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From the 6/11/2021 release of VAERS data:

Found 352,386 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 101 out of 3,524

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VAERS ID: 1347131 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-20
Onset:2021-05-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / 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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Myocarditis


VAERS ID: 1347151 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: RASH ON BOTH ARMS, LEGS, SWELLING OF FEET


VAERS ID: 1347226 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Epistaxis, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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? 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: Bleeding from nose and large blood clots from nose, fever, chills


VAERS ID: 1347248 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Confusional state, Disorientation, Dizziness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: B-Complex 1 daily BD Nano 2nd Gen Pen Needle 32 gauge x 5/32" use 1 PEN NEEDLE to inject MEDICATION subcutaneously four times a day dilantin 100 mg caps Dilantin Extended 100 mg capsule take 2 capsules by mouth every morning and take 3
Current Illness: benign prostatic hyperplasia cerebral artery occlusion history of cardiovascular disease hyperlipidemia hypertensive disorder insomnia iron overload peripheral arterial occlusive disease Type 2 diabetes mellitus without complication
Preexisting Conditions:
Allergies: Levaquin
Diagnostic Lab Data:
CDC Split Type:

Write-up: admitted 1 day after moderna vaccine with dizziness, weakness, disorientation, confusion


VAERS ID: 1347256 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 50mg Viorelle Melatonin 3mg
Current Illness:
Preexisting Conditions: Fibromyalgia PCOS Hypermobile joint disorder
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Muscles aches, severe headache, and a fever of 101 f. Fever broke around six hours later. Muscle pain and headache also subsided gradually thereafter. No fever reducers were taken.


VAERS ID: 1347298 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Paraesthesia, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), 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: Systemic: swelling in both feet, burning sensation in both feet-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: patient reported that 48 hours following first dose she experienced swelling in both feet and a burning sensation in both feet. These symptoms have persisted for greater than 24 hours and have not subsided when reported at 4:42 pm 5/24/21


VAERS ID: 1347314 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Felt dizzy and like she would pass out Felt faint and nauseous and very sweaty. MOM noted she was obviously sweating and left wet marks from her arms on the table Did have a syncope episode


VAERS ID: 1347325 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-05-07
Onset:2021-05-23
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time abnormal, Anticoagulant therapy, Back pain, Catheter directed thrombolysis, Coagulation test abnormal, Deep vein thrombosis, Groin pain, Pain in extremity, Peripheral swelling, Protein S decreased, Renal vein thrombosis, Vena cava thrombosis
SMQs:, Cardiac failure (broad), Liver-related coagulation and bleeding disturbances (narrow), Angioedema (broad), Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Renovascular disorders (narrow), 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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Protein S is low. aPTT abnormal with abnormal mixing study suggesting possible lupus anticoagulant. Further tests pending.
CDC Split Type:

Write-up: Patient presented with one week of back, right leg and right groin pain. Right lower extremity swelling and was diagnosed with deep vein thrombosis from right popliteal vein into IVC involving a renal vein. He is on anticoagulation currently and going for catheter-directed thrombolysis today. Patient has been in hospital two days and hospitalization is ongoing at the time of this report.


VAERS ID: 1347330 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-19
Onset:2021-05-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Angina.
Allergies: Unknown,
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left arm pinky and ring finger are numb. Any pressure put onto the arm causes the numbness intensity to increase. Circulation doesn''t improve numbness, it''s always there at some level.


VAERS ID: 1347358 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-05-01
Onset:2021-05-23
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Swelling, pain, itching and bumpy skin st injection site


VAERS ID: 1347359 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Hip arthroplasty, Muscle spasms, Pain in extremity
SMQs:, Dystonia (broad), Osteoporosis/osteopenia (broad), Osteonecrosis (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt says she started having constant pain from her left leg from the knee to her hip along with muscle spasms that she has had for the past 3 days. She is taking ibuprofen and muscle rub. Pt will contact a doctor if her symptoms get worse.


VAERS ID: 1347391 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-13
Onset:2021-05-23
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, COVID-19, Chest pain, Chills, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Nausea, Rhinorrhoea, SARS-CoV-2 test positive, Surgery, Taste disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: surgery on 5/21/2021
Preexisting Conditions: Type 2 Diabetes Mellitus, Hypertension, Cardiovascular Disease
Allergies:
Diagnostic Lab Data: COVID-19 PCR test result of positive 05/24/2021
CDC Split Type:

Write-up: chills, muscle aches, runny nose, shortness of breath, difficulty breathing, chest pain, nausea, headache, fatigue, abdominal pain, diarrhea, new olfactory or taste disorder


VAERS ID: 1347412 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-20
Onset:2021-05-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Catheterisation cardiac, Chest pain, Troponin
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cymbalta
Current Illness: none
Preexisting Conditions: Fibromyalgia
Allergies: Sudafed Prednisone
Diagnostic Lab Data: Troponin Left Heart Catheterization
CDC Split Type:

Write-up: chest pain


VAERS ID: 1347457 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Lymphadenopathy, Nausea, Pyrexia
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)

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: Had a bad fever, headache, chills and nausea the day after I got the vaccine. Then the next day, my lymph nodes on my underarms were swollen.


VAERS ID: 1347500 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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: Multivitamin, probiotic, fish oil, magnesium/minerals
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness and vertigo


VAERS ID: 1347532 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dermatitis acneiform, Rash
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: bipolar
Allergies: nka
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient grandmother called pharmacy on Tuesday (05/25/2021) that pt has developed rash on his chest and back after getting the J$J covid 19 vaccine on Friday (05/21/2021). The rash appeared on Sunday, two days after the shot was given. Rash is not itchy or painfull. Pt''s grandmother reported AE to v-safe. Patient''s grandfather is a pharmacist. Patient was consulted that he needs to call primary doctor ASAP to rule out other causes. Patient was given J&J contact information. Patient stated that he will call MD, also, he did not start any new medication or new detergent or did not change food or lifestyle in the past weeks. Patient''s primary provider is DR. was called by pharmacist.


VAERS ID: 1347537 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Alanine aminotransferase normal, Aspartate aminotransferase increased, Blood creatine phosphokinase MB increased, Blood creatine phosphokinase increased, C-reactive protein increased, Chest pain, Cytomegalovirus test negative, Echocardiogram abnormal, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Enterovirus test negative, Epstein-Barr virus antibody negative, Headache, Hepatic enzyme increased, Immunoglobulin therapy, N-terminal prohormone brain natriuretic peptide increased, Pain, Painful respiration, Parvovirus B19 test, Pericardial effusion, Pyrexia, SARS-CoV-2 test negative, Troponin increased, Ventricular hypokinesia, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), COVID-19 (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None listed on EMR
Current Illness: None
Preexisting Conditions: None
Allergies: Latex
Diagnostic Lab Data: From our facility: Enterovirus PCR Blood (5/24/21) = negative Adenovirus PCR Blood (5/24/21) = negative CMV IgG and IgM (5/24/21) = both negative SARS CoV2 PCR (5/24/21) = negative Parvo19 PCR Blood (5/24/21) = pending EBV serologies (5/24/21) = indicative of past infection (positive EBNA, negative VCA IgM and IgG) Troponin = 21.1 ng/L (5/23/21), 47.9 (5/24/21), 12.7 (5/25/21) CK = 552 u/L (5/23/21); 979 (5/24/21), 247 (5/25/21) NT pro BNP = 357 pg/mL (5/23/21); 502 (5/24/21) AST = 228 u/L (5/24/21); 126 (5/25/21) ALT = 46 U/L (5/23/21); 45 (5/25/21) CRP = 3.2 mg/dL (5/24/21) WBC = 2.75 x10(3) (5/25/21)
CDC Split Type:

Write-up: Patient received 2nd Pfizer COVID vaccine on 5/21/21. He had fever and headache for about 24-36 hours, which he had also had after the first dose of the vaccine. On 5/23, he woke up with constant substernal chest pain, which worsened with exertion and deep inspiration. The pain increased throughout the day. In the ED, he was found to have elevated troponin ,CK-MB, elevated CPK, and elevated liver enzymes. EKG was concerning for ST elevation initially. Bedside echocardiogram showed low-normal function, normal coronaries, trace effusion, and no evidence of RV strain. Troponin and NT pro BNP were increased upon admission to our facility. Repeat ECHO showed borderline global hypokinesis of the LV with an LVEF of 51%. He received IVIG on 5/24/21 and also was started on ketorolac on 5/24/21. Troponin and CK were trending downwards at the time of this submission.


VAERS ID: 1347540 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
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: n/a
Current Illness: NONE REPORTED
Preexisting Conditions: NONE REPORTED
Allergies: NONE REPORTED
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient''s Mom claimed her son was 12 years old. Ins rejected, said they have different DOB. Mom said that is wrong, she will call insurance to correct dob. Next morning Mom left a voicemail, said she found her son''s birth certificate, and she was mistaken, which makes him 11 and too young for the pfizer covid shot, which is approved for 12 and up. I cancelled patient''s 2nd appt, left the Mom a message explaining he is too young, he should not have received the first vaccine, and I cancelled appt for 2nd dose. No adverse effects have been reported, I am reporting this because of his age.


VAERS ID: 1347548 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-01
Onset:2021-05-23
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Musculoskeletal stiffness, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (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: Sertraline 50 mg Claritin Mirena IUD
Current Illness:
Preexisting Conditions:
Allergies: Egg whites
Diagnostic Lab Data: 5/21/21 5/25/21
CDC Split Type:

Write-up: Fever, chills,stiffness, nausea, diarrhea, headache


VAERS ID: 1347561 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Cyanosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Hypertension (narrow), Hypotonic-hyporesponsive episode (broad)

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

Write-up: Minutes after getting 2nd dose of moderna patient complained of his fingers turning purple. Pharmacist on duty checked patients blood pressure several times which was slightly elevated. Patient complained of no other adverse effects. The color of patient''s fingers turned normal once hands were raised but returned to dark purple color when patient put them down. Pharmacist on duty place a call to 911 and was advised by paramedics to monitor patient closely for worsening of symptoms (over 30 minutes). After over 45 minutes patient was advised to follow up with immidiate care provider (walking distance). Few hours after pharmacist on duty reached out to patient to follow up and at that time patient was already evaluated in ER and sent home in stable condition.


VAERS ID: 1347622 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (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: Ondansetron
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 24-48 hours (besides the instantaneous soreness) it became itchy and really warm/sore to the touch at the injection site. I believe this is called "Covid Arm" and I just wanted to report my case.


VAERS ID: 1347657 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Presyncope
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions:
Allergies: Not on file
Diagnostic Lab Data:
CDC Split Type:

Write-up: The vasovagal episode almost immediately after vaccination. The patient reports that this happens with most needles and anytime blood is drawn. At the time of my arrival, he is drinking juice and reports he is feeling at his baseline. No further intervention required.


VAERS ID: 1347691 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injected limb mobility decreased, Injection site warmth, Lymphadenopathy, Pain in extremity, Pyrexia, Tenderness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies: Naproxen, Amoxicillin, Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5/21/2021 - 2nd dose administered. 6 hours later was exhausted, slept for 24 hours, slight fever, right arm sore and tender to the touch. 5/23/2021 - oh mama! axillary lymph nodes swelled to I don''t know how many times the size. Kids, this was a noticeable difference, like mini side boob difference, I should have taken a pic. injection sight was hot to the touch, I couldn''t rotate my arm at the shoulder, anything above shoulder height really hurt. 5/24/2021 - Swelling in my nodes has gone down considerably, regained most of my mobility, injection site tender but not painful. 5/25/2021 - no more swelling, regained full movement in arm, no tenderness at injection site. hope this helps, it was a wild ride and I''m glad I''m done with that. Thanks for the vaccine!


VAERS ID: 1347731 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Injection site pain, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Vicoden
Diagnostic Lab Data:
CDC Split Type:

Write-up: Minor headache started almost immediately. About 12 hours later, began experiencing muscle pain, joint pain, chills, nausea and fever. These symptoms lasted at least until 10:00pm the next day. Headache still persisted, even two days after other symptoms went away. There was pain and swelling at the injection site which started about 12 hours after the injection. Both persist at least two days after the injection


VAERS ID: 1347744 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: UNKNOWN
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient was underage to get Pfzier COVID-19 VACCINE by three months.


VAERS ID: 1347785 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-23
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Alanine aminotransferase normal, Anticoagulant therapy, Aspartate aminotransferase normal, Blood bicarbonate decreased, Blood bilirubin normal, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood urea increased, Cardiac telemetry, Computerised tomogram abdomen abnormal, Computerised tomogram pelvis abnormal, Flank pain, Haemoglobin normal, Lipase normal, Platelet count normal, Renal infarct, Ultrasound Doppler, Ultrasound scan, Urine analysis normal, White blood cell count normal
SMQs:, Acute renal failure (broad), Acute pancreatitis (broad), Lactic acidosis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Renovascular disorders (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Balsalazide 750 mg 3 capsules t.i.d. Simvastatin 10 mg daily.
Current Illness:
Preexisting Conditions: Ulcerative colitis Hyperlipidemia
Allergies: NKA
Diagnostic Lab Data: CT abdomen and pelvis as described above UA negative White count is 9, hemoglobin 15, platelets of 203. Sodium 136, potassium 4, chloride 103, bicarb 27, BUN 25, creatinine 1.1, glucose of 108. T bili 0.6, AST 21, ALT 15, and lipase of 71.
CDC Split Type:

Write-up: A 57-year-old man with hyperlipidemia and ulcerative colitis presenting with acute abdominal pain that wrapped around his left flank region on the morning of admission without any associated nausea, vomiting. Pain lasted for approximately 1 hour. No associated N/V, hematuria. CT abdomen and pelvis showing multiple wedge-shaped areas of cortical medullary hypo density in the left lateral kidney suspicious for renal infarct. No history of hypercoagulable state or family history of this. Patient was admitted to the hospital for US, doppler, monitoring on telemetry. Started on anticoagulation.


VAERS ID: 1347794 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-04-25
Onset:2021-05-23
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ascites
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: THE PATIENT WAS ADMITTED TO HOSPITAL WITH FLUID AROUND SOME OF HIS MAJOR ORGANS ABOUT 3 WEEKS AFTER THE FIRST DOSE OF MODERNA


VAERS ID: 1347797 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Immediate post-injection reaction, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Seizure at the time of vaccination. Mother in the car and recorded. Known history of seizures and they will follow up with an epileptologist. They are comfortable going home as this happened after the nasal swab as well and they suspected this would happen today. No further information needed today.


VAERS ID: 1347805 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dysphagia, Laboratory test, Lip swelling, Pharyngeal swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Lab work is negative for acute findings.
CDC Split Type:

Write-up: Patient with swelling to left side of lip, throat, and difficulty swallowing after receiving covid-19 vaccine . Pt had vaccine on 5/22/ 2021(Saturday) and had delayed reaction on 5/23/2021 (Sunday). Pt treated in ED with Sodium Chloride 0.9 % IV Bolus, diphenhydrAMINE Inj 25 mg (BENADRYL), Famotidine (PF) Inj 20 mg (PEPCID, methylPREDNISolone Sod Succ (PF) Inj 125 mg (SOLU-Medrol PF).


VAERS ID: 1347811 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram normal, Anticoagulant therapy, Back pain, Chest X-ray normal, Chest pain, Chills, Electrocardiogram, Fatigue, Inflammation, Myocardial necrosis marker increased, Pain, Pain in extremity, Pericarditis, Pyrexia, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Magnesium 250mg aspirin 81 mg omega 3 360 mg
Current Illness: No known illnesses
Preexisting Conditions: No known long standing health conditions.
Allergies: No known allergies
Diagnostic Lab Data: blood draws-05/24 (troponins: positive .12 to .67) and 05/25/21 ecg-05/24 and 05/25/21 (results pending) chest x-ray-05/24/21 (lungs clear, heart and vasculature normal) angiogram-05/24/21 (no obstructive blockages)
CDC Split Type:

Write-up: Friday after the shot was good, just a sore arm. On Saturday I developed a fever of 101 and chills and was very tired. I felt a little better on Saturday night and Sunday morning after some Tylenol 500 mg. My fever would break then come back for a bit By Sunday afternoon my back began to really hurt. I have some chronic back pain so didn''t think too much of it just tried to massage it and stretch it out. However it just kept getting worse and the pain radiated into my chest around 9:00 PM Sunday night. It continued to get worse until about midnight, and I ultimately decided to go to the ER. The tylenol helped reduce the pain by the time I got into the ER but I went in anyway because I was concerned about the intensity of the chest pain I''d had earlier. I was tested for heart enzymes and they were slightly elevated, at .12. On this result, I was admitted to the hospital on suspicion of having suffered a heart attack. I was put on a heparin drip and my troponin levels were tested every 3 hours. They continued to rise to a high of .67. More testing was done, and the cardiology department concluded that I had not suffered a heart attack due to the low troponin levels but that instead I was dealing with heart inflammation. Every doctor and nurse there commented that there had been other patients coming in with cardiac inflammation from vaccines as well. Due to my family history of heart issues and my own existing risks, I was moved to the hospital where I was examined in the cath lab via angiogram. This found no blockages in my arteries, further confirming the cardiology suspicion of cardiac inflammation, and I was given a diagnosis of pericarditis and prescribed colchicine to treat the inflammation.


VAERS ID: 1347821 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Product administered to patient of inappropriate age
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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: vaccine was given to person under age 18. she has only headaches a few days after vaccine was given.


VAERS ID: 1347902 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gingival erosion
SMQs:, Gingival disorders (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: abilify 15 mg, alprazolam 1 mg, norgestimate ethynl Estridiol USP, famotidine 20 mg
Current Illness: none
Preexisting Conditions:
Allergies: apricots, seasonal allergies.
Diagnostic Lab Data: Going to the dentist on May 27, 2021.
CDC Split Type:

Write-up: Serious gum line erosion on TWO top left front incisors. Both approximately 2 millimeters of gum line disappeared.


VAERS ID: 1347926 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Pain, Pyrexia, Skin sensitisation
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Sleep apnea
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, aches, fever-ish, tiredness, skin sensitivity


VAERS ID: 1348048 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-20
Onset:2021-05-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flouxetine 40mg
Current Illness: None
Preexisting Conditions: None
Allergies: Benzaclin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tightness in chest 3 days after first injection. Mild difficulty breathing.


VAERS ID: 1348083 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Headache, Injection site swelling, Mobility decreased
SMQs:, Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor,eliquist,Effector,calcium,iron ,mutivitamin,b1,vitaminD,prazosin, latuda and valacyclovir
Current Illness: Anemia,blood clot had total hip replacement
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Didn''t go to dr just took extra strength Tylenol and my oxycodone pain killers
CDC Split Type:

Write-up: Injection site very swollen, very bad headaches for 2 days couldn''t get out of bed very bad


VAERS ID: 1348089 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Nausea, Pain, Pyrexia, Vaccination complication
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)

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: large (2 inch diameter) swelling as site of flu vaccine, 2015 at 63 years.
Other Medications: pravastatin tamoxifin levothyroxin metopotol magnesium D baby aspirin condriton
Current Illness:
Preexisting Conditions:
Allergies: wheat
Diagnostic Lab Data:
CDC Split Type:

Write-up: After both shots, experienced body aches, chills, mild fever, intense tiredness, "covid arm" - red, feverish, slightly swollen about 4 inches in diameter around injection site. After first shot also experienced nausea and intense headache.


VAERS ID: 1348286 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-20
Onset:2021-05-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: Left arm numbness


VAERS ID: 1348329 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: 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: Dupixent (Dupilumab), every 2 weeks
Current Illness:
Preexisting Conditions: Nasal Polyps
Allergies: Shellfish, dust mites, birch.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lymph node under armpit of left arm (same arm as vaccine shot)


VAERS ID: 1348617 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-04
Onset:2021-05-23
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram normal, Hemiplegia, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (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: Insulin, rapid acting humalog
Current Illness: Type 1 diabetic
Preexisting Conditions: T1 Diabetic
Allergies: none
Diagnostic Lab Data: CAT scan showed no stroke and healthy brain tissue.
CDC Split Type:

Write-up: Developed Bell''s Paulsy with mild symptoms presenting 15 days after 2nd dose. (5/19) Went to ER, but eye droop and numbness subsided. Awoke 5/23 with full numbness on left side of face and went to ER. Left side entirely numb unresponsive/paralyzed from hair line down through tongue/gum. Started Prednisone 60mg daily and antiviral; both for 7-days.


VAERS ID: 1348618 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Axillary pain, Back pain, Chest pain, Chills, Fatigue, Headache, Injection site mass, Mobility decreased, Pain, Pain in extremity, Peripheral swelling, Pyrexia, Sinus disorder, Skin warm
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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: Synthroid, cymbolta, ambein ,vitamins
Current Illness: Had Tested positive for covid April 8th , 2021
Preexisting Conditions: Migraines, celiac ,
Allergies: Gluten , wheat , barley, rye, some oats, sulfa drugs, welding , soldering etc
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lump in my left arm spreading from injection, heat and severe pain in my left arm and armpit - can''t hardley move arm or close hands - fingers , severe swelling . Fever , chills, body aches, body weakness, severe headache, back ache , severe fatigue and not being able to function. Chest hurts and sinuses bothering me .


VAERS ID: 1348628 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oral herpes
SMQs:, Oropharyngeal infections (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: She had a sore throat for a couple of days about 2 weeks before getting the vaccine.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Developed a fever blister on her lip within 24 hours of receiving the vaccine.


VAERS ID: 1348641 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-13
Onset:2021-05-23
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Acoustic stimulation tests abnormal, Deafness neurosensory, Deafness unilateral
SMQs:, Hearing impairment (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: Omeprazole 20mg daily Allopurinol 300mg daily
Current Illness:
Preexisting Conditions: Gout, bradycardia
Allergies:
Diagnostic Lab Data: Date: 5/25/2021 Results: Normal hearing with mild sensorineural hearing loss at 6000 Hz on the right and severe rising to mild sensorineural hearing loss on the left. Speech reception threshold on the right was 10 dB with word recognition score of 100%. On the left, speech reception threshold was 65 dB with word recognition score of 16%. Tympanogram is Type A bilaterally and acoustic reflexes are absent left.
CDC Split Type:

Write-up: Hearing loss in left ear


VAERS ID: 1348646 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Diarrhoea, Fatigue, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Same reaction to first dose of COVID Pfizer
Other Medications: Lisinipril Gabapentin
Current Illness: None, however was positive for COVID Jan 25,2021 and received monoclonal antibodies
Preexisting Conditions: Chronic kidney disease
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, muscle aches, joint pain, fever, chills, diarrhea


VAERS ID: 1348649 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-18
Onset:2021-05-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash, Rash, Rash pruritic
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: I did not take him to the doctor. From the research that I did on the internet, the rash should go away and shouldn?t keep him from being able to receive his next dose. If the rash doesn?t resolve in the next two to three days, I will take him to the doctor.
CDC Split Type:

Write-up: Several days after receiving the first Covid vaccine dose, developed a rash. The rash presented on both of his upper arms and both thighs. The rash was more pronounced near the injection site on his left arm. The bumps looked like small raised pimples without pus. They itched.


VAERS ID: 1348873 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Injection site pain, Muscle twitching, Tinnitus
SMQs:, Dementia (broad), Dyskinesia (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Hearing impairment (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: Bupropion
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: TINNITUS bilateral, loud, persistent Joint soreness Foggy thinking Pain at injection site Headache Weird twinges all over body randomly


VAERS ID: 1349043 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-23
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544922

Write-up: MUSCLE ACHES; FATIGUE; This spontaneous report received from a patient concerned a 70 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: 23-JUN-2021) dose was not reported, administered on 22-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-MAY-2021, the subject experienced muscle aches. On 23-MAY-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from muscle aches, and fatigue. This report was non-serious.


VAERS ID: 1349437 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Decreased appetite, Fatigue, Feeling abnormal, Hot flush, Injection site swelling, Nausea
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Thalassemia, ADHD, Eczema
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling at injection site, fatigue, nausea, chills, hot flashes, mental fog, upset stomach and trouble with appetite for 2-3 days.


VAERS ID: 1349772 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-01
Onset:2021-05-23
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

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

Write-up: Hives and itchy rash all over body 8 days after vaccination. They come and go throughout the day. I have not changed anything in my daily life.


VAERS ID: 1350296 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye disorder, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Corneal disorders (broad), Retinal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin, atorvastatin 30mg, aspirin 80mg, vitamins B, C, D, Magnesium, medical cannabis
Current Illness: None
Preexisting Conditions: Breast cancer, heart palpitations
Allergies: Seasonal
Diagnostic Lab Data:
CDC Split Type:

Write-up: Facial numbness and slight drooping of eyes occurred about an hour after receiving the vaccine. It has gone almost back to normal as of today 5/26/21.


VAERS ID: 1350312 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Presyncope
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pulse 92 Respirations 16 SPO2 99% BP 108/62 (Repeat at 4:45pm 102/60) Exam normal
CDC Split Type:

Write-up: Vasovagal reaction 7mins after vaccine administration Patient laid on the floor and water was provided At 4;47pm, patient felt much better, symptoms resolved Discharged to home


VAERS ID: 1350356 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-17
Onset:2021-05-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Conjunctival haemorrhage, Exposure during pregnancy, Second trimester pregnancy
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Conjunctival disorders (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (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: Pre-Natal Vitamins
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillen
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt is in second trimester of pregnancy- Due date 09/2021. Came to my office 1 week after receiving COVID vaccine with bilateral sub-conjunctival hemorrhages


VAERS ID: 1350358 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Hypotension, Loss of consciousness, Nausea, Pallor, Seizure like phenomena, Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? 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: Fainting / Unresponsive-Severe, Systemic: Hypotension-Severe, Systemic: Nausea-Medium, Systemic: Shakiness-Medium, Systemic: Weakness-Severe, Additional Details: within minute of injection patient passed out, parent and witness said patient had seizure like shaking (I did not personally witness this), became extremely pale and non-responsive for few minutes. Before shot given Mom informed me patient normally faints and has extreme anxiety and aversion to needles.


VAERS ID: 1350370 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH GWO78 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthropathy, Fatigue, Headache, Pain
SMQs:, Arthritis (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: 4 and 9, became ill with the flu, unknown brand flu vaccine, hospitalized both times, fever of 105, consistent diarrhea and vomi
Other Medications: Zoloft (125 mg), Ritalin (10 mg(
Current Illness:
Preexisting Conditions: Chronic Fatigue Syndrome, P.O.T.S, A.D.H.D, depression, anxiety
Allergies: Pollen, grass
Diagnostic Lab Data:
CDC Split Type:

Write-up: - severe aching - headaches - fatigue - joints popping out of sockets


VAERS ID: 1350415 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-16
Onset:2021-05-23
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 - / -

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

Write-up: Patient hospitalized due to COVID-19 after being fully vaccinated. Tested positive on 5/23/2021


VAERS ID: 1350441 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Hyperhidrosis, Injection site swelling, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna #1 injection site reaction
Other Medications: Tylenol, carvedilol, lisinopril, and myrbetriq
Current Illness:
Preexisting Conditions: heart failure, cardiomyopathy, HTN, sleep apnea
Allergies: No know allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received initial Moderna vaccine on 4/21/2021 and had injection site reaction of Left upper arm (erythema and induration about size of soft ball) start 4 to 5 days later and resolved 4-5 days later. She then got the second Moderna vaccine Sat 5/22/2021 in the same arm and the following morning developed nausea, vomiting, diarrhea, fever, and diaphoresis. Her left arm developed injection site reaction starting small and then size of 2 baseballs put together.


VAERS ID: 1350485 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pulse: 70 bpm SPO2: 99% B/P: 77/44 at 2:07 pm. Repeat (86/52 at 02:40 pm not dizzy anymore). Repeat(105/60, pulse 61, SPO2: 100% at 03:04 pm)
CDC Split Type:

Write-up: AE: Syncope Tx: no medication given, monitored symptoms and checked vitals. Juice and water resolved the symptoms Outcome: Patient was discharged to POV/Home.


VAERS ID: 1350500 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK RA / UN

Administered by: Public       Purchased by: ?
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (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:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No medical treatments received
CDC Split Type:

Write-up: Bilateral leg edema was observed on Sunday evening 5/23/2021 at approximately 6:30PM and still present at this time of filling.


VAERS ID: 1350528 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-19
Onset:2021-05-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concerta 27mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Broke out in full body hives. Took her to Dr. And they prescribed steroids and strong antihistamines


VAERS ID: 1350566 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Decreased appetite, Dyspnoea, Fatigue, Headache, Malaise, Oropharyngeal pain, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? No
Previous Vaccinations:
Other Medications: Levothyroxin, zinc, D3, low dose amLodipine, Bystolic 5 mg
Current Illness: None
Preexisting Conditions: Autoimmune thyroiditis, hypertension controlled with low dose meds
Allergies: Sulfa, penicillin
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Severe headache that has been ongoing since 5/23/2021. Also, Covid- like symptoms such as sore throat, coughing, chills, congestion, anorexia, fatigue, shortness of breath, and general malaise. Symptoms are significant at day 5 after shot.


VAERS ID: 1350587 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Lethargy, Listless, Sinus congestion, Upper-airway cough syndrome
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (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: developed small skin sore after shingles vaccine
Other Medications: none
Current Illness: none
Preexisting Conditions: Heart Disease, COPD, Overweight, High Blood Pressure, High Cholesterol
Allergies: penicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Lethargy & tiredness, post-nasal drip and sinus congestion, felt generally listless.


VAERS ID: 1350628 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-10
Onset:2021-05-23
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (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: None
Allergies: Antihistamine Amoxicillin Acetaminophen
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Random nose bleeds for 3 days straight starting 5/23/21


VAERS ID: 1350672 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Injection site pain, Injection site warmth, Pain, Pyrexia, Rash erythematous, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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: Labetalol, Terbinafine
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, fever, body aches, raised red rash around injection site (about 2" in height and 6-7" wide that becomes itchy on the 3rd day of having it. Painful when touched on injection site and warm to the touch on rash)


VAERS ID: 1350709 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, C-reactive protein increased, Chest pain, Echocardiogram normal, Electrocardiogram ST segment elevation, Fibrin D dimer normal, Haemoglobin increased, Pain in jaw, Palpitations, Platelet count normal, Red blood cell sedimentation rate normal, Tachycardia, Troponin increased, White blood cell count normal
SMQs:, Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None, took two baby aspirin after onset of symptoms
Current Illness: None, otherwise healthy
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: At the ED (5/25), he was found to b be intermittently tachycardic, his EKG had diffuse ST elevation, and his troponin was found to be 15.5. He was then transferred to Hospital the morning of 5/26 for concern for peri/myocarditis. At ED he was still found to have intermittent tachycardia, which he felt as heart racing, though without chest pain. His troponin was increasing to 17 on admission. EKG with diffuse ST elevation. Initial ECHO with normal function. WBC normal at 6.76 kcl/mL. Hb high 16.4 gm/dL, platelets low at 163 k/mcl. ESR normal 6, D-Dimer normal < 0.27. CRP elevated at 3.14 mg/dL. BNP normal 581. Troponin 17. He is now being admitted to the hospital today for further monitoring.
CDC Split Type:

Write-up: Patient developed racing heart rate ~18 hours after his vaccine at 5 am the next morning. The racing heart rate was associated with L sided jaw pain. His family gave him 81 mg aspirin x 2 but later that day his heart racing was continuing and he developed mild chest pain, prompting him to go to ED.


VAERS ID: 1350743 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-19
Onset:2021-05-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

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

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

Write-up: Pt developed classic shingles 3 days after first dose.


VAERS ID: 1350750 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Vaccine was given to the recipient who was 17 years and 8 months old.


VAERS ID: 1350767 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Dyspnoea, Fatigue, Malaise, Oropharyngeal pain, Palpitations, Productive cough, Pyrexia, Respiratory tract congestion, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: fluoxetine 40mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Haven''t done any yet, but will if she''s not better soon.
CDC Split Type:

Write-up: The day after my daughter received her vaccine, she began to feel congested and tired. This was on Sunday, May 23. We got up for school on Monday, May 24, but she was complaining about a really bad sore throat. The school nurse called and I picked her up from school because she was also getting more congested. She began to cough and sneeze constantly and took a long nap. When she woke, she was saying that she was getting short of breath and it felt like her heart was racing, even though she was just sitting. The next day her throat felt better, but the congestion was the same - still coughing and sneezing but her shortness of breath started getting more obvious. I emailed her pediatrician to ask about bringing her in, and they said to report this to the CDC and bring her if if she''s not better in the next few days. Today is Wednesday, May 26 and she is still congested, short of breath and overall feels lousy. She is coughing up lots of mucus - greenish and thick. Yuck. I just gave her one pill of a mucus reducer to see if that would help. My biggest worry is about the shortness of breath because that is exactly what I experienced after my first dose of the vaccine. Mine was Moderna and I have seen dr''s about it - and actually ended up in the hospital, but they do not believe it to be connected to the vaccine. I will contact them and let them know about my daughter''s shortness of breath and perhaps they will think differently. Oh, she''s had a slight fever of 99 F on occasions during this.


VAERS ID: 1350796 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 LA / IM

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

Write-up: No adverse event, patient previously received their first dose Moderna on 4/25/21. This is their second dose.


VAERS ID: 1350810 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Injection site pain, Myofascial pain syndrome, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: none that aren''t listed on manufacturer''s side effects
Other Medications: Vitamin D, vitamin C, vitamin E, famotidine, citalopram, loratadine
Current Illness: None
Preexisting Conditions: IBS, myofascial pain syndrome, asthma, dysthymia
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Low-grade fever starting at hour 12 and lasting over 24 hours. Soreness at the injection site lasting over 48 hours. Exacerbation of chronic myofascial pain syndrome starting at hour seven and lasting over 24 hours.


VAERS ID: 1350856 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-29
Onset:2021-05-23
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 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? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: Stage 3a chronic kidney disease 12/4/20 Type 2 diabetes mellitus with stage 3a chronic kidney disease, without long-term current use of insulin 12/4/20 Benign hypertension with CKD (chronic kidney disease) stage III 12/4/20 Hypertension goal BP (blood pressure) < 130/80 12/4/20 Asthma, well controlled 8/12/20 Seasonal allergies 8/12/20 Kidney stone 8/12/20
Allergies: NA
Diagnostic Lab Data: 05/23/2021
CDC Split Type:

Write-up: Patient infected with COVID-19 after being fully vaccinated.


VAERS ID: 1350860 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Rash on my left arm where vaccine was injected.


VAERS ID: 1350873 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-16
Onset:2021-05-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Axillary pain, Back pain, Dizziness, Feeling abnormal, Headache, Loss of personal independence in daily activities, Nausea, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)

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

Write-up: Severe headache and body aches- not relieved by Max dose of OTC Tylenol, ibuprofen or codeine.- 2 days (L)Axilla pain and swelling onset 12 hrs later- still present day 4 Back pain day 1 to present Dizziness and nausea, feeling "off" still persists and interferes with daily function day 4


VAERS ID: 1350998 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-05-23
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Myalgia, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ascorbic acid, vitamin C, (VITAMIN C) 500 mg tablet b complex vitamins capsule ergocalciferol (VITAMIN D2) 1,250 mcg (50,000 unit) capsule(Expired) Lactobacillus acidoph-L.bulgar (FLORANEX) 1 million cell tablet meloxicam (MOBIC) 15 mg tabl
Current Illness:
Preexisting Conditions: Nervous Pain, joint, multiple sites Digestive Gastroesophageal reflux disease without esophagitis
Allergies: NKA
Diagnostic Lab Data: 05/23/21 1910 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/23/21 0845 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: Muscle or body aches Congestion or running nose CLOSE CONTACT


VAERS ID: 1350999 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-29
Onset:2021-05-23
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Rash
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine, mvi
Current Illness: none
Preexisting Conditions: hypothyroid
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: rash, full body


VAERS ID: 1351002 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-19
Onset:2021-05-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram normal, Heart rate increased, Palpitations, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol, Fluticasone, Montelukast, Cetirizine, Omeprazole
Current Illness: Asthma, Obesity (BMI $g99%tile), Allergic Rhinitis
Preexisting Conditions: Asthma, Obesity
Allergies: None
Diagnostic Lab Data: EKG - normal sinus Troponin = 3.32
CDC Split Type:

Write-up: Rapid heart rate, Chest pain, Palpitations


VAERS ID: 1351043 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Bone pain, Decreased appetite, Headache, Pain
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Osteonecrosis (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: Morphine 60mg BID MSIR 15mg QID Baclofen 20mg TID Amlodipine 25mg QHS Spironolactone AM Finasteride 5mg AM Carvedilol 6.25mg BID Pantoprazole 40mg BID
Current Illness:
Preexisting Conditions: HTN, gun shot, amputee left leg, abscess 2016-2018
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache not relieved by Ibuprofen 800mg and BC powder, body achy and bones hurt, sick to his stomach (wanting to throw up), loss of appetite. Patient reports he has taken: Pain killers Ibuprofen 800mg TID, BC powder once or twice a day.


VAERS ID: 1351095 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Hot flush, Migraine, Pain
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: body aches/pains after 1st moderna covid vaccine
Other Medications: Birth control pills
Current Illness: none known
Preexisting Conditions: none known
Allergies: nkda
Diagnostic Lab Data: none
CDC Split Type:

Write-up: okay on day 1. 2nd day sore and tired, 3rd day fatique and tired, 4th day hot flashes, dizzy, light headed, 5th day-migraine and achy.


VAERS ID: 1351187 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ERVO 168 / 2 LA / SYR

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

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

Write-up: Irregular rash/hives on torso, groin, inside of right elbow. Left eyelid, left side of my neck, inner thighs


VAERS ID: 1351192 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Echocardiogram normal, Electrocardiogram normal, Full blood count normal, Metabolic function test normal, Myocarditis, Troponin
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: CBC 5/25: WNL CMP 5/25: CRP 1.1, otherwise WNL Troponin: - 5/25: 1779 - 5/25: 2903 - 5/26: 1719 EKG 5/25, 5/26: normal sinus Echocardiogram 5/25: unremarkable
CDC Split Type:

Write-up: 2 discrete episodes of non-exertional, non-positional chest pain without trigger (5/23/21, 5/24/21); presented to hospital after elevated troponin found at urgent care; suspected myocarditis


VAERS ID: 1351214 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Rash
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? 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: Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash Generalized-Mild, Additional Details: patient reported a rash on neck that appeared in one spot and seemed to be growing a little bit, and also some new redness on her chest


VAERS ID: 1351237 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Gait inability
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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

Write-up: 1639 - directly after receiving covid vaccine pt became dizzy unable to walk to observation area. pt carried by EOA and father to cot. Pt responding slow but appropriate no dyspnea noted. EMS called. 1640 v/s 112/80, 99% o2 sat, 74 pulse, 16 respirations 1645 v/s 110/80, 80 pulse, 18 respirations, 99% 02 sat, dizziness getting better. EMS arrived pt stable refused to go to hospital. 1655 v/s 110/78, 78 pulse, 98% 02 sat, 18 respirations, asking for water sat up denies dizziness drank small amount of water. Denies dizziness. 1700 Pt walked to chair sat down no dizziness or c/o. 1715 Pt v/s 114/80, pulse 84, resp 16, 02 sat 98%, Pt discharged to home via PV with father. Instructed father good idea to follow up with PMD.


VAERS ID: 1351243 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Echocardiogram, Electrocardiogram normal, Myocarditis, Troponin
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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: autism
Allergies: none
Diagnostic Lab Data: EKG- NSR nonischemic Troponin-6.3 Echo- pending
CDC Split Type:

Write-up: Myocarditis


VAERS ID: 1351257 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267-1000 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)

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

Write-up: Severe pain in left hip, nausea


VAERS ID: 1351489 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-16
Onset:2021-05-23
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Computerised tomogram thorax abnormal, Cough, Dyspnoea, Fatigue, Headache, Lung opacity, Pulmonary mass, SARS-CoV-2 antibody test negative, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone 2.5 mg daily, methotrexate 5 mg orally once a week, folic acid 1 mg daily, Vit D 2000 units daily, asa 81 mg daily, amlodipine 2.5 mg daily, lasix 20 mg daily, klor-con 10 meq with lasix, xarelto 15 mg daily, levothyroxine 50 mcg
Current Illness: Rheumatoid arthritis on prednisone and MTX
Preexisting Conditions: HTN, atrial fibrillation, RA, T cell large granular lymphocyte leukemia, hypothyroidism, osteoporosis, insomnia, diverticulitis, osteoarthritis, hyponatreamia, GERD, macular degeneration, asthma, mild CKD
Allergies: Plaquenil, sulfacetamide sodium, metronidazole, vioxx, actonel, miacalcin, evista, flagyl - nausea, celebrex - nausea, macrodantin - nausea
Diagnostic Lab Data: COVID-19 positive 5/23/21 SARS-CoV-2 antibody ELISA test 5/24/2021 non-reactive CTA positive for bilateral pulmonary groundglass opacities and small lung nodules.
CDC Split Type:

Write-up: COVID-19 positive 5/23/21 requiring 4-day hospitalization after vaccination in February. COVID antibody test returned negative. Presented to ED with SOB for 3-4 days prior, headache, fatigue, and cough. CTA positive for bilateral pulmonary groundglass opacities and small lung nodules. COVID PCR positive. Was maintained on 1L of NC. Received PO decadron 6 mg daily and lasixs in hospital.


VAERS ID: 1351496 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-16
Onset:2021-05-23
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, 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: COVID19 test from , unsure if PCR or antigen
CDC Split Type:

Write-up: Patient received 2nd dose of Pfizer COVID19 vaccine on 2/16/21. Patient had a high risk community exposure to a COVID positive non-household member on 5/16/21. Patient reported COVID symptoms starting on 5/23/21. Patient tested COVID positive on 5/24/21.


VAERS ID: 1351517 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-19
Onset:2021-05-23
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Chills, Dizziness, Hyperhidrosis, Impaired work ability, Oral discomfort, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hearing impairment (broad), Vestibular disorders (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: No
Allergies: Frozen shrimp
Diagnostic Lab Data: ER visit. Physical examination on 05/23/21 with Bell''s palsy diagnosis.
CDC Split Type:

Write-up: I received my first Moderna shot on March 22 and my second on April 19. I had very bad side effects both times, though the second was worse with chills, dizziness, some light fever, body aches, sweating. This lasted up to two weeks after my second dose. I hardly ever take sick time off, but I had to leave work several times due to vaccine symptoms showing up. A month later, around May 15th, I started to feel a waxy feeling on the roof of my mouth and I had noticed even before this that I couldn''t whistle like I normally can. By May 23, I went to the ER for facial paralysis on my right side. I was diagnosed with Bell''s palsy. At this moment it''s just my face, no other body parts.


VAERS ID: 1351560 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Major depressive disorder, recurrent episode, severe, without mention of psychotic behavior ? Type 2 diabetes mellitus with complication, with long-term current use of insulin (HCC) ? Benign essential HTN ? Aggression ? Anoxic brain damage (HCC) ? ADHD (attention deficit hyperactivity disorder), inattentive type ? High risk medication use ? H/O kidney transplant
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever


VAERS ID: 1351576 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Disorientation, Fatigue, Loss of consciousness, Pyrexia, Syncope, Thirst
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily vitamins-centrum, omega 3, vitamin D, apple cider vinegar gummies, vitamin b12, chewable baby aspirin 81mg, probiotics taken the night before
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: I did not go to the hospital, all vitals were normal
CDC Split Type:

Write-up: first day: fever 100.7, fatigue, extreme thirsty second day: fever 100.8, very disoriented, extreme fatigue, I passed out and was unconscious for atleast 2-3 minutes 911 was called.


VAERS ID: 1351652 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-18
Onset:2021-05-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Back pain
SMQs:, Retroperitoneal fibrosis (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: Levora (birth control)
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penecillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Constant back pain. Middle back, Tylenol will only make it bearable, won''t go away. 4 days straight now of back pain.


VAERS ID: 1351700 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-05-23
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blister, Herpes zoster, Paraesthesia
SMQs:, Severe cutaneous adverse reactions (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Opportunistic infections (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: Calcium citrate, vitamin D3, Konsyl
Current Illness:
Preexisting Conditions: paraplegic, osteopeonia, neurogenic bladder
Allergies: latex, dairy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shingles manifesting as parathesia and blisters on the right torso (upper back, side of chest, below rib cage)


VAERS ID: 1351870 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphonia, Cough, Dysphonia, Fatigue, Influenza like illness, Initial insomnia, Loss of personal independence in daily activities, Nasal congestion, Nasopharyngitis, Oropharyngeal pain
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Depression (excl suicide and self injury) (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: Gemfibrozil
Current Illness: Sinus Allergies, Asthma
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Two days after the 2nd Pfizer vaccine, Sunday May23rd, I woke up with a slight sore throat. I didn?t make much of it because I thought it was maybe my sinuses dripping more than usual. However, when I woke up Monday, the sore throat was evident and very bothering some. Throughout the day I experienced cold/flu symptoms like tiredness & coughing. I couldn?t function normal so I had to take DayQuil. At night in order to go to sleep I had to take NyQuil. Tuesday morning I woke up feeling worse, my nose was very congested, the sore throat persisted and my voice was changing. Very tired. I still did not have a fever, muscle aches nor chills. Although I did have a congested nose, I did not lose the sense of smell & taste. Today, Wednesday I lost my voice so I?m writing this. I haven?t had a cold in 2 years nor o have been exposed to people or places to catch COVID 19 so I?m almost positive these are side effects and symptoms from the Pfizer second vaccine. These symptoms needs to be brought out to the light. It is very unfair to feel like one is alone on this one. Fortunately, thanks to blogs I was able to read other bloggers who are experiencing the same symptoms, especially the SORE THROAT.


VAERS ID: 1351913 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: UNK
Current Illness: N/A
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: Const: Well-appearing, NAD, alert, conversant Eyes: PERRL, EOMI HENT: NCAT, MMM Neck: Trachea midline, supple CV: RRR, Warm, well-perfused extremities, cap refill <2 seconds RESP: Sy
CDC Split Type:

Write-up: vaccine side effect. tingling in bil cheeks x 1 day, J&J vaccine received Friday; denies any fevers/chills.


VAERS ID: 1351923 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest discomfort, Computerised tomogram, Electrocardiogram
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: November 2018, vasovagal syncope
Other Medications: Citalopram Thermotabs (OTC)
Current Illness: None
Preexisting Conditions: Hypoglycemia Low Blood Pressure
Allergies: None
Diagnostic Lab Data: Had and EKG and a CT Scan in the Emergency Room 5/23/2021
CDC Split Type:

Write-up: Pain in abdomen and lung pressure when taking a deep breath. Symptoms started at about 4:00pm on Sunday 5/23/2021


VAERS ID: 1351935 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Allergic to levequin medication that?s all I?m aware of
Diagnostic Lab Data: Did not see a doctor or go to hospital. My dad called hospital and they said I should take tydenol but I wasn?t able to get up to get the medicine.
CDC Split Type:

Write-up: My first dose I got a reaction - bad joint and body pain. I wasn?t able to move for a couple hours but then it subsided less than 24 hours. It hurt but not so much where I didn?t want to move forward with 2nd dose. About 9 hours after my 2nd dose my joints in my body starting hurting and it was so painful I couldn?t move my body. It was a lot worse than my first dose. I started feeling high fever but I couldn?t get up to check temperature. It felt like someone threw me off a building and I couldn?t get up. That reaction lasted until morning and then that went away and then I got headaches. Headaches eventually went away the next day but it was a very painful experience I was scared. I don?t feel any of the symptoms anymore but wanted to report.


VAERS ID: 1351942 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-05-23
Onset:2021-05-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased
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? 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, robaxin, skelaxin
Diagnostic Lab Data: treated in er with shot and pills
CDC Split Type:

Write-up: 10 hours after receiving shot patient temperature spiked and at the ER the patient said it read 110


VAERS ID: 1351944 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chest discomfort, Dyspnoea, Electrocardiogram normal, Flatulence, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: spironolactone 25mg/day, vitamin D, Magnesium, vitamin C
Current Illness: None
Preexisting Conditions: Scoliosis, Low IgM
Allergies: None
Diagnostic Lab Data: EKG, chest x-ray. Both normal. Vitals ok. Doctor referred me to cardiologist. Prescribed two inhalers to open up breathing.
CDC Split Type:

Write-up: First two days after shot, extreme chest pressure/tightness, extreme shortness of breath, heart palpitations- began 12 -14 hours after 2nd dose of Pfizer vaccine. Improved a little over next two days but still chest pressure/tightness, palpitations, and shortness of breath. I get winded just talking. I have never had these problems before..Went to Urgent care on 5/26/21.


VAERS ID: 1351950 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Blood bilirubin increased, Blood creatine phosphokinase increased, Chest pain, Chills, Differential white blood cell count, Echocardiogram normal, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Electrocardiogram normal, Full blood count abnormal, Headache, Hyperhidrosis, Immunoglobulin therapy, Intensive care, Magnetic resonance imaging, Metabolic function test, Myocarditis, Nausea, Respiratory viral panel, Troponin
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (narrow), Haematopoietic leukopenia (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Arrhythmia related investigations, signs and symptoms (broad), Biliary system related investigations, signs and symptoms (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: hives after taking penicillin 1x as a toddler; no other known
Diagnostic Lab Data: 10/23/21 - EKG & labwork - . EKG normal; Troponin @ .03; no inflammatory markers run. 05/25/21: Clinic: C-Reactive Protien, 5.3 mg/dl (H); CBC w/ Differential - multiple results abnormal; CPK, 1050 ph (HH); EKG - normal sinus rhythym, diffuse ST elevation; Troponin level - 14 05/25/21: Hospital: Troponin level - 16; CPK, 711; Comprehensive Metabolic Panel - elevated bilirubin; Respiratory panel - no virus detected; Echocardiogram showed no apparent problems with heart function. Ped. Cardiologist ordered additional tests and IVIg infusion, which was started at approximately 3 a.m. 05/26/21: Hospital: troponin - 13.85; ECG - 5:44 a.m. Sinus rhythm with marked arrhythmia, rightward axis; ST elevation; possible lateral injury or acute infarct - abnormal. Compared to 10:26 ECG on 5/25, Rt axis deviation now present, ST(T Wave) deviation now present; myocardial infarct finding now present; troponin (2) @ 12.71; CPK @ 228; troponin (3) @ 10.80 (noon draw). (MRI conducted - results not provided yet). * addition tests to be conducted as he is still in the hospital.
CDC Split Type:

Write-up: chest pain, nausea, sweating w/ alternate chills, and headaches onset at approximately 10-11 a.m. Sunday, 5/23/21. Because he was reporting for work to a camp, he reported to the camp nurse. After conferring with parents, he reported to Hospital for testing. EKG there was normal; minimal labwork performed - Troponin test requested by parent came back at 0.03. Advil taken earlier had resolved pain at that time, but pain was persistent the following day. Parent retrieved patient, and he reported to his pediatrician at the PCP Clinic and more labwork was performed at approximately 10 a.m. Troponin level had increased to 14, with other inflammatory markers elevated and abnormal EKG result. Pediatrician consulted with pediatric cardiologists, and parents were advised to proceed to the ER. Mother arrived with Hospital at approximately 5:30 p.m. Troponin results from 6:45 elevated to 16. Ped. Cardiologist performed echo-cardiogram, which showed no abnormal heart functioning. Ped. Cardiolgist diagnosed myocarditis and prescribed 15-hour IVIg infusion. As of Wednesday, 5/26, at noon, troponin level had decreased to 10.8 and other inflammatory markers were improving. Patient is currently still hospitalized in the ICU Step Down Unit at Hospital.


VAERS ID: 1351951 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Cardiac monitoring, Condition aggravated, Decreased appetite, Dementia, Echocardiogram, Gait disturbance, Injection site erythema, Injection site swelling, Injection site warmth, Oedema peripheral, Oxygen saturation decreased, Peripheral swelling, Renal impairment, Thirst, Tremor, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Centrum silver, Celexa
Current Illness: UTI (discovered 5/23)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown- blood work, echocardiogram, urinalysis, etc from 5/23-5/26 at hospital.
CDC Split Type:

Write-up: It started with swelling, redness, and heat at injection site pretty soon after the injection on Friday 5/21. By Sunday, 5/23, patient had instability when standing and walking; her dementia had gotten worse; there was edema in her whole right arm; and she started having tremors. She was brought to Hospital by ambulance that afternoon and has since had decreased appetite and thirst; continuing swelling at injection site and in her whole right arm; terrible tremors; very low oxygen levels; and is almost comatose. The doctors there have said her kidney function has dropped to unacceptable levels and they are also monitoring her heart. She has been put on hospice care as of this time, 5/26.


VAERS ID: 1352160 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Injection site bruising, Injection site erythema, Injection site pruritus, Injection site swelling, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: In the beginning, I had my arm ache, and in the afternoon I had a headache. The next day my arm was sore and hurt. By the 23rd of May, the place where the injection took place was red and swollen. I still had small pain. On the 24th, it was still red, a bit swollen, and felt a bit itchy, I put on some Vaporub. Yesterday, the 25th, I had a mild headache and the injection site looked like a small bruise but with a green color. Today, 26th of May, the bruise is yellow-ish and still itches.


VAERS ID: 1352373 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-16
Onset:2021-05-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Patient reporting increase in chest pain starting 7-8 days after administration of vaccine


VAERS ID: 1352380 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Angina pectoris, Chest discomfort, Heart rate irregular
SMQs:, Anaphylactic reaction (broad), Cardiac arrhythmia terms, nonspecific (narrow), Other ischaemic heart disease (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: Heart pain, chest tightness, irregular heartbeat. Started on May 23, 2021 and is still present on May 26, 2021 although not as intense.


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