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

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



Case Details (Reverse Sorted by Onset Date)

This is page 107 out of 3,524

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VAERS ID: 1346406 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032BZIA / 1 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Eye pain, Eye swelling, Inflammation, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Novolog, vitamin D, simastatin, victoza, acyclovir
Current Illness: Shingles
Preexisting Conditions: diabetes type 1
Allergies: erythromycin, latex
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Adverse event: Two days after first injection, both eyes swollen, hurt to touch and inflamed. Blared vision in left eye. Previously had derma filler in 2017/2018. Treatment: Benadryl, Tylenol, cold packs Outcome: visited PCP on 5/24/2021, still recovering


VAERS ID: 1346409 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Migraine, Nausea, Pain, Pyrexia, Vaccine positive rechallenge
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin, D3, iron supplement, Zyrtec, oxybutynin (15mg)
Current Illness: none
Preexisting Conditions: aneurysm in brain
Allergies: none that i am aware of
Diagnostic Lab Data: did not go to the doctor.
CDC Split Type:

Write-up: About 12 hours after receiving the first AND second dose (both on Fridays), i had symptoms EXACTLY mimicking my original Covid symptoms (which i had in April 2020). Fever of 101.5 for several hours, exhaustion, nausea, extremely achy all over, and migraine headache. Symptoms exactly same longevity and intensity for both shots. Was better the next day (Sunday) for the most part.


VAERS ID: 1346410 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

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

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

Write-up: syncope, nausea, feeling of going to pass out, sweating hot. sat and drank water. was fine but had her mother come and take her home


VAERS ID: 1346437 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-19
Onset:2021-05-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Bilateral lower leg mild swelling and moderate pain, pain worse to right leg Pt is taking Tylenol and ibuprofen with good pain relief Pt is raising legs while sleeping at night which helps reduce the swelling


VAERS ID: 1346439 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site nodule, Injection site pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium, Additional Details: Patient states she feels numbness in her left hand and feel like there is a knot in her arm near the injection site.


VAERS ID: 1346440 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Gastrointestinal pain, Nausea, Pain, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Mirena IUD
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I experienced body aches starting approximately 8 hours after vaccine was administered. This progressed to shaking chills with fever, intestinal cramping, lightheadedness and nausea and vomiting. Symptoms persisted for 24 hours.


VAERS ID: 1346495 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0172 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Hypoaesthesia, Nausea, Retching
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Vit D, Omeprazole, Fish oil
Current Illness:
Preexisting Conditions: Low hemoglobin
Allergies: Penicillins, Novacaine, Lidocaine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt became dizzy after injection. VS were stable and as follow: BP 118/80, 116/80, 120/80, & 118/80; HR 80, 78, 73, &72; OxSat 98%, 98%, 98%, & 97%. Ice pack applied to neck, lying supine on a cot. Reported feeling better. Started feeling dizzy again. EMS called. Also became nauseated over the course. It was reported that patient only had egg w/coffee for breakfast. Took a few sips of V8 fruit and drink prior to EMS arrival. Vitals obtained by EMS also stable but pt continued to gag/vomiting sounds. Was able to sit and stand. Reported she felt better after EMS suggested transport for further evaluation. Pt continued to gag (but no actual vomit) The moment she does any movement pt gets dizzy. Did reporte early on some numbness left hand. Transported to the ER by EMS @2:10PM


VAERS ID: 1346507 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Pain, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, Nausea, Body Aches, Chills, Headache, Severe Arm pain


VAERS ID: 1346528 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-23
Onset:2021-05-22
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Condition aggravated, Contusion, Diarrhoea, Epistaxis, Fatigue, Immune thrombocytopenia, Immunoglobulin therapy, International normalised ratio normal, Occult blood positive, Platelet count decreased, Platelet transfusion
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Systemic lupus erythematosus (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 650 MG tablet atorvastatin (LIPITOR) 80 MG tablet coenzyme Q10 50 MG capsule Fe Bisgly-Vit C-Vit B12-FA (GENTLE IRON PO) Cranberry supplement lansoprazole (PREVACID) 15 MG capsule loratadine (CLARITIN) 10 MG tablet
Current Illness: Immune Thrombocytopenia - Decreased platelet count Acid reflux disease High cholesterol or triglycerides High blood pressure disorder Heart murmur
Preexisting Conditions: Acid reflux disease High cholesterol or triglycerides High blood pressure disorder Heart murmur
Allergies: Azor [amlodipine-olmesartan] Bactrim [sulfamethoxazole-trimethoprim] Benadryl [diphenhydramine] Benicar [olmesartan] Bystolic [nebivolol Hcl] Cardura [doxazosin Mesylate] Ciprofloxacin Feldene [piroxicam] Furosemide Hydrocortisone Hyoscyamine Indapamide Prinivil [lisinopril] Procardia [nifedipine] Quinine Derivatives Relafen [nabumetone] Sular [nisoldipine Er] Tiazac [diltiazem] Voltaren [diclofenac Sodium] Ampicillin Hydrochlorothiazide W-triamterene Latex Penicillins
Diagnostic Lab Data: Labs performed by PCP 5/21/2021 showed platelet count of 2000 and when labs resulted on 5/22/2021 patient was instructed to present to the emergency department where her count was repeated and was less than 2000 Coags on 5/22/2021 with INR 1.07, PTT 38.4 Positive fecal occult blood 5/23/2021 Platelet count increasing but still low, currently at 30000 as of 5/25/2021
CDC Split Type:

Write-up: Approximately 1 week prior to admission patient developed increased bruising and a few minor episodes of epistaxis. She also experienced 1 day of diarrhea which was followed by 4 days of significant fatigue with subsequent improvement. Labs performed by PCP 5/21/2021 showed platelet count of 2000 and when labs resulted on 5/22/2021 patient was instructed to present to the emergency department where her count was repeated and was less than 2000. Patient is receiving 4-day course of IV immune globulin 20 g and prednisone 1 mg/kg (60 mg) daily for 2-3 weeks Patient received 1 unit platelet transfusion in emergency department on 5/22/2021 COVID-19 vaccination could have precipitated relapse of ITP


VAERS ID: 1346533 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Lymph node pain, Musculoskeletal stiffness, Nausea, Pain, Pruritus, Pyrexia, Respiratory tract congestion, Somnolence, Wheezing
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), 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: general arm pain after tetanus shot
Other Medications: Lo lo estrin FE Spironolactone Singular Albuterol
Current Illness: none other than seasonal allergies
Preexisting Conditions: Asthma
Allergies: Had an adverse reaction to Lisinopril once. No other known allergies - but for seasonal allergies and bug bite reactions
Diagnostic Lab Data:
CDC Split Type:

Write-up: Still ongoing 4 days after shot and still ongoing - fever, chills, stiff, achy all over, drowsy, sweats, headache, nausea, wheezing and congestion, terrible pain in lymph nodes in L armpit and neck - - injection site is hard, hot, red, and worsening still today (three days later), getting bigger and bigger. Occasional sharp pain in injection site area. Itchy skin in injection site area.


VAERS ID: 1346578 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dysphagia
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad)

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

Write-up: reports dizziness. denies any difficulty swallowing and/or other s/s. at 1604, c/o difficult swallowing- transferred care to EMS. EMS administered epi & called for transport, 1611- mother agreeable; 1616 pt. reports feeling better- symptoms resolved.


VAERS ID: 1346628 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-19
Onset:2021-05-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Electrocardiogram, Electroencephalogram, Loss of consciousness, Syncope
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), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Blisovi-Fe 24, Claritin
Current Illness: None
Preexisting Conditions: Concussion / post - concussion syndrome - just released from f/u care. Convergence insufficiency Asthenopia Atopic Dermatitis
Allergies: Zofran (Ondansetron) - Rash
Diagnostic Lab Data: ekg and eeg (pending results)
CDC Split Type:

Write-up: Pt was swimming and started to cough (felt swallowed water) and upon getting out of water - collapsed and lost consciousness for a few seconds


VAERS ID: 1346669 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Genital ulceration, Sexually transmitted disease test, Tenderness
SMQs:, Severe cutaneous adverse reactions (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: Oral birth control, 15 mg citalopram once daily
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Onset of 3 small (< 1 cm) non-sexually acquired genital ulcers on the inside of the right labia minor. Ulcers are round, raised on the edges, with whitish/yellow tissue in the middle. Ulcers are painful to touch. Ulcers were newly onset ~36 hrs after the second Moderna dose, and are currently present at time of report submission. Patient has never experienced genital ulcers in the past, and has negative STD panel.


VAERS ID: 1346690 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was booked by his family in system as his 13 year old sister. Information was changed at vaccine site to this patient who was only 11 years 5 months old. This was not caught until after the patient received his shot. We aware of any untoward effects. Patient''s mother was informed this would be reported to the DPH and CDC. Patient''s mother indicated she was aware he was not eligible at this time. This was her second attempt to get him vaccinated as he was turned away at a previous clinic.


VAERS ID: 1346713 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Chest pain
SMQs:, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 14 yo male c/o intermittent upper left chest pain for $g20 min after Pfzier vaccine. Reported pain 3/10, described as sharp and non-radiating. Denied previous episode w/ similar symptoms. Reported feeling some anxiety but denied being diagnosed or treated with anxiety. Upon assessment no acute distress noted. Alert and orientedx4, verbal and able to make needs known. Respiration even and unlabored. Skin pink, warm, dry and intact. No sx of allergic reaction. Chest non-tender, heart rate WNL, noted irregular rhythm, no murmur or extra sounds noted. No loss or altered level of consciousness noted. Mother present with patient and reports having HX of elevated BP which physician recommended increased activity and weight loss, denied medication treatment. No HX of allergies per mother. Past medical HX obtained from patient and physical assessment completed simultaneously. Pt assessed while sitting in chair. VS 160/81, HR 62, O2 97% RR 20, sponataneous resolution on symptoms after 2-3 minutes, patient observed additional 30 minutes, no acute distress noted, pt denied pain or symptoms. Advised mother to have patient evaluated by PCP for irregular heart rhythm ASAP. Advised mother to take patient immediately to ER if symptoms return or develop new symptoms. Advised mother to call 911 if patient develops chest pain, SOB, altered or loss of consciousness. Mother verbalized understanding of all advice and education. Patient went home with mother


VAERS ID: 1346719 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / N/A RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Blood pressure increased, Computerised tomogram normal, Facial paralysis, Headache
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypertension (narrow), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin 81 mg daily acetaminophen as needed betamethasone valerate lotion carvedilol 12.5 mg daily cholecalciferol 1000 units daily docusate 200mg daily ferrous sulfate 325mg daily glimepiride 2mg daily levemir 6 units daily melatonin 3
Current Illness:
Preexisting Conditions: psoriasis anemia constipation type 2 Diabetes Mellitus CAD A fib COPD CHF
Allergies: codeine dexlansoprazole erythromycin penicillin demerol robitussin-DM Zemuron Zithromax
Diagnostic Lab Data: CT scan negative on 5/22/21
CDC Split Type:

Write-up: headache elevated blood pressure left eye drooping


VAERS ID: 1346733 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-18
Onset:2021-05-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Injection site pain, Lip swelling, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patients mom stated her son got the vaccine on Tuesday 5/18/21 and about 4 days later he ate seafood and then started to get an allergic reaction about 2 hours later. Patient started to feel that his lips swelled up along with a rash all around chin, neck and around mouth, on forehead between eyes. He took Benadryl which helped symptoms subside. He also complained of a little chest pain that lasted less than an hour but no shortness of breath. As of Monday 5/24/21 he feels fine no other symptoms. No c/o fever, fatigue, nor headache, body aches. Pain at injection site from vaccine was also reported but that subsided.


VAERS ID: 1346743 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-16
Onset:2021-05-22
   Days after vaccination:67
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Received Pfizer vaccines on 2/23/21 and 3/16/21. Tested positive for COVID-19 by PCR on 5/22/21 after known exposure to person w/ COVID-19. Unknown symptoms began on 5/18/21. Patient received casirivimab-imdevimab 2,400 mg (1,200-1,200 mg) IV on 5/23/21.


VAERS ID: 1346768 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Tunnel vision
SMQs:, Anticholinergic syndrome (broad), Optic nerve disorders (broad), Retinal disorders (narrow), Vestibular disorders (broad)

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

Write-up: Patient reports feeling dizzy spells and tunnel vision. Was not temperature related. As he was working, he felt dizzy enough that he may fall down. Started 24-32 hours after dose, and is still going 5 days later. Referred patient to care or emergency room.


VAERS ID: 1346769 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Dizziness, Erythema, Feeling hot, Flushing, Nausea, Paraesthesia, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer Covid Vaccine, dose 1
Other Medications: ometprazole 20 mg diclofenac 50 mg tumeric 500 mg tylenol 500 mg
Current Illness: none
Preexisting Conditions: none
Allergies: Cat scan contrast leucorovin iodine polyethylene glycol fish
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 5 min after shot was given: warmth, nausea, dizzy, feeling of passing out, throat closing up, pins and needles in face and fingers/hands/forearms, red face and chest, and weakness. Second day, nausea, stomach cramps, dizziness.


VAERS ID: 1346808 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-30
Onset:2021-05-22
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

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

Write-up: Patient reports to the pharmacy on 5/25/21 and says that as of 3 or 4 days (she can''t remember) she has bruising on both arms and bleeding from nose. She attributes this reaction to the vaccine she received on 4/30/21 but also says she suffers from low platelets and anemia. She was urged to go immediately to the hospital and second dose was postponed until further evaluation.


VAERS ID: 1346810 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-24
Onset:2021-05-22
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Positive COVID-19 PCR test 5/22/21.
CDC Split Type:

Write-up: Client tested positive for COVID-19 on 5/22/21.


VAERS ID: 1346824 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cheilitis, Erythema, Lip erythema, Lip swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None at this time.
CDC Split Type:

Write-up: Patient received above noted COVID19 Vaccine on Friday morning and reported symptoms starting Saturday morning. Symptoms include lip swelling, lip rash, and erythema only affected the lip area of the face. Symptoms have persisted for 3 days and that is when the pharmacy was contacted. Mother has given Benadryl to patient to help with itching/swelling. Pharmacist recommended close monitoring for worsening symptoms and to follow-up with primary care provider for further guidance.


VAERS ID: 1346827 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site rash, Pain
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 50mg Slynd 4mg (birth control)
Current Illness: None
Preexisting Conditions: None
Allergies: Rondec
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fatigue and body aches the day after. Rash at injection site second day after persisting for 2 days. Clear by fourth day after.


VAERS ID: 1346834 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Unknown  
Location: Minnesota  
Vaccinated:2021-01-27
Onset:2021-05-22
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Received Pfizer vaccines on 1/4/21, 1/27/21. Tested positive for COVID-19 by PCR on 5/22/21. No known exposures. Onset date of symptoms 5/20/21 w/ fever, diarrhea, H/A, chills. Received casirivimab-imdevimab 2,400 mg (1,200-1,200 mg) IVPB on 5/24/21.


VAERS ID: 1346848 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C2A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: I woke up the next morning feeling a general muscle soreness throughout my body. I was also experiencing mild chills and mild dizziness. I took a 1000mg dose of acetaminophen and a 400mg dose of ibuprofen about an hour after I got up and rested for several hours. The symptoms started to dissipate at around 1pm but the soreness slightly persisted throughout the day. Symptoms were gone the next day.


VAERS ID: 1346872 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-02
Onset:2021-05-22
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ecchymosis, Immune thrombocytopenia, Immunoglobulin therapy, Petechiae, Platelet count decreased, Psychiatric symptom
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atarax as needed, zyprexa as needed
Current Illness: Depression and anxiety
Preexisting Conditions: Depression and anxiety
Allergies: No known allegies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to hospital 5/22 for acute psychiatric emergency. At the time of admission basic labs where obtained and were significant for platelet count of 4,000 (rest of complete blood count unremarkable). Medications and infectious history reviewed and were unremarkable. He has significant ecchymoses and petechiae on initial physical exam. He was started on treatment for Immune Thrombocytopenic Purpura with dexamethasone and Intravenous IgG with significant improvement in platelet count to over 100K.


VAERS ID: 1346874 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Crying, Fatigue, Headache, Hyperacusis, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (broad), 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: We believe she may have been exposed to COVID in March 2020. We did not have her tested at the time but she did lose here sense of smell and displayed flu-like symptoms.
Allergies: none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Immediately after the injection child experienced a severe headache, pain at injection site, and some fatique. The severe headache has continued for 3 days. Over the counter advil has not helped. Headache is so severe that child is crying from pain. Noises above a normal tone (including the sound of a piano playing) triggers the headache and worsens it.


VAERS ID: 1346933 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-14
Onset:2021-05-22
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Deep vein thrombosis, Oxygen saturation decreased, Pulmonary embolism, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine 10 MG tablet Take 10 mg by mouth daily aspirin EC (ASPIRIN EC) 81 MG tablet Take 81 mg by mouth daily cetirizine 10 MG tablet Take 10 mg by mouth daily cloNIDine 0.1 MG tablet Take 0.1 mg by mouth 2 (two) times daily famotidine 2
Current Illness:
Preexisting Conditions: DM type 2, obesity, hypertension
Allergies: sudafed
Diagnostic Lab Data: CTA chest showed saddle pulmonary embolism, DVT scan confirmed R popliteal DVT
CDC Split Type:

Write-up: Right popliteal DVT and Pulmonary embolism Needed oxygen and anticoagulation


VAERS ID: 1346949 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1st dose of COVID vaccine caused pinpoint mildly pruritic rash
Other Medications: losartan, Januvia, atorvastatin, folic acid, multivitamin
Current Illness: breast cancer treatment April 2021 and started exemestane on May 14th.
Preexisting Conditions:
Allergies: metronidazole, metformin, adhesives, cephalexin, clindamycin, ferrous sulfate, exemestane
Diagnostic Lab Data:
CDC Split Type:

Write-up: within 24 hours began with very itchy rash primarily to her thighs, abdomen, back and chest


VAERS ID: 1346958 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dyspnoea, Headache, Pyrexia, Troponin increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: troponin 5/25/21: 8.17
CDC Split Type:

Write-up: patient c/o shortness of breath after receiving 2nd dose of pfizer vaccine. approx 12 hours after he began having chills, headache, fever. felt worse 4 days following 2nd dose. troponin checked at hospital and found to be 8.17.


VAERS ID: 1346964 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-16
Onset:2021-05-22
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE, MULTI VITAMIN, VITAMIN D
Current Illness: NONE
Preexisting Conditions: UNDERACTIVE THYROID
Allergies: PENICILLIN SEASONAL ALLERGIES
Diagnostic Lab Data:
CDC Split Type:

Write-up: RASH ON UPPER ARM OF INJECTION SITE. ON FOURTH DAY OF RASH GETTING REDDER AND BIGGER EACH DAY. DOES NOT ITCH OR HURT.


VAERS ID: 1346979 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O46B21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blister, Burning sensation, Discomfort, Dizziness, Erythema, Fatigue, Hot flush, Malaise, Nausea, Pain in extremity, Paraesthesia, Pruritus, SARS-CoV-2 test negative, Skin discolouration, Swelling, Tenderness
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast Sod 10 mg tab, Phentermine 30 mg capsule, Topiramate 25mg tab, Famotidine 40mg tab, Alive Women''s multivitamin
Current Illness: None
Preexisting Conditions: Asthma -usually seasonal allergy related, Acid Reflux
Allergies: history lactose intolerance/ dairy intolerance; seasonal allergies
Diagnostic Lab Data: None. At home Covid test negative result.
CDC Split Type:

Write-up: Next day following vaccine shot (Saturday), experienced fatigue, dizziness, nausea, hot flashes (about 4 episodes throughout the morning/ afternoon). *Also developed blisters on toes that I thought were insect bites, however they are only on my toes - both feet. Throughout the rest of Saturday they seemed to worsen. Toes became more red -like sun burn, developed tingly, burning sensation. Next day Sunday, they were more like blisters -clearly not insect bites. Sensitive to the touch/ painful. Toes felt swollen and uncomfortable - still had not spread. Someone mentioned "Covid Toes" to me which I looked up online - this is almost exactly what I was experiencing, except not so much purple/ discoloration. Blisters were skin colored. I did an at home COVID test which was NEGATIVE. Monday, a couple of the blisters did turn a darker purple...the burning, tingly sensation continues. They are slightly itchy. No other symptoms of illness at all since Saturday feeling unwell after shot. Uncomfortable to wear shoes. Today, is Tuesday and there is little to no change at this time.


VAERS ID: 1347000 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Breath sounds normal, Dizziness, Hyperhidrosis, Vital signs measurement
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Complained of being light headed, diaphoretic Vital Signs: BP 108/72 HR 104 Resp 20 O2Sat 97 Skin Signs: Diaphoretic Circulation: Cap refill <1sec Respiratory: Breath sound clear bilaterally Initial Treatment: Moved patient to triage, placed her in supine with feet elevated. Offered water and snacks. 3:04 PM Vital Signs: BP 108/61 HR 108 Resp 20 O2Sat 98 Skin Signs: Warm and dry Circulation: Cap refill <1sec Respiratory: Breath sound clear bilaterally Vital Signs: BP 104/64 HR 90 Resp 18 O2Sat 98 Skin Signs: Warm and dry Circulation: Cap refill <2sec Respiratory: Breath sound clear bilaterally Notes: Patient stated she was feeling better after 10 min. Advised patient to seek medical attention if symptoms re-occur or worsen. Home with parent.


VAERS ID: 1347003 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 80777-0273-15 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site induration, Injection site pain, Lymph node pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pain (hardness and burning sensation) in the left arm (injection site) in the lymph nodes in the back of the arm. Still occurring 4 days after receiving the injection.


VAERS ID: 1347008 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Lip swelling, Pain in extremity, Paraesthesia, Peripheral coldness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: When I woke up the day after using the vaccine on 5/21/2021 my lips were swollen and my feet have had a feeling of pins and needles since then. It is a little painful but its more uncomfortable and it''s impossible for me to keep my feet warm. My feet feel better when I''m not walking on them.


VAERS ID: 1347017 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-13
Onset:2021-05-22
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNABLE TO ACCUR / UNK UN / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (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 that I am aware of
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right facial paralysis started over the weekend and was diagnosed as Bell''s Palsy by me in the office on 5/25/21. Prednisone and artificial tears were ordered. Referral made to ophthalmologist and neurologist for further treatment recommendations.


VAERS ID: 1347021 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Cold sweat, Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Faint, anxious, clammy Vital Signs: BP 85/60 HR 72 Resp 18 O2Sat 98 Skin Signs: Clammy Circulation: Cap refill <2sec Respiratory: Breath sound clear bilaterally Initial Treatment: Brought to triage and assisted to supine, Hx of anxiety 12:43 PM Vital Signs: BP 97/61 HR 68 Resp 16 O2Sat 98 Skin Signs: Warm and dry Circulation: Cap refill <1sec Respiratory: Breath sound clear bilaterally Vital Signs: HR 79 Resp 16 O2Sat 99 Skin Signs: Warm and dry Circulation: Cap refill <1sec Respiratory: Breath sound clear bilaterally Notes: Physician advised patient to seek further medical treatment should symptoms return or worsen. Home with parent.


VAERS ID: 1347030 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (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: Immodopine 5mg, Cetirizine, Hormone replacement
Current Illness: Breast cancer
Preexisting Conditions: Breast cancer since 09/2020
Allergies: amoxicillin
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Tissue reaction with redness and heat to area


VAERS ID: 1347046 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Immediate post-injection reaction, Immunisation anxiety related reaction, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Patient is a 16 yo female, experienced syncopal episode immediately after receiving first dose of pfzier covid vaccine. Loss of conciousness noted for less than 60 seconds. Once patient regained consciousness, she presented Alert and oriented x4, verbal and able to make needs known. Respiration even and unlabored. Skin pink, warm dry and intact. No c/c of allergic reaction. No loss or altered level of consciousness noted. Patients mother reports patient has a history of anxiety, especially with medical procedures, reports prior near syncopal episodes but denies actual loss of concern, denies allergies or significant past medical HX. Patient reports feeling very nervous. Mother remained with patient and provided emotional support. Patient was assisted to ground, placed supine with lower extremities elevated, past medical HX obtained from patient and physical assessment completed simultaneously. VS 137/82 HR 75 O2 97% RR 20. Encouraged patient to relax and breathe. Within 60 seconds, patient reported feeling better, although emotional. Once pt was OK, patient was assisted from sitting position and provided oral fluids. Patient denied dizziness or lightheadedness while in sitting position. Patient was then assited to standing positions and escorted to observation area, patient sat in chair while being observed for 30 mins. After observation period, pt denied any symptoms, no acute distress noted, patient went home with mother.


VAERS ID: 1347049 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 2 LA / IM

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

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

Write-up: Patient stated that he has been experiencing dizziness since the first dose of the COVID-19 Moderna shot.


VAERS ID: 1347082 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Heavy menstrual bleeding, Vaginal 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: NONE
Current Illness: none
Preexisting Conditions: none
Allergies: NO ALLERGIES
Diagnostic Lab Data: BLOOD WORK DONE AT DOCTOR''S OFFICE
CDC Split Type:

Write-up: Patient started experiencing severe vaginal bleeding the night after receiving the second COVID Pfizer vaccine. There is heavy flow bleeding throughout the day and slower in the morning and night.


VAERS ID: 1347134 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Fatigue, Injection site swelling, Lethargy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Extreme muscle and joint pain, fever , fatigue and swelling at injection site. Dizziness and lethargy


VAERS ID: 1347141 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-18
Onset:2021-05-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstrual disorder, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Iron, multi vitamins, zinc,
Current Illness: Anemia
Preexisting Conditions: Obesity and anemia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heavy menstrual cycle bleeding; discharged was gushy and with clots.


VAERS ID: 1347155 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Probiotic, digestive enzyme, multi-vitamin, and allegra
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Just seasonal allergies, pork
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had vaginal bleeding starting on the day after my shot. I had an ablation a year ago and haven''t had bleeding since, until after the shot.


VAERS ID: 1347177 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-05-22
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Conjunctival haemorrhage, Episcleritis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Conjunctival disorders (narrow), Scleral disorders (narrow)

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

Write-up: nodular episcleritis, preceded by subconj heme, right eye


VAERS ID: 1347188 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-13
Onset:2021-05-22
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

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

Write-up: half of face is drooping., bell palsy


VAERS ID: 1347208 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-30
Onset:2021-05-22
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

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

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

Write-up: PT REPORTING BRUISING ON BOTH LOWER ARMS AND KNEES. WAS WORKING ON HIS CAR, AND DID NOT BELIEVE HE HAD BRUISED THESE EXTREMITIES, BUT STARTED SEEING BRUISING ABOUT 48 HOURS AFTER THIS ACTIVITY. FELT HE SHOULD ASK PHARMACIST AT VACCINATION SITE IF THIS MAY BE A CONCERN


VAERS ID: 1347223 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: The patient fainted shortly after receiving his vaccination. He claimed to have a history of fainting after blood draws. He was fully recovered shortly after.


VAERS ID: 1347243 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
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: Sore arm; started to have fever (101.5) after 10 hours and fever lasted for 24 hours. After confirming no fever on Saturday morning (45 hours after 2nd dose), I went out for a very slow run on Saturday morning. But I felt dizzy after stopping from a slow and shot run, then I had no consciousness for seconds. I found myself on the trail ground with people around me. I rested the rest of day and felt better on Sunday.


VAERS ID: 1347253 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: School       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:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: The 11 year old student has accidently received a Pfizer covid19 vaccine. The student was under the age of approved indication. No adverse reaction was reported


VAERS ID: 1347329 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-01-12
Onset:2021-05-22
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: + covid test results 5/24 despite being fully vaccinated for covid 19.


VAERS ID: 1347370 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

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

Write-up: Participant received J&J COVID-19 vaccine on 4/11/21 and should not have received Moderna COVID vaccine. participant answered ''no'' to ever receiving a COVID-19 vaccine in the past on the prescreening questionnaire.


VAERS ID: 1347410 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chills, Fatigue, Headache, Hyperhidrosis, Lymph node pain, Lymphadenopathy, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily multi-vitamin; daily vitamin D supplement (1000iu); daily fish oil supplement
Current Illness: None known
Preexisting Conditions: None known
Allergies: None known
Diagnostic Lab Data: None yet completed as of this writing
CDC Split Type:

Write-up: - Fever, chills / sweating, headache, fatigue, body ache lasting approximately 24 hours in total from onset. Significant symptoms at ~16 hours post-vaccine - Significant lymph node swelling on left side of body (side of vaccine administration) - under left arm, groin, neck in particular are noticeably enlarged and tender to the touch. At 96 hours post-vaccine, small pain still noticeable in enlarged lymph node locations (left groin, under left arm, neck). It does seem to be somewhat improved day over day (as of this writing, 100 hours post-vaccine) - Chest tightness from approximately 24 hours post vaccine continuing to this writing (100 hours post-vaccine), though unclear if related to mild pain of left underarm lymph swelling or seperate


VAERS ID: 1347440 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Balance disorder, Dizziness, Fatigue, Headache, Nausea, Visual impairment
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (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: levocetirizine 5 mg daily; Flonase once daily; VitaFusion Women''s Gummy multivitamins two daily; NatureMade magnesium dietary supplements once daily; Vital Proteins Beauty Collagen 6g daily.
Current Illness: None.
Preexisting Conditions: None.
Allergies: Penicillin.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Upon waking 5.22.21 around 6:30 PM, experienced headache, fatigue, stomach pain, and nausea. On attempt to rise from bed and travel to bathroom many feet away, experienced increasing dizziness. Nausea increased with dizziness, knelt to toilet - brief improvement in dizziness at that time. Stood and stepped into walk-in shower, dizziness disrupted my ability to perceive what I was seeing - everything appeared to be violent motion so I couldn''t discern what was immediately in front of me, also extreme nausea. My balance was completely compromised such that I couldn''t determine where I was placing my feet. I found a wall with my hand, and stumbled back to the bed. This entire process took about 10 minutes. I found my bed and vision cleared after lying prone for 30 seconds. I was able to use my phone then to call a family member to help; I was prone for one hour and twenty minutes - fatigued, nauseated, dizzy - while awaiting assistance. I was fatigued and dizzy but recovered after about 6 hours of sleep, hydration, and light eating without medical intervention.


VAERS ID: 1347520 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling cold, Feeling hot, Pain
SMQs:

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

Write-up: Feeling hot and cold, chills and aches and tired


VAERS ID: 1347528 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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: Quetiapine, Buspirone, Venlafaxine.
Current Illness: N/A
Preexisting Conditions: Depression, Anxiety
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Felt extreme dizziness, vertigo, and the feeling of passing out for two days after the vaccine.


VAERS ID: 1347542 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-20
Onset:2021-05-22
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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:
CDC Split Type:

Write-up: Symptoms onset 5/22/2021 with cough, sore throat and fatigue. Tested positive for Covid-19 on 5/24/2021. Vaccinated on 3/20/2021 with Janssen.


VAERS ID: 1347549 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest pain, Headache, Paraesthesia, Pyrexia, Troponin increased
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None reported
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Elevated troponin at 450. Stable on room air. No fevers, Vital signs stable.
CDC Split Type:

Write-up: headache, weakness, tactile fever 1 day after the 1st dose of vaccine. On day 5 (today) developed left arm tingling and chest pain, so seen at ED. Symptoms subsided on ED arrival.


VAERS ID: 1347584 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Panic disorder, migraines, depression, anxiety, hx seasonal allergies
Allergies: Bee Venom Protein, Grass, Milk, Pear
Diagnostic Lab Data:
CDC Split Type:

Write-up: In the postvaccination observation clinic, the patient complained of new "tightness" in her upper airway. She says that this is similar to reactions to grasses that she has had in past. In past, her symptom has responded completely to diphenhydramine 50 mg PO. No respiratory distress either now or in past. On physical exam, she is not in distress, appears clinically well. A- allergic reaction P- Diphenhydramine 50 mg PO now, given at 12:20 pm. Continued observation x 30 min from the time of medication, with full resolution of symptoms. Discharged.


VAERS ID: 1347595 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: The next day following the shot (05/22/2021), the patient had a rash covering his entire body. He said it was itchy and red. The patient went to urgent care and received a steroid shot and steroid pills for 6 days. Called the pharmacy on 05/25/2021 to tell about the reaction


VAERS ID: 1347600 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Confusional state, Feeling abnormal, Loss of consciousness, Orthostatic hypotension, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Not reported
Preexisting Conditions:
Allergies: Not on file
Diagnostic Lab Data:
CDC Split Type:

Write-up: As a clinical monitor, I was called over to assess a driver slumped over in his seat. He had just received the second dose of the Pfizer vaccine approximately 10 minutes earlier. The passenger (his fiance) said he was acting normal until she heard him grunt and then realized that he was passed out. While attempting to lay flat, I performed a jaw thrust that yielded a stridulous inspiration but was still unresponsive. He did not have a palpable carotid pulse. Paramedics was summoned emergently. Within 30-45 seconds, he awoke but was confused and amnestic to the event. He had no physical complaints and no significant medical or allergy history. I auscultated his larynx (no stridor) and his lungs (CTA). His initial vitals: BP 90/51 HR 61 VR 16 SaO2 100% An electrocardiogram demonstrated a sinus rhythm without ischemic changes or evidence of conduction delay. His glucose was 119. Over the next 30 minutes, he was able to drink two bottles of water and some orange juice. That said, he still said he "felt off." Repeat vital signs: BP 118/62 HR 69 SaO2 100%. The medics advised him to follow up with his doctor, preferably today. His fiance agreed to drive him to an ED near their home for a more thorough evaluation. I provided her my phone number to provide to the ED for any questions. His clinical syndrome was consistent with a syncopal episode associated with orthostatic hypotension. Low suspicion for anaphylaxis.


VAERS ID: 1347609 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-01-18
Onset:2021-05-22
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: This is a breakthrough covid case. Patient completed series 1/18/21 and became positive 5/22/21


VAERS ID: 1347615 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions:
Allergies: Not on file
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient c/o throat "tightening" s/p Covid Pfizer#1. No respiratory distress. No hives or rash. Rx cetirizine 10 mg PO and diphenhydramine 25 mg PO with H2O, Observed x 30 min total. No worsening of symptoms. Discharged.


VAERS ID: 1347630 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-19
Onset:2021-05-22
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram normal, Headache, Neuralgia, Pain in extremity
SMQs:, Peripheral neuropathy (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1952 reaction to small pox vaccine, high fever and seizures at just over a year old.
Other Medications: Diltiazam, Hydroxychloroquine, Vitamin D3
Current Illness:
Preexisting Conditions: Sjogren''s, High blood pressure
Allergies: Sulsa, Penicillin, Cipro, Flagyl, Clindamycin, Bactrim, Septra, Cotrim, Terbinafine, Valsartan, Doxycycline Hyalite, Norvasc, Hydrochlorothiazide
Diagnostic Lab Data: CT scan for nerve issue, nothing found
CDC Split Type: vsafe

Write-up: Headache on my left side for a few weeks, Left arm still aches, sharp nerve issue


VAERS ID: 1347665 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-08
Onset:2021-05-22
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Atrial fibrillation, Blood glucose, Blood magnesium, CHA2DS2-VASc annual stroke risk high, Cardiac telemetry normal, Chest X-ray, Chest pain, Computerised tomogram thorax abnormal, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Full blood count, Glycosylated haemoglobin, Metabolic function test, Myocardial necrosis marker normal, Osteoarthritis, Pain, Pericarditis, Scan with contrast, Troponin, Troponin I, Viral pericarditis
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen-codeine (TYLENOL #4) 300-60 MG per tablet Take 2 tablets by mouth 3 times daily as needed for Pain. ? acetaminophen-codeine (TYLENOL #4) 300-60 MG per tablet Take 2 tablets by mouth 3 times daily Exempt-. ? [START ON 6/3/2021
Current Illness: Unknown
Preexisting Conditions: Diabetes type II, GERD, hyperlipidemia, hypertension,
Allergies: Chlorhexidine gluconate, latex, pistachios, string beans, peanuts, flexeril
Diagnostic Lab Data: 5/23/21 CXR, CT Angio Pulmonary w/ contrast, troponin I, CMP, CBC, Magnesium, Hemoglobin A1C, Glucose, 5/24/21 Troponin
CDC Split Type:

Write-up: Patient presents to ER with chest pain that is constant, achy, occasional sharp stabbing, sometimes worse with deep breath and radiates to his back for the last 2-1/2 hours. He said it started at 10 PM. He said he has not had anything to eat since about 5 PM and says it does not feel like heartburn. Work-up included a CT angiogram of the thorax which showed findings consistent with pericarditis. Patient was noted to have diffuse but mild ST elevations on ECG. Cardiac enzymes remained negative however. Cardiology was consulted, and the patient was admitted to the hospital where he was started on colchicine and NSAIDs. Serial cardiac enzymes remained negative. The patient''s chest pain steadily improved, and by last night it had completely resolved. He does have chronic shoulder pain due to osteoarthritis, and this is at its baseline. The patient will finish a 3-month treatment course with colchicine. I am discharging him on as needed ibuprofen for breakthrough pain. It should be noted that the patient did have a brief period of paroxysmal atrial fibrillation which resolved with 150 mg of amiodarone IV. The patient has been continuously monitored on telemetry, and atrial fibrillation has not recurred. After discussion with the patient and his wife, I have elected not to start the patient on aggressive anticoagulation as the period of atrial fibrillation was quite limited and occurred during an acute viral pericarditis episode. Patient''s CHA 2 DS 2 score is 4. I recommended that he further discuss this with his primary care provider. Recommend considering an extended Holter monitor.


VAERS ID: 1347680 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-29
Onset:2021-05-22
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       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: none
Preexisting Conditions: PVC, obesity
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: tinnitus


VAERS ID: 1347772 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Liver function test increased, Myalgia, Pain, Pyrexia, Thrombocytopenia, Vomiting, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NO
Current Illness: No
Preexisting Conditions: PMH is unremarkable
Allergies: NKA
Diagnostic Lab Data: Low WBC, thrombocytopenia, and elevated LFT.
CDC Split Type:

Write-up: fever, bodyaches, myalgia, vomiting.


VAERS ID: 1347774 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Anticoagulant therapy, Back pain, Blood test, Computerised tomogram abnormal, Fatigue, Hot flush, Hyperhidrosis, Pain, Spleen disorder, Splenic vein occlusion
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Many blood tests. 2 CT scans conducted on Sunday through Tuesday. I?m not a dr. You can contact Dr. for more details as I?m sure they have this all on file.
CDC Split Type:

Write-up: Received fax on Thursday. Had ?normal? fatigue next day. On Saturday woke up feeling better. Saturday evening aroun 7:30pm felt hot flash and had sweats and my back started to ache. Pain continued and also radiated from center abdomin and left side and intensified. No sleep as I has fairly severe pain all night. Sunday consulted with nurse and was advised Togo to the ER. Went to ER at Hospital around 5:07pm. Had several tests conducted including CT SCAN which revealed bloackage in the splenic vein. Admitted and started me on morphine and also started Heparin blood thinner. Many many blood tests and additional CT scan conducted. Released on Tuesday around 12:30pm. Still have painful spasms as a result of the damage done to spleen. According to Dr, it may take 2-3 weeks before spleen is healed and spasms are gone. Follow up visit TBD in 2 weeks.


VAERS ID: 1347791 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Dizziness, Fatigue, Immediate post-injection reaction, Malaise, Paraesthesia, Visual impairment
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Patient started to not feel well almost immediately after the vaccine was given per certified pharmacy technician on 5/22/21 around 4:05 P.M. Patient started to experience symptoms not related to anaphylaxis, but more so related to hypotension and/or anxiety. Symptoms include dizziness, body fatigue, pins/needles throughout her body, and also patient started to "see dark spots" when she had her eyes open. No other immediate symptoms were present. Patient''s condition improved over time and was able to get up from the chair by herself approximately 15-20 minutes post injection. Patient initially had a normal body temperature of 98.6 F. Temperature was taken every 5 minutes starting from 4:11 P.M for a total of 5 readings, which gradually increased to 100.5 F. Patient''s condition started to worsen approximately 30 minutes post injection after improvement and looked like she was going to become unconscious. Ambulance was called due to worsening of symptoms again, and patient''s care was transferred over at around 4:45 P.M. Patient was called on 5/25/21 at around 2:40 P.M. for follow-up. Patient has not fully recovered, but is on her way to recovery. Currently, her only symptoms are feelings of pins/needles throughout her body while all other symptoms are gone. Advised patient to follow-up with physician for her current symptom. Patient acknowledged and will see doctor soon. No date was given.


VAERS ID: 1347804 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus, Injection site rash, Injection site warmth
SMQs:, Hypersensitivity (narrow)

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

Write-up: 2 days after my vaccine, I developed a rash a couple inches below the injection site. It was warm to the touch, and itchy. I used a topical cream to treat it. It is now Day 4 and the rash is nearly gone.


VAERS ID: 1347837 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Adverse Events: Exhibited extreme fatigue, persistent headache, persistent muscle aches, persistent joint pain,.


VAERS ID: 1347855 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-18
Onset:2021-05-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Blood pressure increased, Electrocardiogram, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Hypertension (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metropolol
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: EKG 5/25/2021
CDC Split Type:

Write-up: Increased heart rate, raised blood pressure, then went into atrial fibrillation


VAERS ID: 1347868 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

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

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

Write-up: swollen right eye for 10 hours.


VAERS ID: 1347901 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 2 LA / IM

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

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

Write-up: left face numb, headache


VAERS ID: 1347904 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Facial paralysis, Flushing, Nausea, Pharyngeal swelling, Rash, Swelling of eyelid
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (broad), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Dilation swelling in throat minutes after vaccination. Also became nauseated and light headed minutes afterward. Had to lie down at home. About 2 to 3 hours later. Right side of face flushed/light rash and right eye drooped and almost closed. Stayed this way for about 3 hours before eye started to resume to normal. Didn''t affect left side of body.


VAERS ID: 1348030 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 10 mg, levothyroxine 50 mcg, metformin 1000 mg
Current Illness: None
Preexisting Conditions: Thyroid diabetes
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Diarrhea


VAERS ID: 1348047 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bladder discomfort, Culture urine, Lipids, Pollakiuria
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
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin and Cipro
Diagnostic Lab Data: Urine culture and lipid panel done on 5/24/2021 Still haven?t received results.
CDC Split Type:

Write-up: I started feeling discomfort in bladder area the night after I got the Moderna vaccine along with frequent urination. I called my doctor and went to get a urine culture done. I am still waiting for the doctor?s response. I was perfectly fine before I got the vaccine.


VAERS ID: 1348065 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-14
Onset:2021-05-22
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Exposure during pregnancy, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cimzia 200mg/ml injection Prenatal vitamins
Current Illness: None
Preexisting Conditions: Rheumatoid arthritis
Allergies: Bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm still warm to touch, itching and red. Was 15 weeks pregnant.


VAERS ID: 1348287 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MODERNA / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Headache, Influenza like illness, Pain
SMQs:, 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: metformin, C, D, BRAIN SUPPLEMENT , FOLIC ACID, JOINT SUPPLEMENT,
Current Illness: IT WAS REALLY AFTER THE 2ND SHOT GIVEN 5/22/21 - HEADACHE, FLU SYMTOMES AND ON COUCH ALL DAY AND NIGHT WEEK FOR 2 DAYS NOW
Preexisting Conditions: ASTHMA
Allergies: SULPHUR
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: WAS DOWN LIKE A TRUCK HIT ME - FLU SYMTOMES - STILL FEEL WEEK AFTER 3 DAYS - BODY ACHES ALL OVER


VAERS ID: 1348305 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Ocular hyperaemia, Throat irritation
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Vestibular disorders (broad), Hypersensitivity (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: No
Current Illness: Na
Preexisting Conditions: Na
Allergies: Na
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Flushed face, blood shot eyes, felt light headed,itchy throat, took 50mg benadryl. Felt fine about 1 hour later


VAERS ID: 1348312 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-19
Onset:2021-05-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Pain, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 125mcg
Current Illness: Neck shoulder arm pain headaches.
Preexisting Conditions: Thyroidectomy 2001 Headaches caused by neck, shoulder, arm pain from working on the computer. Lower back pain and vertigo.
Allergies: Wellbutrin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain, itchy, tiny blister in left eye.


VAERS ID: 1348325 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-23
Onset:2021-05-22
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

Administered by: Public       Purchased by: ?
Symptoms: Confusional state, Fatigue, Feeling abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

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

Write-up: Brain fog/ tired/ confusion


VAERS ID: 1348822 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Feeling abnormal, Insomnia, Malaise, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Around 10pm (almost 12 hours after I got my 2nd dose), it started with nausea and malaise. Within 10-30 minutes, I got very very dizzy and there was pain (but I can''t remember where, maybe it was a headache). Soon after, I fainted for a few minutes and when I woke up, I felt VERY nauseous. I ended up vomiting 5-10 minutes after. Twice. Then I think I had a fever and chills so I proceeded to sleep it off. It was hard to sleep because my head just felt off (not sure how to describe it). The following days have been better, but still not feeling 100%. Head feels a little weird, but for the most part, feeling okay.


VAERS ID: 1349040 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-05-22
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, 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:
Current Illness:
Preexisting Conditions: Comments: patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544865

Write-up: TINGLING IN ARMS; NUMBNESS; This spontaneous report received from a pharmacist concerned a 31 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 22-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-MAY-2021, the subject experienced tingling in arms. On 22-MAY-2021, the subject experienced numbness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tingling in arms on 22-MAY-2021, and had not recovered from numbness. This report was non-serious.


VAERS ID: 1349052 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-22
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chromaturia, Headache
SMQs:, Rhabdomyolysis/myopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210545214

Write-up: TRANSPARENT URINE; MILD HEADACHE; This spontaneous report received from a patient concerned a 47 year old female. The patient''s weight was 54 kilograms, and height was 60 inches. 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: 205A21A, expiry: UNKNOWN) dose was not reported, administered on 22-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-MAY-2021, the subject experienced transparent urine. On 22-MAY-2021, the subject experienced mild headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from transparent urine, and the outcome of mild headache was not reported. This report was non-serious. This case, from the same reporter is linked to 20210545645.


VAERS ID: 1350307 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Gastritis
SMQs:, Gastrointestinal nonspecific inflammation (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: Triamterene HCTZ 37.5-25 MG CP, Vitamin D3 25mcg. CoQ10 100mg, Milk Thistle
Current Illness: Gastritis unknown origin, 4 days 102+ fever, Covid test negative. Tears in muscles etc. hip IT band region
Preexisting Conditions: ME/CFS since 1990s
Allergies: Allergy: Penicillin, aspirin, Tylenol
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Had postponed vacc in mid April due to gastritis unknown origin. Covid test negative. 1st dose April 30th, resurgence of muscular issues in hips/IT bands within 4 days, lasted more than 7. Nearly unable to walk. 2nd dose May 21st, resurgence of gastric symptoms May 22 8:30pm. Today is May 26th, still having significant discomfort. As if vaccine caused relapse of any recent conditions, worse than they were initially. Pre-existing ME/CFS means recovery always takes longer no matter what.


VAERS ID: 1350327 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Headache, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: gets anxious with needles
Preexisting Conditions:
Allergies: allergic to bactrim
Diagnostic Lab Data: pulse: 76 Respiration: 18 SPO: 98 BP: 100/76
CDC Split Type:

Write-up: dizzy, headache, blurred vision, vomited after vaccination. (at 03:52 pm) outcome: recovered after drinking water and eating crackers and discharged to home.


VAERS ID: 1350341 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-19
Onset:2021-05-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 LA / IM

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

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

Write-up: Patient developed an itchy rash on the neck starting 3-4 days after receiving the Moderna vaccine. Advised patient to speak to doctor about the rash.


VAERS ID: 1350345 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: cholecalciferol 2000IU daily, gabapentin 900mg tablet daily prn, loratadine 10mg daily prn, OTC calcium
Current Illness: N/a
Preexisting Conditions: Fibromyalgia, h/o deep vein thrombosis, allergic rhinitis, vitamin d deficiency
Allergies: robitussin DM, bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness of the left upper extremity site starting 2 days after vaccine, initially with associated soreness and pain that resolved w/in 48 hours, but redness persisting and spreading distally.


VAERS ID: 1350353 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Hot flush, Nervousness, Parosmia
SMQs:, Taste and smell disorders (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: history of anxiety, OCD
Allergies:
Diagnostic Lab Data: Pulse: 111 (repeat: 90) Respiration: 20 SPO: 100% B/P: 146/82 Exam: normal
CDC Split Type:

Write-up: AE: rosey smell, hot flashes, feeling nervous/ anxious(at 10:20am) treatment: n/a ; food and drink helped, ate crackers and drank juice. outcome: felt better after eating crackers, patient discharged home


VAERS ID: 1350364 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pulse: 63bpm Respiration: 20 SPO2: 97% Exam: normal
CDC Split Type:

Write-up: AE: light headed, slight ringing in the ear(resolved), dizzy (at 10:40 am) Tx: n/a, just food and drink Outcome: juice, crackers helped resolve AE. pt was discharged home.


VAERS ID: 1350378 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of similar reaction with injections and vaccine needles
Allergies:
Diagnostic Lab Data: Pulse: 49 bpm Respiration: 20 SPO2: 96% B/P 100/60
CDC Split Type:

Write-up: AE: light headed, dizzy, pale, fainted Tx: n/a, just food and drink Outcome: juice, crackers helped resolve AE. pt was discharged home.


VAERS ID: 1350384 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-04
Onset:2021-05-22
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Catheterisation cardiac abnormal, Chest X-ray normal, Chest discomfort, Chest pain, Dizziness, Echocardiogram normal, Ejection fraction, Fatigue, Left ventricular end-diastolic pressure, Pain, Pain in extremity, Presyncope, Pyrexia, Respiratory viral panel, SARS-CoV-2 test negative, Troponin increased, Ventricular extrasystoles, Viral myocarditis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Ventricular tachyarrhythmias (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Anxiety History of asthma; this is mild. He has a rescue inhaler that he has not used recently.
Allergies: peanuts, nuts, cashews
Diagnostic Lab Data: Initial troponin on 5/22 was 472, second was 558; remained elevated through admission (last taken 5/25 - 444) . COVID test 5/22 negative, chest xray negative. Respiratory virus panel results pending. No premature family history of coronary disease or hypercoagulable states. Cardiac cath completed 5/24/21 CONCLUSIONS: No CAD, likely myocarditis. Ao valve crossed but unable to assess LV EDP secondary to significant ectopy. No gradient across the Ao valve. Ecocardiogram completed 5/24/21 * Normal left ventricular size and systolic function, LVEF 70%. Normal diastolic function. * Normal right ventricular size and systolic function. * Normal atrial sizes. * No hemodynamically significant valvular heart disease present. **Patient was discharged home on 5/25/2021; not fully recovered but improved.
CDC Split Type:

Write-up: 27-year-old gentleman with history of mild intermittent asthma, anxiety, presented with complaints of fever of 99.8 ?F on 5/22/2021 associated to fatigue and body aches and then chest pain, generalized with radiation to left arm since afternoon of 5/23/2021, which got worse on 5/24/2021 and he was admitted for further evaluation with initial troponin of 472. Had an NSTEMI; chest tightness, pain in left arm, lightheadedness, dizziness, presyncope. Discharge diagnosis - probable myocarditis; clinical picture most consistent with viral myocarditis.


VAERS ID: 1350397 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of Cardiac catherization (angiogram) through right arm
Allergies:
Diagnostic Lab Data: Pulse: 91 bpm Respiration: 18 SPO2: 97% B/P 140/78 Exam: normal
CDC Split Type:

Write-up: AE: Patient started feeling itchy on the arms, redness and swelling in the right forearm seen 28 minutes after vaccination. Tx: n/a, water improved rash outcome: patient rash improved spontaneously without medication. patient was discharged home.


VAERS ID: 1350411 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Rash, Rash erythematous, Rash maculo-papular, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: raised reddened maculopapular itchy rash on arms chest, torso


VAERS ID: 1350417 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cold sweat, Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Allergies to PCN
Diagnostic Lab Data: Pulse: 83 bpm Respiration: 18 SPO2: 97% B/P 110/80
CDC Split Type:

Write-up: AE: Patient had not eaten prior to vaccine, started getting dizzy and clammy after receiving vaccine. Tx: no medications, Symptoms improved with crackers and water. outcome: patient improved spontaneously without medication. patient was discharged home.


VAERS ID: 1350438 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pulse: 82 bpm Respiration: 18 SPO2: 99% B/P 100/55
CDC Split Type:

Write-up: AE: patient got dizzy, vomited and syncopal walking. No medication was given. food and water improved the symptoms Outcome: patient discharged to POV/Home


VAERS ID: 1350444 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

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

Write-up: None stated.


VAERS ID: 1350459 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pulse: 67 bpm Respiration: 18 SPO2: 98% B/P 100/60 Exam: normal
CDC Split Type:

Write-up: AE: felt like patient was going to pass out Tx: no medication was given. water resolved the symptoms Outcome: Patient was discharged to POV/Home.


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