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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 106 out of 6,867

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VAERS ID: 1636449 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-02-24
Onset:2021-08-19
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001A21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: QRS axis abnormal
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: Bystolic, Simvaststatin, montelukast,triamtetene/Hctz,Lisinopril/Hctz,Decilant, Timolol (drops), Axopt (drops), Vitamin C, multivitamin, Mucinex-D
Current Illness: None
Preexisting Conditions: HBP, High Cholesterol, GERD, Minieres Ear
Allergies: Codeine
Diagnostic Lab Data: EKG 8/19/2021
CDC Split Type:

Write-up: Recent EKG 1st since vaccine showed abnormal reading 1st time I have had one Moderate left Acis deviation -30 deg. = < QRS axis < -20 deg Recommended to see Cardiologist Scheduled Cardiologist appt for Oct


VAERS ID: 1636508 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Dry eye, Facial paralysis, Headache, Magnetic resonance imaging head, Rhinitis, SARS-CoV-2 test negative
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Corneal disorders (broad), Hearing impairment (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Dehydration (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKDA
Diagnostic Lab Data: MRI; PT
CDC Split Type:

Write-up: Vaccine administered Wednesday 8/18/21. Patient reports he was fine on Wednesday. Thursday, he started to notice his right eye was dry but was tearing in order to rewet the eye. He was also experiencing coryza in his right nostril. Friday, he reported experiencing some pain towards the back of his head behind his ears and near his neck. On Saturday, he reported a little HA throughout the day, and still with coryza and tearing/dryness in the right eye. By Saturday PM, he was still feeling ill with HA. He went to a facility and was tested for COVID; resulted negative and was diagnosed with allergies and was told to take antihistamines. He went home, did not take any meds. Sunday, he still had a HA and coryza. He called out of work for Monday. Upon awakening and drinking some orange juice, he spilled some orange juice on himself. His wife asked him if he was ok, to which he replied yes. His wife then alerted him that he was possibly having a stroke, and that his face was drooping on the right side. He and his wife rushed to ED where he was diagnosed with Bell?s Palsy and was told that it was likely due to his recent vaccination. He was referred to neurology who then ordered an MRi and physical therapy. He was told that his droop will probably resolve in 30-60 days depending on therapy but that it is likely temporary.


VAERS ID: 1636525 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Lymphadenopathy, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asplenia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lymph nodes+ swelling- treated with prednisone (this was patient''s 3 rd booster shot- 2nd shot administered 4/24/2021)


VAERS ID: 1636626 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood bilirubin increased, Dizziness, Fatigue, Headache, Malaise, Oropharyngeal pain, Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Biliary system related investigations, signs and symptoms (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: allopurinol : one tablet by mouth once daily aspirin one tablet by mouth once daily clonazepam: one tablet by mouth two times daily as needed for anxiety dextroamphetamine-amphetamine (ADDERALL XR): one capsule by mouth every morning gab
Current Illness: None
Preexisting Conditions: Anxiety, depression, chronic idiopathic gout (frequent attacks, followed by Rheumatology), GERD, HTN, obesity, alcohol abuse (in remission), and EtOH cirrhosis s/p OLT 12/14/16 with incidental intracytoplasmic globules c/w A1AT.
Allergies: Benazepril--cough
Diagnostic Lab Data: AST: 112; ALT: 474; Total Bilirubin: 1.4; Alkaline Phosphatase: 143.
CDC Split Type:

Write-up: Fever (Oral 101.9F at home), fatigue, malaise, headache with lightheadedness and a mild sore throat.


VAERS ID: 1636661 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Chills, Decreased appetite, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

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

Write-up: Pt. states that after receiving the 1st dose of J&J 08/20/2021, started experiencing symptoms immediately of shaking severe chest pains, loss of appetite, and chills. Still continuing, Primary recommendations "Wait it out".


VAERS ID: 1636700 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray abnormal, Chills, Condition aggravated, Cough, Fatigue, Pain, Pneumopericardium, Pyrexia, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol as needed for headaches Senna laxative 8.5 mg daily
Current Illness: Cough since the week of July 12, 2021
Preexisting Conditions: Asthma and seasonal allergies
Allergies: none
Diagnostic Lab Data: Strep throat swab came back negative
CDC Split Type:

Write-up: Before giving him his first dose of the Pfizer vaccine, I informed the pharmacist that Pt has had a cough for about a week prior. They told me it was ok to give him the shot. Approximately 12 hrs after receiving the shot, he got a fever which got up to 104, body aches, sore arm, tired, and chills. It only lasted for 24 hours but his cough got worse. I took him to his dr. on July 29, 2021, He had a lung infection and was put on a 10 day course of antibiotics. His cough subsided but did not go away. His 2nd dose was given on August 18, 2021. He still had a lingering cough. Approximately 8 hours after getting the 2nd dose is when the symptoms started. He had a fever of 102, body aches, chills are tired. His cough got worse. August 20, 2021 I took him to his doctor for a check up. She ordered an X-ray. X-ray came back showing he had some air pockets around his heart so we were told to go to the ER for further evaluation. At the ER he was monitored, his vitals were all good so we were sent home with steroid liquid medication along with steroid inhaler. He has a follow up appointment with his doctor later this afternoon.


VAERS ID: 1636833 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin
Current Illness: None
Preexisting Conditions: Leukemia
Allergies: None
Diagnostic Lab Data: Doctor visit - put on antiviral and pain medication
CDC Split Type:

Write-up: Shingles


VAERS ID: 1636875 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Louisiana  
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 050C21A / 1 RA / 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: child 13 received vaccine, age not approved at present.


VAERS ID: 1636928 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Texas  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F08448 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Bone pain, Chills, Diarrhoea, Dizziness, Headache, Lethargy, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Osteonecrosis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Exemastrane, Pepcid AC, Melatonin, D3, Calcium
Current Illness:
Preexisting Conditions: Breast cancer, gluten sensitivity
Allergies: Bactrim, PCN, Gluten
Diagnostic Lab Data:
CDC Split Type:

Write-up: 103 fever, nausea, chills, headache, abdominal cramps, diarrhea, bone aches, lethargy and dizziness. The fever lasted 4 days, at day 8 now and still experiencing abdominal cramps and some nausea and lethargy.


VAERS ID: 1636937 (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: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product storage 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1637009 (history)  
Form: Version 2.0  
Age: 74.0  
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 088D21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Adrenocorticotropic hormone deficiency, Asthenia, Blood test, Chest X-ray, Condition aggravated, Confusional state, Dysarthria, Fall, Movement disorder, Muscular weakness, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hydrocortisone Valtrex levothyroxine Dupixent Xolair
Current Illness:
Preexisting Conditions: ACTH Insufficiency Hypothyroidism MGUS Allergic Contact Dermatitis Allergic Urticaria
Allergies: Balsam of Peru Propylene Glycol Cashew nut Eggs Pork/Chicken
Diagnostic Lab Data: Blood work, chest xray.
CDC Split Type:

Write-up: Fever and lost all muscular strength. Fell onto floor and could not get up or turn over. Confused stated of mind and garbled speech. Spouse thought I was having a stroke and called 911. At ER, I was treated for dehydration and given Hydrocortisone due to my ACTH Insufficiency. Recovered in about 2 days.


VAERS ID: 1637078 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Blindness unilateral, Seizure
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Patient reports having a seizure at 2am the day after vaccination. States it lasted about 2 hours and the next day he was unable to balance and lost vision in one of his eyes. A day later he reports that he returned to normal health.


VAERS ID: 1637084 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Disorientation, Dizziness, Feeling abnormal, Hot flush, Hyperhidrosis, Impaired driving ability, Injection site pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Body ache at injection site
Other Medications: Amino acids and L-Carnitine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was extremely sore in my injection site on this 2nd shot. So much so that my entire body was feeling strained. I woke up the next morning feeling out of it and almost had an inebriated sensation in the sense of feeling light headed and partially disoriented. I tried to drive to work when I noticed that my motor skills were lacking as well and almost got hit by a vehicle turning into an intersection and almost hit a vehicle returning home. I also had a completely drained energy feeling and stomach ache and rested in bed for the rest of the day. The next day at work I experienced profuse hot flashes and sweating fits off and on. Later on the day I felt like I might have sweated it out possibly? Every day sense my body seems to be getting better. I''m back to working out moderately and living casually. Was just very alarming and the fact I had to take a point at work was not ideal.


VAERS ID: 1637127 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Colorado  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (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: Acetaminophen
Current Illness: n/a
Preexisting Conditions: obesity
Allergies: NKDA
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient developed a painful itchy lump about the size of a golf ball the day of the injection at the injection site that has persisted for 7 days post-vaccination despite used of HC cream and ibuprofen. On exam, it is slightly erythematous and TTP, approx 2.5 cm in diameter.


VAERS ID: 1637128 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Iowa  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: I was given a Pfizer vaccine that was diluted with 0.9mls of 0.9% of sodium chloride instead of 1.8mls of 0.9% of normal saline. No adverse reaction


VAERS ID: 1637146 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-05
Onset:2021-08-19
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

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

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

Write-up: About two weeks after receiving the 1st does of the Pfizer vaccine.. I started having slight ringing in my ears. It is most noticeable when going to bed or am in a very silent area.


VAERS ID: 1637182 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-15
Onset:2021-08-19
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 UN / IM

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

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

Write-up: PT. FULLY VACCINATED 2/22/21 LOT EM9810; 3/15/2021 LOT EN6198. TESTED + 8/22/2021


VAERS ID: 1637199 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-08
Onset:2021-08-19
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/21/21 2nd dose01/08/21 Diagnosed covid positive:08/19/21 Symptom onset:08/17/21 Exposure: Symptoms:sneezing.


VAERS ID: 1637201 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-20
Onset:2021-08-19
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Diarrhoea, Exposure to SARS-CoV-2, Headache, Myalgia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/30/20 2nd dose01/20/21 Diagnosed covid positive:08/19/21 Symptom onset:08/17/21 Exposure:travel Symptoms:fever, cough, muscle aches,diarrhea, chills HA


VAERS ID: 1637216 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-13
Onset:2021-08-19
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Diarrhoea, Fatigue, Headache, Myalgia, Pyrexia, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/23/21 2nd dose01/13/21 Diagnosed covid positive:08/21/21 Symptom onset:09/19/21 Exposure: Symptoms:fever, cough, muscle aches,diarrhea,fatigue, chills,runny nose,HA


VAERS ID: 1637219 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-05
Onset:2021-08-19
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Myalgia, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose02/12/2021 2nd dose03/05/2021 Diagnosed covid positive:08/19/21 Symptom onset:08/21/21 Exposure:Home Symptoms:Cough, muscle aches, sore throat,runny nose, HA.


VAERS ID: 1637224 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-31
Onset:2021-08-19
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Birth control, vitamins
Current Illness: None
Preexisting Conditions: Deep vein thrombosis ( After vaccine)
Allergies: Naproxen, dairy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Deep vein thrombosis


VAERS ID: 1637240 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
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: Erythema, Skin warm, Swelling, Tenderness, Type IV hypersensitivity reaction
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: localized delayed hypersensitivity reactions- swelling, tender, redness, warm to touch


VAERS ID: 1637255 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inflammation, Limb discomfort, Neuralgia, Paraesthesia, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Consultation with Dr. on August 26, to examine my adverse events. Visual examination, but no laboratory tests at this point. Need to report back to the doctor if adverse events continue and also if they increase. Requested by doctor to keep him updated before proceeding with dose 2 of the EUA Vaccine.
CDC Split Type:

Write-up: 24 hours after vaccination - inflammation to the upper left chest area and tightness in upper left arm 48 hours after vaccination - nerve pain and pulsing in left arm down to the fingers and nerve pain in upper left side of chest 3 days post vaccination - nerve irritation moves down to the left side of the body including the foot and toes, with off and on nerve pulsing in the left arm and left side of the chest 4 days post vaccination - off and on nerve pulsing moves to the right side of the body in the arm, chest, hamstring, and shin. The left side continues to have the nerve irritation as prior days. Some nerve tingles in the back right and right side of the skull. Days 5-8: nerve pain continues to come and go on both sides of the body. The most frequent pulses are in the nerves around the left side of the chest and in the left arm.


VAERS ID: 1637295 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Nevada  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 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: over 42 days. 1st dose 05/25/21, 2nd dose 8/19/21


VAERS ID: 1637318 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-12
Onset:2021-08-19
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19 pneumonia, Embolism, Respiratory symptom, SARS-CoV-2 test positive
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: date of first vaccine 01/12/2021 date of second vaccine 02/20/2021 On the 7th of August, patient was having upper respiratory type symptoms. COVID PCR revealed that he was COVID positive. patient admitted 08/19/2021 with thromboembolism and COVID pneumonia.


VAERS ID: 1637381 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 3 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Stomach pain for 3 days and a rash on the arm.


VAERS ID: 1638240 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Cough, Dyspnoea, Laboratory test, Oropharyngeal pain, Palpitations, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative, X-ray
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None, 32 year male healthy, active, exercises 5 days a week
Allergies: Penicillin
Diagnostic Lab Data: Xray Aug 23 Covid test Aug 23 negative Lab Aug 23
CDC Split Type:

Write-up: Chest palpation, sharp chest pain, shortness of breath congestion, fever,cough,sore throat


VAERS ID: 1638895 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Delaware  
Vaccinated:0000-00-00
Onset:2021-08-19
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Fatigue, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210842993

Write-up: HEART PALPITATION; EXTREME WEAKNESS; FATIGUE; This spontaneous report received from a patient concerned a female of unspecified age. 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 not reported, batch number: Unk) dose was not reported, administered on 18-AUG-2021 19:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 19-AUG-2021, the patient experienced heart palpitation. On 19-AUG-2021, the patient experienced extreme weakness. On 19-AUG-2021, the patient experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from heart palpitation, extreme weakness, and fatigue. This report was non-serious.


VAERS ID: 1640949 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-15
Onset:2021-08-19
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, Nasal congestion, Nausea, SARS-CoV-2 test positive, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler buPROPion SR (WELLBUTRIN SR) 100 mg 12 hr tablet butalbital-acetaminophen-caff (FIORICET) 50-325-40 mg per tablet clonazePAM (KlonoPIN) 0.5 mg tablet DULoxetine (CYMBALTA) 20 m
Current Illness:
Preexisting Conditions: Nervous Episodic tobacco dependence Dysuria Genitourinary Acute cystitis with hematuria
Allergies: PenicillinAnaphylaxis, Dermatitis PenicillinsAnaphylaxis, Dermatitis, Nausea and Vomiting Strawberry Sulfamethoxazole Trimethoprim LatexDermatitis Potassium ClavulanateNausea and Vomiting
Diagnostic Lab Data: 08/21/21 0305 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/19/21 1427 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/19/21 1415 COVID-19 (SARS CoV-2 RNA, RT-PCR) Collected: 08/19/21 1415 | In process | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: Congestion of nasal sinus Contact with and (suspected) exposure to covid-19 nausea, vomiting, and diarrhea


VAERS ID: 1640964 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-19
Onset:2021-08-19
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin (ASPIR-81) 81 mg tablet azaTHIOprine (IMURAN) 50 mg tablet glimepiride (AMARYL) 2 mg tablet lansoprazole (PREVACID) 30 mg capsule multiple vitamins (DAILY VITAMIN) tablet tablet PHOSPHA 250 NEUTRAL 250 mg tablet pravastatin (P
Current Illness:
Preexisting Conditions: Nervous Vitreous opacities Migraine without aura, not refractory Genitourinary Stage 3 chronic kidney disease (CMS/HCC) Renal cysts, acquired, bilateral Musculoskeletal Chronic gout of multiple sites Osteopenia of multiple sites Endocrine/Metabolic Hypophosphatemia Mixed hyperlipidemia Type 2 diabetes mellitus Infectious/Inflammatory (cytomegalovirus infection) status negative Other History of renal transplant
Allergies: NKA
Diagnostic Lab Data: 08/22/21 1316 POCT COVID-19 PCR Collected: 08/22/21 1315 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000277892 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 7/24/2022
CDC Split Type:

Write-up: URI symptoms fatigue and a cough


VAERS ID: 1640975 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Deafness, Diarrhoea, Dizziness, Ear pain, Gait inability, Middle ear effusion, Pain, Peripheral swelling, SARS-CoV-2 test negative, Sleep disorder, Sneezing, Upper respiratory tract infection, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Topiramate; Bupropion; Buspirone; Ferrous Gluc; Allergy medication
Current Illness: None
Preexisting Conditions: Migraine
Allergies: Aspirin; ibuprofen
Diagnostic Lab Data: COVID test- Negative
CDC Split Type: vsafe

Write-up: First day I had hives and start taking Benadryl. Next day I had swollen in arm. I was hurting everywhere. I had trouble hearing and could not walk. It felt as if I was stab in my ear. The pain in my ear I was not able to sleep. That following Saturday I visit urgent care. I was dizzy, coughing, and sneezing. Doctor stated I had upper respiratory infection. Sunday I had diarrhea. Also I was told I had fluid behind the ears.


VAERS ID: 1641048 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dry skin, Injection site erythema, Injection site warmth, Pruritus, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Beginning 2 days after vaccination, the patient became hot and red at injection site. Itching skin began to radiate outwards. Her skin then began to dry and peel in big spots on the side of her body the injection occured. Benadryl and a steroid pack were given for treatment.


VAERS ID: 1641065 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-04
Onset:2021-08-19
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Cough, Dyspnoea, Nausea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: AV creation of arteriovenous fistula, HTN, kidney disease, mixed connective tissue disease, RA, sleep apnea, stented cornary artery.
Allergies: NKA
Diagnostic Lab Data: CXR, covid test.
CDC Split Type:

Write-up: Came to ER with nausea, cough, SOB, and generalized weakness.


VAERS ID: 1641092 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-14
Onset:2021-08-19
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267-1000-1 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Liver function test increased
SMQs:, Liver related investigations, signs and symptoms (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: #Intracranial hemorrhage 2/2 uncontrolled HTN #HTN #HLD #Suspected OSA, obesity:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Elevated liver function tests


VAERS ID: 1641111 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-27
Onset:2021-08-19
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: azithromycin (ZITHROMAX) 250 mg tablet
Current Illness:
Preexisting Conditions: NONE
Allergies: EGG
Diagnostic Lab Data: 08/20/21 1854 COVID-19 (SARS CoV-2, Molecular Amplification) Collected: 08/19/21 1138 | Final result | Specimen: Swab COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/20/21 1854 COVID-19 PCR Collected: 08/19/21 1138 | Final result | Specimen: Swab
CDC Split Type:

Write-up: COUGH, SINUSITIS, CONGESTION, FEVER


VAERS ID: 1641126 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-02
Onset:2021-08-19
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLUoxetine (PROzac) 40 mg capsule methylphenidate HCl (RITALIN) 20 mg tablet rosuvastatin (CRESTOR) 40 mg tablet
Current Illness:
Preexisting Conditions: Musculoskeletal Impingement syndrome of left shoulder Endocrine/Metabolic Adrenal adenoma, right Dyslipidemia Other Anxiety ADD (attention deficit disorder) Controlled substance agreement signed
Allergies: NKA
Diagnostic Lab Data: 08/21/21 0003 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/20/21 1157 | Final result | Specimen: Swab COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/21/21 0003 COVID-19 PCR Collected: 08/20/21 1157 | Final result | Specimen: Swab
CDC Split Type:

Write-up: cough Fatigue and Muscle or body aches


VAERS ID: 1641152 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Blood test, Contusion, Facial paresis, Headache, Hypoaesthesia, Muscular weakness, Musculoskeletal chest pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Immune-mediated/autoimmune disorders (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:
Other Medications: Losartan, Multivitamin
Current Illness: N/A
Preexisting Conditions: Hypertension (controlled by mediciation)
Allergies: Penicillin, Lisinopril
Diagnostic Lab Data: In office examination (8/15 and 8/17), blood work (8/15).
CDC Split Type:

Write-up: Rib cage pain, particularly in sides, sternum and front of armpits. Bruising on chest/front of armpit on right side. Numbness/Pins and Needles/Weakness that comes and goes in arms, thighs and face from nose down through neck. Headache.


VAERS ID: 1641189 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-05
Onset:2021-08-19
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Headache, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: calcium carbonate-vitamin D3 600 mg(1,500mg) -400 unit per tablet carvediloL (COREG) 3.125 mg tablet CONTOUR NEXT TEST STRIPS strip denosumab (PROLIA) 60 mg/mL syringe syringe DEXCOM G6 SENSOR device DEXCOM G6 TRANSMITTER device ELIQU
Current Illness:
Preexisting Conditions: Cough Circulatory Cardiomyopathy (CMS/HCC) Chronic systolic congestive heart failure (CMS/HCC) Left ventricular thrombus Ventricular tachycardia (CMS/HCC) Digestive Colonic polyp Obesity Genitourinary Vaginal prolapse Stage 3 chronic kidney disease Musculoskeletal Osteoarthritis of knee Osteochondral defect Osteoarthritis of carpometacarpal (CMC) joint of right thumb Osteopenia, unspecified location Weakness of shoulder Rotator cuff tendonitis, left Endocrine/Metabolic Mixed hyperlipidemia Type 2 diabetes mellitus without complication, with long-term current use of insulin (CMS/HCC) Other Malignant neoplasm of left breast in female, estrogen receptor positive (CMS/HCC) Aicd mechanical complication Malignant neoplasm of lower-inner quadrant of right breast of female, estrogen receptor positive (CMS/HCC) Pacemaker Preop cardiovascular exam Elective replacement indicated for implantable cardioverter-defibrillator (ICD)
Allergies: Sulfa (Sulfonamide Antibiotics)Hives / Urticaria, Rash AdhesiveRash
Diagnostic Lab Data: 08/20/21 1534 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/20/21 0857 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/20/21 1534 COVID-19 PCR Collected: 08/20/21 0857 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: FEVER, COUGH, HEADACHE, CONGESTION/RUNNY NOSE


VAERS ID: 1641236 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0035C21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Influenza like illness, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prepizone Cipo
Current Illness: Sinusitis
Preexisting Conditions: Asthma
Allergies: Penicillin Codeine Sulfa Polysorbate 80
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that the same day she received flu like symptoms. She started having a pounding in her chest and she was breathing hard. Patient stated that she is still having severe fatigue. patient also stated that after she eats she experiences the chest pounding.


VAERS ID: 1641251 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A - / -

Administered by: Private       Purchased by: ?
Symptoms: Flushing, Pharyngeal paraesthesia
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (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: unknown
Current Illness:
Preexisting Conditions: unknown
Allergies: midazolam
Diagnostic Lab Data:
CDC Split Type:

Write-up: throat tingling, flushing


VAERS ID: 1641281 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Loss of consciousness, Sleep disorder
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), Acute central respiratory depression (broad), 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), Hypoglycaemia (broad)

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

Write-up: I was asleep and woke up and could not breathe. I passed out and when the ambulance came, they took my blood pressure which was 68/39. Heart rate was in the 120?s. Had to be held in observation for 2 days to monitor my vitals.


VAERS ID: 1641357 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-15
Onset:2021-08-19
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol 2.5 mg /3 mL (0.083 %) nebulizer solution atorvastatin (LIPITOR) 20 mg tablet calcium carbonate-vitamin D3 600 mg(1,500mg) -800 unit tablet cyanocobalamin 1,000 mcg tablet fluticasone propionate (FLONASE) 50 mcg/actuation nasa
Current Illness:
Preexisting Conditions: Nervous Polymyalgia rheumatica Trochanteric bursitis of left hip Chronic pain disorder Sciatica associated with disorder of lumbosacral spine Nonintractable episodic headache, unspecified headache type Respiratory Chronic obstructive pulmonary disease Chronic obstructive bronchitis Bronchiectasis without complication Circulatory Essential hypertension Digestive Gastroesophageal reflux disease Irritable bowel syndrome Functional disorder of intestine Genitourinary Overactive bladder Pseudomonas urinary tract infection Musculoskeletal Osteoarthritis Osteoporosis Primary osteoarthritis of right knee Primary osteoarthritis of left knee Endocrine/Metabolic Hyperlipidemia IFG (impaired fasting glucose) Hyponatremia Immune Sepsis Other Ambulatory dysfunction Breast lump
Allergies: AzithromycinMental Status Change MoxifloxacinAgitation LidocaineOther (document details in comments) Macrobid [Nitrofurantoin Monohyd/m-cryst]Rash, Indigestion / GI upset PenicillinsOther (document details in comments) Risedronate SodiumOther (document details in comments)
Diagnostic Lab Data: Updated Procedure 08/19/21 1725 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/19/21 1404 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/19/21 1725 COVID-19 PCR Collected: 08/19/21 1404 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: COUGH, EXPOSURE


VAERS ID: 1641426 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-25
Onset:2021-08-19
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Atelectasis, Blood glucose increased, COVID-19, Cardiomegaly, Chest X-ray abnormal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), 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: Unknown
Current Illness: Unknown
Preexisting Conditions: HTN,DM2
Allergies: NKA
Diagnostic Lab Data: Glucose 800 on arrival, 4 L supplemental oxygen. Chex x ray 8/23 with mild cardiomegaly and subsegmental bibasilar atelecstasis
CDC Split Type:

Write-up: Hospitalized for 3 days then discharged home, weaned off oxygen. Had acute hypoxic respiratory failure secondary to COVID-19 infection.


VAERS ID: 1641429 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / UNK LA / IM

Administered by: Pharmacy       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? 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:
CDC Split Type:

Write-up: no adverse reaction. the problem is the father of the patient lied about childs DOB


VAERS ID: 1641468 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (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: Pfizer vial diluted with 0.9mls of 0.9 sodium chloride instead of 1.8mls


VAERS ID: 1641474 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Hyperhidrosis, Impaired work ability, Injection site erythema, Injection site nodule, Injection site pain, Injection site swelling, Malaise, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Seasonal asthma
Allergies: Fruit (except melons and citrus and bananas), latex, moxifloxacin
Diagnostic Lab Data:
CDC Split Type:

Write-up: about 20 hours after receiving vaccine I started getting a bad headache and then became diaphoretic, shortly after I started feeling dizzy and had to leave work. Around 6:30pm I had the chills and my body was aching, had a 103.0 temperature. Bundled up with blankets and sweatshirts and fell asleep woke up a couple hours later dripping sweat and had nausea. Not feeling well through the night and had a temp of 102.5 the next morning - stayed home from work and started feeling better by late afternoon. Injection site was swollen, mild redness, feels like a knot is there and is it tender to the touch - still has some mild swelling and tender to touch even today (9 days later).


VAERS ID: 1641479 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product preparation issue
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: Pfizer vial diluted with 0.9mls of 0.9% sodium chloride instead of 1.8mls


VAERS ID: 1641482 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-30
Onset:2021-08-19
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute respiratory failure, Bilevel positive airway pressure, Computerised tomogram thorax, Computerised tomogram thorax abnormal, Lung opacity, Oxygen saturation decreased, Pneumonia viral
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), COVID-19 (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, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unkown
Preexisting Conditions: Schizophrenia, HTN, Rheumatoid arthritis, DM2
Allergies: Penicillins, Sulfa (Sufonamide Antibiotics), lisinopril, codeine, oxycodone, methotrexate, azathioprine, fentanyl, paroxetine, risperidone, trazodone, bupropion, meridine, hydromorphone, oxymorphone, citralopram, mirtazapine, celecoxib, duloxetine, pregabalin
Diagnostic Lab Data: 8/24/2021 CTA showing patchy opacities common for COVID pneumonia
CDC Split Type:

Write-up: Ongoing hospitalization, transitioned to hospice, BiPAP dependent, cannot come off, desats to 40s even with Vapotherm 100%, viral PNA, acute hypoxic respiratory failure.


VAERS ID: 1641504 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051E21A / 1 LA / SYR

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: unrelated
Current Illness: unrelated
Preexisting Conditions: unrelated
Allergies: unrelated
Diagnostic Lab Data: none
CDC Split Type:

Write-up: the patient initially received the pfizer 2 dose series. she came in to get a booster shot and didn''t specify which shot she needed. we administered the shot and she was okay. she panicked when she found out she got the Moderna shot. although the patient has no reaction, told me to submit this form.


VAERS ID: 1641639 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Full blood count, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanus toxoid, pt unable to remember how old she was at the time, she was young but over the age of 10.
Other Medications: 1) alendronate 70 mg oral tablet, Take 1 tablet by mouth once daily 2) aspirin 325 mg oral tablet, 1 O daily 3) dexamethasone 6 mg oral tablet, 2 PO weekly on Wednesdays 4) DilTIAZem (Eqv-Cardizem CD) 240 mg/24 hours oral capsule, extended
Current Illness: Multiple myeloma Paroxysmal atrial fibrillation
Preexisting Conditions: Multiple myeloma Paroxysmal atrial fibrillation
Allergies: Td
Diagnostic Lab Data: CBC ordered and pending. Pt advised to go to the ER if worsening over the WE as we will not have results sooner unless lab calls with critical results.
CDC Split Type:

Write-up: Rash began approx. 24hrs after receiving Moderna booster vaccine. She denies pain or burning but reports some itching. It began on her abdomen and has now progressed across her torso and limbs. The rash is a purpura.


VAERS ID: 1641740 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site pain, Product preparation issue
SMQs:, Extravasation events (injections, infusions and implants) (broad), 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: The Pfizer Covid injection was mixed incorrectly. Instead of 1.8 ml of 0.9% sodium chloride is was diluted with 0.9 ml. Pharmacy was called and spoke to pharmacist was directed to call Pfizer. Pfizer was called. Pfizer''s recommendation was to follow CDC recommendation which indicates no harm to patient. Also reported states no adverse reaction has been reported. Only report was very sore arm for three to four days at site of injection. Left voice message for patient to call clinic.


VAERS ID: 1641774 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Incorrect product formulation 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The Pfizer Covid injection was mixed incorrectly. Instead of 1.8 ml of 0.9% sodium chloride is was diluted with 0.9 ml. Pharmacy was called and spoke to pharmacist was directed to call Pfizer. Pfizer was called. Pfizer''s recommendation was to follow CDC recommendation which indicates no harm to patient. Also reported Journal states no adverse reaction has been reported. Only report was very sore arm for three to four days at site of injection. Patient notified.


VAERS ID: 1641781 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow)

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

Write-up: The Pfizer Covid injection was mixed incorrectly. Instead of 1.8 ml of 0.9% sodium chloride is was diluted with 0.9 ml. Pharmacy was called and spoke to pharmacist was directed to call Pfizer. Pfizer was called option three. Pfizer''s recommendation was to follow CDC recommendation which indicates no harm to patient. Also reported Journal states no adverse reaction has been reported. Only report was very sore arm for three to four days at site of injection.


VAERS ID: 1642306 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Autoscopy, Breast tenderness, Dizziness, Exposure to SARS-CoV-2, Eye pain, Fatigue, Headache, Migraine, Nausea, SARS-CoV-2 test negative, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Vestibular disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu Vaccine, migraine, nausea, body aches
Other Medications: Daily Multi Vitamins, B12, D3, Vitamin C
Current Illness: No
Preexisting Conditions: No
Allergies: Codeine, hydrocodone, penicillin antibiotics
Diagnostic Lab Data: I had an exposure to someone with an inconclusive covid test who had been traveling. Original test was retested and it came out negative, followed by a second negative test. I took a PCR test 8/23 with no ?covid symptoms? and received a Positive test result. I retested on 8/25 with another PCR because I didn?t have symptoms and neither did anyone in my household. Results can back negative. Tested with rapid on 8/26 ? still no symptoms of covid myself or in household.
CDC Split Type:

Write-up: Extreme light headed and dizziness beginning 10 mins after vaccination that progressed over the hour. Migraine Within an hour which lasted 24 hours. Extremely fatigued, nausea & ?out-of-body? feeling within the first 24 hours. Headache over Left eye for entire 2nd- 4th day. Headache gone day 5 and felt normal. Breasts have been and very tender especially the past 2 days. This is very abnormal. no chance of pregnancy as my partner has had a vasectomy.


VAERS ID: 1642481 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Malaise, Pyrexia, Suppressed lactation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Functional lactation disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Propanolol, mother?s milk tea, liquid gold lactation tablets, citerinzine
Current Illness: None
Preexisting Conditions: Systemic acidosis, insomnia, and hypertension
Allergies: Penicillin and amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Was extremely ill for several days including a fever over 100? and my milk supply completely dried up the day after the vaccine after months of effort to get it increased.


VAERS ID: 1642679 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site pruritus, Injection site rash, Lymph node pain, Lymphadenopathy, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: rash on left shoulder itching at injection site itching down arm itching at palm of left hand that lasted 6 days Swollen lymph nodes on left side of body that are now painful


VAERS ID: 1643005 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-08-19
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Migraine, Oropharyngeal pain, Pain in extremity
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210855281

Write-up: MIGRAINES; SORE THROAT; SORE LEFT ARM; TIRED; This spontaneous report received from a patient concerned a 30 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 204B21A, and expiry: 11-DEC-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 tired. On 20-AUG-2021, the patient experienced migraines. On 20-AUG-2021, the patient experienced sore throat. On 20-AUG-2021, the patient experienced sore left arm. Treatment medications included: acetylsalicylic acid/caffeine/paracetamol. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from tired, sore throat, migraines, and sore left arm. This report was non-serious.


VAERS ID: 1645397 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-31
Onset:2021-08-19
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Nasal congestion, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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: albuterol 2.5 mg /3 mL (0.083 %) nebulizer solution albuterol HFA (PROAIR HFA) 90 mcg/actuation inhaler cholecalciferol, vitamin D3, (VITAMIN D3) 100 mcg (4,000 unit) capsule esomeprazole (NexIUM) 20 mg capsule (Expired) ferrous sulfate
Current Illness:
Preexisting Conditions: Nervous Bilateral lumbar radiculopathy Cervical radiculopathy Dysmenorrhea TMJ arthralgia Migraine with aura and without status migrainosus, not intractable Hemisensory loss Numbness and tingling Respiratory Allergic rhinitis Mild intermittent asthma, uncomplicated Circulatory Palpitations Digestive GERD without esophagitis Crohn''s disease of colon without complication Irritable bowel syndrome Genitourinary Menorrhagia Recurrent urinary tract infection Musculoskeletal Costochondritis Patellar tendonitis Patellofemoral syndrome Inflammatory bowel arthritis Immune Psoriasis Psoriatic arthritis Other Vertigo Encounter for long-term (current) use of medications History of esophageal stricture Status post vaginal hysterectomy S/P vaginal hysterectomy
Allergies: LansoprazoleNausea and Vomiting PenicillinsDiarrhea, Hives / Urticaria, Nausea Only, Nausea Only Nsaids (Non-steroidal Anti-inflammatory Drug) Adhesive Tape-siliconesRash AmoxicillinRash Amoxicillin TrihydrateDiarrhea ClarithromycinDiarrhea ErythromycinDiarrhea, Nausea Only Erythromycin BaseOther (document details in comments) FluticasoneOther (document details in comments), Rash Fluticasone PropionateRash Hydrocodone-acetaminophenNausea And Vomiting, Nausea and Vomiting, Nausea Only Mite ExtractOther (document details in comments) NaproxenHeadaches OmeprazoleNausea and Vomiting
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: nasal and chest congestion, runny nose, fever, loss of taste/smell, and cough.


VAERS ID: 1645927 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 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: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: patient experiencing continued soreness and swollen area on upper left arm where vaccine was administered - has not subsided as of 8/27/21 patient is contacting her family physician


VAERS ID: 1647388 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site abscess, Vaccination site mass
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: USPFIZER INC202101074868

Write-up: huge lump under the shot that came up on arm; feels like I have an abscess under there; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 30-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation solution for injection) via an unspecified route of administration on 18Aug2021 (Batch/Lot number was not reported) as dose 2, single for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient previously received first dose BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on an unspecified date in 2021, as single dose for COVID-19 immunization. The patient stated that after receiving second dose of vaccine on 19Aug2021 she experienced huge lump under the shot that came up on arm and feels like she has an abscess under there. The reporter stated that her husband and she got their second dose of the Pfizer BioNTech covid vaccine yesterday on 18Aug2021 and she am having problems. When they got there, they were going to give her a dose of the Moderna, her husband witnessed it, so they went somewhere else and got the Pfizer dose. On next day she had a huge lump under the shot that came up on her arm and stated that it feels like she has an abscess under there. The outcome of the events was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1651317 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm pain in the upper part, numb hand, tingling fingers more accentuate in the thumb. It''s been 9 days since I got the vaccine, it seems unusual that I still have these symptoms.


VAERS ID: 1651429 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Influenza like illness, Malaise, Paraesthesia, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan, Triamterene, Verapamil, Trazodone, Omega3 Acid Ethyl Esters, Vitamins : D, C, B complex
Current Illness: none
Preexisting Conditions: Arthritis,
Allergies: Nitrofurantoin, Amox-clav, Ciprofloxacin,
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started to get very sick like bad flu. Shivers, prickly skin, fiver, stomac problems


VAERS ID: 1651526 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest discomfort, Chest pain, Dizziness, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: Went to ER today had blood work and X-ray to rule out a number of things and nothing. I suspect this is chest wall inflammation
CDC Split Type:

Write-up: Shortness of breath 30 mins after, extreme fatigue, chest pain beginning on day 2 after, chest heaviness lightheaded short of breath now on day 9 no resolution


VAERS ID: 1653566 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Anxiety, Dissociation, Dizziness, Headache, Hyperhidrosis, Nausea, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Sweaty hands and feet, tingling right hand, headaches, nausea, dizziness, mental disassociation, anxiety. All these symptoms persist 10 days after vaccination.


VAERS ID: 1653826 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Electrocardiogram normal, Fatigue, Injection site erythema, Injection site warmth, Loss of personal independence in daily activities, Pain, Pyrexia, SARS-CoV-2 test negative, Vaccine positive rechallenge
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (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: Reaction to 2nd Moderna injection in February, 2021. Resolved in about 24 hours.
Other Medications: Atorvastatin 20mg, Hydrochlorothiazide 25mg, Losartan 50 mg, Potassium Chloride ER 20 MEQ
Current Illness: None
Preexisting Conditions: Blood pressure, well controlled, Cholesterol well controlled
Allergies: None
Diagnostic Lab Data: Dr. had a blood test done and EKG, all results were normal. These tests were done on August 24, 2012. A Covid test was also done on the same day, results were Negative.
CDC Split Type:

Write-up: I received the booster Moderna injection on the evening of August 18, 2021. This was 8 months after the second injection. The following morning the body aches, low fever and fatigue set in. I had experienced the same reaction after the second injection in February, 2021. The body aches and low fever resolved in about 12 hours after onset. The injection site was very red and hot, this lasted until approximately August 27. I am still fighting the fatigue although it is better than it was. I walked 3 miles at a time 3 to 4 times a week and I haven''t attempted this since the injection as I''m too fatigued. As I stated, I am feeling better, but not over this reaction yet.


VAERS ID: 1653851 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Neuropathy peripheral, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Pain in leg, parasthesia, neuropathy starting approximately one hour after injection. Health care provider recommended ER/urgent care for possible blot clots. Neuropathy symptoms ongoing to date.


VAERS ID: 1653908 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-12
Onset:2021-08-19
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: CSF protein increased, CSF white blood cell count increased, Dissociation, Facial paresis, Guillain-Barre syndrome, Immunoglobulin therapy, Lumbar puncture abnormal, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Demyelination (narrow), Immune-mediated/autoimmune 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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D3, Flaxseed, Zinc, ketorolac
Current Illness: None
Preexisting Conditions: None
Allergies: Shellfish allergy
Diagnostic Lab Data: Lumbar puncture performed 8/28 showed albuminocytologic dissociation with a protein count of 217 and a white count of 18. Starting on IVIG therapy on 8/28.
CDC Split Type:

Write-up: Ascending paresthesias and paralysis; started one week after vaccination in back and legs and by the time of presentation had ascending up to abdomen and bilateral arms, now with facial weakness.


VAERS ID: 1654144 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH TCHD9VMD / 3 RA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone pain, Cough, Dyspnoea, Pyrexia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Osteonecrosis (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IVIG ( taken 10 days previously NOT on day of vaccination), loratadine, nothing else that day.
Current Illness:
Preexisting Conditions: POTS, mycosis fungiodes, EDS, ME/CFS, presumed immunodeficiency. Uses power wheelchair due to these health conditions and is homebound.
Allergies: celiac disease, shellfish, many additives and colors/dyes
Diagnostic Lab Data: had his lungs listened to, clear covid test- negative
CDC Split Type:

Write-up: CDC called us from our safe and said to report the following: 104.6 degree fever for 28 hours, 101.3 for next 24, fever resolved by 72 hours. Felt like leg bones were breaking from the inside. Also, difficulty taking deep breath, would cause cough. Cough and inability to take a deep breath lasted for 9 days. No other signs or symptoms of illness, but we did a covid test in case he was exposed at the vaccine site, negative.


VAERS ID: 1654980 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Cardiac flutter, Chills, Dysphagia, Hyperhidrosis, Influenza like illness, Malaise, Nausea, Paraesthesia, Tremor, Vertigo, Vomiting, Water pollution
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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 (narrow), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (narrow), Hypoglycaemia (broad)

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

Write-up: Heart is fluttering; Feeling that the room is rotating/Cannot move the head; Feeling sick the entire day; Sweating; Cannot drink water; Stomach is like killing her; Felt like the vaccine gave her a flu; Shaking; Cannot drink water; Tingling in the hand and toes; Chills; Vomiting; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of CARDIAC FLUTTER (Heart is fluttering) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 18-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Aug-2021, the patient experienced CARDIAC FLUTTER (Heart is fluttering) (seriousness criterion medically significant), VERTIGO (Feeling that the room is rotating/Cannot move the head), MALAISE (Feeling sick the entire day), HYPERHIDROSIS (Sweating), DYSPHAGIA (Cannot drink water), ABDOMINAL DISCOMFORT (Stomach is like killing her), INFLUENZA LIKE ILLNESS (Felt like the vaccine gave her a flu), TREMOR (Shaking), PARAESTHESIA (Tingling in the hand and toes), CHILLS (Chills), VOMITING (Vomiting), NAUSEA (Nausea) and WATER POLLUTION (Cannot drink water). At the time of the report, CARDIAC FLUTTER (Heart is fluttering), VERTIGO (Feeling that the room is rotating/Cannot move the head), MALAISE (Feeling sick the entire day), HYPERHIDROSIS (Sweating), DYSPHAGIA (Cannot drink water), ABDOMINAL DISCOMFORT (Stomach is like killing her), INFLUENZA LIKE ILLNESS (Felt like the vaccine gave her a flu), TREMOR (Shaking), PARAESTHESIA (Tingling in the hand and toes), CHILLS (Chills), VOMITING (Vomiting), NAUSEA (Nausea) and WATER POLLUTION (Cannot drink water) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication use information was not provided by reporter. Treatment medication use information was not provided by reporter. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1654987 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-08-19
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Comments: The patient had no known allergies and no history of drug abuse or illicit drug use
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210855565

Write-up: SEVERE HEADACHE THAT WAKES HIM UP; This spontaneous report received from a patient concerned a 45 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included: covid-19, and concurrent conditions included: non alcohol user, and non-smoker, and other pre-existing medical conditions included: The patient had no known allergies and no history of drug abuse or illicit drug use. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: UNKNOWN) dose was not reported, administered on 19-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-AUG-2021, the patient experienced severe headache that wakes him up. Treatment medications (dates unspecified) included: paracetamol, and ibuprofen. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from severe headache that wakes him up. This report was non-serious.


VAERS ID: 1655083 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-19
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210819; Test Name: test for COVID-19; Result Unstructured Data: Test Result: Unknown results.
CDC Split Type: USPFIZER INC202101078785

Write-up: schedule for second dose today however prior doing that she had a test for COVID-19 (Result of the test were unknown); schedule for second dose today however prior doing that she had a test for COVID-19 (Result of the test were unknown); This is a spontaneous report from a contactable consumer or other non HCP (patient) from a Pfizer-sponsored program via Regulatory Authority. A female patient of an unspecified age received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: Not reported) via an unspecified route of administration on an unspecified date as dose 1, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. It was reported that on 19Aug2021 the patient was scheduled for second dose on same day however prior doing that she had a test for COVID-19 and further stated that result of the of the test were unknown. On 19Aug2021 the patient underwent lab tests and procedures which included test for COVID-19 which results was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1655387 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / IM

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

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

Write-up: Systemic: Allergic: Itch Generalized-Medium, Systemic: Allergic: Rash Generalized-Medium, Systemic: open sores near arm pit areas-Medium, Additional Details: pt reported having open sores near armpit area since receiving the second vaccine. he has tried benadryl which hasnt helped, was advised to seek a doctor as he described it as painful.


VAERS ID: 1655390 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Muscle fatigue, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Severe muscle fatigue and pain, 102.9 degree fever


VAERS ID: 1655601 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-12
Onset:2021-08-19
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness bilateral, Ear congestion, Ear pain, Hypoacusis
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: HSV2
Allergies: None
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: I have greatly reduced hearing in both ears that has persisted for over 10 days. Feeling of fullness/pressure in the ears, throbbing pain in both ears at times, and generally muffled sounds. I can?t ?pop? my ears like I?ve been able to do my entire life.


VAERS ID: 1655663 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-13
Onset:2021-08-19
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pain, Product administered at inappropriate site, Pruritus, Rash macular, Skin warm
SMQs:, Anaphylactic reaction (broad), Drug abuse and dependence (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vit d vit c multi fish oil iron magnesium ashwaganda
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: big, hot red angry painful and itchy oval blotch. lasted a week and spread for a week. started small and got big. i also received the shot in the BACK of my arm where there is fat, instead of right below my shoulder on the side of my arm where most shots are usually given .


VAERS ID: 1655699 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Paraesthesia, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Chest pains Feverish Fainted Tingling in body


VAERS ID: 1655893 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-01
Onset:2021-08-19
   Days after vaccination:110
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Nausea, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: underlying medical conditions: cardiac and respiratory
Allergies: unknown
Diagnostic Lab Data: positive PCR for Covid 8/24/2021 done at hospital
CDC Split Type:

Write-up: Client was vaccinated in May, 2021 with 2 doses of Moderna vaccine. Not sure of dates but one was in beginning and one at end of May per client report. Symptomatic on 8/19 for Covid: cough, fever 103 x 2 days, loss of taste and smell, nausea and vomiting. Hospitalized 8/24-8/29. Tested positive for Covid on 8/24. Reported as breakthrough Covid case in fully vaccinated person.


VAERS ID: 1655977 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Not sure.
Allergies: codeine, prednisone
Diagnostic Lab Data: Patient made doctors appointment 8-30-21 and was told symptoms were consistent with cellulitis. mapped size of area and started antibiotic 8-30-21
CDC Split Type:

Write-up: Patient noticed, pain swelling, and redness the day following vaccine. Area grew larger over time and was warm to the touch.


VAERS ID: 1656020 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Headache, Neck pain
SMQs:, Arthritis (broad)

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

Write-up: Severe headache, neck pain, shoulder pain


VAERS ID: 1656142 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site paraesthesia, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Actos, Crestor, Prempro, Armour thyroid, metformin, omeprazole
Current Illness: tick bite
Preexisting Conditions: depression, high blood pressure, diabetes
Allergies: Iodine, mastisol, dermabond
Diagnostic Lab Data:
CDC Split Type:

Write-up: Paresthesia in left arm about 36 hours after injection. Starting at level of injection and goes down to fingers. Painful pins and needles feeling, like hitting the "funny bone". Not helped by NSAIDs, ice, or elevation. This has continued to present, affecting work and sleep. I''ll go to the doctor if this does not subside soon.


VAERS ID: 1656255 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Erythema, Lymph node pain, Pain, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Pregnancy (delivered on July 20, 2021)
Preexisting Conditions: None
Allergies: Amoxicillin Clindamycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever of 101.8 (12-36 hours after vaccine) Body Aches and Chills (12-36 hours after vaccine) Sore lymph nodes (12-36 hours after vaccine) Arm soreness (onset 5 days after vaccine) Redness (onset 5 days after vaccine)


VAERS ID: 1656268 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast pain, Breast swelling
SMQs:, Angioedema (broad), Lipodystrophy (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: MULTIVITAMIN
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: PAIN IN LEFT BREAST. SWOLLEN MILK DUCT ON THE AREOLA. PAIN LASTED FOR A FEW DAYS. STILL SLIGHT PAIN BUT NOT AS BAD AS BEFORE.


VAERS ID: 1656357 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3100 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Burning sensation, Headache
SMQs:, Peripheral neuropathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: was real sick in June thought she had COVID
Preexisting Conditions: no
Allergies: cipro, sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: arm started burning underneath her arm as days went by the burning started get worse and have a dull headache


VAERS ID: 1656361 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Chills, Pain, SARS-CoV-2 test positive, Urinary tract infection
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acyclovir
Current Illness: None. Healthy.
Preexisting Conditions: Asthma
Allergies: Allergic to asprin and motrin
Diagnostic Lab Data: On 8/24, did a video visit with provider for UTI and explained that I was still having reaction to vaccine. She ordered COVID test and it was positive. She also prescribed cephalexin for UTI which was gone after three doses.
CDC Split Type:

Write-up: Got the vaccine on 8/17. Had expected reaction on 8/18 with chills and body ache. Worsened on 8/19 with a UTI. Never had fever.


VAERS ID: 1656442 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, COVID-19, Chills, Cough, Dysgeusia, Exposure to SARS-CoV-2, Fatigue, Headache, Myalgia, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Olmesartan Medoxomil; fenofibrate; Zolpidem tartrate; metoprolol succinate; lorazepam; omeprazole
Current Illness: No
Preexisting Conditions: COPD
Allergies: No
Diagnostic Lab Data: COVID-19 TEST 08/23/2021
CDC Split Type: vsafe

Write-up: On 08/18/2021, right after the injection, I tasted metal in my mouth. On 08/20/2021, I had fever chills. I came down with a sore throat, and cough and it progressively got worse. On Monday, A coworker at work was positive for COVID. I went to urgent care to get tested on, 08/23/2021, for COVID-19 and it was positive, and I started quarantine. On 08/27/2021, I went to urgent care to get the immunotherapy vaccine. It took care of my fever, muscle pain, headache, abdominal pain and I am not as fatigue as I was. I still have the cough. I have mostly recovered from the AEs; the cough still remains.


VAERS ID: 1656468 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003F21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chest pain, Dyspnoea exertional, Electrocardiogram, Fatigue, Pain
SMQs:, Anaphylactic reaction (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma (childhood)-controlled since highschool
Allergies: No
Diagnostic Lab Data: ECG-8/26/2021 Examination- 8/26/2021
CDC Split Type:

Write-up: Stabbing chest paims and constant dull/pressure pain, fatigue, getting winded when singing/talking... some joint pain.


VAERS ID: 1656797 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-17
Onset:2021-08-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Hypoaesthesia, Pain, Pain in extremity, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NO
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data:
CDC Split Type:

Write-up: Been having very bad leg pain in both legs entire legs, pain is so bad it hurts to walk at times, heavy numbness, heavy fatigue, left arm numbness. Blurred vision has been horrible, having dizzy spells, hands have had heavy fatigue pains


VAERS ID: 1656999 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Fatigue, Lymphadenopathy, Oropharyngeal pain, SARS-CoV-2 test negative
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for acne, clindamycin topical for acne
Current Illness:
Preexisting Conditions: Car accident 2020 requiring epidural steroid injection June 2021
Allergies: NKA
Diagnostic Lab Data: Doctor''s appointment scheduled for 9/1.
CDC Split Type:

Write-up: Received first dose of Pfizer vaccine the morning of 8/16. The afternoon of 8/19 developed a sore throat. That evening, bilateral lymphadenopathy noted supraclavicular and along cervical chain. Other side effects included fatigue and chills. Sore throat resolved somewhat 8/20, was COVID tested and was negative. Enlarged lymph node noted supraclavicular on the right side (same side as the vaccine) which remains over two weeks after the injection.


VAERS ID: 1657016 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Bleeding upon injection


VAERS ID: 1658110 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)

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

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


VAERS ID: 1658602 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWOI85 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Atrial thrombosis, Chest X-ray normal, Laboratory test
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (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: Lexapro Trazodone Warfarin
Current Illness: None
Preexisting Conditions: Right atrial thrombus
Allergies: Latex Adhesives
Diagnostic Lab Data: Lab tests 8/23 X-ray 8/23
CDC Split Type:

Write-up: Persistent, dull chest pain Visited local walk-in clinic for treatment after several days of persistent dull pain/ache. Had labs and x-ray. No causes discovered. Was told to take Tylenol. Pain persisted for several more days and is slowly diminishing but still present on day 13.


VAERS ID: 1658605 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: Site: Itching at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Allergic: Itch (specify: facial area, extremeties)-Severe, Systemic: Allergic: Itch Generalized-Severe, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe, Systemic: Allergic: Rash Generalized-Severe


VAERS ID: 1658608 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Injection site swelling, Lip swelling, Lymphadenopathy, Pruritus, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: SWELLING OF TONGUE, LIPS, LYMP NODES UNDER ARM UP TO 6 DAYS AFTER. INJECTION SITE EXTREMELY SWOLLEN , SEVER BODY ITCHING FOR A WEEK., FATIGUE AND LOSS OF APPETITE


VAERS ID: 1658636 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-01
Onset:2021-08-19
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 2 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Biotin, Simvistatin, D3, Flinstones Vitaminsx2, B12
Current Illness: Na
Preexisting Conditions: Arthritis
Allergies: Nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: Slight headache & bodyaches


VAERS ID: 1658687 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-01
Onset:2021-08-19
   Days after vaccination:110
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO 169/ EWO179 / 2 LA / SYR

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

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

Write-up: chest pain, diagnosed pericarditis by CAT scan


VAERS ID: 1658858 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Dyspnoea, Erythema, Headache, Heart rate increased, Injected limb mobility decreased, Pain in extremity
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: cellcept
Current Illness: autoimmune disease, cardiomyopathy, scleroderma raynauds
Preexisting Conditions: autoimmune disease, cardiomyopathy, scleroderma raynauds
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: severe crippling headache, high heart rate, arm completely went red and she couldn''t move it and it was painful, have a hurtful cough cant take deep breaths


VAERS ID: 1658878 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event
SMQs:

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

Write-up: none noted at time of injection, kept for 15min without any reaction noted


VAERS ID: 1658979 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling abnormal, Hypoaesthesia, Muscular weakness, Vaginal haemorrhage, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: So far I have only met with my doctor in person but have not had additional testing done yet. I will have another meeting with them soon.
CDC Split Type:

Write-up: Blurred vision; vaginal bleeding; sharp, stabbing pain in right leg; muscle weakness (ongoing); numbness in limbs and right side of my face (off and on still); brain fog; No treatment yet


VAERS ID: 1658981 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-13
Onset:2021-08-19
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I was taking Xanax, Cymbalta, amitriptyline, and Nexium.
Current Illness: no
Preexisting Conditions: Diverticulosis and Fibromyalgia
Allergies: no
Diagnostic Lab Data: no
CDC Split Type:

Write-up: On 08/19/2021 I woke up with the lymph node swollen and painful in my right armpit, the following day I woke up with the left one in the same condition. I called my doctor on 08/19/2021-on 08/20/2021 she called in Prednisone for the swollen lymph nodes.


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