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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 116 out of 3,524

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VAERS ID: 1353626 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lip pain, Lip swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021585179

Write-up: Lip swelling and pain/swollen to 4x the regular size of lip; Lip swelling and pain/swollen to 4x the regular size of lip; This is a spontaneous report from a non-contactable consumer (patient, herself). A 31-year-old non-pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Lot Number: EW0178 and expiry date was not provided), via an unspecified route of administration, administered in Arm Left on 19May2021 13:15 (at the age of 31-years old) as a single dose for COVID-19 immunisation. Medical history included COVID-19. Prior to vaccination, the patient was diagnosed with COVID-19. The patient''s concomitant medications were not reported. Since the vaccination, the patient had been tested for COVID-19. No known allergies. No other medical history. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not receive any other medications within 2 weeks of vaccination. On 21May2021 12:00 AM, the patient experienced lip swelling and pain, swollen to 4 times the regular size of lip. No treatment received for the events. Seriousness of the events was reported as non-serious. The outcome of the events was not recovered. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1354121 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-01-29
Onset:2021-05-21
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Body temperature increased, Cough, Dyspnoea, Influenza A virus test negative, Influenza B virus test, Respiratory syncytial virus test negative, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Alendronate, Metformin HCL, Nicotine gum, Omeprazole, Pioglitazone, Calcium, Omega-3 Fish Oil
Current Illness: Spina Bifida, Degeneration of LS intervertebral Disc, DM type 2, GERD, Obesity, Spondylolisthesis, Diabetic preipheral neuropathy, Tobacco user, Hyperlipidemia, Osteoporosis, Diverticulosis of colon
Preexisting Conditions: Spina Bifida, Degeneration of LS intervertebral Disc, DM type 2, GERD, Obesity, Spondylolisthesis, Diabetic preipheral neuropathy, Tobacco user, Hyperlipidemia, Osteoporosis, Diverticulosis of colon
Allergies: Silk tape, Motrin, Promethazine, Toradol, Augmentin and Glyburide
Diagnostic Lab Data: 05/21/2021 Patient tested positivea for Covid 19 by Cepheid method. Influenza A & B, and RSV tested negative
CDC Split Type:

Write-up: Routine screening. for Covid-19. Asymptomatic. Date 2 developed shortness of breath with exertion, dry cough and afebrile. Day 5 same symptoms, plus temperature of 100 to 101.1 F


VAERS ID: 1354229 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose 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: aderrall
Current Illness:
Preexisting Conditions:
Allergies: peanuts seafood
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient came in for2nd covid vaccine, which happen to be his 3rd vaccine. looking to check that he received the first dose 4/23/2021 and what was supposed to be the second dose 5/21/2021. Patient had already had a dose 2/19/2021 that didn''t populate into the system when checking.


VAERS ID: 1354240 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 14C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect route of product administration
SMQs:, Drug abuse and dependence (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Wrong Route (SC, IM, etc.)


VAERS ID: 1354263 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Unknown  
Location: Michigan  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypersensitivity
SMQs:, Angioedema (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:
Current Illness:
Preexisting Conditions:
Allergies: PENICILLIN
Diagnostic Lab Data: BP 120/66 HR 74 AND 92% O2 ON ROOM AIR
CDC Split Type:

Write-up: AFTER RECEIVING THE VACCINE, SHE COMPLAINED OF ALLERGIC REACTION SYMPTOMS. ON SITE EMS RESPONDED AND VITALS LISTED BELOW. SHE FELT BETTER AND WAS RELEASED TO HOME


VAERS ID: 1354371 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-02
Onset:2021-05-21
   Days after vaccination:80
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Diarrhoea, Dyspnoea, Influenza A virus test negative, Myalgia, Oropharyngeal pain, Pulmonary congestion, Pyrexia, Respiratory syncytial virus test negative, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Alogliptin, Atorvastatin, Ibuprofen, Lisinopril, Metformin, phenylephrine HCL
Current Illness: Low back pain, obesity, GERD, Alcohol abuse, HTN, DM type 2, Dyslipidemia
Preexisting Conditions: Low back pain, obesity, GERD, Alcohol abuse, HTN, DM type 2, Dyslipidemia
Allergies: None
Diagnostic Lab Data: 5.21.2021: Cepheid Covid 19 test positivea. Influenza A and B, and RSV negative.
CDC Split Type:

Write-up: 05/21/2021 Routine Covid-19 screening. later developed fever (subjective), cough, sore throat, shortness of breath, Chills, headache, muscle aches, lost taste and smell, diarrhea and later developed chest congestion.


VAERS ID: 1354384 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Pyrexia, Sensitive skin
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: Amitryptiline Amandatine Vitamin C Vitamin D Iron N-Acetyl Cysteine Boswellia
Current Illness: none
Preexisting Conditions: Pediatric Acute Onset Neuropsychiatric Syndrome (PANS) also referred to as basal ganglia encephalitis or post-infectious autoimmune or neuroinflammatory encephalitis
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient developed fever, starting low and increasing to 102.1, as well as feelings of hypersensitivity in his skin, chills and extreme fatigue about 20 hours after his first dose of Pfizer. Symptoms resolved by the following morning - lasted about 18 hours.


VAERS ID: 1354394 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-29
Onset:2021-05-21
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaccination complication
SMQs:

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

Write-up: PHARMACY WAS CALLING THE PATIENT TO REMIND HER ABOUT HER APPOINTMENT FOR SECOND COVID SHOT ON 5/27/2021 . PATIENT ONLY PROVIDED THE INTERPETER WITH A BRIEF DETAIL BECAUSE SHE WAS IN THE HOSPITAL. SHE ONLY STATED THAT SHE HAS BEEN HOSPITALIZED FOR A WEEK NOW AND THAT SHE HAD A BAD REACTION TO THE VACCINE WHICH WAS GIVEN ON 4/9/21.


VAERS ID: 1354424 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-18
Onset:2021-05-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Cardiac monitoring, Chest X-ray, Chest discomfort, Chest pain, Computerised tomogram, Dyspnoea, Echocardiogram, Electrocardiogram, Myocardial necrosis marker increased, SARS-CoV-2 test, Urine analysis
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Minolira ER 135 mg, Zyrtec allergy pill 1 tab daily
Current Illness: N/A
Preexisting Conditions: Beta Thalassemia
Allergies: Hydrocodone
Diagnostic Lab Data: Covid test, urninalysis, roughly 9 blood draws, 2- EKG''s, chest x-ray, CT scan, ultrasound of heart
CDC Split Type:

Write-up: 8:30 am - Sudden chest pains, pressure and shortness of breath. Came on suddenly and worsened as time went on. Shortly after 9am placed call to family Dr and was directed to go to ER. Arrived at ER around or shortly after 10am. ER immediately did a EKG then followed by all of the tests listed below. Blood work showed elevated heart enzyme which signaled there was an issue. As day progressed the heart enzyme continued to elevate. 2pm-2:30pm we had a diagnosis and were told she would need to stay overnight for observation while they started her on drugs to get her heart stabilized. She was hooked to a heart monitor throughout the night. Discharged with treatment plan the next day 5/22.


VAERS ID: 1354565 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dizziness, Exposure during pregnancy, Fatigue, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), 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: Prozac (40mg/day), One-a-day prenatal vitamin (1 per day), Prilosec (20mg/day), Iron Supplement (300 mg/day), Zyrtec (1pill /day)
Current Illness: COVID positive on 4/16/2021 with symptoms; migraines, shortness of breath, loss of taste and smell
Preexisting Conditions: Anxiety, Endometriosis, Seasonal Allergies
Allergies: No
Diagnostic Lab Data: Temperature check - normal range Heart Rate check - normal range
CDC Split Type:

Write-up: 7 hours post-vaccination shot started to feel extremely fatigued and dizzy, progressed quickly to nausea then vomiting Muscle aches, chills and nausea through the 1st night post-shot Next day: fatigue and nausea, muscle aches, chills 2 days later: finally resolved Adverse Events At time of vaccination, 30 weeks pregnant due 7/19/2021; did not deliver yet


VAERS ID: 1354597 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 633CZIA / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling jittery, Headache, Laboratory test, Loss of consciousness, Pain, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Began with headache, body aches, and feeling tired. Progressed to hives on stomach - called ER recommended I take Benedryl, I did. Hives progressed and worsened, I passed out and my husband had to call 911. I was taken by ambulance to the ER and admitted to the hospital. I stayed until on Monday 5/24/2021. I was released 1:30pm. Wednesday 5/27/2021 I felt jittery I called my PCP they could not get me in and recommended I go to the walk in clinc, I did and they reduced some of the medications I was put on from the hospital. I have a follow up appointment with my PCP 6/2/2021.


VAERS ID: 1354621 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-10
Onset:2021-05-21
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Transient alteration of awareness Uncontrolled hypertension
Preexisting Conditions: Neurology Lumbar radicular pain DM type 2 with diabetic peripheral neuropathy (HCC) Acute CVA (cerebrovascular accident) (HCC) Cardiovascular Paroxysmal ventricular tachycardia (HCC) Essential hypertension, benign Mixed hyperlipidemia Diastolic dysfunction Paroxysmal tachycardia, unspecified (HCC) S/P ablation operation for arrhythmia Hypertension, uncontrolled Pulmonary Shortness of breath Gastrointestinal Regional enteritis (HCC) Ileostomy in place (HCC) Mild protein-calorie malnutrition (HCC) Nephrology Diabetes mellitus with stage 3 chronic kidney disease (HCC) AKI (acute kidney injury) (HCC) Acute kidney injury (HCC) Hematology Bicytopenia Ophthalmology Primary open angle glaucoma of both eyes, mild stage Nuclear senile cataract of both eyes Dermatology Seborrheic dermatitis Rheumatology Primary osteoarthritis of both knees Musculoskeletal Foot deformity Leg swelling Chronic midline low back pain without sciatica Psychiatry Delirium Other BMI 26.0-26.9,adult Summary Generalized weakness
Allergies: latanoprost, PF, 0.005 % drop Blood Pressure Monitor Blood Pressure Test Kit-Medium kit Blood-Glucose Meter (ONETOUCH VERIO METER) aspirin, enteric coated (ASPIRIN, ENTERIC COATED) 81 mg EC tablet Cholecalciferol, Vitamin D3, (VITAMIN D) 25 mcg (1,000 unit) cap clopidogrel (PLAVIX) 75 mg tablet dilTIAZem CD (CARDIZEM CD, CARTIA XT) 180 mg 24 hr capsule doxazosin (CARDURA) 8 mg tablet furosemide (LASIX) 40 mg tablet gabapentin (NEURONTIN) 100 mg capsule hydrALAZINE (APRESOLINE) 100 mg tablet potassium chloride ER (K-DUR, KLOR-CON) 10 mEq tablet rosuvastatin (CRESTOR) 10 mg tablet sodium bicarbonate 650 mg tablet lancets (ONETOUCH DELICA LANCETS) 30 gauge blood sugar diagnostic (ONETOUCH VERIO TEST STRIPS) test strip acetaminophen (TYLENOL) 500 mg tablet carboxymethylcellulose (REFRESH TEARS) 0.5 % drop multiv,ca,iron,min/fa/phytoste(CENTRUM CARDIO 3 MG-200 MCG-400 MG TAB)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient hospitalized for COVID-19 pneumonia at Hospital: CRITICAL CARE


VAERS ID: 1354654 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-17
Onset:2021-05-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: C-reactive protein normal, Chest X-ray normal, Chest pain, Electrocardiogram normal, Full blood count normal, Pericarditis, Troponin normal
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec 10mg as needed
Current Illness: none
Preexisting Conditions: none
Allergies: Brazil nuts
Diagnostic Lab Data: EKG and CXR were done at Emergency Room on 5/21-22/21 and were reported to the parent as normal. Laboratory tests were done on 5/24: CBC - normal, CRP - normal, troponins - normal
CDC Split Type:

Write-up: Patient presented to ER with severe unrelenting chest pain beginning abruptly 4 days after receiving first dose of Pfizer COVID19 vaccine. He was diagnosed at the ER with pericarditis and discharged with ibuprofen. Chest pain has gradually improved over past 6 days though is still intermittently present.


VAERS ID: 1354691 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Menstruation irregular, Palpitations, Vomiting
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Fertility disorders (broad), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Cinnamon
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme exhaustion, heart palpitations, early start of menstrual cycle, diarrhea, vomiting


VAERS ID: 1354709 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest discomfort, Dysphonia, Periorbital swelling, Swollen tongue, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Epinephrine 0.3mg IM prn anaphylaxis
Current Illness:
Preexisting Conditions:
Allergies: Bee sting - anaphylaxis
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt reported an anaphylactic history to bee stings with his last reaction being in 2017 during his screening. Pt was instructed to wait an additional 30 minutes following his vaccination. Pt was given his vaccine at 1134. Pt reported a sensation of "tongue swelling and chest tightness" at 1139. Pt reported it felt like his past anaphylactic reaction. Pt voice sounded muffled, tongue appeared swollen. Pt self administered 1 adult Epi Pen at 1139 with x1 RN and x1 medic supervision. VS were taken. HR was 107, BP was 137/92, SpO2 was 97%. Lung sounds were clear in the apices and diminished in the bases bilaterally. Periorbital swelling was noted at 1140. 911 was called and an ambulance was dispatched at this time. The pt denied a feeling of nausea, denied dizziness. Pt was alert and oriented x4/4 for the entirety of observation. VS were taken again at 1144. The HR was 97, BP was 131/85, SpO2 was 97%. Last reported oral intake of a "bagel and coffee at 0800". VS taken again at 1147, HR 101, BP 135/86, SpO2 98%. Pt reported a continued feeling of throat tightness, periorbital swelling was increasing. Ambulance arrived at 1154 and was given full report. Paramedic assumed care at 1155. Paramedic team deemed it safe to administer one more dose of epinephrine and transport patient via ambulance to ER. In ER, patient endorses mild chest tightness but denies any shortness of breath, oral pharyngeal edema, difficulty swallowing, wheezing, abdominal discomfort, nausea or vomiting, pruritus, or hives. He was given Benadryl, methylprednisolone, and famotidine while in the emergency department to finish the allergic reaction cocktail. He was observed for a total of 3 hours after his last epi injection and he remained HDS and asymptomatic. He was given a prescription for EpiPen autoinjectors with multiple refills. Patient was advised that he should not receive his second covered vaccination without discussing with his PCM. He was given strict return precautions and patient felt comfortable being discharged home.


VAERS ID: 1354767 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Blood pressure increased, Dizziness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad)

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

Write-up: Approx 24 hrs after receiving vaccination , EE became n/v, upset stomach, dizzy, bp increased, weak, Had covid approx 4 1/2 months prior and received antibodies approx 4 months earlier.


VAERS ID: 1354864 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-13
Onset:2021-05-21
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Ear pain, Fatigue, Inappropriate schedule of product administration, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Medication errors (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: alprazolam, Combivent, Advair, Lantus, Lisinopril, metformin, sertraline
Current Illness: None
Preexisting Conditions: DM type 2, obesity, diverticulosis
Allergies: PCN
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received the Covid vaccine on 5-13-21. She had seen her PCP and did not tell him that she received it. On 5-19-21 she received the Pneumovax and 2 days later she had extreme fatigue, body aches, weakness, fever, ear and throat pain.


VAERS ID: 1354890 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Food aversion, Nausea, Pain, Sleep disorder
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin ER 750mg x 2 daily, Zyrtec once daily, Alieve at night, and Prilosec OTC
Current Illness: None
Preexisting Conditions: PCOS, rosacea
Allergies: Polyquarternium, penicillin
Diagnostic Lab Data: I saw the dr yesterday on 5/26 and they ruled out pregnancy, spleen, gallbladder, or appendix concerns. No fever.
CDC Split Type:

Write-up: Extreme nausea and moderate stomach pain that is still ongoing 6 days after first injection. The nausea is keeping me awake at night and I have strong food aversion. I?ve forced myself to eat toast or ramen a few times to take medication, but otherwise I don?t want to eat. I had chills and an achy body in addition to these other symptoms but those went away after 48 hours but the nausea and stomach pain continue.


VAERS ID: 1354969 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-05-14
Onset:2021-05-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Erythema, Heart rate increased, Pain in extremity, Peripheral swelling, Pruritus, Rash macular, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitolopram Propranolol Biotin Vitamin D3
Current Illness: none
Preexisting Conditions: Anxiety/Depression
Allergies: Amoxicillin - causes stomach sickness/vomiting
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 12 hrs after receiving the vaccine, I was going to sleep and my heart started beating very rapidly on and off for about 10-20 minutes and my chest felt like it was all congested on and off for the same 10-20 minutes. Other than being a little sore, no more issues until 1 week later......my left arm started getting sore and it swelled up, turned red, got very itchy and was extremely hot to the touch. Ice pack did not help much. Swelling started going down 6 days later. Apparently it''s being called "Covid arm?" I also had an odd shaped, non-itchy splotch just behind my armpit. It showed up out of the blue the day after my arm swelled up, but went away on it''s own after a few days.


VAERS ID: 1355045 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Diarrhoea, Dyspnoea, Hypotension, Pruritus, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERALL, SAXENDA, LEVOTHYROXINE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: They took blood when they first put in my IV but I don?t think they did anything with that blood in regards to sending to lab. They took blood later after I had been given the iv fluids and medicines and did send off to the lab for results
CDC Split Type:

Write-up: Had shot 2 around 1:30pm on 5/20 - shortly after midnight around 12:30am 5/21 I woke up with severe stomach cramps which led to diarrhea and throwing up for about 20 minutes then began itching all over my body and broke out in hives everywhere and started having trouble breathing - I immediately took several Benadryl and waited to see if it would help. I ended up falling back asleep and didn?t have to seek medical help. Fast forward to Tuesday, 5/25 I woke up around 11:30 with severe stomach cramps and had diarrhea again. I didn?t throw up this time. Within 10-15 after the diarrhea finished I broke out in severe hives all over my body and the itching was way worse than the first episode. I was having difficulty breathing so had someone drive me to the Emergency Room. I was immediately taken back to a room and administered an epi-pen and given Benadryl and dexamethasone in iv then given iv fluids. Around 4am they decided they needed to keep me for observation because my blood pressure was so low. At that time it was 85/49. They decided to release me around 1:00 and at that time my boss was 94/57?.however when I went to unhook from the machine it had fallen to 89/54. They still release me and told me to follow up with my doctor on 5/27.


VAERS ID: 1355114 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-18
Onset:2021-05-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Military       Purchased by: ?
Symptoms: Blood folate, Blood iron, Blood thyroid stimulating hormone, Dizziness, Exfoliative rash, Full blood count, Glycosylated haemoglobin, Metabolic function test, Rash, Vitamin B12
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Grp C strep- 4/30/21. not ill/asx at time of vaccination
Preexisting Conditions: denies
Allergies: denies
Diagnostic Lab Data: TSH, CBC, B12/folate, A1C, BMP, iron panel
CDC Split Type:

Write-up: lightheadedness 3d after vax and desquamating bilat hand rash 6d after vax


VAERS ID: 1355182 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tresiba Amlodipine Metoprolol Synjardy Hydrochlorothiazide Lasix Spironolactone Montelukast Cyclobenzaprine Tylenol Arthritis 650mg Tramadol Allergy Relief Women''s Multivitamin Temazepam Stool softeners
Current Illness:
Preexisting Conditions: Diabetes Osteoarthritis Asthma
Allergies: Penicillin Aspirin Lisinopril
Diagnostic Lab Data:
CDC Split Type:

Write-up: Entire body ache Chills, (could not get warm) Pain at injection site Pain at touching of site Lg harden area at injection site , the size and shape of half a small orange Presently, the size of a walnut, still hard and painful at touch.


VAERS ID: 1355210 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Injection site reaction, Rash macular, Skin warm
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pharmacist reported on behalf of patient after receiving second dose of Moderna 5/20/2021, 24 hours later on 5/21/2021, two red blotches on vaccinated arm near where shot was given. Patient reported tired, no fever but red blotches were warm to the touch, not raised but painful. Patient reported taking Tylenol for 1 day only. Patient reported less red from initially and still visible,lighter in color and still warm to the touch.Pharmacist referred patient to her GP for evaluation.


VAERS ID: 1355211 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Pt given benadryl
Current Illness: None
Preexisting Conditions: Obesity
Allergies: Sulfas
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt stated arm was feeling numb. pt refused medical attention. was given Benadryl once 25mg tab. pt wait and monitored for 30 minutes and was ok upon leaving. pt was not in respiratory distress.


VAERS ID: 1355270 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-05-11
Onset:2021-05-21
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C214 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cymbalta, Buprenorphine, Tizanidine, Esomeprazole, Fexofenadrine, multivitamin,
Current Illness:
Preexisting Conditions: Fibromyalgia, chronic migraines, spinal stenosis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Skin redness, itching, pain, swelling. Issue started about 2 inches x 2 in. Area effected doubled in size after 24 hours, and covered majority of my upper arm, from injection site to my elbow. My arm was also significantly swollen, maybe 1.5 times the normal size. After speaking to pharmacist, I took 50 MG. Benadryl every 6 hours and rubbed hydrocortisone cream on effected area. Today, day 3 of treatment, redness and swelling dissipated and itching is reduced.


VAERS ID: 1355340 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: 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: Vitamin D 5000ui/day Docusate sodium 500mg/day
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Headache and mild nausea after 2nd dose, starting at about 21hrs post and lasting about 12hrs.


VAERS ID: 1355363 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-17
Onset:2021-05-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: mirtazepine 15mg, tizanidine 4mg
Current Illness: none
Preexisting Conditions: recurrent shingles, orolabial HSV, anxiety, fibromyalgia
Allergies: sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash beginning 4d after the vaccine: diffuse maculopapular/morbiliform rash spreading from L arm across chest to R arm and down the torso to upper legs


VAERS ID: 1355553 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-10
Onset:2021-05-21
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 2 LA / IM

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

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

Write-up: Hives, rash and bumps that appear on different parts of the body, then disappear and reappear on different part of body throughout day. I have never had hives before. They started on scalp and neck and as the week has gone on they appeared on my legs, then torso, back to leg, hands etc.


VAERS ID: 1355567 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D Gummi Multivitamin Sleepytime Xtra Tea ( With Valerian ) Tylenol ( xtra strength 500mg for pain as needed) Antihistamines ( Allergy Pills ) if needed
Current Illness:
Preexisting Conditions: Fibromyalgia Herniated Disc Pinched Nerve Neuropathy PTSD
Allergies: Corn Allergy Soy Allergy Wheat Allergy Peanut Allergy Celiac Disease NSAID & Aspirin Allergy Penicillin Allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left arm where i received my 1st Covid19 MODERNA shot has been throbbing and sore since day of shot & is painful . Minor itchy rash.


VAERS ID: 1355587 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Diarrhoea, Erythema, Fatigue, Headache, Myalgia, Pain, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot Jan 2020, arm pain, swelling and redness?redness lasted months.
Other Medications: Jardiance 25mg PO daily Acetaminophen 500-1000mg PO daily for HA PRN Ibuprofen 200-400mg PO daily for pain PRN Iron plus VitC PO daily
Current Illness:
Preexisting Conditions: Diabetes type 2
Allergies: Trulicity Zinc supplement
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe pain, swelling and redness, headache, muscle and joint pain, diarrhea, and fatigue, lasting 1 week+ after vaccination. Used ibuprofen, acetaminophen, and Benadryl for symptoms but they still persisted. All symptoms are tapering off but continue over this last week.


VAERS ID: 1356066 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 91300 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone decreased, Hyperthyroidism, Thyroxine free increased, Tri-iodothyronine decreased
SMQs:, Hypothyroidism (broad), Hyperthyroidism (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: TSH< 0.008 Free T4 = 4.8 T3 = 16
CDC Split Type:

Write-up: Severe thyrotoxicosis, impending thyroid storm


VAERS ID: 1356080 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Hypoaesthesia, Joint range of motion decreased, Lymphadenopathy, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin, calcium, D3
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen armpit on 5/21 in the morning, pain and tenderness. Daily increasing pain, by Thursday 5/27 in the morning very difficult to lift arm above my head. Around noon, started experiencing a tingling/numb sensation in right wrist and hand. The numb sensation is now beginning to subside but it is still painful.


VAERS ID: 1356092 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Back pain, Chills, Diarrhoea, Dizziness, Fatigue, Gastrointestinal disorder, Hypoaesthesia, Hypoaesthesia oral, Myalgia, Nausea, Pain in extremity, Pyrexia, Renal pain, Salivary hypersecretion, Sensory disturbance, Taste disorder, Tongue pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (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: Pfizer dose 1 (prev submitted)
Other Medications: Aimovig 140 mg, monthly injection
Current Illness: none
Preexisting Conditions: migraines, genetically high cholesterol
Allergies: sulfa drugs, contrast used with CT scan, smoke, chemicals used in many beauty and hair products, alcohol, eggs
Diagnostic Lab Data: none
CDC Split Type:

Write-up: +10 mins, strange taste in mouth, excess saliva +25 mins, numbness in lower half of face and lips, twinge/cramp feeling in heart area +30 mins, sinus clearing and drainage (still continuing 5 hours later) +45 mins, itching under left side of tongue in thin line from base to tip, might be a nerve, arm getting sore +1 hr, gastro symptoms started, unusual feeling in intestines +2 hr, fatigue, tiredness +5 hr, chills +8 hr, dizziness +9 hr fatigue, tiredness +12 hr lower back pain and tenderness in kidney area, both sides +15 hr severe fatigue, tiredness, arm soreness/pain, other muscle pain +24 hr arm soreness, fatigue, tiredness +25-29 hr severe fatigue, tiredness, fever, couldn?t stay awake +54 hr severe fatigue, tiredness, fever, couldn?t stay awake Days 1-5: gastro system upset, nausea, diarrhea


VAERS ID: 1356493 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Musculoskeletal chest pain, Pruritus, Rash erythematous, Rash vesicular, Skin lesion
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: Patient experienced pruritis and tenderness to touch in right pectoralis area extending in T4/T5 dermatome pattern. He then developed a pruritic, vesicular lesion with an erythematous base just to the right of the vertebral column at T4 and T5, 4 cm in diameter. 3 smaller vesicular lesions are noted in the T4/T5 dermatome on the right upper back and right chest. Clinically, this is suggestive of herpes zoster.


VAERS ID: 1356512 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Erythema, Induration, Mass, Mobility decreased, Pain in extremity, Peripheral swelling, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Edirol/Eldecalsitol; Viviant/Bazedxifeneacetate; Supplement containing lactotripeptides; Supplement containing EPA/DHA
Current Illness: None
Preexisting Conditions: Osteoporosis
Allergies: No known allergies
Diagnostic Lab Data: None- resolved
CDC Split Type:

Write-up: PER PT DESCRIPTION:I got the vaccine around 11 am last Friday. Thanks to you, I was calm and relaxed during the vaccination. I was fine and was able to return home safe. However, at around 5 pm, I felt a sudden pain on my right leg. My leg felt hot, became red, and had a big lump or swelling which was about 10 cm. The leg was not just feeling hot but was also hard like board. And I could not move my leg. I was really scared, and was thinking of calling an ambulance. Thankfully, everything went back to normal after 5 minutes - no pain, no swelling, no reddish color, and I was able to move my leg. However, after 30 minutes, the same thing happened to my left leg. But the pain was a little weaker and I could still move it despite the pain. The left one was not so bad compared with right one. And a few minutes after, my left leg was fine. Everything was okay like nothing happened. I did not notice any mark on any of my legs. However, at around 9 pm, I looked at my leg and I noticed a circular trace/mark which was about 10 cm on my right leg. Please see the photo attached.


VAERS ID: 1357030 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210545776

Write-up: SEIZURE (PASSED OUT); WEAK; This spontaneous report received from a consumer concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose 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 patient got the vaccine and passed out, patient had 2 seizures. patient had not eaten much during day so patient might have been weak. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the seizure (passed out) and weak was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: covid-19 vaccine ad26.cov2.s-seizure (passed out). This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1357036 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Fibrin D dimer normal, Heart rate irregular, Injection site erythema, Injection site pruritus, Injection site reaction, Injection site vesicles, Migraine, Nausea, Peripheral swelling, Platelet count, Platelet count decreased, Pyrexia, Ventricular extrasystoles
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Ventricular tachyarrhythmias (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Food allergy (Honey, Fish, Seafood)
Preexisting Conditions: Medical History/Concurrent Conditions: Colon cancer; Heart attack; Smoker (half pack per day); Thrombocytopenia (Low platelet count 130-140); Comments: Patient is allergic to Bees, Honey, Sulfa, Cephalosporins, Moderna Vaccine, Fish, Seafood. Patient tends to run at 142,000 which was the result when a test was done in March. She stated that previously she did get the Moderna vaccine at the end of April and had an anaphylactic reaction.
Allergies:
Diagnostic Lab Data: Test Date: 202105; Test Name: Heartbeats irregular; Result Unstructured Data: not reported; Test Date: 202105; Test Name: Platelet count; Result Unstructured Data: 94,000; Test Name: Fibrin D dimer normal; Result Unstructured Data: 0.5
CDC Split Type: USJNJFOC20210547077

Write-up: BLISTERS AT INJECTION SITE; INJECTION SITE ITCHINESS; LOW PLATELET COUNT; PREMATURE VENTRICULAR CONTRACTIONS; MIGRAINE; SWOLLEN ARM; FEELING HOT AT THE INJECTION SITE; CHILLS; FEELING TIRED; REDNESS AT INJECTION SITE; FEELING FEVERISH; FEELING NAUSEOUS; This spontaneous report received from a patient concerned a 53 year old female. The patient''s weight was 145 kilograms, and height was 60 inches. The patient''s past medical history included history of four heart attacks, thrombocytopenia, and colon cancer, and concurrent conditions included smoker, and food allergy, and other pre-existing medical conditions included patient is allergic to bees, honey, sulfa, cephalosporins, moderna vaccine, fish, seafood. patient tends to run at 142,000 which was the result when a test was done in march. she stated that previously she did get the moderna vaccine at the end of april and had an anaphylactic reaction. The patient experienced drug allergy when treated with cefaclor, erythromycin, cefalexin, nitrofurantoin, penicillin nos, and azithromycin. The patient received covid-19 vaccine (suspension for injection, intramuscular, batch number: 203A21A, expiry: 23-JUN-2021) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On MAY-2021, Laboratory data included: Heartbeats irregular (NR: not provided) not reported, and Platelet count (NR: not provided) 94, 000. On 21-MAY-2021, the subject experienced swollen arm. On 21-MAY-2021, the subject experienced feeling hot at the injection site. On 21-MAY-2021, the subject experienced chills. On 21-MAY-2021, the subject experienced feeling tired. On 21-MAY-2021, the subject experienced redness at injection site. On 21-MAY-2021, the subject experienced feeling feverish. On 21-MAY-2021, the subject experienced feeling nauseous. On 23-MAY-2021, the subject experienced low platelet count. On 23-MAY-2021, the subject experienced premature ventricular contractions. On 23-MAY-2021, the subject experienced migraine. On 24-MAY-2021, the subject experienced blisters at injection site. On 24-MAY-2021, the subject experienced injection site itchiness. Laboratory data (dates unspecified) included: Fibrin D dimer normal (NR: not provided) 0.5. The action taken with covid-19 vaccine was not applicable. The patient recovered from premature ventricular contractions, and migraine on 24-MAY-2021, chills, and feeling nauseous on 22-MAY-2021, and feeling tired, and feeling feverish on 23-MAY-2021, and had not recovered from low platelet count, swollen arm, redness at injection site, feeling hot at the injection site, blisters at injection site, and injection site itchiness. This report was non-serious.


VAERS ID: 1357039 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Eye pain, Fatigue, Injection site swelling, Photophobia, Swelling, Swelling face, Swelling of eyelid, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Periorbital and eyelid disorders (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? 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: USJNJFOC20210547489

Write-up: MODERATE SWELLING AROUND FACE; EXHAUSTION; SWELLING AROUND INJECTION SITE; EYES HURT REALLY BAD; SWOLLEN EYELIDS; SWELLING ALL OVER BODY FROM HEAD TO TOE; LIGHT SENSITIVITY WHEN EXPOSED TO DIRECT SUN LIGHT; BLURRY VISION WHEN EXPOSED TO DIRECT SUN LIGHT; 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 (suspension for injection, route of admin not reported, batch number: 205A21A, 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 swelling all over body from head to toe. On 21-MAY-2021, the subject experienced light sensitivity when exposed to direct sun light. On 21-MAY-2021, the subject experienced blurry vision when exposed to direct sun light. On 23-MAY-2021, the subject experienced eyes hurt really bad. On 23-MAY-2021, the subject experienced swollen eyelids. On 24-MAY-2021, the subject experienced moderate swelling around face. On 24-MAY-2021, the subject experienced exhaustion. On 24-MAY-2021, the subject experienced swelling around injection site. Treatment medications (dates unspecified) included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine was not applicable. The patient recovered from swelling all over body from head to toe, and blurry vision when exposed to direct sun light on 23-MAY-2021, was recovering from light sensitivity when exposed to direct sun light, had not recovered from exhaustion, swelling around injection site, and moderate swelling around face, and the outcome of swollen eyelids and eyes hurt really bad was not reported. This report was non-serious.


VAERS ID: 1357040 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210547632

Write-up: PATIENT RECEIVED EXPIRED AND BEYOND USE VACCINE; VACCINE WAS STORED IN FRIDGE FOR 24 HOURS (VIAL PUNCTURED 24 HOURS PRIOR TO GIVING VACCINE); This spontaneous report received from a pharmacist 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 (suspension for injection, route of admin not reported, batch number: 1808986, expiry: 20-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 subject received expired and beyond use vaccine. On 21-MAY-2021, the subject experienced vaccine was stored in fridge for 24 hours (vial punctured 24 hours prior to giving vaccine). The action taken with covid-19 vaccine was not applicable. The outcome of the patient received expired and beyond use vaccine and vaccine was stored in fridge for 24 hours (vial punctured 24 hours prior to giving vaccine) was not reported. This report was non-serious.


VAERS ID: 1357063 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcoholic (not often at all, in moderation, never drunk); Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies, no any drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210549573

Write-up: INJECTION SITE PAIN; This spontaneous report received from a patient concerned a 54 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non smoker, and alcohol user (in moderation), and other pre-existing medical conditions included the patient had no known allergies, no any drug abuse/illicit drug use. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1805025 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 injection site pain. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from injection site pain. This report was non-serious.


VAERS ID: 1357364 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asplenia; Food allergy; Rheumatoid arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021582546

Write-up: anaphylaxis; This is a spontaneous report from a contactable consumer or other non hcp (Patient). A 60-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 2 via an unspecified route of administration, administered in Arm Left on 20May2021 11:00 (Batch/Lot Number: EW0165) as single dose for covid-19 immunisation (age at vaccination was of 60 years). Medical history included rheuatoid arthritis, surgical asplenia. Patient also allergic to Pineapple. No other vaccine was recieved by the patient in four weeks. The patient received other concomitant medications in two weeks. Historical vaccine included bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 1 via an unspecified route of administration, administered in Arm Left on 30Apr2021 14:30 (Batch/Lot Number: EW0169) as single dose for covid-19 immunisation (age at vaccination was of 60 years). On 21May2021 12:15, the patient experienced short of breath, increasing difficulty breathing, anaphylaxis, in order hoarseness, voice sounds like laryngitis, in order hoarseness, voice sounds like laryngitis, lips tingling, eyes swelling, wheezing, dizziness. Patient took 50mg Benadryl at 12:30 with no relief and went to ER. The ER (emergency room) diagnosed anaphylaxis and started treatment at 13:37. EpiPen, famotidine (Pepsid), SoluMedrol PF was given as treatment. Patient recovered with lasting effects. No covid prior vaccination was reported. Patient was not tested for covid post vaccination. Outcome of all events was recovered with sequelae. Follow up attempts are needed. Further information has been requested.


VAERS ID: 1357424 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Feeling abnormal, Nausea
SMQs:, Acute pancreatitis (broad), Dementia (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? 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: USJNJFOC20210547723

Write-up: DIARRHEA; SEVERE NAUSEA; FEELING BAD; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (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 feeling bad. On 23-MAY-2021, the subject experienced diarrhea. On 23-MAY-2021, the subject experienced severe nausea. The action taken with covid-19 vaccine was not applicable. The patient recovered from severe nausea on 23-MAY-2021, had not recovered from diarrhea, and the outcome of feeling bad was not reported. This report was non-serious.


VAERS ID: 1357649 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Seizure-Medium, Systemic: Vomiting-Severe


VAERS ID: 1357748 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-18
Onset:2021-05-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: He developed a pruritic rash on bilateral upper extremities and trunk with no improvement with benadryl.


VAERS ID: 1357864 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Malaise, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: Tachycardia, elevated temperature without fever, dizziness, generalized weakness, malaise


VAERS ID: 1357910 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood sodium, Injection site pain, Injection site rash, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 100mg - 1 a day
Current Illness: No
Preexisting Conditions: None
Allergies: Tree nuts, bees, cats
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Skin rash - red bump at injection site. Ice / ibuprofen to ease pain


VAERS ID: 1357918 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site inflammation, Injection site mass, Injection site pruritus, Injection site rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient reports dime sized red rash and lump at injection site (left deltoid) 2 days after moderna Covid-19 vaccination 5/19/2021. States it had been was resolving over the following 5 days, until yesterday when size increased, became more red, inflamed and itchy.


VAERS ID: 1357932 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaccination site swelling
SMQs:

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

Write-up: Swelling on arm at vaccine site


VAERS ID: 1357950 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Computerised tomogram, Diplopia, Eye patch application, Magnetic resonance imaging head abnormal, Scan with contrast, VIth nerve paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: None
Preexisting Conditions: Ocular Migraines, fibroidmalia,
Allergies: Codeine
Diagnostic Lab Data: MRI, MRA, Cat scan with contrast. Taken a Hospital on May 21, 2021. No blood clots.
CDC Split Type:

Write-up: Double vision - diagnosed as 6th nerve palsy in right eye. Could take up to 6 months for normal vision if then. Have seen eye doctor and neurologist. Have to wear eye patch.


VAERS ID: 1357957 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole 20mg 1 qd
Current Illness: None
Preexisting Conditions: None
Allergies: Levaquin, Quinolones
Diagnostic Lab Data: Patient given Medrol 80 5/26/2021, and Rx for Zyrtec 10 1-2 once a day.
CDC Split Type:

Write-up: Moderate to extensive Orticaria to Trunk, Axillary, and thigh.


VAERS ID: 1358028 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-11
Onset:2021-05-21
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Magnetic resonance imaging head normal, Mental status changes, Sinusitis
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Oral contraceptive
Current Illness: Viral illness; MRI confirmed left maxillary sinusitis on 5/24
Preexisting Conditions: Overall healthy/well
Allergies: None known
Diagnostic Lab Data: Normal brain MRI (incidental left maxillary sinusitis)
CDC Split Type:

Write-up: Patient experience acute altered mental status on Friday 5/21; seen in ER on Sat 5/22 and Mon 5/24


VAERS ID: 1358217 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-05-17
Onset:2021-05-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy, Peripheral swelling, Rash, Rash erythematous, Rash pruritic
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), 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: Birthcontrol
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: one day 5 feet swelled with a red, itchy rash and were painful to stand on. This lasted 5 days. Currently, lymph nodes in neck are swollen and painful.


VAERS ID: 1358405 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood culture negative, C-reactive protein increased, CSF culture negative, CSF glucose normal, CSF protein normal, CSF white blood cell count increased, Headache, Herpes simplex test negative, Lymphocyte percentage decreased, Macrophage count, Meningitis, Monocyte percentage, Neck pain, Neutrophil percentage increased, Pyrexia, SARS-CoV-2 test negative, White blood cell count increased
SMQs:, Haematopoietic leukopenia (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), COVID-19 (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Rituximab infusion for ulcerative colitis every 4-6 weeks, mesalamine daily
Current Illness: Bilateral otitis media diagnosed 5 days prior to administration of SARS-CoV-2 vaccine.
Preexisting Conditions: Ulcerative colitis
Allergies: TMP/SMX -- $g rash
Diagnostic Lab Data: Blood cultures and CSF culture from 5/24/21 with no growth at 4 days of incubation. Nasopharyngeal swab for SARS-CoV-2 from 5/24/21 negative. 5/24/21 CSF WBC 8 with 55% neutrophils, 31% lymphocytes, 14% macrophages, protein 22.8, glucose 68. 5/24/21 CSF HSV PCR negative for HSV 1 and 2. 5/24/21 CRP 12.1 mg/dL. 5/24/21 WBC 12 with 79% neutrophils, 13% lymphocytes, 7% monocytes.
CDC Split Type:

Write-up: One day after receiving the first dose of the SARS-CoV-2 vaccine the patient developed headache, neck pain, and fever. Her symptoms persisted for 2 more days and she then presented to the hospital where she was diagnosed with meningitis with a CSF WBC of 8. Her infectious work up of the meningitis has not revealed the cause to date.


VAERS ID: 1358493 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

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

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

Write-up: pt seen on floor in prone position per staff pt lost consciouness for 9 secs. staff who witness the accident said pt slid down on chair and fell face forward. vitals: 86/60 p-60 R-16 o2 98% offered food and fluids denied nausea vs bp 106/65 P-75 R 18 o2 98% RA t-98.1 at 337 pt verbalized no dizziness no headache able to move all extremetites without discomfort no vleedign on gums/mouth no change loc 347 BP104/63 P77 R18 o2 99% pt parents will accompany pt to visit primary doc. clininc for further eval.


VAERS ID: 1358500 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-12
Onset:2021-05-21
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Electric shock sensation, Fatigue, Headache, Hypoaesthesia, Metamorphopsia, Neuralgia, Photophobia, Sensitive skin
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium Citrate
Current Illness: None
Preexisting Conditions: Postural Orthostatic Tachycardia Syndrome
Allergies: None
Diagnostic Lab Data: None. My doctor told me, especially since I have never had any symptoms similar to those listed above, that they were likely caused by the Johnson and Johnson vaccine.
CDC Split Type:

Write-up: Episode lasting 30 minutes on 5/22/21: Distorted vision Numbness in both arms Lightheadedness Sensitivity to light Headache Lasting 6 hours: Fatigue From 5/21/21-5/28/21: Symptoms similar to shingles - skin sensitivity above ribs around torso. Nerve pain/?shocks? 10-20 per hour in same area above ribs circling around entire torso. Fatigue.


VAERS ID: 1358538 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-08
Onset:2021-05-21
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head normal, Facial paralysis, Full blood count, Headache
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: Multi-Vitamin, Tart Cherry Extract 1000 mg, Vitamin D3 50 mcg
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa drugs (bactrim)
Diagnostic Lab Data: CT scan and CBC
CDC Split Type:

Write-up: Stroke-like symptoms of headache and left-sided facial droop/paralysis began around 3:30pm on 5/21/2021. Went to Emergency Room. CT scan ruled out blood clot and stroke. Diagnosed with Bells Palsy. 15 day course of treatment of Prednisone is currently underway, starting with 60 mg on days 1-5, followed by 50mg day 6-7, 40 mg day 8-9, 30 mg day 10-11, 20 mg day 13-14, and 10 mg day 14-15. (As of today, 5/28/2021, I am on 50mg day 7). Paralysis has not yet subsided.


VAERS ID: 1358605 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Headache, Nausea, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), 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: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: It was within 5 minutes, she started having hives that went down her arm and spread to other arm, face, trunk, legs, stomach. I went and got a nurse and she called a pediatric team - three nurses and one doctor - they took her vitals and gave her some Benadryl - 30 ML (children''s). They had her sit and drink a bottle of water. We watched to see if the swelling and the hives would shrink and go away. It was probably about 20 minutes later where they went away, but she developed a headache and she was nauseated. We administered Benadryl (gave her regular 25 mg tablet every 6 hours) for the next 24 hors in the dosage times. She was nauseated the first day and she had headache for two days. The hives went away by the time she went to bed the evening of the vaccine.


VAERS ID: 1358629 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Haematocrit increased, Hyperhidrosis, Hypertension, Injection site discomfort, Injection site erythema, Injection site rash, Medical device site burn, Pain, Platelet count normal, Red blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypertension (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: THE FOLLOWING IS GENERAL PER DISCUSSION WITH PATIENT: 5/24/21 - PRIMARY CARE DOCTOR - PLATELETS NORMAL, RBC''S AND HEMATOCRIT SLIGHTLY ELEVATED
CDC Split Type:

Write-up: THE PATIENT CAME TO THE PHARMACY TO BE VACCINATED FOR COVID-19, WITH JOHNSON & JOHNSON, ON FRIDAY, MAY 21, 2021 AT ROUGHLY 2PM. I GAVE HER THE VACCINATION IN HER DELTOID MUSCLE ON HER LEFT ARM. SHE ALMOST IMMEDIATELY COMPLAINED OF DISCOMFORT AND ASKED IF I HAD A COLD PACK. I PROVIDED HER WITH ONE, WHICH SHE USED WHILE WAITING THE 15 MINUTE POST-VACCINATION OBSERVATION TIME. SHE LEFT THE PHARMACY WITHOUT INCIDENT. ONLY A COUPLE HOURS LATER, SHE CALLED THE PHARMACY TO REPORT ERYTHEMA AT AND AROUND THE INJECTION SITE. I DID NOT KNOW AT THAT TIME WHETHER THE ERYTHEMA WAS DUE TO THE COLD PACK OR IF IT WAS A VACCINE-INDUCED RASH, SO I INSTRUCTED HER TO TAKE A DOSE OF ANTIHISTAMINE. AS SHE HAD CETIRIZINE IN THE HOUSE, SHE TOOK THAT. SHE WAS HOME WITH HER HUSBAND. I RECOMMENDED HE KEEP AN EYE ON HER AND IF SHE DEVELOPED ANY ADDITIONAL SYMPTOMS OR WORSENING RASH, SHE SHOULD GO TO THE HOSPITAL FOR EVALUATION. ADDITIONAL SYMPTOMS INCLUDED SWELLING, TROUBLE BREATHING, WHEEZING, CHEST OR THROAT TIGHTNESS, OR HIVES. THOUGH SHE DID NOT EXPERIENCE ADDITIONAL SYMPTOMS, SHE DECIDED TO GO TO UCONN HEALTH CENTER ER IN FARMINGTON. THEY DID BELIEVE THE RASH WAS VACCINE-INDUCED BUT DID NOT FEEL SHE REQUIRED ANY ADDITIONAL TREATMENT AND DISCHARGED HER (I.E., NO EPINEPHRINE). THE PATIENT NOTED THAT HER BLOOD PRESSURE AT THE ER WAS HIGHER THAN "HER NORMAL" AT 152/95. THE FOLLOWING TWO DAYS, THE RASH STAYED THE SAME AND WAS DESCRIBED BY THE PATIENT AS THE "WORST SUNBURN SHE''S EVER HAD". SHE ALSO HAD NORMAL SIDE EFFECTS OF BODY ACHES AND CHILLS/SWEATS. ON MONDAY, 5/24/21, SHE FOLLOWED UP WITH HER PCP. HE AGREED WITH THE HOSPITAL THAT THE RASH WAS VACCINE-INDUCED AND TOLD HER THAT HE DIDN''T WANT HER GETTING ANY COVID-19 VACCINES IN THE FUTURE. HE DID BLOODWORK TO RULE OUT PLATELET ISSUES, WHICH, PER PATIENT, WERE NORMAL; SHE NOTED THAT HER RBC''S AND HEMATOCRIT WERE SLIGHTLY ELEVATED. HER PCP GAVE HER A MEDROL DOSEPAK FOR THE RASH. THE PATIENT IS RECOVERING. I BELIEVE IT IS WORTH NOTING, HOWEVER, THAT THE PATIENT APPLIED THE COLD PACK DIRECTLY TO HER ARM FOR AN EXTENDED PERIOD OF TIME AND DID NOT PROVIDE THIS INFORMATION TO EITHER THE ER OR HER PCP. SHE SENT ME A PHOTO OF HER ARM WHICH SHOWS GENERALIZED ERYTHEMA (THE SIZE OF THE COLD PACK) - THE ONLY PART THAT IS COMPLETELY NORMAL IS THE SKIN BELOW THE BAND-AID. I BELIEVE THE PATIENT CREATED AN ICE BURN BY USING A COLD PACK TOO DIRECTLY, FOR TOO LONG, AND THAT THE UNDER BAND-AID AREA WAS NOT RED BECAUSE IT PROTECTED THE SKIN FROM COLD BURN. I SUGGESTED TO THE PATIENT THAT SHE RUN THIS THEORY BY HER PCP, AS I BELIEVE IT IS IMPORTANT "MISSING INFORMATION", THAT COULD POTENTIALLY CHANGE THE DIAGNOSIS AND ALTER HIS RECOMMENDATION TO AVOID FUTURE COVID VACCINATION. WHETHER OR NOT THE PATIENT CONTACTED HIM AGAIN IS UNKNOWN.


VAERS ID: 1358658 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-01
Onset:2021-05-21
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Dyspnoea, Electrocardiogram, Fatigue, Fibrin D dimer normal, Full blood count normal, Laboratory test normal, Troponin normal
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: fish oil-omega-3 fatty acids 300-1,000 mg Lactobac no.41/Bifidobact no.7 (PROBIOTIC-10 ORAL) multivit-min/vit C/herb no.124 (AIRBORNE, ASCORBIC ACID, ORAL) multivitamin (THERAGRAN) tablet
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: D Dimer 7.63 -X-ray Chest PA/AP and Lateral done STAT: "Normal 2-view chest radiography" -POCT - I-STAT TROPONIN (cTnI): NORMAL -POCT - CBC: NORMAL -POCT - I-STAT CHEM 8 NORMAL -ECG 12 lead: Sinus Rhythm
CDC Split Type:

Write-up: shortness of breath, fatigue, chest pain


VAERS ID: 1358681 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: phentermine, alprazolam, escitalopram, trazodone, gabapentin,
Current Illness:
Preexisting Conditions:
Allergies: Clindamycin, penicillins, NSAIDs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented with infection the week after the vaccine (swelling and erythema at the site that increased over a week). Patient was seen by her PCP and was prescribed oral Bactrim and topical mupirocin.


VAERS ID: 1358709 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EVO179 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Facial paralysis
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Approximately 48 hours after my second Pfizer Covid-19 vaccine, I experienced partial Facial paralysis on right side of face (primarily upper lip). Symptoms progressively worsened over the next 72 hours. After approximately 6 days post vaccine, facial paralysis began to slightly improve. On Thursday, May 27, 2021 I visited my primary care physician, who suggested I report my adverse reaction to the CDC. I continue to experience slight drooping on the right side of my mouth (upper lip).


VAERS ID: 1358766 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-26
Onset:2021-05-21
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Angiogram retina abnormal, Arterial catheterisation abnormal, Arterial occlusive disease, Cerebral artery thrombosis, Cerebrovascular accident, Chest X-ray, Computerised tomogram, Computerised tomogram head, Echocardiogram, Intensive care, Magnetic resonance imaging head abnormal, Retinal artery thrombosis, Scan with contrast, Thrombectomy, Ultrasound Doppler, Urine analysis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Retinal disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 50mg Fluvoxamine Maleate 1X/day, Multi-Vitamin
Current Illness:
Preexisting Conditions: Learning Disability
Allergies: Shellfish
Diagnostic Lab Data: Measurements, Vital Signs, Hematology, Urinalysis, CT Scan of Head, CT Scan w/ Contrast, Chest Xray, Ultrasound of Heart and legs, MRI of Brain
CDC Split Type:

Write-up: Stroke - Blood Clot in M2 Brain Artery Friday, May 21, 2021 - Air lifted from Hospital to Hospital Admitted to Neuroradiology Dept and immediate Thrombectomy to remove blood clot behind left eye via angiogram through the groin via catheter. Proceedure was sucessful in removing 100% blocked artery and he was transfered to Resovery, observation and follow-on diagnostic testing in ICU for 4 days. Discharged May 24, 2021


VAERS ID: 1358790 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Unknown  
Location: Puerto Rico  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Aphasia, Back pain, Chest pain, Coccydynia, Computerised tomogram head, Coombs test, Echocardiogram normal, Electrocardiogram normal, Full blood count normal, Headache, Metabolic function test, Pyrexia, SARS-CoV-2 test negative, Troponin normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrea 1500mg, Aspirin 81mg, Penicillin 250mg, Folic Acid
Current Illness: None
Preexisting Conditions: Sickle Cell Anemia
Allergies: NKA
Diagnostic Lab Data: EKG- negative, Echocardiogram-negative, Covid 19, negative, Head CT normal, Troponins between normal limits. CBC, CMP, Coombs Test
CDC Split Type:

Write-up: On May 21, patient presented fever and headache; he took 2 Advil to alleviate his symptoms. During the following four days, he felt well. However, on May, 26 patient complaints of chest pain, coccyx/back pain and was unable to speak to his parents. At 7:30am he went to the Emergency Room. A head CT and blood test (ABGS,CMP, CBC, COVID-19) were performed. Then he was transferred to another Hospital and admitted to the Intensive Care Unit. Patient continue hospitalized and under the care of a neurologist, hematologist and cardiologist. Prognosis is reserved. Today he patient received 5U PRBC''s.


VAERS ID: 1358814 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Chest pain, Dizziness, Musculoskeletal chest pain
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (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: Gadolinium
Other Medications: None
Current Illness: Gadolinium poisoning from 2 MRIs with gadolinium (Dotarem in 2016 and Gadvavist 10 ml in 2017). These cause me significant health issues: neurological, nervous system issues, etc. for 4 years, I had to use a wheelchair at times etc. These issues had only recently significantly improved.
Preexisting Conditions: As noted above. However, I was finally better and able to live normally. But because of the pandemic, I got the vaccine even though I had serious concerns because of what gadolinium did to my health.
Allergies: MRI Gadolinium dye, metals, latex
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 1. Because of my issues with gadolinium, the facility had me wait 30 mins after my vaccine. I felt transient head issues but nothing notable. I felt a little dizzy as I was leaving the facility but didn''t make much of it. It went, and I felt great. I had ''normal'' side effects for the next two days (a little dizziness off and on, but nothing major). 2. For the last 2 days however (i.e. approx. Days 7 and 8 since the vaccine), I have acute dizziness. 3. I also have other issues which I believe are expected and which have mostly resolved, such as: very bad stomach pain (mostly resolved); very bad headache initially (resolved); pain in left shoulder and chest area above heart last night (resolved now); weird pain/fullness feeling in lung/ribcage area (resolved).


VAERS ID: 1359041 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Injection site pain, Injection site pruritus, Injection site swelling, Migraine, Pain in extremity
SMQs:, Retroperitoneal fibrosis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norco, some type of muscle relaxant, and ipratropium nasal spray
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day after vaccination patient had sore arm, days 2-4 patient had back pains, day 4-8 patient had migraines, day 8 patient woke up with swollen, itchy, and sore arm at the injection site. Patient tried norco and muscle relaxes. Recommended benadryl, and they patient also seen physician who prescribed cephalexin on day 8 after patient contacted pharmacy about adverse reactions


VAERS ID: 1359295 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Migraine, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Severe nausea, vomiting and new migraine onset


VAERS ID: 1359312 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-23
Onset:2021-05-21
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram abnormal, Pericarditis, Troponin normal
SMQs:, Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: left sided chest pain x1 week. Pericarditis on EKG. Troponin negative


VAERS ID: 1359950 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Suspected COVID-19 (Being Exposed to COVID-19 in February from both parents .Patient did not take a test to see if he had it, but had symptoms during that time)
Allergies:
Diagnostic Lab Data: Test Date: 202102; Test Name: Antibody test; Result Unstructured Data: High Antibodies; Comments: Done antibody test for 4 times and Result for All the test is High antibodies; Test Date: 20210524; Test Name: COVID-19 virus test positive; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210551749

Write-up: SUSPECTED COVID-19 INFECTION; This spontaneous report received from a consumer concerned a 24 year old male. The patient''s weight was 195 pounds, and height was 72 inches. The patient''s past medical history included exposed to covid 19.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. Batch number was not reported and has been requested. No concomitant medications were reported. On FEB-2021, Laboratory data included: Antibody test (NR: not provided) High Antibodies. On 21-MAY-2021, the subject experienced suspected covid-19 infection. On 24-MAY-2021, Laboratory data included: COVID-19 virus test positive (NR: not provided) Positive. Treatment medications (dates unspecified) included: paracetamol, and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of suspected covid-19 infection was not reported. This report was non-serious.; Sender''s Comments: V0: Medical Assessment comment not required as per standard procedure as the case assessed as non-serious


VAERS ID: 1359955 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Contusion, Dizziness, Headache
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210552878

Write-up: BRUISING OF ARM; CHILLS; HEADACHE; DIZZY; 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 (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. The patient number not reported and has been requested. No concomitant medications were reported. On 21-MAY-2021, the subject experienced dizzy. On 21-MAY-2021, the subject experienced chills. On 21-MAY-2021, the subject experienced headache. On 22-MAY-2021, the subject experienced bruising of arm. The action taken with covid-19 vaccine was not applicable. The outcome of the headache, dizzy, chills and bruising of arm was not reported. This report was non-serious.


VAERS ID: 1360627 (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: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1077 / 1 - / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Myocarditis, SARS-CoV-2 test
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210522; Test Name: covid-19 test; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC2021594817

Write-up: Myocarditis; This is a spontaneous report from a contactable pharmacist. A 15-year-old male patient received the first dose of BNT162B2 (PFIZER COVID-19 VACCINE, lot number: EW1077), at the age of 15 years old, intramuscularly on 17May2021 at single dose for covid-19 immunisation. The patient medical history was reported as none. The patient had no known allergies. The patient was not diagnosed with covid-19 prior to vaccination. The patient did not receive any other vaccines within 4 weeks prior to vaccination. The patient experienced myocarditis on 21May2021. The event resulted in hospitalization for 2 days. The patient was currently still in hospital. The patient had been tested for covid-19 since the vaccination. The patient underwent lab tests and procedures, which included covid-19 test: negative on 22May2021 by nasal swab. Therapeutic measures were taken as a result of myocarditis and included treatment with analgesic. The outcome of event was not recovered. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: As an individual case report there is not enough evidence to establish a causal relationship with the suspect vaccine. Currently there is no clear biological plausibility between the vaccine use and the even onset. More information such as complete medical history and concomitant medications are needed for fully medical assessment. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.


VAERS ID: 1360920 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Influenza like illness, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Flu like symptoms for two days once those subsided then shortness of breath and heart palpitations began and have not subsided.


VAERS ID: 1360922 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-13
Onset:2021-05-21
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus, Injection site swelling, Injection site vesicles
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Patient reported having a delayed reaction at the injection site that occured 8 days following her shot. She said the injection site became swollen, blistered, and itchy. It was not infected, and cleared 2 days after appearing.


VAERS ID: 1360961 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Cellulitis, Magnetic resonance imaging abnormal, Osteochondrosis, Osteomyelitis, Subperiosteal abscess
SMQs:, Osteonecrosis (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: MRI Tib/Fib 1. Significant diffuse signal abnormality seen throughout the shaft of the tibia as described above compatible with osteomyelitis. Thin rim of circumferential subperiosteal fluid signal and enhancement is seen involving the distal tibia may represent thin rim of subperiosteal phlegmon or even abscess. 2. No significant ankle effusion is seen to suggest septic joint. 3. Small osteochondral defect appreciated involving most medial aspect of the talus. Follow-up radiographs recommended
CDC Split Type:

Write-up: Pt developed right tibial osteomyelitis 2 days following vaccine. Treated with antibiotics


VAERS ID: 1360971 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-21
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007CZ1A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Mild hearing loss and tinnitus in left ear since 2007
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Significant increase in volume of my tinnitus in my left ear - about 2 octaves higher than it was prior to vaccination.


VAERS ID: 1361102 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Fall, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A. NOT DOCUMENTED BY PATIENT AT THE TIME
Current Illness: N/A. NOT DOCUMENTED BY PATIENT AT THE TIME
Preexisting Conditions: NOT DOCUMENTED BY PATIENT AT THE TIME
Allergies: NO KNOWN DRUG ALLERGIES LISTED IN PATIENT PROFILE
Diagnostic Lab Data: EMS CAME IN TO CHECK HER VITAL SIGNS -- THEY CHECKED IT THREE TIMES AND SAID IT WAS ALL WITHIN NORMAL LIMITS. PATIENT REFUSED TRANSPORTATION IN AMBULANCE BUT RATHER HER MOTHER TOOK HER TO THE NEAREST EMERGENCY DEPARTMENT
CDC Split Type:

Write-up: PATIENT WAS SITITNG IN THE LOBBY FOR 15 MINUTES POST VACCINE, AND WAS GETTING UP FROM HER SEAT AND COLLAPSED HEAD FIRST ONTO THE FLOOR AND WAS CONVULSING FOR A FEW SECONDS.


VAERS ID: 1361318 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

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

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

Write-up: Hives all over body starting at the hip and spreading to legs and back also back of the arms. Extremely itchy


VAERS ID: 1361325 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Influenza like illness, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Experienced headache for 4 days, fever and flu like symptoms after 24 hours


VAERS ID: 1361356 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-14
Onset:2021-05-21
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Heavy menstrual bleeding, Menstruation irregular, Pain
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility 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: Prenatal vitamin Vitamin D
Current Illness: None
Preexisting Conditions: Rheumatoid Arthritis Lactating
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Heavy painful period... abnormal timing and extremely heavy. Cramps were so bad that I would be screaming in pain.


VAERS ID: 1361359 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Dizziness, Fatigue, Gastrooesophageal reflux disease, Hypersomnia, Nausea, Pain in extremity, Pyrexia, Somnolence
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Typical 72 hour fatigue, injection site pain, etc. with annual influenza vaccine, all ages, years, brands, etc.
Other Medications: Albuterol, Pulmicort, Nasacort, Zyrtec, famotidine, balsalazide, furosemide, klor-con (potassium,) N-acetyl-cysteine (OTC, oral, 600 mg, taken as prophylaxis for respiratory issues and general anti-inflammatory purposes.)
Current Illness: No acute illnesses at time of vaccination
Preexisting Conditions: Chronic/ongoing: mild asthma & COPD related to CHF, moderate (controlled) Crohn''s Disease (in the past, significant fistulizing disease leading to perirectal abscess - currently controlled and managed via soft seton drain and regular wound care, and treatment with balsalazide,) mild (controlled, asymptomatic) congestive heart failure, seasonal allergies (dust, pollen, feline dander, controlled via Nasacort and Zyrtec,) GERD (mostly controlled via famotidine.)
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm pain (moderate, resolved within 48 hours.) Dizziness (mild, resolved within 48 hours.) Fatigue (severe, resolved within 72 hours.) Arthritic hip pain flare up (moderate, when bearing weight, unilateral. Began 72 hours post vaccination, resolved within 5 days of vaccination.) Exacerbation of GERD and nausea (mild, began 72 hours post vaccination, resolved within 5 days of vaccination.) Low grade fever (mild, 2 degrees F above normal basal body temperature for patient, or less - began within 12 hours of vaccination, resolved within 72 hours.) Somnolence (moderate, excessive sleepiness e.g. 3 or 4 hours beyond normal 8 hour sleep requirement daily - began 4 days post-vaccination and resolved within 1 week of vaccination.)


VAERS ID: 1361364 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Fatigue, Gastrooesophageal reflux disease, Hypersomnia, Nausea, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Typical 72 hour fatigue, soreness, etc. with annual flu shot. Also, with combined tetanus and pertussis vaccination, significant
Other Medications: Albuterol, Pulmicort, Nasacort, Nexium, Vitamin D3 2000 IU, NAC 600 mg, Vitamin C 500% DV
Current Illness: No acute illnesses.
Preexisting Conditions: Mild (controlled) asthma, moderate to severe GERD (partially controlled with Nexium,) season allergies, history of kidney stones, tendency toward protracted respiratory illness with common colds, flus, etc. (e.g. protracted viral bronchitis for several weeks during common illnesses.)
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm pain (moderate, resolved within 24 hours.) Dizziness (mild, resolved within 24 hours.) Fatigue (severe, resolved within 48 hours.) Exacerbation of GERD and nausea (mild, began 72 hours post vaccination, resolved within 5 days of vaccination.) Low grade fever (mild, 2 degrees F above normal basal body temperature for patient, or less - began within 12 hours of vaccination, resolved within 72 hours.) Somnolence (moderate, excessive sleepiness e.g. 3 or 4 hours beyond normal 8 hour sleep requirement daily - began 4 days post-vaccination and resolved within 1 week of vaccination.) Both myself and the older relative who was vaccinated with me (report submitted for them as well, same email address) We still plan to receive our second dose on June 11th and are not concerned by these effects. We will report any additional effects with the second dose as well, in hopes that they are useful data.


VAERS ID: 1361452 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Facial paralysis, Pruritus, Rash, Swelling face, Swelling of eyelid, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Severe, Additional Details: face start drooping once swelling went away per patient


VAERS ID: 1361535 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin 40mg, lansoprazole 15mg, aspirin 81 mg Co Q-10 100mg, D3 1000iu
Current Illness: none
Preexisting Conditions: none
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tinnitus - noticeable a few days after vaccine and has increased in severity


VAERS ID: 1361537 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0BC219 / 2 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Hyperaesthesia, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Valcyclovir
Current Illness: None, cold sore
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: Negative shingles herpes test received back may 28th.
CDC Split Type:

Write-up: Very painful rash believed to be herpes or shingles by various doctors. The bumpy painful rash appeared on my cheek in a perfect triangle that resembled a shingles rash. I also had very itchy painful bumps on my forehead, chin, ears, neck, in between fingers, and all over my privates. Was tested for both shingles and herpes and both came back negative. Was put on steroids by doctor and rash has gotten better but has yet to disappear. I am still sick from when I got the shot and am dealing with a feeling that feels like my whole body is bruised and painful to the touch. Rash and bumps are unknown by doctors and the one on my fingers appears to be spreading on my fingers.


VAERS ID: 1361558 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-05
Onset:2021-05-21
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal distension, Acne, Condition aggravated, Depression, Dysmenorrhoea, Hormone level abnormal, Hot flush, Menstruation irregular
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: levothyroxine, fluoxetine
Current Illness:
Preexisting Conditions: Hypo-thyroidism
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: An extreme period -- longer than usual, increase in cramping, lighter flow, fluctuating hormonal changes - increase in severe depression. Patient is in recovery from an eating disorder and thought she was relapsing. Acne, hot flashes, bloating. All of the above were increased/multiplied in first period after receiving the first dose of vaccine.


VAERS ID: 1361602 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-02
Onset:2021-05-21
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038K20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding, Menstrual disorder
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: Prozac 40mg, Zyrtec, Flonase
Current Illness: About a month post partum
Preexisting Conditions: Anxiety
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: I delivered a baby 12/28/2020, my period returned exactly 4 weeks postpartum and was regular after that, it came every 27-28 days. I got my vaccine 2/2/2021 while on my period and my period completely stopped the night after my second dose and returned two days later. Then 3 months after that (May 21, 2021), I was on day 13 of my cycle and I had a massive amount of bleeding out of no where. I took a pregnancy test to make sure there was no miscarriage and it was negative. I bled/spotted for another 3 days and it stopped.


VAERS ID: 1361652 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-16
Onset:2021-05-21
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Arteriogram coronary normal, Blood culture negative, Brain natriuretic peptide increased, C-reactive protein increased, Chest X-ray normal, Coagulopathy, Culture urine negative, Echocardiogram normal, Fibrin D dimer increased, Headache, Immunoglobulin therapy, Inflammatory marker increased, Multisystem inflammatory syndrome in children, Prothrombin level increased, Pyrexia, Red blood cell sedimentation rate increased, Respiratory viral panel, SARS-CoV-2 antibody test positive, Serum ferritin increased
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Toxic-septic shock conditions (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), 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: None
Current Illness: None
Preexisting Conditions: Seizures when younger-seizure free for several years
Allergies: None
Diagnostic Lab Data: Echocardiogram normal 5/29. Chest CT angiogram normal 5/28. CXR normal 5/28. Covid IgG + 5/28 RPP negative. Cultures of blood and urine negative. DDimer markedly elevated 6529, CRP 164 mg/L, PT elevated.Ferritin 408. PT 19.3. ESR 79.
CDC Split Type:

Write-up: Within 5 days of immunization, developed fever, abdominal pain, headache, elevated inflammatory markers, DDimers, ferritin and BNP and coagulopathy. Admitted to Hospital and evaluated for MIS-C. Observed and treatment recommended for MIS-C with IVIG and steroids.


VAERS ID: 1361715 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Deep vein thrombosis, Malaise, Pain in extremity, Pulmonary embolism, 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), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Ultrasound, CTA Will be transferred to another hospital for higher level of care. IR pulmonology consults.
CDC Split Type:

Write-up: 24 hours later, patient and wife had plans and patient stated that he was not feeling well, generally. Wife then states that he did complain of leg pain since they had been driving in the car. 05/30/2021 Patient presented to ED and was found to have DVT and extensive PEs


VAERS ID: 1361722 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bleeding time prolonged, Epistaxis, Gingival bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Gingival disorders (narrow)

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

Write-up: patient has experienced three episodes of bloody nose and one of prolonged bleeding gum (after tooth loss) in the week since receiving the vaccine (not previously experienced these issues before)


VAERS ID: 1361777 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood electrolytes normal, Blood test normal, Imaging procedure, Pityriasis rosea, Rash pruritic, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Takes Clonidine, Sertraline and dexmethylphenidate XR
Current Illness: None
Preexisting Conditions: Dyslexia ADHD Myopia
Allergies: None
Diagnostic Lab Data: Pictures, normal CBC, normal electrolytes
CDC Split Type:

Write-up: Started to develop a rash a day or two after vaccination. Rash continued to worsen and peaked at about 10 days. Seen in ER and then by myself (Pediatrician). Normal bloodwork. Rash consistent with pityriasis rosea, ? related to the vaccine. Being treated with antihistamines and oral steroids. Rash is itchy, but no signs of trouble breathing.


VAERS ID: 1361794 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature increased, Chills, Confusional state, Erythema, Headache, Injection site movement impairment, Muscle twitching, Myalgia, Oropharyngeal pain, Pain, Paraesthesia, Pruritus, Rash, Skin mass, Sluggishness, Tremor, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penecillan tetanus kiwi strawberry latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: First day couldn''t move arm 2nd day temperature shivers sore throat headache aching nerve twitching shaking all over pins and needles in hands and feet 3rd day as above 4th day headache aching 5th day headache 6th day headache and feeling sluggish and confused 7th day hives on arm small lumps on the skin and aching arm antihistamines advised began taking them 8th day burning arm red patch itching lumps bigger red patch 9th day itching constantly patch bigger redder hotter Day 10 no better red hot to the touch spread all round arms


VAERS ID: 1361817 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-16
Onset:2021-05-21
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xarelto, vitamin D, potassium citrate, multi vitamin
Current Illness: No
Preexisting Conditions: Ocular melanoma
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shingles, Waist/belly, Left side. Belly button to spine Still in rash stage today.


VAERS ID: 1362044 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Injection site erythema, Lymphadenopathy, Myalgia, Nausea, Pruritus, Rash, Urticaria, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Extreme fatigue. Some muscle soreness and mild nausea.
Other Medications: Midol, magnesium, benedryl
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No tests done. Taking benedryl for what is believed to be a non severe allergic reaction. With the fatigue, the benedryl makes normal daily activity difficult. Waiting it out at this time and managing symptoms.
CDC Split Type:

Write-up: Red mark approx 2? long near injection site. Smaller 1? red mark also near injection site. Still present 1 week+ later. Muscle pain only 2 days after injection. Swollen neck, lymph nodes 5-7 days later. Several small red bumps under left ear lobe week later. Nausea daily for over a week. Vomiting and diarrhea a 10 days later. Hives on arms and neck 1-2 days after shot, with itching, ongoing. Severe fatigue since shot.


VAERS ID: 1362077 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-14
Onset:2021-05-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Itchy sensation, red, swelling at injection site starting exactly 1 week after shot with some blood spots on the skin, easily brought on by scratching. Lasting for 3-4 days.


VAERS ID: 1362088 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-11
Onset:2021-05-21
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA ER8729 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Sleep disorder, Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: Right ear started ringing suddenly Friday may 14 2021 as I was sitting down at my computer after work. It has been growing in intensity over time since then, and on may 25th 2021 I went to urgent care, advised them I thought I may have a wax or ear infection problem and was prescribed "ofloxacin 0.3% otic solution commonly known as: FLOXIN" and have been taking the daily drops. The ringing is getting worse and the only thing I can think of that changed in my life recently was the vaccine. I no longer suspect ear infection as I have experienced those before and never taken this long to recover, much less getting worse while taking medication. My day to day life otherwise has been the same. The ringing is so deafening now I cannot sleep and I wanted to make record of this before seeking additional medical help in the morning.


VAERS ID: 1362160 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dizziness, Dyspnoea, Hemiparesis, Immediate post-injection reaction, Muscular weakness, Nausea, Pain, Pain in extremity, Tremor, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: All vaccines, most recent being the 2020 flu vaccine nausea, difficulty breathing, chills etc. Vaccinated Nov. 2020
Other Medications: Cyclobenzaprine, vitamin D3, multivitamin, singular, pantoperazole
Current Illness:
Preexisting Conditions: Fibromyalgia, PCOS, Endometriosis, menhorria, Arthritis, Chronic inflammation,
Allergies: Adhesive, Xulane, ALL vaccines
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediate severe reaction including difficulty breathing, nausea, vomiting, light headedness, dizziness, shaking, muscle weakness, body aches and pains, chills, pain and weakness in the entirety of my left arm which spread to my entire left side including neck and head. I waited out the worst of it and received Benadryl for the reaction and ondansetron ODT for the nausea and was monitored by hospital staff for an hour and clinic staff for an hour.


VAERS ID: 1362381 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-10
Onset:2021-05-21
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Dyspepsia, Dyspnoea, Fatigue, Feeling abnormal, Fibrin D dimer increased, Headache, Hypophagia, Loss of personal independence in daily activities, Pulmonary embolism, Pyrexia
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft 200mg daily Ibuprofen PRN
Current Illness:
Preexisting Conditions: depression GERD digestive bloating
Allergies:
Diagnostic Lab Data: D-dimer elevated CTA showing bilateral diffused PE''s other lab work unknown results
CDC Split Type:

Write-up: 5/21 started feeling poorly, fatigue, shortness of breath, evening headaches 5/24 Fatigue, shortness of breath, unable to complete any task, low grade fever 99.8, unable to eat or drink well 5/25 severe heartburn, shortness of breath continued, extreme fatigue 5/28 went to ER with continued extreme shortness of breath and fatigue. CT scan revealed multiple clots in lungs and was admitted for needing oxygen and to start anticoagulation.


VAERS ID: 1362474 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-13
Onset:2021-05-21
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blister, Herpes zoster
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad), Opportunistic infections (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: HCTZ, Metropolol, Lexapro, Atorvastatin, Nexium
Current Illness: None
Preexisting Conditions: N/A
Allergies: Dilaudid
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Shingles from right mid back across right stomach Evaluated by MD, treated with Valtrex 1 GM 3xs a day x 7 days, topical lidocaine and neosporin, Ibuprofen and Medrol dose pack. Shingles with blisters on back resolving, painful to touch continues.


VAERS ID: 1362565 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-21
Onset:2021-05-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gastrointestinal disorder, Influenza like illness, Injection site erythema, Injection site rash, Injection site swelling, Injection site warmth, Pruritus, Rash erythematous, Swelling face, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram Hydroxychloroquine Levothyroxine Gabapentin Vit d Vit b12
Current Illness: Systemic Lupus Hashimotos Arthritis Depression
Preexisting Conditions: Same as above
Allergies: Metals Levaquin Alcohol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day one - within 4 hours facial swelling, ear itchiness, throat itchiness, not severe enough for ER but benadryl used. Day eight - Thru 11 swelling and red raised hot rash at injection site, flu like symptoms, gastro issues


VAERS ID: 1362618 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Vomiting
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: Zyrtec Flonase
Current Illness:
Preexisting Conditions:
Allergies: Omnicef
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vomiting (6 times in 12 hours) Chills Headache Fatigue


VAERS ID: 1362664 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Myalgia, Pain in extremity, 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? 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: Cefaclor
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: The day after vaccination, I experienced fever, chills, muscle aches, and a sore arm. Symptoms lasted approximately 24 hours, and were self-resolving. Early in 2020, I was diagnosed with Covid-19 infection. The severity of the symptoms from the vaccine were just as intense as the infection; however, the duration was significantly shorter.


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