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From the 1/21/2022 release of VAERS data:

Found 1,049,249 cases where Vaccine is COVID19 and Patient Did Not Die

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 111 out of 10,493

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VAERS ID: 2010231 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855191 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: The Janssen Covid 19 vaccine was given to Clancey, who is 16 years old. This vaccine is only approved for 18 and older.


VAERS ID: 2010253 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-12-28
Onset:2021-12-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041J21A / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Night sweats
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin Vitamin D Folic acid Testosterone cypionate
Current Illness: n/a
Preexisting Conditions: beta thalassemia minor
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: night sweats starting on N2 and continuing for 1 week


VAERS ID: 2010455 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-12-29
Onset:2021-12-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3197 / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Covid-19 test
CDC Split Type: vsafe

Write-up: I had fever, chill, cough, serve headache, congestive and unable to sleep. These lasted for about a week. I call my healthcare provider. She wanted to have the antibody fusion. On Jan 2nd, I got test for Covid-19, positive result.


VAERS ID: 2010459 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7218 / 3 LA / IM

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

Write-up: Patient received Dose 1 of COVID-19 12Y+ Pfizer-BioNtech on 6/14/2021, Dose 2 of COVID-19 12Y+ Pfizer-BioNtech on 12/8/2021, and Booster dose on 12/30/2021. Per CDC guidelines if the second dose is administered beyond 6 weeks (42 days) there is no need to restart the series. Booster dose should have been given 6 months after 2nd dose. Booster dose given too soon.


VAERS ID: 2010498 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (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: Per error, given expired Covid vaccine. no apparent adverse reaction


VAERS ID: 2010520 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-21
Onset:2021-12-30
   Days after vaccination:253
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose increased, COVID-19, Chest X-ray abnormal, Chills, Cough, Lung opacity, Nausea, Pyrexia, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Peritoneal dialysis, diabetes
Allergies: unknown
Diagnostic Lab Data: 12/30/2021: SarsCOV2-positive. Chest x-ray: Scattered ground-glass densities throughout the right lung. The asymmetric appearance of this pathology is not classic for Covid infection.
CDC Split Type:

Write-up: 12/30/2021: Event occurred after 2nd vaccine. Presenting with 4 days of fevers, chills, fever and cough. She took blood sugar at home was found to be 1200 at which time she presented to the emergency department. She has not had a peritoneal dialysis today. She has had occasional nausea and vomiting but denies any chest pain or shortness of breath. Patient denies: Diarrhea, fever, urinary symptoms, blurred vision, back pain, palpitations, dizziness, shortness of breath, and rash. 01/06/2022: Completed remdesivir therapy. Remains in hospital.


VAERS ID: 2010535 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product storage error
SMQs:, Medication errors (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: Per error, given expired Covid vaccine. no apparent adverse reaction


VAERS ID: 2010548 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-17
Onset:2021-12-30
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 - / UN

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest X-ray abnormal, Cough, Exposure to SARS-CoV-2, Fall, Lung infiltration, Pleural effusion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: dementia, kidney disease, hypertension, CKD 3, CAD, CHF
Allergies: unknown
Diagnostic Lab Data: 12/30/2021; COVID test positive CXR showing stable bilat infiltrates/effusions,
CDC Split Type:

Write-up: 12/30/2021: Event occurred after 2nd vaccine. 89-year-old male with a history of mechanical falls on Eliquis for pacemaker presenting for a fall at approximately 3 hours ago. He was too weak to get up after he fell. He states that he fell this time because of weakness and denies any syncope or shortness of breath . He also has a new onset cough and recent exposure to Covid positive people. Patient denies: vomiting, Diarrhea, fever, urinary symptoms, blurred vision, sore throat, back pain, palpitations, dizziness, shortness of breath, rash. COVID test positive in ED. 01/06/2021: remains in hospital.


VAERS ID: 2010596 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product storage error
SMQs:, Medication errors (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: Per error, given expired Covid vaccine. no apparent adverse reaction


VAERS ID: 2010603 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-10-04
Onset:2021-12-30
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Feeling abnormal, Influenza like illness, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: I JUST DID NOT FEEL GOOD I HAD A SEVERE SORE THROAT I GOT THE CHILLS & SO I SLEPT IN A SEPARATE BEDROOM FROM MY HUSBAND I THOUGHT I HAD INFLUENZA A & THE NEXT MORNING MY THROAT WAS EVEN WORSE SO I TOOK A HOME COVID TEST & IT WAS POSITIVE & THEN I WENT TO DRS NOW POP UP SITE & THEY CONFIRMED I WAS COVID POSITIVE & THEN I WENT TO URGENT CARE & WAS TESTED A 3RD TIME & IT WAS POSIITVE SO THE DR RECOMMENDED FOR MONOCLONAL ANTIBODY INFUSION & THEN I WENT HOME & I ISOLATED IN MY ROOM FOR 4 DAYS AND I JUST SLEPT & STAYED HYDRATED I TOOK OVER THE COUNTER MUCINEX DM.


VAERS ID: 2010613 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-12-22
Onset:2021-12-30
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032H21A / 3 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypersensitivity, Rash, 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Loratadine, Cetirizine
Current Illness: None
Preexisting Conditions: Hay fever (dust and mold allergy)
Allergies: None
Diagnostic Lab Data: Urgent care visit 1/1/2022
CDC Split Type:

Write-up: Hives and allergic reaction, rash on arms, chest, other places Went to urgent care facility on 1/1/2022 and was treated with steroids (methylprednisone and others), antihistamines (loratadine, Benadryl) Rash fading as of 1/6/2022


VAERS ID: 2010618 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 025L20A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Patient experience similar but more severe adverse effects from original COVID-19 Moderna primary series received in Dec 2020 an
Other Medications: -Amlodipine 10mg qD -Losartan 25mg qD -Men''s multivitamin qD -Vitamin D 5000IU capsule qD
Current Illness: N/A
Preexisting Conditions: Hypertension, stage 1
Allergies: No known food or drug allergies
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Fatigue, headache, soreness around injection site lasting approximately 12 hours.


VAERS ID: 2010627 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (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: Per error, given expired Covid vaccine. no apparent adverse reaction


VAERS ID: 2010640 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-06
Onset:2021-12-30
   Days after vaccination:327
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray normal, Condition aggravated, Hypertension, Mental status changes, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: hypertension, PTSD
Allergies: unknown
Diagnostic Lab Data: 12/31/2021: SarsCOV2-positive IMPRESSION: chest 12/30/2021: No acute pulmonary process.
CDC Split Type:

Write-up: 12/30/2021: Event occurred after 2nd vaccine.. 71-year-old male with a history of hypertension, PTSD, presenting to the ED today for altered mental status. On ED arrival was noted the patient was significantly hypertensive. Patient is a poor historian, however I am concerned because of his significant change in mental status over the last 24 hours. positive for COVID-19. 01/06/2022; remains in hospital. Completed remdesivir therapy


VAERS ID: 2010651 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-12-28
Onset:2021-12-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait disturbance, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pt just had hip replacement a few weeks before getting his booster shot. Attending physical therapy
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt had hip replacement weeks before receiving the booster dose of Moderna. He went to physical therapy after having his booster dose. The day after physical therapy, every muscle they had worked on in therapy as well as his surgery site was extremely sore and sensitive to the point he couldn''t even walk, unlike his other physical therapy appointments. These symptoms got progressively better over the next day, and went away by day 3 after physical therapy.


VAERS ID: 2010677 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-12-29
Onset:2021-12-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028K21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling hot, Gait disturbance, Headache, Heart rate increased, Pain, Pain in extremity, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergies
Preexisting Conditions: Chest pain due to rib that hits a nerve ending in my spine.
Allergies: Trees; grass
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: It started off my smart watch advised me that heart rate was higher than 120 with no activity for 10 min when I checked my heart rate it told me it was beating at 146 beats per min and then it climbed from there to 164, then I was feeling really hot I took my lunch at work and took my temp, which was 101.9 and then from there I just layed down and tried to take a nap but could not I was shivering and my body was completely aching and I had sharp pain in my left hand right below my thumb in between my joint, it would hurt when I tried to sit up or move it was just that one spot that would hurt. I kept having a fever and took ibuprofen and that did not take any effect but hours later I took Tylenol, that helped a little bit and later in the evening my fever went down to 99.4 and stayed down for awhile but came right back. I could not really walk, I was shivering and my body ached, and I would have a headache in and out as well, my heart rate would go back up to like 140 to 150. The next day I woke up to another fever and took Advil Dual action, and it helped some it would go up and down, and then by the middle of the day the fever finally broke and the soreness went away and I have been better since then and everything is back to normal.


VAERS ID: 2010864 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33130BA / 3 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Cold sweat, Feeling cold, Loss of consciousness, Nausea, Palpitations, Presyncope, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: rinvoq (15mg daily), nurtec every other day, vitamin d 2,000 iu daily, vitamin c 1,000 mg 3x week
Current Illness:
Preexisting Conditions: rheumatoid arthritis, crohn?s, sj?gren?s syndrome, chronic migraine, tinnitus
Allergies: allergic to hydroxychloroquine and penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 1-2 minutes post vaccination, I started becoming extremely nauseous and while looking around for a trash can in case needed, I began blacking out. My vision got narrower and narrower and darker. I called a nurse over who brought me back to lie down. An EMT checked and my vitals were fine but my heart was racing and I was extremely cold and clammy. They had me lie down and gave me a bottle of water while I recovered from nearly passing out. Symptoms fully resolved within 20 minutes.


VAERS ID: 2011218 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-12-15
Onset:2021-12-30
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045J21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: covid+


VAERS ID: 2011225 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-12-29
Onset:2021-12-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Injection site erythema, Injection site swelling, Lymphadenopathy, Migraine, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Red and swollen injection site. Swollen lymph nodes, lasting 2 days. Fever and uncontrollable chills lasting 6 hours. Intense joint pain lasting 6 hours. Migraine is still ongoing 8 days later.


VAERS ID: 2011229 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-28
Onset:2021-12-30
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: covid+


VAERS ID: 2011234 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-12-20
Onset:2021-12-30
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 2 LL / IM

Administered by: Private       Purchased by: ?
Symptoms: Alopecia
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:

Write-up: Mild alopecia (both sideburns and couple of spots in in the back.)


VAERS ID: 2011262 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-12-09
Onset:2021-12-30
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F58757 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Chest X-ray, Computerised tomogram
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dovato
Current Illness: None
Preexisting Conditions: HIV, HSV
Allergies: Sulfa
Diagnostic Lab Data: CT, BLOOD WORK, CHEST XRAY
CDC Split Type:

Write-up: Developed Bells Palsy R side of face within 3 weeks of the booster which was my 3rd pfizer Covid shot


VAERS ID: 2011390 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Impaired work ability, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Had body aches and felt tired and weak when I took second COVID vaccine in April 2021.
Other Medications: Wixela 250/50, Mesalamine 1.2 g 4 tablets, Atorvastatin, Albuterol Inhaler, Adderall
Current Illness:
Preexisting Conditions: Shortness of breath (Asthma)
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: High Fever (Body temperature went up to 102 F.) Weakness and Body aches. Shortness of Breath starting Thursday 12/30 and continued till 1/3. Taking Wixela and Albuterol but did not seem to have helped. Set up appointment with local Care facility for 12/31 evening. Took Spiriva on Friday Night and DuoNeb on Saturday Morning per recommendation. They seemed to have helped but shortness of breath was still there. Visited Urgent Care (but had a virtual visit) on 1/1 and was suggested to wait until Fever goes down. Asked me to continue on Wixela and Albuterol only. On Sunday 1/2. the fever seemed to have gone down but was feeling weak. 1/3- Was still feeling weak so did not log in for work (remote). 1/4- Was feeling much better and was able to log in and work.


VAERS ID: 2011618 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-29
Onset:2021-12-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041J21A / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Cough, Dyspnoea, Headache, Oropharyngeal pain, Pain, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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: Had similar adverse reactions after the 1st dose of Moderna on 4/22/21. Age at time of 1st dose: 28 years.
Other Medications: Pulmicort Flexhaler 180 mcg
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: Bananas, peanuts, hazelnuts
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dec 30 2:30 AM - body aches, chest pain, difficulty breathing Dec 30 4:00 AM - chest pain, difficulty breathing Dec 30 6:30 AM - chest pain, difficulty breathing Jan 3 4:00 PM-9:00 PM - difficulty breathing, headaches, dry cough Jan 5 4:00 PM - 6:00 PM - difficulty breathing, sore throat, dry cough Jan 6 2:30 PM - 3:30 PM - chest pain, difficulty breathing, increasing heart rate for 1 hour (greater than 117 bpm) Jan 6 4:30 PM - 6:00 PM - chest pain, difficulty breathing, intense wheezing


VAERS ID: 2011619 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-12-21
Onset:2021-12-30
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855191 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Decreased appetite, Feeling abnormal, Headache, Impaired work ability, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started 12/30/21 with chill and a headache that is currently on day seven. . Three days ago I added muscle and joint pain to my growing list of adverse reactions. It hurts everywhere in my body. I feel strange and have barely eaten anything over the past 3 days. I also have had a low grade fever of the past three days. I have had to call in sick for work for the past three days.


VAERS ID: 2014054 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33130BA / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose normal, Cold sweat, Seizure, Skin discolouration
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Per pt has had reactions to vaccines in the past, unable to verify due to not administering vaccines to pt prior to this visit.
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: Glucose reading: 106 BP: 122/76 HR: 84 PO: 99
CDC Split Type:

Write-up: Pt came in for Pfizer Booster. After administration pt asked for a glass of water. When returning with glass of water, pt''s girlfriend, was yelling for help. Upon entering room pt was in chair convulsing, clammy and noted color change. Pt was breathing and able to answer questions. Alerted MA to get provider. While in room convulsing lasted for 10-15 seconds. BP was 122/76, HR 84 and PO 99. Provider assessed pt and requested glucose reading. Glucose reading 106. Juice and snacks provided. Pt advised to wait in office for 30 minutes. Continued 5 minute checks on pt. Pt alert and oriented. After 30 minutes assessed by provider. Pt continued to be free of symptoms and feeling better, pt then left office.


VAERS ID: 2014203 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-12-19
Onset:2021-12-30
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033H21A / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Chills, Influenza virus test negative, Peripheral swelling, SARS-CoV-2 test negative, Streptococcus test negative, Swelling face, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 2 Negative COVID19 tests. Blood test where almost all values came back normal. Strep test: Negative Infuenza Test: Negative.
CDC Split Type:

Write-up: 11 days after vaccination I broke out in hives; had swelling in my face; feet; hands; chills.


VAERS ID: 2014240 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-26
Onset:2021-12-30
   Days after vaccination:307
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol, floranex, augmentin, colace, luvox, medrol, spiriva, zincate, ducolax, zyrtec, pepcid, lopressor, lotrimin, seroquel, senokot, valproic acid
Current Illness:
Preexisting Conditions: cerebral palsy, mental disability
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received moderna vaccines on 02/26/21 and 03/23/21. Pt presented to the ED on 12/30/21 with complaints of SOB while at nursing home. Pt was found to have an oxygen saturation in the 70s. Upon arrival to the ED, pt was placed on supplemental oxygen and was found to be COVID positive.


VAERS ID: 2014267 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041J21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Decreased appetite, Dry skin, Illness, Musculoskeletal stiffness, Periorbital swelling, Pruritus, Rash, Swelling, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Have a rash on her neck and her mouth. Stiffness in her neck and tongue is swollen on the left side. Chest pain from the front to the back. Her face is swollen and she has puffy eyes. She also has a big bump on the side of her neck and she feels dry and itchy. She has no appetite and she feels sick all over. Everywhere she feels bad at is on the left side where she took the vaccine at.


VAERS ID: 2014316 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-04
Onset:2021-12-30
   Days after vaccination:301
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 2 - / -

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

Write-up: HOSPITALIZATION WITH COVID-19 BREAKTHROUGH CASE 1/5/22 - ongoing


VAERS ID: 2014372 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330308D / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: PFIZER vaccine that was stored in pharmacy refrigerator given outside of 31 day expiration. Vaccine received at hospital on 11/19/2021. Expiration date on vial 02/2022. NDC# 59267100001


VAERS ID: 2014376 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330308D / 3 RA / IM

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

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

Write-up: PFIZER vaccine that was stored in pharmacy refrigerator given outside of 31 day expiration. Vaccine received at hospital on 11/19/2021. Expiration date on vial 02/2022. NDC# 59267100001


VAERS ID: 2014381 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330308D / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: PFIZER vaccine that was stored in pharmacy refrigerator given outside of 31 day expiration. Vaccine received at hospital on 11/19/2021. Expiration date on vial 02/2022. NDC# 59267100001.


VAERS ID: 2014386 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330308D / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: PFIZER vaccine that was stored in pharmacy refrigerator given outside of 31 day expiration. Vaccine received at hospital on 11/19/2021. Expiration date on vial 02/2022. NDC# 5926710000


VAERS ID: 2014394 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330308D / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: PFIZER vaccine that was stored in pharmacy refrigerator given outside of 31 day expiration. Vaccine received at hospital on 11/19/2021. Expiration date on vial 02/2022. NDC# 59267100001.


VAERS ID: 2014395 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330308D / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: PFIZER vaccine that was stored in pharmacy refrigerator given outside of 31 day expiration. Vaccine received at hospital on 11/19/2021. Expiration date on vial 02/2022. NDC# 59267100001


VAERS ID: 2014458 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330308D / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: PFIZER vaccine that was stored in pharmacy refrigerator given outside of 31 day expiration. Vaccine received at hospital on 11/19/2021. Expiration date on vial 02/2022. NDC# 5926710000


VAERS ID: 2014540 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041J21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest pain, Decreased appetite, Feeling abnormal, Headache, Musculoskeletal stiffness, Paranasal sinus hypersecretion, Rash, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: back/chest pain, headache, rash on face and neck, face swollen, feel like trash, bumps on face, stiff neck, swollen tongue, no appetite, sinuses draining


VAERS ID: 2014685 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-02-17
Onset:2021-12-30
   Days after vaccination:316
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 - / IM

Administered by: Private       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, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient hospitalized.


VAERS ID: 2014721 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-17
Onset:2021-12-30
   Days after vaccination:288
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, COVID-19 pneumonia, Dialysis, Endotracheal intubation, Mechanical ventilation, Renal failure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Angioedema (broad), Interstitial lung disease (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: acute respiratory distress, COVID-19 pneumonia, intubated on ventilator, Renal failure requiring dialysis,


VAERS ID: 2014751 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-12-09
Onset:2021-12-30
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Illness, Product dose omission issue, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Medication errors (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: Unknown
Preexisting Conditions: Asthma, Lupus, Fibromyalgia
Allergies: PCN, Pineapple, Tomato
Diagnostic Lab Data: COVID-19 PCR positive 1/1/22
CDC Split Type:

Write-up: Pt received first dose of Moderna COVID-19 vaccine on 12/9/2021. Around 12/30/2021 she developed SOB which worsened over 2 days. She presented to the hospital 1/1/22 at which point she was diagnosed with acute COVID-19. She became ill before she could complete the series


VAERS ID: 2014778 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-30
Onset:2021-12-30
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 - / IM

Administered by: Private       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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient hospitalized


VAERS ID: 2014851 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-12-30
   Days after vaccination:279
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Exposure to SARS-CoV-2, Feeling hot, Productive cough
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: He stated that he had a positive COVID contact and personally feels mildly short of breath and felt warm at home. He also feels that he has a mildly productive cough and denies any history of bronchitis


VAERS ID: 2014855 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-03
Onset:2021-12-30
   Days after vaccination:330
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: resides in when on entire is a where 5 other residents on her floor have tested positive for COVID. The past couple of days she has had worsening cough but has not had a significant shortness of breath. Because of her symptoms she had a COVID swab done on 01/01 which was positive. Because of her ongoing cough EMS was called. She was placed on 10 L non-rebreather while in route to the emergency department.


VAERS ID: 2014857 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-08
Onset:2021-12-30
   Days after vaccination:297
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Hypervolaemia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Shortness of Breath (Pt presents to ED via EMS with complaints of SOB and being fluid over loaded. Her and husband were covid tested yesterday and result is positive. Pt uses 3 liters of oxygen at home at baseline. )


VAERS ID: 2014858 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-23
Onset:2021-12-30
   Days after vaccination:341
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID infection (diagnosed 12/30, fully vaccinated with booster) who presents with fever.


VAERS ID: 2014922 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-23
Onset:2021-12-30
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 070H214 / 3 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide, Chest discomfort, Dyspnoea exertional, Electrocardiogram, Fibrin D dimer, Full blood count, Heart rate irregular, Laboratory test, Metabolic function test, Tachycardia, Troponin
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin 10mg daily, HCTZ 12.5mg daily, Losartan 100mg daily, Pantoprazole 40mg daily
Current Illness: None
Preexisting Conditions: Anxiety, elevated fasting glucose, HTN, GERD
Allergies: Isoniazid, Vicodin
Diagnostic Lab Data: We did labs including Troponin, D-dimer, crp, BNP CBC, CMP, ECG all of which were normal on 1/4/2022 for labs and 1/7/2022 for ECG but by then symptoms had resolved
CDC Split Type:

Write-up: Patient states he did not have significant side effects after the Moderna booster until about 7 days after the shot (about 12/30/21), but then started having dyspnea with exertion, tachycardia and feeling of irregular heart and also had mild chest discomfort. This lasted for a few days off an on and eventually resolved by 1/4/2022


VAERS ID: 2014938 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-09
Onset:2021-12-30
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood test, Chills, Electrocardiogram, Fatigue, Heart rate increased, Musculoskeletal pain, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro; biotin; daily vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG and blood work.
CDC Split Type: vsafe

Write-up: Covid symptoms started on 12/30/21. I initially had fever, chills, and body aches and specifically my back was really hurting and that lasted for 4 days. The fever was on and off for 4-5 days as well. It was kind of your typical symptoms and I was better during the day than night time. On the 4th day I started experiencing a high heart rate when standing and the only reason I knew that was because I was checking my pulse ox because I was getting bad pain behind my shoulder blade and I could see my heart rate was jumping really high, but if I sat back down it would return to resting heart rate of 52 BPM. As soon as I would get up it would go to 130-140 but I never got dizzy. I went to the ER and they did an EKG and blood work and said it wasn''t an emergency and to go home. That was day 5. On Day 6 I felt a little better and wasn''t getting as high of a heart rate, and by day 8 and 9 I was back to normal. The whole time I had fatigue and I had probably had it for probably a month.


VAERS ID: 2015750 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-29
Onset:2021-12-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dizziness postural, Vaccine positive rechallenge
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: Liothyronine, levothyroxine, Crestor
Current Illness: None
Preexisting Conditions: hypothyroidism
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme dizziness/lightheadedness when standing up from a reclined position. This happened after my 2nd dose as well and lasted for several months. It started happening again after my booster dose.


VAERS ID: 2015751 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adnexa uteri pain, Back pain, Fatigue, Pain, Pain in extremity, Polymenorrhoea, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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: Arm pain after annual flu vaccines
Other Medications: Zyrtec
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: First shot had some arm pain. Second shot, blood sugar impacted because I had not eaten much that day. Felt tired/fatigued for about 36 hours starting after the shot on 14May2021. Took 2 extra strength Tylenol (500mg per pill) on 15May2021 around 1pm. Third dose: fatigue started around 7:30 pm 30Dec2021. Woke around 1:30am 31Dec2021 and had low grade fever. Was feverish and had aches/pains throughout the day until about 9pm on 31Dec2021. Took 2 extra strength Tylenol about every 6 hours, a total of 6 pills. Was also on my period at the time of the shot and had lower back pain/ovary pain. My flow was somewhat interrupted on 31Dec2021 but then continued as normal on 01Jan2022.


VAERS ID: 2016414 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-12-29
Onset:2021-12-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Balance disorder, Cold sweat, Decreased appetite, Dizziness, Fatigue, Head injury, Headache, Hyperhidrosis, Loss of consciousness, Lymph node pain, Lymphadenopathy, Mobility decreased, Nausea, Neck pain, Pain, Pain in extremity, Seizure like phenomena, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Convulsions (narrow), Parkinson-like events (broad), 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), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall 20mg 2x per day, 5,000mcg vitamin D3, Zyrtec,
Current Illness: Motion sickness/vertigo 12/10-12/17
Preexisting Conditions:
Allergies: Diclofenac, midrin, mircet
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Recieved vaccine at 4pm 12/29/2021 and next morning I woke up with a sore arm. About 11am I started to feel very tired, run down feeling and achy/sore, later in the afternoon about 3/4 I started getting very nauseous to the point where I could not eat anything more than an dry English muffin. I went to bed at 5:30pm having a headache and feeling nauseous. When I woke up in the middle of the night the nausea was gone but I was in a lot of pain so I went back to bed. 5 am 12/31 I woke up to get ready for work, my lower back hurt very bad, my left arm was so painful I could barely move it, and the left side of my neck was sore. I managed to get almost fully ready for work when I was brushing my teeth I touched my neck because it was so painful and I noticed I had a large swollen lymph node on my left collarbone. As I was touching it I realized it was very tender. Next thing I know I get very dizzy, lightheaded and nauseous and held onto the sink in my bathroom to steady myself but I had a syncopal event and woke up on the floor with my father holding my head. My father said as I was down he thought I had some seizure activity he held my head until I was alert. When I sat up from that I was drenched in a cold sweat. This had happened about 5:35am 37.5hrs after receiving the vaccine. Once I recovered from passing out I made my way to sit at the kitchen table. I was sitting in a chair at the table for about 10 minutes before I started to feel dizzy and nauseous again so I lowered myself to the floor where I sat for a couple more minutes but the dizziness and nausea intensified til I layed on my left side on the floor and then broke out in a cold sweat again but managed to stay alert. I drank some water and recovered for about 20 mins before deciding to go back to sleep. At this point I was exhausted, having a lot of body pain, and now a headache. When I woke up at 9:30am I still had a headache from hitting my head when I fell and was sore, exhausted. As the day went on symptoms lessened. By 3pm I was only left with a sore spot on my head where I hit it, and a mild headache, otherwise back to feeling myself.


VAERS ID: 2016419 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-11-30
Onset:2021-12-30
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Fatigue, Head discomfort, Headache, Loss of personal independence in daily activities, Migraine
SMQs:, Anticholinergic syndrome (broad), Dementia (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: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Brain pressure, migraine headache and severe dizziness first night after vaccine. Dizziness and headache lasted for up to a week (though not as severe). Fatigue. Barely able to keep up with daily tasks.


VAERS ID: 2017548 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:2021-10-29
Onset:2021-12-30
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939904 / 2 RA / OT

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Cough, Headache, Nasal congestion, Pain, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211230; Test Name: COVID-19 antigen test; Result Unstructured Data: negative; Test Date: 20211231; Test Name: Body temperature; Result Unstructured Data: 100 F; Test Date: 20220102; Test Name: COVID-19 PCR test; Result Unstructured Data: awaiting result
CDC Split Type: USJNJFOC20220104603

Write-up: BODY ACHES; CONGESTION; HIGH FEVER; HEADACHES; COUGH; This spontaneous report received from a patient concerned a female of unspecified age, race and ethnic origin. The patient''s height and weight were not reported. No past medical history or concurrent conditions were reported. The patient previously received with covid-19 vaccine ad26.cov2.s (Dose number in series 1) (suspension for injection, route of admin not reported, batch number: 1805031, Expiry: unknown) dose was not reported, frequency one total administered at right arm on 15-MAR-2021 for prophylactic vaccination. It was unknown whether the patient had any adverse events following vaccination with covid-19 vaccine ad26.cov2.s (Dose number in series 1). The patient received a booster of non-company suspect vaccine included: mrna 1273 (form of admin and route of admin were not reported, batch number: 939904, expiry: unknown) dose was not reported, administered at right arm on 29-OCT-2021 for prophylactic vaccination (dose number in series 2). No concomitant medications were reported. On 30-DEC-2021, the patient experienced cough and headaches (Dose number in series 2). Laboratory data included: COVID-19 antigen test (NR: not provided) negative. On 31-DEC-2021, the patient experienced body aches, congestion, and high fever (Dose number in series 2). Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 100 F. On 02-JAN-2022, Laboratory data included: COVID-19 polymerase chain reaction (PCR) test (NR: not provided) awaiting result. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The action taken with mrna 1273 was not applicable. The patient recovered from body aches, high fever and headaches on 02-JAN-2022 and had not recovered from cough and congestion. This report was non-serious.


VAERS ID: 2017592 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-12-30
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, 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: Test Date: 20211230; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20220108095

Write-up: COVID-19 TEST POSITIVE; This spontaneous report received from a consumer concerned a patient of unspecified age and sex. 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: 1808986, and expiry: 02-OCT-2021) dose was not reported, administered on 27-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 30-DEC-2021, the patient experienced covid-19 test positive. Laboratory data included: COVID-19 virus test (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of covid-19 test positive was not reported. This report was non-serious.


VAERS ID: 2017600 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-12-30
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855191 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20220109746

Write-up: OUT OF SPECIFICATION PRODUCT USE (VIAL WAS PUNCTURED APPROXIMATELY 28-DEC-2021 AT 9:00 AND THEN DOSE WAS ADMINISTERED TO THE PATIENT ON 30-DEC-2021 AT 9:00 IN THE MORNING); This spontaneous report received from a health care professional concerned a 25 year old male. 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: 1855191, expiry: UNKNOWN) dose was not reported, administered on 30-DEC-2021 09:00 for prophylactic vaccination. No concomitant medications were reported. On 30-DEC-2021, the patient experienced out of specification product use (vial was punctured approximately 28-dec-2021 at 9:00 and then dose was administered to the patient on 30-dec-2021 at 9:00 in the morning). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of out of specification product use (vial was punctured approximately 28-dec-2021 at 9:00 and then dose was administered to the patient on 30-dec-2021 at 9:00 in the morning) was not reported. This report was non-serious.


VAERS ID: 2017802 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-12-29
Onset:2021-12-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 070H21A / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Urticaria, Vaccination site mass
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20224

Write-up: hives in left arm are really bad; Big knot in the left arm/knot went down; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (hives in left arm are really bad) and VACCINATION SITE MASS (Big knot in the left arm/knot went down) in a 78-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 070H21A) for COVID-19 vaccination. No Medical History information was reported. On 29-Dec-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Dec-2021, the patient experienced VACCINATION SITE MASS (Big knot in the left arm/knot went down). On an unknown date, the patient experienced URTICARIA (hives in left arm are really bad). At the time of the report, URTICARIA (hives in left arm are really bad) outcome was unknown and VACCINATION SITE MASS (Big knot in the left arm/knot went down) was resolving. After the booster dose, patient had a big knot in the left arm that appeared on 30-dec-2021 and it went down on 01-jan-2022 but was still there. It was reported that concomitant medication included 7 or 8 of them. No treatment medication were reported. This case was linked to MOD-2022-437506 (Patient Link).


VAERS ID: 2017809 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033H21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20224

Write-up: 12 year old received a dose of Moderna; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (12 year old received a dose of Moderna) in a 12-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 033H21A) for COVID-19 vaccination. No Medical History information was reported. On 30-Dec-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Dec-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (12 year old received a dose of Moderna). On 30-Dec-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (12 year old received a dose of Moderna) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication reported. No treatment information was provided.


VAERS ID: 2017896 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 084J21A / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20224

Write-up: Moderna vaccine given to a 9 years old child; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Moderna vaccine given to a 9 years old child) in a 9-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 084J21A) for COVID-19 vaccination. No Medical History information was reported. On 30-Dec-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Dec-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Moderna vaccine given to a 9 years old child). On 30-Dec-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Moderna vaccine given to a 9 years old child) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitants were provided. No treatment was provided.


VAERS ID: 2017900 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066H21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Accidental underdose, Device connection issue
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: USMODERNATX, INC.MOD20224

Write-up: Caregiver possibly received a partial dose of the Moderna booster/Not sure what amount of vaccine the caregiver received; It seemed that the needle wasn''t fully attached and some of the vaccine leaked out during administration; This spontaneous case was reported by a nurse and describes the occurrence of ACCIDENTAL UNDERDOSE and DEVICE CONNECTION ISSUE (It seemed that the needle wasn''t fully attached and some of the vaccine leaked out during administration) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 066H21A) for COVID-19 vaccination. No Medical History information was reported. On 30-Dec-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Dec-2021, the patient experienced ACCIDENTAL UNDERDOSE (Not sure what amount of vaccine received) and DEVICE CONNECTION ISSUE (It seemed that the needle wasn''t fully attached and some of the vaccine leaked out during administration). On 30-Dec-2021, ACCIDENTAL UNDERDOSE (not sure what amount of vaccine received) and DEVICE CONNECTION ISSUE (It seemed that the needle wasn''t fully attached and some of the vaccine leaked out during administration) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications were provided.


VAERS ID: 2017903 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028K21A / 3 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20224

Write-up: 16 year old patient was mistakenly given the Moderna COVID 19 vaccine booster; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 year old patient was mistakenly given the Moderna COVID 19 vaccine booster) in a 16-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028K21A) for COVID-19 vaccination. Previously administered products included for COVID-19 vaccination: Pfizer COVID 19 vaccine and Pfizer COVID 19 vaccine. Past adverse reactions to the above products included No adverse event with Pfizer COVID 19 vaccine and Pfizer COVID 19 vaccine. On 30-Dec-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Dec-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 year old patient was mistakenly given the Moderna COVID 19 vaccine booster). On 30-Dec-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 year old patient was mistakenly given the Moderna COVID 19 vaccine booster) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. It was reported that the patient who received Pfizer COVID 19 vaccine as primary doses was mistakenly given the Moderna COVID 19 vaccine booster. No concomitant medication were reported. No treatment information was reported.


VAERS ID: 2018338 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dizziness, Seizure
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Seizure disorder, bipolar disorder, cigarette smoker, Horizon 14 Disease
Allergies: Penicillins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Seizure, dizziness, weakness


VAERS ID: 2018351 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-12-29
Onset:2021-12-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33025BD / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Joint noise, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: COVID dose 2, as described previously
Other Medications: Vitamin D, Zinc
Current Illness: Headache, possibly influenza 3 weeks prior
Preexisting Conditions: none
Allergies: Pen
Diagnostic Lab Data: None. Self care. I have not reported these events to my doctor because online research indicated that rest of the associated muscles was the best course of treatment for minor rotator cuff injuries.
CDC Split Type:

Write-up: Weakening of rotator cuffs and cracking of shoulders. Occurs identically in both shoulders. This occurred one week after Dose 2 as well, and persisted for several months, including a shoulder injury that occurred during non-strenuous activity (throwing frisbee), but was unreported. I was unable to do work above my shoulders without tremendous pain for about 2 months. I could not do pushups or military press without risking injury. The condition improved after 3 months, and I was back to normal prior to getting boosted. One day after getting boosted, the same weakness and joint cracking returned and has not abated. This is not due to the physical administration of the vaccine because the pain/weakening is identical in both shoulders. The pharmacy staff who administered the vaccine did an outstanding job.


VAERS ID: 2019102 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-02
Onset:2021-12-30
   Days after vaccination:272
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Fatigue, Nasal congestion, Pyrexia, Renal impairment, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, CVA with Right sided Hemiparesis, Gout, CKD stage3
Allergies: No know allergies
Diagnostic Lab Data: SARS CoV AG-Positive
CDC Split Type:

Write-up: Covid19 breakthrough. 1st vaccine received on 03/12/2021. 73 y/o with PMHx of HTN, CVA, CKD, and gout presents to ED with c/o nasal congestion, cough, fatigue and fever. Pt tested Covid + in office and was advised to the ED for increased SOB and labored breathing. Pt febrile, placed on O2 2L NC, pt states feels better. Treated with steroids. Remdesivir held due to kidney fx.


VAERS ID: 2019153 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bone pain, Immunisation, Mass, Myalgia, Pain in extremity, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202200000883

Write-up: I noticed a lump under my shoulder area leading to my breast; I had muscle and bone pain the next day; I had muscle and bone pain the next day, my knee caps were even hurting; My heart was throbbing; There was pain on the arm that I got the vaccine on. On Saturday the pain in the arm where I received the vaccine had progressed.; Dose received 3; This is a spontaneous report received from a contactable reporter (consumer or other non HCP). The reporter is the patient. A 50-year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administration date 30Dec2021 at 19:45 (Lot number: unknown) at the age of 50 years as dose 3 (booster), single for COVID-19 immunisation. The patient had no relevant medical history and no concomitant medications. Vaccination history included: Bnt162b2 (DOSE 1, SINGLE, Lot Number: UNKNOWN, Route of Administration: Unspecified), administration date: an unknown date in May2021, when the patient was 49 years old, for COVID-19 immunisation and Bnt162b2 (DOSE 2, SINGLE, Lot Number: UNKNOWN, Route of Administration: Unspecified), administration date: an unknown date in Jun2021, for COVID-19 immunisation. The following information was reported: IMMUNISATION (non-serious) with onset 30Dec2021 at 19:45, outcome "unknown", described as "Dose received 3"; MYALGIA (non-serious) with onset 31Dec2021 at 19:45, outcome "not recovered", described as "I had muscle and bone pain the next day"; BONE PAIN (non-serious) with onset 31Dec2021 at 19:45, outcome "not recovered", described as "I had muscle and bone pain the next day, my knee caps were even hurting"; PALPITATIONS (non-serious) with onset 31Dec2021 at 19:45, outcome "not recovered", described as "My heart was throbbing"; PAIN IN EXTREMITY (non-serious) with onset 31Dec2021 at 19:45, outcome "not recovered", described as "There was pain on the arm that I got the vaccine on. On Saturday the pain in the arm where I received the vaccine had progressed"; MASS (non-serious) with onset 01Jan2022, outcome "not recovered", described as "I noticed a lump under my shoulder area leading to my breast". Therapeutic measures were not taken as a result of myalgia, bone pain, palpitations, pain in extremity and mass. Additional information: The patient had no known allergies. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The events did not result in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. The patient The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 2019168 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33025BD / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Body temperature increased, Feeling cold, Heart rate, Heart rate increased, Immunisation, Interchange of vaccine products, Off label use, Pain, Pyrexia, Swelling, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Fibromyalgia; Gastroparesis; Lupus erythematosus (Lupus); Rheumatoid arthritis; Thyroid function decreased (Under active thyroid)
Allergies:
Diagnostic Lab Data: Test Date: 20211231; Test Name: Heart rate; Result Unstructured Data: Test Result:120; Comments: at 06:30; Test Date: 20211231; Test Name: Body temperature; Result Unstructured Data: Test Result:100; Test Date: 20211231; Test Name: Body temperature; Result Unstructured Data: Test Result:102.3; Comments: at 08:40; Test Date: 20211231; Test Name: Body temperature; Result Unstructured Data: Test Result:101.4; Comments: at 06:30
CDC Split Type: USPFIZER INC202200004538

Write-up: My fever continued to increase up to 102.3 at 8:40 am; Shaking really bad; Freezing; Neck swollen; Body aches; 101.4 fever; Heart rate 120; Dose 1: Janssen COVID-19 vaccine and Dose 2 (Booster): Pfizer COVID-19 vaccine; Dose 1: Janssen COVID-19 vaccine and Dose 2 (Booster): Pfizer COVID-19 vaccine; Dose number 2 (Booster); This is a spontaneous report from a contactable reporter (consumer or other non-HCP). The reporter is the patient. A 45-year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in arm left, administration date 30Dec2021 at 14:00 (Lot number: 33025BD) at the age of 45 years as dose 2 (booster), single for COVID-19 immunisation. Relevant medical history included: "Rheumatoid arthritis" (unspecified if ongoing); "Fibromyalgia" (unspecified if ongoing); "Gastroparesis" (unspecified if ongoing), "Thyroid function decreased" (unspecified if ongoing), notes: Under active thyroid and "Lupus erythematosus" (unspecified if ongoing), notes: Lupus. Concomitant medications were not reported. Past drug history included: Effexor, reaction: "Drug allergy", notes: Known allergies: Effexor and Reglan, reaction: "Drug allergy", notes: Known allergies: Reglan. Vaccination history included: Janssen covid-19 vaccine (johnson &Johnson) (DOSE 1, SINGLE; Lot Number: 1808980; Anatomical site: Right arm), administration date: 21May2021, when the patient was 45 years old, for COVID-19 immunisation. The following information was reported: OFF LABEL USE (non-serious), INTERCHANGE OF VACCINE PRODUCTS (non-serious) all with onset 30Dec2021 at 14:00, outcome "unknown", and all described as "Dose 1: Janssen COVID-19 vaccine and Dose 2 (Booster): Pfizer COVID-19 vaccine"; IMMUNISATION (non-serious) with onset 30Dec2021 at 14:00, outcome "unknown", described as "Dose number 2 (Booster)"; TREMOR (non-serious) with onset 31Dec2021 at 06:30, outcome "recovering", described as "Shaking really bad"; FEELING COLD (non-serious) with onset 31Dec2021 at 06:30, outcome "recovering", described as "Freezing"; SWELLING (non-serious) with onset 31Dec2021 at 06:30, outcome "recovering", described as "Neck swollen"; PAIN (non-serious) with onset 31Dec2021 at 06:30, outcome "recovering", described as "Body aches"; PYREXIA (non-serious) with onset 31Dec2021 at 06:30, outcome "recovering", described as "101.4 fever"; HEART RATE INCREASED (non-serious) with onset 31Dec2021 at 06:30, outcome "recovering", described as "Heart rate 120"; BODY TEMPERATURE INCREASED (non-serious) with onset 31Dec2021 at 08:40, outcome "recovering", described as "My fever continued to increase up to 102.3 at 8:40 am". Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were not taken as a result of tremor, feeling cold, swelling, pain, pyrexia, heart rate increased and body temperature increased. Additional information: Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. The patient had vaccine on 30Dec2021 at 14:00. Woke up on 31Dec2021 at 06:30 due to shaking really bad, freezing, neck swollen, body aches, and 101.4 fever and heart rate 120. Patient fever continued to increase up to 102.3 at 08:40. Fever started to break around 14:40. Body aches were still present at 17:00 (at the time of this report). Patient did not go to emergency room and if her fever had not broken, she would have gone. Currently temperature was staying around 100. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19.


VAERS ID: 2019175 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Immunisation, Lymph node pain
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:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202200004947

Write-up: Headache; Chills; Sore lymph node in breast on the side vaccine was given in arm.; Dose received: 3; This is a spontaneous report from a non-contactable reporter (consumer or other non HCP). The reporter is the patient. A 58-year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in left arm, administration date 30Dec2021 at 16:00 (Lot number: unknown) at the age of 58 years as dose 3 (booster), single for COVID-19 immunisation. Relevant medical history included: "None". Concomitant medications were not reported. Vaccination history included: Bnt162b2 (DOSE 1, SINGLE, Lot Number: UNKNOWN, Anatomical Location: Left arm, Administration time: 15:00), administration date: 06Apr2021, when the patient was 58 years old, for COVID-19 immunisation and Bnt162b2 (DOSE 2, SINGLE, Lot Number: UNKNOWN, Anatomical Location: Left arm, Administration time: 16:00), administration date: 27Apr2021, when the patient was 58 years old, for COVID-19 immunisation. The following information was reported: IMMUNISATION (non-serious) with onset 30Dec2021 at 16:00, outcome "unknown", described as "Dose received: 3"; HEADACHE (non-serious) with onset 31Dec2021 at 07:00, outcome "recovering", described as "Headache"; CHILLS (non-serious) with onset 31Dec2021 at 07:00, outcome "recovering", described as "Chills"; LYMPH NODE PAIN (non-serious) with onset 31Dec2021 at 07:00, outcome "recovering", described as "Sore lymph node in breast on the side vaccine was given in arm". Therapeutic measures were not taken as a result of headache, chills and lymph node pain. Additional information: The patient had no known allergies. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. Since the vaccination, the patient had not been tested for COVID-19. The events did not result in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 2019178 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-12-30
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Back pain, COVID-19, Cough, Drug ineffective, Fatigue, Malaise, Nasal congestion, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Taste and smell disorders (narrow), Retroperitoneal fibrosis (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Iron deficiency anemia
Allergies:
Diagnostic Lab Data: Test Date: 20211230; Test Name: Covid test/Rapid test; Test Result: Positive
CDC Split Type: USPFIZER INC202200005662

Write-up: I was not feeling well; I am experiencing mild symptoms of cough; nasal congestion; tired; back pain; lost my taste and smell; lost my taste and smell; took a rapid test yesterday which came out positive for COVID; took a rapid test yesterday which came out positive for COVID; This is a spontaneous report received from a contactable reporter(s) (Other HCP). The reporter is the patient. A patient (no qualifiers provided) received bnt162b2 (BNT162B2) (Batch/Lot number: unknown) as dose 1, single for covid-19 immunisation. Relevant medical history included: "Iron deficiency anemia" (unspecified if ongoing). The patient''s concomitant medications were not reported. The following information was reported: DRUG INEFFECTIVE (medically significant), COVID-19 (medically significant) all with onset 30Dec2021, outcome "unknown" and all described as "took a rapid test yesterday which came out positive for COVID"; MALAISE (non-serious), outcome "recovering", described as "I was not feeling well"; COUGH (non-serious), outcome "recovering", described as "I am experiencing mild symptoms of cough"; NASAL CONGESTION (non-serious), outcome "recovering", described as "nasal congestion"; FATIGUE (non-serious), outcome "not recovered", described as "tired"; BACK PAIN (non-serious), outcome "recovering", described as "back pain"; AGEUSIA (non-serious), ANOSMIA (non-serious), outcome "unknown" and all described as "lost my taste and smell". The patient underwent the following laboratory tests and procedures: sars-cov-2 test: (30Dec2021) positive. The lot number for bnt162b2 was not provided and will be requested during follow up.; Sender''s Comments: Based on the available information and a possible contributory role of the suspect product BNT162B2 to the development of events drug ineffective, covid 19 cannot be totally excluded.


VAERS ID: 2019574 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acoustic stimulation tests, Deafness, Headache, Hypoacusis, Swelling, Tenderness, Tinnitus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: after 1 st dose of Pfizer vaccine 10/09/2021 got High frequency hearing loss and tinnitus, shoulder/arm pain with tendonitis, po
Other Medications: tylenol 650mg iron infusion
Current Illness: side effects from 1st dose as reported to Vaers
Preexisting Conditions: anemia
Allergies: eggs
Diagnostic Lab Data: pending hearing test
CDC Split Type:

Write-up: Hours after 2 nd dose of Covid vaccine extremely loud constant ringing in my ears began louder than when the first dose was given. Hearing is muffled, muted and periodically episodes of deafness lasting 10-35 seconds keep happening. My right side of neck and head is swollen and painful to touch. These issues are continued from 1st dose but extremely exacerbated now since the second dose. Daily headaches are more extreme requiring pain meds.


VAERS ID: 2019594 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-21
Onset:2021-12-30
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048J21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Pain in extremity, Rash, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Mild walnut allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 9 days after receiving Moderna booster, I developed itchy rashes and hives all over my body, but particularly my scalp, neck, torso, and groin. They have been remained present until today, 10 days after first appearance, and show no signs of abating. The hives get better and worse over the course of the day, but rarely completely disappear. They are not quite unbearable, but very itchy and unpleasant and get worse if I scratch. I had only mild side effects to the first two shots (also Moderna) - arm pain and fatigue, but no skin issues. I have no known severe allergies (beyond a very minor walnut allergy) and have never had skin issues in the past. Nothing changed with my diet or exposure to detergents etc. I am healthy, normal weight.


VAERS ID: 2019809 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Levothyroxine, Beyaz, Escilatopram
Current Illness: N/A
Preexisting Conditions: Hypothyroidism, Migraines, Asthma, Celiac Disease, Obesity
Allergies: Gluten
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Delayed allergic reaction in the form of a large red raised bump on left arm around the site of injection. Area increased in size and swelling for the following four days after injection, then with Benadryl and ibuprofen reduced swelling and pain until it went away completely 1.5 weeks later.


VAERS ID: 2019812 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-12-01
Onset:2021-12-30
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033421A / 3 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Confusional state, Hyperhidrosis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (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: Moderna COVID, shot #2
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None. Was at Home in bed.
CDC Split Type:

Write-up: Severe chills; joint pain; sweating; fever of 102.4 deg; zero energy; confusion; lasted 48-72 hours


VAERS ID: 2019818 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-17
Onset:2021-12-30
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor, Cymbalta, Lasix, ferrous sulfate, glipizide, aspirin, hydrochlorothiazide, losartan, mag ox, metformin, omeprazole, tizaidine, motrin,. also history of drug seeking behavior recently found he was doing cocaine and failed his test
Current Illness: none
Preexisting Conditions: diabetes, PAD, lumbago with radiculopathy, RLS, OSA, hyperlipidemia, gastritis, fibromyalgia, migraines, disc disease , GIST history, drug abuse
Allergies: amoxicillin , fentanyl , reglan, naproxen
Diagnostic Lab Data: positive covid test
CDC Split Type:

Write-up: covid infection


VAERS ID: 2019966 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-12-27
Onset:2021-12-30
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028K21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Rash pruritic, Skin warm, Swelling face
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? 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: Face swelling at day 3 after vaccine. Lasted 3 days, very itchy rash on chest, neck started on day 10 and spreading to back of head - extremely itchy - skin feels hot


VAERS ID: 2020358 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Paraesthesia, Skin irritation
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Sertraline 25mg, vitamin D, vitamin c
Current Illness: I had a mild cold one week prior to vaccination. Was tested for COVID for cold and PCR test was negative
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 15 minutes of shot I had tingling in my feet and up my leg on left side. Tingling/nerve irritation continued on and off for 10 days now and moves around to different parts of my body, especially hands, fingers, arms below elbow, cheek to chin area on face, and front and back of calves on both legs. 75% of day I feel this tingling somewhere on my skin. Sometimes it also has a light burning sensation. Today is day 10 after shot and the tingling is still moving around but becoming less intense in terms of the amount of skin it is irritating. Seems to be smaller bands of irritation now. Overall, not knowing if these symptoms would go away and getting increasing worse each day until today caused me anxiety about the vaccine, especially because I did not experience this with the 1st or 2nd Pfizer dose. After this experience I will refuse other future COViD vaccinations. This side effect is miserable and worrisome for a healthy person.


VAERS ID: 2020712 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-12-29
Onset:2021-12-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Dyspnoea, Influenza virus test negative, Respiratory syncytial virus test negative, 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin aspirin eliquis dofetilide zetia metoprolol irbesartan montelukast sodium
Current Illness:
Preexisting Conditions: CAD
Allergies: sulfa PCN
Diagnostic Lab Data: chest xray negative 1/6/2022 flu, covid and rsv swabs all negative 1/6/2022
CDC Split Type:

Write-up: Shortness of breath still almost 2 weeks later


VAERS ID: 2020807 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-07
Onset:2021-12-30
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / UNK - / -

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

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

Write-up: Covid positive through work contact


VAERS ID: 2020868 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-07
Onset:2021-12-30
   Days after vaccination:206
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: covid+ test 12/29/21
CDC Split Type:

Write-up: covid vaccine breakthrough


VAERS ID: 2020869 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-11-19
Onset:2021-12-30
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, COVID-19, Computerised tomogram abdomen normal, Cough, Fatigue, Feeding disorder, Head discomfort, Headache, Insomnia, Nasal congestion, Nausea, Oesophagitis, Rhinorrhoea, SARS-CoV-2 test positive, Tachyphrenia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Yes. I do not want to list.
Current Illness: None
Preexisting Conditions: Asthma, Hypothyroidism, Hypercholesterolemia
Allergies: Tetracycline, Sulfa, Ultram, Mangoes, aspartame.
Diagnostic Lab Data: Abdomen CT
CDC Split Type: vsafe

Write-up: 12/30/2021 Covid symptoms began with cough, extreme nasal congestion and discharge, headache, and weakness. The symptoms got a little better at the beginning of January but not completely gone away with the nasal congestion and cough. Even today I''m not completely better. I had extreme coughing and my head felt like it was going to explode. By January 3, it was starting to ease off. Then, I started a whole other set of problems. I started having severe abdominal pain and nausea which lasted until 01/07/2022. My infusion was on 01/04/2022 and the abdominal pain started and I hadn''t been able to eat in 2 days. I did go to the ER and they did an abdomen CT scan and didn''t find anything and said my esophagus was inflamed but they blamed it on Covid. The lingering symptoms I had last week was just profound weakness and any little thing such as taking a shower felt like I had worked all day and needed to go to bed. I also had the inability to go to sleep and my brain was on full kilt and I couldn''t shut it off. I was exhausted but couldn''t sleep. Testing positive on 01/02/2022


VAERS ID: 2020924 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-06-17
Onset:2021-12-30
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / UNK - / -

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

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

Write-up: Covid positive contact unknown.


VAERS ID: 2020930 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-25
Onset:2021-12-30
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 UN / UN

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

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

Write-up: cough, congestion, shortness of breath. + COVID test


VAERS ID: 2020933 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-12
Onset:2021-12-30
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939905 / 3 UN / UN

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

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

Write-up: short of breath + COVID test


VAERS ID: 2020934 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-26
Onset:2021-12-30
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / UNK - / -

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

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

Write-up: Covid positive through work contact


VAERS ID: 2020937 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-11-22
Onset:2021-12-30
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / 3 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: shortness of breath and dyspnea. + COVID test


VAERS ID: 2020949 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-02
Onset:2021-12-30
   Days after vaccination:331
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: rhinorrhea, cough + COVID test


VAERS ID: 2020959 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-12-30
   Days after vaccination:266
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B212A / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Myalgia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: cough, short of breath, myalgias + COVID test


VAERS ID: 2020967 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-12-30
   Days after vaccination:265
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: congestion, sore throat, cough + COVID test


VAERS ID: 2020979 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-23
Onset:2021-12-30
   Days after vaccination:251
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 2 UN / UN

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

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

Write-up: chills, fever, congestion + COVID test


VAERS ID: 2020989 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-03
Onset:2021-12-30
   Days after vaccination:241
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, Dyspnoea, Nausea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: short of breath, diarrhea, nausea + COVID test


VAERS ID: 2020997 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-10
Onset:2021-12-30
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 UN / UN

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

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

Write-up: fever, headache + COVID test


VAERS ID: 2021008 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-26
Onset:2021-12-30
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 UN / UN

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

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

Write-up: cough, short of breath + COVID test


VAERS ID: 2021091 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 070H21A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Dyspnoea, Injection site erythema, Injection site swelling, Pain, Pallor, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: clonazapam, cymbalta, depakote, entyvio, lasiks, hyoscamine, omeprazole, pregsatapin,
Current Illness:
Preexisting Conditions: barratts, arthritis, bipolar, gerd, herpes, migraines, fibromyalgia, osteoarthritis, tmj, ulcerative collitis,
Allergies: cipro, penicillin, sulfa, aspirin, mascrobid, codeine, flagall , latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: swelling, redness at injection site, pain, fever, chills, dizziness, pale, hard to take deep bbreath


VAERS ID: 2021138 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-12-17
Onset:2021-12-30
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F21A / 3 LA / IM

Administered by: Work       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No medications or supplements at the time. Since, I have begun taking Zyrtec.
Current Illness: None
Preexisting Conditions: None
Allergies: none
Diagnostic Lab Data: Saw Dermatologist. Confirmed suspected reaction to Covid Booster.
CDC Split Type:

Write-up: 2 weeks after booster, developed severe itchiness and red-raised hives all over body. Symptoms only relieved with antihistamines. Symptoms are still ongoing 1.5 weeks later.


VAERS ID: 2021239 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 213D21AHRSA / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebral infarction, Cerebrovascular accident, Computerised tomogram head abnormal, Dizziness, Magnetic resonance imaging head abnormal, Malaise, Vertebral artery stenosis, Visual field defect
SMQs:, Anticholinergic syndrome (broad), 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), Noninfectious encephalitis (broad), Optic nerve disorders (broad), Retinal disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Elevated BP
Preexisting Conditions: Hypertension, hyperlipidemia, A-fib.
Allergies: none
Diagnostic Lab Data: 01-03-2022 CT of the head showed right occipital lobe stroke and stenosis of right vertebral artery. Brain MRI re-demonstrated the area of acute infarction and possible P3 branch stenosis/thrombosis. He was treated with aspirin and statin.
CDC Split Type:

Write-up: After receiving the vaccine, suddenly, patient became lightheaded. Was sent to ER. 12/30-discharged. 1/3-pt did not feel well had left visual field difficulties that started the night of 12/30, was sent to different ER. CT of the head showed right occipital lobe stroke and stenosis of right vertebral artery.


VAERS ID: 2021428 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-12-01
Onset:2021-12-30
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: High BP, High Cholesterol
Preexisting Conditions: History of breast CA, kidney tumors, stroke, high BP, high cholesterol
Allergies: PCN
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shingles on left side of forehead and scalp.


VAERS ID: 2021560 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-09
Onset:2021-12-30
   Days after vaccination:82
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / SYR
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. - / N/A RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Ear pain, Head discomfort, Headache, Lymphadenopathy, Musculoskeletal stiffness, Neck pain, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benicar, Vitamin D, C Biotin
Current Illness: N/A
Preexisting Conditions: Obesity, Hypertension
Allergies: Thimerosal Preservative
Diagnostic Lab Data: Covid-19 Positive 12/7/2021 Dose 1 03/03/2021 EN6198 Dose 2:03/24/2021 EP7534
CDC Split Type: vsafe

Write-up: I started to have a runny nose overnight. My nose was running and my ears hurt. I was sneezing and it felt like my head was under pressure. My neck hurt and my Lymph Nodes were swollen. I went to get tested at the city site and I tested positive. The next day I still felt extreme pressure in my head. I still had a headache and the runny nose and coughing. It has been four days and I have started to feel a little better. The headache is milder but my Lymph Nodes are still swollen and my neck is stiff. My nose is still running.


VAERS ID: 2022446 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: EXPIRED VACCINE WAS ADMINISTERED


VAERS ID: 2022447 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: EXPIRED VACCINE WAS ADMINISTERED


VAERS ID: 2022449 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: EXPIRED VACCINE WAS ADMINISTERED


VAERS ID: 2022451 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: EXPIRED VACCINE WAS ADMINISTERED


VAERS ID: 2022452 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-12-30
Onset:2021-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: EXPIRED VACCINE WAS ADMINISTERED


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