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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 111 out of 6,867

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VAERS ID: 1588552 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-09
Onset:2021-08-18
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 2 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, 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? 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: 02/10/2021- RECEIVED FIRST DOSE OF MODERNA 03/10/2021- RECEIVED SECOND DOSE OF MODERNA 08/13/2021- BOTH PATIENT''S PARENTS TESTED POSITIVE. PATIENT IS LIVING WITH HER PARENTS. PATIENT TESTED NEGATIVE FOR COVID 19 WITH A PCR TEST. 08/14/2021- PATIENT STARTED HAVING COVID LIKE SYMPTOMS 08/15/2021- PATIENT TESTED POSITIVE ON A AT HOME TEST 08/19/2021- PATIENT TESTED POSITIVE FOR COVID 19 WITH A RAPID PCR TEST.


VAERS ID: 1588557 (history)  
Form: Version 2.0  
Age: 35.0  
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 017E21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram, Feeling hot, Paraesthesia, Refusal of treatment by patient
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: had paresthesia for a month/tremor after a flu shot
Other Medications: not known
Current Illness: none known
Preexisting Conditions: none known
Allergies: none
Diagnostic Lab Data: ems did ekg and blood pressure
CDC Split Type:

Write-up: patient had tingling all over her body then her feet got really hot like they were on fire. called paramedics and she was stable and refused to go to hospital. patient said would follow up with doctor


VAERS ID: 1588564 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-28
Onset:2021-08-18
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

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

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

Write-up: Pt''s dad "forgot" son''s date of birth at time of first dose and gave DOB of his daughter instead. Gave us the wrong date of birth. Did not discover this till patient came into pharmacy for 2nd dose. At the time of first dose patient was 11 years old. Patient report no adverse reaction to the first dose.


VAERS ID: 1588567 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-19
Onset:2021-08-18
   Days after vaccination:91
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, aspirin, Atorvastin, insulin, lisinopril, metformin
Current Illness:
Preexisting Conditions: DM2, hyperlipidemia, gerd,
Allergies: simivastin
Diagnostic Lab Data:
CDC Split Type:

Write-up: break thru covid case


VAERS ID: 1588574 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-13
Onset:2021-08-18
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: glipizide, lisinopril, metformin
Current Illness:
Preexisting Conditions: dm2 hyperlipidemia
Allergies: milk simivastin rosuvastin
Diagnostic Lab Data:
CDC Split Type:

Write-up: break thru covid case


VAERS ID: 1588582 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-01
Onset:2021-08-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia
SMQs:, Arthritis (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: Entresto, amiodarone, carvidelol
Current Illness: None
Preexisting Conditions: Heart failure
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain in left wrist joint and left ankle


VAERS ID: 1588588 (history)  
Form: Version 2.0  
Age: 12.0  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: fever <12 hours after injection of 103.1, fatigue, tiredness; denies redness, denies swelling, fever persisting $g48 hours


VAERS ID: 1588725 (history)  
Form: Version 2.0  
Age: 53.0  
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 053E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypersensitivity, Injection site erythema, Injection site inflammation, Injection site pain
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (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: COPD
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the pharmacy with visual pain, inflammation, and redness at the injection site only, with the area of about an 1.5 inch in diameter. I informed her to take Tylenol, Benadryl to help with the pain and allergy. I also informed her to ice the area several times as needed throughout the day. Patient does not have a primary doctor as she moved from out of state and did not want to go to emergency room. I informed her to contact us if she did not feel better or if the symptoms worsen or spread. She agreed to notify us or come in if the symptoms did not improve.


VAERS ID: 1588729 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-05-01
Onset:2021-08-18
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: Blood Clots in left leg. Removed. from Dr. from Health Services on Thursday, August 19, 2021. Left groin area down to foot. Was communicated and recommended I have a stent put in the groin area within a week or two to prevent it from happening again. No history in my family. No. Smoker, not on Birth control.


VAERS ID: 1588734 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-30
Onset:2021-08-18
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyshidrotic eczema
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazodone 50mg nightly Melatonin 6mg nightly Crestor 10mg nightly
Current Illness: None
Preexisting Conditions: History of Juvenile Rheumatoid Atypical Neuralgia
Allergies: NKA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dyshidrosis-bilateral feet


VAERS ID: 1588735 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Nevada  
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: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Myalgia, Neck pain, Pain, Pain of skin, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: Meningitis shot, age 18, passed out approx 15 minutes after vaccine, hit head on fish tank in lobby and suffered a concussion.
Other Medications: Enbrel etanercept. 50 ml sure click. Injected weekly
Current Illness: None
Preexisting Conditions: Ankylosing spondylitis
Allergies: Latex
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Fever and chills and headach starting approx 8 hrs after booster vaccine. Body aches, extreme muscle soreness (full body), fatigue, skin hurts to the touch all over, neck pain.


VAERS ID: 1588737 (history)  
Form: Version 2.0  
Age: 24.0  
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 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dehydration, Dizziness, Feeling hot, Hyperhidrosis, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (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: Client received the COVID19 Janssen vaccine at 19:06. It should be noted that our vaccination/observation room is located on the 2nd floor of the building and the air conditioning stopped working at approximately 14:00. The client was accompanied by 2 friends and after receiving her injection, they proceeded to the observation area to wait for 15 minutes. At approximately 19:08, the client?s friends waived for the EMT to come over to where they were sitting. The client stated she felt dizzy, was starting to black out, and felt like she was going to pass out. EMT called out to Lead and Co-Lead RNs who were nearby, and assisted the client into a zero-gravity chair. They sat her in the chair at a 45-degree angle. Lead RN observed that the client was diaphoretic. The client was conscious and the Lead RN asked questions to determine if she was alert & oriented to person, place, time, and situation. Lead RN determined she was. Due to the client stating she was very hot, Co-Lead RN opened the nearest windows while Lead RN gave the client a bottle of water and began fanning her with some cardboard. The client started gulping down the water. Lead RN asked the client when it was that she had last eaten or drank anything. The client stated it was earlier in the morning. Co-Lead gave the client some crackers and a juice box and she immediately began eating and drinking the juice. The client stated she was already starting to feel a lot better. The client stated she does not have any underlying medical conditions, has no allergies, and takes no medications. She also stated that she did not take anything before coming to get the vaccine, but had drank alcohol the night before and was a little dehydrated today. At 19:17, EMT took the client?s vitals (BP: 120/70, HR: 77, SPO2: 97%). The client stated she, ?felt a lot better.? The Lead nurses requested the client sit for an additional 15 minutes to ensure she was feeling fine, and the client agreed. At 19:32 both Lead RNs and EMT observed that the client was no longer diaphoretic and asked the client how she was feeling. She was laughing and joking with her friends, stating ?she felt fine.? Both Lead RNs requested the client stand up to confirm she felt fine. Both Lead RNs observed client stand up with no problems and the client stated she was ?OK.? 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 she understood. Lead RN observed client and her friends and exit the observation room walking with a steady gait.


VAERS ID: 1588738 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
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 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
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: Patient experienced dizziness after receiving the Janssen Covid 19 vaccine


VAERS ID: 1588919 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
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 - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Lip pruritus, Lip swelling, 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: Lymphoma
Preexisting Conditions: Lymphoma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Maybe developing a food allergy Swollen lips, hives, itchy


VAERS ID: 1588927 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
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 - / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling cold, Headache, Injection site erythema, Injection site pain, Injection site warmth, Myalgia, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion, buspirone, dicyclomine, blood pressure meds, tums
Current Illness: None.
Preexisting Conditions: High blood pressure
Allergies: Cinnamon, nutmeg, ginger, clove
Diagnostic Lab Data:
CDC Split Type:

Write-up: 22 hours post vaccine (the same time frame as 1st dose) Fever 101.8, chills, fatigue, muscle aches, headache, sore at injection site. 48 hrs later sore arm, very red at injection site- hot to touch. No other symptoms


VAERS ID: 1588928 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-02-08
Onset:2021-08-18
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 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:
CDC Split Type:

Write-up: Fully vaccinated patient tested positive for covid


VAERS ID: 1589069 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Injection site pain, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Allegra, multi vitamin, fish oil
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: High fever, muscle soreness, cold sweats, painful injection site, nausea


VAERS ID: 1590894 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 88D21A / 1 LA / IM

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

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

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Weakness-Severe, Additional Details: Patient felt weak and faniting. She drank water and rest for 30 minutes and was fine. Asked her if she needs us to call 911 she said no she gets like this all the time whenever she gets vaccine/shot


VAERS ID: 1590937 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-05-01
Onset:2021-08-18
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 AR / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ED7533 / 1 AR / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac flutter, Cardiac murmur, Chest discomfort, Cough, Flushing, Oropharyngeal pain, Paranasal sinus discomfort, Pyrexia, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Pulmonary hypertension (broad), Tachyarrhythmia terms, nonspecific (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium; Fish Oil; and Vitamin D supplements.
Current Illness: None.
Preexisting Conditions: None.
Allergies: Cecile (rash as infant).
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have been experiencing symptoms of myocarditis or pericarditis?a feeling that my heart is fluttering, flushed, or murmuring and a general chest feeling of calm fatigue. I have never experienced these before. My partner and I have both been experiencing symptoms of some immune response to an infection or virus. Both of us have been experiencing: runny nose, some sinus pressure, mild sneezing, and sore throat. But I believe neither of us has experience fever or coughing. She is experiencing none of the chest/heart symptoms, only I am. Is it possible that I am related to other cases tying COVID-19 mRna vaccines in young men to heart inflammation? I am otherwise a very healthy individual. BMI is around 22.4. Diet vegetarian. Moderate/low sugar and salt intake.


VAERS ID: 1590941 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis, Hypotension, Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild


VAERS ID: 1590959 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Headache, Hot flush, Influenza like illness, Muscle spasms, Pain
SMQs:, Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Headache, hot flashes, aching body, chest pain, flu like, leg cramps,


VAERS ID: 1590961 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Fatigue, Injection site discomfort, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Pain, Peripheral swelling, Pruritus, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), 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-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Additional Details: Patient presented at pharmacy 8/19/21 after receiving 2nd dose Pfizer Vaccine on 8/16/21. Patient stated she experienced expected side effects up to 24 hours after vaccination (discomfort at injection site, fatigue, body ache.) and symptoms resolved. Approximately 48-72 hours after vaccination, patient developed new arm tenderness that developed into redness, mild swelling and itching. Recommended oral diphenhydramine with PCP follow-up.


VAERS ID: 1590981 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Tacrolimus 1mg (2X/day), Protonix 40mg (1X/day), Aspirin 81mg (1X/day), Terazosin 5mg (1X/day), Lipitor 20mg (1X/day), Viread 300mg (1X/day)
Current Illness:
Preexisting Conditions: Liver transplant recipient
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lightheadedness, Nausea, Headache, Body Pains, Sore arm


VAERS ID: 1591145 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Ehlers-Danlos syndrome Inflammatory arthritis Celiac disease SIBO Thrombophilia
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intense disabling lower back pain Fever after 36 hours, lasted 6 hours and relieved back pain Then fever disappeared and intense back pain returned


VAERS ID: 1591160 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: Fever and extreme chills 10-15 hours after vaccine. Chills went away, fever, headache, and nausea persisted the day after taking the vaccine. Felt normal 48 hours after taking vaccine.


VAERS ID: 1591173 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-12
Onset:2021-08-18
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna on 2/12 and 3/12. Positive on 8/18 admitted 8/18 to current


VAERS ID: 1591185 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Immediate post-injection reaction, Injection site pain, Injection site warmth, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Suboxone 8mg strips
Current Illness: Fibromyalgia
Preexisting Conditions: Fibromyalgia ADHD Depression Anxiety Autism
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sever muscle and body aches within the hour of getting it.. Burning at injection sight immediately and a very sore arm. All of which is still severe 2 days later.


VAERS ID: 1591192 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Head injury, Loss of consciousness, Swelling face, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (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), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Patient passed out while in seat and hit her head. She appeared to shake for a few seconds and then came out of it. I asked if patient had epilepsy and partner said she had seizures in the past but not diagnosed. She had a large bump on her forehead. EMS was called and they came and evaluated her


VAERS ID: 1591206 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fall, Head injury
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad)

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

Write-up: Patient became extremely dizzy 7 to 8 hours after the vaccine. He fell down and hit his head after 10 hours. He slept and woke up feeling dizzy. Then later on that day, the dizziness went away and he was fine.


VAERS ID: 1591214 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-01
Onset:2021-08-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Fatigue, Myalgia, Pain, Rash papular
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: N/a Will call my doctor today to make appointment.
CDC Split Type:

Write-up: Fatigue, chills, body aches, excruciating mid back pain, muscle aches, small papule rashes


VAERS ID: 1591219 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-14
Onset:2021-08-18
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2nd dose Pfizer given 3/7/21. Hospitalized 8/18/21


VAERS ID: 1591234 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-28
Onset:2021-08-18
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Coma scale, Computerised tomogram head abnormal, Cranial nerve disorder, Dizziness, Facial asymmetry, Fall, Haemorrhagic stroke, Headache, Loss of consciousness, Seizure, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/18/21 CT head - acute bleed
CDC Split Type:

Write-up: Event occurred $g 30 days but < 60 days since vaccine administration. Severe unanticipated event in otherwise healthy 15 yo First dose 6/1/21 (Pfizer) Neurological - Evaluated for stroke; Dizziness,Headache,Loss of consciousness,Seizure Hemorrhagic stroke 15-year-old female with no significant past medical history brought in by EMS as a stroke alert. Per EMS, patient was at school playing lacrosse and fell to the ground. There was no reported trauma prior to incident. EMS was activated approximately 30 minutes prior to arrival. Last known normal is approximately 8:45 AM. Patient unable to provide additional history at bedside as she is actively vomiting. As far as EMS is concerned, patient was otherwise in usual state of health. Fingerstick euglycemic prior to arrival. Acute distress, ill-appearing, toxic-appearing Neurological: Mental Status: She is alert. GCS: GCS eye subscore is 4. GCS verbal subscore is 5. GCS motor subscore is 6. Cranial Nerves: Cranial nerve deficit and facial asymmetry present. Motor: Weakness present. Received critical notification from CT technician that patient has an acute bleed- Life flighted to Hospital.


VAERS ID: 1591240 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-28
Onset:2021-08-18
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 RA / 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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol, albuterol, allopurinol, vitamin d3, voltaren gel, benadryl, doxycycline, mucinex, mag-postassim, toprol XL, singulair, macrobid, prilosec, oxybutynin, KCL, procto-med cream, zanaflex, triamcinolone cream, maxzide, warfarin
Current Illness:
Preexisting Conditions:
Allergies: Clindamycin, codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was vaccinated fully as of March 2021. Presented to ED and diagnosed with COVID-19 infection leading to hospitalization


VAERS ID: 1591261 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-15
Onset:2021-08-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Genital blister
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 0
Current Illness: 0
Preexisting Conditions: Asthma
Allergies: 0
Diagnostic Lab Data:
CDC Split Type:

Write-up: My 13 year old daughter, not sexually active, seems to have a herpes zoster breakout. First ever, blister like breakout on her labia.


VAERS ID: 1591267 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness, Myalgia, Nausea, Pyrexia, Toothache
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pt. states that after receiving the 1st dose of J&J 08/17/2021, started experiencing symptoms 08/18/2021 of flu-like symptoms, nausea, muscle aches, teeth pain, and fever (1st day). Treated with Ibuprofen and rest. No noted Primary visit.


VAERS ID: 1591279 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-22
Onset:2021-08-18
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Atrial flutter, COVID-19, Exposure to SARS-CoV-2, Intensive care, SARS-CoV-2 test positive
SMQs:, Supraventricular tachyarrhythmias (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Norco, Chantix, albuterol
Current Illness:
Preexisting Conditions:
Allergies: Aleve
Diagnostic Lab Data: Covid-19 08/18/2021
CDC Split Type:

Write-up: Patient received 2nd dose of Pfizer vaccine on 04/22/2021. He had an exposure to Covid-19 around 08/16/2021. Presented to the emergency department on 08/18/2021 with symptoms of Covid. Tested positive for Covid-19 on 08/18/2021. He was admitted to ICU on 08/18/2021 for A Flutter related to Covid-19.


VAERS ID: 1591289 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-08-10
Onset:2021-08-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Dizziness
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Non COVID related cough
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I have not seen a doctor reference this side effect at this time, but I will if this condition persists.
CDC Split Type:

Write-up: On day 8 (from my first injection), experienced significant dizziness/equilibrium issues that persisted for 1/2 day, subsided for 8 hours, and has now returned. I am currently experiencing this feeling and am not sure how much longer is will persist. I have not yet taken the 2nd injection since I am within the 3 week window from the first injection.


VAERS ID: 1591300 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO173 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Cough, Dizziness, Eye irritation, Headache, Injection site pruritus, Insomnia, Musculoskeletal stiffness, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Corneal disorders (broad), Vestibular disorders (broad), Arthritis (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: Losarton,81mg Aspirin, Vitamin C,Zinc,D3
Current Illness: N/A
Preexisting Conditions: Hypertension,borderline Diabetes
Allergies: Penicillin, Lysinopryl
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Fever,chills,dizziness,coughing, headache, arm swelling, stiffneck,insomnia,burning eyes,itching injection site and arm.


VAERS ID: 1591318 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-03
Onset:2021-08-18
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Tested positive for COVID19 on 8/18/2021


VAERS ID: 1591334 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 LA / IM

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

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

Write-up: Patient was given his second dose 21 days after his first dose instead of 28 days. Patient has not experience any side effects.


VAERS ID: 1591341 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

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

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

Write-up: 2nd dose was received one week early - individual is a foreign exchange student that did not have her vaccination card present with her


VAERS ID: 1591356 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Induration, Pain in extremity, Peripheral swelling, Skin warm
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (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: Tetanus Toxide Shot: Hospitalized
Other Medications: Lisinopril 10-12 1/2 mg (once daily) Gabapentin 300mg (twice daily) Baclofen 10mg (twice daily) Aspirin 81mg (once daily) Diphenhydramine 25mg(once daily)
Current Illness: None
Preexisting Conditions: None
Allergies: Tetanus Toxide
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dizzy and woozy, arm kept swelling up , painful , hot and got hard, extreme tiredness


VAERS ID: 1591390 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humira, hydrochlorothiazide, venlafaxine
Current Illness: No
Preexisting Conditions: Autoimmune disorders, rheumatoid arthritis, Crohn?s disease, celiac
Allergies: Grass, dust mites, mold
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Covid Arm


VAERS ID: 1591419 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Immediate post-injection reaction, Lymphadenopathy
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: PATIENT STATED THAT SHE HAS EXPERINCED "LYMPHNODE SWELLING" AFTER RECEIVING THE FLU VACCINE
Other Medications: PATIENT IS AWARE OF REACTION OCCURING AFTER FLU VACCINE, SPECIFICALLY SHE STATES "LYMPHNODE INFLAMATION" AND RECIEVES STERIOD FROM PRIMARY MD POST VACCINATION WHEN REACTION OCCURS.
Current Illness: NONE NOTED
Preexisting Conditions: NONE NOTED
Allergies: NONE NOTED ON CONSENT FORM
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT EXPERINCED IMMEDIATE SWELLING UNDER ARMPIT PATIENT REQUESTED IMMUNIZER TO FEEL FOR SWOLLEN NODULE AND IT WAS CONFIRMED. IMMUNIZER OFFERED TO TAKE PATIENT TO ER FOR TREATMENT HOWEVER PATIENT STATED SHE HAS EXPERICED THIS BEFORE AFTER A VACCINE AND WILL CONTACT HER PRIMARY PHYSCIAN FOR STERIODS.


VAERS ID: 1591444 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: THE 1993 AND 1994 FLU VACCINE
Other Medications: PATIENT DID NOT STATE ANY
Current Illness: ANXIETY
Preexisting Conditions: PATIENT STATED SHE IS DIABETIC
Allergies: SULFA,PHENERGAN,IV DYE,GADDLINIUM,FLU VACCINE
Diagnostic Lab Data: WAS SEEN IN VACCINATING HOSPTIAL ER
CDC Split Type:

Write-up: PATIENT STATED ALLERGIES PRIOR TO ADMINISTRATION AND WAS CONCERNED IMMUNIZER ADVISED TO SEEK MD APPROVAL AT WHICH POINT PATIENT STATED SHE ALREADY HAD SPOKEN TO HER PRIMARY DOCTOR. IMMUNIZER AND MYSELF DECIDED TO CLOSELY MONITER HER IN OBSERVATION AFTER ADMINISTRATION. AFTER VACCINE WAS ADMINISTERED PATIENT STATED SHE FELT FLUSHED AT WHICH POINT SHE WAS OFFERED WATER SHE REFUSED,THEN PATIENT ASKED TO USE THE RESTROOM AT WHICH POINT I ACCOMPAINED HER TO THE RESTROOM, SHE EXITED RESTROOM COMPLAINING OF RASH THAT SHE SHOWED ME AND WENT TO SIT BACK DOWN IN OBSERVATION AT WHICH POINT ABOUT 15 MINUTES LATER SHE COMPLAINTED OF ITCHING AT SITE OF RASH AND WAS ESCORTED IMMEDIATLY TO THE ER BY IMMUNIZER WHEN SHE WAS TRIAGED AND TAKEN TO AN EXAMINATION ROOM IMMEDIATLY. APROX AN HOUR LATER IMMUNIZER FOLLED UP IN ER WITH PATIENT WHERE SHE STATED SHE WAS FEELING BETTER JUST GROGY FROM MEDICATION RECIEVED IN ER. ON 8/20/2021 PATIENT CALLED AND STATED SHE IS FEELING 100 PERCENT BETTER, WAS TREATED WITH MEDICATION IN ER AND THANKED US FOR HELPING HER.


VAERS ID: 1591478 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Emotional disorder, Feeling abnormal
SMQs:, Dementia (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: Cholesterol Omega 3 Baby Aspirin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that 2 hours after receiving the vaccine he had a fogginess in his brain. He stated that he wanted to cry for no reason.


VAERS ID: 1591485 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Erythema, Fatigue, Feeling abnormal, Flushing, Headache, Hot flush, Hyperhidrosis, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Red flush, sweating, hot flash, dizziness, light headed, brain fog all within 30 minutes of injection. All but sweating and red flush resolved with 1 hour. Red flush and sweating continued for 48 hours. Headache and fatigue began about 8 hours after injection and resolved after about 48 hours with the assistance of Tylenol. Left sided muscle pain began about 12 hours after injection and resolved over night after taking Tylenol.


VAERS ID: 1591488 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, COVID-19, Cardiac failure congestive, Dyspnoea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: AKI (acute kidney injury); Acute hypoxemic respiratory failure due to COVID-19; Congestive heart failure, unspecified HF chronicity, unspecified heart failure type; SOB (shortness of breath)


VAERS ID: 1591499 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: Patient noticed 1-2 inch raised bump. Bump was red, hot, and itchy. Patient spoke to urgent care doctor to go in for antibiotics. She is currently taking benadryl and ibuprofen for the itchiness.


VAERS ID: 1591511 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-12
Onset:2021-08-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Myocarditis


VAERS ID: 1591514 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-15
Onset:2021-08-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetylcysteine 200mg
Current Illness:
Preexisting Conditions: Follicular Lymphoma Stage IV.
Allergies:
Diagnostic Lab Data: COVID-19 test negative on 8/17 and 8/19.
CDC Split Type:

Write-up: It looks like Myocarditis, where I got shortness of breath while I sleeping 3 times on the first time of onset. I did the proning technique and continue sleeping. The second day of onset, I got shortness of breath one time and I resolved it by proning again afterwards. Both instances happened at night (11PM to 12PM) during my sleep. I did COVID-19 test twice and it was confirmed NOT the COVID-19.


VAERS ID: 1591519 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-06
Onset:2021-08-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

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

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

Write-up: Small red itchy welts across my chest and arms


VAERS ID: 1591540 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-26
Onset:2021-08-18
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic 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? No
Previous Vaccinations:
Other Medications: Lopressor, Proscar, Neurontin, Pepcid, aspirin, Prilosec, Naprosyn, Lupron, Calcium, Lipitor, Hytrin, Hydrodiuril
Current Illness:
Preexisting Conditions:
Allergies: Pencillins, Novocain
Diagnostic Lab Data: Covid-19 08/18/2021
CDC Split Type:

Write-up: Patient received his 2nd Moderna vaccine on 02/26/2021. He had a Covid-19 test done on 08/18/2021 prior to an appointment he had scheduled with respiratory therapy. Tested positive for Covid-19 on 08/18/2021, he is asymptomatic. Patient had Monoclonal antibody therapy on 01/19/2021 due to testing positive for Covid-19 on 01/18/2021. Patient then received his first dose of Moderna on 01/29/2021, which was not the recommended 90 days after received antibody therapy. A phone call was made to the Department of Health in regards to this and they recommended that the patient be revaccinated for Covid-19 once his quarantine from this positive is over.


VAERS ID: 1591551 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-10
Onset:2021-08-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 1 RA / IM

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

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

Write-up: Rashes and swelling on the right hand. Feel itchy and a bit painful


VAERS ID: 1591558 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Unknown  
Vaccinated:2020-12-23
Onset:2021-08-18
   Days after vaccination:238
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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:
CDC Split Type:

Write-up: EE RECEIVED BOTH PFIZER COVID-19 VACCINE DOSES AND TESTED POSITIVE TO COVID ON 8/19/21


VAERS ID: 1591559 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-08-18
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Cough, Dyspnoea, Exposure to SARS-CoV-2, Fatigue
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Norco 5/325 q4hours as needed Eliquis 4mg twice a day Lyrica 150 twice a day amitriptyline 100mg twice a day sertraline 100mg at bedtime Spiriva Trulicity 1.5 every week Lantus 20 units twice daily Humalog 10 units before meals Victoza 1.8
Current Illness:
Preexisting Conditions: CHF Pacemaker Diabetes, type 2 Morbid obesity Hypertension
Allergies: Lasix Metformin Sulfa Pine oil Buspar Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: After her recent discharge from the hospital on 8/4, pt started feeling fatigued, with poor energy, worsening dry cough and shortness of breath. Pt received a message from the Health Department that she had been exposed to COVID. Pt is fully vaccinated from April.


VAERS ID: 1591569 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Electrocardiogram normal, Hypertension, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypertension (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow)

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

Write-up: Started experiencing what felt like a heart flutter frequently throughout the day following the vaccine. I continued to monitor it and could feel my heart pounding while doing low effort activities (working at my desk, watching tv) along with walking and other activity all throughout the day. After three days of this continuing and experiencing a fluttering feeling/heartbeat in my throat regularly, I went to urgent care (on Friday - three days post injection). Blood pressure was high for me at 132/80. ECG was run and came back normal indicating no heart arrhythmia. Heat palpitations were diagnosed.


VAERS ID: 1591575 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Current Medications: No active prescriptions for this patient.
Current Illness: Pt had a recent visit to the ED 7/19 for acute on chronic abdominal pain.
Preexisting Conditions: PMH significant for Asthma, Allergic Rhinitis, GERD, gallbladder disease, fatty liver, and diverticulosis.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: "14mins post vaccination pt c/o dizziness, hot flashes/feeling warm. NO other new/abnormal sxs. Vitals @10:02 BP 135/90, HR 68 O2 Sat 100%. Pt was monitored an additional 10 mins, given fluids. Pt verbalized improvement to sxs. Given ok to be released from clinic. A&Ox4. Pt stable and released from vaccination site. ED precautions given. PMH significant for Asthma, Allergic Rhinitis, GERD, gallbladder disease, fatty liver, and diverticulosis. Pt had a recent visit to the ED 7/19 for acute on chronic abdominal pain. Current Medications: No active prescriptions for this patient."


VAERS ID: 1591583 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Disorientation, Electrocardiogram, Fall, Headache, Hyperhidrosis, Loss of consciousness, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies.
Diagnostic Lab Data: EKG 08/18/2021
CDC Split Type:

Write-up: At approximately 2:43 PM patient slipped off of chair in observation area of clinic and fell face-down unconscious. As patient was turned over, it was noted that he seemed to be experiencing a seizure. Seizure activity lasted for approximately 3 seconds. Upon resolution of the seizure activity, patient began to regain consciousness, alert but not oriented at first. Vital signs were conducted, blood pressure 163/83, pulse regular 62 beats per minute. EMS notified. Patient complained of head pain (occipital region) and was diaphoretic. No apparent trauma to head noted, full extraocular movement. Patient began to regain more consciousness. EMS arrived on scene @ approximately 3 PM. EMS further evaluated patient. Repeat vital signs, blood pressure 147/80, pulse 60 beats per minute, respiratory rate 18 breaths per minute, oxygen saturation within normal limits. EMS also performed an EKG which was found to be normal. Patient refused any further treatment and signed AMA (against medical advice). Ultimately patient was going to be transported home by a fellow co-worker.


VAERS ID: 1591604 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site pain, Injection site rash, Lymph node pain, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (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: Cimzia (biologic)
Current Illness: N/A
Preexisting Conditions: Rheumatoid Arthritis
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Swollen, tender lymph nodes under left armpit. Arm rash 4 inches surrounding injection site on arm. Tender injection site. All symptoms occurring 48 hours after injection and persisting through the time of this report.


VAERS ID: 1591613 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

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

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

Write-up: "15mins post vaccination pt c/o chest pain ""pinching"" 2/10, non-radiating. No other new/abnormal sxs. Vitals @9:57 BP 112/72, HR 90, O2Sat 100%. Pt given fluids and monitored until the pt was given the ok to be released from clinic. Pt verbalized ok to leave. ED precautions given. Pt left w/ steady gait. A&Ox4.


VAERS ID: 1591637 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-25
Onset:2021-08-18
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 LA / IM

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

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

Write-up: Hospitalization with covid-19 after being fully vaccinated


VAERS ID: 1591641 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Injection site pain, Injection site urticaria, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Body Aches Generalized-Mild, Systemic: Chills-Mild, Systemic: Fever-Medium, Additional Details: patient broke out in hives on the arm the vaccine administered


VAERS ID: 1591647 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-13
Onset:2021-08-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Electrocardiogram normal, Fibrin D dimer, Full blood count, Laboratory test, Metabolic function test, Muscle tightness, Pain in extremity, Troponin
SMQs:, Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Topamax, Vyvanse
Current Illness: None, unknown
Preexisting Conditions: ADHD, migraines
Allergies: NKDA
Diagnostic Lab Data: Normal EKG, CXR, labs including cbc, d-dimer, trop, and bmp. (8/18/21)
CDC Split Type:

Write-up: Chest pain, spreading across chest and then into arm. Tightness in neck. occured 3 days after vaccine given, progressed. she went to the ER


VAERS ID: 1591651 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Injection site rash, Neck pain, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad)

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

Write-up: Became dizzy and lightheaded 5 minutes after injection then threw up a minute later. Rash under arm where injection given and neck pain which radiates to head continues today.


VAERS ID: 1591658 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 3 RA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: mmr fever second moderna vaccine fever
Other Medications: fluoxetine acyclover eliquis pantoprazole atorvastatin carvedil buspirone
Current Illness: none
Preexisting Conditions: stem cell transplant 2012 Heart attack 2018 legionallers 2020
Allergies: sulfur
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever day after 101.9 Next day dizzy and dizzy sill after 2 days


VAERS ID: 1591666 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose decreased, Cold sweat, Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (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: EMS TOOK BLOOD GLUCOSE, STATED IT WAS LOW.
CDC Split Type:

Write-up: PATIENT RECEIVED VACCINE, WENT TO HER CAR TO WAIT, WITHI N 10 MINUTES RETURNED TO PHARMACY STATING SHE HAD FAINTED AND FELT LIKE SHE WAS GOING TO FAINT AGAIN. PATIENT WAS RETURNED TO SITTING WITH FEET ELEVATED, TOOK BLOOD PRESSURE, WHICH WAS 80/50. SHE WAS C LAMY AND STILL FEELING FAINT. ALSO STATED SHE HAD NOT EATEN. EMS WAS CALLED AND THEY EVALUATED THE PATIENT AND DETERMINED HER BLOOD GLUCOSE WAS LOW. SHE GOT A SNACK AND LEFT WITH A FAMILY MEMBER. NO FURTHER MEDICAL ATTENTION WAS GIVEN.


VAERS ID: 1591672 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 RA / IM

Administered by: School       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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Came in for a vaccine shot, I greeted him and asked if he was getting his first or second vaccine and he stated that he was getting his second shot and I asked if it was Pfizer he said yes and i directed him to an open nurses station and administer the vaccine once the scribe was done taking his info. the person answered all the questions and then received the shot ,once receiving his vaccination card he said he thinks he took Jansen (J&J) the first shot . at that point he was instructed by the pharmacist of what he could expect for side effects being he got Pfizer on top of J&J. and what to do about the side effects.


VAERS ID: 1591751 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Headache, Pain in extremity
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: metformin, lisinopril, simvastatin, Victoza, Topamax, gabapentin, baby aspirin, multi vitamin
Current Illness:
Preexisting Conditions: diabetic, migraines
Allergies: lobster, halibut, salmon, naproxen
Diagnostic Lab Data:
CDC Split Type:

Write-up: sore arm, headache, mild stroke


VAERS ID: 1591752 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-06
Onset:2021-08-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Haematoma
SMQs:, Haemorrhage terms (excl laboratory terms) (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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated via phone call that she had a hematoma develop on her left arm approximately 10-12 days after her first Covid 19 injection.


VAERS ID: 1591765 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered
SMQs:, Medication errors (narrow)

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

Write-up: Patient was given a third dose Pfizer vaccine by having a card that was incomplete with only one dose noted.


VAERS ID: 1591851 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-18
Onset:2021-08-18
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Headache
SMQs:, Taste and smell disorders (narrow)

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

Write-up: headache, loss of taste


VAERS ID: 1591871 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Albumin globulin ratio, Decreased appetite, Nausea, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called today to ask about some symptoms he was experiencing following receipt of the COVID vaccine. Patient received first dose COVID-19 Pfizer vaccine (lot FC3181 exp 10/31/2021 L Deltoid) Tues 8/17/21. Patient states he started experiencing nausea and vomited the following day 8/18 and again today 8/20/21. He has been feeling achy and hasn''t had much of an appetite. I recommended he call his physician to let them know as well. He denied any issues with staying hydrated, as he had only vomited three times total since the vaccine. I told him he could take tylenol to help the achiness and he should stay on top of his hydration. He is going to let his physician know as well as ask their advice with regards to getting the second dose or not.


VAERS ID: 1591912 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Head injury, Nervousness, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions:
Allergies: None reported
Diagnostic Lab Data:
CDC Split Type:

Write-up: A little after 4pm on 8/18/21 patient got his J&J covid vaccine. He was nervous about the vaccine and did not like needles. After the vaccine he seemed calm and chatted with me for a minute before going and having a seat in the waiting area. A few minutes after he sat down the patient fainted - falling towards another patient who was waiting after his vaccine. The other patient said it looked like he was having a seizure. Staff member called 911 right away. I ran out and saw the patient still falling from his chair. He bumped his head as he fainted and me and the other patient helped him to the ground. He came to within seconds and kept apologizing. I told him not to apologize and got him some water. He kept saying he was fine. EMS arrived and took some vitals. They said the patient could go to the hospital if he wanted and he said he didn''t want to go. They were getting his paperwork together when he fainted a second time. They took him by ambulance to Medical Center.


VAERS ID: 1591918 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-08-18
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PARoxetine (PAXIL) 40 mg tablet Take 1 tablet (40 mg) by mouth 1 time per day metoprolol succinate (TOPROL XL) 25 mg SR tablet (24 hr) Take 1 tablet (25 mg) by mouth 1 time per day levothyroxine 75 mcg tablet TAKE 2 TABLETS ONCE A DAY FOR 1
Current Illness: N/A
Preexisting Conditions: HTN (hypertension) Hot flashes Primary hyperparathyroidism (HCC) Vitamin D deficiency Postsurgical hypothyroidism Goiter SUI (stress urinary incontinence, female) Osteopenia Breast and nipples, absence of
Allergies: Acrylate Copolymer [acrylate Terpolymer] Potassium Dichromate
Diagnostic Lab Data: Covid PCR nasopharyngeal swab
CDC Split Type:

Write-up: Patient contracted Covid


VAERS ID: 1591940 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Headache, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Patient reported multiple food and drug allergies, ranging from a rash to anaphylaxis
Diagnostic Lab Data:
CDC Split Type:

Write-up: From healthcare staff: On 8/18/21 at around 9:10 am I gave a Moderna vaccine to patient. We had discussed before the vaccine that she had multiple allergies (mostly to medications) and with varying reactions (from hives to anaphylaxis). I told her she would need to wait 30 minutes after the vaccine based on her allergy history. Immediately following the vaccine the patient said she had a headache and started feeling like her breathing was shallow and her throat was closing in. I had staff call 911 at that time. The patient was still breathing on her own but it was labored. While staff was on the phone with 911 dispatch I gave the patient Benadryl. At around 9:20 the EMTs showed up. They said the patient''s lungs were clear and her oxygen was fine. She was given the choice of going to the hospital or not. The patient chose to go to the hospital and was taken by ambulance. Spoke to patient the next day and she was doing fine. She has an appointment with her PCP to determine if she can receive the second dose of Moderna, and it will be done at a medical facility if she elects to receive it.


VAERS ID: 1591974 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

Write-up: Patient was screened ahead of vaccination and asked if he had received any previous doses of any covid vaccine. He said that he had not, and specifically wanted the Janssen single-injection. The vaccine was administered, then when it was logged in CIR (vaccine reporting system), it was discovered that he had already previously received both doses of Pfizer (12/21/20 and 01/11/21) and both doses of Moderna (05/28/21 and 06/25/21). No adverse effects have been observed, but he received several more doses than currently recommended.


VAERS ID: 1591996 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin Aspart
Current Illness: No
Preexisting Conditions: No
Allergies: No known allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms within 10-15 mins of the dose: SOB, Dizziness, heart was racing


VAERS ID: 1592028 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-02-10
Onset:2021-08-18
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Diarrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Diabetes Mellitus
Allergies: Unknown
Diagnostic Lab Data: RT-PCR via upper respiratory sample was positive for COVID-19. No other test results reported.
CDC Split Type:

Write-up: COVID 19 related hospital admission on 8/18/2021 for weakness, diarrhea, acute respiratory failure. No admission to intensive care unit during hospitalization and no required mechanical ventilation.


VAERS ID: 1592041 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cough, Eye pain, Fatigue, Headache, Pain
SMQs:, Anaphylactic reaction (broad), Glaucoma (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: Flu vaccine
Other Medications: Tylenol, ibrophen, women multi vitamin, vitamin D, vitamin C.
Current Illness: I had no illnesses at the time of Covid-19 vaccine or up to one month prior of Covid-19 vaccine.
Preexisting Conditions: NONE
Allergies: Eggs, Aloe, lupron, Amoxicillin, Penicillin, Clinadmycin, and Paxil
Diagnostic Lab Data: None. Waiting for the symptoms to stop on its own.
CDC Split Type:

Write-up: Headache, body ache, cough, fatigue, and eye pain. Tylenol and Ibuprofen around clock to help with symptoms. Today is 8/20/2021 and still having symptoms.


VAERS ID: 1592096 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Facial asymmetry, Feeling hot, Hypoaesthesia, Skin tightness
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), 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: Advil, vitamin D, fish oil, magnesium, biotin, spirnolactone, adderall, valtrex, tylenol
Current Illness: NONE
Preexisting Conditions: Herniated discs in neck
Allergies: Cephalexins
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got my first vaccine around 7:30pm. Within five minutes I felt a wave of heat run down from my head to my feet. I was dizzy and waited about 25 minutes before leaving the pharmacy. About 10 -15 mins later my right forearm felt numb and the right side of my face started feeling like someone shot novicane in my gums and face. Along the right side of my face did I have a sudden numbed sensation extending from the tip of my chin, up my jawline to my ear and under my right eye as well as my right cheek and upper jaw gum line. It has been 46.5 hours since I received the vaccine and my face still feels numb. When I try to smile the right side feels tight and my smile is crooked.


VAERS ID: 1592102 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 RA / IM

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

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

Write-up: Deltoid swelling, redness, warmth, pain x 3 days, treated with PCN to cover for cellulitis


VAERS ID: 1592105 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-14
Onset:2021-08-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Extrasystoles, Heart rate increased, Hypertension, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Hypertension (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: heart afib, pounding heart, heart skipping, high blood pressure, high pulse rate. after receiving the first shot. i have not received my second shot. I have never had these problems before.


VAERS ID: 1592111 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Erythema, Fatigue, Headache, Nasal congestion, Neck pain, Pain in extremity, Peripheral swelling, Rash, Swelling, Swelling face, Swelling of eyelid, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), 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:
Other Medications: Sprintec, ashwagandha, ibuprofen/Tylenol(prn)
Current Illness: Na
Preexisting Conditions: Raynauds
Allergies: Ceclor, red dye 40, shellfish, hazelnuts
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: 20 mins in pain from deltoid to deltoid and up neck into head. At 5 hour mark I had a rash/hives and swelling on whole arm that had the injection and it was creeping up my neck to my ear, temp of 99.4, headache, fatigue, and nasal congestion. I took 25mg benadryl and used ice on my arm for 1.5 hrs before I got relief and then went to bed. When I woke at 5am I still had redness where the hives were but no hives and the site still hurt but I''ve been fighting swelling in my face. I''ve been taking chloratab allergy medicine q4-6 hours and ibuprofen to keep it at bay. Awoke this am (8/20) with swelling of my eyelids. Allergy meds are helping.


VAERS ID: 1592144 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Blood creatinine normal, Blood lactic acid, Blood sodium decreased, Blood urea normal, Computerised tomogram abdomen abnormal, Computerised tomogram pelvis abnormal, Diarrhoea, Haemoglobin normal, Large intestine infection, Myalgia, Nausea, Platelet count normal, Pyrexia, Scan with contrast, Vomiting, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Trelegy Ellipta inhaler, albuterol, amlodipine, aspirin, atorvastatin, dulaglutide, hydroxyzine, insulin Aspart 70/30, linaclotide, lisinopril, montelukast, sertraline
Current Illness:
Preexisting Conditions: T2DM, HTN, hyperlipidemia, obesity, COPD/asthma, depression/anxiety, chronic constipation
Allergies: none
Diagnostic Lab Data: Tests from ED on 8/20/2021: WBC 22.2 (82% PMNs), lactate 1.4, Hgb 15.5, plt 303k, BUN/Cr 10/1.1, Na 133. CT abd/pelvis w/ contrast showed wall thickening and pericolonic stranding involving the majority of the colon and most prominent along the ascending and transverse colon, consistent with colitis and likely infectious or inflammatory in etiology.
CDC Split Type:

Write-up: Acute nausea/vomiting, nonbloody diarrhea, abdominal pain, generalized myalgias, and subjective fevers on the day after vaccine administration (vaccine administered 8/17/2021, symptom onset 8/18/2021). Presented to ED 8/20/2021. Initial T 37.5, HR 148, BP 129/99, SpO2 100% on RA.


VAERS ID: 1592307 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Headache, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: VITAMIN D, B12, ASPIRIN, TUMS, FOLIC ACID,multivitamin
Current Illness: no
Preexisting Conditions: arthritis, spinal stenosis
Allergies: no allergies, no reaction to first 2 injections
Diagnostic Lab Data: none that we know of
CDC Split Type:

Write-up: vomiting, headache, nausea, body aches


VAERS ID: 1592362 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-10
Onset:2021-08-18
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

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

Write-up: BREAK THRU COVID CASE


VAERS ID: 1592525 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER Z07AZ1A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Contusion, Dizziness, Injection site pain, Myalgia, Nausea, Pain, Pyrexia, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (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:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 hours after injection nausea and dizziness with slight vertigo. 14 hours after injection shooting pains from the injection site up the shoulder and through the jaw bone. 22 hours after injection fever of 102 with chills and muscle aches. All passed after the 36 hour mark. Now at the 48 hour marker the site is swelling larger with mild bruising and continuing to get larger.


VAERS ID: 1592527 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-18
Onset:2021-08-18
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / UNK AR / IM

Administered by: Pharmacy       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: metformin, losartan, hctz, methotrexate
Current Illness:
Preexisting Conditions: diabetes, hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Currently hospitalized


VAERS ID: 1592529 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Cough, Dyspnoea, Pain, Painful respiration, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: typical vaccine reactions within 24 hours (low grade fever, achiness, cough) that evolved into shortness of breath and chest pain. Seen in the ER 36 hours later and treated with ativan with some decrease in associated anxiety but persistent dyspnea and inability to exertion. Seen again in my office 48 hours later with very limited air movement on exam with pain with inspiration. Treated with albuterol with immediate relief and better air exchange. Sent home with albuterol and monitoring


VAERS ID: 1592538 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A to covid-19 vaccination, not immunocompromised
Current Illness: N/A
Preexisting Conditions:
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: No adverse event, patient/spouse reported having no symptoms or side effects 3 days after vaccination. Patient came for "second covid vaccination" and was processed through system as Pfizer vaccine instead of the Moderna vaccine he had received for initial dosage due to several factors/miscommunication. Patient received Pfizer vaccine on 8-16-21 instead of the 2nd Moderna dose that he expected, but he did not vocalize which vaccine just brought in his card at last step of process. Intern administering vaccine did not remember to confirm with patient/double check the vaccine card and administered Pfizer vaccine (which was processed through Rx system mistakenly due to miscommunication with patient). Patient/spouse were concerned about receiving different manufacturers/differnet mRNA vaccines so VAERS report has been filed to report error. No adverse effects or side effects from vaccination, patient was just concerned that they received 1 dose of Moderna then 1 dose of Pfizer 4 weeks later instead of both Moderna doses.


VAERS ID: 1592546 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-12
Onset:2021-08-18
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 - / IM

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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. tested positive on 8/18/2021; she was asymptomatic that day. In afternoon of 8/19/2021 developed symptoms and called hotline and was swabbed on 8/20/2021- results pending. Covid positive after vaccination


VAERS ID: 1592573 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-08-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: breaking out in hives all over body


VAERS ID: 1592978 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Diarrhoea, Injection site erythema, Injection site pain, Malaise, Oropharyngeal pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Felt sick about 12 hours after the vaccine and still feeling sick a day and a half after. Have had chills, sore injection arm, sore throat and diarrhea. Now my arm is tingling and I have a red square swollen spot at injection site that has just come up. It is very painful and sore.


VAERS ID: 1592989 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-19
Onset:2021-08-18
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Condition aggravated, Malignant pleural effusion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Malignancy related conditions (narrow), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol inh PRN, vitamin D, gabapentin, levetiracetam, melatonin PRN, MVI, Percocet PRN, quetiapine PRN
Current Illness:
Preexisting Conditions: History of prior SAH and left internal carotid aneurysm rupture s/p coiling complicated by hydrocephalus requiring VP shunt and seizure disorder (2011) and chronic left abdominal mass (biopsy on 2013 suggestive of angiomyolipoma), recent diagnosed of malignant pleural effusion.
Allergies: NKDA
Diagnostic Lab Data: COVID status positive on 8/18/21.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 5/29/21 and 6/19/21. On 8/18/21, patient admitted to our facility with acute hypoxemic respiratory failure due to recurrent malignant pleural effusion on the right and COVID pneumonia. As of 8/21/21, patient is still admitted in the med/surg unit.


VAERS ID: 1592992 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Confusional state, Hallucination, Impulse-control disorder, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? 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: Around 10 hours after the injection of the shot I began to feel fever and soon after began to hallucinate, hear voices and violently shake. I began to hurt myself by hitting and pulling my hair out. I then ran out into the street in my underwear and called 911 as I was very confused and concerned I would seriously harm myself and others. I was handcuffed by the police but ran away. After being secured and transported to hospital I was administered a sedative drug and released after I was no longer involuntarily shaking.


VAERS ID: 1593176 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-19
Onset:2021-08-18
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19 pneumonia, Chronic obstructive pulmonary disease, Condition aggravated, Emphysema, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol inh PRN, alendronate, amlodipine, baby aspirin, atorvastatin, calcium, vitamin D, famotidine, ixekizumab inj, levothyroxine, lisinopril, methocarbamol, mirtazapine, propranolol, sulfasalazine, tiotropium inh
Current Illness:
Preexisting Conditions: Psoriatic arthritis on immunosuppression followed by outpatient rheumatology, previous CVA with no residual deficits in 2014, hypothyroid, pulmonary edema/COPD with continued tobacco abuse, hypertension hyperlipidemia.
Allergies: Diphenhydramine, green coffee bean, pineapple
Diagnostic Lab Data: COVID status positive on 8/19/21.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 2/3/21 and 3/19/21. On 8/18/21, patient presented to our ED Medical Center and ended up being admitted for acute hypoxemic respiratory failure due to COVID-19 pneumonia and acute uncompensated COPD/emphysema exacerbation. As of today (8/20/21), patient is still admitted in the med/surg unit.


VAERS ID: 1593196 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait disturbance, Muscle spasms
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Niphedipine, Lobetalol, Zyrelto
Current Illness: hypertension (current), pulmonary embolism 3 months prior. Resolved. Will be completing blood thinners by end of month.)
Preexisting Conditions: Hypertension (since March 2020)
Allergies: Lactose intolerant
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Same day after the 2nd shot, I started experiencing strong cramps in both my feet. I drank water and it resolved. But next day my feet and hands started cramping pretty hard and for longer. Not sure what?s going on. Didn?t happen with first dose. Did not have these symptoms b4. Now left foot so cramped I can barely walk. Haven?t seen a dr yet.


VAERS ID: 1593216 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cold sweat, Decreased appetite, Fatigue, Headache, Hyperhidrosis, Nausea, Pain, Pain in extremity, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Fever chills fatigue for 48 hrs.
Other Medications: Aubagio 14mg Amlodipine 5mg Trintellex 5mg Ozempic 1mg
Current Illness:
Preexisting Conditions: Multiple sclerosis Hypertension Diabetes type 2
Allergies: Narcotic allergy- anaphylactic to oxycodone, hydrocodone, tramadol, dilaudid. Morphine. Latex allergy Cymbalta
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, nausea, vomiting, body aches, fatigue, headache, sore left arm, can?t lift left arm for 48 hrs due to pain, sweating and clammy on head, neck, inner elbows and behind knees. Barely No appetite for 24 hrs. Day 3 still got chills and fever and clammy body with sweating and fatigue.


VAERS ID: 1594436 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210837359

Write-up: HEADACHE; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On AUG-2021, treatment medications included: ivermectin. On 18-AUG-2021, the patient experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of headache was not reported. This report was non-serious.


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