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From the 9/10/2021 release of VAERS data:

Found 686,636 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 104 out of 6,867

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VAERS ID: 1592778 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-13
Onset:2021-08-19
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Rash, Rash erythematous, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, 125 mg, Metformin, CoQ10, Fish Oil Pills, Biotin, Vitamin E, Multi vitamin Prenatal
Current Illness: na
Preexisting Conditions: History of thyroid cancer and hashimotos, infertility
Allergies: Allergy to Ceclor and Nickel
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash one week for vaccine on right breast, right lower abdomen, left forearm, and left hand. Area is red and itchy.


VAERS ID: 1592973 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Diffuse erythematous rash, lymphadenopathy, fever


VAERS ID: 1592983 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-06
Onset:2021-08-19
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash, Pain in extremity, Pruritus, Rash, Skin swelling, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cyclobenzaprine Alprazolam Methadone Trazadone Oxycodone
Current Illness: none
Preexisting Conditions: spinal disk herniations sciatic nerve damage leg cramping and muscle spasms chronic pain
Allergies: Keflex shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Skin rash on upper arm near injection wrapping around the arm ; raised skin, hot, itchy, arm ache 13 days after vaccine


VAERS ID: 1592991 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051E21A / 2 LA / SYR

Administered by: Unknown       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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: None
Preexisting Conditions: PCOS, NASH
Allergies: Augmentin causes a rash (not allergic to penicillin)
Diagnostic Lab Data:
CDC Split Type:

Write-up: 24 hours after the does I broke out in hives on my torso, upper thigh and forearms. The hives subsided and then returned the following evening.


VAERS ID: 1593178 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8UU8 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fall, Feeling abnormal, Feeling hot, Head injury
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Accidents and injuries (narrow), Vestibular disorders (broad)

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

Write-up: My 12 yo daughter became extremely hot, brain fog and dizzy abt 5 min after shot. Facility put her in a plastic chair in middle of the decongestant isle after shot, with customers shopping amongst her. She was wearing her mask and fainted, and fell off the chair into the decongestion rack. Scratching side of face / deck with cut lip and bump on lip. They pharmacy intern who administered the shot did ask if we wanted emt and I said no. Drove her home, ministered her and called her primary doc,.


VAERS ID: 1593185 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Headache, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Red arm pain at touch . Headache


VAERS ID: 1594488 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-19
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Musculoskeletal discomfort, Pain
SMQs:, Rhabdomyolysis/myopathy (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: Abstains from alcohol; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Comments: Patient had no known drug allergies. Patient do not had illness at time of vaccination. Patient do not had illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210840561

Write-up: ACHE AND SORENESS; JOINT DISCOMFORT; CHILLS; HEADACHE; This spontaneous report received from a patient via a company representative concerned a 55 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included: covid-19 infection, and concurrent conditions included: non- smoker, and alcohol abstain from alcohol, and other pre-existing medical conditions included: Patient had no known drug allergies. Patient do not had illness at time of vaccination. Patient do not had illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 18-AUG-2021 16:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 19-AUG-2021, the patient experienced ache and soreness. On 19-AUG-2021, the patient experienced joint discomfort. On 19-AUG-2021, the patient experienced chills. On 19-AUG-2021, the patient experienced headache. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills, and headache on 19-AUG-2021, was recovering from ache and soreness, and had not recovered from joint discomfort. This report was non-serious.


VAERS ID: 1595213 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 RA / IM

Administered by: Pharmacy       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Lymph Node Swelling-Medium


VAERS ID: 1595945 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD4884 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Muscle spasms, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Allergic: Itch Generalized-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Diarrhea-Mild, Systemic: cramps-Mild


VAERS ID: 1595976 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Itching at Injection Site-Severe, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Chills-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fever-Severe, Additional Details: Pt reported severe redness swollen, itchy, warm to touch at injection site. Symptoms started 1 day post injection and have been very severe. Pt is also immunocompromised and on injectable biologics. She will follow-up with her rheumatologist for further management of symptoms


VAERS ID: 1595981 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-09
Onset:2021-08-19
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Eye swelling, Mouth swelling, Pruritus, Rash, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Allergic: Itch Generalized-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash Generalized-Mild, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Additional Details: patient has redness over entire body including scalp area; also facial swelling and redness along with extreme itching. Rash, swelling, and itching occured 10 days after receiving vaccination.


VAERS ID: 1602548 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091021A / 3 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Injection site erythema, Vaccination site pain, Vaccination site swelling, Vaccination site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), 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: Evoxac , oxybutynin
Current Illness:
Preexisting Conditions: Sjogren''s syndrome
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: After a day patient feels pain in the area of the vaccine in the right arm, also redness, warmth, and swelling. Symptoms consist with description of COVID arm.


VAERS ID: 1602580 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pain in extremity, Vertigo
SMQs:, Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Simivistaton Pristiq Trazadone All taken for more than five years
Current Illness: None
Preexisting Conditions: Peripheral neuropathy Arachnoiditis Arthritis Degenerative spinal disease
Allergies: None
Diagnostic Lab Data: None yet. I see doc next Friday
CDC Split Type:

Write-up: Vertigo three days Sore arm HeadAche


VAERS ID: 1602599 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis, Pain, Pain in extremity, Peripheral swelling, Post-acute COVID-19 syndrome, Pyrexia, Rash pruritic
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Vitamins - woman?s multi vitamin - Vitamin c - vitamin e - magnesium
Current Illness:
Preexisting Conditions: Lupus
Allergies: - surgical tape & glue
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day 2 began with headache, body aches, fever & sweats/chills. Day 3 began ?covid arm? pain, swelling & itchy rash


VAERS ID: 1602603 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-02-11
Onset:2021-08-19
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0021321A / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Blood test, Chest X-ray abnormal, Chest discomfort, Computerised tomogram, Discomfort, Dyspnoea, Electrocardiogram abnormal, Pericarditis, Scan with contrast
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Emycin
Diagnostic Lab Data: Confirmed diagnosis from ER which took chest X-ray, CT with contrast, bloodwork and EKG 8/19/2021
CDC Split Type:

Write-up: Diagnosis of pericarditis after symptoms that included shortness of breathe, heavy crushing feeling of chest, back, clavicle, jaw and ear.


VAERS ID: 1602629 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-12
Onset:2021-08-19
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient tested positive for COVID after being fully vaccinated
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient positive for COVID after being vaccinated


VAERS ID: 1602632 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Approximately 15 minutes after vaccination the patient felt light headed and vomited.


VAERS ID: 1602645 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-09
Onset:2021-08-19
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / UNK LA / IM

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

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

Write-up: COVID 19


VAERS ID: 1602651 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram PR segment depression, Electrocardiogram ST segment elevation, Laboratory test normal, Myocarditis, Pleuritic pain, Troponin I increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 8/21 troponin i to 2.93, and diffuse st elevations and pr depression, no bnp, other labs wnl
CDC Split Type:

Write-up: Patient presented 2 days after second vaccine with myopericarditis as per sxs (pleuritic cp, positional, etc), troponin i to 2.93, and diffuse st elevations and pr depression. Sxs started a few hours after 2nd dose. Waiting on echo. Don''t need cardiac mri, pretty solid dx.


VAERS ID: 1602652 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Feeling cold, Headache, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

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

Write-up: I got chills the same night, I was freezing and I know it wasn?t cold then my thumbs started to go numb which trickled to the rest of my fingers going numb. Now I currently just have a headache.


VAERS ID: 1602676 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arrhythmia, Chills, Dizziness, Fatigue, Headache, Myalgia, Nausea, Syncope, Tachycardia
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (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), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Dizzy, nausea, tachycardia, fatigue, arrhythmia, sweaty, chills, collapse, muscle aches, headaches


VAERS ID: 1602716 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:1994-01-07
Onset:2021-08-19
   Days after vaccination:10086
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: PATIENT WAS VACCINATED ON Dose 1 date: hospital 01/06/2021 AND Dose 2 date: hospital 01/27/2021, AND TESTED POSITIVE TO COVID-19 ON 8/19/21


VAERS ID: 1602732 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Antibody test, Chest pain, Echocardiogram normal, Electrocardiogram ST segment elevation, Enterovirus test, Herpes virus test, Mycoplasma test, Myocarditis, Parvovirus B19 test, Troponin increased, Vomiting
SMQs:, Acute pancreatitis (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Digestive Advantage Probiotic 2 Gummy PO BID
Current Illness: Rash 1 week after 1st dose Pfizer COVID vaccine; diagnosed with urticaria vs. erythema multiforme, treated with prednisone of which he received 2 doses (Mom did not want to administer entire prescribed course).
Preexisting Conditions: None
Allergies: Amoxicillin, Cefdinir
Diagnostic Lab Data: EKG with ST segment elevation; troponin elevated highest at 18 ng/mL; Echo normal. Diagnosed with myocarditis. Pending labs include Mycoplasma IgG and IgM, Tick-borne antibody panel, Parvovirus PCR, Enterovirus PCR, Adenovirus PCR, HHV 6 PCR (all in serum).
CDC Split Type:

Write-up: Chest pain 2 days after second dose followed by vomiting


VAERS ID: 1602757 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-01
Onset:2021-08-19
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Migraine, Retching
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Budesonide
Current Illness: Long term severe Crohn?s disease
Preexisting Conditions: See above
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 15 hours after injection severe chills, migraine headache followed by 5 hours of the dry heaves every 20-25 minutes. After last episode I was left exhausted and headache continued for 10 more hours.


VAERS ID: 1602760 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Influenza like illness, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: COVID-19 first injection
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: If you hours after the injection I was having significant pain in my left arm at the injection site and throughout my shoulder muscle. Then I started to feel very tired and had flu like symptoms. I took Tylenol and rested. These effects lasted for approximately 2 and 1/2 days.


VAERS ID: 1602777 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Extra dose administered, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), 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: Moderna 2nd dose
Other Medications: Losartan, Sertraline, Hydrochloride, statin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: joint pain, nausea, headache, weakness


VAERS ID: 1602782 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 5182 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Intermenstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Kurvelo Omeprazole
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I started MenstruaL spotting a day after the shot. It was so light at first I thought I was mistaken as it''s definitely not normal and it has gotten worse since. I got the shot Wednesday afternoon and called my primary care office when I got off work late Friday afternoon. Waiting for Monday to go into the office.


VAERS ID: 1602787 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Headache, Nausea, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (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: Moderna 2nd dose
Other Medications: Tylenol
Current Illness: none
Preexisting Conditions: prostate cancer
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: joint pain, nausea, headache, weakness, trembling


VAERS ID: 1602788 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness: Head cold
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 34 Hours after receiving the vaccine my arm became excruciatingly sore and I developed stomach pain that lasted for an additional 3 days


VAERS ID: 1602860 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Pyrexia, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever of 104.9, tachycardia to the 130s, weakness, fatigue, chills.


VAERS ID: 1602880 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: School       Purchased by: ?
Symptoms: Headache, Pain
SMQs:

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

Write-up: Whole body was very sore, like I had been doing a very rigorous full body workout. Also I had a very bad headache.


VAERS ID: 1602885 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-08-19
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 RA / IM

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

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

Write-up: patient tested positive for COVID after fully vaccinated


VAERS ID: 1602891 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A RA / IM

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

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

Write-up: Janssen COVID-19 Vaccine EAU Severe chills, uncontrollable shaking/tremors


VAERS ID: 1602892 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-12
Onset:2021-08-19
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, Injection site nodule
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: AIMOVIG ONLY MEDICATION ON FILE.
Current Illness: NONE
Preexisting Conditions: NONE LISTED
Allergies: NONE
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Hard nodule and growing redness at injection site that started roughly 6 days after vaccination and is progressively getting larger up to time of report


VAERS ID: 1602912 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Nausea, Pain, Pyrexia, Vertigo
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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: Wellbutrin Prozac Amlodipine
Current Illness: None
Preexisting Conditions: Depression Anxiety
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever up to 104, chills, fatigue, body aches, severe vertigo, dizziness, nausea


VAERS ID: 1602913 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Shortness of breath since the day of injection and still has it


VAERS ID: 1602933 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dysphemia
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient is complaining of chest pains and also stuttering. starting the day after the injection


VAERS ID: 1602937 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Muscle rigidity, Nervousness, Palpitations, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: I received the vaccine in the left arm around 3:20 pm on 8-19-21. I sat on the bench at the pharmacy for approximately 5 minutes after receiving the Moderna vaccine. I felt fine. I got up and walked to my car. It was now approximately 7 minutes after receiving the vaccine. I felt my heart begin to race, and felt light headed/dizzy. I knew I couldn?t drive home in this condition. I laid my car seat back in the parking lot. About a minute after these symptoms began, my hands began tingling uncontrollably, similar to a pins and needles feeling, only 20 times worse. My hands became rigid and paralyzed. I could not bend my hands at all. I considered calling 911 but could not bend my hands to pick up my phone. I laid there for about 5 minutes without improvement. Finally, I began to regain use of my hands. I stayed in my car until all symptoms subsided. I felt ok to drive home approximately 20-25 minutes after receiving the vaccine. I still feel somewhat shaky and it has been 2 days.


VAERS ID: 1602950 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cough, Feeding disorder, Headache, Heavy menstrual bleeding, Nausea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamotrigine, Briviact, vitamin D
Current Illness: None
Preexisting Conditions: Seizures
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was on my second day of my menstrual cycle so I was experiencing heaviness which is normal but I feel maybe I should not have got the shot at that time. The same evening I felt something but I figured it was normal because I don''t even get flu shots , I haven''t had a vaccine since I was a kid and I don''t get sick so I felt that my body was reacting to It. The next morning was awful, I was sore, I had a fever, chills, I tried to eat but had nausea, my head was hurting, I stayed on my couch and bed all day. Since I don''t get sick I had no Tylenol or any fever reducer in my home. I felt to bad to get out and go to the store for some. The next morning I had to work, my coworkers have never seen me like that. I was still nausea''s and sore. They gave me Tylenol and Advil, later I still felt nausea''s. I feel better today but I don''t think I will get the second vaccine just because of how my reaction was to the first one. I hope by giving you my experience that it will help someone else.


VAERS ID: 1602952 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Lymph node pain, Neck pain, Pain, Tenderness, Vaccination site pain, Vaccine positive rechallenge
SMQs:, Arthritis (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Same reaction to second COVID-19 on 02/18/2021
Other Medications: Taken at 9:30 pm on day of vaccine: Metoprolol ER 50 mg, Famotidine 40 mg, Temazepam 15 mg, Gabapentin 300 mg, Ginger Root 550 mg, B12 1000 mcg, D3 50 mcg, Calcium/Magnesium/Zinc 1000mg/400mg/25mg,
Current Illness: Surgery to reverse temporary loop ileostomy7/12/2021
Preexisting Conditions: Addison?s Disease, Hashimoto?s Disease, Autoimmune Gastritis, Pre-Diabetes, Hypoglycemia, Diverticulitis, Hiatal Hernia, Migraines
Allergies: Latex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Lymph Node in neck has a painful nodule, pain radiates up neck and and radiates across clavicle area all the way to the vaccination site on left arm. Very painful to touch.


VAERS ID: 1603051 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O53E21A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Fatigue, Frequent bowel movements, Micturition urgency, Pollakiuria, Pyrexia, Suprapubic pain, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium, magnesium, vitamin D, Hizentra every two weeks
Current Illness:
Preexisting Conditions: hypogammaglobulinemia from past chemotherapy for lymphoma
Allergies: cefzil
Diagnostic Lab Data: Urinalysis showed only microhematuria, a longstanding abnormality.
CDC Split Type:

Write-up: 17 hours later developed urinary frequency, urgency, and suprapublic and low back aching, multiple stools, exhaustion, and low grade fever. Fever rose to 103 through rest of morning. Saw Urgent-Care NP at 2:30 p.m. (signed in 11:30 a.m.) Urine only microscopic hematuria (not new finding) and no evidence bacterial infection. Started on Macrodantin empirically while await culture. Fever resolved on antipyretics (tylenol). Slept rest of day and through the night. Much better in morning of August 20, with resolution GU symptoms and aching. Urine culture negative/antibiotics discontinued. Back to normal by August 20th evening.


VAERS ID: 1603062 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 3 LA / -

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

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: Sirolimus Metoprolol Losartan Allopurinol Sertraline
Current Illness: None
Preexisting Conditions: Liver transplant recipient 2010
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Low grade fever 99.5 for 2 days. "Covid arm"- swelling, hot to touch, redness, itching, sore to raise arm, chills


VAERS ID: 1603817 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-16
Onset:2021-08-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017EZLA OR 017E / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bradyphrenia, Chills, Dizziness, Dysstasia, Emotional disorder, Feeling abnormal, Feeling cold, Feeling jittery, Hypoaesthesia, Insomnia, Nausea, Palpitations, Panic attack, Restless legs syndrome, Tremor, Vertigo
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium glycinate 400 mg daily
Current Illness: None
Preexisting Conditions: Eczema that flares when skin is in contact with fragrances,
Allergies: Eczema flares when skin is in contact with products with fragrances
Diagnostic Lab Data: Scheduling an appointment with my Doctor on Monday Aug 23.
CDC Split Type:

Write-up: Dizziness, vertigo, insomnia, extreme unrelenting panic attacks, light-headedness, jittery, chills, cold and clammy, body wide tremors, nausea, restless legs, shaky hands and vision, racing heart, unable to stand for any amount of time, arms and legs are numb and feel "light", cloudy thinking, emotionless, unable to make eye contact with others. I feel "strange". It feels like my body is floating and i have no control over my limbs. These symptoms started at 10:00 pm on Aug `19 and lasted until today Aug 21. They are unremitting still but the intensity has subsided since morning of Aug 21.


VAERS ID: 1604553 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PA7485 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nodule, Pain in extremity, Peripheral swelling, Pruritus, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tradjenta, Lexapro, Meloxicam, Spironolactone, Propanonol, Lipitor, Estradiol, Aspirin, Lorsartan, Vitamin D, Trazodone, Clonopin
Current Illness: None
Preexisting Conditions: Diabetes, Depression, Anxiety, MVP, PTSD, Cholesterol, Blood Pressure, Osteoarthritis
Allergies: No
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Left arm is hot, very swollen, sore. Good sized knot. Some itching. Started day after vaccination and has gotten much worse. Taking Benedryl and OTC pain relievers.


VAERS ID: 1605733 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-02-03
Onset:2021-08-19
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 LA / IM

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

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

Write-up: covid pos after vaccination


VAERS ID: 1605745 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-04-22
Onset:2021-08-19
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / IM

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

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

Write-up: covid pos after vaccination


VAERS ID: 1605757 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-18
Onset:2021-08-19
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oligomenorrhoea, Pregnancy test negative
SMQs:, Fertility 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: Birth control, Lexapro
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Negative pregnancy test
CDC Split Type:

Write-up: Late menstrual cycle. Always start on Thursday, latest Friday morning. Now Saturday night and still haven''t started. Negative pregnancy test. Nothing has changed otherwise. Birth control for over 5 years, and I''ve never been this late.


VAERS ID: 1609053 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Malaise
SMQs:, Anaphylactic reaction (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: Asthma
Allergies: Amoxicillin, cats, dust
Diagnostic Lab Data:
CDC Split Type:

Write-up: Feeling sick for now 4 days, almost 96 hours after I got my vaccine. Can?t find one section on CDC where it says you?ll be having a bad cough for days; just says fever and it will last 1-2 days. You guys really don?t know shit do you?


VAERS ID: 1609851 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-13
Onset:2021-08-19
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / IM

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

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

Write-up: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild


VAERS ID: 1609865 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Micturition urgency, Pain, 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:
Current Illness: Sjogren''s Syndrome
Preexisting Conditions: Sjogren''s syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, body aches, incessant need to urinate with significant production of urine each time


VAERS ID: 1617369 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angioedema, Eye swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: no known
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: patient called pharmacy 8/21/21 after receiving pfizer covid 19 vaccine 8/18/21. Patient reported swelling of eyes and angioedema. Patient reported receiving steroid shot from a medical facility.


VAERS ID: 1617388 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Hyperhidrosis, Immediate post-injection reaction, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Drug allergies to vancomycin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Started to have arm pain immediately after shot, but fever, chills, sweating, headaches, and diarrhea did not start until shortly after midnight following the shot. Took Tylenol the morning after as they persisted, which helped and most symptoms ceased in the afternoon. Headaches and fatigue have continued.


VAERS ID: 1617424 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-07-01
Onset:2021-08-19
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antibody test, Blood glucose increased, Blood ketone body, Type 1 diabetes mellitus, Urine ketone body present, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/21/21 Blood glucose: 301 UR Glucose 3+ Ur Ketones 2+ Beta Hydroxybutyrate: 41.2 mg/dl AB tests pending
CDC Split Type:

Write-up: Type 1 Diabetes onset. 10lb weight loss


VAERS ID: 1617490 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Blood bicarbonate decreased, Blood chloride increased, Blood creatinine increased, Blood glucose normal, Blood urea decreased, Chest X-ray normal, Chills, Cough, Dizziness, Dyspnoea, Fatigue, Full blood count normal, Headache, Myalgia, Nausea, Oropharyngeal pain, Painful respiration, Pulmonary thrombosis, SARS-CoV-2 test negative, Sinus congestion, Sinus operation, Troponin normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Lactic acidosis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Clonazepam, Duloxetine, Gabapentin, Omeprazole, Topiramate and Geodon
Current Illness: None
Preexisting Conditions: COPD, Bipolar 1 disorder, Schizoaffective disorder, CKD Stage III, GER and Depression/Anxiety
Allergies: Amitriptyline, Wellbutrin, Ativan, Morphine, Nortriptyline, Paroxetine, Seroquel and Chantix
Diagnostic Lab Data: CBC unremarkable, Cl- 111, Bicarb 20, BUN/Cr 9/1.3, Glucose 103 and Troponin < 0.01. COVID-19 negative. CXR: no acute cardiopulmonary findings. CTA Chest: small burden of thrombus single right lower lobe vessel
CDC Split Type:

Write-up: Within 24 hours she noted headaches, lightheadedness, sinus congestion/drainage, sore throat, non-productive cough, nausea, fatigue, chills and myalgias. By day 3 post vaccine, she noted worsening dyspnea and continued worsening fatigue as well as pain with coughing/deep breathing for which she presents to the Hospital ED 8/22/21. She was admitted to Hospital 8/22/21 with pulmonary thrombus single right lower lobe vessel. She is being treated with anticoagulation, vitals stable, and unknown outcomes at this time.


VAERS ID: 1617499 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute kidney injury, Cardiovascular examination, Fatigue, Malaise, Myocarditis, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Myocardial infarction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Cardiomyopathy (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, hydrocortisone, levothyroxine, rosuvastatin, testosterone
Current Illness: none
Preexisting Conditions: panhypopituitarism, htn, hld
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed acute malaise/fatigue and presented to ED with AKI and + troponins felt to represent acute myocarditis based on cardiology evaluation. As a hospitalist I will not have ongoing contact with this patient so please contact his PCP, if additional information is needed.


VAERS ID: 1617504 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Pruritus, Swollen tongue, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot 10/2010, Shingrix 8/2020,
Other Medications: Plaquenil 200 mg BID, Levothyroxine 0.137 mg QDay, Metoprolol ER 100 mg QPM, HCTZ 25 mg QPM, Aleve 200 mg BID (held x 2 days since on Prednisone), Albuterol 2 puffs Q 4 hrs prn. Premedication for vaccine started day before vaccine and day o
Current Illness: None
Preexisting Conditions: HTN, surgically induced hypothyroidism (Hoshimoto''s disease and thyroid cancer), heart arrythmia (PAT/MAT), polyarthritis (not otherwise specified), exercise induced asthma
Allergies: Flu shot (stridor, arm swelling from shoulder to fingers x 3 days, severe itching), Shingrix (stridor, arm swelling from shoulder to fingers x 3 days, severe itching, angioedema 24-48 hours after injection), ACEI and ARB intolerance (hyperkalemia), retinol (swelling, redness, itching at site)
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Given history of anaphylaxis with flu and shingles shot, premedicated w/10 mg Pred x 2 days, Benadryl 100 mg night before, 50 mg 1 hour before injection, Pepcid 40 mg night before, 40 mg 1 hour before injection as well as albuterol 2 puffs prior to walking into site. Received injection, within 2 minutes had moderate itching of right hand progressing to right arm. That lasted most of the day. Also had some itching of trunk and left arm. Waited required 30 mins without breathing issues, only itching. Notified RN on way out that only had itching. Took more benadryl, Pepcid, and albuterol that evening as well as another 5 mg Pred. Next morning had some chest tightness and difficulty getting deep breath, took benadryl 50 mg, Pepcid 40 mg, Pred 5 mg and albuterol 2 puffs with relief in about 30 mins. Took remainder of usual medications as well. Had to use albuterol q 4 hours remainder of day. Benadryl 50 mg and Pepcid 40 mg taken again at QHS. Awakened 8/21 again with some difficulty breathing deeply, repeated same regimen as day before. Pred again at 5 mg this day. Again relief within about 30 mins, took albuterol about q 4-6 hours. Awakened this morning 8/22/21 with swollen tongue that had teeth indentations, tight throat, no difficulty breathing or swallowing. Immediately took 50 mg benadryl, Pepcid 40 mg, albuterol 2 puffs with swelling starting to decrease within 15 mins, down to able to close teeth without biting tongue in 1.5 hours, and completely back to normal within 2.5 hours. Vital signs remained stable, did not go to ER since symptoms decreased within 15 mins of taking Benadryl, Pepcid, Albuterol. Pred 5 mg taken in afternoon. Continuing to take medications to prevent further issues.


VAERS ID: 1617555 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 08821A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dilated pores, Extra dose administered, Injection site erythema, Injection site induration, Injection site warmth, Limb discomfort
SMQs:, Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Revlimid 10mg, Synthroid 175mcg, Losartan 50mg, Bupropion XL 150mg, Rosuvastatin 5mg, Acyclovir 800mg, Cataflam 50mg, Mtv Biotin 10,000mcg
Current Illness: Pt. is transplanted from bone marrow (since April 2018), Multiple sclerosis, Hypothyroidism, Hypertension, High cholesterol
Preexisting Conditions: Pt is transplanted from bone marrow (since April 2018), Multiple sclerosis, Hypothyroidism, Hypertension, high colesterol
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. goes to pharmacy to be oriented about the discomfort that she was presenting in her left arm since the day she was vaccinated (August 19). Upon inspection, the area was red, hot, hard and covered most of the muscle, plus the area was quite porous and hard to the touch. Patient identified Doctor G. as her main provider. I contacted him, explained the situation and he let me know the course to follow, in this case is to send her with antibiotics since she may be presenting an infection in the area. Doxycycline 100mg was given twice per day for 7


VAERS ID: 1617570 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN LOT#202A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Eye irritation, Lymphadenopathy, Lymphoedema, Neuralgia
SMQs:, Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Corneal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levotyroxine 50 mcg
Current Illness: none
Preexisting Conditions: breast cancer surgery 2015 mastectomy right side, no chemotherapy or radiation, no present treatment
Allergies: possibly to ibuprofen and tylenol--not confirmed
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was given shot in left arm. 2 hours later I started to have severe nerve, burning pain in right mastectomy arm and underarm including my hand, (which I have experienced in the past when I did a medical procedure and a nurse had mistakenly started IV in my right arm.) On the day of the vaccination I took voltaren and lyrica and pain subsided after 12 hours , though now August 20, 2021 (4 days later after the vaccination) I am experiencing some light similar pain again. A nurse at my medical oncologist''s office had told me when I asked, if the vaccination would be a problem taken in my non-mastectomy arm , and she assured me that it was OK and that only the lymph nodes in the vaccination arm could possibly swell. I am assuming that swelling lymph nodes are what caused this very painful reaction in my non-vaccination arm. I do not have lymphedema and have never had it.


VAERS ID: 1617631 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3810 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain
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: none that I am aware of
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: no allergies reported at time of immunization
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Redness and pain at injection site


VAERS ID: 1617695 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-02-01
Onset:2021-08-19
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none known
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: PCR + Covid 8/20/21
CDC Split Type:

Write-up: Client vaccinated with Moderna vaccines for Covid in beginning and end of February (cannot recall dates). Client symptomatic for Covid and tested positive on 8/20/2021. Reported as breakthrough Covid in a fully vaccinated person.


VAERS ID: 1617724 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Herpes zoster, Influenza, Pain
SMQs:, Infective pneumonia (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: Daily baby aspirin
Current Illness: None
Preexisting Conditions: None
Allergies: Doxycycline, PEG
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe pain, flu symptoms for 48 hours commencing approximately 10 hours after injection. Emergence of shingles in multiple body locations (right leg, left arm, scalp) began 2 days after injection and has not abated.


VAERS ID: 1617740 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: No


VAERS ID: 1618492 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dysarthria, Feeling abnormal, Headache, Neck pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache and pain down right side of neck within 7 hours. Fever 12 hours after for 48 hours. Foggy words not coming out right 2 days after 2nd shot still l at 4 days later


VAERS ID: 1618506 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-16
Onset:2021-08-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Rash
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pill, Paxil.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: On the Thursday after my vaccine a reaction started on my face in my chin area-itching. Friday it started again but covering my whole face and then my entire body. I received a steroid shot and steroid pack from my doctor. I also had shortness of breath and a tight chest. Saturday I just had a little of the rash left. Sunday morning I woke up at 1 AM not being able to breathe like normal. My chest was tight and I could only take small breathes. I ended up in the ER receiving tests and blood work. To be told I had a reaction to the vaccine causing an entire body rash and not being able t breathe with my chest being tight.


VAERS ID: 1620508 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cold sweat, Disturbance in attention, Dizziness, Flushing, Vision blurred
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: I became flush and felt a cold sweat come over me, I was in mid conversation with a fellow employee when he asked me a question and I was unable to answer due to a lapse in my ability to form a complete thought. I then felt the room getting dark and narrowing quickly, it was then I realized I was in the process of ?passing out?. I don''t believe I passed all the way out, although the next thing I remembers was hearing my charge nurse, asking me a series of questions while I had my legs elevated and I was lying down on the break room couch with a blood pressure cuff on my left arm and a pulse-ox on my right index finger. I was having trouble focusing my eye sight on one object. My blood pressure during the event hit numbers of 210/190 but slowly subsided over the course of a couple hours. I still was dizzy when attempting to ambulate with assistance for the remainder of the day. It took a full two days for me to finally return to normal. My wife came and picked me up from work where I left my personal vehicle as well as my personal belongings secured in my locker until I was able to retrieve them on Saturday.


VAERS ID: 1622031 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Laboratory test, Magnetic resonance imaging, Myalgia, Pyrexia, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (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), 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: Besitran 25mg
Current Illness: Cystitis
Preexisting Conditions: Anxiety
Allergies: Penicillin
Diagnostic Lab Data: antigens test 8/20/2021, Resonance 8/20/2021, Analysis 08/20/2021
CDC Split Type:

Write-up: 36 hours after getting vaccinated I have severe muscle aches, fatigue, cough, and fever. Doctor said I have COVID. I have no contact with anybody with positive COVID. I have not had a social life because I telework very late. I know 5 people who had the same thing. My 19 year old son has no symptoms, we got vaccinated the same day at the same center. Therefore, please assess if COVID is an adverse reaction itself. More than 6 months ago I should have been vaccinated because of my age. I the vaccine and 36 hours later I get COVID.


VAERS ID: 1623072 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Chills, Fatigue, Heart rate increased, Injection site discomfort, Insomnia, Nausea, Sleep disorder
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole 20mg
Current Illness: 1 week prior: severe abdominal pain, suspect gallbladder dz vs worsening hiatal hernia. Symptom resolved 1 week prior to vaccination.
Preexisting Conditions: GERD (well managed), chronic neck pain
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 8/19/21 @ 11:30pm: mild discomfort at injection site. Chills, increased HR (120bpm), nausea, insomnia. Lasted for a few hours. 8/20/21 daytime: moderate discomfort upper right arm. Mild to moderate fatigue. 8/20/21 evening: moderate discomfort upper right arm. 8/21/21: moderate discomfort upper right arm. Mild to moderate fatigue. 8/22/21 evening: insomnia, then waking at 3am on 8/23 with pain in L ankle, anxiety, nausea. Mild discomfort upper right arm.


VAERS ID: 1623081 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-17
Onset:2021-08-19
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, SARS-CoV-2 test positive, Sepsis, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: APAP, albuterol, amlodipine, ASA, atorvastatin, insulin glargine, levetiracetam, metformin, omeprazole
Current Illness: None
Preexisting Conditions: DM, asthma, BPH, COPD, GERD, HTN, Sz
Allergies: Loratidine
Diagnostic Lab Data: PCR + 8/19/2021
CDC Split Type:

Write-up: Breakthrough COVID + 8/19/2021 requiring hospitalization for acute respiratory failure, sepsis


VAERS ID: 1623254 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW01722 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: On 8/19/21 patient reported localized swelling, pain, itchiness and redness; as well as some minor fatigue. Advised patient to take benadryl, acetaminophen or ibuprofen and to apply an ice pack as needed. Instructed patient to seek emergency medical treatment if reaction spread beyond arm, new symptoms developed or if it did not improve in 3-5 days. On 8/21 patient sought assistance at an urgent care facility. Was given a steroid injection (reported by the patient - steroid type unknown) and a topical steroid. By 8/23 patient was reporting feeling much better, stating the swelling is almost completely gone.


VAERS ID: 1623265 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Malaise, Respiratory rate increased, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient got first dose of Pfizer. Was asked to wait 15 minutes and he did. Came up and asked if he can leave after 15 minutes confirmed he felt okay and said it was ok. He came back rushing a couple minutes later saying he wasn?t feeling good. He was leaning on the counter heavy breathing. He looked like he was going to faint so walked him to a chair. When asking more questions patient didn?t respond to any questions being asked. He did have a pulse and was breathing though. He asked for water. When he looked like he was going to faint the ambulance was called. And paramedics took him


VAERS ID: 1623273 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Fatigue, Insomnia, Lymph node pain, Lymphadenopathy, Musculoskeletal chest pain, Pain, Presyncope, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa
Current Illness: none
Preexisting Conditions: Congenital Bicuspid Aortic Valve
Allergies: Doxycycline
Diagnostic Lab Data: None. Nobody wanted any.
CDC Split Type:

Write-up: After receiving first dose of vaccine, within eight hours, I was experiencing 1/10 intermittent chest tightness. I had no other symptoms (I was not anxious or experiencing anxiety). These symptoms resolved on there own within 24 hours. After receiving the 2nd dose of Pfizer, I only had mild aches and fatigue within the first 24 hours. The next day while I was getting a hair cut, I had an episode of syncope where I almost passed out while sitting in the chair. I immediately went over to the couch to lay down before I blacked out. After 48 hours of receiving the 2nd dose of vaccine, I developed severe 6/10 chest pain which felt like a vise grip around my heart after having sexual intercourse. This only lasted 5 seconds and then came back again only lasting a few more seconds. I never had any further episodes since. After 36 hours of receiving the 2nd vaccine, I had tenderness on the LEFT lateral border of my chest. I noticed there was what appeared to be a red inflamed lymph node about the size of a quarter. This was very sore, and I was unable to sleep on this side. I spoke with the family doctor who confirmed this appears to be a swollen lymph node and recommended I take a baby aspirin twice a day.


VAERS ID: 1623300 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Dyspnoea, Headache, Nausea, Photosensitivity reaction, Pruritus, Rash
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: flu vaccine
Other Medications:
Current Illness:
Preexisting Conditions: ? Asthma ? GERD (gastroesophageal reflux disease) ? Hypertension
Allergies: Cat''s claw
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine and 30 mins after admin, she reported a frontal headache and photosensitivity. No respiratory distress. Pulse ox 99%, BP an pulse WNL. Encouraged fluids, snack and rest. She was monitored in a staff office where she was allowed to rest in the dark. Around 1030 MD checked in on her and she then was reporting general pruritis and rash. She was given oral benadryl and observed, vital signs remained stable. She then reported chest tightness and MD at that time recommended she report to ER out of extreme caution. She denied known allergy to Pfizer vaccine ingredients. Per ED Provider note: 23 y.o. female who presented to the emergency department for allergic reaction, onset 1000 hours. Further complains of headache, mild shortness of breath, itchiness, generalized rash, and nausea. Patient received the first dose of the COVID-19 vaccine at 0930 hours and began experiencing these symptoms 30 minutes following the vaccine. She was given benadryl and calamine lotion at Specialty Clinic prior to arrival at ED. She noted having allergic reactions to vaccines in the past. When patient was a child, she experienced arm swelling following IM flu shot and nose bleed with nasal spray vaccine. Also has a history of hypertension. NKDA. Denies chest pain, abdominal pain, and vomiting. Further complains of headache, mild shortness of breath, itchiness, generalized rash, and nausea. No rashes appreciated upon clinical exam. DDx: appears to have significant anxiety overlay to this.w symptom amplification. Patient discharged in stable condition


VAERS ID: 1623306 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-01-29
Onset:2021-08-19
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: posi
CDC Split Type:

Write-up: patient tested positive for covid


VAERS ID: 1623343 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-08-19
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206AZ1A / UNK - / -

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

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

Write-up: positive covid test with symptoms


VAERS ID: 1623356 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache
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: MILD HEADACHE CONTINUOUS HEADACHE


VAERS ID: 1623364 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-16
Onset:2021-08-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Cold sweat, Computerised tomogram normal, Confusional state, Disorientation, Headache, Hyperhidrosis, Nasopharyngitis, Pain, Pyrexia, Seizure, Urine analysis normal
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Perfectly healthy 17-year-old girl who has never had a seizure in her life. It is not a coincidence my daughter had two seizures within days of receiving this vaccine. Prozac a year Birth control over a year
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT scan was clear, no blood clotting - no swelling of the brain. Blood and urine tests came back clear. 8/20/2004
CDC Split Type:

Write-up: Next day 8/17/2021 she was feeling achy, had a headache, slight fever, cold like symptoms. 8/19/2021 she was gurgling in her sleep. I had trouble waking her. I learned later that was probably a seizure. 8/20/2021 She was sweating, clammy, confused and disoriented at school. She went into the wrong class and started convulsing.


VAERS ID: 1623403 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-03
Onset:2021-08-19
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest pain, Cough, Dyspnoea, Hypoxia, Myalgia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: covid positive on 8/19/21 at Health System
CDC Split Type:

Write-up: patient presented to EC at Hospital with shortness of breath, cough, hypoxia, chest pain and myalgia on 8/22/2021


VAERS ID: 1623411 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre 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? 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: xray dye
Diagnostic Lab Data:
CDC Split Type:

Write-up: ABOUT 12 HRS AFTER SHOT GOT A FEVER OF 104 WITH TYENOL WENT DOWN TO 102.5 VERY SORE IN ALL JOINTS BAD HEADACHE FEVER LASTED ABOUT 30 HRS BASICLY WAS INCAPICITATED FOR 3 DAYS STILL FEELING VERY WEAK AT THE MOMENT WHICH IS 86HRS LATER


VAERS ID: 1623423 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-03-24
Onset:2021-08-19
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Fatigue, Headache, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: HYDROCORTISONE SUPPOSITORY, DICLOFENAC GEL, HYOSCYAMINE
Current Illness: HEMOPTYSIS, RECTAL BLEEDING
Preexisting Conditions: OBSTRUCTIVE SLEEP APNEA, MORBID OBESITY, ESSENTIAL HYPERTENSION
Allergies: NKA
Diagnostic Lab Data: 08/19/21: POSITIVE SARS-COV-2 RNA
CDC Split Type:

Write-up: COUGH, SHOB, RUNNY NOSE, CONGESTION, CHILLS, FATIGUE, BODY ACHES, HEADACHE


VAERS ID: 1623443 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-05-13
Onset:2021-08-19
   Days after vaccination:98
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cough, Diarrhoea, Headache
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CYANOCOBALAM INJ, SERTRALINE, ERGOCALCIFEROL, LORATADINE, ASMANEX, FLONASE, ALBUTEROL, HYDROXYZINE, BUSPIRONE
Current Illness: SUPERFICIAL THROMBOPHLEBITIS, DEPRESSIVE DISORDER, ANXIETY DISORDER
Preexisting Conditions: ALLERGIC ASTHMA, MIXED HYPERLIPIDEMIA, PANIC DISORDER, GENERALIZED ANXIETY DISORDER, MILD RECURRENT MAJOR DEPRESSION
Allergies: NKA
Diagnostic Lab Data: 08/19/21: POSITIVE SARS-COV-2 RNA
CDC Split Type:

Write-up: COUGH, DIARRHEA, HEADACHE


VAERS ID: 1623446 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Burning sensation, Hypoaesthesia, Neuralgia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: COVID 7/22/2021
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: None. No availability at the moment.
CDC Split Type:

Write-up: Thursday night I had intense burning/ heaviness numbness on my wrist and hands. Next day nerve pain from my hands to my shoulder/ armpit area. Proceeding to my chest then looser extremities (including groin, genital area).


VAERS ID: 1623457 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Cough, Headache, Pain
SMQs:, Anaphylactic reaction (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: ?Moderna COVID-19 Vaccine EUA" Day after receiving second dose started having major body aches and headaches off and on. Now I have a tickle in my chest whenever I breathe in which then makes me cough.


VAERS ID: 1623458 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-19
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Impaired healing, Nodule, Perfume sensitivity
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Two days after receiving the vaccine, I noticed some excessive immune response in my skin. When I applied my rollerball perfume, my skin turned fiery red in the exact locations I applied it. This is perfume I have been using for years with no problem. I never had allergic reactions to any perfume before. I rinse it immediately and the redness disappeared. I did not think too much of it. Then on August 19 2021, a painful nodule appeared on the rim of my left ear, which is not healing. It appears to be Chondrodermatitis Nodularis Helicis according to online literature and images. I hope it goes away, but according to research, this is related to an autoimmune reaction when it occurs in younger females. Typically it only occurs in elderly people, mostly males. My concern is this is the onset of an autoimmune disorder of the skin triggered by the vaccine. I do not have a history of autoimmune disease, but my mother has very severe psoriasis so I may have genes that predispose me to skin disorders.


VAERS ID: 1623465 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-02-24
Onset:2021-08-19
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Anal incontinence, Cough, Headache, Oropharyngeal pain, Pyrexia, SARS-CoV-2 RNA, Urinary incontinence
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LISINOPRIL, METFORMIN, METOPROLOL, GABAPENTIN, LEVOTHYROXINE, MONTELUKAST, FLONASE, OMEPRAZOLE, MUPIROCIN, MULTIVITAMIN, WIXELA, MAGNESIUM OXIDE, ALBUTEROL, ATORVASTATIN, BUSPIRONE, FLUOXETINE, ESTRADIOL, DICYCLOMINE, CYCLOBENZAPRINE, CETIR
Current Illness: INFECTION OF TOOTH
Preexisting Conditions: HYPERLIPIDEMIA, HYPOTHYROIDISM, ASTHMA, HTN, OBESITY, IBS, DM TYPE 2, CHRONIC PAIN SYNDROME, HEARTBURN, GAD, PTSD, ALLERGIC RHYINITIS, DEPRESSIVE DISORDER, HYPERMETROPIA, ASTIGMATISM, PRESBYOPIA, NUMBNESS OF TOE, PERSONALITY DISORDER, CKD STAGE 3, ENLARGEMENT OF LACRIMAL GLAND, UMBILICAL HERNA WITHOUT OBSTRUCTION, CORONARY ARTERIOSCLEROSIS, POSTSURGICAL MENOPAUSE, DIABETIC PARIPHERAL NEUROPATHY, CHRONIC BACK PAIN, CHRONIC NECK PAIN, LUNG MASS, GERD, SOLAR LENTIGINOSIS, VITELLIFORM DYSTROPHY, PSEUDOPHAKIA
Allergies: ATIVAN, BLUE DYES, LATEX, MORPHINE, PEACHES, PENICILLIN, SUFAMEHTOXAZOLE
Diagnostic Lab Data: 08/19/21: SARS-COV-2 RNA
CDC Split Type:

Write-up: COUGH, FEVER, HEADACHE, SORE THROAT, URINARY AND FECAL INCONTINENCE


VAERS ID: 1623466 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Feeling of body temperature change, Headache, Hyperhidrosis, Hypoaesthesia, Impaired work ability, Injection site discomfort, Injection site warmth, Nausea, Pain, Paraesthesia, Parosmia, Sleep disorder
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrochlorot 50mg
Current Illness: n/a
Preexisting Conditions: High Blood Pressure Left bundle branch blockage
Allergies: Shell fish, acetominophen
Diagnostic Lab Data: None as of yet. Awaiting recommendation from primary care physician.
CDC Split Type:

Write-up: At time of injection, warm sensation at site spreading downwards for approximately 3-inch. Sat for 30-minutes with no other symptoms. Warm sensation gone, just site discomfort. Released back to work. 1-hr post injection mild headache forms. 2-hrs post, heightened sense of smell which was making me nauseous. 3-hrs post, headache, nausea, body aches starting. Loss of appetite. 8/20/2021 Approx. 2am woken from dead sleep with entire right leg numb. Was sleeping on back as is normal and this has never happened before. Took about 5-mins before leg returned to normal. Went back to sleep. Called out sick as I had a headache, nausea, body aches, tire, running hot and cold. Loss of appetite. 8/21/2021 Headache, body aches, running hot and cold, tired. Loss of appetite. 8/22/2021 Tired, get the "sweats" from just walking to the bathroom. Still not much of an appetite. Late afternoon, 3:30-ish, starting getting intermittent tingling sensations running up and down both left and right arms; sometimes simultaneously. 8/23/2021 Returned to work. Some fatigue and "sweats". Intermittent tingling sensations continue in both arms. Contacted primary care physician and am awaiting recommendation.


VAERS ID: 1623548 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site discolouration, Injection site erythema, Injection site induration, Injection site pain, 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: None
Current Illness: none
Preexisting Conditions: history of DVT
Allergies: Morphine, iodine/contrast dyes/percocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: Starting within an hour the site of the shot started getting red, hard, hot and painful to the touch. Each day since (4 days now) the area has grown larger, is not symmetrical, and is still hard, red, hot, and painful. On day 4 the area is still hard, hot, and painful and has now taken on a blueish tint.


VAERS ID: 1623558 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-26
Onset:2021-08-19
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014M20A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / UNK - / -

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

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

Write-up: Covid


VAERS ID: 1623603 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Cough, Dysgeusia, Fatigue, Injected limb mobility decreased, Injection site pain, Lymph node pain, Lymphadenopathy, Myalgia, Pain in extremity, Paraesthesia oral, Pyrexia, Respiratory tract congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan Potassium 100 MG for high blood pressure Spironolactone 25 MG for water retention Alive multi vitamin B-Complex with C and Zinc Calcium 600 MG Magnesium 250MG D3 1000 IU Fish Oil 1200 MG
Current Illness: none
Preexisting Conditions: high blood pressure
Allergies: codeine, eggs, peanuts/legumes, tree nuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Thursday after injection gradual onset until 11:00 am. Then rapidly increasing in intensity - sore arm at injection site, couldn''t lift my arm over my head; muscle pain all over but especially in my back and thighs like I''d been rolled under a bus; tongue had the sensation of being coated with a thick goo that tasted like metal. Friday the tongue goo and metal taste was gone, overall muscle aches were gone except for my back, and every lymph node on my left side was swollen and tender. Saturday back pain had diminished, lymph nodes had returned to normal and no longer sore, spiked a fever of 101.7 on Saturday afternoon. Sunday, remained feverish until 9:00 pm when fever broke. Monday, fever is gone, but I''m exhausted and have congestion and a cough.


VAERS ID: 1623619 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Gait disturbance, Pain in extremity, Walking aid user, Weight bearing difficulty
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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:
Current Illness: no
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt, has pain in his right leg and he can no longer walk without a walker , his leg continues to give out with weight bearing .


VAERS ID: 1623624 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-16
Onset:2021-08-19
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood immunoglobulin G, Blood immunoglobulin M, COVID-19, SARS-CoV-2 antibody test, SARS-CoV-2 test negative, 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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: insulin regular human 100 unit/mL Solution (Active) "Novolin 10 units HS
Current Illness:
Preexisting Conditions: Type I Diabetes Mellitus
Allergies: NKDA
Diagnostic Lab Data: 1.) COVID 19 Antigen testing 8/19 (-) 2.) CVOID 19 PCR testing 8/18 (+) 3.) COVID 19 IgG (0.02) and IgM (0.07) on 8/21 3.) IgG II QT-SPIKE 305.10 on 8/21
CDC Split Type:

Write-up: Hospitalized with COVID+ testing on 8/19, initially to observation, then flipped to inpatient STATUS.


VAERS ID: 1623648 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / UNK - / -

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

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

Write-up: Vaccine administered from another clinic. Patient reported to emergency center for chest pain/tightness the morning after vaccination. History of MDS and pulmonary fibrosis. Discharged home, no further information available.


VAERS ID: 1623669 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 LA / SYR

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

Write-up: Site: Bruising at Injection Site-Mild, Site: Redness at Injection Site-Mild


VAERS ID: 1623671 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

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

Write-up: Patient was given their first Moderna vaccination on July 29th and the second dose of the vaccination was given a week short of the indicated time interval on 08/19/2021.


VAERS ID: 1623682 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088021A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

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

Write-up: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Joint Pain-Medium


VAERS ID: 1623691 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Fatigue, Headache
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril & multivitamin
Current Illness:
Preexisting Conditions: high blood pressure
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heavy fatigue with intermittent mild chest pain and intermittent mild headache continues since receiving vaccine


VAERS ID: 1623791 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-22
Onset:2021-08-19
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Heart rate irregular
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

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

Write-up: Irregular strong heartbeat, shortness of breath, fatigue for several days.


VAERS ID: 1623804 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Fatigue, Immediate post-injection reaction, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mobic 15mg, vitamin C, vitamin D3, Zinc, Fish Oil, B-Complex, Chromium piccolinate
Current Illness: none
Preexisting Conditions: arthritis
Allergies: none
Diagnostic Lab Data: none to this time - appointment with dr scheduled for Friday, 8/27/21
CDC Split Type:

Write-up: Patient reports immediate arm pain from injection site after receiving vaccine on 8/19/21, progressing to fatigue evening of 8/19/21 and muscle/joint/back pain on Friday, 8/20/21. Monday, 8/23/21 patient is still experiencing same symptoms.


VAERS ID: 1623811 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 3180 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase normal, Asthenia, Blood count normal, Blood triglycerides increased, Cerebral infarction, Computerised tomogram head normal, Electrocardiogram normal, Fatigue, Glycosylated haemoglobin, Hemiparesis, High density lipoprotein decreased, Injection site pain, Internal capsule infarction, Laboratory test abnormal, Low density lipoprotein normal, Magnetic resonance imaging head abnormal, Magnetic resonance imaging neck, Magnetic resonance imaging spinal normal, Non-high-density lipoprotein cholesterol, SARS-CoV-2 test negative, Scan with contrast normal, Upper motor neurone lesion
SMQs:, Liver related investigations, signs and symptoms (narrow), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Lipodystrophy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: none known
Allergies:
Diagnostic Lab Data: MRI brain with and without contrast on 8/22/21 revealed acute stroke of his left corona radiata and posterior limb of internal capsule, correlating to his symptoms. Serum labs on 8/22 and 8/23 notable for AST 57, ALT 116, Triglycerides 385, HDL 26, LDL 73, non-HDL cholesterol 150, HgbA1c 5.0, COVID-19 PCR negative, MRI cervical spine normal.
CDC Split Type:

Write-up: Patient received first dose of Pfizer COVID-19 vaccine on 8/18 in his right shoulder and felt sore afterwards. The following day he began to feel weak in his right shoulder and by the end of the day felt weak in his right leg as well. The weakness has progressed and he has also felt chronically fatigued since then. Patient seen at outside hospital ED for the same, had negative CT head without contrast, normal serum chemistries and blood count, normal EKG, and was discharged for low concern for stroke. He denies numbness, tingling, shooting pains, trauma, history of autoimmune disease. He also denies recent illnesses, fever, chills, nausea, vomiting. Patient does have family history of early strokes in his father and uncles. He reported to another ED for progression of weakness. On my exam, patient had weakness of his right upper extremity and right lower extremity, pronator drift on his right arm, but normal sensation throughout.


VAERS ID: 1623836 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 3 RA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS ABXB35AA / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS AMVA569A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered
SMQs:, Medication errors (narrow)

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

Write-up: Patient received a third dose of the Pfizer-BioNTech COVID-19 vaccine. Her second dose had been given on 6/11/21.


VAERS ID: 1623858 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Hyperhidrosis, Lethargy, Loss of personal independence in daily activities, Malaise, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

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

Write-up: Woke up the following morning (shot administered around 1pm) with malaise, fatigue, generalized body aches, headache, lethargy, inability to complete normal daily activities, diaphoresis. I need to take Ibuprofen every 4 hours x24 hours in order to function. The symptoms improved the following day, but I still required several doses of Ibuprofen that day. I am now 5 days out and still experiencing fatigue.


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