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From the 7/16/2021 release of VAERS data:

Found 479,813 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 11 out of 4,799

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VAERS ID: 1463992 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Breast pain, Headache, Impaired work ability, Injected limb mobility decreased, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, diltiazem, Flexeril, naproxen
Current Illness: None
Preexisting Conditions: Osteoarthritis, thyroid, rheumatoid arthritis
Allergies: Prednisone, keflex, erythromycin, levofloxacin, Bactria, Steroids, penicillin,
Diagnostic Lab Data: None. I did send a message to my Dr this morning.
CDC Split Type:

Write-up: Hi I got my second Covid shot on Saturday July 10. Shot was in the left arm. Severe headache within five minutes like last time. Felt like a migraine. After an hour the worse pain was in my left breast & armpit. My left armpit was swollen significantly & my breast felt like I was punched or stabbed. I couldn?t lift my left arm. I applied heat & ice alternately & took Tylenol. Then whole body ached like the flu. No worries there, it?s the swollen left armpit & pain in breast that is bad. Yesterday it got worse. I continued with heat, ice & Tylenol. I took today off because the pain is severe & I can only lift my arm half way up. The severe pain feels like how you feel after a surgery when pain meds start to wear off. Do you know how long this will last?? Thanks & have a great day.


VAERS ID: 1463994 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-06
Onset:2021-07-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Vaccine positive rechallenge
SMQs:

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: 1st COVID vaccine previously reported
Other Medications: None
Current Illness: ? Lyme disease, had same reaction to 1st COVID vaccine, was treated with doxycycline.
Preexisting Conditions: Mild Intermittent Asthma
Allergies: Griseofulvin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Left lower back oval, violaceous mark in the exact same location as previous reaction to 1st COVID vaccine. No other systemic signs and symptoms. Began to diminish today 7/12/21.


VAERS ID: 1463995 (history)  
Form: Version 2.0  
Age: 97.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-02
Onset:2021-07-10
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, prior stroke
Allergies:
Diagnostic Lab Data: Positive SARS-CoV-2 result from NP specimen collected 7/10/2021
CDC Split Type:

Write-up: Presented to ED with 3 week history of increased fatigue, rib pain, 3 day history of cough. Known COVID household exposure. Positive COVID-19 result by PCR after $g14 days vaccination completion.


VAERS ID: 1463997 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Dizziness, Echocardiogram, Electrocardiogram, Headache, Pain
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad)

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

Write-up: After a couple days of symptoms That had subsided , developed a quick headache, light headedness with shoulder and chest pain on the left side. The pain was radiating toward the breastbone area. Waves of chest pain.


VAERS ID: 1464043 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Eye disorder, Loss of consciousness, No adverse event
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), Corneal disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Approx 4:00pm ,Pt in for J&J vaccine, within minutes of receiving injection, pt?s husband said ?we need help? This writer saw pt begin to slide down in chair and eyes flutter, pt lost consciousness for approx 10 seconds, never completely came out of chair. Paramedics also responded with this writer to assist pt. Pt was assisted onto gurney and first set of v/s was taken, pt has become alert and aware of name/place/date/time. Negative history for meds or medical issues but states she did once pass out before from an injection and believes the thought of this particular vaccine made her nervous and she held her breath while getting vaccinated. 4:05pm bp=128/75, Pulse ox = 95%, R=16. Pt denies HA/dizziness/blurred vision/weakness/nausea. Remains alert . Water and Gatorade given to pt. 4:10pm P=78, pulse ox =95%, pt remains calm/alert/responsive/stable 4:15pm, assisted pt to sitting position, pt denies any adverse s/s. 4:20pm: BP= 134/78, P=78, Pulse ox =96%, R= 16. Assisted pt from sitting on gurney to sitting back onto chair that she started in, states she feels fine. 4:35 pm: pt is able to stand w/o assist, remains alert/aware, states she feels fine and is ready to go get her drink. Pt ambulated on her own to her car, accompanied by her husband and this writer. Pt left clinic in stable condition. Home care instructions given and advised on when she would need to seek further medical assistance. Pt and husband verbalize understanding of info given


VAERS ID: 1464068 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

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

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

Write-up: Child vaccinated at a drive thru clinic. On paperwork at clinic, mother documented date of birth as 02/23/2009. Upon entering in data into electronic system, noted that child date of birth is listed as 02/23/2010. Contacted parent to verify birth date. Initially mother stated date of birth was the 2/23/2009 that she listed on the consent form, but then stated "actually, it is 02/23/2010". This nurse then asked parent if she lied about the birthdate so that child could get vaccinated and she stated "yes". Advised parent that vaccine is not licensed for children under 12 years of age and that we would not vaccinate with second dose until that time.


VAERS ID: 1464093 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Limb discomfort, Muscle spasms
SMQs:, Dystonia (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: Saturday patient complained of leg cramps ,she says legs still hurt today on monday.


VAERS ID: 1464096 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Musculoskeletal stiffness, Paraesthesia, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

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

Write-up: Headache for 48 hours and tingling and numbness in hands/fingers and toes. Fingers feel stiff and swollen.


VAERS ID: 1464118 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Feeling cold, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (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: Back pain, arm numb, feel cold
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm numb, back pain, cold


VAERS ID: 1464140 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-06
Onset:2021-07-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus, Injection site reaction, Rash macular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Itchy, blotchy injection site


VAERS ID: 1464176 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Nothing significant
Allergies: Naproxen
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Redness, swelling and itching over upper left arm


VAERS ID: 1464219 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 RA / IM

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

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

Write-up: Client requested a Janssen vaccine. Later it was found in the immunization registry that he had received a Moderna on 4-1-21. No adverse symptoms. Nursing is reaching out to him for follow up.


VAERS ID: 1464259 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-09
Onset:2021-07-10
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 2 - / IM

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

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

Write-up: After being fully vaccinated with the moderna vaccine in March, patient subsequently presented to the ED on 7/11/2021 secondary to symptomatic COVID.


VAERS ID: 1464285 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-01-18
Onset:2021-07-10
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 AR / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID positive after vaccination


VAERS ID: 1464311 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-13
Onset:2021-07-10
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Alvesco, Ventolin and Sildenafil.
Current Illness: none
Preexisting Conditions: Asthma
Allergies: NKA
Diagnostic Lab Data: Pos Covid-19 on 07/10/2021
CDC Split Type:

Write-up: This EE was fully vaccinated on 12/23/2020 and 01/13/2021.


VAERS ID: 1464340 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

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

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

Write-up: Vaccine administered, upon review of vaccine administration patient had stated this was first dose of covid vaccine, however patient was fully vaccinated with moderna prior to receiving 1 dose of Pfizer. Pharmacy was unaware of moderna vaccination at time of administration of Pfizer . No Adverse event from administration was reported. Received a total of 3 covid vaccines ( two moderna and one Pfizer) outside of current guidelines.


VAERS ID: 1464348 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Asthenia, Blood creatine phosphokinase increased, Blood creatinine increased, Liver function test increased, Myalgia, Pain in extremity, Rhabdomyolysis, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (narrow), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advair, plan Next, trazodone, Prilosec, telmisartan, singular, metoprolol, albuterol, Crestor, Caltrate vitamin D, vitamin C, nifedipine, Xeljanz
Current Illness: No recent illnesses reported
Preexisting Conditions: Rheumatoid arthritis, hypertension, asthma, history of stroke, history of coronary artery disease, migraines, history of valvular heart disease
Allergies: Allergies to crab
Diagnostic Lab Data: Elevated CPK, elevated liver functions, elevated creatinine, elevated troponin
CDC Split Type:

Write-up: Patient presented to the emergency department with weakness, was found to have acute rhabdomyolysis and acute renal failure with generalized muscle aches and pains all 4 extremities.


VAERS ID: 1464393 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-18
Onset:2021-07-10
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 LA / SYR

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

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

Write-up: Received Pfizer vaccines on 12/28/20, 1/18/21; tested positive for COVID-19 by PCR on 7/10/21. Unknown if patient was symptomatic.


VAERS ID: 1464406 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO196 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Erythema, Feeling hot, Headache, Neck pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Morning after second dose, experienced severe pain running up the left side of neck, top of head and right side of neck - severe ear aches, both ears - Still happening Following Monday (today) my left arm is swollen, red and radiating heat


VAERS ID: 1464410 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-11
Onset:2021-07-10
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Aortic arteriosclerosis, Atelectasis, COVID-19 pneumonia, Chronic obstructive pulmonary disease, Condition aggravated, Dyspnoea exertional, Hypoxia, Penetrating aortic ulcer, Productive cough, Sputum discoloured
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: PMH of COPD, depression, anxiety, possible Afib, possible CHF
Allergies: nifedipine, nuts, sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chief Complaint hypoxia History of Present Illness Pt is a 67F with PMH of COPD, depression, anxiety, possible Afib, possible CHF who presented as a transfer from OSH for hypoxia in the setting of COPD exacerbation and COVID PNA. She also has a hx of left lower lobe lobectomy many years ago for an infection per patient report. She states that she typically wears 4L o2 at home while sleeping and with exertion, but does not require any at rest. She reports that she completed both COVID vaccines about 1-2 months ago. She did have contact with her daughter who also tested positive recently. She reports that she started to feel dyspneic with minimal exertion at home and took her O2 saturations and found them to be in the 70s, so she presented to the ED. She underwent CTA scan in ED and was found to have left lower lobe collapse, severely calcified and ulcerated thoracic aorta with possible intraluminal hanging thrombus and small penetrating aortic ulcer. She was sent here for further work up and management. She denies any etoh or drug use, but has smoked 1-2ppd for 50 years. Mom and dad with hx of cancer. She denies any fevers, chills, chest pain, tightness, pressure, or worsening dyspnea at rest. She does have a productive cough with yellow sputum production and dyspnea with exertion.


VAERS ID: 1464456 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Costochondritis, Dyspnoea, Electrocardiogram, Hypopnoea, Mobility decreased
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: **Neem leaves, Turmeric
Current Illness:
Preexisting Conditions: Ulcerative colitis (autoimmune) Psoriasis / exzyma rosacea
Allergies:
Diagnostic Lab Data: Chest X ray Blood test Ekg
CDC Split Type:

Write-up: 6/10 chest pain and pangs around 36 hours after 2nd Pfizer dose (Saturday night). Shortness of breath, potential heart flutterings, and chest pain that comes and goes. Intensified around midnight. Sunday, increased around noon. Decided to get checked out at ER. Doctor said no evidence of a blood clot, and diagnosed me with ******"costochondritis"****** has not gone away, although slowly subsided by day 4. I still have shortness of breath, inability to breathe deeply, bend over. Got intense saturday night but is mild now.


VAERS ID: 1464465 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-02-11
Onset:2021-07-10
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Vaccination site nodule, Vaccination site pain
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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient noticed soreness in her arm at the exact spot where she received her vaccine back in February. Initially she had soreness but it resolved within 2 weeks. Then this past weekend she noticed soreness and a knot in that same spot.


VAERS ID: 1464516 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-01-28
Onset:2021-07-10
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Crying, Depression, Diarrhoea, Dyspnoea, Lung consolidation, Malaise, Peripheral swelling, Pyrexia, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: history of ADHD, Depression, sleep apnea on CPAP, hypertension, hypercholesterolemia, and type 2 diabetes
Allergies: chocolate, contrast dye, fish, PCN, shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chief Complaint covid since last friday, getting more SOB, was 88% RA History of Present Illness Patient is a 58-year-old male with a history of ADHD, Depression, sleep apnea on CPAP, hypertension, hypercholesterolemia, and type 2 diabetes presenting for concerns of shortness of breath after being diagnosed with Covid. Patient first started having symptoms 10 days ago with fevers, diarrhea, and malaise. He tested positive for Covid 8 days ago, despite being vaccinated with the Pfizer vaccine in February. He states that he has been getting progressively more short of breath, to the point where he is having to take breaks while going upstairs to his bedroom. He called EMS to the scene, who state that when they arrived that he was saturating 88% on room air, so he was placed on a nonrebreather. Patient states that his fevers have stopped and the biggest issue that he is having is his shortness of breath. He does endorse some intermittent swelling in his lower extremities, which he takes furosemide for. Furthermore, patient started crying thrice during the interview, seemed depressed but had no thoughts of hurting himself. He denies any history of heart failure or heart attacks. He also denies any chest pain. Chest Xray was done in the ED and it showed severe diffuse bilateral lung consolidation, consistent with Covid 19 pneumonia.


VAERS ID: 1464521 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc Copper Pre/Pro Biotic Turmeric
Current Illness:
Preexisting Conditions:
Allergies: Gluten Reglan
Diagnostic Lab Data:
CDC Split Type:

Write-up: Large Grape Sized Bump at Injections Site with Swelling, Red Rash and Heat


VAERS ID: 1464591 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 is 17 years and 11 months old, and was given Moderna shot with is approved for 18 years old and over. Pt has had no symptoms or adverse events.


VAERS ID: 1464605 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-05
Onset:2021-07-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / IM

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

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

Write-up: Patient reports red dime sized circle near injection site. She noticed it on 7-10-21 but is not 100% sure when it began. It is not itchy or painful. Patient advised to follow up with PCP.


VAERS ID: 1464672 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR

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

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

Write-up: Hives in the left armpit. Still have the hives there. Nowhere else. Didn''t itch at first; now itching a lot 48 hours after noticing the hives


VAERS ID: 1464690 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear discomfort, Hypoacusis
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: not reported
Current Illness: none reported
Preexisting Conditions:
Allergies: no known drug allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: He says that overnight after the vaccine his left ear now feels plugged and as a result he cannot hear well. He noticed it starting the morning after the vaccination and is still experiencing the same sensation 3 days later. It still feels plugged.


VAERS ID: 1464720 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Dizziness, Headache, Injection site pain, Lymphadenopathy, Malaise, Myalgia, Pain, Productive cough, Pyrexia, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingrix (Dec. 2019), Influenza (3 different years do not recall which years)
Other Medications: Claritin
Current Illness: None
Preexisting Conditions: Sjogren''s-like autoimmune disorder/Sicca syndrome. I was born with an autoimmune disorder that is similar to Sjogren''s, my doctors have labeled it a "medical mystery". I have been tested for everything under the sun. I also react to sugars and starches....sugars make me feel tired, sluggish and give me heartburn.
Allergies: milk, flax, augmetin, bactrim, cefaclor, Cipro, Biaxin, vancomycin, erythomycin, gentamicin, penicillin, amoxicillin, codeine, tamiflu, clindamycin, soy, nuts, pineapple, sunflower seeds,
Diagnostic Lab Data: I have a long history of adverse reactions to medications, and have had adverse reactions to three flu vaccinations and the first Shingrix vaccination shot . I was very worried that my autoimmune disorder would cause me to have an adverse reaction to the Covid vaccine. I held out this long for this very reason, because no one was willing to advise me as to whether or not I should risk getting the vaccine. At this point I wish I had not done it....it was not worth it for what I am dealing with now. I have not had medical tests, because my doctors know my medical history and usually do not prescribe medications for me due to my history.
CDC Split Type:

Write-up: Received vaccine at 11:09AM on 7/10/2021. The vaccine in my arm was burning rather badly within a few minutes of it being administered. About 10PM the same day I started feeling dizzy, bad headache, muscles and joint started aching all over my body, joints were hurting, a few hives on my torso and I was experiencing chills. Went to sleep that night and was very ill the entire next day with fever, chills, aching all over, swollen lymph notes in my neck, in my left arm pit, coughing out excessive phlem, headache, sore joints, and hives on my arms, legs and torso. It is now 7/12/2021 at 4:34PM, I am still dealing with hives wheels all over my legs, several small hives on my right arm and several hives on my belly and sides. My antihistamine is helping to keep the hives in check. I am still quite sore all over and the arm I received the injection in hurts a lot.


VAERS ID: 1464749 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Erythema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Trinessa 0.18/0.215/0.25MG-35 MCG daily
Current Illness: none
Preexisting Conditions: none
Allergies: Latex
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt reports she was fine the day she received the Vaccine, but when she woke up the next morning she reports her face felt like it was on fire and she noticed it was bright red and covered in Hives. pt went to the ER for evaluation where they administered IM steroids and Benadryl. pt came to PCP office 7/12/21, with some erythema and fine bumps noted to face where the hives had been present. (pt and PCP unsure if ER filled out a VAERS report)


VAERS ID: 1464793 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-12
Onset:2021-07-10
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

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

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

Write-up: SARS-CoV-2 RdRp Resp Ql NAA+probe~COVID-19 rapid diagnostic test (nucleic acid amplification test NAAT) performed on 7/10/21 at a pharmacy and came back positive. Pharmacy most likely is not in location, but in location. Case investigation interview with patient has not been performed at the time of writing this note.


VAERS ID: 1464811 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dry eye, Fatigue, Headache, Injection site pruritus, Injection site rash, Lymphadenopathy, Muscular weakness, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Corneal disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multi-vitamin/mineral; collagen; vitamin D2; Magnesium
Current Illness: none
Preexisting Conditions: none
Allergies: dycloxicillin; morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: After first dose: swelling of lymph nodes behind left knee; arm soreness; slight headache; slight fatigue After Second dose: arm soreness; slight headache; sore throat; overall body aches; fatigue; fever; dry eyes; muscle weakness; rash and itching at injection site


VAERS ID: 1464837 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, 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: Sore arm


VAERS ID: 1464856 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-20
Onset:2021-07-10
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Pharmacy       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: N/A
Current Illness: N/A
Preexisting Conditions: Granulomatosis with polyangiitis
Allergies: N/A
Diagnostic Lab Data: sent positive test result 7/12/2021.
CDC Split Type:

Write-up: Diagnosed with COVID on 7/12/2021.


VAERS ID: 1465345 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: HPV vaccine #1 - prolonged arm pain x 10d
Other Medications: none
Current Illness: none
Preexisting Conditions: mild intermittent asthma (albuterol as needed)
Allergies: no known allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 36hr after first Covid vaccine, developed urticaria multiforme; diffuse head to toe pruritic rash with welt, wheals, hives, some swelling around hands and feet. Also with cough and headache, no fever.


VAERS ID: 1465677 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Unknown  
Location: Arkansas  
Vaccinated:0000-00-00
Onset:2021-07-10
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Headache, Myalgia, Nasopharyngitis, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210722912

Write-up: CANNOT STOP SHAKING; COLD; BACK HURTS; MUSCLES HURTING/MUSCLES ACHE; HEADACHE; This spontaneous report received from a patient concerned a 26 year old of unspecified sex. The patient''s weight was 275 kilograms, and height was 76 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: 1808978 expiry: UNKNOWN) dose was not reported, administered on 09-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-JUL-2021, the subject experienced cannot stop shaking. On 10-JUL-2021, the subject experienced cold. On 10-JUL-2021, the subject experienced back hurts. On 10-JUL-2021, the subject experienced muscles hurting/muscles ache. On 10-JUL-2021, the subject experienced headache. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from cannot stop shaking, cold, back hurts, muscles hurting/muscles ache, and headache. This report was non-serious.


VAERS ID: 1465977 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-06-26
Onset:2021-07-10
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Pain in extremity, Sleep disorder
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clonazepam (I think 5 mg) taken at night for sleep (sometimes, rarely, in day for panic attacks, anxiety) Ibuprofen (taken for minor pain) Anti-depressant (forgot name, unable to check right now, have been taking a long time) Tea (regular b
Current Illness: Depression, anxiety, other mental things
Preexisting Conditions: Depression
Allergies: Allergic to amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Felt minor pain in arm at first, but it went away. Felt fine for at least two weeks. It''s nearly time for my 2nd shot (coming up this Saturday) and for the past two or three days, my arm has been hurting at the injection site. Pain was getting severe so I stretched (followed a 5 minute routine from a video), and now it is _very_ painful. Seems to have made it worse. I did the same routine in my other arm, but it feels fine. The pain is very weird - I have no idea what muscle has the problem. I can lift my left arm above my head without any pain, and I can point it straight in front of me without any pain. I can carry something quite heavy without any pain at all. However, if I lean forward, there is some of the worst pain I have ever felt in my life at my upper forearm where I think I was injected. It has gotten worse the past day, and woke me up from sleep. It''s uncomfortable / nearly impossible for me to lean over to pick something up, even from a table. I have no bruises nor lumps or bumps from the vaccine though. Honestly I''m really not sure if this is from the vaccine or from something else, but I have not lifted anything heavy (except grocery bags, yesterday), and have not stressed my arm in any weird way that the other arm hasn''t been stressed (from stretching). Am not sure if I should get the second shot at this point; am considering seeing my doctor, but so far have not contacted him about this. I''m hoping it just goes away on its own. Must stress that the pain I feel when leaning forward is some of the most intense pain I have ever felt - and I have had both eardrums rupture at once and passed out before. Must also again say that I still am not sure this is from the vaccine and it confuses me if it is because it has been 3 weeks (almost 4?) now since the 1st injection.


VAERS ID: 1466008 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821287 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fatigue and headache, 22, October 2020, Seasonal influenza vaccine
Other Medications: CBD oil Buspirone Fluoxetine
Current Illness: None
Preexisting Conditions: Generalized Anxiety Disorder (GAD) Panic Disorder
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fatigue (duration 2 days) Injection site pain (duration 2 days) Headache (duration 12 hours)


VAERS ID: 1466151 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Lymphadenopathy, Pain, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Yes
Current Illness:
Preexisting Conditions: Multiple Sclerosis
Allergies: Yes
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe body aches and high fever . Swollen arm and enlarged lymph node on left arm .


VAERS ID: 1466592 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0817 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aspartate aminotransferase increased, Blood cholesterol increased, Blood triglycerides normal, Brain natriuretic peptide increased, Chest discomfort, Chest pain, Dyspnoea, Echocardiogram, Electrocardiogram abnormal, Glycosylated haemoglobin, High density lipoprotein normal, Intensive care, Malaise, Non-high-density lipoprotein cholesterol, Rash, SARS-CoV-2 antibody test positive, Troponin increased, Urticaria, Vomiting
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Lipodystrophy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (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: Desmopressin intranasal prn for bleeds Epi Pen prn allergic reaction Allegra 180mg once daily Luvox 200mg (2 x 100mg tabs) at bedtime daily Ibuprofen prn pains/headaches Minocycline 100mg Q12H (for acne) Singulair 10mg at bedtime
Current Illness: nothing in past 30 days In past 60 days however, mom and stepdad in household had COVID (2nd infection - they did not get tested but on-call physician felt fit all symptoms of delta variant type infection so to self-treat at home). Patient was exposed but not known whether he may have had it or not. Did have cold like symptoms and was quarantined in case, but not officially tested.
Preexisting Conditions: Morbid Obesity Von Willebrand Disease Mixed OCD Anxiety
Allergies: Fish Perfume Shellfish Penicillins Sulfa Antibiotics
Diagnostic Lab Data: Troponins being trended. Initial 1708 on 7/10 @2020, highest = 2166 7/11 @0300. Trended down after except for a bump again on 7/13 @0559 = 1399 from lowest of 947 on 7/12 @1400. 7/10 BNP = 309, 7/11 = 558 7/11 AST - 142 7/11 Cholesterol Panel: Total = 117, Triglycerides = 114, HDL = 35, LDL = 59, Non HDL = 82 A1C 7/11 = 5.4 ECHO and various EKG''s performed throughout stay. SARS COV-2 Antibody - POSITIVE on 7/11
CDC Split Type:

Write-up: Patient is currently admitted to the ICU since 7/10/21 with potential post-vaccination myocarditis with associated troponin elevation and EKG changes. Initial symptoms included chest pain (pressure type), shortness of breath, vomiting, and generally not feeling well. Rash was noted by mom on his abdomen that became full body hives and welts (this has now improved). Cardiology is consulted in addition to primary intensivist team. He has been improving from a clinical stability standpoint, is hemodynamically stable now, but is still currently admitted and being monitored.


VAERS ID: 1466618 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incoherent, Loss of consciousness, Pallor, Presyncope, Resuscitation, 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), Psychosis and psychotic disorders (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? 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 had fainted about 5 minutes after the vaccine was give. Patient was pale and non-coherent before fainting. Patient was placed on the floor, her feet were raised and chest compressions were started for 15 seconds before patient came too. EMS was called and arrived shortly after the patient came too EMS checked the patients vitals and gave the okay that there was no need for a hospital visit and the patient was fine. The EMS concluded that it was nothing more than a vagal response to the shot.


VAERS ID: 1466690 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

Write-up: Numbness and tingling in left leg within 15 minutes of receiving shot. Symptoms continue to persist up until now (July 13 and on-going)


VAERS ID: 1466702 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Product preparation issue
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: Oragel
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer vaccine was dilueted by M.A with 0.8ml NS, rather than reccomended 1.8ml NS- resulting in double odse of vaccine. Mother called by provider and informed of medication error.


VAERS ID: 1466710 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Flushing, Headache, Impaired driving ability, Loss of consciousness, Myalgia, Pyrexia, Road traffic accident, Vision blurred, X-ray
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (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), Accidents and injuries (narrow), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: patient reported getting X-ray at hospital
CDC Split Type: AR2146

Write-up: Janssen COVID-19 vaccine EUA- Patient called unit at 1605, she was administered the J&J vaccine on Friday 7/9/21 at a health unit, She waited in clinic X15 minute after vaccination with no side effects felt before leaving. States that evening 7/9/21 she experienced being flushed, muscle aches, HA, chills and fever of 101. On 7/10/21 she decided to go have dinner with friends. States while driving, she felt flushed again and her vision blurry. Stated she passed out at the wheel and was in a car accident, occurred around 12PM. Was taken to ER for observation. She wanted to let us know of situation.


VAERS ID: 1466715 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Medication error, Product preparation issue
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: Amoxicilin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer vaccine was dilueted with 0.8ml, rather than the reccomended 1.8ml, resulting in double dose of vaccine. Mother called by provider and informed of medical error.


VAERS ID: 1466740 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / IM

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

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

Write-up: Patient presented to mobile vaccination clinic on 7/10/21 for a dose of Pfizer vaccine. However, patient did not divulge to clinic employees (including the vaccinator) that he had already previously completed a Pfizer COVID-19 vaccine series. In fact, the patient lied on his completed paperwork (The ''Prevaccination Checklist for COVID-19 Vaccines'') and checked ''No'' on item #2 of the checklist; stating he had not previously received any COVID-19 vaccine. Vaccinator, after reviewing paperwork and health history with the patient as per procedure, proceeded to administer an appropriate dose of Pfizer COVID-19 vaccine. Immediately following vaccine administration, the patient told the vaccinator that ''this is my 3rd shot'' and that he was doing his ''own experiment''. Patient was released from clinic after his 15 minute observation period, per protocol. Vaccinator reported the event to a supervisor (myself) who later looked up patient in registry, and found record of two prior Pfizer vaccine doses: Pfizer #1 was administered on 12/17/20, Pfizer #2 was administered on 1/9/21. Both doses in the series were administered at a facility (hospital) outside of our facility but in same city.


VAERS ID: 1466752 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered, Product preparation issue
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: Pfizer vaccine was dilueted with 0.8ml NS rather than recommended 1.8ml NS-resulting in double dose vaccine.


VAERS ID: 1466758 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-06-29
Onset:2021-07-10
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / IM

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

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

Write-up: itchy Rash, warm to the touch, slight swelling


VAERS ID: 1466778 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: C-reactive protein, Chest pain, Echocardiogram, Electrocardiogram, Pleuritic pain, Red blood cell sedimentation rate, Troponin
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: MMR
Other Medications: UNKNOWN
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: LATEX
Diagnostic Lab Data: TROPONIN, ECHO, EKG, CRP, ESR
CDC Split Type:

Write-up: PLEURITIC CHEST PAIN, STARTING 8 HOURS AFTER VACCINE


VAERS ID: 1466860 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-07-07
Onset:2021-07-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site swelling, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Patient developed swelling at the injection site as well as her bilateral lower legs.


VAERS ID: 1466966 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 04ZAZIA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), 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? No
Previous Vaccinations:
Other Medications: Estarylla 0.25mg/0.035mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Mild Guillain-Barre syndrome in arms and hands, resolved with no additional treatment within 8 hours


VAERS ID: 1466977 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Decreased appetite, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Nausea. No appetite. Current medication now feels ineffective.


VAERS ID: 1467032 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait inability, Influenza like illness, Menopausal symptoms, Thirst, Uterine spasm
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Dehydration (broad)

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

Write-up: The patient reports not being able to walk for two days following the vaccine (the following Saturday and Sunday) as well as having uterine cramps, despite being post-menopausal. Patient also reports extreme thirst and flu-like symptoms after the vaccine.


VAERS ID: 1467052 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-18
Onset:2021-07-10
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       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: nothing happens


VAERS ID: 1467069 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Injection site bruising, Injection site haemorrhage, Lethargy, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: influenza, injectable, quadrivalent, preservative free , 09/22/2014, 35 y/o at injection, brand name unknown, redness, swelling,
Other Medications: Montelukast, buproprion, desvenlafaxine, buspirone, dextroamphetamine/amphetamine salts, allergy shots
Current Illness: None
Preexisting Conditions: depression, anxiety, asthma, allergies, attention deficit disorder, spondylolisthesis, secondary polythycemia
Allergies: macrolide antibiotics (Steven-Johnson syndrome), flu vaccine (arm red and sore, could not move arm), grass, mold, mildew, trees, dogs
Diagnostic Lab Data: None; Advised patient to visit MD if not better in 1-2 weeks post injection.
CDC Split Type:

Write-up: Bleeding at injection and starting to bruise. Quarter size bruising at injection site (purple and yellow) within 4 to 6 hours of injection; joint pain, muscle aching, fever, lethargy within first 24 hours. Still present but less severe 3 days post injection. Patient''s main complaint 3 days post in bruising at injection site and fatigue.


VAERS ID: 1467084 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / IM

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

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

Write-up: Upper torso and extremity rash, itching severe 2 days post-injection. Lasted approximately 12-14 hours. Resolved with Bendadryl 25mg dose x2


VAERS ID: 1467093 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dehydration, Gait inability, Pain in extremity, Pollakiuria, Uterine pain
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Dehydration (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:
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Was unable to walk, pain in uterus, severe pain in lower extremities, constant urination, dehydration.


VAERS ID: 1467110 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Insomnia, Mobility decreased, Neck pain, Pain
SMQs:, Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Site: Pain at Injection Site-Severe, Systemic: Joint Pain-Severe, Systemic: Unable to Sleep-Severe, Additional Details: SEVERE SHOULDER AND NECK PAIN. SHE CAN''T LIFT OR ROTATE HER ARM. SHE CAN''T SLEEP DUE TO THE SEVERE PAIN. THE PAIN STARTED AROUND 4PM ON 7/10, ABOUT 24HRS AFTER THE INJECTION ON 7/9


VAERS ID: 1467119 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Eye swelling, Heart rate increased, Pain in extremity, Peripheral swelling, Pruritus, Swelling, Swelling face, Urticaria, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol sulfate; metoprolot tartrate; amlodipine; fluoxetine; metformin hcl; lisinopril; pro-air; atorvastatin calcium; trelegy
Current Illness: none
Preexisting Conditions: copd, high blood pressure
Allergies: shellfish
Diagnostic Lab Data: went to urgent care Sunday 7-11 about 2 obviously it was an allergic reaction. Dr gave me 60ml of prednsone and a script for 40ml of prednsone a day for the nest five days. also pepsid 40ml a day for 5 days and to continue with the Benadryl
CDC Split Type:

Write-up: Had shot on thursday at 6pm had a very sore arm and back all day friday. saturday about 8 am my wrist started to itch n so did the inside of my elbows. i went to the bathroom n i was completly covered in hives i was beet red n my neck face eyes hands were completly swollen and i threw up. i took two benadryl and it helped alot took three more throughout the day n i was fine. sunday am about 8 again same thing only much more intense itching oh and my heart was beating very rapidly both days took benedryl again and it helped but then went to urgent care because my face was still swollen n wouldnt go down n since it happened twice i was not going to go through that again. ch


VAERS ID: 1467125 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, C-reactive protein increased, Chest X-ray normal, Chest pain, Culture urine, Echocardiogram normal, Electrocardiogram ST segment elevation, Full blood count, Lipase, Metabolic function test, Myocarditis, Troponin increased, Ultrasound abdomen normal, Urine analysis, Vaccination complication
SMQs:, Acute pancreatitis (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: PEDI NUTRITION,IRON,LACT-FREE (PEDIASURE ORAL)
Current Illness: None.
Preexisting Conditions: Joubert Syndrome, congenital nystagmus, developmental delay.
Allergies: No known allergies.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED with 10/10 chest pain. Two days prior, he''d gotten his second COVID-19 pfizer vaccine. He denied any fever, congestion, cough, vomiting, diarrhea, or other signs of infection recently; no sick contacts. On arrival to the ED, he had normal vital signs, but physical exam was notable for sternal/epigastric pain. Laboratory evaluation, including CBC, CMP, CRP, urinalysis, urine culture, high sensitivity troponins, and lipase were obtained and notable for HS troponin of 303 pg/mL with a 2 hour repeat of 291 pg/mL. CRP was 3.5 mg/dL. His EKG had diffuse ST elevations. CXR was obtained with no evidence of cardiac border or consolidation. RUQ ultrasound showed no evidence of cholecystitis or other abnormality. Patient was admitted for presumed COVID-19 vaccine-induced myopericarditis. Echocardiogram showed normal biventricular function and no pericardial infusion. He was treated with IV toradol, with resolution of chest pain. HS troponins reached the 400s, with downtrend to the 300s prior to discharge. He was discharged on PO ibuprofen with follow-up cardiac MRI and labs.


VAERS ID: 1467139 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

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

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

Write-up: Systemic: Allergic: Rash Generalized-Mild


VAERS ID: 1467169 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EW0186 / 2 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: On July 10Th the patient had small rash on her abdomen thigh and down her leg. On July 13th the patient woke up and was covered from head tp toe in the rash. under her arms, behind her ears and neck and private area as well.


VAERS ID: 1467199 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-06-30
Onset:2021-07-10
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Peripheral swelling, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Venus doppler Ultrasound on 7/12/21
CDC Split Type:

Write-up: DVT of the right leg. Diagnosed on 7/12/21. Symptoms of swelling and pain started on 7/10/21


VAERS ID: 1467269 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MULTI-VITAMIN, BIOTIN, VIT D3, ZYRTEC, FLONASE
Current Illness: NA
Preexisting Conditions: NA
Allergies: ONION, GARLIC, CHIVES, SCALLIONS, SHELLFISH, BANDAID ADHESIVE
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: GOT INJECTION AT 11:40AM, DEVELOPED REDNESS AT THE INJECTION SITE BY 4PM, EVENTUALLY BECAME A HARD LUMP BY THAT EVENING, LUMP AND REDNESS INCREASING IN SIZE EVERY DAY, HOT TO THE TOUCH, PAINFUL TO TOUCH AND ALL THE TIME.


VAERS ID: 1467281 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Musculoskeletal chest pain, Paraesthesia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall 20mg PO BID
Current Illness:
Preexisting Conditions:
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: This is an 18-year-old male here complaining of pain in the left chest wall just inferior to the axilla. Patient states it started 3 days ago 1 day after the Covid vaccine of Pfizer was given in the ipsilateral arm. Patient states he feels swollen with some numbness and tingling in that area and also in the left forearm. Mild tenderness to the left chest wall that is improving. Instructed patient to use anti-inflammatories as needed.


VAERS ID: 1467510 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Public       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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PATIENT FAINTED CONSENT AND RELEASE FORM INDICATED NO PAST HISTORY OF FAINTING.


VAERS ID: 1467520 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling cold, Headache, Injection site swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: MULTIVITAMINS
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient awoke to fever (100?), chills, headache, body aches. Patient noted that the back of her neck and shoulders were very achy. These effects resolved within 36 hours. Patient remained fatigues through 7/11. On 7/12 patient observed in mirror that area over right trapezius was swollen and squishy to the touch. The back of her neck remained sore. The area was still swollen and squishy and her neck still sore at the time of this report


VAERS ID: 1467546 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Dizziness, Fatigue, Feeling abnormal, Headache, Loss of consciousness, Nausea, Pain, Pregnancy test, Road traffic accident, Skin warm, X-ray
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: I have eczema
Allergies: Pollen Sulfa Medcations
Diagnostic Lab Data: X-rays & pregnancy test
CDC Split Type:

Write-up: I received my COVID shot on Friday, July 09, 2021 around 12:40pm & started feeling bad, which continued through the rest of that night. I had headache, chills, aches, feverishly hot skin, fatigue, and nausea. On the next day, Saturday July 10th, I thought I was feeling better so I left the house to go meet a friend for lunch. However while I was driving, I started feeling sick to my stomach again. I got very lightheaded, so I tried to pull over. I traveled up & tried to pull over at the gas station, but I passed out before I could stop. When I woke up & regained consciousness, two men from (the bike shop across the street) were helping me out of my vehicle. I didn''t realize that I had passed out or had a wreck. According to the guys I was driving very slowly then my vehicle just sped up, hit the median, ran into a pole, then went airborne before coming to a stop in the middle of the street. Thankfully, I was the only vehicle involved in the accident. The guys at the bike shop also surveillance which captured footage of my accident. The back of my neck was hurting bad & I continued to feel nauseated. So I went hospital. They put me in a neck brace & did x-rays on me, which eventually came back ok. So, they gave me a Toradol shot, prescribed me some muscle relaxers and anti-inflammatory pills.


VAERS ID: 1468196 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-10
Onset:2021-07-10
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Chills, Diarrhoea, Fatigue, Headache, Malaise, Myalgia, Nasal congestion, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: Rapid test for Covid done on 7/13 at Store
CDC Split Type:

Write-up: Client received full series of Covid vaccinations, Pfizer vaccines on March 10 and the second vaccine on April 1, 2021. Client then tested positive for Covid with rapid test on 7/13/2021. Also had symptoms of Covid (chills, fever 101, nasal congestion, diarrhea, fatigue, headache, myalgia, sore throat) that started on 7/10/2021. Reported because this is a case of breakthrough Covid illness s/p full vaccination.


VAERS ID: 1468200 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048CWA / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain lower, Abdominal pain upper, Aphasia, Asthenia, Chills, Cold sweat, Disorientation, Dizziness, Dry mouth, Dysarthria, Fatigue, Hyperhidrosis, Loss of consciousness, Musculoskeletal stiffness, Nausea, Neck pain, Night sweats, Respiratory rate decreased, Respiratory rate increased, Sensation of foreign body, Speech disorder, Terminal state, Yellow skin
SMQs:, Torsade de pointes/QT prolongation (broad), Cholestasis and jaundice of hepatic origin (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: T3/T4 Testosterone Cream Multi Vitamin Krill Oil Vitamin D Vitamin C Calcium supplement B12 vitamin Collagen Creatine BCAA
Current Illness: None
Preexisting Conditions: Hashimoto''s Thyroiditis Autoimmune Disorder
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Concentrated intermittent upper left quadrant pain, then spreading throughout entire upper and lower abdomen region with constant pain turning into excruciating pain. Nausea, sudden profuse sweating, difficulty speaking, slurred speech, turned into not being able to speak, dizziness, some disorientation, death felt imminent, fading out, passed out, dry mouth, skin color yellowish-grey, clammy skin, extreme and sudden weakness, later chills, short, quickened breathing, then later, husband couldn''t tell if breathing was happening or not (it was), felt small, soft lump in back of throat. Hours later, extreme fatigue and weakness, followed by multiple intervals of sudden sweating throughout night. 2nd and 3rd day, fatigue, and neck pain and stiffness. 4th day: fatigue, mouth going dry several times during the day, neck pain and stiffness.


VAERS ID: 1469645 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-07-10
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Cough, Diarrhoea, Dyspnoea, Headache, Nausea, Oropharyngeal pain, Pain in extremity, Rhinorrhoea, Sinus congestion, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210724513

Write-up: SHORTNESS OF BREATH; CONGESTION; SORE THROAT; RUNNY NOSE; VOMITING; DIARRHEA; COUGH; CHILLS; LEFT ARM PAIN; NAUSEA; HEADACHE; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 09-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 10-JUL-2021, the subject experienced shortness of breath. On 10-JUL-2021, the subject experienced congestion. On 10-JUL-2021, the subject experienced sore throat. On 10-JUL-2021, the subject experienced runny nose. On 10-JUL-2021, the subject experienced vomiting. On 10-JUL-2021, the subject experienced diarrhea. On 10-JUL-2021, the subject experienced cough. On 10-JUL-2021, the subject experienced chills. On 10-JUL-2021, the subject experienced left arm pain. On 10-JUL-2021, the subject experienced nausea. On 10-JUL-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chills, cough, shortness of breath, nausea, vomiting, diarrhea, headache, runny nose, congestion, left arm pain, and sore throat. This report was non-serious.


VAERS ID: 1469657 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-07-10
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure high; Diabetes; Hypothyroidism; Sjogren''s
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210725457

Write-up: VACCINE STORED AT OUTSIDE OF RECOMMENDED STORAGE CONDITION; VACCINE GIVEN OUTSIDE OF RECOMMENDED STORAGE CONDITION; This spontaneous report received from a physician concerned a 48 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included hypothyroidism, high blood pressure, diabetes, and sjogren''s. The patient experienced drug allergy when treated with cefaclor, chlorhexidine, clindamycin, doxycycline, and sulfamethoxazole/trimethoprim. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A expiry: 07-AUG-2021) dose was not reported, administered on 10-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-JUL-2021, the subject experienced vaccine given outside of recommended storage condition. On an unspecified date, the subject experienced vaccine stored at outside of recommended storage condition. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine given outside of recommended storage condition and vaccine stored at outside of recommended storage condition was not reported. This report was non-serious.


VAERS ID: 1469723 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Blood test, Chest X-ray normal, Computerised tomogram normal, Depressed mood, Dyspnoea, Electrocardiogram, Feeling abnormal, Memory impairment, Scan with contrast, Sleep disorder, Tinnitus
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations: Sensitive to vaccines I took to travel . Did not feel well. Malaria pills also made my vision blurred .
Other Medications:
Current Illness:
Preexisting Conditions: Adenomyosis potentially
Allergies: Penicillin
Diagnostic Lab Data: ER visit . Blood work. EKG. Chest x ray . CTA scan with contrast . Whatever else they ran . July 11.
CDC Split Type:

Write-up: On initial shot, felt very spacey and out of it , I had to sit down for a while . A few hours after felt shortness of breathe . Blurred vision. Was unable to sleep full night , woke up with brain fog , tinnitus ,. Following day terrible brain fog , tinnitus, shortness of breathe even when laying down . Doctor recommended 36 hours later to go to ER. Went to ER- did tons of tests and cat scan of chest and x ray. No negative scans . Discharged me with no remedy , doctor confirmed adverse reaction. On the 4th day today, tinnitus has gotten worse . Mental brain fog worse . Cannot sleep. Do not feel like myself . Feel depressed , like a cloud is following me in my head .cannot remember things . Brain is not processing and functioning normally . Ringing won?t stop. Feel like I am losing my mind . Shortness of breathe is slowly getting better , but still very prevalent .


VAERS ID: 1470266 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-04
Onset:2021-07-10
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Exposure during pregnancy, Headache, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair, prenatal vitamins
Current Illness: none
Preexisting Conditions: asthma
Allergies: NKDA
Diagnostic Lab Data: Covid-19 positive swab on 7/10/21.
CDC Split Type:

Write-up: Patient is pregnant with a due date of 12/3/21. I am reporting as this is my second patient who has tested positive for Covid-19 after vaccination during pregnancy. (I understand that this is well within the effectiveness range, but wanted to report in case this is happening more frequently with others in pregnancy. ) She began having symptoms on 7/4/21 with runny nose , congestion and headache. She then had loss of taste and smell and got tested. Her Covid-19 swab was positive on 7/10/21. She is currently 19 weeks pregnant. As her symptoms have remained mild, I do not expect any complications for pregnancy.


VAERS ID: 1470400 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (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 states she started having side effects from the vaccine starting on Saturday 7/10/21. This is two days after her vaccine was given. She states she suffered a small seizure and nausea/vomiting. She states the nausea/vomiting has continued and has not resolved going into today, 7/14/21. This is the first time she has called to report this to us. She was advised to go into an urgent care or ED as soon as possible for evaluation due to the seizure and continual vomiting. I advised her to stay hydrated with an electrolyte containing drink such as Pedialyte or Gatorade. I mentioned she could use an over the counter nausea medication in the meantime as well. Unknown at this point if patient went in for an evaluation.


VAERS ID: 1470445 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-06
Onset:2021-07-10
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Headache, Pain
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: cough,loss of taste/smell, body aches,headache


VAERS ID: 1470477 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Chest pain, Dyspnoea, Headache, Hyperhidrosis, Malaise, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Alprazolam, sudafed, flonase, iron supplement, naproxen, MVI
Current Illness: none
Preexisting Conditions: insomnia, allergies
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient recieved her second dose of the Pfizer vaccine at noted facility . During her drive home her heart began racing and she was sweating and gasping for air because she could not breathe. There was a mini ER nearby and she ran inside for help. They called an ambulance transported me to ER. At ER my BP was ~175/105. I had a headache, chest pain, sweating and anxiety and felt generally unwell. They administered IV benadryl and ativan.


VAERS ID: 1470490 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: chest pain and elevated troponin


VAERS ID: 1470555 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-01-13
Onset:2021-07-10
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Nasal congestion, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Vaccinated with Pfizer on 1/13/21 and 2/3/21. Symptom onset 7/10/21 with cough, runny nose, shortness of breath, chills, nasal congestion, fever. Tested positive for Covid-19 on 7./13/21.


VAERS ID: 1470560 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Headache, Insomnia
SMQs:, Anaphylactic reaction (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: Morphine Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extremely painful headache still ongoing 6 days later. Difficulty in sleeping. Cough developed and has not resolved


VAERS ID: 1470568 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-03
Onset:2021-07-10
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Nasal congestion, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Vaccinated with Pfizer on 1/23/21 and 2/3/21. Symptom onset on 7/10/21 with cough, runny nose, shortness of breath, chills, fever, nasal congestion. Tested positive for Covid 19 on 7/13/21


VAERS ID: 1470571 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood urine present, Culture urine, Cystitis, Urine analysis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow)

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

Write-up: Blood in urine Acute cystitis


VAERS ID: 1470572 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-02
Onset:2021-07-10
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest pain, Condition aggravated, Diarrhoea, Hyperhidrosis, Pneumonia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID (+) by rapid PCR (Alere) collected 7/13/21.
CDC Split Type:

Write-up: Patient admitted to MCH-BG on 7/12/21 with complaint of chest pain starting 2 days prior and worsening. No radiation quality of chest pain. Also complaint of diarrhea x2 days and sweating. Diagnosed with community acquired pneumonia on admission. Possible exposure to COVID at residential facility, so COVID testing was ordered which resulted as positive.


VAERS ID: 1470580 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-06
Onset:2021-07-10
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaemia, COVID-19, Cardiac failure, Cardiac valve disease, Chest pain, Dyspnoea, Respiratory failure
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Pt admitted on 7/10 for dyspnea and chest pain. Pt received COVID J&J vaccine on 4/6/2021. Pt was given oxygen ~1.5 days and received dexamethasone and acetazolamide. On 7/14/21, Pt currently on room air. Possible reason for AHRF multifactorial of COVID, acute on chronic anemia and HF exacerbation with severe valvular disease.


VAERS ID: 1470592 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt had swelling of the left eye, under eye, in the corner of eye, and on eyelid. It started at 1:30am the morning after receiving the vaccine and it persisted until 7/11/21 (2 days later).


VAERS ID: 1470611 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-06-17
Onset:2021-07-10
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Diarrhoea, Dyspnoea, Fatigue, Myalgia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (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: Wellbutrin.
Current Illness: None.
Preexisting Conditions: Major Depressive Disorder.
Allergies: NONE.
Diagnostic Lab Data: SARS-COV-19 Nasopharyngeal swab and PCR, Resulted positive 14 JUL 2021
CDC Split Type:

Write-up: SARS-COV-19 Infection. Congestion, Diarrhea, Loss of taste, loss of smell, shortness of breath, fatigue, muscle aches.


VAERS ID: 1470734 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Decreased appetite, Dizziness, Dyspnoea, Fatigue, Influenza like illness, Injected limb mobility decreased, Injection site pain, Injection site swelling, Nausea, Pain, Pyrexia, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), 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: None
CDC Split Type:

Write-up: At 7am the morning after I took the second vaccination, I woke up with major flue like symptoms. My whole body ached all over. My left arm was swollen where they injected me and it so painful where I could not even move my left arm. I hurt every where throughout my body. I literally felt like I had been poisoned. I was running a 100 degree fever, I was nauseated and very fatigued. I felt dizzy and had to lay down all day. I was a bit congested. I could not really taste food and had no appetite. I had some shortness of breath. This lasted for a couple days. The fever finally went away after 24 hours. I was nauseous and still had trouble eating four days after the shot. I?ve been tired and fatigued still five days after the shot but I seem to be regaining my strength slowly.


VAERS ID: 1471029 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-01
Onset:2021-07-10
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Electrocardiogram, Flushing, Full blood count, Metabolic function test, Paraesthesia, Tremor, Urine analysis
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ambien
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: EKG, CMP, TSH, CBC, Urinalysis (completed through hospital ER) 7/12/2021 and 7/13/2021
CDC Split Type:

Write-up: New onset tremors, feeling of flushing, tingling throughout body


VAERS ID: 1471829 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin Vitamin D3 Zinc Vitamin C
Current Illness: No
Preexisting Conditions: No
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Two days after the second dose I had a dark red image appear on my right arm where veins are located. Went away within one day. On 7/14, another dark red image appeared on my left leg below the knee. These spots were not present before the second shot. I have taken a picture of the one on my knee to show my doctor next week at the appt. Appt scheduled for 7/19


VAERS ID: 1474046 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-01
Onset:2021-07-10
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood test, Chest X-ray abnormal, Chest pain, Dyspnoea, Electrocardiogram, Pleurisy
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

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

Write-up: Shortness of breath, chest pain, pleurasy


VAERS ID: 1474174 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PZ654 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac arrest, Pruritus, Rash pruritic
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Itchy skin or rash, cardiac arrest


VAERS ID: 1474211 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Blood test, Chest X-ray, Chest pain, Electrocardiogram, Pain, Pain in extremity, Pain in jaw, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu Vaccine-13 to 14 years ago
Other Medications: Amitriptyline, Metformin, Effexor, Lisinopril, Ambien Cr, Ezetimibe, Hydroxyzine
Current Illness: None
Preexisting Conditions: High Blood Pressure, High Cholesterol, Degenerative Disk Disease, Kidney Stones
Allergies: Morphine, Belsomra
Diagnostic Lab Data: Chest Xray, EKG, blood work
CDC Split Type:

Write-up: Severe body aches and pain, fever, chest pain, jaw pain, back pain upon taking a breathe, Pain across shoulder blades and through arms


VAERS ID: 1474240 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-09
Onset:2021-07-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chest discomfort, Chest pain, Echocardiogram, Electrocardiogram, Fatigue, Fibrin D dimer normal, Laboratory test abnormal, Pain, Pyrexia, Troponin increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: See Above
CDC Split Type:

Write-up: He received Moderna vaccine #2 on 7/9/21 @ 5:30 pm at Pharmacy. Pt states he woke-up on 7/10/21 around 7am and reports he started having, fever, soreness, and extreme fatigue. Symptoms continued into next day, and he started with chest pain /discomfort. Pt reported to hospital on 7/13/21 for further evaluation and treatment. Pt was seen in ER, had elevated Troponin of 17, negative D-Dimer, and abnormal lab results. Chest x-ray was normal, EKG and ECHO performed. Pt started on re. treatment of Colchicine 0.6mg, po, BID, Ibprofen 800mg, po, Q8hrs, and Pantoprazole 40mg, po, daily. Pt scheduled to f/u with Dr. on 7/28/21


VAERS ID: 1474253 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-18
Onset:2021-07-10
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 RA / IM

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

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

Write-up: COVID-19 PCR positive COVID vaccinated.


VAERS ID: 1474295 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK UN / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Laboratory test normal, Neurological examination normal, Paraesthesia, Platelet count normal
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Patient presents with tingling to right sided face and right arm, Johnson and Johnson covid vaccine recieved 7/9/2021. no other neuro deficits. equal bilateral hand grips, equal facial symmetry, negative arm drift. Patient is also complaining of chest pain. Patient states that 4 days ago they received a Johnson & Johnson vaccination at clinic, and since then they have been experiencing the symptoms. He states that he called the clinic advice nurse and he was advised to come to the ED for evaluation. He denies any nausea, vomiting, fever, or diarrhea. On exam, patient moves bilateral upper and bilateral lower extremities with 5 out of 5 strength. Her neurologic exam is unremarkable. Laboratory studies are within normal limits, platelets are 323.


VAERS ID: 1474377 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-08
Onset:2021-07-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Migraine, Ocular discomfort, Rash, Rash erythematous, Rash pruritic, Vision blurred, Visual impairment
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benlysta, Mycophenolate Mofetil, Topiramate, Hydroxychlorquine, Eliquis, Cevimeline, Prednisone, Pregabalin, Allergy Injections, Folic Acid, Tramadol, Emgality, Sumatriptan, Omeprazole, Restasis, Calci Citrate, Vitamin D3
Current Illness:
Preexisting Conditions: Systemic Lupus Erythematosis, Psoriatic Arthritis, Fibromyalgia, Chronic Kidney Disease Stage 3, Chronic Migraine
Allergies: Flagyl, Dairy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash consisting of red bumps on arms, face, between breasts, and a little bit on legs and feet. Also a terrible migraine-type headache on the left side with an unusual (for me) ocular disturbance. The rash seemed to appear first on my left arm, and the rash was worse on my left side (left arm worse than right, left side of face more covered than right). I cannot say exactly when on Saturday I noticed it. The bumps on my face itched terribly. I took Benedryl at night, by Tuesday morning it began to fade. The migraine appeared at approximately 2 PM on Saturday, July 10. I took my usual migraine medication, Sumatriptan. The headache presented with a sudden blurring and sense of pressure in the left eye. This headache and change in vision also persisted until Tuesday morning, July 13.


VAERS ID: 1474516 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-10
Onset:2021-07-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Guest was here for first dose of Pfizer COVID vaccine, reporting a hx of fainting after injection with a quick recovery. Vaccine was injected at 5:15pm by RN. The RN observed the guest losing consciousness briefly; she called for aid at 5:18pm. EMT arrived at 5:19pm. Guest was medically cleared after approximately 5 minutes of observation, stating that he felt recovered. Guest waited 15 minutes in observation area, stated that he felt well enough to walk home, and left on foot.


VAERS ID: 1474522 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-30
Onset:2021-07-10
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Fatigue, Headache, Induration, Joint swelling, Mobility decreased, Pain, Pain in extremity, Peripheral swelling, Pyrexia, Skin warm, Tenderness, Thrombophlebitis superficial
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Thrombophlebitis (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu 1996
Other Medications: Gabapentin 300 mg, Metformin 500 mg, Labetalol 100 mg., Simvastatin 40 mg., Ezetimibe 10 mg., Losartan Potassium 100 mg., Horse Chestnut Extract, Grape Seed Extract
Current Illness: None
Preexisting Conditions: Hypertension, Hyperlipidity, Diabetes Type 2, Neuropathy, Osteoarthritis
Allergies: Ampiclilin, mycins, Sulfa drugs, almonds, chemical fragrances
Diagnostic Lab Data:
CDC Split Type:

Write-up: Initial adverse reactions evening of 6/30/2021, days of 7/1-2/21: extreme fatigue, low grade fever, body aches, bad headache. chills. 2nd more severe adverse reaction - 7/10/21: Upon awakening Saturday, 7/10: extreme pain, swelling of right hand below third joint of thumb to past the right wrist. swollen lump on surface vein below thumb. Tender to touch, warmer than surrounding skin, with red, purplish discoloration. Unable to turn wrist, overwhelming pain. Unable to use hand. Lasted a couple of days. Hard lump in vein still remains. Consulting with a Cardiologist, he diagnosed it as a Superficial Thrombophlebitis and recommended taking an NSAID med and using warm compresses, as well as raising arm above heart.


VAERS ID: 1474561 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-03-20
Onset:2021-07-10
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax, Subclavian vein thrombosis, Ultrasound scan
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Calcium, vitamin D, Celebrex, Bentyl, Tylenol PM, Flonase, Atrovent nasal, Synthroid, metoprolol, omeprazole, pravastatin
Current Illness: None
Preexisting Conditions: HTN, GERD, IBS, hypothyroid, HLD, OA, Sjogren''s, insomnia, post-nasal drip
Allergies: None
Diagnostic Lab Data: CT chest/US PVL 7/10/21
CDC Split Type:

Write-up: L subclavian thrombosis diagnosed 7/10/21


VAERS ID: 1474661 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-10
Onset:2021-07-10
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood culture negative, COVID-19, Chest X-ray abnormal, Chills, Cough, Culture urine positive, Lung opacity, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prior to Admission Medications Prescriptions Last Dos Informant Patient Reported? Taking? acetaminophen (TYLENOL) 325 MG tablet 7/12/2021 Nursing Home
Current Illness:
Preexisting Conditions: frequent falls, lumbar stenosis, peripheral neuropathy, hearing loss, glaucoma and macular degeneration, tremor, diabetes, COPD, CKD III, BPH with hx of recurrent UTI''s
Allergies: gabapentin
Diagnostic Lab Data: See above
CDC Split Type:

Write-up: Received covid (Pfizer) vaccine on 2/18/21 and 3/10/21. Presented to hospital on 7/12/21 with chills, fevers, cough and weakness (symptom onset was a few days prior to admission). CXR = Right basilar airspace opacity concerning for pneumonia. No hypoxia or need for O2. Started on antibiotics for CAP and possible UTI. Urine culture showed $g100K mixed skin flora. Blood cultures x2 were negative. SARS-CoV-2 PCR resulted positive.


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