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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 105 out of 6,867

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VAERS ID: 1623863 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Minnesota  
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 (MODERNA)) / MODERNA 091D21A / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Coeliac disease, Condition aggravated, Dysphagia, Eosinophilic oesophagitis, Fatigue, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prilosec OTC, Budesonide
Current Illness: None
Preexisting Conditions: Celiac Disease, Eosinophilic Esophagitis
Allergies: Eggs, wheat, milk
Diagnostic Lab Data:
CDC Split Type:

Write-up: After the first moderna shot on 7/14/21, I experienced extreme fatigue x 3 weeks and my cornea opening up x 2 within the first two weeks after receiving the first dose. I received my second shot on 8/17 and within 48 hrs my cornea opened again, my eosinophilic esophagitis was flared up and my joints were extremely painful. I could not swallow for 3 days due to the esophagus swelling. All of the symptoms I experienced are ones that happen when I am exposed to wheat/gluten. It''s like the shot made my body think that I had been exposed. I have had my celiac symptoms and eosinophilic esophagitis well controlled for over two years. And now they are out of control.


VAERS ID: 1623864 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-08
Onset:2021-08-19
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 mild symptoms has had infusion treatment had contact with positive case.


VAERS ID: 1623877 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Georgia  
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 0172 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Appendicectomy, Appendicitis, Blood test, Computerised tomogram
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: none
Diagnostic Lab Data: Bloodwork and CT scan to determine appendicitis diagnosis followed by emergency appendectomy.
CDC Split Type:

Write-up: Stomach pain leading to acute appendicitis diagnosis


VAERS ID: 1623909 (history)  
Form: Version 2.0  
Age: 77.0  
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 (MODERNA)) / MODERNA 053E21A / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Atrial fibrillation, Bradycardia, Chills, Decreased appetite, Fatigue, Headache, Heart rate irregular, International normalised ratio, Lethargy, Myalgia, Pyrexia, Rhinorrhoea, Sneezing, Somnolence, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (broad), Arthritis (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna Shot #2, Date 04/05/2021, Lot 031B21A
Other Medications: Toprol XL, Jantoven, Synthroid, Simvastatin, Prilosec, Aspirin.
Current Illness: Lone Paroxysmal Atrial Fibrillation
Preexisting Conditions: AFIB, BPH, Hypothyroid, Hyperlipidemia, GERD
Allergies: None
Diagnostic Lab Data: INR: No Change In INR Anticoagulation Time (Tested 36 Hours After Onset).
CDC Split Type:

Write-up: Symptoms Rapid Onset 12 Hours After Dose 3: Fever 4 Degree Rise Above Normal; Chills; Severe Muscular & Joint Aches; Overwhelming Fatigue; Difficulty Focusing Eyes (Eyestrain); Complete Appetite Loss; Moderate Headache; Erratic Heartbeat (Bradycardia to Brief Episodes of Atrial Fib); Sneezing; Runny Nose; Lethargy; Sleepiness. Duration: 36 Hours After Onset. Treatment: Bed Rest. Outcome: 95% Recovery So Far (72 Hours After Onset).


VAERS ID: 1623915 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: None- I have no primary doctor as i have no illiness
CDC Split Type:

Write-up: Extreme dizziness 1st 3 days. Light dizziness now 5 days later


VAERS ID: 1623956 (history)  
Form: Version 2.0  
Age: 17.0  
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 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: School       Purchased by: ?
Symptoms: Muscle spasms, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Arm is still really sore and muscles still hurt nowshe keeps getting muscle cramps


VAERS ID: 1623996 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Alaska  
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 021A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Eye irritation, Eye pain, Fatigue, Hyporesponsive to stimuli, Immediate post-injection reaction, Impaired work ability, Laboratory test, Lacrimation increased, Migraine, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Lacrimal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Dr. ordered labs and IVF. He responded to anti-emetic phenergan and was sent home.
CDC Split Type:

Write-up: "Instantly" after getting the vaccination, pt. described his left eye "felt on fire". His eye started watering . He later reported he had an "instant" migraine. MD was called to evaluate. He was having no SOB, vitals were stable x 30 minutes. He said he felt well to go home. After he was home, he felt fatigued, SOB, had some chest pain, eye pain and migraine. He went to bed and slept the night. In the AM he awoke, still fatigues, eye pain. Went to work and then sent home. He spiked a fever to 102F. His wife reported he was "barely responsive". He was taken to ED.


VAERS ID: 1624062 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-12
Onset:2021-08-19
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Dizziness, Eye pain, Headache, Impaired work ability, Nasal congestion, Nausea, Pain, SARS-CoV-2 test positive, Throat irritation
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Vestibular disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID19 antigen test via nasal swab on 8/19/21
CDC Split Type:

Write-up: Patient reports being fully vaccinated with Pfizer COVID19 vaccination on 12/21/20 and 2nd dose on 1/12/21. Patient reports COVID symptoms of cough, nausea, body aches, loss of taste, loss of smell, headache, eye pain, dizziness, scratchy throat, congestion starting 8/17/21 and tested COVID positive via antigen test on 8/19/21. Patient remains symptomatic and unable to work as of 8/23/21.


VAERS ID: 1624101 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
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 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient states that it has been 5 days since vaccination and she has been having numbness and tingling down both arms. Advised to contact PCP to make PCP aware of situation.


VAERS ID: 1624167 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Georgia  
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 939902 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Fear, Feeling abnormal, Headache, Heart rate increased, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (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: Tri-Lo Birth control, zyrtec, multivitamin, vitamin c
Current Illness: none
Preexisting Conditions: no
Allergies: lactose, pineapple, figs
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I had the normal predicted pain at the injection site, tiredness, headache, muscle pain, chills, and joint pain. But I also experienced a very rapid heart rate with minor activity that morning, that made me feel like I was going to give out. It scared me pretty bad. My heart rate jumped to 154 and stayed that way until I would sit for an extended period. I did notice on my watch that it stayed higher than normal that whole day. I stayed pretty tired for about 4 days.


VAERS ID: 1624168 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Arizona  
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 NDC:59267-1000- / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Eating disorder, Hypersomnia, Pain
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Minor drowsiness and sore arm
Other Medications: Levothyroxine - 50 MCG Hydroxyurea 500 MG Metoprolol Tartrate 50 MG Eliquis 2.5 MG amLodipine Besylate 5 MG Nature''s Bounty Hair, Skin & Nails with Biotin 3000mcg PreserVision Eye Vitamin & Mineral Supplement
Current Illness: See below
Preexisting Conditions: Lung cancer, COPD, heart disease
Allergies: Codeine-Guaifenesin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severely weak, struggling eating and drinking, sleeping 75% of the day, achy body.


VAERS ID: 1624207 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: South Carolina  
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 EW0177 / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Joint swelling, Mobility decreased, Paraesthesia, Tenderness
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: inability to raise arm past 60 degrees of elevation without significant pain. extreme tenderness to palpation around the glenohumeral joint, acromion process. tingling into the fingers of the ipsilateral hand with $g2 minutes passive elevation range of motion work. pain and weakness in shoulder external rotation, elbow flexion, shoulder extension. swelling at glenohumeral joint. recalcitrant pain unaffected by Ibuprofen and ice.


VAERS ID: 1624222 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-01
Onset:2021-08-19
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH VKX-20048-98930 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Cough, Headache, Pyrexia, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Lo Lo estrogen birth control pill Setraline Oxycarbazapine
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: 8/22/2021- Covid test done awaiting results
CDC Split Type:

Write-up: Roughly 3 weeks after my first Covid vaccine I started to get a cough, chest started hurting, runny nose, headache and fever


VAERS ID: 1624233 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Oregon  
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 035C21A / 1 LA / IM

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

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

Write-up: Patient received moderna covid vaccine that was past the BUD. BUD was labeled for 0411 and patient received dose at 1117. No symptoms or adverse event reported.


VAERS ID: 1624309 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Wisconsin  
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 047B21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adverse reaction, Dizziness, Dyspnoea, Hypoaesthesia, Paraesthesia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: Acetaminophen (shortness of breath), Vicodin (shortness of breath), Gabapentin (hives), Latex (rash), and tramadol (rash)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 5 minutes of receiving the vaccine she complained of numbness/tingling in her right arm. She then also complained of being short of breath and feeling dizzy. She then started demanding to leave the room because she couldn''t breathe with her mask on and wanted to go outside for "fresh air." I called the emergent response team and escorted her outside. Her vitals were taken and were all normal. The emergent response team arrived and she settled down once they were there. Her oxygen was completely normal and she refused oxygen supplementation. After another 5 minutes she said she was feeling better and left. She was given a single dose of Benadryl 50mg IM prior to the response team arriving. On 8/23/2021 she came to see me in person and said that a few hours after leaving she had developed hives and was feeling short of breath again but had not gone to see a doctor. She stated that she was going to be seen on Wednesday 8/25/21 to follow-up to her reaction and get treatment for the hives. I could visibly see that she had hives on her left arm. She said that she hadn''t done or tried anything new that could have caused the hives.


VAERS ID: 1624529 (history)  
Form: Version 2.0  
Age: 52.0  
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 FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Myalgia, Nausea, Pain in extremity, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called on 08/23/21 after receiving vaccine on 08/18/21 stating that he had the normal sore arm and muscle aches and fatigue, but also stated that he has had nausea and vomiting and has not been able to keep any food down since the day after the vaccine. Recommended that patient should go to urgent care or set up an appointment with PCP.


VAERS ID: 1624532 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-15
Onset:2021-08-19
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / UNK AR / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Crying, Feeding disorder, Hypersomnia, Mouth ulceration, Oral pain, Pyrexia, Tongue discolouration
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 12 hours after vaccine she began to run low grade fever for 2 days and slept most of the day and n ight, third day she woke up and seemed fine but Day 4 when she got up she was crying her mouth hurt and when i looked her tongue seemed yellowish and the roof of her mouth and around her gums had this yellowish ulcerated look. She could not eat and it was very painful. I took her to local urgent Care and the provider told me it was a reaction to the vaccine . She prescribed magic mouthwash but i could not find a pharmacy to fill it as it was a compound, so i gave her tyelenol for pain and had her rinse her mouth with a medicated mouthwash. after three days she felt better.


VAERS ID: 1624549 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
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 FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Palpitations, Pruritus, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: allegra, xyzal, xolair, omeprazole, nuvaring
Current Illness: asthma, allergies, OAS, CIU, gerd
Preexisting Conditions: asthma, allergies, OAS, CIU, gerd
Allergies: pineapple, severe oral allergy syndrome to all fruits and vegetable
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5 mintues after injection I became extremely hot and felt like I was going to pass out. Nobody was around to monitor patients so I went to my car to sit in the air conditioning. 45 minutes after I noticed my throat was tight and itchy, my heart felt like it was beating out of my chest, I was itchy from head to toe, and I became dizzy.


VAERS ID: 1624588 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Kansas  
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 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Dyspnoea, Erythema, Fatigue, Myalgia, Pyrexia, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: gabapentin, alprazolam, buproprion, losartan, metoprol, escitalopram, omeprazole, claritan, zinc, biotin, multivitamin, probiotic, b12 complex,
Current Illness: None
Preexisting Conditions: Depression, anxiety, hypertension
Allergies: Sulfa
Diagnostic Lab Data: 2 drs appts, benadryl, ibp, tylenol and ice packs
CDC Split Type:

Write-up: High fever, muscle and joint severe pain, shortness of breath, fatigue, dizziness, swelling, redness


VAERS ID: 1624805 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Georgia  
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 017E21A / 1 LA / IM

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

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

Write-up: Patient reported developing redness of her upper thighs, stomach, chest, inside of arms near elbows on day following vaccination. Reported no itching. Reported on 8/21 but claimed to be getting better.


VAERS ID: 1625267 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-11
Onset:2021-08-19
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Abnormal faeces, Asthenia, Dizziness, Headache
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (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: atorvastatin, pantoprazole, metoprolol, ferrous sulfate, carafate, tumeric, aspirin, miralax, tylenol
Current Illness: Iron level was low, which is normal for the patient. But no other illness at the time of vaccine or the month prior.
Preexisting Conditions: History of a long standing GI bleed, has been going on for many years, reports that provider is unable to locate location of the bleed. Gets IV iron infusions routinely to help with blood loss (approximately every 2 months)
Allergies: NDKA
Diagnostic Lab Data: None performed
CDC Split Type:

Write-up: Patient reports having a headache since the day of the vaccine on 8/11 and reports has not resolved. Reported that on 8/17 she received her IV iron infusion and on 8/19 she experienced severe abdominal cramping which was a 10 on the pain scale, light headed ness, a large quantity of coffee ground looking bowel movements, and was very weak. She noted that she usually feels much better after her iron infusions and she was feeling well and had increased energy on the day after the iron infusion on 8/18, but the symptoms above started on 8/19.


VAERS ID: 1625269 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
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 FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced tingling on left side of ace and left side numbness from hip to foot. Patient visited ER on 8/19/2021 and a stroke was ruled out


VAERS ID: 1627717 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

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

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

Write-up: Error: Booster Given Too Early-


VAERS ID: 1627737 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 2 LA / IM

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

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

Write-up: Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium


VAERS ID: 1627754 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-19
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy, Nodule
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 10mg
Current Illness: None
Preexisting Conditions: None - minor high blood pressure but controlled w/ meds
Allergies: Amoxicillin (maybe)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling of lymph node in left arm pit and now a knot on my forearm near where someone would typically draw blood.


VAERS ID: 1627978 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA D53W21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingrex #2
Other Medications: ToproXL, Plavix, 81 mg aspirin, Isosorbide, Fish oil, B12, D3, Montelukast, Pravastatin
Current Illness: Sprained leg
Preexisting Conditions: Heart disease
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chills; fever, upset stomach; muscle aches


VAERS ID: 1628024 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-19
Onset:2021-08-19
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025821A / 2 - / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Malaise
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: Very little symptoms and case is doing well


VAERS ID: 1628027 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-02
Onset:2021-08-19
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

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

Write-up: Approx 17 days post first dose i began to experience some chest tighness discomfort and heart palpitations


VAERS ID: 1628034 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Expired product administered, No adverse event, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: The patient MAY have received a dose of Janssen vaccine that was administered after the Beyond Use Date. The provider may have given the dose outside of the 6 hour window after the vial was opened. No symptoms or signs. Pt will be contacted and offered to be re-vaccinated to offer full protection.


VAERS ID: 1628044 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphthous ulcer, Lymphadenopathy, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Similar reaction after #2
Other Medications: lipitor, D3; C; Calcium
Current Illness: CLL
Preexisting Conditions: CLL
Allergies: penicillin; Sulpha
Diagnostic Lab Data:
CDC Split Type:

Write-up: RASH; PAIN; LYMPH NODE SWELLING; CANKER SORE


VAERS ID: 1628077 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Asthenia, Chills, Diarrhoea, Dizziness, Dyspnoea, Headache, Injection site pain, Myalgia, Night sweats
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acyclovir, Atorvastatin, Bumetanide, Calcium-Vitamin D, Citalopram, Nexium, Fish Oil, Fluticasone Lorazepam, Metoprolol Succinate, Multi-Vitamin, Pepcid, Lyrica, Preservision Areds 2, Spironolactone, Trazodone, Turmeric, Tylenol Extra Stren
Current Illness: myelodysplastic syndrome, pre-leukemia
Preexisting Conditions: lowered immune system
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Injection site pain, weakness, shortness of breath, muscle aches, joint pain, dizziness, abdominal cramps, headache, chills, night sweats, diarrhea. Still experiencing dizziness, weakness, and abdominal cramps 5 days out, also intermittent diarrhea.


VAERS ID: 1628124 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-27
Onset:2021-08-19
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Public       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 is positive for COVID after being vaccinated


VAERS ID: 1628129 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / UNK LA / IM

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

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

Write-up: During medication reconciliation, it was found that patient was given a non-valid dose of COVID 19 Pfizer vaccine on 8/19/2021. Patient notified and verbalized understanding that patient would need revaccination after 48 hours.


VAERS ID: 1628152 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-17
Onset:2021-08-19
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 2 UN / SYR

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

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

Write-up: None stated.


VAERS ID: 1628159 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-28
Onset:2021-08-19
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19 pneumonia
SMQs:, Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization for COVID pneumonia 8/19-8/22/21. Treated with dexamethasone and Remdesivir.


VAERS ID: 1628163 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Massachusetts  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 6 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 6 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Clinic will be conducting COVID-19 antibodies testing on patients to all patients who received Pfizer from this lot number on 8/19/21, two weeks following their second doses. (~9/2/21 for patients receiving second dose of Pfizer on 8/19/21 and ~9/16/21 for patients receiving second dose of Pfizer on 9/2/21).
CDC Split Type:

Write-up: One vial of Pfizer vaccine was reconstituted on 8/18/21, with two doses having been given. Vial was labeled, but left in refrigerator after expiry. Vaccination administration errors occurred when the remaining for patients in this vial were administered the following day on 8/19/21, later than the 6-hour expiry period after reconstitution. It is unknown which patients received these doses at vaccine clinic this day.


VAERS ID: 1628174 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-10
Onset:2021-08-19
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Fatigue, Lymph node pain, Muscle contractions involuntary, Muscle twitching, Myopathy, Red blood cell count
SMQs:, Rhabdomyolysis/myopathy (narrow), Dyskinesia (broad), Dystonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine (thyroid 112mcg), atorvastatin (10mg)
Current Illness: None
Preexisting Conditions: thyroid, high cholesterol, arrhythmia
Allergies: unknown
Diagnostic Lab Data: Blood work today with doctor (red blood cell count, myopathy)
CDC Split Type:

Write-up: Muscle twitching-fasciculation, predominantly in the legs. Onset not until about 9 days after vaccine. Continuing 5 days after onset and at time of this submission. General fatigue, sore lymph areas (under arms, side of neck).


VAERS ID: 1628238 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Dizziness and loss of consciousness


VAERS ID: 1628256 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Itching from head to toes. (Internal itch)


VAERS ID: 1628281 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-02
Onset:2021-08-19
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Amenorrhoea, Fatigue, Headache, Menstruation delayed, Mood altered, Pain
SMQs:, Acute pancreatitis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), 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: Escitalopram 10mg once daily
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: My period is currently 5 days late, with no chance of pregnancy. I am showing all signs of a period except the bleeding. My periods have always been regular on a 28th day cycle with period lasting 5 days. I have body aches, bloating, headache, fatigue, normal period moodiness but no bleeding.


VAERS ID: 1628325 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Undiluted dose of Pfizer Vaccination given no adverse reactions noted , no additional treatment needed.


VAERS ID: 1628386 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain, Vaccination site pain
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: Celecoxib
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is describing severe arm pain in vaccination arm when raising arms/moving. Does not experience pain when arms are by his side. It is not painful to touch and does not show any bruising/swelling at injection site. States he has felt this way since his shot. Has not improved in a week. Also states he bench presses every day but could only lift the bar post-vaccine compared to his usual $g 200 lbs. It has been recommended to try Tylenol in conjunction with the prescribed celecoxib to see if that would help relieve some of the pain. Patient refused those recommendations. In that case, recommended to have his doctor check it out to see if there is something else going on. Denies any other side effect, including blood clot signs/symptoms such as but not limited to: shortness of breath, chest pain, leg swelling, persistent abdominal pain, severe or persistent headaches or blurred vision, easy bruising or tiny blood spots under the skin beyond the site of the injection.


VAERS ID: 1628414 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Cardiac discomfort, Chest X-ray, Echocardiogram
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Echocardiogram- 8/24/2021 Bloodwork - 8/24/2021 Chest X-ray - 8/24/2021
CDC Split Type:

Write-up: Heart discomfort/pressure that comes and goes in waves with varying intensity and duration.


VAERS ID: 1628459 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: tired, headache, large swollen lymph nodes in the left armpit. The swelling lasted until August 24, headaches and tiredness still persist.


VAERS ID: 1628501 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Lymph node pain, Lymphadenopathy, Myalgia, Neck pain, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu-like symptoms after 2nd vaccine
Other Medications: Liothyronine, Levothyroxine, Progesterone, Spironolactone, Escitalopram
Current Illness: cold-like symptoms the week before
Preexisting Conditions: Systemic Lupus
Allergies: Sulfa
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Severe headache, stabbing pain that traveled around my body, fatigue, muscle aches, lymph nodes under both arms swollen to size of baseballs and painful. Lymph nodes were back to normal by 8/23/21. Other symptoms resolved on 8/22/21 with the exception of the stabbing pain in my left trapezius neck muscle. That continues.


VAERS ID: 1628524 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-31
Onset:2021-08-19
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 LA / IM

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

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

Write-up: Fully vaccinated patient hospitalized with COVID-19.


VAERS ID: 1628590 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Muscle spasms, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil Coq10 Magnesium
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Neuropathy type pain/tingling to brain, both hands ans feet. Legs cramps in am. Achey x1 week


VAERS ID: 1628594 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-02-10
Onset:2021-08-19
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Diarrhoea, Dyspnoea, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin, hyralazine, minoxidil, Prednisone, Losartan, Sulfa- Salazine, Omeprazole, Hydroxychloroquine, Cardizem CD, Folic acit Atorvastatin
Current Illness: Unknown
Preexisting Conditions: DM, Hypercholesterolemia, HTN, Rheumatoid arthritis, Sleep apnea
Allergies: ACE inhibitors
Diagnostic Lab Data: SARS COV2 COVID 10 PCR 08/19/2021
CDC Split Type:

Write-up: The patient presents with COVID-19. 76 year old male, who tested positive 1 day ago, presents to ED with COVID-19 symptoms. Pt states he is experiencing weakness, cough, sob, fever, and diarrhea. Pt denies abdominal pain, chest pain, and palpitations. The onset was 1 days ago. The course/duration of symptoms is constant. Associated symptoms: weakness, cough, sob, fever, and diarrhea, denies chest pain and denies sore throat. Risk factors consist of diabetes mellitus and COVID-19 infection.


VAERS ID: 1628607 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Feeling abnormal, Palpitations, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (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: Reported similar response to Hep B vaccination, lightheadedness and increased heartrate.
Other Medications: Paxal
Current Illness: ---
Preexisting Conditions: Patient stated had previous diagnosis of adrenal reaction to Hep B vaccination.
Allergies: Anaphylaxis to bee stings.
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5:35 pm- Patient c/o heart racing, not feeling so good. Patient place in reclined position. Fingertip pulse ox 99%. Heart rate 99-105. Client hands shaky. Patient has good color, lips pink, talking. No respiratory distress noted. 5:37 pm B/P unable to get reading, client requested cuff be removed and said it was making her feel worse. Cool moist cloth applied to forehead. Bilateral radial pulse present and equal. No wheezing noted. Calm talk with client, encouraged her to take slow deep breaths, talked about general things, weather, Grandma being with her, etc. Heart rate slowed to 85, client sat up a little more. Visual monitoring continued. 6:05 pm- Patient stated she felt response returning. Pulse rate increased to 105, pulse ox 99%, shakiness returned. Patient returned to reclining position. Patient refused to allow B/P pressure to be checked. Radial pulse equal bilaterally, lungs clear to auscultation, no wheezing noted. No respiratory distress noted. Patient color good, lips pink. Client continued with increased heartrate, c/o not feeling better. Patient c/o some chest tightness, but denied pain. Due to return of symptoms and c/o chest tightness. *EMS notified at 6:09 pm. EMS arrived approximately 6:25pm. (LISTED as Other Healthcare professional in Item 21 below.)


VAERS ID: 1628613 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / UNK RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fenofibrate 145mg Lisinopril/HCTZ 20-12.5 mg
Current Illness:
Preexisting Conditions:
Allergies: Penicillin Lopid Statins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Slight itching on the 19th. As the day went on, itching increased in palms of hands and around ankles. Later that evening, upper lip swollen. Took Benadryl and did not help. Went to a Nurse Practitioner and she gave me a steroid shot and a Prednisone pack.


VAERS ID: 1628620 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Received undiluted Pfizer Vaccine, no adverse reactions noted or reported, no additional treatment needed


VAERS ID: 1628688 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-26
Onset:2021-08-19
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time prolonged, Angiogram abnormal, Brain natriuretic peptide increased, Computerised tomogram thorax, Deep vein thrombosis, Fibrin D dimer, Pulmonary embolism, Pulmonary infarction, Right ventricular dysfunction, Ultrasound Doppler abnormal, Ventricular septal defect
SMQs:, Cardiac failure (broad), Haemorrhage laboratory terms (broad), Congenital, familial and genetic disorders (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Pulmonary hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: D Dimer = 12.53 aPTT = 79.4 BNP = 221 on admission to ED 8/19/2021. CT Angio Pulmonary on 8/19/21 reports "Extensive bilateral pulmonary emboli with saddle embolus. Flattening of the interventricular septum consistent with right ventricular strain." Ultrasound Duplex Left lower extremity 8/19/2021: "Deep venous thrombosis left lower extremity"
CDC Split Type:

Write-up: Patient admitted to hospital via ED with left lower extremity DVT and saddle PE. Patient had no prior health issues. CT reports bilateral pulmonary infarction.


VAERS ID: 1628725 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-01-09
Onset:2021-08-19
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Oropharyngeal pain, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: 08/19/21 1715 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/19/21 0859 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/19/21 1715 COVID-19 PCR Collected: 08/19/21 0859 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: Cough Sore throat


VAERS ID: 1628729 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abnormal dreams, Autoscopy, Body temperature increased, Dyspnoea, Enuresis, Feeling abnormal, Full blood count, Hallucination, Hallucination, auditory, Heart rate increased, Hyperhidrosis, Loss of consciousness, Oxygen saturation decreased
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Serquil 13.5mg- .5 tab/ night Methphendate 5mg: 2.5 tab in morning - 2.5 tab at night
Current Illness: No
Preexisting Conditions: No
Allergies: Penicillin
Diagnostic Lab Data: I went and saw my doctor because my hemoglobin was at 9.1 prior to this vaccine and so we did a CBC.
CDC Split Type:

Write-up: After taking my second dose of the moderna shot my body did very well for the first few hours. However, I woke up in the middle of the night and was hallucinating. It felt as if my body was floating but I wasn?t in my body and I could hear someone talking outside. I woke up from a vivid dream of someone telling me to breathe harder and not give up. Once I woke up I could feel myself breathing hard. I had an accident in the bed, and my whole sheets were drenched of sweat. I got up to the bathroom and I passed out on the floor. I woke up in my bed and checked my oxygen. It was at 83, and my pulse was at 155 (I have a pulse ox at home). My temperature was at 102, and I know that can happen with this vaccine. I sat up for a few hours to get my oxygen and temp to calm down.


VAERS ID: 1628755 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-16
Onset:2021-08-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Insomnia, Tinnitus
SMQs:, Hearing impairment (narrow)

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: Multi-vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none that i know of
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed a ringing in my right ear. Never had tinnitus before so this was very new. Its now going on day 6 with ringing in my ear. Cause me to lose sleep.


VAERS ID: 1628799 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-07
Onset:2021-08-19
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amitriptyline 50mg HS Benadryl 100mg HS as needed for insomnia Norethindrone 0.35mg Daily
Current Illness: None Documented
Preexisting Conditions: Secondary oligomenorrhea Migraine with aura
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID-19 after being fully vaccinated


VAERS ID: 1628828 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event
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: NO
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient got her first vaccine on 8/05/2021 and it was not a minimum of 21 days between the 2 vaccines. Patient stayed for 30 minutes and also called patient that evening and no reaction or adverse effects.


VAERS ID: 1628833 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Other       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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: This individual received COVID-19 vaccine JANSSEN twice - first on July 2, 2021, and second on August 19, 2021.


VAERS ID: 1628835 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Laboratory test, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (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: NONE.
Current Illness: DYSURIA DAY OF VACCINE.
Preexisting Conditions: NONE.
Allergies: NKDA.
Diagnostic Lab Data: LAB RESULTS PENDING.
CDC Split Type:

Write-up: DIZZINESS, HEADACHE, VISION BLURRING.


VAERS ID: 1628844 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Condition aggravated, Myocarditis, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metoprolol, Ranexa, Ofloxacin eye drop, Valacyclovir, Atorvastatin, Voltaren gel, Eliquis
Current Illness: unknown
Preexisting Conditions: heart
Allergies: NKA
Diagnostic Lab Data: Pt stated that he was diagnosed with myocarditis as a result of the vaccine per the Dr. Pt was admitted on Thurs, 8/19 and discharged on Sat, 8/21. Symptoms did persist so he returned to hospital on Sun, 8/22 and was discharged on Mon, 8/23 with a recommendation to follow up with Cardiologist.
CDC Split Type:

Write-up: Patient reported chest pain and tightness the same day that he received the vaccine. I asked if he had experienced this before and he said yes but it had been a while since he experienced it. I instructed him to seek medical care if symptoms persist. Patient called back over weekend and stated that he had been hospitalized over the weekend and was then discharged. He was diagnosed with myocarditis.


VAERS ID: 1628869 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Blepharospasm, Eye movement disorder, Hypoaesthesia oral, Mydriasis
SMQs:, Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

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

Write-up: tongue is numb, loss of taste, right eye does not close fully and twitches, and pupil is dilated


VAERS ID: 1629279 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-11
Onset:2021-08-19
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cellulitis, Injection site erythema, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamin, calcium with vitamin D
Current Illness: None
Preexisting Conditions: Seasonal allergies with asthma
Allergies: Penicillin, Keflex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Red splotches at injection site about 6-7 inches in size and warm to the touch. Called my doctor and was advised to go to urgent care (I am not near home). Urgent gave rx for Bactrim for possible cellulitis. 3 days later reaction was barely visible. Returned for follow up and asked about "covid arm". Doctor said it might be and to discontinue rx.


VAERS ID: 1629286 (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: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone decreased, C-reactive protein increased, Chest X-ray, Chills, Cough, Decreased appetite, Dyspnoea, Echocardiogram, Electrocardiogram normal, Fatigue, Hyperhidrosis, Lymph node pain, Palpitations, Pyrexia, Red blood cell sedimentation rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topiramate 25 mg, montelukast 10 mg, vit c, d3, magnesium, liothyronine 5mcg (half tablet only), synthroid 75 mcg, multivitamin, vit b complex 50, zyrtec 10mg, omega 3 1250 mg, vit k2
Current Illness: Migraines (being managed by meds), hypothyroidism (being managed by meds)
Preexisting Conditions: hypothyroidism (being managed by meds)
Allergies: None
Diagnostic Lab Data: Labs for esr, crp, and tsh. Ekg was normal. Pending. Chest xray, echocardiogram, and consult with cardiologist per my pcp, all appts scheduled on 8/26/21. If all clear with cardio, will contact my endocrinologist regarding thyroid being overactive now.
CDC Split Type:

Write-up: Heart rate resting 130, walking around up to 160 for 36 hours after vaccine. Currently 5 days later still resting is in the mid 90s instead of mid 70s. Shortness of breath, especially when talking which causes a dry cough persisting for the past 5 days. Sometimes have palpitations. Pain in left arm lymph nodes on occasion. Fever of 101 with chills and sweats for 36 hours has since resolved. Slept for 14 hrs, fatigue has resolved. No appeptite at all, still persisting after 5 days. Tsh is low now showing HYPERthyroid (was last tested on 7/20/21 and was right in the middle of normal where it has been for 2 yrs). Esr is high. Crp is high.


VAERS ID: 1629530 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: Initially I got a red bump around the injection site shortly after receiving the shot. It went away after 2 days, but 4 days after i got the shot I broke out in hives. They have spread and now cover my whole body. Legs, arms, hands, back, feet are covered in bumps. I have to take Benadryl every 4 hours or else they itch like crazy. Cortisone creams help with the inflammation but it''s been 3 days with the hives and they''re just getting worse instead of better. I had a virtual appointment and my doctor told me to just keep taking benadryl but I am going through a ridiculous amount of allergy creams/pills/ointments and there is no end in sight. Relief for a mere 4 hours before the itching starts again. If I wasn''t mandated by my employer to get the second dose of this stupid vaccine I wouldn''t as I''m concerned I will have a worse reaction! I expected initial discomfort but not endless hives!!!


VAERS ID: 1629730 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling cold, Pain, Piloerection, Pyrexia, Skin discolouration, Skin mass
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer 2nd dose 02/16/2021
Other Medications: Unsure, will call back with that information.
Current Illness: None.
Preexisting Conditions: I was diagnosed with juvenile rheumatoid arthritis when I was young; high triglycerides; breast cancer diagnosis in May.
Allergies: Duricef; erythromycin; family allergy of sulfa.
Diagnostic Lab Data: None.
CDC Split Type: vsafe

Write-up: My arm got a lump and got back and blue, I also had the chills and a slight fever and I was achy. Lump came that night the 19th and the black and blue was the next day and then the chills started in the morning of the 20th and I was cold but I was also in the car because I''m having medical treatment for my reconstruction and It was a rainy day so I didn''t think anything of it. When I came back home from that I got the chills and goosebumps. I went to my room immediately after that. Then I started getting the aches and fever and it was really just overnight and then the next day I was a little tired and a little achy but I felt much better and was up and moving around.


VAERS ID: 1629860 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-11
Onset:2021-08-19
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Nausea, Pain in extremity, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: On Aug 13 I had severe headache follow ed by nausea and heavy vomitinh I spent the afternoon in ER - got IV for the pain and vommitting On Aug 24 I had weird and strong pain and trembling in left leg


VAERS ID: 1629865 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-05-01
Onset:2021-08-19
   Days after vaccination:110
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus
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: Vitamin D, thyroid metabolic, zinc
Current Illness: No other illnesses. I am a healthy person except for allergies and asthma. I never get sick.
Preexisting Conditions: Allergies and asthma. Since birth.
Allergies: I have had severe allergies my whole life. Severe asthma. This is the reason l choose Johnson and Johnson. The other vaccines would of put me into anaphylactic shock. This reaction started last week. My shot site itches on my arm, my upper back itches and it is very annoying. I just wanted to report this just in case it gets worse. My supplements l take l have taken for years. This is not anything new.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: A week ago l began experiencing my arm where the shot was given itched. Then my upper back and occasionally my upper chest. I felt l should report this just Incase it worsens. I am using anti itch meds. I have had asthma and severe allergies my whole life. But felt that Jansen was the safest vaccine to get. I felt l needed to get the vaccine due to my lungs not being ok. Asthma has taken its toll on them.


VAERS ID: 1631056 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Maine  
Vaccinated:0000-00-00
Onset:2021-08-19
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Accidental exposure to product, Eye swelling, Ocular hyperaemia, Product administration error
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210840445

Write-up: ACCIDENTAL EXPOSURE TO EYE (DOSE RESIDUE); SAFETY PROCESS HAVE BEEN DONE OUTSIDE THE ARM (ADMINISTRATION ERROR); MINOR REDNESS OF EYE; MINOR SWELLING OF EYE; This spontaneous report received from a pharmacist concerned a 59 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: Patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820096, and expiry: 21-OCT-2021) dose was not reported, administered on 19-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-AUG-2021, the patient experienced accidental exposure to eye (dose residue). On 19-AUG-2021, the patient experienced safety process have been done outside the arm (administration error). On 19-AUG-2021, the patient experienced minor redness of eye. On 19-AUG-2021, the patient experienced minor swelling of eye. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from accidental exposure to eye (dose residue), and the outcome of minor redness of eye, minor swelling of eye and safety process have been done outside the arm (administration error) was not reported. This report was non-serious.


VAERS ID: 1631103 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-08-19
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Abstains from alcohol; Cigarette smoker (Reporter was a smoker for 25 years, quit at the beginning of the year); Food allergy; Comments: Patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: COVID-19 virus test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210846633

Write-up: SYMPTOMS OF FEVER; FATIGUE; This spontaneous report received from a patient concerned a 39 year old male. The patient''s weight was 332 pounds, and height was 75 inches. The patient''s past medical history included: cigarette smoker, and concurrent conditions included: allergic to mushroom, and non alcohol user, and other pre-existing medical conditions included: Patient had no drug abuse or 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 19-JUN-2021 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 symptoms of fever. On 19-AUG-2021, the patient experienced fatigue. On 23-AUG-2021, Laboratory data included: COVID-19 virus test (NR: not provided) negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the symptoms of fever and fatigue was not reported. This report was non-serious.


VAERS ID: 1631958 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-19
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210819; Test Name: SARS-CoV-2 IgG antibody test; Result Unstructured Data: less than 1.00 (Negative).
CDC Split Type: USJNJFOC20210846558

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient via a company representative concerned a 58 year old male unspecified race and ethnicity. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, 1 total administered on APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 19-AUG-2021 07:20, the patient underwent blood test (COVID-19 Antibody Test, Semi-Quantitative) to determine the level of antibodies. Laboratory data included: SARS-CoV-2 IgG antibody test (NR: not provided) less than 1.00 (Negative) (confirmed immunological vaccine failure) which means there were no detectible antibodies in patient. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210846558- covid-19 vaccine ad26.cov2.s-CONFIRMED IMMUNOLOGICAL VACCINE FAILURE . This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1631987 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chest pain, Chills, Dizziness, Flushing, Headache, Hyperhidrosis, Hypoaesthesia, Insomnia, Nausea, Pain, Pyrexia, Tremor, Visual impairment
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Systemic: Body Aches Generalized-Severe, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fever-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Headache-Medium, Systemic: Joint Pain-Severe, Systemic: Nausea-Severe, Systemic: Numbness (specify: facial area, extremities)-Severe, Systemic: Shakiness-Severe, Systemic: Unable to Sleep-Severe, Systemic: Visual Changes/Disturbances-Medium


VAERS ID: 1632215 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Received undiluted dose of Pfizer, no adverse reactions, no additional treatment


VAERS ID: 1632270 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-05
Onset:2021-08-19
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 030A21A / UNK - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 031B21A / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: HOSPITALIZED AFTER VACCINE


VAERS ID: 1632273 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

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

Write-up: PATIENT DEVELOP BELL''S PALSYNEXT DAY OF VACCINATION PRESCRIBE ANTIINFLAMATORY


VAERS ID: 1632278 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: Patient admitted reporting Moderna Covid-19 vaccine dose #1 in community. Patient provided Moderna dose #2 at based on patient disclosure. Verification revealed patient received Pfizer for #1 dose in community. Information disclosed regarding mixed series dosing. Evaluated and monitored in medical unit for adverse reactions. None were noted or assessed.


VAERS ID: 1632329 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Livedo reticularis, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: joint pain, swelling , modeling of feet and hands.


VAERS ID: 1632355 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN0169 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Cough, Fatigue, Pruritus, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Verapamil 180, Valsartin 120 hydrochilodizide 25, avorsartin 40, c, d 3, tuneric,
Current Illness: Asthma
Preexisting Conditions:
Allergies: All fruit, blue fish, eggs, chicken, rag weed, mold, dogs, cats, grass, trees, Amoxicilin, Tetricycline
Diagnostic Lab Data: Just a doctors visit next day. Given steroids.
CDC Split Type:

Write-up: Itching throughout body inside & out. Throat tightening, coughing, tiredness. Eppi pin, allergy meds, steroids asthma pump. Hasn''t stopped.


VAERS ID: 1632397 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-03
Onset:2021-08-19
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Electrocardiogram normal, Myalgia, Paraesthesia, Ultrasound scan normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Probotics, Omega 3
Current Illness: Inflamation of intestines
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: None offered or given
CDC Split Type:

Write-up: Muscle pain in left arm, chest and left back at shoulder blade. Tingling in left arm. Started on 8/19/2021 and continues, as of 8/25/2021. Had ultrasound and EKG, both negative.


VAERS ID: 1632495 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Epistaxis, Haemoptysis, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

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

Write-up: Started getting sharp pain in upper right chest around 230PM that worsened with activity, got better with resting. Around 9P started severe nose bleed and coughing spitting blood, continued chest pains. Never had a nose bleed of cough blood before. Bleeding stopped around 15 minutes later but chest pains continued for 3 days.


VAERS ID: 1632504 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: medrodroxyprogesterone 10mg tabs
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: patient developed hives and itching the evening of receiving the dose. she followed up with a dr that told her to take an antihistamine. patient said she was stilling having some hives and itching and asked what else she could do to the pharmacy. suggested that she follow up with dr and continue to take antihistamine. if getting worse see ER


VAERS ID: 1632518 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C2IA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamins, Vit D3, Vit B12, Vitamin C
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Severe sore on the injection site, Fever of 101.5, severe muscle aches, and severe headaches


VAERS ID: 1632606 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-01
Onset:2021-08-19
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Cough, Hypoxia, Inflammatory marker test, Liver function test increased, Oropharyngeal pain, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test positive, Sinus congestion
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Coronavirus test: 08/18/2021 - positive
CDC Split Type:

Write-up: 54-year-old female presents the emergency room for evaluation of hypoxia. She has a known positive COVID test. Patient reports 08/11/2021 in which she developed sinus congestion sore throat and cough. She was seen by her primary care physician on 08/12/2021 and had a positive COVID test. She reports that she ran fever to 102 for 4 days. She has not had any fever for the past 3 days. She has not had any nausea vomiting or diarrhea. Patient reports having the Johnson & Johnson immunization in April. She states that she had a video conference with her primary care physician earlier today who advised her to get a home pulse ox which she did. She then sent him a picture of the reading which she states was 89%. This was on room air. He has advised her to come to the emergency room. According to the emergency room physician Dr. the patient did have pulse ox readings of 90% on room air on presentation. She has been placed on 2 liters/minute oxygen. I have been asked to admit the patient due to her hypoxia. Patient has a history of asthma and is on albuterol as needed. Pt was discharged on 08/21/2021 - Admitted with COVID-19 viral pneumonia Vaccinated with J and J in April The patient has been having 7-8 days of symptoms at admission, she was hypoxic per home pulse ox reading and by verbal report her initial pulse ox reading on room air at our facility was 90%, started dexamethasone 6 mg IV daily. Patient has mild elevation of liver function test but they are within the parameters of starting remdesivir Inflammatory marker labs per COVID order set On 3 L, repeat CXR in am stable and same O2 requirements Has stabilized here and unlikely to worsen, will dc home on oxygen and oral steroid course


VAERS ID: 1632617 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 3 LA / IM

Administered by: Unknown       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: Rasuvo, Eliquis, folic acid, sulfasalazine, Vitamin D, citalopram, Olmesartan, LoEstrin Fe, Flovent Diskus
Current Illness: None.
Preexisting Conditions: Rheumatoid Arthritis, Asthma, htn, panic disorder, vit D deficiency, paroxysmal atrial fibrillation, OSA
Allergies: Oxycodone, diltiazem
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Headache since 2 days post-vaccination


VAERS ID: 1632664 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-16
Onset:2021-08-19
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 47Y11M24D / UNK RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 48Y0M18D / UNK RA / IM

Administered by: Public       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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: High Blood Pressure , Asthma
Allergies:
Diagnostic Lab Data: PCR Test
CDC Split Type:

Write-up: Developed Covid 8/19/2021.


VAERS ID: 1632762 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 told us it was his first covid 19 vaccine. He filled out the consent form and indicated he did not receive a dose of COVID-19 vaccine before. When the pharmacy went to log information in the state registry the following day, we saw that the patient had received the J and J covid vaccine on 03/16/2021.


VAERS ID: 1632781 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cellulitis, Erythema, Injection site rash, Pruritus, Rash, Skin warm
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: Alphagan Bisopropol Diazepam dicyclomine fluticasone nasal spray hydrochlorothiazide levothyroxine omeprazole
Current Illness:
Preexisting Conditions: hypothyroidism coronary artery disease renal cell carcinoma s/p nephrectomy essential hypertension malignant melanoma cardiac pacemaker in situ
Allergies: neosporin penicillins
Diagnostic Lab Data: none
CDC Split Type:

Write-up: localized eruption to injection site that has since spread down the arm-- increasing redness, warmth, and itching. Treated for allergic reaction with antihistamines and cellulitis with doxycycline


VAERS ID: 1632817 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2020-12-23
Onset:2021-08-19
   Days after vaccination:239
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 AR / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L02A / 2 AR / SYR

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

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

Write-up: POSITIVE COVID


VAERS ID: 1632819 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-20
Onset:2021-08-19
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Rhinorrhoea
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: runny nose, headache, fatigue


VAERS ID: 1632860 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Differential white blood cell count, Dyspnoea, Electrocardiogram, Feeling abnormal, Full blood count, Lipase, Liver function test, Metabolic function test, Troponin I
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Sulfer
Diagnostic Lab Data:
CDC Split Type:

Write-up: Went to the hospital on Sunday August 22nd with shortness of breath and abdominal pain. The test they ran are basic metabolic panel, CBC with audio differential, hepatic functional panel, lipase, POCT Troponin I, ECG (electrocardiogram ) 12 Lead, they gave me an IV and some oxygen, dicycomine. They sent me home with dicycomine and ondansetron still was feeling bad so went to see my doctor and they prescribed a few other prescriptions and now I''m starting to feel better


VAERS ID: 1632963 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Headache, Rash
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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 REPORTS SHE WOKE UP DAY AFTER VACCINE 8/19/21 WITH HEADACHE/LIGHT HEADEDNESS THAT WENT AWAY AFTER 3 HOURS BUT RECURRED OFF AND ON SINCE VACCINE; PATIENT ALSO REPORTS SHORTNESS OF BREATH DAY AFTER VACCINE 8/19/21 AND THAT GOT NOTICEABLY WORSE 4 DAYS POST VACCINE AND HAS BEEN CONSISTENT SINCE "CANNOT GET A FULL CLEANSING BREATH;" PATIENT ALSO REPORTS RASH DESCRIBED AS DOTS ON TRUNK OF BODY, CHEST, BACK, HIPS, NECK STARTED 8/20/21 AND LASTED UNTIL 8/22/21 GRADUALLY FADING AWAY. THE SHORTNESS OF BREATH IS MOST CONCERNING AS SHE IS A RUNNER AND HAVING TROUBLE WITH CATCHING HER BREATH WITH REGULAR ACTIVITIES.


VAERS ID: 1633042 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Pt is 17 years old and received Moderna, guardian was not present. Staff spoke with mother on 8/25/21. Mother was aware that her son received a COVID vaccine and that it was Moderna. She said he had no side effects. Mother willing to be present and give written consent for future 2nd dose in series.


VAERS ID: 1633162 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 AND FC31 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Exposure during pregnancy, Fatigue, Headache, Muscle fatigue, Tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), 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: Prenatal gummies, low dose aspirin, colace
Current Illness:
Preexisting Conditions:
Allergies: Acetaminophen
Diagnostic Lab Data:
CDC Split Type:

Write-up: 22w at time of 1st shot and 25w pregnant at time of 2nd shot. No issues with health, due date is Nov 27th. A week after 1st I had tachycardia in the morning 2 days in a row with shortness of breath. No treatment and did not see a Dr. About 16 hours after 2nd dose I had tachycardia all day with shortness of breath and major fatigue. Later that evening I also had chills, mild headache and muscle fatigue in legs. No treatment and no dr seen. Next day I was fine but I am concerned about any heart related issues now. I have a cardiologist appt sept 28th.


VAERS ID: 1633345 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash, Injection site swelling, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: complained of swelling and rash at injection site and pain radiating from arm


VAERS ID: 1633379 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-12
Onset:2021-08-19
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal
SMQs:, Dementia (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: Nortriptyline, Tramadol, Lyrica
Current Illness: None
Preexisting Conditions: asthma
Allergies: IV Contrast Dye
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue and extreme crappiness for 3 dang days. Lots of rest. Finally got better.


VAERS ID: 1633774 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-16
Onset:2021-08-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Asthenia, Contusion, Depressed mood, Electric shock sensation, Fatigue, Headache, Hot flush, Hypoaesthesia, Injection site pain, Injection site reaction, Injection site swelling, Intermenstrual bleeding, Loss of personal independence in daily activities, Muscle spasms, Muscle twitching, Pain, Pain in extremity, Paraesthesia, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (narrow), Tendinopathies and ligament disorders (broad), 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? Yes
Hospitalized? No
Previous Vaccinations: I was 5 or 6 not sure which one . I had sever pain very deep throughout body. Felt like glass. Hallucinated.
Other Medications: NA
Current Illness: NA
Preexisting Conditions: Asthma
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Vaccine log moderna - 16th, Monday- twitching/spams in injection sight within the first hour of recovering vaccine. Otherwise feeling sore worse throughout day. Could barely undress for bed - 17th- very sore very painful if touched, or bumped still spasming around injection sight swelling - 18th- pretty sore but easing up. Very tiered. Spasm continue near injection sight - 19th- sore but subsiding a lot. Middle of night arm began going numb, tingling, needle/pin like sensation through arm to fingertips. Alternates between pinky,ring,middle going numb to pointer and thumb, to all. Muscle spams all over body. Anxious - 20TH very tired. Spasms continue, numbness is off and on but getting stronger. A little sore in injection sight still but not bad. Pin and needle sensation continuing through left arm still. Spasm occasionally in random areas of body. Tiered, mild headache. Called pharmacist she said it is a rare side effect go see doctor if left arm becomes painful or week. Went to emergency room, doctor said come back if I loose strength in arm but could just be ?my normal? response to vaccines. She said I am swollen and bruised , could be caused by swelling. She also said how the vaccines are new so they just don?t know yet why some people are responding the way they are. Prescribed Benadryl. I told the nurse I was nervous to get my second does and asked if she had advice. Nurse suggested asking to take another brand, I could have misinterpreted her. Also suggested taking Tylenol before second does. - 21st. Still slightly sore. Spams seem to calm down in the morning but would come back or get stronger throughout day. Feels more like ?vibrating? throughout arm or mild electricity going through it. Very tiered, feeling depressed and not heard or helped. Mild headache - 22nd Very depressed hot flashes and tired. My hand feels numb most of the time with electric shock feeling going through it or like a vibrating. Some spasms still. Getting random aches in right leg and Very mild pin feeling in leg. Mild headache, in areas of head I?ve never felt before. Tired. Started light spotting not supposed to start next menstrual cycle for 3 more days. - 23rd, hot flashes. Very mild Pain/mild numbness , arm spasming. Right leg has some numbness, pain. Mild headache, tired. Saw allergist said it seems like i am having anxiety induced symptoms. I can decide to take moderna again or a non mRNA vaccine. He says I am not having an allergic reaction and that my symptoms will stop once I decide. - 24th numb, hot flashes, sharp pains in arm woke me up twice while sleeping - 25th numb, left hand grip is getting weaker, saw chiropractor to see if adjustment would help. Gave some relief to sharp/needle pains temporarily. Arm is still numb. Arm becomes very tiered if I try to do anything to long


VAERS ID: 1634888 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-08-19
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Disorientation, Head discomfort, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20210820; Test Name: Body temperature; Result Unstructured Data: 100.5 F
CDC Split Type: USJNJFOC20210849037

Write-up: HEAVINESS IN HEAD; FELT DISORIENTED; CHILLS; NOT FEELING GOOD; FEVER; This spontaneous report received from a patient concerned a 33 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included: mild covid. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820095 expiry: 02-OCT-2021) dose was not reported, administered on 18-AUG-2021 19:00 for prophylactic vaccination. No concomitant medications were reported. On 19-AUG-2021, the patient experienced heaviness in head. On 19-AUG-2021, the patient experienced felt disoriented. On 19-AUG-2021, the patient experienced chills. On 19-AUG-2021, the patient experienced not feeling good. On 19-AUG-2021, the patient experienced fever. On 20-AUG-2021, Laboratory data included: Body temperature (NR: not provided) 100.5 F. Treatment medications included: ibuprofen. On 21-AUG-2021, treatment medications included: paracetamol. On 23-AUG-2021, treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills, and fever on 20-AUG-2021, had not recovered from heaviness in head, and felt disoriented, and the outcome of not feeling good was not reported. This report was non-serious.


VAERS ID: 1636119 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Discomfort, Eye pruritus, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Women?s multi-vitamin, omega, Vitex, ashwaganda, vitamin d3, magnesium,
Current Illness:
Preexisting Conditions: GAD
Allergies: Lavender, shrimp, seasonal
Diagnostic Lab Data:
CDC Split Type:

Write-up: Beginning immediately after the injection I began feeling a tingly or itchy sensation in the forearm of the arm I received the vaccine. The sensation has come and went sende receiving the vaccine. There is not any kind of physical action that triggers the sensation. 6 days after the vaccine I have started feeling discomfort in my left armpit - the sensation almost feels like a sore Or tender muscle Sensation and is more tender to touch. I have also had a slightly heavy Or tight feeling in my chest since receiving the vaccine. I plan to both call Walgreens pharmacy where I received the vaccine as well as visit a health care provider should the symptoms persist past a week of receiving the vaccine.


VAERS ID: 1636120 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-03
Onset:2021-08-19
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Headache, Nasal congestion, Pain, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (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: diclofenac sodium (VOLTAREN GEL) 1 % gel ferrous sulfate 325 mg (65 mg iron) tablet mometasone (ELOCON) 0.1 % ointment
Current Illness:
Preexisting Conditions: Nervous Arthralgia of right hand Chronic bilateral low back pain without sciatica Mastalgia in female Digestive Vitamin D deficiency Musculoskeletal Osteoarthritis of fingers of hands, bilateral Costochondritis Hematologic Iron deficiency anemia secondary to inadequate dietary iron intake Other Breast cyst, right Long term current use of non-steroidal anti-inflammatories (NSAID)
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Headache started thursday ? Chills ? Cough ? Nasal Congestion ? Generalized Body Aches


VAERS ID: 1636158 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: no adverse medical side effect from moderna vaccine patient denied having previous vaccine, however when reporting moderna vaccination to Department of Health it was discovered that patient received COVID-19 Janssen vaccine on 04/05/2021


VAERS ID: 1636433 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-06
Onset:2021-08-19
   Days after vaccination:74
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, COVID-19, Caesarean section, Exposure during pregnancy, False labour, SARS-CoV-2 test positive
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PCR test positive 8/19/21.
CDC Split Type:

Write-up: Patient presented to hospital for fetal evaluation,. Patient came with false labor at 38 weeks 6 days. Patient was discharged home and came back to hospital at 39 weeks 6 days for c section. Patient is asymptomatic.


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