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

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

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 121 out of 10,493

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VAERS ID: 2001150 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Breast pain, Breast swelling, Dizziness, Gastrooesophageal reflux disease, Headache, Oedema peripheral, Pain, Pain in extremity, Urticaria, Vaginal haemorrhage
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Lipodystrophy (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot a couple years ago
Other Medications: Allegra, Osello birth control
Current Illness: No
Preexisting Conditions: Anxiety
Allergies: No
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: I came home and I was dizzy and my arm was sore. At 1am my armpit was swollen the size of a baseball and my left breast. Very painful. I broke out in hives on my arms, legs, face. Heavy vaginal bleeding started and lasted 24 hours. Also, headache and body aches. Several acid reflux.


VAERS ID: 2001153 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-12-24
Onset:2021-12-29
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066H21A / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate irregular
SMQs:, Cardiac arrhythmia terms, nonspecific (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: As described above, similar but more intense reaction to getting second COVID Pfizer shot on 2/21 at a age 47.
Other Medications: daily iron supplement; budesonide and formoterol fumarate dihydrate inhalation aerosol
Current Illness: none
Preexisting Conditions: reactive airway syndrome
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intermittent rapid/irregular heartbeat when at rest. Began 12/28 and has intensified slightly since 1/1. Had a similar but stronger reaction to the second vaccine shot (Pfizer, received 2/16/21) that eventually resolved on its own.


VAERS ID: 2001162 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-10-29
Onset:2021-12-29
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CETIRIZINE, FLONASE
Current Illness: NONE
Preexisting Conditions: ADHD
Allergies: NKA
Diagnostic Lab Data: 12/29/21: POSITIVE POC SARS COVID RAPID ANTIGEN
CDC Split Type:

Write-up: COUGH, CHEST CONGESTION, BODY ACHES, CHILLS, LOW-GRADE FEVER, EAR PAIN


VAERS ID: 2001179 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-01
Onset:2021-12-29
   Days after vaccination:272
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Cough, Ear pain, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CHOLECALCIFEROL, CETIRIZINE, METFORMIN, FLONASE, AMLODIPINE
Current Illness: NONE
Preexisting Conditions: ALLERGIC RHINITIS, HTN, DM2
Allergies: NKA
Diagnostic Lab Data: 12/29/21: POSITIVE POC SARS COVID RAPID ANTIGEN
CDC Split Type:

Write-up: 12/29/21: BODY ACHES, CHEST CONGESTION, NASAL DRAINAGE, COUGH, EAR PAIN


VAERS ID: 2001305 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-21
Onset:2021-12-29
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / UNK - / -

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

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

Write-up: Covid positive contact unknown.


VAERS ID: 2001337 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Neck pain
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type: SC2021109

Write-up: Patient complained of left sided neck pain 5/10 10 minutes after receiving the Pfizer Vaccine. The patient''s mother took him to the ER but left before he was evaluated and took him home and gave him Ibuprofen.


VAERS ID: 2001344 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-27
Onset:2021-12-29
   Days after vaccination:246
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / UNK - / -

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

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

Write-up: Covid positive contact unknown


VAERS ID: 2001356 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-11
Onset:2021-12-29
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, Fatigue, Headache, Influenza virus test negative, Middle ear effusion, Nausea, Oropharyngeal pain, Pain, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu
Other Medications: Levothyroxine, Arm thyroid, Boteh, Calcium, Magnesium
Current Illness: n/a
Preexisting Conditions: thyroid disease
Allergies: latex, bananas
Diagnostic Lab Data: Covid-19 test
CDC Split Type: vsafe

Write-up: I had body aches, fatigue, sore throat, congestive, and fluid in both ears. I also had nausea, diarrhea, and a headache. These symptoms are still ongoing after 7 days. I went to my doctor on the Dec. 29th. They did a Covid-19 test, positive results. They did a flu test, negative on that.


VAERS ID: 2001360 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-27
Onset:2021-12-29
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA8899 / UNK - / -

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

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

Write-up: Covid positive through family contact


VAERS ID: 2001369 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8762 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cardiac flutter
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Tachyarrhythmia terms, nonspecific (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: anxiety medication
Current Illness:
Preexisting Conditions:
Allergies: Dental Medication - Anaphylaxis
Diagnostic Lab Data:
CDC Split Type: SC2021110

Write-up: Patient reported feeling "flutters" in chest 25 minutes after receiving the Pfizer vaccine. Patient''s vital signs were stable. Pulse 66. Patient has a history of anxiety. Patient went home, took anxiety medication, and went to sleep. Patient reported feeling better after waking up.


VAERS ID: 2001386 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-27
Onset:2021-12-29
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Covid positive contact unknown.


VAERS ID: 2001482 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Electrocardiogram, Pericarditis
SMQs:, Anaphylactic reaction (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: pericarditis diagnosed by EKG symptoms of chest pain and tightness constant for 48 hours, then improving but persist at night on day 5


VAERS ID: 2001556 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-12-28
Onset:2021-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030H21B / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Heart rate increased, Pain, Palpitations, Pollakiuria, Pyrexia, Skin warm
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Pt reports that the day after her vaccine, her heart rate was much higher. She felt like it was "beating out of her chest". This was intermittent. She also had joint pain, fatigue, achy, chills, subjective fever (hot to touch but chilled and no measurable fever) but not a fever that registered on a thermometer. She also had frequent urination. This lasted throughout Thursday, 12/30, then she seemed to be fine Friday. She did have an episode of achiness Friday night that didn''t last long. Pt had previously tolerated her first two Moderna vaccines without incident.


VAERS ID: 2001587 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-10
Onset:2021-12-29
   Days after vaccination:294
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012A21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: asymptomatic testing for psych placement in ED


VAERS ID: 2001718 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-12-15
Onset:2021-12-29
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939903 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (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: birth control
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Have hives that last about 30 min in area and then go away and appear on other areas of body. Hives itch and burn


VAERS ID: 2001722 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3197 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Donepezil, levothyroxine, metformin, simvastatin, estradiol cream
Current Illness: none
Preexisting Conditions: Diabetes, hypertension, hypothyroidism, hyperlipidemia, peripheral neuropathy, dementia
Allergies: Atorvastatin and Niacin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Covid Vaccine booster 60 days after monoclonal antibodies, instead of recommended 90 days. Patient did not have any adverse events.


VAERS ID: 2001723 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-03
Onset:2021-12-29
   Days after vaccination:301
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Oxygen saturation decreased, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

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

Write-up: Fevers and low pulse ox. Patient has a history of COVID-19. She was admitted due to acute hypoxic respiratory failure.


VAERS ID: 2001774 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 070H21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pepcid 40mg, prilosec 20mg, zoloft 25mg, klor con 20meq, requip 0.25mg, zoloft 50mg, eliquis 5mg, lipitor 10mg, aspirin 81mg, torsemide 20mg, trelegy, synthroid 150mcg, toprol xl 100mg.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received her vaccination and by that evening her injection side was slightly raised and itchy. She used benadryl spray to try to alleviate the itching. The redness spread down her arm and when she was seeing her heart doctor they recommended getting seen by her primary doctor and letting the pharmacy know of the reaction. Her primary doctor didn''t have any availability to see her so on 1/3/21 she went to the urgent care center. They prescribed her Duricef 500mg. They diagnosed her with cellulitis. Her first dose was at 1pm on 1/4/22. So far she hasn''t not experienced any fever.


VAERS ID: 2001784 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-12-29
   Days after vaccination:266
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8762 / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Fatigue, Headache, Oropharyngeal pain, Pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ?Acetaminophen 500 MG Tablet 2 tablets Orally every 6 hrs, prn pain ?Advair Diskus 500-50 MCG/DOSE Aerosol Powder Breath Activated 1 puff Inhalation Twice a day ?Albuterol Sulfate HFA 108 (90 Base) MCG/ACT Aerosol Solution 2 puffs as
Current Illness: none
Preexisting Conditions: TBI 1980''s . Poor memory.
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: sore throat, headache, increase in shortness of breath, fatigue and side pain over last 5 days. took home test and +covid 4 days ago.hasn''t used his resuce inhaler, felt didn''t need it.. starting 12/29/21


VAERS ID: 2001823 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067H21A / 2 LA / SYR

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

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

Write-up: Second Moderna vaccine was given too early (1st dose: 12/07/21, 2nd dose: 12/29/2021).


VAERS ID: 2001829 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8027 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Cough, Fatigue, Headache, Injection site pain, Lymph node pain, Lymphadenopathy, Myalgia, Pain, Pyrexia, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: The evening of the day of the shot I developed a sore arm at the injection site. My lymph nodes under that arm were extremely swollen and very painful. I woke up approx 4am the morning after the shot (12/30) in excruciating body pain. My joints and muscles hurt. On a scale of 1-10 with 10 being the most pain, I was at a 12. I ran a fever the day after, with a cough, running nose, extreme headache that lasted 2 days. Headache is still present but not as bad. Finally feeling a little better on Jan 2. Today, Jan 4, still have a running nose, headache and persistent cough and fatigue.


VAERS ID: 2001882 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8757 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Influenza like illness, Influenza virus test negative, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Mentioned above - only with Moderna COVID vaccines given for first 2 shots
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extremely high fever for 24 hours 102 - 103.5 - only reduced to 101 with Advil. Severe chills and ?flu-like? symptoms for 4 days following booster phizer shot. Several days later I am still very fatigued and will start running a fever with any activity. I tested as a precaution and was negative for flu and COVID. Similar symptoms with Moderna for my 1st two vaccines - 1st shot symptoms lasted 2 days; 2nd shot lasted 4 days but not as high fever a fever as booster - typically 102.5.


VAERS ID: 2001933 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-11-03
Onset:2021-12-29
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

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

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

Write-up: Patient vaccinated for Covid with booster and came to ED for weakness and body aches and admitted for Covid.


VAERS ID: 2001961 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alopecia, Amnesia, Arthralgia, Blood urine present, Contusion, Disorientation, Epistaxis, Fatigue, Haematochezia, Purpura
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Ischaemic colitis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Hair loss, nose bleeds, blood in urine and stools, extreme tiredness, disorientation, blood spots on legs, easy bruising, achy joints, and some memory loss and clarity.


VAERS ID: 2002088 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-12-20
Onset:2021-12-29
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 9399409 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, COVID-19, Computerised tomogram, Echocardiogram, Heart rate increased, Laboratory test, Pyrexia, SARS-CoV-2 test positive, Tachycardia, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: penicillin, codeine
Diagnostic Lab Data: urine test blood work CT scan Echo cardio gram Covid-19 test
CDC Split Type: vsafe

Write-up: I had emulated heart rate. I also had a low-grade fever. I went to the ER (Pukka Hospital). I was diagnosed with tachycardia. They did urines test, lab, CT scan, and a Echo cardio gram. They also did a Covid-19 test, positive result.


VAERS ID: 2002102 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-12-27
Onset:2021-12-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33036BD / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Breast pain, Injected limb mobility decreased, Injection site erythema, Injection site swelling, Injection site warmth, Lymph node pain, Lymphadenopathy, Palpitations, Sleep disorder, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Lipodystrophy (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: After booster shot on 12/27/2021, patient reported "heart palpitations and increasing size in my lymph nodes in my armpit, elbow
Other Medications: Medication list: asparin 81mg - 1 tab Qday - Lisinopril 20mg - 1 tab Qday - Hydrocortisone 2.5% cream - apply to affected areas BID
Current Illness:
Preexisting Conditions: HTN
Allergies: Allergic to Penicillin G
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 days after vaccination, patient reports "heart palpitations and increasing size in my lymph nodes in my armpit, elbow, and left breast. The injection site(left deltoid) is also warm, red, and swollen to the touch. The size in pain in my lymph nodes on the left side have gotten so bad I have limited mobility in that arm. The pain in my left breast wakes me up at night. My heart rate can reach up to 160bpm 6-8 hours following the doses. My vital signs have been within normal limits today and seem to be improving overall". Pt also reported left eye lid swelling after injection and was recommended to go to ED if heart palpitations and swelling persisted. Also educated to use warm compress to help with arm mobility. Patient did not end up going to ED.


VAERS ID: 2002177 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-12-28
Onset:2021-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM
UNK: VACCINE NOT SPECIFIED (OTHER) / UNKNOWN MANUFACTURER - / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site hypersensitivity, Pain, Pain in extremity, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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)

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: Pain and fatigue after initial Moderna vaccination doses, but more mild. After second dose, I got a big red circle around the in
Other Medications: Zoloft, vitamin C, Zinc, Vitamin D
Current Illness: Minor cold (sore throat, dry raw nasal passages)
Preexisting Conditions: Asplenic (spleen removed in 2014), resulted in chronic fatigue syndrome until pregnancy in 2019-2020.
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: The morning after vaccination, I woke up to intense pain and sensitivity at the injection site. Any movement of or contact with my arm was extremely painful. By that evening, I had pain throughout my body. I took 800 mg of ibuprofen that night and again the next day, but the pain was still quite constant and intense. Even when not moving, it still throbbed, like a headache, but throughout my body. About 48 hours after the vaccination, I ran a mild fever for a few hours. By three days after vaccination, the pain subsided. My arm continued to feel slightly raised and hot to the touch around the vaccination site for several more days.


VAERS ID: 2002659 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: New York  
Vaccinated:2021-11-01
Onset:2021-12-29
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8030 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: men''s 1 a day
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: swelling, headache, chills


VAERS ID: 2002677 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3197 / UNK LL / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Chest discomfort, Computerised tomogram normal, Electrocardiogram normal, Feeling hot, Limb discomfort, Migraine, Pain, Pain in extremity, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: chest discomfort/tightness but only for 2 days
Other Medications: migraine medication
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: Cat scan, chest x-ray, EKG, bloodwork
CDC Split Type:

Write-up: Pt says migraines got more intense and longer duration. Lasted 5 days and actually woke up from the pain. Felt uncomfortable tightness in chest with warmth and leg started to ache and feel very heavy. went to ER on 1/3/2022 where did Cat scan, chest x-ray, ekc and bloodwork. Everything came out ok and pt was released with symptoms abating. Did not take any Tylenol or motrin. Says had some chest discomfort for 1st 2 doses but only last 2 days and stopped.


VAERS ID: 2002682 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-12-28
Onset:2021-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059H21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Pleurisy
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (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: n/a
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient was feeling short of breath starting the night of and for 2 days after. He was having chest tightness which led him to going to the hospital, they ran several tests and stated he had inflammation around his lung consistent with side effects from the vaccine.


VAERS ID: 2003163 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-12-23
Onset:2021-12-29
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330258D / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Immunodeficiency, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), 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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, atorvastatin, betamethasone augmented oint, cetrizine, diphenhydramine, fluticasone/salmeterol 250/50 diskus inh, hydrochlorothiazide, prednisone
Current Illness:
Preexisting Conditions: hypertension, asthma, hyperlipidemia and atopic dermatitis on steroid taper for the past 2 weeks (as of 12/29/21)
Allergies: NKDA
Diagnostic Lab Data: COVID status positive on 12/29/21.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine first 2 doses (3/2/21 lot # EN6200 and 3/31/21 lot # ER8737). While in state, patient received the third Pfizer COVID vaccine dose on 12/23/21. On 12/29/21, patient admitted to our inpatient facility with acute respiratory failure with hypoxia due to COVID pneumonia. Patient most likely got COVID during her immunocompromised state while on 18-day prednisone taper started on 12/10/21 for atopic dermatitis. As of today (1/4/22), patient is still admitted in our med/surg unit.


VAERS ID: 2004202 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-30
Onset:2021-12-29
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19, COVID-19 pneumonia, Cardiac failure acute, Left ventricular failure, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Cardiomyopathy (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, baby aspirin, atorvastatin, carvedilol, vitamin d3, vitamin b12, EpiPen as needed, Flonase nasal sp, furosemide, insulin degludec pen, losartan, Glycolax, testosterone gel in metered dose pump
Current Illness:
Preexisting Conditions: chronic diastolic CHF, EF 55-60% 6/2021, insulin-dependent DM2, HTN, OSA on CPAP, and recent right heel osteomyelitis treated with prolonged IV ceftriaxone completing on 11/11/21
Allergies: Shellfish, Fish, Lisinopril, Peanut
Diagnostic Lab Data: COVID status positive 12/29/21.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 7/9/21 and 7/30/21. On 12/29/21, patient admitted to our facility for acute on chronic diastolic CHF, AKI, and pneumonia due to COVID-19 virus. On 12/31/21, patient was discharged home and during hospitalization, patient remained on room air and did not require dexamethasone therapy.


VAERS ID: 2005460 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL0007 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Underdose
SMQs:, Medication errors (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dosage Error, Booster Dose: Pfizer-BionTech 5-11 formulation (orange cap) administered to a person 18 years or older. Patient notified and was informed that repeat dose was available.


VAERS ID: 2005492 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-01-17
Onset:2021-12-29
   Days after vaccination:346
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / UNK RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, Blood gases abnormal, COVID-19, Cough, Dyspnoea, Exposure to SARS-CoV-2, Haemoptysis, International normalised ratio increased, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test positive
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Lactic acidosis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 12/29/2021 home test
CDC Split Type:

Write-up: Patient is a 91 year old male with hx of Afib on chronic warfarin tx, CAD s/p stents, PPM placement, CKD III, and prostate CA s/p suprapubic catheter placement, who presented to the ER due to positive home COVID test 12/29. Pt states that he had approximately 20 family members visiting from all around the country (some of whom are still at his home). Two 13yo family members tested positive yesterday during their drive back and were positive. He reports that his test came back positive, but that 4-5 other household contacts have all tested negative so far. He reports that all of those gathered that were vaccine-eligible were vaccinated and that the adults had received boosters. Pt reports that for the last 2 days he has had some mild increase in his baseline cough, SOB, and pinkish blood-tinged sputum, as well as reported low-grade fever ~100.1. His daughter-in-law, who is a nurse, recommended that he come to the ER. Pt has not noted any change in his taste or smell or appetite, no HA, or myalgias. He has not hand nausea/vomiting, loose stools (notes constipation at baseline), or change in urinary habits. Pt states that his last 2 home INR checks have been elevated (on Tuesday INR$g8) and he did not take a dose last night. He indicates that Prednisone was started a few months ago "for more energy." Pt''s O2 sats were reported as low at home (70''s?), 86% on RA ABG in ER. Discharged on Discharge DX: 1. 2019 novel coronavirus disease (COVID-19), Discharge, 12/30/2021 2. Acute respiratory failure with hypoxemia, Discharge, 12/30/2021 3. Sleep apnea on CPAP, Discharge, 12/30/2021 4. Chronic atrial fibrillation, Discharge, 12/30/2021 5. Chronic anticoagulation, Discharge, 12/30/2021 6. Supratherapeutic INR, Discharge, 12/30/2021 7. Type 2 Diabetes mellitus with hyperglycemia, Discharge, 12/30/2021 8. Peripheral neuropathy, Discharge, 12/30/2021 9. CKD (chronic kidney disease), stage III, Chronic renal insufficiency, stage III (moderate) 10. Anemia, Discharge, 12/30/2021 11. Essential hypertension, Hypertension 12. Sinoatrial node dysfunction s/p PPM, Discharge, 12/30/2021 14. Hypercholesteremia, Discharge, 12/30/2021 15. Chronic diastolic congestive heart failure, Discharge, 12/30/2021 16. Coronary artery disease s/p stents, Discharge, 12/30/2021 17. GERD - Gastro-esophageal reflux disease, Discharge, 12/30/2021 Discharged home with family.


VAERS ID: 2005530 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-11
Onset:2021-12-29
   Days after vaccination:293
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030M20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prn acetaminophen and ibuprofen
Current Illness: kidney stone
Preexisting Conditions: obesity, insulin resistance, hyperparathyroidism
Allergies: none
Diagnostic Lab Data: Sars-Cov-2 by PCR positive on 12/29/2021
CDC Split Type:

Write-up: positive COVID


VAERS ID: 2005561 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL0007 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product administration error, Underdose
SMQs:, Medication errors (narrow)

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

Write-up: Administration Error Booster Dose: Pfizer-BioNTech 5-11 formulation (orange cap) administered to a person age 12-17 years. Parent notified via phone


VAERS ID: 2005569 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7218 / 3 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Fall, Impaired driving ability, Malaise, Mobility decreased, Muscle spasms, Nausea, Peripheral swelling, Rash macular, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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: Pfizer vaccine #2 - 50 years old
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Wednesday - 12/29/21 Day of Vaccine - One hour and 20 minutes after vaccine - Nausea and vomiting , muscle spasms to arms and legs Could not drive home from a store - called wife to pick him up. Placed heating pad on at home - drank 2 sport drinks for hydration. Fell asleep. After 2 hours awakened with visible muscle spasms to arms and legs. Right forearm is swollen. Thursday - 12/30/21 - Muscle spasms continue - fell putting pants on. Went to local Emergency room at 0630 - Was given Ativan, Tylenol and Ibuprofen and a nausea med. Friday - 12-31-21 - In bed all day - muscle spasms continue - nausea continues - Saturday 01/01/22 - Out of bed - eating lightly - spasms continue Sunday 01/02/22 - Nausea - eating lightly - spasms less - continue Monday 01/03/22 - Went to work - eating lightly - spasms continue Tuesday 01/04/22 - AT work - eating lightly - spasms continue. 1"-2" red blotchy patches form on arms and legs. Ate a full meal. Wednesday 01/05/22 - At work- faint red patches remain to arms - left swollen forearm is new symptom. Spasms continue. Feeling ill. Recommend going to ER or Personal Physician. Left work in stable condition per self. States he is OK to drive himself home or to the doctors office


VAERS ID: 2005612 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL0007 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Underdose
SMQs:, Medication errors (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dosage Error Booster Dose: Pfizer-BIonTech 5-11 formulation (orange cap) administered to a person 18 years or older Patient notified and offered repeat dose.


VAERS ID: 2005907 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034F21A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Laboratory test, Pyrexia, Renal pain
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: Mulit vitamin, claritin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: labs done 1/3 vitals normal
CDC Split Type:

Write-up: 1130 pm chills, fever, kidney pain took ibuprofen went back to bed 12/30 same symptoms, alternated tylenol and ibuprofen 12/31 still not well added dayquill 1/1 kidney pain ongoing 1/3 saw a provider for ongoing kidney pain and being very tired, had to return to work 1/4 labs came back normal however I am still tired


VAERS ID: 2005930 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-11
Onset:2021-12-29
   Days after vaccination:232
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, Diabetes,
Allergies:
Diagnostic Lab Data: COVID+ PCR on 1/4/22
CDC Split Type:

Write-up: COVID breakthrough- Per patient, symptom onset 12/29/21. Came to the ED on 1/4/22 with SOB, cough, fatigue.


VAERS ID: 2006108 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-10-28
Onset:2021-12-29
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 2 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051F21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine 2.5 mg daily, aspirin 81 mg daily, atorvastatin 10 mg daily, Voltaren gel prn, Flonase daily, levothyroxine 25 mcg daily, lisinopril 10 mg daily, nasal spray prn
Current Illness: none
Preexisting Conditions: hypothyroidism with multiple thyroid nodules, type II diabetes mellitus, hyperlipidemia, hypertension, CAD
Allergies: lactose intolerance, tuberculin derivative, quinine
Diagnostic Lab Data: sars-cov-2 RNA NAAT positive on 12/29/2021
CDC Split Type:

Write-up: positive COVID


VAERS ID: 2006126 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-10-27
Onset:2021-12-29
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 RA / IM
FLUA4: INFLUENZA (SEASONAL) (FLUAD QUADRIVALENT) / SEQIRUS, INC. P100355694 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Voltaren gel PRN, Fluoxetine 20mg daily, Gabapentin 600mg TID, Iron, Vyvanse 50mg daily, Icy Hot patches PRN, Pantoprazole 40mg daily, Pramipexole 0.125mg at night
Current Illness: None
Preexisting Conditions: Chronic low back pain, restless leg syndrome, depression, cyclical vomiting, GERD
Allergies: Penicillin, Tramadol, Codeine, Lactose intolerance, Morphine, Tylenol with Codeine
Diagnostic Lab Data: SARS-CoV-2 RNA NAAT positive on 12/29/2021.
CDC Split Type:

Write-up: COVID-19 positive.


VAERS ID: 2006180 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-02
Onset:2021-12-29
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Cholecystitis, Cholelithiasis, Computerised tomogram abdomen abnormal, SARS-CoV-2 test positive, Ultrasound abdomen abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Infectious biliary disorders (narrow), Gallbladder related disorders (narrow), Gallstone related disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
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: He has a past medical history of Crohn''s disease (03/2020).
Allergies: none
Diagnostic Lab Data: 12/29/21 COVID19: positive
CDC Split Type:

Write-up: Presented to ED on 12/29/21 and found to be COVID positive. Received pfizer on 09/02/21 and 09/25/21. ER with complaints of vomiting for the past day. Patient had a CT scan of his abdomen done which revealed cholecystitis so an ultrasound was done which confirmed cholecystitis with small gallstones. Patient denies any abdominal pain. Denies any fevers or chills. Patient also incidentally tested positive for COVID. He was asymptomatic. Admitted for cholecystitis not COVID. Discharged on 12/31/21


VAERS ID: 2006192 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-15
Onset:2021-12-29
   Days after vaccination:289
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Chest X-ray normal, Haematuria, Haemorrhage urinary tract, SARS-CoV-2 test positive, Urinary tract infection
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Continued atenolol 25 MG Tabs Commonly known as: TENORMIN 25 mg, Oral, DAILY cetirizine 10 MG Tabs Commonly known as: ZyrTEC 10 mg, Oral, DAILY PRN lisinopril-hydroCHLOROthiazide 10-12.5 MG Tabs Commonly known as: PRINZIDE, ZESTORETIC
Current Illness:
Preexisting Conditions: He has a past medical history of GERD (gastroesophageal reflux disease) (06/23/2021), Hypertension (09/17/2018), and Prostatitis.
Allergies: Sulfa, cats, ragweeks, cane sugar, wheat, mushrooms
Diagnostic Lab Data: 12/29/21 COVID19: positive 12/29/21 chest xray: negative
CDC Split Type:

Write-up: Received moderna COVID19 vaccine on 02/10/21, 03/15/21, and 12/20/21. Presented to ER on 12/29/21. On the 27th he passed some clots but then had normal urine. Last night he developed gross hematuria. on 12/29/21 it continued to so he came to ER. Asymptomatic COVID. Treated for UTI and hospitalized. Discharged on 1/1/22.


VAERS ID: 2006233 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-12-09
Onset:2021-12-29
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029H21B / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amenorrhoea, Menstrual disorder
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanus shot in 1987 -very hot, red, swollen arm. Pfizer Covid vaccine - dose 1, 4/7/21 - hot, swollen arm at injection site.
Other Medications: Synthroid, Vyvanse, Singular
Current Illness:
Preexisting Conditions: Hypothyroidism, Hashimoto''s Thyroiditis
Allergies: Tetanus shot allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Menstruation change. Amenorrhea.


VAERS ID: 2006277 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-12-14
Onset:2021-12-29
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33030BD / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Fatigue, Influenza virus test negative, Pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C; zinc
Current Illness: N/a
Preexisting Conditions: Chronic FC- lumbar; Chronic lyme disease
Allergies: Diary; milk
Diagnostic Lab Data: Covid-19 test; Flu test
CDC Split Type: vsafe

Write-up: I had low-grade fever, SOB, body aches, serve fatigue, and congestive. These symptoms are still ongoing. I went to my primary care on Dec. 30th for a Covid-19 test, positive result. They also did a flu test, negative result on those.


VAERS ID: 2006296 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-12-01
Onset:2021-12-29
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cough, Crying, Dysphonia, Fatigue, Infection, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Sneezing, Throat irritation, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: children''s gummy Multi-vitamin daily, Influenza (Seasonal) FluMist Quadrivalent
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Rapid tests on 12/29/21 & 1/4/22 both positive for Covid-19.
CDC Split Type:

Write-up: Injection 1- was 11/10/2021 Injection 2- was 12/01/2021 Negative PCR tests 12/17/21 & 12/23/21. Patient had breakthrough Covid-19 infection. 12/28/21-sore throat, scratchy throat, fatigue, hoarness, sneezing started 12/29/21- Around 3-4:00 am, fever up to 105, crying, fatigue, coughing, congestion, chills, shaking. Rapid Binax Now Covid test - positive at 10:00am High fever to 103-105 for next couple days controlled with continuous Motrin or Tylenol. Sweating/reduced fever/ improved symptoms with meds. Last dose of Motrin was 4:00 am Friday 12/31/21. After that fever broke. Very low-grade for next 2 days (around 100). Sneezing/ occas coughing/ congestion/ clear snot continues.


VAERS ID: 2006305 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-23
Onset:2021-12-29
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

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

Write-up: Patient had 4 day ED admission from 12/29 until 1/2. Sent by EMS on 1/4 worsening symptoms, weakness and SOB


VAERS ID: 2006324 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-23
Onset:2021-12-29
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bronchitis, Laryngitis, Nasopharyngitis, SARS-CoV-2 test negative
SMQs:, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine
Current Illness: None
Preexisting Conditions: HBP
Allergies: NKA
Diagnostic Lab Data: CoVid Test 11/14 (Negitive) No other test or labs done.
CDC Split Type: vsafe

Write-up: Had cold like symptoms and was worried it might be CoVid 11/14 and went to the ER at a local hospital to get the test done. Results turned out to be negative from the fast test. Mucinex and Robitussin was suggested. Was advised I would be fine after a few days. Developed into Bronchitis and had Laryngitis. Through telehealth got a prescription for antibiotics 5 days.


VAERS ID: 2006447 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL0007 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Underdose
SMQs:, Medication errors (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dosage Error, 2nd dose in primary series: Pfizer 5-11 formulation (orange cap) administered to a person 18 hears or older. Patient notified and encouraged to be revaccinated.


VAERS ID: 2006466 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: New York  
Vaccinated:2021-12-15
Onset:2021-12-29
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Mechanical urticaria
SMQs:, Hypersensitivity (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
CDC Split Type:

Write-up: Dermatographia starting with the scalp, then down to the neck/shoulders, then whole body. Started 15 days after the booster and has persisted for a week.


VAERS ID: 2006473 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-20
Onset:2021-12-29
   Days after vaccination:100
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Arthralgia, Chest pain, Computerised tomogram thorax abnormal, Dyspnoea, Electrocardiogram, Heparin-induced thrombocytopenia, Impaired work ability, Pain in extremity, Pulmonary thrombosis, Scan with contrast abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omeprazole; zolpidem; MELOXICAM; trazodone; napacin; vit D; FLEXERIL; BENADRYL; tramadol; lisinopril; XIIDRA
Current Illness:
Preexisting Conditions: 02/2021 Happened 5 days after my 1st vaccine. Moderate to degenerate into vertebrae; numbness & tingling; BP treated for 10-15 years; Sleep issues that are long lasting; partially related to being a night employee
Allergies: Penicillin; codeine; mangos (anaphylaxis)
Diagnostic Lab Data: EKG; Vital Signs; CT chest with contrast; nodule of blood clot in lungs. Dr. stopped the heparin drip.
CDC Split Type: vsafe

Write-up: 9/20/2021 Vaccination *Sharp ribbon of pain in front of L ankle and left calf. 12/29/2021 I only experienced side effects the day I was hospitalized. Chest pain, very sharp, very localized. I had sharp pain in L posterior Calf. SOB. I am in the healthcare field. I went back to bed after self evaluation. I was very SOB getting ready for work, pushing thru. I got out of the garage and stopped in the driveway. The SOB was not going away, quite pronounced, pain in calf, ankle. I couldn''t get out a whole sentence. I sat in chair by doorway, put my head down, and sat there for about 10 minutes. My husband wanted to take me to the ER. After awhile, I went to work. Between home and work, I had to stop 3 times as I was extremely SOB. It took me another 2 stops to get to the garage to catch breath. I told self I had to stop being in denial and went to the ER with SOB, chest pain; admitted to the Hospital. I had to wait 4 hours for hospital bed as they were so busy. L lateral chest, pain occurred again. Nitroglycerin and heparin drip on me. I developed heparin induced thrombocytopenia. Started another IV Argatroban drip; frequent lab draws and vital signs; therapeutic. I was hospitalized for 7 days. Hematologist diagnosed me with ''vaccine induced immune thrombocytopenia''. *Brand new syndrome vaccine related syndrome to the booster. Hematology appt 1/13/2022; PCM is 1/6/2022; Cardiologist is trying very hard to free a appt time for me in the next week. *1st & 2nd dose, fever of 102-103 w/ chills and body aches.


VAERS ID: 2006734 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-01
Onset:2021-12-29
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: PCR + for Covid 12/29/2021
CDC Split Type:

Write-up: Vaccinated with Pfizer vaccines in September 2021 x 2. Symptom started on 12/29 - runny nose x few days.


VAERS ID: 2008802 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-28
Onset:2021-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 213D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Chills, Discomfort, Headache, Heart rate increased, Hyperhidrosis, Pain, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: 12 pm: Time of vaccination. 6 pm - 12 am: Onset and gradually increasing chills. 12 am - 3 am: In addition to continuing chills, heartbeats per second was approximately in the 2.5 to 3 range. Fell asleep shortly after midnight. 3 am: Awakened with sweating and ongoing rapid heartbeat. Burning heart sensation. 3:11 am: Heartbeat began decreasing. 3:41 am: Heartbeats per second in the 2 to 2.5 range. 4 am: Heart issues subsiding, but still uncomfortable. Throbbing pain in head like someone hitting the back of head with lumber. 6:25 am: Heartbeats per second still above 2. Throbbing pain in head continues. Stabbing sensation in heart. 8:12 am: Out of bed. Issues lessening, but throbbing head pain continues. One week later 1/5/2022: Continued soreness/tightness in heart.


VAERS ID: 2010126 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33056BD / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Pt. states that after receiving the 3rd dose of Phizer 12/29/2021, started experiencing symptoms 15mins later of extreme arm pain throughout the Left arm and middle of the back. No noted Primary visit/communications. Still continuing to experience symptoms.


VAERS ID: 2010140 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-28
Onset:2021-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Inflammation, Lymphadenopathy, Ultrasound scan
SMQs:, 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: Previously described. Dose 2 of Pfizer
Other Medications:
Current Illness: Tested positive for covid on 12/17/21. Tested negative on 12/26/21
Preexisting Conditions: Chronic back and neck pain
Allergies: Penicillin and Sulfur
Diagnostic Lab Data: Back in April I received a chest x-ray and ultrasound which did not show anything.
CDC Split Type:

Write-up: Hard lump appeared on my lymph node in the clavicle region. Appeared there following my Pfizer dose 2 back on 04/15/2021. I also believe there may have been some heart inflammation. I went to the doctor back in April but did not for the lump that appeared following my booster.


VAERS ID: 2010216 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-02
Onset:2021-12-29
   Days after vaccination:271
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PEW0170 / 2 - / IM

Administered by: School       Purchased by: ?
Symptoms: Nasopharyngitis, SARS-CoV-2 test
SMQs:, 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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: Unknown
Diagnostic Lab Data: PCR test
CDC Split Type:

Write-up: cold type symptoms


VAERS ID: 2010218 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-12-28
Onset:2021-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       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:
Current Illness: none
Preexisting Conditions: Hypertension
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: tinnitus


VAERS ID: 2010235 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-12-08
Onset:2021-12-29
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / UNK - / -

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

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

Write-up: Covid positive through family contact...Booster was not 2 weeks


VAERS ID: 2010292 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-22
Onset:2021-12-29
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray normal, Condition aggravated, SARS-CoV-2 test positive, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Seizures, ETOH abuse
Allergies: unknown
Diagnostic Lab Data: 12/29/2021-SarsCOV2-positive 12/29-CXR- The lungs demonstrate no consolidation, pleural effusion or vascular congestion. No evidence of pneumothorax.
CDC Split Type:

Write-up: 12/29/2021: Event occurred after 2nd vaccine. 40-year-old male history of EtOH abuse with a history of seizures and DTs otherwise healthy presents emergency department for witnessed seizure that occurred earlier tonight. Not on any nausea or vomiting at this time. No fever or chills. No chest pain or shortness of breath. No other complaints.


VAERS ID: 2010316 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-12-29
   Days after vaccination:287
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN AD26 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Angiogram pulmonary normal, Anion gap, Appetite disorder, Aspartate aminotransferase normal, Back pain, Basophil count decreased, Basophil percentage decreased, Blood albumin decreased, Blood alkaline phosphatase normal, Blood bicarbonate normal, Blood bilirubin decreased, Blood calcium increased, Blood chloride increased, Blood creatinine normal, Blood glucose normal, Blood potassium decreased, Blood pressure increased, Blood sodium normal, Blood urea increased, Breath sounds abnormal, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chest pain, Chills, Condition aggravated, Cough, Creatinine renal clearance decreased, Diarrhoea, Differential white blood cell count abnormal, Dyspnoea, Eosinophil count decreased, Eosinophil percentage decreased, Fibrin D dimer increased, Full blood count abnormal, Glomerular filtration rate normal, Glycosylated haemoglobin normal, Haematocrit normal, Haemoglobin normal, Haemoptysis, Hypoxia, Immature granulocyte count increased, Lymphocyte count, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Metabolic function test, Monocyte count, Monocyte percentage, Myalgia, Nausea, Neutrophil count, Neutrophil percentage increased, Pain, Pain in extremity, Platelet count normal, Pneumonia, Productive cough, Protein total normal, Pyrexia, Red blood cell count normal, Red blood cell nucleated morphology, Red cell distribution width normal, SARS-CoV-2 test positive, Treatment noncompliance, Ultrasound Doppler abnormal, Vomiting, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Haematopoietic leukopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Myelodysplastic syndrome (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), Hypokalaemia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: metformin (GLUCOPHAGE) 1,000 mg tablet Take 1 Tablet (1,000 mg total) twice daily with meals by mouth, Tizanidine (ZANAFLEX) 4 mg tablet Take 1 Tablet (4 mg total) every 8 hours as needed by mouth for Muscle Spasms, atorvastatin (LIPITOR) 4
Current Illness:
Preexisting Conditions: Past Medical History: Diagnosis Date ? Arthritis ? Depression ? Diabetes mellitus ? Hyperlipidemia no meds at this time ? Hypertension ? Menopause ? Numbness and tingling weak knees ? OA (osteoarthritis) of knee 8/13/2010 ? Sleep apnea no mask/ clautrophobia ? Uterine fibroid ? Vitamin D deficiency 8/13/2010
Allergies: No known allergies
Diagnostic Lab Data: Comprehensive Metabolic Panel (CMP) [361177257] (Abnormal) Collected: 12/31/21 0721 Order Status: Completed Specimen: Blood, Venous Updated: 12/31/21 0806 Sodium Level 140 134 - 146 mmol/L Potassium Level 3.4 3.4 - 5.0 mmol/L Chloride 107 98 - 112 mmol/L HCO3 23 21 - 29 mmol/L Anion Gap 10 9 - 18 mmol/L Glucose Level 171 High 70 - 99 mg/dL Blood Urea Nitrogen 25 High 8 - 20 mg/dL Creatinine 1.00 0.50 - 1.10 mg/dL MDRD eGFR $g60 $g=60 mL/min/1.73 m2 CG eCrCl 51 mL/min/1.73 m2 Calcium Level Total 10.7 High 8.6 - 10.4 mg/dL Protein Total 7.1 6.0 - 8.0 g/dL Albumin Level 3.2 Low 3.5 - 5.0 g/dL Bilirubin Total 0.2 0.2 - 1.0 mg/dL Alkaline Phosphatase 59 35 - 104 IU/L Alanine Aminotransferase 12 10 - 40 IU/L Aspartate Aminotransferase 18 10 - 40 IU/L C Reactive Protein (CRP), Blood Level [361177258] (Abnormal) Collected: 12/31/21 0721 Order Status: Completed Specimen: Blood, Venous Updated: 12/31/21 0806 C-Reactive Protein 14.0 High <=5.0 mg/L D-Dimer [361177260] (Abnormal) Collected: 12/31/21 0718 Order Status: Completed Specimen: Blood, Venous Updated: 12/31/21 0747 D-Dimer Quant 2,290 High 0 - 500 ng/mL FEU Complete Blood Count w/Differential [361177259] (Abnormal) Collected: 12/31/21 0721 Order Status: Completed Specimen: Blood, Venous Updated: 12/31/21 0735 White Blood Cell 10.07 4.00 - 10.80 x10*3/uL Red Blood Cell 4.33 4.20 - 5.40 x10*6/uL Hemoglobin 12.0 12.0 - 16.0 g/dL Hematocrit 37.1 37.0 - 47.0 % Mean Cell Volume 85.7 80.0 - 100.0 fL Mean Cell Hemoglobin 27.7 27.0 - 33.0 pg Mean Cell Hemoglobin Concentration 32.3 32.0 - 37.0 g/dL Red Cell Diameter Width 13.7 11.0 - 16.0 % NRBC Absolute Count 0.00 0.00 - 0.01 x10*3/uL NRBC Automated 0.0 0.0 - 0.1 %WBC Platelet 256 140 - 400 x10*3/uL Mean Platelet Volume 10.1 7.4 - 11 fL Neutrophil Automated 77.2 35.0 - 80.0 % Immature Granulocyte Automated 0.6 0.0 - 0.6 % Lymphocyte Automated 16.6 Low 20.0 - 50.0 % Monocytes Automated 5.6 2.0 - 12.0 % Eosinophil Automated 0.0 0.0 - 6.0 % Basophil Automated 0.0 0.0 - 2.0 % Neutrophil Absolute Count 7.78 1.80 - 7.80 x10*3/uL Immature Granulocyte Absolute Count 0.06 High 0.00 - 0.05 x10*3/uL Lymphocyte Absolute Count 1.67 1.00 - 4.00 x10*3/uL Monocyte Absolute Count 0.56 0.00 - 0.90 x10*3/uL Eosinophil Absolute Count 0.00 0.00 - 0.50 x10*3/uL Basophil Absolute Count 0.00 0.00 - 0.20 x10*3/uL
CDC Split Type:

Write-up: Hospitalized (12.29.21 - 12.31.21); COVID-19 positive (12.29.21); Fully vaccinated - J&J x1 D/c Summary: Discharge Summary (Physician) General Medicine BRIEF OVERVIEW Admission Date: 12/29/2021 Discharge Date: Dec 31, 2021 Active Hospital Problems Diagnosis Date Noted POA ? Type 2 diabetes mellitus without complication, without long-term current use of insulin 12/29/2021 Unknown ? Essential hypertension 12/29/2021 Unknown Resolved Hospital Problems Diagnosis Date Noted Date Resolved POA ? Pneumonia due to COVID-19 virus 12/29/2021 12/31/2021 Yes There are no active non-hospital problems to display for this patient. Discharge Disposition: home or self care Active Issues Requiring Follow-up: There was possible small chronic DVT seen on her venous ultrasound. No follow up indicated at this time unless further symptoms develop. DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypoxia Pneumonia due to COVID-19 virus COVID-1 HOSPITAL COURSE: 67 y/o vaccinated female hx of DM2 and hypertension who presented with COVID 19. She was briefly hypoxic in the ER requiring oxygen via NC but weaned quickly to RA after admission. She did have some chest and arm pain with elevated D dimer so CT angio was obtained that showed no PE. She also had some calf pain so b/l lower extremity venous u/s was obtained and showed no acute DVT (possible small chronic DVT seen). No anticoagulation was indicated. She was feeling well and maintained with no further oxygen needs. She was discharged to home in stable condition. CONSULTS / RECOMMENDATION: Consult Orders (From admission, onward) None INPATIENT PROCEDURES: Surgery and Procedures None Non-surgical Procedures (From admission, onward) None BP 140/87 | Pulse 62 | Temp 36.4 ?C (Oral) | Resp 18 | Ht 1.676 m | Wt 65.8 kg | SpO2 97% | BMI 23.40 kg/m? Physical Exam Constitutional: General: She is not in acute distress. HENT: Head: Normocephalic. Eyes: Conjunctiva/sclera: Conjunctivae normal. Neck: Vascular: No JVD. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Heart sounds: Normal heart sounds. No murmur heard. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No wheezing. Abdominal: General: Bowel sounds are normal. There is no distension. Palpations: Abdomen is soft. There is no mass. Tenderness: There is no abdominal tenderness. Skin: Findings: No rash. Neurological: Mental Status: She is alert and oriented to person, place, and time. Cranial Nerves: No cranial nerve deficit. Psychiatric: Behavior: Behavior normal H&P: Admission History and Physical CHIEF COMPLAINT cough Assessment/Plan ASSESSMENT Principal Problem: Pneumonia due to COVID-19 virus Active Problems: Type 2 diabetes mellitus without complication, without long-term current use of insulin (HCC) Essential hypertension PLAN Covid pneumonia Symptom onset: 12/25 Covid + 12/29 Vaccinated 3/17 with J&J CXR: bilateral patchy lower lung pneumonia c/w Covid -19 O2 Sat 87% on ambulation in ED Decadron 6 mg PO x 10 days Daily covid labs Continuous pulse oximetry Prone as tolerated/ IS Consider remdesevir as patient willing to accept if medical team feels her condition warrants it DM type 2 Hgb A1C = 6.8 in September On metformin - HOLD 24 hour corrective insulin Monitor BG and adjust as needed, likely will need increase regimen with steroids Essential hypertension BP elevated in ED, has not taken meds in a few days Continue home amlodipine-benazapril (sub with lisinopril) HLD Continue statin (reports she is noncompliant with this) OSA Does not tolerate mask due to claustrophobia Chronic pain Home norco prn Diet: Diabetic VTE Prophylaxis: Lovenox Subq Code status: FULL Above assessment and plan discussed with Dr. whose insight is reflected above. Subjective HISTORY OF PRESENT ILLNESS Patient is a 67 y.o. female with past medical history significant for DM type 2, hypertension, and hyperlipidemia who presented to ED with cough and shortness of breath. Patient reports symptoms of fever, chills, body aches, cough and shortness of breath began on 12/25. She has also had vomiting and diarrhea and has not been able to keep medications down for the last few days. She reports a productive cough of blood-tinged sputum. She denies any chest pain, urinary symptoms, or falls at home. She is vaccinated having received 1 dose of the J&J vaccine on 3/17/21. In the ED, she was afebrile, HR 77, RR 16, BP elevated reaching 178/114, and oxygen saturation 98% on room air. She did have a desaturation to 87% while ambulating in ED. Chest x-rays showed bilateral patchy lower lung pneumonia c/w Covid -19. Labs were unremarkable. Covid testing was positive. She received albuterol inhaler, decadron 6 mg IV, and zofran in ED. She is being transferred to Blodgett Hospital for further evaluation and management. Patient Active Problem List Diagnosis ? Pneumonia due to COVID-19 virus ? Type 2 diabetes mellitus without complication, without long-term current use of insulin ? Essential hypertension REVIEW OF SYSTEMS Review of Systems Constitutional: Positive for appetite change, chills and fever. Negative for diaphoresis. HENT: Negative for sore throat and trouble swallowing. Eyes: Negative for photophobia and visual disturbance. Respiratory: Positive for cough and shortness of breath. Cardiovascular: Negative for chest pain and leg swelling. Gastrointestinal: Positive for diarrhea, nausea and vomiting. Negative for abdominal pain and constipation. Endocrine: Negative for polydipsia, polyphagia and polyuria. Genitourinary: Negative for difficulty urinating, dysuria, frequency and urgency. Musculoskeletal: Positive for back pain and myalgias. Skin: Negative for rash and wound. Neurological: Negative for dizziness, light-headedness and numbness. Hematological: Does not bruise/bleed easily. Psychiatric/Behavioral: Negative for confusion and hallucinations. Objective OBJECTIVE BP 165/98 | Pulse 78 | Temp 98.8 ?F (37.1 ?C) (Oral) | Resp 22 | Wt 68 kg (150 lb) | SpO2 97% | BMI 24.21 kg/m? Physical Exam Constitutional: General: She is not in acute distress. HENT: Head: Normocephalic. Mouth/Throat: Pharynx: Oropharynx is clear. Eyes: Pupils: Pupils are equal, round, and reactive to light. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Pulses: Normal pulses. Heart sounds: Normal heart sounds. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: No wheezing. Comments: Clear anteriorly , diminished posteriorly Abdominal: General: Bowel sounds are normal. There is no distension. Palpations: Abdomen is soft. Tenderness: There is no abdominal tenderness. Musculoskeletal: General: Normal range of motion. Right lower leg: No edema. Left lower leg: No edema. Skin: General: Skin is warm and dry. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Psychiatric: Mood and Affect: Mood normal. Behavior: Behavior normal.


VAERS ID: 2010450 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-01
Onset:2021-12-29
   Days after vaccination:331
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: + COVID


VAERS ID: 2010456 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-30
Onset:2021-12-29
   Days after vaccination:274
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 - / UN

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Back pain, COVID-19, Cardiomegaly, Chest X-ray abnormal, Chest discomfort, Fatigue, Pain, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: hypertension, obesity
Allergies: unknown
Diagnostic Lab Data: 12/29/2021: Covid positive tested externally. Not tested in HCF 12/29: The mediastinum and cardiac silhouette are within normal limits. The lungs demonstrate no consolidation, pleural effusion or vascular congestion. No evidence of pneumothorax.
CDC Split Type:

Write-up: 12/29/2021: Event occurred after 2nd vaccine. 55-year-old female with a history of hypertension, DVT presents the ED today for chest heaviness. Patient has had some chest heaviness for 2 days along with back pain, body aches, weakness and fatigue. evaluated in urgent care today at which time she tested positive for COVID-19. Was told on her chest x-ray that her heart looked "enlarged "and so she was sent to our ER for evaluation for possible CHF. Patient denies any history of CHF. Denies any lower extremity edema. She has had some chest heaviness for the last 2 days.


VAERS ID: 2010462 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-10-08
Onset:2021-12-29
   Days after vaccination:82
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: covid +


VAERS ID: 2010465 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-12-29
   Days after vaccination:265
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: + COVID


VAERS ID: 2010468 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-12-29
   Days after vaccination:264
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / UNK - / -

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

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

Write-up: COVID +


VAERS ID: 2010471 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Heart rate increased, Hot flush, Musculoskeletal chest pain, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament 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: lisinopril, caltrate
Current Illness:
Preexisting Conditions: diabetes, htn, hyperlipidemia, sleep apnea
Allergies: codeine,hydrocodone,tramadol
Diagnostic Lab Data:
CDC Split Type:

Write-up: had nausea, vomiting, rib pain for 2 days. muscle aches, hot flashes,cold chills, had an episode of elevated pulse ratefor 50 minutes. fatigue. some lasting for 4 days after


VAERS ID: 2010474 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-15
Onset:2021-12-29
   Days after vaccination:258
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / UNK - / -

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

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

Write-up: covid


VAERS ID: 2010511 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-12-01
Onset:2021-12-29
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 2 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031H21A / 3 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Atelectasis, Blood sodium decreased, Body temperature increased, COVID-19, Chest X-ray abnormal, Condition aggravated, Decreased appetite, Dyspnoea, Gait disturbance, Hyponatraemia, Hypophagia, Lung disorder, Lung opacity, Pneumonia, Respiratory tract congestion, SARS-CoV-2 test positive, Sepsis, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: benzonatate (TESSALON) 200 MG capsule dexamethasone (DECADRON) 6 MG tablet doxazosin (CARDURA) 4 MG tablet escitalopram (LEXAPRO) 5 MG tablet guaiFENesin-codeine (TUSSI-ORGANIDIN NR) 100-10 MG/5ML syrup losartan (COZAAR) 100 MG tablet metop
Current Illness:
Preexisting Conditions: OSA on CPAP HTN (hypertension) AAA (abdominal aortic aneurysm) COVID-19 Gout Hyponatremia Mild cognitive impairment Basal cell carcinoma (BCC) of head Advanced care planning/counseling discussion Current episode of major depressive disorder without prior episode
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 12/30/2021; COVID-19 positive 12/29/2021; fully vaccinated plus booster BRIEF OVERVIEW: Discharge Provider: DO Primary Care Provider at Discharge: MD Admission Date: 12/30/2021 Discharge Date: 01/03/2022 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hyponatremia [E87.1] Sepsis due to pneumonia [J18.9, A41.9] COVID-19 [U07.1] HOSPITAL COURSE: Patient is a 84 y.o. male who presents today with progressive symptoms of shortness of breath, congestion, poor appetite and poor intake, general weakness for the past 4-5 days. He tested positive for COVID 19 on December 29th. Today he was set up for monoclonal antibody therapy which he completed but following this was sent to the ED for further evaluation. Patient lives alone at senior living apartment. He admits he has not been eating due to poor appetite and feels weak to walk. Denies any falls. Does not use walker or cane at baseline. Today his pulse ox reading was 92% so he was sent to the ED for evaluation. He was noted on arrival to the ED to have temp38.1 and HR 124. He was 90-92% on room air. His significant lab findings include sodium 126. In the emergency department he was given Tylenol, 2.5 mg Haldol, 2 L IV fluid. His chest x-ray showed linear opacity in the left lung base represented atelectasis versus airspace disease but no new focal lung consolidation. Patient vent uncomfortable returning to his living facility due to his generalized weakness so opted for observation admission to General Medicine and ongoing care. Hospital course: Patient was admitted for acute hyponatremia, this improved with IVF. Patient did not complain of shortness of breath immediately after admission and was on room air throughout his stay. WBC was elevated but stable, likely due to steroids. He admitted to increased weakness for which PT/OT was consulted. PT/OT recommended home with assist. Patient felt strong enough for discharge and while lives alone, reported he has help he can call. Outpatient PT was arranged. Patient was discharged to home in improving condition on 1/1/22. He may continue Decadron that was previously prescribed.


VAERS ID: 2010515 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-12-07
Onset:2021-12-29
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33030DD / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, COVID-19, Cough, Fatigue, Influenza virus test negative, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Streptococcus test negative, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine; Amoxicillin
Current Illness: N/A
Preexisting Conditions: Low thyroid
Allergies: Nitrofurantoin
Diagnostic Lab Data: Covid-19 test; Flu; Strep.
CDC Split Type: vsafe

Write-up: I had cough, running nose, mild fever, fatigue, joint pain, and vomiting a lot. I have an ongoing cough. On Dec 30th I got tested for Covid-19, positive result. They did a flu and strep test, negative results.


VAERS ID: 2010590 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-12-28
Onset:2021-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Deep vein thrombosis, Injection site pain, Injection site swelling, Pain in extremity, Ultrasound scan
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Jardiance, Flexeril
Current Illness: None
Preexisting Conditions: Diabetes, Obesity
Allergies: Naproxen, Pencillin
Diagnostic Lab Data: Ultrasound of left upper extremity with doppler
CDC Split Type:

Write-up: Aching in left upper arm and shoulder within 6 hours, development of swelling after 4 days, diagnosed with left upper extremity proximal DVT day 8 after vaccine.


VAERS ID: 2010642 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-18
Onset:2021-12-29
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Pain, Pruritus, Pyrexia, Serum sickness, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: finasteride 1mg daily, pantoprazole 40mg BID
Current Illness: Had an EGD for dysphagia 12/3/2021, at which time he''d received: Fentanyl IV mcg: 150 MCG, Versed IV mg: 8 MG, Benadryl IV mg: 50 MG
Preexisting Conditions: dysphagia, GERD. HX of eosinophilic esophagitis December 2020, none seen December 2021 on EGD grossly or via path samples.
Allergies: None
Diagnostic Lab Data: Clinically diagnosed by video and patient submitted photos.
CDC Split Type:

Write-up: serum sickness - diffuse urticaria (pt states 80% of his body), arthralgias of bil hands, wrists, knees, neck, shoulder. fever 100 Symptoms started 12/29/21 Treatment: Zyrtec, Aleve, benadryl at home, 1/1/2022 - Rx prednisone and triamcinolone. Within a few hours of starting prednisone, pain/swelling, itching subsided.


VAERS ID: 2010650 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-12-27
Onset:2021-12-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855191 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diclofenac Atorvastin Sertraline Folic acid Triamcinalone Trazadone
Current Illness: Unknown
Preexisting Conditions: PTSD Depression Insomnia
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Rash at site of injection two days after injection. Client took OTC benedryl that resolved local rash, but came back a couple of days later. He has reached out to his primary care for help with symptoms.


VAERS ID: 2010674 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330258D / 3 LA / IM

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

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

Write-up: Patient''s daughter, reported her arm is still significantly sore today after more than a week since vaccination. Recommend patient sees a doctor.


VAERS ID: 2010750 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-25
Onset:2021-12-29
   Days after vaccination:279
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: SARS-COV-2 RNA, NAAT positive on 12/30/2021
CDC Split Type:

Write-up: developed covid symptoms


VAERS ID: 2010803 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-12-27
Onset:2021-12-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / 3 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol 200mg. Losartan 100mg sertraline 50mg
Current Illness:
Preexisting Conditions: High blood pressure, sinus tachycardia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shingles


VAERS ID: 2010859 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-12-15
Onset:2021-12-29
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 069H21A / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Hypersensitivity, Pruritus, Rash erythematous, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Began getting a red-colored rash and hives on all parts of my body after the third (booster) shot. I had no side effects from the first two shots. They start out as red lines and then expanded in size as time went on. The largest areas are about the size of a dinner plate. The main places I am getting these rashes are chest, back and shoulders (where they are the largest). I am also getting the rashes on my arms, hands, feet and legs. I went to a pharmacy. They instructed me to take Benadryl pills and cream. The pharmacist thought it looked like an allergic reaction. So I took the Benadryl. It cleared up completely most of the time, but returns approximately four to six hours the time the pill states it works for. I waited approximately three days to see if it would get better but it did not. I contacted my doctor to book an emergency office visit. I booked the visit for the same day which was 01/05/2022. The doctor inspected the rash and checked all of my vitals. His conclusion was he also suspects that it is an allergic reaction that could be connected to the booster shot. I have not changed any items in my life like diet, soaps or detergents. The doctor recommended the continued use of the allergy medication for approximately two weeks to see if the rashes continue. If they continue, I am to contact my doctor. He will have me return to his office for further testing. Towards the end of the medications cycle, I can feel that it is beginning to return. The rash mainly fells like a bug bite in the sense that it begins to get itchy. I don''t feel sick, but have felt a little run down since I received the booster shot. I had the same felling after the first two shots but it only lasted a day or two.


VAERS ID: 2011043 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-05
Onset:2021-12-29
   Days after vaccination:238
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None listed
Current Illness:
Preexisting Conditions: No pertinent past medical history per MD note
Allergies: Penicillins
Diagnostic Lab Data: 12/29/21 COVID-19 Result Detected Abnormal
CDC Split Type:

Write-up: 12/29/21 Patient is a 24-year-old female who presents to the ER with fever and cough. Patient is vaccinated for COVID-19. She has not been boosted. Patient reports that starting yesterday she began having fever and cough. She states that her fever made it up to 103.0 ?F. She reports that her fever and cough have continuously worsened. Patient states that nothing makes her symptoms better or worse. Patient took Tylenol this morning with symptom relief for short period of time. Patient does not report any pain. She states she has taken at home test which was positive for COVID-19 and wants a hospital COVID-19 test. 12/29/21 Review of Systems Constitutional: Positive for fever. Negative for chills. HENT: Negative for neck pain and neck stiffness. Eyes: Negative for visual disturbance. Respiratory: Positive for cough. Negative for chest tightness, shortness of breath and wheezing. Gastrointestinal: Negative for abdominal pain, diarrhea, nausea and vomiting. Genitourinary: Negative for dysuria and flank pain. Musculoskeletal: Negative for myalgias, back pain and arthralgias. Neurological: Negative for dizziness, light-headedness and headaches.


VAERS ID: 2011223 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-28
Onset:2021-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Bacterial test, Blood culture negative, Blood lactic acid, COVID-19, CSF culture negative, CSF glucose normal, CSF lymphocyte count normal, CSF monocyte count decreased, CSF oligoclonal band absent, CSF protein normal, CSF red blood cell count positive, CSF white blood cell count increased, Cryptococcus test, Decreased appetite, Electroencephalogram normal, Enterovirus test, Full blood count, Gram stain positive, Haematocrit normal, Haemoglobin normal, Headache, Herpes simplex test negative, Influenza A virus test negative, Influenza B virus test, Listeria test, Lumbar puncture, Meningitis aseptic, Musculoskeletal stiffness, Nitrite urine absent, Platelet count normal, Pyrexia, Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Streptococcus test, Urine analysis normal, Urine leukocyte esterase, Vomiting, White blood cell count normal, White blood cells urine negative
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Symbicort, Zyrtec
Current Illness:
Preexisting Conditions: Asthma, eczema, multiple food allergies
Allergies: Eggs, shellfish, peanut butter, wheat
Diagnostic Lab Data: CSF (01/02/2022): Culture no growth; Gram stain polymorphonuclear leukocytes; Cell count WBCs 116, RBCs 3, Polys 20, Bands 0, Lymphs 65, Monos 13; Protein 39.8; Glucose 68 BioFire Meningitis-Encephalitis PCR Panel (01/02/2022): Negative for: E. Coli; Haemophilus Influenza; Listeria; Neisseria meningitidis; Streptococcus agalactiae; Streptococcus pneumoniae; CMV; Enterovirus; HSV-1; HSV-2; HHV-6; Parechovirus; VZV; Cryptococcus Complete Blood Count (01/02/2022): WBCs 9.24, Hb 12.6, Hct 38.7, Plts 294 Blood Culture (01/02/2022): No growth to date Lactic Acid (01/02/2022): 2.3 Cepheid (01/02/2022): SARS-CoV-2 PCR positive (cycle count 27.3); Influenza A/B negative, RSV negative Urinalysis (01/02/2022): Negative for WBCs, nitrite, leukocyte esterase, bacteria
CDC Split Type:

Write-up: Pt received the COVID-19 vaccine on 12/28/2021. The next day, she developed fever, vomiting, and poor appetite. After 3 days of these symptoms, she also developed headache and weakness. She was brought to a local Hospital where a spinal tap showed evidence of aseptic meningitis, and was started on IV Vancomycin, Ceftriaxone, and Acyclovir. She was also found to have COVID-19 infection. 1 day later, she developed an episode of stiffening and eye blinking concerning for seizure for which she received Keppra and Phenytoin, prior to transfer to another Hospital for video EEG (later negative). Over the following 3 days, her mental status and hydration status improved, and she returned back to baseline.


VAERS ID: 2011255 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-12-27
Onset:2021-12-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast mass, Breast pain, Breast tenderness, Cellulitis, Lymphadenitis, Screaming, Skin discolouration
SMQs:, Hostility/aggression (broad), Lipodystrophy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: No tests. Was given an antibiotic and predesone. I also, am applying an anti bacterial cream to the infected area. I have to keep gauze between the underside of my breast and chest.
CDC Split Type:

Write-up: First of all I decided to get the booster because I had an antibodies test and barley had any, only 7 months later after my 2nd shot. After receiving the booster, I started to have pain in my right breast, same side as injected arm. I looked it up and said this is a side affect due to swollen lymph nodes. After a week the pain got worse and I discovered that I had a red and purple ball under the breast, which was starting to spread to the nipple area. When I touched this area, I literally screamed in pain. I went to see my doctor. I was diagnosed with cellulitis. Most commonly, it occurs in areas that may have been damaged or are inflamed. Seeing that my lymph nodes were inflamed, this makes sense. If this does not get better in a few days than I have to see him again. Cellulitis can be a serious condition, however, remains to be seen what my outcome will be.


VAERS ID: 2012961 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3197 / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Acupuncture, Arthralgia, Fatigue, Headache, Impaired work ability, Massage
SMQs:, Arthritis (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: Fatigue, headaches from second Covid dose, age 47, vaccination date 4/9/2021 in right arm, Pfizer vaccine lot ER8733
Other Medications: SCDophilus 10+ probiotic (from GI Pro Health); Betaine HCL Pepsin (Pure Encapsulations); CoQ10 Ubiquinol 200mg (Bluebonnet); Liquid Vitamin D3 (Ortho Molecular Products); Quercetin Phytosome (Thorne); Algae Omega (Nordic Naturals); Sodium B
Current Illness: None
Preexisting Conditions: Benign neoplasm of liver
Allergies: Penicillin, Tramodol, Wheat, dairy, yeast, apples, mushrooms, celery
Diagnostic Lab Data:
CDC Split Type:

Write-up: Joint pain 12/29/2021-1/1/2022, rest and sleep, Advil Headache not staying in any one place 12/30/2021, 1/2/2022, 1/5/2022, rest, sleep, Advil Headache not staying in any one place, mostly in front near eyebrows and forehead, 1/3/2021-1/4/2022, Acupuncture helped a lot Fatigue, ongoing for days, 12/29/2022-1/6/2022, staying home from work, resting as needed (I experienced fatigue for more than two months after my second Covid shot on 4/9/2021, Acupuncture and massage, and time off work helped)


VAERS ID: 2012975 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3594 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Balance disorder, Cough, Decreased appetite, Discomfort, Dizziness, Fatigue, Headache, Myalgia, Nausea, Pain, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, Vitamin D, Zinc, Colace (as needed), Prenatal Vitamin, Melatonin (new started nightly 12/21/2021), Albuterol (as needed)
Current Illness: None. Recovering from Covid-19 (July 2021) illness and recovering from worsened symptoms from 1st Pfizer Vaccine dose.
Preexisting Conditions: None
Allergies: Clindamycin (c. difficile) and clotrimazole (chest rash)
Diagnostic Lab Data: Provider notified. No appt or tests were ordered.
CDC Split Type:

Write-up: Approximately 6 hours after the vaccine injection, symptoms began and then progressed over the next 24 hours: extreme fatigue, headache, body pain (muscles/joints), specifically aching/uncomfortable feelings in my left breast, left arm pit, left side of abdomen and left buttocks, cough (dry/tight), nausea and abdominal cramps, poor appetite, heart palpitations, dizziness, poor balance, achiness behind sternum. 8 days later some symptoms have lessened the following continues: Fatigue is still present, cough (dry/tight), left breast/chest achiness, dull ache behind sternum, mild heart palpitations, occasional nausea and occasional headache.


VAERS ID: 2014040 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-12-20
Onset:2021-12-29
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7218 / 3 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Accessory spleen, Acute respiratory failure, Alanine aminotransferase increased, Angiogram pulmonary abnormal, Arteriosclerosis coronary artery, Aspartate aminotransferase increased, Blood culture negative, COVID-19, COVID-19 pneumonia, Chills, Cough, Culture urine positive, Diarrhoea, Dyspnoea, Dysuria, Escherichia test positive, Exposure to SARS-CoV-2, Fatigue, Fibrin D dimer increased, Hypoxia, Intervertebral disc protrusion, Lung opacity, Micturition urgency, Nasal congestion, Oropharyngeal pain, Pollakiuria, Procalcitonin increased, Scan with contrast, Ultrasound Doppler normal, Urinary tract infection, Urine analysis abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Congenital, familial and genetic disorders (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler ALPRAZolam (XANAX) 0.5 MG tablet Ascorbic Acid (VITAMIN C) 500 MG tablet aspirin 81 MG tablet Calcium Carbonate-Vit D-Min (CALTRATE 600+D PLUS PO) choleca
Current Illness: Anxiety - 11/17/2021
Preexisting Conditions: Lumbar stenosis Fatigue Mixed anxiety and depressive disorder Migraine OSA (obstructive sleep apnea) Pelvic pressure in female Mixed incontinence urge and stress (male)(female) Essential hypertension OAB (overactive bladder) Gastroesophageal reflux disease with esophagitis Age-related osteoporosis without current pathological fracture Chronic renal insufficiency, stage III (moderate) Septic shock
Allergies: Duragesic Disc Transdermal System Environmental Lexapro Morphine Sertraline Zoloft
Diagnostic Lab Data: USV Venous Lower Extremity Duplex Bilateral [362101418] Resulted: 01/05/22 1609 Order Status: Completed Updated: 01/05/22 1611 Narrative: EXAMINATION: Complete Right and Left Lower Extremity Venous Duplex Doppler Ultrasound EXAM DATE: 1/5/2022 4:04 PM TECHNIQUE: Real-time B-mode imaging with and without compression was used to evaluate the right and left lower extremity for deep venous thrombosis (DVT). Duplex Doppler with color and spectral Doppler was used. INDICATION: Covid with elevated D-dimer COMPARISON: None _____________________ Right Lower Extremity Findings: Right Common Femoral Vein: No DVT. Right Femoral Vein: No DVT. Right Popliteal Vein: No DVT. Right Posterior Tibial Veins: No DVT. Right Peroneal Veins: No DVT. Right proximal Greater Saphenous Vein: No thrombus. Left Lower Extremity Findings: Left Common Femoral Vein: No DVT. Left Femoral Vein: No DVT. Left Popliteal Vein: No DVT. Left Posterior Tibial Veins: No DVT. Left Peroneal Veins: No DVT. Left proximal Greater Saphenous Vein: No thrombus. Duplex Doppler: Spectral Doppler demonstrates bilateral normal respirophasic waveforms in the common femoral veins. Additional Findings: None. _____________________ Impression: There is no deep venous thrombosis in the visualized deep veins of the right or left lower extremity. CT ANGIO THORAX WITH IV CONTRAST [362018135] Resulted: 01/04/22 1605 Order Status: Completed Updated: 01/04/22 1607 Narrative: EXAMINATION: CT Angiography of the Thorax EXAM DATE: 1/4/2022 3:11 PM TECHNIQUE: Standard protocol CT angiogram images were obtained through the chest following the administration of intravenous contrast. Coronal and axial MIP 3-D reformations were performed. IV Contrast: The amount and type of contrast are recorded in the medical record. QPP DOCUMENTATION: At least one of the following dose reduction techniques was utilized: Iterative reconstruction, and/or Automatic Exposure Control, and/or mA/kV adjustment based on body size. INDICATION: PE suspected, low/intermediate prob, positive D-dimer COMPARISON: CTs between 10/15/2011 and 9/4/2020 ENCOUNTER: Not applicable ____________________ CHEST FINDINGS: Base of Neck & Axillae: There is no adenopathy. Mediastinum & Hila: There is no mediastinal or hilar adenopathy. Cardiovascular: The heart has a normal size and atherosclerotic plaque is present on the coronary arteries. There is no pericardial effusion. The thoracic aorta is normal in caliber. Pulmonary Arteries: No pulmonary embolism is present. Lungs and Airways: There are bilateral groundglass opacities involving portions of all lobes. Pleural Space: There are no pleural effusions. There is no pneumothorax. Upper Abdomen: There is a small accessory spleen. Chest Wall & Musculoskeletal: There is a large L1 Schmorl''s node. There are no concerning osseous or soft tissue lesions. ____________________ Impression: 1. No evidence of an acute pulmonary embolism. 2. Bilateral pulmonary opacities are consistent with COVID-19 pneumonia in this COVID-19 positive patient. Peripheral Blood Culture [362101086] Collected: 01/04/22 2051 Order Status: Completed Specimen: Blood, Venous Updated: 01/06/22 2202 Cult Blood Peripheral No Growth 48 hours Peripheral Blood Culture [362101087] Collected: 01/04/22 2052 Order Status: Completed Specimen: Blood, Venous Updated: 01/06/22 2202 Cult Blood Peripheral
CDC Split Type:

Write-up: Patient was seen in the ED 12/29/21 and discharged with COVID-19. Patient returned for care 1/1/22 and discharged for COVID 19. Patient was admitted on 1/4/22 for acute respiratory failure and still hospitalized. Pt. is a 83 y.o. female with a past medical history of mixed anxiety and depressive disorder, migraines, obstructive sleep apnea, mixed urge and stress incontinence, hypertension, GERD, CKD stage 3 who presented to the emergency department due to worsening of shortness of breath and cough. Patient started experiencing nasal congestion sore throat and cough along with shortness of breadth 1 week ago after she had an exposure from a family member. She also has been experiencing diarrhea along with urinary urgency frequency and dysuria that started few days ago. She was prescribed Ceftin for urinary tract infection but she was not able to pick up the prescription and eventually only took 1 dose of antibiotic prior to this presentation for her urinary tract infection. Patient continues to have rigors chills fatigue. In the emergency department patient was hemodynamically stable. Due to hypoxia was placed on 2 L of oxygen. AST and ALT were elevated at 80 and 41. Procalcitonin was high at 3.29. UA positive for urinary tract infection. Cultures consistent with E coli due to elevated D-dimer patient also underwent CT angiogram which was negative for PE. Patient was started on Decadron in the emergency department due to concern for acute hypoxic respiratory failure secondary to COVID and admitted for further management of COVID pneumonia and urinary tract infection.


VAERS ID: 2014141 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-12-10
Onset:2021-12-29
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8762 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Facial pain, Headache, Inflammation, Trigeminal nerve disorder, X-ray
SMQs:, Glaucoma (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: Topamax Prilosec Ultram Aldactone xyzal Regland tylenol advil
Current Illness: none
Preexisting Conditions: Obesity
Allergies: codeine
Diagnostic Lab Data: Blood work; XRAY.
CDC Split Type: vsafe

Write-up: This is an ongoing conditions that your originally reported having on all doses. It is an inflammatory condition of symptoms that occurs with each dose. I experienced head/facial-side of head pain which was diagnosed by my dental provider as trigeminal nerve. It included high inflammation of head and face. I do feel better and do believe that I am fully recovered.


VAERS ID: 2014259 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-18
Onset:2021-12-29
   Days after vaccination:314
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, Bradycardia, C-reactive protein normal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Fibrin D dimer, Hypotension, Pneumonia, Pulmonary congestion, Pulmonary oedema, SARS-CoV-2 test positive, Weight decreased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet amoxicillin (AMOXIL) 500 MG capsule dexamethasone (DECADRON) 6 MG tablet diphenhydramine-acetaminophen (TYLENOL PM EXTRA STRENGTH) 25-500 MG TABS empagliflozin (JARDIANCE) 25 MG tablet gabapentin (NEUR
Current Illness:
Preexisting Conditions: Obstructive sleep apnea (adult) NSTEMI 2012 Arteriosclerosis of coronary artery vein bypass graft Mitral regurgitation Hypertension Atrial fibrillation (HCC) Chronic systolic congestive heart failure (HCC) Pulmonary embolism (HCC) Coronary artery disease Seizures (HCC) Hyperlipidemia S/P CABG x 2 2009 S/P mitral valve repair 2009 Generalized weakness
Allergies: Lipitor Metformin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 12/29/2021; COVID-19 positive 12/29/2021; fully vaccinated BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: , MD Admission Date: 12/29/2021 Discharge Date: Jan 6, 2022 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypoxia Generalized weakness COVID-19 HOSPITAL COURSE: Patient is an 81-year-old man with history of coronary artery disease, CABG, pulmonary embolism, atrial fibrillation, seizure, type 2 diabetes, diastolic congestive heart failure. Patient presents to the hospital secondary to weakness. He is identified to have COVID-19. He had a similar hospitalization in November with weakness requiring a subacute rehab stay, and he did improve following that rehabilitation stint. In the emergency department he is found to have hypotension, he received 2 L of fluids, he was also noted to have O2 saturations of 88% requiring 2 L of oxygen. COVID-19 PCR tested positive. Chest x-ray revealed moderate pulmonary vascular congestion and suspicious alveolar edema versus superimposed pneumonia. He was admitted to the general medicine service for further workup and management. Patient was suspected to have COVID-19 pneumonia with acute hypoxemic respiratory failure, with possible superimposed pulmonary edema. He was placed on dexamethasone 6 mg daily. He completed 5 days of remdesivir. His CRP normalized and his D-dimer was negative. His acute hypoxemic respiratory failure resolved, and was doing well on room air. In regards to his chronic heart failure with preserved ejection fraction, it did not seem that he was decompensated on presentation. His weight was stable from his last cardiology appointment. He was resumed on torsemide, and weight decreased to 93.5 kg. Torsemide was adjusted to attempt to avoid over-diuresis. Patient did tolerate this well, and his discharge weight is 94.2 kg and discharge torsemide dose is 30 mg. He was noted to have some resting bradycardia, his metoprolol XL was decreased to 75 mg daily. Patient was seen in consultation with PT and OT, and subacute rehabilitation was recommended. Discharge was delayed due to transportation issues on 1/5 with plans for discharge today at 1/6. No issues overnight. Patient continues to remain in stable condition on room air with no abnormal vitals signs. Patient is comfortable with plan for discharge to facility.


VAERS ID: 2014301 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-23
Onset:2021-12-29
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Muscle twitching, Pain in extremity
SMQs:, Dyskinesia (broad), Dystonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 0
Current Illness: 0
Preexisting Conditions: 0
Allergies: 0
Diagnostic Lab Data:
CDC Split Type:

Write-up: Since vaccination has had pain in shoulder, down arm and twitching in tricep


VAERS ID: 2014303 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-12-17
Onset:2021-12-29
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030HZ1B / 3 RA / SYR

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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lozartan 100mg
Current Illness: HBP under medical control
Preexisting Conditions: HBP under medical control
Allergies: Not known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Generalized severe urticaria - upper body mainly


VAERS ID: 2014392 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-20
Onset:2021-12-29
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Bladder catheterisation, COVID-19, Caesarean section, Haemoglobin decreased, Hysterotomy, Postpartum haemorrhage, SARS-CoV-2 test positive
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet aspirin 81 MG enteric coated tablet benzocaine-menthol (CEPACOL) 15-3.6 MG LOZG docusate (COLACE) 100 MG capsule enoxaparin Sodium (LOVENOX) 40 MG/0.4ML injection famotidine (PEPCID) 20 MG tablet ferrou
Current Illness:
Preexisting Conditions: Digestive Maternal obesity affecting pregnancy, antepartum Infectious/Inflammatory COVID-19 affecting pregnancy in third trimester Genitourinary Unwanted fertility Endocrine/Metabolic Abnormal maternal glucose tolerance, antepartum Other History of cesarean delivery Language barrier AMA (advanced maternal age) multigravida 35+ Former smoker History of depression
Allergies: No Known Allergies
Diagnostic Lab Data: Collected: 12/31/21 0913 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 12/31/21 1156 COVID-19 PCR Detected
CDC Split Type:

Write-up: Patient is a 41 y.o. female who presented for a scheduled repeat cesarean section. Patient had completed childbearing and desired permanent sterilization via cesarean section. Her pregnancy was additionally complicated by history of two prior cesarean sections, advanced maternal age, obesity with BMI 38 and recent diagnosis of COVID-19 on POD 2. Surgery was complicated by postpartum hemorrhage due to bleeding from hysterotomy. EBL was 1700 ml and patient received 1g TXA intraoperatively. Hemoglobin post-op was 9.0 compared to 12.0 prior to surgery. Patient remained asymptomatic for anemia. She met postpartum milestones and was discharged home in stable condition on post-operative day #3. PO Iron supplement prescribed upon discharge. She is to follow up with her OB in 6 weeks for a postpartum visit. Postpartum depression screening: Edinburgh Edinburgh Postnatal Depression Scale Total: 10 The patient was taken to the operating room, where spinal anesthesia was obtained without difficulty. She was placed in a dorsal, supine position with a leftward tilt. A Foley catheter was sterilely inserted and SCDs were placed on her lower legs bilaterally. She was then prepped and draped in the normal sterile fashion. Anesthesia was tested and determined to be adequate. A low transverse skin incision was made with a scalpel and carried through to the underlying layer of the fascia. The fascia was scored on each side of the linea alba with the underlying rectus muscle visualized. The fascial incision was then extended bilaterally with Mayo scissors. The cephalad aspect of the fascial incision was grasped with the Kocher clamps, elevated and the rectus muscles dissected off sharply and bluntly. Similarly, the caudal aspect of the fascial incision was grasped with Kocher clamps, elevated and the rectus muscles were dissected off sharply and bluntly. The rectus muscles were separated in the midline. The peritoneum was identified and entered bluntly. The peritoneal window was extended using blunt countertraction, avoiding the bladder. The DeLee retractor was inserted and the vesicouterine peritoneum identified. The Alexis retractor was inserted and the lower uterine segment was identified. Bladder was adhered to lower uterine segment, so mid-transverse incision was made on uterus. Brisk bleeding was noted on entry into uterus due to large vessels. The incision was extended bluntly. The infant was in a cephalic presentation. The infant?s head was delivered atraumatically with fundal pressure from the first assistant. The remainder of the infant was easily delivered. The infant was vigorous at birth. Cord clamping was delayed for 60 seconds and then the umbilical cord was clamped with two clamps and cut. The infant was handed off to the awaiting nurses at the warmer. Mixed cord blood was obtained. The placenta was removed spontaneously and the uterus cleared of all clots and debris. The uterus was exteriorized. The uterine incision was repaired with 0 Monocryl in a running stitch in a single layer. Brisk bleeding was noted during hysterotomy closure due to large sinuses near hysterotomy. A second 0 Monocryl was used in running fashion along the right side of the hysterotomy due to venous sinus bleeding. 1g TXA IV was given intraoperatively. Excellent hemostasis was obtained after hysterotomy closure. The tubal ligation was then performed. The left tube was identified and followed out to the fimbriated edge. The tube was grasped with a Percy clamp, elevated, and a 1 cm portion of the tube was suture ligated with 0 Plain x 2. The tube was excised. The tube ends were inspected and were hemostatic. Attention was then turned to the right tube, the tube was followed out to the fimbriated edge. The tubal was done in the same manner as the other side. Each tube was inspected and was hemostatic. The uterus was replaced into the abdomen. The bladder was backfilled using methylene blue, 90cc, to evaluate for injury. No leakage or evidence of injury was noted. The gutters were cleared of all clots and debris. The peritoneum and rectus muscles were inspected and found to be hemostatic. The fascia was reapproximated using 0 PDS in a running stitch from each corner. The subcutaneous layer was irrigated and reapproximated using 3-0 Vicryl in running fashion. The skin was reapproximated using 3-0 STRATA FIX suture. Skin glue was applied. The patient tolerated the procedure well. Sponge, lap and needle counts correct x2. The patient received 2 g of Ancef prior to beginning of the procedure. The patient was transferred to the recovery room in stable condition.


VAERS ID: 2014416 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-12-28
Onset:2021-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013H2113 / UNK LA / IM

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

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

Write-up: headache,severe fatigue,cough, fever, unable to get out of bed.


VAERS ID: 2014425 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-07
Onset:2021-12-29
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood albumin decreased, Blood bilirubin increased, Blood glucose normal, COVID-19, Cerebrovascular accident, Chest X-ray abnormal, Chronic obstructive pulmonary disease, Computerised tomogram thorax abnormal, Condition aggravated, Differential white blood cell count abnormal, Dyspnoea, Dyspnoea exertional, Fibrin D dimer increased, Full blood count abnormal, Granulocyte percentage, Haematocrit decreased, Haemoglobin decreased, Hypoxia, Immature granulocyte count increased, Ischaemic stroke, Lung opacity, Lymphocyte percentage decreased, Metabolic function test abnormal, Neutrophil count increased, Neutrophil percentage increased, Procalcitonin, Productive cough, Prohormone brain natriuretic peptide, Pulmonary fibrosis, Pulmonary mass, Red blood cell count decreased, SARS-CoV-2 test positive, White blood cell count increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), 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), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Myelodysplastic syndrome (broad), Respiratory failure (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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL 8 HOUR) 650 MG extended release tablet albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler alendronate (FOSAMAX) 70 MG tablet ALPHAGAN P 0.1 % SOLN Artificial Tear Solution (TEARS AGA
Current Illness:
Preexisting Conditions: Respiratory Other emphysema Lung nodules/masses RUL, noted June 2017 COPD with acute exacerbation Circulatory HTN (hypertension) History of ischemic left MCA stroke History of ischemic multifocal multiple vascular territories stroke Nervous Glaucoma Rib pain Thoracic back pain Intractable chronic post-traumatic headache Genitourinary Enlarged prostate Prostatism Benign prostatic hyperplasia without lower urinary tract symptoms Endocrine/Metabolic Other specified hypothyroidism Impaired fasting glucose Immune Psoriasis Other Pes planus (flat feet) Tobacco abuse, approximately 50 pack years Depression Anxiety Amputation of toe of right foot Amputation of toe of left foot Other osteoporosis without current pathological fracture Abnormal CT scan, lung
Allergies: No known allergies
Diagnostic Lab Data: COMPLETE BLOOD COUNT (CBC) W/DIFFERENTIAL - Abnormal; Notable for the following components: White Blood Cell 18.72 (*) 4.00 - 10.80 x10*3/uL Final Red Blood Cell 4.00 (*) 4.60 - 6.00 x10*6/uL Final Hemoglobin 13.2 (*) 14.0 - 18.0 g/dL Final Hematocrit 39.7 (*) 42.0 - 52.0 % Final Neutrophil Automated 89.9 (*) 35.0 - 80.0 % Final Immature Granulocyte Automated 0.9 (*) 0.0 - 0.6 % Final Lymphocyte Automated 6.0 (*) 20.0 - 50.0 % Final Neutrophil Absolute Count 16.83 (*) 1.80 - 7.80 x10*3/uL Final Immature Granulocyte Absolute Count 0.16 (*) 0.00 - 0.05 x10*3/uL Final All other components within normal limits COMPREHENSIVE METABOLIC PANEL - Abnormal; Notable for the following components: Glucose Level 129 (*) 70 - 99 mg/dL Final Albumin Level 3.2 (*) 3.5 - 5.0 g/dL Final Bilirubin Total 1.1 (*) 0.2 - 1.0 mg/dL Final All other components within normal limits D-DIMER,QUANTITATIVE - Abnormal; Notable for the following components: D-Dimer Quant 540 (*) 0 - 500 ng/mL FEU Final All other components within normal limits PRO B NATRIURETIC PEPTIDE BLOOD LVL - Normal PROCALCITONIN Imaging: DR CHEST 2 VIEWS FRONTAL AND LATERAL Final Result 1. COPD. 2. Nodular opacity near the right costophrenic angle likely corresponds to findings seen on chest CT of 11/28/2021. 3. Parenchymal scarring most prominent in the medial right upper lobe. 4. No definite evidence of acute cardiopulmonary disease.
CDC Split Type:

Write-up: This is a 58-year-old male with a past medical history of chronic obstructive pulmonary disease and recent CVA this past November, that presents to the emergency room by way of EMS with complaints of cough and shortness of breath. The patient states that symptoms started yesterday. He describes his cough as being productive. The patient is legally blind and cannot describe to sputum. He states that shortness of breath usually occurs with exertional activity including wall walking around. The patient denies any chest pain, abdominal discomfort, nausea, vomiting, diarrhea or urinary symptoms such as dysuria, hematuria or increased/decreased urinary frequency. He denies any dizziness or lightheadedness. Again the patient is legally blind and has visual disturbance including blurry vision secondary to this. He states that this does not feel like his normal chronic obstructive pulmonary disease exacerbation. The patient''s family has tested positive for COVID within the last 90 days, but he himself has had no known exposure as family members did self isolate during the normal quarantine time. He is vaccinated against COVID-19. Ultimately, the patient comes to the emergency department for evaluation and care. Patient is a 58 year old male with a history of left sided multifocal ischemic stroke at the end of November and returned home on December 10, COPD, legally blind, congenital glaucoma, hypothyroid, hypertension, and a lung mass suspected to be cancer who presented to the ER with complaints of worsening shortness of breath and cough over the last 24 hours. He denied fever, chills, loss of taste or smell, nausea, vomiting, diarrhea, headaches, body aches, or falls. While in the ER he was put on 2 liters of oxygen and he maintained oxygen saturations in the mid 90s. Lab work showed an elevated WBC at 18.72, elevated blood glucose at 129, and the patient tested Covid positive. His chest xray confirmed COPD, a nodular opacity near the right costophrenic angle as per previous CT, and parenchymal scarring, though no acute disease. The patient was transferred and admitted observation in hospital with COPD exacerbation, hypoxia and Covid for further monitoring and treatment. He was weaned to room air on arrival to the inpatient; the monoclonal antibody team was contacted as he is a potential candidate for therapy. The patient received one dose of remdesivir and then qualified for monoclonal antibodies which was given on 12/30. He did not require supplemental oxygen while inpatient though he did have episodes of shortness of breath that resolved with time or inhalers. The patient states he has a nebulizer and duoneb solution at home that he normally uses 4 times per day. He also has a walker. He understands that he is to be following up with oncology regarding the CT results from his previous admission. A walking oxygen saturation test was completed and he did not need supplemental oxygen. The patient is being discharged in stable condition on room air to complete a course of azithromycin and steroid taper for COPD exacerbation. Active Issues Requiring Follow-up 12/10/21 CT that identified new lung mass


VAERS ID: 2014447 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-12-01
Onset:2021-12-29
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Gait inability, Magnetic resonance imaging, Pain, Ultrasound scan
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood work, MRI, CT, US
CDC Split Type:

Write-up: Not able to walk. Severe pain and it continues


VAERS ID: 2014720 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-10-25
Onset:2021-12-29
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 3 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PCR positive 12/29/21
CDC Split Type:

Write-up: Breakthrough COVID-19


VAERS ID: 2014813 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-25
Onset:2021-12-29
   Days after vaccination:307
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PCR + 12/29/21
CDC Split Type:

Write-up: Breakthrough COVID-19


VAERS ID: 2014908 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-12-28
Onset:2021-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza
Other Medications: Amlodipine, pre a satin, cymbalta, Wellbutrin, claritin
Current Illness: None
Preexisting Conditions: Hypertension Depression Seasonal allergies
Allergies: Latex, sulfa, shrimp, sensetvie to thymerisol
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Bruise size of quarter hot and red around site 2.5 inches in diameter. Very sore to touch


VAERS ID: 2015574 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Chills, Headache
SMQs:

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

Write-up: Severe headache; chills


VAERS ID: 2016435 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-12-06
Onset:2021-12-29
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / UNK RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (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: Daily prenatal vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was 5 weeks pregnant at the time of taking my COVID booster. Later we found that the fetus stopped growing around the same time as when I received the booster leading to miscarriage.


VAERS ID: 2017472 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Kansas  
Vaccinated:0000-00-00
Onset:2021-12-29
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211D21A / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Influenza like illness, Injection site pain, SARS-CoV-2 test, Suspected COVID-19
SMQs:, Extravasation events (injections, infusions and implants) (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: INFLUENZA VACCINE
Current Illness: Drug allergy (Allergic to most opioid); Hypertension (WELL CONTROLLED)
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 202009; Test Name: COVID-19 virus test; Result Unstructured Data: positive; Test Date: 20211229; Test Name: Body temperature; Result Unstructured Data: 99.8 F
CDC Split Type: USJNJFOC20211264309

Write-up: COVID-19 SYMPTOMS; FLU-LIKE SYMPTOMS; INJECTION SITE PAIN; This spontaneous report received from a patient concerned a 57-year-old male. The patient''s weight was 181 pounds, and height was 71 inches. The patient''s past medical history included: covid-19 (SEP-2020), patient had COVID-19 virus test which was positive, and concurrent conditions included: hypertension (well controlled) and drug allergy (allergic to most opioids). The patient previously received covid-19 vaccine ad26. cov2. s (suspension for injection, route of admin not reported, batch number: 1805018, and expiry: 23-AUG-2021) dose was not reported, frequency 1 total, administered at right arm on 10-APR-2021 for prophylactic vaccination (dose number in series 1). On 10-APR-2021, in the evening, the patient experienced headache, so he stayed in bed for a few days, felt "flu- like" with general body aches, injection site pain (all events with dose number series 1). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had recovered from headache, flu like symptoms and injection site pain. The patient received booster dose covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 211D21A, and expiry: 11-APR-2022) dose was not reported, frequency 1 total, administered at right arm on 28-DEC-2021 for prophylactic vaccination (Dose number in series 2). Concomitant medications included influenza vaccine (received on 28-DEC-2021). The patient stated that after receiving vaccine he felt ok until this morning of 29-DEC-2021, and also checked his temperature with oral digital thermometer, which was at 99.8F. The patient stated that he was experiencing the same symptoms (flu like symptoms, headache, slight fever, injection site pain), most notable was the headache (Dose number in series 2). The patient added that he also "got a flu shot" at same time as covid-19 booster and was unsure if the symptoms he was feeling were from that, the covid booster, or if he actually had covid, as he stated that his symptoms "felt just like when he did have covid back in 2020." (Dose number in series 2). The action taken with covid-19 vaccine ad26.cov2.s, and influenza vaccine was not applicable. The patient had not recovered from flu-like symptoms, injection site pain, and covid-19 symptoms. This report was non-serious. This case, involving the same patient is linked to 20220100850.


VAERS ID: 2017479 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-12-29
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Arrhythmia
SMQs:, Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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: USJNJFOC20211266428

Write-up: ARRHYTHMIA; This spontaneous report received from a consumer via a social media through company representative concerned a male of unspecified age, race and ethnic origin. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient was previously vaccinated with Covid-19 vaccine ad26. cov2.s. (manufacturer not specified) (suspension for injection, route of admin, batch number and expiry date not reported), (dose number in series 1) 01 in total administered, dose was not reported for prophylactic vaccination on an unspecified date. No adverse events were reported following administration of covid-19 vaccine ad26.cov2.s (dose number in series 1). The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, expiry: unknown) dose was not reported, (dose number in series 2) 01 in total administered on DEC-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 29-DEC-2021, the reported stated that her husband was admitted into the emergency room (ER) for arrhythmia (dose number in series 2). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of arrhythmia was not reported (dose number in series 2). This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20211266428-COVID-19 VACCINE AD26.COV2.S-Arrhythmia. 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: 2017583 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-12-29
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211229; Test Name: COVID-19 PCR test; Result Unstructured Data: Positive.
CDC Split Type: USJNJFOC20220107534

Write-up: CONFIRMED CLINICAL VACCINATION FAILURE; CONFIRMED COVID-19 INFECTION; This spontaneous report received from a patient concerned a 29 year old female of unspecified ethnic origin. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A and expiry: 21-SEP-2021) 1 total, dose was not reported, administered to left arm on 04-MAY-2021 for prophylactic vaccination (dose number in series 1). No concomitant medications were reported. On 29-DEC-2021, the patient experienced confirmed clinical vaccination failure. The patient reported that she has covid (confirmed covid-19 infection) after receiving the Janssen covid 19 vaccine (dose number in series 1). On 29-DEC-2021, laboratory data included: COVID-19 PCR test (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the confirmed covid-19 infection and confirmed clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with Product quality compliant: 90000210291.; Sender''s Comments: V0-20220107534-Covid-19 vaccine ad26.cov2.s- Confirmed Clinical Vaccination failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 2017833 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-12-29
Onset:2021-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal discomfort, COVID-19, Chills, Confusional state, Dizziness, Fatigue, Headache, Pain, SARS-CoV-2 test positive, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PROPANALOL, FLUOXETINE, LOSARTAN, RED GOLI VITAMINS, ORANGE GOLI VITAMINS
Current Illness: NOTHING OTHER THAN SEASONAL ALLERGIES
Preexisting Conditions: I TAKE PROPANALOL AND LOSARTAN FOR HBP BUT IT HAS BEEN CONTROLLED FOR AWHILE, I HAVE MIGRAINES A FEW TIMES A MONTH. I TAKE BULTALBITAL WHEN NEEDED FOR THOSE. I ALSO HAVE SCRIPT FOR XANAX WHICH I TAKE AS NEEDED. I HAD NOT TAKEN EITHER OF THOSE TWO SINCE MAYBE THE WEEK BEFORE.
Allergies: MORPHINE, DILAUDED
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: GOT SHOT ON THAT WEDNESDAY MORNING. BY THAT NIGHT HAD CHILLS, CONFUSION, BODY ACHES, HEADACHE. NEXT DAY COULD NOT GET OUT OF BED DUE TO FATIGUE. I TOOK COVID TEST BECAUSE I THOUGHT SHOT WAS GIVEN TO ME ON TUESDAY AND SYMPTOMS WERE STILL SO SEVERE. IT WAS NEGATIVE. BY FRIDAY SYMPTOMS STILL GOING STRONG. I HAD NOT EATEN SINCE WEDNESDAY. I HAD UPSET STOMACH SHAKING DIZZINESS CINFUSION CHILLS BODY ACHES, ETC. SATURDAY MADE M YSELF TAKE SHOWER AND TRY AND MOVE AROUND. I WAS OUT OF BREATH AND DIZZY. SUNDAY WORN OUT TOOK ANOTHER HOME TEST IT WAS NEGATIVE. MONDAY WAS A LITTLE BETTER, NO CHILLS STILL TIRED. TUESDAY WOKE UP WITH HEADACHE, SON HAD SORE THROAT. WE BOTH WENT TO GET TESTED AND BOTH CAME BACK POSITIVE. I DONT KNOW WHEN IT STARTED FOR ME BECAUSE NOT SURE WHEN IT WENT FROM SIDE EFFECTS FROM BOOSTER TO COVID. I WAS FINE PRIOR TO THE SHOT TO THE BEST OF MY KNOWLEDGE.


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