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

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



Case Details (Reverse Sorted by Onset Date)

This is page 110 out of 6,867

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VAERS ID: 1586532 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: Body aches started on 8/18. Woke up 8/19 feeling severely nauseous, experienced diarrhea and severe headache


VAERS ID: 1586538 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysarthria, Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: Imbruvica 420mg Duloxetine 90mg Simvastatin 40mg Lisinopril 25mg
Current Illness: none
Preexisting Conditions: Chronic Lymphocytic Leukemia
Allergies: none
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Blurred vision, slurred speech, bad headache


VAERS ID: 1586544 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1111-20-FC3180 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Hyperventilation, Throat irritation
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (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: unkown
Current Illness: unknown
Preexisting Conditions: obesity
Allergies: Milk Allergy
Diagnostic Lab Data: examined by provider in the office
CDC Split Type:

Write-up: approximately 10 mins after receiving the vaccine member complained of scratchy throat and difficulty breathing. Member also began to hyperventilate. O2 on RA 95%


VAERS ID: 1586555 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Muscle spasms, Myalgia, Pyrexia, Seizure, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Convulsions (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: I woke up at 2AM having what appeared to be a violent seizure with uncontrollable shaking and muscle spasms lasting roughly 40 minutes. This was far worse than just simple chills. Upon arriving at the ER the shaking had ceased but I carried a fever between 102 and 103.5 throughout the following 24 hours, extreme pain in muscles in my feet, legs, back, etc.


VAERS ID: 1586575 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-18
Onset:2021-08-18
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Pyrexia, SARS-CoV-2 test positive, Urinary tract infection, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED on 8/18/2021 for fevers, shortness of breath and vomiting. He was seen earlier in the day and diagnosed with a UTI, started on BACTRIM. He has a history of quadriplegia with neurogenic bladder with indwelling Foley in place. Upon arrival to the ED patient also tested positive for COVID-19, no prior infections. Fully vaccinated. He was admitted to the hospital for further treatment.


VAERS ID: 1586577 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-27
Onset:2021-08-18
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/18/21 COVID-19, positive
CDC Split Type:

Write-up: COVID-19 positive $g14 days post vaccine series


VAERS ID: 1586587 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Feeling abnormal, Gastric disorder, Influenza like illness, Myalgia, Pain, Pyrexia, Swelling, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aubagio, Cosentyx 150mg Monthly, Vitamin D Supplement, Daily Multivitamin.
Current Illness:
Preexisting Conditions: Multiple Sclerosis, Ankylosing Spondylitis, Intermediate Uveitis.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intense Chills/sweating, Low Grade Fever, Body Aches, Fatigue, Gastric Distress, Muscle Pain, "Brain fog", dizziness/vertigo. Far worse than 1st or 2nd shot. Basically felt like I had the flu.


VAERS ID: 1586591 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Myalgia, Nasal congestion, Pyrexia, Respiratory tract congestion, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Atorvastatin Pantoprazole Biotin B12 Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Allergic to penicillin-rash Seasonal allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Started with uncontrollable shaking for about an hour, then followed with muscle aches, chest congestion, stuffy nose, fever, extreme fatigue which lasted approximately 24 hours


VAERS ID: 1586601 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-07
Onset:2021-08-18
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec for allergies One a day vitamins for boys
Current Illness: None
Preexisting Conditions: Asthmas
Allergies: Shell fish
Diagnostic Lab Data: None Will call his doctor after this form is submitted
CDC Split Type:

Write-up: Large rash on his arm


VAERS ID: 1586615 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2020-12-21
Onset:2021-08-18
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Rapid test 2x plus symptoms.
CDC Split Type:

Write-up: Employee is COVID positive after receiving the Pfizer vaccination.


VAERS ID: 1586617 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-15
Onset:2021-08-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066D2/A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Breo, Maxide, Losartan, Glucosamine, Biotin, Multivitamin
Current Illness: None
Preexisting Conditions: Asthma, hypertension, osteoarthritis
Allergies: codeine, NSAIDs
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Covid arm, itchy, warm, mild.


VAERS ID: 1586633 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fibrin D dimer, Heart rate increased, Hypertension, Laboratory test, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: D-Dimer Quant-211.
CDC Split Type:

Write-up: I started to experience shortness of breath while walking around 5:30pm and then felt heart palpitations. My heart rate was checked periodically and it was very high, the highest being 145. My blood pressure was also high. I was taken to the hospital where I was given two bags of fluid to hydrate me. Multiple tests were done but overall there was no treatment provided to me.


VAERS ID: 1586649 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / -

Administered by: School       Purchased by: ?
Symptoms: Chest pain, Headache, Nausea, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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:
Other Medications: Accutane for acne
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Lavendar soaps,lotions, detergents and flowers
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever of 101.2, Bad headache, Really sore left arm, nauseous and Chest pains


VAERS ID: 1586656 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-26
Onset:2021-08-18
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: hospitalized 8/18/21


VAERS ID: 1586682 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 RA / 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: Moderna COVID-19 Vaccine
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: The patient was only 17 instead of the minimum required age per the EUA. The vaccinator missed this detail when giving the vaccine.


VAERS ID: 1586696 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Erythema, Hyperhidrosis, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ALPRAZolam 0.25 mg oral tablet, 0.25 mg= 1 tab, Oral, BID, 2 refills Ambien 10 mg oral tablet, 10 mg= 1 tab, Oral, QHS, PRN, 2 refills buPROPion 150 mg/24 hours (XL) oral tablet, extended release, 150 mg= 1 tab, Oral, q24h, 2 refills cal
Current Illness: None
Preexisting Conditions: Anxiety Chronic cystitis Chronic interstitial cystitis Female genital organ symptoms FH: Cardiac disorder Gastroesophageal reflux disease Latest Comment: OTC med. PRN Glasses H/O: tubal ligation Hiatal hernia History of cholecystectomy Irritable bowel syndrome Low compliance bladder Migraine Tachycardia Tobacco use
Allergies: Morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was brought from health facility after receiving her second Covid vaccination. States she feels like she is having a reaction. She is burning and itching all over with some redness over her chest and arms. Feels like she is very sweaty. Denies any cough, shortness of breath, swelling of her tongue or throat. Has a history of allergic reaction to morphine but was not like this. She had no complications with her initial Covid vaccination.


VAERS ID: 1586700 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007D21A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Dysphagia, Feeling hot, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu-type reaction to influenza vaccine
Other Medications: Levothyroxine 125 mcg Daily Calcium 500 mg Three Times a Day Vitamin C 500 mg Twice a Day Vitamin B12 Complex 1 tablet Daily Magnesium Daily Stool Softener as needed
Current Illness: Cold virus at the end of July 2021
Preexisting Conditions: Anemic Thyroidectomy due to growth
Allergies: Pineapple, Shellfish and Sulfa Drugs
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Vaccine administered at 1 PM. 20 minutes after vaccination patient felt warmth in throat. Benadryl was administered x 2 doses. 15 minutes later throat felt hotter and tighter and patient was having difficulty swallowing. Patient transferred to ER. In ER, patient was administered epinephrine, an oral steroid and ibuprofen. Symptoms resolved around 5 PM.


VAERS ID: 1586701 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Pruritus, Rash, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: penicillin (hives, swelling, rash), benazepril (dizziness), flu (bad reaction), atorvastatin (anxiety), latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: 57 yo F presented to the ED about an hour after receiving dose #1 of vaccine with c/o tongue swelling, itchiness and intermittent cough. Rash noted on bilateral arms. All symptoms resolved. Patient discharged from the ED with instructions to follow up with PCP.


VAERS ID: 1586708 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F214 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Taste disorder
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levonorgestrel and Ethinyl Estradiol Tablets, USP .15mg / .03mg Women''s One Daily Dietary Supplement
Current Illness:
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tightness in chest shortly after receiving shot, currently persistant Strange flavor in mouth persisted several hours but has ceased.


VAERS ID: 1586710 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-05-07
Onset:2021-08-18
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Asthenia, Computerised tomogram head abnormal, Cough, Dyspnoea, Malaise, Nausea, Pulmonary embolism, Respiratory tract infection, Subdural haematoma, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: HTN, CAD, CABG, Paroxysmal A-Fib,
Allergies: Haloperidol
Diagnostic Lab Data: CTA 8/18: chest PE of lower pulmonary artery; 8/18: head CT:2 mm chronic subdural hematoma
CDC Split Type:

Write-up: Ongoing hospitalization after coming to ER with complaints of nausea/vomiting for 4 days, shortness of breath, malaise, weakness, cough, congestion.


VAERS ID: 1586716 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, No adverse event
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: lisinopril 20mg , Advair Diskus, Lipitor 20mg, Amlodipine 5mg, Wellbutrin 300mg, Celexa 20mg
Current Illness: None
Preexisting Conditions: Hypertension Asthma Depression Dyslipidemia
Allergies: NKDA
Diagnostic Lab Data: No adverse reaction.
CDC Split Type:

Write-up: Pt. received Moderna on 8/18/21. Pt. stated he did not receive a covid vaccine. After giving vaccine, electronic record was checked and pt. received J & J on 4/10/21.


VAERS ID: 1586728 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Chills, Headache, Pain, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 10mg Zoloft 100mg Probiotics women''s Multivitamin
Current Illness: none
Preexisting Conditions: anxiety/depression
Allergies: none
Diagnostic Lab Data: another covid test which was negative on 8-19-21
CDC Split Type:

Write-up: temp of 100.0. severe chills and body aches with moderately severe headache.


VAERS ID: 1586745 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-19
Onset:2021-08-18
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Nasal congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DILTIAZEM, LEVAQUIN, FLOMAX
Current Illness:
Preexisting Conditions: BPH A FIB HTN
Allergies:
Diagnostic Lab Data: POSITIVE COVID TEST
CDC Split Type:

Write-up: SOB, COUGH, CONGESTION


VAERS ID: 1586751 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052G21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypopnoea, Jaundice, Unresponsive to stimuli
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (narrow), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: Paramedics were called. Once they arrived on scene they checked the patients vitals and the paramedics took him by ambulance to the hospital.
CDC Split Type:

Write-up: After patient received the vaccine it looked as though he went into shock. His eyes were open but was unresponsive and very shallow breathing. He was jaundice.


VAERS ID: 1586754 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B12A / 3 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site rash, Rash erythematous, Rash macular
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: Tecfidara 240mg 2x/ day, Levothyroxine 0.5mcg 1x daily, Multi-vitamin, biotin, Vit. D3000
Current Illness: none
Preexisting Conditions: MS
Allergies: Penicillin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: red blotchy rash below injection site. Showed up the day after the injection, No heat or itching. Rash is still present but does not seem to be spreading, will keep an eye on it.


VAERS ID: 1586759 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Myosclerosis, Myositis, Nausea, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Senokot, Vitamin D, Singulair 10mg, Zocor 20mg, Labetalol, Nexium, Zyrtec, Rapamune, Percocet.
Current Illness: UTI
Preexisting Conditions: Kidney transplant, Bronchiectasis.
Allergies: Demerol.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea, tingling feeling in upper arm, muscle in arm hardened and inflamed.


VAERS ID: 1586760 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-11
Onset:2021-08-18
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Decreased appetite, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient presented to facility with fever, cough, nausea, decreased appetite. Patient has previous medical history of hypertension, chronic kidney disease, and pre-diabetic. onset of symptoms was three days before admittance. Patient reported to have COVID test done before being admitted, but no record from health department is showing that test was done.


VAERS ID: 1586762 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concerta, L-Thyroxine, Flonase, Zyrtec, Pantoprazole Sod, ...
Current Illness: None
Preexisting Conditions: COPD, Type 2 Diabetes, ADHD, Hypothyroidism, Acid Reflux, Obese
Allergies: Penicillin, Morphine, Erythromycin, LevoFLOXacin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderate pain at injection site, headache, minor aches and pains throughout the body.


VAERS ID: 1586766 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Headache, Injection site pain, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Swine Flu vaccine 2009 at approximately age 22. Patient had injection site soreness and mild body aches slight flu like symptom
Other Medications: Turmeric, multi vitamin, Vit D, Vit B12, Folic Acid
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa drugs
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Injection site pain was present from the time of vaccine at 1pm. First onset of chills began around 9pm approximately 8 hours after vaccine. With the chills shortly after came body aches, muscle and joint pain and mild headache. This lasted through the night until around 8am on 8/19/21. The injection site is still sore, the headache severity worse, and the patient is still feeling feverish. Over the counter Tylenol has been administered.


VAERS ID: 1586772 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PAA165969 / 6 LA / ID

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Breast pain, Dizziness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (broad), Lipodystrophy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PROZAC, Chlortalidone, ZYRTEC
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: BLOOD PRESSURE TAKEN SERVERAL TIMES BY NURSE
CDC Split Type:

Write-up: INCREASED BLOOD PRESSURE, 152/90, DIZZY, FEELING LIKE IM GOING TO FAINT, SORE RIGHT BREAST


VAERS ID: 1586776 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 5 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Incorrect 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to clinic to receive Jansen vaccine. Patient filled out our pre-vaccination checklist and checked "NO" to any previous vaccines. After completion of the vaccine, the vaccine was being placed into system. Upon looking into the patients system, it was noticed that the patient received two doses of Pfizer at Health System and two doses of Pfizer at another Hospital. The patient was questioned, he admits to receiving two doses at Health System, but denied at the other Hospital. Health System and the other Hospital notified, patient did in fact receive all five vaccines. Asked patient to wait for me to call the state or figure out that to do in this case; however, the patient left and would not answer his phone when I tried to reach him.


VAERS ID: 1586777 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Injected limb mobility decreased, Injection site pain, Muscular weakness, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I took ibuprofen the night before. Took excedrin at about 7pm for a headache.
Current Illness: None
Preexisting Conditions: Chronic back pain(it''s why I took the ibuprofen the night before). Had surgery on my spine in 2015.
Allergies: Allergic to Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: My left arm was extremely weak. It was difficult to use that arm for anything besides the lightest of work. It hurt to even open my bedroom door which is light and hollow. Lifting my arm above my shoulder hurt as well. I felt lots of fatigue all over my body. I was so exhausted after a hike that I fell asleep in the afternoon for a couple hours. I hike every other day and haven''t experienced this before. This hike was also way shorter than usual. I hiked maybe a mile. Usual hikes are 2-15 miles. When I returned from the hike I took some excedrin for a headache that started during the hike. I went to bed early. When I woke up today I only have slight fatigue and my arm is starting to feel better, although it is still sore at the injection site.


VAERS ID: 1586780 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain, 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient''s right eyelid started swelling yesterday morning 8:00 am and has since started to increase. The following day it has continued to swell up even more. There is minor pain when blinking.


VAERS ID: 1586792 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 RA / 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? 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 and 2 guardians came to the public health clinic to receive the COVID-19 vaccine from Janssen. Before administering any injections, one guardian asked me to confirm this was a single injection vaccine, which I confirmed with him that was correct. I verified the patient involved in this VAERS report and her birthdate. She and her guardians all confirmed her birthdate. I did not recognize at any point that the patient in this report was under the age of 18 and should not receive the Janssen COVID-19 vaccine. This was brought to my attention after the vaccine was administered and the patient and guardians had left. My supervisor was notified immediately.


VAERS ID: 1586796 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Diarrhoea, Fatigue, Myalgia, Nausea, Pyrexia, Sneezing, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcitriol Bupropion Amlodipine Hydracodine Metoprolol Omeprazole Losartan Levothyroxine
Current Illness: none
Preexisting Conditions: Heart Kidneys Knee injuries
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue Muscle ache Fever Cough Sneezing Vomiting Diarrhea Nausea Symptoms still active Rest, liquids, Tylenol


VAERS ID: 1586806 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1083 / 2 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cymbalta, Flonase
Current Illness: None
Preexisting Conditions: Pre-diabetes, Anxiety associated with depression, seasonal allergic rhinitis
Allergies: Eggs
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pfizer scheduled immunization diluted improperly 0.8 not 1.8,


VAERS ID: 1586810 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-22
Onset:2021-08-18
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: SARS CoV-2, PCR, Rapid, V Detected
CDC Split Type:

Write-up: Developed s/s of COVID and was brought to the ED and then admitted. COVID testing positive.


VAERS ID: 1586832 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-25
Onset:2021-08-18
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 - / -

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

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

Write-up: Dose 1 Pfizer 04/23/2021 EW0172 pt has covid 19 8/18/2021


VAERS ID: 1586839 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-22
Onset:2021-08-18
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 2 - / -

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

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

Write-up: Dose 1 Moderna 01/25/2021 Lot # 029K20A Pt currently has covid 19 8/18/2021


VAERS ID: 1586842 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW164 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Hypertension, Muscle tightness, Nausea, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Womens multi vitamin (one daily)
Current Illness: None
Preexisting Conditions: Asthma, allergies
Allergies: Sulfa drugs, latex allergy, rubber fruit allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediate arm soreness, tightness, dizziness, lightheaded, severe high blood pressure, shortness of breath, nauseated


VAERS ID: 1586848 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-01
Onset:2021-08-18
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 - / -

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

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

Write-up: Dose 1 Pfizer 03/11/2021 Lot EN6208 Pt currently has covid 19 8/18/2021


VAERS ID: 1586879 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Headache, Pain in extremity
SMQs:, Retroperitoneal fibrosis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Sore arm, sore joints, headache, backache, chills


VAERS ID: 1586882 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-08
Onset:2021-08-18
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: PATIENT HAS RECEIVED BOTH COVID-19 PFIZER VACCINE, AND TESTED POSITIVE TO COVID-19 ON 8/18/21


VAERS ID: 1586887 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E218 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Dyspnoea, Feeling abnormal, Nasal congestion, Paraesthesia, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: FLONASE,METFORMIN,TOPIRAMATE,CARBAMAZEPINE,AMITRIPTYLINE
Current Illness: SEIZURES
Preexisting Conditions: SEIZURES
Allergies: SULFUR DRUGS AND PENICILLIN
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: WITHIN 5 TO 10 MINUTES OF RECEIVING THE VACCINE THE PATIENT SAID SHE FELT FUNNY AND HER FACE STARTED TINGLING. 25MG OF BENADRYL WAS GIVEN AT THAT TIME. WITHIN A FEW SECONDS OF THAT HER NOSE STARTED TINGLING AND SWELLING SHUT PER PATIENT JUST AS IT DID WITH HER PENICILLIN ALLERGY. THAT MOVED TO HER THROAT FEELING LIKE IT WAS SWELLING AND A DOSE OF EPINEPHRINE WAS GIVEN AND 911 WAS CALLED. EPI HELPED WITHIN A FEW SECONDS AND PATIENT LEFT THE BUILDING WITH THE EMTS TALKING AND BREATHING MUCH BETTER. SHE WAS DISCARGED AND IS NOW AT HOME.


VAERS ID: 1586896 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Abdominal pain, Bone pain, Chest pain, Heart rate increased, Injection site erythema, Injection site pain, Nausea, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Patient described her adverse symptoms as nausea, abdominal pain, injection site pain and redness, syncope, fever, elevated heart rate (137) chest pain and severe bone pain. Her menstrual also stopped abruptly. First symptoms began late on Tuesday 8/17/2021 the same day as the injection. First symptoms included severe bone pain described as feeling like her bones were being aspirated began around 11pm and continuing to date. Starting the morning of the 8/18/2021 she began to have elevated heart rate and nausea. Continuing through the day and into the night she experienced fever and syncope in addition to the other symptoms previously mentioned. Beginning on 8/19/2021 she began to experience chest pain.


VAERS ID: 1586904 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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''s dad came in without a vaccine card and said they were due, was given Second dose in series, but afterword was discovered that it was only 2 weeks not 3 weeks after their first shot.


VAERS ID: 1586919 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SE3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis, Pain, Pyrexia, Respiratory tract congestion
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: have a high fever, chills, congestion and a horrible headache. sweats and achy


VAERS ID: 1586923 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 LA / IM

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

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

Write-up: Employee did not divulge she had received a Pfizer Covid vaccination in January through Pharmacy . Clinic staff thought they were vaccinating with first dose and used available dose of Moderna. When entering in database the error was discovered.


VAERS ID: 1586938 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-11
Onset:2021-08-18
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022M20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Blood lactic acid, Blood pH decreased, COVID-19, Carbon dioxide increased, Cardiac arrest, Drug screen positive, Dyspnoea, Endotracheal intubation, Hypercapnia, Hypoxic-ischaemic encephalopathy, Intensive care, Lactic acidosis, Mydriasis, Pulseless electrical activity, Pupil fixed, SARS-CoV-2 test positive, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (broad), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), 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), Drug abuse and dependence (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: PMH of DM2, HTN, depression, opioid use disorder, cirrhosis presenting following cardiac arrest
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 8/18/2021 Patient was out with friends. He was noted to be short of breath and then collapsed with PEA arrest. ROSC wasn''t obtained for over 15 minutes. He received 3 mg of epi in total. At the hospital, patient tested positive for meth, methadone, and COVID-19. His pupils were fixed and dilated. One dose of Narcan was administered and his pupils were reactive again. There was concern for seizure activity and ativan was given. He was intubated with a GCS of 3. Targeted temperature management was started. His pH was noted to be less than 6.9 and CO2 of 100. He had a lactate of 15. Patient arrived at hospital intubated, sedated, and non-responsive. Patient is currently in Critical Care (admission date 8/18/2021) and prognosis is uncertain. Active diagnosis include: Acute respiratory failure with hypoxia and hypercapnia (*) Yes ? Post Cardiac arrest (*) Unknown ? COVID-19 virus infection Unknown ? Anoxic encephalopathy (*) Yes ? Lactic acid acidosis


VAERS ID: 1586968 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness, Vomiting
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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe vomiting throughout entire first night after receiving shot. He also had flu like symptoms which were anticipated but he vomited 6 times over night.


VAERS ID: 1586969 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-01
Onset:2021-08-18
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW5318 / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: AMLODIPINE, LOSARTAN, TRAZODONE, MULTIVITAMIN, HYDRALAZINE, LABETALOL, DONEPEZIL, MECLIZINE, CLONIDINE, BUMETANIDE, BUSPIRONE, ELIQUIS, VITAMIN D3, GABATENTIN, ASPIRIN, SINGULAIR, SYNTROID
Current Illness:
Preexisting Conditions: ANXIETY, COPD, ESRD WITH DIALYSIS, HYPERTENSION, PULMONARY HYPERTENSION, THYROID DISEASE, TIA
Allergies: ERYTHROMYCIN, HALCION, QUININE, VALIUM
Diagnostic Lab Data: SARS COV2 COVID19 PCR
CDC Split Type:

Write-up: Fully vaccinated case with Covid-19 positive test


VAERS ID: 1586983 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event, Product administered to patient of inappropriate age, Wrong product 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated on her form that her 1st dose was Moderna. Then verbally she confirmed to the pharmacist giving the shot that she was getting 2nd dose Monderna. She was given the shot and then became aware that she is only 16 and her 1st dose was Pfizer. As far as pharmacist is aware no true adverse effect happened from getting the Moderna shot.


VAERS ID: 1587030 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

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

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

Write-up: Site: Itching at Injection Site-Medium, Systemic: Allergic: Itch (specify: facial area, extremities)-Medium, Systemic: Allergic: Rash (specify: facial area, extremities)-Medium, Additional Details: rash and itching on arm from injection and leg below knee to tip of toes.


VAERS ID: 1587035 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Dysphagia, Dyspnoea, Injection site erythema, Injection site pruritus, Injection site swelling, Pruritus, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Anaphylaxis-Mild, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Allergic: Itch Generalized-Mild


VAERS ID: 1587043 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

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

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

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


VAERS ID: 1587045 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chills, Dizziness, Dyspnoea, Feeling cold
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hydrocodone 10/325 mg, bariatric multivitamin
Current Illness: none
Preexisting Conditions: pre-diabetes, chronic back pain
Allergies: sensitivity to grapefruit, cherries, mild allergy to peanuts, allergic to penicillin, lipitor and latex
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: about 15-20 minutes after receiving the vaccine started experiencing a ( mild) shortness of breath, chest tightness/pressure and dizziness and about 10 minutes after these symptoms started i got very cold and started shivering a lot ( had to use 3 blankets to warm myself up) and I wasn''t running any fever, these symptoms lasted for about 3 hours or so


VAERS ID: 1587056 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none reported
Current Illness: none reported though had attested to being moderately to severely immunocomprised requesting a 3rd dose of covid 19vaccine
Preexisting Conditions: none reported though had attested to being moderately to severely immunocomprised requesting a 3rd dose of covid 19vaccine
Allergies: none reported
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sitting in observation area , approximately 7 min post injection was noted to appear pale on forehead . Asked to remove mask for assessment and if she would please lay down on a cot as she looked a little pale. States she wanted to put something in her car, stood and ambulated towards her vehicle. This RN was walking behind pt with a supportive stance. Pt became syncopal and was immediately fully supported and placed on the cot supine, urinary incontinence noted. Pt rapidly recovered to baseline, awake alert and conversant, attempting to sit on cot. No fall or injury. Provided water to drink and snack. After recovery on cot approximately 15 minutes , ambulated with steady gait to mobile clinic and was provided a change of clothing and privacy. Encouraged to contact someone for a ride. Pt texted parents and said she was going to drive to their house. Remained awake alert oriented conversant and appropriate. Now reports that had fainted post injection a long time ago but hadn''t eaten prior to the shot that day so didn''t think it would happen today as she had breakfast. EMS activated and also assesses pt- all vital signs WNL and was released to self care. After 40 min observation period pt was ambulatory and at baseline- drove off property.


VAERS ID: 1587063 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0088D21A / 1 LA / IM

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

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

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


VAERS ID: 1587066 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0226C21A / 2 LA / -

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

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

Write-up: Vial of vaccine used had been opened and sitting at room temp (68 F-70F)at 3PM on 8/17/2021. Vaccine was given unsure of exact time, but sometime between 8AM and 12PM on 8/18/2021.


VAERS ID: 1587079 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Feeling abnormal, Headache, Hypoaesthesia, Nausea, Paraesthesia, Parosmia, Tinnitus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Medical attention has not been sought at this point. I am hoping the side effects will go away in time.
CDC Split Type:

Write-up: Within 5 minutes of receiving shot, felt a tightness in my chest. Felt extremely dizzy, so much so that I needed to sit down. I started having throbbing in my left temple and felt a wave of nausea. After a few more minutes, those symptoms started to dissipate, but then I started to have intense ringing in my ears. Still had the tightness in my chest and felt like i could not take a deep breath. Waited at the pharmacy for 15 minutes them headed home. By the time I got home, my arms, legs, hands and feet were numb and tingling. I took benadryl and Tylenol to combat any reaction but I felt really crappy. Slept in and off for the last 24 hours. The tightness in my chest has let up some, but my arms, legs, hands and feet are still numb and tingling. I am extremely dizzy and unstable when walking. I am nauseous. I have a headache. I am smelling things that no one else is smelling.


VAERS ID: 1587086 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oedema peripheral, Vaccination site pain
SMQs:, Cardiac failure (broad), Angioedema (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: VITAMINS
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PT HAD PAIN AT THE VACCINATION SITE, BUT A DAY LATER, SHE DEVELOPED SWOLLEN ARMPIT (FEELS LIKE A BALL IN HER ARMPIT), VACCINE AREA IS GETTING BETTER BUT STILL HURTS TO TOUCH. SHE CALLED HER MD AND WAITING FOR MD RESPONSE.


VAERS ID: 1587087 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-10
Onset:2021-08-18
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pulmonary thrombosis, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
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: clonazepam, orphenadrine er, atorvastatin, fluticasone, lyrica, mirtazapine, propranolol, hydroxyzine pamoate
Current Illness:
Preexisting Conditions:
Allergies: thyroid hormones, nitrates
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports blood clots discovered in legs and lungs. Total of 3 in leg, 2 in lungs


VAERS ID: 1587091 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Headache, Pain, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal 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: Certilien, Gabapentin, Melatonin
Current Illness: N/A
Preexisting Conditions: Arthritis
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states that after receiving the 2nd dose of Moderna 08/17/2021, started experiencing symptoms 08/18/2021 of pain throughout the body, weakness, headaches, and blurry vision. Primary visit planned 08/19/2021.


VAERS ID: 1587092 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Nausea, Syncope, Tremor, Unresponsive to stimuli, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Nausea-Severe, Systemic: Shakiness-Severe, Additional Details: Patient was provided Covid vaccine after admistration vision became blurry and pt was light headed. I get immediate care from NP in Clinic who took her pulse and blood pressure. I went to get water to hydrate her and NP stated she fainted and was shaking ( 45 secs). 911 was called and paramedics admistered IV fluids and took vitals. Pt did not want to go to hospital was better and left with hospital.


VAERS ID: 1587096 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0088D21A / 1 LA / IM

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

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

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


VAERS ID: 1587098 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / IM

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

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

Write-up: Vial of vaccine used had been opened and sitting at room temp (68 F-70F)at 3PM on 8/17/2021. Vaccine was given unsure of exact time, but sometime between 8AM and 12PM on 8/18/2021.


VAERS ID: 1587102 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 RA / IM

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

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

Write-up: Vial of vaccine used had been opened and sitting at room temp (68 F-70F)at 3PM on 8/17/2021. Vaccine was given unsure of exact time, but sometime between 8AM and 12PM on 8/18/2021.


VAERS ID: 1587106 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / IM

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

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

Write-up: Vial of vaccine used had been opened and sitting at room temp (68 F-70F)at 3PM on 8/17/2021. Vaccine was given unsure of exact time, but sometime between 8AM and 12PM on 8/18/2021.


VAERS ID: 1587109 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 LA / IM

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

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

Write-up: Vial of vaccine used had been opened and sitting at room temp (68 F-70F)at 3PM on 8/17/2021. Vaccine was given unsure of exact time, but sometime between 8AM and 12PM on 8/18/2021.


VAERS ID: 1587149 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Fall, Hyperhidrosis, Loss of consciousness, Pallor
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), Accidents and injuries (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Incomplete list: Propranolol
Current Illness: None known
Preexisting Conditions: Hypertension
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient lost consciousness momentarily approximately five minutes after receiving the vaccination. Fell to the floor from seated position whereupon we immediately called 911, went to him and tried to verbally arousing him, which was immediately successful. We then assisted patient to a seated position and assessed him. Patient was profusely perspiring , had a strong pulse, was still seemingly out-of-it. His skin was pale and clammy and respirations slowed as he seemed to lose consciousness. A sheriff deputy happened to be on-site and she assisted patient as retrieved an Epi-Pen. Upon the arrival of Epi, patient had made a significant improvement - he became lucid and respiration increased with improved consciousness. Patient said he was hot, wanted cold water which we gave him. Patient was alert and asking questions as EMS arrived after approximately 5-10 minutes and performed assessment and checked vitals - which were apparently in normal ranges at that point. Patient answered EMS questions and stayed for a short while before driving himself home. We requested he call the pharmacy when he arrived at home - which he did, saying he felt ok, but was sore apparently from the fall from his seat.


VAERS ID: 1587155 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007CZIA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Musculoskeletal stiffness, Myalgia, Pyrexia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine, liothronine, L-gluthione, DHEA, oxytocin, multivitamin, NAC, megaspore, Magnesium, zinc, vitamin d3, DIOVasc, morinda, caprylic acid, Formula SF722, sun butyrate, repair vite, vitamin e, gut health....
Current Illness: polycythemia ruba very, ms, hypoglycemia, hypothroidism, arthritis, fibromyalgia, MCS,
Preexisting Conditions: hep c for 50 years, cleared 4 years ago, polycythemia ruba vera, ms, hypothyroidism, hypoglycemia, arthritis, fibromyalgia, MCS, allergies....mold, yeast,pollen, ...
Allergies: tetracycline, grains, MCS, cleaning products, molds, pollen, yeast...
Diagnostic Lab Data: none
CDC Split Type:

Write-up: fever, chills, stiff neck, headache, total body muscle/joint pain, exhaustion, sleepiness...


VAERS ID: 1587159 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (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: Vitamin C, Zinc, Vitamin D, Celexa
Current Illness: none
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Muscle Twitching on left side of chest, under left arm.


VAERS ID: 1587179 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-12
Onset:2021-08-18
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood culture, COVID-19, Continuous positive airway pressure, Cough, Dyspnoea, Hypothermia, Hypoxia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: This is a pleasant 93-year-old female with hypertension, chronic GERD, diabetes, advanced age, chronic kidney disease, patient was diagnosed with COVID-19 infection 2 days ago at the nursing facility, she was brought into the emergency department today due to worsening hypoxia and hypothermia. Patient initially required non-rebreather mask in the emergency department, and high-flow oxygen via nasal cannula, however she continued to have hypoxia therefore currently she is requiring CPAP treatment. Patient currently reports mild improvement of her shortness of breath with CPAP therapy, she denies any chest pain, she has nonproductive cough. She has Bair Hugger in place and her temperature is improving, she is alert and oriented x3. She has DNR code status but she is agreeable for noninvasive mechanical ventilation. Nothing seems to improve or worsen her symptoms. She denies any nausea, vomiting, sweats, headache or syncope. She received 1 L IV fluid bolus per emergency department, blood cultures obtained and received empiric antibiotics. She is currently hemodynamically stable and normotensive. 8/16/2021 tested positive


VAERS ID: 1587180 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: patient reported paresthesia left thigh. no weakness or other symptoms.


VAERS ID: 1587181 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-05
Onset:2021-08-18
   Days after vaccination:105
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood culture, Body temperature abnormal, COVID-19, Continuous positive airway pressure, Cough, Dyspnoea, Hypothermia, Hypoxia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: anxiety, hypertension, hypothyroidism, chronic GERD, chronic diastolic heart failure, immunocompromise, atrial fibrillation, on chronic anticoagulation
Allergies: Cherry, aspirin, latex, NSAIDs
Diagnostic Lab Data:
CDC Split Type:

Write-up: This is a very pleasant 74-year-old female with history of squamous cell lung carcinoma, on chemotherapy, followed by Dr., anxiety, hypertension, hypothyroidism, chronic GERD, chronic diastolic heart failure, immunocompromise, atrial fibrillation, on chronic anticoagulation, recent hospitalization and treatment for UTI, patient presented to the emergency department on 08/18/2021 due to worsening shortness of breath, increased oxygen demands at home and chest congestion. In the emergency department, patient requires 4 L O2 via nasal cannula, she was tested for COVID-19 infection and was found to be positive. Tested positive 8/18/2021


VAERS ID: 1587184 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-08
Onset:2021-08-18
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 03L20A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19 pneumonia, Chronic obstructive pulmonary disease, Cough, Diarrhoea, Pyrexia, SARS-CoV-2 test positive, Sleep apnoea syndrome, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: methotrexate, acyclovir
Current Illness:
Preexisting Conditions: heart disorder
Allergies: erythromycin, tylox
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient comes to ER with Vomiting X 7 from last night and diarrhea. Also reports fever and cough. Denies abd pain. Was treated for COVID viral Pneumonia approx 1.6 weeks ago. She has COPD, OSA, Patient has been in the hospital for _ midnights already. However, due to _ and the risk of _, the patient will require continued acute hospital services. They are being changed to inpatient for this reason. The expected LOS is a total of _ days with an anticipated discharge to _ when stable. Tested positive 8/11/2021


VAERS ID: 1587209 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gaze palsy, Night sweats, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ocular motility disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fleccanaide, metoprolol, aspirin,allpurinol
Current Illness: None
Preexisting Conditions: Afib, diverticulosis
Allergies: gluten (celiac)
Diagnostic Lab Data:
CDC Split Type:

Write-up: 102 degree fever, headache, achiness, night sweats overnight on 8/18. Fever came back today (100.1)


VAERS ID: 1587218 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, throbbing headache, body aches, joint pain, arm pain where shot was. Fatigue worsened throughout the first day and carried into the second as well as the headaches.


VAERS ID: 1587241 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

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

Write-up: Severe chest pain


VAERS ID: 1587247 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-26
Onset:2021-08-18
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Chapped lips, Dyspnoea, Fatigue, Feeling abnormal, Heart rate abnormal, Lip dry, Rash, X-ray
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: snythroid
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood work and x rays so far
CDC Split Type:

Write-up: now trouble breathing, rash spread to face, foggy brain, dry lips and cracking, exhausted, heart beats weird. going to the cardiologist and pulmonary issues, lost 18 lbs in 3 weeks


VAERS ID: 1587249 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: Mild dizziness after vaccine. Patient admits to not eating within several hours before receiving vaccine. Patient sat up and was hot then started to cool down and was ready to stand up. Pharmacist asked 3 separate times if they would like her to call an ambulance and they declined all 3 requests for amubulance. Patient''s mother got her some water and the patient started to feel better and the mom and daughter left the store together. Pharmacist called patient at 11:20am on 8/19/21 the morning after the incident - got voicemail and mailbox was full and could not leave a message.


VAERS ID: 1587259 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Heavy rash on chest and belly. Apply calamine lotion and hydrocortisone and the area clear and get better the next day,


VAERS ID: 1587262 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Cough, Drainage, Eye pain, Hypoaesthesia, Maternal exposure during breast feeding, Muscular weakness, Pain, Respiratory tract congestion, Secretion discharge, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Neonatal exposures via breast milk (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal Vitamin, Hair, Skin, and Nail Vitamin
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Bentil, Z-Pack, Amoxicillin, Penicillin, Sulfates
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states that after receiving the 1st dose of Moderna 08/18/2021, started experiencing symptoms 08/18/2021 right after of stuffiness, eye pain, dry cough, mucus, and drainage. Slight chills, body aches, arm numbness, drowsiness, and weakness in the left arm. Currently breastfeeding (concerned), no noted Primary visit.


VAERS ID: 1587269 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Headache, Hypoaesthesia, Muscle twitching, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Patient report that she has high fever, headache, facial twitching, & severe back pain.. Symptoms started an hour after she received the vaccine... also has numbness in her arm


VAERS ID: 1587290 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-04
Onset:2021-08-18
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tri-Sprintec Daily
Current Illness: none documented
Preexisting Conditions: None Documented
Allergies: Penicillin - Had as a child - Uncertain of reaction
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID after being fully vaccinated


VAERS ID: 1587315 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-14
Onset:2021-08-18
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Miralax, Zofran, Flonase, prenatal vitamins
Current Illness: none, did have COVID diagnosed in December 2020
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: COVID 19 PCR swab
CDC Split Type:

Write-up: Pt was diagnosed with COVID-19 on 8/17/21, + symptoms


VAERS ID: 1587321 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Hyperhidrosis, Hyporesponsive to stimuli, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fainted
Other Medications:
Current Illness:
Preexisting Conditions: She said she had fainted last time she got a vaccine, about 15 years ago.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: She fainted, unwitnessed, shortly after. She then moved to another location and sat while we brought her water. She was very pale and sweaty and slow in response time. She asked for paper towels. She said she would call her mom to come get her. About 5 minutes later, she started to fall forward and to the side with her eyes open and was unresponsive. (She was sitting in a chair at this time). I shook her and asked her repeatedly if she''s ok. Finally after about 8 seconds, she responded with "yes" and then seemed to snap to. We called 911 after this episode. By the time they came, her color had returned and she seemed ok. They let her leave with her mom.


VAERS ID: 1587368 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-11
Onset:2021-08-18
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension, heart disease
Allergies:
Diagnostic Lab Data: SARS CoV-2 PCR
CDC Split Type:

Write-up: Tested positive for COVID19 on 8/18/2021


VAERS ID: 1587378 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-08-15
Onset:2021-08-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Oral candidiasis
SMQs:, Oropharyngeal infections (narrow), Opportunistic infections (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: Junel FE
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt developed severe oral thrush. Pt treated with Diflucan and magic mouthwash.


VAERS ID: 1587383 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-11
Onset:2021-08-18
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / 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: lamoTRIgine (LAMICTAL) 100 mg tablet Take 300 mg by mouth losartan 25 mg tablet Take 25 mg by mouth 1 time per day zaleplon (SONATA) 10 mg capsule 10 mg every night at bedtime metFORMIN (GLUCOPHAGE) 1000 MG tablet Take 1 tablet (1,000 mg) b
Current Illness: none
Preexisting Conditions: Essential hypertension Nonrheumatic aortic valve stenosis Orthostatic hypotension Chronic rhinitis Mixed hyperlipidemia Obesity (BMI 30.0-34.9) Insulin dependent type 2 diabetes mellitus (HCC) Diabetic neuropathy, painful (HCC) Pancytopenia (HCC) Gastroesophageal reflux disease without esophagitis BPH (benign prostatic hyperplasia) Stage 3a chronic kidney disease (HCC)
Allergies: lisinopril, morphine
Diagnostic Lab Data: Positive Covid PCR 8/18/21
CDC Split Type:

Write-up: Patient tested positive for COVID-19 8/18/21


VAERS ID: 1587390 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dysphagia, Lip pruritus, Paraesthesia oral, Pruritus, Throat irritation
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: FLU VACCINE TS 2015-16 (5 YR+) 10/26/2015 Got facial swelling after getting flu shot.
Other Medications: predniSONE (DELTASONE) 10 mg Oral Tab Famotidine (PEPCID) 20 mg Oral Tab EPINEPHrine (ADRENACLICK/EPIPEN) 0.3 mg/0.3 mL Inj AutoInjector Cetirizine (ZyrTEC) 10 mg Oral Tab
Current Illness: N/A
Preexisting Conditions: HTN (HYPERTENSION) HX OF LASIK FEMALE STRESS INCONTINENCE MASTALGIA. FHX OF BREAST CANCER CHRONIC PAIN COUNSELING HX OF THYROIDECTOMY HX OF LASER REFRACTIVE SURGERY BENIGN CARCINOID TUMOR, LUNG ELEVATED H PYLORI ANTIBODY BILAT DRY EYE SYNDROME BILAT AGE RELATED CATARACT
Allergies: Avocado - DietaryAnaphylaxis Dilaudid [Hydromorphone]Hives CodeineRash Covid-19 Vaccine, Ad26.cov2.s (Janssen) Flu Vaccine Ts 2015-16 (5 Yr+) Latex
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 1649 Pt received dose of Janssen (Johnson & Johnson) vaccine today approximately around 1440. Pt states she is "feels like I''m going to throw up". Pt brought back to AR triage for observation. Pt states feeling lightheaded and feels tingling and itching around lips. Vital signs at 1652: BP: 160/103 (Map: 133) HR: 73 SPO2: 99% Temp: 98.2 F RR: 21 1658: Spoke with emergency department Dr. about patients situation. Dr. advises that 911 be called and patient be taken to emergency department, due to high blood pressure and itching around face. 1702: 911 called. Pt still feeling itching around lips and face. Vital Signs at 1702: BP: 212/106 (Map: 139) HR: 67 SPO2: 93% Temp: 97.4 F RR: 22 1720: Pt states itching around lips, face, and now throat. Pt also states "It''s hard to swallow and my tongue feels big". Paramedics arrived and administered IM epinephrine. Pt was taken to ER by paramedics


VAERS ID: 1587426 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site pain, Nausea, Pyrexia, Tenderness, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: SHAKING OF ENTIRE BODY FOR ABOUT ONE HOUR / FATIGUE 24 HOURS / NAUSEA 12 HOURS / VOMITING 1 HOUR / FEVER OF 101 DEGREES 12 HOURS / HEADACHE 12 HOURS / TENDERNESS OF BOTH ARMS FOR 24 HOURS / SORENESS OF VACCINE SITE ARM FOR OVER 48 HOURS


VAERS ID: 1587431 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip erythema, Lip pruritus, Lip swelling, Rash, Rash erythematous, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT PRESENTED TODAY WITH RED BUMPS ON HIS FACE, BACK AND NECK. HIS LIPS WERE SWOLLEN. LOOKS LIKE ENORMOUS HIVES. RED, ITCHY AND SWOLLEN LIPS. NO DIFFICULTY BREATHING. RECOMMENDED NOT GETTING SECOND SHOT, TAKING DIPHENHYDRAMINE AND FOLLOWING UP WITH PHYSICIAN IF SYMPTOMS DO NOT IMPROVE OR GET WORSE


VAERS ID: 1587432 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Heart rate irregular, Hyperhidrosis, Injection site swelling, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot made her sick for 2 weeks
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient state the day after the vaccine she has been having shortness of breath and a an irregular heartbeat. She has been experiencing sweat episodes. Patient also stated that her arm is swelling near the injection site.


VAERS ID: 1587434 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Writer and witnessed arrived to patient home at 1500. Patient asked if this is here first covid vaccine, and patient stated yes this is my first shot. Writer implemented teaching on answering the consent form correctly pt verbalized understanding and signed consent. vaccine given appropriately. . during observation patients friend walked in and stated i got my vaccine card where is yours, patient stated i cant find it, writer re asked patient did you receive a covid vaccine shot and patient stated "oh ya i did i forgot i did it in February at the hospital. teaching implemented to patient, doctor notified in a timely manner, no adverse reaction noted, supervisor notified timely manner.


VAERS ID: 1587453 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Nervousness
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: At 13:40, client received his 1st dose Pfizer vaccination (Lot#FC3183). At approximately 13:55, the client was sitting in the observation area and got up to leave. As he was walking down the hallway, the client stated he, ?began to feel a little dizzy,? and returned to the observation area. He informed EMT and she had him sit down in a chair. EMT radioed Lead Nurse to come over to assess the patient. At approximately 13:56, Lead Nurse addressed the client and found he preferred to speak in Spanish. Lead Nurse requested Co-Lead Nurse come over to translate. EMT took client?s vitals at 13:56 (HR: 87, BP: 150/100, SpO2: 98). The client stated he was feeling a little dizzy, but ?felt fine now.? He stated he was nervous about the getting the vaccine. He stated he has no underlying medical conditions (including no high blood pressure) and takes no medications. He then stated he previously had high cholesterol, but has never taken anything for it. He also stated he had a slight headache this morning, and took Tylenol before he came. He stated he has no allergies and had eaten within the last couple of hours. Lead Nurse asked client if he was experiencing any shortness of breath, difficulty breathing, or chest pain, to which the client responded, ?no.? The client then stated when he felt the dizziness, he also felt a little chest pressure for approximately 1 second and then it went away. At 14:01, EMT took client?s vitals again (BP: 148/90, HR: 71, SpO2: 99%). Client stated he did not feel any side effects anymore. Lead Nurse offered the client some water, which the client accepted and began drinking. The client then stated he could communicate in English. Lead Nurse advised client to continue to sit in the observation area for an additional 15 minutes and alert the EMT if he started to experience any discomfort. Client originally came in with his wife and daughter, but they had to leave. Client stated he could take the bus home or call his brother-in-law for a ride after waiting. Client did not have a phone and the Lead Nurse gave him her phone to use. Client stated his brother-in-law was on the way to pick him up. The Lead Nurse and EMT approached the client at 14:16 and asked how he was feeling. The client stated he felt his headache from earlier might be coming back, but overall he ?felt fine.? The EMT then took client?s vitals (BP: 142/90, HR: 74, SPO2: 97%). Client finished drinking his water and declined a snack. Client stated he was ready to go and would meet his brother-in-law downstairs. At 14:20 Lead Nurse walked client outside. Client walked with a steady gait when exiting the building and continued to state he was ?fine and ready to go.? Client stated he would sit and wait for his ride on the bench outside the building. Lead RN educated client on both the potential side effects and adverse effects of the vaccine, when to seek medical attention, and ER precautions. Client stated he understood and was ?ready to go.?


VAERS ID: 1587454 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Arthralgia, Asthenia, Decreased appetite, Diarrhoea, Fatigue, Headache, Pyrexia, Sensory disturbance, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: first 2 vaccines she had the same adverse events as the 3rd
Other Medications: ambrein, crystor, benicar, amlodipine, estrogen, zofran, tizanidine, neurontin, aggrenox, alegra, turmeric, vit c 1000mg, multi vit, prozac, valium, bio fits
Current Illness: no
Preexisting Conditions: history of TIAs, lupus, fibromyalgia, breast cancer, pacemaker, back stimulator
Allergies: turtle soup, sulfa, lyrica, transdermal patch,
Diagnostic Lab Data: no
CDC Split Type:

Write-up: middle of the night started vomiting, headache, diarrhea, fatigue, legs collapsed, feet feel like she is wearing wool socks, lost of taste, joint pains everywhere and high fever and no appetite


VAERS ID: 1587460 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Hyperhidrosis, Pallor, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), 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: No
Current Illness: Patient marked on Vaccine Administration Record that he did not have a history of seizures. Patient misunderstood question and later revealed that he had two seizures in the past. (i.e. I asked the patient about his medical history and patient misunderstood the question and stated that he never took seizure medication but had seizures in the past)
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: none, patient did not want further treatment at hospital
CDC Split Type:

Write-up: Patient walked to chair to stay for observation after receiving the vaccine and patient started to stare off. And then proceeded to sit down in the chair and started having a seizure. He started sweating profusely and turned very pale. Patient vitals (blood pressure and temperature) were taken and 911 was called. Patient kept asking for water and stating that he was okay. Vitals were within normal range but patient still was sweating very badly. Then EMT and fire department showed up. They continued with care. Patient did not want to go to the hospital and called for a ride to pick him up.


VAERS ID: 1587463 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 severe rash all over body and slight shortness of breath 2 hours after taking vaccine. pt took benadryl. symptoms have not gotten worse. called pharmacy to update the next day. pt has not been seen by provider.


VAERS ID: 1587471 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Dizziness, Fatigue, Headache, Heart rate abnormal, Immediate post-injection reaction, Monoplegia, Myalgia, Nausea, Pain, Pain in extremity, Palpitations, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 8/18/21: immediately after injection (5:00pm) - dizziness, nausea, racing heart, heart rate fluctuating from really high (120bpm) to low (50-60bpm) for about 15min, muscle pain in shoulders 8/18/21: (8:00pm) - arm pain and soreness 8/19/21: (7:00am) - arm pain and soreness 8/19/21: (10:00am) - tiredness, achy 8/19/21: (12:30pm) - extremely achy, extreme muscle pain in lower back and legs, nausea, headache 8/19/21: (3:00pm-6:00pm) - achy, muscle pain, fever, headache, tiredness


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