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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 113 out of 6,867

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VAERS ID: 1627741 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect product formulation administered
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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1627928 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-10
Onset:2021-08-18
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Arrhythmia, Atelectasis, COVID-19 pneumonia, Chest X-ray abnormal, Dehydration, Electrocardiogram normal, Electrolyte imbalance, Fall, Gastrointestinal disorder, Hypoxia, Renal failure, SARS-CoV-2 test, Syncope, Troponin normal
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No reported medications.
Current Illness:
Preexisting Conditions: No reported previous health conditions.
Allergies: No reported allergies.
Diagnostic Lab Data: COVID 19 MOLECULAR Negative Positive Abnormal
CDC Split Type:

Write-up: The patient was seen and examined as above. Differential diagnosis includes Covid pneumonia, dehydration, electrolyte abnormality, renal failure, arrhythmia. I suspect the patient had syncope due to orthostasis. I considered doing a head CT but he fell last yesterday, and has no worsening headache, a nonfocal neuro exam, and is not on blood thinners. He was hypoxic when he got to the room and was placed on oxygen. His sats were 88 to 89% on room air. His chest x-ray shows bibasilar atelectasis. He was given some fluids. He has an acute kidney injury which is likely due to GI losses. His troponin is negative. His EKG shows no concerning signs for arrhythmia. At this time given that he needs oxygen he needs admission. I spoke with with the hospitalist who accepted the admission.


VAERS ID: 1628101 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, Chills, Headache, Malaise, Myocarditis, Pyrexia, Troponin increased
SMQs:, Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Obstructive sleep apnea
Preexisting Conditions: OSA
Allergies:
Diagnostic Lab Data: Troponin 1.520 BNP 2530
CDC Split Type:

Write-up: Myocarditis, fever chill ha ba malaise


VAERS ID: 1628104 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-01
Onset:2021-08-18
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID-19 Antigen test with a positive result
CDC Split Type:

Write-up: Patient received the Pfizer COVID-19 vaccine on 3/11/21 and 4/1/21, so was fully vaccinated when they tested positive for COVID-19 on 8/18/21


VAERS ID: 1628115 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Respiratory tract congestion, Therapeutic response unexpected
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: N/A
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states that after receiving the 1st dose of Phizer 08/18/2021, started experiencing symptoms later that evening and clearing of the chest. Asthmatic known with congestion, states that clearing occurred and feeling better than before. No noted Primary visit.


VAERS ID: 1628120 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Pain, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Progesterone, E2/E3/test HRT (Estrogen)
Current Illness: None
Preexisting Conditions: None
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Events: 14 hours of heart palpations, body aches, chills, headache for 5 days. I did not seek treatment for the heart palpations since they were in the overnight hours. I decided to seek help if it reached the noon hour of the next day and they resolved by 10:00am on the 8-19. The daily headaches were resolved by daily Tylenol.


VAERS ID: 1628131 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-03
Onset:2021-08-18
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache
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:

Write-up: headache


VAERS ID: 1628146 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Injection site erythema, Injection site induration, Injection site infection, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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:
Other Medications:
Current Illness:
Preexisting Conditions: Lupus and Diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had 1st vaccine with no issues. Patient had 2nd shot on 2/4/21 at department, and 3rd shot on 8/16/21. After both 2nd and 3rd shot patient has been left with a "skin infection" at the injection site. She reports it as large, hard, red, warm, itchy, and painful. Both times her doctor has prescribed Ciprofloxacin to be taken to clear it up. She reports that the treatment does work. She has diabetes and lupus, and receives many injections that do not cause this type of reaction for her.


VAERS ID: 1628327 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-15
Onset:2021-08-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Blood test normal, Electrocardiogram normal, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG, ER Visit, Blood Work Performed, all results came back normal.
CDC Split Type:

Write-up: Heart palpitations and heart arrhythmia beginning 3 days after vaccination and lasting over 24 hours straight.


VAERS ID: 1628335 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Injection site erythema, Injection site irritation, Injection site pain, Injection site reaction, Injection site swelling, Joint range of motion decreased, Pain in extremity, Rash, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), 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: Hydroxychloroquine, spironolactone, pristiq, multivitamin, allegra D
Current Illness: no
Preexisting Conditions: autoimmune connective tissue disease
Allergies: none
Diagnostic Lab Data: Went to see Dr. Tuesday August 24th, 2021. Diagnosis was shingles.
CDC Split Type:

Write-up: Night of shot- extreme arm pain for 3 nights couldn''t raise arm above shoulder. Starting Wed. August 18th, 2021 rash on left forearm and left side rib cage rash began to develop. Thurs. August 19, 2021 right should injection site became irritated and sore again. The rashes and irritation progressed and peaked Sunday August 22, 2021 with blistering painful rashes at sites mentioned. Injection site red and swollen several inches around the injection.


VAERS ID: 1628350 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-02
Onset:2021-08-18
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Echocardiogram, Electrocardiogram, Electroencephalogram, Face injury, Fall, Head injury, Magnetic resonance imaging head, Seizure, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Fatigue, loss of appetite, negative PCR tests for COVID-19
Preexisting Conditions:
Allergies: Sesame products
Diagnostic Lab Data: MRI of brain, EEG, cardiac echo, CT of head, EKG
CDC Split Type:

Write-up: Fainting and seizure at about 3:30 on August 18. Fainted from sitting on stool, fell to ground and hit head face-on. Seizure movements and unresponsive to coworkers for 4-5 minutes. Paramedics arrived afteri awoke slightly and took me to emergency room where I stayed from Wednesday afternoon until Friday afternoon for tests and observation.


VAERS ID: 1628368 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA OOZFZIA / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Gait inability, Hypoaesthesia, Pain
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre 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: ESTRADIAL
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data:
CDC Split Type:

Write-up: IT STARTED WITH NUMBNESS AND THROBBING PAIN WHERE THE SHOT WAS GIVEN AND BY 2:00 A.M. MY WHOLE BODY WAS BURNING. I COULDN''T WALK AND HAD TO CRAWL TO THE PHONE TO CALL FOR HELP. MY RIGHT ARM WENT NUMB AND MY RIGHT HAND FELT LIKE WASPS STINGING ME. I DON''T KNOW IF I SHOULD GET THE SECOND SHOT.


VAERS ID: 1628374 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diarrhea since receiving vaccine, started day of vaccine and patient still has upset stomach and diarrhea 6 days later


VAERS ID: 1628379 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 - / -

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

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

Write-up: Itching, rash over entire body, took Benadryl.


VAERS ID: 1628381 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient received a 3rd booster dose of Pfizer Covid Vaccine. First two doses were Moderna. No Adverse reactions reported.


VAERS ID: 1628390 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient received a 3rd booster dose of Pfizer Covid Vaccine. First two doses were Moderna. No Adverse reactions reported.


VAERS ID: 1628396 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-08
Onset:2021-08-18
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Parosmia
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 100mg, prenatal vit.
Current Illness: N/A
Preexisting Conditions: NONE
Allergies: KNA
Diagnostic Lab Data: None yet.
CDC Split Type:

Write-up: On Wednesday, August 18, 2021 around 2:00 pm I started smelling cigarette smoke that was not there. I would estimate that I smell it 9/10 breaths and I smell it everywhere (work, home, outside, in the car, grocery store, restaurants, and when I''m alone by myself), also, I don''t smoke and neither does my boyfriend which I live with. I house have NEVER been smoked in. I have an appointment to see and ENT on August 31st.


VAERS ID: 1628399 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Patient fainted very briefly. He was sitting in the chair talking with his family member his face went white and he dipped his head as he fainted. He did not fall and came back very quickly. I gave him a bottle of water and called 911. 911 came and evaluated him and he did not leave with them


VAERS ID: 1628460 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 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: spironolactone 25mg; losartan 50mg; metformin 500mg; acidophilus lactobacillus; triamterene 50mg capsules; potassium chloride; Lyrica; cardizem 240 mg; protonix; folic acid 1mg 2 tablets 2x per day; zanaflex 40mg; Miralax; norco; hydrocodon
Current Illness: I did not have any illness at the time of my vaccination.
Preexisting Conditions: I have rheumatoid arthritis, I am iron deficient and borderline diabetic.
Allergies: I am allergic to sulfa and beta blockers.
Diagnostic Lab Data: I had a COVID test and it came back positive.
CDC Split Type: vsafe

Write-up: My son had tested positive for COVID two weeks ago, 08/13/2021, and right after receiving my third dose, I tested positive.


VAERS ID: 1628491 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-20
Onset:2021-08-18
   Days after vaccination:210
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Fully vaccinated on 12/30/2020 and 01/20/2021 with Pfizer vaccine, and tested positive for COVID on 08/21/2021


VAERS ID: 1628495 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dyspnoea, Fatigue, Headache, Injection site pain, Nasal congestion, Nausea, Oropharyngeal pain, Pain, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Don''t know
Diagnostic Lab Data: Virtual appointment with doctor on 8/24/2021
CDC Split Type:

Write-up: Body aches, headache, pain in the injection, nausea, diarrhea, sore throat, running nose, chills, difficulty breathing, stuffed nose, overly tired


VAERS ID: 1628504 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-20
Onset:2021-08-18
   Days after vaccination:210
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: fully vaccinated on 12/30/2020 and 01/20/2021. tested positive for COVID on 08/22/2021


VAERS ID: 1628508 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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 after receiving the vaccine was waiting in the observation area when she told us that she was dizzy. Soon after that she briefly passed out on the chair she was sitting on. Patient was passed out for about 5-10 seconds and came out soon after.


VAERS ID: 1628518 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-27
Onset:2021-08-18
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Covid19


VAERS ID: 1628585 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone increased, Body temperature increased, Brain natriuretic peptide normal, C-reactive protein increased, Chest discomfort, Chest pain, Coma scale, Echocardiogram normal, Electrocardiogram S1-S2-S3 pattern, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Fluid intake reduced, Headache, Hypophagia, Immunoglobulin therapy, Intensive care, Mononucleosis heterophile test negative, Myocarditis, Nausea, Retching, SARS-CoV-2 antibody test positive, SARS-CoV-2 test negative, Serum ferritin normal, Thyroxine free normal, Troponin increased, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: HISTORY OF PRESENT ILLNESS: Patient is a 16-year 4-month-old previously well male admitted to the ICU from the emergency room at Hospital where he presented with a 1 day history of chest pain. 3 days prior to admission Patient had his second Pfizer Covid vaccine. The evening of receiving the vaccine he started to have elevated temperature for 2 days to as high as 103. He did not take any medication and it has self resolved. 2 days prior to admission he had occipital headache. He also had decreased p.o. intake of fluids and food. He started to have sternal chest pain that felt pressure like starting 11 AM yesterday morning. This abated but came back in the middle of the afternoon. He had some nausea and retching that self resolved. He was able to eat dinner last night but had recurrence of chest pain about 9:00 that he described as a 7.5 to 8.5/10 on a pain scale. With this he was brought in for evaluation. On EKG he has no evidence of ST elevation and troponin is markedly elevated at nearly 28,000. Cardiology was contacted and recommended admission echocardiogram this morning as well as initiation of aspirin. ASSESSMENT: Patient is a 16-year 4-month-old male with chest pain associated with myocarditis of at this point undetermined etiology but suspect post Covid vaccination Discharge Summary HPI: Patient is a 16-year 4-month-old male admitted early on 8/20/2021 with chest pain, elevated troponin and abnormal EKG 3 days following second Pfizer Covid vaccine. Physical Exam today: He is alert active conversational no acute distress. GCS 15. No neurologic deficit. Heart has a regular rate and rhythm with normal S1 and S2. Lungs are completely clear with equal breath sounds bilaterally symmetrical. Abdomen is soft flat benign exam with no hepatosplenomegaly. Peripheral pulses +2/4 with capillary refill of 2 seconds Hospital Course by Systems: CNS: He had occipital headache the day prior to admission. He has had no significant headaches since. He had very limited chest pain the first day of admission but has had no subsequent chest pain. CV: The a.m. after admission he had an echocardiogram that was normal. Troponins have been followed serially starting at 28,000 (normal reference range <76) decreasing 4 hours later without therapy to 23,000. Echocardiogram showed normal function and no pericardial effusions. Initial EKG showed ST elevation. After consult with cardiology he was given IVIG 2 g/kg. The a.m. after infusion his troponin increased to 25,000. Repeat echo was again normal with vigorous function. Troponin this morning is down to 14,000. CRP started at 10 and is down to 3.5. BNP and ferritins have been normal. He is discharged today with follow-up troponin, BNP, CRP and ferritin to be obtained on an outpatient basis tomorrow. He will see Dr. on Tuesday with echocardiogram. Our office will arrange for cardiac MRI and cardiac Covid team Hospital to see him this week. Limited physical activity with no strenuous activity this week. No caffeine. He will continue with ibuprofen 400 mg 3 times daily and 3 baby aspirin (243 mg) daily. Pulm: From a respiratory standpoint he has had excellent saturations on room air with no need for supplementation FEN/GI: He has been eating well throughout Renal: Urine output has been satisfactory though incompletely collected Hematologic: No acute issues Endocrine: free T4 normal at 1.12 and TSH slightly elevated at 5.67 ID: Respiratory PCR including Covid was negative at the time of admission. Monospot negative. Covid IgG was positive as expected following first Covid vaccine on 7/23/2021. It is felt felt that his myocarditis is related to Covid vaccine. PS: I reviewed all of the above issues with father. Questions were answered including mother''s over the phone. If he has any recurrent chest pain he is to return. Medications: Current Facility-Administered Medications Medication ? aspirin chewable tablet 243 mg ? ibuprofen (MOTRIN) tablet 400 mg ? lidocaine cream 4 % dressing kit ? ondansetron (ZOFRAN) injection 8 mg Current Outpatient Medications Medication Sig ? aspirin 81 MG chewable tablet Chew 3 tablets (243 mg total) by mouth daily. ? ibuprofen 400 MG tablet Take 1 tablet (400 mg total) by mouth 3 (three) times daily for 10 days. Assessment: Patient is a 16-year 4-month-old male with myocarditis secondary to Covid vaccine


VAERS ID: 1628668 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-04
Onset:2021-08-18
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Fatigue, Headache, Myalgia, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler ALPRAZolam (XANAX) 0.5 mg tablet (Expired) buPROPion XL (WELLBUTRIN XL) 300 mg 24 hr tablet cholecalciferol (VITAMIN D3) 1,250 mcg (50,000 unit) capsule clindamycin (CLEOCIN T) 1 % l
Current Illness:
Preexisting Conditions: Nervous Classic migraine with aura Lumbar pain Neck pain Respiratory Allergic rhinitis Intermittent asthma Circulatory Decreased cardiac ejection fraction Digestive Gastroesophageal reflux disease without esophagitis Irritable bowel syndrome with diarrhea Vitamin D deficiency Genitourinary Bacterial vaginosis Musculoskeletal Acne Eczema Hidradenitis suppurativa Lateral epicondylitis of right elbow Other ADHD, predominantly inattentive type Anxiety Hx of abnormal cervical Pap smear Daytime somnolence Memory changes
Allergies: Sulfa (Sulfonamide Antibiotics)Rash Artificial sweetener - facial swelling
Diagnostic Lab Data: Updated Procedure 08/19/21 1146 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/19/21 0911 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/19/21 1146 COVID-19 PCR Collected: 08/19/21 0911 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: Please select any symptoms you are experiencing: Fever or Chills Fatigue Muscle or body aches Headache Sore throat


VAERS ID: 1628809 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Heart rate decreased, Postural orthostatic tachycardia syndrome
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metimazole 5 mg, zonegran 200mg, notriptyline 25mg, lexapro 10mg, ,vitamin d3, ivag, norco 10, zanaflex 4mg, imitrex 50mg, midodrine 5mg,
Current Illness: na
Preexisting Conditions: hosimoto thyroiditis, graves disease, pots, chronic pain, polymyocystis
Allergies: butrans pain patch
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient felt like she was going to pass out and realized it was her blood pressure. pt recorded bp of 76/63 with hr of 140bpm the symptoms quickly resolved after a few minutes and hr decreased to 80bpm after she remained lying down flat. Pt continued to have POTS through out the day and was managed by lying down


VAERS ID: 1628822 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Induration, Pruritus, Skin mass
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (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: Flu vaccine
Other Medications: inhaled steroid
Current Illness: no
Preexisting Conditions: asthma Myasthenia Gravis
Allergies:
Diagnostic Lab Data: contacted pharmacist and was told to draw a ring around it and that if it grows go to the ER. was told it could be Covid Arm
CDC Split Type:

Write-up: On the 3rd day notice a lump the size of a hard boiled egg. Itched and was red .


VAERS ID: 1628827 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure fluctuation, Fluid overload, Pericardial effusion, Pleural effusion, Pre-eclampsia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ibuprofen, prenatal vitamin
Current Illness: 1 week postpartum from a normal, uncomplicated vaginal delivery
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Mild pericardial effusions and pulmonary effusions on 8/18
CDC Split Type:

Write-up: Patient developed fluid overload in her heart and lungs that evening, as well as severe range blood pressures. Was diagnosed with preeclampsia with severe features


VAERS ID: 1628875 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, Migraine, Musculoskeletal discomfort, Neuralgia, Pain in extremity, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Migraine x 3 day at 0700 pm Burning shoulders Left leg nerve pain Sore arm Rash on bilateral arms and chest


VAERS ID: 1629054 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Chest X-ray, Computerised tomogram, Fatigue, Hypoaesthesia, Magnetic resonance imaging, Scan with contrast, Taste disorder
SMQs:, Peripheral neuropathy (broad), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocodone 3x day 10 mg did jot take 12 hrs before
Current Illness: rheumatoid arthritus, anklozing spondilitis
Preexisting Conditions: same as above
Allergies: pennclln, codine, verced, markaine
Diagnostic Lab Data: ct with and without contrast, mri, chest xray, mult bloodwork, meds administered. ivs and anti blood coagulants
CDC Split Type:

Write-up: bad taste directly after shot, next day left side of face went numb. rushed to er for stoke protocol. was admitted into hospital. Had follow up with rheumatologist and new vascular and neuro doctors scheduled. symptoms come and go with one sided face numbness headache and extreme tiredness


VAERS ID: 1629063 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-14
Onset:2021-08-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Blister, Blood pressure increased, Computerised tomogram neck, Computerised tomogram thorax normal, Dyspnoea, Epistaxis, Herpes zoster, Obstructive airways disorder, Rash, Rash erythematous, SARS-CoV-2 test negative, Spinal X-ray, Thrombosis
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Emergenc +
Current Illness: None
Preexisting Conditions: Anxiety/depression
Allergies: None
Diagnostic Lab Data: X-ray and ct of neck and chest at ER on 08/18/2021 were clear. COVID 19 test on 08/20/2021 was negative.
CDC Split Type:

Write-up: I had my 2nd vaccine dose on 8/14/2021. I had a nose bleed on 8/16/2021 and 8/17/2021. While at work on 8/18/2021 I noticed I was having difficulty breathing. I was reading to my students and couldn?t get another word out because it felt like my airway was closing in. I went straight to the ER for evaluation of my airway, but on the way there my nose started gushing blood. Huge clots were coming out. I was looked at but the doctor was only focusing on the nosebleed. My blood pressure was extremely elevated as well. I got not treatment at ER and was referred to my Primary care doctor. She say me on 08/19/2021 where she gave me a breathing treatment and prescribed an anti inflammatory, anti histamine, steroids, and an inhaler and referred me to Allergy/Asthma as well as ENT. That day I also noticed a small red spot on my neck. On 08/20/2021 the spot had spread just a little bit but I just thought it was a small rash that would go away. I called to schedule an appointment with ENT on 08/21/2021 and they said I needed a negative Covid test so I went to urgent care to be tested for COVID. It came back negative. On 08/ 22/2021 I returned to the ER because the rash had now spread down my neck to my shoulder and chest and had blisters forming. I was diagnosed with shingles and given a prescription for Valtrex.


VAERS ID: 1629108 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse 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: paresthesia pins and needles on right side and arm for 3 days, same side, one day later, still has radiating pain in armpit
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


VAERS ID: 1629856 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-13
Onset:2021-08-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267-1000-03 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Antibody test positive, Blister, Diarrhoea, Dysgeusia, Headache, Incontinence, Myalgia, Night sweats, Pain, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vasculitis (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: losartan HCT, allopurinol, multi vitamin
Current Illness: Covid-19 2/17/21, Infusion 2/24,Light case of Gout
Preexisting Conditions: Hypertension since about 2004.
Allergies: None that I''m aware of.
Diagnostic Lab Data: Observation only; prescribed famotidine (Pepcid 40 mg oral tablet) 1 tab one a day (at bedtime), predniSONE (predniSONE 20 mg oral tablet) 2 tablets oral every day. Take benadryl daily until symptoms disappear. There was great improvement within 24 hours. Now the hive areas look like I had bug bites but this is due to the blisters. I will see my doctor on 8/31/21 for a followup. I did take pictures so he could see what they looked like on 8/20. At this time, I will not trust having a booster shot. I had blood work done on June 11th and still had antibodies. Perhaps my system had more than enough antibodies after the second shot which caused the reaction with hives.
CDC Split Type:

Write-up: Time line for my Covid-19: Began aching and low grade fevers approximately 2/17/21. Husband started with a cold on 2/3/21 so cancelled his scheduled Covid shot. He entered hospital on 2/22/21. I had infusion on 2/24/21. I had bad chills, fever, loss of bladder control in night, diarrhea next day but better in two days. Husband died 3/22/21. I did have hair loss for about a week, then it stopped. My doctor thought I should have at least one shot. Waited until July 23rd, had first Pfizer shot. Reactions from 1st shot were achiness and low grade fever. Arm was sore. It lasted about 36 hours. I decided to get the second shot on 8/13/21. Reactions follow: Friday evening & overnight: Fever of 100.5 Degrees, extremely sore muscles, pounding headache, loss of bladder control when going to toilet. Felt better during day hours. Saturday overnight: Night sweating severe enough to soak pj''s and sheets. Sunday: ate breakfast, tasted weird like some chemicals, stomach began to hurt. I had taken my blood pressure medicine before breakfast and thought that was the problem. But later at church, I had diarrhea then felt better. Still a little disoriented. On 8/16, I traveled to another state to see my sister. We went to 3 different cities. On 8/18 I began breaking out with what I thought were bug bites from a swarm on my left arm and back of neck. Blisters began to form. However, my sister had no bug bites. The injection sight had nothing in that area and my arm was never sore. However it kept increasing the next day to my right arm, both hands and more blisters began forming. At that time I thought it might be hives. I returned home 8/20 and I researched side effects from Covid shots since it continued getting worse and found out hives, blisters, etc. were a side effect from 3 to 14 days after a shot. By Sunday 8/22 it began on my face, hip area and on legs. it was severe enough to go to the emergency room that afternoon.


VAERS ID: 1629884 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Menstruation irregular, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Sore arm- 2 hours after vaccine, lasting for 72 hours Early menstrual period- one full week before expected period, extremely heavy, 209% more painful than typical period.


VAERS ID: 1630945 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Injection site pain, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache, pain at injection site same/next day after injection Muscle pain, joint pain, swollen lymph nodes, fatigue one week after injection


VAERS ID: 1631078 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abnormal dreams, Anxiety, Confusional state, Hallucination, Headache, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210844101

Write-up: VOILENT HALLUCINATION; FULL BODY TREMORS; CONFUSION; ANXIETY; VIVID DREAMS; HEADACHE; This spontaneous report received from a health care professional (Nurse) concerned a male of an unspecified, age, race and ethnic origin. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown and expiry: unknown ) dose was not reported, 1 total administered on 18-AUG-2021 for prophylactic vaccination. The batch number was not reported. The Company was unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 18-AUG-2021, 12 hours post vaccination, the patient experienced violent hallucination, confusion, vivid dreams, anxiety, full body tremors and headache. He went to physician office. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the full body tremors, violent hallucination, confusion, anxiety, vivid dreams and headache was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210844101-COVID-19 VACCINE AD26.COV2.S - Violent hallucination. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1631952 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-08
Onset:2021-08-18
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Asthenia, Chills, Decreased appetite, Fatigue, Injection site pain, Lethargy, Malaise, Pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

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

Write-up: Site: Pain at Injection Site-Medium, Systemic: Abdominal Pain-Medium, Systemic: Chills-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: appetite loss-Medium, Systemic: Weakness-Medium, Additional Details: Pt''s husband reported on 8/24/21 pt was still feeling unwell from shot, ( achy, tired, GI upset , appetite loss). Rph advised pt to eat more even if not hungry, take ibuprofen for pain if needed and to advise with MD if symptoms do not subside or get worse.


VAERS ID: 1631990 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered
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: Error: Booster Given Too Early-


VAERS ID: 1632200 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-13
Onset:2021-08-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Condition aggravated, Lip pain, Lip swelling
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? No
Hospitalized? No
Previous Vaccinations: Lip swelling, redness, pain, bleeding of lips, extensive testing. Age 16, experienced this reaction for approximately a year, w
Other Medications: Allergy medication and birth control
Current Illness:
Preexisting Conditions:
Allergies: penicillin, augmenton, sulfa, codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: On August 18th I experienced significant swelling, irritation and pain in both my lips. I have experienced this prior when I recieved the 3rd dose of the gardisil vaccine. My lips were red, swollen, and painful. They also looked as if they had a small rash on them. This lasted for approximately 24 hours. However, I use a topical lip treatment daily to help with irritation.


VAERS ID: 1632210 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-12
Onset:2021-08-18
   Days after vaccination:67
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Exposure during pregnancy, Nasal congestion, Pregnancy, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler prenatal vitamins no.2 (PRENATAL VITAMIN NO.2 ORAL)
Current Illness:
Preexisting Conditions: Genitourinary Oligomenorrhea Other Pregnancy
Allergies: Benzonatate
Diagnostic Lab Data: COVID-19 (SARS CoV-2 RNA, RT-PCR)
CDC Split Type:

Write-up: Patient''s last menstrual period was 02/12/2021 Estimated Date of Delivery: 11/23/21 Cough Nasal congestion


VAERS ID: 1632317 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site swelling, Injection site warmth, Joint stiffness, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rifampin, Eliquis(Apixaban), Bactrim, Atorvastatin
Current Illness: None
Preexisting Conditions: Rheumatoid Arthritis, high cholesterol
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever and swelling at the injection site for 8 days along with joint stiffness in my legs, arms and hands for 5 days.


VAERS ID: 1632319 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Headache, Injection site pain
SMQs:, Retroperitoneal fibrosis (broad), 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: Concerta, CoQ10, Fish Oil, Vitamin B3
Current Illness: None
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills - 1 day, injection site soreness - 2 days, muscle pain (specifically back) - 1 week +, joint pain - 1 week +, headache - 3 days.


VAERS ID: 1632340 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-13
Onset:2021-08-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PAA165969 / 1 - / -

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

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

Write-up: Tested COVID+ on 8/18/21, hospitalized on 8/24/21 with Shortness of breath requiring 2L oxygen.


VAERS ID: 1632399 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-10
Onset:2021-08-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Cardiac monitoring, Cerebellar stroke, Clumsiness, Echocardiogram, Hemiparesis, Ischaemic stroke, Laboratory test, Magnetic resonance imaging head abnormal, Ultrasound scan, Venogram
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic 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), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Larissia, pre natal vitamin, vitamin D
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: MRI, MRV, TEE, Lower extremity ultrasound, and labs all done between 8/18/2021-8/20/2021
CDC Split Type:

Write-up: Patient had a Left ischemic cerebellar stroke on 08/18/2021. Pt started having L sided weakness and clumsiness at 7 pm. Went to the ER at 9 pm. Pt was discharged the next morning and then asked to come back in for an MRI, which confirmed the stroke. Pt is currently on blood thinners and a cardiac monitor for the next 30 days to determine what long term treatment will be.


VAERS ID: 1632414 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Hemiparesis, Peroneal nerve palsy, Pyrexia, Seizure, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Generalised convulsive seizures following immunisation (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benazepril/Amlodipine Atorvastatin Meloxicam
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Starting just after 11:00pm on the 18th of August 2021 I started to slightly shake like the chills. I was not cold or have a fever at this time. While this continued for around an hour or so it gradually became worse until around 1:00am on the 19th of August I started having full body convulsions shaking violently. The left side of my face and body felt like I had no control over it . My face felt like it was drooping and my leg was dragging all on my left side. Eventually around 3:00am the convulsions stopped. While the convulsions finally stopped my fever shot up to 101.9 at this time. I took two Tylenol for the fever and around 4:00 am it finally broke but I was freezing after my temperature went back down to 98.0. The next day I went to my doctor, Dr. I have been extremely weak since these events which have made it difficult to perform my job.


VAERS ID: 1632420 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, SARS-CoV-2 test negative
SMQs:, Taste and smell disorders (narrow), 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: None.
Current Illness:
Preexisting Conditions: High blood pressure, acid reflux.
Allergies: Morphine, Latex, Sulfa.
Diagnostic Lab Data: SARS COVID TEST - NEGATIVE
CDC Split Type:

Write-up: Loss of taste.


VAERS ID: 1632473 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased
SMQs:, Neuroleptic malignant syndrome (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: Lazorton
Current Illness: No
Preexisting Conditions: Immune compromised.
Allergies: Penicillin
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: Temperature of 105.


VAERS ID: 1632484 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Balance disorder, Ear discomfort, Fatigue, Headache, Influenza like illness, Mobility decreased, Myalgia, Neck pain, Neuralgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: only sore shoulder
Other Medications: Gabapentin Omeprazole Tikosyn Eliquis
Current Illness: none
Preexisting Conditions: Diabetes Heart Disease
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After two hours arm started to hurt as with first injection. About 6-8 hours after shot, pain continued up into my neck and head, then proceeded to go down my left side and sciatic nerve. Then I started to feel really bad all over. Ears plugged, equilibrium off. Every joint and muscle in my body ached. Could not get out of bed for about 24 hours, drinking only water and no food. Second day started to feel better and ate a small meal of eggs for dinner. Continued to feel better but still very tired and worn out from the ordeal. Felt like the worst flu I''ve ever had but my husband had the same shot with the same results.


VAERS ID: 1632490 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-01
Onset:2021-08-18
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: Break through COVID case


VAERS ID: 1632562 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-07-28
Onset:2021-08-18
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Catheterisation cardiac, Chest pain, Dyspnoea, Pericardial drainage, Pericardial drainage test, Pericardial excision, Pericarditis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cardiac catheterization procedure on 8/18/21, returned to ER yesterday (8/24/21) with chest pain and shortness of breath. Underwent a pericardial window procedure on 8/25/21 for removal and analysis of pericardial fluid.
CDC Split Type:

Write-up: Patient came to the ER on 8/18/2021 with chest pain and shortness of breath, ultimately diagnosed with pericarditis. Patient reports these symptoms started 3 weeks after his second dose of Pfizer COVID vaccine (Lot number unknown, not given at this facility).


VAERS ID: 1632609 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Rash, Skin ulcer
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: Server Rash and sores in armpit he has been dropped of at school in Virginia and we are working on getting him into a doctor to get looked at.


VAERS ID: 1632614 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Electrocardiogram normal, Inflammation, Pain
SMQs:

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

Write-up: 6 days after, under my right arm and breast was inflamed, The lymph nodes. Limited use very scary. Went to urgent care on 18th. Achy to painful.


VAERS ID: 1632618 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-07
Onset:2021-08-18
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Positive COVID 19 PCR test on 8/22/2021
CDC Split Type:

Write-up: Symptomatic for COVID 19 on 8/18/2021


VAERS ID: 1632622 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-06-17
Onset:2021-08-18
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Contusion, Fatigue, Migraine, Rash, Respiratory disorder, Tachycardia
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Patient complaint of rash on arm and torso, memory loss, fatigue, respiratory issues, bruised veins on left side, migraine, and tachycardia


VAERS ID: 1632644 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-31
Onset:2021-08-18
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 - / IM

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

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

Write-up: Pt. tested positive for COVID-19.


VAERS ID: 1632720 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-21
Onset:2021-08-18
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility 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: I experienced an irregular menstruation cycle. More painful and heavier than usual. I''m currently mid cycle and so unable to determine if the cycles will normalize.


VAERS ID: 1632971 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 - / IM

Administered by: Military       Purchased by: ?
Symptoms: Dyspnoea exertional
SMQs:, Pulmonary hypertension (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: Meloxicam bid, Cetirizine qd, Fluticasone /inh qd
Current Illness: no
Preexisting Conditions: Sleep Apnea
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Persistent shortness of breath with exertion, requiring prescription of the Albuterol inhaler. Conservative outpatient treatment adequate for this case.


VAERS ID: 1633000 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-06
Onset:2021-08-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: None. If rash continues will visit local clinic for further evaluation.
CDC Split Type:

Write-up: Rash erupted on abdomen and chest area following first shot. Subsided with antihistamine and topical steroids. More extensive rash/hives erupted approximately 10 days following second shot that covers from pelvic/top of thigh area all the way to the chest area. Extensive break out of the abdomen and sides that covers to the lower back. Antihistamines and topical steroids used but the rash lasted longer and did not respond as well to OTC treatment.


VAERS ID: 1633052 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 LA / IM

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

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

Write-up: Injection site swelling and red. patient was tired and achy


VAERS ID: 1633058 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0220B20A / 3 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Dizziness, Fall, Limb injury
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient can provide Detailed medical list
Current Illness:
Preexisting Conditions: MS Perkins''s High Blood Pressure Heart Trouble
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: An hour after taking the vaccine the patient felt faint He went and laid down when he woke up he still felt the same way. He fell and hit his shoulder. He has lost all his energy.


VAERS ID: 1633161 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-06
Onset:2021-08-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

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

Write-up: Bell?s palsy


VAERS ID: 1633571 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-11
Onset:2021-08-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Memory impairment
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (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: flonase as needed claritin as needed women''s one a day multivitamin omega 3 supplement
Current Illness: mild cold about 2 weeks prior to vaccination. Negative for covid
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I noticed that I was unusually forgetful beginning about a week following my first dose of the vaccine. Forgetting when I was supposed to be somewhere, things people told me a day or two before etc.


VAERS ID: 1633622 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Joint pain after 2nd COVID vaccine
Other Medications: Plaquenil, Lisinopril, Lexapro, Trazodone, Meloxicam, L-Lysine, Black Seed Oil, Biotin, Centrum, Calcium/Magnesium
Current Illness: None
Preexisting Conditions: Lupus, Depression
Allergies: Codeine
Diagnostic Lab Data: Treatment with Cefdinir and Doxycycline
CDC Split Type:

Write-up: Red raised single hive/lesion 6? long by 3? wide, amorphous shape


VAERS ID: 1633783 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soreness, swelling


VAERS ID: 1634877 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Insulin dependent diabetic
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: SARS-CoV-2 rapid antibody test; Result Unstructured Data: Negative antibodies
CDC Split Type: USJNJFOC20210847388

Write-up: Confirmed Immunological Vaccine Failure; This spontaneous report received from a patient concerned a 73 year male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: insulin dependent. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, and expiry: unknown) dose was not reported, 1 total, administered on 10-APR-2021 in right arm in the morning for prophylactic vaccination. No concomitant medications were reported. On 18-AUG-2021, the patient experienced confirmed immunological vaccine failure. The patient underwent a Immunoglobulin G/Immunoglobulin M (IgG/IgM) COVID-19 combination antibody test, which resulted into negative antibodies (Ab). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210847388-covid-19 vaccine ad26.cov2.s-Confirmed Immunological Vaccine Failure . This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1636155 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-26
Onset:2021-08-18
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg tablet aspirin tablet fenofibrate (TRIGLIDE) 160 mg tablet furosemide (LASIX) 20 mg tablet gabapentin (NEURONTIN) 300 mg capsule omeprazole (PriLOSEC) 20 mg capsule triamterene-hydrochlorothiazid (MAXZID
Current Illness:
Preexisting Conditions: Nervous Myalgia Right lumbar radiculopathy Lumbago Acute pain of right knee Abnormal involuntary movement Epidemic vertigo Epigastric pain Respiratory OSA (obstructive sleep apnea) Circulatory Hypertension Digestive Change in bowel habits Altered bowel function Obesity Genitourinary Urinary tract infectious disease Musculoskeletal Arthritis Cervical spondylosis Segmental and somatic dysfunction of sacral region Lumbar spondylosis Facet hypertrophy of lumbosacral region Primary osteoarthritis of right hip Superficial basal cell carcinoma Osteoarthritis of right hip Actinic keratoses Knee effusion, right Arthritis of knee, right Multiple benign nevi of upper and lower extremities, and trunk Seborrheic keratoses Solar lentiginosis Primary osteoarthritis of right knee Degeneration of lumbar intervertebral disc Primary localized osteoarthritis of right knee Localized, primary osteoarthritis Open wound of knee, leg, and ankle Primary osteoarthritis of left hip Osteoarthritis of left hip Dislocation of hip joint prosthesis Endocrine/Metabolic Hypercholesteremia Nontoxic multinodular goiter Hypercholesterolemia Other Hematochezia Overweight(278.02) Status post right hip replacement History of nonmelanoma skin cancer Edema Status post right knee replacement Status post left hip replacement History of closed hip dislocation Encounter for allergy testing Status post total hip replacement, left
Allergies: Contact Metal AgentRash Tramadol
Diagnostic Lab Data: POCT COVID-19 PCR
CDC Split Type:

Write-up: Fever Cough Congestion Chills Body aches


VAERS ID: 1636389 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Induration, Limb injury, Nausea, Pain in extremity, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: daily gummy vitamin
Current Illness: none, Allergies
Preexisting Conditions: none that I know of. Had a heart murmur as a child, metal rod in leg from a fall in 2018
Allergies: Cinnamon, Latex, Mango
Diagnostic Lab Data: none so far
CDC Split Type:

Write-up: Rash started appearing on my arm a day after the first shot. (Aug 18th). The rash went away after a couple of days (Aug 21) But now this rash is back again (Aug 25 at 7:00 PM) and it is itchy and red and about the size of a baseball. Other symptoms are soreness, hardness in arm, and nausea.


VAERS ID: 1636454 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-02-20
Onset:2021-08-18
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Bilevel positive airway pressure, COVID-19, Caregiver, Cough, Dyspnoea, Fatigue, Hypophagia, Loss of personal independence in daily activities, Malaise, Oxygen saturation decreased, Pneumonia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NO KNOWN ALLERGERIES
Diagnostic Lab Data: 8/15/2021 COVID-19SARSAgFIA = DETECTED
CDC Split Type:

Write-up: 8/15/2021 SEEN AT MEDICAL CENTER ER. REPORTED DRY COUGH, FATIGUE. 8/18/2021 RETURNED TO MEDICAL CENTER ER. REPORTS FATIGUE, COUGH, MELAISE, POOR PO INTAKE PROGRESSIVE DYSPNEA.UNABLE TO CARE FOR HIS WIFE (PATIENT IS THE PRIMARY CARE GIVER) DUE TO HIS CURRENT ILLNESS. DX; PNEUMONIA. O2 SAT IN LOW 90s ON 3 L OF O2. PATIENT ADMITTED TO INPATIENT HOSPITAL ON 8/8/21. AS OF 8/26/21 PATIENT NOW ON BIPAP. STATUS POST REMDESIVIR, TREATMENT CONTI WITH DECADRON, BARICITINIB, LOVENOX, ROCEPHIN STATUS POST AZITHROMYCIN. PATIENT IS CURRENTLY HIGH RISK FOR DECOMPENSATION.


VAERS ID: 1636464 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Ear pain, Fatigue, Feeling hot, Headache, Heart rate increased, Hyperhidrosis, Injection site pain, Nausea, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Upper-airway cough syndrome
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, pulmicort
Current Illness: None
Preexisting Conditions: Hypothyroidism Asthma
Allergies: Tavist D Polyhistine D Amoxicillin Cipro Keflex Phenergain Nablecon E-mycin (erythromycin)
Diagnostic Lab Data: Unknown - follow up with primary care will occur on 9/1/21 for increased heart rate
CDC Split Type:

Write-up: 1 hour after: feeling faint and dizzy, pain at injection site 4 hours after: previous symptoms with additional symptoms: fever (103.7), body aches, chills, horrible headache, fatigue, nausea, increased resting heart rate and non-resting heart rate (see below), Post-nasal drip, sore throat, congestion, ear ache, increased sweating All above symptoms lasted for 48 hours. After 48 hours fever and aches subsided , but increased feeling of being hot and increased heart rate continued. Sore throat and post nasal drip also continued. Still persisting today - 8/26/21 Heart rate - before receiving 2nd covid shot, resting heart rate was 40s - 50s bpm, now resting heart rate is in the 70s bpm. Heart rate is increasing to 120s from very simple activities, like walking across the yard. No history of heart conditions, very healthy, regularly exercise. 5?6? 115lbs Scheduling a follow up with primary care for increased heart rate on 9/1/21


VAERS ID: 1636953 (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: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Hyperhidrosis, Pallor, Seizure, Seizure like phenomena
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Pt. developed seizure like activity for 1-2 minutes 10 minutes after vaccination. Pt. had convulsions, pallor and some diaphoresis. Was transported to Emergency room via ambulance.


VAERS ID: 1637044 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-10
Onset:2021-08-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / SYR

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

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

Write-up: Injection site skin reactions - Red, itchy, swollen, and painful rash at injection site


VAERS ID: 1637136 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-16
Onset:2021-08-18
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 AR / -

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Hypotension, Pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknwon
Preexisting Conditions: Rhumatoid arthritis , Cva , Htn, Spinal stinosis
Allergies: Iodinated Radiocontrast Dye, Pennicillins and sulfa drugs
Diagnostic Lab Data: Still at hospital.
CDC Split Type:

Write-up: Pt was admitted on 08/18/2021 Hypotension r/t dehydration and had diffuse body pain, one week of diarreah and fatigue. Pt received Ive fluids. No need for O2 or steroids.


VAERS ID: 1637139 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: None stated.


VAERS ID: 1637196 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-01-28
Onset:2021-08-18
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/07/2021 2nd dose01/28/21 Diagnosed covid positive:08/18/21 Symptom onset: Exposure: Symptoms:Asymptomatic


VAERS ID: 1637214 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: New York  
Vaccinated:2021-01-27
Onset:2021-08-18
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Exposure to SARS-CoV-2, Fatigue, Myalgia, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/06/21 2nd dose01/27/21 Diagnosed covid positive:09/20/21community Symptom onset:08/18/21 Exposure:community Symptoms:fever, fatigue,muscle aches, loss of smell/taste, chills, runny nose


VAERS ID: 1637282 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-01
Onset:2021-08-18
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood culture, Chest X-ray, Computerised tomogram head, Confusional state, Fatigue, Magnetic resonance imaging head, Monoclonal antibody unconjugated therapy
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Poantoprazole SOD DR, 40 mg/day Methotrexate 2.5 mg x 8 (15 mg) once a week IC Folic Acid 1 mg/day B12 Methylcobalimin 500 mcg/day Vitamin C - 500 mg /day Vitamin E 400 IU/day Vitamin D3, 2000 UI/day
Current Illness: None
Preexisting Conditions: Rheumatoid Arthritis, mild cognitive decline
Allergies: None
Diagnostic Lab Data: blood cultures, brain CT, brain MRI, chest xray, breathing therapy, iv antibodies treatment for COVID
CDC Split Type:

Write-up: Extreme Fatigue, Chronic pain in back, escalated mental confusion


VAERS ID: 1637305 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-04-16
Onset:2021-08-18
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 UN / IM

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

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

Write-up: Patient fully vaccinated. Diagnosed and hospitalized with COVID 19.


VAERS ID: 1638045 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Injection site pain, Lymphadenopathy, Musculoskeletal stiffness, Neck pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: one a day vitamins vitamin d vitamin e omeprasol
Current Illness: none
Preexisting Conditions: stomach spasms
Allergies: novocaine
Diagnostic Lab Data: Appt on August 30, 2021 I could not get in sooner.
CDC Split Type:

Write-up: the following morning my neck was stiff and sore and the injection site. My lymph glad was swollen so I had difficulty turning my head. three days after the injection my lymph glad still swollen, and my feet started swelling. This is day 10 post injection. my lymph glad still enlarged, my neck still sore, although less, and my feet are swelliing yet.


VAERS ID: 1638256 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088DZ1A / UNK LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022M20A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088DZ1A / 3 LA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 032L20A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Arthralgia, Chest discomfort, Fatigue
SMQs:, Anaphylactic reaction (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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: Topicall Estrodial, tetra boron, Vitamins D and E
Current Illness: none
Preexisting Conditions: arthritis, headaches
Allergies: surgical tape
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have had intermittent chest pressure and minor arrhythmias with an intensification of arthritic pain and fatigue. The fatigue is abating.


VAERS ID: 1640959 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-16
Onset:2021-08-18
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain, Acute respiratory failure, Adenovirus test, Blood culture, Bordetella test negative, COVID-19, Chest X-ray normal, Chest discomfort, Chlamydia test negative, Coronavirus test negative, Cough, Diabetic ketoacidosis, Differential white blood cell count normal, Dyspnoea, Enterovirus test negative, Headache, Human metapneumovirus test, Human rhinovirus test, Hyperhidrosis, Influenza A virus test negative, Influenza B virus test, Insomnia, Laboratory test normal, Mycoplasma test negative, Pulmonary congestion, Pyrexia, Respiratory syncytial virus test negative, Respiratory viral panel, SARS-CoV-2 test positive, Urine output decreased
SMQs:, Acute renal failure (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinoL (ZYLOPRIM) 300 mg tablet aspirin 81 mg tablet cetirizine (ZyrTEC) 10 mg tablet colchicine (MITIGARE) 0.6 mg capsule colchicine (MITIGARE) 0.6 mg capsule cyclobenzaprine (FLEXERIL) 10 mg tablet fenofibrate (TRIGLIDE) 160 mg
Current Illness:
Preexisting Conditions: Allergic rhinitis Chronic gout Uncontrolled type 2 diabetes mellitus with hyperglycemia (CMS/HCC) Fatty liver Essential hypertension Hypertriglyceridemia, essential Obesity Obstructive sleep apnea Primary localized osteoarthritis of right knee Acute right-sided low back pain with sciatica Elevated transaminase level
Allergies: PenicillinsSwelling LisinoprilCoughing Polymyxin B Sulf-trimethoprimOther (document details in comments)
Diagnostic Lab Data: 08/23/21 0711 Respiratory virus detection panel Collected: 08/23/21 0518 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected 08/19/21 1043 Respiratory virus detection panel Collected: 08/19/21 0946 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected Procedure Component Value Ref Range Date/Time X-ray chest 2 views [3225507848] Resulted: 08/19/21 1057 Order Status: Completed Updated: 08/19/21 1058 Narrative: XR CHEST 2 VW IMPRESSION: Lungs are clear without evidence of acute process noted. END OF IMPRESSION: INDICATION: Chest tightness/congestion, diaphoresis, and cough. TECHNIQUE: PA and lateral examination of the chest. COMPARISON: Prior examination January 3, 2017. FINDINGS: The heart size is within normal limits. Bilateral lung zones are clear. There is no evidence of pleural effusion. No evidence of pneumothorax is identified. The osseous skeleton is grossly intact. Patient is an 46 y.o. male who presented to the ED with chief complaint of decreased urination, having abdominal bloating and pain. Patient diagnosed with Covid positive on Thursday. He also reported that he is drinking a lot of water and initially producing a lot of urine but urine flow reduced last 2 days. He also reported shortness of breath cough. His saturations are below 94. But he also reported that he thinks he uses CPAP machine during the night. Patient found to have fever of 100.9 in the ER. WBC with differential is within normal limits. Blood cultures ordered elevated for the results Patient denied headache visual disturbance, denied nausea vomiting, denied chest pain palpitations. Patient is on Metformin I withheld patient metformin and Januvia.
CDC Split Type:

Write-up: COUGH, DIFFICULTY BREATHING ED Discharged 8/19/2021 (3 hours) Hospital ED COVID-19 Clinical impression Cough Chief complaint Chief Complaint Patient presents with ? Cough History of Present Illness Patient is a 46 y.o. male presenting to the ED with chief complaint of cough that started last night. Patient reports that he developed some chest tightness throughout the night. Reports he feels it more when he is coughing. Reports mild shortness of breath when coughing. No one else with similar symptoms. Denies any fevers or chills. Reports a slight headache, reports it is starting to get better which is normal for him to have in the morning. He had a difficult time sleeping last night. ED to Hosp-Admission Current 8/23/2021 - present (4 days) Hospital Type 2 diabetes mellitus (CMS/HCC) COVID-19 Diabetic ketoacidosis associated with type 2 diabetes mellitus (CMS/HCC) Acute respiratory insufficiency


VAERS ID: 1640971 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-07
Onset:2021-08-18
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Intermenstrual bleeding, Menstrual disorder, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Synthroid 137mcg
Current Illness: None
Preexisting Conditions: Hypothyroid
Allergies: Aspirin Ibruprofen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Menstrual changes - period is very regular and came 1 week early, then have been spotting ever since General body aches, sore throat and sinus symptoms on and off


VAERS ID: 1641117 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Blood test, Heavy menstrual bleeding, Menstruation irregular, Thrombosis, Ultrasound scan
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C Vitamin b 12
Current Illness: None
Preexisting Conditions: Generalized anxiety
Allergies: None
Diagnostic Lab Data: Vaginal ultrasound and blood work 8/20/2021
CDC Split Type:

Write-up: I started having very dark and heavy vaginal bleeding that lasted for 3 days. I bled through 5 super tampons within 4 hours. I wasn?t due for my period for 2 1/2 more weeks. My period never comes early and is never that heavy. There were dark blood clots in the vaginal bleeding. I bled through several pairs of pants at work. I also was having very bad abdominal pain. It got to the point (on the second day) where i had to leave my work unit (I work in a hospital) and go to my hospital?s ER. They ran blood work and did a vaginal ultrasound.


VAERS ID: 1641177 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Diarrhoea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: APAP
Current Illness: None.
Preexisting Conditions: None.
Allergies: Sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Stomache cramps, diarrhea, low grade fever, chills


VAERS ID: 1641243 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute myocardial infarction, Arteriosclerosis, Brain natriuretic peptide increased, Cardiac failure congestive, Catheterisation cardiac abnormal, Chest pain, Chills, Computerised tomogram thorax abnormal, Coronary arterial stent insertion, Coronary artery stenosis, Diarrhoea, Dyspnoea, Echocardiogram abnormal, Ejection fraction, Fatigue, Full blood count normal, Interstitial lung disease, Left ventricular dysfunction, Pain, Procalcitonin normal, SARS-CoV-2 test negative, Troponin
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Myocardial infarction (narrow), Pseudomembranous colitis (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: losartan, hydrochlorathiazide, norvasc, cardura, levothyroxine, MVI, calcium
Current Illness: otherwise well without symptoms
Preexisting Conditions: hypertension, hypothyroidism
Allergies: none
Diagnostic Lab Data: Cath done 8-23-21 with significant diffuse sclerosis including LAD, requiring 2 stents; troponin .3. Echo with MI and dysfunction at apex but EF 54%. COVID test negative 8-25-21. Normal CBC, procalcitonin level. BNP 1000. CT scan chest - interstitial pneumonitis.
CDC Split Type:

Write-up: On the 18th (evening after shot) developed fatigue, chills, aches. The next day developed diarrhea and then started with chest pain during the night. Pain responded to nitrogylcerin x3 and tylenol. The chest pain increased over the next several days, including exertional chest pains and then became acutely severe on Sunday evening. Called 911 and admitted to the hospital for acute MI. During hospitalization was found to have persistent dyspnea and interstitial pneumonitis (not characteristic of MI) despite active treatment for CHF. Responded to IV prednisolone.


VAERS ID: 1641244 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-06
Onset:2021-08-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Neck mass
SMQs:

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

Write-up: Pt reported a lump the size of a quarter on the left side of her neck near the hairline, below her ear. Reporting occurred 12 days after vaccine; unclear when lump developed


VAERS ID: 1641396 (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: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Fatigue, Headache, Herpes zoster, Influenza like illness, Myalgia, Pyrexia, Rash, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), COVID-19 (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: Zyrtec, Valtrex 500, Chlorthalidone, Symbicort, Nasacort, Montelukast, Protonic
Current Illness:
Preexisting Conditions: Asthma, GERD, Macrocytosis, Hypertension Controlled
Allergies: Wheat, codeine, macrodantin, pollen, dust, Contrast Dye for MRI
Diagnostic Lab Data: Allergist
CDC Split Type: vsafe

Write-up: After the third dose my flu-like symptoms came on sooner. My Shingles outbreak happened with 24 hours in the same place on my right side near my ribs.. I spiked a fever of 102 and I was tested for Covid-19 and the test was negative. My fever did not break for five days. I also got a rash on my right side which has resolved after ten days. I had headache, fatigue and dizziness and muscle aches for 8 days. My joint pain was more severe on the third shot. My immune system went into overdrive. I did not have any flare up of my Asthma or my allergies. The symptoms were similar to the ones that I got for the second dose but they happened faster and lasted longer. They were also a little more severe.


VAERS ID: 1641438 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Dizziness, Electrocardiogram, Heart rate increased, Presyncope, Urine analysis, Vision blurred, Visual impairment
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: Vitamin D3 B12
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Penicillin
Diagnostic Lab Data: ER doctor (Sunday, August 22nd) performed an EKG, various blood tests, blood pressure checks as well as a urine sample.
CDC Split Type:

Write-up: Beginning on the third day I experienced slightly blurred vision and chest tightness as well as rapid heart rate while lying down. By the 5th day I had more rapid heart rate episodes (very short; about 30-40 seconds) but this time it was followed by intense dizziness and darkened vision and almost passing out. I almost wen to urgent care, but decided to take it easy and see a doctor on Monday. Unfortunately, the same thing happened the next day but even longer (on and off for 15 minutes) and it was a Sunday so I had to go to the Emergency room.


VAERS ID: 1641473 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-05
Onset:2021-08-18
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 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 - 3/8/2021 LOT 048A21A; DOSE 2 - 4/5/2021 LOT 021B21A. S/O 8/18/2021. TESTED + 8/19/2021


VAERS ID: 1641477 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Back pain
SMQs:, Retroperitoneal fibrosis (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
Current Illness: No illnesses
Preexisting Conditions: None
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: I started having pains in the center of my back. Even when touching the center of my back it starts to hurt a lot more. I?ve never had pains in the center of my back before and it?s started since the second dat of me having getting the vaccine


VAERS ID: 1641532 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA748S / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle fatigue, Muscle spasms, Muscle twitching, Pain in extremity, Sleep disorder, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pneumovax 23 - I had a sore arm for three weeks. I believe I was 48 or 49 years old when I received it.
Other Medications:
Current Illness:
Preexisting Conditions: Joint issues
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I experienced muscle spasms and fluttering in the muscles after taking the first dose. It was happening every 15 seconds and I could not sleep. I took muscles relaxers. This lasted for 18 hours. The fluttering of the muscles gradually lessened over time. By the afternoon the next day, it stopped around 4pm. I also had a sore arm and tremors in the upper arm. My arm is still a bit sore and I have a bit of fatigue in that muscle, but I do not experience the fluttering or tremors anymore.


VAERS ID: 1641579 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: Patient was given a second dose of J7J vaccine. First dose was given on 7/27/21 with Lot 204A21A and a second dose was administered on 8/18 with lot 207A21A. No adverse reactions noted. Patient was monitored and had no complaints.


VAERS ID: 1641625 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Influenza A virus test negative, Influenza B virus test, Muscle spasms, Muscular weakness, Pain in extremity, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), COVID-19 (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: Patient had 1st Moderna vaccine 7/15 and experienced abrupt onset of similar symptoms as second dose of Moderna. Additionally, o
Other Medications: Depo-Provera
Current Illness: 1st dose of Moderna vaccine 7/15 and had body aches, lower extremity weakness and numbness, left arm pain - same side as injection site, and supraclavicular mass
Preexisting Conditions: asthma
Allergies: peanuts; raspberries
Diagnostic Lab Data: Influenza A and B, and COVID PCR negative.
CDC Split Type:

Write-up: 2nd Moderna Vaccine 8/18, presented to ED with complaints of headache, lower extremity weakness, numbness, and muscle spasms. Also reports right arm pain - same side as injection. Administered 1L normal saline, 60mg IV Norflex, 15mg IV Toradol, and 1000mg oral Tylenol which helped resolve symptoms. Patient discharged from the ED in stable condition.


VAERS ID: 1642011 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Eating disorder, Inflammation, Peripheral swelling, Pharyngeal swelling, Swollen tongue
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Retroperitoneal fibrosis (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pepcid, Allegra, multivitamin, vitamin C
Current Illness: NA
Preexisting Conditions: Post Covid inflammation for 10 months
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: After 5 min, my fingers swelled. After 45-50 min, my tongue and throat swelled. I treated them with antihistamine medication. It led to following days of abdominal pain/difficulty eating and crushing chest pain. All symptoms are indicative of systemic inflammation. It took about 9 days to mostly resolve with home care and use of anti inflammatory herbs and antihistamines.


VAERS ID: 1642261 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: One a day vitamin, fiber, fish oil, probiotic, magnesium
Current Illness: Cold
Preexisting Conditions: None
Allergies: Compazine
Diagnostic Lab Data: Pelvic Blood test
CDC Split Type:

Write-up: I got the shot shortly after 9:00 a.m. and woke up with a very heavy menstrual cycle. I hadn?t had a period since April so thought I was going through menopause. The only time I have passed this much blood and clots was after giving birth. I went to the doctor today as it is still very heavy. I am now 10 days into having this. It would be extremely helpful if you can provide information of how long is it okay to be bleeding like this. My doctor did a pelvic exam and notated I am still clotting and bleeding heavily. She prescribed medroxyprogesterone to stop the bleeding. I am going to hold off on taking that for another week to see if it will slow down or stop. The side effects of that pill are not the greatest. I don?t regret getting the Moderna shot. I am letting you know so you can help women with what to expect and how long should it last before you menstrual cycle is a concern.


VAERS ID: 1642848 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-01-11
Onset:2021-08-18
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

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

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

Write-up: Fully vaccinated employee tested positive for covid-19


VAERS ID: 1645300 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Second dose administered beyond 80 days after the first dose; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a nurse and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second dose administered beyond 80 days after the first dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second dose administered beyond 80 days after the first dose). On 18-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second dose administered beyond 80 days after the first dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication details were provided. No treatment information was mentioned. Reporter did not allow further contact


VAERS ID: 1645313 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Extra dose administered
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: Immunocompromised (Immunocompromised patient.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Immunocompromised patient received a 3rd dose of the Moderna vaccine from a vial that had been first punctured more than 12 hours ago; Immunocompromised patient received a 3rd dose of the Moderna vaccine; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Immunocompromised patient received a 3rd dose of the Moderna vaccine from a vial that had been first punctured more than 12 hours ago) and EXTRA DOSE ADMINISTERED (Immunocompromised patient received a 3rd dose of the Moderna vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Immunocompromised (Immunocompromised patient.). On 18-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Immunocompromised patient received a 3rd dose of the Moderna vaccine from a vial that had been first punctured more than 12 hours ago) and EXTRA DOSE ADMINISTERED (Immunocompromised patient received a 3rd dose of the Moderna vaccine). On 18-Aug-2021, EXPIRED PRODUCT ADMINISTERED (Immunocompromised patient received a 3rd dose of the Moderna vaccine from a vial that had been first punctured more than 12 hours ago) and EXTRA DOSE ADMINISTERED (Immunocompromised patient received a 3rd dose of the Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment information was provided.


VAERS ID: 1645401 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-30
Onset:2021-08-18
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: allopurinoL (ZYLOPRIM) 300 mg tablet atorvastatin (LIPITOR) 20 mg tablet indomethacin (INDOCIN) 25 mg capsule losartan (COZAAR) 50 mg tablet sildenafiL (VIAGRA) 50 mg tablet
Current Illness:
Preexisting Conditions: Respiratory Obstructive sleep apnea syndrome Circulatory Benign essential HTN Musculoskeletal Temporomandibular joint-pain-dysfunction syndrome (TMJ) Chronic idiopathic gout of multiple sites Endocrine/Metabolic Hyperlipidemia Hyperglycemia Other Vaccination not carried out because of patient refusal Daytime somnolence Erectile dysfunction, unspecified erectile dysfunction type
Allergies: PenicillinsOther (document details in comments)
Diagnostic Lab Data: COVID-19 (SARS CoV-2 RNA, RT-PCR)
CDC Split Type:

Write-up: asymptomatic Tested positive for COVID-19


VAERS ID: 1647378 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-08-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101069997

Write-up: headache; This is a spontaneous report received from a contactable consumer (patient) via a Pfizer-sponsored Program Covax Support. A 34-year-old female patient (consumer) received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 01Aug2021 (age at the time of vaccination was not reported), as DOSE 1, SINGLE for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. On 18Aug2021 (reported 17 days after vaccination), she patient experienced headache. The patient received the first dose 17 days ago and has had a headache ever since. She asked if this was normal. The outcome of the event was reported as unknown. Information about Lot/Batch number has been requested.


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