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From the 6/11/2021 release of VAERS data:

Found 352,386 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 114 out of 3,524

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VAERS ID: 1343783 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Headache, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

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

Write-up: HEADACHE,CHILLS,SWOLLEN UNDER LEFT ARM AND LEFT BREAST ,JOINT PAIN MUSCLE PAIN INJECTION SITE SWELLING AND PAIN


VAERS ID: 1343797 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Nausea, Dizziness, Vomiting. Bp 107/59, HR 73, RR 16. Pt stable and released from the vaccination site.


VAERS ID: 1343807 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Invokamet XR 150-1000 MG bid Januvia 100 MG qd Lisinopril 40 MG qd Simvastatin 40 MG qd Glimepiride 2 MG qd Oxybutynin Chloride ER 15 MG Aspirin 81 MG qd
Current Illness:
Preexisting Conditions: Arthralgia- Pelvis/Hip/Femur right side DM 2 with complications Essential HTN Hyperlipoproteinemia Mixed Osteoarthritis Urinary Incontinence
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA Patient developed an itchy rash all over his body was told to use Benadryl and topical anti-itch cream. He states that he is not having any pain or difficulty breathing. I let him know that if he develops any swelling in face and throat, a fast heartbeat, or dizziness and weakness to go to the ER. If the rash has not resolved in 2-3 days he needs to be seen by his PCP. He is scheduled to be seen by his PCP 5/25/21


VAERS ID: 1343824 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hallucination, Paranoia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (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: None
Current Illness: Common cold
Preexisting Conditions: None
Allergies: Penicillin, valtrex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Maintained a 103-104? fever for over 12 hours. Also started having paranoid hallucinations.


VAERS ID: 1343840 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-18
Onset:2021-05-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Migraine, Neurological examination normal, Paraesthesia, Visual field defect
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Optic nerve disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: Blisovi, turmeric
Current Illness: NA
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: NA. Hours later neurological exam was normal.
CDC Split Type:

Write-up: Expressive aphasia. Migraine. Scotoma. Right hand paresthesia.


VAERS ID: 1343854 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-17
Onset:2021-05-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, Myocarditis, Troponin increased
SMQs:, Cardiac failure (broad), Myocardial infarction (narrow), 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? 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: 5/22 troponin levels: 3.17, 7.17, 8.41, 13.98 5/22 BNP 34, 58 5/23 troponin levels: 13.67, 7.79, 10.41, 9.98 5/23 BNP 93, 126, 153 5/24 troponin levels 10.86, 5.98 5/24 BNP 108, 122
CDC Split Type:

Write-up: Myocarditis


VAERS ID: 1343857 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-05-07
Onset:2021-05-21
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Eczema, Herpes zoster, Psoriasis, Skin discolouration
SMQs:, Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune 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: Omeprazole 10mg 1QD, Lisinopril 10mg 1QD
Current Illness:
Preexisting Conditions: Intermittent psoriasis
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: After first shot, had outbreak of psoriasis after 7 days on chest. Have not had an outbreak in that area in 10 years. 2 Weeks after second shot, had second outbreak of psoriasis on left side of body, also had outbreak of shingles on L arm and L side of Face, around and under the L eye Went to the walk in clinic on SAT 5/22/201 after noticing purple colored blemishes/eczema on face , was diagnosed with shingles and prescribed Prednisone and Acyclovir


VAERS ID: 1343872 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Product preparation error
SMQs:, Tendinopathies and ligament disorders (broad), 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: Simvastatin 40mg, Omeprazole 20mg, Metoprolol Tartrate 50mg,
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Forget to dilute the vaccine before administering it. No adverse reactions were reported by the patient, except for a sore arm


VAERS ID: 1343903 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product administration error
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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: Administration error, improper injection technique. Vaccine recipient was stuck 3 times with same needle. Vaccine recipient was revaccinated with a new syringe/needle.


VAERS ID: 1343908 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, 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: received shot to early. Parents brought her back and staff went to check if it was time another nurse gave the vaccine in the drive through, Patient waited 30 mins with no issues and was allowed to go home.


VAERS ID: 1343961 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Eye movement disorder, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Ambulance personal did vital checks and reported no abnormal results
CDC Split Type:

Write-up: Patient fainted (loss consciousness) a couple of minutes after receiving injection. Mom caught him and called for help and reported his eyeballs rolled up and he started down when she caught him. by time Pharmacist and store staff got there (less than a minute) he had regained consciousness but very lightheaded. No breathing difficulty. So got a chair and had him sit with head down and store staff observing. After another 10min he still reported lightheaded and nausea, so ambulance was called. When they arrived and checked him out everything checked out normal and he was feeling better so they released him to his parents care. Called on 5/24/21 at 10:10am and spoke to mom who reported he was doing fine and no apparent after effects.


VAERS ID: 1343968 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cough, Fatigue, Influenza like illness, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Overly tired, severe coughing, flu-like symptoms, sore arm


VAERS ID: 1343969 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Pain in extremity, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Covid toes and hands. Severe painful rash, hives on hands, palms, fingers, toes, feet


VAERS ID: 1343981 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-12
Onset:2021-05-21
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 1 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Computerised tomogram, Condition aggravated, Ear pain, Fatigue, Genital herpes, Headache, Heavy menstrual bleeding, Hypoacusis, Inflammation, Malaise, Myalgia, Pruritus, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Reactions to the 1st dose of Moderna Covid vaccine: headache, fever, chills, body aches, muscle aches, general fatigue for 2-3 days
Preexisting Conditions: On-going fungus living in ears, easily treated by Clotrimazole and Betamethasone Diproprionate cream; Minor acid lining of the stomach; Chronic migraines (ZERO episodes since 2015, regularly treated by chiropractic)
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Adverse effects after 1st dose: Nothing happened until exactly 24-hours later. Then the next day, from 3:00pm to 11:00pm: bad chills, body aches, no headaches though, tiredness, low energy, feverish. Took 2 sets of 2 tylenols. After 11pm, everything cleared. Adverse effects after 2nd dose: BAD!!! Injection was at 2pm, reactions started by 4pm. All of the effects from the 1st dose but almost doubled in intensity and lasted 2-3 days: feverish, tiredness, unable to move body, body aches, muscle aches, headaches. Unable to work during those days!!! Then additional effects: VERY heavy, torrential period! 1st day of period was Tuesday, May 18, one day late. Then: Herpes outbreak on the anus (first outbreak in a long time). WORSE EVENT YET: Around May 18, my ear was itching. I naturally have ear fungus that has been easily treated over the years. But this one did not go away. I tried to apply the cream, clean. Nothing. By Thursday, I felt an inflammation. By Friday afternoon, I could not hear much from the left year and the right year was starting to be itchy too. Went to a Urgent Care, the RNP prescribed a drop and told me to take Ibuprofen if needed. By 10pm that night, I was in excruating pain: fever, chills, body aches, muscle aches, the ear pain gotten really bad (never experienced this level before), unable to chew, gotten really cold (needed 5 blankets). Long night. By morning, I went to the walk-in clinic of my healthcare provider - VERY sick. The ear has gotten worse and the NP explained that the body was probably unable to fight the small infection in the year because body was still under the virus effect. With my science background, I am afraid that she''s right and/or that the Moderna covid vaccine has suppressed my natural immune system!!! I had a really strong immune system prior to the vaccine, records will prove it. Got sent to ER. They never took me seriously when I said that this is ALL related to the vaccine!!! Got a CT Scan, luckily the infection did not make it to the brain. They prescribed an antiobiotics and let me go. Now, ear pain moved to the right. I can''t hear.


VAERS ID: 1343983 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time, C-reactive protein normal, Echocardiogram, Electrocardiogram ST segment abnormal, Electrocardiogram abnormal, Erythema, Full blood count normal, Hypersensitivity, Paraesthesia, Petechiae, Prothrombin time normal, Purpura, Red blood cell sedimentation rate normal, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Myocardial infarction (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Tests: Normal CBC, CRP, ESR, PT/PTT 5/24 EKG: 5/23 and 5/24 diffuse ST elevation ECHO: Pending at time of submission 2 ED visits, one hospitalization Epinepherine x2, steroids, benadrly,
CDC Split Type:

Write-up: Thurs 5/20 4pm 1st COVID vaccine given Friday: tingly all day; 6pm developed diffuse erethema, scc alp brigh tred Sat 5/22: redness, hives worse, facial swelling started. Seen at Danbury ED. Given all supplental anaphalsix stuff, then epi. Discharged home Sunday: 5/23: Facial swelling returns, mom gives IM Epi, returns to hospital. Found to have ST abnormalities on EKG, sent to hospital for prolonged allergic reaction and eval of possible pericarditis. 5/24: continues to have urticaria, now with new petechiae/purpuric breakouts in areas where hives were, but most prominently in bilateral ankles.


VAERS ID: 1343998 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FR8736 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW9175 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenopia, Body temperature increased, Chills, Cough, Diarrhoea, Dizziness, Dyspnoea, Feeling hot, Injection site pain, Malaise, Nausea, Pain, Pain in extremity, Somnolence, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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), Cardiomyopathy (broad), Corneal disorders (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multi-vitamin, Farxiga, B-complex, Dexilant, mirapex, L-lysine,
Current Illness:
Preexisting Conditions: diabetes chronic sinusitis restless leg erythimi multiformi GERD
Allergies: zythromycin (z-pack), phenobarbitol
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 05/21 intermittent breathing issues - full breath hard to take and caused a cough. happened once every few hours lasted through 05/23 05/22 started feeling warm - low grade temp 98.9 around 4pm only lasted about 4 hours 05/22 body aches around 6pm - lasted until 05/23 am 05/23 fatigue - could not fully wake up. even when up eyes were heavy and felt like closing. 05/24 nausea in the morning. included vomitting. brief dizziness when went back to bed 05/22 - 05/23 diarrhea 05/22 - present. injection site sore / upper arm hurts 05/24 - midday - muscular pain around midsection - hurts when taking deep breath or twisting 05/22 - 05/23 chills 05/21 - 05/24 just not feeling good


VAERS ID: 1344028 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-25
Onset:2021-05-21
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysmenorrhoea, 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? 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: Extremely heavy period and painful menstrual cramps that are not eased by over the counter medication.


VAERS ID: 1344037 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Unknown  
Location: Arizona  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Balance disorder, Clumsiness, Hypoaesthesia, Muscle contracture, Muscle twitching, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: She had a hepatitis B vaccine and got a bad rash on both shoulders. Before that she had in the 1990''s got a MMR and got sick
Other Medications: None.
Current Illness: None.
Preexisting Conditions: Hypothyroidism, prediabetes.
Allergies: Penicillin VK
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: She got her vaccine, within 10-15 minutes she was talking to her sister and she put her hands out and she had not read any reactions. She stretched out her arms in front of her and noticed that the middle fingers on the left hand was twitching. Then a little bit later there was a muscular contraction in the middle of her left thigh, midway between her hip and knee on the anterior side. Was an intermittent muscular contraction on the same side she got the shot. The twitching back and forth of her finger was 1/4 of he way. She googled it and saw that it may be related to the vaccine. Friday, it continued twitching back and forth like a metronome. If she stretches her forearms out prone the ring finger, middle finger and especially the middle finger. Saturday the symptoms were still there but not as much. The thigh symptoms continued for about 2 hours. She walked from her sisters house which is about 1/2 block and it disappeared. The finger issues are more long-term and some numbness in the hand itself. Her right hand at times this weekend had jiggling fingers, but the left is the worse. It is intermittent movement and slight 1/8" movement on those 3 fingers still. There is a general numbness in the fingers as well, not 100% like it''s supposed to feel This is going through the entire left arm and down into the hand. It is not as constant that it was on Friday, getting better and just intermittent right now. She has not contacted her doctor yet, but states that she will. She noticed a clumsiness and a sense of unsteadiness with her walking and felt safe doing so. She may have gotten COVD in Feb/March 2020, said she had almost every symptom from COVID and had lost her sense of smell, slight diarrhea, sore throat, runny dose, temp of 100.3. She still has some loss of sense of taste. She was told at one time that she had markers for Sjogren''s.


VAERS ID: 1344051 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Migraine, Myalgia, Nausea, Poor quality sleep, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fatigue, muscle pain, and chills at about 10pm (9 hours post vaccine) Next morning woke up after restless sleep with most severe migraine headache that I''ve had in several years. The headache last to Saturday night. Saturday night as the headache faded I became nauseous and vomited. By 36 hours after the vaccine (around midnight Saturday) I felt much better and was finally able to eat after not being able to all day. On Sunday I was tired but could function, and by today (Monday), I am fully better.


VAERS ID: 1344075 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Faeces discoloured, Fatigue, Headache, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Noninfectious diarrhoea (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin-D, Linzess, Sumitriptan, womens multi-vit, vit d, magnesium, vit c, flax seed
Current Illness: N/A
Preexisting Conditions: Environmental allergies, allergy induced asthma, migraines
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 4 hours after shot experienced extreme fatigue, achy body and headache. 8 hours after shot experienced green colored stool - still had green colored stool up to 36 hours after shot. Injection site still sore 3 days after shot.


VAERS ID: 1344080 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Breast pain, Chest discomfort, Dyskinesia, Hypoaesthesia oral, Presyncope, Taste disorder
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dyskinesia (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Lipodystrophy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: January 2019 after a flu shot she had asthma flare up 3 days later with a strong cough and no fever or other symptoms. She need
Other Medications: probiotic, multi vitamin
Current Illness: pre-existing asthma
Preexisting Conditions:
Allergies: sulfa drugs, amoxicillin
Diagnostic Lab Data: no
CDC Split Type:

Write-up: After receiving dose, pt experienced Vasovagal response which she never had before when receiving a shot. When they woke her she had a lot of jerky arm movement. About half an hour to 1hr after injection she said she had an odd taste in her mouth and her tongue was numb. Her chest felt tight but was not wheezing. About an hour later when she was home (~6pm) gave her "click it albuterol" and it relieved the tightness in the chest. She had pain in her left breast area. Around 6:30pm she continued to comment about her tongue being numb and pain in her breasts. She fell asleep right away and the next afternoon around 1pm she had a temperature of 99F. After motrin the temperature went back to normal and she felt better. No further chest tightness after that and she is feeling normal.


VAERS ID: 1344100 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Anxiety, Blood pressure increased, Dyspnoea, Headache, Hypoaesthesia, Pain in extremity, Tension, Vitreous floaters
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Retinal disorders (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: About 2 hours after vaccination, patient reported headache and numbness/pain in right arm. Blood pressure elevated to 254/110. Patient also described white " floaters" in view and shortness of breath. Patient also had anxiety and tension.


VAERS ID: 1344137 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Pt received 1st dose of Pfizer vaccine and few minutes later while in observation area, she said she''s feeling very hot and sweaty. Rph asked pt to have a seat and drink water. Pt was also offered to lay down in counseling room if that will be more comfortable. Nurse from the Clinic also came over and pt went over to the Clinic to sit on a recliner. She walked herself to the room and was getting a relief upon sitting down and left after 30 minutes. Since pt did not check with nurse or rph before leaving, rph called pt to follow up and she said she''s doing ok.


VAERS ID: 1344179 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-10
Onset:2021-05-21
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site erythema, Injection site pain, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (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: none
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue = Day 3 (May 13th) - present (May 24) Headache = intermittent Painful red rash at jab site = Day 11 (May 21) - present (May 24).


VAERS ID: 1344182 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 LA / IM

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

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

Write-up: Moderna was administered to patient under the age of 18 yrs of age.


VAERS ID: 1344183 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Lip swelling, Swollen tongue, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Shortly after vaccination, patient complained of tongue and lip swelling, broke out in hives on her chest, and began having trouble breathing. Patient was evaluated by EMS, BP & HR elevated, O2 stats stable. EMS administered 50mg Benadryl without improvement. EMS then administered Epinephrine 0.5mg. Pt also placed on VM with 2.5mg Albuterol. Pt began to improve. EMS administered 125mg Solumedrol and transported pt to ED for further evaluation.


VAERS ID: 1344194 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cooling therapy, Erythema, Immediate post-injection reaction, Injection site pain, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: No/ NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced minimal sting at time of injection. Observation period of 15 minutes passed and patient then almost immediately experienced vomiting and increased burning in the arm. She was asked to sit near pharmacy for further observation. After another 5 minutes patient''s arm turned red from injection site to elbow. She was then allowed to go home with her grandmother. They were given a cold pack for the heat and redness of the arm it was recommended to take Benadryl. Upon follow-up next day patient was doing better was tired but no other side effects.


VAERS ID: 1344229 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 AR / IM

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

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

Write-up: patient received her second dose of moderna 7 days early. This was noticed when patient''s husband came to receive his second dose and he was told he was too early. He explained his wife had received her 2nd dose 3 weeks later from the first dose.


VAERS ID: 1344245 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (narrow)

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

Write-up: On 5/21/21, patient and his mom wanted to get Moderna 2nd dose before he headed back to school up north. They were adamant that the vaccine is due. Both technician and I did not see the date on vaccine card when patient was previously received at . I administered second dose for him after asking him about the first dose, and counseled him on adverse effects. When we processed the prescription later in the afternoon, insurance rejected prescription and stated earlier than 24 days. I found patient had received the dose on 5/4/21. Patient and did not answer the phone, and patient called back confirming the date of first dose given on 5/4/21. Patient did not feel anything except a sore arm, and did not have PCP.


VAERS ID: 1344264 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-05-14
Onset:2021-05-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension
Allergies: CT contrast dye, sulfa drugs, variety of trees, flowers, cats, dogs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Small rash that presented 8 days after vaccine and expanded to the top half of my arm, raised, red and warm. It also itches.


VAERS ID: 1344288 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / N/A RA / IM

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

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

Write-up: PATIENT HAD FIRST COVID SHOT OF MODERNA VACCINE, GOT SECOND COVID SHOT OF PFIZER


VAERS ID: 1344292 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-05-13
Onset:2021-05-21
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SC

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: prednisone and atorvastatin
Current Illness: prior Moderna COVID -19 vaccination.
Preexisting Conditions: Sarcoidosis,
Allergies: walnut, sesame seed, wheat extract
Diagnostic Lab Data: ultrasound lower extremity
CDC Split Type:

Write-up: DVT lower extremity


VAERS ID: 1344302 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Chills, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Asthma
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Chills, headaches, nauseous, only for that date.


VAERS ID: 1344319 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Lyme disease
SMQs:, Hearing impairment (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: no
Preexisting Conditions: depressed mood
Allergies: none
Diagnostic Lab Data: Lyme titer, pending
CDC Split Type:

Write-up: Bell''s Palsy, mild


VAERS ID: 1344658 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

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

Write-up: Vaccine given to child who was 11 years old and not eligible to receive the vaccine.


VAERS ID: 1344860 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Basal ganglia infarction, Cerebral artery occlusion, Cerebral infarction, Dysarthria, Headache, Magnetic resonance imaging head abnormal, Sinusitis, Stenosis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: FINDINGS: There is approximately 4.0 x 2.0 cm heterogeneous acute infarct in the left periventricular region involving corona radiata white matter, left caudate and left basal ganglia. A few additional small adjacent satellite acute infarcts left basal ganglia, left corona radiata, inferior left frontal white matter. Minimal associated mass effect. No evidence of intracranial hemorrhage. Ventricles, sulci and cisterns otherwise within normal limits for age. No midline shift. No hydrocephalus. Loss of normal left MCA flow voids on T2 with associated increased signal on FLAIR highly suspicious for proximal left MCA occlusion or high-grade stenosis. Mild ethmoid sinus mucosal thickening. No significant mastoid air cell disease. IMPRESSION: 1. Approximate 4.0 cm acute infarct involving left corona radiata white matter, left caudate, left basal ganglia. A few additional adjacent tiny acute infarcts. 2. Suspicious for proximal left MCA occlusion versus high-grade stenosis. Please see separate MRA studies same day for further details.
CDC Split Type:

Write-up: 5/24/21 - 44-year-old male with a past medical history significant for nicotine dependence, marijuana use, who presents for slurred speech. Accompanied by wife. Patient was in his normal state of health until Friday when he got his Pfizer Covid vaccine. About 5 hours later he was noted to have a headache and some slurred speech but patient and wife did not think anything of it. They went to some graduation parties this weekend and his speech continued to get worse which is what prompted them to present to the ED today. He denies that this is happened before. Feels like it is difficult for him to find words but not to actually say words. He does surf but denies being in murky water or swimming in fresh water. He denies IVDU. No underlying coagulopathy or cardiac history.


VAERS ID: 1344879 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Insomnia, Night sweats, Palpitations, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

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

Write-up: Anxious Insomnia Chills Shakes Night sweats Palpations


VAERS ID: 1344905 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: pt received JJ vaccine yesterday, chills, bodyaches, fatigue, nausea, denies vomiting/dirahea, pt reports HA 9/10 frontal pressure, pt took tylenol 0400 with some relief


VAERS ID: 1345249 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Heart rate increased, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Fever, chills, rapid heartbeat, body aches, headache for 2 days, 3-4th day very tired.


VAERS ID: 1345281 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, 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: Fosamax Plus D Tablet, Naproxen, Omeprazole Capsule Delayed Release, Ergocalciferol Capsule
Current Illness: Vitamin D deficiency
Preexisting Conditions: Vitamin D deficiency
Allergies: N.K.D.A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered higher dose of Janssen, 2.5 ML. Only saturday, 5/22/21. She felt very tired, but no other symptom, she went to sleep early and sunday she woke up better. Today, 5/24, she feels much better, and has no other symptom.


VAERS ID: 1345411 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Productive cough, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

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

Write-up: I have been running a low fever ever since I got the second shot and I have been coughing up a lot of fluid . I was fine before the second shot . Want to know if this is normal? Can you get Covid 19 from the shot?


VAERS ID: 1345426 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever of 101 to 102 for 36 hours, chills, muscle aches, headache, diarrhea.


VAERS ID: 1345448 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Eye swelling, Hot flush, Lethargy, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Swelling, soreness, hot flashes, lethargic, eye swelling


VAERS ID: 1345449 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Ear pain, Fatigue, Gingival pain, Headache, Influenza like illness, Injection site induration, Injection site mass, Injection site pain, Injection site rash, Injection site swelling, Musculoskeletal stiffness, Nausea, Pain, Pain in jaw, Pyrexia, Skin burning sensation, Vision blurred
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Gingival disorders (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyrocine, Vit C, D, E, Magnesium and Probiotics
Current Illness: Covid 13 months prior and dealing with Longhaul syndrome ever since.
Preexisting Conditions: Fibromyalgia due to accidental punctures to intestines years ago where anastomoses was not done properly causing longterm gastric issues. Also Covid See Above Comments in item 11.
Allergies: Replan or any derivative of Reglan.
Diagnostic Lab Data: I am a retired nurse and knew my symptoms were not needing emergency care or tests and knew there was no remedy but to wait till these symptoms passed.
CDC Split Type:

Write-up: Severe pain, swelling hard lump and rash on vaccinated arm the day after vaccination. The rash spread almost down to my elbow also noticed the skin in my entire body felt like a bad sunburn but was not red just felt burned. Other symptoms were like when I had Covid low grade fever 101 and flu type symptoms, bad headache, pain in ears, jaw, gums and overall body stiffness and pain along with nausea, fatigue, stomach ache and diarrhea. Also noticed my eyesight was very blurry and on day 2 tiny moving glitter like spots in my vision. Vision is still very blurry day 5 and seems to have exacerbated Covid symptoms and fatigue I was already dealing with.


VAERS ID: 1345458 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002338 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Chills, Crying, Depressed mood, Depression, Dizziness, Headache, Mood swings, Myalgia, Pyrexia, Somnolence, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mirtazapine 30 mg, Vitamin C-D, mulitvitamin komplex, fish oil
Current Illness:
Preexisting Conditions: depression-anxiety
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day 1: Chills, fever, sleepiness, low mood, muscle pain From Day 2: dizziness, headache, tinnitus, mood swings, crying, anxiety, depression It was the same after the first shot. Tinnitus and dizzines almost lasted 3 weeks after the first shot.


VAERS ID: 1345779 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Pain in extremity, Peripheral swelling, Pyrexia, Splinter haemorrhages
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544426

Write-up: BLOOD LINES BELOW NAIL TO END OF MIDDLE AND RING FINGER; FINGER SWELLING TO BOTH HANDS/RIGHT HAND SWOLLEN; LEFT ARM PAIN; FEVER; PAIN BELOW SHOULDER BLADE; This spontaneous report received from a patient concerned a 30 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 16-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 21-MAY-2021, the subject experienced pain below shoulder blade. On 22-MAY-2021, the subject experienced blood lines below nail to end of middle and ring finger. On 22-MAY-2021, the subject experienced finger swelling to both hands/right hand swollen. On 22-MAY-2021, the subject experienced left arm pain. On 22-MAY-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on MAY-2021, was recovering from finger swelling to both hands/right hand swollen, had not recovered from pain below shoulder blade, and blood lines below nail to end of middle and ring finger, and the outcome of left arm pain was not reported. This report was non-serious.


VAERS ID: 1345785 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Product temperature excursion issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544496

Write-up: ADMINISTRATION ERROR (15MINS PAST THE 2HR INDICATED ROOM TEMPERATURE HOLDING TIME); This spontaneous report received from a consumer concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown expiry date: UNKNOWN) dose was not reported, administered on 21-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 21-MAY-2021, the subject experienced administration error (15mins past the 2hr indicated room temperature holding time). The action taken with covid-19 vaccine was not applicable. The outcome of administration error (15mins past the 2hr indicated room temperature holding time) was not reported. This report was non-serious.


VAERS ID: 1345789 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Seasonal allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544649

Write-up: MUSCLE ACHES; HEADACHE; CHILLS; LOW GRADE FEVER; This spontaneous report received from a consumer concerned a 55 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included seasonal allergy. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: UNKNOWN) dose was not reported, administered on 21-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 21-MAY-2021, the subject experienced chills. On 21-MAY-2021, the subject experienced low grade fever. On 22-MAY-2021, the subject experienced muscle aches. On 22-MAY-2021, the subject experienced headache. The action taken with covid-19 vaccine was not applicable. The patient recovered from chills on 22-MAY-2021, and had not recovered from low grade fever, headache, and muscle aches. This report was non-serious.


VAERS ID: 1345791 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cold sweat, Fatigue, Headache, Hot flush, Hyperhidrosis, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Cannabis abuse, episodic use; Cigarette smoker (4 to 5 cigarettes per day); Sulfonamide allergy (Breakout into welts and hives)
Preexisting Conditions: Comments: The patient never had any flu shots
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544724

Write-up: COLD SWEATS; HOT FLASHES; HOT SWEATS; HAND WARM TO TOUCH; HIVE REACTION ON LEFT THIGH TO LEFT ANKLE; TIRED; HEADACHE; This spontaneous report received from a patient concerned a 58 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included sulfonamide allergy, marijuana occasionally, non-alcohol user, and cigarette smoker, and other pre-existing medical conditions included the patient never had any flu shots .The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1805025 expiry: 25-MAY-2021) dose was not reported, administered on 21-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 21-MAY-2021, the subject experienced cold sweats. On 21-MAY-2021, the subject experienced hot flashes. On 21-MAY-2021, the subject experienced hot sweats. On 21-MAY-2021, the subject experienced hand warm to touch. On 21-MAY-2021, the subject experienced hive reaction on left thigh to left ankle. On 21-MAY-2021, the subject experienced tired. On 21-MAY-2021, the subject experienced headache. Treatment medications included: ibuprofen. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from tired, cold sweats, hot flashes, headache, hot sweats, hive reaction on left thigh to left ankle, and hand warm to touch. This report was non-serious.


VAERS ID: 1345944 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Axillary pain, Erythema, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: patient had no known allergies. patient took 180mg of OTC allergy medication.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544643

Write-up: PAINFUL ARMPITS; REDNESS IN ARMPITS; RASH UNDER BOTH ARMPITS; This spontaneous report received from a patient concerned a 19 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included patient had no known allergies. patient took 180mg of otc allergy medication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 21-MAY-2021, the subject experienced painful armpits. On 21-MAY-2021, the subject experienced redness in armpits. On 21-MAY-2021, the subject experienced rash under both armpits. On 22-MAY-2021, treatment medications included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from painful armpits, and had not recovered from rash under both armpits, and redness in armpits. This report was non-serious.


VAERS ID: 1345949 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210545145

Write-up: ADMINISTERED VACCINE BEYOND EXPIRATION; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 21-MAY-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 21-MAY-2021, the subject experienced administered vaccine beyond expiration. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administered vaccine beyond expiration was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comments not required as per standard procedure as the case is considered non serious.


VAERS ID: 1345993 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Paraesthesia oral, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad)

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

Write-up: Throat tightness, lip and mouth tingling. No wheezing, nausea, urticaria or lightheadedness. Started 1 hr after shot, controlled with Benadryl, famotidine, steroid in the ED.


VAERS ID: 1345994 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Feeling abnormal, Hyperhidrosis, Nausea, Pain, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: I received my Moderna COVID vaccine on Thursday, May 20, 2021 and at that time I only had a slight fever and my arm was a bit sore at the injection site. My reaction to the Moderna began in the wee hours of Friday May 21st. I had a fever of 103.0, I did not go to walk in or my doctor because I took Tylenol and after a few minutes my fever subsided. I went back to sleep. Upon waking up I had body aches, a running fever, my head felt like I was in a fog that I couldn?t shake. I was so tired that I could hardly keep awake. My fever kept getting worse through out the day so I kept taking Advil (I had stopped taking Tylenol because it had stopped working). Advil helped a little bit but I felt like my fever would never go away. This happened through out the entire Friday May 21st. Then in the middle of the night around midnight Friday into Saturday I began sweating profusely all the while having a fever and body aches and I was really really tired. When I woke up at 5am Saturday my clothes were drenched in sweat and I felt better, but the entire weekend I had nausea and diarrhea.


VAERS ID: 1346367 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Confusional state, Decreased appetite, Eye pain, Feeling hot, Flushing, Headache, Mobility decreased, Muscle spasms, Musculoskeletal stiffness, Pain, Pain in extremity, Pyrexia, Somnolence, Spinal X-ray normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 05/24: X-Rays of lower spine. Confirmed no breaks. Better to discuss with ER/O
CDC Split Type:

Write-up: Received second dose of Moderna COVID 19 vaccine at 10AM Thursday 05/20. T+12-18hrs: Feeling flushed. Slightly confused. Body aches build over the night. Wake up with mild/moderate pain in back, knees, arm. Groggy. Went to work on something with a friend at 10:00 AM (T+24Hrs), but had to return home because.... T+24hr: ....headache growing. Went home and found fever at 102?. Slight chills, bit mainly just heat without sweating. Fever hit 103.2 at peak. Went through 10lbs ice to keep the fever in check. Headache from T24hr-T36HR feels like a spike through the top of frontal lobe to my left eye. T+32hr: Headache still intense. Only back pain now. Appetite slowly increasing. T+48hr (Saturday morning). Back pain persists, but mild. Headache gone. Have a relatively normal day. T+60hrs (Sat. Afternoon): Back pain increasing. Stop all unnecessary lifting/moving. T+68hrs (early Sunday morning): Go to ER with the back pain. Absolutely excruciating spasms from top of sacrum - roughly LI/12T. Lower back stiff as wood. Given shot or Toradol, dose/prescription to flexiril. I specifically request this plan because usually takes care of the spasms; basically, get me able to move and the pain/spasms will go away. NOTE: I have a history of back issues in this area, but I have not had an episode in years and certainly never had an episode that works like this with no relief. From about 2017-2019, I r T+70-78hrs: Feel normal. T + 78-88hrs: lower back pain comes back with an absolute vengeance. T+90hrs (early Monday morning): Return to ER. Back pain worse than Sunday morning. Receive toradol shot and prescription Prednisone. Back pain gone by around 10:30 AM. Decide to take prednisone Tuesday morning as its getting a bit late in the day by the time pharmacy fills the prescription. T+90hrs: Back pain returns in similar fashion as Sunday afternoon. Still. Barely mobile. T+96 hours: Wake up with lower back pain similar to Sunday/Monday morning. Took prednisone and flexiril this morning. Please help me.


VAERS ID: 1346377 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Tinnitus, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (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: None
Current Illness: None
Preexisting Conditions: Obesity
Allergies: Novocain
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bleared vision, ringing in the left ear


VAERS ID: 1346398 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Eructation, Flatulence
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Excessive stomach gas build up causing uncontrollable belching. This occurs numerous times throughout the day.


VAERS ID: 1346480 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Flushing, Hypertension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Hypersensitivity (broad)

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

Write-up: After receiving the COVID vaccine patient felt flushed/hot. Upon taking her BP we found it to be extremt.ely high 240/140.. PA did a quick chart review and intake, finding the patient had not been taking blood pressure medication and had not been to her PCP since 2019.


VAERS ID: 1346521 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: felt lightheadedness/fainted and loss of appetite a few hours after getting 2nd shot. called 911, checked vitals, everything normal limits. ems insisted she went to ER.


VAERS ID: 1346543 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Dizziness, Fatigue, Headache, Heart rate increased, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Fever over 100 onset 10 hours after injection, maintained 34 hours. Chills, body aches, severe headache, nausea, dizziness, fatigue 40 hours. Stomach upset manifested 48 hours after and lasted 12. Elevated heart rate for 24 hours.


VAERS ID: 1346547 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pain, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D (5000 IU taken once daily for the past 3 years) , Metformin (1000 mg, taken once daily for the past 8 years), Spironolactone (50 mg, taken once daily for the past 6 months), Iron (65 mg, taken once daily for the past 7 months), Vi
Current Illness: none
Preexisting Conditions: Diagnosed with PCOS ~8 years ago
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: A few hours after my vaccination I began to have searing joint pain in my fingers (right hand). The pain is like a sharp stab which lasts for a few minutes then it goes away. The pain comes and goes every few hours. I have never experienced anything like this in the past nor my family. Note: The only other symptom I had was a sore arm which I felt with both my vaccinations. No flu like symptoms or anything else I am aware of.


VAERS ID: 1346557 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal discomfort, Blood pressure decreased, Chills, Diarrhoea, Eye movement disorder, Fall, Headache, Lethargy, Loss of consciousness, Muscle spasms, Muscle twitching, Nausea, Pain, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Lethargy, fever, chills, body aches, headache...beginning at hour 6 and lasting until hour 24. One episode of fainting, while standing up and using the restroom. Blood pressure dropped severely and blacked out, woken up on the floor in the bathroom by wife who explained my eyes were open, dilated, and darting and body was twitching. Loss of consciousness lasted approximately 20-30 seconds. Occurred at hour 12 after receiving vaccination. Gastrointestinal distress, diarrhea, cramping, nausea from hours 40-76


VAERS ID: 1346561 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 AR / IM

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

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

Write-up: dose given to a 16 year old.


VAERS ID: 1346568 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Decreased appetite, Feeling cold, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: On Friday morning, starting about 9am I felt extreme cold that could only be remedied by laying under three blankets in a 72 degree room, on Friday afternoon I spiked a fever of 101.5 that was successfully treated with Tylenol through the evening. Appetite suppressed through end of day Saturday.


VAERS ID: 1346569 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Decreased appetite, Pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol Over the counter
Current Illness: None
Preexisting Conditions: None
Allergies: none Known to patient
Diagnostic Lab Data: Rapid Covid testing on 05/24/2021: negative results
CDC Split Type:

Write-up: Patient came into clinic 05/24/2021 with fever, shivers, body aches and loss of appetite. Patient was tested for Covid ( rapid testing), once test results showed negative, patient was informed to go to ER in regards to side effects.


VAERS ID: 1346580 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Sleep disorder, Sleep terror
SMQs:

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

Write-up: Systemic: Unable to Sleep-Severe, Additional Details: Night terror


VAERS ID: 1346585 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: concerta 27mg 1 po q am
Current Illness: NONE
Preexisting Conditions: none
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: Per patient he has heart palpitations and some heart racing after the first covid vaccine dose on 4-20-21 he proceeded to then get the 2nd vaccine which further exacerbated the heart racing on 5-20-2021.


VAERS ID: 1346601 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event
SMQs:

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

Write-up: No adverse effect reported. No treatment needed


VAERS ID: 1346632 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-21
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Lymphadenopathy, Odynophagia
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Systemic: swollen lymph nodes on left side; painful to swallow-Severe, Systemic: Lymph Node Swelling-Severe, Additional Details: pt was fine with 1st dose. received 2nd dose on 5/16/21 and developed pain, trouble swallowing on friday 5/21/21 and got progressively worse where pt had to go to er on sunday 5/23/21. Er nurse gave pt an antibiotic and norco for the pain and advised pt to call pharmacy to report. According to pt, er did not advise pt to follow up with primary care md. Rph advised pt to follow up with primary care md


VAERS ID: 1346660 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Chest X-ray normal, Chest pain, Deep vein thrombosis, Dyspnoea, Exposure during pregnancy, Fatigue, Fibrin D dimer, Full blood count, Metabolic function test, Pain, Pain in extremity, Pleuritic pain, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal vitamins.
Current Illness: None.
Preexisting Conditions: None.
Allergies: No known allergies.
Diagnostic Lab Data: Blood work including CBC, CMP, D-dimer, etc. An ultrasound was done on her right lower leg and a DVT was found. A chest x-ray was done but came back negative. She was admitted to the hospital for observation and to get started on blood thinners.
CDC Split Type:

Write-up: This is a 35-year-old female, G2, P1 Ab0, 23 weeks pregnant, who presents to the emergency department for chest pain. Patient reports receiving her second Madura COVID-19 vaccine yesterday at around noon. She states that later that evening, she reports onset of fatigue, and pleuritic chest discomfort. She reports increasing in discomfort into this afternoon, with shortness of breath. She also reports body aches, and bilateral lower extremity calf pain. No fevers, or chills. No nausea, or vomiting. Patient is currently being followed by doctor of OB/GYN, with whom she had a conversation with this morning. Doctor already recommended she come in for evaluation. Otherwise patient denies any vaginal bleeding, discharge. No urinary symptoms. No prior history of a cardiac or pulmonary disease. No lightheadedness, dizziness, or syncope. No prior history of DVTs, pulmonary embolisms.


VAERS ID: 1346664 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Dizziness, Hyperhidrosis, Hypotension, Immediate post-injection reaction, Loss of consciousness, Malaise, Nausea, Pallor, Slow response to stimuli, Tearfulness, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Client approached staff stating she was not feeling well and was tearful. Client was escorted to chair and within a few seconds had loss of consciousness lasting 15-20 seconds. Client was slow to recover and remained pale, diaphoretic, and hypotensive several minutes following event. 30 minutes after LOC client continued to complain of light headedness and developed abdominal pain and nausea. Pt maintained a pulse between 70-80bpm and a normal SPO2 at or above 98% on room air during the entire event. Do to slow recovery and return to baseline and noted emesis the decision to was made to transport client to the local emergency department via mobile medical response.


VAERS ID: 1346680 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-16
Onset:2021-05-21
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Anticoagulant therapy, SARS-CoV-2 test negative
SMQs:, 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: cellulitis
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: Covid PCR negative 5/21/2021
CDC Split Type:

Write-up: Report indicates client was hospitalized on 5/21/2021 for "abnormal diagnostic test". No other details about client condition were noted. It did indicate he received heparin.


VAERS ID: 1346694 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-23
Onset:2021-05-21
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A-1 / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 2 LA / SYR

Administered by: Unknown       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? 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: Newly diagnosed Type I Diabetes mellitus, morbid obesity
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received both Moderna vaccines (#1 on 3/26/21, #2 on 4/23/21) and tested positive for COVID-19 by PCR on 5/21/21. Patient was asymptomatic, testing obtained on admission to hospital for management of Diabetic ketoacidosis.


VAERS ID: 1346696 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 2 RA / IM

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

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

Write-up: Patient has a knot under her skin near the injection site 2 days after receiving her second dose of the vaccine.


VAERS ID: 1346697 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Differential white blood cell count, Dyspnoea, Electrocardiogram, Full blood count, Malaise, Metabolic function test, Paraesthesia oral, Troponin I
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: metFORMIN (GLUCOPHAGE XR) 500 mg extended release tablet Take 1 tablet (500 mg) by mouth 1 time per day 90 tablet 4 ? predniSONE 20 mg tablet Take 1 tablet (20 mg) by mouth 1 time per day 3 tablet 0 ? metFORMIN (GLUCOPHAGE) 500 MG tablet Ta
Current Illness: Depression with anxiety Tobacco use disorder Hepatitis Chronic alcoholism (HCC) Bipolar disorder (HCC) Migraine without aura Neck pain Headache(784.0) Pelvic pain in female Ovarian cyst Pelvic adhesive disease Abdominal pain Vaginal cuff dehiscence BMI 41
Preexisting Conditions: Depression with anxiety Tobacco use disorder Hepatitis Chronic alcoholism (HCC) Bipolar disorder (HCC) Migraine without aura Neck pain Headache(784.0) Pelvic pain in female Ovarian cyst Pelvic adhesive disease Abdominal pain Vaginal cuff dehiscence BMI 41
Allergies: Contrast Dye [Diagnostic X-Ray Materials] Anaphylaxis (High) ? Covid-19 Mrna Vacc (Moderna/Pfizer) Anaphylaxis (High) 2nd dose ? Shellfish-Derived Products Anaphylaxis (High) ? Sulfa Drugs Wheezing/Bronchospasm (High) and Shortness of breath ? Compazine [Prochlorperazine] Confusion Rigidity
Diagnostic Lab Data: Care Timeline 5/20/2021 1113 EKG 1115 diphenhydrAMINE HCl 50 mg 1120 methylPREDNISolone Sodium Succ 125 mg 1122 XRAY CHEST PORTABLE - 1127 COMPLETE BLOOD COUNT WITH DIFFERENTIAL COMPREHENSIVE METABOLIC PANEL TROPONIN I LAB ONLY-COMPLETE BLOOD COUNT WITH DIFFERENTIAL LAB ONLY-MANUAL DIFFERENTIAL Famotidine in NaCl 20 mg 1130 Sodium Chloride 999 mL/hr
CDC Split Type:

Write-up: Shortness of breath, tongue feels funny, generally not feeling well


VAERS ID: 1346703 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-17
Onset:2021-05-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle disorder
SMQs:, Rhabdomyolysis/myopathy (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: Involuntary Muscle Disorder TIC


VAERS ID: 1346717 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Injection site pain, Nausea, Pain, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: flu shot-got sick after with bronchitis
Other Medications: Tylenol, Lexapro 20mg, Vitamin D, Iron
Current Illness:
Preexisting Conditions: anemia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Adverse events experienced and are they still occurring now: Patient called in stating she received the vaccine on Friday 5/21/21 @10:30 am and later she started to experience soreness at the injection site and about the evening time at 6pm she felt nauseous and started throwing up shortly after. She vomited about 5-6 times on Friday night. Saturday morning she woke up with soreness of the body in neck, shoulder body (extreme body aches), fever also started on Saturday. Patient also c/o headache, rash on left wrist (only area), and she also feels fatigued, and chills. **Patient does have a history of blood clots and anemia** She stated as of Monday 5/24/21 @7:26pm she had a fever in the day but that subsided after taking Tylenol. Last time the patient took Tylenol was on 5/24/21 at 2pm.


VAERS ID: 1346735 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: Broke out in hives, had low grade fever, gave Benadryl and Tylenol after3 days seems to be gone


VAERS ID: 1346736 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Ear pain, Tinnitus, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular 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: first moderna vaccine as well
Other Medications: metronidazole, omeprazole
Current Illness: None
Preexisting Conditions: GERD
Allergies: sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Ringing in ears, blurred vision, pain in ears, dizziness


VAERS ID: 1346811 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-09
Onset:2021-05-21
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Tested positive for Covid-19 on 5/21/21


VAERS ID: 1346891 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 RA / IM

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

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

Write-up: Child too young to receive Moderna


VAERS ID: 1346898 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Feeling hot, Injection site pain, Pain
SMQs:, Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: 5/21/21 received 1st covid vaccine at 6:10pm and within 15 minutes felt a heat up the left side of my neck and head, and inner ear, but no pain at all. It lasted about 30 minutes. Later that evening my arm at injection site felt sore and I felt very tired/exhausted. The arm soreness lasted until the morning of 5/24/21, and I am currently still experiencing exhaustion, but along with body aches and occasional diarrhea as of 5/25/21


VAERS ID: 1346907 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-13
Onset:2021-05-21
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Starting on May 20th or 21st I noticed a pain while putting deodorant on under my left armpit. As I went through the day, I noticed that it started to swell under my arm. As the days went on it got continually worse. On Sunday night, in hopes to get the swelling down used Ice & Heat to try and combat the swelling. It did not work. Today 5/25 the swelling is still there along w pain.


VAERS ID: 1346963 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

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

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

Write-up: Pt was in to receive 2nd Pfizer vaccine. After the vaccine was administered, pt admitted that he had already received the Janssen vaccine and was considering getting the Moderna in the future.


VAERS ID: 1346995 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-17
Onset:2021-05-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 1 LA / IM

Administered by: Public       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? 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: Partial paralysis to one side of face, diagnosis of Bell''s Palsy.


VAERS ID: 1347018 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Agitation, Feeling abnormal, Insomnia, Pain, Poor quality sleep, Speech disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)

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

Write-up: Patient reports receiving Pfizer vaccine 5/21/2021 and insomnia since receiving vaccine and feeling "electricity" throughout body. Per patient, went to urgent care on 5/24/21 in PM, had normal vital signs, and was given hydroxyzine and Flexeril and was able to sleep for 2 hours overnight, but it was not a restful sleep. When I spoke with patient on the phone, patient was agitated, and had pressured speech, and appeared to be in pain. I prescribed Lunesta 3 mg and told patient if unable to sleep, to go to Emergency Department for further evaluation.


VAERS ID: 1347050 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: No adverse reaction, patient came to vaccine clinic, filled out consent marking no to any previous COVID vaccination, previous COVID vaccine on March 5th 2021. Patient was given vaccine according to consent and check list.


VAERS ID: 1347077 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 RA / IM

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

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

Write-up: patient completed consent form for vaccine, marked had no other prior COVID vaccination, patient was given/consent and check list


VAERS ID: 1347116 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Insomnia, Myalgia, Neck pain, Pain, Pain in extremity, Peripheral swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (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:
Other Medications: Meloxicam, Citalopram, Oxybutynin, Omeprazole, Triamterene, Estradiol, Rosuvastatin, Tylenol.. Vitamin B, supra B complex plus, AREDS II, potassium.
Current Illness: None.
Preexisting Conditions: COPD, high blood pressure, cataract right eye, high cholesterol, acid reflux.
Allergies: Sulfa, Codeine.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: She got her vaccine, her arm hurt, swollen. She seemed to be fine all day except close to bedtime, around 10:30/11:00 she started getting body aches, her neck hurt, her head hurt and every muscle in her body hurt. She tried putting a cold pack on her neck and did not sleep at all that night. It took her a couple of days to recuperate. Then finally the symptoms went away. She used cold packs and Tylenol, just couldn''t sleep. Since the symptoms have gone she is able to sleep better.


VAERS ID: 1347143 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-21
Onset:2021-05-21
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Facial paralysis, Magnetic resonance imaging
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), 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: Iron supplments.
Current Illness: No
Preexisting Conditions: None
Allergies: NO
Diagnostic Lab Data: MRI
CDC Split Type:

Write-up: Facial paralysis.


VAERS ID: 1347168 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood glucose increased, Chills, Extra dose administered, Fatigue, Headache
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Arthritis (broad), 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: rosuvastatin, hydrochlorothiazide, glipizide, lisinopril, omeprazole, jardiance
Current Illness: none
Preexisting Conditions: diabetes, hypertension, GERD
Allergies: none
Diagnostic Lab Data: none completed
CDC Split Type:

Write-up: Patient received third dose of Covid vaccine. No treatment given, patient told to report adverse events to pharmacy. Patient reported tiredness, headache, joint pain, high blood sugars and chills


VAERS ID: 1347180 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Joint injury, Limb injury, Pain, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)


VAERS ID: 1347219 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-17
Onset:2021-05-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: PT GOT THE VACCINE ELSEWHERE: PT ALSO STATES, THIS IS HIS 2ND DOSE OF pziefer HE STATES HE HAD PAIN ON BOTH LEGS AFTER A COUPLE OF HOURS OF THE VACCINE TODAY HE COMES IN WITH BOTH FEET SWOLLEN AND PAIN


VAERS ID: 1347232 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

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

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

Write-up: There is no adverse reaction. Patient was under the age of 12. Mother states that she has immune compromised person in the household and need to get everyone vaccinated, so she misstate the date of birth of patient to received the vaccine.


VAERS ID: 1347258 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Eye movement disorder, Malaise, Muscle rigidity, Pallor, Paraesthesia, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: 28 year old female, presented to clinic for her second dose of Moderna Lot #003C21A. Approximately 5 minutes after receiving her injection she told her husband she wasn?t feeling well. She then proceeded to become nonresponsive for a period of approximately 20-30 seconds. Her left arm had notable rigidity. Her eyes deviated upward and her skin had notable pallor. She was lowered to the ground by staff and myself and placed in a supine position with her legs elevated. became responsive and was alert and oriented X3. She initially had decreased strength in her left hand and described a ?pins and needles? sensation. was able to sit up and ambulate to a safe area where she proceeded to feel light headed again. She was then placed in a supine position. BP 90/60. Per the patient and husband there is no significant medical history. The patient did have a syncopal episode with vaccines in the past. After consultation with both the patient and her husband we called 911. Patient was stable when EMS arrived and transported to Hospital for further evaluation.


VAERS ID: 1347277 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypomenorrhoea, Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pills: Nortrel 0.5/35
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started spotting (period bleeding) two days after second covid shot. Effects lasted from 5/21/21 - 5/24/21.


VAERS ID: 1347302 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Back pain, Fatigue, Headache, Injection site pain, Musculoskeletal chest pain, Pain in extremity, Presyncope, Pyrexia, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vicodin
Diagnostic Lab Data:
CDC Split Type:

Write-up: After injection 2:01pm - almost passed out. Immediate injection site pain. 4:00pm vaginal bleeding, pain in left and right arm Continuing throughout day- pain in both arms, fatigue, pain in back, feverish and joint pain. 5/22- headache, fever, fatigue, vaginal bleeding, pain under left rib. (Not persistent pain in left rib) feverish and joint pain. 5/23- pain in both arms, shoulder pain, joint pain, fatigue vaginal spotting. Took 1 ibuprofen. 5/24- lessening arm and back pain, fatigue and vaginal spotting, shoulder pain. Pain below left rib (not persistent) and joint pain now localized in left hand/fingers and left ankle area. Took 1 ibuprofen.


VAERS ID: 1347312 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Cardiac stress test abnormal, Catheterisation cardiac normal, Chest pain, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol OTC
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Troponin Stress Test Left Heart Catheterization
CDC Split Type:

Write-up: Day 3 post second vaccination patient experienced chest pain - admitted Hospital. Patient had chest pain , elevated Troponin and positive stress test. taken to the Cath Lab where "normal coronaries, normal LV function".


VAERS ID: 1347313 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: 16yo female pt had syncope episode approx 15 min after vaccination. Parents said they had just come off of a long international flight and that pt was very tired and had not had anything to eat or drink. After vaccination, the family walked around the store, and pt fainted on other side of store. Emergency services were called. Pt was helped to sitting upright in a chair, and had a scraped knee.


VAERS ID: 1347342 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PFIZER REQUIRES 1.8ML OF DILUENT TO BE USED BEFORE ADMINISTERING THE VACCINE. ONLY 0.8ML WAS USED, CAUSING ONLY 4 FILL DOSES TO BE IN THE VIAL. UPON GOING TO DRAW UP THE 5TH DOSE FOR THE DAY, I NOTICED THERE WAS NOT ENOUGHT LIQUID IN THE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: NONE REPORTED


VAERS ID: 1347349 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 6023716 / 1 LA / IM

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

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

Write-up: parents of patients misinformed pharmacy of age of child. Child is 11 years of age. pharmacy team found out due to confirmation from insurance of patient. no issues are aware of signs and symptoms from the patient as we are unable to reach patients of child


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