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

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



Case Details (Reverse Sorted by Onset Date)

This is page 112 out of 6,867

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VAERS ID: 1594452 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210837608

Write-up: HUGE HEAT RASH THAT COVERS ABOUT 25% OF RIGHT SIDE TORSO NEAR THE BREAST AND ALMOST EXTENDS TO THE BACK AND STOMACH; This spontaneous report received from a patient concerned a 26 year old female. The patient''s weight was 264 pounds, and height was 64 inches. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, expiry: UNKNOWN) dose was not reported, administered on 16-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-AUG-2021, the patient experienced huge heat rash that covers about 25% of right side torso near the breast and almost extends to the back and stomach. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from huge heat rash that covers about 25% of right side torso near the breast and almost extends to the back and stomach. This report was non-serious.


VAERS ID: 1594462 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Alabama  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Asthenia, Cough, Gait inability, Loss of personal independence in daily activities, Muscular weakness, Pain, Pyrexia, Sinus congestion, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210837918

Write-up: COUGHING; CONGESTION; CANNOT WALK DUE TO WEAKNESS; ACHING; VERTIGO; DIFFICULTY GETTING UP AND NEED ASSISTANCE TO GET UP / CANNOT SUPPORT HERSELF; EXTREME WEAKNESS IN LEGS; WEAKNESS; HIGH FEVER; This spontaneous report received from a consumer concerned a 75 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: covid-19. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A expiry: 19-SEP-2021) dose was not reported, administered on 17-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-AUG-2021, the patient experienced coughing. On 18-AUG-2021, the patient experienced congestion. On 18-AUG-2021, the patient experienced cannot walk due to weakness. On 18-AUG-2021, the patient experienced aching. On 18-AUG-2021, the patient experienced vertigo. On 18-AUG-2021, the patient experienced difficulty getting up and need assistance to get up / cannot support herself. On 18-AUG-2021, the patient experienced extreme weakness in legs. On 18-AUG-2021, the patient experienced weakness. On 18-AUG-2021, the patient experienced high fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from coughing, congestion, high fever, weakness, cannot walk due to weakness, aching, vertigo, extreme weakness in legs, and difficulty getting up and need assistance to get up / cannot support herself. This report was non-serious.


VAERS ID: 1594483 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Headache, Hyperhidrosis, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: USJNJFOC20210840482

Write-up: HEADACHE; VISION BECAME VERY BLURRY; GOT VERY HOT; STARTED TO SWEAT/SWEATING; FELT LIKE WAS GOING TO PASS OUT.; This spontaneous report received from a parent concerned a 26 year old female. 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:1816022, expiry: UNKNOWN) dose was not reported, administered on 18-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-AUG-2021, the patient experienced vision became very blurry. On 18-AUG-2021, the patient experienced got very hot. On 18-AUG-2021, the patient experienced started to sweat/sweating. On 18-AUG-2021, the patient experienced felt like was going to pass out. On 19-AUG-2021, the patient experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from vision became very blurry, got very hot, and felt like was going to pass out. on 18-AUG-2021, had not recovered from started to sweat/sweating, and the outcome of headache was not reported. This report was non-serious.


VAERS ID: 1594484 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Feeling of body temperature change, Injection site pain, Neck pain, Tension headache
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210819; Test Name: Body temperature; Result Unstructured Data: 98.3 F
CDC Split Type: USJNJFOC20210840484

Write-up: TOP BACK ON NECK SORE; FELT LIKE A FEVER/WARM; TENSION HEADACHE; LITTLE ACHES AT INJECTION SITE; This spontaneous report received from a patient concerned a 35 year old female. 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: 206A21A and expiry: 21-SEP-2021) dose was not reported, administered on 18-AUG-2021 16:30 for prophylactic vaccination. No concomitant medications were reported. On 18-AUG-2021, the patient experienced little aches at injection site. On 19-AUG-2021, the patient experienced top back on neck sore. On 19-AUG-2021, the patient experienced felt like a fever/warm. On 19-AUG-2021, the patient experienced tension headache. Laboratory data included: Body temperature (NR: not provided) 98.3 F. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from little aches at injection site, tension headache, top back on neck sore, and felt like a fever/warm. This report was non-serious.


VAERS ID: 1594486 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Nebraska  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210840522

Write-up: POTENTIALLY ADMINISTRATION OF AN EXPIRED DOSE; DOSE ADMINISTERED ABOUT 15-30 MINUTES AFTER THE RECOMMENDED STORAGE PERIOD FOR PUNCTURED VIAL; This spontaneous report received from a health care professional concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number:1808980, and expiry: UNKNOWN) dose was not reported, administered on 18-AUG-2021 16:30 for prophylactic vaccination. No concomitant medications were reported. On 18-AUG-2021, the patient experienced potentially administration of an expired dose. On 18-AUG-2021, the patient experienced dose administered about 15-30 minutes after the recommended storage period for punctured vial. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the potentially administration of an expired dose and dose administered about 15-30 minutes after the recommended storage period for punctured vial was not reported. This report was non-serious.


VAERS ID: 1595942 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-01
Onset:2021-08-18
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Bradyphrenia, Computerised tomogram head normal, Hypoaesthesia, Hypotonia, Magnetic resonance imaging, Paraesthesia, Transient ischaemic attack
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ct head: was negative Mri results: unknown but she was told to follow up with a neurology doctor. They talked about her having a TIA " mini stroke "
CDC Split Type:

Write-up: She went to ER due to one sided numbness/tingling, one arm became flaccid, half of face was numb, and she could not get her thoughts out.


VAERS ID: 1595949 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Headache, Hyperhidrosis, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Headache-Mild, Additional Details: unresponsive for 1 minute


VAERS ID: 1595951 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cellulitis
SMQs:

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

Write-up: Error: Infection / Cellulitis (diagnosed by MD)-


VAERS ID: 1595984 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 LA / IM

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

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

Write-up: Site: Pain at Injection Site-Severe


VAERS ID: 1602555 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

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

Write-up: Heart palpitations lasting a few seconds occurred while relaxing sitting up before bed, after awakening in the middle of the night while in bed, and in the morning after awakening while in bed. Headache lasting approximately 2 hours after the vaccine.


VAERS ID: 1602561 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-01
Onset:2021-08-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: No issues after 1 shot, after 2nd shot chest tightness & shortness of breath


VAERS ID: 1602571 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-17
Onset:2021-08-18
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Pulmonary embolism, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pravastatin, Metformin, Losartan, Gabapenten, Ezemitibe, ASA
Current Illness: None
Preexisting Conditions: Type 1 Diabetes; CHF
Allergies: None
Diagnostic Lab Data: CAT Scan 8/18 and ultrasound R. leg 8/19
CDC Split Type:

Write-up: Pulmonary Embolism and blood clot in R. leg


VAERS ID: 1602577 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Dysstasia, Electrocardiogram normal, Gait disturbance, Myocardial necrosis marker, Pain, Pyrexia, White blood cell count normal
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cholesterol prescription
Current Illness: None
Preexisting Conditions: None
Allergies: Aspirin
Diagnostic Lab Data: Tested heart enzymes, white blood count for signs of infection and had 2 EKGs. All test were normal. 8/20/2021
CDC Split Type:

Write-up: Body aches, pain & fever for 24 hours. Fever came back in less than 12 hours along with severe pain in the abdomen. Pain is so severe he cannot stand up straight, can barely walk and curls into the fetal position. This has been going on from Wednesday (8/18) and is still happening as I write this on Saturday (8/21). I took him to a Medical Center, on Friday (8/20) to have him checked for an appendicitis. The only thing they found was that he was slightly dehydrated. He was given a bag of fluids at the ER. Since, he has been drinking water and Gatorade to stay hydrated.


VAERS ID: 1602609 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-09
Onset:2021-08-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 3A92G / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: gabapentin 300mg twice daily; gabapentin 100mg in the evening, furosemide 20mg daily, omeprazole 40mg daily
Current Illness: none
Preexisting Conditions: obesity, neuropathy
Allergies: no known allergy
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient stated she went to the ER on 8/18/21 with complaint of redness, hot area on site of injection, Covid 19 Moderna shot (left arm). The ER physician prescribed Amoxicillin 500mg to be taken twice daily. She later presented to the pharmacy letting us know she was diagnosed with cellulitis at the site of injection. Injection was given on 8/9/21.


VAERS ID: 1602611 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immediate post-injection reaction, Injection site erythema, Injection site inflammation, Injection site swelling, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: PATIENT STATES THAT IMMEDIATELY AFTER SHE RECEIVED VACCINE SHE NOTICED ARM PAIN, REDNESS, AND SWELLING AROUND INJECTION SITE. AT THIS TIME, 3 DAYS LATER, THE AREA IS ABOUT THE SIZE OF A BASEBALL AND IS RED, INFLAMED, AND SWOLLEN ON HER LEFT ARM. SHE INITIALLY REPORTED THE REACTION TO A RADIOLOGY TECHNICIAN YESTERDAY AT A ROUTINE SCAN AND THEY DREW A LINE AROUND THE AREA TO MONITOR GROWTH, IT APPEARED TO BE GROWING SLIGHTLY THIS MORNING WHEN SHE REPORTED TO PHARMACY.


VAERS ID: 1602624 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Dizziness, Pruritus
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Dizzyness and lightheaded 10 minutes after shot and periodically 1-3 days after. Bruising on arm and itchyness


VAERS ID: 1602628 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injected limb mobility decreased, Injection site pain, Limb discomfort, Pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Verapamil ER240mg 1 qD, Pantoprazole SOD 40mg 1qD, Atorvastatin 20mg 1qD, Lisinopril 40mg 1qD, Spironolatone 25mg 1qD, Aspirin 81mg x2 once a day, Vitamin B12 1000mcg qD,
Current Illness:
Preexisting Conditions: Hypertension, Sick Sinus Syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe Deltoid muscle pain in the left arm, inability to move my left arm without pain in the muscle when it contracts even in slightly, unable to lift the left arm or move it away from my side without severe pain, the left arm feels extremely heavy when I try to move it and I have swelling of my left arm and hand, the injection area is not sore or painful when touched but the arm muscle is even after 4 days from when I received the vaccine


VAERS ID: 1602647 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-23
Onset:2021-08-18
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Ageusia, Anosmia, Chills, Cough, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Oropharyngeal pain, Rhinorrhoea, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Taste and smell disorders (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ziac, Synthroid, Zoloft, Prilosec, Vitamin C, Ferrous Sulfate, Mucinex
Current Illness: None
Preexisting Conditions: Hpertension, Asthma, Hashimoto Disease
Allergies: Tetracycline, Sulfa, Percocet
Diagnostic Lab Data: Quidel Sofia Antigen FIA
CDC Split Type:

Write-up: Chills, Muscle Aches, Runny Nose, Sore Throat, Lost of Taste & Smell, Headache, Fatigue, Cough, Wheezing, Shortness of Breath, Abdominal Pain, Diarrhea


VAERS ID: 1602657 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Lymphoedema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (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: Bystolic 10mg, Claritin OTC
Current Illness: None
Preexisting Conditions: Asthma, HTN
Allergies: PCN
Diagnostic Lab Data: No e
CDC Split Type:

Write-up: Severe lymph edema left scullery and dorsal left upper and inner arm bruising


VAERS ID: 1602662 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Body temperature increased, Decreased appetite, Headache, Lethargy, Malaise, Muscular weakness, Paraesthesia, Parosmia, Taste disorder, Vision blurred, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: Lilly pollen
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Headache to the brain stem then a dull continuous throbbing lasting 3 days. A temperature lasting 3 days, tingling in both feet, malaise, lethargy, muscle weakness, unable to sit for for more than 10 minutes for 48 hours, taste in impaired, every thing smells fresh like meat even after 4 days, blurry vision, unable to eat for 24 hours, still cannot eat a full meal after 4 days, lost 3.5 lbs. After 4 days still has a low grade temperature and unable to eat a full meal.


VAERS ID: 1602739 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SD8448 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Bone pain, Erythema, Fatigue, Feeling hot, Injection site erythema, Injection site mass, Mobility decreased
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Osteonecrosis (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Code blue on Levaquin 29 years old Code blue on Rochephin 35 years old
Other Medications: Voltaren(skipped night before) , gabapentin,asprin(skipped night before), propanol, benazepril, amlodipine, Dexilant, synthroid,simvistatin,calcitroil,metformin, sulfasalazine,pristique,topamax,lysine,uloric,promethazine
Current Illness: Chrones, type 2 diabetic, asthma, inappropriate sinus tachycardia, anemia
Preexisting Conditions: Chrones, type 2 diabetic, asthma, inappropriate sinus tachycardia, anemia,299 kidney stones, gastritis, migraines, diabetic neuropathy, hypoparathyroidism, hypothyroidism, sleep apnea, hyopcalcemia
Allergies: Penicillin, codeine, Levaquin, morphine, macrobiotic, Macrobid, Bactrim
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Day 2 my bones in shins and forearms ached real real bad and was really fatigue day 4 I had a place come up at the injection site about the size of a quarter that was a hard lump and real red and my whole upper arm hurt, day 5 the size was about 2 quarters side by side and sticking up the lump even bigger and can''t hardly pick my arm up. It''s really red and hot.


VAERS ID: 1602741 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-05
Onset:2021-08-18
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Headache, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes, Hypertension, Cardiovascular Disease
Allergies:
Diagnostic Lab Data: Positive PCR for Covid
CDC Split Type:

Write-up: Runny nose, loss of taste and smell, headache, cough Tested positive for Covid 8/19/2021


VAERS ID: 1602751 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-05
Onset:2021-08-18
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Diarrhoea, Fatigue, Headache, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes, Hypertension
Allergies:
Diagnostic Lab Data: Positive PCR for Covid 19
CDC Split Type:

Write-up: Chills, runny nose, loss of taste and smell, headache, fatigue, cough, diarrhea


VAERS ID: 1602765 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009CC1A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Decreased appetite, Diarrhoea, Mobility decreased, Pain in extremity, Secretion discharge
SMQs:, Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1. Calcium, Magnesium and zinc supplent ...1 tab po daily 2. Iron plus Vitamin c ...1 Tab po daily 3. D3 ...1 tab po daily 4. vitamin c ..1 Tab po daily All over the counter Medications.... Last time taken 08/17/21 @ 0900
Current Illness: None
Preexisting Conditions: None
Allergies: NO known allergies
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Within three hours , started having chills and later in the night 2200 , generalised weakness. next Morning 08/20/21 ,Unable to lift arm above head and soreness , no appetie , chills, mucous drainage and weakness and as the day progressed diarrhea X3 . 08/21/21 still having chills but to a lesser degree, no appettite, weakness ( improved but slightly) , mucus drainage fron throat


VAERS ID: 1602769 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003721A / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Headache, Pain, Paraesthesia, Pruritus, Skin burning sensation, Tinnitus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Ears ringing , achy , and slightly itchy on the inside .intermittent Pain shoots to top of my head and tingles/burning sensation under scalp . Started Wednesday(8/18/2021, two days after second dose) and has progressively gotten worse or maybe just more annoying . Pcp suggested an antihistamine 8/20/2021 otc and it did not help .


VAERS ID: 1602789 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Fatigue, Headache, Paraesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow)

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

Write-up: Fatigue, headache, ringing ears, pins and needles through body continuously


VAERS ID: 1602807 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dyspnoea, Headache, Heart rate increased, Nausea, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), 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: Flu shot years ago, got flu symptoms after
Other Medications: Liothyronin, Vit. C, Multivitamin, Magnesium, D3/K2, Fish Oil
Current Illness: none
Preexisting Conditions: Low Thyroid
Allergies: Cipro
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 1st shot, felt nausea, headache, sore arm for a day, sore arm lasted 5 days. 2nd shot, Chills, bad headache, hard to breath, diarrhea, nausea, very sore arm, high heart rate. 1 1/2 days. Today is 8/21/21 and I still have diarrhea, hard to breath at night and sore arm.


VAERS ID: 1602858 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypersensitivity, Lip swelling, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: allergy. patient face, lips, cheeks, swelled up. patient went to ER and received medrol. feeling better


VAERS ID: 1602884 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chills, Dyspnoea, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad)

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

Write-up: Patient began having shallow labored breathing starting 20 minutes post vaccination. Sweating, severe abdominal cramps, and chills. Patient was take by ambulance to local Hospital Emergency Department. Nothing else is know about the outcome. Phone attempt to reach patient shows unregistered voicemail.


VAERS ID: 1602926 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Decreased appetite, Ear discomfort, Eye irritation, Fatigue, Hyperhidrosis, Injection site inflammation, Injection site pain, Insomnia, Muscular weakness, Oropharyngeal pain, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Corneal disorders (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: Keppra
Current Illness: n/a
Preexisting Conditions: Occasional moderate seizures.
Allergies: Other products:machine exhaust, smog, heavy/thick pollen, outdated insulation/drywall/housing or building products, smoke
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Within 3hrs (after injection) my eyes & ears began to burn, the injection site also began to have a lot of pain & inflamed (as expected/warned about). 10 hours after injection I began to havefever like feeling(checked my temp & it was at 99.7F) then a couple hours later suddenly had very rapid/fast rotating chills then fever-like (I checked again & it was at 100.7F), then after I took 2 tylenol-like pills it wasn''t as "fast" (decreasing temp also) but still sweating for hours. 24 hours after the shot I had a sore throat with weak back & fatigue which continued for at least 6 more hours. I wasn''t able to eat much if anything because I was so weak & hadn''t been able to sleep more than 2 or 3 hours/day in past week. 48 hours after the (2nd/full) injection the inflammation of the injection site was finally starting to decrease along with the pain around it & on my arm, but I might get nausea if I start eating "normally" already, gladly no stomach problems yet. Treatment was "Moderna COVID-19 Vaccine EUA"


VAERS ID: 1602975 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Ischaemic stroke, Magnetic resonance imaging head abnormal, Thalamic infarction
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data: MRI Brain: Small acute/subacute infarct in the right thalamus.
CDC Split Type:

Write-up: Small right thalamic ischemic stroke (proven on MRI) with left-sided total body numbness.


VAERS ID: 1603045 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, Ophthalmic herpes zoster
SMQs:, Ocular infections (narrow), Opportunistic infections (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: Junel 1/20 birth control
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Shingles on eye, progressed to inside mouth (after clinic visit). Prescribed anti-viral Valtrex tablet. Also short of breath, but all other vitals were normal


VAERS ID: 1603047 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Chills, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Subjective fevers, chills, nausea, chest tightness that are improving with time and Tylenol


VAERS ID: 1603072 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Muscular weakness, Rash macular
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Quercetin
Current Illness:
Preexisting Conditions: Crohn''s Disease (in remission), vitiligo, uveitis (remission), enteropathic arthritis
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 6 hours of the vaccine, red spots that looked like pyoderma gangrenosum appeared on both feet and legs all the way up to lower thighs. On August 21st, patient experienced muscle weakness in legs and arms.


VAERS ID: 1605734 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-14
Onset:2021-08-18
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lasix, Nabutome/Naprosyn prn, Lisinopril, Allopurinol, Glipizide, Metformin, Jardiance, Tizandine, Coreg, ASA
Current Illness: No acute
Preexisting Conditions: Chronic condition management for DM2, CAD, CHF, HTN
Allergies: NKDA
Diagnostic Lab Data: COVID + Test
CDC Split Type:

Write-up: Admitted for breakthrough COVID infection. Treating with Dexamethsone and Redemsivir


VAERS ID: 1609049 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Confusional state, Headache, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: About 12 hours after I received the shot when I was about to go to bed I started shivering severely, after about 10 minutes of constant shivering I got a fever that reached 101.9. The shivering continued for a total of 35-45 minutes than subsided to just the fever and a headache. My mother said I was talking out of my head and didn?t make any sense. But I finally fell asleep and here it is 4 days layers those symptoms are gone but I still feel malaise.


VAERS ID: 1609057 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 RA / IM

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

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

Write-up: Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Lymph Node Swelling-Mild


VAERS ID: 1609876 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Nausea, Pain, Syncope, Unresponsive to stimuli, Vomiting
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), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

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

Write-up: Systemic: Body Aches Generalized-Mild, Systemic: Chills-Mild, Systemic: Diarrhea-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Nausea-Mild, Systemic: Vomiting-Mild


VAERS ID: 1617385 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017EZ1A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Headache, Hypophagia
SMQs:, Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: Moderna was manufacturer. Diarrhea that lasted 3 days. No food for first day and then crackers and water. Days 4 and 5 still week and headache but diarrhea stopped


VAERS ID: 1617406 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-14
Onset:2021-08-18
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal Vitamins, flonase
Current Illness: sinus pain and nasal congestion
Preexisting Conditions: none noted
Allergies: None noted
Diagnostic Lab Data: Positive Covid 19 PCR test (NP swab) done on 8/18/21
CDC Split Type:

Write-up: fully vaccinated (dose 1 on 5/14/21 and dose 2 on 6/4/21) and diagnosed with Covid 19 on 8/18/21


VAERS ID: 1617430 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip blister, Lip swelling, Myalgia, Oral herpes, Sensitive skin
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Cetirizine
Current Illness: none
Preexisting Conditions: seasonal allergies
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt had myalgias, skin sensitivity, blister formation on her lip, cold sore and swelling of lips


VAERS ID: 1617508 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip blister, Lip swelling, Oral herpes, Pain
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Zyrtec
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid shot 8/16
CDC Split Type:

Write-up: Cold sores on lips, blisters on lips, swelling of lips. Body aches.


VAERS ID: 1617524 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Injection site pruritus, Injection site rash, Myalgia, Pain, Pain in extremity, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bisoprolol, metformin, levothyroxine, losartan, omeprazole, and Jardiance.
Current Illness:
Preexisting Conditions: Diabetes and high blood pressure. Obesity
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itching on injection site and rash and itching on elbow. Pain in site radiating to shoulder, elbow, and lower arm muscles.


VAERS ID: 1617595 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

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

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

Write-up: PATIENT DEVELOPED RASH ON THE ARM THAT HAS SPREAD TO THE BACK AND HEAD. RASH APPEARED AT 4PM 8/18/21. THE MOM GAVE THE PATIENT BENADRYL. PATIENT ALSO FELT A SWOLLEN LYMPH NODE ON THE ARM WHERE THE DOSE WAS GIVEN. NO OTHER SYMPTOM BUT RASHES AND SWOLLEN LYMPH NODE. THEY CALLED THE PEDIATRICIAN''S OFFICE BUT IT WAS ALREADY CLOSED AND THEY WERE ADVISED BY THE PERSON AT THE DR''S OFFICE TO GO TO THE PROVIDER THAT ADMINISTERED THE VACCINE. I TOLD THEM THERE''S REALLY NOTHING I COULD DO SINCE I AM NOT A DOCTOR. BUT THEY JUST WANTED TO FIND OUT MORE ABOUT THIS SIDE EFFECT AND IF THEY SHOULD BE ALARMED ABOUT THIS. THEY DID NOT WANT TO GO TO THE URGENT CARE SINCE THERE ARE SO MANY PATIENTS THERE BECAUSE OF COVID SURGE. I TOLD THEM I CAN CALL PFIZER AND THE DEPARTMENT OF HEALTH TO SEE IF I CAN GET MORE INFORMATION. PFIZER SAID THAT RASH IS A POSSIBLE SIDE EFFECT TGAT CAN HAPPEN 1-2 DAYS AFTER VACCINATION AND THAT THEY CANNOT GIVE ANY MEDICAL ADVISE, AND THE PATIENT NEEDS TO CHECK WITH HIS DOCTOR. THE DEPARTMENT OF HEALTH SAID THE SAME THING AND TOLD THEM TO GO TO THE URGENT CARE. SO I TOLD THE MOM TO JUST BRING HER SON TO THE URGENT CARE SO THAT SHE''LL HAVE A PEACE OF MIND.


VAERS ID: 1617643 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-11
Onset:2021-08-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / IM

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

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

Write-up: The patient received the Moderna covid 19 vaccine on 08/11/21. From 08/12 to 08/14 she experienced what she described as normal swelling in the arm related to getting an IM vaccine which went away. Then on 08/18 her arm turned red locally around the vaccination site after it had already been cleared of the initial symptoms. She received mupirocin ointment from her primary care provider and now claims that it is clearing up.


VAERS ID: 1617654 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939676 / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006021A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypersensitivity, Injected limb mobility decreased, Pain in extremity
SMQs:, Angioedema (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 60mg Extended Release (XR) Adderall Capsules (30mg XR capsule taken 2x/day). 2-4mg/.5-1mg Suboxone Sublingual (SL) Films (take one to two 2mg/.5mg sublingual films under the tongue 2x/day). 3 tablets per day of Country Life Calcium-Magnesiu
Current Illness: N/A
Preexisting Conditions: Anemia (due to poor diet), cigarette smoker also using nicotine cessation patches
Allergies: Bupropion (Generic form of the medication Wellbutrin) - suffered a 1-time grandmal seizure. All I can recall was having to take 2 tablets per day orally with water. And I could physically feel a shift in my mood/behavior if ever I forgot to take 2nd dose immediately at the time of scheduled dosing.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I had slight tenderness/soreness at the injection site following dose #1. But nothing really notable. It was after the 2md dose I experienced severe, unexpected pain & extreme sensitivity in my entire left arm, from just below my shoulder to just before the arm meets the wrist. It was intolerable, I couldn''t lift or stretch or reach for things with this arm the entire morning, day, and night. At 1st sign of pain upon waking up that morning (morning after injection), I knew I''d never experienced pain like this (in general), especially not after an injection of any kind, so I tried to take immediate action and do what I thought would be best. I sat on my couch for long periods of time with a giant old-fashioned ice pack (big cloth like pouch with round, white screw-on cap, typically used for headaches, "booboo''s," etc.). I replaced it 2-3x throughout that day, and it wasn''t until my partner came home from work around 4pm that day and recommended I take some Tylenol orally, so I took 2 Extra-Strength Tylenol tablets + 1 Advil Migraine liquigel (gelcap), and I felt an immediate decrease in pain and eventually severity no more than 30min after taking OTC medicines. I took on empty stomach, too, which I''d never recommend, especially when taking any form of Tylenol, but the pain was just so bad I feel the medicine headed directly for that and didn''t effect my stomach as it normally would.


VAERS ID: 1617657 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Decreased appetite, Fatigue, Injection site pain, Mobility decreased, Muscle twitching, Pain, Pyrexia, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multi vitamin, calcium/vitamin D3 supplement, atorvastatin 10 mg, occasionally baby aspirin
Current Illness: none
Preexisting Conditions: diabetes, high cholesterol
Allergies: none that I know of
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 1. Muscle twitching on the left side of my head 2. Soreness/tenderness on the injection site of the left arm 3. Body aches, fatigue, lack of appetite, inability to sleep 4. Decreased left shoulder range of motion, pain on the anterior shoulder/ left pectoralis region 5. Fever


VAERS ID: 1617700 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-01-31
Onset:2021-08-18
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 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? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none known
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: PCR + Covid 8/19/2021
CDC Split Type:

Write-up: Client vaccinated with Moderna vaccines for Covid in January/February 2021. Symptomatic and tested positive for Covid on 8/19. Reported as a breakthrough Covid case in fully vaccinated individual.


VAERS ID: 1617705 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Cough, Dizziness, Fatigue, Head discomfort, Headache, Heart rate increased, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: Sertraline - 50 mg/daily Flintstones Gummy Complete vitamins - 2/daily
Current Illness: none
Preexisting Conditions:
Allergies: tree nuts
Diagnostic Lab Data: 8/18/21 - Doctors office - Oximeter reading 8/18/21 - Urgent Care - Oximeter reading, Covid test (negative)
CDC Split Type:

Write-up: 12:00 AM - fever started Day following vaccine, fever (100.0) & heartrate jumping between 94-200 Within an hour, it settled at 119 and stayed around 119 for a few hours By that evening, it was down to 74 and went up to 130 with any activity (for example, walking slowly up the stairs) She also had a sore throat, runny nose, headache and cough on this day and presently. (she tested negative for Covid) Her fever& fatigue lasted off and on for 2 days. As of 8/22, she is still has a cough, sore throat and headache - no fever, Her pulse only jumps up to 120-135 a few times a day. She feels dizzy, weak and her head feels "heavy."


VAERS ID: 1617823 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Prevnar - When she was 12 months
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Seasonal Allergies
Diagnostic Lab Data: None yet - concerned for myocarditis
CDC Split Type:

Write-up: Within 10 minutes of injection in pt''s non-dominant Left upper arm, she developed swelling in Left Gluteus Maximus (possibly lymphatic vessels there). Fever not getter than 100.9 started within 60 minutes and lasted for 2 days. Swelling in Left axilla within 8 hours. Swelling in Left side of body for 4 days Malaise for 4 days. Called Pharmacist and doctor''s office within 12 hours of adverse reaction. Tylenol and Advil given to ease pain and swelling as well as Benadryl.


VAERS ID: 1617825 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-01
Onset:2021-08-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Swollen feet, sore joint exhausted


VAERS ID: 1618494 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Muscle spasms, Pain, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vivelle dot .075, prometrium 200 mg qd
Current Illness: None
Preexisting Conditions: Brca 1 pos
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had an oophrectomy 2.5 years ago and I?m on HRT$g I have not had a period since then. The night of the vaccine i had spotting which has now progressed to heavy spotting /bleeding and severe cramps. I am taking ibuprofen around the clock and IM toradol with minor relief. This is not acceptable. I have already had COVID and have antibodies and now have to go through this excruciating pain. Everting out there stating this is stress related is nonsense. Tell that to someone not in the medical field. I?m a nurse. Stress makes you loose your period not have someone without ovaries start bleeding and cramping heavily. This is directly related to the vaccine.


VAERS ID: 1620507 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Confusional state, Electric shock sensation
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

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

Write-up: Brain zaps A startling ,painless, wave of sensation throughout my brain . The sensation stops me in my tracks and I?m briefly confused but quickly reorient .


VAERS ID: 1620518 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-15
Onset:2021-08-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 - / SYR

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

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

Write-up: Allergic rash, with blisters, all over body Still seeking medical care , have been given steroid, benadryl, pepsid hydoxzine,steroid cream, oatmeal baths


VAERS ID: 1623044 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: South Dakota  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (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: Abstains from alcohol; Immunodeficiency; Lupus erythematosus; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies. The patient had no history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: Antibody test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210840763

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 64 year old male . The patient''s height, and weight were not reported. The patient''s concurrent conditions included: lupus, non-alcohol user, non-smoker, and suppressed immune system, and other pre-existing medical conditions included: The patient had no known allergies. The patient had no history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 1805020 expiry: UNKNOWN) dose was not reported,1 total, administered on 02-APR-2021 to left arm as prophylactic vaccination. No concomitant medications were reported. On 18-AUG-2021, the patient had confirmed immunological vaccination failure. Patient did the Antibody test (NR: not provided) result were Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccination failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0; 20210840763 -Covid-19 vaccine ad26.cov2. S- Confirmed immunological vaccination failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is un labelled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS, MEDICAL HISTORY


VAERS ID: 1623069 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

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

Write-up: 8-10 minutes after I received the vaccine I felt a warm sensation on my throat and chest and after that my heart rate went up to 148-150. This heart rate lasted for about 7-10 m and then started to slow down . After 1 hr my heart rate was 110 and remained like that until next day . When I woke up next day it was back to normal.


VAERS ID: 1623257 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-28
Onset:2021-08-18
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0252208 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: na
Current Illness: none
Preexisting Conditions: na
Allergies: na
Diagnostic Lab Data: positive covid 19 antigen rapid test
CDC Split Type:

Write-up: Tested positive for covid


VAERS ID: 1623258 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-28
Onset:2021-08-18
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Nasal congestion, Rhinorrhoea
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin; multi vitamins; fish oil, Calcium D,
Current Illness: none
Preexisting Conditions: OSA; mild acid reflux; erectile dysfunction, neuropathy of right hand; varicose veins
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: nasal congestion, runny nose starting on 8/16/21


VAERS ID: 1623280 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-21
Onset:2021-08-18
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 LA / IM

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

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

Write-up: Tested positive after being vaccinated


VAERS ID: 1623311 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-24
Onset:2021-08-18
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Oropharyngeal pain, Pyrexia, Respiratory acidosis, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D; Super B complex; Valacyclovir; Cyclobenzaprine
Current Illness: none
Preexisting Conditions: depression, herpes
Allergies: Percocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: Congestion, cough, sore throat, fever


VAERS ID: 1623379 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Fatigue, Headache, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Propranolol
Current Illness: COVID positive 08/03/21
Preexisting Conditions: Asthma
Allergies: Erythromycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, body ache, cough, tired, nausea, metallic taste


VAERS ID: 1623399 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-12
Onset:2021-08-18
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH N/A / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Headache, Nasal congestion, Pain, 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? 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: POSITIVE PCR COVID TEST ON 8/21/21
CDC Split Type:

Write-up: PATIENT CONTRACTED COVID DESPITE BEING FULLY VACCINATED AT TIME OF EXPOSURE. POSITIVE PCR COVID TEST ON 8/21/21 WITH SYMPTOM ONSET 8/18/21: COUGH, RUNNY NOSE, NASAL CONGESTION, BODY ACHES, AND HEADACHES.


VAERS ID: 1623431 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EC3183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: External ear inflammation, Hypoaesthesia, Paraesthesia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: SWELLING, TINGLING, NUMBNESS OF LEFT SIDE OF LOWER FACE AND NECK, EARS INFLAMED,


VAERS ID: 1623478 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling, 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)

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

Write-up: Hives over entire body, hands were swollen like a balloon, feet slightly swollen


VAERS ID: 1623534 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

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

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

Write-up: trouble sleeping, rashes on face 48 hours after vax, rashes are puss, went to urgent care and dr said they think it is contact dermatitis


VAERS ID: 1623535 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-04
Onset:2021-08-18
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19 pneumonia, Dyspnoea, Influenza like illness
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient reported to ED with shortness of breath and flu-like symptoms that started over 1 week ago. Patient confirmed to have COVID pneumonia, given remdesivir, dexamethasone. Patient still in hospital for treatment. Of note, he has his first COVID vaccine on 8/4


VAERS ID: 1623543 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 1 LA / SYR

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

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

Write-up: Approximately 30 hours after receiving the vaccine, I experienced Fever, Chills, and severe pain throughout my body. Pain was centralized in areas where previous pain/injuries have occurred. Right and left knees, shins, lower back/hip, right and left shoulders. Pain was extreme, I would guess 3-4X what I would typically feel on a bad day.


VAERS ID: 1623575 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-08-18
   Days after vaccination:210
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Headache, Injection site pain, Myalgia, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control - Pill Form - Generic Yaz
Current Illness: None
Preexisting Conditions: None
Allergies: ? Keflex ? Latex ? Shellfish
Diagnostic Lab Data: COVID-19 Positive test on 08/19/2021
CDC Split Type:

Write-up: 1st dose - Tenderness at injection site 2nd - High Fever, Sore Throat, Shaking, Headache, Muscle Ache


VAERS ID: 1623618 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-09
Onset:2021-08-18
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: HTN, DEPRESSION, DEMENTIA
Allergies: UNK
Diagnostic Lab Data: POSITIVE PCR- 8/18/21
CDC Split Type:

Write-up: PT DEVELOPED COVID 19 AFTER BEING FULLY VACCINATED.


VAERS ID: 1623643 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Dizziness, Dyskinesia, Loss of consciousness, Pruritus, Screaming, Seizure, Sensory disturbance, Skin warm, Speech disorder, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Dyskinesia (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Follow up appointment with neurologist today. At hospital I was offered blood test and iv fluids, I declined.
CDC Split Type:

Write-up: Five minutes after injection my arm began itching and feeling hot and unusual. Put arm over head, began feeling lightheaded and dizzy. Put arm down, began feeling intense dizziness and a hot burning sensation rip across my body starting from injection arm outward. I began screaming for help, screaming ?what did you do to me, I?m dying?. I began losing control of my arms which cinched in towards my body, I lost control of my head which began to bobble uncontrollably. I said about 4-5 statements before my words began to become unintelligible. I felt an electrical sensation zap from my arm to my body and down my back which felt like I was hit with something. I then lost consciousness. When I awoke medical director of vaccination site, whose name I still don?t have, told me I had just had two seizures. They told that info to emt, upon hospital admittance I was told I had just feinted.


VAERS ID: 1623672 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-05
Onset:2021-08-18
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Parotitis, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal infections (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 any known medications or supplements.
Current Illness: No
Preexisting Conditions: No
Allergies: No known allergies to drugs or food.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient developed facial swelling on the left side of his face on 08/18/21. He was taken to facility in the area. There is was diagnosed with parotitis and prescribed cephalexin. He was seen in our clinic on 08/20/21 for a follow up exam His medication was changed to Augmentin.


VAERS ID: 1623673 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-09
Onset:2021-08-18
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / UNK RA / IM

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

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

Write-up: COVID 19


VAERS ID: 1623676 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

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

Write-up: The parent of patient completed the vaccine consent form and put the patients date of birth down incorrectly and stated she was 12 years old when in fact she was 11 and not eligible for the vaccine.


VAERS ID: 1623776 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-25
Onset:2021-08-18
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Fall, SARS-CoV-2 test positive
SMQs:, Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Tested positive for COVID-19 at assisted living facility on 8/18/21, got progressively weak and fell in his bathroom. Patient is still receiving hospital treatment.


VAERS ID: 1623819 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-21
Onset:2021-08-18
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1623821 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: Itchy, bumpy, red rash. Rash started on my left hip, side of my thigh, about the size of two dollar bills side by side, long ways. Rash spread in small dots to my left forearm, torso, chest, neck.


VAERS ID: 1623841 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-28
Onset:2021-08-18
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Fatigue, Feeling abnormal, Headache
SMQs:, Dementia (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: ADHD Anxiety/depression
Allergies: none
Diagnostic Lab Data: 8/23/21 evaluated at clinic for symptoms.
CDC Split Type:

Write-up: Brain fog/fatigue/headache more than usual since second dose of pfizer vaccine administration one week ago.


VAERS ID: 1623861 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeding disorder, Lethargy, Pain of skin, Sensitive skin
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Novolin R Levemir
Current Illness: Type 1 Diabetes and gastroparesis
Preexisting Conditions: Type 1 Diabetes and gastroparesis
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: I became very lethargic and fatigued. My skin is very sensitive, it hurts. I was not able to eat or drink for 2 days.


VAERS ID: 1623904 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 1 LA / IM

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

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

Write-up: Patient and parent presented to Covid testing / immunization facility located in drive through. The patient requested Pfizer. Pfizer vials were not immediately available downstairs at the time. The patient was asked all questions on the questionnaire. After waiting at least 15 minutes, patient?s parent requested Moderna since it was readily available & they were waiting. Patient was given the Moderna vaccine instead of the Pfizer. Mother was contacted after the event was noted & reports no adverse signs or symptoms.


VAERS ID: 1623925 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 318 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Heart rate increased, Paraesthesia, Skin disorder, Throat tightness, Tremor
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Avelox, Dexilant Shimp, I V contrast die, nespresso coffee
Diagnostic Lab Data: Was given Solumedral IV by Paramedics. End Benadryl tablet tablet at pharmacy while waiting for paramedics
CDC Split Type:

Write-up: Tingling and flushing in arm Of vaccine. Followed by tightening of throat And rapid heart rate. Is followed by uncontrollable shaking of the legs. Blochi skin.


VAERS ID: 1623938 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia
SMQs:, Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient reports loss of taste and smell 2 days after vaccination 8/18/21 and it has not come back as of 8/23/21.


VAERS ID: 1623944 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-11
Onset:2021-08-18
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 2 UN / IM

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

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

Write-up: pt. was fully vaccinated - dose 1 2/4/21 Lot 013M20A; dose 2 3/11/21 Lot 003A21A. Tested + for COVID 8/19/2021


VAERS ID: 1624003 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: There was a discrepancy in between the birth dates provided by parent and listed in the database. Parent provided birth date of 7/20/2009 over the phone and on the signed consent form. This birthdate would make the child eligible for the vaccine administered. However, the birth date in the electronic record is 7/20/2010, which would deem the child ineligible and the dose would be considered a vaccine administration error. HCF was made aware of the discrepancy by Provider Outreach Specialist with the COVID-19 Vaccination task force at the Department of Health Services. In response, a call was made to the mother of the client. Notified her of the discrepancy, and she maintained that Pt''s birth date is 07/20/2009, and that the Registry is incorrect. Provided her with the help desk phone number so the record can be corrected. The mother stated that pt. tolerated the second dose well.


VAERS ID: 1624042 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Red circular itchy rash at site of injection that has lasted up to 10 days post vaccine


VAERS ID: 1624055 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Cardiac failure congestive, Dyspnoea, Echocardiogram, Electrocardiogram, Myocardial necrosis marker
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness:
Preexisting Conditions: HTN, SLE
Allergies: none
Diagnostic Lab Data: cardiac enzymes, EKG, ECHO, CTA chest
CDC Split Type:

Write-up: dyspnea, new CHF, possible myocarditis. This is patien''ts 3rd dose (booster)


VAERS ID: 1624070 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-08
Onset:2021-08-18
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / UNK - / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / UNK - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: She developed COVID-19 08/18/2021


VAERS ID: 1624098 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-14
Onset:2021-08-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cyanosis
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypotonic-hyporesponsive episode (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: Rinvoq Leflunomide Trazadone Icosapent Ethyl Potassium Valacyclovir Folic Acid Sertraline Metformin Lansoprazole Rosuvastatin Calcium Lisinopril Allopurinol B-12 Vit C Vit E Vit D3 Tramadol
Current Illness: High Blood Pressure Diabetes Rheumatoid Arthritis
Preexisting Conditions: Blood Pressure
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left and Right Big Toes turning blue


VAERS ID: 1624108 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Electrocardiogram, Hypoaesthesia, Metabolic function test
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin-Dipyridamole ER 25/200 mg Cap ER 12hr TAKE 1 CAPSULE BY MOUTH TWICE A DAY azaTHIOprine 50 mg Tab TAKE 2 TABLETS BY MOUTH EVERY DAY Lantus SoloStar 100 UNIT/ML Solution Pen-injector INJECT 52 UNITS UNDER THE SKIN AT BEDTIME Losartan
Current Illness: NA
Preexisting Conditions: Diabetes, Crohn''s disease, hx TIA
Allergies: Codeine
Diagnostic Lab Data: 8/23/21 EKG 8/23/21 CMP
CDC Split Type:

Write-up: Day 2 post vaccine SOB and Chest tightness, resolved Day 3 post vaccine L facial numbness Patient called clinic at 4:30 Day 3 post vaccine and was advised to go to ER, pt did not go Day 6 post vaccine patient had office visit and MD advised pt to go to ER for further work up


VAERS ID: 1624144 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Fatigue, Headache, Hypoaesthesia, Nausea, Oropharyngeal pain, Pain in extremity, Paraesthesia, Swollen tongue, Syncope, Throat tightness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Anaphylaxis (throat closing, tongue swelling and numbness) vasovagal syncope, nausea all occured within 10 minutes of receiving vaccine. Pharmacist did not provide epipen and administered benadryl. Symptoms slowly subsided but then worsened whereas I experienced numbing and tingling in my arms. After calling my allergist to discuss getting an allergist appt as the pharmacist was not able to provide the care I needed because she was busy, the nurse at the allergist advised me to get straight to the ER or Urgent care. I went to the emergency room where I was treated with 60 mg prednisone, pepcid, and filled prescriptions for prednisone and an epipen. I have completed my prednisone but I continue to feel a severe headache on one side, sore throat, pain in my arm, and extreme fatigue. I would not say that I have recovered at this point.


VAERS ID: 1624156 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 RA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received moderna and is under the minimum age of 18.


VAERS ID: 1624278 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-02-06
Onset:2021-08-18
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Fatigue, Headache, Impaired work ability, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: annual flu shot always gives her a raised hot spot about hockey puck size.
Other Medications: Letrozole, Metoprolol, Calcium, D-3, Magnesium, Zarelto, Crestore, Potassium
Current Illness: none
Preexisting Conditions: CHF, AFIB, Breast Cancer (2019),
Allergies: Keflex
Diagnostic Lab Data: PCR test sent to Lab. Tested on 8/20/21 with results showing on 8/23/21.
CDC Split Type:

Write-up: 8/17/21 patient had a headache and was tired. Came to work on 8/18/21 but started feeling worse throughout the day so she went home. Fever $g100, headache, body aches, cough, difficulty breathing, fatigue. PCR test done on 8/20/21 with positive results coming on 8/23/21. Patient has had little symptom improvement to date.


VAERS ID: 1624352 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Headache, Oral pain, Skull X-ray normal
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: Severe rash 3 days after Pfizer vaccine #2; diagnosed with eczema
Other Medications: OneADay Women''s 50+ Vitamin; ACAI 3000mg supplement; Restatis eye drops; Fish Oil; Benadryl sleep aid
Current Illness: GPA diagnosed in 2020
Preexisting Conditions: Raynauds; some arthritis
Allergies: None
Diagnostic Lab Data: X-ray of skull; results indicate incident not related to dental issue. Also had adverse effects after second vaccine which have not been reported. Feel possibly with my overactive immune system and diagnosis of GPA, the vaccine has negative effects on my body.
CDC Split Type:

Write-up: Woke up day after vaccine with blazing headache and mouth pain on right side. Never get headaches. Used Tylenol all day with zero relief. By next day, visited dentist at 4pm who did x-ray of skull and determined it was not related to a dental issue. Pain was at 10 which was abnormal (I have high tolerance for pain). Referred me to oral surgeon. Took 2 Tylenol + 1 ibuprofen every 4-6 hours per dentist for pain relief. Helped with pain; however, pain persisted with food or drink. Tried to change behavior by taking small bites and minimizing movement which helped. Six days later still have lingering effects.


VAERS ID: 1624533 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-03
Onset:2021-08-18
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 got the first dose on 8/3/21 with no issues but called pharmacy on 8/23/21 and reported that she was having some pain and swelling in the arm that she recieved the vaccine in that started with in the last several days, patient was advised to take analgesics and antihistamines and use cold compress on area and if symptoms didnt resolve or worsen to seek medical attention


VAERS ID: 1624560 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Fatigue, Headache, Oropharyngeal pain, Pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Myfortic, cyclosporine, prednisone, metoprolol er, valsarten, cervemiline, colon health, Florastor, folic acid, niacinamide, vitamin b, vitamin d
Current Illness:
Preexisting Conditions: Renal transplant
Allergies: Penicillin, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache 1 day, fatigue constant, sore throat, ear pain 2 days, elbow pain 1 day, upper body aches Tylenol


VAERS ID: 1624812 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-05
Onset:2021-08-18
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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? 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: Positive test results


VAERS ID: 1624834 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-10
Onset:2021-08-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 1 AR / IM

Administered by: School       Purchased by: ?
Symptoms: Erythema multiforme, Headache, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient developed erythema multiforme rash of both palms and both feet. Rash started 8/18/21, ten days after Moderna vaccine. Patient had previously received two doses of vaccine on May 14, 2021 and June 9, 2021. Rash worsened on 8/21/21 and started to improve on 8/23/21, but was not completely resolved. Patient had a fever for one day after receiving Moderna and headache for two days. Both of those symptoms had resolved when rash started.


VAERS ID: 1624851 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Work       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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: the injection site is now magnetic. This is limited to the site and nowhere else on the extremity


VAERS ID: 1625272 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Head discomfort, Headache, Pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Date for next COVID - 19 Pfizer shot is 9/8/2021
Other Medications: No
Current Illness: I took the vaccination Pfizer on August 18, 2021 every since then I have been experiencing really really bad headaches for 5 days, my head feels so heavy the pain has been constantly.
Preexisting Conditions: High Blood Pressure AMLODIPINE 10mg, Type 2 Diabetes metFORMIN 1000mg, ATORVASTATIN 20mg.
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: Information in records at

Write-up: None stated.


VAERS ID: 1625466 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-12
Onset:2021-08-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO178 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Headache, Hypoaesthesia, Magnetic resonance imaging, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa
Diagnostic Lab Data: Stroke protocol was taken.Clot buster medicine admin., CT scan, transferred by ambulance. MRI was taken. placed in ICU.
CDC Split Type:

Write-up: I did have a sore arm the 2 days following injection. The 5th day following the injection, my left hand fell asleep/ went numb, about 10 min later my left arm had the same feelings, approximately 10-15 min after my arm, my left leg had the same feeling and about 10 minutes after my leg, my left foot had the same feelings. Approximately 15 minutes after my foot, I had an intense headache. My daughter took me to ER where I was treated for stroke symptoms.


VAERS ID: 1625957 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210843061

Write-up: MIGRAINE; FEVER; This spontaneous report received from a patient via a company representative 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: Unknown) dose was not reported, administered on 18-AUG-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 18-AUG-2021, the patient experienced migraine. On 18-AUG-2021, the patient experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from migraine, and fever. This report was non-serious.


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