cell count increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: None
Current Illness: None
Preexisting Conditions: Asthma Autism
Allergies: None
Diagnostic Lab Data: 09/25 EKG: ST elevation, sinus tachycardia 09/26 EKG: ST elevation now located in inferior leads and more elevated in lateral leads when compared to 09/25 EKG, normal sinus rhythm 09/26 Echo: All cardiac chambers normal size, Mild decreased left ventricular function with estimated 45% - 50% with mildly diffuse hypokinesis, global longitudinal strain is negative 09/25 Troponin: 1,338 with reference range of less than 12 is normal 09/25 CBC: WBC 10.91 (range 3.8-10.8) 09/25 Troponin: 1,381
CDC Split Type:

Write-up: The patient received the first dose of Pfizer COVID vaccine on 08/30/2021 and the 2nd dose on 09/23/2021. The patient presented to the emergency department on 09/25/2021 with complaints of chills, body aches, and chest discomfort since 09/24/2021. The patient also reported a cough, chest tightness relieved by leaning forward, 1 episode of vomitus, nausea, lightheaded and dizziness with standing. The patient was admitted, and is currently admitted at time of note. The patient was diagnosed with acute pericarditis and acute myocarditis.


VAERS ID: 1737419 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-25
Onset:2021-09-25
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (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: No
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dose was given too early after the previous dose.


VAERS ID: 1737430 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-21
Onset:2021-09-25
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 RA / IM

Administered by: Unknown       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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization for trauma and COVID positive on screening


VAERS ID: 1737436 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament 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: Aderral Lamictal Bupropion Xanax Cymbalta
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intense muscle pain in arms and legs still ongoing after 3 days, along with fatigue and joint pain.


VAERS ID: 1737437 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, Rash macular
SMQs:, Anaphylactic reaction (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium, vitamin D+K
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 24 hours after receiving my Covid booster shot, I started to get large red itchy blotches on my left back starting near the back of the armpit area to the top of my tailbone. The next day I also noticed both my wrists had the same red itchy blotches. I took some over the counter antihistamine and used topical hydrocortisone cream. On day three, the red blotches and itchy skin appear to be clearing up.


VAERS ID: 1737439 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-04
Onset:2021-09-25
   Days after vaccination:264
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic reaction, COVID-19, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (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? Yes
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: Hospitalization being treated for anaphylaxis and covid screening positive.


VAERS ID: 1737446 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Ear pain, Headache, Nausea, Peripheral swelling
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: 1st COVID vaccine she became real sick
Other Medications: fetanell, docsozoane,
Current Illness: cancer
Preexisting Conditions: cancer
Allergies: aspirin, penicillin, morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Her arm became swollen, her head hurts so bad til it is making her ear hurt, nausea and feel weak.


VAERS ID: 1737462 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-21
Onset:2021-09-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Catheterisation cardiac, Echocardiogram, Myocarditis, Stress cardiomyopathy, Troponin
SMQs:, Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (narrow), Other ischaemic heart disease (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? Yes
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: Trop Echo Cardiac Cath
CDC Split Type:

Write-up: Acute myocarditis vs stress induced cardiomyopathy 3 days after 3rd dose (booster dose) of Pfizer vaccine.


VAERS ID: 1737468 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Facial paralysis, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Sexual dysfunction (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: No
Current Illness: None
Preexisting Conditions: None
Allergies: Feathers
Diagnostic Lab Data:
CDC Split Type:

Write-up: Facial drooping/slight numbness on left side of face.


VAERS ID: 1737469 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-29
Onset:2021-09-25
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Exposure to SARS-CoV-2
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes
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: Hospitalization chest pain and dyspnea known exposure.


VAERS ID: 1737472 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E0155BA / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Dyspnoea, Laboratory test abnormal
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: 09/26/2021 went to the ER and was given abnormal results... had blood work done and has to have chest exam
CDC Split Type:

Write-up: Patient reported that she started having tightness in her chest and shortness of breath the next day after getting the vaccine...


VAERS ID: 1737473 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Patient received the vacation (2nd dose) around 8:40am on a Friday. By Saturday 4am, patient was throwing up and wife called EMS who diagnosed "non-epileptic seizures". On Sunday he still had some tingling sensation. I received the call from patient on Monday morning and patient was doing find. He had spoke to his PCP also.


VAERS ID: 1737491 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 301358A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Interchange of vaccine products, Product administered to patient of inappropriate age
SMQs:, Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Reporting that a 15 year old individual received both a Moderna and a Pfizer COVID-19 vaccine. This individual received Pfizer on 8/31/2021 and Moderna on 9/25/2021.


VAERS ID: 1737500 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-09
Onset:2021-09-25
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atelectasis, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Fibrin D dimer, Lung opacity, Pleural effusion, Pulmonary embolism
SMQs:, Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: Acetaminophen, acyclovir, aspirin, atorvastatin, calcium-vitamin D, gabapentin, metoprolol, mycophenolate, omeprazole, prednisone, tacrolimus
Current Illness: None
Preexisting Conditions: Hyperlipidemia, hypertension, CAD, Raynaud''s disease, sleep apnea, esophageal reflux, constipation, history of kidney transplant, history of prostate cancer, ED, arthritis, osteopenia, varicose veins, thrombocytosis, s/p splenectomy
Allergies: NKA
Diagnostic Lab Data: 9/26/21: D-dimer: 1100 Chest xray: new opacity left lower lobe CT angiogram: Small-moderate number of proximal subsegmental acute pulmonary emboli to the left lower lobe with some distal consolidative atelectasis and trace left effusion.
CDC Split Type:

Write-up: Pulmonary emboli 9/26/21


VAERS ID: 1737516 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-01
Onset:2021-09-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Public       Purchased by: ?
Symptoms: Chills, Extra dose administered, Migraine, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (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: Zoloft, Claritin, vitamin B and C
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bad migraines, fever, chills for the 72 hours after.


VAERS ID: 1737523 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Palpitations, Sleep disorder
SMQs:, Arrhythmia related investigations, signs and symptoms (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, Augmentin , cephalosporin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Every night since getting the vaccine I have not been able to sleep I am woken up to what feels like my heart racing I have taken my pulse during these moments and have had a pulse over 100 at resting, I have not seeked medical treatment yet due to looking on the internet and finding that this is said to have happened to other people. But if it continues I will be seeking a doctor to see what the recommendation would be.


VAERS ID: 1737563 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-20
Onset:2021-09-25
   Days after vaccination:248
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Exposure during pregnancy, Gestational hypertension, Induced labour
SMQs:, Hypertension (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized for induction of labor asymptomatic COVID 19 . Gestational hypertension, EDD 9/23/2021, Birth 9/26/2021, 40w3d gestational age, wt 3.63 kg.


VAERS ID: 1737582 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-01
Onset:2021-09-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Cough, Diarrhoea, Dizziness, Fatigue, Nasal congestion
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (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: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cold chills, stuffy nose, cough dizziness, tiredness, diarrhea,


VAERS ID: 1737584 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear infection, Fatigue, Headache, Oropharyngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Oral Lamisil 250mg once daily
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Saturday morning was incredibly fatigued, running 100 degree fever, constant headache. Ibuprofen helped but only marginally. As of Monday sept 27 fever has not receded without administering 600mg ibuprofen every 4 hrs. Throat is incredibly sore and beginning of ear infection in right ear. I was totally healthy before the shot.


VAERS ID: 1737587 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Deafness unilateral, Dizziness, Hypoaesthesia, Malaise, Musculoskeletal stiffness, Nausea, Pain, Paraesthesia, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (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: Pantoprazole 40mg, Letrozole 2.5mg
Current Illness: Acid refux
Preexisting Conditions: Breast Cancer
Allergies: Flomax, Taxol, Anastrozole , Alcohol,
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Five minutes after the vaccine I had a numbness from my arm that received the vaccine ( right arm ) , numbness traveled up to my brain, def in right ear ( still no hearing ) , stiff neck, stomach nausea , body aches, chills, fever, tingling in my right hand, weak and dizzy. Still having these issues currently and gets worse at night. Been taking Tylenol every four hours. I called doctor to inform her and never called back as of yet. I didn''t go to my primary Dr. because I was hoping these adverse effects would go away. It'' now two days after the vaccine and still feeling very sick.


VAERS ID: 1737640 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Fear, Malaise, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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: Shingrix-2nd; age:68; 04/20/''21. All the bad symptoms began ~ 6 hours $g jab: deep chills, headache; could only fall into bed sh
Other Medications: No.
Current Illness: No.
Preexisting Conditions: Small, transient psoriasis patches on one hand, opposite elbow & left outer ankle bone; clear now.
Allergies: Had a CNS-type reaction to penicillin, age: 17 Reactions to sulfa drugs & amocycilin (spelling, sorry, can''t leave page): Hives as a young adult. Food allergies: kiwi & other foods
Diagnostic Lab Data: No. Stayed home & rested & did hours of deep, slow breathing to try to calm my system. Recommended to report this.
CDC Split Type:

Write-up: Was fine until about 6.5 hours after the ''jab,'' when I started to feel unwell, general malaise & noticed my heart was pounding heavily; was scared & rested quietly but did not go to sleep -- too scared. It was late night; I live alone, did not want to drive to an urgent care facility somewhere ... felt mostly better after noon yesterday. Today, feel like I have been ''through something'' but progressively better & more ''like myself.'' Nothing I ate or did would have brought on heart & bp pounding like that. No reaction like that after Covid vaxes 1&2. Told I should report this.


VAERS ID: 1737816 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21A / 1 RA / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphonia, Arthralgia, Chest pain, Chills, Confusional state, Cough, Diarrhoea, Disorientation, Fatigue, Food craving, Hair disorder, Hyperphagia, Musculoskeletal pain, Oropharyngeal pain, Pain in extremity, Pain in jaw, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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: Moltrin
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: September 24, I recieved the shot at 11:30am, by 1:30pm, I craved sweets, and eating more than usual. By 3:40pm I was fatigued and with slight confusion. Later that night, I was disoriented. The morning of 9/25, top of my heads hair follicals were sensitive, jaw, left elbow, right wrist, left toes are in pain, and a sharp pain down the righ knee. The evening of 9/25, a soar throat developed, a runny nose, lost of voice, chills and pains on the left shoulder blade. The morning of 9/26, I developed diahrea in the morning which continued at the time of this writing. The eventing of 9/26, I developed a dry cough when I lay down flat however, it stops when I sit up. I have chest pains as a result of the coughs.


VAERS ID: 1737821 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Chest pain, Chills, Headache, Lymph node pain, Lymphadenopathy, Musculoskeletal chest pain, Neck pain, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Olmesartan medox/hctz 12.5mg Medformin
Current Illness: No
Preexisting Conditions: High blood pressure
Allergies: No
Diagnostic Lab Data: Lymphadenopathy
CDC Split Type:

Write-up: Enlarged and painful lymph node on left armpit. The size of a baseball on the second day after the 2nd dose of the COVID vaccine. The day after the vaccine I had Soreness to left neck, chest, arm and ribcage area. Chills and headache.


VAERS ID: 1738024 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Injection site rash, Injection site swelling, Injection site urticaria, Musculoskeletal stiffness, Rash erythematous, Rash pruritic, Wound
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (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: 2nd Pfizer covid-19 dose. February 2021, 43 years old
Other Medications: Multi vitamin, B12,vitamin C,folic acid,iron,
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Tomato,latex
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Extreme swelling and pain in and around the injection site. Stiffness and pain in the elbow of the arm of injection site. Red, burning extremely itchy rash/hives, spreading from the injection site over the upper arm down to the elbow. Still ongoing 3 days after injection. Open sore at injection site. Treating with topical and oral antihistamines, and antibacterial ointment.


VAERS ID: 1738025 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2388 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Extra dose administered, Induration, Pain in extremity, Skin warm, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Medication errors (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: Same type of event; 1st dose Pfizer-BioNTech COVID vaccine December 2020; age 27
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Local reaction - arm soreness; area of induration starting the size of a mosquito bite (day 0) spreading to size of softball (post-vaccine day 4); warm, erythematous; no effect on range of motion or function of arm; no systemic reaction


VAERS ID: 1738041 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetes, Hypertension , Cancer
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: blood pressure 209/107 9/25/21 @ 10:30am
CDC Split Type:

Write-up: Patient stated she was feeling dizzy approximately 15 minutes after immunization. Told patient to sit longer and offered water. Patient became increasingly dizzy then started getting short of breat. Took patients blood pressure which was 209/107. Offered to call 911 and patient accepted


VAERS ID: 1738043 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s wife called on 09/27/21 stating that patient''s arm is red, swollen, and a little bruised at the injection site but not itchy.


VAERS ID: 1738055 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Skin discolouration
SMQs:, Hypotonic-hyporesponsive episode (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: N/A
Current Illness: N/A
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient explained that within just hours of the vaccination administration she noticed the darkening of one of her toes. It continued to the color black and is continuing to move up the foot toward the ankle.


VAERS ID: 1738059 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Chills, Confusional state, Fatigue, Feeling abnormal, Headache, Injection site pain, Nausea, Pain, Pyrexia, Restlessness
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Saturday-headache, body felt like it was on fire, chills, aches and pains throughout, nausea, fatigue, site soreness, fever, restless. Sunday-headache, nausea, fatigue, brain fog Monday-tiredness, fatigue, confusion


VAERS ID: 1738068 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Headache, Lymphadenopathy, Malaise, Pain, Pain in extremity, Sleep disorder
SMQs:, Arthritis (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:
Other Medications: Hydrochlorothiazide 25mg, 1T po d Atenolol 50mg, 1T po d
Current Illness: Status post breast cancer, 12 years
Preexisting Conditions: High blood pressure
Allergies: None known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Entire arm sore, shoulder and elbow throbbing with pain. Underarm pit area swollen and sore. Severe headache interrupting and preventing sleep. Extreme malaise.


VAERS ID: 1738253 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: no adverse event, dose given 1 day per calendar days early, during the six months there are 4 months with 31 days and 1 month 28 days, technically given 2 days post 6 months if you are counting actual days.


VAERS ID: 1738258 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 2 RA / 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? 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: Pt called stating she has having increased swelling and redness at injection site since administration of her second Moderna vaccine on 9/25/21. Pt stated she has tried oral/topical Benadryl, Tylenol, and iced down the area. She stated she had a bit of swelling after the first vaccine, but it is worse this time. She also stated that she has an adhesive allergy and she took off the bandage sooner after the first vaccine than she did after the second vaccine. I advised that injection site swelling/redness are common side effects but recommended she follow-up with her pcp regarding this. I also recommended she try ibuprofen as well for pain/inflammation. I requested pt follow-up with us to let us know how she is doing, she stated she would.


VAERS ID: 1738263 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-25
Onset:2021-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site mass, Injection site pain, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: B12, D3
Current Illness: UTI
Preexisting Conditions: Heart disease
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Below injection-sore, lumpy, raised skin about the size of a golf ball or a little bigger but not raised that high.


VAERS ID: 1738272 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-16
Onset:2021-09-25
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Adderral, wellbutrin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Entire body is exhausted, non-stop muscle weakness, nothing helps


VAERS ID: 1738285 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-23
Onset:2021-09-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure via breast milk
SMQs:, Neonatal exposures via breast milk (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: Prenatal vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Breastfeeding infant had fever at 99-100.5 for 24 hours, extreme irritability/fussiness, decreased appetite and eczema flare up on ankles, wrists, bends of elbows and shoulders.


VAERS ID: 1738625 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin, vitamin c, zinc, vitamin d, elderberry, Claritin
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: 09/25 morning: Fever, headache, body ache, chills, sore throat, sore arm, arm rash, fatigue


VAERS ID: 1738632 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Cough, Dyspnoea, Epistaxis, Injection site swelling, Pyrexia
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (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: Fatigue and nosebleeds for two days
Other Medications: Carvedilol Amitryptaline Losartan Vitamin D Trulicity
Current Illness:
Preexisting Conditions: Diabetes High blood pressure
Allergies: Erythromycin Latex Nifedipine Claritin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme aches in all joints Swelling at injection site that continues to swell more even three days after injection High fever lasting three or more days Cough starting at day three after injection Repeated nosebleeds for first two days after injection Tightness in chest with difficulty breathing


VAERS ID: 1738634 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-22
Onset:2021-09-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Eye swelling, Hypoaesthesia, Muscle spasms, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (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: At 29 years old in August of 2019 I had the Hep A, Yellow Fever and another vaccine to which I cannot remember. Following those
Other Medications: Albuterol, Advair
Current Illness:
Preexisting Conditions: Asthma, psoriasis, eczema, endometriosis
Allergies: Food allergies including: bananas, avocados, fish, shellfish, pineapple, eggs, peanuts, tree nuts etc. The medication: Doxycycline
Diagnostic Lab Data: I reached out to my clinic and the on call doctor said ?if you are able to breathe there is no reason to go to the emergency room. If it gets worse go to urgent department
CDC Split Type:

Write-up: I have submitted a concern regarding the swelling of my eyes within 72 hours of receiving the Moderna vaccine but I have since had irregular numbing in my right cheek where my cheekbone is, irregular dizzy spells, and irregular swelling of my right hand and arm. I have also had muscle spasms in my right leg and thigh. I reported the eye swelling the day it started on Saturday. It is now Monday and it has continued to today.


VAERS ID: 1739741 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-16
Onset:2021-09-25
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypersensitivity, Pruritus, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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? 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: Severe allergic reaction developed 8 days after vaccination- severe hives all over body, face with swelling and itching


VAERS ID: 1740003 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-09-25
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: USJNJFOC20210950650

Write-up: SHAKING; BODY SORE FROM SHAKING; CHILLS; This spontaneous report received from a consumer concerned a 22 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, and batch number: 212A21A expiry: UNKNOWN) dose was not reported, administered on 25-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-SEP-2021, the patient experienced shaking. On 25-SEP-2021, the patient experienced body sore from shaking. On 25-SEP-2021, the patient experienced chills. The action taken with covid-19 vaccine was not applicable. The patient recovered from shaking, and chills on 25-SEP-2021, and the outcome of body sore from shaking was not reported. This report was non-serious.


VAERS ID: 1740556 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Injection site pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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)

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: Benazepril HCT, Fenofibrate, Lovastatin, Allopurinol
Current Illness:
Preexisting Conditions: Hypertension, Gout, Hypercholesteremia, Dedifferentiated Liposarcoma
Allergies: Tetracycline
Diagnostic Lab Data: none
CDC Split Type:

Write-up: vomiting, fever, chills, injection site pain


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